(1.) A suitable hospital for the treatment of venereal disease;
(2.) A legally authorized medical visitation of all known houses of prostitution, with full power to order the immediate removal of any woman found to be infected to the designated hospital;
(3.) The power to detain infected persons under treatment until they are cured, a term of time which none but medical men can decide.
By a suitable hospital is meant an institution devoted to the treatment of such diseases, like the special hospitals of Paris and other Continental cities, and entirely removed from all connection with any punitive establishment. The rules proposed for the government of the Island Hospital, when its name was changed from Penitentiary Hospital, do not, by any means, meet the urgent requirements of the case. The Penitentiary, its officers and inmates, must be entirely shut out from the desired hospital, and no prison-warden or keeper of criminals must have any jurisdiction within its walls or over its grounds. Inmates of hospitals have too long endured the stupid interference of non-medical men, and it is time that medical law exclusively was considered in the direction and management of buildings devoted to medical purposes. This is especially necessary in a syphilitic hospital, on account of the character of its patients. No amount of imprisonment as a punishment ever yet reformed a prostitute, and it never will; all intercourse with prisoners, be it ever so transient, has but confirmed women in vice.
The tendency of imprisonment is directly contrary to any reformation, confirming previous habits instead of rooting them out. The instinctive dread of incarceration has prevented many from availing themselves of the medical advantages offered them, particularly among the better and higher grades of frail women. We want a hospital exclusively for the treatment of syphilis, with the power to place and keep there all women so diseased until cured. Matters of detail can be arranged in such a manner as to admit of a proper classification, based upon the degree of moral turpitude belonging to each. Payment could and should be required from all who possess the means, for expenses actually incurred, and this would contribute a considerable sum to meet the expenditures of the institution. Among these women, as a body, there exists an excessive amount of pride. Those of the upper class will not associate with any of a lower rank, and, in fact, look upon them in very much the same manner that moralists regard the whole body. To be enabled to reach them at all, a liberal management must be adopted. But will not this be deferring to vice because it is dressed in silks or satins? asks some one. Most decidedly not. Let the arrangements be what they might, such a hospital as described would afford no encouragement to vice, for in it all must submit to the same course of treatment, varied only in the minor accessories which surround it.
Even if the arrangements were exposed to an objection like the above, the end would justify the means. The city of New York contains, at this day, venereal infection sufficient to contaminate all the male population of the United States in a very short space of time. It has been proved from official and medical statistics that this malady is rapidly on the increase, and a paramount question is, how to be relieved of the incubus. Rigorous prohibitory measures will not effect this; they only make the matter worse. Punitive hospitals will not effect this; they have been tried and found wanting. Free institutions would, in all probability, succeed in accomplishing far more than any other measure our citizens have ever tried. The question is one, if not absolutely of life, certainly of healthy existence, and its inestimable importance must over-ride all doubts and difficulties. In view of the dangers surrounding our rising generation, even supposing the men and women of the present day exempt from them, it would be perfectly inexcusable to refuse any available plan because some one of its features might not please all tastes. Adopt an arrangement similar to that suggested, and if any crudities are discovered they can be readily cured as experience points them out. The plan is not presented as a perfect one, but merely as an outline sketch of what is necessary.
A regular medical visitation of all prostitutes is an essential part of the scheme, and its organization should be a matter of serious consideration. The Parisian plan already submitted might form a very good basis; and an arrangement which throws the whole system of prostitution open to an effective police supervision, and the establishment of a medical bureau in connection therewith for professional purposes, is suggested as most desirable. This medical visitation, conducted by physicians to be connected with the Police Department, and sustained by the power of that body, should be confided to men of recognized skill and known integrity. To insure public confidence, so essentially necessary in the inception of any social innovation, it would be necessary that the agents upon whom its execution devolved should be men of tried probity and acknowledged reputation, both professional and personal. The slightest symptom of disease should be sufficient evidence to warrant the immediate removal of any woman to the syphilitic hospital. The residence of any woman, be it temporary or permanent, in a known house of prostitution must subject her to a medical examination, as it would afford a very strong presumption that she was there for immoral purposes.
The propriety of a medical examination of prostitutes at certain intervals can not be doubted, and, in fact, it is practically admitted at the present time by some few of the brothel-keepers in the city. These pay a physician a liberal salary to visit their boarders every few days for the express purpose of carrying out the plan suggested now; resorting to treatment whenever he finds it necessary. Some of the most aristocratic houses of prostitution are thus attended, but the system is in use more especially among those natives of Continental Europe who are now keeping houses of ill fame in New York, and who, in bringing to the New World many of the customs of the old, have thus testified to the benefit of the regulations enforced there.
But although such visiting physician may pronounce a girl infected, the world has no security that she will not continue her avocation; and in order to remove all doubt upon this question she should be instantly removed to an institution where she can not possibly propagate the malady. This must be done under conjoint medical and police authority. Among prostitutes of the lower grades systematic visitation is more imperatively necessary. They will not place themselves under medical treatment unless they are compelled, but until their disease assumes a character that prevents the possibility of farther concealment from their visitors, they continue to ply their loathsome and destructive trade. The summit of ambition with them is to keep their liberty; so long as they can earn enough to provide themselves a shelter, and feed their ravenous appetite for intoxicating liquor, they are content to submit to the pains and ravages of syphilis, alike heedless of their own sufferings and the injuries they inflict on others. We have had cases under our own professional treatment where women have actually persevered in this course for many weeks after they had become aware they were diseased, solely for the reasons indicated.
It may be objected that such a plan would offer a premium to lewdness by circumscribing the dangers of infection; but this argument can have little weight, as it is scarcely possible that promiscuous sexual intercourse can be carried on much more extensively than it is at present. The vice seems to have reached its culminating point. Experience proves that in all ages of the world there have been many men whose passions were so violent and so ill regulated that they would attain their gratification at any risk, even though that risk included the probability of venereal infection. As in games of hazard every player hopes to be a winner, so in carnal indulgences every man flatters himself that, because some gratify their lusts unscathed for a long series of years, so may he; that as hitherto he has escaped disease in his unhallowed amours, he may continue equally fortunate to the end of his career. This is confessedly a poor dependence, but it is the reliance of hundreds and thousands of the followers of her whose “house is the way to hell.”