Often such infection may be due to a tragical form of “negligence.” But, as pointed out in a work on Neurosyphilis, 1917, I believe that any form of licensing system, official or virtual, which would permit the purchase of syphilis in or near military zones, abolishes the argument of “negligence.” A man acquiring syphilis under the connivance of government ought to stand as well as a syphilitic hired by the government, when it shall come to the question of compensation for incapacity. Yet, it may be argued, the man might have remained continent after all. The point is left to the mercy of jurists.
17. The share of neurosyphilis in the “crimes” and disciplinary problems of the army is intimated in three cases (Cases [11 to 13]).
18. The latter part of the series (Cases [14 to 31]) embraces problems of a more medical nature, touching traumatic paresis and “Shell-shock paresis.” Unusual, these cases may be readily conceded to be; but their infrequency is not such as to put them out of the field of consideration in the “Shell-shock” group.
Very intriguing to the diagnostician would be the cases of pseudotabes and pseudoparesis (Cases [23] and [26] of Pitres and Marchand), were such cases at all frequent.
[Case 28], in which shell-shock (the physical event) apparently caused recurrence of a syphilitic (!) hemiplegia, is particularly instructive and might better belong with the series (under [Section B: Nature and Causes, Cases 286-301]) in which ante-bellum weak spots were picked out by shell-shock and war conditions. But [Case 28] is placed here for its syphilitic interest.
[Case 29] stands out as a warning example not to crowd the hypothesis and try to make syphilis sponsor for everything, even when it plainly is at work.
[Cases 32-34] are cases in which syphilis played a part, though possibly a minor part, in certain peculiar mental reactions.
To sum up the part played by syphilopsychoses and syphiloneuroses in the war, we find, that
19. Syphilis may have occasionally a serious military effect, as in the case of desertion by a French officer of high rank.
20. Important problems of pension, retirement, and compensation are brought out, and as no previous war has had the benefit of the Wassermann reaction and other exact tests bearing upon the nature, progress, and curability of neurosyphilis, we may hope for a far more scientific determination of these questions by review boards during and after the war.