Chapter XVI
Public Effort Against Syphilis
The World-wide Movement Against Venereal Disease.—This chapter is intended to give some account of the great movements now begun to control syphilis and its fellow-diseases throughout the world. A campaign of publicity was the starting-point of the organized attempt to control tuberculosis, and in the same way a similar campaign has been at the bottom of movements which now, under the pressure of the tremendous necessities of war, are making headway at a pace that generations of talking and thinking in peaceful times could not have brought about. Although this country at the present writing is probably farther in the rear than any other great nation of the world in its efforts to control the venereal diseases as a national problem, it is fortunate in having had the way paved for it by epoch-making movements such as those of the Scandinavian countries, and by the studies of the Sydenham Royal Commission on whose findings the British Government is now undertaking the greatest single movement against syphilis and gonorrhea that has ever been launched. For many years Germany has had a society whose roll includes some of the greatest names in modern science, directing all its energy toward the solution of the problem of sexual disease, and German sentiment on these matters is developing so fast that it is difficult, even for those in touch with such matters, to keep pace with it. In this country progress has been much slower, hampered by peculiarities of mental outlook and tradition very different from those which have controlled the thought of Europe. The association of syphilis with prostitution has been largely instrumental in putting much valuable statistical and general knowledge of the disease into semi-private reports and sources not available to the large mass of the thinking public. The effect of finding the problem of syphilis invariably bound up with discussions of the social evil has been to perpetuate in popular thought an association which simply blocks the way to any solution of the public health problem. While the control of prostitution will influence syphilis, ignoring syphilis, or treating it as incidental, will never contribute anything to the conquest of either. It is one of the most significant features of the great movements now on foot all over the world that they have finally adopted the direct route, and are attacking syphilis and gonorrhea as diseases and not by way of their association with prostitution.
The agencies in this country which are making notable efforts to push the campaign against syphilis and gonorrhea deserve every possible support from the thinking public. The American Social Hygiene Association is a clearing-house for trustworthy information in regard to the problems of sexual disease, and publishes a quarterly journal.[16] The National Committee for Mental Hygiene and its branch societies are also engaged in spreading knowledge of the relation of syphilis to mental disease and degeneration. State and City Boards of Health are active in their efforts to further the campaign, and notable work is being done by New York City, Buffalo, Cleveland, and Rochester, New York, both on publicity and in the provision of facilities for recognizing and treating the diseases in question. Certain states, such as Ohio, Michigan, and Vermont, have made steps toward an intelligent legislative attack on different aspects of the problem. Influential newspapers and magazines have made the idea of a campaign against these diseases familiar enough to the public, for example, to bring a young girl to me to ask outright without affectation that she be told about syphilis, because she had seen the word in the paper and did not fully understand it. The aggregate of these forces is large, and an awakening is inevitable.
[16] Social Hygiene, New York.
To prepare ourselves for an active and intelligent share in the movement, we should review briefly the essential elements of a public campaign against syphilis as they have been developed by recent investigations and legislative experiments.
Undesirable and Freak Legislation.—Syphilis has had a limited amount of recognition in law, unfortunately not always wise or timely. Freak legislation and half-baked schemes are the familiar preliminaries which precede the grim onset of a real attack supported by public sentiment. Typical examples of such premature legislation may be found in the setting up of the Wassermann test as evidence of fitness for marriage by certain states, and in the efforts of certain official agencies to enforce the reporting of syphilis and gonorrhea by name. Proposals to quarantine and placard all syphilis are in the same category, though seriously entertained by some. The plan to establish by state enactment or municipal appropriation special venereal hospitals falls in the same class, since it is obvious that in the present state of opinion none but down-and-outs would resort to them. The stigma attached to them would effectually make them useless to the very group of worth-while people which it is to the public interest to conserve and reëducate.
Value of Conservative Action.—It cannot be said too often that a reasonable conservatism should temper the ardor of reformers, or more harm than good will be done by the collapse and failure of ill-considered special legislation. Unified action against syphilis and gonorrhea as public health problems is as important as unified action on the problems of railroad control, child labor, or corporate monopoly. For that reason it is a matter of some uncertainty how much can be accomplished by individual states in this country in the way of restrictive legislation, such as that controlling the marriage of infected persons, or punishing persons who fail to carry treatment to the point of cure. Under the direction of a national bureau or department of health administration there is no doubt that the movement against syphilis would advance at a much more rapid pace than with the sporadic and scattered activities of mixed state and private agencies.