course of mercurial injections, especially in early cases. It
requires the combination of mercury and salvarsan to secure the highest
percentage of good results.

+The Five-year Rule.+--The truth of the matter is that, as Hoffmann
says, no treatment can _guarantee_ the non-infectiousness of a
syphilitic in the first five years of his disease. Time is thus an
essential element in pronouncing a person non-infectious and hence in
deciding his fitness for marriage, for example. The person with active
syphilis who has intimate relations with uninfected persons, who will
not abandon smoking or take special precautions about articles of
personal use which are likely to transmit the disease, is unsafe no
matter what is done for him. In spite of this qualifying statement it
may be reiterated, however, that good treatment with salvarsan and
mercury reduces the risk of infecting others in the ordinary relations
of life practically to the vanishing point, and of course reduces, but
not entirely eliminates, the dangers of the intimate contacts.

+Personal Responsibility of the Patient.+--If we are compelled then to
fall back to some extent upon the personal sense of responsibility of
the patient himself to fill in the gap where treatment does not entirely
control the situation, it becomes increasingly important that in the
irresponsible and ignorant, when the patient fails to meet his
obligation, we should push treatment to the uttermost in our effort to
prevent the spread of the disease. To supply this necessary treatment to
every syphilitic who cannot afford it for himself, and make it
obligatory, if need be, will be a long step forward in the control of
the disease. The educational campaign for it is well under way all over
the world, and the money and the practical machinery will inevitably
follow. We have the precedents of the control of tuberculosis, smallpox,
malaria, and yellow fever to guide us, to say nothing of a practical
system against sexual disease already in operation in Norway, Sweden,
Denmark, and Italy.

+Syphilis and Marriage.+--The problem of the relation of syphilis to
marriage is simply an aspect of the transmission of an infectious
disease. The infection of one party to the marriage by the other and the
transmission of that infection to children summarizes the social
problem. Through the intimate contacts of family life, syphilis attacks
the future of the human race.

+Estimated Risk of Infecting the Wife