tever should be taken
for granted in such cases, and the necessary examinations and questions
should not give offense to either party to the bargain. Syphilis is not
a respecter of persons, and exists among the rich as well as among the
poor.

+Hereditary Syphilis in Older Children.+--Hereditary syphilis may become
a latent or concealed disease, just as acquired syphilis does. None the
less, it leaves certain traces of its existence which can be recognized
on examination. These are chiefly changes in the bones, which do not
grow normally. The shin bones are apt to be bowed forward, not sideways,
as in rickets. The skull sometimes develops a peculiar shape, the joints
are apt to be large, and so on. Syphilis may affect the mental
development of children in various ways. Perhaps 5 per cent of children
are idiots as a result of syphilis. Certain forms of epilepsy are due to
syphilitic changes in the brain. On the other hand, syphilitic children
may be extraordinarily bright and capable for their years. Some are
stunted in their growth and develop their sexual characteristics very
late or imperfectly. It is one of the wonders of medicine to see a
sickly runt of a child at fifteen or sixteen develop in a few months
into a very presentable young man or girl under the influence of
salvarsan and mercury. A few syphilitic children seem robust and healthy
from the start. The signs of the disease may be very slight, and pass
unrecognized even by the majority of physicians. Some of them may be
splendid specimens of physical and mental development, but they are
exceptional. The majority are apt to be below par, and nothing shows
more plainly the insidious injury done by the disease than the way in
which they thrive and change under treatment. Even those who are
mentally affected often show surprising benefits.

+Destructive Changes, Bones, Teeth, Etc.+--Syphilis in children, since
it is essentially late syphilis, may produce gummatous changes of the
most disfiguring type, fully as extreme as those in acquired syphilis
and resulting in the destruction or injury of important organs, and the
loss of parts of bones, especially about the mouth and nose. Certain
changes in the teeth, especially the upper incisors in the second set,
are frequent in hereditarily syphilitic children, but do not always
occur. These peg-shaped teeth are called Hutchinson's teeth. Individuals
with hereditary syphilis who survive the early years of life are les