From Dr. Gibson, M.O.H. Wakefield

From Dr. Gibson, M.O.H. Wakefield

!919: PUBLIC HEALTH. DR. FOSBROX_~desired to express the opinion t h a t there was much cry and little work about this Act. In Worcestershire they h...

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!919:

PUBLIC HEALTH.

DR. FOSBROX_~desired to express the opinion t h a t there was much cry and little work about this Act. In Worcestershire they had had health visitors f o r about twenty years, and a complete scheme in operation, yet this Act gave no additional power. The offer of a 50 per cent. grant is not the bait that the Local Government Board think it is - - i n the long run it comes out of the same pocket. And in accepting the grant the hands of local authorities will be tied regarding any scheme which might be undertaken. The difference it will make to Worcestershire is that the work will go from the Public Health and Housing Committee, which has dealt with this so far, to the Midwives Committee. The co-option of members on a spending committee is not going to be very useful--it is for advertisement. DR. GIBBONS WAI~ pointed out that there was a driving power behind this Act so far as the smaller authorities were concerned, in that if they did not carry out the Act, the County Council would. DR. HAmL~O~ Wood referred to work in connection with Child Welfare which had been carried out in Warwickshire for the last 14 years. Recently a Maternity and Child Welfare Committee had been appointed on lines suggested b y the °Local Government Board, which provides for the cooption of members outside the Council. Representatives for this purpose have been suggested b y various bodies, but only those have been appointed who were considered specially qualified through previous interest taken in Child Welfare generally.

CORRESPONDENCE. The Editor does not accept responsibility for the opinions of correspondents.

T H E P R E V E N T I O N OF % ~ N E R E A L DISEASE. From Dr. G I B S O N , M.O,H. Wakefiela.

SIR,--I am writing in support of the views put forward b y Dr. John Robertson and Dr. E. M. Smith with regard to the question of the prophylactic treatment of venereal disease. I am not at all satisfied, having regard to the conditions under which the bulk of venereal disease is contracted, that the methods recommended for prophylaxis are likely in practice to be generally efficient and reliable. But, whether reliable or not, are we not by advocating their use directly encouraging or, at least, condoning the practice of immorality ? Indeed, the more reliable prophylactic measures prove, the more confidence will the public have in their use, and consequently the more prevalent will irregular sexual intercourse tend to become. The position is a novel one for public health officers, a n d the novelty arises out of the unique position of venereal

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diseases as regards their causation, but it is not to be met b y the statement that we are n o t concerned with morals but only with the prevention of disease. I may be old-fashioned in my views, but I certainly regard sexual immorality as a serious social evil in itself, apart from the opportunities it provides for the dissemination of disease, and in my opinion any measure taken to make it " safe " will react disastrously on the well-being of the nation. The well-being of a nation depends just as much, to say t h e least, on the moral character and habits of its people as it does on their physical efficiency, and for me a nation of robust profligates has little attraction.. I am therefore in complete sympathy with the educational methods employed b y the National Council for Combating Venereal Disease, and completely opposed to the views put forward b y Sir Bryan Donkin and others and endorsed by yourself. I am not at all sorry that the subject has been ventilated in your columns, but at the time it must not be allowed to go forth to the public that the Society of Medical Officers of Health approves of a matter upon which it has not, as far as I know, expressed any opinion. I am, Sir, Yours faitMulty, THOMAS GIBSON. Correspondence from " T h e Times."

(From " The Times," Jan. 4th, i919 .) SIR,--The time has come for a little plain speaking. I t is admitted b y doctors that i f certain simple precautions are taken before, or within a short time after, the act, the danger of infection is practically nil. Treatment before the act i s termed " prophylaxis "--afterwards "" early treatment." Prophylaxis is objected to by Lord Sydenham, Sir Thomas Barlow, and some clergy and dissenting ministers on the ground that it is immoral, but with a few exceptions they acquiesce in early treatment. If the critical hour is, say, ! I p.m., they object to the use of disinfectants at IO.45, but raise no objection if the treatment is used at I1.15. The sinner must not prepare for immorality, but he may use the best means known to science to escape the consequences. How this attitude Of mind is justified I have not yet been able to discover, although I can appreciate the position of those who say that the Almighty has sent venereal disease as a punishment for immorality, and that no steps are justified to interfere with this dispensation. But even these stalwarts are not prepared to go the length of denying medical treatment to those who are suffering from the disease. Indeed, every one agrees that the infected person should submit to treatment at the earliest possible moment, so as to minimize the attack and the danger to himself and others. Of course, the whole subject bristles