A SOCIAL EVIL.

Dominion, Volume 3, Issue 913, 5 September 1910, Page 5

A SOCIAL EVIL.

WHAT DR. FINDLAY PROFESSES. ALARMING STATISTICS. An interesting address on-certain social ([unslions was delivered at the King's Theatre' yesterday afternoon by the Hon. Dr. Findlay, Minister for Justice. The mooting- was held under the auspices. of the Wellington Men's Brotherhood, and the Rev. B. 0. Blamires.'presided.■'. f Tho audience was composed exclusively of men. Dr. :Findlay, after. dealing with the social evil of crime, dealt with one of its causes,,the social evil of vice, and in this connection took an. opportunity of /referring/ to, his recent proposals to check. the spread of venereal diseases.' He.'saVdlthat most people except doctors, and hospital arid prison; authorities were in-this matter living in, a fool's'paradise. Many, a goodly looking apple wa3 rotten at the. core. The existence and effects of these foul diseases wure. hidden From, knowledge and.view with the'.utmost care. .Even their men., lion Was doomed indelicate,; and while silence, ignorance, or indifference towards them prevailed they wero spread-, ing. like a.' cancer through -.'an everincreasing number of our people. "The alarming, spread of venereal, evils in Now Zealand was placed by the'figures in'.my possession; beyond all question., What'is to-be. done?"- continued Dr. Findlay. "Let" us,' of course, attempt to check, this.'plague' by .moral .and educational 'influences. I. .do. not .undervalue these;, agencies. ■. Bui, thoy must, in... the;,present -situation,,, be _ supplemented by. more/direct, and stricter remedies. ~ Wei do not limit our treatment ; of; drink and alcoholism'to moral suasion.'. ■;■, We -do liofc.-now .hesitate tp; isolate-, s'lifferers . from'. certain., contagious aucV-'iufeotious;.diseases -for,the .protection; i'of the - health "of .the community.. .1 am told that .the.; best' calculation, that can : .be'-made oii:the 'yt-atistics. 1 and othei-, figures/obtainable' is that' CO per cent.' of all: males' contract ; sexual disorders before .they -/reach;:'. 30.. (Voices': ■*-'Stiam'c-;!?.: ; "Don',t believe it,") I have' it;on ; highdiitlibnty that; from '65 per ,ccht: ; tu' 80 ■ per cent.'of' tlio abdominal aiid. uelyic operations pn, : womon are idueto ...tfio.,infectiph that ensuesj that an; .enormous percentage 'of-"baldness" in the liew-borh. and'young-infants is due, to. the'.samo cause,''and that probably.from; .one'-isnih'tij.ono-fdurtdeiith'of.'.tlio-whole: population - is. -.infected . ■ with ' syphilis alone.' .BetweW' 6000..and 7000:die,ol this disrai/i every; year; in Great Bn-j' tain,, while, tht-. diSi'roiit. diseases and. deaths indirectly';connected.wiSh.it, are .appalling.' , '•'■.. ;/■", ";.■ ;■;■,".: '' : "' r :\ , '■; .. ■ : ,,-'

;'A Principle', to bs : Avoided. ,'.,'"l ■ j'adrhit' 'the' problem 'is ' a very difEculf' and. delicate. . one. ..These diseases: 'differ from ; most. others., of a contagious or infectious nature 'in; that they'' .are' what: is called.:'; discreditable. This .co'mplieate.s, the '.problem. Again, no 'scheme' for.'ohecking the evil.. must expose itself .to, .the charge of, ,aiding or. abetting .prostitution by. making . >it safe. .■'.'., Thus;, their, we must' respect altogether'.the'basic priucirjlo ■ of . the 0;i).. Act.', The law'must apply equally. ■'toVbpHi 'sexes.' vlt m.iist. aim only at Jthe protection'of the health of the.com-; • the health of inhbcent.wbruen.'and children—and hot.at 'any; ;kin'd,.of-' regulation: or'''recognition" of'■vice'::;" Hence-.; I-, have suggested that evo'ry': doctor,": chemist,",' or other person: consulted? ;byt ariyo'hb ; suffering from, a ■venereal must report iti,to ,'thci' Public-Health /Officer, \who, .;• ias.;'you know,'.is'in ,overy' case,: art: experienced. medical'• man:,;: „to, : do\this\will; involve 'heavy;'penalties. ■;•:The' '.Public .Health". Omcei';:.'must treat .the . communication .Vwith;.all possible "secrecy,. •,but ; it;;.*ilK:bevhis duty.to see,.as, far as -he .'reaspiiably -can, that" proper, steps ■ are, being .taken both for .the ■sake of:-.th'e;.diseased.person, .himself' 'and:'for the'protectioii ,of others.-.'As helpful ■ to:- the 'last-mentioned 'purpose, it:should bo-matfe an r . offence severely punishable for a diseased person—knowing ; ho', or' ■.': she '.is ■'.-. so . diseased—to -.wilfully: expose I .others to. its contagion. This is' the .existing 'law, .'as -regard*', ■other infectious diseases.- ■_ Now,- no oiio claim's that' these provisions, if mado law,, will, eradicate the evil. The. question" is: ■ Will. : they check'.it ? . I thinkthat: undoubtedly .'they.-:would: First,, they. will t act as.', a deterrent upon; ]n largo , number of. men who would fear notification ,as much almost as they' fear: the. disease itself;',secondly, the power of the Public Health Officer could .make' itself felt ■ without... being in any. way obtruded. His advice would be-taken,, his .warnings, obeyed, including .obedience to prohibition in tho interest of; the; health' of ' innocent persons,;.-.' If not .quietly, and reasonably obeyed,'.-actual..isolation" of, tho,offondor' would'rcmain' £s'\a Isiit:resource, whilst: the. law against-wilful communication wouldvaot.i'as ..a; further deterrent., .'<

An Objection Answered; . ,' "These, proposals : .are not .'hew.-'.-I found,.indeed,: only_yesterday, that an eminent'"authority, in .America,' Dr.-, C S. .Woods, declares that ; . 'within','.ten' years i ,sexu'al l ,(lisprder;'wilLbp : ;just' as. regularly reported,- to --health':! officers as cases ; of'.small-pox, diphtheria, ;scarlet fever,'measles,y and' ether - infectious and; contagious, diseases are no\y reported.', But'lyam told. that some doctors, will'not :: report these, .cases. They-'havc now to: report infectieus diseases under the Public.Health .Act," and they obey the law loyally. • Why ! not ■these contagious diseases? : One medical; man often' calls in another, sometimes even. in these■'■ca'sesi..'. 'Why objeot for tho sake of the health of the community; to notify another : doctor, who would be the Public Health Officer? Similar; objections •; .wero made -by in . America regarding the notification yof tuberculosis. It was said that 'a notification /that an individual ; was suffering/from .that disease would often mean; family, social,' and business ostracism.'- But: they got oyer their qualms. The groat majority 'of th'e- medical. profession in New Zealand are in 'favour :6f these proposals,: and will faithfully assist their operatien. The: law could do; its ' best to enforce- notification, and - - although .there.'would, be excoptions, tho great bulk of tho cases would bo notified: ';. I yadmit- the ! administration. of suph; a law will 'call for care, tactfulness, on the part of the health officers,. but they, in common with the rest of their profession, possess these qualities in high degree. Soon it would be seeti that the health officer■ wab :to be trusted, that his was not the hand' of a prosecutor, but a helping hand, and just as the system of. .notification and supervision under tho : Public Health Act, in respect ■ of infectious diseases, has worked, out such splendid results,, so I' believe this proposed system, based; upon the ex* isting - system, would check tho appalling prevalence ..of- -these vener<jal diseases, and protect thousands of innocent wpmon and'children who are to-day-victims to infection. This is a dia— tasteful and'unsavoury subject, but we cannot remedy; a-great evil by ignoring it. The information brought undor my notico as a Minister from police prisen and medical sources, demanded that I should attempt to devise some remedy. I have tried my best. I believe that if wo can put upon our Statute-book something like that I liavo outlined, wo shall have done much towards coping with this terriblo black plague." (Applause.) Dr. Fincllay had a sympathetic audience, and at tho close a motion oxpressing appreciation of Dr. Findlay's

"frank, outspoken utterance" and sympathy with his efforts to'cope with the deadly social' evil referred'to, was carried by acclamation.

STATEMENTS BY DOCTORS AND CHEMISTS. THE DISEASE AND~THE REMEDY. A number of local doctors and chemists wore interviewed, last week by a . Dominion representative, as to the extent of,the evil, and the advisableilcss of. legislative action. ''; ■"All,the authorities consulted," said a well-known :chemist, "were unanimous as, to the dangers by which perfectly innocent people are constantly, surrounded through" contiguity, with persons suffering from this disease, who' not infrequently are ignorant of the gravity of their, own condition, and, in any event, desire to" conceal'it'from the knowledge of others,". : "If the public only knew of the prevalence of this disease and of- its awful consequences," stated one. of our leading physicians,. in discussing the proposed compulsory notification; ."they would insist upon.a much more stringent Bill than the amendment of the Public. Health Act now proposed." What Dr. Collins Thinks. "I am:in entire' sympathy l with, the compulsory notification provided for in the..Bill now before Parliament," said. the Hon. Dr. Collins,', on '•.being asked His, opinion ' regarding' the''measure, "provided everything with regard to ; tho privacy of the.patient is.properly saleguarded. I'think everything ought to be done to ensure absolute privacy . and secrecy—that no person's private business . should pe. in •any way ] divulged— but in the interests,'of"'the:'community at large I think it, is necessary that' some specified action should'be taken. There is no doubt that this disease is •on tlie increase.'' I do not .approve pi the.CD; Act or of any Act that can-, not "bo enforced, and: is against, : :. the moral sense of the. community.. I regard: the 'compulsory notification '.provided for. in'this measurers, being the •remedy." '■'.'':■. '':'•'.' -'''" ' V; -~-■ ... : ' ■. ."'■■ '■■■.•■"ls .there not a danger," .suggested our representative,' "thatthe effect of this, compulsory: notification, willibo ; '-to drive people affected, with;the disease to concealing, it) even ■ more so than at present?";. ,f ./. ■ . ;-\ '.'';//■•;,' .-''''■'•' . "I: do not'think; so," was. the. reply,: "I think" it will make. them come to, the doctors for treatment.'! . i . •'v :.

.;. Questioned a's : ,to- whether,. chemists ..were in; the-habit.: of'.'/.prescribing , in cases'.of'this; kind,' Div-Collins,said no doubt some.;chemists !did ■ so, - which;siin-. plj' meant that they,were dealing 'with -a disease of whieh> they 'were not/supposed, to- have aliy knowledge: .He did, not. say, this.'of •chemists! as.a body, .but: in',; plenty of cases aj.patient, camo . to a doctor six or •. eight -'months after he or she became:affected,,'arid the effect was to make; successful treatment, more .difficult. , '~'Therecan.be'no' doiibt that the disease is.on: the-increase, and Dr, -Findlay's Bill'is. on. the' right lines for ;dealinj.'; with' it," concluded Dr. Coir lihs. ■>' -.. ■'.-•■■'■■; ' '■'.'.. '■'-:

..'-'..,:":•: Dr. Cahill's Viows.;'■-: ; : Our roportcr-'iiext sought: an .irite. .: view ; wit'h Dr. Thqs:,;.Cahill;-who- contributed what.'an/,'eminent:.; colleague pronounced v to be'■ ah.'admirable '.paper .on. the subject at-a\ meeting of / the -Wellington branch of: the British Medical Association some'months, ago, and .who, as,a : delegate'.to ; the recent medical ; congress -at'.'Melbourne, .has 1 .had opportunities' of rstudyin'g .the'..Australian ';■ aspect .of: ; the/ question; i-. ■■';.■ ■' . : ', v'.'Thoro .is. no > doubt that': Dr. .-Findlay's .Bill will do; a great deal to/niink niise -the•amount of. this:disease ; -in'thn community," .was:: Dr. VCahill's ompha-. tic pronouncement. /,''l.think', it: will also . liayo, a-.considerable ..rubral effect. The,' entire medical -profession in the Australian; States is m favour of Jegis,'lativo interference'to 1 check: the:growth of.this. evil. .-.At the lastV/medical'/con-gress.-in-Melbourne .wo darried,a resolution unanimously asking'• : : Coin- 1 monwealth .Government to: enact-suit-able -legislation,:', and the then 1 Premier' :(Mr.v. r Deakin)_'agreed with-thb, medical, .profession'. Not only'was. legislation- .desirable; but-obligatory on the Government, _ considering :tho ..terrible" ravages ! thisjdjseaso was making iii-tlie'popula-tion. The; appalling 'death; rates.,in the I children's'hospitals ,due ,tb.this diseaso, ■and'the amount of it-prevaleiit;in every class,of the'community'.--'in,. Melbourne, . staggered even the medical 'profession. The; statements made by:doctors' who Had specially ,' investigated- the; matter astounded; the-congress. . Medical./ineiv hero have not investigated the question as in ,; Australia,.and lnauy.pf them'are' under the impression that it,is far less prevalent than it really is./ The pre-' valence'of this diseaso in New/Zealand, I..unhesitatingly say, demands stringent legislative measures to prevent: its . spread. Unfortunately, it is a' question" . one cannot well 'discuss • iii- 'the \ public press, 'but I -consider'-'that':Dr. Fmdlay is mailing: a, splendid attempt-to cope ' with-it.. I .also/think that it ought tb: bo made, a/statutory offence -for a-' chemist to attempt to treat oases of/, this kind. . He knows; as iriuchr about clinical inediciiiefor clinical' surgery as. the maker- of.-.-a',. surgical'., instrument .does of the /operation ; ' it. is'-. intended tb ner,.form.: :AVhore-people cannot afford: to pay for proper .treatment by a qualified medical nian,,l think the State ought, ito dO:So.' Treatment,by unskilled people -usually ends 'in;'. disaster '.'tb. .the, ;patient, and consequently., to the xom-. munity v Treatment forms'ho .part of a chemist's ■ ,A, considerable number: of, cases, of this .kind, inipro-' ,perly handled, result in lunacy or othei chronic, disease—the .result of/ignorant and.inefficient treatment, -People have no idea of the gravity, /of this disease or. of its.:awful : :preyaleiicfl. This iswhat a great authority says of the more serious typo of/venereal disease:—.: /

■."'.'lt; tuberculosis, arid alcoholism ■ - have been well described as' the v three great/ plagues of'modern so-, ' ciety, but while we have, crusades!:against tubei'fculosis and ■ alcohol-.. '. ism, the greatest; of these plagues '!. ' is neglected arid 'tabooed. In Erig- - .land, and nearly all'.the,British:, States, it" is 'hot.'only;tabooed, but' : : if; is actually encouraged' by : the repeal of the Contagious' Diseases V,Act.' "■•' : '•.'''.■'..•.:■•. "• ";•■•..'■' ■•'■•'.■ "Will this riot result in .a certain amount:' of' concealment being resorted, top"- ( ,tlie. doctor /-was asked., ' "The penal clauses, to meet cases of concealment;ought to bo -bo'"'severe, that they .would deter, anybody from trying to hide these, affections.. Once they are completely cured, the Bill provides for the-destruction of all records of cases, so that patients have no need to bo apprehensive on that score. It is a disoase that requires to be treated by abs-.lutely competent' persons, and' chemists or unqualified .peoplo _of any kind who attempt to deal with -it, ought' to be severely penalised. ' In! tho majority of cases I think the .treatment ought, to be provided by the State."

Dr. Ewart's Word of Warning. Dr. John Ewart—whoso extensive practice and long experionco as medical superintendent of tho Wellington Hospital enablo him to. speak with particular authority on ' matters of this kind —said, in reply to our interviewer:— _ "Unquestionably this disease is very prevalont in both forms, and I don't know which is the worse. A largo proportion-'of tho abdominal operations performed have to be undertaken because the patients have : had .the troublo previously. In ,my timo at tho Wellington Hospital, approximately, 30 per cent, of tho out-pationts—men, women, and children—were- affected with it. I'recognisc that it is a vory difficult, problem to deal with, and one that will require a great deal of tact in the Health Department. With a tactful man in the position of District

Health Officer, the administration of tho proposed enactment would be all right; but, it must bo obvious that without the, most tactful treatment great harm might very easily result." AVoidd you suggest any alternative remedy 1,0 that proposed—compulsory notification? ■ ' ' ' "1 do not biow of anything better that you can do." Is the disease, in your judgment, on tho increase? "Well, I do not know that, but it has always been very prevalent hero. Nobody- but the medical men ..know how. common it is. I'am quito clear that something ought to. be.. done to chock it; and provided nobody but the doctor, the l patient, and tho Health Officer knows of' the existence of a case it will work all.right. How-' ovei,.v«rj- great euro will have .to bo exercised. -All forms of tho disease aro infectious, and it is 'hereditary.- I quite concur with Dr. Cahill's view thai; tliosu who are; unable to pay should be treated at the expense of tho State. '■' .. . ' The Chemists' Attitude. . Mr. Fred. Castles, presidenC of th«> New Zealand Pharmniiv 'Hoard, did not wish, to commit himself to any opinion regarding tho proposed amendment in the law; as he explained ho had not ; studied'it,"and the" matter. will come up for discussion by the Pharmaceutical Board in its relation to chemists. He agreed as to the-existence of a real necessity .• for . preventive. measures being taken to check tlio spread of tho disease. . Medical men, as a rule, came in contact,first with: the gravor .class of cases, as.no responsible chemist would attempt to treat them; but, for tho mi]dcr forms, peoplo frequently asked.for certain, medicines, , arid ho. thought there was ,a fair: amount., of treatment■-. '-'of . that class done by chemists. Certain : well-known drugs were stocked- for that '■ purpose' alone.Mr.'Len.M'Kenzic, saw no objection to aNrecord of.-cases' being kept," so long as it was strictly private, and not likely to bo used for any purpose detrimental . to. ...the ..patient.','. ,Tlie, objection he I :saw tevthe proposal- was' ' that a, person contracting the .: disease was liable tp.becomo: his or,her .own' doctor,: and thereby '"' cause ..a.; great amount of liarm, .People-naturally- re-' sented ' publicity of .such, matters, -hi any shape, or form;."and-' tho future' results-.might, very easily become more detrimental te,the community -than' tho present state-of affairs.;: '.; It. -was quite, true that the. disease-waa very preva-' lent, but lie. did not know'that it-was. more* uo now than, formerly. . . The desire for concealment amongst a certain section of the' populace would; he -considered, always be, a, great;,.stumblihgblcck, to the- .efficacy of, preventative" measures. ,'' Oho /good l feature, lib.snw in,the new Bill. wus' that, it piovided ; .a step, towards ..stopping' the quack ; 'who professed 'to, cure the .disease,' and only extorted money,' from his victim..,'. It would.the nioro easily enable: that class to., bo . identified and prosecuted. From his experience, the contagion was'very frequently'. spread by Innocent ,peoplo.' Ho considered that. medical' men aud every .respectable chemist would agree that, the. Bill was aiming, in , the. right direction,' as. prevention! must always bo' bettor than: euro... The self-consti-tuted doctor was a'real evil In thismatter. , ;.'/ '-.., ~ -~'■:■'''' {.' ... ... '." -,•';.:.;'

. Mr. .Dunbar. jSloaiio: was equally ouV . spoken,in/bih c views-' ; Ho repudiated ,tno;.; suggestion. : that'reputablo chemists wero_'in . tho\liabit ■of .prescribing in casos'iol; this kind, ..Their' Usual practice was to- advise a : .patient 'to' go. and see: a doctor,'/as',tho treatment of diseaso ; did 1 , not come 'within"a chemist's .■knowledge, or. scope; ■.'■ .'lie saw ■ difficulties in '.the-.' way' of .'• reporting '.'cases, owing /to ■■ tho reluctance-, of'' peoplo': to Jiavo' their -ailments,' known I .'/' /Ho thought, peoplo would -bej very'chary if they knew their names: were going to ■bo disclosed.. He thought it "should bo. rnado ai criminal offehco for .any cliem-. Ist. to attempt to ..treat a .'serious 'case.' jNo .conscientious: chemist'' would' do '.so.■ He, agreed that there was. a [good 'deal of this: class of. diseaso prevalent. <liihis -opinion the■ proposed measure was. a \ very-desirable ; thing,.- and. it should work well: in practice. , 'Half'.the people.' ;did not realise' what, a 'serious diseaso this was; ;, ''■, < .'• ■■]■■. ■■' ' ; ',/''"