Diseases of a syphilitic nature are viewed by some persons as special punishments for special sins, and hence they argue that it would be an interference with the order of Providence to attempt to eradicate them. The discussion of a theological question would be altogether out of place in these pages, but the supposition may be met by a parallel case. Delirium tremens is the result of an excessive use of intoxicating liquors, and may justly be considered a special punishment for that offense; but did any body ever know a case in which those who object to the treatment of syphilis extended a single obstacle to the case of a drunkard? If it is right to adopt curative measures in one case, why exclude them in the other? But even supposing that the treatment of syphilis is open to this objection so far as the guilty parties are concerned, shall their descendants be involved in suffering because the parents sinned? If a rigorous medical examination offers additional inducements to prostitution by reducing the probabilities of disease, it also guarantees that helpless wives and unborn children shall not be included in its list of victims. Go to the thousands of married women now childless or suffering from abortion; ask their opinion. Go to the thousands of disappointed husbands whose hopes of offspring have been blighted in consequence of their own youthful dissipation; ask their opinion, and see what the answers would be. Go and ask the diseased children on Randall’s Island, and in their emaciated frames read their testimony. The evidence thus obtained would prove unanswerable arguments in favor of the plan proposed.
It can not be imagined that forcing diseased women to submit to a specific routine of treatment in a special hospital involves any undue interference with their personal liberty. The right to commit a wrong, be it social, moral, or physical, never can exist; the slightest reflection upon such a proposition will at once prove it untenable. The spread of venereal disease is a positive wrong, and, therefore, a woman who is suffering from it, and is certain or likely to propagate it, is as legitimate an object for compulsory treatment as would be a maniac whom we should find roaming through the streets of the city, or a person afflicted with small-pox, yellow fever, or any other contagious or infectious malady. If either of these cases were to come before any member of the community, he would not for one moment regard it an infringement of personal liberty to place the subject under proper care and restraint. On the contrary, he would think of the danger to which he and his family were exposed, and, flinging theory to the winds, would immediately urge prompt and practical measures. This is all that is asked respecting prostitution. Let the public be once thoroughly convinced of the extent and danger of syphilitic infection, and there would be but few objectors to these suggestions. Among that few, the principal portion doubtless would be the advertising empirics whose disgusting announcements occupy so much space in the columns of our daily journals. That they derive a large income from this source is indisputable, and it is equally certain that if the recommendations now made were adopted they would find their “occupation gone.” Speaking in all candor, the health, decency, and good morals of the city would be better cared for in their absence than it now is, with all the combinations of their “extraordinary success,” “unequaled experience,” and “unparalleled facilities.” In a financial view, the money they extort (we refrain from using a harsher term) from their credulous patients could be far better applied than in contributing to their wealth.
Farther: Such an institution and organization as has been described would be useless did it not possess the absolute power to retain every patient under treatment until cured. Whatever modification of principle or mode of action may be ultimately adopted (and, sooner or later, something must be done), this is an indispensable requisite. One half the danger of venereal infection arises from imperfectly cured cases. Under the existing system, as already explained, writs can be issued at an almost nominal cost to remove any, or all of the prostitutes now under medical treatment on Blackwell’s Island; and such an abuse of a valuable privilege on account of mere technical errors must be fatal to the success of any remedial project. It would be as reasonable for a lawyer to petition the courts to order a vessel detained in Quarantine by the Board of Health because she was infected with yellow fever to be brought to her wharf in this city, and there to have permission to disseminate the disease on board, as it is for the same individual to apply for a writ of certiorari, the effect of which is to take an abandoned woman reeking with disease from an institution where she is under treatment, and allow her to extend the venereal poison to every one who may have intercourse with her. This must not be understood as indicating a wish to curtail the constitutional privileges attached to writs of habeas corpus or certiorari, but merely their applicability to cases like the supposed one. How can the evil be prevented? Simply by making any legislative enactment on the subject so plain that it can not be misunderstood or evaded. No lawyer would find any difficulty in drafting a short act giving the Police Department the power, based upon an affidavit made by a member of their own medical bureau, to remove any diseased woman to a proper hospital, and retain her there until cured.
It may appear to a casual observer that this detention would be of the same nature as the imprisonment required by the existing mode, but a little thought will point out a wide difference. Now, we force a woman to become an inmate of a penitentiary, and add disgrace to her disease by assuming her to have been guilty of crime. Then, we should require her to become an inmate of the Hospital, with no additional disgrace but that arising from the fact that she had contracted syphilis by vicious habits. In the one case, we make her the companion of some of the vilest wretches on the face of the earth; in the other, she would have no associates but those of her own class.
The Medical Bureau to whom these reforms should be intrusted, although connected with the Police Department, would require to be an independent body so far as professional duties are concerned. Its connection would be necessary, because there would be many cases requiring the intervention of the civil power; and its isolation would be equally important, because much would depend on the discretion of the examiners, and many contingencies might arise where a strict line of routine duty would defeat the object in view. They would be literally a “detective corps,” and with a known amount of duty before them must be left to choose their own method of performing it. Any definite arrangements or positive orders from a non-medical board would only embarrass their action, for medical and non-medical executives always clash when they aim at one common object.
Of course a leading requirement in their instructions must be that their examinations be rigid and thorough. No half-way measures in this respect could meet the absolute demands of the case, or satisfy the expectations of the community. It must be plainly understood by the world that the Medical Bureau was required to perform its whole duty, uncompromisingly and fearlessly; and that its members were men who would not evade the responsibility. In their investigations many cases would occur where their services would be valuable to society, beyond the pale of professional duty. It is not to be expected that they would become evangelists, but they could be the willing and efficient coadjutors of those who delight to bear the Gospel to these poor degraded beings; and even while listening to a recital of bodily sufferings, instances would arise where the acts of the good Samaritan would be required at their hands. They would be the depositaries of many a narrative of wrong and outrage, of sorrow and suffering, and it is not unreasonable to believe that of the histories poured into their ears some would indicate a channel by which the lost one might be restored to home and friends and virtue, or point to some chord in the mind which would give a responsive sound when touched by the hand of pity.[430]
The adoption of these suggestions would be, at least, a step in the right direction, and lay the foundation of a system which can be gradually enlarged until it embraces regulations as to registry, management of houses of ill fame, etc., to the same extent as is now done in Europe.
And here a few words relative to the licensing system may not be inappropriate. The propriety of granting licenses, and thus making vice a sort of revenue, is open to grave objections, but on the other hand acknowledged social evils have, ere this, been made to contribute to the public funds. Witness the dealing in ardent spirits. The city does now, and has for years derived a considerable income from licenses to sell liquors. A great number of wise and good men contend that the sale or use of intoxicating beverages is not only an unmitigated evil, but even criminal; they have entertained and publicly declared these sentiments for years, but still the license system is continued. It may be a question for decision whether prostitution is not as liable for taxation as drunkenness, and if both were equally taxed whether, as a body, we should be more responsible for the results of one or the other. En passant, it may be noticed that an annual tax of one per cent. upon the property engaged in the business of prostitution, and a similar assessment upon the revenue of houses of ill fame, would amount to over one hundred thousand dollars.
The plan here shadowed forth would not be likely to extend prostitution, but on the contrary there is very little doubt but it would check it. Even if it did not, the community would reap an advantage in the sanitary reform it would enforce. In low neighborhoods many of the brothels are as dangerous to public health on account of their crowded and excessively filthy state, as are the syphilized inmates themselves. Such places would legitimately come within the province of the medical inspectors, and their reports thereon to the police executive would insure immediate attention.
Public morals would be advanced by such visitations. These houses, or a great number of them, are the resort of all species of dishonest characters who would unquestionably abandon them, at least as places of residence, if they knew they were at any moment liable to a domiciliary visit. Again, almost every person has in his remembrance some female who left home and could not be found, because securely secreted in some one of these houses of prostitution; at least it is not uncommon to read of such cases in the daily papers, accompanied with an account of the unsuccessful search of her friends and the police. Occurrences like this could not take place if all known houses of bad repute were under the surveillance of the Medical Police Department.