FILM LABORATORY
OF THE SETCHENOV 1st MOSCOW MEDICAL INSTITUTE
1979
These children
will never be beautiful, healthy and complete human beings.
Here's the reason why:
their parents suffer from a severe illness called syphilis.
SYPHILIS
MEDICAL RECORD
A young man with no occupation,
a medical student, a maid,
a chancellor, a cook, a civil servant,
a tradesman, an estate agent,
a nobleman, a bailiff,
a servant, a duke, a housekeeper.
In pre-Revolutionary Russia, all classes
were exposed to this dangerous disease.
Because of their dissolute ways,
shameful contamination did not spare royal nobility.
Syphilis
and the other venereal diseases spread mainly from brothels.
According to statistics, 1 prostitute out of 5
had syphilis.
From the brothels, the disease flooded all of Russia
in abject waves.
World War I
and the Allied intervention in the Civil War weakened
already inadequate medical surveillance.
Among the health problems
the young Soviet Republic was facing:
syphilis.
Archives,
case reports and photographs
paint a tragic picture
of the devastating effects of syphilis
for thousands of people.
Some of the outwards signs of syphilis
can only be found in textbooks today.
By stamping out prostitution,
creating a vast network of medical institutions,
and carrying out health education initiatives,
the Soviet State put an end to syphilis as a social disease.
But in recent years,
the medical community
has once again been faced with this almost forgotten foe.
The infectious agent is well known:
Treponema pallidum
or spirochete,
discovered in 1905
by Fritz Schaudinn.
Treponema enters the body mainly through sexual contact,
but also in other ways.
The incubation period
lasts 25 to 35 days.
The primary stage of the condition occurs within 6 to 8 weeks.
The secondary stage
lasts 2 to 4 years.
The tertiary stage, the most severe, follows later.
After contamination,
syphilis immediately spreads throughout the whole body.
However, its clinical manifestations
can only be detected after the incubation period.
The 1st symptom of the primary stage
develops where the treponemata entered the body.
It is called a chancre.
It looks like an erosion
or a round ulcer
with smooth edges and a shiny pink-red floor,
raising
over the surrounding skin.
Around the base of the erosion or ulcer,
a typical indurated infiltration is felt.
A chancre
can appear anywhere on the skin and mucous membranes.
It can be found
wherever treponemata entered the body.
Depending on the location,
the aspect, outline and size of a chancre
can vary.
Cervical chancres
form a limited, red, granular erosion.
Erosive hard chancres spontaneously cover with epithelium,
if not treated.
Chancres on the pubis and abdomen are large,
and ulcerative forms may persist for a long time,
until the rash breaks out in the secondary stage of the disease.
A chancre always comes
with the 2nd clinical sign of primary stage syphilis:
the local bubo,
an inflammation of nearby lymph nodes.
For some time now, we have observed in the primary stage
the presence of multiple ulcerative chancres.
In the event of a secondary infection,
a chancre's clinical presentation may vary.
Complications in men
can be phimosis
and paraphimosis.
They impede the diagnosis of primary stage syphilis,
even more so because inguinal nodes
can become painful, immovable, adherent,
and the skin above them drops.
In case of erosive lesions of the genitals and mucous membranes,
one should always consider a syphilitic infection.
Due to its variety of clinical manifestations,
syphilis used to be called "the great imitator".
The secondary stage rash
is remarkable for the diversity of its morphological traits.
It may be maculose, papular,
vesicular or pustular syphilides.
During that period, typical breakouts
are ubiquitous, abundant
and of a dull blue-red colour.
One of the prevailing characteristics of syphilis
is that breakouts are often located
on the palms and soles.
They are palmoplantar variants of secondary stage syphilis.
The breakouts look like blotches,
lenticular and annular papules,
and syphilitic keratoderma.
Most diagnostic errors
occur at the secondary stage.
Syphilitic papules on oral mucous membranes
are whitish because of maceration.
The loose epithelium of syphilitic genitalia
at the secondary stage, erodes easily
and desquamates.
Erosive syphilis is particularly contagious.
In very humid areas and with constant friction,
the look of the papules changes.
Not only do they macerate, they also proliferate,
forming thick raised papules and large condylomata.
This type of lesion
is the most characteristic one of recurring secondary syphilis.
At the secondary stage, pigmentary syphilide
is the equivalent of a positive Wassermann test drawn on the neck.
Every doctor should know
that alopecia warrants a Wassermann test.
Generally, leucoderma and specifically alopecia
appear 5 to 6 month after infection.
Tertiary syphilis occurs after a latency period.
The Sword of Damocles always hangs above the head
of a non or badly treated patient.
It can fall at any given moment.
Tertiary syphilis usually appears
4 to 5 years after contamination.
Trauma, chronic illness,
drug or alcohol abuse contribute to its development.
At this stage, clinical signs such as tubercles and gummata,
may appear on the skin, in subcutaneous tissue, in muscles,
bones and internal organs.
There are few tertiary syphilides.
They are not insignificant though
as they always leave mosaic or star-shaped scars.
When they are located on mucous membranes,
tertiary syphilis ulcers
destroy both soft tissues and the skeletal system
deeply and widely.
In many countries,
health professionals and social scientists
worry about the propagation of syphilis.
The causes of these new waves of venereal diseases are
young people's early independence,
migration, alcoholism,
ignorance
of sexual hygiene,
the loosening of marital ties,
too much free time, tourism,
the culture of sex and pornography in movies,
television, advertising and newspapers.
Promiscuity
and casual relationships
ruin people's health
and cause
infertility and family drama.
MALARIA - MENINGITIS
"Nowadays, current dreadful illnesses such as malaria
"meningitis, tuberculosis and hepatitis
"are far behind syphilis
"as far as number of cases go",
stated venereologist at the 1st Moscow Medical Institute,
Robert Babaiants.
Naturally, the worldwide ravages of venereal diseases
are bound to affect us all.
Due to foreign communication and contacts,
and a few other issues,
we need to focus all our efforts and resources
on prophylaxis.
The USSR does not have the social roots that give rise to venereal disease
but we must remain highly vigilant.
Here is a case study
in a dermatovenereology clinic.
A young man came in
a few weeks after a one night stand.
The examination found syphilis.
The patient was drunk during intercourse.
He only remembers
the woman's name, not her address.
His description of the neighbourhood
is insufficient for social services
to locate the source of the illness.
The clinic's head doctor,
eager to prevent other people
from falling ill,
starts his investigation.
The lack of information
turns this case into a detective story.
The doctor's perseverance bears results.
He finds the woman.
She is immediately sent to the hospital.
Later it turns out
that she did not know she was ill,
and had not noticed any symptom
because she was taking antibiotics for minor reasons.
Promiscuity:
that is how one person can become
the source of contamination of dozens of others.
SCRIPTWRITER: Dr B. ZOUDINE
SCIENTIFIC CONSULTANT: PROFESSOR R. BABAIANTS
CINEMATOGRAPHER: V. SOSNINE
ANIMATOR: B. CHANI WRITER: L. PANOVA
SOUND ENGINEER: Z. KAUROVA EDITOR: A. BELOBOKOV
THE END