Committee Of The Board Of Health.

Venereal Diseases in New Zealand (1922) Report of the Special Committee of the Board of Health appointed by the Hon. Minister of Health online

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1922.

NEW ZEALAND.


VENEREAL DISEASES IN NEW ZEALAND.


REPORT OF THE COMMITTEE OF THE BOARD OF HEALTH APPOINTED BY THE HON.
MINISTER OF HEALTH.


_Presented to both Houses of the General Assembly by Leave._


CONSTITUTION OF THE COMMITTEE.

Hon. W.H. TRIGGS, M.L.C., Chairman.
J.S. ELLIOTT, M.D., Member of the Medical Board.
Mr. MURDOCH FRASER (New Plymouth), representing the
Hospital Boards of the Dominion.
J.P. FRENGLEY, M.D., D.P.H., Deputy Director-General of Health.
Lady LUKE, C.B.E.
Sir DONALD McGAVIN, K.C.M.G., C.M.G., D.S.O., Director-General of
Medical Services.


CONTENTS.

PART I. - INTRODUCTORY AND HISTORICAL. Page

Section 1. - Origin and Scope of Inquiry: Witnesses; Sittings, Date and
Place of; Appreciation of Services rendered 2

Section 2. - Venereal Diseases and their Effects: Ignorance, Effect of;
Sex Education for Young; Syphilis and Gonorrhœa, Origin and
Description; Treatment after Exposure; Diagnosis, Methods of; Treatment,
Importance of Early and Completed 4

Section 3. - Accidental Infection: Sources of Infection; Metchnikoff's
Investigation; Food-conveyance; Lavatories, Towels, Drinking-cups, &c. 5

Section 4. - Previous Inquiries and Conferences: Contagious Diseases Act,
England; Royal Commission, 1913, Evidence, View of Compulsory
Notification, Divorce and Venereal Disease, Sex Education, Instruction,
and Propaganda; Australasian Medical Congresses. Committee appointed;
Auckland Congress, 1914, Report presented, Nature of Notification
recommended; Melbourne Conference, 1922, Review of Legislation, Comments
and Recommendations; England, Committee recently appointed to report on
Venereal Diseases 5

Section 5. - Legislation in New Zealand, Past and Present: Contagious
Diseases Act, 1869 (A), Reference to; Cases Cited (B) which require New
Legislation to deal with; Hospital and Charitable Institutions Act, 1913
(C); Detention Provisions; The Prisoners Detention Act, 1915 (D);
Provisions for dealing with Venereal Diseases in Convicted Persons;
Social Hygiene Act, 1917 (E); Provisions of the Act outlined; Subsidy
for Maintenance in Hospitals 7


PART II. - PREVALENCE OF VENEREAL DISEASE IN NEW ZEALAND.

Section 1. - Medical Statistics (A): Medical Practitioners, Special
Returns from, Cases reported, Gonorrhœa and Syphilis: Chancroid;
Prevalence. Clinic Statistics (B): Department of Health Data; Clinic
Distribution; Age Distribution; Marital Condition. Mental Hospital
Statistics (C): Syphilis and Dementia Paralytica; Computations as to
Prevalence of Syphilis based on Fournier's Estimate. Incidence among
Maoris (D): Early Days, Miscarriages; Prevalence at Present, Origin.
Death-certificates (E): Two Certificates, one for Relatives, other for
Registrar; British Empire Statistical Conference, Resolutions passed;
Committee's Conclusion 9

Section 2. - Causes of the Prevalence of Venereal Diseases in New
Zealand: Infected Individuals, neglect to undergo or continue Treatment;
Chiropractors; Herbalists: Overseas Introduction; Promiscuous Sexual
Intercourse; Professional Prostitution; Police Evidence; "Amateur"
Prostitution; Social Distribution; Extra-marital Sexual Intercourse,
Result of; Parental Control; Sex Education; Housing and Living
Conditions; Hostels, Advantages of; Moral Imbeciles, Danger from;
Delayed Marriages; Alcohol; Accidental Infections; Dances; Cinema;
Returned Soldiers 11


PART III. - BEST MEANS OF COMBATING AND PREVENTING VENEREAL DISEASES.

Section 1. - Education and Moral Control: Chastity, Value of;
Relationship between Sexes; Infected Persons, Responsibility; Church and
Press influence; Parents duty to Children; Pamphlet for Parents; Sex
Hygiene in Schools, Mode of Teaching; School Mothers, Value of, in
Girls' School; Instruction in Sex Hygiene; Adolescents; Moral Standard,
Value of 12

Section 2. - Clinics for the Treatment of Venereal Disease: Distribution;
Work performed; Male and Female Attendance; Locality of Clinics; Hours
of Attendance; Lady Doctors; Supply of Apparatus and Drugs for certain
Cases; Advertising Clinics; Extension of Clinics; Training at Clinics
for Nurses, Students, &c.; Cases attending until non-infective; Male and
Female; Lady Patrols; Social Hygiene Society, Work of; Laboratories and
Free Treatment: Complement Fixation Test for Gonorrhœa 14 Page
Section 3. - Licensed Brothels: Observations on; Dangers of Infection
from; Statistics; North European Conference's Resolution; Flexner's
Views; American Opinion. 15

Section 4. - Exclusion of Venereal Cases from Overseas: Health Act, 1920,
Provisions; Attendances at Clinics; Recommendations; Immigration
Restriction Act and Syphilis. 16

Section 5. - Prophylaxis: Packet System; Early Treatment;
Inter-departmental Committee on Infectious Diseases, Conclusions;
Notices in Public Conveniences; Prophylaxis, Efficiency of 16

Section 6. - Legislation required: Conditional Notification (A) - National
Council of Women, View on; Number or Symbol Notification; Infectious
Diseases Notification Bill, England (1889), Opposition to, Comparisons
with Control of Infectious Diseases; Present System, Disadvantages of;
West Australia Act; New Zealand Legislation suggested. Compulsory
Examination and Treatment (B). - Department of Health, proposed
Legislation, Contagious Diseases Act compared with; West Australia
Legislation, Effect on Attendances at Clinics 17

Section 7. - Marriage Certificate of Health: Royal Commission on Venereal
Diseases; National Birth-rate Commission; Medical Certificate; Statement
before Registrar, Communicable and Mental Disease; Recommendation;
Medical Practitioners' duty 20

Section 8. - Treatment of Unqualified Persons: Chemists, Herbalists,
Chiropractors; Effect of such Treatment; Clinic Statistics relating to
same; West Australian 20

Section 9. - Mentally Defective Adolescents: Danger and Cost to the
State; Supervision and Control proposed 20


PART IV. - SUMMARY OF CONCLUSIONS AND RECOMMENDATIONS.

Section 1. - Conclusions 21

Section 2. - Recommendations 21

Section 3. - Concluding Remarks 22

APPENDIX 24

* * * * *

REPORT.

The Hon. the Minister of Health, Wellington.

SIR, -

The Committee of the Board of Health appointed by you to inquire into
and report upon the subject of venereal diseases in New Zealand have the
honour to submit herewith their report.


PART I. - INTRODUCTORY AND HISTORICAL.


SECTION 1. - ORIGIN AND SCOPE OF INQUIRY.

A perusal of departmental files reveals that many persons and bodies
have during recent times urged upon the Government the desirability of
setting up a Committee or Commission of Inquiry to go into this subject.
The appointment of the present Committee, however, arose out of a
suggestion forwarded to the Chairman of the Board of Health, under date
of the 20th June, 1922, from the Council of the New Zealand Branch of
the British Medical Association. The Board of Health duly considered the
representations of the Association and passed a resolution recommending
the Minister to set up a committee to gather data and to make
recommendations as to the best means of preventing and combating
venereal diseases. The proposal thereafter took concrete form, following
the receipt by the members of this Committee of the under-quoted letter,
dated 13th July, 1922, sent out under your direction by the Secretary of
the Board of Health: -

"I am directed by the Hon. the Minister of Health, Chairman of this
Board, to inform you that, acting upon the recommendation of the
Board, he has decided to appoint a special Committee from among the
members of the Board to conduct an inquiry into the question of
venereal diseases in New Zealand. The following members are being
asked to become members of the Committee, and the Chairman trusts
you will see your way to accept the position: Dr. Valintine, Dr.
Elliott, Lady Luke, Hon. Mr. Triggs, Sir Donald McGavin, Mr.
Fraser. The Hon. the Minister has asked the Hon. Mr. Triggs to
accept the chairmanship of the Committee.

"I am further directed to state that the function and duty laid
upon the Committee is as follows: -

"(1.) To inquire into and report upon the prevalence; of venereal
disease in New Zealand.

"(2.) To inquire into and report any special reasons or causes for
the existence of venereal disease in New Zealand.

"(3.) To advise as to the best means of combating and preventing
venereal disease in New Zealand, and especially as to the necessity
or otherwise of fresh legislation in the matter.

"The Minister of Health is anxious that the Committee should hear
such evidence and representations on the above-mentioned matters as
may be necessary to fully inform the Committee on the items
referred to it, and with respect to which it is asked to report,
and he further suggests to the Committee that the various
organizations and persons likely to be interested should be
notified that the Committee will, at a certain place and date, in
Wellington, hear any evidence they may desire to tender."

The Committee regrets that owing to ill health Dr. Valintine,
Director-General of Health, was unable to act as one of its members. His
place was taken by Dr. J.P. Frengley, Deputy Director-General of Health.
Unfortunately, illness also overtook Mr. Murdoch Fraser, who has been
unable to attend the sittings of the Committee since the middle of
August. The remaining members have been present at all sittings of the
Committee, details of which are appended in the following table: -

- - - - - - - - - - - - - - - - + - - - - - - - - - - - - - - - - - - - - -
Places and Dates of Sittings. | Witnesses examined or Work done.
- - - - - - - - - - - - - - - - + - - - - - - - - - - - - - - - - - - - - -
Wellington, 26th July, 1922 | Preliminary meeting.
(forenoon only) |
Wellington, 8th August, 1922 | Dr. M.H. Watt, Director, Division of
(forenoon only) | Public Hygiene.
| Dr. B.F. Aldred, Officer in Charge
| Venereal Diseases Clinic.
Wellington, 9th August, 1922 | Hon. Dr. W.E. Collins, M.L.C.
(forenoon only) | Mr. J. Caughley, M.A., Director of
| Education.
Auckland, 17th August, 1922 | Dr. Falconer Brown, Officer in Charge
| Venereal Diseases Clinic.
| Dr. Hilda Northcroft.
| Dr. Frank Macky.
| Dr. W. Gilmour, Bacteriologist and
| Pathologist, Auckland Hospital.
| Dr. C.E. Maguire, Medical Superintendent,
| Auckland Hospital.
| Dr. W.H. Parkes.
| Dr. J. Hardie Neil.
| Dr. R. Tracy Inglis, Medical Officer, St.
| Helens Hospital.
| Dr. E.W. Sharman, Port Health Officer.
| Dr. W.H. Pettit.
Auckland, 18th August, 1922 | Mrs. De Treeby, representing Women's
| International and Political League.
| Dr. D.N.W. Murray, Medical Officer to
| Prisons Department.
| Mr. R.J. Pudney.
| Mr. Egerton Gill.
| Mrs. Harrison Lee Cowie.
| Mrs. E.B. Miller.
| Dr. Kenneth Mackenzie.
| Dr. E.H. Milsom.
| Dr. E. Carrick Robertson.
| Rev. Jasper Calder.
| Mr. F.L. Armitage, Government
| Bacteriologist.
| Dr. W.A. Fairclough.
| Dr. A.N. McKelvey, Medical Officer,
| Costley Home.
Christchurch, 29th August, 1922 | Dr. A.C. Thomson, Officer in Charge
| Venereal Diseases Clinic.
| Dr. P.C. Fenwick.
| Mrs. E. Roberts, President Women's
| Branch, Social Hygiene Society.
| Mrs. A.E. Herbert.
| Dr. A.B. Pearson, Bacteriologist and
| Pathologist, Christchurch Hospital.
| Nurse E.M. Stringer, Health Patrol.
| Dr. W. Fox, Medical Superintendent,
| Christchurch Hospital.
| Dr. C.H. Upham, Port Health Officer.
| Dr. C.L. Nedwill, Medical Officer to
| Prisons Department.
| Dr. D.E. Currie.
| Dr. J. Guthrie.
| Dr. W. Irving, Medical Officer, St.
| Helens Hospital.
| Dr. A.C. Sandston, President, Men's
| Branch Social Hygiene Society.
| Major R. Barnes, Salvation Army Officer.
| Dr. A.B. Lindsay.
Dunedin, 31st August, 1922 | Dr. A. Marshall, Officer in Charge
| Venereal Diseases Clinic.
| Dr. A.R. Falconer, Medical
| Superintendent, Dunedin Hospital.
| Dr. H.L. Ferguson, Dean Medical Faculty,
| Otago University.
| Dr. Emily H. Seideberg, Medical Officer,
| St. Helens Hospital.
| Dr. J.A. Jenkins.
| Canon E.R. Nevill, representing the
| Dunedin Council of Sex Education.
| Miss Pattrick, Director of Plunket
| Nursing.
| Mr. J.M. Galloway, representing Society
| for Protection of Women and Children.
| Dr. F.R. Riley.
Wellington, 12th September | Dr. W. Young.
(forenoon only) | Mr. T.R. Cresswell, Headmaster,
| Wellington College.
| Mr. W.W. Cook, Registrar-General.
| Mr. Malcolm Fraser, Government
| Statistician.
| Mr. W.D. Hunt.
| Rev. R.S. Gray.
Wellington, 13th September | Dr. Frank Hay, Inspector-General of
(forenoon only) | Mental Defectives.
| Mrs. Henderson, Representative Women
| Prisoners' Welfare Society and
| Wellington Branch National Council of
| Women.
| Rev. Van Staveren, Jewish Rabbi.
Wellington, 14th September | Dr. Agnes Bennett, Medical Officer, St.
| Helens Hospital.
| Mrs. F. McHugh, Health Patrol.
| Mr. F. Castle, President Pharmacy Board,
| and Chairman Wellington Hospital Board.
| Dr. D.M. Wilson, Medical Superintendent,
| Wellington Hospital.
| Mr. A.H. Wright, Commissioner of Police.
| Mr. W. Dinnie, ex-Commissioner of Police,
| representing Bible in Schools
| Propaganda Committee.
| Rev. J.T. Pinfold, D.D., representing
| Wellington Ministers' Association.
| Canon T. Feilden Taylor, appointed by the
| Bishop of Wellington.
Wellington, 15th September | Major Winton, Salvation Army.
| Mr. W. Beck, Officer in Charge Special
| Schools Branch, Education Department.
| Dr. D.E. Platts-Mills, representing Young
| Women's Christian Association.
| Mrs. Morpeth, representing Young Women's
| Christian Association.
| Miss Dunlop, representing Young Women's
| Christian Association.
| Mrs. Glover, Salvation Army.
Wellington, 26th September | Consideration of report.
Wellington, 10th October | Consideration of report.
Wellington, 12th October | Consideration of report.
Wellington, 13th October | Consideration of report.
Wellington, 18th October | Final meeting.
|
- - - - - - - - - - - - - - - - + - - - - - - - - - - - - - - - - - - -

It will thus be seen that, apart from time spent in travelling, the
Committee have met on seventeen days and have heard seventy-four
witnesses in person.

The Committee would like to express their thanks to the witnesses, many
of whom had gone to considerable trouble to collect information and
prepare their evidence. Thanks are also due to the British Medical
Association for their willing co-operation and assistance; to the large
number of members of the medical profession throughout the Dominion who
responded to the Committee's request for information; to Dr. J.H.L.
Cumpston, Federal Director-General of Health, Melbourne, for much
Australian information on the subject, particularly in relation to
Commonwealth quarantine provisions; to Dr. Everitt Atkinson,
Commissioner of Public Health, Perth, West Australia, for a most lucid
and informative report on the working of the legislation in force in
that State; and to many other persons who by means of correspondence and
literature have placed at the Committee's disposal a large amount of
information which has been of material assistance in considering various
aspects of the problems involved.

The Committee desire to acknowledge their indebtedness to their
secretary, Mr. C.J. Drake, whose wide knowledge of public-health matters
has been of material assistance in their investigations and who has
discharged his duties with marked zeal and ability.


SECTION 2. - VENEREAL DISEASES AND THEIR EFFECTS.

One result of the Committee's investigations has been to show that the
public in general are very ignorant regarding the nature of venereal
diseases, and their lamentable effects not only upon the individuals
infected, but upon the health and well-being of the community as a
whole. This ignorance of the nature of the problem and of the grave
issues involved naturally stands in the way of the evil being grappled
with effectually. Furthermore, the policy of reticence which has
prevailed in the past, while it has led to the omission of proper
instruction of the young, either by their parents or as part of our
system of education, has not prevented the dissemination of an
incomplete or perverted knowledge of the facts relating to sex, which,
being derived as a rule from tainted sources of information, has been
productive of a great deal of evil.

In these circumstances the Committee feel it their duty, before making
known their recommendations, to state in as plain terms as possible the
medical aspects of the problem they have had to consider.

There are three forms of venereal diseases namely, syphilis, gonorrhœa,
and chancroid - and of these the first two are the common and most
serious diseases. That sporadic syphilis existed in antiquity and even
in prehistoric times is probable, but there is no doubt that the disease
was a malignant European pandemic in the closing years of the fifteenth
century. The first reference to its origin is in a work written about
the year 1510, wherein it is described as a new affection in Barcelona,
unheard of until brought from Hayti by the sailors of Columbus in 1493.
The army of Charles VIII carried the scourge through Italy, and soon
Europe was aflame. "Its enormous prevalence in modern times," says Dr.
Creighton, "dates, without doubt, from the European libertinism of the
latter part of the fifteenth century." Gonorrhœa also has its origin in
the shades of antiquity, but that it became common in Europe about 1520
is a fact based on the highest authority.

Syphilization follows civilization, and syphilis is an important factor
in the extermination of aboriginal races. Syphilis was introduced into
Uganda when that country was opened to trade with the coast, and Colonel
Lambkin reported that "In some districts 90 per cent. suffer from it....
Owing to the presence of syphilis the entire population stands a good
chance of being exterminated in a very few years, or left a degenerate
race fit for nothing." The earliest known account of the introduction of
syphilis into the Maori race is in an old Maori song composed in the far
North. The Maori population in a village on the shores of Tom Bowline's
Bay was employed in a whaling-station on the Three Kings Islands, and
there they became infected and carried the disease to the mainland.
Venereal disease is not common now among the Maoris, but it made great
ravages in the early days of colonization, to which may be attributed
much of the sterility and repeated miscarriages in the transitional
period of Maori history.

Through the ages great confusion existed as to the origin and nature of
venereal disease, but in 1905 a micro-organism, the _Spironema
pallidum_, was demonstrated as the infective agent in syphilis, and the
gonococcus as the infecting organism of gonorrhœa had been discovered in
1879. As regards modes of infection, syphilis is contracted usually by
sexual congress; occasionally the mode of infection is accidental and
innocent, and congenital transmission is not uncommon. Gonorrhœa is
contracted by sexual congress as a rule, but occasionally from innocent
contact with discharges, as in lavatories.

Syphilis, therefore, is a markedly contagious and inoculable disease. It
gains entrance, and usually in three weeks (although this period may be
much shorter) a slight sore appears at the site of infection. It may be
so slight as to pass unnoticed. This is the primary stage of syphilis.
Later, often after two months, the secondary stage begins, and if not
properly treated may last for two years. The patient is not too ill
usually to attend to his avocation, and has severe headache, skin
rashes, loss of hair, inflammation of the eyes, or other varied
symptoms. The tertiary stage may be early or delayed, and its effects
are serious. Masses of cells of low vitality, known as "gummata," with a
tendency to break down or ulcerate, may form in almost any part of the
body, and the damage that occurs is considerable indeed. Various
diseases result which the lay mind would not associate with syphilis,
but it would be difficult to overestimate the resultant diseases that
may occur in any organ of the body: -

This racks the joints; this fires the veins:
That every labouring sinew strains;
Those in the deeper vitals rage.


Many deaths ascribed to other causes are the direct consequence of
syphilis. It cuts off life at its source, being a frequent cause of
abortion and early death of infants. It slays those who otherwise would
be strong and vigorous, sometimes striking down with palsy men in their
prime, or extinguishing the light of reason. It is an important factor
in the production of blindness, deafness, throat affections,
heart-disease and degeneration of the arteries, stomach and bowel
disease, kidney-disease, and affections of the bones. Congenital
syphilis often leads to epilepsy or to idiocy, and most of the victims
who survive are a charge on the State. This indictment against syphilis


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Online LibraryCommittee Of The Board Of HealthVenereal Diseases in New Zealand (1922) Report of the Special Committee of the Board of Health appointed by the Hon. Minister of Health → online text (page 1 of 7)