CHAPTER VII. THE SOCIAL EVIL AND ITS MEDICAL ASPECTS. No phase of the social evil can be demonstrated with more scientific certainty than the physical aspect. It has been clearly proved through many and accurate sources that no danger to the integrity of the race is so great as the diseases which accompany prostitution. The greatest attention must be paid to every means which makes for the control of venereal diseases and of dissemination of reliable information concerning them for the protection of the innocent. With these facts in mind let us study the various classes of men and women who are involved in this vice. The Professional Female Prostitute. The testimony shows that the professional female prostitute is broken down within ten years after she begins to ply her trade. No better argument as to physical harm could be offered than this statement. Practically all professional prostitutes have had syphilis or gonorrhoea or both. It is the exception when either of these diseases is completely cured. During a certain part of the time they are communicable. Not infrequently these diseases are communicable and at the same time difficult to recognize. Therefore, a professional prostitute having intercourse with from ten to sixty men in a single night will infect a large number of men. Drug habituation also is more widespread amongst prostitutes than amongst any other class of society. Occasional Prostitutes. Occasional prostitutes are frequently infected with venereal disease. They are highly dangerous when so infected. Venereal diseases are bacterial in origin. From the epidemiologic standpoint they belong in the category with smallpox, diphtheria and scarlet fever. They cause most of the sterility, most of the peritonitis in females, most of the salpingitis. They cause a large part of the joint inflammations-a large part of the insanity and nervous diseases and a long train of diseases which go by other names but have syphilis as an underlying factor. Congenital defects and deformities are largely syphilitic in origin. In spite of all this a study of mortuary statistics does not give us much information, since the immediate or determining cause is usually some factor other than the venereal disease. The group of men who are infected by occasional prostitutes are somewhat more liable to spread venereal disease to innocent women, children and men than those who are infected by professional prostitutes. Clandestine Prostitutes. Clandestine prostitutes spread infection. They get peritonitis and salpingitis. They are prone to have babies born with infected eyes and therefore they increase blindness. They are frequently sterile. Amongst this and the preceding class are most of the illegitimate children. The death rate amongst illegitimate children is barbarously high. The morbidity rate amongst clandestine and occasional prostitutes is higher than amongst moral women of the same age-periods and in the same strata of society. Amongst the medical phases of these forms of prostitution is their tendency toward professional prostitution. Male Prostitutes. (Principally perverts.) They spread infection. They have a high mortality and morbidity rate. They increase the number of drug habitues. Occasional and Clandestine Male Prostitutes. They spreal infection. An infected man will not infect as many people as an infected woman, but an infected woman usually infects non-virtuous people; a large part of those infected by men are virtuous-wives and young children. An infected man usually takes infection into a clean home. -an infected woman seldom does. Amongst male occasional and clandestine prostitutes there is an increase in the morbidity and mortality rate. The diseases caused are in some measure immediate. Such as brain disease, insanity, paralysis, kidney and heart disease. They are usually remote. They spread infection of eyes and add to blindness. They beget children that are defective and deformed. Men given to great sexual excesses die from conditions due to those excesses. But the disability and inefficiency caused by such excesses is greater than its effect on the death rate. A consideration of the medical aspects of vice is not complete. without reference to the congenital and acquired physical conditions which tend towards prostitution, the woman or man being driven to it almost irresistibly as the result of congenital or acquired physical conditions. Of more importance in a consideration of the medical aspects of this subject is the inefficiency which follows the increased morbidity and immorality. The short period of self-maintenance is followed by the long years of dependency in hospitals and poor houses, the spread of contagious diseases, the inherited defects and the blindness, the syphilis and gonorrhoea amongst innocent children. The medical aspects of control are: 1. Registration of venereal disease. 2. Segregation of the infectious. 3. Supervision of candidates for marriage. 4. Registration of births. 5. Compulsory treatment of the eyes of newly born babes. 6. Hospitalization of infected prostitutes. 7. Hospitalization of those innocently infected. 8. A study of eugenics. VENEREAL DISEASES. How to Diminish Venereal Diseases. The time is ripe for a united attempt to diminish venereal diseases. To accomplish this both sexes should be taught the social and personal dangers of the black plague, far more to be dreaded than the white plague-venereal disease. They should be taught with emphasis that these diseases, like all other contagious diseases, may be innocently acquired and transmitted. Woman peculiarly needs such instruction, not only that she may protect herself, but that she may protect her child against danger from those to whose care it may be intrusted. Both sexes should be so instructed that they may teach sexual hygiene in all its relations. Innocence is too often dangerous ignorance. The period of instruction should be at the onset of adolescence since careful studies by Fournier in France and Erb in Germany have shown that it is about this period that first infection is most likely. The work of national, state and municipal organizations with the fundamental aim of instruction in sexual hygiene and sanitation should be encouraged and broadened. The public should be educated when practicable by exhibits as to the results of venereal disease, its causes and germs, its methods of spreading and control. In this instruction the viewpoint should be that of prophylaxis and not the impracticable one of creating terror. Public lectures should be given at night at social centers, at school, and churches, so that the parents of school children can obtain information needed to enable them to give proper instruction at home. Similar instruction should be given the employes of large business houses, manufacturing plants, etc., so that this class which is thrown on its own resources at an early age may profit by this training.1 Infection of the Innocent. No marriage should be legal unless both parties furnish certificates of health and freedom from venereal diseases given by legally qualified physicians. In these certificates, the physician giving them should assume all civil and criminal responsibility for them. The person officiating at a marriage ceremony should be obliged by law to require such certificate. Infection of an innocent wife by a husband under the common law principle of the Kentucky decision in Hoove v. Hoove is a criminal offense in itself and unlike adultery cannot be condoned by the wife. Under the Canon law since infection interferes with procreation which the Canon law regards as essential to marriage. Such infection can under the spirit of the Canon law create annulment of marriage, like any other factor of sterility. Under these principles the marital limitations of evidence would be nullified. The penalty for such infection should be one which would punish the criminal and not the family or the innocent wife as does most of the legislation against cruelty, abandonment and like offenses involved in marital relations. As quarantine and isolation require increased hospital provision, especially since, as shown by experience, police regulation is a failure so far as venereal disease is concerned being replaced in the Scandinavian speaking countries by sanitary supervision quarantine and isolation, hospital provision and dispensary facilities for the care of venereal disease should be increased along the lines shown to be practicable by the English lock hospitals. Health Department and Venereal Diseases. Under the police powers now granted by the State, except where specifically limited by statute, the Department of Health could quarantine persons when notified 1See Chapter V, "Child Protection and Education," page 253. |