DEAR DR. DONOHUE: Fifty years ago, when I was in the Army, we were drilled about venereal diseases. At that time, the most feared one was syphilis. We were told it could rot your brain. How come I hear nothing about it these days? Has it gone? Now I hear about many venereal diseases that weren’t talked about back then. Is syphilis no longer a threat? Will you refresh my memories of it? — J.J.

ANSWER: Syphilis hasn’t gone away. Numbers have declined. Worldwide, the estimate of yearly syphilis cases is given as 12 million.

I can provide a brief summary of syphilis, but realize that the time intervals I give vary greatly from person to person.

Four to six weeks after sexual relations with an infected partner, a man or woman develops a painless, slightly raised small red bump on the genitals. That bump erodes into an open sore, which is called a chancre (SHANK-er). The open sore isn’t painful. Without any treatment, it heals in four to six weeks. This is the first stage of syphilis. The second stage appears about two months after the chancre heals. A rash breaks out, consisting of small, flat or slightly raised red dots. The rash doesn’t itch and can occur anyplace. It can even be on the palms and soles, places regularly immune to rashes. Lymph nodes swell. This second stage of syphilis vanishes without treatment in two to six weeks.

Now the infection enters a latent stage, a stage without signs or symptoms. The syphilis bacterium still lives in the body and carries out destructive work that eventually turns into the third stage. Third-stage syphilis develops in about one-third of untreated patients. It shows itself 10 to 30 years after the second stage. Signs of brain dysfunction, the development of aneurysms (bulges) on the aorta and the appearance of painless nodules (gumma) on the skin and internal organs are the hallmarks of the third stage.

Penicillin is still the drug used to treat syphilis. If a person is allergic to penicillin, other antibiotics can take its place.

DEAR DR. DONOHUE: I get zero exposure to the sun in the winter. In the spring and summer, I get a little exposure, but not much. Because of this, I think I might be low in vitamin D, the sunshine vitamin. What dose of it should I take? — B.D.

ANSWER: Vitamin D is called the sunshine vitamin because the sun’s rays convert a substance in the skin into the vitamin. In people who live in Northern latitudes, sun conversion of the vitamin is minimal in the winter. Older people lose their capacity to use sunlight as a source of vitamin D. The vitamin is essential for the absorption of calcium and for strengthening muscles.

Claims that vitamin D prevents colon, breast, prostate and pancreatic cancer are cited often. It also is said to prevent type 2 diabetes, lessen the risk of heart disease and stave off rheumatoid arthritis. I get suspicious when so many good things are attributed to one substance.

Adult males and females between the ages of 19 and 70 are advised to take in 600 IU a day. For older people, 800 IU is the recommendation. The upper safe limit is 4,000 IU a day. Don’t take that much on your own. You can be checked for your vitamin D level if you want to know if you are deficient in it.

DEAR DR. DONOHUE: I felt a soft lump on the left side of my neck. It was sort of tender when I kept touching it. My temperature was normal all the time I had it — more than a month. I didn’t have a sore throat ever. My doctor didn’t know what it was, but he had me get a scan. It’s a lymph node. Now what do I do? — E.S.

ANSWER: Has your doctor suggested a course of action? Touch base with him.

If an enlarged node remains tender, big and undiagnosed for more than a month, it should be removed for microscopic examination.

Your doctor should be the one who’s guiding you in this matter.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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