The Pamphlet Collection of Sir Robert Stout: Volume 3
Summary of the Effects of Contagious Disease
Summary of the Effects of Contagious Disease.
Doubts have recently been expressed as to the magnitude of the evil occasioned by venereal disease, it being imagined by some that not only is the disease comparatively infrequent but productive of mere ephemeral mischief; it has moreover been hinted by the medical officer of the Privy Council, and asserted m the protest issued by the Ladies' Association that the object of those who advocate the extension of the Contagious Diseases Acts to the civil population is simply to enable men to indulge their sexual passions with impunity.
In consequence of these grave misconceptions it seems necessary to say a few words as to the extent, the rigour, and the insidious character of the venereal disease, also as to the mortality occasioned by it.
As to the Extent
.—In my treatise on syphilis I have shown that in our leading public hospitals in London, one-half or fifty per cent of the surgical outpatients came there in consequence of being affected with venereal diseases, page 52. * I have proved that at the time my statistics were taken at St. Bartholomew's Hospital, about one in every five surgical out-patients was a woman or child, Loc. Cit. p.54. Before the Contagious Diseases Act was put in force in the British Army, 325per l000 soldiers were annually affected with venereal disease, † Loc. Cit. p.8. At page (S3, evidence is given that 35 per cent, per annum of sailors were rendered unfit for service by this scourge of our seaport towns. ‡ I have also shown that* Captain Harris has kindly placed the following data at my disposal, which are even more alarming than those referred to by Dr. Stewart with reference to Greenwich, see p. 28. They are most valuable as showing the amount of disease discovered in the newly protected districts immediately on their being brought within the provisions of the act, and as furnishing us with authentic evidence of the enormous amount of disease that must be existing in all the unprotected districts, i.e. throughout by far the greater part of the United Kingdom.
"The first 250 women brought up for examination in the Plymouth district were found to be diseased without a single exception."
"Return of the number of women examined in the Winchester District since the acts came into operation there (Thursday, Jan. 6 to Feb. 1, 1870), shewing the number found diseased, number free, and also the nature of the diseases, whether syphilis or gonorrhœa. Number examined, 76. Number found diseased, 50. Number found free 20. Nature of disease: syphilis, 28; gonorrhœa, 28."
† It is instructive to compare these returns with those showing the freedom from venereal disease among soldiers in foreign armies. "In Paris 40 per 1000 men only were affected with venereal disease in the garrison of Paris in the years 1858 to 1880."— Acton on Prostitution, p. 125. "At Brussels when I visited that city, only 1 men were laid up out of a garrison of 3500 soldiers."— Loc. Cit., p. 131. "In the Prussian army the proportion of venereal was 62 per 1000."— Loc. Cit., p. 143.
‡ During the discussion which followed the reading of this paper, Dr. Kidd, Staff-Surgeon of the Army Medical Service, said the last report of the Army Medical Department was for 18G7, and was published in September. The returns for the United Kingdom show that from 1860 to 1866, even before the application of the Contagious Diseases Act, there had been a progressive decrease in the cases of venereal diseases. In 1860 the proportion of admissions per 1000 of the strength was 369, in 1866 it was 258. In 1860 the proportion constantly sick from venereal disease was 23-69 per 1000, in 1866 16.19 per thousand. In 1867 an increase had occurred. The proportion of admissions was 291 and of constantly sick 17-13. Dr. Kidd quoted statistics from Dr. Parke's work on hygiene as to the relative number of soldiers attacked with primary venereal sores in 1868, at "protected" and at "unprotected" stations "In the protected stations, the number attacked in 1868 is not only below the mean in the previous four years in every station, but is, in every case, lower than the minimum of any former year, whereas, in two out of the four non-protected stations, the number of attacks in 1868 is above the mean of the previous four years; in one station is only-just below, and in only one station is lower in 1868 than in any of the preceding years. The mean number of attacks in the five protected stations in 1864 was 108-98, and in 1868 was 67-63. In the four unprotected stations the corresponding numbers were 115-13 and 101-08." "On the whole, considering how imperfectly, and for how short a time, the Act has been applied, I think there is every reason to hope that the lessening of syphilis at all the protected stations in 1868 (though it is inconsiderable in the ease of Aldershot) is really owing; to the influence of the Act." Dr. Kidd thought the recruiting returns would furnish some means of comparing the civil population with the army in respect to the prevalence of venereal diseases. The returns from 1860 to 1866 showed that the proportion of recruits rejected for venereal diseases was about 16 per 1000 annually, or very nearly the same as the proportion of soldiers constantly sick from the same causes during the last few years. While, however, there has been a marked diminution in the number of soldiers constantly sick, there has been no corresponding diminution in the proportion of rejected recruits for venereal diseases."
II.— As to The Rigour.—There is no doubt that the disease, though quite as frequent, is less virulent now than it was a few years ago. The decrease in its virulence is attributable, of course, to the improved method of treatment, to the altered and more regular habit of living, and better hygienic conditions of the population, and shows how much may be done in the way of mitigating the syphilitic poison, where the opportunity of exercising his skill is afforded to the medical man. This decrease of the activity of the disease seems to me a strong reason for giving to the profession increased facilities for dealing with it. It must not be imagined that because the poison is now followed by by less serious consequences than formerly, that the mischief produced by syphilis is not of very great magnitude; it is true that, if taken in time, and if the patient have a strong constitution, permanently injurious results are generally avoided; but wherever these conditions are not fulfilled—and, in many cases, even, where they are—broken constitutions and a poisoned state of the blood, which make the procreation of healthy offspring a physical impossibility, are the results.
The Insidious Nature of the Disease
.—I will now say a few words on the insidious nature of syphilis. It is generally assumed that the sufferer from syphilis is necessarily an immoral person. This is a great mistake; the disease doubtless comes in every case primarily from an immoral source-In the present day it never arises spontaneously, it does not follow, however, that the individual sufferer is the guilty party. For instance, the drunken husband, waylaid in his cups by the harlot, contracts the disease syphilis. Would that the complaint stopped here! We have the innocent mother becoming infected, and the babe that she conceives inherits the taint, which it may communicate to a stranger suckling it—who, again, may contaminate her own child, and the chain of contagion may thus be indefinitely lengthened out. Again, in the case of a trade, such as glass-blowing, a diseased man * may communicate his complaint to any of his fellow workmen who may use the same mouthpiece with himself, and they, of course, in their turn infect their wives. Cases, moreover, like the following are far from uncommon. A single man consorts with prostitutes, and, as a consequence, becomes* For many years the medical school in which I was educated in Paris was reluctant to admit that contamination could be spread in these ways. Private practice during the last thirty years, and the facilities for accurate observation among the middle and upper classes of society, now enable me to assert that syphilis may be thus communicated. In making this statement, let me not be understood as admitting that all the published cases of asserted contagion by spoons, drinking-cups, or other vehicles, are true. The medical man has many appeals made on his credulity, and experience can alone sift the true from the false evidence.
IV.— Mortality Arising from Syphilis.—The weekly average of deaths from syphilis in London, within the last ten years, (1860-9 inclusive) varies from 4.9 to 9.0.
The Registrar-General has kindly supplied me with the following most important tables, showing the mortality arising from syphilis, and my readers will not fail to remark the appalling but incontrovertible fact that the greatest mortality exists among infants under 1 year of age. What a sad commentary do they furnish on Scripture, "visiting the iniquity of the fathers upon the children."
Years. | Deaths Registered. | Temperature. |
1858 | 263 | 49.2° |
1859 | 288 | 50.7° |
1860 | 256 | 47.0° |
1861 | 327 | 49.4° |
1862 | 282 | 49.5° |
1863 | 335 | 50.3° |
1864 | 356 | 48.5° |
1865 | 369 | 50.3° |
1866 | 408 | 49.8° |
1867 | 423 | 48.6° |
1868 | 473 | 51.6° |
1869 | 466 | 49.5° |
Mean of the 12 years, 1858-69 | 354 | 49.5° |
Ages. | England and Wales. | London. |
Under I year | 1,364 | 361 |
1 and under 2 years | 82 | 21 |
2 and under 3 years | 19 | 2 |
3 and under 4 years | 6 | 2 |
4 and under 5 years | 1 | — |
Total under 5 years | 1,472 | 386 |
I think I have now disposed of the notion suggested by the medical officer of the Privy Council "that very exaggerated opinions are current as to the diffusion and malignity of contagious diseases (p. 13), and have shown conclusively that syphilis is an evil too great to be left to work its fatal course unchecked, and may now proceed to indicate the means by which it can be most efficiently contended with.