r as
it goes, but it is not so reliable as to deserve incorporation into law
as sole sufficient evidence of the absence of syphilis, as has been done
in one state. From what has been said, it is plain that a single
negative Wassermann is no proof of the absence of syphilis. The subject
must be approached from other angles, and when syphilis may be
suspected, the question should be decided _by an expert_. A thorough
general or physical examination is desirable, and if this reveals
suspicious signs, such as scars, enlarged glands, etc., it is then
possible to investigate the Wassermann report more thoroughly by
repeating the test, sending it to another expert for confirmation. In
some cases it may even be necessary to insist that the patient submit to
a special test, called the provocative test, in which a small injection
of salvarsan is used to bring out a positive blood test if there is a
concealed syphilis. These are, of course, measures which are seldom
necessary except in patients who have had the disease. Much depends on
the attitude of the patient toward the examination and his willingness
to cooeperate. A resourceful physician can usually settle the question of
a person's fitness for marriage, and the result of a reliable
examination offers a reasonable assurance of safety.

+Laws Crippling Physicians in Such Matters.+--What shall the physician
do when confronted with positive evidence that a patient who is about to
marry has an active syphilis? It is important for laymen to understand
that the law relating to professional confidence between physician and
patient ties the hands of the physician in such a situation. For the
doctor to tell the relatives of the healthy party to such an intended
marriage that the other has active syphilis would make him subject to
severe penalties in many states for a violation of professional
confidence, or to suit for libel. Of course, if the patient has agreed
to submit to examination to determine his fitness for marriage, the
physician's path is clear, but if the condition is discovered in
ordinary professional relations, there is nothing to be done except to
try to persuade the patient not to marry--advice he usually rejects. To
this blind policy of protecting the guilty at the expense of the
innocent an immeasurable amount of human efficiency and happiness has
been sacrificed. Fortunately there are signs of an awakening. For
example, Ohio has recently amended the law so as to pe