The factors which predispose a patient to neurosyphilis have been much discussed, but they are still obscure. In general three factors may be said to determine involvement of the central nervous system: variations in reaction of infected persons to Spirochaeta pallida, the strain of the infecting organism, and the amount and character of antisyphilitic treatment. Antisyphilitic treatment, properly employed, may prevent or suppress the development of clinical neurosyphilis; on the other hand, such treatment may, under certain conditions, favor its development or hasten its clinical onset.
The occurrence of precocious clinical neurosyphilis following one or several doses of arsphenamin soon sobered early enthusiasm in the drug. It is unnecessary to dwell on the controversy concerning the origin of these so-called neurorecurrences or neurorecidives; they are now considered syphilitic in nature.
From the opening of the Syphilis Clinic of the Johns Hopkins Hospital in 1914 to Sept. 1, 1921, 7,065 patients