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Ettie A. Rout >> Safe Marriage
[Illustration: ETTIE A. ROUT. [_Vandyk, London._]]
SAFE MARRIAGE
A RETURN TO SANITY
BY
ETTIE A. ROUT
WITH PREFACE BY
SIR WILLIAM ARBUTHNOT LANE, BART., C.B., M.S.,
(Consulting Surgeon to Guy's Hospital), etc.
LONDON:
WILLIAM HEINEMANN
(Medical Books) Ltd.
1922
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| |
| _PREVENTION OF VENEREAL DISEASE_ |
| |
| By SIR ARCHDALL REID, K.B.E., M.B. |
| |
| With an Introduction by SIR BRYAN DONKIN, M.D. |
| |
| _Crown 8vo. 447 pages. 15s. net. Weight 2 lbs. Inland |
| postage, 9d._ |
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| This book is addressed on the one hand to those who would |
| prevent venereal disease in themselves, and on the other, to |
| those who would prevent it in the community. |
| |
| _Lancet._--"A powerfully written and valuable volume." |
| |
| _The Medical Press._--"We _positively assert_ that it is the |
| duty of every medical man to _master_ its contents." |
| |
| LONDON: WM. HEINEMANN (Medical Books) Ltd. |
| |
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The French Government has bestowed the premier decoration for
women, The Reconnaissance Francaise, upon Miss Ettie Rout, of the
New Zealand Volunteer Sisters, "for work done during the war (as
head of Anzac Soldiers' Club in Paris), and in 1919-1920 as head of
American Red Cross Depot and Canteen at Villers-Bretonneux, where
she helped a great many French soldiers, and rendered precious
service to the civilian population of the commune." The War Office
also conveyed thanks to Miss Rout "for gallant and distinguished
services in the field." "I have it in command from the King," wrote
the Secretary of State for War, on 1st March, 1919, "to record His
Majesty's high appreciation of the services rendered."
PREFACE.
It affords me great pleasure to write a short preface to this book, since
it deals with a matter in which I (in common with all those who are
intensely interested in the health of our race) am glad to take an active
part.
To no woman has it been permitted to do the same amount of good, and to
save more misery and suffering, both during and after the war, than to
Miss Ettie Rout. Her superhuman energy and indomitable perseverance
enabled her to perform, in the most efficient manner possible, a work
which few women would care to handle, and of which but an infinitesimally
small number are capable. The French Government fully recognised the great
services she rendered to the Allies, and did her honour. The book she has
written is one of very great value, in that its object is the Health,
Happiness, Morality and Well-being of the Community.
Not only has Miss Ettie Rout the qualities that characterise all great
humanitarians, but she also possesses, in a unique degree, an intimate
knowledge of the terrible troubles that arise from irregular intercourse,
and of the manner in which they can be reduced and perhaps eliminated.
In this book she deals with such simple hygienic measures as are little
known in England, though they are in common use in France and in the
United States, in both of which countries sound practical common sense
prevails.
She is persuaded that marriage is the goal to be reached by all, and that
everything possible should be done to facilitate it, and so to diminish
vice. In her efforts to bring about this happy issue she has the good
wishes and congratulations of all who have the health of the community at
heart.
W. ARBUTHNOT LANE. 21, Cavendish Square, London, W.1.
_March 25th, 1922._
CONTENTS.
PAGE
FOREWORD xiii
I. INTRODUCTION 17
II. PRACTICAL METHODS OF PREVENTION
A. FOR WOMEN 32
B. FOR MEN 51
III. MEDICAL FORMULAE 59
IV. COMPULSORY TREATMENT 63
V. CONCLUSION 65
APPENDIX I 69
APPENDIX II 73
NOTE AND ADVERTISEMENT 75
"Knowledge comes, but Wisdom lingers, and I linger on the shore,
And the Individual withers, and the World is more and more."
TENNYSON.
FOREWORD.
This book embodies the considered opinions of twenty-five years' practical
experience of adult life--as an official reporter and journalist, as a
voluntary war-worker, and as a married woman. For many of the thoughts and
expressions used I am indebted to large numbers of men and women whom I
cannot name, and with whom I have been personally and professionally
associated in different parts of the world. I am also indebted to the
following medical journals for the publication, during the last five
years, of many letters, articles, notes, etc.: _The Lancet_, _The British
Medical Journal_, _Public Health_, _Municipal Engineering_, _Hospital_,
_New York Medical Journal_, etc., etc.
I have to thank the Society for the Prevention of Venereal Disease, the
National Birth-Rate Commission, and the Joint Select Committee (House of
Lords) on Criminal Law Amendment Bills for recording various statements
and evidence.
It remains only to state this fact: That on January 25th, 1922, Sir
Arbuthnot Lane, Sir Frederick Mott, Surgeon-Commander Hamilton Boyden, of
the Royal Navy, and Mr. Harman Freese, of Freese & Moon, manufacturing
chemists, of 59, Bermondsey Street, London, S.E.1, met at my home to
decide upon the best medical formulae for self-disinfecting ointment for
men and contraceptive-disinfecting-suppositories for women. Mr. Freese
made up sanitary tubes and sanitary suppositories in accordance with these
formulae, but he is prohibited by law from recommending these for the
prevention of venereal disease, and forbidden to supply printed directions
with them, whereas similar medicaments are being retailed with printed
directions in the State of Pennsylvania, and the Health Department
circularises medical practitioners thus:--
"The self-treatment packet, obtainable at drug stores, to arrest
venereal infection after exposure, is approved by the State
Department of Health on the same principle as is antitoxin given to
diphtheria contacts. Proof is lacking that the use of this packet
lowers social standards. Reduction in the incidence of venereal
disease is a direct result."
But not only in the clear, cool air of American State Departments of
Health is the knowledge and love of sexual cleanliness fructifying. In the
_Dublin Review_ for January-March, 1922, there is a wonderfully fine
article on "The Church and Prostitution," by the Right Rev. Monsignor
Provost W.F. Brown, D.D., V.G., in which he quotes from a very recent
Moral Theology, "De Castitate," by the Rev. A. Vermeersch, S.J., Professor
of Moral Theology at the Gregorian University, Rome, published in May,
1921. The author of "De Castitate" gives brief answers to three questions
put to him, which Mgr. Brown quotes in the original Latin, and of which
the following is a translation furnished by a Catholic priest:--
"You ask
1. Whether or not it is formally sinful to use antiseptic ointment
before illicit intercourse.
2. Whether or not the use of such ointment may be advocated.
3. Whether or not it is lawful for chemists to sell it.
Ad. 1. Although it seems that in England (_cf. Times_, January,
1917) some have made a scrupulous distinction between the use of
this ointment _before_ and _after_, and have forbidden the former
while approving the latter, you need make no such distinction (of
course, supposing the ointment is not used by a woman to
sterilize). It is not wrong to seek means, indifferent in
themselves, which will prevent the evil consequences of sin.
Ad. 2. It would indeed be a sin to reveal such drugs or to persuade
their use with the intention to induce a man to commit sin; but
there is no harm in telling a man who is certainly going to sin how
to avoid the consequences. Ad. 3. If men could be restrained from
vice by prohibiting the sales, this should be done; but so many are
ready to expose themselves to danger that you cannot hope for such
a result from forbidding the sale. It is true this removes _fear_,
but the general good, and the removal of danger to the innocent
justifies this. Besides, it is a poor virtue which is kept from sin
only by the fear of disease."
Having gone so far as to admit the desirability and necessity of the
medical prevention of sexual diseases, the Roman Catholic Church will
certainly find itself later unable to deny the desirability and necessity
of preventing the birth of children liable to be born diseased or unfit.
It is not practicable for a wife to take any suitable precautions against
infection by a diseased husband, which precautions will not at the same
time be effective, to a greater or lesser extent, in the prevention of
conception. There is no half-way house in the matter of sexual hygiene.
ETTIE A. ROUT.
I.--INTRODUCTION.
At present marriage is easily the most dangerous of all our social
institutions. This is partly due to the colossal ignorance of the public
in regard to sex, and partly due to the fact that marriage is mainly
controlled by lawyers and priests instead of by women and doctors. The
legal and religious aspects of marriage are not the primary ones. A
marriage may be legal--and miserable; religious--and diseased. The law
pays no heed to the suitability of the partners, and the Church takes no
regard for their health. Nevertheless, the basis of marriage is obviously
mating, or sexual intercourse. Without that there is no marriage, and with
it come not merely health and happiness but life itself. Cut out sexual
intercourse, and society becomes extinct in one generation. Every
generation must, of necessity, pass through the bodies of its women; there
is no other way of obtaining entry into the world. Hence, it is clearly
the duty of women to understand precisely the processes involved, from
beginning to end.
With the lower animals sexual intercourse is desired only seasonally, and
only for the purpose of reproduction. With the higher animals--man and
women--sexual intercourse is desired more or less continuously throughout
adult life, and desired much more for romantic than for reproductive
considerations--that is, for the sake of health and happiness rather than
for the sake of procreation only. A few women, and still fewer men, have
no sexual desires. To them sexual abstinence seems more natural than
sexual satisfaction. But for the majority of mankind and womankind--for
all normally healthy men and women--there is this continuous desire to be
happily mated.
For the sake of health and happiness there is everything to be said for
early marriage, but better late than never.[A] The chief obstacles to
early and happy marriage are financial, and these would largely disappear
if women were able to control fecundity. The chief obstacles to healthy
marriage are the venereal diseases, and these could be extirpated in two
or three generations if sexual cleanliness was properly taught to all
adults, and if promiscuous intercourse was properly regulated during the
same period. Unfortunately most women's idea of regulating promiscuous
intercourse is to have none of it. This is impossible in the present stage
of moral evolution, but it will become increasingly possible as we
succeed in extirpating the venereal diseases, particularly syphilis.
Syphilis is the one great cause of immorality, because persons born with a
syphilitic taint (and what family is entirely free from this hereditary
disease?) are apt to be mentally and morally deficient; hence, tend to
indulge in anti-social and unnatural practices, such as engaging in
promiscuous intercourse.
[Footnote A: Marriage, whether early or late, cannot of course benefit and
elevate society until the present mischievous and archaic Divorce Laws are
simplified and reformed in accordance with modern sociology and ethics.
Unhappy and unsuitable marriages necessarily foster immorality and promote
disease, and the community as a whole gains by their being dissolved in a
ready but responsible and dignified manner. The refusal of the Church to
marry diseased persons would greatly benefit the nation, whereas its
refusal to marry healthy divorced persons not only injures the nation but
dishonours the Church.--E.A.R.]
The normally healthy man is a highly selective creature, and the normally
healthy woman still more fastidiously selective in romantic relationship.
Neither man nor woman is naturally in the least attracted by promiscuous
intercourse. On the contrary, it is repugnant to both. Both regard the
elements of romance, reciprocity and permanence as essential. These
elements are present in marriage and absent in prostitution. Therefore, it
is beneath the dignity of any decent, intelligent woman to suppose that
promiscuous relationship can ever be as happy and satisfying and
attractive as marriage. This, apart altogether from the fact that marriage
is fertile and prostitution infertile. No, both man and woman desire
love-relationship, not loveless-relationship; and they are really quite
fit to be trusted with the evolution of the race through passionate love
and the worship of beauty, as soon as society makes harmonious provision
for their normal sexual needs. Until society does make early marriage
practicable for all healthy adult men and women, say between twenty and
twenty-five years of age, extra-marital relationship, however undesirable,
is inevitable, because there are many men to whom, at times, any woman is
better than no woman.
But extra-marital relationship is never even safe, because of its
promiscuity and impermanence, except in properly conducted and effectively
supervised tolerated houses. The tolerated house is absolutely necessary
at present to protect women from disease and immorality, by confining this
kind of intercourse as far as possible in certain definite channels. The
abolition of the tolerated house spreads both disease and immorality into
classes of women who would otherwise be immune, and enormously increases
the dangers of promiscuous intercourse. Separated from their toilet
equipment the women cannot make and keep themselves clean; on the streets
they are not taught to refuse intercourse with diseased men; thus their
occupation becomes more and more dangerous as medical supervision is
removed. They inevitably become diseased; sometimes contract mixed
infections, which they pass on to their clients--the future husbands and
fathers of the nation--and "The sins of the fathers are visited upon the
children even unto the third and fourth generation." All this would be
impossible if women generally would recognise the primary fact that
because a man is immoral that it is no reason why he should become
syphilitic. We all want to abolish sin, but failing that we must cease
wanting to poison the sinner. We must actively work to save him from the
penalties of his folly, for that is the only way in which we can save his
victims and succeed ultimately in "Making Marriage Safe."
Similarly every effort should be made to prevent women becoming diseased,
no matter how immoral they may be. The prostitute is very often a woman of
peculiar mentality or overdeveloped animal instincts; and many women are
driven to prostitution by drink and poverty. The prostitute class is
largely recruited from mentally and morally deficient girls, who are
themselves the offspring of syphilitic or alcoholic parents. Prostitution
is the effect--not the cause--of anti-social acts and conditions. We must
remedy the causes of these before we can hope to remove the effects. Under
present social conditions, attempting to abolish prostitution by shutting
up tolerated houses is just as idle as attempting to lower the temperature
of a room by smashing the thermometer. All we can do is to make and keep
these women clean. If we decline to do even that, then diseased women will
succeed in contaminating our men much faster than we can instruct the men
in sexual cleanliness.[B]
[Footnote B: Diseased women will continue to cater for men so long as they
are left free to do so, but as knowledge grows their clients will tend to
be limited to _diseased men_. Once men clearly understand that _every_
casual connection is a risk of disease, they will certainly tend to run
fewer risks.--E.A.R.]
And again, just as the medical prevention of venereal disease was not
proposed, and has not been applied for the purpose of fostering or
condoning promiscuous intercourse,[C] so the conscious control of
fecundity by contraception must not be applied in such a way as to lessen
the proportion of well-born citizens in the nation taken as a whole.
Birth-control applied only by the responsible classes of the community
combined with indiscriminate fecundity among the irresponsible masses,
must inevitably lead to the lowering of the general average in character,
brains and physique. It is a form of reverse selection--the responsible
being out-bred by the irresponsible. What is wanted is the general
application of birth-control by voluntary contraception, and the
particular application of voluntary and compulsory sterilisation of the
feeble-minded and unfit.
[Footnote C: My own experience among the troops quite convinced me that
the more thoroughly and carefully self-disinfection was taught, the less
immorality there was. It was impossible to teach self-disinfection
properly without at the same time instilling a living sense of danger into
the minds of men and women; and this danger-sense certainly led to more
self-restraint.--E.A.R.]
Enthusiastic advocates of birth-control claim it as a means of _improving
the race_. It is not necessarily anything of the kind. You cannot improve
a flock of sheep or a herd of cattle by letting all the individuals breed;
whether each individual has a small number or a large number of offspring
makes comparatively little difference. The way to improve the flock or
herd is to breed only from _the best_ and eliminate the unfit as breeding
material. Changes in environment may improve or deteriorate the
individuals of one generation, but such changes are not inheritable,
excepting in the case of venereal disease. Syphilis, _e.g._, may damage
the germ-cells of a man's body, and thus lead to his procreating diseased
and damaged offspring--idiots, imbeciles, mental or moral deficients, and
so forth, who unfortunately are fertile. Thus the prevention of venereal
disease is a eugenic force. It is in fact the _only_ eugenic force in
operation at present. Generally speaking, it is the well-developed and
high-spirited and enterprising young men who travel most, and who,
therefore, are most likely to contract and spread venereal disease. They
come in contact with a much larger number of women than those who stay at
home instead of wandering abroad. These well-to-do young travellers often
marry the finest of our women, and later in life damage or sterilise them
through latent or chronic venereal disease. Hence many one-child
marriages--due not to the use of contraceptives, but to the action of the
gonococcus transferred to the body of the wife.
But there is this hope. It is among the mentally alert and well-informed
men and women that birth-control is first understood and applied, and it
is among this very same class that the medical prevention of venereal
disease is also first understood and applied. Thus, there will tend to be
less disease among this class than among the mentally torpid and
ill-informed masses of the community. This in itself will not _improve_
the race, but it will prevent the deterioration of certain classes and
increase their numbers. Nevertheless, so long as the irresponsible and
feeble-minded and diseased are permitted to multiply indiscriminately, as
at present, they must ultimately outnumber and overwhelm the classes which
are practising self-restraint or applying birth-control. This process may
even be hastened by a political enfranchisement, which enables twelve
feeble-minded persons to outvote two wise men six times over. Thus, to
succeed democracy must raise and maintain the general average of brains
and character throughout the community. In so far as it permits low-grade
individuals to be born in the homes of the masses, and high-grade
individuals in the homes of the classes, it is manufacturing a rod to
thrash its own back, successful rebellion against which mode of Government
ends in mere anarchy and chaos.[D]
[Footnote D: The present need of the white race is to increase its numbers
of fit and decrease its numbers of unfit. Over-population (except in a few
patches of the Old World) is not likely to be a problem for the white race
for centuries. They have several continents practically empty and
undeveloped, and science has as yet touched only the fringe of the
possible productivity of the earth in the matter of food supplies. The
worst feature of the British Empire is that there are too many Englishmen
and not enough Anzacs.--E.A.R.]
One duty at any rate is quite clear. No woman should run any chance of
conception unless she is certain of her own health and the health of her
partner--the man who is to be the father of the child she is to bring into
the world. If her husband's health is unsound, and she cannot avoid
intercourse, she can certainly take precautions against conception and
against infection. The control of fecundity and the control of infection
are parallel problems, and generally speaking, the measures a woman takes
to prevent conception will also prevent infection. If these precautions
are not taken, a woman may not only become seriously ill herself, but she
may blast the health of her unborn babe--or infect it herself during or
after birth. Clearly then it is her personal, as well as her maternal and
national, duty to apply preventive measures.
Women should understand that there is _always_ a great deal of venereal
disease--millions of fresh cases every year in the British Empire. During
the war there were about half-a-million fresh infections per annum among
the soldiers in the British armies alone--about two million men infected
altogether at the very least.[E] Some were cured, others patched up; some
very badly treated; some not treated at all; many demobilised while in an
infective condition, and thus liable to come home and sow in the bodies of
clean women the seeds of diseases picked up in foreign lands in moments of
excitement and folly. Blame these men if we must, but in all fairness let
us ask ourselves: _Who infected them?_ And the answer is: _Diseased
women._
[Footnote E: The devastation of these diseases among the British armies
abroad (in the Rhine, Black Sea, and Palestine areas, etc.) has been much
worse since the Armistice than during the war. Approximately one-fourth
(sometimes one-half) of these armies become infected with venereal disease
every year. From 1919 to 1921 somewhat soothing statistics were issued for
the army of the Rhine, but these have now been admitted in Parliament to
be "_quite unreliable_" (Parliamentary Debates, House of Commons, November
3rd, 1921, p. 1952). It must be remembered that, owing to the exchange
value of the L, the English soldier on the Rhine is now being paid about
L8 or L10 per day; that is, he draws a far higher salary than the highest
paid German official; hence there is no riotous pleasure, however
expensive and extravagant, which he cannot afford. These conditions do not
promote manly virtue or even sexual cleanliness.--E.A.R]
The venereal diseases are passed on from one sex to the other in a
continuous chain, but the chain can be broken at any time _by either sex_.
And now it is the _married women_ on whom we must rely to see that these
infections are stopped. Leaving women to the chance protection of their
partners is demonstrably a failure. Here is an extract from a letter sent
me recently by an old and experienced medical practitioner:--