COMMENT AND REVIEW
The spread of social ethics among the medical profession is cause for great rejoicing. Long and justly celebrated as benefactors of humanity, and upholding with devotion the high ideals of their profession, they have now begun to widen their usefulness and extend their ideals under the general social awakening of our time.
Social sanitation is a rapidly extending process; as fast as our discoveries reveal the nature of disease or new remedies therefor, our governments, local and national, are beginning to safeguard the community.
In the general movement to lengthen and strengthen human life, doctors are necessarily most prominent because of their special knowledge. They have long been necessary. they have become more and more valuable, but their usefulness is still checked (as is true of all of us) by the persistence of conservatism and old ideas.
Very recently the advance of bacteriological science has thrown new light on a group of especially dangerous diseases; and still more recently the doctors themselves, with a splendid exertion of social conscience against tradition and habit, have begun to disseminate this new light to the general public.
Those special payments of the “wages of sin,” spoken of in varying euphemisms, most commonly as “social diseases” are now better understood by physicians; and they are making noble efforts to spread this understanding among the people. Their efforts are gravely hindered by two obstacles; one the professional tradition known as “the medical secret,” the other the universal prevalence of that primordial superstition—the sex tabu.
This last belongs to the very deepest sedimentary deposit in the human mind. The first rules the lowest savage peoples began to make were the sex tabus and food tabus. Secrecy, mystery, all manner of childish hocus pocus, were used to establish these primitive ideas; and the weight of that black past is upon its yet.
The less developed a race, the less educated a class, the more solemn and earnest they are in preserving the sex tabus; whereas with wide scientific knowledge this field of facts is seen to be like others; important and worth understanding; but not as special arcana to be concealed and avoided.
If the doctors come forward to tell us how the typhoid bacillus is disseminated, how dangerous it is, and how it is to be avoided, we are interested, grateful, and more or less willing to profit by the instruction. But when they try to tell us how the gonococcus attacks humanity, how dangerous it, and how it is to be avoided, we say, “Sh! That is something you mustn’t talk about!”
To the credit of the profession they have kept on talking, many of them. To the credit of some of our bravest and wisest editors the talk has been widely published. And right here I wish to pay a well deserved tribute to the “Ladies’ Home Journal,” which ought to have a Nobel prize for great public service.
That paper—long scorned by me as the arch-type of all small ultra-feminine backwardness, did the bravest thing a paper can do, risked its whole position by flying in the face of the public and printing the clearest, fullest, most enlightening accounts of the present status of these “social diseases,” their terrible effects, and our duty toward them. It lost subscribers by the thousand and hundred thousand, but it did the work; and did it better than any other publication could; not only on account of its enormous circulation, but because it went into the homes of pious and unenlightened persons who would never have seen the information in more progressive magazines.
The negative inertia and positive resistance of the popular mind cannot forever resist the constantly increasing pressure of knowledge now poured forth on this subject.
But there is that other obstacle—the tradition of secrecy in the medical profession.
Doctors take the Hipprocratic oath. They solemnly swear not to reveal the confidences of their patients; or, more properly their innocent confidences. They are not bound like priests in the confessional; if a patient tells the doctor he has poisoned his mother or is about to poison his father, the doctor is not bound to conceal the facts.
Nevertheless, if a patient afflicted with one of these highly contagious diseases tells his doctor that he has poisoned his wife, or is to poison his child—the doctor feels professionally bound to keep silence.
What puzzles an outsider is to see why the medical mind discriminates so sharply here between the conduct required in cases of small pox or scarlet fever, and in this case. If you tell the doctor you have leprosy—there’s nothing sacred about that. Off with you to the pest house, at any cost of pain and shame to you or your family. Is the whole community to be exposed to infection just to save your feelings?
So even with measles, with diphtheria, with yellow fever. The privacy of the home is invaded, families are ruthlessly separated, the strong arm of the law is reached out to protect the public against this danger; and the doctor, so far from conniving with the patient, is legally required to record all cases of this sort.
Now where is the difference?
These special diseases are more dangerous—and far more common, than most of these mentioned above; and their effects, hereditary as well as contagious, of measureless evil.
We are told that the difference is one of moral obliquity.
But surely there is no veil of secrecy about moral obliquity! If a man is a thief or a murderer we do not respect his confidence and conceal his offence. The papers justify their fierce blazonry of crimes and sins by saying that it strengthens public opinion—protects the people. No, it is not because of moral obliquity.
It is for precisely the same reason that you must not make inquiries of a Chinaman as to his wife’s health, or see a Turkish lady without her veil—it is “improper!”
The doctors and the boards of health together can soon change this silly convention, and the physician be required to register every case of this sort as he does in other contagious diseases.
All this is called up at this time by a little book named “Never Told
Tales,” sent me by the author, Dr. William Robinson of New York City.
It is a brave little book. Dr. Robinson is not a novelist by profession, but his heart is so wrung and his brain so roused by the hidden tragedy he sees all about him that he has reached out into literature for aid. Everywhere this mischief creeps about, centering rankly in every large city; carried everywhere by those infected; bringing death, deformity, and hideous diseases into thousands of innocent families; spreading, growing, and nobody saying anything about it!
Dr. Robinson has said something. He has thrown out the little book of stories, hoping that in the vivid narrative form it may reach and appeal to those who would not read “medical literature”; or even the new and impressive books now to be had on this subject.
For solid information of a clear and serious sort, readable and clean, Dr. Prince Morrow’s book, “Social Diseases and Marriage” is the best I know. Dr. Morrow is the founder of the American Society of Sanitary and Moral Prophylaxis in New York City; a splendid effort on the part of the medical profession to spread even to unwilling ears this necessary knowledge.
The New York Federation of Women’s Clubs has lately taken action on the subject; passing resolutions urging in this state an amendment to the Domestic Relations law requiring every marriage certificate to be accompanied by a medical certificate also, certifying the applicant to be free from contagious disease. This is already required in several western states. It seems a simple and righteous proposition. If a man wishes to join the army or navy, or to have his life insured, he has to pass a physical examination, and is refused if he is unfit. Is not marriage and parenthood as important as carrying life insurance?
There is a large and growing interest in these matters among intelligent women; and it is a natural and proper one. If a woman is to unite her life with a man, she surely has a right to know whether her own life is to be risked by the union. If she looks forward to motherhood as every normal woman should, she should be safeguarded from this terrible possibility.
It is time there was wide, full public knowledge on this subject.