The influence of hereditary syphilis is often manifest in a native debility or inherent inca pacity for life. Many syphilitic children are endowed with a feeble vitality, so that they succumb to slight causes of disease. They die at an early age, often with no obvious signs of disease but simply from an inability to support Me. They are the subjects of what may be termed 'sudden, inexplicable death?' In another class of cases there is an arrest or retardation of development; the children are stunted or dwarfed; they develop slowly physically and mentally; they are often feeble minded or idiotic. The term "infantilism' has been employed to express the sum total of these characteristics.. In other cases there are pre sented anomalies or marked deviations from the normal development, seen in the bones of the cranium and in the long bones, producing malformations of varied types, such as incurva tion of the tibia, pigeon-breast, deformity of the thorax, curved spine, deformed pelvis, etc. These dystrophies may be expressed in such marked deviation from the normal type that the result is a monstrosity.
Heredo-Syphilis.—The effects of hereditary syphilis are not limited to the immediate de scendants, but they in turn are capable of trans mitting these dystrophies and organic defects to the third generation. Observation shows in the most positive manner that the influence of heredo-syphilis in determining abortions, still born children and various organic defects is scarcely less marked than that of syphilis directly acquired. It would seem that while the contagious activity of the disease is entirely extinct, the nutritive disturbances set up in an organ or system of organs of the progenitors may be handed down to their offspring. • Syphilis as a Social It is now generally recognized that syphilis, with alcohol ism and tuberculosis, are the three great plagues that afflict modern humanity. Owing to its wide prevalence and the dangers to the per sonal health and life of the individuals affected, syphilis constitutes a serious menace to the pub lic health. The amount of morbidity from this cause in any country or community is an un known and unknowable quantity, since owing to its secret and shameful character cases of this clisease are not subject to official registra tion. The spread of syphilis is favored not only by the fact that its contagious activity and transmissive power persist uring a prolonged period but because it is exceedingly prolific in as sources and modes of contagion. While it is commonly propagated through sexual rela uons, syphilis is not necessarily so contracted. It may be conveyed by accidental inoculations, in the ordinary relations of life, in various industrial and professional occupations. Kiss ing is a very common mode of infection and a very large number of cases of contagion occur in this way. A syphilitic infant may infect a healthy nurse, or a healthy infant may receive infection from a syphilitic nurse in the act of suckling. Syphilis may be transmitted through the intermediary of any object upon which the secretions of the syphilitic have been acciden tally deposited. It may be conveyed by drink
ing vessels, spoons, knives and forks, household effects, pipes, toilet articles and other objects too numerous to mention. Certain occupations favor the spread of syphilis, especially that of glass blowing, where the infected blow-pipe is passed from mouth to mouth. Syphilis is not infrequently communicated in barber shops, through razor wounds or through the use of shaving brushes, soap or towels. Infections in professional life are not uncommon. Physi cians and accoucheurs have acquired syphilis in the examination and treatment of syphilitic patients. Every syphilitic individual is the source of possible danger to persons with whom he comes in intimate contact. A case of syph ilis in a family. may be tile origin of many inno cent infections. The syphilitic child may infect the nurse and members of the family; these in turn may affect others. Veritable endemics of syphilis, amounting to 10, 15, 20 or more infec tions, have originated in this way. It is this quality of expansiveness, this capacity of mor bid irridiation through family and social life, that gives to syphilis its superior significance as a social danger.
It is especially, however, in its relation with marriage that the ravages of syphilis as a social plague are of the highest interest and impor tance. By its inhibitory influence upon the pro ductive energy of the family, syphilis may seri ously compromise or entirely defeat the social aim of marriage — the raising of children. When it does not destroy the product of con ception, it may blight its normal development. The subjects of inherited syphilis that survive are stamped with inferiority and compelled to pass through life bearing the stigmata of de generation or disease. A syphilitic man should not marry so long as he is capable of carrying contagion to his wife or begetting syphilitic children. Since the contagious and transmis sive power of the disease is gradually ex hausted, syphilis constitutes only a temporary barrier to marriage, which may be removed by time and treatment. It may be formulated as a general rule that a syphilitic man should not marry until after a certain period (on an aver age four years) has elapsed since the date of his infection, during which time he should re ceive sufficient specific treatment. A still longer period of probation would afford an additional guarantee of safety. It is to be observed, how ever, that there may be contra-indications to marriage which arise from risks to the per sonal health of the individual by reason of his disease. The syphilitic man may be exposed to dangers, the consequences from his disease, which unfit him for the responsible position of head and support of a family. The possible existence of such disqualifying conditions must always be taken into consideration when the question of marriage is concerned.