+Factors Influencing the Cure of Syphilis.—­Cost.+—­We must admit that, as matters stand now, few patients are interested in more than a symptomatic cure.  Yet the increasing demand for blood tests, for example, shows that they are waking up.  Ignorance of the possibility and necessity for radical cure, and of the means of obtaining it, explains much of the indifference which leads patients to disappear from their physician’s care just as the goal is in sight.  But there is another reason why syphilis is so seldom cured, and this is one which every forward-looking man and woman should heed.  The cure of syphilis means from two to four years of medical care.  All of us know the cost of such services for even a brief illness.  A prolonged one often sets the victim farther back in purse than forward in health.  The better the services which we wish to command in these days, usually, the greater the cost, and expert supervision, at least, is desirable in syphilis.  It is a financial impossibility for many of the victims of syphilis to meet the cost of a radical cure.  It is all they can do to pay for symptomatic care in order to get themselves back into condition to work.  We cannot then reasonably demand of these patients that they shall be cured, in the interest of others, unless we provide them with the means.  In talking about public effort against syphilis, this matter will be taken up again.  We have recognized the obligation in tuberculosis.  Let us now provide for it in syphilis.

+Factors Controlling the Cure of Syphilis—­Stage, Time, Effective Treatment.+—­Three factors enter into the radical cure of syphilis, upon which the possibility of accomplishing it absolutely depends.  The first of these concerns the stage of the disease at which treatment is begun; the second is the time for which it is kept up; and the third is the cooeperation of doctor and patient in the use of effective methods of treatment.

+Cure in the Primary Stage.+—­It goes almost without saying that the prospect of curing a disease is better the earlier treatment is begun.  This is peculiarly so in syphilis.  In the earliest days of the disease, while the infection is still local and the blood test negative, the prospects of radical cure are practically 100 per cent.  This is the so-called abortive cure, the greatest gift which salvarsan has made to our power to fight syphilis.  It depends on immediate recognition of the chancre and immediate and strenuous treatment.  So valuable is it that several physicians of large experience have expressed the belief that even in cases in which we are not entirely sure the first sore is syphilitic, we should undertake an abortive treatment for syphilis.  This view may be extreme, but it illustrates how enormously worth while the early treatment of syphilis is.