Syphilis and Marriage.
The question, when can a syphilitic marry? is as momentous and difficult to answer as a similar question in Gonorrhea; in other words, this question means, When can a syphilitic be declared perfectly cured and free from any danger of transmitting the infection to his wife and children? Until very recent years, before the three great discoveries in the realm of Syphilis had been made (the discovery of Spirocheta, Wasserman blood test, and Salvarsan), the physicians adopted from experience a rule which proved to hold good in the majority of cases. This rule reads that no syphilitic should be allowed to marry before three years passed since the time of primary infection. This rule was adopted on the assumption that the effects of three years’ treatment and the natural weakening of the virulence (intensity) of the syphilitic poison with the age of the disease give a reasonable assurance of safety to the wife and offspring. It is true that in most of the cases the family was fairly well protected by the long duration of observation period, and remained free from the infection, yet the physician had no exact and definite basis for such prediction, and while the family was well, some of these men developed many years later various dangerous and incurable complications of the advanced Tertiary Syphilis. Fortunately, now, in the light of new knowledge at our command about Syphilis, we are able to gauge the condition of the patient as to the degree of his cure of Syphilis in a very exact and definite manner. One test, tho, is not conclusive, particularly if it be negative. Positive Wasserman test is a fairly good evidence that syphilitic germs, spirochetae, are still present in the body in a dormant, if not an active, state, but a negative test, to be conclusive, must be repeated several times, covering a long period of time under various conditions, such as before and after a course of treatment. It should be remembered that while different active lesions in Syphilis are controlled and cleared up under modern methods of treatment very rapidly, a perfect elimination of spirochetae from the system is much more difficult, and it is always a time-consuming procedure. There are many cases of Syphilis where, after the primary general rash, sore throat, and other symptoms of the early secondary period, no other active symptoms of any kind develop subsequently, so that the actual manifestations of Syphilis are limited to a very few weeks or months, but even in these cases should a blood test be persistently negative for a period of half a year’s time, at least another half year should elapse before a final blood test is made. In the mildest and most thoroughly treated cases, a year’s time should be the shortest waiting period for giving a permission of marriage. In many more cases, probably in the majority, this period must be extended to two or three years, and in a few cases of malignant or destructive character, even much longer than this.
Thus the modern methods of treatment have shortened enormously the period of active manifestation of Syphilis, and have placed in our hands powerful means to control and to check the most malignant and destructive syphilitic lesions, but the period of quarantine in regard to marriage is not shortened very much, though its estimation is made immeasurably more certain, definite, and reliable.
Syphilis can be considered at the present time as perfectly curable and readily amenable to treatment, provided a correct and early diagnosis is made and a thorough, systematic, and persistent treatment is administered.