e details relating to the question of how the disease is
spread about.

Two bed-rock facts stand out as the basis for the whole discussion.
First, for practical purposes syphilis is contagious only in the primary
and secondary stages. Second, syphilis is transmitted only by open sores
or lesions whose discharges contain the germs, or by objects which are
contaminated by those discharges. Infection with syphilis by such fluids
as the blood, milk, or spermatic fluid uncontaminated by contact with
active lesions is at least unusual.

+Contagiousness in the Primary Stage.+--The chancre is always
contagious. If it is covered with a dry crust, it is, of course, less
so, but as soon as the crust is rubbed off, the germ-infested surface is
exposed and the thin, watery discharge contains immense numbers of the
organisms, especially in the first two or three weeks. This is just as
true of a chancre on the lip or chin as on the genitals. Chancres which
are in moist places, as in the mouth, or on the neck of the womb, or
under the foreskin, are especially dangerous, because the moisture keeps
the germs on the surface.

+Contagiousness in the Secondary Stage.+--In the secondary period, when
the body is simply filled with germs, one would expect the risk to be
even greater than in the primary stage. As a matter of fact, however, no
matter how many germs there are in the body, the only ones that are
dangerous to others are those that are able to get to the surface. A
syphilitic nodule or hard pimple on the hand or face is not contagious
so long as the skin is dry and unbroken over it. The sores which occur
in the moist, warm, protected places, like the mouth, on the lips, about
the genitals, and in the folds of the body, such as the thighs, groins,
armpits, and under the breasts in women, are, like the chancre, the real
sources of danger in the spread of the disease.

+Relatively Non-contagious Character of Late Syphilis.+--The older a
syphilis is, the less dangerous it becomes. It is the fresh infection
and the early years which are a menace to others. It will be recalled
that the germs die out in the body in immense numbers after the active
secondary period is over, so that when the tertiary stage is reached,
there is only a handful left, so to speak. The germs in a tertiary sore
are so few in number that for practical purposes it is safe to say they
may be disregarded, and that for that reason late syphilis is
practically harml