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.