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A study of Russian prostitutes
A STUDY OF RUSSIAN P R O S T I T U T E S . arranged that they can be kept clean, the character of the tenants undergoes improvement. A number of putrefactive nuisances special to Oldham were gone into, with the steps necessary to remedy them. A matter of great consequence in Otdham is the damp subsoil in which the foundations of houses are laid. The subject was then considered from the point of view of an accomplished fact. The Oldham death-rate has dropped from 3 ° per I,ooo in 1872 , to about 20 per I,OOOin 1889, and a number of improvements were memioned which helped in the reduction. By far the most important was the cessation in the building of back to back houses in 1865, and the providing of every new house with a certain amount of surrounding air space and with adequate ventilation. Other factors mentioned were the closing of cellar dwellings in 1872 , the disconnection of slop pipes, the replacement of cesspools by cans, the notification of disease in 188% the provision of a fever hospital more adequate than the average, and the great improvement of the carding-room of cotton mills. This paper leaves out of account factors specially dealt with elsewhere, such as the emission of black smoke and the spread of tubercular disease, which, it is hoped, may be subsequently considered at an early date. The reading of the paper (which was illustrated by many interesting maps and plans) was followed by a discussion, in which the president, Drs. Kenyon, Vacher, Rhodes, Graham, and Martin took part. As the paper naturally introduced the larger subject, " T h e Preventable Causes of Death in Urban Districts," it was resolved to resume the discussion of the question in this form at the next meeting. The president exhibited three photographs, representing the face, arms, and feet of a suspected case of leprosy--the Swedish woman who lately emigrated to America, and was sent back by the New York Sanitary Authority. (End of Proceedin~s of Society of 2Vledical O~cers ef Health .) DISTRIBUTION OF I%{ILK THROUGH PIPES.--A proposal has been seriously made to convey milk by means of pipes to the various consumers. A central reservoir is to be constructed and-the milk flow to the customers as in a town water supply through a system of pipes. It is stated that this idea is being taken up in New York, and that a company has been already formed with a capital of three million of dollars. The idea is an insane one ; every one should know that it is alone liquids like water incapable of fermentation which can be distributed in this way successfully. I f the experiment is tried the pipes will become so foul from the various ferments, that sour, putrid milk is all that the customers will obtain.
ttbIi A STUDY
OF
lO3
,aIt .
RUSSIAN P R O S T I T U T E S . I. FOR absolutely the first time we possess a severe and accurate study of the "nucleus of prostitution." The methods adopted by the accomplished lady physician, Dr. Pauline Tarnowsky, * for this purpose were to minutely weigh, measure, and medically examine iso.registered, confirmed, and hopeless Russian prostitutes : whores by choice, without desire for purer lives. These are compared with too illiterate Russian women, but of ordinary good character, and 50 educated Russian women. Pauline sets herself the task to discover the reason why there can be found women in full possession of their faculties who are ready to deliver their bodies up to the lust of any male, old or young, brutal, drunken, or unattractive. "Putting on one side," says she, "cases of nymphomania, which are too rare and exceptionable to be taken into account~ how is the physiological state to be explained of a woman daily exercising the act ten or even twenty times with the first comers, refusing even the perogative of female animals in the matter of choice, for the fllle des maisans abdicates the right: of preference . . . . . . All these women eat, drink, sing, laugh, and, far from thinking their state desperate, they commit suicide rarely. They have no notion of the anomaly of their condition ; they regard their manner of gaining a livelihood much in the same way that other people look upon such occupations as that of a shopkeeper, a workwoman, or a servant." It may be incredible that the individuals constituting this lowest, and therefore most repulsive, form of prostitution will not revert to more wholesome methods of livelihood if a chance occurred ; but the fact is irrefutable that a large proportion bought out by their relations and provided with easy methods of living by work yet return to the old life. This is not alone proved by the registers, but it has talkn under the personal notice of Tarnowsky, and she gives details of several such instances. One of these may be briefly cited as an exalaple. In i88o a girl 18 years of age arrived at the St. Petersburgh railway station from the country, and owing to the lateness of the train and the bustle could not find friends who had promised to meet her and ultimately to get her employment. She was accosted by a procuress in the guise of an old lady who seemed to take an interest in her, offered her employment as a servant, and took her to her house, which was in effect a maison de lalemnce. A year later she was confined, and the father of the child * Etude Anthropometr:que sur les Prostitufics et lcs Voleuses. par le Docteur Pauline Tarnowsky. Pari% 1889.
104
A STUDY OF RUSSIAN PROSTITUTES.
b~ught her out. The father was a rich man, and he put her in a position in which she could support life pleasantly, the one condition being that of c'~astity. At the end of six months she deposited her child with her relations and again entered the maison de tolerance, declaring that she preferred that life to any other. In the study of Russian prostitutes, Tarnowsky recognizes several degrees. Those who have become so through the cruel compulsion of procurers, or from want, and who gladly seize the first opportunity of returning to honest lives are designedly excluded from the investigation ;. and justly so, for such are not likely to exhibit any marked deviations from other women of the same class. Although the numbers of facts (3oo) is small, yet such care was taken in the selection of the subjects that conclusions based upon them may be with some confidence accepted. In the first place, the prostitutes had all been at least three years in a maison de tolerance, they exercised their trade "willingly, were pleased with it, and had no desire of change." A second condition was that they were able to furnish full facts upon their past history, their family, social state, diseases, and so forth. Hence orphans left at an early age, and those who had been foundlings, were necessarily excluded. A third condition was that of race. Not alone were they t o be all Russians, but pure Russians ; if one father alone was a foreigner, or was derived, eg., from Finland, the -Baltic Provinces, Poland, or other countries, the case was also excluded. The same conditions were observed in the ,5 o honest women which served as a "control." ~Veasurements of the Pace and •ead.--A large number of measurements were taken by the most approved anthropometric methods, and the result may be stated as follows : The general size of the skull of the Russian whores was smaller than that of the honest women, while the face was decidedly larger.
Signs oj Physical Degeneration.mMalformations of the skull were frequent, heads conical (oxycephalic), heads flat (platycephalic), heads narrow (stenocephalic), and asymmetrical heads (plagioce. phalic) are the forms met with in far greater frequency than among chaste women. Many of these abnormalities coincided with a notable development of the occipital protuberance. These deformations are real, and not the effect of syphilis. There were also anomalies of the face ; the features were generally asymmetric, or there was more or less prognathism. The nose was sometimes on one side, and in many there was a deep excavation at the root (nez camus). NarrGw, high palates were frequent, and especially frequent were defects of the dental arch, such as irregularity of the dental line, atrophy, or absence of the lateral superior incisors, and absence of the wisdom teeth. On the contrary, the i5o Russian women of better morals had splendid teeth. Notes were taken of
the shape of the ears ; these were in some cases with the lobule adherent, in some were almost triangular shaped, and a few had Darwin's tubercle strongly developed. The following list is a summary of the anomalies observed in the 15o prostitutes : Women. Malformations of the head .,. D e v e l o p m e n t of the occipital protuberance ... Foreheads much sloping ......... t l y d r o c e p h a l i c foreheads .. Various anomalies of the face"(progn'athism; asymmetry, etc.) . . . . . . . . . . . . Ogivale palatine arch . . . . . . . . . . . . C o n g e n i a l cleft palate . . . . . . . . . . F a u l t y i m p l a n t a t i o n of the teeth ...... 'f l i u t c h i n s o n s " teeth . . . . . . . . . . . . Absence o! lateral incisors ...... Mal/ormations or detects of t h e ' e a r s . . . . . . A n o m a l i e s of the extremities . . . . . . . . . Local anaesthesia of the extremities . . . . . .
6z 62 I8 I5 64 38 I4 6z I9 IO 63 8 2
Of course, an individual possessing only one of the above defects would not be considered abnormal, but it is the coincidence of several of these deviations in the same person, often joined to disorder of the moral disposition, which renders them good evidences of degeneration. Fifteen of the i5o possessed only one deviation from the normal; throwing out these I5, of the remaining 134 82'6 per cent. showed decided signs of physical degeneration. Hereditary Influences.--Next, hereditary influences were studied, and the first striking fact which comes out from the research is the large number of ascendants addicted to drink. Of the i5o Russian whores no less than 124 were derived from drunken parents. Of these I24 in 5 ° cases both father and mother were drunken; in other words, exactly one-third were born with the blemish of alcohol on both sides of the sexual equation. In 69 cases the father was alone addicted to strong drink, in 5 cases the mother alone. Taking the whole, 82"66 per cent. were derived from alcoholic parents. The prostitutes themselves were much addicted to drink: 95 drank excessively, 49 got drunk occasionally, 6 alone cared not for drink. Among the illiterate peasant women taken for comparison i6"o per cent. only had drunken parents. PMAisis.--The intimate connection that the public health has with morality is accentuated by the fact that of the i5o , the parents of no less than 44 had died of phthisis ; in twelve of these there was the convergent hereditary influence of phthisis on both sides. This m~ty be better appreciated when we find that of " t h e control," that is, of the t5o chaste women, only 15 had parents which had died of phthisis. Sy~Ailis.--Hereditary syphilis was only traced in 4 per cent. of the prostitutes, but epilepsy and nervous maladies were hereditary in a large proportion. TAt Last of their Race.mA yet stronger proof of degeneration than the physical signs enumerated
O P T I M I S T I C R E P O R T S - - R E P O R T OF M E T R O P O L I T A N ASYLUMS BOARD. is the fact that these low, drunken women were in so many cases the only representatives of large families. The family, in their sterility, was doomed to extinction. Many of the individuals had 8, io, and even 13 brothers and sisters, all of whom had died, some in infancy, but all childless.
Wkat is the Cause of the Sterility of Prostitutes/-Tarnowsky first discusses minor causes, such, for example, as the early abuse of the sexual organs ; 65 had relations with men before 16 years of age, 32 had began even before x5. The other influences are those of syphilis, gonorrhea, abortions, alcoholism, etc. But besides and beyond all these, there is the insufficience of the creative force to be found in all degenerate beings which successively leads to the extinction of race. The interesting question of the moral character and the careers of the rso prostitutes, and lastly, the entire lesson the study teaches, must be left for consideration in a future article.
O P T I M I S T I C REPORTS. IN a recent report by Mr. John Spear occurs the following passage in reference to a certain local medical officer of health: " T h e optimistic tone adopted by him in his annual reports--a tone quite unwarranted by the actual sanitary conditions existing-has naturally impaired the force of any serious criticism or warning that, in a less formal way, he may have offered to the authority." Without going into the question whether in this particular instance the rebuke be just or not, it is obvious that, speaking generally, it is wrong as a matter of duty, weak as a matter of policy for any health officer to take the r61e of a special pleader for the sanitary condition of his district. We notice that this optimistic tendency is most pronounced in the annual statements concerning not a few of the watering places and health resorts--so much so, that the public generally, if they desire a true statement of the sanitary condition of certain seaside towns, have to rely upon special independent inquiry, or to take matters as they are. On the other hand, a few health officers show their independence of thought in lecturing their boards with considerable force of expression and even invective. The proper course is evidently between these two extremes; but the real cause of optimistic reports is the painful position in which the bulk of health officers of the kingdom have been placed by the indifference of the Legislature, the officers being dependent for their daily bread upon the whims, passions, and caprices ef local authorities. It is much to the credit of the health officers as a body that so few reports of the nature alluded to are made, the bulk of them being careful, deliberate statements of fkct and advice, being given in a firm but courteous manner.
to 5
T H E R E P O R T OF T H E S T A T I S T I C A L C O M M I T T E E OF T H E M E T R O P O L I T A N ASYLUMS BOARD. A FEATURE of the report is a series of " s p o t " maps, giving a graphical representation of the localities from whence cases have been admitted into the hospitals during 1889. The value of this graphic information is reduced, because the hospitals have hitherto isolated only the pauper, the servant.maid, and the artisan ; hence a muchspotted street does not necessarily indicate a feverbreeding area, but rather population density, and tenement property. It is necessary ever to bear this in mind, otherwise a hasty observer would decl~re that in the Metropolis, typhus, in 1889, was more prevalent than small-pox, for, indeed, the maps show more black typhus spots than those indicating variola. At the end of this year the Committee declare their intention of preparing a notification m a p ; if they do so, and have it shaded according to density of population~ we shall have for the first time a most valuable source of information, and if such a map were repeated annually, it may be possible to prepare upon such a basis an accurate "Metropolitan zymotic disease chart." The dangerous nature of the task of treating and nursing diphtheria is shown by the deaths of Mr. Ponsford, the assistant medical officer, and assistant nurse Musk, at the South Eastern Hospital, the death of a gardener at the North Western Hospital, and cases of diphtheritic illness in the staff of all the hospitals. It is to be hoped thaf'the medical officers have carefully studied the manner of infection in these cases, and that ultimately some means may b e devised to minimise the risk. For example, we may ask whether there is any systematic daily examination of the fances of each nurse or attendant on duty in a diphtheritic ward? Such an examination should be able to detect the earliest stage, and prompt local treatment would in all probability render the attack abortive. It is also to be confidently expected that the injection of attenuated cultures will confer immunity; when this is thoroughly established, and the technique worked out, nurses and doctors who have to live many hours daily in a diphtheritic infected atmosphere will certainly take advantage of a process at once advantageous to themselves and the public health service. The report shows by means of a diagram the complete way in which the Asylum Board is connected by telephone with the hospitals and ambulance stations, but to make this of still higher efficiency, the office of each Metropolitan Sanitary Authority ought also to be directly connected by wire ; when this is effected, the removal of infectious cases will be even speedier than at present.
ttbIi A STUDY
OF
lO3
,aIt .
RUSSIAN P R O S T I T U T E S . I. FOR absolutely the first time we possess a severe and accurate study of the "nucleus of prostitution." The methods adopted by the accomplished lady physician, Dr. Pauline Tarnowsky, * for this purpose were to minutely weigh, measure, and medically examine iso.registered, confirmed, and hopeless Russian prostitutes : whores by choice, without desire for purer lives. These are compared with too illiterate Russian women, but of ordinary good character, and 50 educated Russian women. Pauline sets herself the task to discover the reason why there can be found women in full possession of their faculties who are ready to deliver their bodies up to the lust of any male, old or young, brutal, drunken, or unattractive. "Putting on one side," says she, "cases of nymphomania, which are too rare and exceptionable to be taken into account~ how is the physiological state to be explained of a woman daily exercising the act ten or even twenty times with the first comers, refusing even the perogative of female animals in the matter of choice, for the fllle des maisans abdicates the right: of preference . . . . . . All these women eat, drink, sing, laugh, and, far from thinking their state desperate, they commit suicide rarely. They have no notion of the anomaly of their condition ; they regard their manner of gaining a livelihood much in the same way that other people look upon such occupations as that of a shopkeeper, a workwoman, or a servant." It may be incredible that the individuals constituting this lowest, and therefore most repulsive, form of prostitution will not revert to more wholesome methods of livelihood if a chance occurred ; but the fact is irrefutable that a large proportion bought out by their relations and provided with easy methods of living by work yet return to the old life. This is not alone proved by the registers, but it has talkn under the personal notice of Tarnowsky, and she gives details of several such instances. One of these may be briefly cited as an exalaple. In i88o a girl 18 years of age arrived at the St. Petersburgh railway station from the country, and owing to the lateness of the train and the bustle could not find friends who had promised to meet her and ultimately to get her employment. She was accosted by a procuress in the guise of an old lady who seemed to take an interest in her, offered her employment as a servant, and took her to her house, which was in effect a maison de lalemnce. A year later she was confined, and the father of the child * Etude Anthropometr:que sur les Prostitufics et lcs Voleuses. par le Docteur Pauline Tarnowsky. Pari% 1889.
104
A STUDY OF RUSSIAN PROSTITUTES.
b~ught her out. The father was a rich man, and he put her in a position in which she could support life pleasantly, the one condition being that of c'~astity. At the end of six months she deposited her child with her relations and again entered the maison de tolerance, declaring that she preferred that life to any other. In the study of Russian prostitutes, Tarnowsky recognizes several degrees. Those who have become so through the cruel compulsion of procurers, or from want, and who gladly seize the first opportunity of returning to honest lives are designedly excluded from the investigation ;. and justly so, for such are not likely to exhibit any marked deviations from other women of the same class. Although the numbers of facts (3oo) is small, yet such care was taken in the selection of the subjects that conclusions based upon them may be with some confidence accepted. In the first place, the prostitutes had all been at least three years in a maison de tolerance, they exercised their trade "willingly, were pleased with it, and had no desire of change." A second condition was that they were able to furnish full facts upon their past history, their family, social state, diseases, and so forth. Hence orphans left at an early age, and those who had been foundlings, were necessarily excluded. A third condition was that of race. Not alone were they t o be all Russians, but pure Russians ; if one father alone was a foreigner, or was derived, eg., from Finland, the -Baltic Provinces, Poland, or other countries, the case was also excluded. The same conditions were observed in the ,5 o honest women which served as a "control." ~Veasurements of the Pace and •ead.--A large number of measurements were taken by the most approved anthropometric methods, and the result may be stated as follows : The general size of the skull of the Russian whores was smaller than that of the honest women, while the face was decidedly larger.
Signs oj Physical Degeneration.mMalformations of the skull were frequent, heads conical (oxycephalic), heads flat (platycephalic), heads narrow (stenocephalic), and asymmetrical heads (plagioce. phalic) are the forms met with in far greater frequency than among chaste women. Many of these abnormalities coincided with a notable development of the occipital protuberance. These deformations are real, and not the effect of syphilis. There were also anomalies of the face ; the features were generally asymmetric, or there was more or less prognathism. The nose was sometimes on one side, and in many there was a deep excavation at the root (nez camus). NarrGw, high palates were frequent, and especially frequent were defects of the dental arch, such as irregularity of the dental line, atrophy, or absence of the lateral superior incisors, and absence of the wisdom teeth. On the contrary, the i5o Russian women of better morals had splendid teeth. Notes were taken of
the shape of the ears ; these were in some cases with the lobule adherent, in some were almost triangular shaped, and a few had Darwin's tubercle strongly developed. The following list is a summary of the anomalies observed in the 15o prostitutes : Women. Malformations of the head .,. D e v e l o p m e n t of the occipital protuberance ... Foreheads much sloping ......... t l y d r o c e p h a l i c foreheads .. Various anomalies of the face"(progn'athism; asymmetry, etc.) . . . . . . . . . . . . Ogivale palatine arch . . . . . . . . . . . . C o n g e n i a l cleft palate . . . . . . . . . . F a u l t y i m p l a n t a t i o n of the teeth ...... 'f l i u t c h i n s o n s " teeth . . . . . . . . . . . . Absence o! lateral incisors ...... Mal/ormations or detects of t h e ' e a r s . . . . . . A n o m a l i e s of the extremities . . . . . . . . . Local anaesthesia of the extremities . . . . . .
6z 62 I8 I5 64 38 I4 6z I9 IO 63 8 2
Of course, an individual possessing only one of the above defects would not be considered abnormal, but it is the coincidence of several of these deviations in the same person, often joined to disorder of the moral disposition, which renders them good evidences of degeneration. Fifteen of the i5o possessed only one deviation from the normal; throwing out these I5, of the remaining 134 82'6 per cent. showed decided signs of physical degeneration. Hereditary Influences.--Next, hereditary influences were studied, and the first striking fact which comes out from the research is the large number of ascendants addicted to drink. Of the i5o Russian whores no less than 124 were derived from drunken parents. Of these I24 in 5 ° cases both father and mother were drunken; in other words, exactly one-third were born with the blemish of alcohol on both sides of the sexual equation. In 69 cases the father was alone addicted to strong drink, in 5 cases the mother alone. Taking the whole, 82"66 per cent. were derived from alcoholic parents. The prostitutes themselves were much addicted to drink: 95 drank excessively, 49 got drunk occasionally, 6 alone cared not for drink. Among the illiterate peasant women taken for comparison i6"o per cent. only had drunken parents. PMAisis.--The intimate connection that the public health has with morality is accentuated by the fact that of the i5o , the parents of no less than 44 had died of phthisis ; in twelve of these there was the convergent hereditary influence of phthisis on both sides. This m~ty be better appreciated when we find that of " t h e control," that is, of the t5o chaste women, only 15 had parents which had died of phthisis. Sy~Ailis.--Hereditary syphilis was only traced in 4 per cent. of the prostitutes, but epilepsy and nervous maladies were hereditary in a large proportion. TAt Last of their Race.mA yet stronger proof of degeneration than the physical signs enumerated
O P T I M I S T I C R E P O R T S - - R E P O R T OF M E T R O P O L I T A N ASYLUMS BOARD. is the fact that these low, drunken women were in so many cases the only representatives of large families. The family, in their sterility, was doomed to extinction. Many of the individuals had 8, io, and even 13 brothers and sisters, all of whom had died, some in infancy, but all childless.
Wkat is the Cause of the Sterility of Prostitutes/-Tarnowsky first discusses minor causes, such, for example, as the early abuse of the sexual organs ; 65 had relations with men before 16 years of age, 32 had began even before x5. The other influences are those of syphilis, gonorrhea, abortions, alcoholism, etc. But besides and beyond all these, there is the insufficience of the creative force to be found in all degenerate beings which successively leads to the extinction of race. The interesting question of the moral character and the careers of the rso prostitutes, and lastly, the entire lesson the study teaches, must be left for consideration in a future article.
O P T I M I S T I C REPORTS. IN a recent report by Mr. John Spear occurs the following passage in reference to a certain local medical officer of health: " T h e optimistic tone adopted by him in his annual reports--a tone quite unwarranted by the actual sanitary conditions existing-has naturally impaired the force of any serious criticism or warning that, in a less formal way, he may have offered to the authority." Without going into the question whether in this particular instance the rebuke be just or not, it is obvious that, speaking generally, it is wrong as a matter of duty, weak as a matter of policy for any health officer to take the r61e of a special pleader for the sanitary condition of his district. We notice that this optimistic tendency is most pronounced in the annual statements concerning not a few of the watering places and health resorts--so much so, that the public generally, if they desire a true statement of the sanitary condition of certain seaside towns, have to rely upon special independent inquiry, or to take matters as they are. On the other hand, a few health officers show their independence of thought in lecturing their boards with considerable force of expression and even invective. The proper course is evidently between these two extremes; but the real cause of optimistic reports is the painful position in which the bulk of health officers of the kingdom have been placed by the indifference of the Legislature, the officers being dependent for their daily bread upon the whims, passions, and caprices ef local authorities. It is much to the credit of the health officers as a body that so few reports of the nature alluded to are made, the bulk of them being careful, deliberate statements of fkct and advice, being given in a firm but courteous manner.
to 5
T H E R E P O R T OF T H E S T A T I S T I C A L C O M M I T T E E OF T H E M E T R O P O L I T A N ASYLUMS BOARD. A FEATURE of the report is a series of " s p o t " maps, giving a graphical representation of the localities from whence cases have been admitted into the hospitals during 1889. The value of this graphic information is reduced, because the hospitals have hitherto isolated only the pauper, the servant.maid, and the artisan ; hence a muchspotted street does not necessarily indicate a feverbreeding area, but rather population density, and tenement property. It is necessary ever to bear this in mind, otherwise a hasty observer would decl~re that in the Metropolis, typhus, in 1889, was more prevalent than small-pox, for, indeed, the maps show more black typhus spots than those indicating variola. At the end of this year the Committee declare their intention of preparing a notification m a p ; if they do so, and have it shaded according to density of population~ we shall have for the first time a most valuable source of information, and if such a map were repeated annually, it may be possible to prepare upon such a basis an accurate "Metropolitan zymotic disease chart." The dangerous nature of the task of treating and nursing diphtheria is shown by the deaths of Mr. Ponsford, the assistant medical officer, and assistant nurse Musk, at the South Eastern Hospital, the death of a gardener at the North Western Hospital, and cases of diphtheritic illness in the staff of all the hospitals. It is to be hoped thaf'the medical officers have carefully studied the manner of infection in these cases, and that ultimately some means may b e devised to minimise the risk. For example, we may ask whether there is any systematic daily examination of the fances of each nurse or attendant on duty in a diphtheritic ward? Such an examination should be able to detect the earliest stage, and prompt local treatment would in all probability render the attack abortive. It is also to be confidently expected that the injection of attenuated cultures will confer immunity; when this is thoroughly established, and the technique worked out, nurses and doctors who have to live many hours daily in a diphtheritic infected atmosphere will certainly take advantage of a process at once advantageous to themselves and the public health service. The report shows by means of a diagram the complete way in which the Asylum Board is connected by telephone with the hospitals and ambulance stations, but to make this of still higher efficiency, the office of each Metropolitan Sanitary Authority ought also to be directly connected by wire ; when this is effected, the removal of infectious cases will be even speedier than at present.