m sexual relations or
other contacts that are apt to subject others to risk. Average patients
will almost never remain under the care of a physician until cured. A
year, or at the most two years, is all that can be expected, and a
second or third negative blood test is usually the signal for their
disappearance. They are, of course, lost in the great unknown of
syphilis, and swell the total of deaths from internal causes of
syphilitic origin, such as diseases of the arteries and of the nervous
system. A good many have to be treated for relapses, but the amount of
infection spread by them, while of course unknown, is probably small
considering how many of them there are.

+Effect of the High Cost of Treatment.+--A factor which is extremely
influential in forcing average treatment and ideals on those who, if
opportunity were more abundant, would be conscientious about the
disease, has already been mentioned as the cost of treatment, which is
such that persons with small incomes, who are too proud or sensitive to
seek charitable aid, can scarcely be expected to meet. The cost of
salvarsan under present conditions is a burden that few can hope to
assume to the extent that modern treatment tends to require, and the
slower methods of treatment are more of a tax on the patient's courage
and determination, and less effective in preventing the danger of
infectiousness, although quite as reliable for cure. There is no more
serious problem in the public health movement against syphilis than to
get for the average man who can pay a moderate but not a large fee the
benefits of expensive and elaborate methods of recognizing and treating
a disease such as syphilis. Some practical methods of doing this will be
taken up in the next chapter.

+The Irresponsible.+--The irresponsible attitude of mind about syphilis
forms the background of the darkest and most repellent chapter in the
story of the disease. Yet we ought to confront it if we wish to master
the situation. The irresponsible person has either no regard for, or no
conception of, the rights of others where a dangerous contagious disease
is concerned, and often little conception of, and less interest in, what
is to his own ultimate advantage. Irresponsible syphilitics lack
character first and sense next. Many of them, through the gods-defying
combination of stupidity and ignorance, cannot be approached through any
channel of reason or persuasion. The only argument capable of
infl