Chapter XXIV

THE VENEREAL DISEASES.

Note:—We are permitted to quote this chapter from the book "Man and Woman," by Dr. Wm. T. Belfield, Professor in Rush Medical College, and Secretary of the Chicago Society of Social Hygiene organized by the Chicago Medical Society.

Promiscuous and clandestine indulgence of the reproductive instinct, everywhere prevalent, is for obvious reasons especially common in our large cities, where even children of both sexes are frequently initiated into sexual practices before puberty—a fact familiar to physicians and often revealed in our Juvenile Courts, though apparently unsuspected by parents in general. Chicago papers recently recorded the discovery of such practices among pupils of a public school.

The illicit sexual relation is the chief though not the only factor in the dissemination of the two serious venereal diseases; so prevalent are these in our large cities that at least half the adult male population of all social grades, according to conservative estimates, contract one or both of them. (In Germany gonorrhoea is the most frequent of all diseases, with the single exception of measles; in America it is about as frequent.) Were the evil effects of these diseases limited to those who seek clandestine indulgence, discussion of this distasteful topic might be reserved for them only; but since he who has acquired either of these diseases is, for an indefinite period, a possible source of contagion to his associates—especially to his bride and her children—the essential facts should be understood by every adult. These facts, so far as they concern the public welfare, are here briefly summarized:

1. Every prostitute, public or private, acquires venereal disease sooner or later; hence all of them are diseased some of the time, and some of them practically all of the time. The man who patronizes them risks his health at every exposure.

2. Medical inspection is an advantage to the prostitute chiefly because it gives her patron a false sense of security. Even the most elaborate and painstaking examination—and such is not bestowed upon the prostitute—may fail to detect a woman's lurking infectiousness; the perfunctory, routine examination actually made affords but a feeble protection to the patron. Moreover, at the first cohabitation after such examination she may acquire disease which she may transmit to every subsequent patron, until it is perhaps discovered at the next examination.

3. The many antiseptic washes, lotions and injections upon which the ignorant rely for protection from disease, are inefficient; not because they cannot destroy the germs of disease, but because they do not penetrate the skin and mucous membranes in which these germs have been sheltered.

4. Gonorrhoea in the male, while usually cured without apparent loss of health, has always serious possibilities; it kills about one in two hundred; it permanently maims one in a hundred; it impairs the sexual power and fertility of a much larger number; it often produces urethral stricture, which later may cause loss of health and even of life; and in many cases it causes chronic pain and distress in the sexual organs, with severe mental annoyance and depression. The loss of health, time and money entailed by these sequels and their treatment may far exceed that occasioned by the original disease.

The prevalent notion among the uninformed that gonorrhoea is a mere annoyance, "no worse than a cold," is based entirely upon lamentable misapprehension.

5. The persistence of this disease in the deeper parts long after it is outwardly cured, leads to the unsuspected communication of the disease to women with whom the individual may cohabit. Among these women may be his bride, who thereupon enters upon a period of ill-health that may ultimately compel the mutilation of her sexual organs by a surgical operation to save her life. Much of the surgery of these organs performed upon women has been rendered necessary by gonorrhoea, contracted from the husband. Should she while infected with this disease, give birth to a child, the baby's eyes may be attacked by the infection, sometimes with immediate loss of sight. Probably 25 per cent of the blindness of children is thus caused.

6. The other serious venereal disease, syphilis, infects the blood and therewith all parts of the body. For months after infection with this disease, the individual may communicate it by a kiss as well as by cohabitation; and articles moistened by his secretions—towels, drinking glasses, pipes, syringes, etc.—may also convey the infection. While under proper treatment the disease is not dangerous to life in the earlier years, yet the possibilities of transmitting the contagion should forbid marriage for at least three years.

The most serious results of syphilis appear years after its acquisition, when the individual has been lulled into a false sense of security by long freedom from its outward manifestations. It attacks all organs of the body, slowly and insidiously producing the symptoms of consumption, dyspepsia, liver disease and many other ailments. Since we have at present no reliable means for proving that one who has acquired the disease is absolutely cured thereof, physicians impress upon these patients two injunctions: first that they shall take the known remedies for the disease one or two months in every year, and second that they shall confide to every physician whom they may consult for any chronic or obscure ailment, the fact that they have been infected with syphilis. This latter injunction is especially important; for nearly all disorders produced by syphilis can be promptly checked by certain remedies; yet many of these disorders affecting internal organs of the body, may not be identified as of syphilitic origin by the unsuspecting physician, who therefore fails to administer the needed and successful remedy. By directing the doctor's attention to the possible syphilitic origin of the disease through a frank confession of his early infection, the patient may save his health or even his life.

These serious and intractable results of syphilis appearing years after its contraction, occur especially in the shape of disorders of the blood-vessels and of the nervous system—apoplexy, paralysis, insanity and locomotor ataxia for example; and these but too often appear after the man has acquired a family that is dependent upon him for support. The mental state of the husband and father whose bread-winning capacity is suddenly abolished through the natural result of his early folly, may be imagined.

That the syphilitic parent may transmit the disease to his offspring is common knowledge; some of his children are destroyed by the inherited disease before birth; others are born to a brief and sickly span of life; others attain maturity, seriously handicapped in the race of life by a burden of ill-health, incapacity and misery produced by the inherited taint; while still others apparently escape these evil effects.

Absolute freedom from venereal contagion, admittedly a prequisite for marriage, must be determined by expert medical skill; apparent recovery does not prove that the disease is really eradicated. Ignorance of the difference between real and apparent cure is responsible for most of the venereal infection of brides and taint of children.

The present popular crusade against tuberculosis is laudable and must result in a distinct restriction of the "great white plague"; but the greater black plague, syphilis, could be virtually eradicated in a few generations, through the universal practice of circumcision. Although apparently introduced into Europe less than four centuries ago, it has already tainted perhaps one-sixth of the total population, and it is steadily spreading; in the United States the ratio is but little better. (These percentages are merely estimates, since there are no official records of the venereal diseases except in public institutions.)