Tertiary  lesions  are  said  to  occur  in  from  5  to  40  per  cent,  of
cases  of  syphilis.  The  most  usual  time  for  their  appearance  is  from
three  to  five  years  after  infection,  although  long  periods  of  latency,


M


i^^^^'^^-:^.
VTI.  Gumma  of  the  Testicle.
a,  Central  portion,  seat  of  coagulation-necrosis.        />,  Peripheral  zone  formed  by  infiltration  of  small  ronnd  cells
c,  Compressed  tubuli  seminileri.        d.  Interstitial  small  round-celled  infiltration.
^%...:


a^'-ri^.
VIII.  Endarteritis  (Artery  from  the  Fi.ssure  of  Sylvius).
o,  Swollen  and  infiltrated  endothelial  lining.  6.  New  formation  composed  of  connective  'J^'^"!,  »"•!  ""^''.'Xv.
celled  infiltration.         c.  Membrana  elastica.         rf.  Muscular  coat.        e.  Med.a.         /,  Ad^entitia.    All  »Do>e
lavers  infiltrated  with  small  ronnd  cells.        g.  Nutrient  artery  (vas  vasonim).
(From  "Die  Syphilis  und  die  Venerischen  Krankheiten,"  von  Dr.  Ernest  Finger.)


TERTIARY  STAGE.
309


I


even  as  much  as  fifty  years,  during  which  the  patient  is  entirely  free
from  symptoms,  may  intervene  before  the  tertiary  lesions  appear.
Characteristics  of  Lesions  of  Skin  and  Mucous  Membrane. The

characteristics  of  the  syphilides  in  the  tertiary  period  differ  greatly
from  the  secondaries,  and  may  be  summarized  as  follows: —

I.  They  attack  a  limited  area.
II.  They  have  a  tendency  to  extend  and  cause  destruction  of
tissue,  with  the  formation  of  scar-tissue  and  its  subsequent  contrac-
tion.
III.  They  do  not  tend  to  spontaneous  recovery,  but  rather  break
down  and  ulcerate.
IV.  They  extend  deeply  into  the  tissues.
Tertiary  lesions,  in  whatever  organ  or  structure  of  the  body  they
may  occur,  are  the  direct  result  of  chronic  vascular  lesions,  and  are
commonly  accompanied  by  the  so-called  gumma.
PATHOLOGY.
