FOOTNOTES:
[1] The full list of authorities is given in The Physician's Answer, by M.J. Exner, M.D., Secretary, Student Department, International Committee, Young Men's Christian Associations, Association Press, New York, 1913. This is the best treatment of the question of physiological necessity. It is freely quoted in this chapter. [Editor.]
CHAPTER IV
medical phases
By Andrew C. Smith
Some idea of the prevalence of venereal diseases in the United States may be obtained from the following statistics of the census for 1910. The registration area covered a population of 48,877,893 persons. The figures are here extended to cover a population of 90,000,000 people: Deaths ascribed to venereal disease, 5275; spinal cord diseases, 2598; paresis, 4845. Other diseases partly due to syphilis: softening of the brain, a term indiscriminately used to cover a number of diseases including brain syphilis and paresis, 2111; paralysis, usually meaning apoplexy, but always including many cases of brain syphilis, 14,479; premature birth, by some believed to be the result of syphilis in one half of all cases, 34,174; congenital debility, deaths due in many cases to feebleness of the child resulting from syphilis, 25,285; blindness, one fourth the total number of blind in this country estimated at 15,000 to 20,000. Many estimate that over half of the entire male population have had gonorrhea. The principal reason for this alarming distribution among all classes of these infections and their steady increase is ignorance and misunderstanding of physiological facts, particularly the viciously false teaching of the street corner that sexual activity is a physiological necessity.
These diseases would be arrested were there a widespread knowledge of their disastrous effects. Although young men hear the mischievous lie that "gonorrhea is no worse than a bad cold," thousands of them are punished with sterility as a result of the disease. Nearly all the neglected cases result in so-called ascending infections, reaching the bladder and kidneys and causing many deaths, and many men carry the infection in dormant form, to infect innocent wives in later years.
Appalling as are the consequences of gonorrheal infection in men, they are not so fatal or so far-reaching as syphilis. The causative parasite of this disease spares not a single tissue in the body and may disturb any or all of its functions, not even mentality escaping. As a cause of death it is extremely frequent. Our statistics ordinarily ascribe to syphilis but a small percentage of the deaths actually due to it; for instance, many of our cases of spinal disease, paralysis, arterial and other organic diseases are tabled under other names, although directly due to syphilis.
In women gonococcic infections are even more destructive than in men, as it is extremely common for the infection to extend to the tubes and to the peritoneal cavity, thus necessitating dangerous and mutilating operations, generally followed by sterility and often by death. Syphilis, though less frequent in women than in men, is nearly if not quite as fatal as in men, and otherwise similar in its baneful effects. I The child suffers the most tragic results of venereal infection, for it is always wholly innocent, yet infected to a greater or less extent, if the parents be syphilitic, and frequently if the birth-canal be gonorrheally infected. Although silver nitrate is a remedy for gonorrheal infection, if applied to the eyes immediately after birth, nevertheless the babe frequently suffers with infected eyes, and not infrequently with blindness.
If the child's sad infection is syphilis, instead of gonorrhea, there are still other miseries in store for it. If it is not so fortunate to be stillborn, it may have infection that ranges from almost imperceptible degrees to the most loathsome extent that it is possible for animal tissue to harbor. Its brain may be so invaded by the syphilitic parasites that it can never attain any degree of mentality; its spinal column maybe so involved that paralytic conditions will surely result; and if these nerve centers escape special involvement, other organs may be affected, such as the stomach, bowels, and liver; if these escape, the bones may be so deficient in vitality as to be incapable of sustaining the frame as development proceeds; the skin only may be involved, or the mucous membranes so affected as to make of the child a perpetual snuffler and inefficient breather. In most cases of lesser as well as greater mental defect, the tests show syphilitic infection. Endless are the complications that may be visited upon the innocent progeny of syphilitic antecedents.
The gonorrheal infections occur in the mucous membranes lining the cavities, especially those of the urethra and female genital tract. It is in these tissues that the germ of gonorrhea finds lodgment, and once there its development is hard to interrupt. Although the growth of the gonorrheal germ produces acute symptoms, such as discharge and pain, these pass off under treatment in a few weeks. Unfortunately the disease is far from cured, for the microbe has found its natural habitat in the inter-cellular structure of the genital mucus, from which it cannot readily be dislodged, and from which it may invade other tissues. It may remain in a state of latency for an indefinite time; then transferred to a new field, it may resume its original activities. While in this stage of latency it is difficult to destroy. At this time it is more likely to be further disseminated, as the patient, ignorant of the condition, is more likely to convey the disease, which so often occurs in married life after a long forgotten infection.
The gonococcus (the microbe of gonorrhea) is a pus—producing bacterium, occurring in pairs, resembling in form two coffee grains, generally with a distinct interval of separation. Although its natural habitat is the mucous membrane lining the genito-urinary tracts it may invade the muscular and serous and other tissues. If often affects the Fallopian tubes and ovaries and the serous lining of the pelvic and abdominal cavities. The deeper sub-mucous tissues of the uterus and the male genito-urinary tracts are also frequently involved, it being sometimes impossible to eradicate it from these deeper retreats. From these deeper tissues it is more commonly taken up by the circulation and deposited in distant parts, frequently in the joints. When it becomes thus systematically disseminated, the so-called secondary or metastatic lesions are almost as numerous, though not as virulent, as syphilitic infection. Recent pathological researchers have found that occasionally the gonococcus becomes the causative factor in inflammations of the muscles, tendons, and glands, and in inflammatory conditions of the lungs, kidneys, heart, and even the brain, spinal cord, and the serous membranes enveloping these great cranial and spinal viscera.
The individuality and characteristics of the syphilis microbe were not positively determined until in 1905, Schaudinn, of Germany, convinced the medical world that it was a spiral, corkscrew-like organism, from a quarter to one millimeter in thickness, and from four to twelve millimeters in length. It is not so discriminating as the gonococcus in its points of inoculation, nor is it as vulnerable to attack; and it is vastly more destructive to the tissues invaded. It spares no tissue in the human frame, and resists destruction by any known drugs of vegetable origin. When in a latent state its presence was often impossible to determine until, two years after its discovery, a test was worked out by Wasserman, also of Germany, by which diagnosis of the infection may be made,—even in latent form,—as in a hereditary case where no clinical manifestations have yet asserted themselves. There is another valuable blood test worked out by Noguchi. With these two tests we are now able to diagnose the disease, almost absolutely, and follow up the treatment till cure is complete, except in some of the incurable brain and spinal cord cases.
In 1909, Ehrlich determined, after a series of laboratory experiments on animals inoculated with the syphilis germ (spirochæta pallida), that a complex compound, with arsenic as its base, had the desired effect of destroying the parasite, in a dose not poisonous to the animal. This compound, first designated as "606," representing its number among his many laboratory experiments, he later named "salvarsan." With the assistance of his clinical friends, he soon demonstrated the action of his compound on man, and gave it freely to the world. Although it is now almost universally used, it has not proved to be the absolute cure that it was hoped it would be, as some of the spirochætæ seem to be hidden away where they are protected from the circulating poison,—to bring forth new progeny,—thus producing so-called recurrence.
The possibility of the infection of innocent persons is always uppermost in the mind of the medical man, and should equally concern the layman. Contaminated articles and utensils, such as towels and common drinking-cups, have caused many infections. This danger is greater from syphilis than from gonorrhea, for the reason that the spirochæta pallida is more virulent than the gonococcus. In our own fields, camps, and mines, it is common for men to drink from one jug or dipper. Infection almost surely follows if one of the crowd has a syphilitic sore on the lip. So intense is the activity of the spirochæta pallida in the primary stage that it may be borne to innocent parties by unwashed clothes and utensils of any kind, that have been in recent contact with a primary syphilitic sore. A dentist's or a doctor's instruments, for instance, are extremely dangerous as infection carriers, if they are not thoroughly sterilized by boiling. The danger of infection in syphilis and gonorrhea depends largely upon the virulence of the individual infection. As some living tubercle bacilli may be harbored and thrown off with impunity, while others will destroy the strongest man, regardless of all treatment, so some spirochætæ or gonococci may be safely disposed of, while others are most deadly.
Of all the sad instances of germ infection, the saddest are those from venereal germs, for they are disseminated mostly in vice, and inoculated into the innocent through ignorance. A common cause of infection of the innocent is the false popular belief that venereal germs are transmitted only in sexual congress. The truth is that any part of the body is in danger of inoculation from syphilis if the germ be virulent. So may any membranous point be infected by the gonococcus, whether conveyed by hand or instrument or fabric. This explains the number of gonococcic infections occurring in girl children. They come in membranous contact (at the outlet of vagina or rectum, or in the eye) with a contaminated article of clothing, or with the contaminated hands of an infected person. Ignorance is the cause of nearly all venereal infections. Why, then, should venereal infection not be eradicated? With adequate education, if there is not eradication, there will at least be compensation, for the sacrifice will be mainly of those who will not accept education—the unfit.
The possibility of recovery from syphilis is greater at present than it has been in the past, but we cannot yet say that the disease is absolutely curable in a given case. While most cases treated early with salvarsan, and followed by judicious use of mercury, are curable, there are nevertheless those which do not thus respond, and which in spite of all treatment go from bad to worse, till the patient's miseries are ended in insanity, paralysis, and death.
While the venereal diseases are the greatest physical evils to be attributed to sex ignorance, there are others chargeable to the same cause. There are, for instance, important physiological phenomena pertaining to sex development, ignorance of which is often baneful to the developing adolescent of either sex. When the boy's voice begins to change, and hair begins to appear on his face and body, and more thrilling sensations occasionally command his attention, he should be told, modestly but distinctly, that a pure and manly function is developing within him, the sole object of which is reproduction, and he must not consider it in a vulgar way, nor discuss it with others than his parents or physician or minister. Tell him that these physical changes of oncoming manhood are due to the establishment of the secretion of the procreative fluid,—the semen,—and will be safely cared for by nature. Fortify him against the mental pollution of the quack advertisement, and the satanically false teaching of ignorant associates that sexual intercourse is physiologically necessary, by impressing him with the fact that nature cares for the disposal of the seminal secretion. When clearly made aware of these simple sex principles, and convinced that it is unmanly and depraved to consider them vulgarly, the rapidly developing manly boy will not become a masturbator or a frequenter of bawdy-houses and a victim of the gonococcic or spirochætic infections; nor will he become a moral assassin, a seducer of girls.
The sister, no less than the brother, needs pure, plain, non-prudish sex education. If her mother is not qualified to impart it, she, like the boy, should seek the aid of her minister, or physician, or a qualified school teacher; better a few suggestions from an experienced, modest source than many suggestions from inexperienced and often lewd companions. As the brother was told of the physical phenomena accompanying his sex development, so the sister should be apprised of the physiological necessity of her periodical functions, and of nature's kindly care and development of her delicate and wonderful sex mechanism, the sole purpose of which is maternity. It will fortify her maidenliness to tell her that much of the world is deceitful and degrading in sex matters, and that if she would be a perfect woman, mentally and physically, she must vigilantly guard her virtue, maintaining absolute purity, not only with persons of the opposite sex, but with persons of her own sex, and the person of her own self. Incalculable good can be done toward the uplift of wayward humanity by sex education.
CHAPTER V
economic phases
By Arthur Evans Wood
In any effort for social improvement it is necessary to know conditions that make both for and against success. This is especially so in social hygiene, for it is closely related to all aspects of modern life. Lack of education and false instruction are largely responsible for sexual immorality. It is not so generally known that economic conditions are responsible for vice, opinions on this matter ranging all the way from a denial that economic conditions have anything to do with vice to the assertion that vice would disappear with the increase in the incomes of working-people. Assuming that ignorance is the fundamental cause of vice (an assumption which does not "stand to reason") the results of ignorance must manifest themselves through the institutions of society. Some institutions, such as slavery, encourage vice. Likewise, any caste system, such as feudalism in the Middle Ages, in which there must be depths as well as heights, supplies the vicious classes. The aim of this chapter is to show that, while modern economic conditions do not create "the social evil" they furnish an environment favorable to its spread. If this is so, an improvement in these conditions must accompany all other measures for the eradication of vice.
One of the most significant facts of the industrial evolution of the last half-century is the increase in the number of women who have become wage-earners outside the home. According to the Federal Census the number of females fifteen years of age and over, employed as breadwinners in 1900, was 5,007,069, an increase of 34.9 per cent over the number thus employed in 1890.[2] The largest number in any one occupation, 1,213,828, were servants and waitresses. Of this class the domestics were not employed "outside the home." The homes, however, were not their own, and salutary influences of home life do not exist for the majority of domestics. In the decade between 1900 and 1910 the increase in the number of wage-earning women has been even more accelerated than in previous decades, and to-day probably from 8,000,000 to 10,000,000 women in the United States are industrially employed.
One important aspect of this influx of women into industry is that the proportion of those in domestic and personal service, which has always been women's work, has decreased; whereas the proportion of those in manufacturing, trade, and transportation, which are new employments for women, has increased.[3] This means that not only are working-girls and women leaving the homes, but they are also abandoning in increasing numbers those occupations to which in times past their sex has been most accustomed. It is impossible that this prodigious change in the sphere and work of women should not be accompanied by some change in the social and moral standards that were nourished in the seclusion of the home. Miss Jane Addams has made the suggestion that perhaps the superior reputation of women for virtue is due to the fact that, generally speaking, women have been secluded from the influences of the world.[4]
The increase in the proportion of girls engaged in non-domestic pursuits means that industrial vocations for women are becoming more dissociated from the arts of home-making,—a fact which is doubtless the cause of many an inner struggle.
In the present lack of industrial education young girls who must work to support themselves or their families drift about from place to place with no definite vocational aims. Frequently they come to the offices of child labor commissions wanting work, but not knowing what they can do, or even what they would like to do. If they do find work, it is rarely of a sort that offers incentives for a career. Lack of skill, of interests, and of ambitions result in industrial inefficiency. They are also the usual accompaniments of moral delinquency.
Even where opportunities for industrial training are offered, they may not lessen the disparity between industrial opportunities that exist for girls and womanly tastes. A recent report on the need for a trade school for girls in Worcester, Massachusetts, advocates a school that will train for skill in the machine-operating trades, because there is most demand for workers in these trades.[5] One might think in reading the report that machines for stitching corsets and underwear provided the ideal vocation for women. Biological considerations, if no others, would favor distribution of wage-earning women away from the mechanical pursuits into those which are more or less associated with the domestic arts.
A further significance for social hygiene of the entrance of women into industry is that it places a strain upon the spirit of chivalry which is a basis of right relations between the sexes. Chivalry in men has accompanied the comparative seclusion of women from the world, and is due to those instincts which lead men to protect those who are weaker than themselves. The term "the weaker sex" has a sound physiological basis. With the passing of the domestic system of industry, however, the seclusion of women becomes more and more a thing of the past. In factory and shop they mingle promiscuously with men. Crowds of young working-girls in every large city at the noon hour throng the streets. If they walk to and from work they sometimes have to pass unprotected through parts of the city given over to vice.[6] They thus become familiar with vice conditions and are often subject to ungentlemanly, if not insulting, conduct. There are in every community a number of men who are decent only under restraint, and the economic position of wage-earning girls weakens that restraint.
Moreover, the phrase "the weaker sex" has lost some of its significance. Many occupations, such as clerking, stenographing, laundering, and certain kinds of unskilled factory work are almost entirely taken over by women, who labor throughout the same working-day as men, and usually at a lesser wage than men would receive for the same kind of work. Under these conditions, to talk of the physical weakness of women is to accuse our civilization of cruelty.
Around wages most of the discussion has centered concerning the economic aspect of vice. The investigations conducted throughout the country have revealed a great variety of opinion concerning the relation between low wages and immorality. There has been much confusion of thought on the question. It is true, on the one hand, that injustice is done to wage-earning girls and women of the country when the report is circulated that the difference between morality and immorality is only one of dollars and cents. On the other hand, to deny that low wages paid to working-girls has any bearing on the question of vice is evidence of failure to grasp the moral problem involved. Morality, to be sure, is always expressed in the overcoming of difficulties. Yet we can hold a person blameworthy only if in the full possession of his or her faculties. A poorly nourished, fatigued girl has no such self-possession. If she does not earn enough on which to live, and "goes wrong," her inadequate wage is a factor in her wrong-doing, and the one who pays it to her cannot be rid of his share of the responsibility. "Sin is misery, misery is poverty. The antidote for poverty is income,"[7] says Professor Simon N. Patten, who is doing a vast deal toward bringing economics and morals on speaking terms with each other.
Vice investigations in Chicago, Minneapolis, Portland, Oregon, Philadelphia, and elsewhere snow that there are many economic factors besides wages involved as causes of vice. Some of these other factors are housing, hours of work morally dangerous employments, associations at work, and fatigue. The wage, however, is more important than all of these, for the wage largely governs living conditions, associations and recreation. The wage often makes the difference between life as mere existence and life with the opportunities for self-improvement that should belong to a human being.
It will be of value, then, to note some of the facts about wages that have appeared in recent surveys made by the Consumers' League of Oregon, by the State of Massachusetts, and by the Federal Government. After showing that the minimum cost of living for a self-supporting woman in Portland is $10 a week, the Oregon Survey shows that in the nine principal occupations employing women in Portland, from 22 to 92 per cent are receiving less than $10 a week. The table is as follows:—
| Occupations | Per cent under $10 |
| Department stores | 58.2 |
| Factories | 74.7 |
| Hotels and restaurants | 49.2 |
| Laundries | 92.6 |
| Offices (clerks) | 46.4 |
| Offices (stenographers) | 22.4 |
| Printing-shops | 56.1 |
| Telephone exchanges | 50. |
| Miscellaneous | 48.7 |
Another table shows that in five different employments,—laundries, factories, offices, department stores, and miscellaneous employment,—out of 509 women all but 31 (office workers) close the year with a deficit.[8]
A significant point is that among all but factory workers the excess of expenditures over incomes is greatest among those who live at home. This disproves the statement often made that those who live at home do not need a living wage. In conclusion, the Report of the Oregon Survey says: "The investigation has proved beyond a doubt that a large majority of self-supporting women in the State are earning less than it costs them to live decently; that many are receiving subsidiary help from their homes, which thus contribute to the profits of their employers; that those who do not receive help from relatives are breaking down in health from lack of proper nourishing food and comfortable lodging quarters, or are supplementing their wages by money received from immoral living."[9]
The Massachusetts Commission on Minimum Wage Boards reports even lower standards in wages for women. Among wage-earning girls and women over 18 years of age, 93 per cent of the candy-workers, 60 per cent of the workers in retail stores, and 75 per cent of laundry-women receive less than $8 a week.[10] In the cotton textile industry, among the 8021 women over 18 years of age whose wages were investigated, 38 per cent received less than $6 a week.[11] Among the individual stories that are buried in the Report, the following are typical:—
Ernestine is an eighteen-year-old Canadian girl, very pretty and neatly dressed. Her parents both died several months ago and left her utterly alone, without living relatives. She worked as a stock girl at $4.50 a week for two months, was laid off, and went to a summer hotel as waitress for $3 a week, room and board. She worked there for two months, or until the season was over, and then came to another store for $5 a week. She pays $1.50 for her room, including light and heat, has no carfare, does her laundering, except for shirt waists which cost her $.30 during the summer. She goes without breakfast or eats only a banana, gets her lunch for ten or fifteen cents, and her dinners for twenty or twenty-five cents. She has never paid more than twenty-five cents for a meal since she started to work. She is just a child, and is quite bewildered over the problem of facing life on $5 a week, and is terribly afraid of debt. She is intelligent and clever.[12]
Jennie is a frail little body, about 40 years old. After working 16 years in a Boston department store her wage was $5 a week.... For eleven years Jennie's little $5 a week had been the sole support of herself and her aged mother.... When her astonished employer learned that she had worked 16 years in his store and attained a wage of only $5 a week, he raised it $1. So the wage is supplemented by the girls (in the store) underpaid themselves, but comprehending the woman's need.... Thus seventeen years of faithful service to one master has won for Jennie this position of semi-dependence upon charity, increasing anxiety over an unprovided-for future, and declining health as a result of her pitiless struggle to stretch a miserable $5 over the cost of support of herself and mother.[13]
The most comprehensive report has been made by the Federal Government, and includes a survey of conditions among women in stores and factories in seven cities[14]. According to this report the average earnings of the women in retail stores of these cities is $6.88 in the case of those who live at home, and $7.89 in the case of those who are "adrift."[15] Among the factory women of these cities the average wage of those who live at home is $6.40, and of those who are "adrift," $6.78. The Boston investigation shows that from 11,000 to 12,000 women and girls were living in lodging- or boarding-houses at an average cost of $5.18 a week for prime necessities, leaving only $2.24 for clothing and all other expenses. The following comment is made on this government report by the Massachusetts Minimum Wage Commission:—
Although more than half the adrift women (in Boston) live in lodging- or boarding-houses,—numbering be it remembered between 11,000 and 12,000 girls and women,—two thirds of them lack the use of a sitting-room and must entertain men as well as women in their bedrooms. Not a few indications were seen in the course of the investigation of the demoralizing results of this practice. Many of the young women in lodgings were young and were friendless and were earning very low pay. Eighteen per cent of those who were reported without the use of a sitting-room were under twenty-five. The housing or food, or both, were reported as bad for a number of these perilously defenceless young women.[16]
Consideration of wages and standards of living leads to the question, What is a living wage? Studies in different parts of the country agree that it is about $10 a week. An estimate made by social workers for the Massachusetts Minimum Wage Commission places the minimum at $10.60 for girls who are adrift, and $8.37 to $8.71 for girls and women living at home. This estimate, however, made no allowance for unemployment, sickness, accident, or old age.[17] The Portland Vice Commission and the Consumers' League of Oregon have adopted a $10 minimum.[18] The first conference called by the Oregon Industrial Welfare Commission adopted $9.25 a week, or $40 per month, as "the sum required to maintain in frugal but decent conditions of living a self-supporting woman employed in mercantile establishments in Portland."[19] To this, however, representatives of the employees on the conference made objection, stating that a straight $10 a minimum was the only safe one.
If the minimum is rightly placed at $10, and if the investigations are true in showing that the majority of self-supporting women the country over are receiving less than this amount, we may now come to a more detailed discussion as to the relation between underpayment and vice. It is just here that it is easy to jump at conclusions. Most people approach social questions not with a scientific mind, but with preconceptions which mar their judgment. For example, the socialist exaggerates the effect of bad wage conditions, and the Woman's Auxiliary Department of the police exaggerate the influence of home conditions. Again, personal testimony is unreliable, because, on the one hand, victims of the social evil are liable to blame external conditions; and, on the other hand, well-fed, well-housed investigators often underestimate the bad moral effect of poor nourishment and fatigue.
Of this much we may be certain: low wages poor living, which involves poor housing, poor food, no savings, and either no recreation or dependence on others for it. In the federal report on living conditions of women in stores and factories, it is estimated that in the seven cities where the investigation took place approximately 65,000 women are adrift.[20] Since the majority of these are receiving less than the minimum cost of a decent living, they are "perilously defenseless young women."
Another federal report,[21] bearing directly on the relation between conditions of work and vice, concludes that whereas few girls "go wrong" on account of poverty, the misstep once taken, poverty and want are powerful deterrents to reform. A fourfold classification is made of immoral women, as follows: (1) Unmarried mothers; (2) girls who leave and regain the path of virtue, having their fling for the sake of good times; (3) occasional prostitutes, who enter the career as a business for a while; (4) professional prostitutes. Mention should be here made of this report, because its total effect is to minimize economic causes of prostitution, placing the responsibility elsewhere than on industrial conditions. It is to be noted, however, that it does emphasize the indirect effects of poverty, and does speak of the moral danger lurking in certain occupations, and of the bad effects of the lack of industrial education.
More definite responsibility for vice is ascribed to low wages in the reports of vice commissions. The Chicago Report says that of one group of 119 immoral women, 18 came from department stores, and 38 said that they had taken up the career for the need of money. The Portland Report presents 22 women as "Cases in which Low Wage and Vice are closely associated."[22] The Report continues:—
In presenting the foregoing table and statements from girls, this commission does not take the position that the low wages of self-supporting girls is the sole contributing cause of their delinquency, realizing that there are thousands of girls who would endure the utmost hardships before yielding themselves to those who are ready to seduce them. The evidence as to the effect of wage conditions is taken from the girls themselves, who, perhaps lacking adequate moral training, have, in the extremities of their position, allowed themselves to be driven "the easiest way."[23]
In the vice investigation conducted by the Illinois State Senate, 50 girls in one day testified under oath, 45 of whom said that their downfall had been due to the lack of money. The foregoing evidence is the kind unfortunate girls would be likely to give. Nevertheless, making due allowances, this evidence tends to confirm reports of vice commissions whose purpose has been strictly scientific.
If a conservative estimate of the proportion of vice due to low wages of girls would be 10 to 15 per cent, it must not be concluded that this represents all of the baneful moral effect of poverty. Whatever the other non-economic causes of vice, they are aggravated where poverty exists. Not only is this so, but alleged other causes may be partly economic. Bad home conditions are due not only to the lack of moral discipline, but also to the lack of income. The average wage of the adult male wage-earner of that section of the United States lying east of the Rockies and north of Mason and Dixon's line is said to be about $600. Sometimes the wage is as low as $500, and in only a few instances as high as $750.[24] If wage-earning men attempt to support families on these incomes, it means that they are not able to provide adequately for their wives and children. If they do not attempt to do so, it means, taking men as they are, an increase in the army of men who support prostitution. Professor H.R. Seager has said that prostitution in aid of wages is the greatest disgrace of our civilization.[25] An accompanying disgrace lies in the fact that economic conditions and other factors prevent the average male wage-earner in so large a section of our country from fulfilling his desire for marriage and a home of the sort that makes for health and happiness.
Besides the low wages of women and men, other economic facts have their bearing upon sexual hygiene and morals. These facts may be grouped under the head of industrial stress and strain which is moral as well as physical. The underpaid factory or store girl is subject to constant fatigue. In the rush season in department stores, girls often depend upon opiates for dulling the nervous strain. No trade is free from its special physical strain. There are, moreover, many morally dangerous trades. Work as chambermaids in hotels is conspicuously perilous for girls. The Chicago Juvenile Protective Association says, "The majority of girls who work in hotels go wrong sooner or later." The modern department stores, which employ the majority of young working-girls, offer temptations. Mrs. Florence Kelley refers to work in these stores as "the most dangerous to morals and health, of all occupations into which children can go."[26] Of course, it may be said that a "good girl" will not go wrong. It may also be said that a good social order will not place even good girls daily under conditions that are liable to bring about a physical or moral breakdown. Closer analysis of human character reveals the fact that physical and moral health are more closely associated than we have hitherto believed them to be.
According to statistics about female offenders, domestic service is morally the most dangerous employment.[27] The reasons for this are two: the social ostracism and the loneliness, and the low grade of worker. Each of these causes augments the influence of the other. The application of industrial standards to this neglected form of work should lead to improvements.
For those dependent upon employment offices, the seeking of a job may involve moral danger. The practice of private employment bureaus in sending unsuspecting girls to immoral places under the pretext of finding legitimate employment is common. The director of the Municipal Employment Bureau in Portland says that, the managers of houses are sometimes so bold as to telephone to the bureau for girls, telling for what purpose the girls are wanted.[28] One of the private bureaus was detected several times coöperating in such practices. The menace of such places can scarcely be overestimated.
We may now conclude our review of the economic phases of social hygiene. Economic conditions to-day are under indictment as endangering the health and morals of working-girls and women. Moral delinquency may arise through temptations met and hardships endured at the place of work; through scanty wages, inadequate for daily necessities; through lack of sympathetic consideration on the part of employers; through the stupidity of the community in adhering to worn-out educational methods that do not train wage-earners for earning a livelihood; through lack of protective legislation in regard to hours and conditions of labor. As a matter of fact, each of these conditions has been found to be an accompaniment of vice; and taken all together they constitute an environment that makes clean living difficult. Against the dark background of modern industry should be portrayed the luxurious conditions that are apparently enjoyed by those who have taken "the easiest way." In ancient society the status of the prostitute was that of slave: to-day it is that of an industrial citizen.[29] If the program of social hygiene comprehended only talking about sex to working-girls—to laundry-girls, for example, who, after a day's work of ten hours at the machines, go at night to their boarding-houses where they wash dishes to eke out a living,—then this program would not be unlike the advice of a physician who tells a poor man with tuberculosis that he must go to the country for a year and live on cream and eggs.
Even in the case of wage-earning girls who adopt loose ways to satisfy extravagant desires, their tastes are established by women of the wealthy and middle classes. The leisure of these women is due to their wage-earning sisters, who in factories and mills make the cloth, prepare food-stuffs, and do all sorts of tasks that formerly kept women of the upper classes at home. Through the instinct of imitation, combined with the American feeling of democracy, the habits of the well-to-do determine the ambition of many a working-girl.
Other factors are industrial arrangements which segregate men in construction and lumber camps for a part of the year, and then, without providing for their further employment, turn them loose into cities where only saloons welcome them and cash their checks, and where disease-infected lodging-houses are their only places of abode. Furthermore, standing armies take thousands of able-bodied men out of normal industrial relationships, and keep them in camps that become the congregating places of prostitutes.
The most hopeful phase of the whole problem that it lies within the power of the State to transform the industrial environment through progressive legislation. The law cannot form character, but it can protect that which has been developed through voluntary effort. Vice is partly a by-product of industrial chaos which can be eradicated by industrial organization. When working-people can establish themselves more generally in homes of their own,—"every man under his vine, and under his fig tree," as it were,—then they will be able to give more time to their children, and will perhaps coöperate better in the program for sex instruction.
Economic improvements should include a minimum wage for women, and one for men based upon the needs of a family; the eight-hour day; insurance against sickness, old age, and accidents; relief of unemployment; one day's rest in seven for all continuous industries; industrial education compulsory for all children; abolition of child labor; and amelioration of conditions under which women work.
When wage standards are raised, there arises the problem concerning those who cannot earn a living wage. "Who will pay poor, ignorant Mary Konovsky more than $6.90 a week?" is a question asked by a manufacturer during a minimum-wage discussion in New York State. The reply is, If Mary is really not worth more, she must be sent by the State to an industrial school until she can earn her living; and if she should be proved to be mentally deficient (as about 50 per cent of prostitutes are said to be), then she must be placed in an institution where she can be humanely and permanently cared for. The impossible alternatives are that she should be denied a living wage when she can earn it, or that she should be allowed to drift, in danger of becoming the prey of vicious men.
Meanwhile, before the machinery of a full legislative program can be set to work, the field is open for voluntary philanthropic endeavor. Welfare work in stores and factories that is done by some one who acts, not as a detective with condescending side interests in welfare, but whole-heartedly and sympathetically can avail much. Real social work in business establishments should be profitable to employers as well as to employees. The aim of all public and private effort should be to make industry not the occasion of stumbling, but what it should be, the universal means of progress.