o us. Syphilis as a medical problem offers comparatively few
difficulties at the present day. What blocks our progress now is largely
an affair of mental attitudes, of prejudices, of fears, or shame, of
ignorance, stupidity, or indifference. Mental strain, a powerful
influence in many diseases, is a factor in syphilis also, and the state
of mind of the patient has often almost as much to do with the success
of his treatment as has salvarsan or mercury. For that reason it is
worth while to devote a chapter to picturing in a general way the mental
side of syphilis.

+The Public Attitude Toward Syphilis.+--First of all, in order to
understand the mental state of the patient, consider once more the
attitude of the world at large toward the victim of syphilis. A few who
are frankly ignorant of the existence of the disease to start with are
unprejudiced when approached in the right way. But ninety-eight persons
in a hundred who know that there is such a disease as syphilis are alive
to the fact that it is considered a disgrace to have it, and to little
else. Such a feeling naturally chokes all but secret discussion of it.
Most of us remember the day when newspaper copy containing reference to
tuberculosis did not find ready publication. Syphilis is just crossing
this same threshold into publicity. It is now possible to get the name
of the disease into print outside of medical works and to have it
referred to in other ways than as "blood poisoning" in quack
advertisements. The mention of it in lectures on sex hygiene is an
affair of the last twenty years, and the earlier discussions of the
disease on such occasions were only too often vague, prejudiced, and
inaccurate. There are many who still believe, as did an old librarian
whom I met in my effort to reach an important reference work on syphilis
in a great public library. "We used to keep them on the shelves," he
said, "until the high school boys began to get interested, and then we
thought we would reserve the subject for the profession." Syphilis has
been reserved for the profession for five hundred years and the disease
has grown fat on it. The lean times will come when a reasonable
curiosity about syphilis can be satisfied without either shame or
secrecy by a reasonable presentation of the facts. We need the light on
this subject and the light on reserved shelves is notoriously poor. The
stigma attaching to syphilis as a disease is one of the most tragic
examples of a gr