an enormous resistance to the disease, which in a measure compensates for the hold which it has on him.  Treatment in hereditary syphilis becomes an extremely difficult problem because it must in many cases be carried out during infancy, and for that reason the cooeperation of the patient cannot be secured.  By treating the mother, we now know that we can accomplish a great deal for the unborn child.  Once the child is born, its salvation will depend on unremitting care and labor.  If it is skilfully treated and kept at the breast, it is estimated that it has even as high as ninety chances in one hundred of surviving to a useful life.  Salvarsan can be given to even very small babies, and mercury also is employed with excellent results.  Persistence and skill are essential, and for that reason, if possible, hereditary syphilis in active form in later childhood should have the advantage of occasional or prolonged treatment in special hospitals or sanitariums where the child could go to school while he is being built up and cared for.  This is not like trying to salvage wreckage.  Many syphilitic children are brilliant, and if treated before they are crippled by the disease, give every sign of capacity and great usefulness to the world.  Welander, who was one of the greatest of European experts on syphilis, has left himself an enduring monument in the form of the so-called Welander homes, which have been established by cities like Copenhagen, Berlin, and Vienna to provide for such children the combined benefits of the school and the hospital.  We cannot be too prompt in adopting similar provision for such cases in this country.  There can be little excuse, eugenic or otherwise, for not doing the utmost that modern medical science is capable of for their benefit.

Chapter XI

The Transmission and Hygiene of Syphilis

The problem of the control of syphilis as a contagious disease is the least appreciated and the most important one in the whole field.  It should be the key to our whole attitude toward the disease, and once given its rightful place in our minds, will revolutionize our situation with regard to it.  For that reason, while some repetition of what has gone before may be unavoidable, it will be worth while to gather in one chapter the details relating to the question of how the disease is spread about.

Two bed-rock facts stand out as the basis for the whole discussion.  First, for practical purposes syphilis is contagious only in the primary and secondary stages.  Second, syphilis is transmitted only by open sores or lesions whose discharges contain the germs, or by objects which are contaminated by those discharges.  Infection with syphilis by such fluids as the blood, milk, or spermatic fluid uncontaminated by contact with active lesions is at least unusual.