+Effect of Syphilis on the Child-bearing Woman.+--What does syphilis mean for the woman who is in the child-bearing period? In the first place, unlike gonorrhea, which is apt to make women sterile, syphilis does not materially reduce the power to conceive in most cases. A woman with active syphilis alone may conceive with great frequency, but she cannot carry her children through to normal birth. The syphilitic woman usually has a series of abortions or miscarriages, in which she loses the child at any time from the first to the seventh or eighth month. Of course, there are other causes of repeated miscarriages, but syphilis is one of the commonest, and the occurrence of several miscarriages in a woman should usually be carefully investigated. The miscarriage or abortion occurs because the unborn child is killed by the germs of the disease, and is cast out by the womb as if it were a foreign body. Usually the more active the mother's syphilis, the sooner the child is infected and killed, and the earlier in her pregnancy will she abort. Later in the disease the child may not be infected until well along, and may die only at the ninth month or just as it is born. In other words, the rule is that the abortions are followed later by one or more still births. This is by no means invariable. The mother may abort once at the third month, and with the next pregnancy bear a living syphilitic child. The living syphilitic children are usually the results of infection in the later months of the child's life inside its mother, or are the result of higher resistance to the disease on the part of the child or of the efficient treatment of the mother's syphilis. +Variations on the Rule.+--It should never be forgotten that all these rules are subject to variation, and that where one woman may have a series of miscarriages so close together that she mistakes them for heavy, irregular menstrual flows, and never realizes she is pregnant, another may bear a living child the first time after her infection, or still another woman after one miscarriage may have a child so nearly normal that it may attain the age of twenty or older, before it is suspected that it has hereditary syphilis. Again a woman with syphilis may remain childless through all the years of her active infection, and finally, in her first pregnancy, give birth to a healthy child, even though she still has the disease in latent form herself. Still another may have a miscarriage or two and then bear one or two healthy children, only to have the last child, years after her infection, be stillborn and syphilitic. The series of abortions, followed by stillborn or syphilitic children, and finally by healthy ones, is only the general and by no means the invariable rule.