Some of Hinton's views were set forth by a writer intimately acquainted with him in a pamphlet entitled The Future of Marriage: An Eirenicon for a Question of To-day, by a Respectable Woman (1885). "When once the conviction is forced home upon the 'good' women," the writer remarks, "that their place of honor and privilege rests upon the degradation of others as its basis, they will never rest till they have either abandoned it or sought for it some other pedestal. If our inflexible marriage system has for its essential condition the existence side by side with it of prostitution, then one of two things follows: either prostitution must be shown to be compatible with the well-being, moral and physical, of the women who practice it, or our marriage system must be condemned. If it was clearly put before anyone, he could not seriously assert that to be 'virtue' which could only be practiced at the expense of another's vice.... Whilst the laws of physics are becoming so universally recognized that no one dreams of attempting to annihilate a particle of matter, or of force, yet we do not instinctively apply the same conception to moral forces, but think and act as if we could simply do away with an evil, while leaving unchanged that which gives it its strength. This is the only view of the social problem which can give us hope. That prostitution should simply cease, leaving everything else as it is, would be disastrous if it were possible. But it is not possible. The weakness of all existing efforts to put down prostitution is that they are directed against it as an isolated thing, whereas it is only one of the symptoms proceeding from a common disease."

Ellen Key, who during recent years has been the chief apostle of a gospel of sexual morality based on the needs of women as the mothers of the race, has, in a somewhat similar spirit, denounced alike prostitution and rigid marriage, declaring (in her Essays on Love and Marriage) that "the development of erotic personal consciousness is as much hindered by socially regulated 'morality' as by socially regulated 'immorality,'" and that "the two lowest and socially sanctioned expressions of sexual dualism, rigid marriage and prostitution, will gradually become impossible, because with the conquest of the idea of erotic unity they will no longer correspond to human needs."

We may sum up the present situation as regards prostitution by saying that on the one hand there is a tendency for its elevation, in association with the growing humanity and refinement of civilization, characteristics which must inevitably tend to mark more and more both those women who become prostitutes and those men who seek them; on the other hand, but perhaps through the same dynamic force, there is a tendency towards the slow elimination of prostitution by the successful competition of higher and purer methods of sexual relationship freed from pecuniary considerations. This refinement and humanization, this competition by better forms of sexual love, are indeed an essential part of progress as civilization becomes more truly sound, wholesome, and sincere.

This moral change cannot, it seems probable, fail to be accompanied by the realization that the facts of human life are more important than the forms. For all changes from lower to higher social forms, from savagery to civilization, are accompanied—in so far as they are vital changes—by a slow and painful groping towards the truth that it is only in natural relations that sanity and sanctity can be found, for, as Nietzsche said, the "return" to Nature should rather be called the "ascent." Only so can we achieve the final elimination from our hearts of that clinging tradition that there is any impurity or dishonor in acts of love for which the reasonable, and not merely the conventional, conditions have been fulfilled. For it is vain to attempt to cleanse our laws, or even our by-laws, until we have first cleansed our hearts.

It would be out of place here to push further the statement of the moral question as it is to-day beginning to shape itself in the sphere of sex. In a psychological discussion we are only concerned to set down the actual attitude of the moralist, and of civilization. The practical outcome of that attitude must be left to moralists and sociologists and the community generally to work out.

Our inquiry has also, it may be hoped, incidentally tended to show that in practically dealing with the question of prostitution it is pre-eminently necessary to remember the warning which, as regards many other social problems, has been embodied by Herbert Spencer in his famous illustration of the bent iron plate. In trying to make the bent plate smooth, it is useless, Spencer pointed out, to hammer directly on the buckled up part; if we do so we merely find that we have made matters worse; our hammering, to be effective, must be around, and not directly on, the offensive elevation we wish to reduce; only so can the iron plate be hammered smooth.[219] But this elementary law has not been understood by moralists. The plain, practical, common-sense reformer, as he fancied himself to be—from the time of Charlemagne onwards—has over and over again brought his heavy fist directly down on to the evil of prostitution and has always made matters worse. It is only by wisely working outside and around the evil that we can hope to lessen it effectually. By aiming to develop and raise the relationships of men to women, and of women to women, by modifying our notions of sexual relationships, and by introducing a saner and truer conception of womanhood and of the responsibilities of women as well as of men, by attaining, socially as well as economically, a higher level of human living—it is only by such methods as these that we can reasonably expect to see any diminution and alleviation of the evil of prostitution. So long as we are incapable of such methods we must be content with the prostitution we deserve, learning to treat it with the pity, and the respect, which so intimate a failure of our civilization is entitled to.

FOOTNOTES:

[107] See, e.g., Cheetham's Hulsean Lectures, The Mysteries, Pagan and Christian, pp. 123, 136.

[108] Hormayr's Taschenbuch, 1835, p. 255. Hagelstange, in a chapter on mediaeval festivals in his Sueddeutsches Bauernleben im Mittelalter, shows how, in these Christian orgies which were really of pagan origin, the German people reacted with tremendous and boisterous energy against the laborious and monotonous existence of everyday life.

[109] This was clearly realized by the more intelligent upholders of the Feast of Fools. Austere persons wished to abolish this Feast, and in a remarkable petition sent up to the Theological Faculty of Paris (and quoted by Flogel, Geschichte des Grotesk-Komischen, fourth edition, p. 204) the case for the Feast is thus presented: "We do this according to ancient custom, in order that folly, which is second nature to man and seems to be inborn, may at least once a year have free outlet. Wine casks would burst if we failed sometimes to remove the bung and let in air. Now we are all ill-bound casks and barrels which would let out the wine of wisdom if by constant devotion and fear of God we allowed it to ferment. We must let in air so that it may not be spoilt. Thus on some days we give ourselves up to sport, so that with the greater zeal we may afterwards return to the worship of God." The Feast of Fools was not suppressed until the middle of the sixteenth century, and relics of it persisted (as at Aix) till near the end of the eighteenth century.

[110] A Meray, La Vie au Temps des Libres Precheurs, vol. ii, Ch. X. A good and scholarly account of the Feast of Fools is given by E.K. Chambers, The Mediaeval Stage, Ch. XIII. It is true that the Church and the early Fathers often anathematized the theatre. But Gregory of Nazianzen wished to found a Christian theatre; the Mediaeval Mysteries were certainly under the protection of the clergy; and St. Thomas Aquinas, the greatest of the schoolmen, only condemns the theatre with cautious qualifications.

[111] Spencer and Gillen, Northern Tribes of Central Australia, Ch. XII.

[112] Journal Anthropological Institute, July-Dec., 1904, p. 329.

[113] Westermarck (Origin and Development of the Moral Ideas, vol. ii, pp. 283-9) shows how widespread is the custom of setting apart a periodical rest day.

[114] A.E. Crawley, The Mystic Rose, pp. 273 et seq., Crawley brings into association with this function of great festivals the custom, found in some parts of the world, of exchanging wives at these times. "It has nothing whatever to do with the marriage system, except as breaking it for a season, women of forbidden degree being lent, on the same grounds as conventions and ordinary relations are broken at festivals of the Saturnalia type, the object being to change life and start afresh, by exchanging every thing one can, while the very act of exchange coincides with the other desire, to weld the community together" (Ib., p. 479).

[115] See "The Analysis of the Sexual Impulse" in vol. iii of these Studies.

[116] G. Murray, Ancient Greek Literature, p. 211.

[117] The Greek drama probably arose out of a folk-festival of more or less sexual character, and it is even possible that the mediaeval drama had a somewhat similar origin (see Donaldson, The Greek Theatre; Gilbert Murray, loc. cit.; Karl Pearson, The Chances of Death, vol. ii, pp. 135-6, 280 et seq.).

[118] R. Canudo, "Les Choreges Francais," Mercure de France, May 1, 1907, p. 180.

[119] "This is, in fact," Cyples declares (The Process of Human Experience, p. 743), "Art's great function—to rehearse within us greater egoistic possibilities, to habituate us to larger actualizations of personality in a rudimentary manner," and so to arouse, "aimlessly but splendidly, the sheer as yet unfulfilled possibilities within us."

[120] Even when monotonous labor is intellectual, it is not thereby protected against degrading orgiastic reactions. Prof. L. Gurlitt shows (Die Neue Generation, January, 1909, pp. 31-6) how the strenuous, unremitting intellectual work of Prussian seminaries leads among both teachers and scholars to the worst forms of the orgy.

[121] Rabutaux discusses various definitions of prostitution, De la Prostitution en Europe, pp. 119 et seq. For the origin of the names to designate the prostitute, see Schrader, Reallexicon, art. "Beischlaeferin."

[122] Digest, lib. xxiii, tit. ii, p. 43. If she only gave herself to one or two persons, though for money, it was not prostitution.

[123] Guyot, La Prostitution, p. 8. The element of venality is essential, and religious writers (like Robert Wardlaw, D.D., of Edinburgh, in his Lectures on Female Prostitution, 1842, p. 14) who define prostitution as "the illicit intercourse of the sexes," and synonymous with theological "fornication," fall into an absurd confusion.

[124] "Such marriages are sometimes stigmatized as 'legalized prostitution,'" remarks Sidgwick (Methods of Ethics, Bk. iii, Ch. XI), "but the phrase is felt to be extravagant and paradoxical."

[125] Bonger, Criminalite et Conditions Economiques, p. 378. Bonger believes that the act of prostitution is "intrinsically equal to that of a man or woman who contracts a marriage for economical reasons."

[126] E. Richard, La Prostitution a Paris, 1890, p. 44. It may be questioned whether publicity or notoriety should form an essential part of the definition; it seems, however, to be involved, or the prostitute cannot obtain clients. Reuss states that she must, in addition, be absolutely without means of subsistence; that is certainly not essential. Nor is it necessary, as the Digest insisted, that the act should be performed "without pleasure;" that may be as it will, without affecting the prostitutional nature of the act.

[127] Hawkesworth, Account of the Voyages, etc., 1775, vol. ii, p. 254.

[128] R.W. Codrington, The Melanesians, p. 235.

[129] F.S. Krauss, Romanische Forschungen, 1903, p. 290.

[130] H. Schurtz, Altersklassen und Maennerbuende, 1902, p. 190. In this work Schurtz brings together (pp. 189-201) some examples of the germs of prostitution among primitive peoples. Many facts and references are given by Westermarck (History of Human Marriage, pp. 66 et seq., and Origin and Development of the Moral Ideas, vol. ii, pp. 441 et seq.).

[131] Bachofen (more especially in his Mutterrecht and Sage von Tanaquil) argued that even religious prostitution sprang from the resistance of primitive instincts to the individualization of love. Cf. Robertson Smith, Religion of Semites, second edition, p. 59.

[132] Whatever the reason may be, there can be no doubt that there is a widespread tendency for religion and prostitution to be associated; it is possibly to some extent a special case of that general connection between the religious and sexual impulses which has been discussed elsewhere (Appendix C to vol. i of these Studies). Thus A.B. Ellis, in his book on The Ewe-speaking Peoples of West Africa (pp. 124, 141) states that here women dedicated to a god become promiscuous prostitutes. W.G. Sumner (Folkways, Ch. XVI) brings together many facts concerning the wide distribution of religious prostitution.

[133] Herodotus, Bk. I, Ch. CXCIX; Baruch, Ch. VI, p. 43. Modern scholars confirm the statements of Herodotus from the study of Babylonian literature, though inclined to deny that religious prostitution occupied so large a place as he gives it. A tablet of the Gilgamash epic, according to Morris Jastrow, refers to prostitutes as attendants of the goddess Ishtar in the city Uruk (or Erech), which was thus a centre, and perhaps the chief centre, of the rites described by Herodotus (Morris Jastrow, The Religion of Babylonia and Assyria, 1898, p. 475). Ishtar was the goddess of fertility, the great mother goddess, and the prostitutes were priestesses, attached to her worship, who took part in ceremonies intended to symbolize fertility. These priestesses of Ishtar were known by the general name Kadishtu, "the holy ones" (op. cit., pp. 485, 660).

[134] It is usual among modern writers to associate Aphrodite Pandemos, rather than Ourania, with venal or promiscuous sexuality, but this is a complete mistake, for the Aphrodite Pandemos was purely political and had no sexual significance. The mistake was introduced, perhaps intentionally, by Plato. It has been suggested that that arch-juggler, who disliked democratic ideas, purposely sought to pervert and vulgarize the conception of Aphrodite Pandemos (Farnell, Cults of Greek States, vol. ii, p. 660).

[135] Athenaeus, Bk. xiii, cap. XXXII. It appears that the only other Hellenic community where the temple cult involved unchastity was a city of the Locri Epizephyrii (Farnell, op. cit., vol. ii, p. 636).

[136] I do not say an earlier "promiscuity," for the theory of a primitive sexual promiscuity is now widely discredited, though there can be no reasonable doubt that the early prevalence of mother-right was more favorable to the sexual freedom of women than the later patriarchal system. Thus in very early Egyptian days a woman could give her favors to any man she chose by sending him her garment, even if she were married. In time the growth of the rights of men led to this being regarded as criminal, but the priestesses of Amen retained the privilege to the last, as being under divine protection (Flinders Petrie, Egyptian Tales, pp. 10, 48).

[137] It should be added that Farnell ("The Position of Women in Ancient Religion," Archiv fuer Religionswissenschaft, 1904, p. 88) seeks to explain the religious prostitution of Babylonia as a special religious modification of the custom of destroying virginity before marriage in order to safeguard the husband from the mystic dangers of defloration. E.S. Hartland, also ("Concerning the Rite at the Temple of Mylitta," Anthropological Essays Presented to E.B. Tyler, p. 189), suggests that this was a puberty rite connected with ceremonial defloration. This theory is not, however, generally accepted by Semitic scholars.

[138] The girls of this tribe, who are remarkably pretty, after spending two or three years in thus amassing a little dowry, return home to marry, and are said to make model wives and mothers. They are described by Bertherand in Parent-Duchatelet, La Prostitution a Paris, vol. ii, p. 539.

[139] In Abyssinia (according to Fiaschi, British Medical Journal, March 13, 1897), where prostitution has always been held in high esteem, the prostitutes, who are now subject to medical examination twice a week, still attach no disgrace to their profession, and easily find husbands afterwards. Potter (Sohrab and Rustem, pp. 168 et seq.) gives references as regards peoples, widely dispersed in the Old World and the New, among whom the young women have practiced prostitution to obtain a dowry.

[140] At Tralles, in Lydia, even in the second century A.D., as Sir W.M. Ramsay notes (Cities of Phrygia, vol. i, pp. 94, 115), sacred prostitution was still an honorable practice for women of good birth who "felt themselves called upon to live the divine life under the influence of divine inspiration."

[141] The gradual secularization of prostitution from its earlier religious form has been traced by various writers (see, e.g., Dupouey, La Prostitution dans l'Antiquite). The earliest complimentary reference to the Hetaira in literature is to be found, according to Benecke (Antimachus of Colophon, p. 36), in Bacchylides.

[142] Cicero, Oratio pro Coelio, Cap. XX.

[143] Pierre Dufour, Histoire de la Prostitution, vol. ii, Chs. XIX-XX. The real author of this well-known history of prostitution, which, though not scholarly in its methods, brings together a great mass of interesting information, is said to be Paul Lacroix.

[144] Rabutaux, in his Histoire de la Prostitution en Europe, describes many attempts to suppress prostitution; cf. Dufour, op. cit., vol. iii.

[145] Dufour, op. cit., vol. vi, Ch. XLI. It was in the reign of the homosexual Henry III that the tolerance of brothels was established.

[146] In the eighteenth century, especially, houses of prostitution in Paris attained to an astonishing degree of elaboration and prosperity. Owing to the constant watchful attention of the police a vast amount of detailed information concerning these establishments was accumulated, and during recent years much of it has been published. A summary of this literature will be found in Duehren's Neue Forshungen ueber den Marquis de Sade und seine Zeit, 1904, pp. 97 et seq.

[147] Rabutaux, op. cit., p. 54.

[148] Calza has written the history of Venetian prostitution; and some of the documents he found have been reproduced by Mantegazza, Gli Amori degli Uomimi, cap. XIV. At the beginning of the seventeenth century, a comparatively late period, Coryat visited Venice, and in his Crudities gives a full and interesting account of its courtesans, who then numbered, he says, at least 20,000; the revenue they brought into the State maintained a dozen galleys.

[149] J. Schrank, Die Prostitution in Wien, Bd. I, pp. 152-206.

[150] U. Robert, Les Signes d'Infamie au Moyen Age, Ch. IV.

[151] Rudeck (Geschichte der oeffentlichen Sittlichkeit in Deutschland, pp. 26-36) gives many details concerning the important part played by prostitutes and brothels in mediaeval German life.

[152] They are described by Rabutaux, op. cit., pp. 90 et seq.

[153] L'Annee Sociologique, seventh year, 1904, p. 440.

[154] Bloch, Der Ursprung der Syphilis. As regards the German "Frauenhausen" see Max Bauer, Das Geschlechtsleben in der Deutschen Vergangenheit, pp. 133-214. In Paris, Dufour states (op. cit., vol. v, Ch. XXXIV), brothels under the ordinances of St. Louis had many rights which they lost at last in 1560, when they became merely tolerated houses, without statutes, special costumes, or confinement to special streets.

[155] "Cortegiana, hoc est meretrix honesta," wrote Burchard, the Pope's Secretary, at the beginning of the sixteenth century, Diarium, ed. Thuasne, vol. ii, p. 442; other authorities are quoted by Thuasne in a note.

[156] Burchard, Diarium, vol. iii, p. 167. Thuasne quotes other authorities in confirmation.

[157] The example of Holland, where some large cities have adopted the regulation of prostitution and others have not, is instructive as regards the illusory nature of the advantages of regulation. In 1883 Dr. Despres brought forward figures, supplied by Dutch officials, showing that in Rotterdam, where prostitution was regulated, both prostitution and venereal diseases were more prevalent than in Amsterdam, a city without regulation (A. Despres, La Prostitution en France, p. 122).

[158] It was in 1802 that the medical inspection of prostitutes in Paris brothels was introduced, though not until 1825 fully established and made general.

[159] M.L. Heidingsfeld, "The Control of Prostitution," Journal American Medical Association, January 30, 1904.

[160] See, e.g., G. Berault, La Maison de Tolerance, These de Paris, 1904.

[161] Thus the circumstances of the English army in India are of a special character. A number of statements (from the reports of committees, official publications, etc.) regarding the good influence of regulation in reducing venereal diseases in India are brought together by Surgeon-Colonel F.H. Welch, "The Prevention of Syphilis," Lancet, August 12, 1899. The system has been abolished, but only as the result of a popular outcry and not on the question of its merits.

[162] Thus Richard, who accepts regulation and was instructed to report on it for the Paris Municipal Council, would not have girls inscribed as professional prostitutes until they are of age and able to realize what they are binding themselves to (E. Richard, La Prostitution a Paris, p. 147). But at that age a large proportion of prostitutes have been practicing their profession for years.

[163] In Germany, where the cure of infected prostitutes under regulation is nearly everywhere compulsory, usually at the cost of the community, it is found that 18 is the average age at which they are affected by syphilis; the average age of prostitutes in brothels is higher than that of those outside, and a much larger proportion have therefore become immune to disease (Blaschko, "Hygiene der Syphilis," in Weyl's Handbuch der Hygiene, Bd. ii, p. 62, 1900).

[164] A. Sherwell, Life in West London, 1897, Ch. V.

[165] Bonger brings together statistics illustrating this point, op. cit., pp. 402-6.

[166] The Nightless City, p. 125.

[167] Stroehmberg, as quoted by Aschaffenburg, Das Verbrechen, 1903, p. 77.

[168] Monatsschrift fuer Harnkrankheiten und Sexuelle Hygiene, 1906. Heft 10, p. 460. But this cause is undoubtedly effective in some cases of unmarried women in Germany unable to get work (see article by Sister Henrietta Arendt, Police-Assistant at Stuttgart, Sexual-Probleme, December, 1908).

[169] Thus, for instance, we find Irma von Troll-Borostyani saying in her book, Im Freien Reich (p. 176): "Go and ask these unfortunate creatures if they willingly and freely devoted themselves to vice. And nearly all of them will tell you a story of need and destitution, of hunger and lack of work, which compelled them to it, or else of love and seduction and the fear of the discovery of their false step which drove them out of their homes, helpless and forsaken, into the pool of vice from which there is hardly any salvation." It is, of course, quite true that the prostitute is frequently ready to tell such stories to philanthropic persons who expect to hear them, and sometimes even put the words into her mouth.

[170] C. Booth, Life and Labour, final volume, p. 125. Similarly in Sweden, Kullberg states that girls of thirteen to seventeen, living at home with their parents in comfortable circumstances, have often been found on the streets.

[171] W. Acton, Prostitution, 1870, pp. 39, 49.

[172] In Lyons, according to Potton, of 3884 prostitutes, 3194 abandoned, or apparently abandoned, their profession; in Paris a very large number became servants, dressmakers, or tailoresses, occupations which, in many cases, doubtless, they had exercised before (Parent-Duchatelet, De la Prostitution, 1857, vol. i, p. 584; vol. ii, p. 451). Sloggett (quoted by Acton) stated that at Davenport, 250 of the 1775 prostitutes there married. It is well known that prostitutes occasionally marry extremely well. It was remarked nearly a century ago that marriages of prostitutes to rich men were especially frequent in England, and usually turned out well; the same seems to be true still. In their own social rank they not infrequently marry cabmen and policemen, the two classes of men with whom they are brought most closely in contact in the streets. As regards Germany, C.K. Schneider (Die Prostituirte und die Gesellschaft), states that young prostitutes take up all sorts of occupations and situations, sometimes, if they have saved a little money, establishing a business, while old prostitutes become procuresses, brothel-keepers, lavatory women, and so on. Not a few prostitutes marry, he adds, but the proportion among inscribed German prostitutes is very small, less than 2 per cent.

[173] G. de Molinari, La Viriculture, 1897, p. 155.

[174] Reuss and other writers have reproduced typical extracts from the private account books of prostitutes, showing the high rate of their earnings. Even in the common brothels, in Philadelphia (according to Goodchild, "The Social Evil in Philadelphia," Arena, March, 1896), girls earn twenty dollars or more a week, which is far more than they could earn in any other occupation open to them.

[175] A. Despres, La Prostitution en France, 1883.

[176] Bonger, Criminalite et Conditions Economiques, 1905, pp. 378-414.

[177] La Donna Delinquente, p. 401.

[178] Raciborski, Traite de l'Impuissance, p. 20. It may be added that Bergh, a leading authority on the anatomical peculiarities of the external female sexual organs, who believe that strong development of the external genital organs accompanies libidinous tendencies, has not found such development to be common among prostitutes.

[179] Hammer, who has had much opportunity of studying the psychology of prostitutes, remarks that he has seen no reason to suspect sexual coldness (Monatsschrift fuer Harnkrankheiten und Sexuelle Hygiene, 1906, Heft 2, p. 85), although, as he has elsewhere stated, he is of opinion that indolence, rather than excess of sensuality, is the chief cause of prostitution.

[180] See "The Sexual Impulse in Women," in the third volume of these Studies.

[181] Tait stated that in Edinburgh many married women living with their husbands in comfortable circumstances, and having children, were found to be acting as prostitutes, that is, in the regular habit of making assignations with strangers (W. Tait, Magdalenism in Edinburgh, 1842, p. 16).

[182] Janke brings together opinions to this effect, Die Willkuerliche Hervorbringen des Geschlechts, p. 275. "If we compare a prostitute of thirty-five with her respectable sister," Acton remarked (Prostitution, 1870, p. 39), "we seldom find that the constitutional ravages often thought to be necessary consequences of prostitution exceed those attributable to the cares of a family and the heart-wearing struggles of virtuous labor."

[183] Hirschfeld states (Wesen der Liebe, p. 35) that the desire for intercourse with a sympathetic person is heightened, and not decreased, by a professional act of coitus.

[184] This has been clearly shown by Hans Ostwald (from whom I take the above-quoted observation of a prostitute), one of the best authorities on prostitute life and character; see, e.g., his article, "Die erotischen Beziehungen zwischen Dirne und Zuhaelter," Sexual-Probleme, June, 1908. In the subsequent number of the same periodical (July, 1908, p. 393) Dr. Max Marcuse supports Ostwald's experiences, and says that the letters of prostitutes and their bullies are love-letters exactly like those of respectable people of the same class, and with the same elements of love and jealousy; these relationships, he remarks, often prove very enduring. The prostitute author of the Tagebuch einer Verlorenen (p. 147) also has some remarks on the prostitute's relations to her bully, stating that it is simply the natural relationship of a girl to her lover.

[185] Thus Moraglia found that among 180 prostitutes in North Italian brothels, and among 23 elegant Italian and foreign cocottes, every one admitted that she masturbated, preferably by friction of the clitoris; 113 of them, the majority, declared that they preferred solitary or mutual masturbation to normal coitus. Hammer states (Zehn Lebenslaeufe Berliner Kontrollmaedchen in Ostwald's series of "Grosstadt Dokumente," 1905) that when in hospital all but three or four of sixty prostitutes masturbate, and those who do not are laughed at by the rest.

[186] Jahrbuch fuer Sexuelle Zwischenstufen, Jahrgang VII, 1905, p. 148; "Sexual Inversion," vol. ii of these Studies, Ch. IV. Hammer found that of twenty-five prostitutes in a reformatory as many as twenty-three were homosexual, or, on good grounds, suspected to be such. Hirschfeld (Berlins Drittes Geschlecht, p. 65) mentions that prostitutes sometimes accost better-class women who, from their man-like air, they take to be homosexual; from persons of their own sex prostitutes will accept a smaller remuneration, and sometimes refuse payment altogether.

[187] With prostitution, as with criminality, it is of course difficult to disentangle the element of heredity from that of environment, even when we have good grounds for believing that the factor of heredity here, as throughout the whole of life, cannot fail to carry much weight. It is certain, in any case, that prostitution frequently runs in families. "It has often been my experience," writes a former prostitute (Hedwig Hard, Beichte einer Gefallenen, p. 156) "that when in a family a girl enters this path, her sister soon afterwards follows her: I have met with innumerable cases; sometimes three sisters will all be on the register, and I knew a case of four sisters, whose mother, a midwife, had been in prison, and the father drank. In this case, all four sisters, who were very beautiful, married, one at least very happily, to a rich doctor who took her out of the brothel at sixteen and educated her."

[188] This fact is not contradicted by the undoubted fact that prostitutes are by no means always contented with the life they choose.

[189] This point has been discussed by Bloch, Sexualleben unserer Zeit, Ch. XIII.

[190] Various series of observations are summarized by Lombroso and Ferrero, La Donna Delinquente, 1893, Part III, cap. IV.

[191] History of European Morals, vol. iii, p. 283.

[192] Similarly Lord Morley has written (Diderot, vol. ii, p. 20): "The purity of the family, so lovely and dear as it is, has still only been secured hitherto by retaining a vast and dolorous host of female outcasts ... upon whose heads, as upon the scapegoat of the Hebrew ordinance, we put all the iniquities of the children of the house, and all their transgressions in all their sins, and then banish them with maledictions into the foul outer wilderness and the land not inhabited."

[193] Horace, Satires, lib. i, 2.

[194] Augustine, De Ordine, Bk. II, Ch. IV.

[195] De Regimine Principum (Opuscula XX), lib. iv, cap. XIV. I am indebted to the Rev. H. Northcote for the reference to the precise place where this statement occurs; it is usually quoted more vaguely.

[196] Lea, History of Auricular Confession, vol. ii, p. 69. There was even, it seems, an eccentric decision of the Salamanca theologians that a nun might so receive money, "licite et valide."

[197] Lea, op. cit., vol. ii, pp. 263, 399.

[198] Rabutaux, De la Prostitution en Europe, pp. 22 et seq.

[199] Burton, Anatomy of Melancholy, Part III, Sect. III, Mem. IV, Subs. II.

[200] B. Mandeville, Remarks to Fable of the Bees, 1714, pp. 93-9; cf. P. Sakmann, Bernard de Mandeville, pp. 101-4.

[201] These conditions favor temporary free unions, but they also favor prostitution. The reason is, according to Adolf Gerson (Sexual-Probleme, September, 1908), that the woman of good class will not have free unions. Partly moved by moral traditions, and partly by the feeling that a man should be legally her property, she will not give herself out of love to a man; and he therefore turns to the lower-class woman who gives herself for money.

[202] Many girls, said Ellice Hopkins, get into mischief merely because they have in them an element of the "black kitten," which must frolic and play, but has no desire to get into danger. "Do you not think it a little hard," she added, "that men should have dug by the side of her foolish dancing feet a bottomless pit, and that she cannot have her jump and fun in safety, and put on her fine feathers like the silly bird-witted thing she is, without a single false step dashing her over the brink, and leaving her with the very womanhood dashed out of her?"

[203] A. Sherwell, Life in West London, 1897, Ch. V.

[204] As quoted by Bloch, Sexualleben Unserer Zeit, p. 358. In Berlin during recent years the number of prostitutes has increased at nearly double the rate at which the general population has increased. It is no doubt probable that the supply tends to increase the demand.

[205] Goncourt, Journal, vol. iii, p. 49.

[206] Vanderkiste, The Dens of London, 1854, p. 242.

[207] Bonger (Criminalite et Conditions Economiques, p. 406) refers to the prevalence of prostitution among dressmakers and milliners, as well as among servants, as showing the influence of contact with luxury, and adds that the rich women, who look down on prostitution, do not always realize that they are themselves an important factor of prostitution, both by their luxury and their idleness; while they do not seem to be aware that they would themselves act in the same way if placed under the same conditions.

[208] H. Lippert, in his book on prostitution in Hamburg, laid much stress on the craving for dress and adornment as a factor of prostitution, and Bloch (Das Sexualleben unsurer Zeit, p. 372) considers that this factor is usually underestimated, and that it exerts an especially powerful influence on servants.

[209] Since this was written the influence of several generations of town-life in immunizing a stock to the evils of that life (though without reference to prostitution) has been set forth by Reibmayr, Die Entwicklungsgeschichte des Talentes und Genies, 1908, vol. ii, pp. 73 et seq.

[210] In France this intimacy is embodied in the delicious privilege of tutoiement. "The mystery of tutoiement!" exclaims Ernest La Jennesse in L'Holocauste: "Barriers broken down, veils drawn away, and the ease of existence! At a time when I was very lonely, and trying to grow accustomed to Paris and to misfortune, I would go miles—on foot, naturally—to see a girl cousin and an aunt, merely to have something to tutoyer. Sometimes they were not at home, and I had to come back with my tu, my thirst for confidence and familiarity and brotherliness."

[211] For some facts and references to the extensive literature concerning this trade, see, e.g., Bloch, Das Sexualleben Unserer Zeit, pp. 374-376; also K.M. Baer, Zeitschrift fuer Sexualwissenschaft, Sept., 1908; Paulucci de Calboli, Nuova Antologia, April, 1902.

[212] These considerations do not, it is true, apply to many kinds of sexual perverts who form an important proportion of the clients of brothels. These can frequently find what they crave inside a brothel much more easily than outside.

[213] Thus Charles Booth, in his great work on Life and Labor in London, final volume (p. 128), recommends that "houses of accommodation," instead of being hunted out, should be tolerated as a step towards the suppression of brothels.

[214] "Towns like Woolwich, Aldershot, Portsmouth, Plymouth," it has been said, "abound with wretched, filthy monsters that bear no resemblance to women; but it is drink, scorn, brutality and disease which have reduced them to this state, not the mere fact of associating with men."

[215] "The contract of prostitution in the opinion of prostitutes themselves," Bernaldo de Quiros and Llanas Aguilaniedo remark (La Mala Vida en Madrid, p. 254), "cannot be assimilated to a sale, nor to a contract of work, nor to any other form of barter recognized by the civil law. They consider that in these pacts there always enters an element which makes it much more like a gift in a matter in which no payment could be adequate. 'A woman's body is without price' is an axiom of prostitution. The money placed in the hands of her who procures the satisfaction of sexual desire is not the price of the act, but an offering which the priestess of Venus applies to her maintenance." To the Spaniard, it is true, every transaction which resembles trade is repugnant, but the principle underlying this feeling holds good of prostitution generally.

[216] Journal des Goncourt, vol. iii; this was in 1866.

[217] Rev. the Hon. C. Lyttelton, Training of the Young in Laws of Sex, p. 42.

[218] See, e.g., R.W. Taylor, Treatise on Sexual Disorders, 1897, pp. 74-5. Georg Hirth (Wege zur Heimat, 1909, p. 619) narrates the case of a young officer who, being excited by the caresses of his betrothed and having too much respect for her to go further than this, and too much respect for himself to resort to masturbation, knew nothing better than to go to a prostitute. Syphilis developed a few days after the wedding. Hirth adds, briefly, that the results were terrible.

[219] It is an oft-quoted passage, but can scarcely be quoted too often: "You see that this wrought-iron plate is not quite flat: it sticks up a little, here towards the left—'cockles,' as we say. How shall we flatten it? Obviously, you reply, by hitting down on the part that is prominent. Well, here is a hammer, and I give the plate a blow as you advise. Harder, you say. Still no effect. Another stroke? Well, there is one, and another, and another. The prominence remains, you see: the evil is as great as ever—greater, indeed. But that is not all. Look at the warp which the plate has got near the opposite edge. Where it was flat before it is now curved. A pretty bungle we have made of it. Instead of curing the original defect we have produced a second. Had we asked an artisan practiced in 'planishing,' as it is called, he would have told us that no good was to be done, but only mischief, by hitting down on the projecting part. He would have taught us how to give variously-directed and specially-adjusted blows with a hammer elsewhere: so attacking the evil, not by direct, but by indirect actions. The required process is less simple than you thought. Even a sheet of metal is not to be successfully dealt with after those common-sense methods in which you have so much confidence. What, then, shall we say about a society?... Is humanity more readily straightened than an iron plate?" (The Study of Sociology, p. 270.)



CHAPTER VIII.

THE CONQUEST OF THE VENEREAL DISEASES.

The Significance of the Venereal Diseases—The History of Syphilis—The Problem of Its Origin—The Social Gravity of Syphilis—The Social Dangers of Gonorrhoea—The Modern Change in the Methods of Combating Venereal Diseases—Causes of the Decay of the System of Police Regulation—Necessity of Facing the Facts—The Innocent Victims of Venereal Diseases—Diseases Not Crimes—The Principle of Notification—The Scandinavian System—Gratuitous Treatment—Punishment for Transmitting Venereal Diseases—Sexual Education in Relation to Venereal Diseases—Lectures, Etc.—Discussion in Novels and on the Stage—The "Disgusting" Not the "Immoral."

It may, perhaps, excite surprise that in the preceding discussion of prostitution scarcely a word has been said of venereal diseases. In the eyes of many people, the question of prostitution is simply the question of syphilis. But from the psychological point of view with which we are directly concerned, as from the moral point of view with which we cannot fail to be indirectly concerned, the question of the diseases which may be, and so frequently are, associated with prostitution cannot be placed in the first line of significance. The two questions, however intimately they may be mingled, are fundamentally distinct. Not only would venereal diseases still persist even though prostitution had absolutely ceased, but, on the other hand, when we have brought syphilis under the same control as we have brought the somewhat analogous disease of leprosy, the problem of prostitution would still remain.

Yet, even from the standpoint which we here occupy, it is scarcely possible to ignore the question of venereal disease, for the psychological and moral aspects of prostitution, and even the whole question of the sexual relationships, are, to some extent, affected by the existence of the serious diseases which are specially liable to be propagated by sexual intercourse.

Fournier, one of the leading authorities on this subject, has well said that syphilis, alcoholism, and tuberculosis are the three modern plagues. At a much earlier period (1851) Schopenhauer in Parerga und Paralipomena had expressed the opinion that the two things which mark modern social life, in distinction from that of antiquity, and to the advantage of the latter, are the knightly principle of honor and venereal disease; together, he added, they have poisoned life, and introduced a hostile and even diabolical element into the relations of the sexes, which has indirectly affected all other social relationships.[220] It is like a merchandise, says Havelburg, of syphilis, which civilization has everywhere carried, so that only a very few remote districts of the globe (as in Central Africa and Central Brazil) are to-day free from it.[221]

It is undoubtedly true that in the older civilized countries the manifestations of syphilis, though still severe and a cause of physical deterioration in the individual and the race, are less severe than they were even a generation ago.[222] This is partly the result of earlier and better treatment, partly, it is possible, the result also of the syphilization of the race, some degree of immunity having now become an inherited possession, although it must be remembered that an attack of syphilis does not necessarily confer immunity from the actual attack of the disease even in the same individual. But it must be added that, even though it has become less severe, syphilis, in the opinion of many, is nevertheless still spreading, even in the chief centres of civilization; this has been noted alike in Paris and in London.[223]

According to the belief which is now tending to prevail, syphilis was brought to Europe at the end of the fifteenth century by the first discoverers of America. In Seville, the chief European port for America, it was known as the Indian disease, but when Charles VIII and his army first brought it to Italy in 1495, although this connection with the French was only accidental, it was called the Gallic disease, "a monstrous disease," said Cataneus, "never seen in previous centuries and altogether unknown in the world."

The synonyms of syphilis were at first almost innumerable. It was in his Latin poem Syphilis sive Morbus Gallicus, written before 1521 and published at Verona in 1530, that Fracastorus finally gave the disease its now universally accepted name, inventing a romantic myth to account for its origin.

Although the weight of authoritative opinion now seems to incline towards the belief that syphilis was brought to Europe from America, on the discovery of the New World, it is only within quite recent years that that belief has gained ground, and it scarcely even yet seems certain that what the Spaniards brought back from America was really a disease absolutely new to the Old World, and not a more virulent form of an old disease of which the manifestations had become benign. Buret, for instance (Le Syphilis Aujourd'hui et chez les Anciens, 1890), who some years ago reached "the deep conviction that syphilis dates from the creation of man," and believed, from a minute study of classic authors, that syphilis existed in Rome under the Caesars, was of opinion that it has broken out at different places and at different times, in epidemic bursts exhibiting different combinations of its manifold symptoms, so that it passed unnoticed at ordinary times, and at the times of its more intense manifestation was looked upon as a hitherto unknown disease. It was thus regarded in classic times, he considers, as coming from Egypt, though he looked upon its real home as Asia. Leopold Glueck has likewise quoted (Archiv fuer Dermatologie und Syphilis, January, 1899) passages from the medical epigrams of a sixteenth century physician, Gabriel Ayala, declaring that syphilis is not really a new disease, though popularly supposed to be so, but an old disease which has broken out with hitherto unknown violence. There is, however, no conclusive reason for believing that syphilis was known at all in classic antiquity. A.V. Notthaft ("Die Legende von der Althertums-syphilis," in the Rindfleisch Festschrift, 1907, pp. 377-592) has critically investigated the passages in classic authors which were supposed by Rosenbaum, Buret, Proksch and others to refer to syphilis. It is quite true, Notthaft admits, that many of these passages might possibly refer to syphilis, and one or two would even better fit syphilis than any other disease. But, on the whole, they furnish no proof at all, and no syphilologist, he concludes, has ever succeeded in demonstrating that syphilis was known in antiquity. That belief is a legend. The most damning argument against it, Notthaft points out, is the fact that, although in antiquity there were great physicians who were keen observers, not one of them gives any description of the primary, secondary, tertiary, and congenital forms of this disease. China is frequently mentioned as the original home of syphilis, but this belief is also quite without basis, and the Japanese physician, Okamura, has shown (Monatsschrift fuer praktische Dermatologie, vol. xxviii, pp. 296 et seq.) that Chinese records reveal nothing relating to syphilis earlier than the sixteenth century. At the Paris Academy of Medicine in 1900 photographs from Egypt were exhibited by Fouquet of human remains which date from B.C. 2400, showing bone lesions which seemed to be clearly syphilitic; Fournier, however, one of the greatest of authorities, considered that the diagnosis of syphilis could not be maintained until other conditions liable to produce somewhat similar bone lesions had been eliminated (British Medical Journal, September 29, 1900, p. 946). In Florida and various regions of Central America, in undoubtedly pre-Columbian burial places, diseased bones have been found which good authorities have declared could not be anything else than syphilitic (e.g., British Medical Journal, November 20, 1897, p. 1487), though it may be noted that so recently as 1899 the cautious Virchow stated that pre-Columbian syphilis in America was still for him an open question (Zeitschrift fuer Ethnologie, Heft 2 and 3, 1899, p. 216). From another side, Seler, the distinguished authority on Mexican antiquity, shows (Zeitschrift fuer Ethnologie, 1895, Heft 5, p. 449) that the ancient Mexicans were acquainted with a disease which, as they described it, might well have been syphilis. It is obvious, however, that while the difficulty of demonstrating syphilitic diseased bones in America is as great as in Europe, the demonstration, however complete, would not suffice to show that the disease had not already an existence also in the Old World. The plausible theory of Ayala that fifteenth century syphilis was a virulent recrudescence of an ancient disease has frequently been revived in more modern times. Thus J. Knott ("The Origin of Syphilis," New York Medical Journal, October 31, 1908) suggests that though not new in fifteenth century Europe, it was then imported afresh in a form rendered more aggravated by coming from an exotic race, as is believed often to be the case.

It was in the eighteenth century that Jean Astruc began the rehabilitation of the belief that syphilis is really a comparatively modern disease of American origin, and since then various authorities of weight have given their adherence to this view. It is to the energy and learning of Dr. Iwan Bloch, of Berlin (the first volume of whose important work, Der Ursprung der Syphilis, was published in 1901) that we owe the fullest statement of the evidence in favor of the American origin of syphilis. Bloch regards Ruy Diaz de Isla, a distinguished Spanish physician, as the weightiest witness for the Indian origin of the disease, and concludes that it was brought to Europe by Columbus's men from Central America, more precisely from the Island of Haiti, to Spain in 1493 and 1494, and immediately afterwards was spread by the armies of Charles VIII in an epidemic fashion over Italy and the other countries of Europe.

It may be added that even if we have to accept the theory that the central regions of America constitute the place of origin of European syphilis, we still have to recognize that syphilis has spread in the North American continent very much more slowly and partially than it has in Europe, and even at the present day there are American Indian tribes among whom it is unknown. Holder, on the basis of his own experiences among Indian tribes, as well as of wide inquiries among agency physicians, prepared a table showing that among some thirty tribes and groups of tribes, eighteen were almost or entirely free from venereal disease, while among thirteen it was very prevalent. Almost without exception, the tribes where syphilis is rare or unknown refuse sexual intercourse with strangers, while those among whom such disease is prevalent are morally lax. It is the whites who are the source of infection among these tribes (A.B. Holder, "Gynecic Notes Among the American Indians," American Journal of Obstetrics, 1892, No. 1).

Syphilis is only one, certainly the most important, of a group of three entirely distinct "venereal diseases" which have only been distinguished in recent times, and so far as their precise nature and causation are concerned, are indeed only to-day beginning to be understood, although two of them were certainly known in antiquity. It is but seventy years ago since Ricord, the great French syphilologist, following Bassereau, first taught the complete independence of syphilis both from gonorrhoea and soft chancre, at the same time expounding clearly the three stages, primary, secondary and tertiary, through which syphilitic manifestations tend to pass, while the full extent of tertiary syphilitic symptoms is scarcely yet grasped, and it is only to-day beginning to be generally realized that two of the most prevalent and serious diseases of the brain and nervous system—general paralysis and tabes dorsalis or locomotor ataxia—have their predominant though not sole and exclusive cause in the invasion of the syphilitic poison many years before. In 1879 a new stage of more precise knowledge of the venereal diseases began with Neisser's discovery of the gonococcus which is the specific cause of gonorrhoea. This was followed a few years later by the discovery by Ducrey and Unna of the bacillus of soft chancre, the least important of the venereal diseases because exclusively local in its effects. Finally, in 1905—after Metchnikoff had prepared the way by succeeding in carrying syphilis from man to monkey, and Lassar, by inoculation, from monkey to monkey—Fritz Schaudinn made his great discovery of the protozoal Spirochoeta pallida (since sometimes called Treponema pallidum), which is now generally regarded as the cause of syphilis, and thus revealed the final hiding place of one of the most dangerous and insidious foes of humanity.[224]

There is no more subtle poison than that of syphilis. It is not, like smallpox or typhoid, a disease which produces a brief and sudden storm, a violent struggle with the forces of life, in which it tends, even without treatment, provided the organism is healthy, to succumb, leaving little or no traces of its ravages behind. It penetrates ever deeper and deeper into the organism, with the passage of time leading to ever new manifestations, and no tissue is safe from its attack. And so subtle is this all-pervading poison that though its outward manifestations are amenable to prolonged treatment, it is often difficult to say that the poison has been finally killed out.[225]

The immense importance of syphilis, and the chief reason why it is necessary to consider it here, lies in the fact that its results are not confined to the individual himself, nor even to the persons to whom he may impart it by the contagion due to contact in or out of sexual relationships: it affects the offspring, and it affects the power to produce offspring. It attacks men and women at the centre of life, as the progenitors of the coming race, inflicting either sterility or the tendency to aborted and diseased products of conception. The father alone can perhaps transmit syphilis to his child, even though the mother escapes infection, and the child born of syphilitic parents may come into the world apparently healthy only to reveal its syphilitic origin after a period of months or even years. Thus syphilis is probably a main cause of the enfeeblement of the race.[226]

Alike in the individual and in his offspring syphilis shows its deteriorating effects on all the structures of the body, but especially on the brain and nervous system. There are, as has been pointed out by Mott, a leading authority in this matter,[227] five ways in which syphilis affects the brain and nervous system: (1) by moral shock; (2) by the effects of the poison in producing anaemia and impaired general nutrition; (3) by causing inflammation of the membranes and tissues of the brain; (4) by producing arterial degeneration, leading on to brain-softening, paralysis, and dementia; (5) as a main cause of the para-syphilitic affections of general paralysis and tabes dorsalis.

It is only within recent years that medical men have recognized the preponderant part played by acquired or inherited syphilis in producing general paralysis, which so largely helps to fill lunatic asylums, and tabes dorsalis which is the most important disease of the spinal cord. Even to-day it can scarcely be said that there is complete agreement as to the supreme importance of the factor of syphilis in these diseases. There can, however, be little doubt that in about ninety-five per cent. at least of cases of general paralysis syphilis is present.[228]

Syphilis is not indeed by itself an adequate cause of general paralysis for among many savage peoples syphilis is very common while general paralysis is very rare. It is, as Krafft-Ebing was accustomed to say, syphilization and civilization working together which produce general paralysis, perhaps in many cases, there is reason for thinking, on a nervous soil that is hereditarily degenerated to some extent; this is shown by the abnormal prevalence of congenital stigmata of degeneration found in general paralytics by Naecke and others. "Paralyticus nascitur atque fit," according to the dictum of Obersteiner. Once undermined by syphilis, the deteriorated brain is unable to resist the jars and strains of civilized life, and the result is general paralysis, truly described as "one of the most terrible scourges of modern times." In 1902 the Psychological Section of the British Medical Association, embodying the most competent English authority on this question, unanimously passed a resolution recommending that the attention of the Legislature and other public bodies should be called to the necessity for immediate action in view of the fact that "general paralysis, a very grave and frequent form of brain disease, together with other varieties of insanity, is largely due to syphilis, and is therefore preventable." Yet not a single step has yet been taken in this direction.

The dangers of syphilis lie not alone in its potency and its persistence but also in its prevalence. It is difficult to state the exact incidence of syphilis, but a great many partial investigations have been made in various countries, and it would appear that from five to twenty per cent. of the population in European countries is syphilitic, while about fifteen per cent. of the syphilitic cases die from causes directly or indirectly due to the disease.[229] In France generally, Fournier estimates that seventeen per cent. of the whole population have had syphilis, and at Toulouse, Audry considers that eighteen per cent. of all his patients are syphilitic. In Copenhagen, where notification is obligatory, over four per cent. of the population are said to be syphilitic. In America a committee of the Medical Society of New York, appointed to investigate the question, reported as the result of exhaustive inquiry that in the city of New York not less than a quarter of a million of cases of venereal disease occurred every year, and a leading New York dermatologist has stated that among the better class families he knows intimately at least one-third of the sons have had syphilis. In Germany eight hundred thousand cases of venereal disease are by one authority estimated to occur yearly, and in the larger universities twenty-five per cent. of the students are infected every term, venereal disease being, however, specially common among students. The yearly number of men invalided in the German army by venereal diseases equals a third of the total number wounded in the Franco-Prussian war. Yet the German army stands fairly high as regards freedom from venereal disease when compared with the British army which is more syphilized than any other European army.[230] The British army, however, being professional and not national, is less representative of the people than is the case in countries where some form of conscription prevails. At one London hospital it could be ascertained that ten per cent. of the patients had had syphilis; this probably means a real proportion of about fifteen per cent., a high though not extremely high ratio. Yet it is obvious that even if the ratio is really lower than this the national loss in life and health, in defective procreation and racial deterioration, must be enormous and practically incalculable. Even in cash the venereal budget is comparable in amount to the general budget of a great nation. Stritch estimates that the cost to the British nation of venereal diseases in the army, navy and Government departments alone, amounts annually to L3,000,000, and when allowance is made for superannuations and sick-leave indirectly occasioned through these diseases, though not appearing in the returns as such, the more accurate estimate of the cost to the nation is stated to be L7,000,000. The adoption of simple hygienic measures for the prevention and the speedy cure of venereal diseases will be not only indirectly but even directly a source of immense wealth to the nation.

Syphilis is the most obviously and conspicuously appalling of the venereal diseases. Yet it is less frequent and in some respects less dangerously insidious than the other chief venereal disease, gonorrhoea.[231] At one time the serious nature of gonorrhoea, especially in women, was little realized. Men accepted it with a light heart as a trivial accident; women ignored it. This failure to realize the gravity of gonorrhoea, even sometimes on the part of the medical profession—so that it has been popularly looked upon, in Grandin's words, as of little more significance than a cold in the nose—has led to a reaction on the part of some towards an opposite extreme, and the risks and dangers of gonorrhoea have been even unduly magnified. This is notably the case as regards sterility. The inflammatory results of gonorrhoea are indubitably a potent cause of sterility in both sexes; some authorities have stated that not only eighty per cent. of the deaths from inflammatory diseases of the pelvic organs and the majority of the cases of chronic invalidism in women, but ninety per cent. of involuntary sterile marriages, are due to gonorrhoea. Neisser, a great authority, ascribes to this disease without doubt fifty per cent, of such marriages. Even this estimate is in the experience of some observers excessive. It is fully proved that the great majority of men who have had gonorrhoea, even if they marry within two years of being infected, fail to convey the disease to their wives, and even of the women infected by their husbands more than half have children. This is, for instance, the result of Erb's experience, and Kisch speaks still more strongly in the same sense. Bumm, again, although regarding gonorrhoea as one of the two chief causes of sterility in women, finds that it is not the most frequent cause, being only responsible for about one-third of the cases; the other two-thirds are due to developmental faults in the genital organs. Dunning in America has reached results which are fairly concordant with Bumm's.

With regard to another of the terrible results of gonorrhoea, the part it plays in producing life-long blindness from infection of the eyes at birth, there has long been no sort of doubt. The Committee of the Ophthalmological Society in 1884, reported that thirty to forty-one per cent. of the inmates of four asylums for the blind in England owed their blindness to this cause.[232] In German asylums Reinhard found that thirty per cent. lost their sight from the same cause. The total number of persons blind from gonorrhoeal infection from their mothers at birth is enormous. The British Royal Commission on the Condition of the Blind estimated there were about seven thousand persons in the United Kingdom alone (or twenty-two per cent. of the blind persons in the country) who became blind as the result of this disease, and Mookerji stated in his address on Ophthalmalogy at the Indian Medical Congress of 1894 that in Bengal alone there were six hundred thousand totally blind beggars, forty per cent. of whom lost their sight at birth through maternal gonorrhoea; and this refers to the beggar class alone.

Although gonorrhoea is liable to produce many and various calamities,[233] there can be no doubt that the majority of gonorrhoeal persons escape either suffering or inflicting any very serious injury. The special reason why gonorrhoea has become so peculiarly serious a scourge is its extreme prevalence. It is difficult to estimate the proportion of men and women in the general population who have had gonorrhoea, and the estimates vary within wide limits. They are often set too high. Erb, of Heidelberg, anxious to disprove exaggerated estimates of the prevalence of gonorrhoea, went over the records of two thousand two hundred patients in his private practice (excluding all hospital patients) and found the proportion of those who had suffered from gonorrhoea was 48.5 per cent.

Among the working classes the disease is much less prevalent than among higher-class people. In a Berlin Industrial Sick Club, 412 per 10,000 men and 69 per 10,000 women had gonorrhoea in a year; taking a series of years the Club showed a steady increase in the number of men, and decrease in the number of women, with venereal infection; this seems to indicate that the laboring classes are beginning to have intercourse more with prostitutes and less with respectable girls.[234] In America Wood Ruggles has given (as had Noggerath previously, for New York), the prevalence of gonorrhoea among adult males as from 75 to 80 per cent.; Tenney places it much lower, 20 per cent. for males and 5 per cent. for females. In England, a writer in the Lancet, some years ago,[235] found as the result of experience and inquiries that 75 per cent. adult males have had gonorrhoea once, 40 per cent. twice, 15 per cent. three or more times. According to Dulberg about twenty per cent. of new cases occur in married men of good social class, the disease being comparatively rare among married men of the working class in England.

Gonorrhoea in its prevalence is thus only second to measles and in the gravity of its results scarcely second to tuberculosis. "And yet," as Grandin remarks in comparing gonorrhoea to tuberculosis, "witness the activity of the crusade against the latter and the criminal apathy displayed when the former is concerned."[236] The public must learn to understand, another writer remarks, that "gonorrhoea is a pest that concerns its highest interests and most sacred relations as much as do smallpox, cholera, diphtheria, or tuberculosis."[237]

It cannot fairly be said that no attempts have been made to beat back the flood of venereal disease. On the contrary, such attempts have been made from the first. But they have never been effectual;[238] they have never been modified to changed condition; at the present day they are hopelessly unscientific and entirely opposed alike to the social and the individual demands of modern peoples. At the various conferences on this question which have been held during recent years the only generally accepted conclusion which has emerged is that all the existing systems of interference or non-interference with prostitution are unsatisfactory.[239]

The character of prostitution has changed and the methods of dealing with it must change. Brothels, and the systems of official regulation which grew up with special reference to brothels, are alike out of date; they have about them a mediaeval atmosphere, an antiquated spirit, which now render them unattractive and suspected. The conspicuously distinctive brothel is falling into disrepute; the liveried prostitute absolutely under municipal control can scarcely be said to exist. Prostitution tends to become more diffused, more intimately mingled with social life generally, less easily distinguished as a definitely separable part of life. We can nowadays only influence it by methods of permeation which bear upon the whole of our social life.

The objection to the regulation of prostitution is still of slow growth, but it is steadily developing everywhere, and may be traced equally in scientific opinion and in popular feeling. In France the municipalities of some of the largest cities have either suppressed the system of regulation entirely or shown their disapproval of it, while an inquiry among several hundred medical men showed that less than one-third were in favor of maintaining regulation (Die Neue Generation, June, 1909, p. 244). In Germany, where there is in some respects more patient endurance of interference with the liberty of the individual than in France, England, or America, various elaborate systems for organizing prostitution and dealing with venereal disease continue to be maintained, but they cannot be completely carried out, and it is generally admitted that in any case they could not accomplish the objects sought. Thus in Saxony no brothels are officially tolerated, though as a matter of fact they nevertheless exist. Here, as in many other parts of Germany, most minute and extensive regulations are framed for the use of prostitutes. Thus at Leipzig they must not sit on the benches in public promenades, nor go to picture galleries, or theatres, or concerts, or restaurants, nor look out of their windows, nor stare about them in the street, nor smile, nor wink, etc., etc. In fact, a German prostitute who possesses the heroic self-control to carry out conscientiously all the self-denying ordinances officially decreed for her guidance would seem to be entitled to a Government pension for life.

Two methods of dealing with prostitution prevail in Germany. In some cities public houses of prostitution are tolerated (though not licensed); in other cities prostitution is "free," though "secret." Hamburg is the most important city where houses of prostitution are tolerated and segregated. But, it is stated, "everywhere, by far the larger proportion of the prostitutes belong to the so-called 'secret' class." In Hamburg, alone, are suspected men, when accused of infecting women, officially examined; men of every social class must obey a summons of this kind, which is issued secretly, and if diseased, they are bound to go under treatment, if necessary under compulsory treatment in the city hospital, until no longer dangerous to the community.

In Germany it is only when a woman has been repeatedly observed to act suspiciously in the streets that she is quietly warned; if the warning is disregarded she is invited to give her name and address to the police, and interviewed. It is not until these methods fail that she is officially inscribed as a prostitute. The inscribed women, in some cities at all events, contribute to a sick benefit fund which pays their expenses when in hospital. The hesitation of the police to inscribe a woman on the official list is legitimate and inevitable, for no other course would be tolerated; yet the majority of prostitutes begin their careers very young, and as they tend to become infected very early after their careers begin, it is obvious that this delay contributes to render the system of regulation ineffective. In Berlin, where there are no officially recognized brothels, there are some six thousand inscribed prostitutes, but it is estimated that there are over sixty thousand prostitutes who are not inscribed. (The foregoing facts are taken from a series of papers describing personal investigations in Germany made by Dr. F. Bierhoff, of New York, "Police Methods for the Sanitary Control of Prostitution," New York Medical Journal, August, 1907.) The estimation of the amount of clandestine prostitution can indeed never be much more than guesswork; exactly the same figure of sixty thousand is commonly brought forward as the probable number of prostitutes not only in Berlin, but also in London and in New York. It is absolutely impossible to say whether it is under or over the real number, for secret prostitution is quite intangible. Even if the facts were miraculously revealed there would still remain the difficulty of deciding what is and what is not prostitution. The avowed and public prostitute is linked by various gradations on the one side to the respectable girl living at home who seeks some little relief from the oppression of her respectability, and on the other hand to the married woman who has married for the sake of a home. In any case, however, it is very certain that public prostitutes living entirely on the earnings of prostitution form but a small proportion of the vast army of women who may be said, in a wide sense of the word, to be prostitutes, i.e., who use their attractiveness to obtain from men not love alone, but money or goods.

"The struggle against syphilis is only possible if we agree to regard its victims as unfortunate and not as guilty.... We must give up the prejudice which has led to the creation of the term 'shameful diseases,' and which commands silence concerning this scourge of the family and of humanity." In these words of Duclaux, the distinguished successor of Pasteur at the Pasteur Institute, in his noble and admirable work L'Hygiene Sociale, we have indicated to us, I am convinced, the only road by which we can approach the rational and successful treatment of the great social problem of venereal disease.

The supreme importance of this key to the solution of a problem which has often seemed insoluble is to-day beginning to become recognized in all quarters, and in every country. Thus a distinguished German authority, Professor Finger (Geschlecht und Gesellschaft, Bd. i, Heft 5) declares that venereal disease must not be regarded as the well-merited punishment for a debauched life, but as an unhappy accident. It seems to be in France, however, that this truth has been proclaimed with most courage and humanity, and not alone by the followers of science and medicine, but by many who might well be excused from interfering with so difficult and ungrateful a task. Thus the brothers, Paul and Victor Margueritte, who occupy a brilliant and honorable place in contemporary French letters, have distinguished themselves by advocating a more humane attitude towards prostitutes, and a more modern method of dealing with the question of venereal disease. "The true method of prevention is that which makes it clear to all that syphilis is not a mysterious and terrible thing, the penalty of the sin of the flesh, a sort of shameful evil branded by Catholic malediction, but an ordinary disease which may be treated and cured." It may be remarked that the aversion to acknowledge venereal disease is at least as marked in France as in any other country; "maladies honteuses" is a consecrated French term, just as "loathsome disease" is in English; "in the hospital," says Landret, "it requires much trouble to obtain an avowal of gonorrhoea, and we may esteem ourselves happy if the patient acknowledges the fact of having had syphilis."

No evils can be combated until they are recognized, simply and frankly, and honestly discussed. It is a significant and even symbolic fact that the bacteria of disease rarely flourish when they are open to the free currents of pure air. Obscurity, disguise, concealment furnish the best conditions for their vigor and diffusion, and these favoring conditions we have for centuries past accorded to venereal diseases. It was not always so, as indeed the survival of the word 'venereal' itself in this connection, with its reference to a goddess, alone suffices to show. Even the name "syphilis" itself, taken from a romantic poem in which Fracastorus sought a mythological origin for the disease, bears witness to the same fact. The romantic attitude is indeed as much out of date as that of hypocritical and shamefaced obscurantism. We need to face these diseases in the same simple, direct, and courageous way which has already been adopted successfully in the ease of smallpox, a disease which, of old, men thought analogous to syphilis and which was indeed once almost as terrible in its ravages.

At this point, however, we encounter those who say that it is unnecessary to show any sort of recognition of venereal diseases, and immoral to do anything that might seem to involve indulgence to those who suffer from such diseases; they have got what they deserve and may well be left to perish. Those who take this attitude place themselves so far outside the pale of civilization—to say nothing of morality or religion—that they might well be disregarded. The progress of the race, the development of humanity, in fact and in feeling, has consisted in the elimination of an attitude which it is an insult to primitive peoples to term savage. Yet it is an attitude which should not be ignored for it still carries weight with many who are too weak to withstand those who juggle with fine moral phrases. I have even seen in a medical quarter the statement that venereal disease cannot be put on the same level with other infectious diseases because it is "the result of voluntary action." But all the diseases, indeed all the accidents and misfortunes of suffering human beings, are equally the involuntary results of voluntary actions. The man who is run over in crossing the street, the family poisoned by unwholesome food, the mother who catches the disease of the child she is nursing, all these suffer as the involuntary result of the voluntary act of gratifying some fundamental human instinct—the instinct of activity, the instinct of nutrition, the instinct of affection. The instinct of sex is as fundamental as any of these, and the involuntary evils which may follow the voluntary act of gratifying it stand on exactly the same level. This is the essential fact: a human being in following the human instincts implanted within him has stumbled and fallen. Any person who sees, not this essential fact but merely some subsidiary aspect of it, reveals a mind that is twisted and perverted; he has no claim to arrest our attention.

But even if we were to adopt the standpoint of the would-be moralist, and to agree that everyone must be left to suffer his deserts, it is far indeed from being the fact that all those who contract venereal diseases are in any sense receiving their deserts. In a large number of cases the disease has been inflicted on them in the most absolutely involuntary manner. This is, of course, true in the case of the vast number of infants who are infected at conception or at birth. But it is also true in a scarcely less absolute manner of a large proportion of persons infected in later life.

Syphilis insontium, or syphilis of the innocent, as it is commonly called, may be said to fall into five groups: (1) the vast army of congenitally syphilitic infants who inherit the disease from father or mother; (2) the constantly occurring cases of syphilis contracted, in the course of their professional duties, by doctors, midwives and wet-nurses; (3) infection as a result of affection, as in simple kissing; (4) accidental infection from casual contacts and from using in common the objects and utensils of daily life, such as cups, towels, razors, knives (as in ritual circumcision), etc; (5) the infection of wives by their husbands.[240]

Hereditary congenital syphilis belongs to the ordinary pathology of the disease and is a chief element in its social danger since it is responsible for an enormous infantile mortality.[241] The risks of extragenital infection in the professional activity of doctors, midwives and wet-nurses is also universally recognized. In the case of wet-nurses infected by their employers' syphilitic infants at their breast, the penalty inflicted on the innocent is peculiarly harsh and unnecessary. The influence of infected low-class midwives is notably dangerous, for they may inflict widespread injury in ignorance; thus the case has been recorded of a midwife, whose finger became infected in the course of her duties, and directly or indirectly contaminated one hundred persons. Kissing is an extremely common source of syphilitic infection, and of all extragenital regions the mouth is by far the most frequent seat of primary syphilitic sores. In some cases, it is true, especially in prostitutes, this is the result of abnormal sexual contacts. But in the majority of cases it is the result of ordinary and slight kisses as between young children, between parents and children, between lovers and friends and acquaintances. Fairly typical examples, which have been reported, are those of a child, kissed by a prostitute, who became infected and subsequently infected its mother and grandmother; of a young French bride contaminated on her wedding-day by one of the guests who, according to French custom, kissed her on the cheek after the ceremony; of an American girl who, returning from a ball, kissed, at parting, the young man who had accompanied her home, thus acquiring the disease which she not long afterwards imparted in the same way to her mother and three sisters. The ignorant and unthinking are apt to ridicule those who point out the serious risks of miscellaneous kissing. But it remains nevertheless true that people who are not intimate enough to know the state of each other's health are not intimate enough to kiss each other. Infection by the use of domestic utensils, linen, etc., while comparatively rare among the better social classes, is extremely common among the lower classes and among the less civilized nations; in Russia, according to Tarnowsky, the chief authority, seventy per cent. of all cases of syphilis in the rural districts are due to this cause and to ordinary kissing, and a special conference in St. Petersburg in 1897, for the consideration of the methods of dealing with venereal disease, recorded its opinion to the same effect; much the same seems to be true regarding Bosnia and various parts of the Balkan peninsula where syphilis is extremely prevalent among the peasantry. As regards the last group, according to Bulkley in America, fifty per cent. of women generally contract syphilis innocently, chiefly from their husbands, while Fournier states that in France seventy-five per cent. of married women with syphilis have been infected by their husbands, most frequently (seventy per cent.) by husbands who were themselves infected before marriage and supposed that they were cured. Among men the proportion of syphilitics who have been accidentally infected, though less than among women, is still very considerable; it is stated to be at least ten per cent., and possibly it is a much larger proportion of cases. The scrupulous moralist who is anxious that all should have their deserts cannot fail to be still more anxious to prevent the innocent from suffering in place of the guilty. But it is absolutely impossible for him to combine these two aims; syphilis cannot be at the same time perpetuated for the guilty and abolished for the innocent.

I have been taking only syphilis into account, but nearly all that is said of the accidental infection of syphilis applies with equal or greater force to gonorrhoea, for though gonorrhoea does not enter into the system by so many channels as syphilis, it is a more common as well as a more subtle and elusive disease.

The literature of Syphilis Insontium is extremely extensive. There is a bibliography at the end of Duncan Bulkley's Syphilis in the Innocent, and a comprehensive summary of the question in a Leipzig Inaugural Dissertation by F. Moses, Zur Kasuistik der Extragenitalen Syphilis-infektion, 1904.

Even, however, when we have put aside the vast number of venereally infected people who may be said to be, in the narrowest and most conventionally moral sense, "innocent" victims of the diseases they have contracted, there is still much to be said on this question. It must be remembered that the majority of those who contract venereal diseases by illegitimate sexual intercourse are young. They are youths, ignorant of life, scarcely yet escaped from home, still undeveloped, incompletely educated, and easily duped by women; in many cases they have met, as they thought, a "nice" girl, not indeed strictly virtuous but, it seemed to them, above all suspicion of disease, though in reality she was a clandestine prostitute. Or they are young girls who have indeed ceased to be absolutely chaste, but have not yet lost all their innocence, and who do not consider themselves, and are not by others considered, prostitutes; that indeed, is one of the rocks on which the system of police regulation of prostitution comes to grief, for the police cannot catch the prostitute at a sufficiently early stage. Of women who become syphilitic, according to Fournier, twenty per cent. are infected before they are nineteen; in hospitals the proportion is as high as forty per cent.; and of men fifteen per cent. cases occur between eleven and twenty-one years of age. The age of maximum frequency of infection is for women twenty years (in the rural population eighteen), and for men twenty-three years. In Germany Erb finds that as many as eighty-five per cent men with gonorrhoea contracted the disease between the ages of sixteen and twenty-five, a very small percentage being infected after thirty. These young things for the most part fell into a trap which Nature had baited with her most fascinating lure; they were usually ignorant; not seldom they were deceived by an attractive personality; often they were overcome by passion; frequently all prudence and reserve had been lost in the fumes of wine. From a truly moral point of view they were scarcely less innocent than children.

"I ask," says Duclaux, "whether when a young man, or a young girl, abandon themselves to a dangerous caress society has done what it can to warn them. Perhaps its intentions were good, but when the need came for precise knowledge a silly prudery has held it back, and it has left its children without viaticum.... I will go further, and proclaim that in a large number of cases the husbands who contaminate their wives are innocent. No one is responsible for the evil which he commits without knowing it and without willing it." I may recall the suggestive fact, already referred to, that the majority of husbands who infect their wives contracted the disease before marriage. They entered on marriage believing that their disease was cured, and that they had broken with their past. Doctors have sometimes (and quacks frequently) contributed to this result by too sanguine an estimate of the period necessary to destroy the poison. So great an authority as Fournier formerly believed that the syphilitic could safely be allowed to marry three or four years after the date of infection, but now, with increased experience, he extends the period to four or five years. It is undoubtedly true that, especially when treatment has been thorough and prompt, the diseased constitution, in a majority of cases, can be brought under complete control in a shorter period than this, but there is always a certain proportion of cases in which the powers of infection persist for many years, and even when the syphilitic husband is no longer capable of infecting his wife he may still perhaps be in a condition to effect a disastrous influence on the offspring.

In nearly all these cases there was more or less ignorance—which is but another word for innocence as we commonly understand innocence—and when at last, after the event, the facts are more or less bluntly explained to the victim he frequently exclaims: "Nobody told me!" It is this fact which condemns the pseudo-moralist. If he had seen to it that mothers began to explain the facts of sex to their little boys and girls from childhood, if he had (as Dr. Joseph Price urges) taught the risks of venereal disease in the Sunday-school, if he had plainly preached on the relations of the sexes from the pulpit, if he had seen to it that every youth at the beginning of adolescence received some simple technical instruction from his family doctor concerning sexual health and sexual disease—then, though there would still remain the need of pity for those who strayed from a path that must always be difficult to walk in, the would-be moralist at all events would in some measure be exculpated. But he has seldom indeed lifted a finger to do any of these things.

Even those who may be unwilling to abandon an attitude of private moral intolerance towards the victims of venereal diseases may still do well to remember that since the public manifestation of their intolerance is mischievous, and at the best useless, it is necessary for them to restrain it in the interests of society. They would not be the less free to order their own personal conduct in the strictest accordance with their superior moral rigidity; and that after all is for them the main thing. But for the sake of society it is necessary for them to adopt what they may consider the convention of a purely hygienic attitude towards these diseases. The erring are inevitably frightened by an attitude of moral reprobation into methods of concealment, and these produce an endless chain of social evils which can only be dissipated by openness. As Duclaux has so earnestly insisted, it is impossible to grapple successfully with venereal disease unless we consent not to introduce our prejudices, or even our morals and religion, into the question, but treat it purely and simply as a sanitary question. And if the pseudo-moralist still has difficulty in cooeperating towards the healing of this social sore he may be reminded that he himself—like every one of us little though we may know it—has certainly had a great army of syphilitic and gonorrhoeal persons among his own ancestors during the past four centuries. We are all bound together, and it is absurd, even when it is not inhuman, to cast contempt on our own flesh and blood.

I have discussed rather fully the attitude of those who plead morality as a reason for ignoring the social necessity of combating venereal disease, because although there may not be many who seriously and understandingly adopt so anti-social and inhuman an attitude there are certainly many who are glad at need of the existence of so fine an excuse for their moral indifference or their mental indolence.[242] When they are confronted by this great and difficult problem they find it easy to offer the remedy of conventional morality, although they are well aware that on a large scale that remedy has long been proved to be ineffectual. They ostentatiously affect to proffer the useless thick end of the wedge at a point where it is only possible with much skill and prudence to insinuate the thin working end.

The general acceptance of the fact that syphilis and gonorrhoea are diseases, and not necessarily crimes or sins, is the condition for any practical attempt to deal with this question from the sanitary point of view which is now taking the place of the antiquated and ineffective police point of view. The Scandinavian countries of Europe have been the pioneers in practical modern hygienic methods of dealing with venereal disease. There are several reasons why this has come about. All the problems of sex—of sexual love as well as of sexual disease—have long been prominent in these countries, and an impatience with prudish hypocrisy seems here to have been more pronounced than elsewhere; we see this spirit, for instance, emphatically embodied in the plays of Ibsen, and to some extent in Bjoernson's works. The fearless and energetic temper of the people impels them to deal practically with sexual difficulties, while their strong instincts of independence render them averse to the bureaucratic police methods which have flourished in Germany and France. The Scandinavians have thus been the natural pioneers of the methods of combating venereal diseases which are now becoming generally recognized to be the methods of the future, and they have fully organized the system of putting venereal diseases under the ordinary law and dealing with them as with other contagious diseases.

The first step in dealing with a contagious disease is to apply to it the recognized principles of notification. Every new application of the principle, it is true, meets with opposition. It is without practical result, it is an unwarranted inquisition into the affairs of the individual, it is a new tax on the busy medical practitioner, etc. Certainly notification by itself will not arrest the progress of any infectious disease. But it is an essential element in every attempt to deal with the prevention of disease. Unless we know precisely the exact incidence, local variations, and temporary fluctuations of a disease we are entirely in the dark and can only beat about at random. All progress in public hygiene has been accompanied by the increased notification of disease, and most authorities are agreed that such notification must be still further extended, any slight inconvenience thus caused to individuals being of trifling importance compared to the great public interests at stake. It is true that so great an authority as Neisser has expressed doubt concerning the extension of notification to gonorrhoea; the diagnosis cannot be infallible, and the patients often give false names. These objections, however, seem trivial; diagnosis can very seldom be infallible (though in this field no one has done so much for exact diagnosis as Neisser himself), and names are not necessary for notification, and are not indeed required in the form of compulsory notification of venereal disease which existed a few years ago in Norway.