The series of articles this week will be on different phases of the venereal disease question. It will tell the truth, seeking to avoid offense, and striving to make the presentation plain enough to be easily understood. As a further aid The Tribune will send a pamphlet on venereal disease to any one sending a self-addressed envelope and 6 cents postage. In this pamphlet will be a list of books proper to read.
We advise that, wherever feasible, girls go to their mothers and boys to their fathers for further information, or better still, that parents discuss these subjects with their children. Family physicians hold an important relationship to these questions. Finally, there are a multitude of excellent books on these subjects, books that speak frankly, the tone of which is thoroughly wholesome.
These books are of the new style, in that the words employed and the ideas and illustrations used are chosen with a view of full understanding of them by the below average man and woman.
Insofar as the venereal diseases are concerned, conditions are bad. They are bad because the subject has been taboo. The flood of light that has been turned on everything else has been kept away from this subject. The mediaeval method has been abandoned as to every other subject. Here a dark, jungle island has been left in a sea of light.
We believe that generalized information will clear out this plague spot as it has the others.
Venereal diseases should be reported, registered, and controlled from the health department, but these departments will not control it for years to come. Occasionally an exceptionally good city health department, such as those of New York City and Detroit, and such as California’s among state departments, will attempt to register venereal disease. But the attempt at control does not go beyond registration, with some educational features attached. In our generation this is as far as government will go; that is, outside the army and navy.
Where is there hope of relief?
Thousands of people are killed; ten of thousands are made invalids for life. No class escapes. It blinds babies; it mutilates innocent women; it lays low the men.
It is called the “ red plague.” It deserves the name; it is a plague, and it is stained red.
When the government fails us what remains ? Education—such a knowledge of the facts as will lead to self-government. This paper sees its duty. It proposes to do it.
Much of venereal disease can be prevented by greater morality. There will be groups of the young to whom chastity can best be taught by religious teachers.
Some of the education necessary to prevent venereal disease is properly the function of these teachers, as other parts must be done by parents; others by physicians; others by school teachers; others by health departments; others, by the drama, and still others, by the public press.
Webster’s definition of virtue is rectitude; strength; efficacy; valor, chastity. It would be a good idea to remove the semi-colons and allow strength to flow into the other meanings. The meaning of this suggestion is that it is wise to promote virtue by ending the blindness of virtue.
The problem of morality is not the problem of venereal disease. With it, however, it has many points in common. Efforts to promote morality will result in bettering the venereal disease conditions.
Therefore, the student of the venereal disease problem is in sympathy with the workers in the morality problem. However, venereal disease is one matter and immorality another.
The venereal diseases should be classed with the contagious diseases. They should be reported at the health departments, and measures for their control planned by health departments.
One of the reasons why the movement to prevent venereal diseases has not made headway is because it has got mixed up with several other movements and these have introduced elements that have made all sorts of difficulties.
One of these is the relation between the transgressions of the moral law and venereal disease. The popular idea that all venereal disease results from immorality has put a check on preventive measures.
Accurate information about venereal disease will remove some of this hindrance. Several truths about venereal disease should be more widely known.
Not every venereal infection results from transgression of the moral law. A large part of venereal disease is innocently acquired. Infants, homes, orphan asylums, and children’s hospitals find it well nigh impossible to keep free from venereal infections. If they think otherwise it is because they have never followed the policy of proper examination of their inmates.
Within the last ten years two of the most up to date hospitals in Chicago have had experiences of this character. New buildings had been erected; every detail represented the last word in hospital construction and maintenance. The intention was to maintain everything so attractively that people with homes would prefer to go to the hospital. Each had provided an attractive, up-to-date children’s ward.
Alas! within a month after opening venereal disease was epidemic among the children.
A meeting of the hospital superintendents of the city was called by the health department. The upshot of this meeting was that the careful, high grade hospitals in the city adopted the policy of inspecting children on entrance and sending the infected to the county hospital.
The county hospital, already under great strain to separate the children into scarlet fever groups, measles groups, and other groups, was further required % to divide each group into two subgroups—the venereally infected and those not so infected.
The superintendents decided that the county could not escape getting venereally infected children in its wards. They were compelled to maintain separate wards, and it was wise for other hospitals to unload the venereally infected children into them.
About this condition there was nothing temporary. The condition has existed for a long time. It will continue to exist until a definite policy to prevent it is inaugurated.
It is not a local condition. There is about as much innocently acquired gonococcal infection amongst young girls and babies in one portion of the country as in another.
Nor is the innocent acquirement of gonococcal infection limited to children. Most of the women suffering from pus tubes are not so suffering as the result of their own immorality, and many of them not as the result of anybody’s immorality.
In order to understand the manifestations of gonococcal infections it is necessary to know something about the germ which causes it. The germ of gonorrhea is known as the gonococcus. It is one of the pus cocci. As a general proposition, we get on comfortably with the pus cocci. They make fairly good neighbors. With some of them we live in peace and harmony all the time. With most of them the lower animals (horses, dogs, chickens) live in complete harmony about all the time. Some of them have but slight capacity to harm and then only for a brief season.
For instance, a puss coccus, the staphylococcus, will crawl down a hair and get under the skin. Inflammation is set up; leucocytes rush to the field; a boil results. Within a week the leucocytes will have whipped out the pus germs, and the boil will be well.
Other cocci are usually bad neighbors, their peaceful states being rarer than the belligerent ones. The gonococcus, being of the pus germ family, behaves in a similar manner. It has the family traits.
In its generally known role it produces a violent suppurative inflammation. This stage starts after a three day incubation period. This violent period lasts two weeks.
In this period there is a good deal of local soreness and swelling. The pus cocci get into the lymph stream and are carried to the lymph glands.
Occasionally one of these suppurates just as happens in an abscess or a boil. There is some fever and some aching. The toxins of the coccus are circulating in the blood.
Then follow the weeks in which the germs are getting accustomed to their neighbors. The suppuration gets less and the swelling passes away.
This is followed by the stage in which the germ is quite well adapted to its new surroundings. The germs have got into some gland or some fold that does not easily clean itself, and there they may lie, quiet and harmless, for an indefinite period.
The stage of violent infection in the new host is succeeded by the stage of mild, latent infection, as in the first host.
This tendency to become adapted to its surroundings is what makes gonorrhea hard to control—that is as a contagion spreading from person to person. You will remember that I said this same character made malaria hard to control—this tendency to become chronic, to relapse; this tendency of the parasites to make themselves halfway at home in the blood of the host.
More than half of the men have gonococcal infections at some time or other in their lives.
A large percentage of the women suffer from such infection.
A small proportion of the children are infected by it.
The gonococcus infects the moral about as often as the immoral; the innocent as often as the guilty.
It produces sterility, blindness, and congenital deformity.
It kills by the thousands; maims by the tens of thousands; it disables by the hundreds of thousands.
It rarely gets into the blood stream.
Once an infection occurs, the gonococcus is liable to lurk near the site of infection for years. When its symptoms are cured it is still there and ready to harm; then is the time of the truce of the bear.
Under a policy of ignoring gonorrhea the community is growing worse infected all the time. The policy of reporting and registering it, as with other forms of contagion, will come slowly. It will crawl with painful, discouraging, halting advances.
In the meanwhile we must hope for escape through education. There are other things we had rather learn about. There is nothing that we have more need to learn about.