Two Cases of Third-generation Syphilis.

The question whether third-generation syphilis does occur has in the past been the subject of much debate and controversy. The following criteria laid down by Fournier (1891) and Finger (1900) still provide the yardstick by which third-generation syphilis is judged: (1) Acquired syphilis must be demonstrated in the grandmother and preferably also in the grandfather. (2) Pre-natal as distinguished from acquired syphilis must be demonstrated in the mother of the third-generation case. Acquired syphilis must be excluded in her case and the father must be proved to be healthy. (3) There must be incontrovertible evidence of pre-natal syphilis in the third generation. (4) Manifestations must appear soon after birth in both the second and third generations. Nabarro (1954), who devoted the greater part of his professional life to the study of congenital syphilis, was firmly convinced that third-generation syphilis did occur and personally observed 42 families with probable syphilis in three generations. American observers have tended not to regard third-generation syphilis sympathetically, but Beerman, Wammock, and Magnuson (1942) reported a case in a family group in which they considered that there was sufficient authentic information to permit its classification as a probable case of third-generation syphilis. They also reviewed the case reports published between 1933 and 1941, omitting those reported before 1933, and divided them into more probable and less probable categories, but they could place only seven cases in the first category. Sauer (1951) also reported a case of third-generation syphilis which in his opinion conformed to the Fournier-Finger doctrine as far as it is ever possible to do so, and he urged the continued reporting of cases. In a study of the incidence of neurosyphilis among parents of congenital neurosyphilitic children,