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.
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 gonorrhœa 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 gonorrhœa 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.
When the German offensive was impending a sanitary method was published, so effective that the venereal rate was reduced from 92 to 15 per thousand per annum. The Government proposed to bring the method into general use in the Army, but was prevented by influences which preferred to see the country poisoned and the British Army defeated. While the opponents of sanitation sat snugly at home hundreds of thousands of British soldiers were killed or maimed, enormous material was lost with territory which other hundreds of thousands of brave men had died to win, the war was prolonged, thousands of millions were added to the National Debt, and half trained boys and elderly fathers of families were hurried into the firing line. At that time there were in hospitals or in depots, convalescent from venereal disease, enough fully-trained allied soldiers to furnish, not an army corps but a great army, complete almost from G.O.C. to trumpeter.
Fear of disease does not prevent immorality, as may be judged from the immense prevalence of venereal disorders. But it does drive baser characters to the pursuit and seduction of “decent” girls. In this way nearly all prostitutes begin their careers. Prostitutes are much more diseased than other women, who, though often diseased, are seldom suspected of disease. Yet, since it has been found statistically that three out of four men acquire their maladies from amateurs, it is manifest that prostitutes only hang on the fringe of a vaster immorality. Men, who know more of these diseases than women, are, on the average, much less chaste. Medical students who know most are not more moral than other men. Plainly venereal diseases are causes, not preventives, of immorality. Nothing, therefore, is gained from their prevalence except a flood of death, disability, and misery, which falls alike on the just and unjust.
During the war Sir Archdall Reid, employing very simple means, reduced the incidence of disease among the large body of troops in his charge almost to the vanishing point. He could not make them more moral, he did not make them less moral, but at any rate he preserved their services for the country in its hour of need. And he preserved their future wives and children from unmerited death and suffering. Other doctors were equally successful. The town authorities of Portsmouth and many other boroughs are about to employ these methods for the prevention of disease among the civil population. This book describes them and tells the story of the fight against a wicked and cruel fanaticism. Its policy is endorsed by many of the leading men and women in the Kingdom—members of both Houses of Parliament, town authorities, doctors, authors, sociologists and others.
PREVENTION OF VENEREAL DISEASE
By Sir ARCHDALL REID, K.B.E., M.B. With an Introduction
by Sir BRYAN DONKIN, M.D.
Crown 8vo, 15s. net.
SEX-PROBLEMS IN WOMEN
By A.C. MAGIAN, M.D. Demy 8vo, 12s. 6d. net.
THE SEXUAL QUESTION
A Scientific, Psychological and Sociological Study. By
Dr. AUGUST FOREL. Royal 8vo, 25s. net.
THE SEXUAL LIFE OF OUR TIME
In its Relation to Modern Civilization. By IWAN BLOCH,
M.D. Medium 8vo, 25s. net.
Sold only to the Medical and Legal Professions.
THE SEXUAL LIFE OF WOMAN
A Physiological, Pathological and Hygienic Study. By
Professor HEINRICH KISCH. Super royal, 25s. net.
Sold only to the Medical and Legal Professions.
PSYCHOPATHIA SEXUALIS
With special reference to Antipathic Sexual Instinct. A
Medico-forensic study by the late Dr. R. VON KRAFFT
EBING. Royal 8vo, 25s. net.
Sold only to the Medical and Legal Professions.
WILLIAM HEINEMANN (Medical Books) Ltd.,
20, BEDFORD STREET, LONDON, W.C.2.
“Speaking in regard to licensed houses, Captain Walker said that he had not found one case of venereal disease contracted in a licensed house in the City of Paris, and he could only suppose that the people who were responsible for putting the licensed houses in Paris out of bounds knew nothing at all about the real facts of the case.... In the licensed houses in the City of Paris, during the year 1917, only five cases of venereal disease were contracted; and in 1918, up to April 20th (the day he was speaking), there had not been one case of venereal disease contracted in a licensed house in the City of Paris. But out of 200 women arrested on the streets of Paris during the month of April, over twenty-five per cent. were found to be infected with venereal disease. In the months of November and December, 1917, the French authorities had made a round-up on one boulevard of seventy-one women, of whom fifty-five were infected with venereal disease; a few days later the French authorities repeated the same procedure on another boulevard; something like one hundred women were arrested, and ninety-one per cent. were infected with venereal disease.”—p. 134, Public Health (England), September, 1918.
I supervised a tolerated house in Paris for over twelve months (1918-1919), and had no cases of disease either among the women or the men. The women attended from 2 p.m. to midnight and resided in their own homes.—E.A.R.
The successful results of the Port Said efforts are quoted in full by Colonel Sir James Barrett in his book, “A Vision of the Possible” (Lewis), and Colonel Barrett had early in 1917 sent me to London the following tremendously valuable letter of advice and warning:—
“I suppose my instinct is rather more in the moral direction than many people, but I recognise, as you will see from these articles (published by Lancet), that it is by direct prophylaxis, and direct prophylaxis alone that we are likely to get rid of this abomination. I should never in any campaign exclude all the additional aids—proper soldiers’ clubs, such as I have established in Egypt, the influence of decent women, and the one hundred and one factors that go to make a decent and reputable life; but you have, in the long run, to recognise the fact that a percentage of men are certain to seek women who are prepared to cater for them. If the steps indicated are taken, the proof is absolute that the disease can be practically extirpated and without great difficulty. The failure of prophylaxis depends on two factors—firstly, it requires someone charged with responsibility, earnestness and high character to explain to men precisely what they are doing and what it means; and secondly, prophylaxis is of very little use to drunken men. My experience has been that when these precautions are properly used venereal disease may disappear.”
That proved to be exactly my own experience in the army. Failures in the army were due to the absence of proper personal instruction of the men and the laxity of control, and these conditions can always be assumed to exist in any army having a high v.d. infection rate.—E.A.R.
Notes
A Marriage, whether early or late, cannot of course benefit and elevate society until the present mischievous and archaic Divorce Laws are simplified and reformed in accordance with modern sociology and ethics. Unhappy and unsuitable marriages necessarily foster immorality and promote disease, and the community as a whole gains by their being dissolved in a ready but responsible and dignified manner. The refusal of the Church to marry diseased persons would greatly benefit the nation, whereas its refusal to marry healthy divorced persons not only injures the nation but dishonours the Church.—E.A.R.
B Diseased women will continue to cater for men so long as they are left free to do so, but as knowledge grows their clients will tend to be limited to diseased men. Once men clearly understand that every casual connection is a risk of disease, they will certainly tend to run fewer risks.—E.A.R.
C My own experience among the troops quite convinced me that the more thoroughly and carefully self-disinfection was taught, the less immorality there was. It was impossible to teach self-disinfection properly without at the same time instilling a living sense of danger into the minds of men and women; and this danger-sense certainly led to more self-restraint.—E.A.R.
D The present need of the white race is to increase its numbers of fit and decrease its numbers of unfit. Over-population (except in a few patches of the Old World) is not likely to be a problem for the white race for centuries. They have several continents practically empty and undeveloped, and science has as yet touched only the fringe of the possible productivity of the earth in the matter of food supplies. The worst feature of the British Empire is that there are too many Englishmen and not enough Anzacs.—E.A.R.
E The devastation of these diseases among the British armies abroad (in the Rhine, Black Sea, and Palestine areas, etc.) has been much worse since the Armistice than during the war. Approximately one-fourth (sometimes one-half) of these armies become infected with venereal disease every year. From 1919 to 1921 somewhat soothing statistics were issued for the army of the Rhine, but these have now been admitted in Parliament to be “quite unreliable” (Parliamentary Debates, House of Commons, November 3rd, 1921, p. 1952). It must be remembered that, owing to the exchange value of the £, the English soldier on the Rhine is now being paid about £8 or £10 per day; that is, he draws a far higher salary than the highest paid German official; hence there is no riotous pleasure, however expensive and extravagant, which he cannot afford. These conditions do not promote manly virtue or even sexual cleanliness.—E.A.R
F It would be much less untrue to say that the remedy for the venereal problem is clean women.—E.A.R.
G Judging by certain original letters (dated December, 1888, to November, 1892), which I have seen myself, by the courtesy of Messrs. E. Lambert & Son, of 60, Queen’s Road, Dalston, London, E.8, the rubber spring pessary was first suggested here by an English doctor, and manufactured for him by Mr. E. Lambert Sen. Under date December 23rd, 1888, the doctor wrote:—
“I think highly of the watch-spring rim. There will be very little fear of conception with one of these new pessaries properly adjusted, as the rim will press equally all round. The inflated pessary would be the most perfect, however, if you could only contrive some method to prevent escape of air and consequent flattening. Such a pessary would be most comfortable.”
H The chief pioneers in teaching Birth-Control in England were Mrs. Annie Besant, Mr. Charles Bradlaugh, and Dr. Drysdale, Senior.
I The following is taken from a paper read by Captain H.L. Walker, Canadian Medical Service, O.C. Report Centre (British), Paris, at Conference on V.D., organised by the American Red Cross in April, 1918:—
J Among the first medical men in Great Britain to recognise the importance and effectiveness of self-disinfection was Mr. Frank Kidd, M.A., M.Ch. (Camb.), F.R.C.S. (Eng.), etc., of the London Hospital. A full statement of his evidence before the Royal Commission on Venereal Diseases is given in Mr. Kidd’s book, “Common Diseases of the Male Urethra” (published by Longmans, Green and Co., 39, Paternoster Row, London, etc., in 1917). The diagram of male organs of generation I have used on page 36 was taken in outline from Mr. Kidd’s frontispiece, and during the war I found all the illustrations he gave most helpful with the soldiers, although the book itself was written for the purpose of enabling doctors in outlying districts to treat patients on modern lines with success. Mr. Kidd designed prophylactic tubes, which have been sold in England on his order for more than fifteen years. He tells me they have been used all over the world by his patients, and that as far as he can ascertain “they have never failed, when used properly and intelligently.”—E.A.R.
K Since this was written, a large number of experiments have been made with the single treatment tube, containing an ointment destructive of all forms of venereal disease microbes, whether used before or after connection. The Pennsylvania Department of Health is within measurable distance of finding a solution of this problem—the production of a cheap, portable, easily applied and thoroughly efficient self-disinfecting ointment.—E.A.R.
L In 1915-1916 Colonel Sir James Barrett, then A.D.M.S. of the Australian Force in Egypt, had successfully applied prophylaxis, but unfortunately he was invalided for a time to England in November, 1916, and with the evacuation of the Dardanelles there was a severe outbreak of v.d. in Egypt. Prophylaxis was then steadily applied during 1917 by Colonel Sir James Barrett and others, and at the end of 1917 v.d. had been reduced to small proportions. In December, 1917, Colonel P.G. Elgood, Base Commandant of Port Said, wrote:—
“Fortunately, however, at this stage, I came into contact with Colonel Sir James Barrett, K.B.E., R.A.M.C, and Miss E. Rout, New Zealand Volunteer Sisterhood. The first suggested that the solution of the problem would not be found in police measures or in medical examination, but in prophylaxis; while the second, in correspondence relating to her own experiences gained in England, encouraged me to advocate this remedy.”
M The New Zealand Times daily newspaper published my first article and was severely reprimanded by the New Zealand Government for doing so, and all New Zealand newspapers were then prohibited from publishing any further articles relating to V.D. in the New Zealand Forces.—E.A.R.
N See Publishers’ notice, p. 75.
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.
P Chinesol (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.
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.
R The argument that compulsory treatment would “drive the disease underground” is absurd. Venereal disease is underground now.—E.A.R.
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.
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.