Volume 6 — CHAPTER VIII. (continued 2)

[230]

Even within the limits of the English army it is found In India (H. C. French, Syphilis in the Army, 1907) that venereal disease is ten times more frequent among British troops than among Native troops. Outside of national armies it is found, by admission to hospital and death rates, that the United States stands far away at the head for frequency of venereal disease, being followed by Great Britain, then France and Austria-Hungary, Russia, and Germany.

[231]

There is no dispute concerning the antiquity of gonorrhœa in the Old World as there is regarding syphilis. The disease was certainly known at a very remote period. Even Esarhaddon, the famous King of Assyria, referred to in the Old Testament, was treated by the priests for a disorder which, as described in the cuneiform documents of the time, could only have been gonorrhœa. The disease was also well known to the ancient Egyptians, and evidently common, for they recorded many prescriptions for its treatment (Oefele, "Gonorrhoe 1350 vor Christi Geburt," Monatshefte für Praktische Dermatologie, 1899, p. 260).

[232]

Cf. Memorandum by Sydney Stephenson, Report of Ophthalmia Neonatorum Committee, British Medical Journal, May 8, 1909.

[233]

The extent of these evils is set forth, e.g., in a comprehensive essay by Taylor, American Journal Obstetrics, January, 1908.

[234]

Neisser brings together figures bearing on the prevalence of gonorrhœa in Germany, Senator and Kaminer, Health and Disease in Relation to Marriage, vol. ii, pp. 486-492.

[235]

Lancet, September 23, 1882. As regards women, Dr. Frances Ivens (British Medical Journal, June 19, 1909) has found at Liverpool that 14 per cent. of gynæcological cases revealed the presence of gonorrhœa. They were mostly poor respectable married women. This is probably a high proportion, as Liverpool is a busy seaport, but it is less than Sänger's estimate of 18 per cent.

[236]

E. H. Grandin, Medical Record, May 26, 1906.

[237]

E. W. Cushing, "Sociological Aspects of Gonorrhœa," Transactions American Gynecological Society, vol. xxii, 1897.

[238]

It is only in very small communities ruled by an autocratic power with absolute authority to control conditions and to examine persons of both sexes that reglementation becomes in any degree effectual. This is well shown by Dr. W. E. Harwood, who describes the system he organized in the mines of the Minnesota Iron Company (Journal American Medical Association, December 22, 1906). The women in the brothels on the company's estate were of the lowest class, and disease was very prevalent. Careful examination of the women was established, and control of the men, who, immediately on becoming diseased, were bound to declare by what woman they had been infected. The woman was responsible for the medical bill of the man she infected, and even for his board, if incapacitated, and the women were compelled to maintain a fund for their own hospital expenses when required. In this way venereal disease, though not entirely uprooted, was very greatly diminished.

[239]

A clear and comprehensive statement of the present position of the question is given by Iwan Bloch, Das Sexualleben Unserer Zeit, Chs. XIII-XV. How ineffectual the system of police regulation is, even in Germany, where police interference is tolerated to so marked a degree, may be illustrated by the case of Mannheim. Here the regulation of prostitution is very severe and thorough, yet a careful inquiry in 1905 among the doctors of Mannheim (ninety-two of whom sent in detailed returns) showed that of six hundred cases of venereal disease in men, nearly half had been contracted from prostitutes. About half the remaining cases (nearly a quarter of the whole) were due to waitresses and bar-maids; then followed servant-girls (Lion and Loeb, in Sexualpädagogik, the Proceedings of the Third German Congress for Combating Venereal Diseases, 1907, p. 295).

[240]

A sixth less numerous class might be added of the young girls, often no more than children, who have been practically raped by men who believe that intercourse with a virgin is a cure for obstinate venereal disease. In America this belief is frequently held by Italians, Chinese, negroes, etc. W. Travis Gibb, Examining Physician of the New York Society for the Prevention of Cruelty to Children, has examined over 900 raped children (only a small proportion, he states, of the cases actually occurring), and finds that thirteen per cent have venereal diseases. A fairly large proportion of these cases, among girls from twelve to sixteen, are, he states, willing victims. Dr. Flora Pollack, also, of the Johns Hopkins Hospital Dispensary, estimates that in Baltimore alone from 800 to 1,000 children between the ages of one and fifteen are venereally infected every year. The largest number, she finds, is at the age of six, and the chief cause appears to be, not lust, but superstition.

[241]

For a discussion of inherited syphilis, see, e.g., Clement Lucas, Lancet, February 1, 1908.

[242]

Much harm has been done in some countries by the foolish and mischievous practice of friendly societies and sick clubs of ignoring venereal diseases, and not according free medical aid or sick pay to those members who suffer from them. This practice prevailed, for instance, in Vienna until 1907, when a more humane and enlightened policy was inaugurated, venereal diseases being placed on the same level as other diseases.

[243]

Active measures against venereal disease were introduced in Sweden early in the last century, and compulsory and gratuitous treatment established. Compulsory notification was introduced many years ago in Norway, and by 1907 there was a great diminution in the prevalence of venereal diseases; there is compulsory treatment.

[244]

See, e.g., Morrow, Social Diseases and Marriage, Ch. XXXVII.

[245]

A committee of the Medical Society of New York, appointed in 1902 to consider this question, reported in favor of notification without giving names and addresses, and Dr. C. R. Drysdale, who took an active part in the Brussels International Conference of 1899, advocated a similar plan in England, British Medical Journal, February 3, 1900.

[246]

Thus in Munich, in 1908, a man who had given gonorrhœa to a servant-girl was sent to prison for ten months on this ground. The state of German opinion to-day on this subject is summarized by Bloch, Sexualleben unserer Zeit, p. 424.

[247]

A. Després, La Prostitution à Paris, p. 191.

[248]

F. Aurientis, Etude Medico-légale sur la jurisprudence actuelle à propos de la Transmission des Maladies Venériennes, Thèse de Paris, 1906.

[249]

In England at present "a husband knowingly and wilfully infecting his wife with the venereal disease, cannot be convicted criminally, either under a charge of assault or of inflicting grievous bodily harm" (N. Geary, The Law of Marriage, p. 479). This was decided in 1888 in the case of R. v. Clarence by nine judges to four judges in the Court for the Consideration of Crown Cases Reserved.

[250]

Modern democratic sentiment is opposed to the sequestration of a prostitute merely because she is diseased. But there can be no reasonable doubt whatever that if a diseased prostitute infects another person, and is unable to pay the very heavy damages which should be demanded in such a case, she ought to be secluded and subjected to treatment. That is necessary in the interests of the community. But it is also necessary, to avoid placing a premium on the commission of an offence which would ensure gratuitous treatment and provision for a prostitute without means, that she should be furnished with facilities for treatment in any case.

[251]

It has, however, been decided by the Paris Court of Appeal that for a husband to marry when knowingly suffering from a venereal disease and to communicate that disease to his wife is a sufficient cause for divorce (Semaine Médicale, May, 1896).

[252]

The large volume, entitled Sexualpädagogik, containing the Proceedings of the Third of these Congresses, almost ignores the special subject of venereal disease, and is devoted to the questions involved by the general sexual education of the young, which, as many of the speakers maintained, must begin with the child at his mother's knee.

[253]

"Workmen, soldiers, and so on," Neisser remarks (Senator and Kaminer, Health and Disease in Relation to Marriage, vol. ii, p. 485), "can more easily find non-prostitute girls of their own class willing to enter into amorous relations with them which result in sexual intercourse, and they are therefore less exposed to the danger of infection than those men who have recourse almost exclusively to prostitutes" (see also Bloch, Sexualleben unserer Zeit, p. 437).

[254]

The character and extent of such lectures are fully discussed in the Proceedings of the Third Congress of the German Society for Combating Venereal Diseases, Sexualpädagogik, 1907.

[255]

I leave out of account, as beyond the scope of the present work, the auxiliary aids to the suppression of venereal diseases furnished by the promising new methods, only now beginning to be understood, of treating or even aborting such diseases (see, e.g., Metchnikoff, The New Hygiene, 1906).

[256]

Max von Niessen, "Herr Doktor, darf ich heiraten?" Mutterschutz, 1906, p. 352.