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January 1938


Author Affiliations

From the Neurological Service, the Bellevue Hospital, and the Neuropsychiatric Service, the United States Marine Hospital, Ellis Island.

Arch Ophthalmol. 1938;19(1):68-80. doi:10.1001/archopht.1938.00850130080008

Sir William Osler many years ago characterized syphilis as "the great imitator" because it can simulate or complicate nearly every condition known in the field of internal medicine. The converse of Dr. Osler's statement is that many of the conditions known in the field of internal medicine can simulate syphilis. But while the original dictum has become a familiar part of medical training, its logical converse has received little attention.

It is our purpose in this paper to draw attention to a symptom complex which has repeatedly been mistaken for syphilis of the central nervous system. Many unfortunate persons presenting it have been treated for tabes dorsalis, and in some instances it has played a major role in disrupting family life and leading to a vast amount of unnecessary anxiety and misery. Ordinarily it presents a rather simple picture, consisting merely in tonic reactions of one or

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