+Efficient Treatment.+—­The third essential is efficient treatment, about the nature of which there is still some dispute.  The controversy, however, is mainly about details.  In the modern methods for treatment of syphilis both salvarsan and mercury are used, as a rule, and keep the patient decidedly busy for the first year taking rubs and injections, and pretty busy for the second.  The patient is not incapacitated for carrying on his usual work.  The intervals of rest between courses of salvarsan and mercury are short.  In the third year the intervals of rest grow longer, and in the absence of symptoms the patient has more chance to forget the trouble.  Here the doctor’s difficulties begin, for after two or three negative blood tests with a clear skin, all but the most conscientious patients disappear from observation.  These are the ones who may pay later for the folly of their earlier years.

The aim in syphilis, then, is to crush the disease at its outset by a vigorous campaign.  Not until an amount of treatment which experience has shown to be an average requirement has been given, is it safe to draw breath and wait to see what the effect on the enemy has been.  Dilatory tactics and compromises are often more dangerous than giving a little more than the least amount of treatment possible, for good measure.  This is, of course, always provided the behavior of the body under the ordeal of treatment is closely studied and observed by an expert and that it is not blindly pushed to the point where injury is done by the medicine rather than the disease.

+The Importance of Salvarsan.+—­Salvarsan is an absolute essential in the treatment of those early infections in which an abortive cure can be hoped for, and in them it must be begun without a day’s delay.  To some extent, the abortive cure of the disease, with its 100 per cent certainty, will therefore remain a luxury until the public is aroused to the necessity of providing it under safe conditions and without restrictions for all who need it.  At all stages of the disease after the earliest it is an aid, and a powerful one, but it cannot do the work alone, as mercury usually can.  But though mercury is efficient, it is slow, and the greater rapidity of action of salvarsan and its power to control infectious lesions give it a unique place.  The combination of the two is powerful enough to fully justify the statement that none of the great scourges of the human race offers its victim a better prospect of recovery than does syphilis.

Is a cure worth while?  There is only one thing that is more so, and that is never to have had syphilis at all.  The uncured syphilitic has a sword hanging over his head.  At any day or hour the disease which he scorned or ignored may crush him, or what is worse, may crush what is nearest and dearest to him in the world.  It does it with a certainty which not even the physician who sees syphilis all the time as his life-work can get callous to.  It is gambling with the cards stacked against one to let a syphilitic infection go untreated, or treated short of cure.  It is criminal to force on others the risks to which an untreated syphilitic subjects those in intimate contact with him.