At the second congress of the Society for the Suppression of Venereal Diseases, held in Munich in March, 1905, the question of the public recommendation of protective measures was opened to discussion, and was dealt with in two admirable addresses by O. Neustätter[340] and Georg Bernhard.[341] Bernhard proposed that to Section 184, paragraph 3, of the Criminal Code, which declares it to be a punishable offence to “expose for sale articles intended for an indecent use, or to recommend or sell such articles to the public,” should be added a legal definition in the following sense: articles which are used either to prevent venereal diseases or to prevent conception are not regarded as “intended for an indecent use”; and Neustätter pleaded for an alteration of the existing state of the law, in the sense that the public recommendation of means for the prevention and cure of venereal diseases should be legally permissible, being restricted merely by certain regulations against quackery, extortion, and other misuse. The regulation of the recommendation could best be associated with the necessary control of the recommendation of therapeutic and preventive measures in general. A supreme sanitary authority should be constituted, part of whose duties should be to examine the form and contents of recommendations of this character.
Another juristic relationship of the prophylaxis of venereal diseases concerns legal protection against venereal infection. Franz von Liszt,[342] von Bar,[343] and Schmölder,[344] opened the discussion on the biological and criminal aspects of the prophylaxis of venereal diseases at the first congress of the Society for the Suppression of Venereal Diseases, held at Frankfurt-on-the-Main in the year 1903.
Hitherto the heedless or deliberate transmission of venereal disease was punishable only as personal injury, since in the Criminal Code there was no paragraph directly relating to this matter. Only in the Criminal Code of Oldenburg of 1884 was such punishment expressly provided for (Article 387), and by this provision the intercourse of an infected person with a healthy one was punishable, without regard to the subsequent infection. In the legal regulations of other countries than Germany, we find several instances in which the witting transmission of venereal infection by means of sexual intercourse is punishable. In Germany a measure proposing this was rejected by the Reichstag in 1900. Von Liszt advocated the introduction of the following paragraph into the Criminal Code:
“One who, being aware that he is suffering from a contagious venereal disorder, performs coitus, or in any other way exposes another human being to the danger of infection, shall be punished with imprisonment for a term of two to three years, and in addition shall be deprived of civil rights.”
Schmölder enlarged this clause by an amendment relating to the punishment of prostitutes disseminating venereal diseases.
On the other hand, von Bar drew attention to the inconveniences and dangers which a punishment of this nature would involve, especially to the dangers of blackmail, and to the duty it would impose on physicians of breaking their obligations of professional secrecy. Moreover, a proof of the knowledge of venereal infection is difficult to obtain; the proof that infection is derived from a definite person is also far from easy. Von Bar opposed the addition of such a clause on this and other grounds. In the discussion upon the motion, this view was shared by C. Fränkel, Ries, Oppenheimer, and others; Neisser was in favour of a punishment of this kind, because then, at any rate, there would be a public recognition of the fact that such an action was open to severe punishment, and was a disgraceful one; thus, by the mere existence of the paragraph an educative influence would be exerted.
In any case, such a punishment would be a two-edged weapon, and as far as present necessity goes, we have sufficient powers in the application to such offences of the paragraphs of the Criminal Code relating to bodily injury.
The second great means for the limitation and entire suppression of venereal diseases is to deal with them by medical treatment, to cure as speedily as possible persons suffering from syphilis of gonorrhœa, and thus to prevent these persons from becoming sources of fresh infection. Systematic, methodical treatment on a large scale—that is the goal at which we have to aim. To the poor man or woman suffering from venereal infection the same advantages should be opened as to the wealthy voluptuary. The provision of means of treatment of venereal diseases cannot be too free. In public hospitals, private clinics, ambulatoria, and sanatoria, in convalescent homes, and polyclinics for prostitutes, everywhere must be provided means for an intelligent treatment of venereal diseases. Just as tuberculosis is now attacked systematically and vigorously, so must it be with venereal diseases.
Since syphilis constitutes only about 25 %—only one-fourth part, that is to say—of venereal diseases in general, since also during the last four centuries the disease has shown a natural tendency to decline in virulence, since a mitigation in the intensity of the virus is clearly recognizable, it is in the case of this disease that the hope of radical success is especially great.
Our forefathers carried out for us a great part of the campaign against syphilis. The comparatively mild course of syphilis in the majority of uncomplicated cases leads us to infer that there has been a relative immunization against syphilitic poison.