[11] Schamberg, J. F.: "An Epidemic of Chancres of the Lip from Kissing," Jour. Amer. Med. Assoc., 1911, lvii, 783. +The Sexual Transmission of Syphilis.+--The sexual transmission of syphilis is beyond question the most important factor in the spread of the disease. Here all the essential conditions for giving the germ a foothold on the body are satisfied. The genitals are especially fitted to keep the germs in an active condition because of the ease with which air is excluded from the numerous folds about these parts. It is remarkable what trifling lesions can harbor them by the million, and how completely, especially in the case of women, syphilitic persons may be ignorant of the danger for others. Sexual transmission of syphilis is simply a physiologic fact, and in no sense to be confounded with questions of innocence and guilt in relation to the acquiring of the disease. A chancre acquired from a drinking cup or pipe may be transmitted to husband or wife through a mucous patch on the genitals and to children through an infected mother, without the question of innocence or guilt ever having arisen. On the other hand, chancres on parts other than the genitals may be _acquired in any but innocent ways_. It is impossible to be fair or to think clearly so long as we allow the question of innocence or guilt to color our thought about the genital transmission of syphilis. That syphilis is so largely a sexually transmitted disease is an incidental rather than the essential fact from the broadly social point of view. We should recognize it only to the extent that is necessary to give us control over it--not allow it to hold us helplessly in its grip because we cannot separate it from the idea of sexual indiscretion. There is a form of narrow-minded self-righteousness about these things that sets the stamp of vice on innocent and guilty alike simply on the strength of the sexual transmission of syphilis. In the effort to avoid so mistaken and heartless a view, we cannot remind ourselves too often that syphilis is a disease and not a crime, and as such must be approached with the impulse to heal and make whole, and not to heap further misfortune on its victim or take vengeance on him. +Extragenital and Marital Syphilis.+--Estimates of the ratio of genital to non-genital or so-called extra-genital infection in syphilis vary a good deal, and are largely the products of the clinical period in the history of the disease before the days of more exact methods of detecting its presence. The older statistics estimate from 5 to 10 per cent of all syphilitic infections to be of non-genital origin, while the remaining 90 per cent are genital. As we become better able to recognize hidden syphilis, we shall probably find that the percentage of non-genital infections will increase.