the danger of secret diseases

“the abolition of prostitution and the suppression of venereal diseases would be almost tantamount to the solution of the entire sexual problem.”—iwan bloch.

so far in writing of marriage and of the irregular partnerships entered into outside of marriage i have ignored the question of venereal diseases and of prostitution, so intimately connected with them, but to continue to do this would be to make my inquiry useless, as, properly speaking, they constitute the central problem of the sexual relationships. there are no other factors of the same importance to motherhood and to the life and health of the race.

without doubt the subject is eminently complicated, while the problems involved are so immense, far-reaching and perilous, linking themselves with the deepest interests of the race, that i hesitate almost in making an attempt to discuss so wide a subject briefly, and necessarily inadequately, in the short space at my disposal. yet it is clearly impossible to take the easy way and pass these matters over in silence.

on the question of prostitution i have written already in my earlier book, the truth about woman, where i stated as truthfully as i could some facts i had come to know about the prostitute class, as well as my own opinions on this very complex social phenomenon. i shall, therefore, now as far as possible leave this side of the problem without[286] further comment. it must, however, be remembered that the problem of prostitution and the problem of venereal diseases are inseparably interconnected, the former evil being the chief cause of the latter. indeed, if prostitution could be ended venereal diseases would of themselves disappear.

and here we touch at once the grave difficulty of the position. these diseases are set apart from all other sicknesses of our bodies. moral considerations become confused with practical values. i do not see that this in itself can be wrong. for there can be no greater ideal than that of removing the poisonous sting that with such abundant activity has worked evil in our midst.

there is, however, danger in too much and wrongly directed moral enthusiasm. it is of vital importance that a contagious disease should be isolated and cured, and if moral condemnation acts to defeat these objects, it cannot but be a danger. a contagious disease that must be kept secret cannot be properly dealt with and healed.

i hope i made my own position clear when i wrote on prostitution, where i tried to avoid a purely moral and idealistic treatment of the subject.[99] i shall follow the same plan here. i shall limit myself to the aspects of the question that to me seem to be of special importance, choosing by preference facts about which i have some little personal knowledge, or a fixed opinion of my own. in this way i may be able to contribute a word or two of worth to this difficult question.

the report of the royal commission on venereal disease brought the subject before a reluctant and apathetic public. it was time. according to the commission one-tenth[287] of the city population is infected by syphilis. the number of those affected by gonorrh?a is much larger. the latter disease is the more terribly injurious to women and children, because it is often considered a triviality by men. syphilis serves as the origin of many functional and organic diseases, and its hereditary influence is truly disastrous. blindness, deafness and insanity, as well as a weakened nervous resistance, are the inheritance handed to the children of the syphilitic. gonorrh?a is the chief source of sterility in women, probably accounting for one-half of all cases.

at a time when infant life is of such supreme value to the nation as it is to-day, it is impossible to exaggerate the importance of these facts. we have to realise that could we act strongly and wisely so that in one generation we grappled with this great evil and cured it, we could make good the suffering and waste of life caused by the war.

is it not worth while to do this? it can be done. there was a time when syphilis did not exist in our civilisation. it cannot be traced with any certainty in europe before the fifteenth century, although its origin is involved in some controversy. the attempt to suppress venereal diseases by proper treatment is of less than twelve years’ duration. three men—wassermann, ehrlich and noguchi—have supplied the knowledge and given the means whereby the evil may be attacked. up to the present little use has been made of the effective means of diagnosis and cure that we now possess. the cure has been left to private doctors. no general hospital would treat these diseases, and the special hospitals are few in number. benefit societies and insurance commissioners have refused to grant the usual benefits to patients suffering from these diseases. the inoculations[288] are very expensive, and many patients, even among the wealthy, have not used them, as they have feared to discover the truth. the desire for concealment has done everything to make cure difficult.

i must emphasise constantly the danger of secrecy. we have to face the facts as they are, not as we wish them to be. and for this reason, because the results are what we now know them to be, we must demand the clearing away of the moral stigma that has been placed as a ban upon the infected. it is so plain. until every one attacked by these diseases seeks the best remedies, there can be no cure; and they will not seek the remedies while the presence of the diseases is considered as evidence of sin. in the past we have relied on fear as a deterrent and ignorance as a safeguard. they have failed. let us now try practical cures. a pharisaic attitude is so highly mischievous that it becomes immoral.

the government has taken prompt and fine action. it has removed one great difficulty, and effected all that can be done without fresh legislation. a comprehensive scheme of free diagnosis and treatment in general hospitals is to be organised by local authorities, who are to receive a grant from the imperial exchequer amounting to 75 per cent. of the cost. it is to be hoped that this admirable action will counteract the evils due to the increase of venereal disease certain to accompany the war.

the chief recommendations of the commission other than those connected with direct immediate cure, which the government has been able to carry out by an administrative act, are as follows—

(1) the presence of infective venereal disease should[289] be a cause for the prevention or annulment of marriage; further, the process of annulment should be made available for all persons, however poor.

(2) a communication made by a medical practitioner to a parent, guardian, or other person directly interested in the welfare of a woman or man in order to prevent or delay marriage with a person in an infectious condition should be a “privileged communication.” it should not, in such circumstances, be libel or slander to state that an intending husband cannot safely marry.

(3) it is further strongly recommended that better instruction be given on sexual subjects. “the evils which lead to the spread of venereal diseases are in great part due to want of control, ignorance and inexperience, and the importance of wisely conceived educational measures can hardly be exaggerated.”

there should be no delay in dealing with the last recommendation. a strong president of the board of education could, by an order of his pen, give instruction in an afternoon, and start arrangements which could introduce such teaching in all schools. it is, however, another matter whether there would be teachers capable to give the instruction. it is doubtful also whether sex teaching, introduced in this way as something apart from the usual educational course, could ever safeguard from sin.

i need, however, say little in this chapter on the important and difficult question of sexual education, as the whole of the last section of my book deals with that subject. i shall there try to show that the greater number of the evils connected with marriage and motherhood are due to false ideals and wrong methods of training in early life.[290] i am, in particular, convinced of the mistakes we have been making in the education of girls—mistakes which prevent them as young women from having any clear aim to guide their lives, and act, as i believe, disastrously on their whole nature as well as spoiling their happiness. this public recommendation for a recognition of the sexual life and the problems connected with it as being of vital importance in the training of the young generation fills me with strong hope. but everything will depend on how such instruction is going to be given. unwisely undertaken, it may easily lead to more harm than good. to be really efficacious it will need a sweeping change in the home and a revolution in the school. now is the appointed time to act; if the opportunity be allowed to pass, it may not come again. the force of tradition and the convention of silence has been broken as it has not been broken before. we are all convinced that the time to change has come and to do something; when so many are agreed upon what ought to be done, the danger lies chiefly in the dispersion of energy by the weariness brought on by endless discussions on the way to give the education—a subject which unfortunately lends itself to much talking and disagreement.

but to return to the royal commission report. recommendations (1) and (2) cannot be carried out without special legislation. to obtain the support of the house of commons for measures which would necessarily be opposed by some persons in every constituency, which have no vote-catching value and have not been chewed to pulp by long-continued party platform oratory, is a difficult task. the ordinary member of parliament feels afraid to have convictions which are unsupported by powerful organisations; convictions which may cost him much opposition[291] at election times. probably such a measure to safeguard marriage could be more easily initiated by a vigorous and fearless member of the house of lords. the house of commons at the present time, even apart from the great war and its urgency, is often busy for months with intricate government measures, which take up nearly all the time available. marriage laws cannot be dealt with in half an hour on a friday evening.

this need not discourage us too much. it will not serve to leave matters to official action alone. if the victory against venereal diseases is to be won, strong signs of general interest must be shown. more even than this is necessary. the interest shown must be of an enlightened character. i feel it is urgent to emphasise this need for wise, and not hasty, action. women have of late been taking a quite new concern in sexual questions, in particular in venereal diseases, so intimately connected with their interests. this is as it should be. but i have been forced to the knowledge that this interest, unbacked by wide knowledge and still more by experience of the facts of life, often leads them into folly. the possession of the vote by women has been expected to achieve immediate magical effects; it has been forgotten that women voters would be neither united in their aims nor possessed of the political capacity which would enable them infallibly to gain all for which they wished. women ought not to hope to solve the ancient, fierce enigmas which have vexed mankind in every modern civilised society.

in my opinion, the greatest cause of error in women’s judgment arises from the tendency (doubtless due to what their sex has suffered) to throw the whole blame for sexual sins on men. some women carry sex antagonism like[292] a flag, which they flourish in every wind. these are, of course, a small minority; but the majority of women fail to take a wide, sane view of both the question of prostitution and that of venereal diseases.

let me give an illustration. i recently attended a meeting where a paper was read on the report of the venereal disease commission. the reader of the paper, being a woman doctor, took the wise view that the most important matter was the cure of the disease. in the discussion that followed, it was plainly evident that few of the audience agreed with her. these were women who had read about, and to some limited extent thought and studied these questions. yet the general view was that the men ought to be punished. one speaker, who stated that she was married, said that no true woman could or ought to forgive a husband who had become infected with venereal disease.

now, it is this view, here so crudely expressed, that i am writing to combat. such an attitude of blame and unforgiveness has to be changed, or no legislation or public action will effect a real cure. women are really responsible for the secrecy of these diseases. and what is the result? because these infectious diseases are secret they are largely uncured.

i hasten to say that i am not taking an unfair view of the position. it is, of course, easy to understand the attitude taken up by women. blame is not easily avoided. i would, however, ask them very earnestly to consider whether there is not some confusion in their minds.

the sin that the man commits against his wife is being unfaithful. having caught the venereal disease is a misfortune. the effect must not be blamed by itself. let me illustrate this point of view by considering a different case.[293] your child gets scarlet fever by an act of direct disobedience or sin. he goes to play at a house he has been forbidden to enter. would you, because of his sin, refuse to pity and nurse him? rather would you not forget his disobedience and desire only to help and to heal him?

do you see what i mean now? it is not that i uphold immoral conduct in the husband or in the lover that i plead thus for pity and understanding on the part of women.

few men are intentionally evil. they do not even act foolishly in this question of infectious disease because they are wantonly careless. often they are fully alive to the danger that may result to their wives from their own infection. i repeat they are not necessarily bad men, and they may love their wives and children; but they are cowards. all men are cowards when it comes to facing their wives with their own wrong doings. if they cannot rely on the pity of their wives, few men will dare to tell the truth. if they cannot tell the truth, they cannot avoid infecting their wives. this may lead to the birth of infected children, and who may say that in this case the crime is the man’s alone? it is to prevent this crime against the child and against life, that i urge upon women a wiser and more tolerant attitude.

for greater clearness, i may state the matter thus: there are three attitudes that may be adopted towards sexual disease. first, that of the pure moralist, who says only, “this is a sin to be punished.” on the opposite side is the purely utilitarian, who says, “this is only a disease to be cured.” but both attitudes may be alike wrong, or, more correctly, the truth lies midway between the two. the disease, as a disease, needs to be cured. this is the first step with which nothing should interfere. but far[294] different and much more complex is the treatment required to alter the actions that lead to the disease.

as a first step, public opinion ought to condemn too late marriage, instead of recommending it on economic grounds. the mania for making economics the centre of life should now surely cease: the falsity of this view has been exposed by many great writers, but much stronger is the condemnation that must be given to it by all who can understand the evils that it has wrought in our sexual lives. late marriages must be one of the causes contributing to men’s use of prostitutes before marriage. this subject has been dealt with already in chapter xii.

a natural division of the subject here presents itself. the problems of venereal infection are different before and after marriage. a practical knowledge of the physical facts of sex should be the possession of every girl some years before the age of marriage. sex must cease to be a subject on which it is not decent for a girl to speak. until this has been achieved, it will be impossible to have that frankness between lovers which will make certain an acknowledgment being made of infection, if it is or ever has been present in the man, so as to do away with the dangers of concealment and further disease. in my opinion, this openness is of necessary importance to the wise choice on the part of girls of the men they are to marry.

our whole attitude towards youth in relation to sex is mistaken. and some of our worst mistakes take a direction not usually recognised. we often over-emphasise the possibilities of romantic love and chivalrous devotion, or we leave our children to gain this false attitude from the books they read. this is bad for both boys and girls. to personify all inspiration and nobility as woman often but[295] acts to make unknown vice attractive to youth. the unknown is almost always desirable. it is probable that times and places where excessive respect for women has been expressed in poetry and romance have been distinguished by looseness of sexual habits; just in the same way and for the same reason that extremely vulgar behaviour between the sexes is compatible with the strictest physical chastity.

in the case of girls, the evil that may be done by over-exalting romantic love is a different one. to idealise the male virtues of courage, adventurousness and self-confidence comes near, in many cases, to teaching the girls admiration for the calm, reckless don juan. this is the man who is likely to have been infected by venereal diseases.

in the story of the beauty and the beast we have material out of which part of the great sex difficulty can be explained. in the fairy story, the husband before marriage looks like a beast, after marriage he becomes a prince. in real life, the story is inverted. there is a deluding force in the mere skin and limbs of those of the opposite sex at the time when maturity is reached which may give princely attributes to those who would be seen as beasts at other times. the prince seen as a beast after marriage is a tragedy into which the romantic, ignorant girl must beware of drifting. the man who most boldly plays up to the romantic part expected of him—reciprocating to the perhaps unconscious encouragement of the girl—is not the man who will be the most agreeable to live with. i believe there is real danger in the sentimental view of love that is common to most girls. they do not know the poverty of feeling that loudly expressed sentiment may hide. the defect of many unfaithful lovers is not sensuality, but[296] sentimentality. the lower types of lovers are strangely, almost incredibly, sentimental. such teaching as this about the danger of an over-romantic view of love will not safeguard from all evils, but it will at least give knowledge that may protect in some time of peril.

the problem of the wife infected by a husband, who becomes diseased after marriage, is one that is different and more complicated. i have spoken already of the urgent need on the part of the wife that she should feel pity for the husband, even if she does this as the only means of protecting herself and her children. without this pity, men will not dare to tell the truth. and even against their judgment and their wish, they will have sexual intercourse with their wives to prevent suspicion.

there is a further question that must be placed before women, and it is necessary for me to speak plainly. there is a question which i would ask the wife whose husband has become infected since marriage with one or other of the two forms of venereal disease: what is it that sends the man who is married to seek sexual satisfaction with the prostitute? it will not do to dismiss this question with the old, unreasoning condemnation of the male and his brute passions. in the case of the man of average decency, it is not deliberate choice that first sends him to dissipation.

let us look at the matter a little closer and with greater truth. in marriage the woman dominates more often than usually is known. she has the children on her side. undeniably the greatest function of any man in the life of the average woman is to be the father of her child. all other things that he means to her are secondary to this. for this reason, after the birth of her children she frequently ceases physically to desire her husband. thus the[297] position arises that many husbands, after some years of marriage, find themselves in a condition of loneliness in their own homes. and the cleavage is wider than the physical needs, and extends to the mental and spiritual plains. the woman’s life is filled with her children; she ceases to belong to her husband as completely as he belongs to her. she holds back more and more of herself—the vital part that he wants. the man feels that he is losing, and, after some bluster and conflict, he begins not to care.

this, i believe, is the history of many marriages that started with love. the result in the end is almost certain. the lower types of husband from time to time will break away and seek distraction in wild love. other men of more refinement will suffer much more, till they seek to find love with some woman in a permanent union outside marriage.

it may, and i expect will, be said that i am looking at this question from the man’s side only. this is not because i do not feel the woman’s position, but because the facts i am trying to state are so often neglected, in particular by women themselves. women have been taught to believe, and do really feel, that by sexual unfaithfulness a husband does them the cruellest possible wrong that a man can do to a woman. but is the man ever wholly to be blamed? after all, he has given away only what his wife has shown him she does not want for herself. most english wives always are acquiescent rather than passionate in the sexual embrace. even when in love they are unresponsive, hiding what they feel, and rarely showing their husbands that they want them with any real desire. after a few years of marriage, his embraces are suffered as a duty. and here i would re-state an opinion given in an earlier chapter: i do hold that man is by his nature faithful. if he has once[298] loved a woman, he does not cease to desire her until after she has ceased to desire him.

this brings me to the last question i want to consider. why does the desire of the wife so often cease towards her husband? it is a difficult question to answer. one reason has been given already in the false attitude of the woman, which in so many cases makes her ashamed of expressing openly the passion that she feels. yet there is, i think, another and much deeper part of the truth that is fairly clear. each man is able to enforce his sexual desire upon his wife at a time when she feels no desire, whereas she cannot gain her desire unless he gain his. we may perhaps trace back to this cause the feeling of disharmony and waning of desire which injures the woman’s power to love. of course, this disharmony is not always conscious even to herself, and the man is quite unaware of the evil. but his acceptance of the woman’s subordination, however gladly given, does exhaust the passion in her.

this difference in the power for sexual sacrifice between the two sexes is, i have frequently thought, one of the gravest causes of our misery. it will take very long to overcome it. only as we advance in refinement and knowledge of love can this antagonism in the sex act lessen, as the woman gains in frankness and the man comes to know how to arouse and keep aflame her desire.

and there is here a question i would put to those husbands who are suffering to-day from the sexual coldness of their wives. i would ask them: have they taken sufficient trouble to understand, both on the physical and psychical side, the sexual nature of woman, which is much more complex and difficult than their own? the art of love is not understood by western people. if we paid[299] more attention to this subject marriage would be freed from the greatest cause that brings it to disaster. greater openness and sexual confidence between the husband and the wife is the first necessary step. but we shall never have this until we have rooted out of our moral conscience the idea of “the body as the prison of the soul.” i have often asked myself if this misconception of love is not the real cause of all sex trouble.

and the remedy? yes, that is the difficult matter. we cannot alter these evils by any cut-and-dried plan. the expression of sex is a question of refinement, and its regeneration must begin with a movement towards consciousness.

it may seem that we have reached no very definite conclusion. we have not solved the problem of venereal diseases. there is nothing to be gained by denying the difficulties that visit us in our sexual lives, or in talking, as many do, as though there were an easy way out. there is not.

i hold preaching on all these complicated questions to be quite useless. no platitudinous formul?, no recrimination of one sex against the other sex, will do any good. the wrong is deep down in our attitude towards love, in our system of education, and in the very prevalent vulgarity of our surroundings. it is there that we must seek for it and destroy it.

i dare to think of a regeneration of our sexual lives through education and a fuller understanding of the meaning of love. by education must be understood all that influences the desires and imaginations, so that our children shall be turned to seek health and clean living.

yet it were unwise to be too hopeful. we cannot be[300] architects of life. our sons and our daughters will make new mistakes, even should they escape our follies. we can see a very short way along the path of life, and often we are confused. the wisest amongst us are only as bricklayers, and the best can but lay two or three bricks in a lifetime. our work is to do that if we can. we can guess very feebly at the whole design. many mistakes must be made by us, as they have been made by those before us. and it may be the duty of a new generation to pull down the work that in sorrow we have toiled to build up.