Syphilis and chronic liver disease.

With the advent of the antibiotic era and the improvement in serological diagnostic techniques, there has obviously been a need to reappraise the clinical aspects of syphilis. Karmi, Thirkettle, and Read (1969) reported the results of such a study on the relationship between patients with cirrhosis and syphilitic infection. For many years the consensus of opinion was that a relatively high proportion of patients with cirrhosis also had syphilis (Stokes, Beerman, and Ingraham, 1944). More recently Karmi and others (1969) summarized the results of ten series and came to the conclusion that 10 to 20 per cent. of patients with cirrhosis were likely to have syphilis. The great bulk of the clinical cases on which these studies were based had in fact presented before the advent of antibiotic therapy, but Karmi and his associates found the incidence of syphilis among patients with cirrhosis of the liver in the Bristol area to be still in the region of 10 per cent., 20 years after the introduction of penicillin therapy. We felt that it would be interesting to carry out a further evaluation of the relationship between syphilis and cirrhosis