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Bejel: Syphilis as a Contagious Disease of Children

1. Appreciation of the fact that bejel is a disease contracted subsequent to birth is fundamental to an understanding of this primitive form of syphilis.

2. That bejel is not "inherited", but must be regarded as a contagious disease of childhood is supported by strong clinical evidence.

3. Six family series are presented in detail, tracing the course of the infection from one person to another, and establishing the contagious nature of bejel.

4. Reference is made to the inoculation of two rabbits with spirochetes from bejel lesions.

5. Bejel demonstrates the fallacy of differentiating syphilis from yaws on the basis of congenital transmission; for though—like venereally acquired syphilis—bejel is caused by T. pallidum, it stands with yaws in its failure ordinarily to produce prenatal infections. The congenital transmission of syphilis is therefore not an integral and inalienable character of that disease, but only occurs under certain epidemiological, (e.g., venereal) conditions. Change these conditions, give syphilis the environment of yaws, and congenital transmission disappears. Syphilis under these conditions becomes—like yaws—a contagious disease of children.

6. The congenital transmission of syphilis is linked with epidemiology, and is therefore not a valid etiological distinction between syphilis and yaws.

Received March 30, 1938.