Either do not risk infection at all, or, risking infection, take proper precautions. These are quite simple. If you take the following precautions _without delay_ you are very very unlikely to contract disease:--
1. Use vaseline or some other grease (such as calomel ointment) _beforehand_, to prevent direct contact with the source of infection.*
(* Note: Any personal discomfort or unpleasantness grease causes is counteracted by the woman"s having douched beforehand, as should always be done for the sake of cleanliness. A mere film of grease is sufficient to fill up pores of the skin, cover over abrasions, and prevent penetration of microbes, and it greatly facilitates subsequent cleansing.)
2. Urinate _immediately_ after _each_ connection to wash away all infective material, and to prevent the invasion of the urethra by the microbes of V.D.
3. Wash thoroughly with soap and water, because ordinary soap is destructive to germs--of syphilis and of gonorrhoea--and bathe parts with weak solution of pot. permang.
You had far better carry a blue-light outfit with you as a "town dressing," in the same way as you would carry a "field dressing."
If you cannot get an outfit, carry a tiny bottle of pot. permang.
lotion and a sc.r.a.p of cotton wool. If you swob yourself _carefully_ with this, you will not become diseased. Remember always _it is delay that is dangerous_. If there has been delay, use a syringe sufficiently large for the contents to flood the urethra and slightly distend it, so that every nook and cranny is cleansed.
Whatever you do, make certain of _going home clean_. Be sure of your health and doubly sure before you embark. While you are in the army and on this side of the world you can be cured easily and privately. If you go home infected, there will be embarra.s.sment and expense to yourself and _great danger_ to the women and children you love.
_Get cured NOW._" (Paris, April, 1919).[K]
[Footnote I: The following is taken from a paper read by Captain H.L.
Walker, Canadian Medical Service, O.C. Report Centre (British), Paris, at Conference on V.D., organised by the American Red Cross in April, 1918:--
"Speaking in regard to licensed houses, Captain Walker said that he _had not found one case of venereal disease_ contracted in a licensed house in the City of Paris, and he could only suppose that the people who were responsible for putting the licensed houses in Paris out of bounds knew nothing at all about the real facts of the case.... In the licensed houses in the City of Paris, during the year 1917, _only five cases of venereal disease_ were contracted; and in 1918, up to April 20th (the day he was speaking), _there had not been one case of venereal disease contracted in a licensed house in the City of Paris_. But out of 200 women arrested on the streets of Paris during the month of April, _over twenty-five per cent. were found to be infected with venereal disease_. In the months of November and December, 1917, the French authorities had made a round-up on one boulevard of seventy-one women, of whom _fifty-five were infected with venereal disease_; a few days later the French authorities repeated the same procedure on another boulevard; something like _one hundred women_ were arrested, _and ninety-one per cent. were infected with venereal disease_."--p.
134, _Public Health_ (England), September, 1918.
I supervised a tolerated house in Paris for over twelve months (1918-1919), and had no cases of disease either among the women or the men. The women attended from 2 p.m. to midnight and resided in their own homes.--E.A.R.]
[Footnote J: Among the first medical men in Great Britain to recognise the importance and effectiveness of self-disinfection was Mr. Frank Kidd, M.A., M.Ch. (Camb.), F.R.C.S. (Eng.), etc., of the London Hospital. A full statement of his evidence before the Royal Commission on Venereal Diseases is given in Mr. Kidd"s book, "Common Diseases of the Male Urethra"
(published by Longmans, Green and Co., 39, Paternoster Row, London, etc., in 1917). The diagram of male organs of generation I have used on page 36 was taken in outline from Mr. Kidd"s frontispiece, and during the war I found all the ill.u.s.trations he gave most helpful with the soldiers, although the book itself was written for the purpose of enabling doctors in outlying districts to treat patients on modern lines with success. Mr.
Kidd designed prophylactic tubes, which have been sold in England on his order for more than fifteen years. He tells me they have been used all over the world by his patients, and that as far as he can ascertain "_they have never failed, when used properly and intelligently_."--E.A.R.]
[Footnote K: Since this was written, a large number of experiments have been made with the single treatment tube, containing an ointment destructive of all forms of venereal disease microbes, whether used before or after connection. The Pennsylvania Department of Health is within measurable distance of finding a solution of this problem--the production of a cheap, portable, easily applied and thoroughly efficient self-disinfecting ointment.--E.A.R.]
It was clearly proved that so long as men took these simple precautions (which I always explained _personally_) they were very unlikely to contract disease; most cases of disease came from multiple connections with the women of the cafes, etc. It was difficult to impress on ordinary men"s minds the fact that _each and every connection was a danger_; that the danger of infection began immediately there was any contact, and that it continued until disinfection, and was renewed as well with each fresh connection during the night. If the danger had continued for several hours in this way, the men were told to go to the medical depot or report to a doctor as soon as possible. When they did so they were saved from disease in the vast majority of cases, even up to twenty-four hours afterwards or a little longer.[L]
[Footnote L: In 1915-1916 Colonel Sir James Barrett, then A.D.M.S. of the Australian Force in Egypt, had successfully applied prophylaxis, but unfortunately he was invalided for a time to England in November, 1916, and with the evacuation of the Dardanelles there was a severe outbreak of v.d. in Egypt. Prophylaxis was then steadily applied during 1917 by Colonel Sir James Barrett and others, and at the end of 1917 v.d. had been reduced to small proportions. In December, 1917, Colonel P.G. Elgood, Base Commandant of Port Said, wrote:--
"Fortunately, however, at this stage, I came into contact with Colonel Sir James Barrett, K.B.E., R.A.M.C, and Miss E. Rout, New Zealand Volunteer Sisterhood. The first suggested that the solution of the problem would not be found in police measures or in medical examination, but in prophylaxis; while the second, in correspondence relating to her own experiences gained in England, encouraged me to advocate this remedy."
The successful results of the Port Said efforts are quoted in full by Colonel Sir James Barrett in his book, "A Vision of the Possible" (Lewis), and Colonel Barrett had early in 1917 sent me to London the following tremendously valuable letter of advice and warning:--
"I suppose my instinct is rather more in the moral direction than many people, but I recognise, as you will see from these articles (published by _Lancet_), that it is by direct prophylaxis, and direct prophylaxis alone that we are likely to get rid of this abomination. I should never in any campaign exclude all the additional aids--proper soldiers" clubs, such as I have established in Egypt, the influence of decent women, and the one hundred and one factors that go to make a decent and reputable life; but you have, in the long run, to recognise the fact that a percentage of men are certain to seek women who are prepared to cater for them.
If the steps indicated are taken, the proof is absolute that the disease can be practically extirpated and without great difficulty.
The failure of prophylaxis depends on two factors--firstly, it requires someone charged with responsibility, earnestness and high character to explain to men precisely what they are doing and what it means; and secondly, prophylaxis is of very little use to drunken men. My experience has been that when these precautions are properly used venereal disease may disappear."
That proved to be exactly my own experience in the army. Failures in the army were due to the absence of proper personal instruction of the men and the laxity of control, and these conditions can always be a.s.sumed to exist in any army having a high v.d. infection rate.--E.A.R.]
Nevertheless, the people who would put sacerdotalism before science, and the still meaner minds who would subst.i.tute legality for morality, raised storms of objection to my work, in the midst of which came a few strong, clear calls of understanding and encouragement.
One Scotch padre wrote me in 1918:--
"It is a magnificent adventure for a woman to go practically alone on the very edge of things, and I salute you, and congratulate you, and wish you _G.o.d-speed_."
An old family doctor, then with a colonial ambulance, wrote:--
"Many women ... will owe their health and happiness to you, and not a few will be indebted to you for their lives."
The editor of the Sydney _Bulletin_ (Australia) was continually publishing helpful articles and paragraphs--after my letters and articles were censored;[M] and from Dr. W.H. Symes, of Christchurch, New Zealand, I heard by personal correspondence steadily and wisely all through the war.
Much later came the following tribute, in a most valuable book written by Sir Archdall Reid and Sir Bryan Donkin ("Prevention of Venereal Disease,"
published by William Heinemann (Medical Books) Limited)[N]:--
"Sir Bryan Donkin"s letter, which appeared in _The Times_, in January, 1917, and other communications which he published as opportunity offered, brought him an introduction from Sir J.W.
Barrett, M.D., then serving as A.D.M.S. with the Australian Force in Egypt, to Miss Ettie Rout, who, by profession a journalist, had come with the Australian and New Zealand Forces with the object of ameliorating, as far as possible, the hardships of war. She had been horrified by the pestilence of venereal disease which broke out among the troops in Egypt, England, and elsewhere, and, with extraordinary resolution and courage, had embarked almost single-handed on a campaign of prevention. She furnished Sir Bryan, and later myself also, with much valuable information, and for her own part fought the battle most strenuously--living among the men, lecturing, finding and instructing lecturers, providing disinfectants, importuning authorities, writing most trenchant letters, establishing medical clubs in England and France, and the like. I think that when the names of those who opposed her are forgotten, the memory of this brave lady will still be green among the descendants of the valiant men for whose welfare she struggled"--p. 176-177.
[Footnote M: The _New Zealand Times_ daily newspaper published my first article and was severely reprimanded by the New Zealand Government for doing so, and all New Zealand newspapers were then prohibited from publishing any further articles relating to V.D. in the New Zealand Forces.--E.A.R.]
[Footnote N: See Publishers" notice.]
ALCOHOLISM.
It should be noted here that another great difficulty we had was to make men _beware of the dangers of drink_. A man who is in liquor is much more liable to contract venereal disease than a man who is sober. Alcohol increases s.e.xual desire, lessens s.e.xual ability, and lowers the sense of responsibility. Hence, drunkenness, immorality and disease go hand in hand: a dreadful three. But more than this. The drunken man takes much longer over the s.e.x-act, thereby prolonging the risk of disease, and he runs risks which he would rule out instantly if the fumes of alcohol had not changed the tawdry girl into the glittering fairy. Worse than all, he neglects to apply disinfection properly and _promptly_--he falls asleep or forgets all about it till _too late_. Men who are determined to have a "night out" should use calomel ointment (or some other subst.i.tute) _before they start_; and if they have been in liquor they should disinfect instantly when they recover their sober senses. Generally speaking, _an ounce of calomel is worth a ton of salvarsan_.
As with young men, so with young girls: a few gla.s.ses of wine taken at a supper or a dance--and the first downward step is taken, not because any wrong was intended, but the simple actualities of s.e.x were unknown, and the stimulant took advantage of the ignorance that is miscalled innocence.
This kind of thing will continue till the older generation realise that morality depends--not on the maintenance of ignorance and the fear of disease, but on the spread of knowledge and the promotion of virtue.
It is not morality, but caution, that is developed by fear, and in this case caution is counteracted by the practical experience that many men are immoral without becoming diseased. One man commits many immoral acts and suffers not at all; another man becomes syphilitic by yielding for the very first time; the penalty is purely fortuitous. There is no necessary connection at all between immorality and disease. The dangers of s.e.xual intercourse are due to dirt and promiscuity rather than to immorality, and in part to the physical conformation of the individual. Virtue has far deeper and more substantial foundations than the mere gusts of fear. It is founded on necessary and responsible guardianship of the very gates of life.
III.--MEDICAL FORMULae.
The medical formulae for venereal disease preventive ointments for men, and venereal disease preventive suppositories and ointments for women, should be decided upon, after thorough investigation and test, by the Departments of Public Health, and none other should be permitted to be sold. Printed directions should be issued, duly authorised by the Departments of Public Health, and no other directions should be supplied to the public with the venereal disease preventives. In these respects, to the best of my belief, the Division of Venereal Diseases of the Pennsylvania Department of Health, co-operating with the United States Public Health Service, will play the leading part; is, indeed, already doing so. Under the direction of Dr. Edward Martin, Commissioner of Health, and Dr. S. Leon Gans, Director, Division of Venereal Diseases, specimen tubes are tested and approved (with directions and other printed matter)[O] by the Health Laboratories of the Department; and certificates are issued to manufacturing chemists authorising the manufacture of ointments made in accordance with approved formulae. Requests are made officially by the Department to retail chemists and druggists to sell, and to medical pract.i.tioners to recommend, suitable venereal disease preventives to the general public in a proper manner. In time it will probably be found advisable to authorise only a standard type of tube--preferably the metal tube with elongated nozzle and expanded metal cap--filled with one simple self-disinfecting ointment.
[Footnote O: In some cases the printed matter used by the drug companies also bears the "_Official Endors.e.m.e.nt_" of the local "_Social Purity a.s.sociation_" stamped upon it in indelible ink--a magnificent tribute to the educative work of the Public Health Department, as well as to the enlightened courage of the Social Purity a.s.sociations.
The following is quoted as sample of directions authorised in U.S.A.:--
"The use of this package is not to be construed as a licence to exposure.
Pro-Ven, the original preventive. _The only sure_ way to prevent infection: _Do not expose yourself._ All exposures should be considered as infections, for 90 per cent. of all "easy women" are infected. By proper use of the contents of this package disease may be prevented, as the action upon the germs is as effective as can be secured by the latest scientific knowledge; if exposed, _use within two hours_. After contact: 1st. Urinate. 2nd. Remove the cap from tube; take organ in the hand, holding the ca.n.a.l open; insert tip of the tube and squeeze half of the contents into the ca.n.a.l. 3rd. Squeeze the remainder on the outside of the organ, rubbing well into the creases and folds under and back of head and clear to the body. 4th. Leave ointment on three or four hours. Remember: It is best to use _Pro-Ven_ immediately after exposure; never delay more than two hours if possible. _Pro-Ven_ is not a cure--it is designed to keep men from getting disease; it can be used as a lubricant and preventive both before and after exposure. _Pro-Ven_ is harmless and will not cause pain or injury to the s.e.xual organs. Insist upon having _Pro-Ven_. At all good druggists, or directly by mail, 25 cents a tube; 5 tubes, $1.00. Booklet mailed free upon request. The Pro-Ven Laboratories, Washington, D.C. This product has been tested and approved by the Pennsylvania State Department of Health Laboratories."
In addition to _Pro-Ven_, the following proprietary tubes of self-disinfecting ointment have, to my knowledge, been authorised by the Department of Health, and samples were sent to me:--
_Procaline_, manufactured by the Hawthorne Drug Speciality Co., Inc., 88-90, Reade Street, New York City.
_Cargenios_, manufactured by H.K. Mulford Company, Philadelphia.
_Andron_, manufactured by Andron Hygienic Co., 120, W. 32nd St., New York City.