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Journal of social hygiene (Volume 28) online

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Below Preventing babies' sore eyes by application of silver nitrate solution at birth an outstanding

accomplishment of modern medicine.





To get authentic pictures, of this method of
preventing gonococcal infection, cameraman
and director in gowns and masks waited four
hours for this baby to be born in New York
Hospital. At left, they are just about to



The new production

HEALTH IS A VICTORY

the Story of the fight against Gonorrhea like others of
the American Social Hygiene Association's films, was
made in response to a steady demand for a film to tell
briefly, scientifically and accurately the facts about the
campaign against gonococcus infections. It is suitable
for mixed audiences of high school age and up, and for
both professional and lay groups.

Produced by Willard Pictures, who made the popular
With These Weapons, the Story of Syphilis, under the
medical direction of Dr. Walter Clarke, assisted by J. L.
Stenek of the A.S.H.A. staff, Health Is a Victory is clear,
concise and effective. Presentation is dramatic and doc-
umentary, with voice and sound throughout, and a notable
cast.

Running time: 10 to 12 minutes.

Price: 35 mm., $75. 16 mm., $50. Transportation extra.

Rental: $5 per day in the hands of the consignee, plus
transportation.



Write tor free film folder, Publication No. A-428, describing
other A.S.H.A. films both talking and silent.

AMERICAN SOCIAL HYGIENE ASSOCIATION
1790 Broadway, New York City



Social Hygiene




VOL. 28 FEBRUARY, 1942 NO. 2

A Special Number on Progress in Prevention and
Control of Venereal Disease among Industrial Workers

INDUSTRY'S OPPORTUNITY

SOME COMMENTS ON PAST, PRESENT AND FUTUEE EPPOBTS TO
SOLVE THE VENEREAL DISEASE PROBLEM AMONG WOBKEBS *

WALTER W. R. MAY

Director of Public Belations, Portland General Electric Company

There is a premise that should be stated, and from which
we can begin.

Preceding the last War, some medical men and health offi-
cers, some educators, some laymen and some public agencies
pioneered social hygiene education in many of its ramifica-
tions with sufficient success to establish the need for its con-
tinuance and development as a war-time public policy. Fed-
eral Government, through the United States Public Health
Service, the Army and Navy and other government bureaus ;
the State Boards of Health and many City Health Officers, at
the request of the American Social Hygiene Association,
undertook a program of popular education which filtered into
public consciousness with some degree of success and in
which industry had a part.

* Remarks at the Northwest Regional Conference on Social Hygiene, Multnomah
Hotel, Portland, Oregon, February 12, 1942, Sixth National Social Hygiene Day.
The general theme of this conference was: Social Protection in War Time with
Particular Emphasis on the Venereal Diseases. The sub-section on Industry was
a part only of a panel, The Community Faces Its Problem, which included representa-
tives of The Citisen, The Army, Labor, The Private Physician and The United
States Public Health Service.

69



70 JOUBNAL OF SOCIAL HYGIENE

By the time the war ended the control of venereal diseases had
become a subject of international significance, and social hygiene in
its broader aspects was accepted as a part of the League of Nations'
program. In the reconstruction period after the peace the program,
although interrupted or broken down in varying degrees, was con-
tinued, with the American Social Hygiene Association carrying the
torch among private and semi-private agencies and pointing the way
for local similar societies.

The United States Public Health Service, the State Boards of
Health and some City Health Departments, vigorously in some
instances and perfunctorily in others, held their gains or advanced
or receded in varying degrees.

With the coming of the Social Security program, the United
States Public Health Service and State Boards of Health, with aid
through tax money; some educational institutions, some labor unions
and some industrial establishments and groups, depending upon the
pressure applied or the sales effort exercised, utilized the opportunity
of that Social Security program to make some new starts, and to
establish some new emphases in the movement. One of the great
advances was in transforming social hygiene education and venereal
disease control from the " untouchable " to the "touchable" group
of social problems. Newspapers and magazines, largely as a result
of the work done during the war period and since, and in recent
years under the vigorous pressure of Surgeon General Parran's
realistic and bold attack, began some time ago to admit to lay language
and the publisher's and editor's vocabulary a terminology that made
for a more general and accurate understanding. This was perhaps,
the greatest of all advances and was the cumulative result of all these
considerable efforts. The universities, through the medical and social
science schools, have prepared some new leadership, which is another
advance.

These facts and others are admitted and given due credit in what
I am about to say. There is a widespread public awareness of the
social hygiene movement. But, so far as I can discern, except for
scattered efforts, industry has not, since the last war, voluntarily or
under sales pressure, made it one of its compelling industrial group
problems, although many individual accomplishments may be cited.

Among other reasons for this, one undoubtedly is that industry
has had some other considerable problems to wrestle with. Another
is that Government, having assumed some paternalistic guidance in
this and other social problems of industry, discouraged industrial
initiative in this field of social advance. Another is that there has
been no consistent nation-wide request of industry to make this one
of its major concerns and no sufficient private or public fund available
for this particular field of activity to invite expert initiative to bring
it about on a scale large and general enough for us to say that indus-
try as a group is on the alert. It will take leadership and money.

If we could assume, for the moment, that this conference represents
this community and that the problem of further control of the



INDUSTRY'S OPPORTUNITY 71

venereal diseases is accepted by the community, and that we are
actually attempting study and solution of the problem on the six
fronts represented in this panel discussion, the future of the newly
established Division of Social Hygiene Education at the University
of Oregon Medical School would be a busy and promising one.

The late Dr. E. C. Brown, whose will and bequest made this new
division of work at the Medical School and indeed this conference,
possible, would feel his money was usefully spent if we could accept
as a fact that the community does face its problem in this respect
and that we could proceed on the theory that the money from this
large bequest could be used in forthright constructive work in
education for the further cure and control of these diseases. If we
could assume that the community by facing this problem, again is
accepting it, the many men and women who first pioneered and then
maintained for 35 years the Oregon Social Hygiene Society, now inac-
tive as a formal organization, would feel that their educational work
had been eminently worth while and was ready to be turned over
to the community as a whole.

Of course, that is not the case. The community faces the problem
but no one is ready to say that it has accepted it. This conference,
in so far as it may speak for and represent the community, we can
assume, does accept the problem and that is about as far as we can
go. One of the results of this conference should be to bring a step
nearer the community's acceptance of the problem.

It is readily understood that I can only speak of industry and not
for it in this instance, and in the words of Patrick Henry, ' ' I have but
one lamp by which my feet are guided and that is the lamp of
experience. I know of no way of judging of the future, save by
the past."

Therefore, I have concluded that the most valuable contribution
I could make to this conference would be to bring to it a summary of
the work that actually was done in the period 1918-1920, in industry,
and to a large extent by industry, when it did for a year accept the
problem. By Presidential order and Congressional action during the
last War a program of education, treatment and cure of the venereal
diseases was set up in industry. In that period I served as Assistant
Director of Education in the Division of Venereal Diseases of the
U. S. Public Health Service. My particular responsibility was the
"Industrial Program," officially sponsored and directed by the
Public Health Service but coordinated with the work of the Amer-
ican Social Hygiene Association, the various State Boards of Health,
the individual state or community social hygiene societies, and the
War Department Commission on Training Camp Activities.

If we can judge of the future by the past this conference may
with some assurance point the way to an effective program in indus-
try. Although this industrial work carried over a full year and a half
after the armistice in 1918 it was then, of necessity, interrupted, and
what has been done since, while effective, of course has been much



72 JOURNAL, OF SOCIAL HYGIENE

modified and of scattered emphasis. Had that program gone on
jointly with the aid of tax and private money, the impact it would
have made in the intervening twenty years would have been an
illuminating addition to industrial education and perhaps to indus-
trial medicine. It should be stated here that some of the work
established then has been continued and some of the gains made
have been held.

The formal report issued in June, 1920, of the work of the Indus-
trial Section of the United States Public Health Service would make
even now, I believe, a valuable handbook if it could be printed and
placed in the hands of federal and state health officials and made
available to lay societies and the medical schools that are now engaged
in some phases of the venereal disease control work. I present here-
with the opening paragraphs from that report, dated July 1, 1920 :

"The work of the Industrial Section of the Division of Venereal
Diseases (United States Public Health Service) in its educational
activities during 1919 and 1920, has been largely in developing a
'public health conscience' among employers of groups of men and
women and the actual application in industrial establishments of the
principles laid down and approved for the control of venereal diseases.

' ' This has been done in various ways, principally as follows :

' ' 1. By Presenting an ' Outline of Plan for Combatting Venereal Diseases in
Industry' to more than 50,000 firms.

' ' 2. By getting together at two conferences the chief surgeons, or their rep-
resentatives, of the 287 railroads under federal control, and by communi-
cating with all railroads (686) not under federal control.

" 3. By a series of other conferences of industrial groups.

' ' 4. By utilizing trade publications or house organs for educational articles.

" 5. By enlisting the aid of such organizations as the American Social Hygiene
Association, the American Red Cross and the Y.M.C.A. for the application
of the venereal disease control program wherever possible in their work.

"6. And, by using 'sales methods' in showing both employers and employes
the value of the venereal disease educational and medical program, and
in helping them to shape their programs so as to accord with the Public
Health Service plan of action.

"In doing this 117,360 communications have been sent to execu-
tives and managers of industrial establishments; employers and
employes have been assembled in 29 conferences of major importance
and 36 lectures given by Bureau representatives ; 11 showing of films
dealing with venereal diseases have been made; 6 resolutions indors-
ing the venereal disease program and pledging aid have been adopted
by industrial organizations; 20 articles of informative value have
been written for trade and other publications ; 755,423 pieces of edu-
cational material have been distributed exclusive of those distributed
free by state boards of health as a result of requests referred to them
and exclusive of reprinting done by industrial establishments.

"Of these 755,423 pieces of material distributed, 654,756 pieces
have been printed and paid for without cost to the Government and



INDUSTRY'S OPPORTUNITY 73

only 100,676 pieces of printed material paid for out of governmental
appropriations have been sent direct from the bureau to industrial
establishments. Of the total number of pieces of educational material
put into use during the year 6,813 pieces were placards framed under
glass and therefore having an increased period of usefulness.

"The interest of industrial executives in this work of the Public
Health Service has gone beyond the Bureau facilities for keeping an
adequate record of it and much work started as a result of the
bureau's suggestions and sample educational material has, of neces-
sity, been turned over to the medical department of the firm con-
cerned or referred to the state board of health for development. ' '

The foregoing few paragraphs are presented to this conference as
they were written twenty-two years ago mainly to show that some
effective work in venereal disease control through educational and
clinical services undergirds the present war effort in this field and
any program that may grow out of this conference. How spiritedly
industry responded to the invitation to do something is an experience
of the past by which the future might be judged if an effective and
modernized program is set up. The formal report catches but the
slightest significance of the far-reaching effect of educational work
under proper auspices. One concern for instance reprinted 60,000
copies of the pamphlet and placard which were the backbone of the
educational effort. This was the great Westinghouse Electric &
Manufacturing Company, which, with the distribution of the pamph-
lets and placards, reorganized its medical department for the first time
to provide venereal disease treatment. The American Steel Foundries,
with nine scattered plants, reprinted 5,000 pamphlets and followed
the educational campaign with medical service. Allied with this
industrial effort was the almost revolutionary accomplishment of
getting into the men's washrooms of every Pullman ear in the coun-
try a placard framed under glass, and in subsequent years this work
was extended, with great care and caution, and with the aid of most
appealing modern art, to many of the women's washrooms in the
Pullmans of the country. This type of work was duplicated in hun-
dreds of industrial plants of which the two foregoing are but typical
examples.

This so-called industrial program, the ramifications from which may
be found in the development of many industrial medical services and
first aid programs in hundreds of industries in the country today,
grew out of the educational work among industrial workers that had
been done by the American Social Hygiene Association prior to the
war in 1917 and by the Public Health Service in the period of 1918-
1920. For a few months this work was augmented by the War Depart-
ment Commission on Training Camp Activities, where in fact the
skeleton for the Industrial program was put together, for it was soon
evident that venereal disease control work in the cantonments of
the country would be ineffective if the control work could not be
carried into the extra-cantonment zones, and if carried into these
extra cantonment zones would be ineffective unless carried to the



74 JOURNAL, OF SOCIAL HYGIENE

industrial centers and farms, from which men were being recruited
by enlistment and the selective service of that day.

What the program undertook to do, and what it proved could be
done, was, by education, to pre-condition the men who were about
to go into service in so far as the venereal diseases were concerned.
This educational work resulted in treatment in civilian life of existing
venereal diseases in many instances, so that men were acceptable for
service, and it had a forceful and convincing influence upon the many
new officers who for the first time were coming face to face with this
problem in the handling of men. I have no personal doubt that it had
a considerable influence upon a lot of hard-bitten older officers of the
regular military establishment.

Following the armistice the American Social Hygiene Association
again assumed active direction of the program, in close coordina-
tion with the Public Health Service, and at this time between Novem-
ber, 1918, and July, 1920, a fine demonstration was made of the
cooperation between private enterprise and federal agencies that is
possible in an effort of this kind.

The Association made available $6,988.63 to reprint sample litera-
ture and outlines of the plan for the further circularizing of industry,
and by July 1, 1920, industrial establishments of the country had
returned to the treasury of the association the sum of $5,514.57 or
five-sixths of the cost. More than 50,000 plants were reacquainted
with the problem as a peace-time responsibility. Industry not only
agreed to accept the venereal disease problem as its problem among
its employes, but it practically paid for the cost of having the problem
presented to it!

In addition, thousands of industrial establishments and their key
executives and some employes had been exposed to the educational
idea in venereal disease control, the far-reaching good effects of which
cannot be estimated.

In my opinion, the wide public acceptance which greeted Surgeon
General Parran when he placed emphasis on venereal disease control
in the Social Security program and his follow-up expanded activities
for the preservation of health and the alleviation of misery among
the poor and others, was partly due to the conditioning effect of this
educational effort in industry in 1918. To neglect it further now in
the face of what we know can be done in mass groups of industrial
workers, is stupid and little short of neglect of opportunity in a
field of social service.

This community faces this problem in industry. There is no
question about it. It would now accept the problem in industry under
any kind of adequate leadership from a lay group, to supplement the
work of the State Board of Health. But, is it now not significant that
with all the work that had been done with tax money during the
last war by the Federal and state health agencies and with the aid
of private money, in Oregon, an early proving ground of social
hygiene education, each year the State Board of Health has to
fight for enough money from the legislature to do any kind of



INDUSTRY'S OPPORTUNITY 75

an educational or clinical job in venereal disease control, and that
we had to wait until private initiative had led a venerable, wise and
somewhat unusual doctor to leave the residue of his entire estate to
the educational aspect of this work ? Our universities, operating with
tax money, have done little in this vital field of education which
touches more persons more closely perhaps than any other one group
of diseases with which our medical schools are concerned.

The educational effort in industry, if reestablished, should of
course be coordinated with the program of law enforcement ; with the
educational work in our schools and colleges ; with our efforts to have
general hospital facilities made available to industrial workers at a
cost they can afford; with the physical fitness program of the Office
of Civilian Defense and the social protection and recreation work of
the Federal Security Agency. Certainly it should be coordinated with
what we are doing in the army camps and naval bases.

What we learned in our industrial work twenty-two years ago will
be found to be not vastly different from what we would find today.
We admit the advances in medical science and in the improved tech-
nique in treating gonorrhea and syphilis. We know something of
the almost sensational success of the new drugs in treating these dis-
eases, a development which may lead laymen to a refuge in a false
security. All of these things will be more effective if their applica-
tion can rest upon a sound foundation of social hygiene education.

I hope that because the work formerly done by the old Oregon Social
Hygiene Society, which was effective beyond dispute, now is
taken over by the Medical School, there will not be any great
lessening of the emphasis upon the moral values in social hygiene
education. Efficiency in the technique of treatment and in the power
of drugs are not enough. The late Doctor Brown, I am confident from
a long association with him, wanted some preventive educational work
done, first, in the hope that the reclamation work that must always be
done will become less and less a burden upon the taxpayers. The man
or woman who through proper education, harnesses some of his sexual
energies discriminately and sublimates some of his primordial
nonsense into modern, constructive thinking, is a more valuable worker
in industry and a better citizen than the man or woman reclaimed
solely by medical science from the ravages of these diseases, however
glamorous and satisfactory it may be to medical men to exhibit these
accomplishments.

The best medical science, conscience and technique and the almost
magical modern drugs have but scattered therapeutic value and
efficiency, so far as the masses are concerned, until education, sweep-
ing like a powerful magnet over the population draws the infected
men and women, literally en masse, under the curative influence of
these two forces, or draws the uninfected masses away from exposure.
For preventing disease there is no prophylaxis as potent as education.

Until the power of education in this field is let loose upon the popu-
lation the venereal diseases will remain, figuratively speaking, epi-
demic in spite of these medical and pharmaceutical advances.



76 JOURNAL, OF SOCIAL HYGIENE

If through this conference this community begins again to face this
problem the Outline of Plan, proposed by the United States Public
Health Service for combatting venereal diseases in industry, in which
the work of the American Social Hygiene Association, the War Depart-
ment Commission on Training Camp Activities and the State Boards
of Health was coordinated during the last war, might again be tried
out. It should, of course, be modified, to accord with the scientific and
educational advances we have made in the meantime. The plan
then was :

1. Distribution of educational pamphlets, posting of bulletins, placards,
et cetera.

2. Confidential interviews between employes and executives entrusted with
execution of the plan. Free lectures by federal and state health officers
who will visit the plant upon request.

3. Examination by competent doctors of employes who have or think they
have venereal disease. If feasible, time off with pay should be allowed
where gonorrhea or syphilis is in infectious stages. Utilizing of existing
medical or welfare organization in plant to include venereal disease
control work and investigation by proper person into family condition of
infected married workers.

4. Disposition of cases for treatment either by individual physician, at hos-
pital or plant clinic with conscientious follow-up work. Clinics operated
by U. S. Public Health Service or local Boards of Health are now available
in many communities. Ascertain whether your community has one and
use it.

5. Physical examinations of patients for a reasonable time after they are
pronounced cured of gonorrhea. Few cases of syphilis can be cured in
less than several years' time but they will cease to be infectious and
dangerous to others as soon as all open sores have been healed which will
require usually only a few months.

6. ^Realization on the part of citizens generally that, for purposes of protecting
the public health, venereal diseases are diseases not crimes necessarily.

In submitting that Plan to thousands of employers in 1918, the ques-
tion was asked of employers: "Is it worth while?" and the answer
was given by direct statements of which the following are but a few :

One plant, with a payroll of $125,000 annually increased its efficiency 33%
per cent by reducing venereal infection among its employes.

In Northern New York one firm engaged a competent doctor to treat 36



Online LibraryAmerican Social Hygiene AssociationJournal of social hygiene (Volume 28) → online text (page 11 of 71)