venereal disease preventive suppositories and ointments for women, should
be decided upon, after thorough investigation and test, by the Departments
of Public Health, and none other should be permitted to be sold. Printed
directions should be issued, duly authorised by the Departments of Public
Health, and no other directions should be supplied to the public with the
venereal disease preventives. In these respects, to the best of my belief,
the Division of Venereal Diseases of the Pennsylvania Department of
Health, co-operating with the United States Public Health Service, will
play the leading part; is, indeed, already doing so. Under the direction
of Dr. Edward Martin, Commissioner of Health, and Dr. S. Leon Gans,
Director, Division of Venereal Diseases, specimen tubes are tested and
approved (with directions and other printed matter)[O] by the Health
Laboratories of the Department; and certificates are issued to
manufacturing chemists authorising the manufacture of ointments made in
accordance with approved formulæ. Requests are made officially by the
Department to retail chemists and druggists to sell, and to medical
practitioners to recommend, suitable venereal disease preventives to the
general public in a proper manner. In time it will probably be found
advisable to authorise only a standard type of tube--preferably the metal
tube with elongated nozzle and expanded metal cap--filled with one simple
self-disinfecting ointment.
[Footnote O: In some cases the printed matter used by the drug companies
also bears the "_Official Endorsement_" of the local "_Social Purity
Association_" stamped upon it in indelible ink--a magnificent tribute to
the educative work of the Public Health Department, as well as to the
enlightened courage of the Social Purity Associations.
The following is quoted as sample of directions authorised in U.S.A.:--
"The use of this package is not to be construed as a licence to exposure.
Pro-Ven, the original preventive. _The only sure_ way to prevent
infection: _Do not expose yourself._ All exposures should be considered as
infections, for 90 per cent. of all "easy women" are infected. By proper
use of the contents of this package disease may be prevented, as the
action upon the germs is as effective as can be secured by the latest
scientific knowledge; if exposed, _use within two hours_. After contact:
1st. Urinate. 2nd. Remove the cap from tube; take organ in the hand,
holding the canal open; insert tip of the tube and squeeze half of the
contents into the canal. 3rd. Squeeze the remainder on the outside of the
organ, rubbing well into the creases and folds under and back of head and
clear to the body. 4th. Leave ointment on three or four hours. Remember:
It is best to use _Pro-Ven_ immediately after exposure; never delay more
than two hours if possible. _Pro-Ven_ is not a cure--it is designed to
keep men from getting disease; it can be used as a lubricant and
preventive both before and after exposure. _Pro-Ven_ is harmless and will
not cause pain or injury to the sexual organs. Insist upon having
_Pro-Ven_. At all good druggists, or directly by mail, 25 cents a tube; 5
tubes, $1.00. Booklet mailed free upon request. The Pro-Ven Laboratories,
Washington, D.C. This product has been tested and approved by the
Pennsylvania State Department of Health Laboratories."
In addition to _Pro-Ven_, the following proprietary tubes of
self-disinfecting ointment have, to my knowledge, been authorised by the
Department of Health, and samples were sent to me:--
_Procaline_, manufactured by the Hawthorne Drug Speciality Co.,
Inc., 88-90, Reade Street, New York City.
_Cargenios_, manufactured by H.K. Mulford Company, Philadelphia.
_Andron_, manufactured by Andron Hygienic Co., 120, W. 32nd St.,
New York City.
_Sanitube_, manufactured by the Sanitube Co., Newport, R.I., U.S.A.
Excellent printed directions and pamphlets accompany these tubes.--E.A.R.]
It has been found that the 30 per cent. to 33 per cent. calomel ointments
(and suppositories) are not suitable in all cases; and careful
investigations are being made to ascertain the best germicide to use.
Whatever is used must be non-irritating, odourless, stainless, and yet
strongly antiseptic. It is possible, I think, that _chinosol_[P] best
fulfils the required conditions. It was first suggested by
Surgeon-Commander Hamilton Boyden, R.N., of the Whale Island Gunnery
School, England, who was led to choose it because of its known usefulness
in ophthalmic work. It does not matter to the general public what drug is
finally selected; all that matters is that it should be of proven value
for the purposes required. Women can help forward this great work by
deciding in their own mind: (1) That the medical prevention of venereal
disease is right and wise; and (2) That the authorisation by the Public
Health Departments of efficient means of preventing venereal disease will
consequently have their support.
[Footnote P: _Chinosol_ (C9H6NKSO4), potassium oxyquinol in
sulphonate, is a proprietary disinfectant and deodoriser. After some
little experience of it in ointments and suppositories, I believe it
deodorises these--an important advantage. But further investigation is
necessary.--E.A.R.]
We must all of us first learn to separate the moral from the medical
campaign. Both are necessary, but they must be conducted independently.
America is doing this; England is not. In England venereal disease is
still officially regarded as something to be discussed; in America--as
something to be destroyed. Thus America is winning and England losing the
battle against the venereal microbe. The Overseas British Dominions will
undoubtedly follow the lead of America--particularly that of Pennsylvania.
Hence, these newer countries may have a glorious future, England--only a
splendid past.[Q]
[Footnote Q: In England the Ministry of Health refuses to authorise the
sale of v.d. preventives; refuses to authorise suitable printed
directions; recommends immediate and thorough cleansing but refuses to
explain methods or name disinfectants; and claims that persons who sell
v.d. preventives as such, with directions, are liable to police
prosecution and imprisonment. (_Vide_ Circular 202, Ministry of Health,
May 31st, 1921.) This may be mere "politics," but it looks uncommonly like
fooling with death.--E.A.R.]
IV.--COMPULSORY TREATMENT.
All women should be in favour of reasonable measures for ensuring the
voluntary, and failing that the compulsory, treatment of venereal disease
among men and among women.[R] It is troublesome to prevent a man getting
disease if he is running into a pool of infection, and such cesspools
should be cleaned up or cleared out of the community--_i.e._, cured or
quarantined. Similarly, it is even more troublesome to prevent a woman
becoming infected if she is having relationship with an active
gonorrhoeic or syphilitic man, and such men should be treated
voluntarily, or compulsorily if they refuse or neglect voluntary
treatment. Free treatment should be available to poor persons only;
providing free treatment for all and sundry, whether they can afford to
pay for it or not, is simply encouraging men and women to trust to luck
rather than to disinfection. This presupposes that the teaching of
self-disinfection has been done confidently and authoritatively. When
prevention has been properly taught, then it is fair to penalise those who
wilfully neglect to take precautions. It was a great misfortune to the
Anglo-Saxons when the Contagious Diseases Acts were abolished; instead
they should have been improved and extended to both sexes. Their
abolition was the worst blow ever struck at marriage. Fortunately, their
main principles we are now beginning to re-enact in various Sexual Hygiene
Acts. The more "drastic"--_i.e._, the more efficient--these are, the more
they should be supported by those who honestly desire to _make marriage
safe_.
[Footnote R: The argument that compulsory treatment would "drive the
disease underground" is absurd. Venereal disease is underground
now.--E.A.R.]
Apart from voluntary and compulsory treatment for venereal diseases, we
certainly need voluntary and compulsory sterilisation of the
unfit--diseased and feeble-minded and otherwise unfit persons, who,
whatever their other qualifications may be, are unsuitable as parents. But
whatever operation is decided upon, for men and for women, must in no way
interfere with ordinary sexual activity; otherwise it will be promptly
turned down by the general public, no matter what its medical advocates
may say. In marriage the partner to be sterilised is obviously the one who
is unfit for parenthood.[S]
[Footnote S: Towards the end of last year, extraordinary interest was
aroused throughout the United States by a decision of Judge Royal Graham,
of the Children's Court of Denver. He had ordered Mrs. Clyde Cassidente to
submit to an operation to make further motherhood impossible, because of
the under-nourishment of her five children and the habitual insanitary
condition of her home. This was the first time any American court had
imposed such conditions. Judge Graham could not legally compel the mother
to agree to the operation, but he told her that if she refused he would
commit all her children to a home. She then agreed. Judge Graham was much
influenced by the testimony of Dr. Sunderland, who described the
progressive insanitary environment as more children came, and declared
that in his opinion the home condition was not due to poverty but to too
frequent child-bearing.
In the February, 1922, issue of _The Birth Control Review_ (New York)
edited by Mrs. Margaret Sanger, the Medical Officer of a London Welfare
Centre (Dr. Norman Haire, M.B., Ch.M.) definitely advocates contraception
and sterilisation as a result of his experiences in a very poor part of
London. Medical officers of many welfare centres now hold similar views.
In _The New Generation_, the official organ of the Malthusian League, Dr.
Barbara Crawford, M.B.E., M.B., Ch.B., strongly urges birth-control, and
says:--
"I would go further and say that all those with incurable transmissible
disease, all addicted to drugs or alcohol in excess, those habitually
criminal or vicious, and the mentally defective, should be rendered
sterile by operation, for such as these cannot or will not use control,
and their children tend to inherit their parents' taint and to lead maimed
and vicious lives."--Vol. I, No. 4, p. 3. _The New Generation._--E.A.R.]
V. CONCLUSION.
With the moral and social aspects of birth-control there is no need to
deal further, except to say that they have recently been endorsed in
England, with fine grace and high authority, by Lord Dawson of Penn
(one of the King's Physicians), in an address given before the Church
Congress at Birmingham, on October 12th, 1921, which has since been
republished by Messrs. Nisbet at a shilling, under the title of
"Love--Marriage--Birth-Control." The following short extract may be
quoted here:--
"Generally speaking," says Lord Dawson, "birth-control before the
first child is inadvisable. On the other hand, the justifiable use
of birth-control would seem to be to limit the number of children
when such is desirable, and to spread out their arrival in such a
way as to serve their true interests and those of their home."
As to the prevention of venereal disease, as I have said, what we must
aim at is not merely the prevention of sin, but the prevention of the
poisoning of the sinner; for, if not, we shall have blind babies, invalid
wives, and ruined husbands: broken-hearted and broken-bodied mothers
adding one fragment after another to the Nation's pile of damaged goods.
To the great-hearted public this is becoming intolerable. But they know so
little, and they wait so long for what the wise ones fear to tell. Not all
these fears are sordid; there is a kind and gracious reluctance to shatter
ideals. It is hard at times to combine beauty and duty. The way of the
truth-teller is not made easier by charges of iconoclasm. "To know all is
to forgive all"; that is not paganism but Christianity. So also, "Let him
that is without sin cast the first stone." "To err is human: to forgive
divine." Humanity, wisdom, tolerance, are wrapped up in these sayings. Yet
when we think, as think at times we must, of the romantic faith that once
was ours, contrasted with the realities of present experience, sex seems
to have lost something of its soul of loveliness. And yet--can it ever
regain this till men and women are at least _clean_?
If not--if the immoral man cannot be made better but rather worse, much
worse, by needlessly infecting him with syphilis, then clearly the ideals
of beauty and duty demand that we should apply effective sexual sanitation
to the Nation until such time as we are all, every one of us, free from
venereal disease. That time is not yet--and this is the essence of the
whole problem. But victory is within sight. When it comes--then, and not
till then--sex will regain its soul of loveliness. To this end--
"Let knowledge grow from more to more,
But more of reverence in us dwell,
That mind and soul, according well,
May make one music as before,
But vaster."
_Tennyson._
NOTE.
_The Author will reply personally to any serious question concerning the
subject matter of this book, provided stamped and addressed envelope is
sent to her, c/o the Publishers._
APPENDIX I.
OTHER METHODS OF CONTRACEPTION.
1. _Withdrawal._--Immediately before emission the male organ is quickly
withdrawn, to avoid emission of seminal fluid in the vagina. Many men and
women feel this to be unromantic and nerve-racking, and otherwise
objectionable. The method is quite commonly practised, but it is
unreliable in multiple connections, and where the man has not complete
control over himself. It leaves the woman at the mercy of the man for
protection against impregnation.
2. _Sheath or Condom_ ("French Letter").--This prevents both conception
and infection (excepting in parts not covered by the sheath), but sheaths
are apt to break, and sometimes a man infects himself whilst removing the
sheath. Sheaths impose an impermeable medium between husband and wife,
destroy contact, and may thereby prevent the joy of sexual intercourse. In
some cases both husband and wife become nervous wrecks, recovering their
health when the sheaths are discarded; in other cases it is claimed that
no harm has resulted.
3. _Antiseptic Syringing._--This is generally successful, but not entirely
reliable by itself, because seminal fluid may enter the womb during
connection. This method is unreliable unless applied _immediately_ after
each connection, and syringing at that time is inconvenient and
unromantic.
4. _Douche Can._--This is better than syringing in some ways, because the
irrigation can be so arranged as to let the lotion flow into the vagina
faster than it can flow out--hence distension of walls of vagina and
thorough cleansing. But the arrangement of a runaway for outflowing lotion
is inconvenient in most households.
5. _Quinine Pessaries, etc._--By themselves these are unreliable, no
matter what the makers claim on the label. There is usually not enough
quinine in them; or if there is enough, it proves irritating.
6. _Solid-Ring Check Pessary._--These are reliable only when carefully
adjusted over the mouth of the womb, and many women find it very difficult
to adjust this kind of pessary correctly; hence numbers of failures.
7. _Vaseline and Soap-and-Water._--Using vaseline beforehand, and
urinating and using soap-and-water _immediately_ after _each_ connection,
is a fairly safe way of avoiding conception and infection. But the
vaseline needs to be inserted fairly high up--if possible over the mouth
of the womb, and the subsequent washing needs to be very thoroughly done
(internally and externally). This method is commonly used by Continental
women, but it is not entirely reliable by itself.
8. _Gold Spring Check Pessary._--This is an instrument, the arms of which
spread out inside the womb, and the gold spring keeps the mouth of the
womb open, thus facilitating infection and conception. It is claimed as a
"preventive"; it is really an abortifacient, and cannot be too strongly
condemned, as causing septic miscarriage (authentic records of this are
available). A woman can neither insert nor remove this instrument herself.
9. _Safe Period._--It is often supposed that sexual intercourse midway
between the menses is unlikely to result in pregnancy. There is no such
"safe period."
NOTE.--The method of "self-control" is not referred to here, because one
marital relationship per annum might lead to an annual child. In the
matter of limitation of offspring, therefore, "self-control" has no value.
APPENDIX II.
MEDICAL SUPPLIES.
_Rubber Pessaries._--Medical practitioners can obtain sets of occlusive
rubber pessaries from Messrs. E. Lambert & Son, of 60, Queen's Road,
Dalston, E.8. This firm has been manufacturing such articles in England
since 1888, and now makes them in a wide range of sizes, and of special
shape where required.
_Bidets and Syringes._--Syringes are easily procurable, but bidets in
England at present are sometimes difficult to obtain. Good strong enamel
bidets can be obtained from Messrs. E. Lambert & Son, of 60, Queen's Road,
E.8., and they also keep the contraceptive suppositories made by Mr.
Harman Freese in accordance with medical directions mentioned in Foreword.
_Soluble Suppositories (for women)._--These are now being manufactured by
Mr. Harman Freese, of Freese & Moon, 59, Bermondsey Street, S.E.1, from
whom they can be obtained. These suppositories are disinfective as well as
contraceptive, but they are at present sold for the ordinary purposes of
birth-control.
_Sanitary Tubes (for men)._--These tubes are also manufactured by Mr.
Harman Freese, of Freese & Moon, 59, Bermondsey Street, S.E.1, in
accordance with medical directions mentioned in Foreword. It is quite
possible to manufacture an ointment which, if properly used, would be a
preventive of all forms of venereal disease. The sale of such an ointment
is authorised by the State Health Department of Pennsylvania.
_Information_ as to the medical prevention of venereal disease may be
obtained from the Hon. Sec., Society for the Prevention of Venereal
Diseases, 143, Harley Street, W.1. Information regarding birth-control
has been made available to adults in England for the last half-century by
Dr. Drysdale, Sen., and his family and supporters, through the Malthusian
League, whose present address is 124, Victoria Street, London, S.W.1.,
and these pioneers have made a most self-sacrificing effort for the
benefit of poor women by establishing a welfare centre at 153a, East
Street, Walworth, London, S.E.17, where free advice is given in
birth-control and sexual hygiene, and where medical supplies are available
at nominal prices. This centre is supported entirely by voluntary
subscriptions and at present stands in dire need of financial
help.[T]--E.A.R.
[Footnote T: At my personal request the publishers have agreed to name the
firms and societies mentioned in Appendix II. These notifications are made
gratis for the benefit of the medical profession and the general public,
and not by way of advertisement.--E.A.R.]
NOTE.--Every thoughtful woman is urged to buy and study carefully the
great work entitled: "PREVENTION OF VENEREAL DISEASE," by Sir Archdall
Reid, K.B.E., M.B., C.M., F.R.S.E., with an introductory chapter by Sir
Bryan Donkin, M.D., F.R.C.P., in order that she may understand the nature
of the problems involved and the strength of the opposition to
_cleanliness_.
_This book is endorsed by the Society for the Prevention of Venereal
Disease and contains the evidence and arguments on which the Society bases
its policy, and is addressed to all who would prevent venereal diseases in
themselves or in the community._
Children may be taught any system of morals--sexual or other; Christian,
Mahomedan, Hindoo, Papuan, or other. They are intensely imitative and
acquire a bias towards local ideas of right and wrong through association
with intimate companions. A bias once acquired tends to persist. For that
reason parents choose good companions and schools. On the other hand, it
is difficult or impossible to convert "hardened sinners," for example,
adult non-Christians. Children, therefore, may be really taught; adults,
as a rule, can only be preached at. Any man may test the truth of all this
by examining his own consciousness. Would any amount of preaching cause
him to change his present ideas of right and wrong? As little can he alter
the bias of other men. As the twig is bent so the tree grows.
In various times and places, almost everything from promiscuous sexual
intercourse to absolute abstinence from all intercourse has been held
holy, or permissible, or damnable. Even among Christians the widest
differences have prevailed as regards the local and contemporary tone.
Among them, especially among the English speaking peoples, a convention
forbids the familiar discussion of sexual matters between children and
adults. This convention may be right or wrong. In any case it exists, and
is likely to persist for ages. But a knowledge of sex is traditional among
boys, and to some extent among girls of the school age. For good or evil,
therefore, children are the real teachers of sexual morals in England.
Children deal with the impressionable age and give the early bias. Adults
stand aside, and teach only extreme reticence. The discussions of boys are
often obscene. As a consequence vast numbers grow up with the idea that
unchastity is a gallant adventure, or, at worst, only a peccadillo. Even
in old age such men look back to past intrigues with satisfaction. After
marriage another tradition, or bias, also taught by English boys, comes
into action--the tradition to keep the plighted word, to "play the game."
The great majority of married Englishmen, therefore, are chaste.
Judging from history, the world, and in particular England, is not
more--or less--immoral to-day than at any time during the last 2000 years.
During all that time children have taught and adults have preached.
Doubtless there have been many campaigns of purity in the past--mere
campaigns of preaching to adults. They were ineffectual and are forgotten.
Epochs of licence have almost invariably followed epochs of austerity.
Modern campaigns of purity never arise except as consequents on medical
attempts to prevent venereal disease, and always cease when the attempt to
procure sanitation has ceased. In effect, they have been merely campaigns
to secure the poisoning of sinners and their victims.
The extent of current immorality may be judged from the prevalence of
venereal disease. The Royal Commission of 1913-16 found that ten per cent.
of the urban population suffered from syphilis. Eighty per cent. of the
population of the United Kingdom is now urban, and gonorrhoea is six or
seven times as prevalent as syphilis. It follows that at least every other
person in the Kingdom has suffered from venereal disease. Probably not a
family has escaped infection. In proportion to its prevalence syphilis is
not very deadly, yet it has been reckoned as the fourth killing disease.
The victims of gonorrhoea are incalculable. Venereal diseases fill our
hospitals, asylums, and workhouses. They are the principal causes of heart
disease, apoplexy, paralysis, insanity, blindness in children, and of that
life of sterility and pain to which so many women are condemned. It is
said that chastity is the only real safeguard against venereal disease.
But this is always said by people who have never stirred a finger to teach
chastity, but who have only preached it. At any time there are at least a
million of perfectly innocent sufferers, principally women and children,
in the United Kingdom.
During the war a disloyal faction in every Dominion endeavoured to prevent
the sending of help to the Mother Country. A principal cry of this faction
was, "Do not let us send our clean lads to that cesspool, England."
England is more than the world-cesspool. Since Englishmen are the greatest
travellers, she has been the principal source of infection for the world.
At one time during the war the Australasian Governments threatened to
withdraw their forces unless measures were taken to protect them.