This concludes the published reports of charitable institutions, and the question next arises, What amount of syphilis is treated by physicians in private practice? It is impossible to obtain any reliable data upon this head. The Medical Board of Bellevue Hospital, composed of some of the leading members of the profession in the city, state that they “are unable to say what proportion of the practice among regular and qualified physicians in this city is derived from the treatment of venereal diseases, but they know it is large, and that many receive more from this source than from all other sources together.”

There are also a very large number of advertising pretenders who offer their services for the treatment of secret diseases; and many drug-stores whose main business is derived from a similar source; together with an infinity of patent medicines announced and sold as specifics for all venereal maladies. Upon the simple commercial principle of supply and demand these are so many proofs of the extent of the evil they profess to relieve. Should the number of cases of venereal disease treated in private practice by qualified physicians and by advertisers, added to the number of patients who supply themselves with patent or other medicines from drug-stores, be regarded as equal to the aggregate of those treated in public institutions, the estimate could not be deemed extravagant.

The design is now to ascertain how much venereal disease exists in New York at the present time, and to do this it will be necessary to recapitulate the information already given. The cases below are those treated in 1857:

Institutions. Cases.
Penitentiary Hospital, Blackwell’s Island 2090
Alms-house, Blackwell’s Island 52
Work-house, Blackwell’s Island 56
Penitentiary, Blackwell’s Island 430
Bellevue Hospital, New York 768
Nursery Hospital, Randall’s Island 734
New York State Emigrants’ Hospital, Ward’s Island 559
New York Hospital, Broadway 405
New York Dispensary, Centre Street 1580
Northern Dispensary, Waverley Place 327
Eastern Dispensary, Ludlow Street 630
Demilt Dispensary, Second Avenue 803
Northwestern Dispensary, Eighth Avenue 344
Medical Colleges 207
King’s County Hospital, Flatbush, Long Island 311
Brooklyn City Hospital, Brooklyn, Long Island 186
Seaman’s Retreat, Staten Island 365
Total 9847

Medical men, and those acquainted with the internal arrangements of public institutions, need not be reminded that the general system of record in hospitals includes only what may be called the prominent malady. Thus, if a man were admitted with a broken limb, it would be registered as a fracture; and if the same man were suffering indirectly from syphilis at the same time, no entry would be made thereof, although the physician rendered him every professional assistance toward its cure. It is estimated that in this manner a large number of the cases of venereal disease treated in all public institutions, except such as make a specialty of those maladies, is never recorded elsewhere than on the private case-books of the attending physicians. More particularly is this the rule in institutions supported wholly or in part by voluntary contributions. Their benevolent directors have not yet outlived the prejudice which formerly held it almost as disgraceful to treat as to contract syphilis. Some of the spirit which drove the unhappy men and women so afflicted from civilized life to perish in the fields or woods, as in London, Edinburgh, and Paris, during the fifteenth and sixteenth centuries, and at a later period drew from the Papal government a bull recognizing the affliction as a direct punishment from the Almighty for the sin of incontinence, still survives in the present generation. The trustees of more than one of the dispensaries in New York have directed their medical officers not to prescribe for such complaints, and a hospital in a sister city, which receives a yearly grant from public funds, has in its printed rules and regulations: “No person having ‘Gonorrhœa’ or ‘Syphilis’ shall be admitted as a charity patient.” Some remarks are made hereafter upon this course, and the facts are mentioned now to explain why many cases of venereal disease never appear upon the reports of institutions where patients are treated.

Practically such prohibitions are a dead letter. No physician of a public institution, applied to by a poor wretch suffering from syphilis, could pass him by without attempting to relieve, let the orders of the board of trustees be what they may. His mission is simply to apply the aid of science and skill to the alleviation of any ailment which may be presented to his notice, and his appreciation of the responsibility of his office is too keen to allow him to refuse the prayer of such an applicant. Hence arises the circumstance that the case is treated under some other name.

If then the cases recorded are but two thirds of the aggregate, the numbers stand thus:

Cases recorded in public institutions 9847
Cases not recorded 4923
Total 14770

cases in the year 1857 in public institutions.

The difficulty of forming an opinion as to the extent of venereal disease treated in private practice has been already mentioned. In the absence of all information, collateral circumstances form the only guide to a conclusion. The amount is unquestionably very large; so large that, if its full magnitude could be discovered and announced, every reader must be astonished. The first consideration to support this view may be found in the army of advertising empirics who make it a source of revenue. Each of these men must have numerous patients; he could not keep up his business without them. Any practical advertiser knows that to insert an announcement of some twenty or thirty lines every day in at least two daily papers, to repeat the same in weekly journals, and, in addition to this, to post handbills on the corner of every street, and employ men or boys to deliver them to passengers at steam-boat docks, ferry landings, and rail-road depôts, can not be done without a considerable outlay, whatever its prospective advantages may be. No one supposes these charlatans to be actuated by pure disinterested benevolence. They crowd the columns of our journals, and insult us with their printed announcements in the public thoroughfares, simply because “it pays.” These means obtain them customers, and whenever this result ceases the announcements will be discontinued. While they appear there is positive proof that their issuers are gathering patronage.