58 SPIROCHETES 



cure, though some doctors consider a negative Wassermann reac- 

 tion for two years necessary to indicate a certain cure on account 

 of rare cases of relapse, even after a year of apparent absence of 

 the spirochsetes. In contrast to the 85 per cent of relapses which 

 occurred when mercury alone was used to treat syphilis, less than 

 four per cent of relapses occur after treatment with both mercury 

 and salvarsan. Certainly salvarsan may justifiably be con- 

 sidered " one of the mightiest weapons in medicine." 



Prevention. — The control and ultimate eradication of syphilis 

 is, in spite of our present methods of diagnosis and treatment, a 

 dream of the distant future. In its prevention are involved so 

 many social and moral problems upon which people will not 

 agree that the task is beset with great difficulties. 



According to Dr. Snow of the American Social Hygiene Asso- 

 ciation, the means of controlling and preventing syphilis fall 

 into three groups: (1) care and treatment of existing cases with 

 a view to preventing their spreading the infection, (2) protection 

 of the uninfected by education and administrative measures, (3) 

 the development of social defenses against the disease. 



As regards the first type of preventive measures, practically 

 all medical men and public health workers are agreed. Adequate 

 means for the diagnosis and treatment of syphilis should be pro- 

 vided in all cases. At present not only are there no laboratories 

 for diagnosis or free hospitals or clinics for treatment provided at 

 public expense, but most of our private physicians and hospitals 

 shun syphilitics, and refuse to care for them. Many physicians 

 at the present time have little knowledge of venereal diseases. 

 The suggestion of the British Royal Commission on Venereal 

 Diseases urging that this subject be given a prominent place in 

 all medical schools is certainly worthy of being put into practice 

 immediately. In many of our large cities and in most of' the 

 small ones there is not a single hospital which will admit a patient 

 for a venereal disease. Of 30 general hospitals in New York 

 City, only ten receive patients with recognized syphilis in the 

 infective stages. Theoretically a syphilitic in the infective stages 

 should be as carefully watched and cared for as a leper or small- 

 pox patient, yet the syphilitic, the victim of immorality usually, 

 but sometimes only of the carelessness of some other culprit, 

 is turned loose without treatment, but with full power to infect 

 all with whom he comes in contact directly or indirectly. We 



