5. Detention hospitals for contagious uncoöperative cases.

6. Free expert treatment and free drugs (state or privately paid) for the poor.

7. Pay clinics for persons of moderate means.

8. Locating source of infection and establishing treatment.

Infectious, contagious diseases are always matters of importance to the whole community. The effects of syphilis are even more far-reaching than of acute diseases such as typhoid fever or smallpox and do not end with the spread of the disease. However, the matter of contagiousness is very pertinent. Accidental extragenital infections are by no means infrequent and if one numbers among the innocent victims the mates and children of the syphilitic, the extent of this phase of the problem is quite stupendous, and comes within the purview of the public-health departments, municipal, state and national.

But syphilis is of greater interest to society than in its aspect of accidental contagiousness. It causes much loss of economic efficiency, it disables men and women in their prime, it leads to various defects in children, who either die early or go through life handicapped. It is a considerable factor in race suicide through its part in lessening the marriage rate and producing sterility, unsuccessful pregnancies, and infant deaths. The apparent cost to the community, great as it is, does not give more than a small fraction of the total cost.

Whether viewed from the standpoint of its effect on the individual, his mate, and children, the family group, or of the dangers of contagion, the cost to society for medical and social care, the loss of economic productivity in industry, the difficulties of the mentally deranged, syphilis is always a community problem. In all its manifestations the social structure is involved. Any problem implicating the community at large to such a degree deserves the intelligent attention of the members of the community, and per contra the members of the community are entitled to a knowledge of a subject of such major importance to them individually and collectively.

REFERENCES

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BULKLEY, L. D., Syphilis in the Innocent, New York, Bailey and Fairchild, 1898. COLLINS, H. G., Syphilis in the Innocent, Journal of the Kansas Medical Society, vol. 21, no. 7, Jan., 1921.

Department of Medical Social Work, Boston City Hospital Report, Feb. 1, 1919. DIDAY, P., Treatise on Syphilis in New-born Children and Infants at the Breast, translated by D. Whitley with notes by F. R. Sturgis, New York, Wm. Wood and Co., 1883.

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LANE, J. E., A Few Early Notes on Syphilis in the English Colonies of North America, Archives of Dermatology and Syphilis, vol. 2, no. 2, Aug., 1920. MERCIER, C., Clinical Aspects of General Paresis, System of Syphilis, second edition, London, 1914, Frowde, Hodder, and Stoughton, vol. iii.

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