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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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cases whose cards showed particulars, 104 consulted chemists in the
first place and received more or less treatment from them. He was able
to give details of twenty-three cases showing the type of treatment
given. In several cases there were severe complications which could have
been avoided by proper treatment. There were also cases in which the
patient, after taking medicine for a time, had communicated the
infection to others. This witness further stated that some chemists
charged consultation fees in addition to charges for drugs applied, and
in certain cases charges for drugs were made which were little short of
blackmail.

The Committee recommend that, in place of section 7 of the Social
Hygiene Act, a more comprehensive clause from the West Australian Act be
adopted. This is to the following effect: "No person [other than a
registered medical practitioner] should attend or prescribe for any
person for the purpose of curing, alleviating, or treating venereal
disease, whether such person is in fact suffering from such disease or
not."

The Committee would suggest that if the Pharmaceutical Society were to
do all in its power to discourage its members from treating these
diseases it would have a good effect.


SECTION 9. - MENTALLY DEFECTIVE ADOLESCENTS.

Mr. J. Caughley, Director of Education, stated in evidence: "From a
general inquiry made by the Department a few years ago it was
ascertained that there were at least six hundred or seven hundred mental
defectives in New Zealand under the age of twenty-one. I need scarcely
point out the moral danger to the community of so many of these
defectives being at large. In particular, the girls are a source of
danger to themselves and to the community, since they have little or no
will-power or sense of restraint. I am of opinion that all such cases
should be registered, and that, unless it can be shown that the mental
defective is under thoroughly safe and proper care at home, he should be
taken charge of by the State. I am certain that by this means the
increasing number of mental defectives would be reduced to a minimum,
since mental defectiveness is almost entirely hereditary."

Mr. Beck, Officer in Charge of the Special Schools under the Education
Department, cited illustrative cases, one of which may be thus stated:
"Two feeble-minded parents in New Zealand have had up to the present
time ten degenerate children, all of whom are a lifelong burden on the
State. Taking the case of these children, and assessing the cost to the
State of maintaining them, the total amount for this family will not be
less than £16,000."

The Committee are of opinion that supervision of mentally defective
children and adolescents is an important factor in lessening venereal
disease, and urge the Government as soon as possible to adopt a system
of registration and classification of mental defectives, and of
segregation where necessary, either in mental hospitals or in special
institutions where these defectives may be suitably taught, and, where
possible, usefully employed to defray the cost of their maintenance.


PART IV. - SUMMARY OF CONCLUSIONS AND RECOMMENDATIONS.


SECTION 1. - CONCLUSIONS.

Following are some of the conclusions drawn from the evidence by the
Committee: -

There is very general ignorance among the public on the subject of
venereal disease, and this has stood in the way of its being grappled
with effectively.

Syphilis not only causes loss of life directly, but many deaths ascribed
to other causes in the Registrar-General's returns are due to the
after-effects of this disease. It is responsible for many still-births
and abortions, and its evil effects are seen in such children as
survive. These effects may persist until the third generation.

Gonorrhœa, popularly, but quite erroneously, supposed to be a
comparatively mild complaint, is regarded by medical men as being as
serious a disease as syphilis. It is difficult to cure, especially in
women, unless properly treated at the outset. It is a great cause of
sterility in both sexes.

Owing to the absence of accurate statistics it is impossible to make
comparisons between New Zealand and other countries as regards the
prevalence of venereal disease, or to say whether it is increasing or
decreasing in this country.

There are in New Zealand no fewer than 3,031 persons being treated by
registered medical practitioners for venereal disease in some form, or
for the effects thereof - 1 person in every 428 of our population. At the
clinics since their establishment 3,634 patients have been
treated - 3,038 males, 596 females.

An interesting calculation as to the prevalence of syphilis in New
Zealand has been made by Dr. Hay, Inspector-General of Mental Hospitals.
Working on what is known as Fournier's Index - the relation of the number
of cases of dementia paralytica existing at any one time to the number
of concurrent syphilitic infectious - he computes the number of persons
in New Zealand now who have or have had syphilis to be 33,000, or 1 to
every 38 of the population.

The Committee desire to state, however, that in their opinion there can
be no accurate estimate of the prevalence of venereal disease until some
system of obtaining accurate statistics has been adopted. One point
which has come out clearly in their investigations is that venereal
disease is sufficiently prevalent to cause serious concern and to call
for energetic action.

Evidence was given to the Committee to show that children with mental
and physical defects due to venereal diseases may become a charge on the
State; that a proportion of these on being released become parents of
defective children, who in their turn have to be supported at the public
expense. It was also shown that such defectives have little sexual
control, and are usually very prolific.

According to the Commissioner of Police there are only 104 professional
prostitutes in New Zealand.

There is, however, a great deal of "amateur" prostitution, and this is
chiefly responsible for the spread of venereal diseases.

The evidence points to a good deal of laxity of conduct among young
people of all social conditions, especially in the large towns. This is
generally attributed by the witnesses to the weakening of home influence
and the restlessness of the age.

Apart from the venereal disease among those who indulge in promiscuous
intercourse, there are many cases in which innocent wives are infected
by their husbands, and other cases (not so frequent) of innocent
husbands being infected by their wives.

Children suffer innocently from venereal disease, not only by
inheritance from infected parents, but by accidently coming in contact
with the germs on towels, &c., which have been used by a patient. There
are also cases which come before the Courts where disease has been
conveyed directly in crimes of violence by sexual perverts.

The free clinics in the chief centres are conducted by experts, and are
doing good work. Their influence for good is greatly impaired, however,
by the fact that a proportion of the male patients and the majority of
the female patients leave off treatment before they are cured. As the
law stands there is no power to compel them to continue treatment, and
in many cases they resume promiscuous intercourse and spread the
disease.

Evidence has been given of other cases, some of them of a very shocking
character, in which persons suffering from venereal disease are not
seeking medical treatment and are communicating the disease to others.
As the law stands at present there is no power to restrain them from
such conduct or to compel them to receive medical treatment.


SECTION 2. - RECOMMENDATIONS.

The Committee stress in the strongest terms the duty of moral
self-control.

They urge the cultivation of a healthier state of public opinion. The
stigma at present attached to sufferers from venereal disease should be
transferred to those who indulge in promiscuous sexual intercourse.

Parents have a great responsibility as regards the instruction and
training of their children so as to safeguard them against the dangers
resulting from ignorance of sexual laws. There is too little parental
control generally in New Zealand. The Committee recommend the training
of teachers, and provision for giving appropriate instruction in
schools.

Classification and, where necessary, segregation of mentally defective
adolescents is recommended.

The following medical measures for preventing and combating the disease
are recommended: -

The clinics should be made more available by being open continuously.
Every effort should be made to secure privacy. A specially trained nurse
should be in attendance at women's clinics, and women doctors should be
secured where possible.

The Committee recommend that provision be made at the clinics for prompt
preventive treatment of those who have exposed themselves to infection.

Lady patrols should be appointed in other centres to perform the kind of
work that is being carried on in Christchurch.

The Committee, having regard to the good work especially of an
educational nature which is being done by the Social Hygiene Society,
Christchurch, consider voluntary effort of the same kind in other
centres would be very helpful.

The Committee are entirely opposed to the Continental system of licensed
brothels, or a revival of the C.D. Acts in any shape or form.

They recommend legislation be introduced providing for what is known as
conditional notification of venereal disease. It will be the duty of a
doctor to notify to the Health Department, by number or symbol only,
each case of venereal disease he treats. If a patient, however, refuses
to continue treatment until cured, and will not consult some other
doctor or attend a clinic, it will then be the duty of the doctor last
in attendance to notify the case to the Department by name.

If the patient continues recalcitrant and refuses to allow himself to be
examined by the medical practitioner appointed by the Director-General
of Health, then the latter should be empowered to apply to a Magistrate
for the arrest of such person and his detention in a public hospital or
other place of treatment until he is non-infective.

The Committee also recommend further provision to deal with cases in
which persons suffering from venereal disease are not under medical
treatment and are likely to infect others. If the Director-General of
Health has reason to believe that any person is so suffering he may call
on that person to produce a medical certificate, which may be procured
free of charge from any hospital or venereal-disease clinic. If the
person refuses to produce such a certificate he or she may be taken
before a Magistrate, who may order a medical examination. Penalties,
including detention in a prison hospital, should be provided for
recalcitrant cases. The proceedings in all these cases are to be heard
in private unless defendant desires a public hearing.

The Committee recommend that before a license to marry is issued the
intending parties must sign a paper answering certain questions as to
freedom from communicable disease and from mental disease, and must make
a sworn statement that the answers to such questions are true.

They recommend the adoption of a provision in the Queensland Act making
venereal disease a ground for annulling a marriage contracted whilst one
party is suffering from such a disease in an infectious stage, provided
the other party was not informed of the fact prior to marriage. Also
that it should be the duty of a medical practitioner attending a case of
venereal disease, if he has reason to believe that the patient intends
to marry, to warn him or her against doing so, and if he or she persists
it should be the duty of the doctor to notify the case by name to the
Director-General of Health, whose duty it should be to inform the other
party, or the parents or guardian of such other party. Such
communications made in good faith either by the doctor or the
Director-General of Health should be absolutely privileged.

The Committee recommend that the law prohibiting treatment of patients
for venereal disease by unqualified persons shall be strengthened, and
suggest that the Pharmaceutical Society might assist in preventing such
practices.


SECTION 3. - CONCLUDING REMARKS.

The Committee in carrying out their task have been brought into contact
with some uninviting aspects of our social life. Some of the facts
disclosed are of a character to give serious concern to those lovers of
their country who rightly regard it as exceptionally favoured by nature,
and desire to see its people healthy and vigorous, clean in body and
mind, worthy of their heritage. The late war showed that the pick of our
population, physically as well as mentally, were of the finest possible
type, the admiration of all who saw them; but the medical examination of
the recruits disclosed that of 135,282 examined after the introduction
of the Military Service Act - mostly young men in the prime of life - only
57,382, or say, 42½ per cent., could be accepted as fit for training,
unmistakably proving that the nation as a whole was much below the
standard of physical fitness which it ought to exhibit.

The investigations of the Committee show that already there is far too
large a proportion of mental and physical defectives reproducing their
kind. In the absence of accurate statistics it is impossible to say what
proportion of these defectives are the direct product of venereal
disease, but there is clear evidence that a tendency to lead dissolute
lives is especially noticeable in the females belonging to this
unfortunate class. "A feeble-minded girl," says Mr. Beck, "has not sense
enough to protect herself from the perils to which women are subjected.
Often amiable in disposition and physically attractive, they either
marry and bring forth a new generation of defectives, or they become
irresponsible sources of corruption and debauchery in the communities
where they live." Obviously some method of dealing with mental
defectives - by segregation or otherwise - must be found as part of the
problem of dealing with venereal disease.

As regards the effect of venereal disease on the general health of the
community, we have the statement of the late Sir William Osler that he
regards syphilis as "third on the list of killing diseases"; while
Neisser, a leading authority, says that "with the exception of measles,
gonorrhœa is the most widely spread of all diseases. It is the most
potent factor in the production of involuntary race suicide, and by
sterilization and abortion does more to depopulate the country than does
any other cause."

In view of the facts brought out in the course of the inquiry, the
Committee are strongly of opinion that it would be criminal neglect to
allow the evil to go on without taking energetic steps to check its
ravages. They believe that the legislative and other measures which they
recommend for the medical prevention and treatment of venereal disease
will, if given effect to with the loyal co-operation of the medical
profession, have a very beneficial result in reducing the prevalence of
disease, and will save an incalculable amount of sorrow and suffering
which in too many cases falls upon the innocent. In what is proposed in
this report there is nothing approaching a revival of the old Contagious
Diseases Acts. To use the words of Dr. Emily Seideberg, the principle of
the legislation now proposed is "To improve the health of the community,
and not, as in the old Contagious Diseases Acts, to make sexual
immorality safe for men of low morals."

The Committee are of opinion that, far from conditional notification and
compulsory treatment on the lines proposed being prejudicial to woman in
any way, it is they who will reap the greatest benefit from these
measures. In fact, sufferers from venereal disease, as a whole, have
everything to gain and nothing to lose so long as they will continue
under treatment, and to enable them to do this the best medical skill is
placed at their disposal free of cost. The only persons in the community
who will be penalized by the proposed legislation are those who, having
contracted venereal disease, are so reckless and unprincipled that they
will take no pains to avoid communicating it to others.

The Committee, it will be seen, regard the legislative and medical
measures which they propose as of great importance, but with all the
earnestness at their command they desire in conclusion to emphasize the
moral and social aspects of the question. With the changing social
conditions, especially in the larger towns, we are losing the home
influence and home training which are the best safeguards to preserve
the young against the temptations and dangers which beset their path in
life. The Committee would impress upon parents the paramount duty they
owe to their children in this matter. There is also a duty cast upon all
leaders of public opinion, and upon the community at large, to do what
is possible to bring about better living-conditions, especially for
girls in the towns, to encourage all forms of healthy sport and
amusement, and to cultivate a higher moral standard. Whatever sanitary
laws may be passed, and whatever success may be attained in dealing with
bodily disease, there can be no true health if the soul of the nation
remains corrupt. If this inquiry should serve to remove some of the
popular ignorance regarding venereal disease, and to quicken the public
conscience so that appropriate steps may be taken to deal with this
dreadful scourge, the Committee feel that their labours will not have
been in vain.

W.H. TRIGGS, Chairman.
J.S. ELLIOTT, \
M. FRASER, \ Members
J.P. FRENGLEY, > of
JACOBINA LUKE, / Committee.
D. McGAVIN, /


APPENDIX.


GRAPH A.

AVERAGE AGES OF BRIDEGROOM AND BRIDE AT MARRIAGE, 1900-1921.

[Illustration]


TABLE A.

ILLEGITIMATE BIRTHS, AND BIRTHS WITHIN ONE YEAR AFTER MARRIAGE, IN NEW
ZEALAND, 1913-21.

NOTE. - The figures refer to accouchements, not to children born,
multiple cases being counted once only (Only live births are included.)

- - - + - - - - - - + - - - - - - - - - - - - - - - - - - - - - - - - -+
|Illegitimate| Duration of Marriage (in Complete Months) |
Year |Births + - -+ - -+ - - -+ - - -+ - - -+ - - -+ - - -+ - - -+ - - -+
| | | | | | | | | | |
| | 0.| 1.| 2. | 3. | 4. | 5. | 6. | 7. | 8. |
- - - + - - - - - - + - -+ - -+ - - -+ - - -+ - - -+ - - -+ - - -+ - - -+ - - -+
1913 | 1,173| 96|122| 145| 241| 255| 350| 398| 306| 327|
1914 | 1,291| 83|122| 146| 216| 247| 354| 398| 294| 335|
1915 | 1,137| 56| 96| 158| 231| 219| 288| 353| 286| 336|
1916 | 1,139| 63| 95| 135| 170| 212| 269| 326| 266| 343|
1917 | 1,141| 68| 66| 119| 137| 184| 216| 291| 264| 250|
1918 | 1,169| 42| 64| 99| 141| 148| 215| 259| 213| 212|
1919 | 1,132| 52| 98| 101| 125| 161| 202| 258| 222| 238|
1920 | 1,414| 69|125| 167| 220| 295| 347| 445| 377| 407|
1921 | 1,245| 82|140| 177| 228| 253| 341| 456| 370| 382|
+ - - - - - - + - -+ - -+ - - -+ - - -+ - - -+ - - -+ - - -+ - - -+ - - -+
Totals| 10,841|611|928|1,247|1,709|1,974|2,582|3,184|2,598|2,830|
- - - + - - - - - - + - -+ - -+ - - -+ - - -+ - - -+ - - -+ - - -+ - - -+ - - -+

- - - + - - - - - - - - - - + - - - - - - - - + - - - - - +
| |Total Legitimate| |
Year + - - - + - - - + - - - | First Births | Total |
| | | |within One Year |Registered|
| 9. | 10. | 11. | after Marriage | Births |
- - - + - - - + - - - + - - - + - - - - - - - - + - - - - - +
1913 | 831| 669| 462| 4,202| 27,935|
1914 | 720| 642| 487| 4,044| 28,338|
1915 | 769| 621| 457| 3,870| 27,850|
1916 | 793| 694| 512| 3,878| 28,509|
1917 | 575| 505| 449| 3,124| 28,239|
1918 | 443| 298| 279| 2,413| 25,860|
1919 | 469| 397| 314| 2,637| 24,483|
1920 | 859| 802| 575| 4,688| 29,921|
1921 | 979| 804| 670| 4,882| 28,567|
+ - - - + - - - + - - - + - - - - - - - - + - - - - - +
Totals| 6,438| 5,432| 4,205| 33,738| 249,702|
- - - + - - - + - - - + - - - + - - - - - - - - + - - - - - +

MALCOLM FRASER,
Government Statistician.


TABLE B.

TABLE SHOWING NUMBER OF CASES TREATED AND ATTENDANCES AT THE
VENEREAL-DISEASE CLINICS DURING THE YEARS 1920-21 AND UP TO JUNE, 1922.

- - - - - - - - - - - - - -+ - - - - - - - - - - - - - - -+
| Auckland |
| - - - - -+ - - - - -+ - - - - -|
| 1920 | 1921 | 1922 |
- - - - - - - - - - - - - -+ - - -+ - -+ - - -+ - -+ - - -+ - -+
Number of persons dealt | | | | | | |
with at or in connection | | | | | | |
with the out-patients' | | | | | | |
clinic for the first time| | | | | | |
and found to be | | | | | | |
suffering from - | M. | F.| M. | F.| M. | F.|
Syphilis | 174| 30| 100| 44| 81| 29|
Chancroid | 10| ..| 25| ..| 10| ..|
Gonorrhœa | 81| 8| 345| 24| 189| 20|
No V.D. | 59| 10| 73| 25| 21| 8|
Total attendance of all | | | | | | |
persons at the | | | | | | |
out-patients' clinic who | | | | | | |
were suffering from - | | | | | | |
Syphilis |1,875|462|1,759|474| 830|313|
Chancroid | 100| ..| 72| ..| 37| ..|
Gonorrhœa |4,702| 95|9,232|141|3,384|172|
No V.D. | 134| 26| 227| 35| 53| 17|
Aggregate number of | | | | | | |
in-patients' days of | | | | | | |
treatment given to | | | | | | |
persons suffering from - | | | | | | |
Syphilis | ..| ..| ..| ..| ..| ..|
Gonorrhœa | ..| ..| ..| ..| ..| ..|
- - - - - - - - - - - - - -+ - - -+ - -+ - - -+ - -+ - - -+ - -+


- - - - - - - - - - - - - -+ - - - - - - - - - - - - - - - - +
| Wellington |
| - - - - - + - - - - - + - - - - - |
| 1920 | 1921 | 1922 |
- - - - - - - - - - - - - -+ - - - + - -+ - - - + - -+ - - - + - -+
Number of persons dealt | | | | | | |
with at or in connection | | | | | | |
with the out-patients' | | | | | | |
clinic for the first time| | | | | | |
and found to be | | | | | | |
suffering from - | M. | F.| M. | F.| M. | F.|
Syphilis | 93| 34| 80| 10| 41| 8|
Chancroid | 1| ..| 8| ..| 7| ..|
Gonorrhœa | 190| 18| 298| 11| 141| 9|
No V.D. | 40| 10| 52| 25| 33| 17|
Total attendance of all | | | | | | |
persons at the | | | | | | |
out-patients' clinic who | | | | | | |
were suffering from - | | | | | | |
Syphilis | 1,388|448| 2,089|616| 1,156|269|
Chancroid | 6| ..| 16| ..| 29| ..|
Gonorrhœa |13,436|180|19,369|520|10,853|423|
No V.D. | 40| 10| 89| 35| 68| 35|
Aggregate number of | | | | | | |
in-patients' days of | | | | | | |
treatment given to | | | | | | |
persons suffering from - | | | | | | |
Syphilis | 1,624| ..| 1,711| ..| 790| ..|
Gonorrhœa | 3,024| 77| 4,098| ..| 1,998| ..|
- - - - - - - - - - - - - -+ - - - + - -+ - - - + - -+ - - - + - -+


- - - - - - - - - - - - - -+ - - - - - - - - - - - - - - - +
| Christchurch |
| - - - - -+ - - - - -+ - - - - - |
| 1920 | 1921 | 1922 |


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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 6 of 7)