e family
especially. Many a syphilitic who realizes that he should not have
sexual relations with his wife while he has the disease in active form
will thoughtlessly infect her or his children by kissing. Kissing games
are potentially dangerous, and a classical example of this danger is
that of a reported case[11] in which a young man in Philadelphia
infected seven young girls in one game, all of whom developed chancres
on the lips or cheeks. It is no great rarity to find a syphilis dating
from a sore on the lip that developed while a young couple were engaged.
Certainly the indiscriminate kissing of strangers is as dangerous an
indulgence as can be imagined. Syphilis does not by any means invariably
follow a syphilitic's kiss, but the risk, although not computable in
figures, is large enough to make even the impulsive pause. The
combination of a cold sore or a small crack on the lip of the one and a
mucous patch inside the lip of the other brings disaster very near.
Children are sometimes the unhappy victims of this sort of thing, and it
should be resented as an insult for a stranger to attempt to kiss
another's child, no matter on what part of the body. It would be easy to
multiply instances of the ways in which syphilis may be spread by the
careless or ignorant in the close associations of family life, but
little would be accomplished by such elaboration that would not occur to
one who took the trouble to acquaint himself with the principles already
discussed.

[11] Schamberg, J. F.: "An Epidemic of Chancres of the Lip from
Kissing," Jour. Amer. Med. Assoc., 1911, lvii, 783.

+The Sexual Transmission of Syphilis.+--The sexual transmission of
syphilis is beyond question the most important factor in the spread of
the disease. Here all the essential conditions for giving the germ a
foothold on the body are satisfied. The genitals are especially fitted
to keep the germs in an active condition because of the ease with which
air is excluded from the numerous folds about these parts. It is
remarkable what trifling lesions can harbor them by the million, and how
completely, especially in the case of women, syphilitic persons may be
ignorant of the danger for others. Sexual transmission of syphilis is
simply a physiologic fact, and in no sense to be confounded with
questions of innocence and guilt in relation to the acquiring of the
disease. A chancre acquired from a drinking cup or pipe may be
transmitted to husban