e on the neck of the womb. Children
infected in this way at birth do not develop the true hereditary form of
the disease, but get the acquired form with a chancre and secondary
period, just as in later life.

+Effect of Syphilis on the Child-bearing Woman.+--What does syphilis
mean for the woman who is in the child-bearing period? In the first
place, unlike gonorrhea, which is apt to make women sterile, syphilis
does not materially reduce the power to conceive in most cases. A woman
with active syphilis alone may conceive with great frequency, but she
cannot carry her children through to normal birth. The syphilitic woman
usually has a series of abortions or miscarriages, in which she loses
the child at any time from the first to the seventh or eighth month. Of
course, there are other causes of repeated miscarriages, but syphilis is
one of the commonest, and the occurrence of several miscarriages in a
woman should usually be carefully investigated. The miscarriage or
abortion occurs because the unborn child is killed by the germs of the
disease, and is cast out by the womb as if it were a foreign body.
Usually the more active the mother's syphilis, the sooner the child is
infected and killed, and the earlier in her pregnancy will she abort.
Later in the disease the child may not be infected until well along, and
may die only at the ninth month or just as it is born. In other words,
the rule is that the abortions are followed later by one or more still
births. This is by no means invariable. The mother may abort once at the
third month, and with the next pregnancy bear a living syphilitic child.
The living syphilitic children are usually the results of infection in
the later months of the child's life inside its mother, or are the
result of higher resistance to the disease on the part of the child or
of the efficient treatment of the mother's syphilis.

+Variations on the Rule.+--It should never be forgotten that all these
rules are subject to variation, and that where one woman may have a
series of miscarriages so close together that she mistakes them for
heavy, irregular menstrual flows, and never realizes she is pregnant,
another may bear a living child the first time after her infection, or
still another woman after one miscarriage may have a child so nearly
normal that it may attain the age of twenty or older, before it is
suspected that it has hereditary syphilis. Again a woman with syphilis
may remain childless t