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The Pamphlet Collection of Sir Robert Stout: Volume 3

Objections Against Instrumental Examination

Objections Against Instrumental Examination.

Dr. Taylor alleges that disease is communicated by the speculum. This is a question of fact. I may observe, that Dr. Taylor has given no instance that has come under his own knowledge. During the last thirty years I have had some personal experience, and I fearlessly assert that if ordinary and proper precautions be taken, no qualified medical man will thus spread contagion.*

* In the discussion which followed the reading of this paper, the possibility of spreading contagion by means of the instrument was denied/ Dr. Stuart, the examining surgeon at Woolwich, stated "that he had examined thousands, and he had never known a case of any woman accusing him of having contaminated her with the speculum. Dr. Letheby, the Medical Officer of Health for the city of London, and Professor of Chemistry in the College of the London Hospital, said in reply to the above hypothetical statement, "that he did not believe it to be true—that one drop of pus would communicate infectious properties to a pint of water; for, according to his experience, hardly anything was so powerful as water in destroying the contagium of pus, and such like cell structures which exist naturally in a dense albuminous liquid, for the water quickly enters them by endosmose and destroys their vitality by overdistention, or even by bursting them. But even if it were true, it is not of any serious importance, seeing how easy it is to destroy the contagious matter by immersing the speculum for a minute or two in boiling water, which might be always at hand in a vessel with a small gas jet under it. Another vessel of cold water might be used to cool the speculum, and thus with a couple of instruments, the examining surges might continue his examinations with absolute safety, and without unnecessary delay."

page 25

I have personally seen all the classes of registered and unregistered filles clandestines and public women examined in Paris on several occasions, and I may refer the sceptical to page 119 of my last edition on Prostitution, where I state that I recently assisted at the examination of at least fifty registered prostitutes, brought promiscuously from different parts of Paris, and not a single one was found diseased—this arising from the efficiency of the police regulations in that city; similar visits have corroborated these views. How contagion can be spread where precautions are taken to cleanse the instruments, I am at a loss to conceive.

The officers of the different Lock Hospitals will, I am sure, bear me out in saying that contagion ought not to, and, in fact, does not take place in this manner. Dr. Taylor further objects that in a large proportion of cases it is impossible to say with certainty whether a woman is diseased or not. This, again, is a question of fact. If this assertion proves anything, it shows only that incompetent men must not be appointed to these responsible situations. I think men conversant with the subject will agree with me that if a woman presents to the practised eye no recognizable traces of disease, the instances are rare indeed in which she will prove a source of contagion.

Another statement in the above-quoted pamphlet, which will not bear investigation, is one made at p. 11:—

"That the Rev. Dr. Hooppell, Principal of the Marine College at South Shields, proved by the tables given in the Parliamentary reports that contagious diseases have increased at every station where this Act had been applied."

It is worthy of remark that Dr. Taylor does not page 26 assert that be believes in these statistics, or has authenticated them, but quotes a clergyman, who believes he has proved by tables—which he gives us no means of referring to—that disease had increased;* if this is not disingenuous conduct, I know not what is. I take upon myself to deny in toto the assertion, and my medical opponent ought, I think, to have discovered that he was misquoting the Parliamentary reports.

All the evidence I have read contradicts this statement of the Reverend observer, as all the figures prove that the disease is, on the contrary, rapidly diminishing. I may subjoin the following, winch I have already published (page 243) in my work on Prostitution.—

"The real fact is, that it is precisely these forms of disease in which society is most interested—namely, syphilis—which have been most beneficially influenced by the system of inspection now in practice, and that it is on the slighter and less important forms that the least impression has been made. 'The percentage of syphilis has steadily diminished. In the first period the proportion of syphilitic cases was 57-45. The percentage of syphilis decreased gradually during the succeeding periods, till it reached the number of 17-72 per cent, in the half-year ending March 31, 1869—Letter of the Devonport Surgeons to the Lords of the Admiralty, p. 9.

"In the London Lock Hospital, Mr. Lane reports that in 1867 42 per cent, and in 1868 only 35 per cent, of the prostitutes admitted laboured under syphilis, thus showing that the working of the Contagious Diseases Act has very considerably diminished the syphilitic average."

Those who maintain that the Contagious Diseases Act has not been attended with satisfactory results, forget to state that many of the soldiers said to be diseased, and

* Since the discussion took place on my paper I have been at some trouble to discover where this Reverend gentleman could have obtained his information, as the latest official returns of the army only come down to 1867, although published in 1860. I obtained my latest statistics from the valuable treatise of Dr. Parks on Hygiene, prepared especially for the army. At page 503, that accurate observer remarks—"Taking all the stations, namely, Aldershot, Chatham, Plymouth, Devonport, Portsmouth and Woolwich, the mean admissions for Syphilis were, in the year 1867, 84.98 per 1000 men, and in the year 1868, 65.95 per 1000 men. It seems therefore clear that a good effect has been produced, and I think in the stations where it would have been anticipated."

page 27 who swell the statistics, are merely instances of relapse, and in other cases the diseases from which they suffer have been contracted beyond the protected district.

The Westminster Review, one of our most logical and powerful opponents, objects that the English Contagious Diseases Act confounds all prostitutes of every grade into one indistinguishable crowd of common prostitutes, and forces all the prostitutes to become inhabitants of brothels, in order that the hold upon them may be more secure.

The answer I have to make to this objection is, that the Contagious Diseases Act, as at present carried out at Aldershot and Woolwich, has no such tendency as this. Those who will read my description of these garrison towns, will see that the brothel proper is a house almost unknown in London! and in the above-named garrison towns the women live in lodgings, for which they pay a rent like any other lodger. My object—as the following extract from a letter I have recently written will show—is to abolish the brothel proper.

"I have so recently pointed out the objections to tolerated brothels in London, particularly if modelled on the French system, that I will not now repeat my objections to them. I may, however, remind ray readers that a brothel (proper) is a house almost unknown in London, the police returns only giving two for the whole metropolis, thus showing that the institution is alien to English feelings. In any future legislation, therefore, society must consider how we are to deal with clandestine prostitutes—that is, girls living in their own lodgings—as no one desires to introduce the French system or allow man or woman to profit by the prostitution of another. A further fundamental difference between the present system in France and that which I desire to sec introduced into England is that, whereas in France it is the object of the police to register and confine in a brothel every woman gaining her livelihood by prostitution, all that is proposed for England is to give authority to medical men by the Contagious Diseases Act to examine periodically all women who are known to be common prostitutes, and, if they find that they are diseased, to confine them in hospital as long as they are capable of communicating venereal complaints to those who may have relations with them. This interference with the liberty of the subject in England seems necessary, not only for the prevention of disease page 28 in the soldier or civilian, but even for the sake of the woman herself, who will in a few years give up a life of profligacy, and gain her livelihood by some other means.

"The English plan will not use up the prostitute, as must necessarily be the case if she enters a brothel; for, as I have shown elsewhere, girls once inmates of these dens of iniquity in Paris gradually descend from a higher to a lower grade of house, until they are useless for even the vilest of them. Under the foreign system there is no hope for the amelioration of the prostitute, we in England profess to believe that we can assist the girl in redeeming her position at the same time that we do so on purely sanitary grounds, without legalising vice."—Medical Times, January 15th, 1870.

As our opponents reiterate in different forms these assertions, I think I cannot give the reader too many authentic statements proving the contrary.*

* Dr. Stuart in the discussion before the Association of Medical Officers of Health of the Metropolis, said "that in the inspected districts, the proportion of disease found was less than one in ten, and of a very mild character, while in the new district of Greenwich the cases of disease bore a proportion of from one-third to one-half of the women examined, one-third of these being cases of syphilis, mostly of a severe character, and many evidently of long standing."

Mr. Lane, Assistant Surgeon Grenadier Guards, writes to the Lancet on January 8th, 1870, and says, "I send you a few facts which may prove not only interesting, but instructive, as to its efficient working in one of our garrison towns. The battalion to which I belong left London for Windsor on the 1st of March, 1869, and as the Contagious Diseases Act was in force in that town, the men were carefully examined immediately after their arrival, and those found affected were sent to hospital for treatment. The admissions for venereal during the first four months of our stay were only of; nearly all the cases were of a mild form, and readily amenable to simple treatment. Upon the 1st of September the battalion re-turned to town, and was quartered at Chelsea barracks; the number under treatment was then only 7. From that date to the present, venereal disease has been greatly on the increase; as many as 108 cases have been admitted into hospital during the last four months,

"Admissions for Venereal Diseases.
Windosor.
March 11
April 6
May 6
June 7
Total 30
London.
September 17
October 29
November 23
December 30
Total 108

"I may add that formerly, before the Contagious Diseases Act was put in force at Windsor, the number of cases admitted, and the severity of the disease, were greater at that station than at any other."