+Estimated Risk of Infecting the Wife.+—­How serious is the risk of infecting the wife if a man should marry during the contagious period of syphilis?  This will depend a good deal on the frequency of relapses after the active secondary stage.  On this point Sperk estimated that in 1518 patients, only ten escaped relapses entirely.  These were, however, not patients that had been specially well treated.  Keyes, quoted by Pusey, estimated, on the basis of his private records, that the chances taken by a syphilitic husband who used no special precautions to prevent infecting his wife were twelve to one the first year in favor of infection, five to two the second year, and one to four the third year, being negligible after the fourth year.

+Syphilis in the Father.+—­Even while we recognize the infection of women and children as the greatest risk in marriage we should not lose sight of the cost to society which syphilis in the father of the family himself may entail.  For such a man to be stricken by some of the serious accidents of late syphilis throws his family as well as himself upon society.  A syphilitic infection which has not been cured not only makes a man a poor risk to an insurance company, but a poor risk to the family which has to look to him for support and for his share and influence in the bringing up of the children.  A sufficient number of men and women in the thirties and forties are crippled, made dependent, or lost to the world entirely, to make the responsibilities of the family when assumed by persons with untreated or poorly treated syphilis a matter of some concern, whether or not they are still able to transmit the disease to others.

+The Time-treatment Principle and the Five-year Rule.+—­In setting a modern standard for the fitness of syphilitics for marriage it may be said at the outset that there is little justification for making the mere fact of a previous syphilitic infection a permanent bar in the majority of cases.  The risk of economic disaster to the parent and wage-earner, and the risk of transmission of the disease to the partner and the children, are both controllable by a combination of efficient treatment and time.  The man who has conformed to the best practice in both particulars may usually marry and have healthy children.  The woman under the same circumstances need not fear that the risk of having offspring injured by her disease is any greater than the risk that they will be injured by any other of the unforeseen risks that surround the bringing of a child into the world.  A vast experience underlies what might be called the time-treatment principle on which permission to marry after syphilis should be based.  It has recently been ably summarized again, and with commendable conservatism, by Hoffmann in the rule that a syphilitic who has been efficiently treated by modern standards, with mercury and salvarsan, over a period of two to three years, and who has remained free from all symptoms and signs of the disease for