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LAWS AND LAW ENFORCEMENT

This remodeled law not only attempts to reach all promiscuous sex delinquents, but renders more serviceable the legal weapons against the third parties to prostitution. Furthermore, it eliminates fines and provides for indeterminate sentences of such minimum length as to afford opportunity for rehabilitation. For its further effectiveness, state reformatories for women, prison farms for men, training schools for boys and girls, and colonies for the custodial care of the feeble-minded sex delinquents are necessary

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LAW ENFORCEMENT CHECKS THE SPREAD OF VENEREAL DISEASES

This chart illustrates an almost complete reduction, mainly by means of law enforcement, of the infection rates for venereal diseases in a military force averaging about 12,000 men, stationed on the Canal Zone, Panama, from 1913 to 1918.

institutions and should be included in every state's legislative campaign. Detention houses, probation officers, and policewomen are other agencies that are valuable in preventing sexual offenses."

Progressive lawmakers can be depended on to provide equal justice for citizens of both sexes and facilities for the care and rehabilitation of those who require these remedial aids.

are: Connecticut, Delaware, Maine, Maryland, New Hampshire, North Carolina, North Dakota, Ohio, Rhode Island, Vermont, and Wisconsin. New York and Virginia have adopted parts of this law.

7 Detailed suggestions as to states needing these and other laws may be found on pp. 51-53.

MEDICAL METHODS FOR COMBATING VENEREAL DISEASES

Few, if any, diseases are more completely understood by science than are the venereal diseases. Much of the knowledge necessary to eliminate them is available. Yet they are notoriously uncontrolled. In fact, Sir William Osler ranked syphilis as "the greatest killing disease," while gonorrhea is generally calculated to be from three to five times as prevalent as syphilis.

The tremendous loss in dollars and cents caused by this group of diseases is being recognized as never before by employers of labor. The cost to industry in loss of time and decreased production due to syphilis and gonorrhea is estimated at many millions of dollars per year.

The time lost during the year 1918 by officers and enlisted men in army service on account of venereal diseases amounted to 3,937,710 days. In other words, an average of 10,788 men and officers were absent from duty each day of the year on account of this class of diseases.9

The task of curing venereal diseases is, of course, one to be performed by the physicians of the community. It cannot be done by laymen, but the latter can give the doctors their unstinted support. The public must show that it wants the job done and is willing to support the measures needed to do it.10

The first essential from a medical point of view is that prompt and scientific diagnosis and treatment be made available to every infected person. Efficient clinics providing free, part-pay, and pay treatment must be maintained. Hospitals and doctors, instead of turning away cases of gonorrhea and syphilis as they have done in the past, should provide treatment for them just as they do for others of an infectious nature. It is essential also that the price of treatment be brought within the reach of every person. This can be effected either by the state's manufacturing the curative preparations, particularly arsphenamine, or buying them in wholesale

8 See "Cost to Employer and Employee,” p. 36.

9 See "Venereal Diseases in the Army," p. 32.

10 See Standard Form of Law No. 4, p. 63. All states except Rhode Island, Pennsylvania, Nevada, and Idaho now require venereal diseases to be reported; Idaho, Massachusetts, and Nevada are the only states which do not have statutes providing for the compulsory examination and detention of persons reasonably suspected of being venereal-disease carriers.

MEDICAL METHODS

quantities and distributing them free or at cost to reliable physicians and clinics. The value of this procedure was proved in dealing with diphtheria. Not until diphtheria antitoxin was provided by the state, so that its prompt use and reduced price was in reach of every one, did this disease cease taking its toll of thousands of lives annually.

Another point to be emphasized is the need for suppressing the sale of "patent" or proprietary remedies for venereal diseases, except on a physician's prescription. There are laws or regulations of the state board of health forbidding this in seventeen states.11 The practice of self-medication is probably nowhere as dangerous as in the treatment of syphilis and gonorrhea. Unrelenting warfare must be made on unscrupulous doctors, "medical institutes,” museums of anatomy, advertising specialists, and all forms of quackery which attempts to capitalize the credulity of their patients. The law forbids quack advertising in twenty-three states.11 Thousands of unfortunate men and women contribute millions of dollars annually to the incomes of advertising doctors, in return for which they often receive inadequate and unscientific

treatment.

In order to control venereal diseases it is essential that the public be taught the truth concerning them. All should know of their dire results if permitted to spread unchecked. All should realize that "Keep well" beats "Get well." It is of equal or greater importance, however, that practicing physicians know the best technique for diagnosing and treating these diseases and have facilities for actually giving the treatment. To the majority of physicians these are not readily accessible, but as several states have already demonstrated, this information can be taken to the physicians by means of lectures, motion pictures, and clinics. These, as well as treatment facilities, can be provided at comparatively small expense to the state. These features of educational health work can be effectively carried on by the bureaus of venereal diseases of the state boards of health.

It is a duty of scientific government to control widespread endemic diseases. In the performance of this duty a state is justified in spending a sum of money equal to the amount lost through the ravages of these diseases on its citizens, if capable of wise

11 See folded charts containing Tabular Analysis of Social Hygiene Legislation, facing pp. 40, 42, and 44.

MEDICAL METHODS

expenditure in any given period. It is true economy for every commonwealth to support liberally the measures needed by its health authorities to bring venereal diseases under permanent control. A reasonable investment for these public-health necessities will pay dividends forever.

Legislation designed for the protection of the marriage relation is commanding increasing attention, especially in view of the need for a uniform marriage law in all states. Among the most important proposals are the abolition of common-law marriages, the publication of banns, and the physical and mental examinations of both parties to determine their general fitness. Some just measure in the interest of children born out of wedlock is also being sought.'

12

12 A medical certificate of freedom from venereal disease, on the part of the male applicant for license, is required in Alabama, North Dakota, Oregon, and Wisconsin.

In New York a statement is made by both applicants under oath, that they are free from venereal disease, and in Pennsylvania, that they are free from any communicable disease.

In Washington the male applicant for a license is required to make oath before the marriage license clerk that he is free from venereal disease and tuberculosis.

In Indiana, Michigan, New Jersey, Vermont, and Oklahoma, it is a misdemeanor for persons having a venereal disease to marry.

In Maine it is a misdemeanor for persons suffering with syphilis to marry. Utah provides that marriages between persons afflicted with venereal diseases shall be void.

In Virginia the law provides that in case the woman is under the age of forty-five, the man must take oath that he is free from any contagious venereal disease and he may also make affidavit that he believes the woman named in the license is free therefrom.

See American Marriage Laws in their Social Aspects, published by the Russell Sage Foundation, 130 East 22d Street, New York City.

PROTECTIVE SOCIAL MEASURES

In none of society's problems has the value of prevention as against the cost of cure been so clearly demonstrated as in the work of preventing girls and boys from becoming recruits for the underworld. In the past it has been the policy of states and communities to pay little or no attention to their morally endangered and waywardly inclined youths until they became harmful to society and "repeaters” in the courts. Now it is known to be the more effective, cheaper, and wiser plan to provide measures of protection and prevention.

In the light of present-day knowledge concerning the prevention of delinquency and concerning reformative treatment, each state is called upon to adopt a rational program for safeguarding its youth and reclaiming its unfortunates. Particularly is this imperative in any state's campaign for the repression of prostitution and the control of venereal diseases. The attack on the business of prostitution through a policy of strict and persistent law enforcement and adequate facilities for medical treatment should be supplemented by institutional care for those apprehended as prostitutes, and protective care for those who would become prostitutes if left to their own devices.

Prostitutes are human beings and must be dealt with intelligently. When they are arrested and deprived of earning a livelihood by possibly the only means they know, they must be taught ways of earning an honest living. Because of the nature of their occupation, nearly all prostitutes need medical treatment for venereal diseases and opportunities for restoration to normal health. (Examination of thousands of apprehended prostitutes in the United States during the past few years has shown that, without much difference due to color or social status, from 60% to 95% are infected with gonorrhea or syphilis or both.)

All prostitutes and wayward girls are not of one class. Some are first offenders, or are arrested before their first grave offence is committed. Some are hardened and vicious. Proper treatment for one type would not be proper treatment for another type. Long confinement may be necessary for incorrigibles, while young girls need to be given scholastic, ethical, and vocational training and opportunity to have another chance in life. Hence the need for adequate rehabilitation measures, which should include the passage

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