Why Permit Conditions to Continue as They Are?—When one faces the easily ascertained facts regarding venereal disease, it seems incredible that we, an intelligent people, can go on complacently handing our daughters and sisters over to the surgeon’s knife and a life of personal misery, and even in not a few instances to become mothers of incurably defective children, yet the dire fact confronts us that we do. We can no longer excuse ourselves on the plea of ignorance, for the grisly record may now be read in many medical and not a few popular treatises, and we find the theme entering even into the modern drama, as witness Brieux’s Damaged Goods. Further indifference to these conditions can only be attributed to culpable apathy or prudery.
The extreme dangers to which parents are subjecting their daughters if they do not demand a clean bill of health on the part of their prospective husbands are obvious. Fathers and mothers perfectly willing to inquire into their future son-in-law’s social connections, his income, securities, or business chances become strangely “modest” when it comes to determining whether he is physically fit for marriage.
One great cause of ignorance in the past was the prudish taboo against frank discussions of venereal diseases which has thrown the veil of silence about the subject. To-day, however, it is coming to be recognized that these maladies are diseases and not a standard of social propriety, and that like most other diseases the surest way to secure prevention and gradual eradication is through the enlightenment of the public. They are prevalent in all classes of society. Moreover, it must not be forgotten that there is no form of venereal disease which may not be innocently acquired. Even where acquired through transgression of moral law an ignorant attitude toward the sexual instinct is often at the bottom of the difficulty.
Medical Inspection Before Marriage.—Ante-nuptial medical inspection is certainly as necessary to the welfare of society as the certification of age and of the single state now required by law. No one objects to a medical examination pertaining to venereal and other diseases when it comes to taking out a life insurance policy, and why there should be any more objection to it as a preliminary to marriage is a mystery. A few states already have compulsory ante-nuptial medical inspection. The laws have been enacted too recently to judge adequately of their working. There has been much debate in Wisconsin as to whether their law (Chapter 738, Laws of 1913), which went into effect January 1, 1914, is constitutional and whether it requires a Wasserman test. The Wisconsin law applies to males only. The Supreme Court of the state has declared it constitutional and that its requirement of “the application of the recognized clinical and laboratory tests of scientific search” involves only such examination as the ordinary licensed physician is equipped to make and can reasonably be expected to make for three dollars, the maximum fee specified in the law.
A number of the physicians of the state are still dissatisfied with the wording, although most do not oppose the principle of the law. Many believe that it should apply to the women as well as to the men, and others feel that the law should be extended to cover still other kinds of marital unfitness. Most of the practitioners with whom I have discussed the matter appreciate the motive underlying the law and are endeavoring to make it successful.
The general public of the state as a whole seems to be in favor of the provision. At least one hears much favorable comment and little dissension among those who understand its purpose. The very controversy over it which sprang up after its passage proved to be of great benefit in the education of the public regarding the necessity of such measures. Such physicians as I have been able to question report that the candidates for marriage rarely object to the requirement, but on the contrary strongly favor it. Especially where they have suffered from venereal disease earlier in life most are eager to know their condition and to have medical advice. To my own mind this last fact is the most significant of all, as it will give every candidate for marriage a chance to know the truth. Most men are not so much brutal or vicious as ignorant in such matters. The vast majority of those unfit for marriage as a consequence of venereal disease will, when they realize the danger their condition imposes on wife and children, take every possible means to put themselves into proper condition.
Desirable as the Wasserman test may be, it requires special laboratory facilities and equipment as well as a specially trained examiner to make it a reliable test. Moreover it can not be given by the general practitioner for the very moderate fee that must obtain in a pre-nuptial examination compelled by law. If it or the serum test for gonorrhea are to be applied then the legislative body of the state will find it necessary to establish a special public laboratory or laboratories for their application. This, however, is not a matter of particular difficulty and would be capital well invested in any state.
The Perils of Venereal Disease Must Be Prevented at Any Cost.—However, no matter what the cost may be to the state, no matter what the exaction from the individual, the grave perils of venereal disease to society must be prevented. We owe it to the cause of humanity that there be fewer victims born into a world of eternal night, that from a parentage of polluted blood there spring no longer hosts of children with feeble misshapen bodies or with tarnished intellects, death-marked at the door of life.
Bad Environment Can Wreck Good Germ-Plasm.—In conclusion it is evident from our discussion of prenatal influences that not all of being well-born is concerned with heredity in its proper sense, since the unborn young may be influenced either directly or indirectly by environmental conditions which are in no sense products of heredity, although as far as the immediate child is concerned the result may be quite as disastrous where the influence is a baneful one. As to the production of beneficial prenatal effects, while parents can do nothing toward modifying favorably such qualities as are predetermined in their germ-plasm, nevertheless they must come to realize that bad environment can wreck good germ-plasm. They can see to it that they keep themselves in good physical condition by wholesome temperate living, and thereby insure as far as possible healthy germ-cells for the conception and good nutrition for the sustenance of their progeny. Their one sacred obligation to the immortal germ-plasm of which they are the trustees is to see that they hand it on with its maximal possibilities undimmed by innutrition, poisons or vice.