Report of Royal Commission upon the Administration and Operation of the Contagious Diseases Acts.
- Great Britain. Royal Commission on the Contagious Diseases Acts
- Date:
- 1871
Licence: Public Domain Mark
Credit: Report of Royal Commission upon the Administration and Operation of the Contagious Diseases Acts. Source: Wellcome Collection.
Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.
834/952 page 736
![FOU'iV- 20,107. For the purpose of detecting disease ?— I'lFTH DAY. Yes. T— 20,108. Do you think that with the kind of exami- ('R iJn sJak which these women are subjected, the \ ■ object of detecting the disease is generally attained 13 May iSTl examining a number of women once a fortnight? Do you think that an effectual mode of detecting the presence of disease in these women ?—Not effectually. I sliould like to qualify that very much, I should think it would detect some diseases, but it would not detect others. 20.109. With regard to the venereal disease, what class of disease would such an examination as that be effectual in detecting ?—I think it would effectually detect any well-marked ulceration, but Avould not in any way detect gonorrhoea in the female ; nor would it, I think, detect gonorrhoeal discharge, which might give syphilis to the males in many cases. 20.110. You think that ulceration could be easily detected by such examination, but that gonorrhoeal dis- charges might elude the observation of the practitioner ? —Yes. 20, 111. Do the persons of prostitutes present greater facilities for detecting disease than the parts of women who ai'e not habitually in the habit of prostitution ?— That also, I tiiink, depends on circumstances. You are not able to tell that the woman is a prostitute by inspection of the organs of generation in anyway as a general rule. 20.112. Is it very much in the power of a woman to prevent the doctor detecting whether she is diseased or not ?—To a great extent it is. By using lotions it is very easy to prevent a great deal of the discharge being noticed. 20.113. Would that answer apply to gonorrhoeal discharge ?—Yes. 20.114. Not to ulceration?—As to ulceration, it would be almost impossible for her to prevent ulceration being detected in the external parts. 20.115. Does the introduction of the speculum go far to defeat the efforts of the women to mislead the doctor ?—That, of course, has an effect, but it is not perfect in any way, because the discharges may jilvvays be removed by injections beforehand. 20.116. Does it require a very careful examination of a woman to detect the disease, supposing the disease is not patent ?—It does, a very careful ex- amination. 20.117. Is it difficult to ascertain generally, for prac- tical purposes, whether a woman is in a condition to communicate syphilis?—I tliiuk it is. I should say so. 20.118. Is it possible to contract venereal disease from a woman who is not affected by it ?—I would not like to answer that categorically ; it is not at all impossible ; the matter has often been stated so. I do not think there is anything positively against it. Indeed, I should think it is probable in cases where prostitutes have much to do with many persons, one succeeding another, that it might happen. 20.119. Rut the question which I propose to you was, whether it is notorious in the profession, or whether you have known in your own practice, cases of venereal disease contracted from virtuous women ? —Gonorrhoea I have frequently myself seen contracted by the male from women who were apparently free from anything, and who were not in any way pros- titutes. 20.120. I will put it in this form: it has been said before this Commission by a gentleman, that he knows about 100 cases in which persons have contracted venereal disease from their virtuous wives ?—I have known a great number of cases similar to that, where husbands have contracted gonorrhoea, which they said Avas entirely owing to connexion with their wives. In fact, no iator than yesterday I saw such a case. 20.121. Do I understand you to say that you know of such cases ?—I do ; I know a great many of them. 20.122. Are you acquainted with the French sys- tem of inspection and registratioji ?—I am very well acquainted with it. 20.123. What has been, in your own judgment, the effect of that system in checking or preventing disease ?—I think it has no effect in Paris at all, except on the prostitutes themselves. The prostitutes, com- prising about 3,000 or 4,000 women, who may be under the police, are certainly kept very free from the disease, and that I have observed, but it has no effect upon the city of Paris, for instance, I am convinced from my own observation of many years standing, for I have been there every year for the last 10 years for some time. I believe that there is much more disease in Paris than there is in London. 20.124. Were you present at the Medical Congress in Paris in ] 867 ?—I Avas. 20.125. Was this particular subject discussed there ? —Yes, this subject was discussed in all its bearings there. 20.126. 7'he subject of venereal disease ?—And its prevention. 20.127. And the system in force in Paris ?—It was. 20.128. And what was the result of that discussion ? —The result was that various opinions were expressed, but it was admitted on all hands that the French system had been practically almost useless, as a very great deal of disease existed in the country. 20.129. Is it within your knowledge that clandes- tine prostitution prevails much in Paris ?—I should say it is quite enormous, having examined the subject for several years; because the existence of clandestine prostitution in Paris is alarmingly great. I may state that at the Congress I mentioned that fact, and men- tioned it before a very large assembly of medical men ot all countries, and said I had found more syphilis and more gonorrhoea in Paris than I did in London, and, in- stead of being contradicted, several gentlemen expressed the same opinion, and one gentleman of great ability, Monsieur Lefort, said I was perfectly correct, there was much more prostitution in Paris than in London, as he was well acquainted with tlie two towns, and thei-e was, he believed, very much more venereal disease. That was at the Congress in 1867. 20.130. Are you much acquainted with the state of prostitution in London ?—I see a great number of prostitutes, belonging to the Free Hospital as I do. A large number of them come there for treatment. 20.131. Is the venereal disease very prevalent amongst that class of people in London ?—I think it is very prevalent indeed. 20.132. Is it of a very aggravated character ?—I think not very aggravated now. I have not seen more than one or two deaths from syphilis in adults in its early stages for many years past, 20.133. In the course of your experience has the type of the disease in your opinion been mitigated ?— I think it is less severe now, because the people live in a morn healthy way than they used to do, 20.134. Habits of cleanliness ?—Habits of cleanli- ness seem to be more prevalent than they were formerly, 20.135. Then is the type diminished and the pre- valence diminishing ? Is that your ojiinion ? — I think the prevalence is veiy great, but I think the disease does not seem to me quite so severe as it used to be. 20.136. Does the prevalence consist more of a syphilitic than a gonori'hoeal character ? — Far more gonorrhoeal of course than syphilitic. 20.137. You stated you hatl experience in voluntary hospitals, t think, for this disease ? — I have the experience of my own hospital, of the Royal Free Hospital, at which I attended for some time, and also of others. I think with regard to voluntary hospitals that they do all we can expect them to do in the way of public health, in the way of keeping back venereal disease. My experience of the Metropolitan Free Hos- pital, and other hospitals I am connected with, is that the prostitutes were always too glad to enter hospitals when they could get into them, that there was always a miserable want of accommodation for them, that I have seen them turned away hun- dreds of times with the most grave ulcerations to](https://iiif.wellcomecollection.org/image/b21365945_0834.jp2/full/800%2C/0/default.jpg)
