Book II Sy PHILIS 139

This obstinate callosity appeared especially on the arms and
legs; sometimes it became ulcerated, sometimes persisted with—
out change until the patient's death.

Besides all the above symptoms, as though they were not bad
enough, violent pains attacked the muscles, often at the same
time as the pustules, sometimes before them, and occasionally
following them. 'These pains were persistent, tormented the
sufferer chiefly at night, and were the most cruel of all the
symptoms. 'The pain was not precisely in the joints but in
the muscles themselves and the sinews.*? But some felt no
pain at all on the appearance of the pustules, others had the
pains without the pustules, though the majority suffered from
both symptoms. Meanwhile there was lassitude of all the
organs; the body became emaciated, and there was no desire
for food, no sleep, but great depression, constant irritability;
the patient longed to lie on his back; the face and legs became
swollen. Sometimes these symptoms were accompanied by
slight fever, but rarely; some had headache, and then the pain
was persistent and would yield to no remedies. When blood
was let, it was seen to be impure and to contain mucus; the
urine was rather thick, oily, troubled (sedimentary) and reddish,
and from these indications of the urine alone, even when there
was no fever, we knew beforehand, in many cases, that patients
had  contraeted this disease. 'The voidings were painful and
difficult, mucous and dry.*$  These, then, were the symptoms in
those who were at that time afflicted by this malady.

I use the past tense in describing these symptoms, because,
though the contagion is still flourishing today, it seems to have
changed its character since those earliest periods of its appear—
ance. I mean that, within the last twenty years or so, fewer
pustules began to appear, but more gummata, whereas the
contrary had been the case in the earlier years.  Moreover,
whenever the pustules did appear, they were drier, and the ac—
companying pains (if any) were, in every case, more acute.
Moreover, in the course of time, within about the last six years
of the present generation, another great change in this disease
has taken place. I mean that pustules are now observed in
very few cases, and hardly any pains, or much less severe, but
many gummata. Also, to the general amazement, the hair
falls out from the head and the other hairy parts to such an ex—
tent that it makes men look ridiculous; for some go about in