VENEREAL DISEASES.

White Ribbon, Volume 23, Issue 276, 18 June 1918, Page 5

VENEREAL DISEASES.

PROPHYLACTIC ANI) ABORTIVE TREATMENT. (Copied from “British Medical Journal,” 16th February, 1918). In the House of Commons on January 22nd, Mr Macpherson, Under Secretary of State for War, was asked by Mr Peto:- Whether it was proposed to take any further steps to stop the spread of infection b> venereal poisons among British troops; whether there was any Army Order which forbade or discouraged the necessary prophylactic: medical measures, and whether it was propose d to issue* an Army Order instructing army medical office!s of superior rank the necessary action as a part of their regular medical duties. Mr Macpherson, in reply, said that there was no Army Order authorising the use of such preventives or forbidd;ng them. The answer to the last part of the question was in the nega five. In reply to a further question, Mr Macpherson cxpr°ssed the opinion that this was really a national question, and not so much a military question. On February Ist, Mr Peto asked a further question with regard to a War Office letter to General Officers Commanding, dated March 18th, 1916, which stated that th** Army Council could not accc’pt suggestions with regard to prevention which would imply the adoption of any system of prophylaxis which might be said to afford opjiortunities for unrestrained vice, whether this deterred aimy medical officers from taking steps to prevent the* spread of venereal disease in the army, and whether the Army Council would now withdraw any restrictions which prevented effective measures being taken to avoid the waste of man power in the army from this cause. Mr Macpherson declined to add anything in his answer of January 22nd. and in reply to a further question, stated that lie could not give acurate statistic s of the number of men who passed through hospital suffering from venereal diseases in a year, and who wer° at any one time incapacitated from that cause. He added that it was not to be inferred that medical ofticeis were prevented from taking every posible step to cur** the disease. We have asked Mr FI. B Turner, Chairman of Representative Meetings of th'* Briti'-h Medical Association, and Representative of the Association on the National Council for Combating

Venereal Diseases, for an expression of his views, and he has replied as follows : “I have be p n asked b> the Editor to furnish him with a statement from my personal knowledge of the matters referred to by Mr Macpherson with regard to prophylac tic treatment of venereal disease, and the orders issued by the Army Council relating thereto. “I have given lectures on venereal disease ever since the comn»‘ , oceim*nt of the war, and I have h < n distinctly directed and ordered by the authorities not to introduce into the lectures any description of chemical personal prophylaxis, or in any way advocate its use. The lecturers are allowed to impress upon the men the importance of the earliest possible treatment if th p y find themselves infected, and also the wisdom of consult ng their medical officers with regard to preventive or abortive early treatment if thov have run the risk of infection, but rlo not >et know whether they have been infected. Thus far the lecturers have been authorised to go by the Army Council. “With regard to the whole question of the issue of prophylactic outfits my personal opinion is that it might not be of much real use in diminishing the actual number of cases of venereal disease occurring in the army. In the first place no one can say that the methods afford absolute 1\ certain and sure protection from tin* infect;.*n either of gonnorrhoea or syphilis. Figures arc always fallacious, but m the cases which have come under my personal knowledge, the percentage of failure has been very high, and this can be easily understood when one considers the conditions under which infection generally take s place. The principle medical officer of one of the largest hospitals for venereal disease® in London lately traced the source of infection in the last 100 cas*‘s admitted into that institution; he found that of these 100 men only 28 had got the disease from professional prostitutes; the remaining 72 were the victims of what might be described as the amateur flapper. It therefore stands to reason that in many cases the necessary precautions to avoid infection would have to he taken not in the “order'd circumstanc e of a harlot’s room” but in the open air, in barns, copses, or commons, or behind a hedge, and therefore unless a man was extremely sober, very cold-bloodtd and skilful with his fingers, the chances arc that he might fail to protect himself eftiej.

ently. It is pretty certain that an intoxicated or semi-intoxicated man would almost infallibly fail in the minutiae of the protective process, and therefore become infected. If a man, as is very probable in some circumstances, incurs a risk of infection three or four times in a few hours, it is very improbable that before each performance he is likely again satisfactorily to protect himself. “It follows from all this that there will always be a certain percentage of cases infected even if prophylactic precautions are taken. If 100 men were expos p d to the chances of infection unprotected, and ioo protected by prophylactic measures, in all prooability the percentage of cases of infection would be a good deal larger in thost? unprotected. Hut if the doctrine of prophylaxis were widely preached and the efficacy of the methods insisted on, the chances are that a very much larger number of young men would run the risk of infection than is now the case. “I have no doubt myself that fear of contracting venereal disease of either sort is a very potent inducement to a number of young men to keep straight, and I am sme that the impression that a perfectly sure method of avoiding infection could be used would lead a larger number of me n to run the risk. If they know and thoroughly understand the fact that gonorrhoea is a very serious disease, and that syphilis in its latest stages spells ataxia and general paralysis of the insane, they are afraid of running the chance of contracting either. “It is a well known fact to all social workers that th-' standard of what T may call practical morality among young women of every class of society has gradually deteriorated since, some twenty years ago, the Malthusian propaganda began and the public display and advertisement of Malthusian appliances followed. The fear that a lapse from morality would mean an increase in the population was an extremely iK)tent factor in ensuring the chastity of young girls. “I am certain that among young men the fear of infection with venereal disease acts in the same way, and I consider that on this matter I am probably better fitted to speak with authority than most men of my age and standing, because I was a competitor in first-class athletic events until I was 38 years old, and before that

time and ever since 1 have been in the closest touch with young men athletes, in every class of th * community, serving on committees and acting as president of athletics, cycling, and football clubs, and as a member of the governing bodies of sport. If the .dca that illicit sexual intercourse could be indulged in with impunity became at all general, I am sure that th p gross number of cases of venereal disease would be by no means diminished, though the ac tual percent.igc of cases of infection aft“r exposure would probably be a great deal lower. “Where l have spoken on several occasions at varying intervals at a camp, depot, or training centre for soldiers, 1 have been informed by l the commanding officers that, after putting before them the results of these diseases and exhorting them by everything that a young man particularly holds sncr p d his honour, his patriotism, his chivalry, and his sportsmanship to keep straight, the first result of the lecture has been to induce a certain number of men to re|>ort sick who had been previously concealing disease; a second result was that, so long as the particular unit to which the lecture had been addressed remained, there was a diminution varying from 50 to 80 per cent, in the number of case*, of vnereal diseases reported. “If prophylactic outfits are issued and prophylaxis taugnt in the army, it stands to reason that the practice must b<* extended to c ivilians. Workers in munition factories are nearly as important as soldiers in the fighting line, and among them there is a fairly extensive prevalence of the disease. Further, if these methods are taught and put before men, it folows that they must also be put b“fore women, a prospect from which I am not ashamed to say I recoil with horror. “In giving this statement, I have put on one sale every question of religion, morality, or aesthetics, and have confined myself simply to what as a physician and man of the world, I c msid*r likely to happen. “B. B. TUCKF.R, F.R.C.S.” The Women's Chri.-tian Temperance Union strong’) 4 mdr mils and opposes th“ pruti e of issuing to soldiers going on leave, prophylactic packets of appli inn s and drugs intended to enable them to indulge in licentiousness without danger of infection.

Kven if such protection were reliable (which it is not) th~ practice is mischievous and indefensible. It embodies in the worst form the error of treating men as bodies only. Such protection cannot he provided, or even connived at, without conveying the impression that the authorities do not really expect self-control, however much they may talk about it. The result will inevitably be to lessen the resisting power of tempted men, and to increase the number of those who yield. When immorality is thus encouraged, habits are formed which must lead to far-reaching evil consequences, and ultimately to increased disease.