lesions give it a unique place. The combination of
the two is powerful enough to fully justify the statement that none of
the great scourges of the human race offers its victim a better prospect
of recovery than does syphilis.

Is a cure worth while? There is only one thing that is more so, and
that is never to have had syphilis at all. The uncured syphilitic has a
sword hanging over his head. At any day or hour the disease which he
scorned or ignored may crush him, or what is worse, may crush what is
nearest and dearest to him in the world. It does it with a certainty
which not even the physician who sees syphilis all the time as his
life-work can get callous to. It is gambling with the cards stacked
against one to let a syphilitic infection go untreated, or treated short
of cure. It is criminal to force on others the risks to which an
untreated syphilitic subjects those in intimate contact with him.

+The Meaning of "You are Cured."+--How do we judge whether a patient is
radically cured or not? Here again we confront the problem of what
constitutes the eradication of the disease. In part we reckon from long
experience, and in part depend upon the refinement of our modern tests.
Repeated negative Wassermann tests on the blood over several years,
especially after treatment is stopped, are an essential sign of cure.
This must be reinforced, as a rule, by a searching examination of the
nervous system, including a test on the fluid of the spinal cord. This
is especially necessary when we have used some of the quick methods of
cure, like the abortive treatment. When we have used the old reliable
course, it is less essential, but desirable. Can we ever say to a
patient in so many words, "Go! you are cured"? This is the gravest
question before experts on syphilis today, and in all frankness it must
be said that the conservative man will not answer with an unqualified
"Yes." He will reserve the right to say to the patient that he must from
time to time, in his own interest, be reexamined for signs of
recurrence, and perhaps from time to time reinforce his immunity by a
course of rubs or a few mercurial injections. Such a statement is not
pessimism, but merely the same deliberate recognition of the fallibility
of human judgment and the uncertainty of life which we show when we
sleep out-of-doors after we have been suspected of having tuberculosis,
or when we take out accident or life insurance.

Chapter X

Hereditary