Most health problems resolve themselves into questions of heredity or environment. The health problem presented by the social evil is a question involving both of these and, in addition, the sexual instinct. The three combined produce a problem that has vexed humankind throughout all history.
This poster warning of venereal disease clearly presents the woman as responsible. Courtesy of Images in the History of Medicine, National Library of Medicine, http://ihm.nlm.nih.gov.
Sexual intercourse is a response to a primal instinct; an instinct as insistent as that of hunger or thirst. Its promiscuous gratification creates the social evil with its attendant health problem.
Man’s lust is the cornerstone on which the whole problem rests. Heredity and environment are conditions created by man’s lust and, once established, form a vicious circle which contaminates those coming within its influence.
Until quite recently the medical profession has been chiefly concerned in caring for the pathological end of the problem; dealing with end results.
No sanitary problem has ever been solved by caring for its victims. Treating syphilis and gonorrhea has about as much influence in getting at the base of the evil as would the snipping off of a few leaves have in cutting down a forest.
Practically everyone has a remedy. All of these remedies fail when applied. Social ostracism, branding, imprisonment, burning at the stake—all have failed.
Recently it has been suggested that visitors to places of prostitution be photographed, and by another social worker that they be compelled to register their names. These suggestions were made in all seriousness and are given as samples of the impractical ideas that are being born. . . .
Any scheme which ignores the sexual instinct as the basic cause of the social evil is bound to fail.
Education, segregation, suppression, regulation, and medical inspection have all been tried, and all have failed. They have failed because you cannot eliminate a primal instinct by education. Segregation failed because only a small proportion of prostitutes declared themselves, and segregation—no difference how perfect it may be—does not eliminate the social evil but simply concentrates it within certain boundaries.
Suppression failed because it does not suppress but scatters and multiplies the centers of infection.
Regulation failed because it was a compromise and because it placed an instrument in the hands of officials that was used for purposes of extortion and blackmail and that led to the debauching of public officials.
Medical inspection, the only method which gives any reason to hope that the evils resulting may be mitigated, has failed or succeeded according to the individual point of view. As carried on in this city by some private physicians, it not only contributes to moral delinquency but actually increases the number of cases of venereal disease.
A sanitary inspection was recently made in this city of about one third of the inmates of known houses of prostitution. Twenty per cent of the inmates were found diseased and were working under certificates of health dated within a week of the inspection and, in most instances, within from twenty-four to forty-eight hours of the inspection.
In a number of cases the diseased prostitute was under treatment of venereal disease by the man signing the certificate of health, in which he stated over his signature that she was free from venereal disease.
This is not medical inspection, but one way of securing money by false pretense, and leaves no doubt as to which is the worse prostitute, the woman or the physician signing the certificate.
Some people see a solution in a minimum wage law. Granting the constitutionality of such a law, how are employers of labor to be forced to employ people whose services are worth less than the minimum wage?
On the present standard of wages, a great army of women is living respectably and comfortably, although not luxuriously. What is to become of these if a minimum wage law makes it impossible for them to work? They must eat, have clothing, and places of shelter! Isn’t there a very grave probability that the method employed, instead of protecting them from lives of prostitution, will throw them into it as the only source of livelihood? . . .
Others find a solution in a single standard of purity. Back of everything that exists lie definite causes, and the double standard of purity exists because of a variety of reasons.
Society condones man’s moral lapse. If a woman falls, she is eternally damned. Society merely elevates its eyebrows when a man goes wrong. He is the victim of a designing woman. When the woman comes up for judgment, it is a case of thumbs down. The father of the race may be a past master in debauchery, but society demands that the mother be without taint or blemish of immorality. These are some of the reasons why the double standard of purity exists. . . .
Would the establishment of a single standard wipe out these reasons? . . . How is man to have his sexual instinct robbed of its dross, thereby placing him on a par with woman? Who would suggest that her high ideals be toned down thereby consigning her to the ooze and slime of man’s moral degradation? . . .
What are some of the more important factors contributing to the social evil and to the health problem under discussion? . . .
Every time that a match is struck in a powder magazine, the elements necessary for an explosion are present. In proportion as modern industrialism brings the sexes in close contact, in the same proportion are the chances of sexual explosions made possible. . . .
The medical profession is partially responsible for the health problem due to the social evil.
Some physicians advise young men to commit immoral acts, giving as a reason that continence is followed by nervous conditions due to a failure to exercise a normal physiological function. While this may be true in a few isolated instances, it can be said without fear of successful contradiction that where continence causes one neurasthenic, incontinence causes hundreds to go insane, or to become paretic, or blasts the offspring with idiocy or with blindness from birth, or sends him through life with the evidence of a dissolute ancestry stamped on his features.
In no other condition, with the possible exception of alcoholism, are the sins of the father visited upon the children with greater certainty than in venereal diseases. . . .
The claim has been made time and time again that without the support of married men 50 per cent of immoral houses would go out of existence.
An incident occurring during the recent sanitary survey may throw some light on this phase of the problem. In what is technically known in red-light society as a “five dollar house,” nine inmates were examined and four found actively infectious. The madam registered a vigorous protest in the health department against quarantining these four, giving as a reason that there couldn’t possibly be anything wrong with her “little girls” as they entertained regular customers only and that these were all married men. . . .
The influence of alcohol as a contributor to moral delinquency and to the social evil with its attendant health problem cannot be over-estimated. The saloon is the most powerful factor in the pollution of a community. Alcohol destroys judgment and dissipates fear of consequences. It is supposed to act as an erotic stimulant, but the truth is that it paralyzes fear. . . .
A large percentage of cases of venereal disease are contracted while the victim is under the influence of alcohol. Judgment and discretion are thrown to the four winds, and with them centuries of training and refinement. Owing to the widespread systemic paralyzing influence of the poison, resistance is lowered and infection is made easy. Cut out the saloon, and the sale of intoxicants in disorderly houses, and a great step toward the solution of the social evil will have been taken! . . .
Education in sex hygiene unquestionably has done a great deal of good, but it has its limitations. Many of those best qualified, from an educational standpoint, to resist temptation are far from being examples of morality, and the possession of knowledge does not necessarily mean its application. . . .
Medical inspection is employed in various European and American cities. It is good or bad according to the individual point of view. Theoretically, one diseased prostitute separated from her business should remove one dangerous center of infection, and the good thus accomplished should be multiplied by the total number of centers of infection eliminated.
One great trouble with medical inspection has been that it has failed to eliminate the diseased woman. As a means of petty graft, it has been a success.
The lying certificates of health secured by a payment of fifty cents serve one useful purpose in that they illustrate the market price placed on some souls by their owners. . . .
Students of this problem have estimated that 450 000 young men in this country are infected every year, that 80 per cent of the deaths from inflammatory diseases peculiar to women, 75 per cent of all special surgical operations performed on women, and over 60 per cent of all the work done by specialists in diseases of women are the result of gonococcus infection.
In addition, 50 per cent or more of these infected women are rendered absolutely and irremediably sterile.
Fully 80 per cent of the ophthalmia which blots out the eyes of babies and 20 to 25 per cent of all blindness is due to gonococcus infection.
Syphilis is transmitted to the offspring in full virulence. Its effect upon the product of conception is simply murderous. Sixty to 80 per cent of all infected children die before being born or come into the world with the mark of death upon them. . . .
The fact that these diseases constitute the most potent factor in the causation of blindness, deaf mutism, idiocy, insanity, paralysis, locomotor ataxia, and other incapacitating and incurable affections, imposes an enormous charge upon the state and community. . . .
Realizing, as we all must, that the ideal conditions outlined are difficult to bring about and that years must pass before they are obtained, I believe that the health problem created by the social evil should receive the same careful attention from the medical profession that is accorded other infectious disease problems.
Prophylaxis is not only the watchword in modern medicine, but its pride and glory. The debt owed our profession is not because of those we have cured but because of those we have kept well; not because of emergencies met, but because of emergencies avoided. . . .
Shall we build more hospitals, more insane asylums, more blind asylums and more penal institutions in which to house the victims of this problem while the seeds of moral suasion are being sown, cultivated and brought to full fruition in the dim future, or shall we apply the same sanitary principles which have stayed the plague, eliminated yellow fever, stopped the spread of cholera, and rendered smallpox less deadly than measles? . . .
Shall science be given a free hand, or shall the future be sacrificed to well intentioned emotionalism and hysteria?
Which shall it be?