ermann test and
by noting the therapeutic effects of grey powder, which, in syphilitic
infants, usually effects a marked and rapid improvement both in the
symptoms and in the general health.

While a considerable number of syphilitic children grow up without
showing any trace of their syphilitic inheritance, the majority retain
throughout life one or more of the following characteristics, which may
therefore be described as _permanent signs of the inherited disease_:
Dwarfing of stature from interference with growth at the epiphysial
junctions; the forehead low and vertical, and the parietal and frontal
eminences unduly prominent; the bridge of the nose sunken and rounded;
radiating scars at the angles of the mouth; perforation or destruction
of the hard palate; Hutchinson's teeth; opacities of the cornea from
antecedent keratitis; alterations in the fundus oculi from choroiditis;
deafness; depressed scars or nodes on the bones from previous gummata;
"sabre-blade" or other deformity of the tibiae.

#The Contagiousness of Inherited Syphilis.#--In 1837, Colles of Dublin
stated his belief that, while a syphilitic infant may convey the disease
to a healthy wet nurse, it is incapable of infecting its own mother if
nursed by her, even although she may never have shown symptoms of the
disease. This doctrine, which is known as _Colles' law_, is generally
accepted in spite of the alleged occurrence of occasional exceptions.
The older the child, the less risk there is of its communicating the
disease to others, until eventually the tendency dies out altogether, as
it does in the tertiary period of acquired syphilis. It should be
added, however, that the contagiousness of inherited syphilis is denied
by some observers, who affirm that, when syphilitic infants prove
infective, the disease has been really acquired at or soon after birth.

There is general agreement that the subjects of inherited syphilis
cannot transmit the disease by inheritance to their offspring, and that,
although they very rarely acquire the disease _de novo_, it is possible
for them to do so.

#Prognosis of Inherited Syphilis.#--Although inherited syphilis is
responsible for a large but apparently diminishing mortality in infancy,
the subjects of this disease may grow up to be as strong and healthy as
their neighbours. Hutchinson insisted on the fact that there is little
bad health in the general community that can be attributed to inherited
syphilis.

#