ery case, to forestall even the
remotest possibility of mistake or oversight.

Where both husband and wife have had syphilis, even though both are past
the infectious stage, both should be treated, and a complete cure for
the wife is advisable before they undertake to have children. This must
mean an added burden of responsibility on both physician and patient,
and one extremely difficult to meet under existing conditions. A
reliable means of birth control used in such cases would place the
problem in women on a par with that in men, and give the physician's
insistence on a complete cure for the woman a reasonable prospect of
being needed. Where his advice is disregarded and a pregnancy results,
the woman should be efficiently treated while she is carrying the child.

+Syphilis and Engagements to Marry.+--If a five-year rule is to be
applied to marriage, a similar rule should cover the engagement of a
syphilitic to marry, and it should cover the sexual relations of married
people who acquire syphilis. It is not too much to expect that an
engaged person who contracts syphilis shall break his engagement, and
not renew it or contract another until by the five-year rule he would be
able to marry with safety.

Engagements nowadays may well be thought of as equivalent to marriage
when the question of syphilis is considered. They not infrequently offer
innumerable opportunities for intimacies which may or may not fall short
of actual sexual relations. Attention has been called to this situation
by social workers among wage-earning girls. It has been a distressingly
frequent experience in my special practice to find that the young man,
overwrought by the excitement of wooing, has exposed himself elsewhere
to infection and unwittingly punished the trustfulness of his fiancee by
infecting her with syphilis through a subsequent kiss. The publication
of banns before marriage is worth while, and unmistakable testimony as
to the character and health of the parties concerned might well be
exchanged before a wooing is permitted to assume the character of an
engagement. It is of little use to say that a Wassermann and a medical
examination should be made before marriage, when the damage may be done
long before that point is reached.

+Medical Examination for Syphilis before Marriage.+--How shall we
recognize syphilis in a candidate for marriage? The prevailing idea is
to demand a negative Wassermann test. Assuredly this is good as fa