There are few things about our situation with regard to syphilis that deserve more urgent attention than questions connected with the cure of the disease, and few things in which it is harder to get the necessary coöperation. On the one hand, syphilis is one of the most curable of diseases, and on the other, it is one of the most incurable. At the one extreme we have the situation in our own hands, at our own terms--at the other, we have a record of disappointing failure. As matters stand now, we do not cure syphilis. We simply cloak it, gloss it over, keep it under the surface. Nobody knows how much syphilis is cured, partly because nobody knows how much syphilis there really is, and partly because it is almost an axiom that few, except persons of high intelligence and sufficient means, stick to treatment until they can be discharged as cured. Take into consideration, too, the fact that the older methods of treating syphilis were scarcely equal to the task of curing the disease, and it is easy to see why the idea has arisen, even among physicians, that once a syphilitic means always a syphilitic, and that the disease is incurable.
+Radical or Complete Cure.+--In speaking of the cure of syphilis, it is worth while to define the terms we use rather clearly. It is worth while to speak in connection with this disease of radical as distinguished from symptomatic cure. In a radical cure we clear up the patient so completely that he never suffers a relapse. In symptomatic cure, which is not really cure at all, we simply clear up the symptoms for which he seeks medical advice, without thought for what he may develop next. Theoretically, the radical cure of syphilis should mean ridding the body of every single germ of the disease. Practically speaking, we have no means of telling with certainty when this has been done, or as yet, whether it ever can be done. It may well be that further study of the disease will show that, especially in fully developed cases, we simply reduce the infection to harmlessness, or suppress it, without eradicating the last few germs. Recent work by Warthin tends to substantiate this idea. So we are compelled in practice to limit our conception of radical cure to the condition in which we have not only gotten rid of every single symptom of active syphilis in the patient, but have carried the treatment to the point where, so far as we can detect in life, he never develops any further evidence of the disease. He lives out his normal span of years in the normal way, and without having his efficiency as a human being affected by it. In interpreting this ideal for a given case we should not forget that radical methods of treating syphilis are new. Only time can pass full verdict upon them. Yet the efficiency of older methods was sufficient to control the disease in a considerable percentage of those affected. There is, therefore, every reason to believe that radical cure under the newer methods is a practical and attainable ideal in an even higher percentage of cases and offers all the assurance that any reasonable person need ask for the conduct of life. It should, therefore, be sought for in every case in which expert judgment deems it worth while. It cannot be said too often that prospect of radical cure depends first and foremost upon the stage of the disease at which treatment is begun, and that it is unreasonable to judge it by what it fails to accomplish in persons upon whom the infection has once thoroughly fastened itself.