d by its failure to learn to talk,
although it may seem perfectly normal in every other way. Again, the
child may hear well at birth and deafness may come on in later life,--as
late as the twentieth year,--suddenly or gradually, and become complete
and permanent. It is often ascribed to colds or to falls and accidents
that happen to occur at the same time. If syphilitic deafness comes on
before the age of ten years, it is very apt to result in the child's
forgetting how to talk, and becoming dumb as well. It goes without
saying that children whose syphilis made them deaf at birth never learn
to talk at all, and are therefore deaf and dumb. Very little is known
about how many of the inmates of asylums for the deaf are hereditary
syphilitics, but there is reason to suspect the percentage to be rather
large. Deafness in hereditary syphilis is practically uninfluenced by
treatment.

+Accident and Injury in Hereditary Syphilis.+--It is a matter of great
importance to realize the large part played by accidents, injury, poor
health, or lowered resistance in bringing a hidden hereditary syphilis
to the surface. A child may show no special signs of the disease until
some time during its childhood it has a fall which injures or bruises a
bone or breaks a limb. Then suddenly at the place where the injury was
done a gumma or tertiary syphilitic change will take place and the bone
refuses to heal or unite or a large sore may develop which may be
operated on before the nature of the condition is realized. In the same
way a woman with hereditary syphilis may seem in perfect health, marry,
and suddenly after the birth of her first child, even as late as her
twenty-fifth year, may develop syphilitic eye trouble. It must be
realized that hereditary syphilis is as treacherous as the acquired
disease, and can show as little outward signs before a serious outbreak.
It is part of the duty of every person who suspects syphilis in his
family or who has it himself to let his physician know of it, for the
sake of the help which it may give in recognizing obscure conditions in
himself or his children.

+Marriage and Contagion in Hereditary Syphilis.+--In general it may be
said that, in the matter of marriage, persons who have hereditary
syphilis and live to adult life with good general health can, after
reasonable treatment, marry without fear of passing on the disease.
Hereditary syphilis apparently is not transmitted to the children as
acquir