. When a gonorrheal patient is cured, so far as
infectivity is concerned, and is not sterile, there is no apprehension
as to the offspring. Gonorrhea is not hereditary, and the child of a
gonorrheal patient does not differ from the child of a nongonorrheal
person. In the case of syphilis, it is different. The patient may be
safe so far as infecting the partner is concerned, but yet there may
be danger for the offspring.

The rules for permitting a man or a woman who once had syphilis to
marry, therefore, are different from those applied to the gonorrheal
patient. Here are the rules:

1. I would make it an invariable rule that no syphilitic patient
should marry or should be permitted to marry before _five_ years have
elapsed from the day of infection. But the period of time alone is
not sufficient; other conditions must be met before we may give a
syphilitic patient permission to marry.

2. The man or the woman must have received thorough systematic
treatment for at least three years, either constantly or off and on,
according to the physician's judgment.

3. For at least one year before the intended marriage, the person must
have been absolutely free from any manifestations of syphilis; that
is, from any eruptions on the skin, from any mucous patches, swelling
in the bones, ulcerations, and so on.

4. Four Wassermann tests, taken at intervals of three months and at a
time _when the patient was receiving no specific treatment_, must be
absolutely negative.

If these four conditions are fully met, then the patient may be
permitted to marry.

It is important, however, to state that, in permitting or refusing
syphilitic persons to marry, we are guided to a great extent by the
fact as to whether they _expect to have children soon or not_.

In the case of a couple who are anxious to have children soon after
their marriage, the conditions for our permission must be more severe
than when the couple are willing or anxious to use contraceptive
measures for the first years of their married life. For, if a man is
free from any skin lesions and from any mucous patches, his wife is
safe from infection _as long as she does not become pregnant_. But, if
she does get pregnant, she may become infected through the fetus; and,
of course, the child also is liable to be syphilitic. Hence, much
stricter requirements for syphilitics who expect to become parents are
necessary than for those who do not.

In case both the man and the