Thus 40 per cent. of the pregnancies terminated in the death of the fetus before term. If the parents had been healthy and of the same social strata we might have expected 30 to 35 deaths before term, or a mortality of 10 per cent. instead of 40 per cent. Considering next the 200 living births: At the time the data were collected 39 were dead and 161 alive, but 12 of the 161 died during the course of the investigation. Of the 161 examined 107 had both clinical signs of syphilis and a positive Wassermann; 5 were clinically positive but gave negative tests (in all of these the family gave a history of syphilis); 16, although negative as regards clinical manifestations, gave positive reactions, and therefore belong to the group of latent syphilitics. Thus but 33 of the 161 living children were free from the infection, and if we attribute the deaths occurring before term to syphilis, we find that of the 331 pregnancies in 100 syphilitic families but 10 per cent. escaped the infection. The toll is summarized in the following table: 331 PREGNANCIES IN 100 SYPHILITIC FAMILIES 131 or 40 per cent. died before term } 51 or 15 per cent. died after birth } 55 per cent. dead 116 or 35 per cent. living but syphilitic 35 per cent. syphilitic 33 or 10 per cent. living and free from 10 per cent. escaped syphilis ——— 331 If we add to this record and take into consideration the physical condition of the parents—both of whom were syphilitic in almost all of our cases—we begin to grasp the appalling importance of syphilis from a social standpoint. In order to show this in another way, studies[52] were made in our clinic in which the waste (total deaths to total pregnancies) occurring in 100 families in which we were treating children with contagious disease, and in 100 families selected at random from our records, were contrasted with the waste in 100 syphilitic families. These groups are designated as C. R. and S. respectively and the data briefly summarized in the following table: Footnote 52: Jeans and Butler, Hereditary Syphilis as a Social Problem, Am. Jour. Dis. Child., 1914, viii, 327. Total Deaths Born living Per cent. Group pregnancies before now dead Total waste birth C. 444 46 70 116 26 R. 442 42 59 101 22 S. 453 116 104 220 48 The increase in the waste for the syphilitic group of 100 per cent. does not represent the total waste, as it is fair to assume that three-quarters of the living children are syphilitic and many of these defective.