The editor of the Sydney Bulletin (Australia) was continually publishing helpful articles and paragraphs—after my letters and articles were censored;[M] and from Dr. W.H. Symes, of Christchurch, New Zealand, I heard by personal correspondence steadily and wisely all through the war. Much later came the following tribute, in a most valuable book written by Sir Archdall Reid and Sir Bryan Donkin ("Prevention of Venereal Disease," published by William Heinemann (Medical Books) Limited)[N]:—
"Sir Bryan Donkin's letter, which appeared in The Times, in January, 1917, and other communications which he published as opportunity offered, brought him an introduction from Sir J.W. Barrett, M.D., then serving as A.D.M.S. with the Australian Force in Egypt, to Miss Ettie Rout, who, by profession a journalist, had come with the Australian and New Zealand Forces with the object of ameliorating, as far as possible, the hardships of war. She had been horrified by the pestilence of venereal disease which broke out among the troops in Egypt, England, and elsewhere, and, with extraordinary resolution and courage, had embarked almost single-handed on a campaign of prevention. She furnished Sir Bryan, and later myself also, with much valuable information, and for her own part fought the battle most strenuously—living among the men, lecturing, finding and instructing lecturers, providing disinfectants, importuning authorities, writing most trenchant letters, establishing medical clubs in England and France, and the like. I think that when the names of those who opposed her are forgotten, the memory of this brave lady will still be green among the descendants of the valiant men for whose welfare she struggled"—p. 176-177.
ALCOHOLISM.
It should be noted here that another great difficulty we had was to make men beware of the dangers of drink. A man who is in liquor is much more liable to contract venereal disease than a man who is sober. Alcohol increases sexual desire, lessens sexual ability, and lowers the sense of responsibility. Hence, drunkenness, immorality and disease go hand in hand: a dreadful three. But more than this. The drunken man takes much longer over the sex-act, thereby prolonging the risk of disease, and he runs risks which he would rule out instantly if the fumes of alcohol had not changed the tawdry girl into the glittering fairy. Worse than all, he neglects to apply disinfection properly and promptly—he falls asleep or forgets all about it till too late. Men who are determined to have a "night out" should use calomel ointment (or some other substitute) before they start; and if they have been in liquor they should disinfect instantly when they recover their sober senses. Generally speaking, an ounce of calomel is worth a ton of salvarsan.
As with young men, so with young girls: a few glasses of wine taken at a supper or a dance—and the first downward step is taken, not because any wrong was intended, but the simple actualities of sex were unknown, and the stimulant took advantage of the ignorance that is miscalled innocence. This kind of thing will continue till the older generation realise that morality depends—not on the maintenance of ignorance and the fear of disease, but on the spread of knowledge and the promotion of virtue.
It is not morality, but caution, that is developed by fear, and in this case caution is counteracted by the practical experience that many men are immoral without becoming diseased. One man commits many immoral acts and suffers not at all; another man becomes syphilitic by yielding for the very first time; the penalty is purely fortuitous. There is no necessary connection at all between immorality and disease. The dangers of sexual intercourse are due to dirt and promiscuity rather than to immorality, and in part to the physical conformation of the individual. Virtue has far deeper and more substantial foundations than the mere gusts of fear. It is founded on necessary and responsible guardianship of the very gates of life.
III.—MEDICAL FORMULÆ.
The medical formulæ for venereal disease preventive ointments for men, and venereal disease preventive suppositories and ointments for women, should be decided upon, after thorough investigation and test, by the Departments of Public Health, and none other should be permitted to be sold. Printed directions should be issued, duly authorised by the Departments of Public Health, and no other directions should be supplied to the public with the venereal disease preventives. In these respects, to the best of my belief, the Division of Venereal Diseases of the Pennsylvania Department of Health, co-operating with the United States Public Health Service, will play the leading part; is, indeed, already doing so. Under the direction of Dr. Edward Martin, Commissioner of Health, and Dr. S. Leon Gans, Director, Division of Venereal Diseases, specimen tubes are tested and approved (with directions and other printed matter)[O] by the Health Laboratories of the Department; and certificates are issued to manufacturing chemists authorising the manufacture of ointments made in accordance with approved formulæ. Requests are made officially by the Department to retail chemists and druggists to sell, and to medical practitioners to recommend, suitable venereal disease preventives to the general public in a proper manner. In time it will probably be found advisable to authorise only a standard type of tube—preferably the metal tube with elongated nozzle and expanded metal cap—filled with one simple self-disinfecting ointment.
It has been found that the 30 per cent. to 33 per cent. calomel ointments (and suppositories) are not suitable in all cases; and careful investigations are being made to ascertain the best germicide to use. Whatever is used must be non-irritating, odourless, stainless, and yet strongly antiseptic. It is possible, I think, that chinosol[P] best fulfils the required conditions. It was first suggested by Surgeon-Commander Hamilton Boyden, R.N., of the Whale Island Gunnery School, England, who was led to choose it because of its known usefulness in ophthalmic work. It does not matter to the general public what drug is finally selected; all that matters is that it should be of proven value for the purposes required. Women can help forward this great work by deciding in their own mind: (1) That the medical prevention of venereal disease is right and wise; and (2) That the authorisation by the Public Health Departments of efficient means of preventing venereal disease will consequently have their support.