“SYPHILIS is one of the most important complications of pregnancy,” in the opinion of Dr. Williams, “as it is the most important single cause of fetal death.” In support of this contention, Dr. Williams reports upon a series of 10,000 consecutive deliveries which took place under his observation, and in which syphilis caused 26.4 per cent. of the deaths among 705 babies who died after the seventh month of pregnancy or during the first two weeks after birth. Furthermore, nearly as many more babies who were discharged alive, at the age of two weeks, died in a short time or gave evidence of having syphilis later on in life. Believing in the importance of diagnosing and treating this disease during pregnancy, Dr. Williams subsequently made observations upon 4,000 cases in which Wassermann tests were given, and to which 421 women gave positive reactions. In this series of 4,000 deliveries, 302 babies died during the last two months of uterine life, or the first two weeks of extra-uterine existence. The relative frequency of the various causes which worked destruction in these 302 little lives is given by Dr. Williams in the following table:— Syphilis 104 cases 34.44% Dystocia 46 cases 15.20% Toxemia 35 cases 11.55% Prematurity 32 cases 10.59% Cause unknown 26 cases 8.61% Placenta prævia and premature separation 16 cases 5.28% Deformity 11 cases 3.64% Eleven other causes 32 cases 10.69% ——— ——————— Total 302 100.00% It will be seen from these figures that syphilis caused almost as many deaths as the three causes, next in order, combined. The effect upon the child’s chances for life, of treating the expectant mother for syphilis, is suggested by comparing the results among the 421 syphilitic women who were not treated at all; those treated insufficiently by receiving but two or three doses of salvarsan and no after-treatment of mercury (because of the patient’s lack of cooperation or because treatment was instituted too late in pregnancy); and those treated satisfactorily, which meant the administration of from four to six doses of salvarsan followed by mercurial treatment continued sufficiently long to result in a Wassermann reaction that was negative, and remained so. Among those mothers who were not treated, 52 per cent. of the babies were born dead or had syphilis; among those treated incompletely, 37 per cent. and among those treated until cured, syphilis caused the death of or was demonstrable in but 6.7 per cent. of the babies.[5]