VOLUME IV, No. 6. JUNE, 1914 THE DELINQUENT
(FORMERLY THE REVIEW)
A MONTHLY PERIODICAL, PUBLISHED BY THE
NATIONAL PRISONERS’ AID ASSOCIATION
AT 135 EAST 15th STREET, NEW YORK CITY.
THIS COPY TEN CENTS. ONE DOLLAR A YEAR
- T. F. Garver, President.
- Wm. M. R. French, Vice-President.
- O. F. Lewis, Secretary, Treasurer and Editor The Delinquent.
- Edward Fielding, Chairman Ex. Committee.
- F. Emory Lyon, Member Ex. Committee.
- W. G. McLaren, Member Ex. Committee.
- A. H. Votaw, Member Ex. Committee.
- E. A. Fredenhagen, Member Ex. Committee.
- Joseph P. Byers, Member Ex. Committee.
- R. B. McCord, Member Ex. Committee.
Entered as second-class mail matter at New York.
MENTAL AND PHYSICAL FACTORS IN PROSTITUTION[1]
By Edith R. Spaulding, M. D.
[Resident Physician, Reformatory for Women, South Farmington, Mass.]
That a better knowledge of the mental and physical characteristics of the prostitute herself could be obtained, and the causes as well as the results of her life be understood, the following study was undertaken. 240 women who have recently been inmates at the Massachusetts Reformatory for Women have been studied. All cases were included in which at any time there had been a history of commercialized promiscuous sex immorality. Only those cases were discarded in which the physical examination was incomplete, if the history obtained gave no evidence of disease.
A study such as this does not aim to discover the fundamental physical or mental causes of prostitution as a social problem in the community. Such a problem is too involved to be considered from this limited standpoint. Recognizing, however, the fact that there is the demand in society, this aims to show the types of women from whom the supply is obtained and the benefits which may be derived for the community by further study and treatment of such types.
Two hundred and five of the cases studied have received a psychological examination. This has included the history of their educational advantages and a study of the results obtained, as well as psychological tests which estimate native ability aside from formal educational training. In all doubtful cases, or in cases in which there appeared to be mental defect, the Binet-Simon tests have also been used. As a result of these examinations the cases have been roughly classified as follows:
| Per Ct. | |||||
| Mentality | Good | 43 | cases | 20.9 | 32.6 |
| ” | Fair | 24 | ” | 11.7 | |
| ” | Dull | 30 | ” | 14.6 | |
| ” | Subnormal | 62 | ” | 30.3 | |
| Moron | 45 | ” | 22.5 | 52.8 | |
| Imbecile | 1 | case | |||
| ----------- | |||||
| Total | 205 | cases | |||
About a third of the cases showed fair or good mentality. These cases have been studied in detail for evidence of other mental and nervous defects aside from mental deficiency. The results will be given later. Over half of the cases studied were found to be defective mentally. This corresponds to the results of the investigation of the White Slave Commission[2] made recently in Massachusetts, in which 51 per cent. of 300 cases studied mentally were found to be defective and represented segregable types. We should consider at least one quarter of our own cases segregable from a standpoint of mental defect alone, and besides these perhaps, another 20 per cent., candidates for a defective delinquent institution, if such a classification should include those cases which show marked psychopathic tendencies associated with subnormal mentality. The cases which are considered segregable types appear to be unable to care for themselves in the community. Besides the harm that may be done to them on account of their weakened resistance they become an active menace to others; first, through the spread of venereal disease; second, through their immoral influence in the community; and third, through bringing into the world children who will grow up to be as much a menace to society as they themselves have been. It should be the responsibility of representative members of society to see that provision is made for the care of such individuals, and that they are not punished for offences for which they can in no way be considered responsible.
Besides the cases showing mental defect alone, there are many cases both among the mentally defective and those showing normal mentality, which show other mental or nervous defects, such as epilepsy, hysteria and psychopathic tendencies. In the study of criminality of all kinds, such abnormal mental and nervous conditions play an important part. This is especially true of the class of women which is arrested on account of sex offences. In the environment of mill towns and certain sections of large cities, from which a large part of this population comes, the temptations which appeal to sex are tremendous, even to the individual who has a normal mentality and is well balanced. If through such conditions as slight mental dullness or extreme nervousness, the equilibrium is disturbed, the power of resistance is lost and the individual is unable to cope with the temptations which are usually about her.
Eighteen cases or 7.5 per cent. of the 240 cases studied have been epileptics; 16 cases or 6.6 per cent. have hysteria. Both conditions are very important as factors of social instability. The variability of epileptics and the extremes of which they are capable are well known to students of criminology. Many times we find cases suggesting a latent epilepsy among individuals in whose families there are other cases of the same disease. In these cases we see only what appear to be psychic manifestations or great irregularity in tests and behavior.
The cases of hysteria are also interesting on account of their extreme suggestibility. It is only necessary to watch the manifestations of this characteristic in an institution, to realize what an important factor suggestibility has been in the outside world in leading to their delinquencies. Mental imagery in such cases is of immense importance. One case of hysteria which we had under observation would while in her attacks of unconsciousness, often repeat (naming a woman who was living a life of prostitution outside), “Mary, I will come to you; I will give up my child; there is nothing else for me in the world and I will come to you and do as you say.” In studying her mental processes, the pictures which had been drawn for her of luxury and gaiety in such a life were continually before her, too strongly contrasted with any reasonable pictures which it was possible for us to conjure up for her.
Another important class is that which includes the borderline cases, which have perhaps never been satisfactorily classified. Many of these would be in the group termed by one authority “control defectives.” The term expresses well their explosive natures which may be seen when, without provocation they attack any person who happens to incite their enmity, whether she be officer or other inmate, or when by unreasonableness and loss of temper they bring unruliness and the necessity for discipline into an otherwise peaceful and well-behaved group. Many of these cases come from families in which there are many cases of insanity, and although they themselves show no signs of a definite psychosis, there appears to be much inherited instability. Other cases show the results of a meningitis or an encephalitis which they have had in childhood. Occasionally we see cases in which the instability apparently followed a head injury.
Besides these cases there are many who have previously been confined in hospitals for the insane, and who represent very unstable types. They may or may not have defective mentality, associated with the defect in self-control. They are one of the hardest classes of cases to deal with in institutions of any kind. The officers of penal institutions recognize their abnormality, and feel that they should be confined in insane hospitals because of their dangerous character. On account of the lack of a definite psychosis the insane hospitals naturally take them very unwillingly. Even though they show marked mental defect, institutions for the feebleminded are unwilling to admit them because of the demoralizing effect they produce on the more amenable types and the upsetting influence they have upon the institution routine. Many of these cases will doubtless be sent to defective delinquent institutions when those institutions shall at last be established. Whether the defect is a mental one or a nervous one matters little in their menace to society. The following case may be cited as an illustration of such a type:
A woman was arrested for assault after trying to throw vitriol in her lover’s eyes. At that time she was taken from the jail to a hospital for the insane because she had marked hallucinations of sight and hearing. These at the time were thought to be of alcoholic origin, and disappeared quickly. She was transferred to the reformatory where she had previously served a sentence. At various times since her confinement there she has assaulted other inmates and matrons, often violently. Recently, after such an attack on a matron, she apparently seemed ignorant of what she had done. While she acknowledged having attacked people in the past, she felt that this time they had attacked her. A few days later she was found in a vague although rather savage mental condition, with marked delusions. She had had hallucinations of sight and was not oriented as to time or place. The woman is subnormal mentally and it would have been hardly possible for her to have feigned the condition. That evening, becoming annoyed at something, she flew into a tremendous rage, which was much more characteristic of her usual self than the previous dazed condition had been. Her violent temper seemed to bring her to herself, and the next morning she could recall but faintly what she had said the day before, although she remembered vaguely being much more frightened at what she thought she had seen in her room. Two days later she laughed at what she was told she had said, realizing the ridiculousness of it and could hardly believe that it was true.
Although the condition and its quick recovery suggested an hysterical basis (no evidence of epilepsy has been found, and alcohol was ruled out by her long stay in the institution) nevertheless, the condition while it lasted made her wholly irresponsible, and it can easily be seen what a menace such an individual would be in a community. Thirty-seven per cent. of the 240 cases studied represent aberrational types of greater or less intensity. It can readily be understood what a factor such types would be in furnishing individuals of weakened resistance to help fill the demand of prostitution.
The 67 cases showing apparently normal mentality when studied further have revealed the following characteristics:
Twenty-eight cases have shown hysteria, epilepsy or marked aberrational tendencies. Of the 39 cases remaining, 8 show innate characteristics, which, combined with the unfortunate conditions of home and environment in which they were placed, were apparently responsible for their delinquency. The innate characteristics of these cases include the following:
The aggressive untamed personality with primitive passions; the woman who has gone through life with a chip on her shoulder, believing that the world owed her a living; the sensual type which has over-developed physical characteristics; the immature personality, non-resisting in temperament (often called weak-willed), which is unable to appreciate and shoulder responsibility; excessive vanity and love of pleasure in an indolent nature, or the craving for excitement and applause and the love of leadership, with only undesirable avenues open in which to exercise it.
Three cases were due largely to home environment alone. In these cases there has been immorality between different members of the family. Five cases were due to the environment in the community alone,—with an apparently good home environment a single bad companion or group of companions had definitely influenced them to lead immoral lives. The factors in two cases were unresolved. Twenty-one cases appear to be due to the environment in the home and in the community, and were apparently normal types. The last group of 31 cases, however, represents but 15 per cent. of the 205 cases studied. Considering that those cases which show poor mental ability are perhaps not able to cope fairly with their environment on account of their slight mental defect, we find 85 per cent. of the cases studied showing some underlying defective mental or physical factor. We do not believe that this represents to any extent the cause of prostitution, for there are doubtless large numbers of individuals in the community with the same mental and physical defects who are not leading such a life. Still we feel that this class of women, if not sufficiently protected, represents the ones who are first (on account of their weakened resistance) to offer themselves to fill the demand. It may be interesting to note, in this connection, that although all of these cases have been studied from a social standpoint, and their own reasons for going into such a life have always been inquired into, in only two cases have we been able to find any definite relation between the economic conditions and the choice of this means of livelihood.
The Physical Aspect.
As complete a clinical history as possible has been obtained from each woman, and has been supplemented in as many cases as possible by laboratory tests to determine the extent of venereal disease. If the clinical history or the laboratory findings have given evidence of venereal disease, the individual has been considered to have the disease without the verification by both methods. As has been stated before, those cases in which there was no evidence of disease, but in which it was impossible to make a complete physical examination, have been discarded. As a result of these examinations we have found only one case, which after complete examination, did not show the presence of either disease. Thus over 99-1/2 per cent. of the cases show the presence of one of the two venereal diseases—134 cases or 55.8 per cent. gave no evidence of having had both.
Of 238 cases which were examined for syphilis, 156 or 65.5 per cent. gave evidence of having had the disease. The results of the examinations for syphilis are as follows:
| Per cent. | |||
| Number of cases giving evidence of the disease clinically or having a positive Wassermann reaction | 156 | or | 65.5 |
| Number of cases giving positive Wassermann reaction | 137 | or | 57.5 |
| Number of cases giving a positive history or presenting symptoms of the disease | 85 | or | 35.7 |
| Number of cases which were verified by both history and Wassermann reaction | 64 | or | 26.9 |
| Number of cases giving a negative Wassermann reaction and presenting no clinical evidence of the disease | 82 | or | 34.9 |
| Number of cases giving evidence clinically or bacteriologically of the disease | 216 | or | 96.8 |
| Number of cases which gave a clinical history of the disease | 209 | or | 93.7 |
| Number of cases verified by bacteriological examination | 159 | or | 71.3 |
| Number of cases verified by both methods | 152 | or | 68.17 |
| Number of cases examined clinically and bacteriologically which gave no evidence of the disease | 7 | or | 3.1 |
If only the cases were selected in which it was possible to obtain complete examinations both clinically and by laboratory methods also, these percentages would undoubtedly be much higher. However, as they stand at present, they represent a great factor in the problem of prostitution. Statistics have shown that 22 per cent. of first admissions in hospitals for the insane are cases with general paresis, which is considered psychosis resulting from syphilis. This factor alone should make us realize the importance of the treatment of such a disease in the community and the necessity for hospitals (as pointed out by the report of the White Slave Commission of Massachusetts) where people could be invited to come for the treatment of this disease as well as for gonorrhoea. At present, as is only too well known, there are very few hospitals where either of these diseases are treated, and it will be remembered that these are the only contagious diseases which have not been made reportable by the Board of Health.
In studying the lives of these individuals for the factors which have determined their mode of life, there are several physical characteristics which should be mentioned. First, the perfectly normal condition of adolescence is always to be taken into consideration. In many cases of individuals with less than normal stability and insufficiently protected environment, it has been the adolescent tendencies which have been the dominant factor in determining their life. Again, the factor of too early development has often been seen. Puberty appears before the inhibitions which come with adolescence have had time to be correspondingly developed. This is a very noticeable factor in the study of such cases found in the juvenile court, and has been recognized in our own cases and verified by the histories obtained from the parents of the individual. Besides these factors, there is the type in which the physical characteristics predominate from birth. While it may be possible for these individuals to have their energy directed along constructive lines, it is often impossible to reach them and recognize their struggles until habits of an unfortunate nature have been irrevocably formed in their lives.
Summary.
In reviewing the 240 cases, which we appreciate represent the types which come to reformatories and are not necessarily characteristic of all types of prostitution in society, we find the following facts: 52 per cent. defective; 16 per cent. dull; 28 of the remaining 67 cases with normal mentality showed other mental and nervous defects. Only 15 per cent. of the whole number appeared to be normal mentally and physically. Probably 40 per cent. could be considered segregable types and should be placed permanently, or at least during the child-bearing age, in custodial institutions. If these cases who are apparently unable to care for themselves could be removed from the community, we believe the supply for prostitution would be materially lessened and that such a movement would be a help in attacking the problem.
As has already been said, practically 100 per cent. of the cases studied show the presence of at least one of the two venereal diseases, while over 55 show the presence of both.
Of the cases studied for evidence of syphilis, over 65 per cent. had had the disease; of those studied for gonorrhoea over 96 per cent. gave evidence of having had it. Should we not recognize the far-reaching results of such diseases in a community and use every means possible to help eliminate them?
No one disputes the fact that the problem of prostitution is largely a moral one, and must be solved through educational methods. However, while we believe that certain conditions can be much alleviated, we believe also that the problem will never be fully solved from the moral standpoint alone. The most crying need of the present time is in the mental and physical aspect of the situation, and we believe that the greatest possible emphasis at this time should be laid on these factors and their great menace to society.
[1] Read at the National Conference of Charities and Corrections, Memphis, May, 1914.
[2] Report of the Commission for the Investigation of the White Slave Traffic so called.