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Journal of social hygiene (Volume 28) online

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health techniques for dealing with disease, itself.

That, I submit, represents a real and important advance.

The average police officer will not move very far in response
to purely moral arguments. He wants facts. When he has
the facts and a really effective grasp of the law and the
police methods for dealing with the problem, you will find
no more cooperative group of officials in any profession.

Morals are important. They are among the most impor-
tant things in the world. But no sane police officer is going
to close down the 'red-light' district in his community if he
honestly believes that the result will be an increase in crime
and venereal disease.

And the arguments that will convince him must be related
to the police profession, itself. I am looking forward with
keen interest to the plans of the American Social Hygiene
Association for professional police education. American
police are on their way to a full working partnership with
the medical, public health, and welfare professions now work-
ing for venereal disease control. All along the line, we are
working to obtain the full cooperation of local officials. It
is our purpose to keep the local problem, local.


But that does not imply an avoidance of our fundamental
responsibility to stamp out venereal disease in the armed
forces. It does not imply tolerance of any disease threat to
defense workers of any community.

During this last month, the Secretary of War, the Secretary
of the Navy, and I have acted to bring some lagging cities
into line. We will use the full power of the high offices
entrusted to us to make it clear to the mayors and city
officials of such cities that there is a unity of policy between the
Services, and that the Federal Government means business.

A continuing committee representing our three depart-
ments is continually working to strengthen detailed admin-
istration of the venereal disease control and prostitution
problem. That committee is creating a closer liaison and a
more adequate field service stemming out of the offices of all
three Surgeons General. It calls for full use of the newly
developed professional collaboration of the International
Association of Chiefs of Police. And I might add, that
though we all hope every town does its duty, close collabora-
tion with the Federal Bureau of Investigation is a vital and
important element in our discussions.

And, finally, I come to that part of the subject which is of
special interest to me as Federal Security Administrator.

We have not done our job if we merely treat the disease
and repress prostitution. One would never stamp out malaria
by swatting mosquitoes. One must do an engineering job
by eliminating the swamp which breeds the mosquitoes.

There are social swamps, too. Packing-box shanties, far
from schools. Boys and girls that do not have a chance at
sound training for jobs. Towns that think they cannot
afford recreation facilities but let honky-tonks and road
houses serve as a substitute. Towns that will not establish
decent jails, and throw first offenders, hardened prostitutes,
and habitual criminals together in the same cell. Half of
the jails in America, according to the Federal Bureau of
Prisons, are not fit for Federal prisoners.


None of these are rhetorical illustrations. Those are things
that exist. They may not be typical, but they happened and
are happening.

Towns where such things exist, pay three ways :

They pay the cost of crime, and disease, and unproductive people.
They pay for bad public administration.

On their relief rolls, they pay for the salvage, or the support of the
human derelicts their shoddy brand of community service produces.

Add to the normal social responsibilities of an ordinary
town, the acute problems a defense boom brings. Thousands
of new workers looking for something to do when off the job.
Hundreds of petty racketeers and camp followers, trying to
grab off a few dollars of workers' and soldiers' incomes. A
community that has not shouldered its social responsibility
in normal times, may find it has to buck up and shoulder a
rather extraordinary responsibility that a military camp, or
a new defense industry has tossed into its lap. Honest, pro-
fessional policing, effective welfare service cannot be built
in a day.

So it is that the social protection program of the Federal
Security Agency does not contemplate merely clinics and the
padlocking of houses of prostitution. It proposes construc-
tive action action which involves such things as :

.(1) A constructive liaison between the police department and the
welfare agencies which will enable the police to pick up migrant boys
and girls that they find in unsafe situations and have them dealt
with, not as criminals, but as human beings, each with a problem to
be solved.

(2) The establishment of detention facilities which are not jails,
but are homes for reclaiming and rehabilitating the girl who has
started down the road to prostitution.

(3) Vocational training in recognition of the fundamental fact
that prostitution is very commonly an expression of economic inability
of a girl to establish herself in a job.

(4) Supervision of the employment of young girls and women in
cafes, taverns, honky-tonks, and places of commercial recreation. The
working conditions hours, wages, and adherence to age limitations
in such places should be carefully ascertained, and proper regulations
should be enforced.



We see in our Bureau of Public Assistance the reports of
welfare agencies from every part of the country. Not mere
statistics are those reports. Not mere cases. Within them,
written deep is the tragedy of human lives. In them one
reads the failure of communities to accept social responsi-
bility for the evils they permit to exist.

Through such failure, in times of peace or war, the nation
loses. We lose in dollars. We lose in the strength and
stability of the people. But in peace we still let local action
set its own pace.

In war, we cannot afford that luxury.




Surgeon General, United States Navy

The subject of this talk today might
seem to apply to the time which has
elapsed since December 7, 1941. In fact,
however, it applies to the last World War,
during 1917 and 1918, the intervening-
years, and to the period when President
Roosevelt declared a National Emer-
gency. I am making no attempt to sum-
marize all that has happened during those
years, for the members of this audience
are completely familiar with it. It is
only necessary to say that the fine work
that was done by the American Social Hygiene Association
and state and local social hygiene agencies in the last war
taught valuable lessons. Unfortunately, these were not fol-
lowed as they should have been during the succeeding years,
and so we come to another great war and the age-old question
of how to protect the fighting men of our country from a social
menace that is as deadly as enemy fire.

After many years of concerted effort and scientific study
in waging a continuous battle to stamp out or bring the
venereal diseases under control, the American Social Hygiene
Association has developed a six-point program, which if
followed rigidly will unquestionably result in the absolute
local control of venereal disease. Briefly, the points in this
program are :

1. Search out the venereally infected.

2. Treat every case of venereal disease discovered.

3. Stamp out commercial prostitution.

* Presented at the Tenth Annual Regional Conference on Social Hygiene
under the auspices of the New York Tuberculosis and Health Association, and
114 cooperating agencies, Hotel Astor, New York City, Wednesday, February 4,
1942, Sixth National Social Hygiene Day.



4. Drive out the quack doctor who preys upon those having a
genito-infectious disease.

5. Continue repeatedly to reveal the facts about venereal disease
and commercialized prostitution.

6. Provide wholesome recreations and diversions.

Such a program recognizes the broad sociological, medical,
and public health aspects of venereal disease control. I
should like to be able to say to you today that everyone is in
accord with this program, but unfortunately that is not so,
and yet we all know that once such a program is established
and put into effect in a community, rapid and conclusive
reduction in venereal disease morbidity will become a reality.
Many of the six points of this broad program have been a
part of the Navy's venereal disease program for many years.
The greatest difficulty we have found in putting this into
effect has been the lack of a sufficient number of officers
trained in this field whereby each Naval District could be
provided with a leader.

The case-finding procedure of the Navy Medical Corps
extends from the recruiting stations through the training
stations to the dispensaries and hospitals, and even to the
smaller medical laboratory units aboard ship or in the field.
In the recruiting station the applicant is examined thoroughly.
Those having a venereal disease in the infectious stage are
rejected forthright and the local health organization notified
whenever practicable. The remaining applicants who are
otherwise acceptable are then given a blood serological test
for syphilis. Any whose blood tests are repeatedly positive
are rejected. Whenever a member of the Services is admitted
to a naval hospital a blood serological test is done on him as
a routine case-finding measure. This is a screening procedure
and is invaluable in discovering latent infections of syphilis
which otherwise might remain unrecognized until permanent
impairment of health had developed. Periodically, through-
out the Navy and Marine Corps enlisted men are examined
for concealed venereal disease. Medical activities throughout
the U. S. Navy maintain close cooperation with local health
authorities. Information on known sources of venereal
disease is exchanged, and frequently results in unearthing


cases of venereal disease in the Service and among civilians.
These cases so discovered and brought under treatment might
otherwise have remained undetected and untreated and
thereby might have constituted a focus for the further dis-
semination of the disease. All food handlers are examined
weekly for communicable diseases. This includes examina-
tion for venereal diseases. All of these case-finding methods
are being pursued vigorously in the naval service.

As for the second point in the above mentioned program,
namely: treatment it can be stated with pardonable pride
that the men of the Naval and Marine Corps Services receive
treatment second to none. In the Services, unlike in civilian
or dispensary practice, conditions are more favorable for the
absolute therapeutic control of the case of venereal disease.
All are required to undergo treatment. The indifferent or
careless individual is closely supervised and required to
report for treatment. All cases of venereal disease are
restricted to their ship or station while in the infectious
stages. This measure prevents further possible spread of
the disease and prevents indulging in activities which might
interfere with treatment. As newer technics in the treatment
of the venereal diseases are developed and accepted by the
medical profession, these are added to the Navy physicians'

The Navy is extremely fortunate in the high calibre of the
men who enlist in either the Navy or the Marine Corps. For
this reason it is not difficult for the Medical Department of
the Navy to carry out a continuous educational program for
the men in personal hygiene, sex hygiene, and sanitation.
From the time of acceptance into the Service, and continually
throughout his career in it, the enlisted man is exposed to a
constant repetition of instruction on these subjects. He is
taught by means of lectures, lantern slides, and motion pic-
tures. He is never permitted to forget the seriousness of
venereal disease and the effect which it may have on his
efficiency in the Service, and the hazard which it constitutes
to his future health and happiness. The part played by
commercialized prostitution in the Services, and the methods
by which it thrives, are presented to him repeatedly.


It has been my experience that the medical officer who is
responsible for educating the men in this program must show
understanding in presenting his subject to these boys, and
not be swayed by the constant urge to do the spectacular.
I like to think of our men in the Service as healthy, intelli-
gent, and honest young Americans who are representative of
the youth of the country. It is very easy to show these boys
that they have a part and a place in winning this war ; that the
place of duty to which they are assigned makes them a part
of the team and when any of them are forced off, by reason
of illness or disease, untrained substitutes can not keep up
that smooth team work. It is by appealing to the loyalty and
common sense of our men that we will make our program a

No effort is overlooked in providing wholesome recreation
for the men aboard ship, and whenever practicable while
ashore. Athletic teams and contests are encouraged and
motion pictures and libraries are provided for use during
spare time. Unfortunately, military necessity takes prece-
dence, and space is at a premium aboard a combatant ship.
In time of war little space is available. Ashore, sightseeing
parties, dances, and social gatherings are encouraged. Every
effort is made to encourage the local populace to take an
interest in the men during their off-duty periods.

It must be recognized that in the military Services not all
of the six points of this well-rounded program of venereal
disease control can be instituted. I refer specifically to the
points covering commercialized prostitution and medical
quackery. Control or elimination of these are functions which
become divided among the local police, public health, and
medical authorities. It is generally recognized that the chief
source of venereal disease in the Services is commercialized
prostitution. Both commercialized prostitution and quackery
are evils, the roots of which lie deeply imbedded among
civilian elements of the population. Normally, under our
democratic system, military authorities have no control over
the civilian population. Commercialized prostitution is a
1,'irue scale racket somewhat similar in scope to the "boot-
legging" racket of prohibition days. Its ramifications include


a long list of hangers-on who seek to derive profit from the
prostitute and her patron. This racket is designed to prey
upon the uninitiated. Its ill-gotten gains are derived by
attempting to exploit the baser side of human nature. Its
patrons are chiefly the gullible and immature youths with
idle time on their hands. It flourishes or is stamped out
according to the attitude of local police and health authorities,
and these in turn are influenced by local public opinion. If
local opinion is willing to tolerate prostitution, it will remain.

In the Navy and Marine Corps, it can be shown that the
greatest incidence of venereal disease occurs among men in
their first enlistment and particularly during the first two
years of their service. Since the average age at first enlist-
ment is 19.8 years, it is evident that most venereal infections
are acquired while the men are relatively less mature, young,
inexperienced, easily led, and not fully adjusted to military
life. Observations indicate that these men are not inherently
inclined towards exposing themselves to venereal disease, and
that given choice, they would much prefer wholesome feminine
company. In many localities this is lacking, or the men in
uniform are actually discriminated against. Combine with
this the wartime activity in a Navy port; overcrowding of the
civilian population; insufficient wholesome diversions; over-
taxing of local police and public health facilities, and an
attitude of indifference towards prostitution, and conditions
become favorable for the prostitution racket to flourish at its
worst. This is especially true if local police facilities are
insufficient or if civil authorities assume an attitude of tol-
erance towards it.

Consider, too, that the men of the Navy and Marine Corps,
even in peacetime, visit ports throughout the entire world;
and consider again that the moral standards in many parts
of the world, especially in the Orient, are not those of our
country, and you have a picture that can not compare with
that in our home land. Many years ago the ship on which I
was the Senior Medical Officer visited all the principal ports
of the Far East and I well remember the first port visited,
for we had been at sea almost continuously for over a month.
In this city there was legalized prostitution, but because of


the moral standards, which were not those of our country,
sexual contact was not limited to the prostitutes. After two
weeks' stay in this port we found we had over ten per cent
of our crew infected with venereal disease. It was forced
on me at that time that ordinary restrictive measures would
never do the job that had to be done while cruising in that
part of the world. We used every means known to bring to
the attention of the men the necessity for self-control and
certainly common sense in caring for themselves. Added to
this we brought the weight of the opinion of the crew as a
whole on the men who were foolish enough to get themselves
infected and thereby be forced apart from their fellows. In
less than three months after this occurrence, the venereal
rate on this ship dropped to practically nothing. It was a
rare thing to have more than five or six cases of venereal
disease among 450 men.

The public should be educated to the fact that venereal
disease quackery also is a nefarious racket in which unprin-
cipled individuals seek to prey upon and profit from those
who are venereally infected. Those participating in this
racket have no genuine interest in the infected individual.
They have no knowledge of or interest in the importance of
venereal disease control. Their only concern is in the illegiti-
mate profit to be derived from the victim. There is sufficient
evidence to believe that this form of quackery plays a very
insignificant part, if any, in the venereal disease problems of
the U. S. Navy. The men are encouraged to go to their medi-
cal officers for treatment and these are well versed in the
latest treatment for venereal diseases.

The Navy Medical Corps in approaching this war effort
numbers only nine hundred and some regular officers. We
have in the past based our strength on 6.5 medical officers
per 1000 men. Now that the Navy has quadrupled and wil]
double again in size, it is not difficult for you to realize the
problem that faces the Medical Department of the Navy in
securing well-trained venereal control officers. A part of our
training program then is to provide for every section of this
country, where naval activities exist, competent doctors who
will do the job as it is laid down in these six points. This, of


course, calls for close cooperation between the Commanding
Officer of the station, the Medical Officer, and the civil authori-
ties in that location. This is where the American Social
Hygiene Association has been, and still is, of the greatest
assistance. We are receiving splendid cooperation from
certain civil institutions in the training of our young doctors
in this very necessary work and it is my belief that we will
have a sufficient number by the middle of this summer.

In closing I wish to emphasize several points. First, per-
sonnel of the Navy and Marine Corps are free of venereal
disease when entering the Service. Since any form of mor-
bidity lowers the efficiency of the individuals affected and
collectively of the naval service at large, it is the grave
responsibility of the Navy Medical Corps to prevent that
morbidity, or when once an infection has been acquired, to
cure it as promptly as possible. Every day lost on the sick
list means the loss of one trained man to the Service. The
more highly skilled he is, the more difficult it is to replace
his services.

Second, every evidence points to the fact that commercial-
ized prostitution is the chief source of venereal disease in
the armed services.

Finally, it is my opinion that in communities where the local
populace takes an active interest in the Service man, and
where local police and health authorities are actively engaged
in setting up high standards, commercialized prostitution can
not nourish.

Let me say to all of you here today that the Navy is seri-
ously embarked on the program that I have outlined. Let
me say also to you and to the people of our country that the
morbidity rate for venereal disease, putting it in lay figures,
was seven per cent lower in the year 1941 than it was in 1940 ;
that the rate of syphilis is lower than at any time during the
past forty years. This is not enough for us, however, and
we will continue to find some means of lowering this rate. To
the members of the American Social Hygiene Association, and
the affiliated state and local societies, let me express the


gratitude of the Navy for the fine cooperation you are giving
it, and also express to you personally my thanks for your
continued help.





Left to right: Major General Merritte W. Ireland, Dr. William F. Snow, Brigadier
General Frederick F. Russell, Dr. Claude C. Pierce.





at the General Session of the Twenty-ninth Annual Meeting

of the American Social Hygiene Association

in Boston, Massachusetts, February 3, 1942

For the fifth consecutive year, the William Freeman Snow
Award for Distinguished Service to Humanity was presented
at the Annual Meeting of the American Social Hygiene Asso-
ciation. The meeting this year occurred as the luncheon ses-
sion of the New England Regional Conference for Sixth
National Social Hygiene Day, on February 3, in Boston,
Massachusetts, with Philip R. Mather, Chairman of the Asso-
ciation 's Committee on National Defense Activities, presiding.
Following the medal presentation, Mr. Geoffrey May, Assis-
tant Director of the Federal Office of Defense Health and
Welfare Services gave the meeting's principal address on
the topic Health and Morale the Federal Wartime Program.

Major General Merritte W. Ireland, representing General
John J. Pershing as a member of the Committee on Award,
presented the medal which symbolizes the award to Brigadier
General Frederick F. Russell, the ceremony being broadcast
over NBC Stations WBZ (Boston) and WBZA (Springfield).
On this occasion also Honorary Life Memberships were
awarded to Colonel Claude Connor Pierce of the United
States Public Health Service and to Mr. Bascom Johnson of
the American Social Hygiene Association staff.

A notable gathering of members and friends included:

* See frontispiece.



Dr. Joseph Bolten, Medical Director, U. S. Public Health Service; Dr. Walter
B. Cannon, Chairman, Massachusetts Anti-Syphilis Committee; Mary E. Driscoll,
Secretary, Women's Civic Federation of Massachusetts; Mary S. Gardner, former
president, Providence Visiting Xurse Association, and former A.S.H.A. board
member ; Dr. and Mrs. Joel E. Goldthwait ; Dr. Paul Jakmauh, Commissioner,
Massachusetts Department of Health; Capt. H. L. Kelley, District Medical Offi-

Online LibraryAmerican Social Hygiene AssociationJournal of social hygiene (Volume 28) → online text (page 17 of 71)