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A Dual Alliance against Venereal Disease.
1075
THE
LANCET.
LONDON: SATURDAY, JL4}’ 1920.
A Dual Alliance against Venereal Disease. EARLY in 1917 the Borough of Portsmouth opened clinic for the treatment of persons suffering from venereal diseases, which has since been enlarged and is generally admitted to be doing good work. In February last Dr. A. MEARNS FRASER, medical officer of health for the Borough, presented to his Health Department a special report on means for the prevention of the same diseases. The chief duty of a sanitary authority is, as all will agree, preventive rather than remedial. In this able and, in parts, moving little pamphlet Dr. FRASER set forth the case for prevention, and concluded by recommending his local authority to take the a
would like, to enforce perfect orderliness on those using it, should yet insist that swords be cleaned after use in case they should be put back in the wrong scabbards. And in the end the scabbards would remain clean. The other real difficulty, also of a fundamental and reasonable nature, is felt by those who fear the effect of prophylactic propaganda upon the mind of the young man or woman growing up to the consciousness of virility and sexual potency. How can information be conveyed for making promiscuous intercourse safer from risk of infection without suggesting to the adolescent that his sanitary authority expects him to be clean but not continent ? This is a crucial point to which earnest groups of seekers have devoted attention without as yet finding a solution of wide acceptance. Portsmouth has cut the Gordian knot. Before the Council meeting all the omens were unfavourable to the acceptance of Dr. FRASER’S report except by a bare majority and in a controversial atmosphere. Wisely construing his duties as chief magistrate and first citizen, the Mayor of Portsmouth called a meeting at which the various conflicting interests were represented and which The reasonableness was addressed by Dr. FRASER. of the proposals struck home, and after very full discussion the supporting resolution (no formal vote was in order) was proposed by the Rural Dean, seconded by Bishop INGHAM, and supported by the President of the Free Church Council. With one corollary: that along with the municipal action in the domain of hygiene, there should run concurrently a voluntary campaign to promote chastity. Evidently some of those present at the meeting were not satisfied that they had done all that they could in social, educational, and moral directions. Dr. FRASER’S demand for a hygienic campaign undoubtedly precipitated a moral campaign. For the statistician this may be unfortunate, as the moral campaign will invalidate the hygienic as a scientific experiment. But for all other thinking people the prosecution of the two campaigns side by side may well suggest a solution for one of the most pressing problems of civilisation.
necessary steps to spread a knowledge of the means of self-disinfection, so that those who insist upon satisfying their sexual appetites by promiscuous intercourse should be in a position to protect themselves, and possibly their innocent families, against loathsome disease. On March 3rd the Portsmouth Health and Housing Committee approved and adopted Dr. FRASER’s report and decided to urge the Council to empower them at On April 27th the Council once to act upon it. itself confirmed this decision, and the principle of popularising the methods of venereal prevention among the male population is now the official policy of the municipality of Portsmouth. Where others have discussed Portsmouth has The manifold difficulties and objections acted. raised by both parties to a warm controversy have been more than sufficiently studied during the last few months. Some of the objections have been too much in the nature of Aunt Sallies stuck up expressly to be knocked down by cogent and clever argument. Advocates of self-disinfection are apt to assume as prevalent among their opponents the mediaeval view in favour of retaining disease The Cæsarean Scar. No responas a method of enforcing chastity. SINCE the magnitude and exhaustive nature of sible body of thinking people now takes this view or regards fear as a useful deterrent the task achieved by Mr. EARDLEY HOLLAND is only from venereal infection. Many of the opponents faintly reflected in the brief abstract of his paper of self-disinfection profess to see nothing in it at present available, the genesis of the discussion but the issue of prophylactic packets from an on Caesarean section at the joint meeting of automatic machine. Setting aside bogies and bug- Obstetrical Societies, reported on pp. 1062-68 of this bears, there remain two difficulties keenly felt issue, may be recalled. In a letter dated Feb. 10th by many who are not fanatics in regard to of this year, addressed to obstetric surgeons in popularising self-disinfection. The first is in active hospital practice throughout the country, essence that in so far as the male genital tract is Mr. HOLLAND sought the cooperation of his colrelatively easy to disinfect, and the female rela- leagues in an attempt to obtain definite information tively difficult, to advocate self-disinfection is to on the risk of rupture of the uterine scar after set up that different moral standard as between Caesarean section. In order to ensure a uniform men and women against which it is increasingly plan for this collective investigation he enclosed the spirit of the age to protest. It is said that to sample tables compiled from his " follow-up" advocate a method of disinfection applicable only records of cases from the London and City of to men is to revive the spirit of the ill-famed London Maternity Hospitals under these headings : C.D. Acts; in a word, to make fornication safe for (1) Indication for and year of operation; (2) - age of men. To this it may be replied that whereas to fix the patient; (3) her parity ; (4) period of pregnancy a different moral standard is wilful, the anatomical or labour when Caesarean section was performed; difficulty is not of our own seeking, is at (5) the type of uterine incision; (6) the site of the present inevitable, and is to be overcome by placenta; (7) the method of suture and material improvement in technique. Illustrations do not used; (8) the presence, absence, or degree of pyrexia carry us far, but the analogy might be suggested during convalescence; (9) the interval in years of an armoury in which the curator, unable, as he since the operation; (10) the condition of the
THE
LANCET.
LONDON: SATURDAY, JL4}’ 1920.
A Dual Alliance against Venereal Disease. EARLY in 1917 the Borough of Portsmouth opened clinic for the treatment of persons suffering from venereal diseases, which has since been enlarged and is generally admitted to be doing good work. In February last Dr. A. MEARNS FRASER, medical officer of health for the Borough, presented to his Health Department a special report on means for the prevention of the same diseases. The chief duty of a sanitary authority is, as all will agree, preventive rather than remedial. In this able and, in parts, moving little pamphlet Dr. FRASER set forth the case for prevention, and concluded by recommending his local authority to take the a
would like, to enforce perfect orderliness on those using it, should yet insist that swords be cleaned after use in case they should be put back in the wrong scabbards. And in the end the scabbards would remain clean. The other real difficulty, also of a fundamental and reasonable nature, is felt by those who fear the effect of prophylactic propaganda upon the mind of the young man or woman growing up to the consciousness of virility and sexual potency. How can information be conveyed for making promiscuous intercourse safer from risk of infection without suggesting to the adolescent that his sanitary authority expects him to be clean but not continent ? This is a crucial point to which earnest groups of seekers have devoted attention without as yet finding a solution of wide acceptance. Portsmouth has cut the Gordian knot. Before the Council meeting all the omens were unfavourable to the acceptance of Dr. FRASER’S report except by a bare majority and in a controversial atmosphere. Wisely construing his duties as chief magistrate and first citizen, the Mayor of Portsmouth called a meeting at which the various conflicting interests were represented and which The reasonableness was addressed by Dr. FRASER. of the proposals struck home, and after very full discussion the supporting resolution (no formal vote was in order) was proposed by the Rural Dean, seconded by Bishop INGHAM, and supported by the President of the Free Church Council. With one corollary: that along with the municipal action in the domain of hygiene, there should run concurrently a voluntary campaign to promote chastity. Evidently some of those present at the meeting were not satisfied that they had done all that they could in social, educational, and moral directions. Dr. FRASER’S demand for a hygienic campaign undoubtedly precipitated a moral campaign. For the statistician this may be unfortunate, as the moral campaign will invalidate the hygienic as a scientific experiment. But for all other thinking people the prosecution of the two campaigns side by side may well suggest a solution for one of the most pressing problems of civilisation.
necessary steps to spread a knowledge of the means of self-disinfection, so that those who insist upon satisfying their sexual appetites by promiscuous intercourse should be in a position to protect themselves, and possibly their innocent families, against loathsome disease. On March 3rd the Portsmouth Health and Housing Committee approved and adopted Dr. FRASER’s report and decided to urge the Council to empower them at On April 27th the Council once to act upon it. itself confirmed this decision, and the principle of popularising the methods of venereal prevention among the male population is now the official policy of the municipality of Portsmouth. Where others have discussed Portsmouth has The manifold difficulties and objections acted. raised by both parties to a warm controversy have been more than sufficiently studied during the last few months. Some of the objections have been too much in the nature of Aunt Sallies stuck up expressly to be knocked down by cogent and clever argument. Advocates of self-disinfection are apt to assume as prevalent among their opponents the mediaeval view in favour of retaining disease The Cæsarean Scar. No responas a method of enforcing chastity. SINCE the magnitude and exhaustive nature of sible body of thinking people now takes this view or regards fear as a useful deterrent the task achieved by Mr. EARDLEY HOLLAND is only from venereal infection. Many of the opponents faintly reflected in the brief abstract of his paper of self-disinfection profess to see nothing in it at present available, the genesis of the discussion but the issue of prophylactic packets from an on Caesarean section at the joint meeting of automatic machine. Setting aside bogies and bug- Obstetrical Societies, reported on pp. 1062-68 of this bears, there remain two difficulties keenly felt issue, may be recalled. In a letter dated Feb. 10th by many who are not fanatics in regard to of this year, addressed to obstetric surgeons in popularising self-disinfection. The first is in active hospital practice throughout the country, essence that in so far as the male genital tract is Mr. HOLLAND sought the cooperation of his colrelatively easy to disinfect, and the female rela- leagues in an attempt to obtain definite information tively difficult, to advocate self-disinfection is to on the risk of rupture of the uterine scar after set up that different moral standard as between Caesarean section. In order to ensure a uniform men and women against which it is increasingly plan for this collective investigation he enclosed the spirit of the age to protest. It is said that to sample tables compiled from his " follow-up" advocate a method of disinfection applicable only records of cases from the London and City of to men is to revive the spirit of the ill-famed London Maternity Hospitals under these headings : C.D. Acts; in a word, to make fornication safe for (1) Indication for and year of operation; (2) - age of men. To this it may be replied that whereas to fix the patient; (3) her parity ; (4) period of pregnancy a different moral standard is wilful, the anatomical or labour when Caesarean section was performed; difficulty is not of our own seeking, is at (5) the type of uterine incision; (6) the site of the present inevitable, and is to be overcome by placenta; (7) the method of suture and material improvement in technique. Illustrations do not used; (8) the presence, absence, or degree of pyrexia carry us far, but the analogy might be suggested during convalescence; (9) the interval in years of an armoury in which the curator, unable, as he since the operation; (10) the condition of the