That doctrine about ovariotomy, if it includes double ovariotomy, is disputed by physicians because, they say, such a woman is sterile and she knowingly is going to deprive the man of his chances of having children; secondly, a woman upon whom double ovariotomy has been performed is almost always a neurasthenic invalid with a marked tendency to insanity, and it is a grave injustice to any man to saddle such a degenerate upon him for life by treachery. The prospective injury to the man is so great that the physician should first try to induce the woman to divulge her condition, and if she does not, the physician at least _may_ divulge it. Secondly, I deny most emphatically that any physician can tell that a man who once has had syphilis is completely cured and is not a source of infection. The facts I have cited in this chapter prove conclusively that once a syphilitic always probably a syphilitic, and the risk is always so great that the physician is obliged first to insist that the man does not marry, and if the man persists the physician may let the woman know. If preparations for the marriage have been made publicly, the physician will, as a rule, for his pains from the woman and her family get only a rebuff and the woman will later get her syphilis more or less certainly. If the man is actively infective the physician is bound to let the woman know, through her confessor if no other way presents, provided the man cannot be frightened out of his scoundrelism. If nothing else avails, the physician would be justified in reporting such a man to the Board of Health or the sanitary police. Barrett says the physician may be excused from divulging that the man has infective syphilis if such a revelation would cause the physician to lose the confidence of his patients. It never does have such an effect, although physicians constantly expose such cases in the interests of humanity. Because a man who is apparently cured of syphilis may or may not infect the woman, this doubt probably excuses the physician from the strict obligation of divulging the condition, although he _may_ tell her if he wishes to do so, _salvo meliore consilio_, as far as the release from strict obligation to divulge is concerned. If a patient with syphilis goes to a physician for the treatment of some other physical disability, and the physician discovers the syphilis in the course of the examination, this knowledge of the syphilis would be a tacitly entrusted secret. Whether, however, a secret that a man is actively infective or very probably infective is entrusted either tacitly or directly, it is not a privileged secret owing to the danger or certainty of extraordinary calamity to the innocent second party.