Journal of social hygiene

Bound
eriodicat H74758

Hanssas Cttp
$trf)Kc library

This Volume is for
REFERENCE USE ONLY

Journal

of

Social Hygiene

INDEX
VOLUME 30

1944

PUBLISHED MONTHLY EXCEPT JULY, AUGUST AND SEPTEMBER
AT ALBANY, NEW YORK, FOR

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

EDITORIAL AND GENERAL OFFICES

1790 BROADWAY, NEW YORK 19, N. Y.

r :«•* • •'• -'-;

: • J •;. .-.-..;:.;

Copyright, 1944, by

The American Social Hygiene Association, Inc.
1790 Broadway, New York 19, N. Y.

Vol. 30 January, 1944 No. 1

s*

Journal

of

Social Hygiene

Social Hygiene in Wartime. XIL
The Federal Program of Venereal Disease Education

CONTENTS

The Current Status of Venereal Disease Control Education . .Thomas Parran 1

The Venereal Disease Education Institute E. Douglas Doak 12

Venereal Disease Education in the Army Gaylord Anderson 20

Venereal Disease Education in the U. S. Navy C. S. Stephenson and

G. W. Mast 29

The Venereal Disease Education Process in the U. S. Navy . .Howard Ennes 40

National Events 43

Announcements .... 48

National Social Hygiene Day
February 2, 1944

The American Social Hygiene Association presents the articles printed in the
JOURNAL OF SOCIAL HYGIENE upon the authority of their writers. It does not
necessarily endorse or assume responsibility for opinions expressed or statements
made. The reviewing of a book in the JOURNAL OF SOCIAL HYGIENE does not
imply ite recommendation by the Association.

EDITOEIAL BOARD
O.-E. A. WINSLOW, Chairman

RAY H. EVEEETT WILLIAM F. SNOW

JOSEPH K. FOLSOM JOHN H. STOKES

EDWARD L. KEYES JOHN C. WARD

JEAN B. PINKEY, EDITOB
WILLIAM F. SNOW, EDITORIAL CONSULTANT

The JOURNAL OF SOCIAL HYGIENE is supplied to active members of the American
Social Hygiene Association, Inc. Membership dues are two dollars a year. The
magazine will be sent to persons not members of the Association at three dollars
a year ; single copies are sold at thirty-five cents each. Postage outside the United
States and its possessions, 50 cents a year.

Entered as second-class matter at post-office at Albany, N. Y., March 23, 1922.
Acceptance for mailing at special rate of postage provided for in Section 1103,

Act of October 3, 1917, authorized March 23, 1922.
Published monthly (nine issues a year) for the Association by the Boyd Printing

Company, Inc., 372-374 Broadway, Albany, N. Y.

Copyright, 1944, by The American Social Hygiene Association, Inc.

Title Kegistered, U. 8. Patent Office.

PUBLISHED MONTHLY EXCEPT JULY, AUGUST AND SEPTEMBER
AT 372-374 BROADWAY, ALBANY 7, N. Y., FOE

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

EDITORIAL OFFICES and NATIONAL HEADQUARTERS
1790 BROADWAY, 19, NEW YORK CITY

WASHINGTON LIAISON OFFICE
Room 609, 927 15th St., N.W., Washington 5, D. C.
JEAN B. PINNEY, Director in Charge
REBA RAYBURN, Office Secretary

FIELD OFFICES

ATLANTA, GEORGIA. 506-508 Citizens and BALTIMORE, MARYLAND. Care of Baltimore

Southern National Bank Building. Serv- Community Fund, 22 Light Street.

iug Alabama, Florida, Georgia, Missis- Serving Delaware, Maryland, Pennsyl-

sippi, North Carolina, South Carolina and vania and Virginia.

Tennessee. KENNETH R. MILLER, Field Eepresenta-

CHARLES E. MINER, Field Representative. tive, Home address 260 Bridge St., Drexel

MRS. EDNA W. Fox, Field Representative. Hill, Pa.

COLUMBUS, OHIO. Care National Confer-

ence of Social Work, t 1 High Street CHICAGO ILLINOIS. Eoom 615 360 North

WeTv^S™' KentUCky' °hl° and Michigan Avenue. Serving Illinois, Michi-

WADE T. SEARLES, Field Representative. San and Wisconsin.

WARREN H. SOUTHWORTH. Field Eepre-

OMAHA, NEBRASKA. 736 World Herald tentative

~ . , f -rr- oc>/frtl*6tt/t/.

Building. Serving Colorado, Iowa, Kan-
sas, Minnesota, Missouri, Nebraska, North

Dakota, South Dakota and Wyoming. DALLAS, TEXAS. Cliff Towers. Serving

GEORGE GOULD, Assistant Director, Arkansas, Louisiana, New Mexico, Okla-

Division of Legal and Social Protection homa and Texas.

Services, in Charge. BASCOM JOHNSON, Director in Charge.

SALT LAKE CITY, UTAH. 402 Mclntyre MRS. GERTRUDE R. LUCE, Office Secretary.
Building. Serving Arizona, Idaho, Mon-
tana, Nevada, Utah, California, Oregon

and Washington. SAN FRANCISCO, CALIFORNIA. 45 Second

GEORGE GOULD (see above), temporarily Street,

w dharge. W. F. HIGBY, Field Consultant.

Journal

of

Social Hygiene

VOL. 30 JANUARY, 1944 NO. 1

Social Hygiene in Wartime. XII.
The Federal Program of VD Education.

EDITOR'S NOTE: Many Federal agencies carry on activities in
the general field of social hygiene education. A somewhat
smaller number are concerned with venereal disease education
in particular. In this issue of the JOURNAL are described the
educational programs of the agencies which probably touch
more people directly than the others, on the subject of venereal
diseases : the Army and Navy, both vitally interested in having
our millions of young men and women understand and be on
guard against VD for the sake of the efficiency of the armed
forces and civilians; the Public Health Service, responsible at
the Federal level for VD education of the general public, for
their own sakes and for the production efficiency so necessary
in time of war; and the VD Education Institute which coop-
erates with Government Agencies and the American Social
Hygiene Association in creating educational materials for gen-
eral and special uses, and in evaluating methods and programs.

THE CURRENT STATUS OF VENEREAL DISEASE
CONTROL EDUCATION*

THOMAS PARBAN
Surgeon General, U. S. Public Health Service

Venereal disease control education has had to face many of the
wartime difficulties that confront other phases of expanded govern-
mental activity. The degree of success which has met our efforts
to overcome these difficulties is a good indication of the strength of
our belief that education is an important arm of the control program.

* An address delivered before the Conference on Venereal Disease Control Needs
in Wartime, Hot Springs, Arkansas, October 24, 1942; with supplementary notes.

1

But the war has presented us with magnificent opportunities as
well as difficulty, and again the extent to which we have exploited
these opportunities is a good index to our convictions regarding
the value of education.

A major difficulty Federal, State, and local educational efforts
have faced is the shortage of trained educational personnel coupled
with the increasing inability of physicians and nurses to spare the
time which is required for adequate education of patient and the
community. Other handicaps are found in a growing shortage of
physical materials such as motion picture projectors and films; and
in such factors as the competition for attention in the news columns
which tends to push our usual educational press releases back among
the classified advertisements.

Paramount among our advantages is the opportunity for education
inherent in the blood-testing of millions of young men. Other benefits
are to be found in the discovery that, with a little training, intelligent
laymen can do a very good job of venereal disease education ; and in
the fact that, if properly handled, news about the venereal disease
control program will receive space on Page One, right along with
the latest stories about Commando raids or gasoline rationing.

The common denominator of all our opportunities is the demon-
strated fact that the public will support any activity which definitely
contributes to ultimate victory over our nation's enemies.

In spite of recent advances in the scientific measurement of public
opinion, in the use of psychology and quasi-scientific methods by
propaganda experts, mass adult education remains an art rather than
an exact science. Usually, the health officer and his aides must pro-
ceed empirically or by intuition, impelled by the belief that, after all,
venereal disease education works.

Therefore, my comments on the current status of education must
consist less of evaluation and more of quantitative measurement, plus
a description of the difficulties which lie in our path and the oppor-
tunities which have added strength to our armament.

At the Federal level there has been wide recognition of the urgent
need for expanded education to aid in the control of venereal disease.
The result is that close working relationships have been developed
between the Public Health Service and the various branches of the
armed forces, as well as with other Federal agencies such as the Office
of Defense Health and Welfare Services, the Office for Civilian

VENEREAL DISEASE CONTROL EDUCATION 3

Defense and the War Manpower Commission. Similar relationships
have been established or strengthened with numerous non-govern-
mental agencies such as the American Social Hygiene Association,
the National Committee for Health Education in Schools, the National
Safety Council, and various national organizations representing man-
agement, labor, civic, fraternal, and other groups.

To implement these relationships the educational staff of the Service
has been expanded, the output of informational materials increased,
and consultation and advisory services established.

Beginning with the special meeting of State and Territorial Health
Officers on venereal disease control, held in Washington in 1940, there
has been a steady increase of educational activity by the States and
the larger cities. This has been accelerated considerably since the
outbreak of hostilities.

The manpower problem in all health agencies has become increas-
ingly critical. The ranks of physicians, nurses, and technicians have
been depleted, while at the same time, as a result of selectee exam-
inations and other factors, clinic case loads have increased steadily.
The natural result has been that nurses and physicians must devote
more of their time to treatment and clinic administration and less to
educational activities.

It was to meet this educational manpower problem that I proposed
to the States in 1943 that budgets include provision for full-time
employees to be responsible for venereal disease education. I sug-
gested a possible need for these workers at both State and local levels,
with particular emphasis in areas where the most urgent need existed.

Several States had already taken these steps at the time of my pro-
posal, and since then a number of others have done likewise, or have
immediate plans for initiating this policy.

Of course, manpower is still a problem since there are very few
experienced information people available who have special qualifica-
tions in health education. However, many energetic and intelligent
people are available whose experience and sympathies are such that
with a little training they can be developed into good educators. In
one State it was found that unemployed automobile salesmen quickly
became useful educators, while in others social workers, school teachers,
newspaper reporters and former agricultural extension workers have
demonstrated their capabilities.

Where the States desire such assistance the Public Health Service is.
willing to help in the training of new recruits for special educational
effort, either on a group basis or individually. We have not set any
hard and fast rules as to the type of personnel to be selected nor the
type of special training that should be given to them. We believe, and
experience has borne us out in this, that the States are the best judges,
as to the people who may be available and the kind of training they
will require.

JUL 12 194b

4 JOURNAL OF SOCIAL HYGIENE

Of particular importance as a partial solution to the personnel
problem, and as evidence of the place education holds as an integral
part of the over-all control program, is the increased use of lay
workers in venereal disease epidemiology. Throughout the country
there are now almost 10,000 follow-up workers, a large proportion of
whom are non-professional.

It is obvious that a follow-up worker is, among other things, an
educator who uses an intensive, individualized technic in the teaching
of basic factors about venereal disease. Nearly all of the States are
recognizing the inherent educational nature of this work by regular
in-service training aimed at improving the teaching capabilities of
the workers.

Still broader educational use of these workers is found in the prac-
tice of having them develop cooperative relationships with druggists,
tavern-keepers, and others whose business is such that they are brought
in daily contact with actual or potential venereal disease cases. The
druggists, for example, are persuaded to permit the use of their store
windows for educational exhibits and posters. They are also encour-
aged to give appropriate literature to customers wrho ask advice about
venereal disease symptoms, about prophylaxis, and about the claims
of various proprietary medicines.

In some communities the lay follow-up worker is actively aiding
the health officer or the nurses in an educational capacity by arranging
for group meetings. The worker takes care of minor but time-con-
suming details such as arranging for advance publicity, operating the
motion picture or slide projectors and handing out appropriate litera-
ture. This arrangement relieves the health officer or nurse, or the
cooperating private physician, of all details except those which require
the attention of a professional person.

The most effective use of the tremendous educational potential in a
large number of follow-up workers requires intelligent planning,
smooth integration with other phases of health education and com-
municable disease control, and capable administration. Procurement
of educational materials, instruction as to their proper use, and
constant stimulation, consultation and demonstration are equally
important. These functions require the full-time attention of a
capable person working at the State level. Part-time administration
will usually do only a part time job.

It is evident from experience gained thus far out of wartime
necessity that a well-planned program of venereal disease education
at State and local levels can be created out of the services of one or
more full-time people who have the ability, the responsibility, and the
time to plan and execute programs which make maximum use of
•existing or added personnel and materials. Further, we have learned
that good educational people can be recruited from teaching, jour-
nalism, salesmanship, community organization, and other fields which
require ability to convey information to the public.

VENEREAL DISEASE CONTROL EDUCATION 0

Another problem which has been not too serious thus far, but which
may grow worse as we move deeper into the war, is that of obtaining
a sufficiency of good educational materials. Shortages of paper and
of the metals used for engraving are becoming noticeable. The
strain on Federal government printing facilities is quite apparent.
As a result, many States have experienced considerable delay in the
execution of their orders for educational materials produced by the
Government Printing Office.

SOME OP THE STANDARD VD FOLDERS PUT OUT BY THE
U. S. PUBLIC HEALTH SERVICE

A mimeographed list of VD educational materials is available from the
U. S. Public Health Service, Washington, D. C. Most of the materials are
available at quantity rates from the Government Printing Office.

Because of this unavoidable situation I have already authorized
many States to reprint materials originated by the special writers
and artists of the Public Health Service. Another device is that
employed by several States in the South who, prior to the beginning
of the current fiscal year, formed a pool through which they expect to
produce jointly the special materials required for their intensified
education programs. If either or both of these experiments are suc-
cessful, we will be able to offer all States proven methods of solving
some of their educational materials difficulties.

Closely related to the materials production problem is that of their
evaluation. In recognition of this problem, the Public Health Service
has established a cooperative project with the North Carolina State
Health Department and with the Zachary Smith Reynolds Fund for
the purpose of measuring the effectiveness of specific educational
devices and materials.* It is expected that out of this venture will be

* See article on Venereal Disease Education Institute, page 12.

6 JOURNAL OF SOCIAL HYGIENE

developed new and effective methods and technics for reaching the
Negro and rural sections of our population. It is further planned to
arrange for distribution of materials, the effectiveness of which has
been demonstrated on the project, to other States and localities.

A related project in the same State is that devoted to the demon-
stration of intensive generalized health education methods. For
several months highly qualified Federal health education specialists
have been assigned to a five-county area which presents a combination
of military, industrial and rural conditions. Following a policy of
general health education rather than intensive work on any special
problem, these Federal workers have demonstrated the value of edu-
cation so effectively that the State has decided to replace them with
full-time State employees who wall train for a necessary period under
the supervision of the demonstration workers. When these State
people are ready to take over, the Public Health Service will make
Federal workers available to other States for similar demonstration
projects in areas presenting health problems affecting the war effort.

This combination of a research project in the production and evalu-
ation of venereal disease education materials and methods, with a
project which demonstrates the most effective use of these materials
within the framework of generalized health education programs, is a
unique experiment. The results should contribute much to our spe-
cific knowledge on the subject of venereal disease and general health
education.

While on the subject of educational materials, I should like to call
attention to a significant educational trend observed in the extraor-
dinary emphasis being given to prophylaxis information. The prophy-
laxis film entitled Know For Sure, produced by the U. S. Public
Health Service, has enjoyed a phenomenal success since its release
about ten months ago. Nearly every State and many cities have pur-
chased one or more copies of this film. While no exact figures are
available, we estimate the total number of civilian men who have seen
this film already to be well over 250,000. Probably as many of our
soldiers have been exposed to its teaching influence since many Army
posts are using it to implement their own materials. So successful
has been the Army's experience that we have made available to them
100 additional prints.

The companion piece to the prophylaxis film is the Public Health
Service folder entitled It Doesn't Pay. We are informed by the Gov-
ernment Printing Office that this folder has enjoyed one of the most
remarkable sales records of any piece of literature in the history of
government printing. The States have ordered this booklet in quan-
tities totaling about a million copies and the orders continue to come
in. We believe that this unprecedented demand proves we are faced
with our greatest opportunity for teaching American manhood the
facts about syphilis and gonorrhea. To implement this belief we have
begun to work out a method by which the States may print their own
version of this booklet at a considerable reduction in cost. Our joint

VENEREAL, DISEASE CONTEOL EDUCATION" /

objective might well be to place a copy of this or a similar booklet in
the possession of every adult male in the United States.

Earlier I outlined the war-induced dichotomy of problem and oppor-
tunity, and I have described some of the major problems. Some of
the opportunities deserve brief mention.

Foremost among our opportunities, as 1 have already said, is the
educational experience and the opportunity for control that is inherent
in the blood testing of young men who are examined for the armed
services. It has been estimated that probably 200 men are tested
for every 100 who are actually taken into the Army or Navy. Even
if the final proportion is not this high, it is obvious that in building
the announced strength of the Army to 7,500,000 by the end of 1943,
15,000,000 men will have received a blood test for syphilis. Each man
will thus have added to his experience in a most direct and personal
manner one of the most important of all our venereal disease educa-
tional messages — the Know For Sure message of the blood test. In
many places cooperative programs between health officers and Selec-
tive Service officials are fully exploiting the educational opportunity
thus presented. Lectures, films, literature and posters are being used
in varying degrees and combinations at this point.

The many problems involved in the use of Selective Service tests
as a case-finding device are approaching solution. Thus the infected
men and their contacts are being taught as Avell as brought to
treatment.

The inter-relationship of opportunity and problem is thus clearly
demonstrated. If blocked by lack of educational manpower or mate-
rials for effective educational work, it will be impossible for the health
department to take full ml vantage of the educational potentiality of
the Selective Service blood tests.

Another opportunity which is at the same time a most difficult
problem is found in the nationwide campaign for prostitution repres-
sion. Here again we find it impossible to separate education from the
over-all control program. In a democracy, law enforcement depends
largely on public opinion. It has been demonstrated many times dur-
ing recent months that civilian law enforcement authorities can seldom
repress prostitution effectively if the general public fails to understand
the public health need for such action.

In support of this demonstrated fact, the Public Health Service and
the Office of Community War Services have recently issued a manual
suggesting methods by which the health officer can educate his com-
munity to the need for repression. This manual grew out of nation-
wide experience of Federal and private agencies, and the practical
advice of Army and Navy officials and of civilian police leaders. The
type of intensive community education program envisioned in this
manual, which we have given the title Victory Versus VD will result
not only in spreading knowledge of the major sources of venereal
disease, but will logically lead to wider public knowledge of symptoms,

8 JOURNAL OF SOCIAL HYGIENE

prophylactic methods and of the necessity for early and adequate
treatment.

Energized by the war, venereal disease education is progressing on
many other fronts. There is not time for me to do more than just
mention some of the more important of these activities, most of which
are already familiar to you because in one way or another you are
actively participating in them.

Reinforced by the imperative demand for maximum industrial pro-
duction, venereal disease control in industry is on the march. Its
future progress depends largely on two factors : national cooperation,
on the part of management and labor, in wrhich education will play a
major role; and expanded cooperation between local health officers
and the leaders of local industry, labor, and the local representatives
of those governmental agencies responsible for the maintenance of
production.

Preceding speakers have given you the details of educational efforts
in the Army and Navy, so there is little need for me to expand on
this exceedingly important -phase of the national control program. I
might say, however, that the effects of education which the men, and
also the women, receive while in uniform will carry over into the post-
war civilian control of syphilis and gonorrhea. Therefore our col-
leagues in the Army and Navy medical services will readily under-
stand why we are so interested in their activities, and so anxious to
cooperate with them.

Another significant development in venereal disease education is
the increased use of Negro workers in epidemiology and education.
These Negro workers are doing a magnificent job, particularly in
some of the Southern States, and it is the responsibility of us all to
encourage and expand this fine work in every possible manner.

A well known amateur German psychologist back in 1937 had this
to say about mass education :

"The intelligence of the masses is small, their forgetfulness is great.
Effective propaganda must therefore be confined to a few issues which
can be easily assimilated. . . . They must be told the same thing a
thousand times. ' '

We in America differ with Ilerr Adolf Schickelgruber 011 many
things, including his concept of the intelligence of the masses. If he
said that the level of education of the masses is small, then we might
agree with him. The educational level of the people we must deal with
most of the time in venereal disease education is unquestionably low.
But their intelligence, their ability to receive information and to
relate it to their experience as a guide to future conduct, is high. Our
task is to give them, all of them, the infected and the potentially
infected alike, the information they need about venereal disease in
order that they may help us and help themselves. The perseverance,
the intelligence, and the industry which we give to this task will
determine in large measure whether we will ultimately succeed in
eliminating from America the twin scourges of syphilis and gonorrhea.

VENEREAL DISEASE CONTROL EDUCATION

SUPPLEMENTARY NOTES

In the year that has elapsed since this paper was presented, there
have been a number of new developments in the venereal disease
education phase of Federal, State, and local civilian control programs
which should be described briefly.

Most important of these is the intensified national campaign of
information and education which has been planned for 1944. If
present plans are carried out this program will consist of articles
and sponsored advertisements in magazines of national circulation,
display of venereal disease films in commercial theaters, and feature
articles, news stories, photographs, and editorials in the daily and
weekly press. It is hoped that the national radio networks will
also include venereal disease programs as part of their contribution
to the public service.

This national program is being organized jointly by the Public
Health Service, the American Social Hygiene Association, the Division
of Social Protection (Federal Security Agency), and the Office of War
Information. Through this latter agency, the assistance of the
nation's advertising experts, artists, and writers has been obtained.

It is hoped that the national program will stimulate State and local
health departments, social hygiene agencies affiliated with the national
Association, and other official and voluntary organizations interested
in venereal disease control to intensify their local informational-edu-
cational programs. Special materials for local use are being developed
and distributed to health officers throughout the country. With
these materials have gone memoranda offering suggestions as to how
they might be used. The American Social Hygiene Association has
accepted the responsibility of obtaining coordinated national and
local support from all types of voluntary organizations. Through
this joint effort a vigorous, sustained, and highly integrated educa-
tional program can be conducted wherever venereal disease presents
a definite problem in terms of damage to the war effort.

This entire plan may be summarized as a determined attempt to
enlist the Nation's mass education media and expert practitioners
in the manner advocated by Dr. Rogers Deakin in a letter to the
membership of the American Neisserian Medical Society :

Is it not time to call upon those whose training and experience in public
relations, education, advertising, newspaper and radio work, and publicity make
them specialists in bringing something to the attention of the public, and to
enlist this sort of help in the campaign against gonorrhea? It is as inappropriate
for the physician to assume this educational responsibility as it would be for
the executive of a prominent advertising agency to treat a gonorrhea! infection.
If there are moral or religious issues involved in public education on gonorrhea,
why should not moral, religious, and educational leaders sit in conference with
physicians and publicity experts to find out what is proper and feasible? Surely
there are many fine minds throughout this country who can discuss this problem
and arrive at conclusions which will be uniformly acceptable. Again, the war
— and a therapy full of hope and promise — justify, indeed make eminently
desirable, a broader view of this problem of mass education and a broader use
of all our media of communication.

10 JOURNAL OF SOCIAL HYGIENE

Throughout the country there have been a number of energetic
local educational programs in recent months. Their success has indi-
cated the feasibility and value of the national campaign described
above, which in turn is expected to stimulate and aid local activity
of this kind. Outstanding among these, to mention only a few, are
the programs carried out in Philadelphia, St. Louis, and Louisiana.
' ' Social Hygiene Month ' ' was celebrated in Louisiana in March, 1943,
climaxed by an all-day conference on wartime social hygiene problems,
with officials and voluntary agency representatives meeting to discuss
future plans and appoint a committe on recommendations to carry on
from there. (See JOURNAL OF SOCIAL HYGIENE, Vol. 29: 246.) St.
Louis put on an educational campaign September 13-October 31,
1943, using public meetings, billboard advertisements, leaflets, car
cards, newspapers and periodicals — display advertising as well as
stories and editorials — and radio time, in a highly organized distribu-
tion system designed specifically to reach all groups "where they
are." (See JOURNAL OF SOCIAL HYGIENE, Vol. 29 : 554.) A week-long
campaign in Philadelphia, October 3-9, making use of all public rela-
tions media, was conducted on an experimental basis, with a more
inclusive program in view for February 1944, in connection with
Social Hygiene Day. (See JOURNAL OF SOCIAL HYGIENE, Vol. 29 : 560.)
Many other communities have 'carried out, or are planning similar
programs. And these very effective local activities are the point and
substance of the national campaign.

Other developments which deserve mention include the motion
picture * produced by Mr. Walter Wanger and Universal Studios in
cooperation with the California State Health Department, and dis-
tributed nationally under Public Health Service sponsorship by the
Office of War Information and the War Activities Committee of the
motion picture industry. Here, for the first time, is an opportunity
to bring our message to the scores of millions who make up the
movie-going public. This film should have far-reaching consequences.
Much credit is due Mr, Wanger and Mr. Jean Hersholt and other
actors and technicians associated with Mr. Wanger who donated
their time to this project.

Another example of cooperation from the motion picture industry
is found in the Warner Brothers Studio, which made available the
classic film Doctor Ehrlich's Magic Bullet, in which Edward G.
Eobinson starred. The Public Health Service has cut this production
from 11 to 3 reels, making available in 16-mm. size a useful venereal
disease film, with all the interest of a dramatic motion picture of high
artistic merit.

Despite the pressing and immediate problems of social hygiene in
wartime, the future of the health education program is an important
element in all these plans and projects. The needs most specifically
related to the future — i.e. the evaluation of methods and the training
of personnel — are focussed most sharply in the work of the VD Edu-
cation Institute in Raleigh, North Carolina. (See p. 12.) Mention
should be made also of the health education fellowships awarded by

* To The People of the United States.

VENEREAL DISEASE CONTROL EDUCATION

11

the Public Health Service through funds made available by the W. K.
Kellogg Foundation. (See JOURNAL OF SOCIAL HYGIENE, Vol. 29 : 542.)

During the year — from the Army, Navy, Coast Guard and Maritime
Commission, and from official and voluntary civilian agencies, federal,
state, and local — comes evidence of increasing recognition of educa-
tion as an essential factor in the wartime venereal disease control.

Left — A brief, easily-read warning
about syphilis and gonorrhea. One
of the AVorkrrs ' Health Series of
folders on various health subjects.
These folders available from Gov-
ernment Printing Office at 5 cents
each and quantity rates.

Below, riylit — The important facts
about gonorrhea and its cure. Gov-
ernment Printing Office, Washing-
ton, D. C. $1.00 per 100.

Below, left — An illustrated leaflet
about syphilis and gonorrhea with
a special appeal to women to know
the facts for the protection of their
homes and families. Available from
VD Education Institute, Raleigh,
North Carolina.

THE VENEREAL DISEASE EDUCATION INSTITUTE

E. DOUGLAS DOAK
Editorial Assistant, Venereal Disease Education Institute

At no time in the history of venereal disease control in this country
has greater stress been laid on the role of education in the fight to
eradicate these diseases. And at no time has so large an army of
doctors, nurses, social workers, and lay helpers been engaged in the
effort to further venereal disease education. As a consequence there
is an ever increasing demand from every station on this battle front
for more and more ammunition to use in this educational war.

The acuteness of this situation is familiar to both workers engaged
in venereal disease control who are constantly on the outlook for
additional educational materials, and the agencies engaged in pro-
duction of such materials. Everywhere there is a steady demand
from the field for more booklets, more posters, more films . . . any
new and effective weapons which the "factories" can supply.

In cognizance of these forces of demand and supply, the Venereal
Disease Control Division of the United States Public Health Service
sponsored, in the summer of 1942, the setting up of a new "factory"
on the production line, the Venereal Disease Education Institute.

With full realization that there are many excellent agencies already
engaged in the production of educational materials in this field, it
has been the hope of those responsible for organizing the Venereal
Disease Education Institute that a fresh approach to the problems
of venereal disease education, and a centralized source of supply of
timely materials would supplement the arsenal of weapons in the
attack on these diseases.

The primary purpose of the Venereal Disease Education Institute
is, therefore, to provide a constant flow of new and effective educa-
tional materials, not only to governmental health agencies but to any
agency engaged in venereal disease control.

Given a wide freedom of activity within its organization, the Insti-
tute is intended not only to produce educational materials, but
through actual projects and demonstrations to develop guides and
outlines for educational methods in the venereal disease control field.
Once they have reached full development, these materials and aids
are made available to any interested agency.

In line with good business policy of establishing the source of
supply near the largest source of demand, the Institute was located

12

VEXEREAL DISEASE EDUCATION INSTITUTE 13

in Raleigh, North Carolina, since this state is near the geographical
center of the country's highest incidence of venereal infections. Other
factors influencing the location of the Institute in this state were the
record of service of the North Carolina State Board of Health in
venereal disease control, and generous contribution to the support
of the Institute from the Zachary Smith Reynolds Foundation, which
has been giving financial aid to the North Carolina control program.
The Institute has also enjoyed the sympathetic and helpful interest of
other agencies in this field, such as the American Social Hygiene
Association and various state departments of health.

Additional advantages are incurred through location of the Insti-
tute in a state which provides a fairly typical cross-section of rural
and urban centers of population where field demonstration projects
may be carried on. Further, there are obvious advantages in the
location of such an organization where it may maintain constant
contact with actual workers in the field of venereal disease education.
Such contact provides valuable direction and guidance in the pro-
duction of materials which will really fit the needs of the workers
who ultimately are to use them. Through constant consultation with
venereal disease control workers and through evaluation of its pro-
ductions in actual demonstrations, the Institute attempts to make
its materials of the very highest practical service to workers in
the field.

As will be readily admitted the Institute's aims are both wide
in scope and difficult of achievement. How well it will succeed is
yet to be seen, since the organization has barely entered its second
year of activity. Without attempting to evaluate the Institute's use-
fulness in the venereal disease education field — which, in the last
analysis, will depend on the judgment of the agencies it is intended to
serve — the following resume of the Institute's activities and methods
of operation may provide some notes of interest for educators who are
on the alert for additional sources of material and educational aids.

In the selection of staff members the Institute has followed the
recent trend in health education and procured a staff of experienced
laymen to man the assembly lines of its "factory," including artists,
writers, and specialists in venereal disease and sex education. In
the graphics department, a staff of both commercial and fine artists
are engaged in production of many types of visual aids. Several
writers are engaged in the composition of various pieces of literature,
film and radio script, and other copy. A specialist in venereal
disease education, and a specialist in sex education are employed in
directing the field demonstrations and evaluation tests. The Institute
is under the direction of Capus Waynick, former editor and public
administrator.

Fully aware that the layman may lend the necessary ingredient
of skill in presentation, but that educational material fails imme-
diately if not backed up by scientific accuracy, it has been the policy
of the Institute to seek advice and criticism from professional
sources at every turn. Since the start of production every piece of

14

JOURNAL, OF SOCIAL HYGIENE

material lias been submitted to authoritative medical criticism, as
well as to the scrutiny of leading educators in the venereal disease field.

As an example of this, a handbook of visual aids for use by clinic
interviewers, which is now in the process of production, was first
drawn up in rough draft, then presented during a personal visit to
several venereal disease medical experts throughout the country for
their review, and later to a number of clinicians and nurses in the
North Carolina clinics. The handbook was then revised and edited
in light of the score or more critiques received in this manner.

STAFF MEMBERS OF INSTITUTE CONFER ON ARTIST'S DRAWINGS
Left to right : Lester A. Kirkendall, Education Specialist ; T. S. Ferree, Director
of Art Department ; H. I. F. Nanton, Education Specialist ; James A. McLean,
Artist; Miss Douglas Doak, Editorial Assistant.

Production of materials by the Institute is a highly cooperative
affair. Suggestions for new pieces of material, particularly new
forms of presentation, are constantly solicited from the staff, from
other agencies, from clinicians, educators, or from anyone who
wishes to contribute suggestions to the production department or call
on the Institute for production of specific materials.

Once designed by the appropriate members of the staff, the
material is reviewed by the staff as a whole, and later submitted to
selected authorities before it is put into the mill.

Although the Institute was formed with the purpose not only of
producing materials but also of surveying the field to determine
specific needs for various media, as well as evaluating existing edu-
cational programs, the pressing demands for venereal disease educa-

VENEBEAL. DISEASE EDUCATION" INSTITUTE 15

tion aids at the time of the Institute 's initiation indicated the wisdom
of proceeding at once with production rather than waiting on a
lengthy program of survey and evaluation. Therefore, during its
first year the organization produced a fair quantity of posters and
booklets and is now in the process of producing other forms of
educational materials.

At the time the Institute was founded there was on every side a
very large demand for venereal disease materials among the control
officers in the armed services. In accordance with this immediate
demand, the Institute set to work on a series of posters designed for
the service man. This series includes several posters bearing a
general warning against venereal disease, and a series displaying
humorous cartoons, featuring a character called Private Caution.
A pamphlet for service men, entitled A Message from Your Medical
Officer, was recently released. As indicated by the increasing demand
for these materials, they have met with the approval of many service
control officers.

For more general use the Institute has produced a series of
posters lithographed in three and four colors, which have also been
favorably received in the field.

In the publications line the Institute has printed three booklets.
Its first publication was a fairly detailed booklet directed at the
general public and entitled Out In The Open, which includes a dis-
cussion of the venereal disease problem and facts about these diseases.
This publication is generously illustrated, and is available in two
editions, one with illustrations of white characters, the other with
Negro characters, a feature which has attracted much interest from
the field.

A Fifth Freedom, the second publication, is directed at civic clubs
and other groups interested in aiding community venereal disease
control programs, and contains suggestions for lending aid to such
programs. What Every Woman Should Know, a purse-size booklet,
with attractive illustrations, is a digest of facts about venereal disease
important to women. This has to date proved a most popular
publication.

While the Institute has devoted itself chiefly to producing and
testing materials during the early stages of its work, " grapevine"
information among health agencies has brought it to the attention
of many educators and clinicians. The result is that there is an
ever-increasing number of requests coming from every part of the
country, as well as the territorial possessions for productions bearing
the Institute's VDgraphic imprint.

Among materials now in the process of production, there are three
which may be of particular interest. During the past two months,
with the aid of the U. S. Public Health Service, the Institute has
developed a series of kodachrome slide sets, for use in selectroslide
machines or other slide film projectors. These are designed for
assistance in case-holding, patient education, and general education.

16 JOURNAL OF SOCIAL HYGIENE

Each set will be composed of 48 slides, provided with self-explanatory
captions, or a narrative for an operator to use while showing the
slides.

An illustrated guide for use by clinic interviewers is scheduled for
production during the present year. This handbook contains simple,
non-technical illustrations designed to assist the interviewer in
explaining the nature, cause, and effects of venereal disease to the
clinic patient. Each illustration is accompanied by a few lines of
explanatory text to guide the interviewer.

The third project to be mentioned specifically, is a series of news-
paper advertisements. These advertisements, copy and illustration,
are intended to appear in sequence, though each may be used apart
from the series. The series will tell the story of the venereal disease
problem, the forces now mobilized against it, and what the individual
or the community can do to help. It is planned to make this series
available through a mat service.

It is obvious that an organization which attempts to provide edu-
cational materials with no thought to the objectives of those materials,
and rests content with production without questioning the results
achieved, is as foolish as the doctor who diagnoses a complaint with-
out seeing the patient, and expects a cure without observing the
progress of his treatment. Accordingly along with its launching into
the production field, the Institute has initiated a program of survey
and evaluation. This program is as yet too embryonic for an assess-
ment of results, but its inclusion in the work of the Institute has
already proved of value in the experience gained through first hand
contact with the public, and with the various phases of venereal
disease control.

To carry on this survey and evaluation work, the Institute evolved
a plan entailing the promotion of venereal disease education programs
in several cities in the State of North Carolina. It should be clearly
understood that the Institute in no way engages in educational
activity as an end in itself, but that these field projects have been
in the nature of demonstrations and have provided the Institute
with an opening for surveys to determine objectives in venereal
disease education, as well as an opportunity for supervised use of
its materials for the purposes of evaluation.

The field service unit of the Institute is made up of four members of
the staff, experienced in the fields of venereal disease and social
hygiene education, as well as public relations. With this unit the
Institute has promoted and supervised projects in venereal disease
education in four North Carolina cities. The active cooperation of
local health departments and civic groups has been of utmost value
in these projects.

On the next two pages are reproduced some of the posters — »
developed by the VD Education Institute. For further information
about these and other materials, write the Institute at Raleigh, North
Carolina.

VENEREAL DISEASE EDUCATION INSTITUTE

17

18

VENEREAL DISEASE EDUCATION INSTITUTE 19

Aii over-all educational program, employing newspaper articles,
radio broadcasts, motion pictures, lectures, posters and pamphlets
has been carried on in each city, with the Institute's field service
unit doing much of the actual work in cooperation with some spon-
soring local civic club.

The interest aroused through these activities has enabled the
Institute to go ahead in each city with evaluation projects. A social
hygiene survey in the form of a questionnaire has been employed in
each city early in the course of the campaign, with the cooperation
of industrial groups, high schools, and civic clubs. It is the purpose
of this survey to determine as nearly as possible, the level of public
information concerning the venereal diseases, what conceptions, and
particularly what misconceptions are held. Returns from this survey
are still being collected.

In the evaluation field, attempts have been made in each city to
determine both the result of the over-all campaign and the effects
of specific pieces of literature or graphics. This has been done
through surveys of increased attendance at clinics ; increased requests
for blood tests; solicitation of opinions from key people in the
community as to the program's effectiveness; "before" and "after"
questionnaires where literature or posters have been distributed. This
evaluation is as yet experimental and on a very small scale, but plans
are going forward to perfect reliable methods.

As an outgrowth of the field projects, the Institute is now prepar-
ing a handbook for the guidance of local health departments or civic
groups which want to engage in venereal disease education campaigns.
The suggestions in this handbook will be based on the experience
of the field service unit in carrying out actual projects, and the
publication will include a kit of materials for use in the program,
including sample news releases, radio scripts, bibliographies of films,
posters, pamphlets and other materials, and form letters which might
be used in promoting the program.

It is the purpose of the Institute to be of assistance to any individ-
uals or groups interested in or engaged in venereal disease education.
With this in mind a collection is being made of data concerning
venereal disease education projects throughout the country, both
public and private, and information concerning any research wThich
has a bearing on that field. A library of venereal disease education
materials is also being collected. It is hoped that the Institute files
will eventually become a source of assistance to all workers in the
field of venereal disease education. Already the Institute has been
visited by a number of venereal disease educators from different states.

As can be seen, the scope of activity of the Institute is wide, and
it is perhaps unique in its opportunity to operate as a research agency.
It is the aim of the Institute to serve as a laboratory for experimenta-
tion in perfecting the materials and techniques of venereal disease
education. The results of these experiments will at all times be
available to the agencies engaged in combating venereal disease. The
Institute welcomes inquiries and visits from interested persons.

VENEREAL DISEASE EDUCATION IN THE ARMY *

GAYLOED W. ANDEKSON

Lieutenant Colonel, Medical Corps

Education of the soldier is essential to the success of the
venereal disease control program of the Army. While immuni-
zation may so protect the troops against smallpox, typhoid
and tetanus that a high degree of safety is provided without
any further thought on the part of the person protected, the
control of venereal disease is dependent upon the soldier's
individual participation in the program. Measures to repress
prostitution will reduce, though not entirely remove, the
opportunities for exposure ; follow-up of sources of infection
will diminish the risk of infection of those who expose them-
selves ; and provision of facilities for prophylaxis will reduce
the risk of infection if exposure occurs. The individual, how-
ever, is the final arbiter in deciding whether or not he will
risk exposure or will utilize prophylactic measures if exposed.
Since the ultimate decision rests with the individual, educa-
tion is the foundation upon which the success or failure of the
program depends.

The formulation of an educational program for the Army is
based on certain fundamental tenets :

1. Continence is the most desirable and most certain method of
avoiding venereal disease. This basic principle is clearly set forth in
Army regulations and directives.

2. The sex habits of the man of military age have been largely
determined before he enters the Army. The man who has been
promiscuous in civil life will probably not change his habits upon
entering military life. A study at one Army post showed that half
of all the soldiers contracting venereal disease gave a history of hav-
ing had a similar infection before entering the Army.

3. Since there is a certain group who will expose themselves to
infection in spite of measures to promote continence, instruction in
prophylaxis must be given. To withhold instruction would just as

* From the Division of Preventive Medicine, Surgeoa General 's Office, War
Department.

20

VENEREAL DISEASE EDUCATION IN THE ARMY Zl

certainly increase the amount of venereal disease as would discon-
tinuance of immunization increase the rate of typhoid and smallpox.
Deliberate adoption of measures that increase the amount of disease
is contrary to the highest traditions and ethics of medicine.

4. Since it is not possible to separate those who are in need of
instruction in prophylaxis from those who, because of continence, do
not so need it, instruction must be given to all.

5. Instruction regarding venereal diseases and their prevention
must be presented in a straight-forward unemotional manner without
attempting to frighten the individual. There is no evidence that
fear of infection and of the awful consequences that are at times so
luridly portrayed is a forceful deterent to sexual exposure. Morbid
and excessive fear is a poor substitute for understanding and morals.

6. Instruction must be presented in such a form as to appeal to
all levels of intellect, with special attention to those in the lower half
of the intellectual range. The average intelligence quotient is a poor
scale by which to determine the level of approach, for the average
is raised by those who have had advanced educational opportunities
which often included instruction in sex hygiene and venereal diseases.
These men are therefore less in need of such instruction (or have
shown themselves resistant to it) than are those in the lower half of
the intellectual scale who have had fewer educational opportunities
and are therefore less well informed.

7. A wide variety of educational techniques must be employed in
order to reach the largest number of individuals. The poster, movie
or pamphlet that appeals to one person may be completely lacking in
appeal to someone else. Measures should be employed that appeal
to all ranges of taste, education and emotion.

8. Whatever educational measures are used must be such as will
appeal to the individual to be reached, viz. the soldier. It must not
be forgotten that his emotional and intellectual reaction is different
from that of the older individual who has spent years in the study of
medicine, sociology, law, theology, or any of the other disciplines from
which the venereal disease program draws its support. What appeals
to the youth lacking technical knowledge may appear puerile to the
middle-aged scholar, yet it is to the youth, not the scholar, to whom
the appeal must be directed. The only true guide as to the suitability
of educational material is therefore the reaction of the individual to
whom it is directed, not the academic opinion of those responsible for
the preparation of the materials. Study of the manner in which the
soldier expresses himself when given an opportunity is a valuable
guide to his reactions.

9. Memory is relatively short in competing with a biological urge
as strong as that of sex. Resort must therefore be had to measures
which frequently remind the individual of the basic instruction.

10. While instruction regarding venereal diseases must be fre-
quently repeated, it must not be made monotonous or so tiresome as
to arouse resentment. Thus the soldier who sees the same motion
picture six to eight times not only fails to be impressed but develops-

22 JOUENAL, OF SOCIAL HYGIENE

a sense of resentment as well as contempt for the whole program.
There is obviously room for considerable difference of opinion as to
where desirable repetition merges into resented monotony.

11. Instruction must be in such a form as to command the respect,
not the ridicule of the soldier. Sloppy sentimentalism and childish-
ness are just as out of place as is vulgarity.

12. Instruction of officers as to the importance of venereal diseases
and sound measures that can be taken to effect their control is as
essential as is instruction of the men regarding measures of individual
protection. Since Army policy places the ultimate responsibility upon
the commanding officer, he is the key individual in the success or
failure of the program within a particular unit. His understanding
and cooperation are therefore essential.

THE ARMY PROGRAM

The present Army program of venereal disease education,
based on these tenets, is designed to provide a progressive
process of instruction as the soldier goes through his basic
training, by the end of which time he should have received
the essential instruction. This is supplemented by the use of
such reminder devices as are best adapted to the need of the
unit. The program is set forth in Training Circular 28,
March 3, 1943, as follows:

"SEX HYGIENE AND VENEREAL DISEASES.— 1. Necessity for training.
— Education of the soldier regarding venereal diseases and their prevention is
considered to be an essential part of training. The educational program should
therefore be curried out in such a way as to assure proper instruction of all
personnel.

2. Authority. — Section VII, AE 40-210, provides for instruction in venereal
diseases and their control.

3. General program of instruction. — To carry out the intent of AB 40-210 the
f olloAving general program of venereal disease instruction will be carried out :

a. Basic Instruction.

(1) Induction Stations. — Distribution of such pamphlet material and display
of such posters as may be made available through The Adjutant Gen-
eral's Office or The Surgeon General's Office. Commanding officers may
further authorize use of such pamphlets and posters as may be obtained
from civil agencies.

-(2) Reception Centers.

(a) Showing of TF 8-154. An appropriate entry will be made in the
service record (W. D., A. G. O. Form No. 24) of the enlisted man
at the time of the showing of this film.

(b) Distribution of War Department pamphlet ,on Sex Hygiene and
Venereal Disease.

(c) Brief talks by the commanding officer (or his representative),
chaplain, and medical officer.

(3) Replacement Training Centers.

(a) Lecture on venereal diseases by the medical officer. See FS 8-57
and accompanying notes (to be released on or about March 15, 1943).

VENEREAL DISEASE EDUCATION IN THE AKMY 23

(b) Lecture on venereal disease prophylaxis by the medical officer. See
FS 8-58 and accompanying notes (to be released on or about
March 15, 1943).

(c) Showing of TF 8-154 to those men whose service records do not
indicate that they saw the film at the reception center.

(d) Entries will be made in the service records at the time of the lecture
on venereal disease and the lecture on prophylaxis, and also at the
time of the showing of TF 8-154 to those men to whom the film
is shown.

(4) Troops Who Have Not Passed Through Replacement Training Centers.
— Unit Commanders receiving troops who have not passed through
replacement training centers will make suitable arrangements for instruc-
tion comparable to that which would have been received at such centers.

(5) Officer Candidate Schools. — Lecture on measures for the control of
venereal diseases, emphasizing responsibility of unit commanders for
instituting and supporting such measures. See FS 8-59 and accompany-
ing notes (to be released on or about March 15, 1943).

b. Supplemental Instruction. — Supplemental instruction will be largely in the
form of measures that remind the individual of the above basic instruction.
Unit Commanders will make suitable arrangements for use of such reminders,
including posters, talks, motion pictures, pamphlets, bulletins, news items, and
such other devices as are best adapted to the needs of the post. Attention will
also be given to measures to remind officers of their responsibilities for preventing
venereal disease in their respective commands.

c. Special Instruction. — Those responsible for training of specialized personnel
will provide for such further special instruction as may be deemed necessary."

(A. G-. 352.11 (12-17-42).)
By Order of the Secretary of War:

G. C. MARSHALL,
Chief of Staff.
OFFICIAL:
J. A. ULIO,
Major General,

The Adjutant General.

EDUCATIONAL MEASURES

1. Pamphlets.

Four pamphlets have been officially distributed within the Army :
(a) Off to a Good Start, for use in induction stations and designed to
stress the hazards of infection during the period of furlough on inac-
tive duty between acceptance for the Army and beginning active
service; (b) Sex Hygiene and Venereal Diseases, distributed to all
soldiers in Reception Centers; (c) Venereal Disease Overseas, dis-
tributed in staging areas; (d) It Doesn't Pay, reprint of II. S. Public
Health Service prophylaxis pamphlet on prophylaxis, also distributed
in staging areas. In addition many posts have made use of pamphlets
obtained through state and local health departments, of those pre-
pared on the post and of those obtained from the American Social
Hygiene Association, especially So Long Boys — Take Care of Your-
selves. This leaflet has been furnished in large quantities by the
Association to many camps, induction stations, and draft boards.*

* Editor 's Note: Distribution to July, 1943, 1,700,000 copies.

24 JOURNAL OP SOCIAL HYGIENE

2. Posters.

Posters for use throughout the Army are released periodically and
sent to all Army installations. These range from the serious, dig-
nified and conventional type of poster to those built on the pattern
of a comic strip. Some of the latter are serious, others whimsical.
Use of the comic strip techniques employed frequently in com-
mercial advertising is based upon the enormous popularity of the
so-called "comic books" purchased in the post exchanges for soldier
reading. Tests are under way to determine the relative effectiveness
of the various types of posters. Many of the commands and Army
posts have also developed posters for local use. Notable among these
have been the series developed by the Gulf Coast Training Center
and the South East Training Center of the Air Force. In certain
camps poster contests have brought out many good ideas. Though
the quality of art work in such posters is often inferior to that
obtainable from certain commercial sources, these posters have a
certain spontaneity that, in the opinion of many, brings them closer
to the soldier. Unquestionably they portray the soldier's thought
with respect to these diseases. In many camps liberal use has been
made of posters prepared by civil agencies. Posters obtained from
the American Social Hygiene Association have had a wide distribu-
tion in the Army. Certain health departments have furnished poster
material, some of it prepared especially for Army use. Posters have
also been obtained from the U. S. Public Health Service and from
the Reynolds Foundation. Special mention should be made of those
prepared and donated by the John Wyeth Companyy, posters which
have had a wide appeal.

3. Movies.

The Army sex hygiene film (TF 8-154) is shown in all Reception
Centers so that it reaches the soldier within a few days after his entry
upon active military service. The film Know for Sure prepared and
made available to the Army by the U. S. Public Health Service,
has been used extensively to supplement the Army film. Use has
also been made of films provided by the American Social Hygiene
Association.

4. Film Strips.

These have been prepared for use in conjunction with the formal
lecture. Three strips have been made available, one dealing with the
diseases, one with prophylaxis, and the third with control measures.
The first two are designed for use with enlisted personnel, the third
with officer candidates and officers to inform them of their respon-
sibilities and the methods they can use.

5. Lectures.

The educational value of a formal lecture depends more upon the
individual who gives it than upon the material presented. The best
of subject matter may be spoiled by a poor lecturer; conversely, a
good lecturer may make effective use of poor material. A few lectures
are prescribed as part of the basic training. Subsequent talks are at
the discretion of the commanding officer. Frequently the most

VENEREAL DISEASE EDUCATION IX THE ARMY 25

POSTERS USED IN ARMY VENEREAL DISEASE EDUCATION

YOU CANT SIA?

AJAEJOBITHE

Vf

PREVENTS
VENEREAL DISEASE

TOO STATIONS IN THIS AREA

AT AU DltPlMlAIlII

WWIrt It M.ZOVfTUIT- COUNUD III TWO* irwiT
•UCO - JO* f . »M»W«r

A Prize-Winning Poster in a Contest at Camp Maxey, Adapted from a
Poster Designed and Used at the Southeast Air Force Training Center

Prophylaxis Prevents Syphilis and Gonorrhea

An Effective Army Poster

A Poster Prepared for the Army by the
John Wyeth Company

26

JOURNAL OF SOCIAL HYGIENE

ARMY POSTERS

An Army Poster
Presenting
A Popular

Comic Strip Hero

.

k«o~ ,t .u lii ^f,,

o^ ,t

American Social Hygiene Association Cartoon
Posters Widely Used by the Army

VENEREAL DISEASE EDUCATION IN THE AEMY 2(

effective of these are brief informal talks given around payday and
before furloughs, times at which the risk of infection is at its
maximum and at which therefore a reminder is of value.

6. Competitions.

American youth is highly competitive. For years industry has
capitalized upon this competitive spirit in its program of accident
prevention. It is not surprising, therefore, that many Army posts
have attempted to stimulate a spirit of interunit competition for low
venereal disease rates. At times this has been through formal com-
petitions; at others it has been promoted through monthly posting
of comparative rates or listing of units that have had no cases. Such
procedures have not only yielded results in reducing the venereal
disease rates, but have also aroused interest in the program and
promoted a spirit of unit pride.

7. Use of non-commissioned assistants.

Specially appointed medical officers as venereal disease control
officers have been the keystone in the venereal disease control pro-
gram. While these have been very effective, they have not been able
to get as close to the enlisted man as can someone chosen directly
from the ranks. Many units have therefore employed non-commissioned
personnel as assistant control officers, their responsibilities in venereal
disease control being additional to their regular military duties. As
these men are part of the body of enlisted men, they can carry instruc-
tion more readily and more effectively than can the medical officer.
They bridge the gap between the enlisted man and the officer, bringing
to the latter the questions and misunderstandings of the soldier and
carrying back the answer. Through use of these assistants who have
been given special instruction informed persons are placed in the
midst of the informal sex discussions which are so frequently heard
in the barracks or wherever men of this age congregate. Wherever
such non-commissioned assistants have been tried they have shown
their worth.*

8. Other measures.

A great variety of other educational devices has been used in
various posts, depending upon local ingenuity and interest. These
vary from sound transcriptions and amateur movies to pictures,
exhibits, ;flyers and news items in camp papers.

KESULTS OF EDUCATION

Nowhere in the field of health education have adequate tests been
developed to measure the relative effectiveness of various educational
procedures or even to measure the accomplishments of the educational
program as a whole. In venereal disease education this is particularly
true. Opinion must therefore vary as to what can be or has been

* Editor's Note: This was found to be true in. the educational program con-
ducted by the Commission on Training Camp Activities for the Army during
the First World War, when the "Social Hygiene Sergeants" established within
the cantonments and equipped with exhibits, stereomotorgraphs and literature,
played an important role in education of the soldier concerning venereal diseases.

28

JOURNAL OF SOCIAL HYGIENE

accomplished through the educational program. Even when the
war is over and the soldiers of today return to the tasks of peace
there will be no thoroughly satisfactory measure as to how much
the educational program will have contributed to the control of
venereal disease in the Army. It is of interest to record, however,
that certain of the Army commands in which the most active educa-
tional programs have been carried out have experienced some of the
greatest declines in the venereal disease rates. The rates of some
of these units have shifted from among the highest to among the
lowest of the Army. While it would be wrong to ascribe all of this
decline to the educational program, there can be little doubt that the
interest and alertness created by educational measures have brought
about an increased awareness of the venereal disease problem and
therefore greater individual participation in the measures adopted
for control.

So long
boys

...take

care of

yourselves!

SEX HYGIENE

AND

VENEREAL
DISEASE

WAR DEPARTMENT

SOME OF THE PAMPHLETS USED FOR ARMY EDUCATION

VENEREAL DISEASE EDUCATION IN THE U. S. NAVY *

C. S. STEPHENSON
Captain (MC), U. S. Navy

and

GEORGE \V. MAST
Lieutenant-Commander (MC), U. S. Navy

In the control of venereal disease, education can no more be
ignored or inefficiently utilized than the arsenicals or sulfas can be
omitted in therapy. Education is a fundamental element of the
venereal disease control program, especially in its preventive aspects
— as, indeed, education is an axiomatic part of practically every
preventive medicine endeavor.

We are inclined, however, to do a lot of talking (sometimes dignified
by the term "education") somewhat to the exclusion of practical
activity based on understanding and investigation of the facts
involved. Let us pause for a moment, therefore, and look at some
of these facts, especially as they pertain to the Navy.

It would seem that at least three points must be considered as to
the need for and character of venereal disease education: One, the
nature and extent of venereal disease, including its relative bearing
on our main objective — i.e., Victory; two, the conditioning effect of
public attitudes and opinions; and three, the people specifically
involved, their social and cultural backgrounds and environments,
their present and future objectives in life. A fourth point, of course,
is involved — that of the status of medical and public health knowledge
— but can be held over for other consideration.

As to the first point: The detailed and extensive data which are
available should leave no doubt as to the urgency of maintaining
the Navy's venereal disease rate at the lowest point possible.1 Certain
special aspects of these rates should be noted, however. Forces
afloat uniformly register higher rates than forces stationed ashore.
In both instances forces on foreign duty outrank in venereal disease
incidence those within the continental limits of this country. Studies

* Delivered at Session V, Wartime Venereal Disease Control Education Program,
of the Conference on Venereal Disease Control Needs in Wartime, sponsored
by the U. S. Public Health Service, Hot Springs, Arkansas, October 24, 1942.

Note: This paper has been revised as of January, 1944, with the addition of
new material by the Division of Preventive Medicine, Bureau of Medicine and
Surgery, Navy Department.

29

30

JOUKISTAL. OF SOCIAL HYGIENE

covering the 10-year peace-time period 1929-1938 indicate that for
both syphilis and gonorrhea, enlisted personnel in the Navy and in
the Marine Corps have rates higher than other personnel.2 Firemen
and seamen lead the major occupational groups, although the rela-
tively smaller group engaged in the culinary art has a higher rate.

The inescapable conclusion to be drawn from the data is that the
venereal diseases are the most serious and dangerous preventable dis-
eases to concern the Naval medical officer, civilian health and medical
authorities- — and the civilian population — of the United States.

What of the civilian population? Specifically, what have the
attitudes and opinions of the "general public" to do with the Navy's
task of reducing venereal disease to manageable terms?

What people think about venereal disease — today we call it ' ' public
opinion" — has beeri a controlling and limiting factor in progress
toward intelligent medical and public health action from the time
syphilis and gonorrhea were "discovered." The legions of Mrs.
Grundy have seen the wages of sin to be venereal disease. The history
of the battle against Spirochaeta pallida and the gonococcus has
been, in a very real sense, as much the story of a struggle to reshape
the psychological content of words and the resulting attitudes as it
has been the record of scientific medical investigation.

An "overthrow of a moral censorship" about 1936 — courageously
precipitated by Surgeon General Parran — is often credited with
making possible the broad public health venereal disease control
activities now under way. Undoubtedly, the willingness to talk
facts in the press, over the radio, in conversations, has been a decisive
element. But it was not something that came suddenly from the blue.
The genesis of present-day attitudes may be traced many centuries
back through history.

COMPONENTS OF PUBLIC OPINION

ABOUT SYPHILIS AND GONORRHEA. 2000BC-I94I

2000K 500K

Columbian Period
AGES OF VENEREAL DISEASE

' Columbian Period

r >tt**^*i22£XJ:i^^

IOOOK 500K

INDEX OF PUBLIC OPINION

ABOUT SVPHILIS AND GONORRHEA, 2000 BC- 1941

FIGURE 1

Figure 1 graphically portrays the changing composition of those
elements which go to make up the complexity of "public opinion J>

VENEREAL DISEASE EDUCATION" IN THE U. S. NAVY 31

on venereal disease. This material is from an unpublished but com-
prehensive analysis of the socio-psychological aspects of venereal
disease through the ages. It is of significance to note that while
civilization appears to have outgrown some of its unfounded fears
and superstitions, even today we may consider only 45 per cent of
the public attitude as completely "objective"; that "sin and religious
taboos ' ' appear to influence attitudes at least a third ; and that ' ' fear
and superstition" and "bravado and indifference" still play 10 per
cent parts each.

Few problems of social organization and governmental action
have been so emotionally supercharged as those dealing with the
control of venereal diseases. In their very nature, the venereal dis-
eases are deeply personal matters. Around them walls of taboo and
morality have been erected as an integral part of the cultural pattern.3
Naturally, these factors directly influence both the policy of the Navy
and the personal habits and opinions of the men in the Navy — who,
after all, are part of the "public" in its broadest definition.

In important particulars, however, Navy men are different. They
live differently, under vastly different circumstances and at tasks
significantly different from their land-lubber compatriots. They are,
of course, recruited from civil life. They have variously good and
bad mental qualities, depending upon inheritance and their environ-
ment. Although every effort is made to enlist men of the highest
calibre, sometimes a minus-quantity slips through. And it is not to
be expected that discipline in the Navy will completely overcome
the lack of discipline and restraint in earlier years to the degree that
young men who have not learned to control their desires, or at least
to temper them with judgment, can be trusted to avoid dangerous
contacts while on liberty away from Naval jurisdiction.

The ' ' typical ' ' Navy man, it has been said,4 comes from a relatively
good home consisting of at least a living room, a dining room, a bed
room or so, and a kitchen. There he had absolute freedom and
ample space in which to live. In many instances he has at least sev-
eral years of college education and, not infrequently he is a graduate.
Now he comes into the Navy and the transfer from training stations
to battleships produces a wrench and a shock. To the novelty, the
strangeness, the discomfort, the loneliness, and the isolation of his
new environment the American youth but slowly if ever becomes
habituated.

The recruit learns to use a bucket for his ablutions, to wash his own
clothes, accepts a hammock in place of a bed, acquires the habit of
being on his feet throughout the greater part of the day or of using
as an alternative a seat on his ditty box (a small wooden box where
he harbors his keepsakes) or the iron deck, and if he has leisure and
inclination for a siesta, he stretches out on the iron deck with con-
siderable risk of being frequently stepped on. There is no privacy.
He dresses and undresses, bathes, shaves, sleeps, reads, rises, and
partakes of his meals on deck in public. His clothes closet becomes
a sea bag. He sleeps in his underwear.

32 JOURNAL OF SOCIAL HYGIENE

Iii a superficial way the young bluejacket likes this and is amused
by it. It represents a change which he tinctures with a sense of
romance derived from youthful reading and he is supported by a
conception and a picture of himself as he appears to others — to the
girl ashore, the visitor in port, the people at home. But in spite of
the multiplication of battleships, submarines, and aircraft, man is a
terrestrial animal with arboreal rather than aquatic or amphibious
instincts, and if generations of sea-going ancestors in Scandinavia,
Great Britain or Newfoundland have somewhat modified tempera-
mental inclinations in sailors from other parts of the world, the
majority of Americans are conscious of no such heritage.

To these physical details of life on a battleship we must add the
circumstances of military discipline and restriction of movement.
The sailor wears a prescribed uniform, regulation shoes, socks, under-
wear and headgear. When the captain is chilly, the sailor dresses in
blue ; when the captain is warm he w'ears white. He moves to the
sound of a bugle. He turns in and turns out to the stroke of the
ship's bell and the boatswain's whistle. He eats what the Government
provides and abuses it, though the food is good and usually well-
prepared. He is at the beck and call of superiors — he, the freeborn
American, possible bank director, embryo President.

Very often for weeks, sometimes for months, he is cooped up on a
ship. The hours of drill are many, and the day's work is never done.
He must toil early and late for the maintenance and upkeep of his
perishable, floating abode, incessantly attacked by salt water and
oxidizing air, whose inroads must be neutralized by ceaseless scraping,
chipping, reel leading, and painting, from the double-bottoms to the
platform of the cage mast.

The very designation of the sailor's relaxation from work and his
opportunity for change is suggestive. "Liberty!" It requires a
considerable feat of imagination on the part of landsmen to appre-
ciate what liberty means after weeks or months at sea. No matter
how reasonably and justly discipline has been administered aboard
ship and however ingenious may have been the efforts to lessen the
monotony of the routine life, the feeling at liberty is that of the time-
expired man.

In point of fact the bluejacket offers an easy prey to all the sharks
and harpies that infest the water front. There is no lack of oppor-
tunity for him to spend his money and beguile his time. The trouble
is that the easy ways of finding diversions are usually bad ways, the
companions ready to hand, the pleasant and quickly formed associa-
tions frequently pernicious. Good influences are far to seek, clothed
in drab, with nothing to offer which compares in attractiveness with
the others. And it was not for gospel talk that he had his hair clipped,
that he shaved to the roots, got himself as clean from head to foot as
soap and water could make him, donned his immaculate undershirt
and the best shore-going uniform he possessed, drewr all the money
he had on the books and flung himself into the liberty boat with his
cap set at a rakish angle.

VENEREAL DISEASE EDUCATION IF THE U. S. NAVY

33

Any effort to influence his behavior while on liberty must be
circuitous, indirect, made at long range, unrecognized by him; made
with infinite tact and complete comprehension of the man's tastes,
needs, strength, and weakness. His chief craving is for amusement,
and in default of the best, he of necessity compromises with some-
thing less. He wants music, dancing, companionship, a few good
meals differently served and differently flavored from the good
"chow" he gets on board. In fact, his whole being hungers for a
different flavor. And while, of course, many sailors are mature men
of whom a certain proportion have fixed habits of vice, the bulk are
in a formative, plastic state.

QUESTIONNAIRE STUDY OF VENEREAL DISEASE INFORMATION
200 NAVY OFFICERS AMD MEN

TOTAL ENTIRE MOUP tOO

0. I Information about aonorrhta

a II Information about lyphilit

a IH Oiffaranca btlwaan l
- - and- gon

a IV Prophylaiit

Olit»rto«

FIGURE 2

Thus the great bulk of Navy personnel are susceptible to the edu-
cational process as regards venereal disease. Just prior to the war
the medical officer of one of our larger ships reported on the extent
and type of information held by the officers and men of his activity.
Figure 2 illustrates the percentage distribution of replies to four
pivotal questions in terms of degree of knowledge. The results should
stimulate us to increased efforts, for the degree of distortion, the
generalized mixture of a pinch of fact with a pound of hearsay, is
far too great.

These data hold important indications that our present educational
program is not by far the full answer. At the same time, we must
keep in mind that knowledge, per se, is no guarantee that the sailor

34 JOUUNAL OF SOCIAL HYGIENE

will react as we desire under all conditions. An eminent psychol-
ogist has pointed out •:'

Mere knowledge represents only potential action. To know what a man can
do furnishes no guarantee of what he will do at a particular moment. Before lie
actually uses this knowledge, lie must have the urge to use it.

And the determination of the character of that urge presupposes
complete understanding on our part of those whom we wish to influ-
ence. Within the whole personnel of the Navy, we must be concerned
basically with the young men — the men with more plastic minds and
habits, and men who have the least reliable information. For example,
Figure 2 indicates that men with less than one year's service had
significantly less satisfactory knowledge than men of longer service
and that men with histories of venereal disease were in some cases
even less well informed. Statistical data show that the highest rates
for both syphilis and gonorrhea are for enlisted Navy and Marine
Corps personnel in the younger age periods, and closely reflects
reported civilian rates.

What is the Navy doing? Venereal disease education is an impor-
tant part of the responsibility of all medical officers in general, and in
particular of the more than 50 venereal disease control officers now
on duty. These officers received special training at Johns Hopkins
University Medical School, including suggestions as to education
as a control measure. Many medical officers go through a general
indoctrination course at the Naval Medical School in Bethesda, Mary-
land, and a special section in the Naval Medical Bulletin helps to
keep them up to date. The importance of the medical officer being
able to impart practical information effectively to his patients is
underlined by the paucity of correct information possessed by many
patients.

Until the recent past, main reliance has been placed on lectures
to inform Nayy personnel. Some limitations of lectures in venereal
disease education have been noted by recent Navy medical writers.6
Youngkin remarks :7

A lecture on this subject must of necessity contain many concise related
facts and our average audience is simply not able to grasp them all. As a result,
a few facts are picked up which are coupled with the distorted knowledge the
average adolescent boy gets from his "wise" buddies, and the resulting con-
ception is unsatisfactory and sometimes worse than no knowledge whatever.

The quoted author suggests five criteria for an educational program :

(1) Is the material presented in a medium whereby it can be grasped, studied,
and digested by the slow as well as the fast thinker?

(2) Is the material presented in words and manner which the average enlisted
man can grasp?

(3) Is there any inducement for the average enlisted man to acquire this
knowledge?

(4) Is there a way of forcing the naturally sluggish group to acquire this
knowledge?

(5) Is the primary presentation of the subject matter supported by supple-
mentary types of instruction?

VENEREAL DISEASE EDUCATION IN THE U. S. NAVY 35

To these questions may be added a sixth: Do the content and
motivation elements of this education take into account the practical
problems, needs, and circumstances surrounding the man in situations
when the possibility of infection becomes an issue?

In content the Navy's education program approximates closely
the general civilian pattern — emphasis on the fact that we are dealing
with diseases not moral matters; that gonorrhea and syphilis are
not the same, and are not caused by strains, etc. ; that quack treat-
ment is dangerous and ineffective, but Navy medical service effective
and reliable; that prostitutes are generally infected, inspection or
regulation to the contrary notwithstanding; that sex relations are
unnecessary for the preservation of manhood and good health ; that
prophylaxis is effective and painless if used properly and at the
right time. Fear as an educational motif has largely gone, but
penalties linger on in the form of loss of pay, limitation of certain
types of service and promotions. We are much inclined to agree
with Bishop Lawrence who, back in 1918, said :s

Ay.-iin it is interesting to note how, when the Christian Church has given up
saving the heathen by threatening them with the terrors of hell, many social
reformers and doctors are bringing that motive to bear upon men and women,
on boys and girls, to save them from vice. The threat works sometimes — it
probably brought some heathens to Christ, but as a motive power, it is really
very weak.

Revision of some time-honored practices seems in order if education
is to pull its fair load. For example the Bureau of Medicine and
Surgery has been placing more and more reliance upon audio-visual
methods of education. A recent report by the Navy's Bureau of
Aeronautics (which handles the production of motion pictures and
slide films for the Navy) is in point:9

Traditionally, lectures and textbooks have been the primary materials of
instruction. If films were used at all, they were employed merely to supplement
the spoken and written word. In many instances, motion and still pictures
were, and still are, looked upon as frills and novelties rather than basic instruc-
tional materials. However, alert instructors, realizing that studies have shown
that films can speed up learning and increase retention, are turning to this medium
of instruction. There are signs that films, rather than being mere appendages
to teaching, may serve as basic materials, or "anchor" points around which
courses of study are organized. In such cases lecture notes and textbooks are
not thrown out the window. However, rather than being fundamental to instruc-
tion they serve to amplify and clarify the pictorial material.

As not infrequently has been the case in other agencies, initial
film work in the Bureau of Medicine and Surgery was done with
venereal disease, but is now growing by leaps and bounds into many
other areas. To handle such work, a Section of Audio-Visual Edu-
cation has been established by the Surgeon General in the Division
of Preventive Medicine, and has been given cogiii/ancf of all such
activities in the Navy.

For some time now, a film under the title, Sex llij</i< n< , has been
used throughout the Navy and shown especially to recruits. It is a
basic factual film which covers the field of venereal disease specifically
as it relates to prevention, and attempts to put into practice some

36

JOURNAL, OF SOCIAL HYGIENE

HEAR THEY HAVE SOHE GALS UP
THERE-LETS 6IVE THE JOINT A PLAY-

, NOJHANK YOU -THATS HOW I GOT
BURNEtHHAT KtNb OF STUFF bONTPAY-

OH-RBABY/ HOW I WORRIED/ WHAT
A SAP I WAS/- BUT, SAY™

THEN DAYS IS GONE

CAETOOXS RECALL THE LESSONS PREVIOUSLY GIVEN THROUGH
LECTURES, FILMS AND PAMPHLETS

FIGURE 3

VENEREAL DISEASE EDUCATION IN THE TJ. S. NAVY 37

of the things we have learned about information and motivation.
Prophylaxis especially offers critical problems in this regard — prob-
lems which in the past some have been prone to sidestep, although it
is encouraging to see the response which has been accorded to recent
steps in the right direction by the U. S. Public Health Service and
many State health departments.

Not only must progress 011 the prophylaxis front hurdle many
obstacles of public opinion in general, but the persons who should
use these measures represent other stumbling blocks. At least three
main difficulties are involved: (1) ignorance on the part of the
potential user both as to the potentialities for protection and the
correct procedures of use; (2) alcohol, which considerably inhibits
the use of prophylactic measures, but which is probably not the
culprit as often as reported, the chances being that it is used as a
convenient excuse; and (3) esthetic factors which very definitely
militate against the use of mechanical and to a certain extent chemical
measures. In addition might be mentioned the reliability of the
condom from a breakage and slippage point-of -view ; the doubtful
efficacy of chemical prophylaxis from a therapeutic standpoint and
especially the practical time element problem; the cost to the indi-
vidual, especially in the civilian population; and of course,
contraception.

In addition to treatment in the film Sex Hygiene, prophylaxis and
general venereal disease information are covered in a series of new
leaflets now (January, 1944) being utilized throughout the entire Navy.
These leaflets represent a further development in the modern concept
of venereal disease education. They are designed with a specific use
in mind — i.e., one is directed to the recruit who has just entered
the Navy and finds himself face-to-face with a multitude of new
problems but very likely without much accurate factual background.
This leaflet attempts to set him straight as to the basic elements of
sex hygiene and social conduct. Venereal disease is only casually
mentioned in recognition of the fact that fear of disease is a poor
reed upon which to lean a code of social conduct.

Three leaflets separately discuss syphilis, gonorrhea, and the minor
venereal diseases. Another pamphlet outlines the essential elements
of prophylaxis. These will be given to recruits at intervals during
their training period and also to all men already in the Navy and
Marine Corps.

A fifth leaflet is directed to the man who has been infected and
is under treatment. It suggests to the patient that one infection is
enough — that in the future he '11 be smart to look before he leaps. A
final leaflet emphasizes the venereal disease problem overseas, stressing
the increased importance of avoiding exposure and of using
prophylaxis.

Each of these leaflets is illustrated in color and is of a size to fit
easily into the sailor's or marine's pocket. They have a sort of
"delayed action" effect in that none of them are obviously about

38 JOURNAL OF SOCIAL HYGIENE

venereal disease but, rather, appear to be interesting, almost fiction-
like stories. Titles will illustrate : The Story of Old Joe, Ed Puts 'Em
Wise, For Service to To jo, Hull Down. .Story plots are in terms of
experiences and environments familiar to the reader and in keeping
with conditions he faces during liberty hours — the "VD hours."

A similar approach is being incorporated into a series of motion
pictures now in production, the first of which will be available shortly.
These are semi-entertaiument-docuinentary films designed for screen-
ing during regular off-duty hour entertainment bills. The sailor's
liberty hour problems are looked at from his own point-of-view, and
the dramatic, action-stories told by the films are so developed as to
make it easy for each man in the audience to put himself in
the situation pictured. Again, as in the case of the pamphlets, the
venereal disease aspects are camouflaged and held back until the deci-
sive moment, when the fact can hit hardest and make the strongest
impression. Some films are more subtle, and the venereal disease
point is developed so as to "sink in" more slowly but none the less,
we feel, securely.

While heavy reliance is placed on motion pictures, there are maiiy
situations in the Navy where projection is not possible. Destroyer
escorts, submarines, landing craft, merchant vessels are examples.
Here leaflets play a decisive role, together with graphic-arts devices,
notably posters.

The Bureau of Medicine and Surgery inaugurated as of January lr
1944, a "poster-a-month" distribution plan which brings to the
attention of every man on shore or at sea a meaningful and attractive
poster. Figure 3 * is a reproduction of one of three current poster*
which were prepared in cooperation with the Office of War Infor-
mation and are published in full color.

Another new educational headache — new at least to this man's Navy
— has been involved in the recruiting and training of women in the
Navy and Marine Corps Reserves. The Waves and lady Marines
pose some fundamental and difficult health and hygienic problems —
problems which must be recognized and met with courage, tact, and
dispatch, and problems which you may be sure have been receiving
the earnest consideration of all concerned.

A coordinated plan of education in personal hygiene is now under
way involving a Navy-prepared film and pamphlet, and utilizing
as well educational materials from public health and social hygiene
sources. Lectures are given by Medical Officers who are always
available for private interviews regarding personal problems.

Inclusion of women in the armed services of this and other Nations
is symptomatic, perhaps, of the scope and depth of the conflict in
which we are engaged. No group nor person will be left unaffected.
Little that is done — or not done for that matter — in civilian life
fails to have its effect on a multitude of military activities — and

I'M KP 36.

VKXKREAL DISEASE EDUCATION IN THE U. S. NAVY 39

vice versa. Just as the rate of venereal disease infection is directly
related to civilian health conditions, so the status of knowledge and
attitudes toward the venereal diseases on the part of military per-
sonnel is a direct reflection of the efficacy and completeness of the
total educational program. Certainly, with all of the attention that
is being given to prevention of venereal disease by repression of
prostitution, we cannot, under any circumstances, neglect the practical
preventive potentialities of education and prophylaxis.

The opinions or assertions contained herein are the private ones of the writers
and are not to be construed as official or reflecting the views of the Navy
Department or the nav;il service at large.

REFEBENCE8

1. Stephenson, C. A.; Mast, G. W. ; and Keynolds, Frank W. ; Gonorrhea
from the Standpoint of the Navy, A. J. Syph., Gonor., & Yen. Dis., St. Louis,
27; 393-402 (July) 1943.

Stephenson, C. S. ; and Mast, G. W. ; Present Venereal Disease and Prostitu-
tion Problems as They Eelate to the Navy, Conference on Ven. Dis. Control
Needs in Wartime, Hot Springs, Ark., Oct., 1942 (mimeo.).

Carter, T. J.: New Patterns in Venereal Disease Control, as Seen by the Navy
Medical Officer, Amer. Soc. Hyg. Assoe., New York, Pub. No. A-497, 1943.

2. Lang, F. E. : A Ten-year Study of Gonorrhea in the United States Navy.
U. S. Nav. Med. Bull. 40: 225-36; 480-502; 745-59 (Jan. Apr., July) 1941.

Mast, G. W. : A Ten-year Study of Syphilis in the United States Navy. Un-
published thesis for D.P.H., Johns Hopkins University. (1942).

3. Ennes, Howard : VD — A Study in Social Control. From a book in preparation.

4. Boone, Joel T. : The Sexual Aspects of Military Personnel. Jour. Soc. Hyg.,

27: 113 (March) 1941.

Taylor, J. S. : The Social Status of the Sailor. Jour. Soc. Hyg., 4 (April)
1918.

5. Doob, Leonard W. : Propaganda — 7/s Psychology and Technique, Henry Holt
& Co., New York: 1935, p. 27.

6. Reynolds, Frank W. : Suggestions to the Naval Medical Officer for Talks on
Venereal Disease, Nav. Med. Bull., Washington, 61: 889-903 (May) 3943.

7. Youngkin, C. K. : Venereal Disease Education in the Navy: A Questionnaire
Study with Comment and Suggestion for Improvement. U. S. Nav. Med. Bull.,
39: 535-43 (Oct.) 1941,

8. Lawrence, the Rt. Rev., William, D.D. : Lecture at Harvard Medical School,
Jour. Soc, Hyg., 4: 330, 1918.

9. Sackett, Robert S., and Orchard, Thomas: Principles, of Instruction with
Films. Memorandum from the Training Film Unit, Photography Section.
Bureau of Aeronautics, U. S. Navy, Nov. 1, 1941.

THE VENEREAL DISEASE EDUCATION PROCESS IN THE'

U. S. NAVY *

A NOTE ON THE CHART

HOWARD ENNES

Lieutenant (Junior Grade) H-V(S) U.S.X.R.

Section of Venereal Disease Control, Division of Preventive Medicine,
Bureau of Medicine and Surgery, Navy Department.

In this chart an attempt is made to project graphically the
admittedly complex and numerous elements which bear upon each
sailor and marine and which materially condition his actions and the
efforts of Naval and civilian authorities to protect him from venereal
disease.

The key element, of course, is the man himself. He is pictured
in the center panel as (1) the civilian youth who (2) passes through
the Selective Service induction process to become (3) a recruit in
the basic training station. Graduating, he may be transferred (4) to
active duty or further training at a continental shore station, or
he may go (5) to sea duty or (6) foreign duty ashore.

It becomes apparent that study of this ' ' typical ' ' boy-become-sailor
or marine cannot be without prime consideration of the time factor.
The uppermost section of the chart suggests this relationship in
terms of disease rates. The prevalence of syphilis is impressive
among Selectee age-groups, is thinned out substantially in the induc-
tion mechanism or is brought under treatment in the early days of
Naval Service. But thereafter the all-venereal disease incidence
rate begins slowly to be built up, and as the ultimate objective of the
new Navy man is reached — i.e., sea and foreign duty — the peak of
venereal incidence is also approached.** Such a charting serves to
highlight points of emphasis.

The remainder of the chart may now be considered as describing-
two main elements in the venereal disease syndrome: First, the
major factors in the social environment; Second, efforts to inform
and guide our "typical" subject, and by whom.

Across the lower portion we find indicated the leading environ-
mental elements. The general customs and mores of his community,
the practices of his own gang, the deepness of his feeling of "belong-
ing"— all enter into the background of our composite youth. In

* Abstracted from a lecture delivered before the Army-Navy Venereal Disease
Control Officers' Class, Johns Hopkins University School of Hygiene and Public
Health, Baltimore, 25 August 1943.

** Caution should be exercised not to directly compare the syphilis prevalence
figures with the incidence of all venereal disease.

40

Syphilis prevalence
per 1000 Selectees blood
tested Oct. '40 -Sept. '41
age 21-35.

New admissions per 1000 men per year, all venereal diseases, U. S. Navy, 194

N R I

PREVALENCE
of SYPHILIS

BOOT TRAINING STATIONS

HOME -SCHOOL- CHURCH

WELFARE
RECREATIC

General training and
example in social re-
lationships, habits, and
personal hygiene.

Sex education
and VD facts.

Basic VD facts, validity of continence,
dangers of pick - ups and prostitutes,
importance to the Navy of avoidingYD,
effectiveness, logic, and techniques of
prophylaxis.

BASIC VD INDOCTRINATION U RECALL.

"BOOT"
TRAINING
STATION

STATIOh

or
(additional tra

INDUCTION

IMPACT OF NAVY (ADULT) LIFE

On his own, perhaps just now 'feeling his oats or still impressed by hi:
tends to search for customary 'home town' recreation, girls, atmosphe
has to take what is offered ... he adapts to new customs, standards, m
he is taken into a new 'gang'.

General
mores and
customs

Influence
of his own
age -group

THAT
"LAST
FLING"

NOT singled
out by uniform

MAJOR

F ACTORS

THE

NAVY

{•FORCES AFLOAT '

60
so

40
30
20
10

-

)N

1

r VJ SHORE my i

• PATROL H

MEDICAL t
DEPARTMENT '

ion on
liaison
zations

Maintains 'decorum in
liberty ports, directs to
'pro' stations.

Conducts health educa-
tion, provides medical
services, rrrophylaxis

When infected=

diagnosis and treatment
plus:

1. Exposure-contact
interview

2. Additional VD facts

3. Special emphasis
on prophylaxis

ERATION AND PRACTICE PERIOD

; uniform . . .
re ... but he
jtivations . .

=== Sea and foreign duty tend to exaggerate his inclinations . . . oppor-
tunities for exposure and chances of infection likewise increase . . . the
tension of combat conditions, plus long periods in an all-male atmos-
phere serve to intensify his reactions when on shore liberty.

THE

VENEREAL

DISEASE

EDUCATION

PROCESS
IN THE

U.S. NAVY

SOCIAL

E NVIRONM ENT

VENEREAL DISEASE EDUCATION PROCESS IN THE U. S. NAVY 41

general it may be said that the lad in civvies is subject, at present,
to less exploitation and to less attention than the man in uniform.

With his 1-A card and certificate of fitness, however, begins a
transformation (and transmutation, in some respects) marked by one
or a series of ' ' last flings, ' ' unfortunately too frequently of venereal
disease significance. He begins to absorb the impact of a reasonably
adult Navy life during "boot" training, follows it up with (generally)
a furlough back home. Then to a continental station for active duty
or further training.

It is here that our "typical" new sailor comes into first, direct
contact with community conditions predisposing either to "good
times in good company" or sordidness and venereal disease. Here
he finds "pro" does not stand for the kind of professional he may
have thought. It is here that community venereal disease control,
recreational facilities, and public attitudes toward Service personnel
play their roles.

While he is finding his sea legs aboard a pitching destroyer, a
waddling LST, or a lumbering battlewagon, he finds time also to
dream and to discover that wearisome days of convoying and cruising
build up a tremendous urge for liberty — for release from the confines
of his ship, for different food, for the companionship of the nearest
approximation of a Varga girl. So when he hits the beach it is
largely what is within him as the result of his background and
constant drumming 'of the Navy system that maintains his balance in
the midst of generally unfavorable environmental circumstances.

Retracing our steps to the upper mid-panel of the chart, let us
see of what the "Navy system" consists. In the first instance, the
organized background training of our "typical" youth most likely
has been haphazard, the home, the school, and the church at best
working only loosely together to furnish him with a firm factual
foundation. Early military health education efforts, of necessity,
are given and received with a certain gratuitous air, and consist
possibly of a few words from a recruit officer, together with exposure
to one or two posters, and a pamphlet.

Within the Navy itself his training in venereal disease discipline
becomes a combined operation of command officers, the chaplains,
welfare and recreation units, the shore patrol, and, primarily, the
medical department. During "boot" training he receives basic indoc-
trination in venereal disease. Films, lectures, pamphlets, posters,
personal interviews and so on are utilized. An attempt is made to
see that each man develops a reasonable degree of understanding of
the problem and his relation to it, that he accumulates a fair number
of crucial facts, and that he understands the technique of prophylaxis.

After basic "boot" indoctrination, the venereal disease education
process turns from a training or teaching objective to one which
attempts to provide motivation toward positive venereal disease
discipline. Reiteration of salient points, recall of previously learned
information, and practice, so to speak, in the application of sucb

42

JOritXAL OF SOCIAL HYGIEXE

lessons are the techniques employed. This, obviously, is a continuing
process and one which must be carried on with every man at every
post, afloat or ashore.

Finally, the educational process must be repeated and strengthened
with every patient, for every venereal disease case is evidence of a
breakdown, at some point, of venereal disease discipline in general
and the educational process in particular.

The bpinions or assertions contained herein are the private ones of the writer
and are not to be construed as official or reflecting the views of the Navy Depart-
ment or the naval service at large.

YOUR BEST FRIEND CANT
TELL YOU IF YOU HAVE

IF NEGLECTED CAN CAUSE
SERIOUS COMPLICATIONS

EARLY CONTINUOUS TREAT-
MENT MEANS PREVENTION OF
COMPLICATIONS AND CURE

\\\\ EDUCATIONAL POSTERS

Among the excellent educational materials which have been developed is a
series of poster-placards designed and issued through the Third Naval District,
90 Church Street, New York City. Two of the series are shown herewith.
Lieutenant Commander M. Wishengrad, District Venereal Disease Control Officer,
writes that the posters grew out of requests for such material for education of
Third Naval District personnel, the text being reviewed by a number of health
education experts, including Dr. Walter Clarke of the American Social Hygiene
Association, Dr. J. A. Goldberg of the New York Tuberculosis Association Social
Hygiene Committee, and Dr. Herman Goodman of the New York City Department
of Health. The completed series wras developed in several eye-attracting colors
by the Art Project of the local Work Projects Administration, and an edition
of five thousand sets was produced, so that the Third District has been able to
supply requests from other Naval Districts and outside agencies. A limited
number of sets are available on request to Dr. Wishengrad at District Head-
quarters. The series includes seven placards, on medium weight cardboard, size
11 by 14 inches.

NATIONAL EVENTS

REBA RAYBURX

Washington Liaison Office, American Social lltnj'n m Association

U. S. Public Health Service Re-Organizes. — In line with Congres-
sional legislation adopted during 1943,* the various activities of the
Public Health Service are organized under three Bureaus, each
headed by an Assistant Surgeon General, ami the Office of the
Surgeon General. A Medical Director heads each Division under the
various Bureaus. The Bureaus, with their heads are : Bureau of
State Services, Assistant Surgeon General Lewis R. Thompson;
Bureau of Medical Services, Assistant Surgeon General R. C. Wil-
liams; National Institute of Health, Assistant Surgeon General R. E.
Dyer. The former Division of Venereal Diseases comes under the
Bureau of State Services, and is now known as the Venereal Disease
Division. The main officers of this Division stationed at USPHS
headquarters in Bethesda, Maryland, are listed below, together with
the list of Directors and V'.D. Control Officers of the USPHS Districts,
and the Liaison Officers attached to the Army Service Commands :

Venereal Disease Division: Headquarters Staff, Washington, D. C.
Bethesda Station

Medical Director John R. Heller, Jr., Chief

Senior Surgeon Otis L. Anderson, Assistant Chief

P. A. Surgeon George E. Parkhurst

Lida J. Usilton, Principal Statistician

Judson Hardy, Education Specialist

Mrs. Eleanor Walker, Administrative Assistant

a. Public Health Service District Directors and District V.D. Control Officers

District No. 1: Sub-Treasury Building, 15 Pine Street. \e\v York, X. Y.
Director: Medical Director E. R. Coffey ; V.D. Con I ml Ofjici-i': Surgeon Erwin
C. Drescher.

District No. 2: National Institute of Health, Bethesda, Maryland.

Dh-i'ctor: Medical Director Winfield K. Sharp, Jr.; V.D. Control Officer: Sur-
geon Noka B. Hon.

District No. 3: Em. 852 U. S. Customhouse, 610 South Canal Street, Chicago,
Illinois; Director: Medical Director F. V. Meriwether; V.D. Control Officer:
Senior Surgeon Alfred J. Aselmeyer.

District No. 4: 1307 Pere Marquette Building, New Orleans, Louisiana; Direc-
tor: Medical Director Charles L. Williams; V.D. Control Officer: Surgeon
Eugene A. Gillis.

District No. 5: 1223 Flood Building, San Francisco, California; Director:
Medical Director Walter T. Harrison.

District No. 6: San Juan, Puerto Rico; Director: Medical Director R. A.
Vonderlehr.

Public Law 184— 78th Congress, Chapter 298— 1st Session.

43

44 JOURNAL, OF SOCIAL HYGIENE

District No. 7: 215 West Pershing Road, Kansas City, Missouri; Director:
Medical Director C. C. Applewhite; V.D. Control Officer: Surgeon Arthur B.
Price.

District No. 8: 617 Colorado Building, Denver, Colorado; Director: Medical
Director Fred T. Foard.

District No. 9: 831 Mercantile Bank Building, Commerce at Ervay Sts., Dallas,
Texas; Director: Medical Director K. E. Miller; V.D. Control Officer: P. A.
Surgeon Thomas H. Diseker.

District No. 10: Territorial Board of Health, Honolulu, T.H.; Director:
Medical Director Robert H. Onstott.

District No. 11: Juneau, Alaska; Director: Medical Director E. W. Norris.

b. Public Health Service Liaison Officers for U. S. Army Service Commands *

First Service Command: Boston Army Base, Boston, Massachusetts. Senior
Surgeon O. F. Hedley.

Second Service Command: Governors Island, New York. Senior Surgeon Albert
E. Russell.

Third Service Command: U. S. Post Office and Court House, Baltimore, Mary-
land. Senior Surgeon F. W. Kratz.

Fourth Service Command: Post Office Building, Atlanta, Georgia. Medical
Director Joseph Bolten.

Fifth Service Command: Fort Hayes, Columbus, Ohio. Senior Surgeon Ralph
Gregg.

Sixth Service Command: Medical Branch, 20 N. Wacker Drive, Chicago, Illinois.
Senior Surgeon Adolph Rumreich.

Seventh Service Command: 320 Faidley Building, Omaha, Nebraska. Medical
Director Lon 0. Weldon.

Eighth Service Command: 831 Mercantile Bank Building, Commerce at Ervay
Sts., Dallas, Texas. Medical Director Knox E. Miller.

Ninth Service Command: Fort Douglas, Utah. Senior Surgeon Paul D.
Mossman.

Army Preventive Medicine Units Stepped Up. — At a time when
news stories from far-off battlefronts show the increasing impor-
tance of preventive measures comes word from the Office of the
Surgeon General that the Division of Preventive Medicine has been
given a higher status as signified by its new title of the Preventive
Medicine Service. The former Venereal Disease Control Branch
now becomes the Venereal Disease Control Division, and the Sections
under it become Branches. Colonel Thomas B. Turner (now a full
Colonel), former head of the V.D. Control Branch, heads the new
Civil Public Health Division in the Preventive Medicine Service ;
and Major Glen W. McDonald, former V.D. Control Officer at

* Mail address follows this style : Senior Surgeon O. F. Hedley, U. S.
Public Health Service Liaison Officer, First Service Command, U. S. Army,
Boston Army Base, Boston, Massachusetts.

NATIONAL EVENTS 45

First Service Command Headquarters, will likewise work for this
new Division.

Acting Director of the V.D. Control Division is Lt. -Colonel
Thomas H. Sternberg, formerly in charge of the Treatment Section.
Captain Granville W. Larimore remains with the V.D. Control
Division, and Captain Paul G. Reque, until recently V.D. Control
Officer for the Eastern Defense Command and First Army, becomes
Chief of the Education Branch in the V.D. Control Division.
Below are listed V.D. Control Officers of the various Commands
within continental United States. In cases where no Officer is
listed, address Chief, Medical Branch, at the respective Command
headquarters :

a. Service Commands

First Service Command: 808 Commonwealth Avenue, Boston, ^Massachusetts.
Second Service Command: Governor's Island, N. Y. Lt.-Col. Lyman Duryea (MC)

Third Service Command: U. S. Post Office and Court House, Baltimore, Mary-
land; Major Albert F. Doyle (MC)

Fourth Service Command: Post Office Building, Atlanta, Georgia; Major Ernest
B. Howard (MC)

Fifth Service Command: Fort Hayes, Columbus, Ohio; Lt. Col. Walter B.
Lacock (MC)

Sixth Service Command: P. O. Bldg., Chicago. Illinois.

Seventh Service Command: New Federal Building, 15th and Dodge Sts., Omaha,
Nebraska; Lt.-Col. James H. Gordon (MC)

Eighth Service Command : Sante Fe Building, Dallas, Texas.

Ninth Service Command: Fort Douglas, Salt Lake City; Major Wayne C.

Sims (MC)

Caribbean Defense Command: Quarry Heights, Panama Canal Zone; Major
Daniel Bergsma (MC)

b. Armies

Eastern Defense Command and First Army: Headquarters, Governor's Island,
New York.

Second Army: Headquarters, Memphis, Tennessee; Major R. R. Sullivan (MC)

c. Army Air Forces

Army Air Forces Headquarters: Office of the Air Surgeon, Washington, D. C.,
Major Robert Dyar (MC)

First Air Force: Headquarters, Mitchell Field, Long Island, New York, Captain
Frank W. Parker (MC)

Second Air Force: Headquarters, Colorado Springs, Colorado, Major Thomas K.
Gibson (MC)

Third Air Force: Headquarters, Tampa, Florida, Major Onis G. Hazel (MC)

Fourth Air Force: Headquarters, San Francisco, California, Major William H.
Bennett (MC)

Eastern Flying Training Command: Maxwell Field, Alabama, Captain O. M.
Stout (MC)

Central Flying Training Command: Randolph Field, Texas, Major Louis B.
Arnoldi (MC)

Western Flying Training Command: Santa Ana, California, Captain Paul
Levan (MC)

•ib JOURNAL OF SOCIAL HYGIENE

Army Air Forces Proving Ground Command: Eglin Field, Florida, Lt. Richard
Lee (MC)

Army Air Forces Air Service Command: Headquarters, Patterson Field, Fair-
field, Ohio, Captain W. L. J. McDonald (MC)

Army Air Forces Troop Carrier Command: Headquarters, Stout Field, Indian-
apolis, Indiana, Captain R. B. Allen (MC)

Army Air Forces Air Transport Command: Headquarters, Washington, D. C.
Major Robert H. Riedel (MC)

Army Air Forces School of Applied Tactics: Orlando Army Air Base,
Orlando, Florida, Captain A. L. Stebbins (MC)

Navy Venereal Disease Control Officers. — The up-to-date roster of
Navy venereal disease control officers in the United States and
West Indies, and the staff at the Navy Bureau of Medicine and
Surgery in Washington, D. C., are as follows :*

Note: NAS-— Naval Air Station NOB — Naval Operating Base

NH — Naval Hospital NT Sell. — Naval Training School

NTS— Naval Training Station

Bureau of Medicine and Surgery, Division of Preventive Medicine: Officer in
Charge, Captain Thomas J. Carter, MC, USN; In Charge, Venereal Disease
Control, Commander Walter II. Schwartz, MC, USX; Lieut, (j.g.) Howard W.
Ennes, .Jr. Address: Navy D"pt., Potomac Annex, Washington, D. < '.

First Naval District

Headquarters, Boston, Massachusells; Lieut. John L. Ward, MC'-Y(S), USNR

Shore Activities, Caseo Bay, Portland, Maine; Lt. Comimlr. Calvin C. Torrance.

MC-V(S), USNR

NAS, Quonset Point, Rhode Island; Lt. William Feltman, MC-V(S), USNR
NH, Newport, Rhode Island; Lt. Commdr. Frederick M. Lee, MC-Y(S), USNR
NTS, Newport, Rhode Island; Lt. (j.g.) John A. Caswell, MC-V(G), USNR

Third Naval District

Headquarters, New York, N. Y.; Lt. Commdr. Harold F. Smith, MC-V(S), USNR

NTS, Sampson, New York; Lt. Commdr. Robert H. Abrahamson, MC-V(S), USNR

Submarine Base, New London, Connecticut; Lieut. Grant M. Dixey, MC-V(G),

USNR

Section Base, Tompkinsville, S. L ; Lieut. Douglas J. Giorgio, MC-V(G)

NTS (WR), Hunter College, Bronx, N. Y.; Lieut, (j.g.) Pauline K. Wenner,

W-V(S), USNR
Armed Guard Center, Brooklyn, N. Y.; Lt. Ernest K. Keel, Jr., MC-V(S), USNR

Fourth Naval District

District headquarters, Philadelphia, Pennsylvania; Lt. Commdr. Clarence J.

Buckley, MC-V(S), USNR
Receiving Station, Philadelphia, Pennsylvania; Lt. Commdr. Frank P. Massaniso,

MC-V(S), USNR

Fifth Naval District

District headquarters, Norfolk, Virginia; Capt. Reginald B. Henry (MC), USN,

Retired

NAS, Norfolk, Virginia; Lt. Harold W. Klewer, MC-V(S), USNR
NTS and NOB, Norfolk, Virginia; Lt. Commdr. Alexander E. Rosenberg, MC-

V(S), USNIi

NTS, Bainbridge, Maryland; Lt. Harry W. Savage, MC-V(S), USNR
Amphibious Training Base, Little Creek, Va. ; Lt. Commdr. Locke L. MacKenzie,

MC-V(S), USNR
Naval Construction Training Center, Camp Peary, Williamsburg, Va. ; Lt. Commdr.

Samuel Tripler, MC-V(S), USNR
Medical Company Headquarters, Camp LcJeune, New River, X. C. ; Lt. Lorenzo

Q. Hunk, Jr., MC-V(S), USNR

*A11 stations and bases are listed under the Naval Districts in which they
are located geographically, although some are independent commands.

NATIONAL KVF.XTS 47

Sixth Naval District

District headquarters. Charleston, South Carolina; Lt. Commdr. Howard W. Eeed,

MC-V(S), USNR
Marine Barracks, Parris Island, South Carolina; Lt. Commdr. Carroll B. Jones,

MC-V(S), USNR
NAS, Jacksonville, Florida; Lt. Leonard F. Ciner, MC-V(S), USNR

Seventh Naval District

District headquarters, Jacksonville, Florida; Lt. (jg) Arthur F. Turner, Jr.,

MC-V(G), USNR

Naval Station, Key West, Florida; Lt. Bernard H. Shallow, MC-V(S), USNR
Submarine Chaser Training Center, Miami, Florida; Lt. Commdr. Joseph H.

Olson, MC-V(S), USNK

Eighth Naval District

District headquarters. New Orleans, Louisiana; Commdr. Thaddeus A. Fears,

MC-V(S), USNR
U. S. Naval Station, New Orleans, Louisiana; Lt. Commdr. Rexel Goodman,

MC-V(S), USNR
NTSch. (Aviation Maint.), Norman, Oklahoma; Lt. Commdr. Aloysius P. Rieman,

MC-V(S), USNR

NAS, Corpus Christi, Texas; Lt. Jack L. Derzavis, MC-V(S), USNR
NAS, Pensacola, Florida; Lt. Morris Leider, MC-V(G), USNR
NTSch., Memphis, Tenn.; Lt. Commdr. Jas. R. Stites, MC-V(S), USNR

Ninth Naval District

District headquarters, Great Lakes, Illinois; Lt. Commdr. Sol S. Schneierson,

MC-V(G), USNR

NAS, Grosse Isle, Mich.; Lt. Commdr. John W. Ferree, MC-V(S), USNR
NAS, Olathe, Kansas; Lt. (jg) William K. Hall (MC), USN
Naval Air Technical Training Command, Chicago, Illinois; Lt. Commdr. Bernard

L. R. Toothaker, MC-V(S), USNR

Tenth Naval District

District headquarters, San Juan, Puerto Rico; Lt. Frank W. Reynolds, MU-V(G),

USNR

NOB, Trinidad, R. W. I.; Lt. Jerome J. Burke, MC> USN
NOB, Guantanamo Hay, Cuba ; Lt. Commdr. E. C. Smith, MC-V(S), USNR

Eleventh Naval District

District headquarters, San Diego, California; Lt. Commdr. Ammon B. Litterer,

MC-V(S), USNR

NOB, San Pedro, California; Lt. Commdr. Irving D. Litwack (MC), USN, Retired
NTS, San Diego, California; Lt. (jg) Leonard Klein, MC-V(G), USNR
Marine Corps Base, San Diego, Calif.; Lt. Israel Zeligman, MC-V(S), USNR
Marine Barracks, Camp Elliott, San Diego, Calif.; Lt. Commdr. Howard S. Reiter,

MC-V(S), USNR
Marine Barracks, Camp Pendleton, Oceanside, Calif.; Lt. Commdr. Albert L.

Van Dale. MC-V(S), USXI!

Twelfth Naval District

District headquarters, San Francisco, California; Commdr. Benton Van Dyke

Scott, (MC), USN, Retired

NAS, Alameda; Commdr. Benton Van Dyke Scott, (MC), USN, Retired
Rec. Station, San Francisco; Lt. Philip R. Partington, MC-V(S), USNR
Navy Yard, Mare Island, Calif.; Lt. Commdr. Harold R. Weidner, MC-V(S),

USNR

Thirteenth Naval District

District headquarters, Seattle, Washington; Lt. Commdr. Alstvup N. Johnson,

MC-V(S), URNR
Puget Sound Navy Yard, Bremerton, Washington; Lt. Commdr. Samuel J.

Sullivan, MC-V(S), USNR
NTS, Farragut, Idaho; Lt. Alexander D. Campbell,' MC-V(S), USNR

48

JOURNAL OF SOCIAL HYGIENE

Fourteenth Naval District

District headquarters, Pearl Harbor, Hawaii; Capt. John B. Farrior, (MC), USN;
Lt. Commdr. Edward J. Muldoon, MC-V(S), USNR

Potomac and Severn Naval District

Potomac River Naval Command, Navy Yard, Washington, D. C.; Lt. Israel
Kruger, MC-V(G), USNR

ANNOUNCEMENTS

November JOUKNAL. — The Attack on
Juvenile Delinquency, subject of this
number, is much before the public eye
these days. Some copies of the num-
ber are still available, as well as
reprints of various of the articles,
which are 10 cents each unless other-
wise indicated: To AttacJc Delinquency;
A Seven-Point Program, Charles P.
Taft, Pub. No. A-526; The Community
and Its Youth in Wartime, Josephine
D. Abbott, Pub. No. A-555; What the
Local Parent Teacher Association Can
Do About Juvenile Delinquency, Bess
N. Rosa, Pub. No. A-529, single copies
free.

Last Month. — The Social Hygiene Day
Number is still in stock, and a number
of reprints are available at ten cents
each unless otherwise indicated:
"Quick Cures" for Venereal Diseases,
Walter Clarke, Pub. No. A-524; Boom-
town Wins a Battle, Joseph Hirsh,
Pub. No. A-513; Why Youth Should
Know the Important Facts About
Venereal Diseases, Maruice A. Bige-
low, Pub. No. A-525, single copies
free; What Is "Sex Education"?
Ray H. Everett, Pub. No. A-517;
Editorial: Social Hygiene Day — A Call
to Action, Pub. No. A-544, free.

This Months — A number on the Federal
Program for VD Education, which
represents the four main agencies con-
cerned most directly with VD educa-
tion. Already preprinted is Venereal
Disease Education in the Army, Gay-
lord Anderson, Pub. No. A-533, 10
cents. Reprints of the other articles
will depend on the demand.

Next Month. — The February issue
will contain a number of items on
VD education projects of special in-
terest. See back cover for the list
of main articles.

Future Numbers.— Present plans call
for an Anniversary Number containing
an account of the ASHA Annual

Meeting and other Social Hygiene Day
events; and an Annual Library Num-
ber. Tentative plans also include a
number on Rehabilitation and Redirec-
tion, and an Inter- American Number.

Social Hygiene Legislation. — Most state
legislatures convened during 1943, and
summaries of the status of social hy-
giene legislation following these ses-
sions are now available in up-to-date
form, as revised by George Gould,
ASHA Legal Consultant. Laws against
Prostitution and TJteir Use, Pub. No.
A-458x is 10 cents. The Summary of
State Legislation Requiring Premarital
and Prenatal Examinations for Venereal
Disease, containing charts which show
details of the laws and reciprocity
agreements between states, is 25 cents.

Snow Series. — The well-known series
of three pamphlets — Health for Man
and Boy (Pub. No. A-540), Health for
Women and Girls (Pub. No. A-541),
and Marriage and Parenthood (Pub.
No. A-542)— by Dr. William F. Snow,
has recently been revised by the au-
thor to include the latest information
on therapy. In attractive new covers,
the series sells for 25 cents a set,
or 10 cents for each pamphlet. Quan-
tity prices will be quoted by the ASHA
Publications Service.

Some Dangerous Communicable Dis-
eases.— A plan and script by the well-
known health education authority,
Maurice A. Bigelow, with editorial
suggestions by a number of other
experts, has developed this Special Unit
of Study in Health Education for
Senior High Schools and Junior Col-
leges. Planned as a project in visual
education, it is adaptable to lecture
and textbook methods. The materials
include a Manual for Teachers and
Students, a Handboolc for Students,
sets of cards for reflecting projectors,
and sets of lantern slides for rental
01- purchase. Write for free circular,
Pub. No. A-552, which describes these
materials and gives prices.

Vol. 30 February. 1944 No. 2

Journal

of

Social Hygiene

CONTENTS

The Neighborhood War Clubs as a Channel for Popular
Education in Venereal Diseases Shata Ling 49

Plan for Reaching Industrial Workers through Industrial
Health Committees Percy Shostac 58

Biography of a Civilian Committee on Venereal Disease

Control M. Leider, S. Brookins and

V. McDaniel 67

Venereal Disease Health Education Project for Negroes in
Texas Bascom Johnson 72

Conference with Negro Leaders on Wartime Problems in

Venereal Disease Control: Abstract of Proceedings 76

Sex Education in School Programs on Health and Human

Relations Maurice A. Bigelow 84

New Problems in the Control of Syphilis and Gonorrhea. . . . Carl A. Wilzbach 88

Editorial:
Health Education and Health Educators 93

National Events 95

News from Other Countries. . 98

National Social Hygiene Day
February 2, 1944

The American Social Hygiene Association presents the articles printed in the
JOURNAL or SOCIAL HYGIENE upon the authority of their writers. It does not
necessarily endorse or assume responsibility for opinions expressed or statements
made. The reviewing of a book in the JOURNAL OF SOCIAL HYGIENE does not
imply its recommendation by the Association.

EDITOEIAL BOARD
O.-E. A. WINSLOW, Chairman

BAY H. EVERETT WILLIAM F. SNOW

JOSEPH K. FOLSOM JOHN H. STOKES

EDWARD L. KEYES JOHN C. WARD

JEAN B. PWNIY, EDITOR
WILLIAM F. SNOW, EDITORIAL CONSULTANT

The JOURNAL OP SOCIAL HYGIENE is supplied to active members of the American
Social Hygiene Association, Inc. Membership dues are two dollars a year. The
magazine will be sent to persons not members of the Association at three dollars
a year ; single copies are sold at thirty-five cents each. Postage outside the United
States a«d its possessions, 50 cents a year.

Entered as second-class matter at post-office at Albany, N. Y., March 23, 1922.
Acceptance for mailing at special rate of postage provided for in Section 1103,

Act of October 3, 1917, authorized March 23, 1922.
Published monthly (nine issues a year) for the Association by the Boyd Printing

Company, Inc., 372-374 Broadway, Albany, N. Y.

Copyright, 1944, by The American Social Hygiene Association, Inc.

Title Eegistered, U. 8. Patent Office.

PUBLISHED MONTHLY EXCEPT JULY, AUGUST AND SEPTEMBER
AT 372-374 BROADWAY, ALBANY 7, N. Y., FOR

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

EDITORIAL OFFICES and NATIONAL HEADQUARTERS
1790 BROADWAY, 19, NEW YORK CITY

WASHINGTON LIAISON OFFICE
Room 609, 927 15th St., N.W., Washington 5, D. C.
JEAN B. PINNEY, Director in Charge
REBA RAYBURN, Office Secretary

FIELD OFFICES

ATLANTA, GEORGIA. 506-508 Citizens and BALTIMORE, MARYLAND. Care of Baltimore

Southern National Bank Building. Serv- Community Fund, 22 Light Street,

ing Alabama, Florida, Georgia, Missis- Serving Delaware, Maryland, Pennsyl-

sippi, North Carolina, South Carolina and vania and Virginia.

Tennessee. KENNETH R. MILLER, Field Representa-

CHARLES E. MINER, Field Representative. tive, Home address 260 Bridge St., Drexel

MRS. EDNA W. Fox, Field Representative. njn, pa.

COLUMBUS, OHIO. Care National Confer-
ence of Social Work, 82 High Street. CHICAGO ILLINOIS. Room 615, 360 North
Serving Indiana, Kentucky, Ohio and Miclligan Avenue. Serving Iuinoig> Michi.

WADE T?S£tt«8, Field Representative. &? and Wisconsin.

WARREN H. SOUTHWORTH, Field Repre-

OMAHA, NEBRASKA. 736 World Herald sentative.
Building. Serving Colorado, Iowa, Kan-
sas, Minnesota, Missouri, Nebraska, North

Dakota, South Dakota and Wyoming. DALLAS, TEXAS. Cliff Towers. Serving

GEORGE GOULD, Assistant Director, Arkansas, Louisiana, New Mexico, Okla-

Division of Legal and Social Protection homa and Texas.

Services, in Charge. » BASCOM JOHNSON, Director in Charge.

SALT LAKE CITY, UTAH. 402 Mclntyre MRS. GERTRUDE R. LUCE, Office Secretary.
Building. Serving Arizona, Idaho, Mon-
tana, Nevada, Utah, California, Oregon

and Washington. SAN FRANCISCO, CALIFORNIA. 45 Second

GEORGE GOULD (see above), temporarily Street.

»n dharffe. W. F. HJQBY, Field Consultant.

Journal

of

Social Hygiene

VOL. 30 FEBRUARY NO. 2

THE NEIGHBORHOOD WAR CLUBS AS A CHANNEL FOR
POPULAR EDUCATION IN VENEREAL DISEASES

SHATA LING

Community Organization Specialist, Wayne County, Michigan,
Venereal Disease Control Unit

All who participate in popular health education are interested in
methods and procedures. The following narration of an effort to
utilize a portion of the machineries of the Office of Civilian Defense,
with particular reference to venereal disease education, may prove to
be of interest and, perhaps, of some value.

The Director of the Wayne County Venereal Disease Control Unit
was interested in carrying out an educational program for the
general public. He had already experimented with the more tradi-
tional form of lay education, such as with clubs, schools, churches,
and other civic groups, but he wanted a method of education that
would more nearly reach into the community. The Neighborhood
War Clubs, or Block plan, of the Office of Civilian Defense seemed
a natural channel. The problem that confronted the Venereal Disease
Control Officer was: Would the Block Organization be a practical
medium for this type of education? What were the advantages and
disadvantages of this approach?

In January, 1943, by using the Selective Service figures as an
index for the rate of incidence in a community, River Rouge was
selected since it met the criterion of a high venereal disease rate, and
satisfied other criteria, such as: the community must be one with
sufficient diversification of population and industry; proximity to
defense and military centers; a community with an existing venereal
disease clinic ; a community with a well-organized block plan.

River Rouge is a metropolitan satellite community situated about
twelve miles below Detroit, with a population of about 17,000, of
which 3,000 are Negroes. The town has two local weekly newspapers,

49

50 JOURNAL OF SOCIAL HYGIENE

and for its daily news depends on the large Detroit papers. The town
has a variety of employment facilities: the huge River Rouge Ford
plant, the Great Lakes Steel Corporation a few miles below Rouge, at
Ecorse. Fort Wayne, a military reservation, and the Grosse He Naval
Training Station are almost equidistant from the center of River
Kouge.

It takes little imagination to see that this community offered every
element to make it ripe for an increase in the venereal diseases. Did
it also contain the machinery for education as to prevention?

The Block Organization

Nearly everyone is familiar with the first division of the Office
of Civilian Defense, the protective service, but few people know
that the Civilian War Services is organized along the same plan;
that is, there is a block leader for each city block or a portion of
the block. The Block Plan, originating many years ago as the Social
Unit Plan l and streamlined for the present emergency of war, is
basically sound as a medium for venereal disease education since
its purpose is:

To stimulate participation of all households for Civilian War Service. Civilian
War Services are all those activities, other than protection, with which com-
munities and individuals must be concerned as part of their contribution to
the war.

The Neighborhood Block leaders are, as a rule, women. They are
the so-called morale wardens of the community. These leaders are
organized as the arm of defense that deals with problems of the
home front. Nationally, there are sections on Health, Education,
Nutrition and Victory Gardens.

In the area under discussion, River Rouge, the Chairman of
Civilian War Services was quite willing to give over the health
section of his program, temporarily, to venereal disease control. A
general planning group was formed, composed of all the people
naturally found on a health planning group — the local health officer,
the school nurse, the city nurse, the superintendent of schools, the
librarian, representatives from the Council of Social Agencies. The
addition of the following people, in official capacity, made this plan-
ning group different : The Civilian Defense Coordinator, the Chair-
man of the Neighborhood Block Clubs, and the Chairman of the
Civilian War Services. The Wayne County Venereal Disease Control
Officer served as an over-all consultant for the entire committee.

River Rouge had organized, on paper, 125 Neighborhood Block
Clubs, with a tentative leader for each block. The constant call for
women in industry had made deep inroads into this organizational
structure, and by the time the venereal disease education program
began to function there were considerably less than 100 who could
or would devote even a little time to bringing news to the people on
the blocks.

i Philips, Wilbur C., Adventuring in Democracy.

NEIGHBORHOOD WAR CLUBS IF VD EDUCATION 51

The General Plan

The general plan for reaching the community was: (1) Train the
block leaders through educational talks, movies, group discussions,
and questions. (2) Encourage these block leaders to go back to their
original neighborhoods, call together the people on the block, and give
their own version of the talk, distribute the pamphlets and materials.
If they wished, they could arrange for the showing of the movies in
their own neighborhoods.

The training period was to be short ; it was to be given in language
that was readily understood by any of the laity, no matter what
their educational level might be.

The Chairman of the Civilian War Services, in cooperation with
the Venereal Disease Control Officer, sent a letter 1 to all neighbor-
hood block leaders stating the importance of the training period and
the need for their help in fighting this home front enemy. A
flexible schedule was arranged so that as many block leaders as possi-
ble would be able to attend. Of the 120 to whom letters were sent
the last week of April, announcing classes for May 3, 4, and 5, a
total of forty block leaders attended the training groups. Out of
the forty block leaders participating in the first meeting, only nineteen
remained for more than one meeting. It appears that when the
leaders had heard the talk, had seen the movie and participated in
discussions, they felt they had enough information to call themselves
informed.

In the whole training period emphasis was laid on certain phases
of venereal disease control. The leaders were impressed with the
following premises, conclusions, and facts, stated in the simplest
terms :

1. That syphilis is a disease; and needs the efficient, kindly confidential treat-
ment of patients, which we give tuberculosis, typhoid fever, or malaria
patients.

2. That syphilis can be diagnosed.

3. That syphilis can be cured, if discovered soon enough. In. all cases, it can
be made non-infectious (we used the word "catching" for communicable).

4. That a complete examination, plus a blood test, is the accepted method of
diagnosing syphilis; and helps find those who may have been exposed and
infected.

5. That quacks and drugs recommended by friends are harmful and delay
effective treatment.

6. That prostitution, which spreads the disease, should be repressed.

7. That the teen-age girl is a frequent and often unknowing spreader of
syphilis; and that absence of family influence, whether owing to work on
the part of the mother or other factors, is partly responsible for this.

8. That Eiver Eouge having a venereal disease clinic in which persons unable
to pay for treatment can come for help provides protection to the whole
community.

i See end of article — Exhibit I.

52 JOURNAL OF SOCIAL HYGIENE

9. That this protection could be broadened if Kiver Rouge had adequate
hospital facilities; and follow-up services.

10. That through better health, recreational and educational facilities, and
effective police service, a community can lower its venereal disease rate if
it uses these for that purpose.

When the leaders first met, they were given a short questionnaire2
to determine how much they knew about the spread of the venereal
diseases. The questionnaire, of the true and false type, proves a
false indicator since good guesswork would result in a misleading
score. Whatever questionnaire was to be used at the end of the
demonstration, it should be one that required thought and education
along community lines. After careful consideration, a multiple choice
test was selected as the best method for obtaining information and
educating. Such a multiple choice test was devised by the Wayne
County Venereal Disease Control Officer in cooperation with the lay
educator in Venereal Diseases for the Detroit Board of Health, the
Chairman of the Civilian War Services and the writer.

The American Social Hygiene Association's film, With These
Weapons was shown for mixed groups of block leaders, while for
all male audiences, either in the neighborhood or groups of leaders,
the Navy film, Sex Hygiene was found to be most satisfactory. At
the end of the training period, the film, Fight Syphilis, a United
States Public Health Service release, was found to be an excellent
film for enlisting community participation and showing individual
and community responsibility.

The hope of the plan was that the block leaders would themselves
do the ' ' educating, ' ' but as the plans developed it was found that the
factual material on the subject was too new to most of them, and
their timidity in disseminating it was too great. The best thing the
block leaders could do for the program was to call together the people
of their neighborhoods and have the talk presented by a lay educator.
Only in five instances, did the block leaders, themselves, present the
information in a more formal manner. However, the calling together
of the people on the block, the distribution of the leaflets, Wake Up
Main Street, and Venereal Disease and National Defense; arranging
for a bookshelf in the public library ; the distribution of the question-
naire ; and as a final activity, the placement of the washroom card 3
in public washrooms were all activities of block leaders and their
neighbors.

Any educational method is difficult to measure or evaluate. There
is no way of knowing how many acquaintances, friends and members
of families were helped to a better and a sounder knowledge of the
principles of venereal disease control. But the following may be
cited :

1. Forty Block Leaders, representing large population groups, took training
in venereal disease education.

2. Twenty-five men and women were interested enough to attempt organization
of block educational groups.

2 See end of article — Exhibit II.
s See end of article — Exhibit III.

NEIGHBORHOOD WAR CLUBS IN VD EDUCATION 53

3. Ten neighborhood groups received information, discussed the problems and
became links in a widening chain of participation.

4. Participation on the part of the Block Leaders gave concrete evidence of
what the public wants to know about venereal disease. (See list of 127
questions asked during discussion periods.) 4

5. The leaders demonstrated that there is an available nucleus in nearly every
block; that it is possible to work out a net-work of informed, responsible
home groups and families who care.

The failure to carry out, in its entirety, the purpose of the Neigh-
borhood War Club, whether in venereal disease education or any
other activities is due in part to the following factors :

1. Its leadership is not necessarily representative of the people. Theoretically,
the Block Leader is an elected representative of the group. In practice, he
or she is the one person on the block who has volunteered for war services
in the community. Many times, that person is considered either too
energetic or the ' ' busy-body ' ' type ; or only someone whom the war has
projected into participation, and who is scarcely known to any one in the
neighborhood.

2. The. emphasis was on a physical protection service while the home front
was deteriorating. The change over to the Civilian War Services, such as
health and welfare, came when the community and its leaders were devoid
of enthusiasm and felt no sense of contribution to the war effort.

3. From a venereal disease control standpoint, the Block Plan was not as
effective as it might have been since in many instances the Block Leader
was meeting neighbors for the first time in connection with venereal disease.
The strong, social taboos against these diseases, in addition to the lack of
established neighborliness, were serious obstacles in this venereal disease
education program.

Conclusion

In conclusion, certain recommendations might be in order. Basic-
ally, the Block Plan, whether a part of an Office of Civilian Defense,
or as a mere geographic unit, is a sound channel for winning par-
ticipation of the people to a program or an idea. However, it is a
process of community organization that can best be developed through
a voluntary agency or a group of people undisturbed or frightened by
the "budget bugaboo." The secret of changed attitudes — and that
is what is being called for in venereal disease control — lies in the
degree of participation of the youth of America. Participation in
reducing the venereal disease rate must spring from morale developed
within the schools and homes. Ordway Tead defines morale as "that
pervasive attitude of voluntary, enthusiastic and effective mobiliza-
tion of a group's effort for the accomplishment of some purpose."

It takes time, care, patience, and above all a sound philosophy to
build morale into a community. Machine gun tactics in spraying
information over a community is not the way towards sound homes
and communities. The worker in venereal disease education needs a
positive philosophy for the fight; he needs to be free from sense of
pressure as to numbers; he needs a sense of responsibility and chal-
lenge. At one and the same moment, we must teach our young to

* See end of article — Exhibit IV.

54 JOURNAL OF SOCIAL HYGIENE

build and man the tanks, planes and guns, while rearming their
hearts to win the peace as well as the war.

I know of no agency better fitted to supply the above supporting
factors than the American Social Hygiene Association. Its underlying
philosophy is in accord with the fundamental premise of public health :
that disease can be prevented. People can be different; people can
change. People change when they have been educated into caring
what happens, first, to themselves, then to their families, their com-
munities and finally their country.*

* The contents of the letter and questionnaire, and the list of questions asked
at meetings, referred to in this article, have been added below in fine print to give
the reader a clear picture of the procedures — and at the same time to save space.

EXHIBIT I— OFFICE OF CIVILIAN DEFENSE— River Rouge Michigan
Dear Neighborhood Block Leaders:

You realize that you have volunteered for vital war service. You have enlisted in
the great home army — enlisted in the fight against ill health and waste in your
community.

War changes the patterns of our lives. War creates many strains and pressures on
community life. Each of us has a part in fighting to maintain our way of life —
particularly in its guarantee of a healthy, sound nation.

Dr. Thomas Parran, Surgeon General of the United States Public Health Service
says, "For Victory, America has mobilized millions of soldiers, has raised ship-
building towns, crowded industrial cities with men and women working to produce
the tools of war. Wherever these people go, there too go the camp followers — syphilis
and gonorrhea. The venereal diseases thrive among dislocated, lonely people who do
not have the opportunity to participate in wholesome community life . . . ."

As a part of our training institute we are including courses on the prevention and
control of venereal diseases. Information, movies, pamphlets, as well as discussion,
will be part of the War Services' Training Institute. You will need this training to
carry the fight to your own block area.

WE NEED YOU IN THIS VITAL BATTLE OF THE HOME FRONT!

Classes will be held: Tuesday, May 4th— 2-4 P.M., Dunn School. Tuesday, May 4th
— 7:30-9:30 P.M., River Rouge High School. Wednesday, May 5th— 2-4 P.M., Northrup
School.

You are urged to select the class most convenient for you but be sure to attend one
of them.

GAYLORD M. SPEAKER, War Service Chairman.

EXHIBIT II— QUESTIONNAIRE FOR RIVER ROUGE

I. Which of these disease do you think are the most serious in your community at
the present time? Check five: 1. Smallpox; 2. Typhoid Fever; 3. Scarlet Fever;
4. Tuberculosis ; 5. Whooping Cough ; 6. Syphilis ; 7. Malaria ; 8. Measles ; 9. Cancer ;
10. Diphtheria.

II. Have you heard a talk or read any literature on the spread of syphilis? Yes
, No In the last three months

III. If you wanted to tell someone about the seriousness of syphilis, would you
say it was : 1. Bad blood ; 2. A disease passed on by a germ ; 3. A disease caught in
the air; 4. A disease caused by filth.

IV. How would you know you had syphilis? 1. Ache all over; 2. Feel depressed;
3. Spots before your eyes; 4. Have a blood test; 5. Have dizzy spells; 6. Have sores
on the sex organs.

V. If you wanted to find out if you had syphilis, would you go to : 1. A drug store ;
2. A friend who knew about syphilis; 3. A beer garden; 4. A doctor; 5. A school
teacher; 6. A clinic.

VI. If syphilis is caught by loose living, which groups would most likely have the
greatest number of cases? 1. Married couples; 2. People away from home; 3. High
school girls ; 4. High school boys ; 5. Young people whose mothers are working ;
6. Young people from broken homes ; 7. Soldiers and sailors.

VII. What part can you play in the battle for a syphilis-free community? 1. Being
a good neighbor; 2. Letting your child run the streets; 3. Taking responsibility for

NEIGHBORHOOD WAR CLUBS IN VD EDUCATION

55

recreation in your block; 4. Cooperation with law enforcing bodies to wipe out
prostitution ; 5. Giving your children correct sex education in the home : 6. Making an
effort to give your child a chance to share the work, the fun and the job of building
a sound, clean, and united home.

EXHIBIT III
Placard used in Kiver Eouge OCD Block plan: River Kouge, Michigan

DO YOU KNOW?

Syphilis and Gonorrhea are two separate diseases.
They are both Germ Diseases.
Syphilis and Gonorrhea are catching.
Anybody can catch Syphilis and Gonorrhea.
These diseases are usually spread through sexual contacts.

Avoiding sexual contacts, outside of marriage, is your best
preventative against Syphilis and Gonorrhea.

* * * *

Syphilis is a serious disease. It may cause Death, Heart
Disease, Blindness, Paralysis or Insanity.

Many times, the signs of Syphilis are so slight that the dis-
ease can be found only by a Blood Test.

If treatment is put off, your chances for cure are lessened.

Treatment for the disease must be regular in order to keep
others from catching it.

Regular treatment is needed for a Cure.

* * * *

Persons who think they may have Syphilis or Gonorrhea
should see their Family Doctor.

Persons unable to Pay for Medical Care may come to the
V. D. Clinic, Basement City Hall, River Rouge.

This display sponsored by OCD and CWS as part of the
NWC Program for improved Health and Welfare.

Michigan Department of Health in cooperation with River
Rouge Health Department and U. S. Public Health Service

KNOW FOR SURE!

56 JOUENAL. OF SOCIAL HYGIENE

EXHIBIT IV— QUESTIONS ASKED AT EDUCATIONAL MEETINGS

1. What effect does syphilis have on the throat?

2. Can syphilis be caught except through bodily contact?

3. Does treatment make syphilis non-infectious?

4. Does everyone in the Army have to take treatment if he has a venereal disease?

5. How long has the law regarding prenatal examinations been on the records?

6. When a boy is deferred because of venereal disease, does the government force
him to take treatment?

7. What is the life expectancy of a child born with syphilis?

8. What is the combination of drugs used in the treatment of syphilis?

9. If the treatment takes over a year and you miss one, must you start over again?

10. What are the first symptoms of syphilis?

11. What are the first symptoms of gonorrhea ?

12. Is a chancre always a sign of syphilis?

13. Is the sore contagious?

14. How has congenital syphilis been decreased?

15. Wouldn't it be expensive to take daily treatments?

16. Could a person stand to take daily treatments?

17. What is done with those found to have syphilis when examined by the draft
boards ?

18. Is the disease contagious after many years?

19. Can venereal diseases be spread in restaurants?

20. Are the sulfa drugs used in the treatment of syphilis?

21. What are the signs of a baby born with syphilis?

22. Are there other venereal diseases than syphilis and gonorrhea?

23. Does positive blood test always mean syphilis?

24. Does syphilis always give a positive test?

25. If a child is born with syphilis, will it go through life with it, and Is it
infectious ?

26. Will a doctor know a child has syphilis at birth, even if he doesn't know the
mother has it?

27. If a test shows negative, can it really be positive and not show up?

28. Can congenital syphilis be cured?

29. If a man has a negative blood test before marriage, does it mean he is free
from syphilis when he marries?

30. In case of treatment, if a person knows he has syphilis and he is pronounced
cured, is it possible for him to catch it again?

31. Will people object to taking a spinal test?

32. Why don't they make "shots" compulsory?

33. Would people get syphilis if they worked as janitor or scrubwoman in large
public buildings?

34. Is it possible for the germ to stay alive in nutrient matter?

35. Could flies carry the disease?

36. How does gonorrhea compare with syphilis in number of cases?

37. What are you supposed to do if you have any doubt as to whether you have a
venereal disease?

38. Suppose a man has an itching sore for the past 10 years, do you think it could
be syphilis?

39. Is gonorrhea more serious than syphilis?

40. When should a person have a blood test?

41. Is the amount of infection higher in men than in women?

42. Can a woman give the disease to a child before it is born ?

43. What effect does syphilis have on a young girl's tubes?

44. Does the disease increase in infection while the mother is carrying a baby?

45. How soon after you come in contact with the disease do you know you have It?

46. How does syphilis act on the body ?

47. When a pregnant woman takes treatment, does she receive treatment for herself
or for the baby ?

48. If a woman is badly infected, can she be cured?

49. Can a reliable cure for syphilis be bought in the drugstore?

50. Do you have figures on the amount of venereal diseases among young people
of high school age?

51. How can you tell you have syphilis?

52. How young a child should have a blood test?

53. If syphilis is so common, why haven't we forced people to take treatment?

54. If there is an infected child in the family can other members get syphilis
through bodily contact?

55. Does the test always have to be a Kahn or Wassermann?

56. Is syphilis infectious in all stages ?

57. Does a young congenital receive the same treatment as an adult?

58. How scientific are the really "quick" cures for syphilis?

59. Are the armed forces keeping venereal diseases in check?

60. Do you feel encouraged about the problem of venereal disease prevention and
control?

61. Is it difficult to get people to accept educational programs?

62. How do we, as a community, organize to control syphilis?

63. Why are we so far behind in our control of venereal diseases?

64. How did Sweden do such a good job of control?

65. (a) Can films be shown to high school students in the schools?

(b) Can we show this film and have these talks for fathers' and sons' clubs?

66. Are editorials available for our newspaper?

67. Why is there a difference in army and civilian rate of venereal disease infection?

68. What can a PTA do as a community organization to help in the control of the
venereal diseases?

NEIGHBOBHOOD WAR CLUBS IN VD EDUCATION 57

69. Do you think we should have blood tests for our young children at around
12 or 13?

70. Would it be legally possible to include blood tests in our school examinations
along with tests for TB?

71. Do you think if a slip were sent home asking for permission to do a blood
test on school children, it would do any good?

72. How long does it take to cure syphilis?

73. Is treatment the same for all stages of syphilis?

74. Does syphilis show up in the second or first generation?

75. Is the progress of gonorrhea stopped by treatment as syphilis is?

76. Do the sores of syphilis ever appear externally?

77. To what extent does the lack of immediate prophylaxis for civilians and Its
requirement for the armed forces account for lower rates of infection in the latter.

78. Do you believe that the present army is leading a cleaner life than in the last
war or is their control program better?

79. If you are taking treatment, can you give the disease to another person?

80. Can you get it again if you have had treatment and been cured?

81. Is a midwife required to give a blood test?

82. Can she give a blood teet at the time of delivery ?

83. If a midwife has the disease can she give it to the newborn baby?

84. Can you get a blood test free?

85. Does Wayne County have as high a venereal disease rate among young girls as
other parts of the country?

86. What do you do about Joints that you know are frequented by "barflies"
and pick-ups?

87. How long are patients checked after cure?

88. Are patients cooperative about keeping in touch for check-up?

89. Is the five-day treatment a hospitalized treatment?

90. Is publicity on juvenile delinquency overdone?

91. What do you think is the most startling fact about the newest figures on
venereal diseases ?

92. Did the venereal disease rate decrease after the last war?

93. Is there more education for prevention and control of venereal disease during
this war?

94. When did Michigan pass the prenatal law?

95. How many states have premarital laws?

96. Does syphilis affect children always in the same way?

97. How can a baby get syphilis if it is not born with it?

98. Can the baby give it to someone else?

99. Does syphilis, if untreated, remain in the blood stream for life?

100. Can syphilis be transmitted if it is in the dormant stage?

101. If a man has syphilis, but the mother does not, can the child be born with
syphilis?

102. What does the chancre look like?

103. What effect does the curfew have on the control of venereal disease?

104. Couldn't we take care of our Juvenile delinquency problem with a curfew?

105. How can we get people to have a blood test?

106. Could you get syphilis from other sources than through sexual contacts?

107. Are doctors required to report syphilis?

108. How do you get a doctor to give an expectant mother a blood test early In
pregnancy?

109. Does the draft board tell you if you are deferred because of syphilis?

110. How long do children live who are born with syphilis?

111. Will syphilis cause a "blue baby" ?

112. Does syphilis pass from generation to generation as it says in the Bible?

113. Does drinking contribute to the higher venereal disease rate?

114. Can one person in the family have syphilis without infecting other members?

115. How would one know if infected, without going to a physician?

116. Must the microscope be powerful to see the germ of syphilis?

117. How is the blood test made?

118. Does the germ of gonorrhea show in a blood test?

119. Is the test that is given upon hospital admittance the test for syphilis?

120. If you had syphilis, would they tell you if the test was positive ? (Questions 119
and 120 are from same person.)

121. Is syphilis hereditary?

122. What precaution can a mother take?

123. Does it come back after "cured"?

124. What are some of the signs of a baby with congenital syphilis ?

125. Does treatment while pregnant prevent syphilis in the child?

126. Is syphilis mentioned in the Bible? How old is lues?

127. Can you get syphilis from a bathtub?

PLAN FOR REACHING INDUSTRIAL WORKERS THROUGH
INDUSTRIAL HEALTH COMMITTEES*

PERCY SHOSTAC
Consultant on Industrial Cooperation, American Social Hygiene Association

Industrial Cooperation

Cooperation by management and labor, in unorganized as well as
union plants and firms, offers a challenging, and as yet only slightly
explored, method of bringing health education to industrial com-
munities on terms most acceptable to the workers there employed.

Experience has shown that effective results in spreading health
information in the industrial field can be achieved only occasionally
with the help of management alone. A plant may have excellent
medical facilities, may be willing to give blood tests to employees,
may wish to distribute educational material, and yet these efforts
may not be sympathetically received. The industrial worker is
inclined to regard such efforts with suspicion unless his own organ-
ization is included as an equal partner in the planning and execution.

It is with the object of evolving an instrument with which to
achieve such employee-management cooperation on behalf of a com-
prehensive and permanent health education program that the Asso-
ciation is now engaged in helping to establish a functioning Indus-
trial Health Committee in the Fort Greene-Bedford District of
Brooklyn, New York.**

It is hoped that this demonstration in adult health education will
provide a pattern for use in industrial communities throughout the
country. Our thought is that affiliated social hygiene societies, coop-
erating with business men in their localities, with the trade union
movement, local health authorities, the U. S. Public Health Service,
organized medicine and other interested groups, can initiate and
help to establish such projects in their communities.

The suggestions which follow are for the guidance of social hygiene
societies and other cooperating groups wishing to achieve this end.
They are offered in the belief that they can be used by men and

* This article brings up to date a report prepared for the Conference r f
Social Hygiene Society Executives, held in New York on September 14-15, 1943.
** Now known as the Fort Greene Industrial Health Committee.

58

59

women with the will, the devotion and the inspiration necessary to
bring a comprehensive program of popular health education to the
industrial workers of America.

The Field

A sympathetic reception by organized labor is a most valuable asset
in reaching industrial workers. This does not mean that the con-
siderable number of unorganized employees in industry are to be
overlooked.

It does mean that the unions comprise the majority of our most
skilled, most stable, best paid workers. It means that the 13,000,000
union members in the United States are the vanguard of our working
population; that the improved conditions achieved by labor through
years of struggle have not only benefited trade unionists, but have
raised the living standards of all who work.

Furthermore, our trade union population is organized into coherent
groups and is represented by elected spokesmen. The very nature
of these organized groups makes them more able to carry out as a
body any program which they consider vital to their well-being. The
unorganized workers are less readily approached and more difficult
to move toward an objective.

As a timely example, it is estimated that at the end of 1943, eighteen
million women were employed in the United States. About 6,000,000
of these are in war production industry, and of these, some 3,000,000
are members of trade unions. Furthermore, these 3,000,000 are
employed largely in our most vital war plants. The conditions
achieved by the organized group will affect the well-being of the entire
18,000,000. If these union women can be interested in planning for
their better health, their unorganized sisters are more likely to follow
the example.

It should be repeated that the unorganized workers must be
included in any plan which hopes to cover an industrial community.
There are, of course, many centers which employ mostly non-union
workers. However, in the over-all picture, reliance must be placed
on the organized groups for help in initiating and carrying through a
program. The major relief agencies are aware of this and are
stressing the trade union approach in their fund-raising campaigns.

The community chests of the country, the Red Cross, the major
foreign relief agencies and the U. S. Treasury Staff have recognized
the importance of support from the 13,000,000 men and women of
organized labor. Bond sales through unions have set an enviable
record. The National War Fund has received a substantial portion
of its 1943 total from trade union members. Numerous community
chests reached or exceeded their 1943 quotas because of union par-
ticipation. Red Cross collected $15,000,000 of its 1943 War Fund
from organized labor, as well as a substantial portion of donations
to the blood bank. The national health organizations can draw an
important lesson from the large fund-raising groups.

60

JOURNAL. OF SOCIAL HYGIENE

The labor movement is a great reservoir whose resources have been
tapped only slightly by our national health agencies. These resources
consist of more than potential funds. In addition to dollars, the trade
unions can contribute new forces and new enthusiasm to any projects
which they know to be democratic instruments for meeting the needs
of their communities.

In order to enlist active cooperation by labor for any health educa-
tion program, local trade union leaders must be approached with
some knowledge of the labor point of view. To provide a basis for
such an approach, some fundamentals about the labor movement
are given here.

Trade Union Fundamentals

To begin with, we should recognize that men and women join unions
in order to better their working conditions and gain greater security,
and very rarely because of coercion; that the labor movement has
become a vital part of our democracy ; that, generally speaking, union
members make up the most socially-aware group of our working popu-
lation ; that trade unions holding closed shop contracts include leading
artists of the theatrical and musical professions, top-notch newspaper
men, professional people of many categories, the conductors and
locomotive engineers on our trains, as well as men and women who
work for a living with their hands or minds in most occupations.

In fact, the trade unions have long been centers of cultural, educa-
tional and welfare activities. Unions have carried on extensive
amateur and professional theatrical projects; recreational programs
and schools have been conducted. They have provided insurance
and death benefits for their members, and in some instances medical
services. The International Ladies Garment Workers Union produced
Pins and Needles. The National Maritime Union, as part of its war
activities, is conducting a seamen's training school, sponsored by the
Maritime Commission, to enable its members to gain higher ratings.
Increasingly successful servicemen's canteens, popular because of
their democratic atmosphere, have been established by many unions.

Labor history discloses that the trade union movement was a
pioneer in the cultural-educational field for the common man; that
as early as 1830 the unions played a decisive role in the winning of
free public education. Today the labor movement can be an important
influence for the introduction of social hygiene instruction in our
elementary and high school curricula. The primary efforts of the
unions are for the economic welfare of their members ; they must also
be recognized as a great potential in the cultural life of our country.

It would be well for us to realize, too, that while the 13,000,000
men and women of organized labor are divided into three major
groups — AFL, CIO, and Railroad Brotherhoods — and into many
unions at times antagonistic to each other, all union people are loyal
to the basic principle of trade unionism: collective bargaining for
greater security, leisure, and better working conditions. In regard to
strikes, it can be stated categorically that the union man, knowing

PLAN FOR BEACHING INDUSTRIAL WORKERS 61

better than anyone else what this last resort entails, dreads a strike
as a peaceful man dreads war.

While, unfortunately, racketeers are in control of a few unions,
this is the exception, not the rule. The unions themselves are making
steady progress in eliminating dishonesty. Most unions are run
according to democratic principles of election and representation;
most union members are loyal to the leaders whom they have elected.

It would be a mistake to underestimate the capability, skill and
fortitude of the union official. It is true that he is seldom a college
graduate. Yet at the bargaining table he has successfully matched
wits with our most highly-paid corporation lawyers and the presidents
of our most powerful industrial enterprises.

Trade unionists are realistic; they will not respond to vague ideas
of uplift; they want to know what concrete benefits their members
will get from participation in a program. Once convinced that a
project is genuine, they are likely to respond wholeheartedly.

Search for a Plan

The importance of the trade unions in the industrial picture has
been described in some detail. It has also been pointed out that any
sound plan for bringing a program to the largest possible number
of industrial workers throughout the country must enable us to
reach the unorganized employees, as well as the trade union groups.

Heretofore the Association has brought its message to working men
and women through the cooperation of individual firms and on some
occasions through individual union groups. The extension of our
venereal disease control program through trade unions will be con-
tinued and amplified. However, the special needs and new problems
arising from the war situation made us all realize that a more com-
prehensive method, one that would cover entire industrial com-
munities, was called for.

We saw that we could no longer be limited by the friendly reception
extended to us by the presidents or personnel heads of scattered indus-
trial enterprises. We knew that we must find a way of enlisting both
management and labor on city-wide bases in a virtual crusade for the
elimination of venereal diseases from the ranks of our workers. When
the Fort Greene-Bedford District Health Committee of Neighborhood
Health Development, Inc., asked Dr. William F. Snow for the Asso-
ciation's help in reaching the industrial plants of that neighborhood
of Brooklyn, New York, we were given an opportunity to make a
demonstration of our theories.

The Brooklyn Demonstration

The Industrial Health Committee of the Fort Greene-Bedford
District has developed as a project in which employees and manage-
ment (functioning through joint health committees in the partici-
pating firms) are cooperating with public and voluntary health

62 JOURNAL OF SOCIAL HYGIENE

agencies, trade unions, and the medical profession to conduct a care-
fully planned program of popular health education in the industrial
community. The venereal diseases are featured in a comprehensive
list of health subjects to be dealt with.

Eecognizing that education is a cornerstone of preventive medicine,
the Committee is convinced that effectively informed men and women
will take the necessary precautions to avoid health hazards or seek
early treatment when illness occurs. Through a job of real teamwork
on the part of workers and management, carrying out together a pro-
gram which includes the publication and distribution of a semi-
monthly illustrated health tabloid; through the intensive use of
posters, placards, pamphlets, movies and the spoken word, and above
all by the fostering of active democratic health committees within
each firm, the program will seek to make the Fort Greene-Bedford
District industrial community health conscious.

The Fort Greene-Bedford neighborhood is a highly industrialized
section of Brooklyn in which more than 200 important plants and
firms are located, with a heavy concentration of war production,
including the Brooklyn Navy Yard. Other firms are widely varied,
including large department stores, chain bakery factories, 14 of
Brooklyn's major laundry establishments, milk companies, important
candy, clothing and paper box manufacturers and public utility com-
panies. According to present plans, with the Navy Yard included,
the Committee would hope to reach 150,000 workers with its program.

Six months have passed since the initial meeting was held, with
Dr. Walter Clarke present, when representatives of industry, unions,
the Navy and the New York City Health Department took the first
steps toward forming the Industrial Health Committee.

To date almost 60 of the largest firms in the neighborhood have
affiliated with the Committee, and more than half of the $20,500
estimated as needed for a year's activities has been subscribed by
participating firms. It was pointed out to the firms that their
contributions were payments for services to be rendered rather than
gifts. On a similar basis support is expected from local trade union
groups, all of which are working actively with the Committee. Con-
tributions of printed material and help in preparation of the tabloid
were offered by most of the national and local health agencies when
56 representatives met on January 18th at the invitation of New York
Health Commissioner Ernest L. Stebbins to hear and to discuss the
Committee's plans.

The Committee's roster of officers is representative of the various
groups in the community which are cooperating to make the program
a reality. R. E. Gillmor, Committee Chairman, is President of the
Sperry Gyroscope Company, the largest war plant in the neighbor-
hood; Louis Hollander, Co-Chairman, representing labor, is Manager
of the New York Joint Board of the Amalgamated Clothing Workers
of America, and President of the New York State Industrial Union
Council; Dr. Charles F. McCarty, Secretary, is Executive Secretary
of the Kings County Medical Society; J. V. Gilloon, Jr., Treasurer,

PLAN FOE BEACHING INDUSTRIAL WORKERS 63

is Industrial Administrator for A. Schrader's Son, an important
unorganized firm ; Dr. L. Holland Whitney, Chairman of the Execu-
tive Board, is Medical Director for the Sperry Gyroscope Company;
Dr. Jacob H. Landes, District Health Officer, serves as the Com-
mittee's official representative from the New York City Health Depart-
ment. A full-time Executive Secretary, Mrs. Carmen Henry, has
been employed.

The Brooklyn demonstration project officially launches its pro-
gram on February 28th at the Hotel St. George when some 400
representatives of participating groups and interested citizens are
expected to attend the Committee's Inaugural Dinner. On this
occasion a panel discussion on the theme Here's To Your Health
will be conducted by Mr. Gillmor with the following taking part:
Dr. Victor G. Heiser, Consultant, Committee on Industrial Health
of the National Association of Manufacturers, and author of An
American Doctor's Odyssey; David L. Tilly, President of the Brooklyn
Chamber of Commerce ; Dr. Erval B. Coffey, District Director, U. S.
Public Health Service; Mrs. Betty Hawley Donnelly, Vice-President,
New York State Federation of Labor; Mr. Louis Hollander; Dr.
Ernest L. Stebbins; Dr. Jacob H. Landes; and Philip E. Mather,
Chairman, Committee on War Activities, American Social Hygiene
Association. The first issue of the tabloid will be presented at the
dinner in conjunction with the appearance of a union shop steward
from one of the participating war plants and an employee from a
department store which is unorganized.

Organizational Procedure

To communities which may be inspired by the Brooklyn demon-
stration to undertake similar projects, a few suggestions on procedure
are offered. These steps must be taken only as guide posts by which
to steer a general course of action. Each locality will present its
special problems with the trade unions, the local health department
setup, the business community, the social hygiene society, and other
interested organizations. In larger cities care should be taken to
limit the area that is to be serviced so that the project does not become
unwieldy. The important thing is to make use of all available local
forces and to remember that if the approach is sincere and determined,
a way will be found for effective accomplishment.

In the near future the American Social Hygiene Association will
issue a procedure manual based on the experiences in the Brooklyn
project. This manual will include samples of the tabloid and other
printed material, lists of movies shown, programs of meetings, data
about health committees in the firms, samples of form letters and other
relevant material. Meanwhile the items which follow may be of
assistance in starting organization work in your community.

I. Initial Steps

The social hygiene secretary should first gather together a few enthusiastic
people from his own society and elsewhere. It would be well to enlist the
local health officer and some labor people at the very beginning. Head-

64 JOURNAL OF SOCIAL HYGIENE

quarters should be planned for, if possible in a health department building.
The local TB society, Red Cross and other important voluntary health
groups should be approached, but the principal tie-up must be with the
health authorities. The active participation of employee representatives
should be sought and encouraged at all stages of the Committee's develop-
ment, for it must be remembered that this is not only a project for workers,
but fry workers.

One or more staff workers should be assigned to the project by the social
hygiene society, the Health Department and any other cooperating groups
willing to do so. However, as the work of the committee progresses, the
services of a specially employed executive secretary will probably be needed.

II. Visits to Key Leaders

Enthusiasm for the health committee plan should now be fostered. Among
those who should be visited are important union people, leading indus-
trialists, plant physicians and personnel directors who have been sympa-
thetic to the social hygiene program, representatives of U. S. Public Health
Service and of the VD control commands of the Army and Navy, as well
as some socially minded citizens. Right from the beginning it should be
made clear that the Committee plans to function on a basis of equal
cooperation by management and employees.

During this period an outstanding and enlightened industrialist should
be enlisted as chairman.

III. Organising Conference

The Industrial Health Committee can be officially established at a con-
ference or luncheon to which the press (including labor and plant publi-
cations) may be invited. The agenda of the conference must be carefully
prepared and the meeting short. After a presentation by two or three
speakers of the need for such a committee and what it can accomplish,
a detailed organizational plan must be offered. The Committee should be
described as a permanent organization that will concern itself with various
health problems, including the venereal diseases.

Discussion should then be invited, with a few key employee and firm
representatives primed beforehand to endorse the plan and to introduce
a motion for its adoption. The chairman should appoint a Continuation
Committee of eight or ten to carry on the organizational details necessary
for bringing the project into operation. Those to be named should be
thought out carefully, and should include representatives of all participat-
ing groups, particularly industry and labor, and including a non-union
employee.

IV. Continuation Committee

Until the Executive Board is elected, the Continuation Committee must
act as a temporary board, making decisions on methods of organization
and policy. It should concern itself with the program to be undertaken,
with enlisting new forces and a group of representative sponsors, with
getting firms and employee groups to participate, and with raising the
necessary funds.

V. Form Letters to Firms and Sponsors

After lists of business firms have been obtained (from Chamber of Com-
merce, local Red Cross or Community Chest), they should be invited to
participate by letters signed by the chairman on his business stationery.

PLAN FOR BEACHING INDUSTRIAL WORKERS 65

Letters should also be sent to individuals asking for sponsorship. A
mimeographed statement of aims should be enclosed. Care should be
taken to have all letters individually typewritten or multigraphed by a
competent letter shop. The union label should appear on all printed
matter including Committee stationery when possible.

VI. Follow Up

Follow-up of important firms should be made by telephone and by visits.
When firms agree to cooperate, a confirming letter should be sent.

VII. Executive Board

An executive board should be chosen which might very well include the
Continuation Committee members. Since this group will be the core of
the Health Committee's vitality, it must be chosen with great care and
should include an equal number of management and union or employee
representatives as well as physicians, etc.

For more efficient functioning, the Executive Board can be divided into
subcommittees with special responsibilities such as editorial-publicity,
medical, contacting, and finances.

VIII. Health Committees in Firms

A democratic employee-management health committee in every participating
firm is the basis for a successful reception of the Committee's program
and effective distribution of its material. Such firm health committees can
sponsor the showing of movies and arrange for speakers in plants and
unions; above all, they can promote true participation by employees in
the program. They are the instruments through which the workers can
become conscious and articulate about their better health.

Monthly meetings of the health committees in all participating firms should
be planned.

IX. Budget and Funds

The budget decided upon for a year's program should include estimated
cost of all material and printed matter to be used and distribution costs,
as well as the salary of the executive secretary and any office assistance
and incidental expenses necessary.

As already pointed out, when firms are approached for a contribution, it
should be made clear that such contributions are to be regarded as payment
for services to be rendered and not as gifts.

X. Inaugurating Bally or Dinner

The launching of the Health Committee's program can be the occasion for
a rally or dinner to which every effort is made to bring all participating
firm and employee representatives, sponsors, the representatives of interested
and cooperating organizations, officials of the state AFL and CIO and field
representatives of the relief committees of both groups, as well as the
general public. At this meeting the mayor might be asked to speak in
addition to the chairman, a union representative, a physician (possibly a
spokesman for the county medical society) and a representative of an
unorganized employee group. The first issue of the health tabloid can be
presented and a radio broadcast arranged for if possible.

66 JOURNAL. OF SOCIAL, HYGIENE

XI. Scope of Program

Most industrial health committees will at first wish to limit their activities
to purely educational programs. It must be realized, however, that health
education will create new demands for case finding and treatment facilities.
It is recommended that when questions arise regarding blood tests, periodic
health examinations, X-rays, etc., every effort be made to find practical
means of making these services available. It is possible also that the
Committee will be asked to support health legislation. It is to be hoped
that the sincere interest of the leading Committee members in the welfare
of our industrial workers will lead them to face these questions with
courage and imagination. The industrial health committee is a pioneering
effort for better health in the community. It must fulfil this noble purpose.

Ill-health, of body or of mind, is defeat. . . . Health alone is victory.
Let all men, if they can manage it, contrive to be healthy.

SIR WALTER SCOTT

BIOGRAPHY OF A CIVILIAN COMMITTEE ON VENEREAL
DISEASE CONTROL

THE NEGRO WAR-TIME HEALTH COMMITTEE OF PENSACOLA, FLORIDA

LT. M. LEIDEE (MC)
United States Naval Reserve

S. BROOKINS
Bepresentative, National Association for the Advancement of Colored People

V. McDANIEL
Principal, Booker T. Washington H, S.

Introduction

This is the story of the conception, birth and early development of
a civilian Negro Committee on Venereal Disease Control. In Novem-
ber 1943, preparing for an intensive state-wide campaign of public
education on matters of venereal disease control, the authors set out
to organize a civilian Negro community to implement part of the
program. January 1944 was to be declared, and actually was declared,
to be Venereal Disease Control Month in the state of Florida by
Governor 's proclamation.

The town of Pensacola in the County of Escambia, Florida, abuts
upon a large Naval Air Station. About 25 per cent of the civilian
county population is Negro, but only four per cent of the military
complement is Negro. It is expected that the Negro fraction of the
station strength will shortly rise to 15 per cent.

During the period when Negroes constituted a mere two to four per
cent of the military complement, statistics revealed that they were
contributing between one-fourth and one-third of the total number
of cases of venereal disease. With the anticipated increase in Negro
complement, a runaway situation was feared. The civilian situation
as regards venereal disease attack rate was like that of Florida gen-
erally, which is unusually high.

Organization

During the month of November 1943, preliminary meetings were
held with a small group of Negroes. Some were military personnel
who were natives and residents of Pensacola; others were civic-
minded lay persons. At these sessions the nature of the Venereal
Disease Control problem and related technical matters were explained.
When it was felt that this nuclear group were sufficiently indoctrinated
an organizational meeting was called.

About twenty persons responded. The composition of this group
was as follows: the local representative of the National Association

67

68 JOTJBNAL OF SOCIAL HYGIENE

for the Advancement of Colored People, the principal of the county
Booker T. Washington High School, two Negro physicians, two min-
isters, the Negro investigator of the county health department, several
Negro merchants and business men and miscellaneous others. The
senior author acted as technical advisor.

It was immediately clear that the articles of organization would
have to be letter perfect in terms of democratically elected officers
and subsidiary committees, and that the subsequent proceedings must
follow strictly the rules of parliamentary procedure. Consequently,
a chairman, secretary, treasurer, and committees on fund raising,
publicity, professional relations (church and medical) and material
were elected. With this foundation, the Negro War-Time Health
Committee set to work. Despite the implication in the title that the
organization was designed for the limited duration of the war, a
reservation for reorganization into perpetuity was made. A sense
of permanence was thus instilled.

Shortly thereafter, the organization flowered to include most of
the Negro professionals, a large percentage of the ministers, several
teachers, and a large number of workaday people of both sexes.

The Formulation and Implementation of a Program of Action

The following broad program was adopted as feasible for the
immediate and remote future and adapted to the local conditions :

1. Education of individuals and of the community at large in sex
hygiene and venereal disease control by:

(a) Mass meetings with movies and qualified speakers.

(b) Distribution of printed matter and posters in a regular and planned way.

(c) Newspaper and radio publicity with either sponsored and donated ads or by
actual purchase, and by press releases.

(d) A high school course in sex hygiene for the civilian school population and
a curriculum of general supplementary education for Negro Navy personnel.

2. Eepression of commercial prostitution and non-mercenary prom-
iscuity by:

(a) Direct appeal with the club of persuasion to the owners or operators of bars,
jukes, rooming houses and known or suspected brothels. A canvassing com-
mittee of prominent citizens was set up to visit, and revisit, flagrant places.
Where persuasion seems likely to fail, law enforcement or other pressure
mechanisms are to be set in motion.

(b) The employment of an attendance officer to combat truancy and juvenile
delinquency in the school population. Pro tempore, the committee is financing
this officer out of its own meagre funds with official permission of the school
board. When the results have justified the step, budgeted appropriation
for this activity will be demanded.

3. Case finding and case holding by:

(a) Close cooperation and working arrangements with the Negro investigator of
the county health department.

BIOGEAPHY OP A CIVILIAN COMMITTEE 69

(b) A mass blood testing project of the high school population. This project
is designed to serve as an educational measure, as a case-finding scheme and
as an immediate medical benefit to a young group and to the public health.

(c) General social pressure to make diagnosis and treatment sought for. A
general expansion of social services is being planned as a catch-all mechanism
to serve in many aspects of the program.

This bare outline does not convey in minute detail the elaborate
nature of the activities. In actual operation innumerable subtle and
difficult techniques involving ingenuity and plain physical exertion
are employed. The labor necessary for planning and executing a
successful public meeting, the eloquence and hours of argument re-
quired to convince indifferent, or even hostile, public servants, the
collection of money and wise disbursement from an inevitably anemic
treasury — all these things mean hours of time and work, unselfishly
given. The intelligence, enthusiasm and effort of the committee
members are phenomena difficult to describe, but those qualities are
present in astonishing degrees.

Achievement

In barely three months of activity a significant record of accom-
plishment has already been made. A simple listing would read as
follows :

1. An organizational firmness has been developed so that com-
mittee affairs are managed efficiently and expeditiously. Seemingly
routine, but fundamental, matters of the weekly meetings, like a
fixed and adequate place of meeting, prompt attendance of the
membership, and strict attention to committee business have been
thoroughly settled. The officers of the group perform their duties
with imagination and smoothness. Previous minutes are reviewed,
new minutes are recorded, various subcommittees report, old busi-
ness is concluded and new business is generated. Stationery has
been printed and numerous matters that can be carried on by
correspondence are taken care of quickly and strategically. Psy-
chological moments and situations can thus be taken advantage of
as they arise without difficult personal approaches.

2. Popular subscriptions to date amount to more than $300. The
welfare fund of the local Naval reservation has seen fit to make
a cash contribution of $1,000 for a six-month period as a token
of appreciation of the fineness of the program and its demon-
stratedly successful pursuit. Several fraternal orders and organ-
ized philanthropies, namely the Elks, the Junior Chamber of Com-
merce,- and Jewish Federated Charities, have made substantial con-
tributions. Two types of dues-paying membership, participating
and sustaining, have been developed and a yearly income of some
$500 is realizable in this manner.

3. Official permission to employ an attendance officer has been
obtained from the school board. This officer has been qualified and
appointed. For the time being, the committee is underwriting the

70 JOURNAL OF SOCIAL HYGIENE

salary of this employee until the obvious wisdom of the move
forces his support from public funds. A voluntary subcommittee
of social service workers has been set up to assist this officer.
Appreciable results in combating truancy and delinquency are
already evident. Among high school populations this is a major
venereal disease control measure.

4. The Negro community has been saturated with striking posters,
printed literature and word-of -mouth education. Two local Negro
newspapers have carried donated advertisements and have written
editorials about venereal disease control. Several mass meetings in
schools and churches with programs of films and explanatory talks
by medically qualified persons have been held. All this is a mere
beginning.

5. A course in supplementary general education for Negro Navy
personnel has been organized. Several school teachers of the
Booker T. Washington High School have volunteered to spend one
hour each per week for classes to be held every evening at the
high school. The curriculum is planned to consist of (1) arithmetic
and elementary mathematics, (2) American history, (3) English
composition and literature, (4) music appreciation, spiritual and
choir singing, (5) physical and sex hygiene.

6. The problem of pimping and facilitating activity by taxicabs
has been attacked. Bootleg taxicabs are being run off the streets
and licensed ones have been informed of O.D.T. action if they
do not remain legitimate. Clear-cut promises of obedience have
been obtained from individual taxi drivers and from their asso-
ciation as a body. As an immediate token of good faith, the cabs
are carrying venereal disease posters as a mobile display and
numerous cab drivers have made generous contributions to the
committee treasury.

7. A subcommittee consisting of a minister and two others have
been canvassing the neighborhood bars, dance halls, and suspicious
boarding houses with appeals for cooperation in venereal disease
control and warnings against offensive transactions. Preliminary
promises, which will be followed up, have been obtained.

8. A spirit of friendly competition has been created so that the
hitherto unorganized white population is starting to climb on the
venereal disease control bandwagon. Fraternal orders have sent
members as observers of this established group and have come
away amazed at its smooth, business-like proceedings. The local
commercial press has carried news items and a long commendatory
editorial. In general, the quickly attained prestige of the Negro
War-Time Health Committee has stimulated similar action far
and wide.

9. A delegate from the Negro War-Time Health Committee was
invited recently to attend a state wide conference on venereal
disease control at the Bethune-Cookman School at Daytona Beach,
Florida. This delegate returned as secretary-treasurer of a state

BIOGRAPHY OF A CIVILIAN COMMITTEE 71

committee and was further appointed editor of a projected monthly
publication.

Nothing flies so much in the face of hard won social betterment by
previous bitter social struggle and nothing insults human aspiration
so much as common cynicism that ordinary people are stupid, that
they cannot successfully conduct their affairs democratically, that they
must be led (read, usually misled) by guile or force. That is Nazi
Doctrine which is not absent from the formulations of even apparently
"good" lay people, some scientists and many public servants.

The formation and operation of this committee is a living refutation
of such authoritarian drivel.

The desiderata for successful committees of this sort seem to be :

1. A membership that knows, or is willing to learn, what the
nature of human problems is.

2. A membership that is willing to expend, seemingly sacrificially
and lavishly of time, energy and money commensurate with the
long term benefits it hopes to achieve.

3. An organizational solidity, resting on democratic procedure,
so perfectly run by elected officers and participating personnel
that problems are discovered, solutions planned and execution
instituted with verve and dispatch.

4. A philosophy of humanism that does not get riddled with
factionalism about specious argument of WHAT Is DESIRABLE. The
simple yardstick of the greatest good to the greatest number coupled
with the egalitarianism of "without regard to race, creed or color"
is readily available and automatically definitive. The sole questions
of debate are How TO Do WHAT Is DESIRABLE for the people,
rarely WHAT Is DESIRABLE, which is usually the song and dance
of a malicious Pied Piper. The latter formulation is the technique
of the premeditating confuser, the "superior" person who leads
into blind alleys. It is not even a question of How TO Do BEST
WHAT Is DESIRABLE because the continuous act of doing is a guar-
antee that the best method will be evolved in the long run.

5. Finally a modicum of technical guidance is desirable. A care-
ful qualification for this item is that technical advisors should not
be dictatorial, nor sectarian, nor dominating nor impatient when
the group is awkward or unskillful.

The prospects for such committees are enormously encouraging.
They make possible of realization the hope that another group of
diseases will be conquered by a public health effort, the only type of
effort that has conquered any disease hitherto.

The opinions or assertions contained herein are the private ones of the writers,
and are not to be construed as official or reflecting the views of the Navy
Department or the Naval Service at large.

VENEREAL DISEASE HEALTH EDUCATION PROJECT
FOR NEGROES IN TEXAS

BASCOM JOHNSON
Director in Charge, Dallas Office, American Social Hygiene Association

After favorable conference with the Commanding General and the
medical officers of the Eighth Service Command, with other Federal
officials and those of the departments of Health and Education of
Texas most concerned, the following letter was sent to eight Negro
leaders * in Texas, inviting them to serve as an Advisory and
Sponsoring Committee for this project, and to attend an organization
meeting in Houston on June 5th, 1943:

"In explanation of the telegram sent you today, the establishment
of the educational project therein referred to resulted from the
deep concern felt by health and educational leaders throughout the
country because of the high proportion of Negro selectees who had
to be rejected by the Army, the Navy, and their auxiliary services
because they were infected with syphilis or gonorrhea.

"As you are doubtless aware, also, the incidence of these diseases
among Negroes now in the armed services is far too high, and the
efficiency of our armed forces is seriously threatened thereby.

"It is known that many Negro leaders throughout the country share
this concern and, if given an opportunity, would be glad to do
what they could to remedy the situation.

"The American Social Hygiene Association is the national volun-
tary association which has studied this problem for thirty years,
and has promoted successfully, both nationally and locally, many
legislative, public health, and educational projects for the better
control of these preventable diseases.

"The Association has authorized me, as its representative in the
southwestern section of the country, to select and employ a Negro
educator for the three summer months to carry on an intensive
project of health education among Negroes on the nature, causes,
methods of spread, and cure of the venereal diseases.

"If this project is well received, demonstrates its value, and pro-
duces good results which are measurable, I shall recommend to my
association that it be continued after the three months' demonstra-

* Dr. Charles W. Pemberton, Houston ; Dr. J. M. Franklin, Prairie View ;
Mr. W. B. Banks, President of Prairie View College; Mr. Leslie J. White,
President of the Teachers Association of Texas, Longview; Dr. Henry E. Lee,
Houston; Mr. Joseph J. Ehoads, President of Bishop College; Dr. S. A. Pleasants,
Houston; Dr. Connie Yerwood, Texas State Department of Health.

72

VD EDUCATION PROJECT FOR NEGROES 73

tion period and extended to other areas in Texas and perhaps to
one or more of the other states which comprise the Eighth Service
Command.

"I hope very much that you will consent to serve on a committee
to sponsor this project and to advise on plans and policies to be
followed. The first meeting of the committee will be held in the
office of the City Health Officer of Houston (Dr. Austin E. Hill)
at 10 A.M., Saturday, June 5th.

"I hope to have selected, employed, and bring with me to the
meeting the Negro educator who will carry on this project under
the plans and policies that the committee may decide are most
likely to produce worthwhile results."

All except one of the Negro Advisory Committee invited accepted.
The one who declined did so because of ill health. Of those who
accepted, five attended on short notice and at their own expense the
organization meeting in Houston. One of the remaining two was
unavoidably absent from the city and the other was delayed so long
by late train connections that he gave up the trip.

To this meeting, also, were invited representatives of the State
Departments of Education and Health; Mr. Whitcomb H. Allen,
Regional Social Protection Representative, Federal Security Agency;
Dr. Thomas H. Diseker, Venereal Disease Control Officer, District
No. 9, U. S. Public Health Service; and Lieutenant Colonel W. C.
Summer, in charge of Venereal Disease Control, Eighth Service Com-
mand. All of these State and Federal officials had endorsed the
project but only Doctor Diseker was able to attend the first meeting.

At this first meeting, Mr. Caesar Francis Toles, teacher at Booker
T. Washington High School in Dallas, who had been well recom-
mended, was introduced to the Committee in the office of the City
Health Officer, Dr. Austin E. Hill, who presided and opened the
meeting with an excellent statement of the need for such a project
in Houston and his promise to assist and cooperate with it in every
way. I then read to the meeting the following extract from the
letter of appointment of Mr. Toles which defined the purposes and
objectives of the project and his duties in connection therewith:

Confirming our conversation concerning your employment by the American Social
Hygiene Association for health education work among Negroes this summer, the
purposes, objectives, terms and conditions of that employment are as follows:

The purposes are to acquaint as many Negroes as possible with the basic facts
concerning the venereal diseases, — how they are acquired, how they are spread,
and how cured; also their infectiousness and prevalence, and their menace unless
promptly discovered and adequately treated, to the lives and health of infected
individuals and to the continuity and solidarity of home and family life.

74 JOURNAL OF SOCIAL HYGIENE

The objectives are to encourage Negroes to avoid exposure to these diseases, to
take periodic tests, particularly blood tests for syphilis, to avoid exposing others
when found infected, to go to qualified doctors for treatment if infected, and
to continue treatment until cured.

You will be expected to carry out these purposes and objectives supplemented by
such detailed instruction and suggestion as to methods and procedures as the
American Social Hygiene Association or its local representative and the Advisory
Committee shall jointly determine are appropriate and desirable.

Each week during the three months, you will be expected to prepare and submit
to the American Social Hygiene Association and to the Advisory Committee
progress reports on the project, and at the end of the three months a final report
which shall contain statements of the work done and results accomplished.

On the basis of these reports and other data, the American Social Hygiene Asso-
ciation, in consultation with the Advisory Committee, will estimate the value of
the project and determine whether it should and can be continued.

There followed a general discussion in which most of those present
participated. It was made clear that Mr. Toles would be expected
to acquaint himself first hand, under the guidance of Dr. Hill and
his staff, with the basic facts concerning the venereal diseases, and
that he must then rely heavily on the Advisory and Sponsoring Com-
mittee to help him plan his work and to provide opportunities for
meetings which he would address and other contacts with those
Negroes who most needed venereal disease education.

The Negro Sponsoring Committee then met separately and privately
with Mr. Toles, made general plans, and elected its chairman and
other officers, including an executive committee to manage the details
of the project.

During my absence in the east, from which I returned early in
August, Mr. Toles had requested that he be authorized to transfer
his activities to Dallas. This request was approved, and he therefore
remained approximately five weeks in Houston, one week of which
he spent in gathering the necessary information at the Health
Department and its clinics.

During this four weeks, he addressed 12 groups of Negroes, aggre-
gating 1,600 persons. At some of these group meetings, he showed
the four motion pictures of the American Social Hygiene Association
entitled, With These Weapons, Health Is a Victory, Plain Facts, and
In Defense of the Nation, The groups included ministers, beauty
culturists, women's organizations, young peoples' groups, insurance
agents, and labor groups. At all meetings, the literature of the
Association was distributed.

The remaining six weeks of this three months' project were spent
by Mr. Toles in Dallas, and at four Negro summer schools and colleges.
During this period, some 25 groups were contacted, with audiences
aggregating approximately 12,000. In addition, the films of the
Association were shown to the general public at one of the commercial
moving picture theaters in Dallas on five separate days.

One concrete result of this project was the increase in the number
of Negroes who requested and obtained blood tests for syphilis in

75

both Houston and Dallas. The Health Officer of Dallas estimated
this increase over a comparable period as about 25 per cent. This
increase is believed to be fairly attributable to this project because
every audience addressed by Mr. Toles was urged to have such tests
periodically.

Another interesting fact brought out by the project was the very
general interest manifested in it by the Negro clergy who for the
most part cooperated wholeheartedly, and even set aside Sunday,
August 7th, as Social Hygiene Day, and preached special sermons
on the subject of venereal disease and incorporated in them material
furnished by Mr. Toles. To those who understand the immense
influence on the Negro people exercised by their ministers, their
support of the program is most encouraging.

In conclusion, I quote the general statement prefacing the final
report made by Mr. Toles and distributed to the Sponsoring
Committee :

For a long time, the high incidence of syphilis among Negroes has been known.
Explanations of how the Negro came to have the disease are beside the point.
The point is to teach him to do the things necessary to free himself from the
clutches of the disease.

Experiments in Macon County, Alabama, Albemarle County, Virginia, show that
wherever Negroes are intelligent and have access to good treatment, the incidence
of syphilis among them is the same or less than that of whites of the same
community.

So, the reason for the work done in Texas this summer is not far to seek. It is
felt that a program of education, along non-technical lines, will go a long way
toward solving the problem of venereal diseases in the Negro.

The wonder is that the problem was not tackled earlier. The need for the work
is obvious.

It will take a long-time program of education to achieve lasting results. We
must overcome superstitions, preconceived, wrong notions regarding cause and
treatment; we must overcome skepticism on the part of Negro leaders who feel
the Negro has been the scapegoat. Negro children in schools must receive
instruction on venereal diseases and personal hygiene. Negroes must learn that
' ' syphilis is a disease, not a disgrace. ' ' They must hear the social diseases
discussed at school, at home, at church, over the radio, in the newspapers.
Physicians must give blood tests as an integral part of any physical examination.
In short, every agency having to do with Negro community life must be pressed
into service. A start has been made; follow-up is needed now!

The final report was read by Mr. Toles to a group of Army, Navy,
Public Health Service, Federal and State officials who met in Dallas
on September 3d. The unanimous conclusion of this group was that
the project had demonstrated sufficient value to justify the American
Social Hygiene Association in continuing it for another year. Kecom-
mendation, therefore, to this effect was made to and approved by
the Board of Directors of the Association, with the understanding
that it would be expanded to include communities in the other states
in the Eighth Service Command. The State Health Officers in three of
these states, namely, Oklahoma, Arkansas and Louisiana have asked
for the loan of the Negro educator for a period of two or three months
in their states, and have agreed to pay his traveling expenses while
in their respective states.

CONFERENCE WITH NEGEO LEADERS ON WARTIME
PROBLEMS IN VENEREAL DISEASE CONTROL*

ABSTRACT OF PROCEEDINGS

The Conference with Negro Leaders on Wartime Problems in
Venereal Disease Control grew out of both governmental and volun-
tary discussions of next. steps leading toward reducing the number
of syphilis, gonorrhea and other venereal disease cases and preventing
new infections so far as possible.

It was recognized that these diseases attack people without dis-
tinction as to race, creed, color or national origin, and must in turn
be fought in the open by all the people. It was also recognized that
limitations of economic, social, medical and educational opportunities
and facilities conspire to give these diseases special opportunities
for spread among certain population groups, including Negro groups.
It was known, too, that the Negro citizens are' eager to do their
utmost to eradicate these diseases from the nation, as an aid in War
and for community life when peace is restored.

With these views in mind, it was proposed that the American
Social Hygiene Association arrange a Conference for consideration
of what might be done by united action at federal, state and local
levels, to reduce the venereal diseases as a serious handicap to Negro
health and efficiency. Accordingly, this Conference was held in New
York City, under the auspices of the Association in its national
office, November 22 and 23, 1943. A list of those attending is attached.
A Continuation Committee was appointed to follow up the Conference
recommendations. The Conference membership is being proposed as
a temporary section of the General Advisory Committee of the
American Social Hygiene Association.

Discussion centered about three major questions :

The prevalence and incidence of venereal disease among Negroes
and specific problems involved in the control program.

The part, in the solution of this problem, that Negroes themselves
can undertake through their voluntary organizations on a national,
state and local level.

The assistance that these voluntary groups will need from public
and private agencies on the national, state and local level.

* New York City, November 22 and 23, 1943.

76

CONFERENCE WITH NEGRO LEADERS 77

As an introduction to the section meetings which had been agreed
upon, the Chairman called upon the following members of the Con-
ference for general statements on current venereal disease problems
and the status of these diseases in relation to the armed forces, indus-
trial workers, and the civilian population generally. These speakers
pointed out how the facts, procedures, and programs to which they
alluded affected Negroes, and what the latter could do to advance
the campaign for eradication of these diseases.

Opening statement by Dr. Walter Clarke, Executive Director,
American Social Hygiene Association.

A general statement concerning the prevalence of venereal diseases
among Negroes by Dr. John R. Heller, Assistant Surgeon General,
Division of Venereal Diseases, United States Public Health Service.

Some specific problems resulting from the high rejection rate of
Negroes because of venereal diseases by Colonel Campbell C. John-
son, Executive Assistant, Selective Service System.

Current venereal disease infection rate among men in the Army
by Lt.-Col. Thomas B. Turner, Chief, Venereal Disease Control
Branch, Office of the Surgeon General, United States Army.

Current venereal disease rates among men in the Navy by Com-
mander W. Schwartz, Office of the Surgeon General, United States

Navy.

Law enforcement problems in Negro communities by Eliot Ness,
Director and Raymond F. Clapp, Associate Director, Social Protec-
tion Division, Federal Security Agency.

The Committee on Medical Facts considered and made recommenda-
tions covering the following:

A statement of facts on the prevalence and incidence of venereal
diseases among Negroes, suitable for release to Negro newspapers and
organizations.

The medical aspects of the venereal disease control program, taking
into consideration all phases of this problem specially relating to the
Negro population — such as the quality, quantity, availability and
use of medical facilities and personnel.

Financial resources available through federal, state and local agencies
for the improvement of such medical facilities and services.

The Committee on Social Facts addressed itself principally to
these topics:

A statement of progress in dealing with community conditions favor-
ing the spread of the venereal diseases.

Social protection policies and procedures of value, especially relating
to the Negro population.

78 JOURNAL, OF SOCIAL HYGIENE

Financial and administrative aids through federal, state and local
agencies for improving related social welfare facilities.

The Committee on Action adopted as a basis for discussion the
following points:

How can Negro voluntary organizations promote the venereal disease
control program?

What can official and voluntary agencies do to help these groups on
the federal, state and local levels?

The report of the Committee on Medical Facts was presented to
the Conference at the final session ~by the Chairman, Dr. T. K.
Lawless, with the following introductory remarks:

The venereal diseases are as old as the Middle Ages. The most
largely accepted history of the prevalence of syphilis is that it had
appeared in Europe in epidemic form in the fifteenth century and
was spread to other lands through military campaigns, explorations
and trade routes. There are other theories, but all emphasize the
distant origin of the disease.

From this period through succeeding centuries and years, syphilis
has infected, disabled and killed many millions of people of all
continents, nations, peoples and races. Gonorrhea, though less
dramatic in its origin and history, also is a very prevalent, serious,
disabling venereal disease. There are other serious venereal diseases
though less well known; such as chancroid, granuloma inguinale,
and lymphopathia venereum * which are also disabling to civilian
and military population.

The experience of the Negro people with communicable diseases
has been similar to that of the white people of the civilized world.
The present unfavorable position of the Negro, in the progress of
control and prevention of venereal diseases and rates of infection is
one of degree rather than of kind, for these diseases are a serious
problem in both races and in military as well as in civil life. In part,
this is due to disadvantageous social and economic conditions, to
limited opportunities for utilizing medical and public health services,
and in the case of syphilis, possibly to differences in susceptibility
and resistance to the infecting organism. However, the trend of
experience and control in the Negro population is following the
general pattern of the earlier experience of the white population.

The current prevalence of the venereal diseases in the nation, at
large, is of immediate interest, particularly because of the war
emergency and the military and industrial manpower needs, and
much attention and service is being directed to the problem of
venereal disease control and venereal disease education for all seg-
ments of the population and all sections of the country. Hence, it is
considered timely, desirable, and judicious to direct an adequate share
of attention and available personnel and facilities for prevention,

* Also frequently called lymphogranuloma venereum.

CONFERENCE WITH NEGRO LEADERS 79

treatment, and control, to the Negro population, which authori-
tatively and admittedly has at present a comparatively high rate
of venereal disease infection. The Negro should accept the oppor-
tunity and assume responsibility of contributing help and influence
from within the race to the solution of the problem and the
removal of whatever measure of stigma there is associated with it.
Obviously, the Negro cannot solve this problem alone. It can be
solved only by the support and action of the community as a whole.

Among recommendations with reference to medical aspects were:

A Manual of Facts : A manual of facts should be developed which
could be used by various organizations interested in the reduction
of venereal diseases.

Training of Professional Personnel: Much progress has been
made in the training of Negro professional personnel for venereal
disease control. However, there is yet a great need for competently
trained individuals, and every attempt should be made to increase
their numbers and facilities for training.

This training of Negro personnel should not be limited to
physicians only, but should apply to all personnel that may be
connected with this program, such as nurses, health educators,
social workers and laboratory technicians.

Employment of Negro Professional Personnel: Negro physicians,
nurses, and others are being employed to some extent in venereal
disease control programs. It is the opinion of the committee that
this should be continued and expanded as rapidly as possible. In
the employment of Negro professional personnel, consideration
should be given to their training, experience and interest. Where it
exists, the Merit System should be used to govern all appointments.

Medical Services: Intensive support should be given to the
private practitioner:

Provide opportunities for post-graduate training both on the level
of refresher courses and more especially on the level of formal
university matriculation and training.

Provide drugs and laboratory facilities for indigent people, irre-
spective of location.

Provide for expert advice and counsel in complicated cases.
Provide for adequate follow-up services.

Progress has been made toward the provision of adequate medical
facilities for diagnosis and treatment for Negro and white patients
so that today there are over 3,800 treatment centers in this country.
The major responsibility for developing comprehensive venereal dis-
ease programs rests with the state and local official agencies and,
therefore, they should provide the best medical services for all groups.

80 JOUKNAL OP SOCIAL HYGIENE

Health education opportunities for patients should be provided at
all treatment sources.

Financial Resources: The committee reviewed the available
funds for development of venereal disease control programs, and
suggested that every effort should be made by health departments
to adapt their programs in terms of the various groups in the popu-
lation, and to allocate funds on the basis of actual needs rather
than on any basis of population ratios and other less important factors.

The Report of the Committee on Social Facts was introduced by the
Chairman, Judge John M. Goldsmith, and presented by the secretary,
Thomas A. Larremore. Among the conclusions with reference to
social aspects were :

The committee concluded, from an overall standpoint, that not
enough real progress has been made, with respect to controlling
community conditions favoring the spread of venereal disease to
justify any statement about such progress.

Basically, the high venereal disease rate among Negroes is due to
socio-economic factors, the correction of which will require time and
involves questions beyond the purview of this Conference. Never-
theless, there are more immediate causes, many of which are suscepti-
ble to remedial action at this time.

Among the more immediate causes of high venereal disease rates
among Negroes are the following:

Low wage income in the Negro population group; the necessarily
large employment of mothers; and the resulting heavy dislocation
of the family group, exposing the children to unguarded adolescent
relations.

The low level of educational advantages available to the Negro
population, with resulting wide-spread illiteracy and near illit-
eracy, and a lack of specific information concerning the venereal
diseases.

An attitude of defeatism toward the problems of venereal disease
control on the part of many white community leaders and of
frustration among leaders in the Negro community.

Failure to enlist the support of the intelligent and able Negroes
in each community for venereal disease control, and failure to
develop effective collaboration between white and Negro leaders.

Inadequate housing, recreational and other community facilities
for Negroes; also inadequate recreational and temporary-lodging
facilities for Negro members of the armed forces on leave or liberty.

Failure to enforce laws against commercialized prostitution and
allied activities in Negro communities. This is caused largely by
a failure of law enforcement officials to practice a single standard

CONFERENCE WITH NEGRO LEADERS 81

of law enforcement, and to give appropriate training to law-
enforcement personnel, in the problems and methods of law
enforcement as related to Negro communities.

Insufficient utilization of Negro personnel in medical, educational
and law enforcement aspects of the venereal disease control program.

The Report of the Committee on Action was introduced by the Chair-
man, Forrester B. Washington, who summarized the discussions of
ways and means of informing the public and securing their active
participation. The need for coordination in planning and carrying
out programs was emphasized in the recommendations submitted by
this Committee.

In addition to approving a small Continuing Committee, the Con-
ference adopted the following general observations:

Considerable money is now available, through Federal and volun-
tary agencies, with which to effect a substantial improvement in
various factors mentioned in the foregoing paragraphs, provided this
money is allocated and used according to demonstrated need.

Improvement is needed in administrative practices in order to
insure the most effective utilization of these funds at the local level.

There should be Negro representation on the Board and staff of
organizations both voluntary and official, which are concerned with
planning and policy making in the field of venereal disease control.

ASSIGNMENT TO SECTIONS

Section A — Medical Facts: Chairman, Dr. T. K. Lawless; Secretary, Dr. Paul
Comely; Dr. Eoscoe Brown, Dr. Walter Clarke, Dr. John E. Heller, Colonel C.
Johnson, Dr. John Kenny, Dr. Oma Price, Dr. T. M. Smith, Mrs. Mabel K.
Staupers.

Section B — Social Facts: Chairman, Judge John M. Goldsmith; Secretary,
Thomas A. Larremore; Dr. Eoseoe Brown, Dr. George Haynes, Colonel Campbell
C. Johnson, Paul M. Kinsie, Eliot Ness, Commander W. H. Schwartz, John
Sengstacke, Lt.-Col. Thomas B. Turner.

Section C — Action Facts: Chairman, F. B. Washington; Secretary, Blake
Cabot; Mrs. Mary McLeod Bethune, Ambrose Caliver, Raymond F. Clapp, Judson
Hardy, Dr. Mordecai Johnson, Dr. Jesse Jones, Vinita Lewis, Dr. Edgar Love,
Philip Mather, Mrs. Eleanor Brown Merrill, John Eagland, Bishop E. E.
Wright, Jr.

MEMBERS OF CONTINUATION COMMITTEE

Mrs. Mary McLeod Bethune John A. Sengstacke

Dr. Paul Comely, Secretary Mrs. Mabel K. Staupers

Colonel Campbell C. Johnson Lt.-Colonel Thomas B. Turner

Dr. Mordecai Johnson F. B. Washington

Dr. T. K. Lawless Bishop B. E. Wright, Jr.
Dr. William F. Snow, Chairman

82

JOURNAL OF SOCIAL HYGIENE
LIST OF CONFERENCE MEMBERSHIP

1. **Bethune, Mrs. Mary, President,

Council of Negro Women; Wash-
ington, D. C.

2. *Bray, Bishop James A., Presi-

dent, Fraternal Council of Negro
Churches in America; Chicago,
Illinois.

3. Brown, Dr. Roscoe, Senior Health
Education Specialist, U. S. Public
Health Service; Washington, D. C.

4. Browning, Charles P., National
Representative of Chicago De-
fender; Chairman, Board of Di-
rectors, P.E.P. (Negro Press
Trade Journal) ; Chicago, Illinois.

5. Cabot, Blake, Acting Director,
Public Information Service, Amer-
ican Social Hygiene Association;
New York, N. Y.

6. Caliver, Ambrose, Specialist, Of-
fice of Education; Washington,
D. C.

7. Clapp, Eaymond F., Associate Di-
rector, Social Protection Division,
Federal Security Agency; Wash-
ington, D. C.

8. Clarke, Dr. Walter, Executive Di-
rector, American Social Hygiene
Association; New York, N. Y.

9. **Cornely, Dr. Paul B., Head, De-

partment of Bacteriology, Pre-
ventive Medicine and Public
Health, Howard University ;
Washington, D. C.

10. Goldsmith, Judge John M., Le-
gal Consultant, Social Protec-
tion Division, Federal Security
Agency ; Chairman, Committee
of Social Protection, American
Bar Association ; Washington,
D. C.

11. *Guild, Dr. St. Glair, Director of

Special Programs, National Tu-
berculosis Association; New York,
N. Y.

12. Haynes, Dr. George, Secretary,
Department of Race Relations,
Federal Council of Churches of
Christ in America; New York,
N. Y.

13. Hardy, Judson, Education Officer,
U. S. Public Health Service;
Washington, D. C.

14. Heller, Dr. John R., Assistant
Surgeon General, U. S. Public
Health Service, Washington,
D. C.

15. *Hinton, Dr. William A., The

Boston Dispensary, Boston, Mass.

16. ** Johnson, Col. Campbell C., Ex-

ecutive Assistant, Selective Serv-
ice System, Washington, D. C.

17. * Johnson, Dr. Charles, Director,

Department of Social Sciences,
Fisk University ; Nashville,
Tenn.

18. ** Johnson, Dr. Mordecai, Presi-

dent, Howard University; Wash-
ington, D. C.

19. Jones, Dr. Jesse, Director,
Phelps-Stokes Fund; New York,
N. Y.

20. Kenney, Dr. John, Superintend-
ent, John A. Andrews Memorial
Hospital, Editor of the N. M. A.
Journal; Tuskegee Institute,
Ala.

21. Kinsie, Paul M., Director of
Field Studies, American Social
Hygiene Association; New York,
N. Y.

22. **Lawless, Dr. T. K., Dermatologist

and Consultant, Provident Hos-
pital, Chicago, 111.

23. Larremore, Thomas A., Legal
Consultant, American Social Hy-
giene Association; New York,

N. Y.

24. Lewis, Vinita, Consultant in So-
cial Services, U. S. Children's
Bureau; Washington, D. C.

25. Love, Dr. Edgar, Director, Divi-
sion of Negro Workers, Board
of Church Missions of the
Methodist Churches; New York,
N. Y.

* Those who telegraphed inability to attend because of illness, travel difficulties

or unexpected government orders.
** Those named to serve on the Continuation Committee.

CONFERENCE WITH NEGEO LEADERS

83

26. Mather, Philip R., Chairman,
War Activities Committee, Amer-
ican Social Hygiene Association;
Boston, Mass.

27. Merrill, Mrs. Eleanor Brown,
Executive Director, National So-
ciety for the Prevention of Blind-
ness; New York, N. Y.

28. Ness, Eliot, Director, Social Pro-
tection Division, Federal Security
Agency; Washington, D. C.

29. *Paige, Judge Myles A., Court

of Special Sessions; New York,
N. Y.

30. *Poston, Theodore, Consultant,

Office of War Information;
Washington, D. C.

31. Price, Dr. Oma, Epidemiologist,
Bureau of Social Hygiene, De-
partment of Health; New York,
N. Y.

32. Ragland, John M., Specialist in
Social Protection, Social Protec-
tion Division, Federal Security
Agency; Washington, D. C.

33. *Riddle, Mrs. Estelle Massey, Con-

sultant, War Nursing Council;
New York, N. Y.

34. Schwartz, Commander W. H.,
Bureau of Medicine and Surgery,
United States Navy; Washing-
ton, D. C.

35. **Sengstacke, John A., President,

Negro Publishers Association ;
Managing Editor, Chicago De-
fender; Chicago, 111.

36. Smith, Dr. T. M., President,
National Medical Association ;
Chicago, 111.

37. **Snow, Dr. William F., Chairman,

Executive Committee, American
Social Hygiene Association; New
York, N. Y.

38. **Staupers, Mrs. Mabel K., Ex-

ecutive Secretary, National Asso-
ciation of Colored Graduate
Nurses; New York, N. Y.

39. **Turner, Lt. Col. Thomas B., Chief,

Venereal Disease Control Branch,
United States Army; Washing-
ton, D. C.

40. ** Washington, F. B., Director,

Atlanta University School of
Social Work; Atlanta, Ga.

41. **Wright, Bishop R. R., Jr., Ex-

ecutive Director, Fraternal Coun-
cil of Negro Churches in
America; Wilberforce, Ohio

* Those who telegraphed inability to attend because of illness, travel difficulties

or unexpected government orders.
** Those named to serve on the Continuation Committee.

SEX EDUCATION IN SCHOOL PROGRAMS ON HEALTH
AND HUMAN RELATIONS

MAURICE A. BIGELOW

Chairman, Committee on Education, American Social Hygiene Association
Professor Emeritus of Biology, Columbia University

NOTE: The following is little more than an outline of the present trends of
education which relates to sex in human life. There are hopeful signs that such
education which has long been neglected is coming to have an important place
in broad programs of education for more helpful understanding and management
of the inevitable human relations — biological, mental and social.

It is now accepted by many competent educators that the essentials
of sex education should be taught as integral parts of programs on
health and human relations. This statement obviously gives no basis
for use of the term " human relations" as a new name or euphemism
for social hygiene or sex education. It should be clear that " human
relations" includes much more than "sex relations," and that school
programs in health and human relations offer opportunities for
integration of the important topics selected from the field of the
larger sex education.*

The larger sex education or social hygiene education has long
included the biological, hygienic, mental and social relations of the
two human sexes. Either name is quite satisfactory for use in dis-
cussions of education relating to sex, but both have failed to win
general approval as designations for school programs. Meanwhile
in the past twenty-five years a considerable amount of the desirable
sex education, without names that suggest ' ' sex " or ' ' social hygiene, ' '
has been developing in many schools as integrated and incidental
studies. Most such instruction is connected with units or courses in
biology, health education, social studies and family life education.
Such school work which as "science" deals with the biological,
hygienic, mental and social relations of men, women and children has
the approval, at least in principle and outlines, of many prominent
parents, teachers and religious leaders.

We now need better organization, correlation and especially admin-
istration of education for improving education in health and human
relations connected with sex in human life. In short, the time is

* This point of view was stated by Bigelow in a paper entitled Human Relations
Education in School and Society, Vol. 54, pp. 499-500, November 1941. Keprints
are still available, free, in the office of the American Social Hygiene Association.

See also Notes 1 and 2 at end of this article.

84

SEX EDUCATION IN SCHOOL PROGRAMS 85

ripe for rapid advance in teaching the essentials of sex education,
without the name, as an integral part of school programs in health
education and human relations education. This is a logical plan
because the major part of the desirable instruction bearing on the
relations of the sexes deals with physical and mental health and
with the human relations (biological, mental and social) in personal
and family life.

The first radical step towards re-organization of sex education
came about 1940 when many leaders in public health education agreed
that the venereal diseases should be placed in health education as
communicable diseases. Thus the "new sex education," without VD,
was left with the normal aspects of sex as the center of interest.
Gradually in the past three or four years it has come to be recog-
nized by many leaders in education that these normal aspects are
topics which belong in what we are rapidly coming to call programs
of education in health and human relations. These recent changes in
terminology and planning of school curricula may be summarized by
the following outline:

*. A- *- in Health EduraUo°

(see A and B below)

The sub-headings A and B in the outline above emphasize the fact that only
certain topics in Health Education and in Human Eelations Education are
directly connected with Sex Education. Obviously, "education in health and
human relations" should be used to designate broad programs of studies, and
not a new name for sex education.

A. Sex Education topics in Health Education

Personal sex hygiene — health as affected by normal functioning of
the reproductive organs.

Venereal diseases — health as affected by these communicable diseases.

(This second topic is covered by the recently published special unit
on Some Dangerous Communicable Diseases, which includes in two
or three lessons the essential facts about venereal diseases which
maturing youth ought to know.)

B. Sex Education topics in Human Relations Education

The significant topics concerning the normal relations of the sexes
are biological, mental and social. These are primarily personal or
individual, but they naturally lead towards a center in family life.
Hence, in planning the teaching concerning sex, in the larger sense, in
programs of Human Relations Education, we must present the bio-
logical, the mental and the social relations of the sexes with due
regard for the interests of the individual and of the family.

86 JOURNAL, OF SOCIAL HYGIENE

Outlines of Human Relations Basic to Sex Education

I. Biological relations (Heredity and Eugenics, Biology of Reproduction,

Biological Basis of the Family).

II. Mental-social relations (A fertile field which is not yet well cultivated in
schools. Education for inter-personal relations is desirable as foundation
for family social relations). •

III. Family-social relations (This should be the center of family-life courses
and books for schools and colleges; but many of these still neglect opportuni-
ties for integrated studies in biological, and mental-social relations, I and II)-

Supplementary Notes

1. The ASHA Committee on Education, is watching with great
interest school programs which are officially designated Health and
Human Relations in some public schools, especially in Lexington,
Kentucky, and in Philadelphia, Pennsylvania. A preliminary report
on Lexington schools was issued in March, 1943. In Philadelphia, a
Preliminary Statement was issued by the office of the Superintendent
of Public Education in November, 1943 (Educational Bulletin No. 3).
This states that the title Health and Human Relations was chosen as a
broader term for a program or curriculum "designed to develop in
every child and adolescent sound emotional attitudes and patterns of
conduct in the entire realm of sex and social living." While many
facts of social hygiene are important in education, "they are in
reality incidental to the larger program and can best be approached
as a part in the general panorama of wholesome living in its widest
aspects."

2. Referring to the first paragraph concerning broad use of the
term human relations: The fields of science which are obviously most
concerned with the human relations that are most important for
general educational programs are social biology (biology applied to
human relations), sociology, cultural or social anthropology, psy-
chology, human geography, political and economic science.

3. The idea that education concerning normal relations or behavior
of the sexes should be an integral part of a program in human rela-
tions has been suggested, in essentials, by several workers in the social
sciences. In particular, the present writer acknowledges that his
thinking has been influenced most by the views of human relations
advanced by Professor Malinowski, founder of the "functionalist
school" of anthropology, according to which human behavior is based
upon biological mechanisms, whose reactions may be modified pro-
foundly by social or cultural environment. As I understood Mali-
nowski through his writings, lectures, seminars and personal contacts
between 1930 and 1940, he was interested in the sex education of the
social hygiene movement in England and America because it was
part of human relations in functional anthropology. We agreed that
an approach through human relations in general would be the most
logical and acceptable basis for sex education. We also agreed that
study of the biology of human behavior should be the foundation for
study of human relations, including sex ; and that competent teachers
of biology, sociology and anthropology should collaborate in trying to
develop a course on human relations for youth of the later teens and

SEX EDUCATION IN SCHOOL PKOGEAMS 87

early twenties. It may be more than a dream that within the next
dozen years the present rather narrow family relations courses may
develop under the guidance of adequate books and broadly trained
teachers into courses deserving the name human relations, and attrac-
tive to youth of both sexes.

4. It must be obvious to any reader of the foregoing outlines that
human relations education belongs in general education, and concerns
social hygiene in the broadest sense only as it deals with the rela-
tions of the sexes. But even this limited phase of human relations is
not a monopoly of social hygiene; for other fields, such as anthro-
pology, biology, psychology and sociology deal extensively with sex.

It also should be noted that human relations are more social educa-
tion than health education (as that is organized in America). It,
therefore, is quite undesirable that there should be any official merg-
ing of human relations under departments of health in governmental
agencies and in educational institutions.

5. It is especially important that the developing movement for
education in normal human relations should be dissociated from
venereal disease control education. Such association came from the
fact that organized sex education had its origin during the first
decade of this century in the international movement for control
of venereal diseases by applying all possible measures, one of which
was sex education in its social aspects. As indicated in a preceding
part of this paper, the connection between venereal diseases and
normal human relations was broken when public health educators
recognized that for most efficient teaching these diseases should be
grouped with the others which are communicable. However, it
appears that there is still great danger of confusion resulting from
the fact that many leaders and agencies in public health and social
hygiene are continuing to emphasize the social side of sex education
as one essential measure for prevention of disease, by promoting
standards of conduct. This should not be taken as meaning that
venereal disease control continues to be the center, or even an integral
part, of the studies of human relations which concern sex. Moreover,
the fact that national and local agencies for public health and
social hygiene continue to encourage social education that makes
for approved sex conduct ("sex-social education" of yesteryear and
"human relations education" of tomorrow) does not mean that
these agencies are claiming for their own fields what is clearly a
part of general and liberal education. On the contrary, it is
indeed fortunate that such health agencies have a limited margin
of funds which can be devoted to a phase of social health which
affects their special problems.

6. Since human relations education has elements which attract the
interest of many educational organizations and agencies, we need a
national council or permanent conference for developing cooperation.
We have such a national conference for cooperation in health edu-
cation, but it does not include the social scientists who must have a
large measure of responsibility in human relations education. Here
is a proposition which seems to deserve careful examination in the
early post-war years.

NEW PROBLEMS IN THE CONTROL OF
SYPHILIS AND GONORRHEA

CARL A. WILZBACH, M.D.
Commissioner of Health, Cincinnati, Ohio

There are many phases of the seeming breakdown during this
war period in the controls and restraints of adolescent boys, girls,
and older youth. These phases include social, economic, educational,
religious, law enforcement, health, and others. All agencies con-
cerned with these divisions of life should help solve these problems.
Above all, parents must be called upon to assist in correcting what
has been said to be a weakness in the modern family.

The Board of Health's chief concern is preventing the spread of
disease and protecting the public health. During the War Emer-
gency, Boards of Health have imposed upon them, by the Army, the
Navy, the Selective Service, the United States Public Health Service,
and the State Departments of Health, additional obligations for
keeping down the rate of syphilis and gonorrhea in the civilian popu-
lation and of preventing the spread of these diseases to the men of
the armed forces.

New Problems

Reports of men infected with syphilis or gonorrhea after passing
through Cincinnati are reported to the Fifth Service Command and
then through the Ohio State Health Department to the local health
department. For Cincinnati the number of men reported to have
been infected will vary from twenty to as many as sixty-five per
month. Information is also furnished such as name, place of meeting
and exposure, as well as whether or not the girl was a pick-up, friend
or professional prostitute, and other data.

A study of these War Department reports shows that for Cincinnati
about 80 per cent of the men were infected by "pick-up girls," or
"friends," that exposure many times occurred in private homes,
rooming houses, and automobiles, and that no fee was paid to the
sexual partner. Less than 10 per cent of the infections were received
from paid prostitutes. When these girls are examined at the request
of the Army and Navy, many of them are young girls 15 to 17 and
18 years of age, and more than 60 per cent have syphilis, gonorrhea,

88

NEW PKOBLEMS IN THE CONTROL OF VD 89

or both of these diseases. Some of the girls are older, but are not
known prostitutes.

This situation is new, it requires different methods for dealing with
it and many of the measures required go beyond the normal functions
of the Health Department and are baffling to the law enforcement
authorities.

Cincinnati is by no means unique in this respect. Similar condi-
tions exist in most large communities in the United States. About
the same conditions exist also in Great Britain, and Australia has
a higher rate of infection by non-prostitutes than Cincinnati.

Another factor which has made Cincinnati's problem greater has
been the large number of troops and men passing through the city.
Informed railroad authorities say that Cincinnati is one of the large
railroad centers, and a terminal point where changes are made on the
same railroad and from one railroad to another. Frequently, large
numbers of men arrive in the morning and leave at night, or they
reach the city in the early evening and leave in the early morning
hours. This arrangement allows, in some instances, five or six hours
' ' lay-over. ' '

The Task

The task and methods of the Health Department for preventing the
spread of syphilis and gonorrhea have been well understood for years,
but were reemphasized by the Surgeon General of the United States
Public Health Service when he started his campaign to stamp out
syphilis in 1937. They are : "Find the infected men and women with
syphilis and gonorrhea, get them under treatment promptly, and
render them non-infectious as soon as possible. Learn of other con-
tacts; find and treat them in a like manner." In time of War,
because of the thousands of manpower days lost to the Armed Forces
and to workers producing critical war materials, it is vital that every
effort be made to keep these diseases to a minimum in the civilian
population, as well as in the Armed Forces. Strict regulation and
control of these diseases in the Army and Navy are in effect. That
these joint efforts have been successful is shown by the fact that the
Army reports only 25 cases per one thousand men. The Navy
reports comparable figures. These are the lowest records for venereal
disease in the history of the Armed Forces.

Neither can we ignore the effects of syphilis on mothers and the
children of the future. Modern treatment has made it possible to
get these diseases under proper treatment and control more speedily.

90 JOUENAL OF SOCIAL HYGIENE

If discovered in time, it is possible for the expectant mother having
syphilis to bear a perfectly normal child and herself be improved in
health. With the untreated syphilitic pregnant woman, the results
are shocking. On the average, in 100 untreated syphilitic expectant
mothers the results will be 50 abortions, 25 still births, and 25 living
defective babies; some blind, some deaf, some crippled and badly
handicapped. Now with the advances in medicine and allied sciences
and with proper treatment of the mothers with syphilis, there will
result more than 95 normal healthy babies out of each 100 pregnancies.
This indicates what can be done when we find persons with syphilis
and are able to treat them properly.

Sow the Task Is Done

In protecting the service men from syphilis and gonorrhea, the
Military Police have been most cooperative. Military authorities at
Fort Thomas have assigned a detail of Military Police to duty at the
Union Railroad Terminal and at the Bus station. Two prophylactic
stations are operated on a twenty-four hour basis.

The Chief of Police and his Department have always assisted fully
with law enforcement measures as well as with health measures. More
recently a Crime Prevention Bureau has been established to deal with
certain phases of this problem.

The Police Court Judges have also been most understanding and
have helped wherever it has been possible to do so under the law.

The Public Welfare Department has recently developed a pre-
ventive program directed to girls and young women.

The Quarantine Hospital, with Dr. Jerry Lavender as the Head
Physician, is an important cog in the machinery dealing with the
control of these infectious diseases. More than 500 men and women
with syphilis and gonorrhea are quarantined each year.

The Juvenile Court is the recognized agency for dealing with
juvenile delinquency. The Judge of the Juvenile Court and his able
assistants can always be depended upon to assist with juvenile boys
and girls.

The voluntary social agencies of the Community Chest have like-
wise helped in this work. A conference was held in the Safety
Director's office a few months ago, and representatives of all these
agencies agreed to assist with the rehabilitation of the girls and women
discharged from the Quarantine Hospital.

NEW PROBLEMS IN THE CONTROL OF VD 91

Col. C. C. Sherrill, former City Manager, has been keenly interested
from the start of the program and was responsible for bringing many
of these groups together. With his backing many matters dealing
with various city departments concerned with this problem were
expedited.

The City Council has also supported the efforts of the Board
of Health whenever funds were requested for medical and nursing
services associated with the treatment of the venereal diseases.

Cincinnati has been dealing successfully with the control of syphilis
and gonorrhea for many years and is known elsewhere as a progres-
sive city in this respect. In the control of syphilis in Industry,
Cincinnati is rated as one of the leaders in this country. We have had
for some 27 years an active Social Hygiene Society which, in coopera-
tion with the American Social Hygiene Association, brought to the
city the best methods used in the United States and in other parts of
the world for controlling syphilis and gonorrhea. They have cooper-
ated with the Health Department, the law enforcing officers, and
have carried on an extensive, sensible, and effective sex education
program in the schools and in the community at large.

Cincinnati has received Federal and State venereal disease funds.
In addition, the city has furnished through its Health Department,
its Out-Patient Dispensary, and its Quarantine Hospital, fairly ade-
quate facilities for treating syphilis and gonorrhea. The city has
also provided salaries for doctors, nurses, stenographers, and clerks
operating the clinics. The public and voluntary agencies have estab-
lished for children and adults, 37 weekly clinics for treating syphilis
and 23 weekly clinics for treating gonorrhea. All chronic cases
are tabulated and reported to the Health Department for check and
follow-up investigations when necessary. An effective program of
follow-up of contacts and suspects has been established using one
head nurse as supervisor, 41 public health nurses, sanitary officers,
and the city police.

Conclusions

The problem in the past has been mainly the known prostitute who
has been declared legally and medically to be a prolific source of
syphilis and gonorrhea. But today we are dealing with young girls,
many of them of adolescent age and some older ones whose activities
are often unknown to their parents.

92 JOURNAL, OF SOCIAL, HYGIENE

To meet these new hazards, Health Departments should ask for
the help of parents, of church, of lay groups, and of interested
individuals. There should be additional assistance from the City,
State, and Federal Government Departments, as well as from volun-
teer social and welfare agencies in meeting this situation. Boards
of Health must give full and complete cooperation to the law enforce-
ment agencies whose job it is to deal with the legal phases of this
problem.

Finally, in order to prevent the spread of syphilis and gonorrhea,
the infected individual must be found promptly, treated, and rendered
non-infectious.

EDITORIAL

HEALTH EDUCATION AND HEALTH EDUCATOES

This number of the JOURNAL contains unusually interesting
articles and constructive suggestions about health informa-
tion and promotion activities. A recent report * of the
American Public Health Association speaks of health educa-
tion rapidly becoming recognized as one of the important
fields of service in the modern public health program. "The
health educator assists in helping people to become intelli-
gently aware of individual and community health problems
and to share the responsibility for their solution. He inter-
prets health needs, desirable health behavior, and the serv-
ices of professional health agencies. Successful health edu-
cation can rarely be accomplished by the use of publicity
technics alone. It almost always includes the development of
satisfactory learning, experiences within organized groups,
and the training of other public health personnel to aid them
in improving the educational opportunities presented by their
contacts with individuals."

The report also significantly points out that the health
educator in the health department works under the adminis-
trative leadership and direction of the health officer, while the
health educator working in the school system as a teacher,
supervisor, or consultant, is a member of the staff of the
school and will, of course, meet whatever professional edu-
cational standards are set by the school for the type of work
involved. It is recognized that health educators may be
employed jointly by health departments and school systems ;
and that they are also employed by voluntary agencies. But
the educational qualifications of a health educator, whether
employed by a governmental or by a voluntary agency,
should meet generally accepted standards. The Committee
on Professional Education has rendered a great service in
studying this problem of health education and personnel
needs.

* The Educational Qualifications of Health Educators, approved by the govern-
ing council of the American Public Health Association, October 23, 1943.

93

94 JOURNAL, OF SOCIAL HYGIENE

Teamwork of health departments and schools and volun-
tary agencies is of great importance to the social hygiene
program. The home and church organizations, as well as
those concerned specifically with health and welfare need to
be included. The capable leadership of religious groups and
the influence of home and family life are guiding forces of
inestimable value. Particularly are such forces important in
promoting and safeguarding constructive sex education and
counselling on social problems arising out of relations of the
two sexes in schools and community activities.

An essential task in which all these agencies must take
part, is to educate and help the individual so to direct his
conduct that his sex endowment, like the other parts of his
mental and physical equipment, may contribute most r.ichly
to self-development and successful living, and at the same
time conserve the welfare of society.

An equally important task is the moulding of public
opinion to support such modification and adjustment of
community approval and regulation of sex conduct that the
average individual may have opportunity to achieve in his
lifetime normal adolescence, satisfactory marriage, whole-
some family life, and wise parenthood. Changing social,
economic and other conditions of present-day living are limit-
ing or endangering these opportunities for millions of our
youth and children.

The preservation of the family and enrichment of family
life for all its members are of major concern to the American
people not only in the field of social health, but equally in
relation to individual and public health. We are in the midst
of war, and necessarily measures against the venereal dis-
eases claim priority of attention from health officers and
health educators, in promoting social hygiene activities in
1944; but plans can be laid now for expanding our work on
these other tasks when peace is restored. There is no con-
flict of interest or program in this. In fact even the campaign
against the venereal diseases cannot fully succeed without
achievement of success in the moral, social and educational
programs, which are so closely related to health conservation
activities in the social hygiene field.

NATIONAL EVENTS

REBA RAYBURN

Washington Liaison Office, American Social Hygiene Association

National Voluntary Agency Executives Discuss Social Hygiene
Problems. — Thirty executives of national voluntary agencies met
at a luncheon in Chicago on December 15 at the Palmer House as
guests of the American Social Hygiene Association, to discuss the
participation of their groups in social hygiene programs and activi-
ties. The organizations represented include some of the largest civic,
professional and social work groups having their headquarters in or
near Chicago. Dr. Bertha Shafer, Executive Director of the Louis E.
Schmidt Foundation, presided at the meeting; and speeches were
given by Dr. Walter Clarke, ASHA Executive Director ; Mrs. Horace
B. Ritchie, Chairman, Public Welfare Committee, General Federa-
tion of Women 's Clubs ; and Dr. Harriet S. Cory, Executive Secretary
of the Missouri Social Hygiene Association. Brief talks were also
given by Mrs. W. A. Hastings, President of the National Congress of
Parents and Teachers; Douglas Timmerman, Executive Vice Presi-
dent, U. S. Junior Chamber of Commerce; and Eleanor Shenehon,
Director, ASHA Division of Community Service.

A statement distributed at the luncheon, Social Hygiene: A
Cooperative Program, described the various ways in which national
voluntary agencies concerned with health, welfare, education, pro-
tection of children and the conservation of family have participated in
social hygiene activities by setting up social hygiene committees,
including social hygiene and health and welfare programs; by adopt-
ing resolutions in support of some part of the social hygiene program,
by distribution of literature, publication of articles in the field of social
hygiene ; and in other ways. Among executives in attendance were :

Mabel F. Meek, Secretary-Treasurer, and Lucille Hecht, Editor, Altrusa Clubs,
Inc.; Leona Massoth, Executive Secretary, and Dora Goldstein, American Asso-
ciation of Schools of Social Work; Dr. Howard Miller, American Dental Associa-
tion; R. B. Corbett, Secretary, American Farm Bureau Federation; Byron C.
Hopkins, Editor of American Library Association Bulletin, American Library
Association; Thomas G. Hull, Bureau of Health Education, American Medical
Association; Mrs. S. M. (Evelyn Millis) Duvall, Director, Association for Family
Living; Mrs. Charles W. Sewell, Administrative Director, Associated Women of
the American Farm Bureau Federation; Mrs. Frances H. Higgins, Chairman, and
Josephine Dayo, Chairman-elect, Committee on Unmarried Parenthood; Mrs.
Horace B. Ritchie, Chairman, Public Welfare Committee, General Federation of
Women's Clubs; Walter Ingram, Manager, Service Department, Kiwanis Inter-
national; Guy A. Edgar, Assistant Secretary, Lions International; Mr. Troegger,
National Committee on Boys and Girls Club Work; Mrs. W. A. Hastings, Presi-
dent, and Ruth Bottomly, Director of Office, National Congress of Parents and
Teachers; Mrs. Helen E. Tyler, Managing Editor of The Union Signal, and
Regina Moede, National Woman's Christian Temperance Union; Douglas H.
Timmerman, Executive Vice President, and Harold Herman, Secretary, United
States Junior Chamber of Commerce; George Gould, ASHA Legal Consultant;
Charles E. Miner and Wade T. Searles, ASHA Field Representatives.

95

96 JOURNAL OF SOCIAL HYGIENE

Social Hygiene Day Contest for Negro Colleges.— One hundred and
ten Negro colleges all over the country have received announcements
of a contest for the best Social Hygiene Day project by any group or
groups of students. First, second, third and fourth prizes will be
awarded by the American Social Hygiene Association, which is spon-
soring the contest in cooperation with the National Student Health
Association. Dr. Paul B. Comely, Executive Director of the National
Student Health Association, to whom all entries are to be sent, at
Howard University, Washington, D. C., announces the following rules
and regulations :

1. The National Social Hygiene Day Contest is opened to all Negro colleges.
This is a contest for the college student body as a whole rather than for indi-
vidual students; and therefore classes, clubs, organizations, etc., may participate
in this activity.

2. The contest is for the purpose of stimulating a more widespread and effective
observance of National Social Hygiene Day in all Negro colleges, so that students
attending these institutions and those participating in the various programs will
become better informed about the whole field of social hygiene.

3. The contest is designed to select the best project in the form of plays,
programs, lecture series, radio skits, information polls, and any other educational
activities developed and presented by any group, or groups of students in any
Negro college or university.

4. Groups, classes or organizations planning to enter their projects in the
contest should observe the following rules:

(a) Whatever activity is developed by any student group should be
formulated with the idea of its being presented to the student body as a
whole on National Social Hygiene Day, February 2, 1944, or during
that week.

(b) A complete report of the project, typewritten in duplicate, must be
submitted by March 1, 1944, to Dr. Paul B. Comely, Executive Director of
the National Student Health Association, Howard University, Washington 1,
D. C. Such a report should be detailed, including the names of participants,
number of students reached, and pictures taken, any comments from the
press, and any other indication of the success of the project.

(c) The report should include a letter of transmittal signed by the presi-
dent of the institution and the person in charge of the activities.

5. All the reports of the projects will be judged by a committee of five, three
selected from the membership of the National Student Health Association and
two from the staff of the American Social Hygiene Association.

6. Awards: The prizes donated by the American Social Hygiene Association,
sponsors of National Social Hygiene Day, will be as follows:

First Prize — books to the value of $40.00

Second Prize — " " " " " 30.00

Third Prize — " " " " " 20.00

Fourth Prize — " " " " " 10.00

These prizes will be awarded to the libraries of the winning colleges in the
form of books on subjects included under the general title of social hygiene and
selected from a list which the American Social Hygiene Association will pro-
vide to the president of the winning colleges. Every college entering this
competition will receive a year's subscription to the Journal of Social Hygiene.

7. Announcements of the winners of the contest will be made on April 1, 1944.

NATIONAL EVENTS 97

General Magee Joins Staff of National Research Council. — Major
General James Carre Magee (MC), Surgeon General of the Army
(retired), has been appointed executive officer of the Informational
Service, Division of Medical Sciences of the National Research
Council, according to an announcement by Professor Ross G. Harri-
son, Chairman of the Council. ' ' This service has been established by
the National Research Council under the recent grant of the Johnson
and Johnson Research Foundation, by which the sum of $75,000 was
made available to the council for the period ending June 30, 1945,"
says the announcement. "The purpose of the grant was to enable
the council to assemble and disseminate, as far as possible medical
information pertaining to the war effort. ..."

General Magee, who is a member of the ASHA Board of Directors,
retired last May as Surgeon General of the Army. He recently
received the Distinguished Service Medal for his accomplishments in
that office. In his new position, he is devoting full time to the organi-
zation of a central office in the National Research Council for collect-
ing medical reports and records dealing with military medical
progress, civilian progress as affected by the war, medical education
and research, and the distribution of diseases.

Rehabilitation to Be Discussed at National Conference of Social
Work. — Ray H. Everett, Chairman of the Section on Social Hygiene
of the National Conference of Social Work, announces that the sec-
tion will meet from 11 : 00 A.M. to 12 : 30 P.M., Monday and Tuesday,
May 22 and 23, during the Annual Conference in Cleveland. The
two sessions will be devoted to the subject of rehabilitation and the
list of speakers includes : Miss Katharine Lenroot, Chief of the U. S.
Children's Bureau; Eliot Ness of the Social Protection Division;
Bascom Johnson of ASHA staff, and probably a prominent police-
woman. Other details, including place of meeting, will be announced
later.

Plans are also under way for an evening meeting, open to the
public under ASHA sponsorship. Watch the NEWS and JOURNAL for
further announcements.

NEWS FEOM OTHER COUNTRIES

Canada Holds VD Conference. — The Minister of Pensions and
National Health of the Dominion of Canada, called a National
Venereal Disease Control Conference in Ottawa, December 6-9, which
was attended by 105 delegates and visitors, including some from the
United States and other countries. Delegates represented the various
divisions of the Department of Pensions and National Health, the
Navy, the Army, the R.C.A.F., the Department of Indian Affairs,
the Department of Trade and Commerce, the Provincial Departments
of Health, Department of Health representatives from nine leading
cities and the Departments of Preventive Medicine from eight univer-
sities. The Canadian Hospital Council, the Canadian Medical Asso-
ciation, the Health League of Canada and other bodies were well
represented. The United Kingdom was also represented by members
of the Royal Navy, the R.A.M.C., the R.A.F., the British Ministry of
Health and the Medical Research Council. The United States was
represented by Col. Thomas B. Turner U. S. Army; Commander
W. H. Schwartz, U. S. Navy; Dr. John R. Heller of the U. S. Public
Health Service; Dr. Walter Clarke of the ASHA; Dr. Earl Moore of
the National Research Council. Australia was also represented.

The four days of sessions provided opportunity to discuss recent
advances in diagnosis and treatment; the use of educational media;
records and statistics; administration; epidemiology; and other sub-
jects. The Conference was divided for part of its work into sectional
committees of :

1. Armed Forces Medical Services delegates.

2. Civilian Federal, Provincial and Municipal delegates.

3. University Departments of Preventive Medicine delegates.

The following partial account is an abstract from an article appear-
ing in The Canadian Hospital, for January, 1944 : *

The seriousness of the venereal disease situation in Canada has recently aroused
the general interest of the public and their governing agencies. The need was
recognized by all for the earliest implementation of action to reduce the threat of
venereal infection to Canada 's war effort and to Canada 's home life. On July 1,
1943, a comprehensive control programme was launched. This effort, initiated by
the Army, integrated the control measures of the Navy, Air Force, Department of
Pensions and National Health, and Provincial Health Departments.

Appreciative of the importance of coordinating and unifying the control
measures of all interested agencies in Canada, the Minister of Pensions and
National Health called a National Venereal Disease Control Conference in
Ottawa, December 6-9.

* Canada 's First National Venereal Disease Control Conference, by Lt. Col.
D. H. Williams, M. D. The Canadian Hospital, January, 1944.

98

NEWS FROM OTHER COUNTRIES 99

The purpose of the conference was to consider how best the existing administra-
tive facilities for the prevention of venereal disease could be utilized in Canada;
and what need existed for modification and extension of these facilities. As a
result of the deliberations of the conference, guided by the wisdom and experi-
ence of visitors from the United Kingdom and the United States, the basis of a
National Venereal Disease Control Programme was laid down. Principles and
policy which would guide this programme were approved. Definite specific
types of preventive action and the spheres within which this action was to be
taken, were determined.

A Four-Sector Front

A charter to guide the Canadian venereal disease control effort on a com-
prehensive basis was approved. This charter interpreted Canada's response to
the threat of venereal infection as envisaging a four-sector Canadian Front
against venereal disease. These are the Health, Welfare, Legal and Moral Sec-
tors— components of an indivisible whole aligned against a common foe. The
ultimate objective is to destroy syphilis and gonorrhea. The purpose of each
sector is to take the offensive with the weapons peculiar to its own method of
attack. Waging unrelenting war on the Health Sector with weapons of modern
medical science and public health procedure, will be physicians, nurses and
Health Departments. Leading the attack on the Welfare Sector will be found
social workers and welfare agencies armed to battle squalor, overcrowding, lack of
food, neglect and insecurity. Directing a vigorous action on the Legal Sector
will be the courts, the legal profession and police agencies whose action seeks
out and brings to justice those who for personal gain purvey to men's weak-
nesses. On the Moral Sector the battle is to be led by the churches and homes of
Canada, strengthening the moral fibre of our nation and upholding the security of
marriage and family life. Each sector has its own territories, its own personnel
and armaments. The ultimate objective is the same.

Health Sector

A six-point strategy on the Health Sector was adopted by the National
Conference :

1. Health Education

The facts concerning VD will end the conspiracy of silence, banish outworn
fallacies, and remove false fears. Lectures, motion pictures, posters and
pamphlets will tell the story of how VD may be vanquished.

2. Medical Care

Every Canadian who requires examination and treatment should have the best
that medical science can provide. Free blood tests, free drugs and free clinics
are being provided by Health Departments. It is cheaper to cure and prevent
VD than to pay taxes for the end results of neglected infection.

3. Abolition of Quackery

Laws exist in Canada to protect citizens from the quack and charlatan. Only
qualified physicians are permitted by law to care for those suffering from VD.
The public must be protected from the incompetent and the rogue.

4. Prenatal Blood Tests

Every expectant mother must have a blood test for syphilis before the Fifth
Month. Demand it! Insist upon it! It is the only protection many unborn
children have.

5. Premarital Blood Tests

Health examinations, including blood tests, are a safeguard against the sinister
encroachment of syphilis on home and family life.

100 JOURNAL OF SOCIAL, HYGIENE

6. Contact Investigations

Careful search must be made for all who have been contacts to known VD.
Only by seeking these people and by bringing them under medical supervision
can the extending network of VD be destroyed.

Today, as never before, events and conditions are favorable for the final
eradication of the venereal diseases in Canada. The urgency of removing this
threat to the health and efficiency of the Armed Forces is recognized by all.
There is a full tide of wholesome public interest, concern and support for meas-
ures directed against these master saboteurs of war effort. Never before has
there been such an imposing show of force representing all the available human
resources arrayed against the serious threat of syphilis and gonorrhea.

If every citizen in Canada takes his battle station on the Health, Welfare,
Legal and Moral sector of Canada's four-sector front against venereal disease,
the favorable outcome of the battle is assured and the purpose for which the
National Venereal Disease Control Conference was called will have been fulfilled.

COMING EVENTS

April 2-9 National Negro Health Week

April 24r-27 American Association for Health, Physical Educa-
tion and Recreation Conference. Theme: Fitness for Today and
Tomorrow! New York, N. Y.

May 1 Child Health Day

May 7-14 National Family Week

May 21-27 National Conference of Social Work, Cleveland,
Ohio. (See page 97.)

Vol. 30 March, 1944 No. 3

Journal

Social Hygiene

Thirty-First Annual Meeting Number
CONTENTS

Award for Distinguished Service to Humanity Merritte W. Ireland 101

Nations United for Health and Welfare in Peace and War. . Hugh S. Cumming 103

Teamwork in Venereal Disease Prevention Walter Clarke 107

The Thirty-first Annual Meeting (Business Session) 134

The Annual Dinner Meeting 144

New Honorary Life Members 149

Social Hygiene Day— 1944 Eleanor Shenehon 155

Editorial:

" Looking Backward " — and Forward 162

The American Social Hygiene Association presents the articles printed in the
JOUKSAL or SOCIAL HYGIENE upon the authority of their writers. It does not
necessarily endorse or assume responsibility for opinions expressed or statements
made. The reviewing of a book in the JOURNAL OF SOCIAL HYGIENE does not
imply its recommendation by the Association.

EDITOEIAL BOAED

C.-E. A. WINSLOW, Chairman

RAY H. EVERETT WILLIAM F. SNOW

JOSEPH K. FOLSOM JOHN H. STOKIS

EDWARD L. KEYES JOHN C. WARD

JEAN B. Punnr, EDITOR
WILLIAM F. SNOW, EDITORIAL CONSULTANT

The JOURNAL OP SOCIAL HYGIENE is supplied to active members of the American
Social Hygiene Association, Inc. Membership dues are two dollars a year. The
magazine will be sent to persons not members of the Association at three dollars
a year; single copies are sold at thirty-five cents each. Postage outside the United
States and its possessions, 50 cents a year.

Entered as second-class matter at post-office at Albany, N. Y., March 23, 1922.
Acceptance for mailing at special rate of postage provided for in Section 1103,

Act of October 3, 1917, authorized March 23, 1922.
Published monthly (nine issues a year) for the Association by the Boyd Printing

Company, Inc., 372-374 Broadway, Albany, N. T.

Copyright, 1944, by The American Social Hygiene Association, Inc.

Title Registered, II. 8. Patent Office.

PUBLISHED MONTHLY EXCEPT JULY, AUGUST AND SEPTEMBER
AT 372-374 BROADWAY, ALBANY 7, N. Y., FOB

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

EDITORIAL OFFICES and NATIONAL HEADQUARTERS
1790 BROADWAY, 19, NEW YORK CITY

WASHINGTON LIAISON OFFICE
Room 609, 927 15th St., N.W., Washington 5, D. C.
JEAN B. PINNEY, Director in Charge
REBA RAYBURN, Office Secretary

FIELD OFFICES

ATLANTA, GEORGIA. 506-508 Citizens and BALTIMORE, MARYLAND. Care of Baltimore

Southern National Bank Building. Serv- Community Fund, 22 Light Street,

ing Alabama, Florida, Georgia, Missis- Serving Delaware, Maryland, Pennsyl-

sippi, North Carolina, South Carolina and vania and Virginia.

Tennessee. KENNETH R. MILLER, Field Eepresenta-

CHARLES E. MINER, Field Representative. tive, Home address 260 Bridge St.. Drexel

MRS. EDNA W. Fox, Field Eepresentative. ypn Pa.

COLUMBUS, OHIO. Care National Confer-

ence of Social Work, I High Street. CnICAQO ILLINOIS. Koom 615 360 North

WeTfir in^^' KeQtUCk7' °hl° *** Michigan Avenue. Serving Illinois, Michi-

WADE T^S^RLES, Field Eepresentative. f>an and Wisconsin.

WARREN H. SOUTHWORTH, Field Bepre-

OMAHA, NEBRASKA. 736 World Herald sentative
Building. Serving Colorado, Iowa, Kan-
sas, Minnesota, Missouri, Nebraska, North

Dakota, South Dakota and Wyoming. DALLAS, TEXAS. Cliff Towers. Serving

GEORGE GOULD, Assistant Director, Arkansas, Louisiana, New Mexico, Okla-

Divition of Legal and Social Protection homa and Texas.

Services, in Charge. BASCOM JOHNSON, Director in Charge.

SALT LAKE CITY, UTAH. 402 Mclntyre MRS. GERTRUDE R. LUCE, Office Secretary.
Building. Serving Arizona, Idaho, Mon-
tana, Nevada, Utah, California, Oregon

and Washington. SAN FRANCISCO, CALIFORNIA. 45 Second

GBORGE GOULD (see above), temporarily Street.

ti» dftarffe. W. F. HIGBY, Field OontvUemt.

WILLIAM FREEMAN SNOW AWARD

FOR DISTINGUISHED SERVICE TO HUMANITY

Presented to
HUGH SMITH GUMMING, M.D., Sc.D., L.L.D.

1944

To : HUGH S. GUMMING . . .

. . . Public health administrator, statesman, scientist, international
counselor, friend . . .

. . . We salute you

. . . Better than words of our own choosing, the testimonial on the
opposite page signed by the twenty-one nations of the Pan American
Union, expresses the esteem and affection in which you are held by
your hosts of friends in all parts of the world, among whom are
numbered the members of this Association.

. . . Now that the tides of global war have engulfed or are threat-
ening all nations, it becomes imperative to safeguard health and wel-
fare as never before. International experience, teamwork, and skill
in adapting to these ends all the tactics of modern warfare — defense,
delaying action, counter attack, decisive battle — are vital needs.

... In the Americas we still have the opportunity to hold all the
gains of past years and to forge steadily ahead through united
action of all peoples and their governments. . . . Under these con-
ditions we are most fortunate in having you as Director of the Pan
American Sanitary Bureau — the oldest active international organi-
zation "for the control of epidemic diseases" — cooperating with the
newest agencies, the Office of Coordinator of Inter-American Affairs,
and related bodies in other countries linked together for the common
good.

... In its special field, the American Social Hygiene Association
has long been privileged to work with both voluntary agencies and
officials of all the nations of the Western Hemisphere; and tonight,
with their commendation, the 1944 William Freeman Snow Award
for Distinguished Service to Humanity is presented by the Associ-
ation to you, Dr. Gumming, in recognition of this fiftieth year of
your worldwide public health activities, and the years of continued
leadership and service which lie ahead for you and Mrs. Gumming.

*

*••* "is y3»s 5S t? ' s: s

O ^ sw ^ \i C « ** * * SB

O ?"* £* ^ !§ "5 "^ ."^ "^ »s *^*

_____ ~~ '*&•+ *^* ^3% •& ?** ^ ^|| ."•*•$ — , -^ §K

SDr ^ c*,H>§*^ ^ c?i^ ^ ^

J/f :f"ji ^ • S § I ^"^ ^ ^ C g

H/^ ^ 'J ^ ^$ "s -^ >

pf $2 ^^C'^'^c''

*** *"* * £** ^* ***** ^fc **•• * "*

& si * S.^.^^^

sS ~*~ fi^'Zz ^ is ~ "*

f*» S^**^ ,-_ »^; S5> 2

W.J&
U

^•KW C- ^*»** "*<* *"*» ta -^ ^**m

>-3 W -^.t w s» w **<^ w ^T

BIOGRAPHICAL NOTES

HUGH SMITH GUMMING— Born August 17, 1869, Hampton, Virginia.

Graduate of University of Virginia, Doctor of Medicine, 1893.

Sc.D., University of Pennsylvania, 1930.

LL.D., Yale University, 1933.

Appointed to U. S. Public Health Service, 1894.

Surgeon General, U. S. Public Health Service, 1920-1936.

In charge, Medical Division, Ellis Island and Philadelphia, 1898.

Chief Quarantine Officer, South Atlantic and San Francisco, 1900-1906.

Medical Officer attached to U. S. Consulate, Yokahama, Japan, 1906-1910.

Chief Quarantine Officer, Hampton Eoads, 1910-1913.

In charge investigation of pollution of tidal waters and streams, 1913-1917.

Adviser in Sanitation to U. S. Navy during World War I.

Inspector of sanitary conditions of ports used by American Expeditionary Forces.

Postwar Inspection of European emigration areas and embarkation ports to
United States.

Head of Inter- Allied Medical Mission to Poland following the first World War.

Member of the Cannes Conferences, and of the Advisory Committee of the
League of Red Cross Societies, 1919.

Delegate of United States on Permanent Committee, Office International
d 'Hygiene Publique, Paris, 1920 to present time.

Member of Health Committee, League of Nations, since its creation, and
Vice-President since 1937.

Member of Board of Visitors, Saint Elizabeth's, Garfield Memorial, and Columbia
Hospitals.

President National Board of Medical Examiners, 1934-36.

American Delegate to Immigration Conference, Rome.

Honorary Chairman, Section on Public Health and Medicine, Eighth American
Scientific Congress.

Chairman, Public Health Service and Administration, White House Conference
on Child Health and Protection.

Director, Pan American Sanitary Bureau, 1920 to present time.

President, Association of Military Surgeons, 1924; Southern Medical Associa-
tion, 1930; American Public Health Association, 1931.

Honorary Fellow — American College of Surgeons; College of Physicians; College
of Dentists; Royal Society of Medicine (London); National Academy of
Medicine (Peru); National Academy of Medicine (Mexico).

Honorary Professor — University of Santo Domingo; Member Medical Society
of Dominican Republic; Honorary Director, National Public Health Service
of Paraguay; Member Sigma XI and other honor societies.

Decorated by governments of France, Poland, Chile, Colombia, Cuba, Dominican
Republic, Ecuador, Haiti, Mexico, Peru.

Hartley Gold Medal of National Academy of Sciences for "Application of
Scientific Knowledge to Public Service", 1936.

Gorgas Medal and Prize of Association of Military Surgeons, "For distin-
guished service in the field of National and International Public Health", 1943.

Dr. Gumming is the son of Samuel and Diana Whiting (Smith) Gumming.

Married Lucy Booth, daughter of EdAvin Gilliam Booth, October 28, 1896, at
Carter's Grove, Virginia.

Dr. and Mrs. Gumming have had three children : Lucy Booth (deceased) ; Hugh
Smith; and Clara Diana (Mrs. Manville Kendrick).

Home: 2219 California Street, Washington, D. C.

Social Hygiene

VOL. 30 MARCH, 1944 NO. 3

Thirty-First Annual Meeting Number

AWAED FOR DISTINGUISHED SERVICE
TO HUMANITY

MAJOR GENERAL MERRITTE W. IRELAND

Surgeon General, (Eetired) United States Army

We are met this evening to honor Dr. -Hugh S. dimming and to
congratulate him upon this fiftieth consecutive year of his leader-
ship and service in the fields of public health and medicine.

The Award Committee of the American Social Hygiene Association
has prepared a brochure for your interest on this occasion of award-
ing its Medal to Dr. dimming. In it you Avill find biographical
statistics about his fruitful ami varied career; but little about the
man himself. It does not tell you, for example, about his life as
a boy during the Reconstruction days of the South, in a town which
had been burned in the Civil War period.

It does not say that this boy had opportunity for only one year
in what we know as a grammar school — the Symmes Eaton Academy
(which was the oldest public school in America) ; and one high
school year in the Baltimore City College.

It does not give yon a picture of this young man as a soldier
in the Spanish American War, fighting the battles against yellow
fever, smallpox and plague. Perhaps through no other early experi-
ences could this man have gained the broad concepts of Education
and Medicine which have shaped his brilliant career.

To understand his success you ought to know, too, that his for-
bears came from Wigtonshire, Scotland ; and that promptly after
graduating in Medicine he had the good fortune to marry Lucy
Booth. She organized their household on a mobile basis so that
they could live and work and bring up their children together,
wherever in the United States or other parts of the world, Dr.
dimming 's duties might take them.

101

102

OF SOCIAL HYGIENE

Consider too the period of momentous change since his birth in
ISO!), when the new discoveries of Pasteur were just beginning: their
influence on the Science and Art of Medicine. All through his
life he has been on the frontiers, busy with searching investigations
covering a wide field of inquiry. His contributions to the Social
Hygiene movement were summarized by this Association when electing
Dr. dimming to Honorary Life Membership * ; his contributions to
Science and Sociology have been recorded by other organizations
which have sought to do him honor. You have copies of the Award
Committee's citation before you as I speak.

I consider it a great privilege tonight to present this medal to
my friend — Hugh S. dimming.

MAJOR GENERAL IRELAND (left) PRESENTING THE MEDAL TO
SURGEON GENERAL GUMMING

'See pages 134H5 March, 1941 (Vol. 27, No. 3), Journal of Social Hygiene.

NATIONS UNITED FOR HEALTH AND WELFARE IN
PEACE AND WAR *

by

HUGH S. GUMMING, M.D.

.Director, Pan American Sanitary Bureau
Surgeon General (Retired) U. S. Public Health Service

Mr. Chairman, Ladies and Gentlemen:

It is needless for me to say that I highly appreciate this honor
which you have seen fit to confer upon me. Unless one is hopelessly
egocentric, he must feel a thrill at the receipt of any honor conferred
upon him by such a representative body as this. Decorations awarded
by foreign governments are naturally highly appreciated; but when,
toward the end of a long life, as one approaches very nearly the
sunset and evening star, special significance and appreciation sur-
round the honors received in one's own country and by one's own
kin with whom he has been closely associated for nearly half a century.

I know of no three friends and associates in public health work
with whom I would rather sit at this table, than the former Secretary
of the Interior who is former President of the University, former
President of the American Medical Association, and above all a
great Doctor, Ray Lyman Wilbur, to whom I have so often gone for
advice and assistance in the past. I particularly recall my associa-
tion with and work under him in connection with the great "White
House Conference 011 Child Health and Protection" while he was
Secretary of the Interior under President Hoover, who was so deeply-
interested in and initiated many of our present social reforms.

And General Ireland here, whom I first remember seeing as a tall,
handsome young officer standing in the opening of a tent at Montauk
Point, in 1898, who is not only one of the ablest public officials,
but one of the truest friends a man ever had. The older ones
amongst us remember how much his intelligent and deep interest
in the campaign against venereal disease, both in the Armed forces
and the general population, has had to do with our successful
progress along this line.

It is peculiarly gratifying to receive this medal carrying the

*Eemarks at the Annual Dinner of the American Social Hygiene Association,
New York Academy of Medicine, February 1, 1944, on receiving the William
Freeman Snow Award for Distinguished Service to Humanity.

103

104 JOURNAL, OF SOCIAL, HYGIENE

name of a gentleman with whom I have been associated for many
years, and whose high personal character, energy combined with
tact, and devotion to the cause, has probably done more to forward
the great crusade against venereal diseases than any other one
person whom I know.

I am not unmindful of the fact that you have awarded me this
honor, not because of any great accomplishment of mine in this
crusade, but because possibly through fortuitous circumstance or
the "Divinity that doth shape our ends" I have been given the
opportunity of at least becoming familiar with not only the research
and administrative side of the crusade in local, State and national
fields in this country, but more or less in international health matters.
Seeing Colonel Snow sitting here, 1113* memory travels back to several
incidents over a quarter of a century ago immediately following the
first world war as perhaps having some lessons for us in the prob-
lems which we are now facing or approaching.

I have a photograph showing Doctor Welch, Fred Russell, Colonel
Snow and myself sitting on the steps of the old Roman theater at
Aries, France, upon our return trip from the now famous Conference
called by the Committee of Red Cross Societies and held at Cannes
in April 1919 for the purpose of planning the future for our inter-
national war against disease, particularly venereal diseases, child
welfare, tuberculosis, and malaria. There were intellectual giants
present at that Conference, among whom I recall our own Doctor
Welch, Biggs, Wickliffe Rose, and Richard Strong ; while from Europe
there were such men as Roux, Marchiafava, Sir Arthur Newsholme,
Maragliano, Calmette, Kabeshima, and others equally able and
devoted, most of whom have gone through the Open Door into the
Great Beyond.

In the quarter of a century which has elapsed since this meeting
in France, there has been remarkable progress in our increased
knowledge of the methods and therapeutic agents for the treatment
of venereal diseases. I feel sure that there has been a remarkable
change for the better in the attitude of public opinion with reference
to the importance of these diseases. As a consequence we have now
in hand tools which were not available at the time of that Conference.
It would be presumptous, however, for us to think it would be pos-
sible to get more intelligence and wisdom than were present at
that Conference.

Probably because of my being an "elder" if not an "elder states-
man," I am not infrequently asked my ideas on our future health
organization, both national and international. There is, I think,

NATION'S UNITED FOR HEALTH AND WELFARE 105

too much of an iconoclastic psychology prevailing in many quarters,,
which apparently forgets the good which has been accomplished,
exaggerates the failures, and assumes superior wisdom as to future
planning. Personally, I feel that whenever possible, as in other
organized procedures, we should be reluctant to violate the admo-
nition of the Holy Scripture, "Destroy not the landmarks of Thy
Fathers!'.'

It would be well, therefore, for us in approaching the problem of
local, national, and international planning to study rather carefully
the accomplishments as well as mistakes which have been made in
the past, and take advantage of the experience which has resulted
in the campaigns following this meeting which I mentioned at Cannes^
i.e. the organization of the League of Nations, the work of the Inter-
national Health Office in Paris, such Hemispheric organizations as
the Pan American Sanitary Bureau, which is senior in age to all
the official international health organizations, as well as the splendid
work which has been done by such great voluntary organizations
as the American Social Hygiene Association and other similar
organizations both here and abroad.

In planning for our future campaigns, it would be well to bear
in mind that all these organizations are still in existence and are
doing very effective work even during war time and under adverse
circumstances, such, for instance, as the International Health Office
in Paris, which exists under a Treaty signed by nearly every Govern-
ment throughout the world; the Health Section of the League of
Nations with its regional offices; not to speak of the Pan American
Sanitary Bureau, whose activities have been rather enchanced by
conditions accompanying the war. It may be worthwhile to recall
in this connection the international work being conducted under
its auspices such as the sanitary survey of the Inter- American High-
way, the campaign against onchocerciasis, and more perhaps to the
point on this occasion, the joint work being carried on along the
Mexican border in cooperation with this Government and the Mexican
Government in the control of venereal disease, which it is hoped
eventually to extend to other countries.

It is generally agreed, I think, among those of us who have had
both here and abroad an opportunity to study the situation that
one of the most important factors in successful international health
procedure is the organization or continuance of the idea of regional
and local, in addition to international, organizations. This is par-
ticularly true, I think, in the problem which immediately concerns
us, a problem which in many respects is unique and differs from
any other phase of our public health.

106 JOURXAL OF SOCIAL HYGIENE

In perhaps 110 other group of diseases has greater progress been
made in discovering new therapeutic remedies, and certainly much
progress has been made, thanks largely to the efforts of this organi-
zation,' in the question of the control and prevention of disease.
The Latin American countries have kept up with this procession
both in regard to organization and control, as well as research. There
remains, however, the biological factor, which we would not if we
could suppress, but which must be directed into proper channels.
While there are certain fundamental unchangeable factors in the
campaign against and the lessening of the opportunity for infection,
there are nevertheless factors which differ in different localities,
nations, races, social and economic conditions, and these must be
considered in any regional or even national campaign.

I have heard that there are those who, I think short-sightedly,
believe that we may relax our vigilance because of the improvement
in the therapeutic side. With this I disagree. Eternal vigilance
is no less the price of success in public health than in liberty. Our
past and present progress should serve only as a stimulus for increased
activities. In this campaign it seems to me wise that we should
take advantage of the experiences and the failures of other countries
as well as our own through cooperative effort. I am sure that the
devotion, energy, and ability comprised within this organization
will see that the campaign is carried on to the successful lessening
so far as is humanly possible of the prevalence of these great scourges.
While campaigns for education, both moral and scientific, should
not be lessened, the most immediate and practical measure is that
of providing adequate, easily obtainable centers of treatment.

We need organized education and research, good will and energy,
and faith to succeed. It takes more than one \vheel to keep going
along smoothly and efficiently. Of course leadership must be at
the steering wheel. I see it magnificently represented all around
and in front of me.

I cannot resist mentioning what must be evident to all of us, the
ever increasing tendency to centralization and governmental control
not only in political fields but in such activities as those with which
we are directly concerned here. It is my studied opinion that the
importance of the continuance and independence of such voluntary
organizations as this should not be minimized. Their field should
not and indeed could not be covered by governmental activities. This
is particularly true in the educational field. I believe that it would
be well for the different national organizations, particularly in
this Hemisphere, to attempt some coordination and interchange
of efforts.

TEAMWORK IN VENEREAL DISEASE PREVENTION

A REPORT OF 1943 ACTIVITIES TO THE FRIENDS OF THE
AMERICAN SOCIAL HYGIENE ASSOCIATION

Lei us set for ourselves a standard so high that it
will be a glory to live up to it.

— Woodrow Wilson (1917)

/ call for united effort of all citiiens for the establishment
of total physical and moral fitness.

—Franklin D. Roosevelt (1942)

BACKGROUND

The American Social Hygiene Association was founded in 1913
by a group of distinguished national leaders including President
Charles W. Eliot who became the Association's first President. The
Association adopted a program for combating the venereal diseases,
for repression of prostitution and for the encouragement of sex edu-
cation. During the first World War the Association worked in close
relation with the Army and the Navy, to maintain the lowest possible
venereal disease rate and to protect the armed forces from prostitution
and related conditions. Many Association staff members served as
officers of the Army or Navy in charge of various social hygiene
activities and the Association supplied to a large extent the educa-
tional materials used by both services to inform soldiers and sailors
regarding syphilis and gonorrhea.

In the postwar period the Association successfully advocated the
establishment by Congress of the Interdepartmental Social Hygiene
Board, the creation of the Division of Venereal Diseases in the United
States Public Health Service and in connection with these, the first
appropriation of funds by the Federal Government for allocation
to the states for combating venereal diseases. When Congress failed
in 1922 to continue the appropriation for this purpose the Association
began the long process of building public opinion to the point where
in 1938 new and more adequate annual appropriations were begun,
permitting the renewal of a large scale attack on the venereal diseases.

In the meantime the Association had aided many states and cities to
set up modern venereal disease control activities; conducted many
basic surveys, studies and experiments upon wrhich are based present
day procedures; advised regarding laws and law enforcement;
suggested venereal disease control activities in great industries;
encouraged basic medical research ; developed popular, scientific and
educational motion pictures and publications; and encouraged sex
education, properly integrated, in colleges and high schools.

With mobilization in 1939 the Association again made its personnel
and facilities available to the Federal Government; aided in estab-
lishment of national policies for venereal disease control and repression
of prostitution ; advised regarding the framing and passage of the May

107

108 JOURNAL OF SOCIAL HYGIENE

Act and the establishment of the Social Protection Division of the
Federal Security Agency; assisted in the finding and training of
Venereal Disease Control Officers for the Army and Navy; studied
and reported upon prostitution and related conditions in the vicinity
of every important Army and Navy establishment; provided educa-
tional materials to the armed forces; and rallied public opinion to
support the national program for protection of soldiers, sailors and
industrial workers from prostitution and the venereal diseases. All
these correlated and cooperative activities have been continued and
increased from year to year since then.

The venereal disease rate of the armed forces during the first
World War was the lowest in our military history up to that time.
It is much lower in the present war. Team work between govern-
mental and voluntary agencies achieved these results. The Associ-
ation is proud to be included in this team.

In the present war emergency the American Social Hygiene Asso-
ciation is a participating service of the National War Fund. The
Association's budget for 1943 totaled three hundred fifty thousand
dollars ($350,000.).

GENERAL STATEMENT

Despite the fact that much progress has been made in their control,
syphilis and gonorrhea remain this country's most serious wartime
health problem. They constitute a leading cause of lost man days
among the armed forces and war industrial workers.

These infections are not acquired in camp, on shipboard or at the
shop bench, but in the communities where men spend their off-duty
hours. For this reason, and especially because sick men can't work
or fight, the Army, the Navy and industry continued throughout 1943
to seek the active cooperation of the American Social Hygiene Associ-
ation, and its state and local affiliated societies. A nationwide,
war-stimulated program has been carried out. It has helped to
increase the efficiency of the armed forces and war industry workers
and to protect the welfare of the public, especially the youth of our
nation.

Teamwork Developed:

Over a period of thirty-one years the American Social Hygiene
Association has served as a close working partner of the official govern-
ment agencies. An Eight-Point Agreement, drawn up in 1940,
recognized the services to be developed by state and local health and
police authorities in cooperation with the Army, the Navy, the Public
Health Service, the Social Protection Division of the Federal Security
Agency, and the American Social Hygiene Association. A later
official statement entitled Relationships in Venereal Disease Control;
Army, Navy, U.S.P.H.S., Office of Defense Health and Welfare
Services and the American Social Hygiene Association*, outlines

* JOURNAL OF SOCIAL HYGIENE, February, 1943, p. 100. Also separate reprint,
Pub. No. A-499.

TEAMWORK IX VENEREAL DISEASE PREVENTION 109

specifically the functions of these official agencies and the Association,
and recognizes the latter 's unique partnership with government
.services.

In accordance with this working agreement the Association has,
during the past year, continued to :

1. Gather information relative to commercialized prostitution in communities
adjacent to military or naval establishments and those frequently visited by
soldiers or sailors.

2. Gather and evaluate information relative to the laws for the prevention of
venereal disease, and for the repression of vice conditions.

3. Through state and local social hygiene societies and influential citizens' groups,
create public sentiment against prostitution and related conditions and bring
about a public demand for enforcement of existing laws and for the enactment
of additional legislation should it be necessary.

4. Through societies mentioned above, create public demand for the financing
and promotion of efficient venereal disease, social protection, and educational
programs in states and localities in which present programs are inadequate.

The Association gave first attention during 1943 to those com-
munities where studies showed the greatest need existed. Serving
as a distribution center for social hygiene information and experience,
the Association made known to communities throughout the country
the essential facts about the venereal diseases, the harm they do and
how they can be prevented, treated and cured. This activity aided
the venereal disease control programs of local and state public health
officials. Reports indicate that wherever civilian communities have
succeeded in informing the public, repressing prostitution, main-
taining efficient health services, and providing adequate wholesome
recreation for young people, the infection rates for syphilis and
gonorrhea have been reduced.

Interesting Statistics :

The 1943 combined venereal disease rates of the Army and Navy
were under 30 per 1,000 per annum or less than half the average
rate for the first World War. Noneffective days have also been greatly
reduced due to greatly improved methods of treatment. However,
in reports on the health of the Army and Navy, gonorrhea was still
at the top and syphilis near the top of the list of infectious diseases.
More man days were lost due to syphilis and gonorrhea than from
any other communicable disease.

At the beginning of the year the Public Health Service published
the data obtained from the reports of blood tests given to 2,093,138
selectees and volunteers to the armed forces through August 31, 1941.
Syphilis rates per 1,000 White and Negro men, age 21-35 in the
United States, based on 1,895,778 selectee blood test reports, were
computed and arranged in descending order by states. Of the 85,839
men in which syphilis was detected, 56,839 were Negro and 28,995
were White. The reported rate of infection by states varied from
more than 100 per 1,000 in Mississippi, Florida, South Carolina,
Georgia, and Louisiana to less than 15 per 1,000 in Montana, Nebraska,

110 JOURNAL OF SOCIAL HYGIEXE

Connecticut, Rhode Island, Massachusetts, South Dakota, Minnesota,.
Utah, Wisconsin, North Dakota, and New Hampshire.*

Dr. R. A. Vonderlehr estimated that among approximately 53
million civilian workers, a million to a million and a half have
syphilis.** No reliable estimates exist as to the prevalence of gon-
orrhea in this part of the population but it is believed on the basis
of military experience that in general the ratio of gonorrhea to
syphilis is at least 3 to 1.

Inquiry sent during the year to the health authorities of large
cities and populous states revealed that there is some evidence of
an increase in syphilis and/or gonorrhea in the civil population. In.
some places, as for example New York City, the increase is reported
to be alarming especially as it is occurring particularly in the 15 to
24 year age group. In San Francisco there appears to be a con-
siderable increase in gonorrhea.

It should be noted that increases in these infections among the-
civil population is likely soon to be reflected in increased military
venereal disease rates.

Boom Towns:

War production needs and the location of large military establish-
ments had by January, 1943, caused great concentrations of popula-
tions and created boom towns unprepared to meet emergency social
hygiene needs. It became evident that community consciousness of
developing problems must be aroused before remedial action could
be instituted.

Thus, in addition to providing the services of consultants, it became
necessary to put into the field specially trained and qualified com-
munity organization representatives, and to establish additional
regional or branch offices. These field representatives and their
regional offices were able to render many services directly to the
armed forces in their areas, especially with regard to educational and
law enforcement activities. In addition they stimulated citizen
interest in and support of the war-time social hygiene program. All
field representatives are experienced persons having professional
training.

Conditions in many areas of the country adversely affecting the
health and morale of the armed forces and industrial war workers
and their families were studied, the findings were made available
to responsible authorities, and activities were initiated by the field
or headquarters staff of the Association. These pages are devoted
to an account of the more important and interesting work of the

* Syphilis Among Selectees and Volunteers. Prevalence in First Million Men
Examined Under the Selective Service Act of 1940, R. A. Vonderlehr, M.D. and
Lida J. Usilton, M.A., Journal of the American Medical Association, October 18,
1941. pp. 1350 and 1351.

** No Venereal Disease Tragedies in the World of Tomorrow, E. A. Vonderlehr,.
M.D., Journal of Social Hygiene, April, 1943. p. 201.

TEAMWORK IN VENEREAL DISEASE PREVENTION 111

Association during the year 1943. Activities and services may be
described under the four generally accepted divisions of the Associa-
tion 's work :

I. Medical and Public Health Activities
II. Legal and Protective Activities

III. Educational Activities

IV. Information and Extension Activities

I — MEDICAL AND PUBLIC HEATLH ACTIVITIES

During the war emergency the emphasis of the Association is
being placed on the prevention of venereal diseases in the armed
forces and in the civilian population especially among war industry
workers. This involves much more than strictly medical and public
health measures, as shown later in this report, out in order to main-
tain a sound scientific basis medical and public health facts, prin-
ciples and procedures must be constantly considered in all the Asso-
ciation's work which deals in any way with syphilis, gonorrhea and
the so-called "minor venereal diseases" — chancroid, granuloma
inguinale and lymphogranuloma venereum.

In addition to special activities mentioned below, medical and public
health staff members have provided guidance to the activities of the
Association, its 150 affiliated societies, and to many cooperating vol-
untary agencies. Since these activities often involve scientific knowl-
edge of the venereal diseases, their means of spread, diagnosis, treat-
ment and control, professional guidance of the total social hygiene
program is essential.

Medical Consultant and Teaching Services:

Medical members of the staff participated in the planning of gov-
ernment agency policy as members of the U. S. Interdepartmental
Committee on Venereal Disease Control, the National Research
Council, the Committee on Venereal Diseases in Industry (U.S.P.H.S. ),
and as Consultants to the Secretary of War, to the U. S. Public Health
Service and the U. S. Office of Indian Affairs.

The Executive Director of the Association was appointed Clinical
Professor of Public Health Practice in the Harvard University. Staff
members served as lecturers in the orientation course for Public Health
Service officers in Washington and at Johns Hopkins School of
Hygiene and Public Health, and the Army Medical School where
medical officers of the Army and Navy were in training. This
service of instruction is of value not only in the present emergency
but extends into the future when most of these physicians will return
to their normal pursuits better equipped to aid in the fight against
syphilis and gonorrhea. The students at the Harvard School of
Public Health will occupy positions in public health administration
not only in the United States but in many other countries. Valuable
and lasting contacts are established through this educational effort.

112 JOURNAL OF SOCIAL HYGIENE

In cooperation with the Public Health Service, a special medical
consultant of the Association has continued a study of the training
of public health personnel and the use of Federal funds by the states
for combating venereal diseases. This service of evaluation from year
to year has proved of service to the nation and particularly to the
Public Health Service and the state health authorities.

A medical staff member continued participation in research projects
dealing with the venereal diseases and as a member of the Advisory
Committee for the New York City Rapid Treatment Center.

Cooperation of Labor and Management:

Medical Consultants of the Association visited the medical depart-
ments of many large war industries, advising plant medical directors
regarding principles and practices for venereal disease control in
industry. An extensive report of the Association's observations and
experience during the past five years of field work was prepared and
submitted to the Public Health Service with which the Association
cooperates in this work.

Recognizing that interest in and support by organized labor of
community social hygiene programs would help to secure a sympa-
thetic reception of venereal disease control efforts by large segments
of the population, the Association last May obtained the services of
a Consultant for Labor Cooperation. Under his guidance, an "indus-
trial health education project," sponsored by the Neighborhood
Health Development Committee, the New York Health Department
and the Association has been organized as a demonstration in
Brooklyn, New York. Trade unions in this area have pledged full
support of a popular health educational program for unionized and
unorganized employee groups. Both management and labor are
interested and willing to support this plan to bring health information
to employees. This project may serve as a model procedure for other
industrial communities.

At its annual convention in Boston in October, the American
Federation of Labor, at the suggestion of the Association, recom-
mended to its 6,400,000 members that they submit to blood tests in
order to know whether or not they have syphilis. The Federation
declared itself in full accord with the thought that workers, for their
own welfare, should have blood tests and other tests from time to
time. A resolution directed that the Federation bring to the atten-
tion of its affiliated unions the fact that health departments are
prepared to give blood and other tests without charge. Union mem-
bers were encouraged to make use of available health protection
facilities.

' ' Such a resolution, ' ' stated Surgeon General Thomas Parran in a
letter to the convention, "by a large and influential national organ-
ization would, in my opinion, be a significant and progressive forward
step in the national venereal disease control program . . . and would
aid substantially in the national effort to eliminate syphilis as a
national hazard to public health and industrial productivity."

TEAM \VOKK IX VKXEKEAL DISEASE PREVEXTIOX 113

The Washington Post, editorializing on the action taken by the
AFL Convention, said: "If the public at large will follow the lead
of the AFL (and the legislature of the State of Alabama, which we
are told, has before it a law to make blood tests compulsory for all of
its citizens), it will now be possible to dispel forever the smoke screen
of ignorance and fear which has prevented us from making a case
of syphilis as rare anil outmoded as a case of smallpox."

COOJH ration n-itli I.'!i</rnHicistx:

The Association continued to participate in a joint project with
the American Pharmaceutical Association intended to provide an
opportunity for pharmacists to play a key role in the educational cam-
paign against the venereal diseases. We have had the cooperation
of the Public Health Service in this project.

During the year more than 125,000 copies of the Association's
special leaflet, A Tip from Your Pharmacist, were distributed by phar-
macists. The leaflets advised the drugstore customer that the phar-
macist cannot lawfully diagnose or treat venereal disease but can be
counted on to give valuable counsel in the interest of venereal disease
prevention. Since many people come to the pharmacists with ques-
tions about syphilis and gonorrhea, the active cooperation of the
pharmacist distributing educational material can be of great value.
Many pharmacists agreed to refer to physicians all persons seeking
diagnosis or treatment at drug stores. More than a thousand sets of
a specially prepared window display were provided to pharmacists
by the Association. Thus large numbers of pharmacists were enlisted
as powerful education instruments in the dissemination of medically
approved information.

With the assistance of the Association a special demonstration was
carried on by the Bridgeport, Connecticut Pharmacists' Association.
Every pharmacist in the city cooperated in a popular educational
program which reached the entire community through public meet-
ings, broadcasts, pamphlets, window displays and the press. The
project was so successful that other communities are taking up the
plan with the encouragement both of the Association and the American
Pharmaceutical Association.

There has been nationwide publicity in the professional and trade
publications of pharmacists. Every state pharmaceutical society has
endorsed social hygiene educational activities in formal resolutions of
its membership and boards and many local societies have taken
similar action.

II — LEGAL AND PROTECTIVE ACTIVITIES

The services of the Association's legal and medical staff are con-
stantly in demand for advice regarding sound laws and regulations
based on practical studies in the field and in law libraries regarding
legal mechanisms that have proved helpful in dealing with very real
social and public health problems. Publications embody the results
of these studies. It is apparent of course that the mere existence of a

114 JOURNAL OF SOCIAL HYGIENE

law does not solve any problem. Good laws however are powerful
instruments in the hands of able and conscientious officials, and a
basis for citizen support and cooperation. Also the lack of suitable
laws is a legitimate excuse for failure to correct conditions which
are dangerous to health and welfare.

The Association increased its legal and protective activities in 1943
to meet the need for studies and other services requested largely by
governmental agencies and in response to a continued determination
of public officials and citizens to extend the protection afforded by good
laws and regulations. The Association's legal consultants conferred
with persons interested in good laws and law enforcement in 31
states. Excellent progress can be recorded.

Studies of Laws and Law Enforcement:

Alabama adopted a unique law requiring all inhabitants of the
state between the ages of 14 and 50 to have an approved blood test
for syphilis. An appropriation of $75,000 was provided to carry
out provisions of the law. This is of considerable interest as an
experiment.

Indiana, Nebraska, Missouri and Wyoming passed premarital exam-
ination laws requiring, as a prerequisite for obtaining a marriage
license, examination by the physician of both applicants for a mar-
riage license including a blood test for syphilis by an approved labora-
tory. Idaho, Georgia, Kansas and Nebraska adopted prenatal exam-
ination laws requiring physicians to test pregnant women for syphilis
as a part of prenatal examinations. There are now 30 states which
have " premarital examination laws" and 30 having "prenatal exam-
ination laws. ' '

The premarital examination laws of California, Connecticut, Illi-
nois, Iowa, Massachusetts and Vermont were amended to obtain more
smooth operation. An interesting feature of the Massachusetts pre-
marital law, as amended, permits marriage of applicants under certain
conditions even though one or both may have syphilis in an infectious
stage. The physician who discovers evidence of syphilis must inform
both applicants to the marriage of the evidence and nature of such
disease.

Arkansas, Florida, Georgia, Oklahoma, Tennessee, Texas and West
Virginia adopted new laws for the repression of prostitution, making
a total of 19 states which now have adequate legislation against most
of the aspects of prostitution. Ten other states have generally good
legislation against prostitution but lack certain provisions which
are regarded as important and valuable.

Connecticut, Florida, Indiana, Maine, Maryland, Montana, New
Mexico, North Dakota, Oklahoma, Oregon, Tennessee, Vermont and
West Virginia strengthened their venereal disease control laws, par-
ticularly in relation to the reporting, treatment, quarantine, follow-up
or finding of persons with an infectious venereal disease.

TEAMWORK IX VENEREAL DISEASE PREVENTION 115

Two laws of special interest were passed by the Florida legislature.
One permits the revocation of a license of a boarding house, rooming
house, hotel and restaurant for any violation of the laws against pros-
titution, lewdness or assignation. The second statute requires all
persons rejected or deferred from military service who are infected
with a venereal disease to report to a venereal disease clinic operated
by the Florida State Board of Health and to take treatment from a
private physician or at public expense if indicated.

In Oklahoma, the Governor signed H.B. 37 on March 18, 1943,
relating to the examination and treatment of persons confined in
public or private institutions, or any person arrested by lawful war-
rant for vagrancy, prostitution or other sex crimes for the purpose
of determining if they are infected with syphilis or gonorrhea.

Studies of Prostitution Conditions:

The studies made by specially selected, carefully trained, reliable
field assistants of the Association provide the Army, Navy, Public
Health Service, Social Protection Section of the Federal Security
Agency, and state health and law enforcement officials with specific
detailed information regarding prostitution conditions, activities of
prostitution facilitators, and so far as possible, non-commercialized
sex promiscuity. The Federal and state officials depend on reports
of these studies for facts upon which to determine what actions if
any are necessary and what progress has resulted from actions
already taken.

This is believed to be one of the most important services rendered
in the war emergency as special attention is given to communities
near Army or Navy establishments or having large war industries.

A great improvement in prostitution conditions has been reported
since January 1, 1942. Continual vigilance will be necessary to
maintain the gains made thus far.

Requests for confidential surveys of prostitution and related activi-
ties continued to increase indicating the value placed on these studies
by governmental authorities. Careful planning was necessary in order
to meet the requests in order of urgency. During the year 697 dif-
ferent studies were made in 580 different communities. A total of
11,152 copies of reports were distributed to representatives of official
agencies for their confidential information. This is an average dis-
tribution of 16 copies of each survey report.

The value of frequent studies in a single community where con-
ditions were fluctuating became increasingly apparent. In a number
of communities the ominous words wrere heard:

When the Avar 's over the signal will be given . . . and the red lights will
go on again.

Contrary to widespread opinion, the closing of houses of prostitu-
tion is but one of the steps which must be taken if conditions favoring
the spread of venereal diseases are to be permanently improved.

1 1 (5 JOURNAL OF SOCIAL HYGIENE

A striking illustration of that which can be accomplished along
law enforcement lines may be gleaned from the following extracts of
reports covering six studies made over a period of two years in a com-
munity recognized throughout the nation as a prolific vice center and
since the war a playground for members of the armed forces.

March 1942 — Many soldiers go into this town every day. Some make a inad
rusk for the joints they have heard about and others appear content with the
city's safe and sane forms of recreation and points of interest. It is generally
known that there are always an abundance of women, that there are many inmates
in brothels, that hustlers and "come on" girls can be had in many taverns and
"call girls" in many hotels and that cab-drivers, bell-boys and other types of
' ' ropers ' ' act as ' ' go-betweens. ' '

July 1942 — At the instigation of the Federal and State authorities, the municipal
authorities were persuaded to repress prostitution in general.

October 1942 — Regardless of whether or not a man is in uniform, law enforce-
ment has reached the stage where it is difficult to find any prostitutes.

January 1943 — It is exceedingly difficult to find any white prostitutes. A few
brothels, camouflaged as massage parlors, are found to be operating very cau-
tiously. Some ' ' hustlers ' ' are found in ' ' Nite Clubs. ' ' Prices are high. Girls
have to be " sneaked ' ' into a hotel room.

June 1948- — Some former "hot spots" are found to be padlocked. Getting
girls is mighty expensive business. Bell-boys will not help and neither will cab-
drivers. "Go-betweens" receive stiff jail sentences which act as a deterrent to
others. The vast majority have abandoned the practice.

September 1943 — Some former brothels are being "held down" by caretakers
for the duration in hope that during the postwar period erstwhile operators
will be able to resume business. The police are found to be checking up closely.
White commercialized prostitution lias been reduced to a minimum. Police
started an intensive drive against Negro prostitutes who ' ' switched ' ' their
activities from white trade to their own race. Many were arrested. Negro
service men now find it difficult to locate "hustlers" or " chippies. " However,
the grapevine had it that "as soon as the war is over the heat will be turned off."

In only two states to date — Tennessee and North Carolina — have the
designated authorities decided it to be necessary to invoke and carry
out the provisions of the May Act. This law makes prostitution and
related activities a Federal offense, once a zone has been created by
the Secretary of War or the Secretary of the Navy. In 12 counties in
North Carolina along the network of highways which permeates the
territory surrounding a great military camp, juke joints and honky-
tonks formerly did a thriving business.

In studies made by the Association over a period of time prior to
July, 1942 :

It was shown that prostitutes invade the hotels. Through the aid of bell-boys ,ind
cab-drivers, these "hustlers" managed to get a good share of soldiers' pay
envelopes on the last day of each month.

Khaki -struck girls — some mere youngsters in their early, middle and late teens —
also roamed the highways and streets of the various communities. Many literally
threw themselves at the boys in uniform. Others played "hard to get" and
waited to be approached. Operators at some tourist cabins unhesitatingly rented
quarters to soldiers and their female companions. Many ostensibly respectable
hotels provided similar accommodations. If a soldier did not have a girl of his
own, hotel employees often were able to provide "real hustlers." Spasmodic

TEAMWORK IX VENEREAL DISEASE PREVENTION1 117

law enforcement took place. Whenever police activity relaxed a renascence
occurred. Sometimes the racket was stamped out in one place, but quickly loomed
up in another.

July 31, 1942 — (The May Act was invoked by the Secretary of War.)

October, 1943 — Reinvestigation in the May Act territories disclosed that Federal
and State authorities had succeeded in substantially cleaning up these areas.
Operators of juke joints and hotels indicated that it was precarious business
"fooling with Uncle Sam!"

The representatives of the Social Protection Division of the Federal
Security Agency, the venereal disease control officers of the Army,
the Navy and the United States Public Health Service, the state
and local health and law enforcement authorities have done and are
continuing to do a magnificent job in repression of commercialized
prostitution. They have been aided materially not only by the Ameri-
can Social Hygiene Association but also by such organizations as the
International Association of Chiefs of Police, the National Sheriffs'
Association and the American Bar Association. Representatives of
all these and other agencies, official and voluntary, comprise a team
which, with the support of public opinion, may be able to reduce
prostitution in the United States to the lowest point in our national
history. Members of the Association's staff served in 1943 on a
special Social Protection Committee of the American Bar Association
and on the National Advisory Police Committee on Social Protection
of the Federal Security Agency.

Sex Delinquency in Wartime:

Early in the year the Association embarked on a field study to
determine, insofar as possible, the extent and seriousness of sexual
promiscuity among girls and the types of measures which give promise
of curing or alleviating conditions found in different parts of the
country.

Army authorities have reported to the Association their concern
regarding an increase in the proportion — in some areas as much as 70
per cent — of venereal infections traced to girls and women who were
promiscuous or delinquent, though not prostitute's.

A committee of the Association, composed of leading authorities
in the legal and protective fields of service, made a preliminary report
and recommendations which have now been published.*"

In a progress report on study findings, made on September 14th,**
the Association's consultant, who had up to that time visited some
fifty communities in the east and mid-west, stated that conditions
affecting youth included increased employment of mothers in war
industry, migrant workers, Army and Navy cantonments encroaching
on already overburdened communities, racial hostilities, changing
social mores, poor parental standards and broken homes.

* Sex Delinquency Among Girls: A Committee Report, Bascom Johnson.
JOURNAL OF SOCIAL HYGIENE, November, 1943. p. 492.

** The Community and Its Youth in Wartime, Josephine D. Abbott. JOURNAL.
OF SOCIAL HYGIENE, November, 1943. p. 511.

118 JOURNAL OF SOCIAL HYGIENE

Among the subjects included in the field study are community
recreation facilities, control of places serving alcoholic beverages,
protection of migrant and homeless girls, activities of churches, schools
and social agencies, police and especially women police services, and
special projects of youth groups.

Special note is being made of programs introduced into school
curricula. Good examples reported are : the Philadelphia course for
teachers and counsellors; the Skokie Elementary School, in Watseka,
Illinois, which starts sex education in the fifth grade; and the
Cincinnati, Ohio, Pre-Inductioii Health Program for the Efficient
Management of Personal Living in Wartime. Courses and institutes
on Sex and Religion in Columbus, Ohio; on Functional Religion in
Stephens College, Columbia, Missouri ; the Youth Consultation Center
of the Episcopal Church in Newark, are illustrations of important
adaptations of current activities to the demands of community needs.

Mention also was made in our consultant's preliminary report of a
number of projects planned and organized to meet the needs of
youth, among them the following- :

Teen Town in Columbia, Missouri, where youth is organized on a basis com-
parable with the city administration.

The Teen Age Canteen in Monroe, Michigan, an example of youth's efforts to
solve its own problems.

Teen Age Club in Ealeigh, North Carolina, open every day and packed evenings
for dancing, games, etc., and operated and managed by youth.

Junior Counsellors of Bethlehem, Pennsylvania, an organization which now has
similar set-ups in some other cities.

Tlie House of Friendship for youth in Jacksonville, Florida, which is backed
by the Kiwanis Club.

Detailed case studies of sexually delinquent girls reveal a number
of basic background factors including : grave maladjustment of the
girl in the home and often in school, low standards of sex morals and
sometimes criminality in the parents (incest, adultery, desertion and
brutality), and often low intelligence in the girl herself. Jealousy
of parents or of siblings appears as a factor surprisingly often. Girls
with such a background of experience and native endowment are
less likely than more fortunate girls to maintain conventional stan-
dards of conduct under war conditions.

The correction of the basic factors is indeed a long time task. It
may be possible, however, so to modify the forces impinging on these
unfortunate young people as to protect a good many of them from
further disaster. The main purpose of the Association's study is to
ascertain what measures give most promise of accomplishing this
result.

Since September, the consultant has visited 16 additional com-
munities in the south and west, and gathered more specific information
on community provision for meeting the special needs of teen-age
boys and girls. A full report will be rendered in 1944.

TEAMWORK IN VENEEEAL DISEASE PREVENTION 119

III — EDUCATIONAL ACTIVITIES

Boys now enter the armed services at eighteen and girls enter war
industries at about the same age. The Association suggests that high
schools should make provision to give needed health instruction,
including instruction regarding syphilis and gonorrhea, as a part of
pre-induction education.

In order to meet requests from school authorities for information
which youth should have concerning the chief communicable diseases,
the Association prepared, printed and distributed 12,000 copies of
a manual * for teachers and students. This manual, planned as a
project in visual education but adaptable to lecture and textbook
methods, is entitled Some Dangerous Communicable Diseases, and is
a complete special unit of study in health education for senior high
schools and junior colleges. It gives special emphasis to syphilis and
gonococcus infections. A note calls attention to the fact that the
manual is not a study in sex education. The demand for this practical
manual has been most encouraging.

A special conference was called of a small group of physicians, psy-
chologists and sociologists, experienced in educational activities with
young people, to advise regarding the preparation of a booklet for
young women confronted by wartime social hygiene problems. Thiss
proved a more difficult task than might be imagined by those who
have not addressed modern young people on sex problems. A vast
amount of work went into the preparation of a booklet which was
finally issued under the title Boy Meets Girl in Wartime. It has been
welcomed by agencies working with young women and has now taken
its place among the Association's recommended educational material.

The educational consultants of the Association also revised and
brought up to date other standard pamphlets for young people and
for parents and teachers.

The responsibility for sex education and training for family life
rests mainly on the home, the school and the church, and on organ-
izations serving children and young people. Through the distribu-
tion of informative and educational material and through the provi-
sion of a consultation service, the Association endeavored in its edu-
cational activities to promote ethical attitudes and standards of
conduct in the relations between the sexes. Family life and parent
education, child development, eugenics and health education, coordi-
nated and integrated in the school curriculum as health and human
relations education, were suggested to school authorities as an essen-
tial part of the high school curriculum. It was pointed out that,
generally, instruction in human relations is best provided by well-
adjusted teachers of health, biological sciences and home economics.
The demand from parents and teachers for educational materials
continues heavy and has been met, so far as possible, by the
Association.

* With 60 stereopticon sli'lrs of illustrations and text.

120 JOURNAL OF SOCIAL HYGIENE

Educational Activities in Negro Colleges:

The Association continued cooperation with Howard University and
the National Tuberculosis Association in the promotion of the health
program in Negro colleges, emphasizing social hygiene, tuberculosis
prevention and maternity and child health. College Health Review**
published monthly from November through May, was sent to 850
health workers in Negro collegiate institutions and individuals in a
number of voluntary health agencies. Fourteen colleges in the south-
eastern area including Florida, Georgia, North and South Carolina,
were visited by a health educator. Definite progress was noted in
health educational activities. Student health service provisions,
including those for the giving of serological tests and routine chest
X-rays, were studied. One hundred and ten requests for guidance and
advice were filled and assistance was given in health education insti-
tutes for teachers participated in by 1,338 persons.

An interesting experiment was made in Texas during the summer
of 1943, under the direction of the Association's field representative.
A Negro educator employed by the Association, working in Dallas
and Houston, Texas, visited four Negro colleges, 15 churches, one high
school, four office workers' groups, three war industry groups and
five groups giving educational talks to a total of more than 15,000
Negroes. The fine cooperation secured from Negro ministers, school
teachers and the Negro Chamber of Commerce was gratifying. A
sponsoring committee, declaring the demonstration a success, recom-
mended the continuance of the activity.

Development of Negro professional leadership in health education
appears to be one of the essentials for a sound approach to the
serious problems of this part of the population. To a limited degree
the activities mentioned above will prove helpful. It is desirable
greatly to extend them.

IV — PUBLIC INFORMATION AND EXTENSION

It is through its publications, publicity releases, articles, posters,
exhibits, radio broadcasts and motion pictures that the Association
reaches the millions with information and points of view regarding
social hygiene. These are instruments which can be applied to special
problems as they arise. Since the war emergency began all these
means of informing and influencing individuals and groups have been
utilized to protect the armed forces and war industrial workers of
the nation from the venereal diseases which sap manpower and from
prostitution which not only spreads disease but destroys character and
morale. New materials have been prepared and are being prepared
for service men, workers, both men and women, and for the general
public. Large quantities have been provided to the Army and Navy
and to war workers on request. Smaller numbers have been dis-
tributed to and through numerous cooperating health and welfare

**

Published by Division of Hygiene & Public Health, School of Medicine,
Howard University.

TEAMWOEK IN VENEREAL DISEASE PREVENTION 121

agencies. Popular materials deal with the essential facts which every
one should have. For the professional worker more elaborate scientific
information is provided. Informational and educational materials
have been distributed to every state and territory and almost every
community throughout the nation. The armed forces overseas have
reproduced certain educational materials with the permission of the
Association.

These services have greatly increased in 1943 as indicated by the
following table comparing 1942 and 1943 distribution.

A COMPARATIVE RECORD

194% 1943

Pamphlets 1,512,286 3,189,228

Posters, charts and exhibits 14,451 29,089

Social Hygiene News (12 issues) 148,218 171,671

Journal of Social Hygiene (9 issues) . . . 19,627 27,944

A total of 556 sound motion pictures were distributed in 1943, and
of these 245 went to the armed forces. These forces also secured
17,753 posters as compared with 12,236 distributed to the general
public.

The Association 's ' ' house organs ' ' are the JOURNAL OP ' SOCIAL
HYGIENE and SOCIAL HYGIENE NEWS. The former carries substantial
material on wartime aspects of social hygiene by nationally known
leaders. The latter is a news sheet of current events. Both these
publications are sent to all Army, Navy and Public Health Service
venereal disease control officers and to representatives of the Social
Protection Section. Circulation has increased substantially as indi-
cated above.

The single soldier-sailor-and-marine leaflet, So Long Boys — Take
Care of Yourselves, with a total distribution of 1,475,517 copies, nearly
equalled last year's total distribution record for all pamphlets.
Practically all of So Long Boys went to men just prior to joining the
armed forces or after their, enlistment. The leaflet, Calling All
Women, with a distribution of 573,566 copies to women in war
industries, was second in demand. Next in demand was the informa-
tive little pamphlet, Questions and Answers About Syphilis and
Gonorrhea. Of a total of 228,785 copies distributed, approximately
one-half was requested for the armed forces. The two editions of
the booklet, Boy Meets Girl in Wartime reached a distribution total
of 150,747, mainly to young women engaged in war services.

Fourth most popular pamphlet was Vital to Victory, which went
to 159,834 men workers in war industry, including many civilian
employees in Army and Navy installations.

A distribution to Negroes, of 116,830 copies of Our Family Is
Having Its Blood Tested, was recorded.

The Facts Behind the Fight Against Venereal Disease went to
27,786 friends of the Association.

122 JOURNAL OF SOCIAL HYGIENE

During the year the Public Information Service periodically sent
news releases and material for editorial comment to leading daily
newspapers throughout the country. It also placed special news
stories and articles in the journals of professional and lay organiza-
tions, with particular attention being given to the labor press and
the publications of medical, public health and pharmaceutical groups.

To aid the Army the Association brought to the United States two
excellent Canadian motion pictures produced by the Royal Canadian
Air Force for their personnel. A British motion picture entitled
Sex in Life, dealing with the biology of reproduction, has been given
wide distribution in the United • States and arrangements are being
made to obtain the American rights for its reproduction and
distribution.

A new motion picture designed to inform women regarding syphilis
and gonorrhea was started in 1943 and will be completed early in 1944.

One of the staff of the Association served in 1943 as a member of
the Women's Interest Section of the War Department Bureau of
Public Relations and with other women leaders visited the training
centers of the Women's Army Corps. Enthusiastic reports of the
WAC and their splendid training and patriotic services were brought
back by those fortunate enough to go on the tour of inspection.

The Association provided sets of educational materials for each
chaplain in training at the Army School for Chaplains at Harvard
University.

Social Hygiene Day Observance:

With the theme Social Hygiene Takes Battle Stations, the Associa-
tion again sponsored in 1943 the nationwide observance of Social
Hygiene Day on February 3rd. Preceded by special proclamations
by Governors and by Mayors, thousands of communities held meetings
sponsored by many different groups.

Citizens were brought together in conferences on methods for
protecting the health and morale of soldiers, sailors, marines, workers
in war industries, and civilians alike, from syphilis and gonorrhea
and from conditions which favor their spread. They heard responsible
social hygiene leaders make known vital facts and urge united action.

The United States Public Health Service, and the Social Protection
Division of the Office of Community War Services, joined in national
sponsorship of Social Hygiene Day. Closely cooperating were rep-
resentatives from the Army and Navy headquarters at Washington
and from the nine Army Service Commands and the fifteen Naval
Districts. State and local branches of federal and national voluntary
agencies worked with Social Hygiene Day Committees for the success
of regional and community meetings and other events.

Every state, plus the territories of Hawaii, Puerto Rico and Alaska,
participated in some or all of the ways suggested in Program and

TEAMWORK IN VENEREAL DISEASE PREVENTION 123

Publicity Aids sent out by the Association. More than 3,000 "kits"
were mailed in this outstanding educational project of the Association.

Newspapers made Social Hygiene Day meetings, including the
dozen or more regional conferences, front page news, and supple-
mented the news stories by feature articles, editorials and cartoons.
The radio "forum" prepared by the Association was adapted for
local use in many communities. Reports received indicated that
film showings were numerous. Exhibit material provided by the
Association was widely used in libraries, and department and drug
stores. Car cards, posters and contributed advertising focussed
public attention on social hygiene objectives.

Highspot at the Association's Thirtieth Annual Meeting in Buffalo,
was the presentation of the William Freeman Snow Award for Dis-
tinguished Service to Humanity to Dr. Ray Lyman Wilbur, President
of the Association, with the citation. Physician, Teacher, Scholar,
Public Servant and Administrator. A special feature pf the anni-
versary meeting was a salute to The Social Hygiene Pioneers. The
list of 244 pioneers, who had been identified with the movement
for twenty-five years or more constituted an impressive Roll of Honor.
Honorary Life Membership was conferred on Doctor J. E. Moore,
Doctor C. A. Harper, Doctor R. A. Vonderlehr, Doctor George Baehr,
Mrs. Frances Payne Bolton, Professor Ralph E. Wager, and Doctor
Henry Hazen at Social Hygiene Day meetings in several cities.

Preparations for Social Hygiene Day, February 2, 1944, were
already far advanced at the close of 1943.

Conference with Negro Leaders:

The Association arranged a conference on November 22 and 23
between representative Negro leaders, government officials and rep-
resentatives of cooperating voluntary agencies to consider "what
might be done by united action to reduce the venereal diseases as a
serious handicap to Negro health and efficiency." Doctor William
F. Snow, chairman of the Executive Committee of the American
Social Hygiene Association, served as chairman of the conference.

Representatives of eight government agencies, seven voluntary
health and welfare agencies, and fourteen Negro voluntary organ-
izations heard a presentation of medical and social facts having to
do with the prevalence and incidence of venereal disease among
Negroes and the available resources for federal, state and local action.

Among the organizations and agencies represented were the U. S.
Army and Navy, Social Protection Section of the Federal Security
Agency, Selective Service System, Children's Bureau, U. S. Public
Health Service, U. S. Office of Education, Office of War Information,
War Xursing Council, American Bar Association, Phelps-Stokes Fund,
Council of Negro Women, Negro Publishers Association, National
Medical Association, Fraternal Council of Negro Churches, Federal
•Council of Churches of Christ of America, Board of Church Missions

124 JOURNAL OF SOCIAL, HYGIENE

of the Methodist Chun- lies, Atlanta University, Fisk University,
Howard University, and Tuskegee Institute.

A continuation committee was appointed to give further considera-
tion to recommendations for positive action adopted at the conference
and to take preliminary steps in carrying them out. Approval was
given to a plan for effective collaboration between white and Negro
leaders.

Among the recommendations being studied are those which
suggest that an attempt be made to increase Negro trained personnel
including nurses, health educators, social workers and laboratory
personnel as well as physicians; that health education opportunities
be provided for patients at ail treatment centers and that law
enforcement in prostitution repression be stimulated.

Special Projects:

The great importance of California as an area of military, naval
and war industrial concentration led the Association to continue aid
for the development of educational service, particularly with employee
groups in that state through the California Social Hygiene Association
headed by Doctor Ray Lyman Wilbur. Excellent progress has been
made in cooperation with the health authorities, local committees and
labor groups.

Similarly in Massachusetts the Association has cooperated in exten-
sion of social hygiene activities throughout this highly industrialized
state, working in cooperation with the Massachusetts Society for
Social Hygiene.

In Missouri through aid to the state Social Hygiene Association
real progress has been made in popular education and in a study of
basic causes of delinquency especially in St. Louis.

The Association aided the Pittsburgh Syphilis Control Project in
a basic study of methods for dealing effectively with this infection
in an industrial population.

The Kentucky Social Hygiene Association was aided in efforts to
extend its activities to communities in the neighborhood of important
Army establishments in that state.

Washington Liaison Office:

The importance of liaison activities with Federal agencies and with
national voluntary organizations, such as the American Red Cross,
the American Legion, the General Federation of Women's Clubs,
National Education Association, International Association of Police
Chiefs, and National Sheriffs Association, located in Washington or
at present maintaining liaison activities there, made necessary the
establishment, in 1941, of a year-round office of the American Social
Hygiene Association with a full-time representative.

Contact is maintained with administrative units of the Army,
including the Surgeon General's Office, Morale Branch, Provost
Marshal, Medical School, Women's Interests Section, and other

TEAMWOEK IN VEXEREAL DISEASE PREVENTION 125

agencies of the War Department, the Welfare and. Recreation Sec-
tions; similar offices and serArices of the Xavy; U. S. Public Health
Service; U. S. Office of Education; Social Protection Division of
the Office of Community War Services, and other administrative
units and offices under the Federal Security Agency; U. S. Children's
Bureau, Department of Labor ; Health and Sanitation Division, Office
of the Coordinator of Inter- American Affairs; Office of Civilian
Defense; Office of War Information; President's War Relief Control
Board; United Nations Relief and Rehabilitation Administration;
Federal Bureau of Investigation, Department of Justice ; Office of
Indian Affairs, Department of the Interior; Extension Service,
Department of Agriculture; Federal Works Agency; and National
Archives.

This office is also called upon, by Senators and Representatives in
Congress, for a wide variety of information relating to data and
activities in the social hygiene field.

Field Services and Organization:

Association field service was increased in 1943 in order tc meet
community needs as indicated- in conferences with representatives of
the Army, Navy and other government agencies and of private organ-
izations. Experienced workers are now assigned to each of the nine
Army Service Commands, and branch offices exist in all of them except
the First (New England) which is served from the New York City
headquarters of the Association.

The Association's field representatives aid the Army and Navy
venereal disease control officers in educational activities with the
armed forces and in dealing with problems arising in civilian com-
munities near military establishments, especially those problems which
can best be solved by a non-official worker. The task of the field
representative in such a situation is to interpret government policies
and procedures and the reasons for them and to secure civilian
cooperation.

The regional officers of the Army, Navy, Public Health Service and
the Social Protection Section of the Federal Security Agency with the
Association's representatives form a team which is able to work closely
together and accomplish results of far reaching importance.

The above mentioned services are welcomed and given every coop-
eration by the Army and Navy as well as the Public Health Service
and the Social Protection Section of the Federal Security Agency
which are primarily concerned with civilian problems.

Reports of field representatives in the nine Service Commands
noted that all important communities had been visited and that the
Association had assisted in the development of activities in most of
these communities. A constant effort was made to find community
leaders who could be counted on to take responsibility for community
support of programs carrying out Association objectives.

126 JOURNAL OF SOCIAL HYGIENE

Whenever it appeared that the time was opportune for the estab-
lishment of a new committee to sponsor locally a social hygiene pro-
gram, assistance was given in the organization of a group which could
become affiliated with the Association. Among the new associations
organized or revived into real activity were those in San Diego,
California; Provo, Ogden and Salt Lake City, Utah; Columbus,
Georgia; Omaha and Lincoln, Nebraska; Columbia, South Carolina
and the Virginia and Washington state associations.

In many instances it was found that the hope for the future in a
social hygiene community program could best be assured by the incor-
poration of social hygiene activities in existing going organizations.
Thus the Kansas Tuberculosis and Health Association has agreed to
accept responsibility for the development of social hygiene activities
in that state. This is indeed a great step forward in the central states.

In Steptember, 1943 a conference of social hygiene society executives
was held with the field and headquarters staff of the Association in
New York City. The conference resulted in closer union of the
Association with its affiliates throughout the country — and greater
solidarity in helping to win the war by preventing venereal diseases
among soldiers, sailors and war wrorkers.

It has long been the policy of the Association to cooperate with all
reputable voluntary welfare organizations willing to serve as channels
for social hygiene educational materials. Among many which have
aided our program over a long period of time are the National Con-
gress of Parents and Teachers, the General Federation of Women's
Clubs, the Junior Chamber of Commerce, the Federated Churches of
Christ in America, the American Legion, National Y.M.C.A., National
Y.W.C.A., American Medical Association, American National Red
Cross, and American Pharmaceutical Association.

On December 15, 1943 a conference of some of these national col-
laborators was called by the Association in Chicago and an afternoon
was profitably devoted to reviewing mutual interests and common
objectives.

CONCLUSION

If history repeats itself, there is grave danger of a great increase
in the prevalence of venereal diseases after this war such as occurred
following World War One. It is essential, therefore, that every effort
be made to hold the gains against these infections made before and
during the present world- wide conflict.

More widespread and effective measures are now employed against
venereal diseases as a wartime menace than have ever existed before
in the United States. These measures must be continued in the post-
war period.

With the end of the war a recrudescence of "red light districts "
and flagrant prostitution conditions in many places may be expected,
unless we are very vigilant and resourceful. Evidence at hand indi-

TEAMWORK IN VENEREAL DISEASE PREVENTION 127

cates that the racketeers who expect to profit from prostitution are
now planning and fully expecting to re-establish their vicious traffic
at the end df the war. They count on a slackening of law enforce-
ment efforts. Only a thoroughly convinced and vocal public opinion
can prevent such a backward step.

It is reasonable to hope that the new discoveries, especially the
modern intensive therapy of syphilis, and penicillin treatment of
gonorrhea may make it possible, in the not too distant future, to
bring venereal diseases under control. The Association can then
expand and emphasize other aspects of its social hygiene program.
Education of youth regarding the place of sex in life — the socially
and personally beneficial exercise of the reproductive instinct, in a
word, the training of youth for happy marriage and satisfactory
family life — is a long-range undertaking which will require for
success the cooperation of educational institutions, churches and social
welfare agencies of every description. As soon as possible after the
war the Association should be able to turn its principal attention to
this undertaking.

But in order to enjoy the privilege of participating in this future
constructive work, the war must first be won. Hence, all our resources
of money, strength and ingenuity are devoted now to helping assure
full victory for the armed forces of the United States, and to
mitigating the deleterious effects of war on young people. To help
keep soldiers, sailors, marines, airmen, at their battle stations and fit
to fight and win; to keep workers fit to produce the instruments of
warfare; and to protect youth in wartime, are the present major
purposes of the American Social Hygiene Association.

WALTEE CLARKE, M.D.

Executive Director

In accordance with the By-Laws and procedures which have been
approved by the membership, the Executive Committee prepares a
program and budget for each fiscal year (the calendar year) which
are submitted to the Board of Directors for action and reporting
to the members at annual meetings.

Subsequently the Executive Committee reviews the program and
budget prior to quarterly meetings of the Board and confers with
its members regarding any current revisions which may be deemed
advisable. Pages 128-132 present a summary of the program and
budget for 1944. On page 133 is included a list of field offices to
illustrate one method by which the Board seeks to keep in close
touch with all parts of the nation and to provide its services where
most needed from year to year.

128 JOURNAL OF SOCIAL HYGIENE

PROGRAM AND BUDGET FOR 1944

1. Public Information and Community Service

This is the activity which reaches all types of com-
munities and groups throughout the United States
with interpretative material concerning the war-
time social hygiene problems and the approved
activities for dealing with conditions which
adversely affect the health and welfare of the
armed forces and war industrial workers. The pro-
duction and distribution of pamphlets, posters,
exhibits, films and slides is the responsibility of
this Division. Most of this material goes to the
armed forces and to war industrial workers.
Contact is maintained with state and local social
hygiene societies and with many cooperating
national, state and local organizations. The
organization of new social hygiene societies and
committees is stimulated, the adoption of social
hygiene programs by cooperating agencies facili-
tated, and help with special problems is given.
Meetings are arranged and speakers provided
for national, state and local meetings $50,217.68

2. Legal and Protective Activities

These activities aim directly at the repression
of prostitution and the prevention of sex delin-
quency and promiscuity — conditions which spread
the venereal diseases. Such action is extremely
important in wartime because these conditions
directly threaten the nation's manpower 18,610.10

3. Medical and Public Health Activities

This activity includes not only professional direc-
tion of the health and medical aspects of the
Association's work and the activities of our 145
affiliated societies and committees but also expert
services to the Army, the Navy, the Public Health
Service, the Social Protection Division of the Fed-
eral Security Agency and many state and local
official and voluntary bodies. The staff partici-
pates in instruction of Army, Navy and civilian
Venereal Disease Control Officers. Medical officers
of the staff represent the Association on the Inter-
departmental Venereal Disease Control Committee
and the National Eesearcli Council and serve as
Consultants to the Secretary of War, the U. S.
Public Health Service and the Federal Security
Agency. They also serve on numerous other
committees, guiding important social hygiene
efforts and research projects which are vital parts
of the wartime program 12,1] O.JO

4. Educational Activities

These activities include consultant services and the
preparation and distribution of educational mate-
rials to help youth-serving groups, parents,
churches and schools meet the wartime social
hygiene problems of young people. At present
there is an urgent need to inform and stimulate
such groups with regard to the extremely difficult

TEAMWORK IN VENEREAL DISEASE PREVENTION 129

personal problems which confront young people
under war conditions. It is particularly neces-
sary to encourage and aid educational institutions
in preparing 'teen age boys and girls to cope
with situations which they meet immediately
after leaving high school. The fact that boys now
enter the armed services at eighteen and girls
enter war industries at about the same age means
that high schools carry a responsibility for
giving health instruction, especially in the junior
and senior years. This educational work is called
' ' Pre-induction health instruction ' ' and educa-
tional authorities are responding satisfactorily to
the initiative which the Association is taking in
this matter 11,955 . 05

5. Field Services

Through the services of its staff in the field the
Association's wartime program is brought directly
and personally to leaders of national, state and
, local agencies. The Association's office for con-
tinuous liaison with the War and Navy Depart-
ments, the U. S. Public Health Service, Federal
Security Agency and numerous other agencies is
in Washington, D. C. The Association has estab-
lished Field Offices in each of the nine Army
Service Commands, except the First wrhich is
served from the New York Office in the Second
Service Command. Service Command Offices are
located as follows:

For First and Second Service Commands
.... New York City

For Third Service Command . . . Baltimore

For Fourth Service Command . . . Atlanta ,

For Fifth Service Command . . . Columbus . .

For Sixth Service Command Chicago

For Seventh Service Command. . .Omaha

For Eighth Service Command Dallas

For Ninth Service Command

Salt Lake City and San Francisco ,

Field Representatives work in each of these Serv-
ice Commands under the supervision of the
Headquarters Office. The Field Representatives
are highly trained and experienced professional
men and women who enjoy the confidence of the
officers of the Army and the Navy and other
government representatives in their respective
areas 65,832 . 57

6. Special Projects

Under Special Projects are grouped certain Asso-
ciation activities which are carried on in relation
to various cooperating official or voluntary agen-
cies. A brief, explanatory note regarding the
more important of these projects follows 110,595.00

a. The Coordinator 's Project

This project is under the supervision of the
Division of Legal and Protective Activities. It
provides for field studies of prostitution and re-
lated conditions throughout the United States

130 JOURNAL OF SOCIAL HYGIENE

and reports on these studies to the appropriate
Federal and state authorities. Studies are made
principally at the request of the Army, the
Navy, the U. S. Public Health Service and the
Federal Security Agency and occasionally vari-
ous state health and law enforcement officials.

6. Youth Services

This project provides personnel to maintain liai-
son particularly with the member agencies of
the USO and also with numerous youth agencies
with which we constantly cooperate.

c. Social Hygiene Day

Social Hygiene Day, February 2, 1944, is the
annual high point of social hygiene popular in-
struction activities in the United States. Thou-
sands of meetings and much publicity results
from the promotion which focuses public atten-
tion on wartime problems; and on review of the
past year's program and plans for the coming
year.

d. Industrial Project

The Industrial Project aims to secure the coop-
eration of labor and management in the protec-
tion of war workers from syphilis and gonorrhea,
thereby saving manpower. Special emphasis is
being given at present to enlisting the interest
and support of organized labor in these
educational activities.

e. Educational Project

This is a study of methods of public education
and training of personnel in wartime. These
studies are particularly important as they follow
and evaluate Federal, state and local health
activities aimed at the protection of the armed
forces, industrial workers and the general public
from the venereal diseases under the conditions
of the present emergency.

/. Pharmacy Project

This project is succeeding in enlisting the par-
ticipation of pharmacists in the wartime pro-
gram for controlling venereal diseases. Pharma-
cists can help or hinder this program and it is
assumed that they will help it to the degree
that they understand the nature of the problem
and the methods by which venereal diseases can
be controlled

g. Appropriations for Special Projects with Co-
operating Organizations

From the funds of the Association small appro-
priations are being made this year to the Cali-
fornia Social Hygiene Association, the Missouri
Social Hygiene Association, the Massachusetts
Society for Social Hygiene, and the Pittsburgh
Syphilis Control Project, to aid them in state
and local activities. Such activities directly aid
wartime venereal disease control programs in
these areas, and are selected as being of special
value in relation to the National Agency
program.

131

TEAMWORK IN VENEREAL DISEASE PREVENTION

7. Publications Service

The Association produces and distributes a large
number of pamphlets, posters, exhibits, motion
picture films and slides to state and local health
authorities and various other tax-supported health
and welfare agencies. To the extent possible these
tax-supported organizations are requested to reim-
burse the Association for cost of materials which
they obtain. This operation is set up as a special
project to keep it separate from the Association's
general activities material 28,000 . 00

8. Committee Activities

These are activities of the Executive Committee,
the Finance Committee, the Membership Com-
mittee, the Board of Directors and such Special
Committees as may be set up from time to time in
connection with governing the Association's policy-
making, and supervising its general program. It
should be noted that no allocation is made to the
Finance Committee since the fund-raising program
has for the present been undertaken by the
National War Fund 5,245 . 00

9. Administration, Publicity and Promotion

Under this item is included the necessary overhead
expenses of carrying on the Association's activi-
ties. The total amounts to about twelve per cent
(12%) of the whole budget 42,209.50

10. Contingent Fund

It is evident from the experience of past years,
and especially in 1943, that some portion of the
1944 budget must be kept free from specific
assignment, in order to enable the Executive Com-
mittee to deal effectively with emergencies 15,225.00

Total $360,000.00

Financial Statement for Year 1943
INCOME — January 1 to December 31, 1943

Contributions . $245,589.40

Membership dues and subscriptions to JOURNAL OF

SOCIAL HYGIENE 5 122 . 29

Income from books, pamphlets, films, exhibits and

other materials 28,840 . 10

Miscellaneous income . . .' 28. 75

Total Income 1943 $279,580 . 54

EXPENSE — January 1 to December 31, 1943

Public Information and Extension $32,081 . 01

Legal and Protective Activities 14'698.04

Medical and Public Health Activities 15^590 . 45

National Education Committee Activities 11,2881 10

Executive Committee Activities. 3?862.16

Membership Committee l'549 49

National Anti-Syphilis Committee, including finan-

cial campaign 10,221.53

General Field Service 60 767 74

132

JOURNAL OP SOCIAL HYGIENE

Publications: Journal of Social Hygiene, Social

Hygiene News, books, pamphlets, films, exhibits 42,974.35

Special Projects: Field studies of prostitution and
related conditions in states and communities;
Youth Service ; Social Hygiene Day ; Cooperation
with Labor Organizations and Industrial Lead-
ers in War Industries, Health Authorities,
Pharmacists; Development of Educational Ac-
tivities in California; and miscellaneous 101,616.85

Total Expense 1943

In addition to the expenditure of $294,649 . 72
from the funds of the Association, other agen-
cies contributed $24,423.06 to projects of the
Association. Some of the personnel employed
in these projects were paid directly by such
cooperating agencies. This expenditure is,
therefore, in addition to the $294,649.72 item-
ized above.

$294,649.72

MARGIN OF EXPENSE OVER INCOME FOR 1943.

15,069.18*

ASSETS :

Special Funds — William Freeman Snow Medal

Fund $182.63

General Funds —

Cash for generjfl purposes, including revolving

funds and petty cash 20,174. 75

Advances to staff for travel 5,333 . 70

Accounts receivable for publications 3,940.67

Securities — 10 shares Boston Wharf Company
stock — estimated value as of December 31,
1943 165.00

Total Assets $29,796 . 75

LIABILITIES :

Accounts Payable $5,116 . 42

NET WORTH — December 31, 1943 $24,680 . 33

* Paid from balance carried over from previous year. Net worth December 31,
1942, plus minor adjustments, was $39,749.51.

TEAMWORK IN VENEREAL DISEASE PREVENTION
FIELD OFFICES*

133

WASHINGTON, D. C.

ATLANTA, Georgia.

COLUMBUS 15, Ohio.

OMAHA 2, Nebraska.

SALT LAKE CITY 1, Utah.

Washington Liaison Office, Room 609, 927 15th
St., N.W.

JEAN B. PINNEY, Director in Charge
REBA EAYBUKN, Office Secretary

506-508 Citizens & Southern Nat'l Bank Build-
ing. Serving Alabama, Florida, Georgia,
Mississippi, North Carolina, South Carolina
and Tennessee.
CHARLES E. MIXER, Field Representative

Care National Conference of Social Work, 82
North High Street. Serving Indiana, Ken-
tucky, Ohio and West Virginia.
WADE T. SKARLES, Field Representative

736 World-Herald Building. Serving Colorado,
Iowa, Kansas, Minnesota, Missouri, Nebraska,
North Dakota, South Dakota and Wyoming.
GEORGE GOULD, Assistant Director, Division of
Legal and Protective Service, in cJiarge

402 Mclntyre Building. Serving Arizona,

Idaho, Montana, Nevada Utah, California,

Oregon and Washington.

GEORGE GOULD (see above), temporarily in

charge,

Care of Baltimore Community Fund, 22 South
Light Street. Serving Delaware, Maryland,
Pennsylvania and Virginia.
KENNETH R. MILLER, Field Representative,
home address, 260 Bridge St., Drexel Hill, Pa.
EDNA W. Fox

Room 615, 360 North Michigan Avenue.
Serving Illinois, Michigan and Wisconsin.
DR. WARREN II. SOUTIIWORTII, Field Repre-
sentative

Cliff Towers. Serving Arkansas, Louisiana,
New Mexico, Oklahoma and Texas.
BASCOM JOHNSON, Director in Charge
MRS. GERTRUDE R. LUCE, Office Secretary

SAN FRANCISCO 5, California. 45 Second Street.

W. F. HIGBY, Field Consultant

BALTIMORE 2, Maryland.

CHICAGO 1, Illinois.

DALLAS 8, Texas.

* The New England states, New York, and New Jersey are served from the
Association's headquarters in New York City.

THE THIRTY-FIRST ANNUAL MEETING

OF THE

AMERICAN SOCIAL HYGIENE ASSOCIATION

(Business Session)

February 1, 1944
Academy of Medicine, New York, N. Y.

ABSTRACT OF PROCEEDINGS

The members and delegates attending this session of the Annual
Meeting of the American Social Hygiene Association were called
to order by the President, Dr. Ray Lyman Wilbur, at 6 :00 P.M., the
Academy of Medicine, New York City. The Committee on Credentials
reported a quorum present.

President Wilbur announced the following Committees of the
Association on (1) Credentials, (2) Resolutions, (3) Nominations
for the year 1944 ; explaining that these Committees also serve during
the interim between Annual Meetings, as Standing Committees on
(1) Membership, (2) Public Statements, and (3) Personnel
Questions, respectively.

1. Committee on Credentials

1. Dr. Bertha Shaf er, Chairman Chicago, Illinois

2. Mr. Elias L. Day Salt Lake City, Utah

3. Miss Margaret Flynn Louisville, Kentucky

4. Mr. Lawrence Arnsteiii San Francisco, California

5. Mr. Bailey B. Burritt New York, N. Y.

2. Committee on Resolutions

1. Mr. Ray H. Everett Washington, D. C.

2. Dr. Carl A. Wilzbach Cincinnati, Ohio

3. Mrs. S. W. Miller Boston, Massachusetts

4. Mrs. Elwood Street Houston, Texas

5. Professor Ralph E. Wager Atlanta, Georgia

3. Committee on Nominations

1. Mr. Alan Johnstone Newberry, South Carolina

2. Mr. Walter W. R. May Oregon City, Oregon

3. Dr. John M. Sundwall Ann Arbor, Michigan

4. Dr. Harriet S. Corey St. Louis, Missouri

5. Dr. Felix J. Underwood Jackson, Mississippi

Mr. Bailey B. Burritt, as Secretary of the Association, reported that there
were no corrections for the minutes of the previous meeting, and on motion
seconded and carried the minutes were approved. Mr. Burritt then presented
the Report of the Board of Directors for the year 1943. After discussion of

134

THE THIRTY-FIRST ANNUAL MEETING 135

this report and inspection of the several reports * of Committees and Officers,
submitted therewith, on motions duly approved, these were accepted and filed.

The Committee on Kesolutions * was represented by Dr. Walter Clarke in
the absence of the chairman, Mr. Ray H. Everett. On motion, seconded and
carried, this report was adopted.

The Report of the Committee on Nominations * was presented, and after
discussion the nominated officers and members of the Board of Directors were
unanimously elected.

Following the transaction of the above required business, the President
called upon the Secretary, Mr. Burritt, for a statement regarding the Annual
Dinner to be served at the Academy, and plans for the presentation of the
Award to Dr. Hugh S. Gumming. Dr. Robert L. Dickinson was called upon
to describe his scientific work and activities in preparing visual education
materials. The members accepted the opportunity to visit Dr. Dickinson's
laboratory and museum in the building following adjournment. After a period
of general discussion of plans for the coming year, a motion to adjourn was
carried.

REPORT OF COMMITTEE ON CREDENTIALS

The Committee finds that there is a quorum of members present and qualified
to vote at this annual meeting of the Association. The membership now totals
18,201, comprising contributory, honorary, collaborating, corresponding, library
and society members.

Community and state interest and citizen participation have increased during
the year. However, concentration of the Association's effort on war activities,
and the financing of the budget by the National War Fund have resulted in
fewer new members being added to the rolls of national membership. The
report of the year records 460 new members.

Tin' Committee has no specific recommendations to present at this meeting.
Attention is called to the reports for previous years in which emphasis is placed
on the importance of adding new members— particularly young men and women.
Even now in the midst of war, the Committee hopes ways and means will be
considered for strengthening the youth group representation in the Association's
membership. We may expect to emerge from this war period into a new world
in which our children now in their adolescence will have to plan their lives.
Much that the Association has to contribute can be passed on to them only
by enlisting their active participation now.

Two questions of interest recently referred to the Committee on Credentials,
serving as the Membership Committee, are outlined in the attached
correspondence — -

1. The question of authorizing its affiliates to use the Association's Emblem
(which it uses on its letterheads and some publications).

2. The question of defining ' ' society membership ' ' more definitely.

Unless the members desire to discuss and act directly on these questions,
they will be considered by the Committee and recommendations will be made
later to the Executive Committee.

Respectfully submitted.

REPORT OF THE BOARD OF DIRECTORS

To the Members of the Association :

It has been the practice of members attending the annual meetings to have
the reports of the Executive Committee, the Finance Committee, the Treasurer,
the Auditor, and the Corporation Report for the year introduced for general
discussion, then circulated for inspection before action is taken. These reports
are now submitted for your consideration.

The Reports of the War Activities Committee, the Committee on Awards,
and the General Advisory Committee are also presented for notation, comment
and filing.

Summaries of reports are included in this abstract.

136 JOURNAL OF SOCIAL HYGIENE

On July 31, 1939, President Wilbur appointed a Special Committee to consider
ways and means of maintaining the strongest continuous program . . . adapted
to changing conditions and personnel requirements. . . .

That Committee began its work with Dr. Livingston Farrand as Chairman ;
but his death and the advent of war delayed its progress. Recently however,
President Wilbur and the Committee members have discussed the importance
now, in the midst of war, of studying the plan and scope of alternative pro-
grams and personnel needs of the post-war and future periods. Dr. Bishop
has agreed to accept the Chairmanship of this Committee, and Dr. Parran,
Dr. Emerson, Mr. Mather and Captain Babcock will serve with him. An item
has been included in the budget to be held for such expense as may be deemed
necessary for the purpose of this Committee.

Father Schwitalla has submitted the timely suggestions quoted below which
the Board also believes should be brought before you for consideration:

1. ' ' Intensification of efforts to bring both the health and the educational
attitudes of the American Social Hygiene Association to the attention of
social hygiene committees of other associations with a view of developing
greater unanimity and uniformity of effort.

2. The place of the Association in the present venereal disease campaign.

3. The desirability of further efforts to clarify the objectives and procedures
of the American Social Hygiene Association and of the social hygiene
movement. ' '

Similarly Dr. Rachelle S. Yarros has written : " If I could be with you
this year, I would particularly invite discussion of any serious proposal that
the social hygienists drop the term Sex-Education and use the phrase public
health and human relations." The advisability of any such action is questioned.

Finally the Board desires to report its action in approving a temporary
section of the General Advisory Committee on ' ' Special Wartime Problems of
Venereal Disease Control. ' ' This section comprises the membership of the
recent Conference with Negro Leaders. A small Continuing Committee of this
Conference Group was named to advise with the staff and the Board of Directors
on cooperative projects with governmental and other voluntary agencies in
promoting greater initiative and participation of Xegroes in the venereal
disease campaign.

Respectfully submitted.

SUMMARY OF REPORT OF THE EXECUTIVE COMMITTEE
_ To the Board of Directors :

The Executive Committee presents herewith, as the basis of its final report
for the year 1943: (1) the minutes of the meetings; (2) supporting state-
ments and reports filed for reference; (3) quarterly reports of the Executive
Director; (4) reports of the sub-committee on budget and salary adjustments
approved. (See pp. 128-132 for 1944 Program and Budget.)

The Committee considers the work of the year to have been unusually impor-
tant and successful in this difficult war period. The staff members have worked
untiringly to carry out their assignments. The Executive Director was instructed
to prepare an annual statement summarizing the more important projects
undertaken during the year. This is attached * and copies are available for
members attending the annual meeting. If this statement is approved for
more general circulation, it will be submitted to the Editorial Board for pub-
lication in the JOURNAL, and in preprint form with such revisions and addition
of illustrative material as may be deemed desirable.

For the months which lie immediately ahead, the continuance of the program
and budget of the past quarter (i.e. $30,000.00 per month) is indicated; and
the Committee has no special recommendations to make.

The Committee would like, however, to present briefly several projects for
action or intructions at this time. These may be listed as follows:

* See text of this statement on pages 107-27 of this issue of the JOURNAL.

THE THIRTY-FIRST ANNUAL MEETING 137

1. Cooperative Project with the Massachusetts Social Hvgiene Association
for 1944.

2. Cooperative Project with the Missouri Social Hygiene Association for 1944.

3. Cooperative Project with the Kentucky Social Hygiene Association.

4. Completion of film for women and increase in the allocation therefor.

5. Addition of a Negro educator to the staff for assignment to activities
in the Eighth Service Command and other areas.

6. Addition of a Special Consultant for temporary field service in promoting
Negro participation in the venereal disease campaign.

7. Cooperative Project with Government and Voluntary Agencies, in pro-
moting the planning and participation of Xegroes in the campaign against
the venereal diseases.

The chairman of the Executive Committee and the Executive Director have
been requested to furnish any details regarding each of these projects.

.Respectfully submitted.

SUMMAEY OF REPORT OF THE FINANCE COMMITTEE

To the Board of Directors:

The Finance Committee revised and adapted the fund raising and book-
keeping methods of the Association to meet the requirements of the National
War Fund, when the latter took over the responsibility for providing funds
to cover expenditures under the approved budget of the Association not pro-
vided by other sources.

At the same time on request of the War Fund the Association gave leaves
of absence to the Campaign Manager and Associate Director for the year
to serve on the staff of the War Fund, and arranged for the release of another
member of the staff for this purpose.

These arrangements have been mutually helpful and the underwriting of
our budget has enabled the Association to continue its vigorous and successful
war essential activities without retrenchment. It is expected that this agree-
ment will be continued in 1944.

It should be kept in mind, however, that the original agreement with the
National War Fund, in relation to the War, does not at present make provision
for any post-war period or peace time program.

The Treasurer's Report shows the receipts and expenditures for the year.
The net worth of the Association December 31, 1943 was $24,680.33, as com-
pared to $39,525.19 December 31, 1942.

The Committee has no specific proposals to present at this time.

Respectfully submitted.

REPORT OF THE TREASURER
FOR THE YEAR 1943

. January, 27, 1944

To the Board of Directors:

The following statements and data have been compiled for submission,
together, with pertinent comments, as the report of the Treasurer for the
year 1943:

1. The auditor has filed with me a report * in which he states that his
examination of the Association 's records and supporting evidence con-
firms the schedules and exhibits which set forth the results of the Associ-
ation's operations for the year. A copy of the report is attached for
your information.

2. The net worth of the Association at the beginning and at the end of the
year 1943 were as follows:

* This report has been filed for reference in the office of the Association.

138 JOURNAL OF SOCIAL HYGIENE

Net Worth — December 31^ 1942 $39,525.19

Net adjustments to surplus (credit) 224.32

$39,749.51

Total Income for 1943 $279,580.54

Total Expense for 1943 294,649.72

Excess of Expense over Income 15,069.18

Net Worth or surplus as of December 31, 1943 $24,680.33

3. A summary of expenditures for the year 1943 reported on in the audit
shows the following :

Personnel $89,450.45

Travel 19,036.97

JOURNAL OF SOCIAL HYGIENE, SOCIAL HYGIENE XEAVS and

Publications 11,881.86

Books, pamphlets, films and exhibits 31,092.49

Publicity Materials 1,318.22

Operating Expense 24,619.70

Finance Committee Activities 10,221.53

Executive Committee Activities 3,862.16

Membership Committee Activities 1,549.49

Special Projects 101,616.85

$294,649.72**

4. The Treasurer's cash account during the year shows:

Cash on hand December 31, 1942 $ 36,052.78

Cash deposits during 1943 287,921.42

$323,974.20
Transferred to the Disbursing Account 311,000.00

Cash in the Treasurer's Account — December 31, 1943 $ 12,974.20

In addition, we have cash balances in —

The Disbursing Account — Chase National Bank 4,928.76

The Emergency Account — Chemical Bank & Trust Co 2,360.45

Greenwich Savings Bank 18.97

Petty Cash and Stamp Fund — In office of the Association. . 75.00

$20,357.38

5. The Chairman of the Executive Committee, and the Executive Director
have continued under authorization from the Board to make such transfers
among the several accounts and funds of the Association as have been
necessary under the exigencies of carrying on the work of the year. The
Association has continued to act as custodian for the William Freeman
Snow Medal Fund; an amount of $182.63 is on hands as of December
31, 1943. The Association has also accepted and held subject to the
order of state and local Social Hygiene Societies Anti-Syphilis com-
mittees, certain contributions received through joint financial campaigns
for which sharing agreements have been made. The sums held for this
purpose have all been disbursed.

6. The following recapitulation of the years' receipts and disbursements
may present a clearer picture:

** It will be noted from the Auditor's report, that $24,423.06 was paid
by other agencies as compensation directly to members of the staff assigned
to cooperative projects.

THE THIRTY-FIRST ANNUAL MEETING 139

December 31, 1942 — Cash in the Treasurer's

Account $ 30,052.78

Receipts in 1943 287,921.42

$323,974.20
December 31, 1942 — Cash in the Disbursing Account .... 3,159.79

$327,133.99

Less paid on 1942 bills.. $ 7,819.70
Less paid on 1943 bills.. 301,411.33 309,231.03

December 31, 1943 — Balance in Treasurer's and Disbursing

Accounts $ 17,902.96

December 31, 1943— In Treasurer's Account... $32,974.20
In Disbursing Account. . . 4,928.76

Total $ 17,902.96'

Cash on hand — Emergency Account... 2,360.45
Greenwich Savings

Bank 18.97

Petty Cash and

Stamp Fund 75.00

Total Cash on Hand.. $20,357.38

Securities 165.00*

Accounts Receivable... 9,274.37

$29,796.75
Accounts Payable.. 5,116.42**

December 31, 1943— Net Worth or Surplus $24,68/).33

7. The Auditor lias been of special assistance this year in advising on,
and checking data which we have furnished the National War Fund. The
Finance Committee has successfully arranged our bookkeeping and related
details to the mutual advantage of the War Fund and our Association as a
participating member of the Fund. The reports of the Auditor and the Finance
Committee and the Executive Committee constitute a satisfactory source of
details on income and expense throughout the year 1943.

Respectfully submitted.

SUMMARY OF CORPORATION REPORT FOR 1943
As Required by Article II, Section II of the Membership Corporation Law

The American Social Hygiene Association herewith reports for the year
January 1, 1943 to December 31, 1943 the following information:

1. The whole amount of real and personal property owned by the cor-
poration, where located, and where and how invested.

(Grand Total— Inventory of all Personal Property $29,976.75)

2. The amount and nature of the property acquired during the year immedi-
ately preceding the date of the report and the manner of acquisition.

(Contributions from all sources $279,580.54)

3. The amount applied, appropriated, or expended during the year immedi-
ately preceding such date and the purposes, objects, or persons to or
for which such applications, appropriations, or expenditures have been made.

(Total Expense $294,649.72)

* Estimated value as of December 31, 1943.

'* In addition to the liabilities recorded on the books there have been com-
mitments made at the end of 1943 amounting to $3,097.31 for expenditure
in 1944.

140 JOURNAL OF SOCIAL HYGIENE

4. The names and places of residence of the persons who have been admitted
to membership in the corporation during such year.

(New Members enrolled 460)

A copy of the full report has been filed with the records of the corporation,
and an abstract thereof will be entered on the minutes of the proceedings of
the annual meeting, as required by law. The details of this report are filed
under the above divisions. See explanatory notes and figures on pages
in this number of the JOURNAL.

[Signed by the Members of the Board of Directors]

EEPORT OF THE COMMITTEE OX WAR ACTIVITIES

To the Board of Directors:

This Committee was set-up in 1939 to provide a ready means of conferring
with officers and agencies of the Federal Government and State and City
officials, on matters requiring clear understanding of policies, programs, and
activities.

In the period of early training and military maneuvers, and immediately
following the declarations of war, the Committee was necessarily very active
between meetings of the Board of Directors.

In the past year, however, it has been possible to work largely through
the Executive Committee, and the National Office and Field Staff.

At this time the Committee has no specific recommendations to make: I nit
will continue to keep closely in touch with the Government authorities through
its members and the Association's general officers and staff.

Respectfully submitted.

REPORT OF THE COMMITTEE ON AWARDS

To the Board of Directors:

The Committe decided this year to recommend the award of the "William
Freeman Snow Medal for Distinguished Service to Humanity ' ' to Dr. Hugh
S. Gumming, Surgeon General of the United States Public Health Service,
Retired, and Director of the Pan American Sanitary Bureau.

A copy of the brochure is enclosed containing biographical notes and the
citation.

The Committee also selected for recommendation for honorary life member-
ships— Lieutenant Colonel Donald H. Williams of Canada, Dr. Enrique Villela
of Mexico, and Dr. Antonio Fernos-Isern of Puerto Rico. Citations have been
prepared.

Arrangements have been made to present these awards as follows:

Major General Merrittee W. Ireland Avill present the medal to Dr. Gumming
at the Annual Dinner Session of the Association, Academy of Medicine, New
York, February 1. 1944.

Surgeon General Thomas Parran will present the life memberships to Dr.
Villela and Dr. Fernos-Isern at the Regional Social Hygiene Conference in
San Juan, Puerto Rico, February 9, 1944. Owing to military necessity, the
presentation to Colonel Williams will be postponed until later in the year.

The Committee calls to your attention its report of last year, reviewing
the basis of organization of this Committee and its procedure in selecting
recepients of the awards. The Committee members were impressed with the
interest shown in the "Roll of Honor" list of pioneers. It is believed that
the continuance of the Honor Roll would serve a useful purpose historically
and offer a further means of recording biographical reference notes about
members and others who richly deserve to be remembered for their constructive
work and influence on the growth and development of this social hygiene
movement.

Respectfully submitted.

THE THIKTY-FIRST ANNUAL MEETING 141

EEPORT OF THE GENERAL ADVISORY COMMITTEE

To the Board of Directors:

The General Advisory Committee was established in 1916 when President
Eliot retired from the office of President. He agreed to serve as Honorary
President and Chairman of this new committee, which was to have a small
nucleus of continuing members and such additional members appointed for
temporary service as might be required. The original continuing members
were assigned to a series of sections, and a varying number of temporary appoint-
ments frequently changing as to individuals, were added as experience showed
the value of referring special problems to them for consideration or action.

In consultation with the President, revisions have been made, from time
to time in this committee to better adapt it to current needs. An outline is
attached covering the present status together with a list of the major prob-
lems which the committee and its sections are now studying.

In November 1943, the Association arranged for a conference with Negro
leaders on "Special Wartime Problems of Venereal Disease Control." At the
conclusion of this conference, the possibilities of promoting a nation-wide
program of activities for securing the extension of participation of Negroes
in the control of venereal diseases were considered to be so promising, that
it was recommended that the members of the conference be added as a Tem-
porary Committee on Special Wartime Problems of Venereal Disease Control.

It is suggested that the Executive Committee in further consultation with the
President review the entire personnel of this Committee and be empowered to
make such revisions and additions as may be deemed appropriate.

Respectfully submitted.

GENERAL ADVISORY COMMITTEE 1944

Plan of Organization
I. Permanent Members

1. Honorary Life Members.

2. Recipients of the Snow Medal Award.

3. Individuals elected at Annual Meetings of the Association.
II. Advisers and Consultants

1. Annual appointments on nomination by the President and confirmation

by the Board of Directors.
III. Temporary Members

I. Appointed by the Board of Directors for temporary assignment to
designated committee activities or special projects ; each appoint-
ment subject to termination within the fiscal year, unless renewed
by action of the Board.

IV. Designated Sections and Special Committees
(A) SECTIONS

1. Public Information and Community Service.

2. Medical and Allied Professional Services and Public Health.

3. Law Enforcement and Social Protection.

4. Education and Teacher Training.

5. Marriage and the Family.

6. Research and Special Inquiries.

7. Organization and Administrative Policies.
(B). SPECIAL COMMITTEES

1. National Anti-Syphilis Committee.

2. Education Committee of the American Social Hygiene Association. -

3. Temporary Committee on Special Wartime Problems of Venereal
Disease Control.

SOME MATTERS BEING CONSIDERED BY THE GENERAL
ADVISORY COMMITTEE

Problem 1. Ways and means of securing greater initiative and participation
of industry and management in the campaign against Venereal
Diseases.

142 JOURNAL OF SOCIAL HYGIENE

Problem 2. Practical integration of instruction on the venereal diseases in
high school health education courses.

Problem 3. Juvenile delinquency in relation to the spread of venereal diseases,
and to sexual promiscuity.

Problem 4. The venereal diseases and their control among racial and other
special population groups.

Problem 5. Conditions to be met in controlling venereal diseases during demo-
bilization of the military forces.

Problem 6. International relations and cooperation in the social hygiene field.

Problem 7. Post war voluntary organization for social hygiene activities.

Problem 8. New drugs and techniques for diagnosis and treatment, and medi-
cal supervision of persons infected with syphilis and gonorrhea.

Problem 9. Improvement of laws and regulations related to the field of social
hygiene.

Problem 10. Relations of the Social Hygiene Program to activities of Agencies
dealing with Education and training for marriage and family
life, planned parenthood, divorce, illegitimacy, economics and other
factors affecting marriage and family welfare.

REPORT OF THE COMMITTEE ON RESOLUTIONS

The Committee recommends adoption of the following resolution, after cir-
culation and discussion of the reports of the Officers, Board of Directors,
and consideration of the Annual Corporation report :

RESOLVED: That the acts and proceedings of the Board of
Directors and the Executive Committee, and of the officers of this
Association heretofore had, be and the same are hereby ratified, adopted,
and approved, and made the acts and proceedings of the Association
at this meeting, to take effect as of the several dates on which the
acts and proceedings purport respectively to have been had.

The Committee expects during the year to collaborate with the Board of
Directors and other standing Committees in the formulation of a number of
useful resolutions relating to policy and to the position which the Association
takes on issues arising in its field. At the present time, however, none of
these matters are sufficiently advanced to warrant their being placed before
you at this meeting.

The Committee prepared during the past year resolutions on the irreparable
loss of Dr. Thomas A. Storey, and Dr. Max J. Exner. Other friends and
active co-workers whom death has removed from our membership are: Dr.
Frederick Paul Keppel, Dr. Ira S. Wile, Dr. A. T. McCormack, Dr. Lcwellyn
F. Barker, Mr. John E. Zimmerman, Governor Frank O. Lowden.

Respectfully submitted.

REPORT OF THE NOMINATIONS COMMITTEE

To the Members of the Association:

Your Committee has canvassed the .recommendations submitted during the
past year, and considers that the immediate war time needs of the Association
require the continued services of the incumbent Officers and Board of Directors.

Accordingly the Committee presents for re-election the following general
officers.

Honorary President Edward L. Keyes

President Ray Lyman Wilbur

I'it;- I'rcxidritt Frances Payne Bolton

I' let- President John H. Stokes

Secretary Bailey B. Burritt

Treasurer. . . Timothv N. Pfeiffer

THE THIRTY-FIRST ANNUAL MEETING 143

For membership in the Board of Directors, the Committee recommends that
Captain Charles H. Babcoek, Dr. George Baelir, Dr. Eobert H. Bishop, Jr.,
Dr. Kendall Emerson, Dr. Percy S. Pelouse be reelected for the term ending
December 31, 1946.

The Constitution provides for four vice presidents, traditionally selected
from the eastern, central, southern and Avestern areas of the United States.
There are two vacancies at the present time. There are also three vacancies
in the Board of Directors. In view of present conditions the Committee sug-
gests that no action be taken to fill these positions at this meeting, but that
the Board of Directors be requested to take such action during this year as
circumstances may require. If this proposal is approved, the Nominating
Committee will be prepared to submit recommendations at any time.

Respectfully submitted.

AMERICAN SOCIAL HYGIENE ASSOCIATION
1790 BROADWAY, NEW YORK 19, N. Y.

1944
Officers and Board of Directors

Honorary President Dr. Edward L. Keyes, 116 East 63rd Street, New

York, N. Y.

President **Dr. Ray Lyman Wilbur, Stanford University,

California

Vice Presidents Mrs. Frances Payne Bolton, House Office Building,

Washington, D. C.

Dr. John H. Stokes, 4228 Spruce St., Philadelphia,
Pennsylvania

Secretary **Mr. Bailey B. Burritt, 105 E. 22nd St., New York.

Treasurer Mr. Timothy N. Pfeiffer, 15 Broad St., New York,

Board of Directors Capt. Charles H. Babcoek, 120 Broadway, New York,

*Dr. George Baehr, 110 East 80th St., New York,
*Dr. Robert H. Bishop, Jr., 2065 Adelbert Road,

Cleveland, Ohio
Dr. Albert J. Chesley, 91 Arthur Avenue, S. E.,

Minneapolis, Minn.

Dr. Louis I. Dublin, 1 Madison Ave., New York.
Dr. Kendall Emerson, 1790 Broadway, New York,
Dr. Robert P. Fischelis, 28 West State Street,

Trenton, N. J.
Col. Ira V. Hiscock, Yale University, School of

Medicine, New Haven, Conn.
*Major General Merritte W. Ireland, 1870 Wyoming

Ave., Washington, D. C.
Mr. Alan Jolmstone, Room 6133, North Interior Bldg.,

Washington, D. C.
Major General James C. Magee, 1740 Poplar Lane,

N. W., Washington, D. C.
Vice Admiral Ross T. Mclntire, Surgeon General,

U. S. Navy, Washington^ D. C.
Rt. Rev. Arthur R. McKinstry, Cathedral Church of

St. John, Wilmington, Delaware
*Mr. Philip R. Mather, 16 Arlintgon St., Boston 16,

Mass.
Surgeon General Thomas Parran, U. S. Public Health

Service, Washington, D. C.
Dr. Percy S. Pelouze, 1216 Drexel Avenue, Drexel

Hill, Pa.
Rev. Alphonse M. Schwitalla, S.J., 1402 South Grand

Blvd., St. Louis, Missouri
*Dr. William F. Snow, 464 Riverside Drive, New York.

* Members of the Executive Committee.
f* Ex officio members of the Board of Directors and the Executive Committee.

Following the annual dinner at the Academy of Medicine, President
Wilbur opened the meeting by introducing the speakers and inter-
national guests of the Association. Attention was drawn to the
flags of all the nations of the Americas displayed in honor of the
Union of American Republics. Dr. Wilbur referred to the great
task before the Allied Nations; and spoke of the privilege and duty
of the American Social Hygiene Association to play its part in
accomplishing this task.

Mr. Bailey B. Burritt, Secretary of the Association, was called
upon for the Annual Report. Mr. Burritt summarized the actions
taken at the annual business session, and announced the election of
officers and directors for the year 1944.* Mr. Burritt said the year
had been marked by important war essential services, the continuance
of which were requested by the Government through the coming
year. He said the Board of Directors had expressed appreciation
of the cooperation of the National War Fund and both Government
and voluntary national agencies.

Speaking of international cooperation, Mr. Burritt stressed the
encouraging growth of Inter- American activities and mentioned the
Regional Social Hygiene Conference to be held in Puerto Rico
on February 9th, to be attended by representatives of the nations in
the Caribbean Area and officers of the military forces. In this
connection a telegram from Governor Tugwell and Dr. Fernos-Isern,
Chairman of the Conference Committee, was read, pledging their
support to the national program. Telegrams and letters from Frances
Payne Bolton, Vice President of the Association ; Dr. Rachael Yarros,
Honorary Life Member, and other officers and members were
presented.

Mr. Burritt said in conclusion that he would like to call on
Dr. Walter Clarke, Executive Director, to speak briefly of the
program for the year.

Dr. Clarke said, "If history repeats itself, there is grave danger
of a great increase in the prevalence of venereal disease after this
war as there was following World War I. It is essential, therefore,
that every effort be made to hold the gains against these infections
made before and during the present world-wide conflict.

"More widespread and effective measures are now employed against
venereal diseases as a wartime menace than have ever existed before
in the United States. These measures must be continued in the
post-war period.

* See pages 134, 143 in this issue of the JOURNAL OF SOCIAL HYGIENE.

144

THE ANNUAL DINNER MEETING

145

. „•

H£«

H« £ *"

o s ^

co 2 -2

CO o ^

H- 1 ~

W3 53 •

O 3 « 3

CO S W JS

s o £
^ rt^£

<J » S 2

s

fa c '2
O-

146 JOURNAL OF SOCIAL HYGIENE

"With the end of the war a recrudescence of "red light districts"
and flagrant prostitution conditions in many places may be expected,
unless we are very vigilant. Evidence at hand indicates that the
racketeers who expect to profit from prostitution are now planning
and fully expecting to reestablish their vicious traffic at the end of
the war. They count 011 a slackening of law enforcement efforts.
Only a thoroughly convinced and vocal public opinion can prevent
such a backward step.

"It is reasonable to hope that the new discoveries, especially the
modern intensive therapy of syphilis, and penicillin treatment of
gonorrhea may make it possible, in the not too distant future, to
bring venereal diseases under control. The Association can then turn
to and emphasize other aspects of social hygiene. Education of
youth regarding the place of «ex in life — the socially and personally
beneficial exercise of the reproductive instinct, in a word, the training
of youth for happy marriage and satisfactory family life — is a long-
range undertaking which will require for success the cooperation of
educational institutions, churches and social welfare agencies of every
description. As soon as possible after the war the Association should
turn its principal attention to this undertaking.

"But in order to enjoy the privilege of participating in this future
constructive work, the war must first .be won. Hence, all our resources
of money, strength and ingenuity are devoted now to helping assure
full victory for the armed forces of the United States, and to
mitigating the deleterious effects of war on young people. To help
keep soldiers, sailors, marines, airmen at their battle stations and
fit to fight and win. and to keep workers fit to produce the instru-
ments of warfare, »and to protect youth in wartime, are the present
purposes of the American Social Hygiene Association.''

In the medical sector of the social hygiene movement, Dr. Wilbur
said, "We have learned to treat both syphilis and gonorrhea more
effectively in the last decade than in all of the years before in
human history. We are in one of these periods of medicine when
we are able to destroy almost completely — if not completely — living
organisms that have invaded the body and caused these and some
other diseases. The results are particularly encouraging in the
use of the sulfa drugs and penicillin in the treatment of the venereal
diseases.

"It now becomes important to take on the mass treatment of the
human carriers. Fundamentally, these venereal diseases are spread
only by human carriers. If we can destroy all of the organisms in
the bodies of these carriers, we can stop the spread of these diseases
almost without limit.

"No real progress can be made, however, unless there is a general
public understanding of just what the situation is — what must be
done, and a willingness on the part of all concerned to join in
the fight.

"At the bottom is the question of human conduct. We need

THE ANNUAL DINNER MEETING 147

always to think in terms of the youth of the nation and of methods
of teaching them the great values of good self-management and self-
control, and of a wholesome, healthy family as the only sound basis
for an enduring civilization."

It was pointed out that such voluntary agencies as the American
Social Hygiene Association must continue and expand activities for
promoting this general public understanding of the whole social
hygiene program. The Association is constantly being asked by
visitors or through correspondence to give information about scientific
discoveries in the fields of medicine and public health and about
information on improving our administrative procedures in the broad
field of social hygiene.

Dr. Wilbur said, "The Committee on Arrangements thought that
you would be interested in a half-hour's panel discussion of the
problems of encouraging research in these directions and at the
same time safeguarding the application of new methods which grow
out of such research. You will find, as the second item on your
program, the title 'Convoying New Methods from Discovery to Estab-
lished Practice.' When we think of the human enemies against
whom we are now fighting and of the brilliant planning and untiring
teamwork which have gone into the United Nations' progress 'to
date, we have a basis for comparison with what we can and must
do in successfully fighting our disease enemies throughout the world.
It is important that we should understand the necessity for convoying
new methods, which are developing from discoveries in our scientific
laboratories, clinical studies, and administrative experience, until we
can successfully imbed them in established practice. By way of
illustrating this concept and indicating the relationships of any new
discovery to what has gone before and what may be expected to
follow its incorporation in established practice, I think you will be
interested in centering our discussion around penicillin."

The panel of speakers comprised : Dr. John F. Mahoney, Director,
Venereal Disease Research Laboratory, U. S. Public Health Service ;
Rear Admiral Charles S. Stephenson, U.S.N. ; Director Mark
McCloskey, Office of War Community Services; Rear Admiral E. V.
Reed, Chief Surgeon, 3rd Naval District, U.S.N. ; Colonel C. M.
Walson, Chief Surgeon, 2nd Service Command, U.S.A.; Major Gen-
eral James C. Magee (Retired), National Research Council; Dr. Frank
G. Boudreau, Director, Milbank Memorial Fund. The members of
the Association and guests found the discussion most interesting and
informative. Requests were made for publication of the statements
and comments of the participants ; and it was agreed that the Editorial
Board would be asked to take this matter up with the members of
the panel and consider printing a symposium of the views expressed.

Dr. Wilbur then called upon Major General Merritte W. Ireland
to present the Report of the Committee on Awards.1 General Ireland
explained that Surgeon General Parran, Chairman of the Committee,

1 See Eeport of the Award Committee, page 140, and presentation of Life
Memberships, pages 149-54.

148 JOUKNAL OF SOCIAL HYGIENE

was unable to attend because of his participation in the Puerto Rico
Regional Conference. General Ireland then addressed Dr. Hugh
S. Gumming, presenting to him the William Freeman Snow Award
for Distinguished Service to Humanity.2

Dr. Gumming 's remarks 3 were of deep interest to the members
and friends present not only from the United States, but from the
other member nations of the Pan American Union.

In closing Dr. Wilbur thanked the speakers, the Pan American
Union, the Academy of Medicine, and other agencies for their partici-
pation in making the annual meeting most enjoyable and successful.
He called attention to the New York Regional Conference to be
held the next day (February 2nd) at the Pennsylvania Hotel, and
suggested that all who could remain over would find it profitable
to do so.

2 See text of brochure facing the first page of this JOURNAL, and pp. 101-2.

3 See text beginning pp. 103-6, this number of the JOURNAL.

TRUE TODAY, AS WHEN WRITTEN

"What forces can now be put into play against the formidable
evils which gravely threaten family life, human happiness, civiliza-
tion in general, and the very life of the race! ... It is clear that
no one force or agency is to be exclusively relied on. All the
uplifting forces of society must be simultaneously enlisted in this
cause — state, church, school, college, industrial and charitable
corporations, and both preventive and remedial medicine. ..."

CHARLES W. ELIOT, First President of the Association

"The individual and his life and happiness are basic in any
scheme of human welfare — if the height of human happiness is
to be obtained, then every advantage must be taken of all that is
known of health and relief from sickness. ... It takes time,
patience, education to make things better. . . . History tells us that
we ... can lose all that we have gained if we fail to follow the
guidance of experience and fact. . . . Progress requires constant
thought, planning and foresight."

BAY LYMAN WILBUR, President Since 1936

NEW HONORARY LIFE MEMBERS

The Committee on Awards announced the election of three Hon-
orary Life Members in recognition of their contributions to the
advancement of social hygiene. These are Dr. Antonio Fernos-Isern
of Puerto Rico, Dr. Enrique Villela of Mexico, Lieutenant Colonel
Donald II. Williams of Canada.

In announcing these awards the Committee commented upon the
wartime importance of teamwork among nations in combating the
venereal diseases and related conditions favoring their spread. Ref-
erence was made to the constructive programs now being carried
out by the Canadian Provinces and the States all along our Northern
border from the Atlantic to the Pacific; and similarly between the
Republic of Mexico and the United States along our southern border.

In relation to such encouraging examples of teamwork, the Com-
mittee commented on the strategic importance of work in this field
of health conservation in Puerto Rico, which stands as an outpost
of our mainland in the Caribbean Area. The selection of these three
leaders and resourceful public health administrators at this time
emphasizes the great opportunity which exists for united action based
on Inter-American understanding and agreement upon the essentials
of successful campaigns to stamp out syphilis and gonorrhea; and
at the same time to protect the social health of the community,
and provide education for home and family life.

The Committee felt that added emphasis would be given to this
opportunity by presenting these awards during the Regional Social
Hygiene Conference in Puerto Rico,* which would be attended by
delegates from other nations represented in the Caribbean Area,
from the Panama Canal zone, from Mexico and other countries.
Arrangements were made for Surgeon General Thomas Parran,
Chairman of the Committee,** to carry out this plan in San Juan,
February 9th, 1944.

REMARKS OF SURGEON GENERAL THOMAS PARRAN

Ladies and Gentlemen: It is my pleasure and privilege this eve-
ning, as Chairman of the Awards Committee, to present Honorary

* Full details and illustrations will appear in the April JOURNAL OF SOCIAL
HYGIENE.

* The Award Committee for 1944: Surgeon General Thomas Parran, Chairman;
General John J. Pershing, Sybil Neville Eolfe, Brigadier General F. F. Russell,
Chancellor Ray Lyman Wilbur.

149

150 JOURNAL OF SOCIAL HYGIENE

Life Memberships in the American Social Hygiene Association to
Dr. Enrique Villela of Mexico and to Dr. Antonio Fernos-Isern of
our own nation, and to announce a similar award in absentia to
Lieutenant Colonel Donald H. Williams of Canada, who, owing
to military necessity, cannot be present.

It has been the custom of our Association each year to make such
awards on the occasion of its Annual Meeting or at Regional
Conferences, for distinguished service in the advancement of social
hygiene.

I am particularly happy that this year our Committee's choice
falls upon men who have won recognition among their peers, but
are still young men at the full tide of their scientific and
administrative abilities.

At this time, when the maximum of military and civilian man-
power is so vitally important, it is a matter for congratulation
that the United States and its neighboring countries to the North
and to the South are in agreement upon the major, objectives and
methods of a venereal disease program for our respective countries
in this hemisphere.

Today in Puerto Rico, the outpost of our Nation in the Caribbean,
it is fitting that we examine, in consultation with our distinguished
visitors from the other nations concerned, the established program
of the mainland and its applicability here, or reasons for its revi-
sion under conditions obtaining in this area. Discussion of this
problem will be continued in an executive session tomorrow.

PRESENTATION TO DR. VILLELA

DR. ENRIQUE VILLELA : Known affectionately to your colleagues in
Mexico as ' ' Maestro ' ' ; known throughout our continent as a tireless
fighter for social health; a pioneer in practical cooperative disease
control measures along the common frontier between our two coun-
tries. Supported by President Avila Camacho and your Minister
of Health, Dr. Gustavo Baz, you have demonstrated that two nations
can create frontiers of health and can work together for the scientific
advancement of each.

To those who heard you earlier today no words of mine can add
to your stature as an ambassador of health.

It is in this spirit of recognizing your character and achievements
that I present to you this Honorary Life Membership in the American
Social Hygiene Association.

"DR. PARRAN: I have no words in which to express my deep
thanks. I appreciate very much this honor which the American
Social Hygiene Association has conferred upon me. I lack the merit
to receive it, but I accept it for my country. It will be for me a
great and valued incentive to continue my work with more and
more courage. Again thank you ! ' '

NEW HONORARY LIFE MEMBERS 151

PRESENTATION TO DR. FERNOS-!SERN

DR. ANTONIO FERNOS-!SERN : Throughout your professional career
you have devoted yourself without limit to advancing the health
and welfare of the people. Distinguished as a physician, a health
administrator, a statesman, one can even say you emulate the leading
scientist-philosopher statesman in our history, Benjamin Franklin.

Your aggressive leadership in combating such underlying causes
of ill health as malnutrition and poor housing, no less than your
deep understanding of social hygiene and venereal disease control
problems, has brought you the admiration of your colleagues through-
out our nation, and among neighboring countries as well. In recog-
nition of your participation in voluntary health conservation activities
in our Nation and your services in behalf of Puerto Rico, the
American Social Hygiene Association honors itself in conferring
upon you Honorary Life Membership.

' ' GENERAL PARRAN : I consider it a very great privilege to receive
this Honorary Life Membership in the American Social Hygiene
Association. There are three things which are necessary to carry
out a successful program in the control of venereal diseases : decision,
knowledge, and inspiration.

"Decision, I have, — born out of my own free will.
"Knowledge, I should derive from your teachings.

"Inspiration, I should take from your own life work and from
the splendid services you have rendered the nation as head of the
Public Health Service.

"With all due respect to the Awards Committee, I do not consider
myself entitled to this high distinction, but I take it as a challenge
and shall do all in my power to attain the high merit through devoted
services to the cause of the health of the people."

ANTONIO FERNOS-!SERN, M.D.
Medical biographers record for general reference the following :

FEBN6S-ISEKN, AXTONIO, M.D.— Born at San Lorenzo, Puerto Eico. Son
of Buenaventura Fernos-Isern and Dolores Isern Aponte. Christian.

Doctor of Medicine, College of Physicians and Surgeons, School of Medicine,
University of Maryland — 1915. General practice at Caguas — from 1915 to
1918. Cardiology — from 1934 to 1942 at San Juan.

Visiting Cardiologist, University Hospital and Consulting Cardiologist,
Presbyterian Hospital.

Professor of Public Health, School of Tropical Medicine— from 1931 to 1937.

Public Health Officials are primarily interested in other facts about
his career:

Health Officer, City of San Juan— 1918 to 1919.

152 JOURNAL OF SOCIAL HYGIENE

Chief, Bureau of Transmissible Diseases and Statistics of the Department
of Health of Puerto Rico— 1919.

Assistant Commissioner of Health of Puerto Eico — from 1919 to 1921 ; and
from 1923 to 1931.

Commissioner of Health — 1931-33; 1942-.

Educators refer to his having been :

Chief, Division of School Hygiene of the City of San Juan — 1922 to 1923.

United States delegate to the Fifth Pan American Child Welfare Conference
held at Havana, Cuba, in December — 1927.

Chairman, Puerto Rico Child Welfare Board— from 1926 to 1933.

Member of various Sub-committees of the Third White House Conference for
Child Protection, Washington, D. C. — 1931.

Head Physician, FERA Nursery Schools — 1935.

Sociologists and Welfare Agencies call attention to his services as :
Head of the Hurricane Relief Expedition to the Dominican Republic — 1930.
Metropolitan Area Director, Civilian Defense — 1942.

Executive Director, Food and General Supplies Commission of Puerto
Rico— 1942.

Administrators and Statesmen point to his periods of service as:
Acting Governor of Puerto Rico in 1943-44.

In common with all these groups the American Social Hygiene
Association recognizes in this brief summary the qualities of executive
ability and leadership which are so essential to the practical
application of science and the humanities to better living.

As never before, the Mainland and this strategic island outpost
of the nation are dependent on understanding and teamwork among
officers and citizens for successful conduct of the war and promotion
of permanent peace.

In both war and peace Puerto Rico can continue to contribute
notably to the development of new and sound methods for attaining
the maximum in health and well being of all our people. To translate
such methods into nationwide action requires cooperation of federal,
state and local governments and voluntary agencies.

DR. FERN6S-ISERN All through Dr. Fernos-Isern 's education in

the states, and his varied activities in Puerto
Rico, he has kept in touch with and aided the
social hygiene movement and other movements
represented by organizations holding member-
ship in the National Health Council.

In recognition of his participation in their
voluntary activities for the common good, and
his official services in behalf of Puerto Rico, the
Committee on Awards is privileged to present
to Dr. Feros-Isern this Honorary Life Member-
ship in the American Social Hygiene Association.

NEW HONORARY LIFE MEMBERS

153

ENRIQUE VILLELA, M.D.

"He who bears in view
The end from the beginnim/
Invariably succeeds ' '

This quotation from a famous Spanish writer well illustrates Dr.
Enrique Villela's history. From the beginning of his medical career he
has driven straight towards one goal to conquer the dangerous infec-
tions of syphilis and gonorrhea, deadly enemies of the health of his
native land, Mexico, as they are of all other nations. The record
shows :

He was born in Toluca, State of Mexico,' February 4, 1901.

He attended high school in the Scientific and Literary School in
the same city. He graduated as a doctor from the National University
of Mexico in 1926, and subsequently received his diploma as an
official Health Officer.

Since then he has devoted his activities to the fight against venereal
diseases, serving first during fourteen years as Doctor of the Hospital
' ' Moreles, ' ' the name by which is designated the hospital for venereal
diseases, in Mexico; and during the last seven years as Chief of
the Division of Venereal Diseases in the Department of Health, now
promoted to the position of Secretary of Health and Assistance.

He is founder of the National Association of Venereology and of
the Mexican Society of Dermatology ; Professor of the Medical Clinic
(female) in the School of Medicine of the University of Mexico; he
belongs also to the American Public Health Association and to the
American Neisserian Medical Society. Honorary professor of the
School of Health of Mexico.

Always concerned with progress in the control of venereal dis-
eases, he began to make known and to popularize the work of the
Cooperative Clinic Group for the treatment of syphilis and the
work of the American Neisserian Medical Society for the treatment
of gonorrhea.

In 1941 he was empowered by the Governor of Mexico to travel
over the frontier — jointly studying conditions together with repre-
sentatives of the USPHS and of the Pan Ameri-
can Sanitary Bureau. As a result of the study DR. ENRIQUE
of the above mentioned commissioned persons,
plans for international cooperation were formu-
lated in accordance with those developed pre-
viously in regard to venereal diseases along the
frontier between both countries.

In 1940 when the plans and laws for the
fight against venereal diseases, and for the
repression of prostitution and of white slavery
were to be discussed before the Federal Con-
gress, he published a book having the necessary
documentation with regard to the subject and
this greatly assisted the passage of the bill.

His latest work in collaboration with

154 JOURNAL OF SOCIAL HYGIENE

Dr. J. S. Spoto is entitled "Minimum Program for Anti- Venereal
Dispensaries." It was published in 1943 by the office of the Pan
American Sanitary Bureau.

He is editor of "Archives Mexicanos de Venereo-Sifilis y Derma-
tologia" and is a member of the editorial committee on Information
Venereal Disease, a publication of the Pan American Sanitary Bureau
for the promotion of the fight against venereal diseases in the
Latin- American countries.

These facts present only a slender outline of Dr. Villela's efforts
and achievements, which have played so large a part in the progress
of venereal disease control in Mexico during the past fifteen years
and which now permit the American Social Hygiene Association the
honor of adding an illustrious name to its roster of Honorary Life
Members. May our sister Republic long enjoy the results of Dr.
Enrique Villela's loyal services, and may we of the United States
continue to claim a share of the benefits growing out of his untiring
industriousness, his searching knowledge and his long range vision.

The April Number of The Journal of Social Hygiene will
include illustrations and full details of the Puerto Rico
Regional Social Hygiene Conference.

SOCIAL HYGIENE DAY— 1944

ELEANOR SHENEHOX

Director, Division of Community Service

The call for Social Hygiene Day is a call to action — a call to
move forward along the whole social hygiene front against those
disruptive forces that threaten the well-being of the family — the
family of today and the family of tomorrow. Its most character-
istic observance is the community Social Hygiene Day meeting, a
modern version, as has frequently been pointed out, of the early
American Town Meeting that our ancestors knew. Allied with the
meeting are the radio and the public press, carrying word of the
campaign to listeners and readers everywhere. Social Hygiene Day
is a day of assessment, of stock-taking: how far have we come and
what have been our successes? Where do our next steps take us,
and what are the difficulties to be surmounted along the way?

The answers to these questions on February 2nd, 1944 were not
the same for every city and town in the country, because every city
and town has its special problems. It is a healthy sign of public
determination to face those problems that meetings have been held
or planned in every state in the Union and in the Territorial and
Insular outposts of the nation. Across our northern border, our
good neighbor, Canada, gave thought to the same questions and
pondered the answers in public meetings. Our good neighbor,
Mexico, to the south, likewise has developed nationwide activities,
and other nations of the Americas have held meetings or sent rep-
resentatives to the Regional Social Hygiene Conference in the
Caribbean Area, held in San Juan, Puerto Rico.

It would be impossible to mention in this brief report all the
"populated places" that observed Social Hygiene Day. A recital
of the names of only a few of them will paint a picture of this
great country stretching from ocean to ocean, and from the pine-clad
north to the south where palms grow: Boston, San Diego, Atlanta,
Seattle, Philadelphia, Portland, Oregon and Portland, Maine; Cleve-
land, Omaha, El Paso, New York, Salt Lake City, Pittsburgh, Poca-
tello, Fort Wayne, Corpus Christi, Syracuse, San Francisco, Kansas
City, Buffalo, Lincoln, Daytona Beach, Rochester, Cincinnati, Newark,
Los Angeles, Washington, New Orleans, Harrisburg on the broad
Susquehanna and Galveston on the Gulf of Mexico ; New Brunswick,

155

156

JOURNAL OF SOCIAL HYGIENE

INVISIBLE. .DANGEROUS. ..BUT VULNERABLE

Three million spirochetes could lodge together on the head of a pin
The spirochete is liny, but * killer with a long record. For centuriei
this pate, corkscrew- shaped microbe — the cause of syphilis — hai

500,00q new cases are reported yearly.)

on the home front, in which there it participation by doctor, health
liter, youth leader, bjliness man. and by ju>* plain John Q. Citiien.

muni*y support of oil measure! needed to control venereal
disease, row can start now. On February 2. 1944, take part in
the observance of Social Hygiene Day.

A PROGRAM OF ACTION

With youi
More t

vip.ng I

>e, exhibits, conference}.

rlout. few myiteriei about these deadly micro-organisms now re
Medical science hat the weapons needed for their dettruct

of venereal infections. To expand these gains rapidly two '
of the public.

VD DELAYS VICTORY

Urge provision of adequate facilities for diagnosis, treatment and
isolation. Support the activities of your health and police depart-
ments and private health and welfare organizations, aimed at the
control of venereal disease.

UNITE AGAINST VD

NATIONAL SOCIAL HYGIENE DAY

February 2, 1944

This advertisement approved by THE AMERICAN SOCIAL HYGIENE ASSOCIATION

ij sponsored by

THE

JUNIOR CHAMBER OF COMMERCE

tint space contributed by

SOCIAL HYGIENE DAY NEWSPAPER ADVERTISEMENT

In cooperation with the American Social Hygiene Association, the United States
Junior Chamber of Commerce undertook sponsorship of this -advertisement to
help promote interest in Social Hygiene Day. Through the efforts of local
Junior Chambers of Commerce, the advertisement appeared in various newspapers

throughout the country.

SOCIAL HYGIENE DAY 1944

157

that tree-shaded eastern college town; Topeka, on the great plains
of the middle west; Reno, where mountains and desert meet; Denver
in the very heart of the mountains. Indianapolis, Minneapolis, St.
Louis, Frankfort, Chattanooga, and Poughkeepsie. Fort Defiance,
Arizona and Fort Smith, Arkansas. Sioux City, Iowa; Charleston,
South Carolina ; Vermillion in South Dakota and Rutland in Vermont.
Winston-Salem, North Carolina, and Clovis, New Mexico. Kalama-
zoo and Baltimore and Montgomery. Lac du Flambeau, Wisconsin
and Worland, Wyoming. The list could go on almost indefinitely
but the places named must stand for America. Names, many of these
speak of our past and of the earliest waves of settlers on these
shores. All one people now, these first-comers and those who
followed them ; fighting a war, doing a good job on the home front,
planning a better world, resolving to make those plans come true.

Social Hygiene Day meetings and other observances in all these
places — and many more — did not of course spring into being with
the beautiful and apparently effortless inevitability of the wave
of flowers that washes over the western desert with the first spring

2.000.000 SELECTEES BLOOD TESTED FOR SYPHILIS

every siale has a syphilis problem...

H'HERK DOLS VftlB SI'AH STAND

SELECTEE MAP

This poster map, in two colors, was included in the kit of materials sent to
sponsors of Social Hygiene Day activities.

158

JOURNAL OF SOCIAL HYGIENE

. Th. «~P

DO YOU KNOW THESE FACTS?

Syphilii is Dangerous! It is a contagious
disease and may be contracted inno-
cently.

If untreated, it can destroy health and
mind. It can wreck marriages. It can
cause disability among productive work-
ers. Early symptoms may disappear, de-
ceiving the victim into neglecting medi-
cal care. Then, sometimes years later,
syphilis strikes.

Syphilis is Curable! The first step toward
cure is the guidance of a reputable phy-
sician. Prompt, regular treatment cures
most cases. Delay reduces the chance of cure

Medical science is continually searching

for improved methods of treatment. Just
now, its attention is directed toward
ways of safely shortening the period of
treatment. Meanwhile, it is advisable to
continue treatment over the longer period
which is known to give excellent results.
"The Facts About Syphilis" is the title of
a free booklet which Metropolitan will
gladly send you upon request.

Eighth National Social Hygiene Day is

being observed on Wednesday, February
2, 1944. The American Social Hygiene
Association Headquarters, 1790 Broad-
way. New York 19, New York, will gladly
send you literature and full particulars.

Metropolitan Life
Insurance Company

{A MUTUAL COMfANY)

F'ldtrick ». Eck,,,

CHAIRMAN OF TH
•Leroy A. Lituoln,

I MA

E. NB

1 10, N. Y.

1 Madison Avenue, New Virk 10, N. Y

Please send me a copy of your booklet,
--M2, "The Facts About Syphilis."

. PRESS 61500 PRINTED I

NATIONAL ADVERTISING

Again in 1944 the Metropolitan Life Insurance Company devoted an advertise-
ment to social hygiene. Appearing in nationally circulated monthly and weekly
magazines during January, this advertisement helped stimulate interest in the
fight against venereal disease, contributed to the success of Social Hygiene Day.

SOCIAL HYGIENE DAY 1944 159

rain. They were the result of the hard work and careful planning
of a great many men and women, of time and effort and money
spent by a great many organizations. Federal agencies contributed
able and distinguished speakers, printed materials to aid those
organizing programs, gave wide publicity to the Social Hygiene
Day effort. National voluntary agencies carried on during the
Social Hygiene Day period with the good work that has had so much
of their help and interest, giving space in their official publications
to the project, contributing materials, distributing announcements
and program aids to their members. Any list of such cooperating
agencies should include the American Medical Association, the
American Pharmaceutical Association, the Federal Council of
Churches, the National Congress of Parents and Teachers, the
Chamber of Commerce of the United States, the General Federation
of Women's Clubs, the United States Junior Chamber of Commerce,
the National Student Health Association, Kiwanis International,
the National Woman's Christian Temperance Union, the National
Society for the Prevention of Blindness, the Association of Junior
Leagues of America, the National Organization for Public Health
Nursing, the American Dental Association. Mention should here
be made also of the aid given the project by the Metropolitan Life
Insurance Company, which gave it publicity through its national
advertising, and distributed literature concerning Social Hygiene
Day to its representatives throughout the country.

In many of the states of the Union, February 2nd was officially
designated as Social Hygiene Day by the governor. State Boards
of health, State Junior Chambers of Commerce, State Tuberculosis
and Health Associations, State Pharmaceutical Associations, State
Medical Associations, State Federations of Women's Clubs, State
Parent Teacher Associations gave the project their support. That
the observance of Social Hygiene Day was so widespread is in
part a tribute to the support given it by these and other state
organizations.

When we come to the individual communities of the country the
Social Hygiene Day picture grows more complex, with a very great
variety and number of agencies sponsoring meetings, broadcasts, and
other educational and informational programs. Social hygiene socie-
ties affiliated with the American Social Hygiene Association observed
the Day generally. Health departments were active in the program,
as were social protection committees, councils of social agencies,
Junior Chambers of Commerce, settlement houses, churches, schools,
and colleges, libraries, Indian agencies, service clubs, women's clubs,

160

JOURNAL OF SOCIAL HYGIENE

NATIONAL SOCIAL HYGIENE

.2

1 944

THREE COLOR POSTER

This poster, in red, black and white, was used in communities all over the

country to attract attention to the meetings and conferences held in observance

of National Social Hygiene Day.

SOCIAL HYGIENE DAY 1944

161

parent- teacher associations. Mayors issued
proclamations concerning the Day. Meetings,
from big regional conferences to smaller
group gatherings grew in number beyond the
numbers of other years. Newspapers blossomed
fortJi with editorials, news and feature stories,
photographs and cartoons. Posters and placards
appeared on walls and in shop windows. Xew
projects were launched and older programs
were strengthened. It is difficult to estimate
the number of persons reached by all these
activities in the home towns of America but
it must in the grand total be very large.
Limitations of printing and paper permit only
a few illustrations from the interesting and
constructive programs carried out this year.

The call for Social Hygiene Day was a call
to action — a call to the people to conserve our
freedom and our way of life and to defeat
all opposing forces. The people heard that
call — there is good reason to believe that they
heeded its message. February 2, 1944 is now
just another date in social hygiene history.
Such dates are quickly forgotten, but the
events that made them important at the
moment are not lost in the evermoving stream
of time. Carried on down that stream into
a future that we cannot now clearly foresee
will be the interest and the enthusiasm, the
plans and the determination engendered on this
one winter, wartime day.

EDITOKIAL

11 LOOKING BACKWARD" — AND FORWARD

The American Social Hygiene Association began officially
in September, 1913, in Buffalo, N. Y., when President Charles
W. Eliot of Harvard University called for a vote to merge
the American Federation for Sex Hygiene and the American
Vigilance Association ; and agreed to serve as the first presi-
dent during the early years of growth and development. That
date may well be considered the starting point of "Social
Hygiene Day" as it is now observed in every part of the
Union. The reports and articles in this number with illus-
trations of the past year's progress and outlines of programs
for the current year, concern this latest link in the long chain
of annual conferences from which we derive great satisfac-
tion by looking backward over the permanent gains, and from
which we may look forward with confidence to greater gains
in future years.

The Editorial in the December Journal referred to plans
for Social Hygiene Day February 2, 1944, and indicated that
necessarily in these wartimes great emphasis must be placed
upon "Venereal Diseases — The Target for Today." This
has been true of the recent programs; but in the long series
of annual meetings and intervening activities this phase of
the whole program is shown in proper perspective.

The Constitution states that "The purpose of this Asso-
ciation shall be to acquire and diffuse knowledge of the
established principles and practices and of any new methods,
which promote or give assurance of promoting, social health ;
to advocate the highest standards of private and public
morality; to suppress commercialized vice, to organize the
defense of the community by every available means, educa-
tional, sanitary, or legislative, against the diseases of vice ;
to conduct on request inquiries into the present condition
of prostitution and the venereal diseases in American towns
and cities ; and to secure mutual acquaintance and sympathy
and cooperation among the local societies for these or
similar purposes."

The Board of Directors has never deviated from the course
laid down by this declaration of purpose. Early in the

162

EDITORIAL 163

experience of the members it became evident that to attain
these objectives and to secure "mutual acquaintance and
sympathy and cooperation" the advocated "principles and
practices and new methods" must be fully correlated with,
and must support the Nation's larger program of protection
and conservation of family life. It was demonstrated that
public health and social health were interdependent, and not
in conflict with "the highest standards of private and public
morality." The Constitution which President Eliot, James
Cardinal Gibbons, John D. Rockefeller, Jr., Grace M. Dodge,
Major Henry Lee Higginson, Jane Addams, David Starr
Jordan, and Charter Members of the Association approved
has stood the test of time.

The twenty-nine volumes of the Journal of Social Hygiene
and the innumerable reprints and special pamphlets and the
books published by the Association record the evidence of
progress in this field. The Association was incorporated in
the Spring of 1914 and the Annual Meetings came to be held
in February. This Annual meeting was divided into two
sessions: (1) a general conference of members and other
interested citizens for discussion of "established principles
and practices and of any new methods,"-— knowledge of
which was worthy of being disseminated and applied; and
(2) a business session for completing the corporate business
of the Association. As public interest and the membership
grew, there were increasing demands for these meetings—
especially the general conference sessions — to be held in
various cities or in connection with Conventions of other
national organizations. This plan was carried out, for a
period of years, through joint meetings with affiliated state
or local societies or national cooperating associations. Sub-
sequently after careful study it was decided to try the experi-
ment of holding the business session at the national office,
following a series of simultaneous regional conference ses-
sions in selected cities and states, arrangements being made
to send members of its own Officers, Board of Directors, and
Staff to take part in the regional programs.

Social Hygiene Day, as the date for this form of national
annual meeting has come to be named in news and editorials,
has steadily developed to its present importance as a means
of public information and stimulation of further community
planning and action in social hygiene and related fields.

Looking backward over the vears one mav find manv occa-

164 JOURNAL OF SOCIAL HYGIENE

sions when "the setting of the stage"* made possible sudden
and great advances. Looking forward one may expect to
see similar advantage taken of changing conditions which
permit periods of rapid progress. However, in the future
as well as in the past, it will undoubtedly be found that the
greatest factor in permanent gains is patient, persistent,
resourceful wTork of official and voluntary agencies which
carry on a balanced program from day to day. Social
Hygiene Day in 1944 has reaffirmed the determination of
the American people to stamp out syphilis and gonorrhea
as dangerous communicable diseases, and at the same time
to protect the social health of the Community and provide
education for home and family life. These are sound objec-
tives attainable with the support of home, church, school
and all community forces. By united action of these forces,
it will be possible in due course for the Xation to write
"mission accomplished."

*In 1887 Edward Bellamy based his challenging novel, "Looking Backward",
on a prophecy of social conditions in the year 2000. He had been deeply
stirred by what he termed "the prodigious moral and material transformation
of the end of the nineteenth century." He said "All thoughtful men agree
that the present aspect of Society is portentious of great changes. " He wrote
his book "in the belief that the Golden Age lies before us and not behind us,
and is not far away." "Our children will surely see it" he said, "and we,
too, who are already men and women, if we deserve it by our faith and our
works. ' '

"What is the teaching of history" asked Professor Bellamy, "but that
great national transformations, while ages in unnoticed preparation, when once
inaugurated are accomplished with a rapidity and resistless momentum pro-
portioned to their magnitude, not limited by it?" "On no other stage are
the scenes shifted with a swiftness so like magic, as on the great stage of
history when once the hour strikes. ' '

"The question is not, then, how extensive the scene-shifting must be to set
the stage — but whether there are any indications that a social transformation
is at hand."

In this field at least, the past fifty-six years since "Looking Backward" was
published, and the present indications of social transformation give encourage-
ment that the Golden Age lies before us. In the next fifty-six years before we
reach the year 2000, bv our faith and our works we should be able to write
"mission accomplished" to all these tasks of social hygiene.

April, 1944 No. 4

Journal

of

Social Hygiene

Proceedings of the Puerto Rico Regional Conference
on Social Hygiene

CONTENTS

Introduction 165

Proceedings

Morning Session: The National Campaign for Venereal Disease Control in Wartime... 174

Luncheon Session: The Americas Go Forward Together 191

Afternoon Sessions: Puerto Rico Does Her Part in the Fight

Group I. Knowledge Is a Strong Weapon 202

Group II. Medical Diagnosis and Treatment Are Strong Weapons 208

Group III. Good Laws and Law Enforcement Are Strong Weapons 224

Group IV. Youth Has Priority 233

Evening Session: The Nations Unite for Victory over Venereal Disease 250

Resolutions Presented by the Conference Committee on Resolutions 264

Greetings and Messages Received from the Other American Republics 267

The American Social Hygiene Association presents the articles printed in the
JOURNAL or SOCIAL HYGIENE upon the authority of their writers. It does not
necessarily endorse or assume responsibility for opinions expressed or statements
made. The reviewing of a book in the JOURNAL or SOCIAL HYGIENE does not
imply its recommendation by the Association.

EDITORIAL BOARD
O.-E. A. WINSLOW, Chairman

RAY H. EVERETT WILLIAM F. SNOW

JOSEPH K. FOLSOM JOHN H. STOKES

EDWARD L. KEYES JOHN C. WARD

JBAN B. PINN»Y, EDITOR
WILLIAM F. SNOW, EDITORIAL CONSULTANT

The JOURNAL OF SOCIAL HYGIENE is supplied to active members of the American
Social Hygiene Association, Inc. Membership dues are two dollars a year. The
magazine will be sent to persons not members of the Association at three dollars
a year ; single copies are sold at thirty-five cents each. Postage outside the United
States and its possessions, 50 cents a year.

Entered as second-class matter at post-office at Albany, N. Y., March 23, 1922.
Acceptance for mailing at special rate of postage provided for in Section 1103,

Act of October 3, 1917, authorized March 23, 1922.
Published monthly (nine issues a year) for the Association by the Boyd Printing

Company, Inc., 372-374 Broadway, Albany, N. Y.

Copyright, 1944, by The American Social Hygiene Association, Inc.

Title Registered, U. 8. Patent Office.

PUBLISHED MONTHLY EXCEPT JULY, AUGUST AND SEPTEMBER
AT 372-374 BROADWAY, ALBANY 7, N. Y., FOB

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

EDITORIAL OFFICES and NATIONAL HEADQUARTERS
1790 BROADWAY, 19, NEW YORK CITY

WASHINGTON LIAISON OFFICE
Room 609, 927 15th St., N.W., Washington 5, D. C.
JEAN B. PINNEY, Director in Charge
REBA RAYBURN, Office Secretary

FIELD OFFICES

ATLANTA, GEORGIA. 506-508 Citizens and BALTIMORE, MARYLAND. Care of Baltimore

Southern National Bank Building. Serv- Community Fund, 22 Light Street,

ing Alabama, Florida, Georgia, Missis- Serving Delaware, Maryland, Pennsyl-

sippi, North Carolina, South Carolina and vania and Virginia.

Tennessee. KENNETH R. MILLER, Field Representa-

CHARLES E. MINER, Field Representative. five, Home address 260 Bridge St., Drexel

COLUMBUS, OHIO Care National Confer- g£ f£ w> Representative.

ence of Social Work, 82 High Street.

Serving Indiana, Kentucky, Ohio and

West Virginia. CHICAGO, ILLINOIS. Room 615, 360 North

WADE T. SEARLES, Field Representative. Michigan Avenue. Serving Illinois, Michi-
gan and Wisconsin.

OMAHA, NEBRASKA. 736 World Herald WARREN H. SOUTHWORTH, Field Repre-

Building. Serving Colorado, Iowa, Kan- sentative.

sas, Minnesota, Missouri, Nebraska, North

Dakota, South Dakota and Wyoming.

GEORGE GOULD, Assistant Director, DALLAS, TEXAS. Cliff Towers. Serving

Division of Legal and Social Protection Arkansas, Louisiana, New Mexico, Okla-

Services, in Charge. h°ma and Texas.

BASCOM JOHNSON. Director in Charge.

SALT LAKE CITY, UTAH. 402 Mclntyre MKS GERTEUDK R. LucE office Secretary.

Building. Serving Arizona, Idaho, Mon-
tana, Nevada, Utah, California, Oregon

and Washington. SAN FRANCISCO, CALIFORNIA. 45 Second

GEORGE GOULD (see above), temporarily Street.

in Charge. W. F. HIGBY. Field Consultant.

PUERTO RICO REGIONAL CONFERENCE
ON SOCIAL HYGIENE

At the reception given at La Fortaleza by Governor
and Mrs. Rexford G. Tugwell on the evening of February
in honor of Mr. Benjamin W. Thoron, Director of
Territories and Island Possessions, Department of the
Interior, Washington, D. C., and Conference delegates
and guests.

Thoron, Mrs. Tugwell, Governor Tugwell,
Mr. Luis Munoz Marin

Left to right, back row: Eliot Ness, Director, Division of Social Protection, Washington, D. C.; Dr. Felix Laraque, of
the Bureau of Health, Haiti; Dr. Donald Huggins, in Charge Venereal Disease Control, Health Services of Trinidad;
Dr. William F. Snow, Chairman of the Executive Committee, American Social Hygiene Association; Mrs. Tugwell; Dr.
R. A. Vonderlehr, Director, District No. 6. U. S. Public Health Service, San Juan; Miss Rafaela Espino, Executive Secretary,
Puerto Rico Committee of Social Protection. Front row: Dr. Enrique Villela, Chief, Venereal Disease Control,
Department of Health, Republic of Mexico; Dr. Thomas Parran, Surgeon General, U. S. Public Health Service;
Governor Tugwell; Dr. A. Fern6s Isern, Conference Chairman, and Health Commissioner of Puerto Rico; Sir Rupert
Briercliffe, C.M.G., Medical Advisor to the Comptroller for Development and Welfare to the West Indies, Medical
Advisor for Great Britain, Anglo-American Caribbean Commission.

Maj. Gen. Stayer and
Maj. Gen. Shedd

Dr. Villela, Miss Jean Pinney, Sir Rupert
Briercliffe, Miss Alice Miller, Dr. Huggins

Gov. Tugwell, Bishop A. J.
Willinger and Bishop James P.

THE PEOPLE OF PUERTO RICO
Office of the Executive Secretary

San Juan, P. R., February 2, 1944.
Administrative

Bulletin
No. 875.

BY THE GOVERNOR OF PUERTO RICO
A PROCLAMATION

Social Hygiene Day

Whereas, the venereal diseases syphilis and gonorrhea, despite
the great progress made in their control, remain serious health
problems among the people, and a leading cause of absence from
duty among the armed forces;

Whereas, the President of the United States has called for
" united effort for the establishment of total physical and moral
fitness for the freedom we cherish ";

Whereas, National Social Hygiene Day has been designated as
an occasion for renewed attack on the venereal diseases and con-
ditions which favor their spread, by means of wide-spread public
and education; and

Whereas, the Department of Health of Puerto Rico, the Puerto
Rico Committee on Social Protection and other Insular agencies
which are carrying on a continuous campaign against these dis-
eases and conditions, will sponsor a Regional Conference on Social
Hygiene in San Juan on February 9, 1944, in which the American
Social Hygiene Association, the United States Public Health Serv-
ice, the Division of Social Protection, the Army, Navy and other
Federal agencies and distinguished guests from the mainland and
the Caribbean area will join,

Now, Therefore, I, R. G. Tugwell, Governor of Puerto Rico,
do proclaim the ninth day of February; 1944, as Social Hygiene
Day in Puerto Rico, and call upon the people of the Island to

Unite Against Venereal Disease ", to hasten victory in health,
both in war and in the peace to come.

In Witness Whereof, ! have hereunto set my hand and caused
to be affixed the Great Seal of Puerto Rico at the City of San
Juan, this 2nd day of February, A.D. nineteen hundred and
forty-four.

[Seal] R. G. TUGWELL,

Governor.
Promulgated according to law, February 2, 1944.

E. D. BROWN,
Executive Secretary.

"FIGHT SYPHILIS AND GONORRHEA

CELEBRATE SOCIAL HYGIENE DAY"

Four hundred copies of this placard, 11x14 inches, designed by Dr. Tomas
Blanco and produced in three colors by silk-screen process in the Bureau
of Health Education, Puerto Rico Department of Health, advertised the
evening session of the Regional Conference. The placards were distrib-
uted by Boy and Girl Scouts to stores, theatres, libraries, waiting-rooms,
and other public places.

The photographs of Conference guests which accompany the Proceedings,

except as otherwise indicated, are by the photographic staff of

PUERTO Eico ILUSTRADO and EL MUNDO

The small photographs of Puerto Eico places and people, unless otherwise stated,
are from the private collection of Miss Jean B. Pinney

o
o

LU

Z)
o_

u_

O

Q

•z.

_i
t/>

LU

I

a>
to

ID
4)

I

.-r

0. —

O *:

I

00)0

CQ CQ Q

Q

CT>

C

O

<D

I

0)

CL
0)

O

a.

ID

rs — Pu

So J

Journal

of

Social Hygiene

VOL. 30 APRIL, 1944 NO. 4

Proceedings

of the
Puerto Rico Regional Conference on Social Hygiene

The Regional Conference on Social Hygiene at San Juan, Puerto
Rico, February 9-10, 1944, was one of about 18 such events held
in the United States and Canada in observance of National Social
Hygiene Day, which is sponsored each year by the American Social
Hygiene Association during the month of February for the purpose
of promoting wider understanding of and stronger support for the
campaign against venereal diseases. This campaign becomes more
than ever important in connection with the war effort, and the
1944 Social Hygiene Day events of special significance.

In this nation-wide observance every state in the Union, as well
as the territories, and insular outposts, take part. Aside from the
Regional Conferences in large cities such as New York. Boston,
Philadelphia, Chicago, St. Louis, Omaha, New Orleans and in the
Southwest and Far West, literally thousands of community and
group meetings are held in smaller cities and towns, and in rural
areas. Numerous radio programs and special showings of social
hygiene films carry information to their respective audiences. News-

165

166 JOURNAL OP SOCIAL HYGIENE

papers and magazines contribute many columns of space for edi-
torials, feature stories and news. Every known means is used to
tell the public the facts about syphilis and gonorrhea and the fight
against them, to the end that more people may know how to protect
themselves against these diseases and what to do if infection occurs,
and that strong community action may be organized to advance
social hygiene objectives generally.

Each year, Puerto Rico has taken an active part in Social Hygiene
Day, and in the autumn of 1943, the Board of Directors of the
American Social Hygiene Association accepted an invitation from
Governor Rexford G. Tugwell, Health Commissioner Dr. A. Fernos
Isern and Medical Director R. A. Vonderlehr, Director of U. S.
Public Health Service District Number 6, to hold a Regional
Conference on the Island in observance of 1944 's Social Hygiene Day.

It was proposed that the sessions occupy two days, the first day
to be given over to general and group meetings to which the public
would be invited, and an Executive Session to be held on the second
day, for discussion of further efforts to meet needs revealed by the
Conference, particularly as related to administrative methods of
venereal disease control and repression of prostitution in the
Caribbean Area.

Aside from the general objective of calling public attention to
the campaign against syphilis and gonorrhea, it was believed that
the meetings might stimulate :

1. Public support for new legislation proposed for introduction
in the 1944 Puerto Rican legislature;

2. Stronger and more effective teamwork and action through
organized groups in Puerto Rico.

3. Increased cooperation among the countries of the Caribbean
Area.

With the Puerto Rico Committee on Social Protection, organized
in October, 1943, as chief local sponsor, and with cordial and vigor-
ous cooperation from every side, the two-day series of meetings
was held on February 9 and 10, as reported in the Proceedings
which appear here. For convenient reference for those who attended
and for the information of the many others who have expressed
interest, a summarized program, with various facts concerning the
Conference background, development and participants, is also
included.*

Tke results of such a Conference are best measured in years to
come, but some effects were apparent even before the sessions began,
and other developments which occurred during the meetings and

* Readers desiring further details are invited to address the Committee on
Social Protection, Santurce, Puerto Eieo, or the American Social Hygiene
Association, 1790 Broadway, New York 19, N. Y.

INTRODUCTION

167

soon after indicate that real progress has already been made toward
the objectives suggested. Among these were :

The splendid cooperation of the Puerto Rican press and radio in
the weeks previous to the Conference, as well as the excellent cover-
age given the actual events (see opp. page 237), helped to arouse new
public interest and added to public knowledge.

Active participation brought to many of the 58 insular and com-
munity agencies which joined with the Committee on Social Protec-
tion and the other principal "auspice agencies" in sponsorship of the
Conference (see page 168), a new concept of the opportunities for
progress through united action in the social hygiene field.

The Committee itself, taking note of needs brought out in the Con-
ference talks and discussions, and as recorded in the Resolutions
adopted (see pages 264—8) was able to chart its course for future work
to advantage, and with assurance of the approval and cooperation of
other agencies.

The vigorous Conference discussion of practical community meas-
ures for prevention and control of syphilis and gonorrhea, including
laws and law enforcement, did much to prepare the way for adoption
of new and needed legislation by the Puerto Rico Legislature in
its session which opened February 15th.

Best of all, the Conference forged another link in the chain of
united effort in the Western Hemisphere for the better health of its
peoples, and marked especially another advance in the conquest of
the venereal diseases in the Caribbean Area.

The JOURNAL OF SOCIAL HYGIENE takes pleasure in devoting this
issue to the Proceedings of the Conference, and thanks all who have
joined in preparing this permanent record.

JEAN B. PINNEY, Editor

KHITO I ICO wetLB JCUtKAL — UTU«B*r, J*NU*IT f>, I»M.

Health Group Maps Out
VDLegislative Acti

NEWSPAPER NOTICE OF LEGISLATIVE PROGRAM

REGIONAL CONFERENCE ON SOCIAL HYGIENE

San Juan, Puerto Rico, February 9, 1944
under the auspices of

The Puerto Rico Committee on Social Protection
The Health Department of Puerto Rico

The Division of Social Protection, Federal Security Agency
The United States Public Health Service

The American Social Hygiene Association

with the cooperation of

Medical Corps, U. S. Army, Antilles Department
Medical Corps, U. S. Navy, Tenth Naval District

and
Fifty-eight Sponsoring Agencies

Club Altrusa

Asociacion Americana de Trabajadores

Sociales — Capitulo de Puerto Rico
Asociacion Bibliotecaria de Puerto

Eico
Asociacion de Empleados del Gobierno

Insular
Asociacion de Enfermeras de Puerto

Rico
Asociacion de Iglesias Evangelicas de

Puerto Rico
Asociaci6n de Maestros de Puerto

Rico
Asociacion de Mujeres Graduadas de

la Universidad de Puerto Rico
Asociacion de Salud Publica
Asociacion General Antituberculosa
Asoeiacion Medica de Puerto Rico
Asociacion Pro Education de Adultos
Asociacion Pro Salud Maternal e

Infantil

Ateneo Puertorriqueno
Caballeros de Colon de Puerto Rico
Camara de Comercio de Puerto Rico
Colegio de Abogados de Puerto Rico
Colegio de Cirujanos Dentales de

Puerto Rico
Colegio de Trabajadores Sociales de

Puerto Rico
Colegio de Farmaceutieos de Puerto

Rico

Compaiiia de Fomento de Puerto Rico
Congreso del Nino
Confederaci6n General de Trabajadores

de Puerto Rico
Club Civico de Damas
Club de Damas de la Y.M.C.A.
Comision de Seguridad Social
Comite Auxiliar de Damas de la

Asociaci6n Medica de Puerto Rico

Community "War Services

Club Rotario

Cruz Roja Americana

Defensa Civil de Puerto Rico

Departamento de Educacion

Divisi6n de Bienestar Publico del

Departamento de Sanidad.
Escuela de Medicina Tropical
Farm Security Administration
Federaci6n de Comerciantes de Puerto

Rico
Federation Libre de Trabajadores de

Puerto Rico
Hijas Catolicas de America — Corte de

Granada No. 579, San Juan
Hospital de la Universidad
Junta de Bienestar Publico
Junta de Planificacion, Urbanizaci6n, y

Zonificacion de Puerto Rico
Junta Vocacional Para Ciegos Adultos
Legion Americana
Leones Internationales
Liga Civica Reformista
Liga Insular de Asociaciones de Padres

y Maestros

Ninas Escuchas de Puerto Rico
Nines Escuchas de Puerto Rico
Club Optimistas de San Juan
Puerto Rico Nutrition Committee
Servicio de Extension Agricola de !a

Universidad de Puerto Rico
Sociedad Para Evitar la Tuberculosis

en los Nifios

Sociedad Para Evitar la Mendicidad
Sociedad Para la Protection y Defensa

del Nino

Sociedad Puertorriquena de Periodistas
Universidad de Puerto Rico
United Service Organizations
Young Men's Christian Association

168

REGIONAL CONFERENCE ON SOCIAL HYGIENE 169

OFFICERS AND PROGRAM COMMITTEE FOR THE
CONFERENCE

Honorary Chairman

His EXCELLENCY BEXFORD G. TUGWELL

Governor of Puerto Rico

Chairman

DR. A. FERNOS ISERN
Health Commissioner of Puerto Rico

Secretary

Miss JEAN B. PINNEY
American Social Hygiene Association

Program Committee

Chairman: CONRAD VAN HYNING, Regional Director, Community War Services,

Federal Security Agency
MEDICAL DIRECTOR R. A. VONDERLEHR, Director District No. 6, U. S. Public

Health Service

LT. COL. WILLIAM F. DUE, Provost Marshal, U. S. Army, Antilles Department
Lr. COM. PRANK W. REYNOLDS, MC-USNR, V. D. Control Officer, Tenth Naval

District

DR. JOSE GANDARA, Assistant Commissioner of Health for Puerto Rico
DR. ERNESTO QUINTERO, Chief, Venereal Disease Control, Health Department of

Puerto Rico
MRS. DOLORES DE LA CARO, Chief, Bureau of Medical Social Services, Health

Department of Puerto Rico

In charge of Exhibits

DR. TOMAS BLANCO AND Miss ALICE H. MILLER

In Charge of Radio Program

MR. FRANCISCO ACEVEDO

SUMMARY PROGRAM

(for details of programs see Proceedings of sessions)

Theme: "Unite against Venereal Disease . . . VD Delays Victory ..."

Morning Session — 9 A.M.: School of Tropical Medicine
Subject: The National Campaign for Venereal Disease Control in Wartime

Presiding: DR. A. FERNOS ISERN, Insular Commissioner of Health and Chairman

of the Conference

Speakers: MAJOR GENERAL M. C. STAYER, MC-U. S. Army; LIEUTENANT COM-
MANDER FRANK W. EEYNOLDS, MC-USNR, U. S. Navy; MEDICAL DIRECTOR
B. A. VONDERLEHR, TJ. S. Public Health Service; ELIOT NESS, Division of
Social Protection; DR. WILLIAM F. SNOW, American Social Hygiene
Association

Luncheon Session Hotel Condado 1 P.M.
Subject: The Americas Go Forward Together

Presiding: SIR BUPERT BRIERCLIFFE, C.M.G., Anglo-American Caribbean

Commission

Speakers: DR. CHARLES E. SHEPARD, Office of the Coordinator of Interamerican
Affairs; DR. ENRIQUE VILLELA, Republic of Mexico

Introduction of distinguished guests from the Caribbean Area and from the
other American republics

Afternoon Sessions 3 P.M. School of Tropical Medicine

Group Sessions
Subject: Puerto Eico Does Her Part in the Fight

Group I: Knowledge Is a Strong Weapon

Group II: Medical Diagnosis and Treatment Are Strong Weapons

Group III: Good Laws and Law Enforcement Are Strong Weapons

Group IV: Youth Has Priority

General Session 4:30 P.M.

Presiding: DR. FERNOS ISERN

Beports of Group Chairmen or Secretaries
Eesolutions
Conference Summary: DR. SNOW

\

Evening Session 8:30 P.M. Central High School Auditorium

Music by Army Band and by the University of Puerto Eico Chorus
Subject: The Nations Unite for Victory over Venereal Disease

Presiding: DR. CARLOS MUNOZ McCoRMiCK, Puerto Eico Medical Association

Presentation of Honorary Life Memberships in the American Social Hygiene

Association to DR. FERNOS ISERN and DR. ENRIQUE VILLELA of Mexico,

by SURGEON GENERAL THOMAS PARRAN, Chairman ASHA Committee on

Awards, and responses by the recipients.

Speakers: DR. FERN6s ISERN

SURGEON GENERAL PARRAN, U. S. Public Health Service

170

171

FACTS ABOUT THE CONFERENCE

Program participants:

50 persons served as Chairmen of sessions, speakers, or discussants, or in
some connection with the organization and presentation of the program. As
indicated by the program, leading medical, health, welfare and law enforcement
authorities and officials from both Puerto Rico and the mainland contributed
time and thought to the meetings. Distinguished guests, including those from
continental United States, the Caribbean Area, and the other American
Republics included:

SURGEON GENERAL THOMAS PAREAN
United States Public Health Service,

Washington, D. C.
DR. WILLIAM F. SNOW

Chairman, Executive Committee,
American Social Hygiene Associa-
tion, New York
MR. ELIOT NESS

Director, Division of Social Protec-
tion, Federal Security Agency,
Washington, D. C.
SIR RUPERT BRIERCLIFFE, C.M.G.

Medical Advisor to the Comptroller
for Development and Welfare of
the West Indies; Medical Advisor
for Great Britain, Anglo-American
Caribbean Commission, Barbados,
British West Indies
DR. DONALD HUGGINS

In charge of Venereal Disease Con-
trol for Trinidad Health Services,
British West Indies
DR. ENRIQUE VILLELA

Chief, Venereal Disease Control,
Department of Health, Republic
of Mexico

MAJOR GENERAL M. C. STAYER, MC
Surgeon, Caribbean Defense Com-
mand, U. S. Army, Panama
MAJOR GENERAL WILLIAM E. SHEDD
Commandant, Antilles Department,

U. S. Army

COLONEL CLYDE C. JOHNSTON, MC
Department Surgeon, Antilles De-
partment, U. S. Army
MAJOR DANIEL C. BERGSMA, MC

Venereal Disease Control Officer,
Caribbean Defense Command,
U. S. Army, Panama

CAPTAIN STIRLING S. COOK

Medical Officer in Charge, Tenth
Naval District, U. S. Navy De-
partment
DR. CHARLES E. SHEPARD

Director, Training and Education
Office of the Coordinator of Inter-
American Affairs, Washington,
D. C.
DR. KNUD KNUD-HANSEN

Commissioner of Health, St. Thomas,

Virgin Islands
DR. Luis F. THOMEN

Assistant Secretary of Health,
Dominican Republic, and repre-
senting the P(an American Sanitary
Bureau
MR. MANUEL M. MORILLO

Consul to the Dominican Republic
DR. FELIX LARAQUE

Representing the Director General

of Health of Haiti
DR. F. MARTINEZ RIVERA

Representing the Secretary of Health

of Costa Rica
MR. J. HERNANDEZ USERA
Consul to El Salvador
MR. JUAN ANTONIO IRAZUSTA

Consul to Colombia
MOST REVEREND JAMES P. DAVIS, D.D.

Catholic Bishop of San Juan
RT. REV. MSGR. RAFAEL GROVAS

Diocesan Chancellor, Catholic Church,

San Juan
MOST REVEREND A. J. WILLINGER,

C.S.S.R., D.D.
Catholic Bishop of Ponce
BISHOP CHARLES B. COLMORE
Episcopal Bishop of San Juan

Program distribution:

5,000 programs were printed and distributed in advance of the Conference
through the sponsoring agencies and other channels.

Attendance: 1,000.
Exhibits:

2,000 pieces of literature from the U. S. Public Health Service, the American
Social Hygiene Association and the Insular Department of Health, were taken
away by conferees. The display of posters, charts and other graphic materials
arranged by Miss Miller and Dr. Blanco, received many compliments. Con-
ferees were especially interested in the poster brought by Dr. Villela from
Mexico, which was the prize-winnnig entry in a contest sponsored by the Mexican
Anti-Venereological Society.

EXAMPLES OF SPONSORING AGENCY COOPERATION

LETTER SENT TO HOME DEMONSTRATION AGENTS THROUGHOUT
PUERTO RICO BY THE AGRICULTURAL EXTENSION SERVICE

COOPERATIVE EXTENSION WORK

IN
AGRICULTURE AND HOME ECONOMICS

PUERTO RICO
College of Agriculture
and Mechanic Arts of the
University of Puerto Rico
U. 8. Department of Agriculture
Cooperating

Extension Service
Rio Piedras, Puerto Rico
19 de enero de 1944
Memorandum #1

OFFICE OF HOME DEMONSTRATION WORK.

A LAS AGENTES DE DEMOSTRACION DEL HOGAR Y AGENTES AGRICOLAS :

El dia 9 de febrero es el dia fijado para la celebracion del "Dia de Higiene
Social" en Puerto Rico. Como en otros afios, el Servicio de Extension Agricola
cooperara con las Agencias de Salud Publica federates e insulares en la
celebraci6n de este dia, contribuyendo a que la poblaci6n rural de Puerto Rico
reciba el mayor beneficio de la campana contra este enemigo publico — las
enfermedades vene'reas.

Hoy mas que nunca necesitamos que tanto la poblacion civil, como las fuerzas
armadas se mantengan en el mejor estado de salud. Por lo tanto es necesario
que ustedes dediquen todos sus esfuerzos a esta campana de higiene, reuniendo
grupos de jovenes y adultos para ilustrarles sobre los distintos aspectos de las
enfermedades venereas. Hay que desarrollar en la zona rural el interes y
responsabilidad que debe tener cada individuo de evitar el desarrollo de estas
enfermedades cuyas consecuencias pueden destruir los pueblos. Esto solo se
consigue si ustedes prestan la atencion que dicha campana requiere. Asi lo
esperamos.

Ustedes deberan prolongar esta campana de higiene social durante todo el
mes de febrero, aprovechando asi el mes para hacer los examenes de sangre al
mayor numero de ninos y nifias 4-H, asi como de adultas.

Este servieio tiene a su disposicion la pelicula titulada "Fight Syphilis,"
que puede facilitarsele a requerimiento nuestro. Igualmente el Departamento
de Sanidad tiene "Con Esta* Armas," y pueden facilitarla si ustedes la piden.
Aquellas agentes que deseen cualesquiera de estas peliculas escriban en seguida
a esta oficina informando para que dia la necesitan y haremos cuanto este a
nuestro alcance por enviarselas.

Deseo recalcar que esta actividad debera ser atendida por ustedes durante todo
el mes de febrero, y que deberan rendir un informe detallado sobre el alcance
de la misma en el informe mensual.

Atentamente,

ELENA BONILLA, R.N.
Especialista en Salud e Higiene

172

EXAMPLES OF SPONSORING AGENCY COOPERATION

173

LETTER SENT TO SUPERINTENDENTS OF SCHOOLS FROM THE
OFFICE OF THE COMMISSIONER OF EDUCATION

GOVERNMENT OF PUERTO RICO

DEPARTMENT OF EDUCATION

OFFICE OF THE COMMISSIONER
SAN JUAN

February 8, 1944
Circular Letter No. 135
Subject: SOCIAL HYGIENE DAY
To: Superintendents of Schools
Ladies and Gentlemen :

The Department of Health of Puerto Rico, The American Social Hygiene
Association, The United States Public Health Service, and several other
institutions are sponsoring the celebration of a Regional Conference on Social
Hygiene, to be held at San Juan on Wednesday, February 9, 1944. It is the
purpose of this meeting to discuss different phases of the problem created
by venereal diseases.

In order to cooperate with those at the head of this movement, you are
hereby requested: (1) to invite doctors and nurses to talk to children and
parents about these diseases; (2) to have pupils and teachers read news,
lectures, and other pertinent articles on the subject of venereal diseases.

Full information about this subject may be obtained from Miss Jean B.
Pinney, Conference Secretary, P. O. Box 3788, San Juan, P. R.

Yours very truly,

(Signed) Jos£ M. GALLARDO

Commissioner of Education

SIETE LAMINAS CONTRA LA SfFILIS

LQSEXTP COLUMN)

"

DECOLOGO K LAS (MFEKMEDDDCS

CCWIMMFECCIOSAS

0 NOUS VENEREOS

PUBLICATIONS OF THE INSULAR DEPARTMENT OF HEALTH

PROCEEDINGS
REGIONAL CONFERENCE ON SOCIAL HYGIENE

Morning Session — Auditorium, School of Tropical Medicine

Presiding: DR. A. FEEN6s ISEEN, Commissioner of Health for Puerto Eico, and
Chairman of the Conference

GREETINGS
FROM GOVERNOR REXFORD G. TUG WELL

Honorary Chairman of the Conference

This Regional Conference on Social Hygiene is a very significant
occasion in Puerto Rico, and I am glad to have had the opportunity
of serving as Honorary Chairman of the Committee which has been
responsible for the local arrangements.

You will realize, of course, that the only function I have here
today, as a layman, is to welcome you to Puerto Rico and to express
to you our gratification that this meeting is taking place.

From the point of view of civil government, of which I am a
representative, I think it is of great importance that meetings of
this kind be held. From the national point of view they make a
contribution to the health and welfare of the people which we cannot
afford to miss. I am sure that your sessions will be extremely
valuable to you, to the Island, and in fact to the whole Caribbean
area. Thank you for coming to San Juan. I wish you success
in your program and anything that the civil government can do
to facilitate such events of this kind, I can assure you we shall
be happy to do.

THE NATIONAL CAMPAIGN FOR VENEREAL DISEASE
CONTROL IN WARTIME

THE ARMY'S CAMPAIGN

MAJOR GENERAL M. C. STAYER, M.C.
U. S. Army, Surgeon, Caribbean Defense Command

Army Venereal Disease Trends in War and Peace

Historically all armies have had to contend with the venereal
diseases as a cause of non-effectiveness. A definite rise in the trend
of the venereal disease rates has been observed shortly after the
onset of each war. However a definite gradual drop in the trend

174

PROCEEDINGS REGIONAL CONFERENCE 175

of venereal disease rates was observed during successive wars par-
ticipated in by American troops. A similar downward trend existed
during successive between-war, or peace-time, Army rates. At the
beginning of active participation of Americans in World War II
the venereal disease rates were at an all time low. A definite rise
developed soon afterward. The modified venereal disease program
adopted by the Army, plus other factors, has prevented the degree
of rise in the venereal disease rate which might have been antici-
pated and at the present time the overall Army rate is lower than
in any previous war.

Basic Principles Which Are Operative

Basically a few general principles are operative. For example,
if no civilians had any venereal disease in a communicable stage
there would be no venereal disease problem in the Army, because
with very rare exceptions the infections are acquired from members
of the opposite sex. Similarly, if no soldier practiced non-marital
coitus the rates would be very low indeed because most enlisted
men are not married and marital sexual intercourse is not the common
source of infection. Furthermore, if every non-marital sexual con-
tact were associated with the proper use of mechanical prophylaxis
plus soap and water and/or prompt adequate chemical prophylaxis
the venereal disease rates would again be extremely low. Clearly
none of these separate combinations are attainable in absolute per-
fection. Only the last mentioned, namely, the use of proper pro-
phylaxis whenever exposure to possible infection occurs is within
the direct responsibility and control of the Armed Forces.

Responsibility for Civilian V.D. Rates and Their Effect Upon
Army Rates

The rates of venereal disease within a civil population are depend-
ent principally upon the proportion of the population which partici-
pates in sexual intercourse with more than one sex partner and
the frequency with which they change sex partners. This relative
promiscuity determines the frequency of the chances for disease
germs to be passed from an infected person to a healthy one. I
am sure all of my present audience fully appreciates the fact that
this relative sexual promiscuity is influenced by many emotional,
economic, social and other factors. I am equally sure that all my
present audience fully appreciate that the control of all these
factors is the combined responsibility of the various official and
non-official agencies which exist within a modern civil community,
state, or nation. These include the educational, religious, welfare,
social, economic and health agencies. The Armed Forces have an
interest in, but no direct responsibility for, these civil functions.
When the civil agencies excel in their efforts the Armed Forces find
their venereal disease control program that much easier. Whenever
the civil agencies collectively fail to attain and maintain a low
prevalence of communicable venereal disease among their civilians

176 JOURNAL OP SOCIAL HYGIENE

the Armed Forces must compensate by increased efforts to protect
themselves from such infections.

Sexual Promiscuity — Its Background and Origin in Civilian Life

The question of sexual promiscuity among a certain proportion
of all soldiers is not fundamentally different from sexual promiscuity
practiced by civilians. This applies equally to men and women since
one of each is involved in each instance. Some studies have been
conducted to estimate the proportion of soldier populations who
do practice non-marital sexual intercourse and the frequency of
same as well as the degree of their relative promiscuity — that is
the frequency of their change of sex partner. These data cannot
be presented at this time. The data clearly implies, however, that
the female partners are by no means limited to a few very promis-
cuous persons. Clearly the emotional make-up, age, the present
love-status, the educational, religious, social and economic back-
ground of each person, whether male or female, will determine in
part how a given person, civilian or military, will react under any
given set of conditions. These factors are largely determined before
men enter the Armed Services and hence they represent a summa-
tion of past civilian influences more than Army-controllable factors.
Some evidence has been collected to show that sex habits are brought
by recruits into the Armed Forces from civilian life and that no
significant proportion of service men alter their basic attitudes or
practices in relation to sex following induction into the service.

Army Controllable Factors and the Techniques Which Have Been

Found to Be Effective

Now let us consider the Army-controllable factors and the tech-
niques which have been found to be effective. Especially trained
and experienced full time venereal disease control officers were
assigned to all major commands to analyze local problems and to
recommend appropriate techniques for dealing with any special
situations.

Punishment as a method to prevent sexual exposure to infection
and/or to increase the use of prophylaxis if sexual contact occurred
was eliminated as less desirable and less effective than exact knowledge
and self respect as motivating influences.

Each Commanding Officer was made specifically responsible for
the control of venereal diseases among the personnel under his
Command. This was carried to its logical conclusion in some ar,eas
so that every commissioned and every non-commissioned officer includ-
ing corporals were made responsible to their superiors for venereal
infections occurring among the men under their supervision. This
was based on the idea that actual infections would reach an acceptable
low level if every soldier really knew and understood all the facts
relative to the spread of these diseases, the damage which sometimes
results to vital organs, the complications which occur even under
ideal therapy as well as the details of adequate prophylaxis should
exposure to potential infection occur.

PROCEED1MGS REGIONAL CONFERENCE 177

This premise necessitated an educational program comparable
in scope and detail to other instruction given to soldiers relative
to the proper use of protection from gas attack by gas masks or the
use of rifles and machine guns in attacking an enemy-held position.
In some areas courses were held including lectures, demonstrations
and discussions for all commissioned officers on a scheduled basis
to give them detailed instruction in all significant scientific facts
pertaining to these diseases. They were also informed of the basic
principles underlying the control program and their responsibilities
in connection therewith. These commissioned officers with the aid
of the original medical officer instructors then conducted similar
courses for all of the non-commissioned officers. These in turn
trained their subordinates to the last and newest recruit. Visual
aids in the form of movies, film strips, exhibits, posters, bulletin
notices, and so on, were all used where maximum results were
obtained. Eternal vigilance is the price that each officer must pay
if he is to succeed in attaining and maintaining low rates in his unit.
The fact that such is possible even under adverse environmental
conditions in the surrounding civilian areas has been repeatedly
demonstrated. Admittedly it requires even greater effort and more
attention to details to succeed under such circumstances.

In addition to making certain that every soldier clearly under-
stands all pertinent facts it is necessary to provide both mechanical
and chemical prophylactics at all strategic locations under such
esthetically acceptable circumstances that no soldier in need of using
same will have an excuse for not availing himself of such prophylaxis.
Both individual prophylactics and station prophylaxis must be
provided. The former must be available without difficulty or
embarrassment and station prophylaxis must be provided under
conditions which inspire respect for the importance of the medical
procedure involved. It is a false premise to suppose that the removal
of prophylactics, or making it difficult to obtain such, will stop,
or even significantly reduce, the number of sexual contacts. The only
observable effect has been to increase the number of infections
appearing because an increased percentage of unprotected exposures
occur.

Another useful technique is to have every soldier returning from
pass to report to his charge of quarters. If the returning soldier
is significantly under the influence of alcohol immediate chemical
prophylaxis is required. If the soldier is sober, or at least not too
intoxicated to be relied upon he is questioned about the possibility
of having acquired an infection. If the slightest possibility of
exposure to infection exists he is urged to take the necessary
prophylaxis at once provided he has not already done so. Thus
the educational program follows through including special attention
at the crucial moment. Military police render a preventive service
by transporting any soldier who has had too much alcohol to the
prophylactic station and then placing him in the care of a suitable
person such as the charge of quarters. This can be done without
arrest and prevents quarrels and accidents as well as venereal disease.

178 JOURNAL OF SOCIAL HYGIENE

Early diagnosis and therapy of venereal diseases in the Armed
Forces help to lower the subsequent rate for both the Army and
the civilian population. This is true because an undetected infectious
soldier, who acquired his disease from one civilian, may pass his
infection on to other civilians. These newly infected females in turn
would subsequently infect not oni> other civilians but also other
soldiers. All soldiers diagnosed as having a venereal disease are
not only promptly treated to make them non-infectious and to cure
them but also they are placed under working quarantine for a
reasonable period to make certain that they will not spread their

disease.

/

All infected soldiers are carefully questioned to obtain all available
data about their sexual contacts during the incubation periods
of the disease involved. Such data is promptly submitted to the
civilian health authorities to permit them to locate and examine
such probably infected persons. If they are quickly located, properly
diagnosed and adequately treated a real contribution is made to
both civilian and military control of venereal disease. Those less
reliable or recalcitrant infectious persons need isolation also to
provide regular treatment and to stop the exposure of others to
disease.

Religion is of considerable influence in the lives of some service
personnel just as it is in the lives of some civilians. It does not
influence all persons and it must be understood that not all church
or chapel visitors are free of venereal disease. Similarly, the others
are not all infected.

Recreation in all its forms ; music, dancing, movies, shows, athletics,
and so on, are indirectly helpful, if wholesome in type, to provide
emotional satisfaction to certain persons. These facilities if adequate
in quality and quantity completely meet the emotional needs of
some persons while others are only partly satisfied and still others
have never learned to appreciate or use these aids. Recreational
features in which the individual actively participates are usually
more helpful than those which permit only passive participation.

An outline of Army-controllable factors and the techniques which
have been found to be effective therefore includes:

a. Assignment of Venereal Disease Control Officer.

b. Punishment ruled out and replaced by exact knowledge and
self respect as motivating influences.

c. Responsibility of each officer — commissioned and non-com-
missioned.

d. Educational program.

e. Provision of adequate and acceptable prophylaxis.

f. Check-pass system.

g. Early diagnosis and therapy for service personnel.

h. Epidemiological data provided to civil health agencies,
i. Various other aids.

PROCEEDINGS REGIONAL CONFERENCE 179

Results of Suck a Program in the Army

As stated above the overall American Army venereal disease rates
are the lowest in wartime history. However these rates vary con-
siderably by race and by location of the troops. Again as indicated
previously this variation is definitely influenced by the venereal
disease prevalence rates of the civilians in the area of troop con-
centrations. In areas of high civilian rates only a relatively few
service men need expose themselves to infection without adequate
prophylaxis to maintain an Army venereal disease rate which is
considered to be too high.

Let us consider a hypothetical example. Let us assume that out
of one thousand soldiers one out of five has sexual intercourse.
Let us assume that on the average they do so once each week and
again on the average that one-sixth of these experiences are not
associated with adequate prophylaxis. That combination in the
course of a four-week month would yield one hundred thirty-three
unprotected sexual contacts. Clearly, if the civilian infection rate
is very low only an occasional case of venereal disease will result
but if the civilian rate is high the infections acquired during these
unprotected contacts will rise proportionately.

A definite decrease in the Army venereal disease rates occurred
in the Caribbean area during the year 1943. The venereal disease
rate for all troops in the Antilles area in January, 1943 was 105.
That means the rate of new venereal disease for this area in January,
1943 if continued over a whole year would have yielded 105 new
infections among every one thousand troops. Two infections in
one soldier counts as two diseases and hence two infections. This
high rate persisted through February and March and then a down-
ward trend occurred with a rate of 55 in December, 1943. This means
that 52 per cent of the Army venereal disease problem which existed
in January, 1943 was still present in December, 1943.

It will be understood that the total Caribbean venereal disease
rates will be a composite of results from the Antilles area and the
Panama Canal area. Hence the total rate will of necessity always
be in between the two Department rates. The total Caribbean rate
for January, 1943 was 85. It dropped to 73 in February and
remained constant through March, April and May. Since then the
rate has dropped to 38 in December. This rate is 55 per cent
lower than the rate of January, 1943.

Truly gratifying progress in venereal disease control has been
made in the Panama Canal Department. The rate was 68 in
January, 1943. It dropped to 50 in February ; was constant through
March and April; rose to 62 in May and dropped rapidly thereafter
to only 23 in December, 1943. This represents a drop of 71 per
cent as compared with January, 1943.

The significant drops in the venereal rates in the Caribbean area
since May, 1943 must be compared with the trends in the venereal
disease rates for the last six months of each of the previous years.
For example the Panama Canal Department Ground Force rate

180 JOURNAL OF SOCIAL HYGIENE

dropped from 60 in May, 1943 to only 20 in December. This
represents a drop of 66 per cent in seven months. It becomes a
more spectacular result, however, when it is compared with the
trend in 1942. In May, 1942, the same command had a rate of 43
and it rose to 86 in August and was still at 73 in December, 1942.
Thus in 1942 between May and December the venereal disease
rate rose 74 per cent instead of dropping 66 per cent as it did in
1943. A similar rise rather than a fall occurred in the years
1941 and 1940.

Wliat is the Irreducible Minimum?

The Army venereal disease rate would be zero if civilians had no
venereal disease but that is too much to expect. If no soldier
had sexual intercourse with more than one woman and each such
woman in turn limited her sex contacts to one man, both the civilian
and Army venereal disease incidence rates would drop practically
to zero. No influence or combination of influences has succeeded
in inducing any large population groups to rigidly follow this scheme
to date. Once again if every soldier used properly timed and
adequate prophylaxis during and/or following each potentially
infectious contact the Army venereal disease incidence rate would
be essentially zero. This would be equally true among a civilian
population. However this too is more than can be expected since
ignorance of the facts, indifference to disease, diminished self-respect,
alcoholism and other factors make perfection in prophylaxis impos-
sible in all instances.

The question remains — What is the irreducible Army venereal
disease rate? This varies somewhat with the rate among nearby
civilians but it is much more closely correlated with the effectiveness
with which the Army controllable factors are applied. One Command
of considerable size in the Caribbean area has had an average rate
of under 20 for the past six consecutive months. It attained a rate
of only 11 in January, 1944, which rate may be compared with
the rate of 59 in January, 1943. This remarkable achievement
proves that the irreducible minimum if not zero is actually not
more than about 15. It must be made clear that the troops in the
command referred to are not particularly favored in any way. They
simply have taken their job seriously and have applied to the
logical upper limits every seund control technique that could be
devised. They used no techniques not referred to above.

THE NAVY AND VENEREAL DISEASE CONTROL IN THE CARIBBEAN

LIEUTENANT COMMANDER FRANK W. REYNOLDS, MC— USNR

Venereal Disease Control Officer, Tenth Naval District,
San Juan, Puerto Rico

A concept difficult for many to grasp is that of preventive medi-
cine. So often we associate the doctor with the delicate surgical
operation or picture him ministering to an acutely ill patient with
pneumonia or malaria. But there is another and even more impor-

PROCEEDINGS REGIONAL CONFERENCE 181

tant phase of medicine — that phase wherein the physician seeks to
prevent disease rather than to cure it after it has occurred.

Of course there are some conditions which medical science does not
have the required knowledge to prevent — the common cold, cancer
and diabetes, for example. For other conditions the fundamental
knowledge is available, and all that is required is diligent applica-
tion of that knowledge before these conditions are wiped out com-
pletely. The venereal diseases fall into the latter category. We know
their cause and the method of spread. We have effective remedies.
To wipe these plagues from the face of the globe requires only the
application of sound public health procedures.

The venereal diseases constitute one of the most important problems
of preventive medicine with which the Navy has to deal. The
number of man-days lost to the Navy from venereal infections is
still extremely high.

But venereal infections, particularly syphilis, mean more to the
Navy than lost man-days. The treatment of syphilis requires regular
and prolonged therapy by a Medical Officer. Many of the smaller
Naval units do not carry a Medical Officer. Therefore, crew members
of such vessels who contract syphilis must be sent to duty elsewhere,
and their trained service is lost for many months. Remember that
the Navy, more perhaps than any other branch of the Armed Forces,
is composed of specialists — gunners, radiomen, radar operators,
mechanics. Each man is an integral part of a smoothly working
team. To lose the service of a key man in the team means delay in
reestablishing a crew of maximum efficiency.

The theme of this Conference is Venereal Disease Delays Victory.
Yes, ladies and gentlemen, venereal disease does delay victory. Each
infection slows down the war effort, and when one considers the num-
ber of these infections which occur each month, he w'll realize how
great the problem really is.

Here in the Caribbean, the problem is especially acute. In 1942
(the last year for which all the statistical data are available at this
time), the venereal disease rate for this area was higher than in any
O'tiher Naval District, and six times as high as in the Continental
United States.

This problem is recognized by the Navy, and is being attacked vig-
orously. During the year just past, the venereal disease rate for the
Tenth Naval District was nearly halved. This reduction in incidence
has been noticeable throughout the entire District, which extends
from the Bahamas to British Guiana.

I wish I could tell you that the greatest reduction in the incidence
of Navy venereal infections has been in Puerto Rico. Unfortunately,
this is not the case. In fact, of all the major areas of manpower con-
centration in the Caribbean, the highest rate and the least reduction
over the previous year has been right here in the San Juan area.
During 1943, over 500 venereal infections were contracted by Navy

182 JOURNAL, OF SOCIAL, HYGIENE

personnel in San Juan, with, over 10,000 man-days lost to the war
effort!

This, I think, brings the problem home and presents a challenge
to all of us who are in any way concerned with venereal disease con-
trol in this area.

We fully realize that the influx of large numbers of service men in-
creases the venereal disease problem for the civilian community. Con-
versely, it is also true that the presence of a large reservoir of vene-
real infections in the civilian community is bound to be reflected in a
high incidence of infection among servicemen stationed in that area.

If one were to compare two maps of the United States — one de-
picting the prevalence of syphilis among selectees (the best available
index of civilian prevalence) and the other showing the venereal dis-
ease rates in the various Naval Districts throughout tthe country, the
two maps would be nearly identical. This indicates how closely inter-
dependent the two are.

I mentioned previously that the Navy venereal disease rate in the
Caribbean was six times that of the Continental United States in
1942, and that the venereal disease control program has succeeded in
one year in reducing this by half, i.e., to three times the continental
rate for 1942. Toward the end of 1943, rates for the Continent were
approximately half of ours. I understand that the prevalence of
syphilis among selectees from Puerto Rico, and therefore, presumably,
in the civilian community as a whole, is about two and one-half times
as great as in the Continental United States. A remarkable coin-
cidence— but what does it mean?

It means that the Navy venereal disease control program in this
area is approaching bed rock, and that we are becoming increasingly
dependent upon the civilian community for further progress. Until
this vast reservoir of infection can be brought to light and removed,
the Navy will ( ontinue to have a venereal disease problem.

We are trying to do our part — by finding, treating and keeping
isolated all infectious cases of venereal disease among our. own men so
that the infection may not be seeded back into the community; by
providing for and stimulating the use of effective prophylaxis; by
providing more adequate on-the-station recreational facilities ; by con-
centrated educational measures; by reporting all contacts and pos-
sible sources of infection of which we have knowledge. I give you
every assurance that this work will be continued and intensified.

It is our sincere hope that this Conference may result in a more
widespread appreciation of the venereal disease problem, not only as
it affects the civilian community, but also as it reflects upon the effi-
cient use of manpower in the Army and Navy. With knowledge
should come action, and with well directed action, reservoirs of in-
fection gradually will be drained — the accomplishment of which
swiftly will be reflected in improved health for the people of Puerto
Rico, and a further decline in the incidence of venereal disease among
men of the Navy.

PROCEEDINGS REGIONAL CONFERENCE 183

THE CAMPAIGN WITH SPECIAL REFERENCE TO THE CARIBBEAN AREA

MEDICAL, DIRECTOR R. A. VONDERLEHR
Director, U. S. Public Health Service District No. 6, San Juan, Puerto Eico

Increased services for venereal disease control have marked the
progress of the campaign during the last several years. On a nation-
wide basis, the Public Health Service reports the performance of
30 million blood tests for syphilis in 1943 as contrasted with 10
million three years previously; the distribution of 11 million doses
of arsenical anti-syphilitic drugs in 1943 as contrasted with 7 million
in 1940; and a monthly syphilitic patient load of 450,000 as con-
trasted with 300,000 three years before. In the three-year period
the amount of sulfonamide drugs distributed by state health depart-
ments for the treatment of gonorrhea has increased 350 per cent,
and there has been almost as large an increase in the admission of
gonorrhea patients to clinics throughout the land.

These are impressive figures, and if comparable data were available
for each of the islands of the Antilles, similar progress would be
shown in most places. Yet all of the information available is not
encouraging. In the fiscal year 1943, 600,000 cases of syphilis were
reported to state health departments. This represents a 21 per
cent increase over the number reported in 1942. A 28 per cent
increase in gonorrhea patients in 1943 resulted in the recording
of approximately 300,000 case reports. While a considerable part
of this increase may represent an expansion in the development of
control services, there does appear to be a rising rate of infection
in the larger population centers — the boom towns and the areas
of military and naval concentrations. Due to the marked expansion
in the venereal disease control work of civilian health departments
and the splendid efforts of the Army and Navy on a nation-wide
basis, the venereal disease rates in the armed forces have so far
failed to rise to those heights that experience from previous wartime
periods indicated. In order to maintain this gain, it behooves us
all to give complete support to the civilian venereal disease control
program in the coming years.

One of the real contributions of the past year has been the formal
adoption by an Interdepartmental Venereal Disease Committee of
a United States Government Policy on Venereal Disease Control
in the Caribbean. This statement, released in the autumn of 1943,
has the endorsement of the Secretary of War, the Secretary of the
Navy, the Federal Security Administrator, and the Surgeons Gen-
eral of the Army, Navy and Public Health Service. In the Antilles
Department of the U. S. Army it was given public endorsement by
the Department Surgeon during a meeting of medical officers of the
Army, Navy and Public Health Service last November.

Since this policy was adopted after careful deliberation, it is par-
ticularly important that we give it careful study. In terms of

184 JOURNAL OF SOCIAL HYGIENE

developing civilian venereal disease control services it charges the
Public Health Service, the Pan American Sanitary Bureau, and the
Anglo-American Caribbean Commission with the responsibility of
stimulating the organization and operation of such services by the
respective insular Caribbean governments. The facilities and the
services recommended are :

(1) Effective methods of diagnosis;

(2) Clinics operated in accordance with best scientific standards;

(3) Hospital facilities for the isolation of infectious patients;

(4) Qualified follow-up workers for contact tracing and case
holding work; and

(5) A modern program of public education.

Provision is being made in cooperation with the Anglo-American
Caribbean Commission for the installation of a program of this
kind on the island of Trinidad. This, the first attempt at Anglo-
American collaboration in a movement against the venereal diseases
in the New World, will establish, with the joint financial support
of both the United States and the British Government, an up-to-date
venereal disease control program based on the above principles.
Such a program is urgently needed in Trinidad and the other Antilles,
not only for the health of the armed forces but for the civilian
population as well. It is to be hoped that this program will set
a pattern of Anglo-American health cooperation which will gradually
be extended to all of the Antilles and, with the aid of the Anglo-
American Caribbean Commission, the Office of Inter-American
Affairs and the Pan American Sanitary Bureau, to the entire Western
Hemisphere.

To those of us in the United States portion of the Antilles, a
review of present facilities and services is of special interest in the
light of the recommendations made by the Interdepartmental Com-
mittee on Venereal Disease. Generally speaking, effective methods for
the diagnosis of venereal disease are available. There has been,
however, some evidence advanced that due to some defect in collec-
tion, transportation, or processing, the reporting of results of serologic
blood tests and other laboratory methods is delayed in Puerto Rico.
The Insular Health Department, to my personal knowledge, is
working on this problem in an attempt to ascertain the causes and
to correct the defects. There is also a tendency in this part of
the United States to rely too much on serologic tests for the diagnosis
of syphilis and on microscopic smears for the diagnosis of gonorrhea.
Darkfield examinations for the detection of the spirochaeta pallida
in suspected primary syphilis are of fundamental importance, and
everything possible should be done to develop a rapid delayed system
of darkfield examination including the telegraphic report of results
both in Puerto Rico and in the Virgin Islands. Wherever possible,
and especially in areas of dense population, adequate laboratory
service for the provision of cultures for the recognition of the
gonococcus should be established.

A fairly adequate number of clinics now exists. There is much
need for improvement in the quality of present clinic service. Too

PROCEEDINGS REGIONAL CONFERENCE 185

frequently physicians neglect the management of syphilis and gonor-
rhea in the clinic patients under their charge, and because of limita-
tions on their time and greater interest in private practice, they
delegate to clinic nurse such important work as the early detection
of untoward reactions to previous treatment and the actual respon-
sibility for determining the indications for the administration of
therapeutic agents.

Isolation hospitals are planned which should prove adequate,,
quantitatively, when placed in operation. Everything possible should
be done to insure the efficient operation of these isolation hospitals,
in accordance with best administrative, diagnostic and therapeutic
practices. Furthermore, it should be remembered that the health
department faces a hopeless task unless some attempt is made to
redirect the patients in these hospitals into respectable jobs, and
unless law-enforcement agencies develop an active campaign to
repress prostitution and thereby limit the constant and unending
stream of infected prostitutes who are brought to these hospitals.

It is in the field of follow-up work that some of the most serious
deficiencies exist in Puerto Rico. There are few competent public
health nurses available, and most public health nurses spend their
time doing chores in the clinic instead of the more important follow-up
work with patients attending the clinic. A basic need, therefore,
is for the provision of as large a number of follow-up workers as
possible without reference to prolonged formal training for the
duration of the war, but with the requirement that such follow-up
workers demonstrate their ability before being accepted for wartime
service. This make-shift arrangement shbuld be supplemented by
a long term program which will insure the training of nurses in
accordance with the present plans for expansion of the Insular Health
Department.

Actual experience has shown that the need for contact tracing
can be greatly decreased quantitatively by limitation of the number
of sex exposures in the total population. Under the present system of
tolerated prostitution in Puerto Rico, the exposure rate in the armed
forces is unreasonably high, and far too many indiscriminate con-
tacts are made by civilians. The number has become so great
that the time may soon come when an ample follow-up staff can not
be trained and maintained by the Insular Health Department to
insure that all of the contacts of patients freshly infected with
the venereal diseases actually are traced and brought to examination
and treatment. The law-enforcement agencies, by a rigid program
of repression of commercialized prostitution and the enforcement of
the proposed new law recommended by the Social Protection Com-
mittee of Puerto Rico — which, parenthetically, it is expected the
Insular Legislature will pass — can do more at the present time
than any other branches of the Insular Government to lighten the
venereal disease load. Without this action, progress in venereal
disease control faces a difficult course and a gloomy future indeed
in the United States portion of the Antilles.

186 JOURNAL OF SOCIAL HYGIENE

A very hopeful sign, which has become apparent in recent months,
is the increased interest of the population in venereal disease control
problems. Agencies for the dissemination of public information
are to be congratulated on the support that has been given to the
attempts of the Insular Government to develop an intelligent pro-
gram. May I emphasize the fact, however, that the venereal diseases
are so insidious that the course of syphilis runs over a period of
decades; that treatment and control of the venereal diseases are
slow; and that public support will be needed for many years. A
flash of interest by the press and radio will direct attention to,
but will not solve the long term problems. Again and against the
systems for the dissemination of public information must be activated
if the program is to be successful, and this public education program
must:

(1) Reiterate frequently the harmful effects of syphilis and
gonorrhea to the individual and to the community and describe
individual and community control measures;

(2) Tell how the venereal diseases decrease our armed strength
and our productive capacity; and

(3) Encourage the lasting support and cooperation of all official
and voluntary agencies, and educational and religious groups.

Venereal disease control is not a phase of public health which can
be developed and continued by health departments alone without the
full support of the public. This work requires the cooperation of
the armed forces in adherence to the policy defined by the United
States Government for the Caribbean. It requires also the support
of legislative bodies in passing adequate laws and in providing suffi-
cient funds for the maintenance of facilities and services. When
demobilization comes it will be necessary to insure that the members
of the armed forces are returned to the civilian population as free of
venereal diseases as when they entered the Army and Navy. Law-
enforcement agency cooperation is imperative in a part of the world
where the prevalence of syphilis and gonorrhea is so high. The
support of unofficial agencies can be of the greatest help to health
departments in further insuring proper action on the part of all
governmental agencies. Without continued action and support the
venereal diseases will remain rampant in the Antilles. With such
support and the full backing' of the people, the venereal disease
control program can be waged as successfully here as in any other
part of the world.

SOCIAL PROTECTION IN THE COOPERATIVE PROGRAM

ELIOT NESS

Director, Division of Social Protection, Federal Security Agency,
Washington, D. C.

In 1941, the police in the various towns and cities of the United
States knew little about the connection between spread of the venereal
diseases and commercialized prostitution. Many eminent police
authorities sincerely believed that a tolerated "red light" district,

PROCEEDINGS REGIONAL CONFERENCE 187

with frequent inspection and registration of prostitutes, was a neces-
sity in control of venereal disease.

When men from the civil population were medically examined for
Selective Service and the figures came in to health authorities, it
was found that more than 100,000 of the first 2,000,000 American men
examined were infected with syphilis. On the basis of these figures,
the United States Public Health Service estimated that 3,200,000
persons on the continent had that disease. Traditionally, the number
of gonorrhea infections is always much higher than those of syphilis.
But it is significant that Selective Service figures also showed that
in communities tolerating organized prostitution, the rates of venereal
disease were from two to five times those of comparable communities
where commercialized prostitution was not tolerated.

The Eight Point Agreement, outlining a National program for
venereal disease control, was formulated in 1939 by representatives of
the Army, the Navy, and the United States Public Health Service.
Point Six of this Agreement contains the first authoritative pro-
nouncement of the medical profession on the necessity for repression
of prostitution for venereal disease control, recognizing the fact that
it is impossible to effect any sizeable reduction in these infections as
long as commercialized prostitution is permitted to operate.

The Agreement informed the police that they would fte responsible
for the repression of prostitution — that the local authorities must
work to eliminate prostitution from their own communities.

At that time there were houses of prostitution in practically every
city in the United States. They were there because the police did
not know the role that prostitution played in spreading venereal
disease, had not considered prostitution a problem of sufficient im-
portance to require official concern. In a great many cities there were
segregated "red light districts.'*

During the years since then the police profession has moved for-
ward to repress prostitution. Since 1941, 662 cities on the continent
have closed these "houses" and "districts." Through the Interna-
tional Association of Chiefs of Police, the National Sheriffs' Associa-
tion, and state associations of police chiefs and sheriffs, law enforce-
ment has gone on record as supporting the Eight Point Agreement.
And I may say that in practically every one of those 662 cities, the
venereal disease rate, as indicated by the rate of the nearby Army
camps and Naval Stations, has gone dramatically down. .

In the field of law enforcement there are many different programs
that must be carried on; and each one competes for the maximum
amount of time and attention from the police officer. This is true in
enforcement against traffic violations, in the repression of any type
of crime. Each program calls for intensified effort. Emphasis must
be applied again and again.

Many dire results were predicted concerning the closing of "red
light districts." One of these was the belief that the prostitutes

188 JOURNAL OF SOCIAL HYGIENE

would spread all over town. But if a thing is a crime, it should not
be tolerated anywhere. Certainly, for example, law enforcement does
not work on the theory that in certain districts we should allow certain
individuals to engage freely in the art of "holding up" people or
otherwise threatening the public safety. Every such situation is a
separate police problem and should be attacked as such. Moreover,
the fact has been proven that intelligent police work in repression of
prostitution helps to keep down the rate of venereal infection in any
community. In the 662 communities mentioned previously, there has
been no evidence whatsoever of an increase in venereal disease rates.

I was very much interested to hear Doctor Vonderlehr tell this
morning about the new legislation that is contemplated here. In our
Social Protection work on the continent we found need for new legis-
lation in a great many sections, and for strengthening existing legis-
lation in others. A number of states have made these necessary
changes in the law, on the recommendation of Social Protection Com-
mittees, some of them having to start from the beginning to pass
legislation making prostitution illegal.

Other professions have also gone seriously into this problem on
the continent. We are not basing our program on a moral issue, but
are considering it as an important public health problem, in the light
of new scientific medical information. In developing sound legislation
and in all similar professional activity for Social Protection, attention
has been directed to the resolution of the House of Delegates of the
American Medical Association, which reads as follows:

' ' The House of Delegates of the American Medical Association takes
the following stand:*

"FIRST, that the control of venereal disease requires elimination of
commercialized prostitution.

"SECOND, that medical inspection of prostitutes is untrustworthy,
inefficient, gives a false sense of security, and fails to prevent the
spread of infection.

"THIRD, that commercialized prostitution is unlawful, and phy-
sicians who knowingly examine prostitutes for the purpose of pro-
viding them with medical certificates to be used in soliciting are
participating in an illegal activity, and are violating the principles of
accepted professional ethics."

We in law enforcement are following the lead of the medical pro-
fession. Our best authority for attacking Social Protection problems
is that of specialized medical information.

There are many persons on the continent whose business enter-
prises are affected by enforcement against prostitution. But the hotel
people, for instance, have realized that they have a duty to perform
in helping to reduce venereal diseases. The American Hotel Associa-
tion has given particular attention to developing policies that will

* A statement adopted at the meeting of the American Medical Association,
June 9, 1942.

PROCEEDINGS REGIONAL CONFERENCE 189

further the Social Protection effort. This Association refuses to allow
its member hotels to be used for furthering the activity of organized
prostitution. Tavern owners and other dealers in liquor are also
interested in developing this kind of cooperation.

I should like to emphasize one or two points. We hear a great deal
about the protection of girls, but in any community where the finan-
cial opportunity offered by commercialized prostitution is an im-
portant factor, you will have an attraction to that field and
continuing recruitment to that field. A vigorous law enforcement
campaign, however, will make commercialized prostitution definitely
less attractive.

On the continent we have developed a new police policy. Arrest
for prostitution is regarded by the prosecuting attorney as consti-
tuting sufficient evidence for the health officer to suspect the persons
apprehended may be infected with venereal disease. He can therefore
require submission to examination, and the possibilities of finding
such persons infected with a venereal disease are great.

Here, as in all phases of our law enforcement campaign, the coopera-
tion of the judiciary is essential. The work of law enforcement
authorities cannot do a. complete job without the support of the
courts. Police should not be requested to engage in any activity that
will not be actively supported by ensuing legal action.

We in the law enforcement field feel that we are playing an im-
portant role in a new, great cleaning-up program for the suppression
of venereal disease. We are confident that this program will result
in better health and greater strength for our Nation, and give grateful
acknowledgment to the work of Surgeon General Parran and all other
persons who have had the courage to face the problem and conceive
this program.

WILLIAM F. SNOW, M.D.

Chairman, Executive Committee, American Social Hygiene Association,

New York

Dr. Snow referred briefly to the high points brought out by the
previous speakers, and reviewed progress in coordinated effort among
the voluntary and official agencies, which beginning in World War I,
now has reached a high peak of effectiveness in World War II and
is resulting in ' ' the lowest venereal disease rate in wartime history. ' '

He reviewed the program of the American Social Hygiene Asso-
ciation as the national organization heading up participation of
voluntary social hygiene agencies in the wartime campaign, stating
that this program includes these activities :

190

JOURNAL OF SOCIAL, HYGIENE

Kally more citizens to fight syphilis
and gonorrhea and commercialized
prostitution through community action.
Train leaders to guide such action,
and teach others.

Tell the great masses of the people
the truth about these dangerous dis-
eases— how they attack the nation's
strength, how they may be avoided,
how cured.

Aid employers and workers, espe-
cially in war industries, to strengthen
manpower and stop financial loss and
needless suffering by striking at
syphilis and gonorrhea.

Lessen opportunities for exposure to
venereal diseases by helping to enforce
existing laws against the commercial-
ized prostitution racket; advise and
assist in securing better laws where
needed.

Help communities to provide "good
times in good company" for young
people as the best safeguard against

' ' bad times in bad company ; ' ' to
clean up community conditions leading
to delinquency; to aid victims of bad
conditions make a new start, particu-
larly women, girls and young men
exploited by the prostitution rack-
eteers.

Help health officers, physicians,
pharmacists, nurses, social workers
and other trained persons to drive
out the venereal disease quacks and
charlatans; to give sound counsel to
infected persons.

Help parents, teachers and church
leaders provide suitable sex education
for children and youth and practical
preparation for marriage, parenthood
and family life.

Study national and community con-
ditions and programs, official and
voluntary, and keep all concerned in-
formed regarding progress and results,
in peace or in war.

Dr. Snow also explained the special functions of the Association
and the state and community social hygiene agencies under the
"working agreement" between Army, Navy, Public Health Service
and Social Protection Division,* and emphasized the part that Puerto
Bico can play in helping to carry out this program, quoting in this
connection a part of the citation which was addressed to Dr. Fernos
Isern later in the Conference when Surgeon General Parran, as
Chairman of the Association's Committee on Awards, presented Hon-
orary Life Membership to him :

As never before, the Mainland and this strategic Island outpost of the
Nation are dependent on understanding and teamwork among officers and
citizens for successful conduct of the war and promotion of permanent
peace.

In both war and peace Puerto Rico can continue to contribute notably
to the development of new and sound methods for attaining the maximum
in health and well being of all our people. To translate such methods
into nationwide action requires cooperation of federal, state and local
governments and voluntary agencies.

See Relationships in Venereal Disease Control, ASHA Pub. No. A-499.

PROCEEDINGS REGIONAL CONFERENCE 191

Luncheon Session — Hotel Condado
THE AMERICAS GO FORWARD TOGETHER

REMARKS BY THE CHAIRMAN

SIR RUPERT BRIERCLIFFE, C.M.G.

Medical Advisor to ihe Comptroller for Development and Welfare to the
West Indies; Medical Advisor for Great Britain, Anglo-
Caribbean Commission

I have been given the pleasant privilege of presiding at this session
of the Conference and of introducing to you the Consular Representa-
tives of some of the neighboring Republics, who are our distinguished
guests at this luncheon.

The slogan for this session is The Americas Go Forward Together.
I represent the Development and Welfare organization in the British
West Indies here today, and though the British West Indies form
only a very small part of the Americas, they are dotted about over
such a wide arc of the Caribbean Sea that strategically they are
of importance for defense purposes, and with the large influx of
American troops into them their health conditions have become of
direct interest and concern to the Americas!

At the present time their health conditions are of special interest
and concern to Puerto Rico because a very large part of the American
garrisons of the United States bases in the West Indies now consists
of Puerto Rican soldiers. I should like to take this opportunity
to say what an excellent impression these Puerto Rican soldiers
have already created in the British West Indies. In the course
of my duties I have to visit the various places where they are sta-
tioned— Antigua, St. Lucia, Trinidad and British Guiana, and
everywhere I have been recently I have heard the highest praise
given to the conduct of the Puerto Rican troops and to the friendly
relations they have established with the peoples of the British
West Indies.

General Stayer told us at the first session of this Conference that
wherever you have large numbers of troops stationed, the problem
of venereal disease control becomes of importance, and two years
ago when the United States and British Governments created the
Anglo-American Caribbean Commission, the first health problem
which the Commission took up for consideration was the question
of venereal diseases. Dr. Vonderlehr told earlier today, how, as
the result of the Commission's recommendations, a cooperative pro-
gram has been worked out in which both the United States and
the Governments of the various West Indian countries are taking
part. That is an example in which "the Americas go forward
together" and I think the two speakers at this session — Dr. Shepard,
who represents the Co-ordinator of Inter-American Affairs, and
Dr. Villela of the Public Health Service of Mexico, who is also a

192 JOURNAL OF SOCIAL HYGIENE

representative at this Conference of the Pan American Sanitary
Bureau, — I think that these two speakers will be able to give you
other examples of the good neighbor policy which is being followed
in the problems which this Conference has to consider.

THE AMERICAS VERSUS THE VENEREAL DISEASES *

DE. CHAELES E. SHEPAED

Senior Surgeon (E), U. S. Public Health Service, Chief, Professional Training

and Health Education Section of the Office of the Coordinator of

Inter-American Affairs, Washington, D. C.

A prime public health responsibility of the Americas in this time
of war is to provide facilities and services to protect the personnel of
the armed forces and workers engaged in strategic production. Nine-
teen American republics, including the United States, are carrying out
this responsibility jointly under the inter- American cooperative health
program. Such a responsibility inevitably entails venereal disease
control. These diseases nourish on war, migration, and separation
from home and familiar influences.

The health of rubber workers is of vital concern to the Americas,
and in the rubber-producing regions of Central and South America
the inter-American cooperative health program is aimed toward
protecting these workers from malaria, the dysenteries, hookworm,
the venereal diseases and other diseases of these regions. In Brazil, a
series of hospitals and dispensaries has been established from
Belem, gateway to the Amazon, up the rubber country to provide
medical and sanitary services for the workers and their families.
All through these rubber regions the task of promoting the health of
the migrant workers is complicated by the prevalence of venereal
disease and the prevalence of infected women. The sanitary post in
the Sao Luis camp in Brazil has found it necessary to treat the
women of the surrounding districts. The incidence of venereal dis-
ease has become so serious in some places that special barracks are
needed to house the cases.

In Colombia, the river ports offer many public health problems.
Boats take on strategic supplies at these ports for the United Nations.
The tumultuous life of a busy river port attracks prostitutes and
favors the venereal diseases. A report from the newly established
venereal service in one city stated that 60 prostitutes were under
control, 15 were hospitalized and under treatment for gonorrhea.
In one large city with a serious venereal problem, a new hospital is
being planned which will provide facilities for out-patient treatment
of venereal disease, a diagnostic laboratory and provisions for the
hospitalization of women. For this inter-American project 20,000

* A paper prepared jointly with Hazel O 'Hara, Health Education Specialist,
Professional Training and Health Education Section, Office of the Coordinator
of Inter-American Affairs.

PROCEEDINGS REGIONAL CONFERENCE 193

pesos will be contributed by Colombia and 35,000 by the Office of the
Coordinator of Inter-American Affairs.

In Ecuador, public health workers are concentrating on venereal
disease control in the areas immediately adjoining the United States
bases. Prostitution is being curbed and new cases receive continuous
treatment for a period of several weeks at least. Salinas affords a
good example of how venereal disease work fits into a general health
and sanitation program. A prophylactic station is maintained there,
and this is but one project in a considerable program for the control
of venereal disease, malaria, dysentery, and for the supervision of
hotels, restaurants and other gathering places frequented by armed
forces of the United States.

In the countries of Central America, the inter-American projects
emphasize the health of members of the armed forces, Pan American
highway builders, rubber workers, cinchona gatherers.

In Nicaragua, the venereal disease work includes the periodic ex-
amination of prostitutes. Cases found to be infectious are isolated in
a small unit supported by the customs authority and guarded by a
sanitary policeman.

When Captain Joseph Hirsh of our Health and Sanitation Division
was in Nicaragua last spring, he drafted both semi- and full-suppres-
sive venereal disease control programs for a Naval Base. Arrange-
ments have been made with the Navy to set up a clinic under one
of the medical officers of the Direccion General de Sanidad for periodic
clinic and laboratory examination of prostitutes as a means of com-
batting disease rates among Navy personnel. Plans are also being
worked out for malaria control and venereal disease control among
the civil population.

In El Salvador, health authorities point to consistent follow-up in
addition to the provisions for treatment. In the twelve health centers,
the attendant physicians are provided with supplies of drugs for the
maintenance of venereal disease clinics, and a strenuous attempt is
being made to follow up contacts and bring them into the clinic for
treatment. We are advised that in one health center which is open
six days weekly there are usually about 1,500 cases of syphilis under
treatment.

In Costa Rica, conferences were held in 1943 to develop a coopera-
tive anti-venereal disease campaign among Salubridad, Seguro Social,
Pan American Sanitary Bureau and the inter- American cooperative
health Service of that country. The cooperative Service is supplying
the essential drugs, technical training and campaign publicity.

The inter-American staff in Honduras reported for October 1943
that a venereal disease clinic was being organized as a part of the
public health center in Choluteca. The basic aim of this clinic is
to locate infectious cases of venereal disease and to bring them under
proper medical care. For individuals who cannot afford the services
of a private physician, the health center itself supplies treatment.

194 JOUENAX, OF SOCIAL HYGIENE

An important duty of the clinic is the location and study of all
contacts of the cases found.

In the clinic in Tegucigalpa, a consistent effort is being made to
find cases. They are being located with the assistance of the visiting
nurse group through laboratory reports obtained from the Honduras
Health Department.

The October report on this clinic stated that activities in venereal
disease control have increased tremendously. In one month 118 cases
were diagnosed and brought under treatment by the clinic. It is
hoped that in a short time the follow-up work will be thoroughly
organized and operated efficiently through visiting nurses.

The control program at the United States Mexican border is one
of the most interesting public health stories of this war. The Office
of the Coordinator of Inter-American Affairs has contributed funds
to support this work. In 1942 and 1943, two grants-in-aid to the
Pan American Sanitary Bureau were approved in the amount of
$152,420 to carry out the program for the control of venereal disease
in the Mexican border states in cooperation with the United States
Public Health Service and the Mexican Federal Health Department.
The fine cooperation of the officials on the Mexican side of the border
has helped to make these activities a real control program.

In bringing the venereal diseases under control, health education
is one of our best allies. Our success depends upon having an
informed public who will seek treatment, will avoid infection, who
will support the public services, and will pass information on pre-
vention and treatment along to others. Health education, thanks to
the graphic arts, is an attractive ally. Health posters can be striking.
Health pamphlets can be readable. Health movies can be absorbing.

We are sending to the other Americas materials produced in the
United States that may be used for reference and as a stimulus to
local production. I think it is very interesting that of all the litera-
ture on the gamut of health subjects we have sent them, they say
they are particularly impressed with that on venereal disease. Litera-
ture from the American Social Hygiene Association, American Public
Health Association, the U. S. Public Health Service and the state
health departments is receiving favorable mention from all quarters.

These educational activities will help to make the health centers,
hospitals, dispensaries, drainage and sanitation projects, and all the
facilities which are going up under the inter-American activities,
enduring parts of each country's structure of health. They will help
to line up the people against toleration of the venereal diseases and
other diseases that are menacing health, strength and long life.

The inter-American cooperative program to raise the western
hemisphere's defenses against disease was born of the war. A major
responsibility in the program is to protect workers and the armed
forces to carry on the war.

PROCEEDINGS REGIONAL CONFERENCE 195

Like many public health programs born as emergency measures,
it is benefiting countless people and is advancing the control of dis-
ease by many years. Because of these long-range virtues, we dare
to hope that the work going on under its auspices will survive and
expand as an • integral part of the defense against disease in the
Americas. The advance of public health crosses all political borders.
Disease is our common enemy. Its control in this hemisphere is our
common goal. This is truly an inter- American program.

MEXICO'S CONTRIBUTION TO THE VENEREAL DISEASE CAMPAIGN

DR. ENRIQUE VILLELA

Chief, Venereal Disease Control, Department of Health,
Republic of Mexico

Toward the second half of the year 1941 concentrations of armed
forces began to be located for training purposes in different parts
of the United States, particularly along the Mexican Border. There
then inevitably arose, among other problems, that of protecting
the military personnel, as well as the civilian population, against
the dangers of venereal diseases. This paper is designed to tell how
the problem was attacked and how plans were prepared for its
adequate solution.

On the initiative of the Pan American Sanitary Bureau plans
were outlined for undertaking the work, through cooperation of the
three organizations directly interested; that is, the Department of
Health of Mexico, the U. S. Public Health Service, and the Bureau
itself.

With the object of securing a sound base which would guarantee
the success of future work, it was agreed, as a first preliminary
step of chief interest, to perfect the training of the personnel who
would be in charge of the services on behalf of Mexico. These had
already been selected because of former experience in venereal
disease control. And so a group composed of eight officers, Mexican
physicians trained in public health, took an intensive course at
the U. S. Public Health Service Medical Center in Hot Springs
National Park, Arkansas, during the first months of 1942. At the
end of the course a general conference took place in El Paso,
Texas, in order to establish firmly the program to be developed, five
fundamental points of which may be stated as follows:

1. Provision of facilities for diagnosis and treatment.

2. Within the resources available, application of the best possible
clinical and laboratory techniques. Technical clinics and lab-
oratories as efficiently operated as possible.

196 JOURNAL OF SOCIAL HYGIENE

3. Investigation of contacts.

4. An educational campaign, using recognized means and methods
—brochures, posters, lectures, radio programs, the press, etc.

5. A campaign for the repression of prostitution.

(1) In regard to the first point, there were established seven free
clinics, in the Mexican towns of Matamoros, Nuevo Laredo, Piedras
Negras, Ciudad Juarez, Agua Prieta, Nogales and Tijuana — places
which were considered to be the best strategic, geographic, demo-
graphic and sanitary locations to render most useful services.

(2) In regard to the second point, various problems arose. There
were duly trained technicians, but diagnostic equipment was not
complete. From the start some clinics were able to use their former
installations and to make microscopic examinations by means of
stained slides; a few months later, the valuable help of darkfield
microscope service was secured. Serological work was the object
of special consideration, first being done with the splendid cooperation
of Tucson, Arizona, for Nogales and Agua Prieta, El Paso, Texas for
Ciudad Juarez, and San Diego, California, for Tijuana. But in
order to give such work all the importance and scope it rightfully
deserved, the creation of two Mexican laboratories was decided upon.
One was located in Ciudad Juarez, to serve the western half of the
Border; the other was set up in Nuevo Laredo, for the eastern half.

On the therapeutic side, drugs were carefully selected and stand-
ardized. For syphilis, trivalent arsenic, of the arsenoxide type
(mapharsen or clorarsen) and subsalicylate of bismuth. Infectious
cases were given a continuous treatment, alternating series of arsenic
and bismuth, until 30 injections of each of these drugs had been given,
to the end that the infectious state might be controlled and a
recurrence prevented. For gonorrhea, sulfathiazole was used exclu-
sively, according to the plan of treatment recommended by the
American Neisserian Medical Society.

(3) and (4) Work relative to the discovery of new cases by
means of investigation of contacts, and the educational campaign,
followed, as did the other work, a gradual and progressive develop-
ment. At the beginning, there were only pamphlets with popular
appeal. At present there are posters, projection equipment and
educational films. In the technical field, the Pan American Sani-
tary Bureau publishes in Spanish a quarterly edition .of the excellent
magazine Venereal Disease Information, which has come to be an
active factor for a better and wider understanding of the efforts
and progress made in the control of said diseases. And in order
to increase these technical assets in yet greater proportion and to
maintain constant live interest in the study of problems involved,
as well as to interest private physicians in these campaigns and
to stimulate a scientific interchange, in 1943 the Public Health Asso-
ciation of the United States-Mexican Border was established, and
annual meetings planned. The first of these took place in June
1943, with outstanding success.

MORNING
SESSION

School of

Tropical

Medicine • San Juan

The School • Main Entrance

Photograph from Puerto Rico Trade Council

BEFORE THE MORNING PROGRAM

.eft to right, standing: Dr. Jose Gandara, Assistant Commissioner, Puerto Rico Department of Health; Dr. Muggins;
)r. E. Martinez Rivera of San Juan, representing Costa Rica; Dr. Laraque; Dr. Villela; Dr. Luis F. Thomen, Assistant
iecretary of Health, Dominican Republic, and representing the Pan American Sanitary Bureau. Sitting: Dr. Snow,
Surgeon General Parran, Dr. Fernos Isern, Major General Stayer, Sir Rupert Briercliffe.

Gallery Leading
to Auditorium *

Scenes at the School of Tropical Medicine

Photographs by Harwood Hull

AT THE

LUNCHEON SESSION
HOTEL CONDADO

Official U. S. Navy photographs

ARMY AND NAVY EXCHANGE GREETINGS

Major General William E. Shedd, Commanding General,

Antilles Department, U. S. Army; Major General M. C.

Stayer, Surgeon, Caribbean Defense Command, and

Captain Cook

JUST BEFORE THE LUNCHEON SESSION

Left to right: Sir Rupert Briercliffe; Dr. Charles E. Shepard, Director of Training and Education, Office of the Coordinat
of Interamerican Affairs, Washington, D. C., Dr. Thomen, Most Reverend James P. Davis, Bishop of San Jua.
Surgeon General Parran; Captain Stirling S. Cook, Chief Medical Officer, Tenth Naval District; Eliot Ness; Lt. Co
William F. Due, Provost Marshal, U. S. Army, Antilles Department; Dr. Villela; Miss Pinney; Dr. Huggins, and Dr. Snoi

THE BRITISH WEST INDIES, WASHINGTON,
AND THE U. S. NAVY

Sir Rupert, Dr. Parran and Captain Cook

AT THE SPEAKERS' TABLE

eft fo right: Bishop Davis, Lt. Col. Due, General Shedd, Mr. Ness, Dr. Femes Isern, Dr. Villela, Sir Rupert, Dr.
hepard, Surgeon General Parran, Dr. Thomen, Dr. Laraque. Facing Dr. Laraque is Dr. Muggins. Back to camera are

Captain Cook and Dr. Martinez Rivera.

SOME OF THE 150 LUNCHEON GUESTS

EVENING SESSION

Central High School

The High School

Photograph from Puerto Rico Department a
Agriculture and Commerce

SPEAKERS AND GUESTS AT THE EVENING PROGRAM

Left to right, standing: Bishop Charles B. Colmore of San Juan; Dr. Snow; Dr. Muggins; Dr. Shepard; Dr. Thomen;
Sir Rupert Briercliffe. Sitting: Dr. Fernos Isern; Surgeon General Parran; Dr. Carlos Munoz McCormick; Dr. Villela,

and Major General Stayer.

Surgeon General Parran Presents Certificates of Honorary Life Membership in the American
Social Hygiene Association to Dr. Villela and Dr. Fernos Isern

PROCEEDINGS REGIONAL CONFERENCE 197

(5) I have left to the last discussion of the point relative to the
repression of prostitution, because, that being a part of the program
of fundamental importance, I emphatically desire to make myself
clear on that particular point. For an easier and clearer compre-
hension, I will explain that the word "repression" has been deliber-
ately chosen, instead of the terms "suppression" or "prohibition,"
which imply a Utopian concept, impossible of translation into
practical action, as centuries of experience have demonstrated.

Repression signifies a concerted effort by health organizations,
legislatures, civilians, the military, social welfare societies, and all
concerned to reduce sexual promiscuity, particularly that caused
by organized commercialized prostitution. I will give an example:
A young student falls in with a companion of greater experience
who invites him to the "tolerated district," where sexual commerce
is publicly and entirely accessible. In the "district" all the prosti-
tutes are easily found, since they exhibit themselves in the streets
and the houses are marked with a variety of colors and signs. All
is at hand openly, the merchandise is known, the price, the places,
and the signs. Then think of a place where sexual commerce is
not organized in this way. The prostitute, in order to work, has
to seek out her clientele, and take care of it clandestinely. In this
way "business" is restricted, the clientele is more or less regular,
and in such circumstances when the first signs of venereal diseases
appear they are limited to the circle of her clientele. The physician
or health official is able to know the origin and fight more effectively
against its spread.

Now consider the matter from the point of view of the women
who become involved in prostitution. If this commerce is organized
and tolerated and protected by law, that woman has only to present
herself at a house of prostitution where she will be admitted and
her price for services fixed. Repression, on the other hand, consid-
erably lessens her facility for carrying on sexual commerce, since
it is more difficult to build up a private clientele than simply to
enroll in a house of prostitution already established and having
commercial relations with other establishments in the same busi-
ness well backed with capital for financing the commerce and its
exploitation.

It is true, of course, that repression of prostitution does not stop
this evil entirely, but by making the prostitute less accessible, the
facilities for contacts are diminished considerably and in consequence
the frequency of exposure to infection is less. And even in cases
where infection occurs, every day events show that it is easier to
limit the focus of infection when prostitution is conducted privately
than when this dangerous traffic serves anonymously for the
exploiters of vice centers.

I have made this digression for the purpose of making very clear
a basic and capital point of doctrine — which amounts only to the
application and utilization of principles universally admitted in
epidemiology. Let us now return to the campaign on the Border.

198 JOURNAL, OP SOCIAL HYGIENE

In all our Border cities circumstances favored the incidence and
spread of venereal diseases, since here was found flagrant prostitution,
completely organized, installed in tolerated districts, existing even
more freely outside the districts, as is always the case under similar
circumstances, and being given plenty of advertising by the busy
agents of the underworld. And all this had been going on for
many years, so that the "business" had deep and tortuous roots
within various commercial and community interests.

This was the situation in the City of Juarez, just across the
Border from El Paso, Texas.

But the program of repression of prostitution found strong support
in June, 1942 in Juarez, whose Mayor, Mr. D. Antonio Bermudez,
an exemplary official of unimpeachable honesty and proven energy,
closed up the tolerated districts, punished the traffickers and exploiters
of prostitution, and vigorously repressed both individual and the
flagrant and open advertising of opportunities for sexual promiscuity.
And in Juarez, which had had the shameful distinction of occupying
first place among the brothel cities of the Border, a singular trans-
formation took place. Tourist travel, which it had been thought
would vanish, instead increased. The number of soldiers crossing
the Border from El Paso to Juarez grew from 24,512 in May to
24,754 in June and to 29,735 in July. Local business, which had
prophesied ruin, was not long in seeing improvement. The people
grew to be self-respecting, so that a city which was previously a
stigma, today is transformed into a dignified town, open to progress —
a town which has thrown off the corruption and vice which were
submerging and asphyxiating it. What was believed to be a com-
munity ideal so remote and difficult as to be impracticable and
impossible, by rapid and positive action became fully realized, con-
summate, visible, palpable, irrefutable.

In respect to venereal diseases, the measures taken had tran-
scendental consequences which may be easily seen. Given below
are data from El Paso and Juarez, two neighboring cities separated
only by the Rio Grande as a dividing line, and as they are linked
by a constant commercial and social interchange, so they are mutually
influenced by health or sickness. I have here the comparative results
in six successive steps, something like the times and phases by
means of which a laboratory experiment is conducted. The figures
indicate cases observed among civilians in El Paso and whose source
of infection originated in that city or in Juarez.

Phase I (March-June 1941) In El Paso there was no repression
of prostitution; in Juarez prostitution was flagrant. The respective
figures are: 56.9 per cent infection were found to have occurred
in El Paso, 24.4 per cent in Juarez.

Phase II (July-September 1941) Repression of prostitution in
El Paso had caused infections originating in this city to drop 25
per cent; but as prostitution continued in Juarez, the tide was
turned toward the latter town, whose market afforded a greater

PROCEEDINGS REGIONAL CONFERENCE 199

supply, and the proportion of infections coming from Juarez rose
sharply, from 24.4 to 50 per cent.

Phase HI (October-December 1941) Repression eased up a little
in El Paso, which increased to a certain degree the preceding figure
(from 25 to 33.8 per cent). At the same time there was a slight
drop in the standing of Juarez as a center of disease spread (from
50 to 42.7 per cent).

Phase IV (December 1941 to February 1942) The relaxed situa-
tion continued in El Paso, causing the proportion of infections
occurring there to rise appreciably (from 33.8 to 49.6 per cent).
In this phase, however, a temporary closing of the International
Bridge between the two cities took place, cutting off the Juarez
prostitution market. The figures dropped to an unusual level.
2.1 per cent of cases seen got their infections in Juarez.

Phase V (February to June 1942) The reopening of the Inter-
national Bridge saw a brisk rise in the number of infections having
their source in Juarez (from 2.1 during the time the Bridge was
closed to 34.5 per cent after the opening). El Paso's figure dropped
somewhat (from 49.6 to 34.5 per cent) on the reopening of the
market to the south of the dividing line.

Phase VI (June to August 1942) In Juarez repression of prosti-
tution was initiated, and this sufficed to diminish the Juarez figures
from 34.5 to 10.6 per cent. The system of repression was continued
vigorously during the following months, keeping the figure at the
minimum level to date.

Official statistics on infections among soldiers in the same area —
more easily controlled because of their military situation and their
being subject to strict prophylactic precautions after each exposure>
correspond absolutely with data secured from the civil population:*

1942

March April May June July

Number of soldiers who

crossed the Border to

Juarez 24,632 23,477 24,512 24,754 29,735

Venereal diseases developed

after their exposure in

Juarez 23 30 25 17 12

Report per thousand 0.93 1.27 1.02 0.69 0.40

The sanitary and social experience of primary interest which
is being developed in these two neighboring cities is creating extensive
repercussions throughout our Republic, including the Capital. The
example of Juarez in closing up prostitution was followed recently by
the Border cities of Sonora : Nogales, Naco, Agua Prieta and others.
States in the interior of the Republic are adopting similar regulations,
inspired by the same purpose of social protection. The President
of the Republic, General D. Manuel Avila Camacho, has given his

* See article reprinted from December, 1942 JOURNAL OP SOCIAL HYGIENE,
When Brothels Close, V.D. Bates Go Down, by Bascom Johnson, Jr.

200 JOURNAL OF SOCIAL HYGIENE

wholehearted support to this work and has addressed a circular
letter to Governors of the States with the object of calling their
attention — "to one of the dangers which most threaten and com-
promise the success of our present defense measures : that of venereal
diseases, which cause a greater number of disqualifications than
any other single cause, and as much in the civilian as in the military,
constitute one of the most serious factors of inefficiency."

The letter says further:

"It is proved without a doubt that the most propitious means for
the rapid propagation of these pernicious evils are the vice centers,
since a very high percentage of their residents are found to be
infected. These vice centers are equally the focus of a cumulation
of dangerous and anti-social activities which increase delinquency
and which, under present circumstances, may be utilized as agencies
or bases of operation for subversive and disloyal elements."

"This grave danger may be successfully combatted by means
of health programs intelligently coordinated with measures of
administrative and judicial character and with vigorous educational
campaigns. It has been demonstrated that the recent successful
experience in Juarez is perfectly feasible. We should attack this
problem with resolution and energy, which is so much more urgent
now that the civilian population has to such a large degree par-
ticipation in the activities of national defense."

"In view of the above, I ask that you encourage the enactment
of federal and local laws for the purpose of developing a national
campaign for repression of prostitution, not only in cities, but also
in rural areas, closing tolerated districts, doing away with periodic
medical examinations of prostitutes, repressing clandestine meetings
of all kinds and applying pressure of the penal law to all who
exploit vice. The adoption of measures of this nature will be a
valuable aid in increasing the results of the activities which the
Public Health Service of the Eepublic of Mexico is carrying on,
in its three-fold aspect — educational, preventive and curative —
with the object of successfully controlling venereal diseases. This
program of repression has been started and is in full swing in
Juarez, where there is the finest cooperation between the Department
of Health, the Pan American Sanitary Bureau and the Municipal
Authorities. A reduction of more than 50 per cent in the number
of infectious contacts has already been effected, with consequent
benefit and advancement for the entire population . . . . "

There is yet another lesson to be learned from this experience
on the Border, and which I desire to point out and stress especially.
As I have explained, in the western cities on our dividing line — •
Juarez, Nogales, Nace, Agua Prieta — a program for repression of
prostitution has been started. But on the other hand, in cities
in the eastern area — Matamoros, Reynosa, Nuevo Laredo, Piedras
Negras, Villa Acuna — as yet no repression has been initiated and
there still exists a system of regulation and tolerance of prostitution.
Under these conditions, with the true facts in our possession, we

PROCEEDINGS REGIONAL CONFERENCE 201

can make an easy comparison of the two systems: Repression vs.
Tolerance, in regard to the results. And from pure and simple
observation of the bare facts, we can deduce categorically the con-
clusions condensed in schematic form, as follows:

TOLERANCE

AND

REPRESSION REGULATION

Lessens the number of contacts Increase the number of contacts

Checks the growth of prostitution Favor and stimulate the development

of prostitution

Represses the clandestine contacts Increase clandestine contacts

Facilitates location of the focus of Make difficult or impossible location of
infection the focus of infection

Reduces the prevalence of venereal Increase constantly the prevalence of
diseases venereal diseases

If any doubt remains about what road to follow regarding prosti-
tution, considered from the point of view of the spread of venereal
diseases, I can answer with this experience and affirm emphatically
that the repression process should be adopted without further dis-
cussion and all idea of regulating prostitution should be definitely
abandoned. Regulation, as is abundantly demonstrated, means
not only tolerance, but protection, stimulation, and fomentation,
with steady aggravation of all the pernicious consequences and all
the evils which flourish along with prostitution itself: venereal
dangers; sordid exploitation of women and minors, as instruments
of a sordid, well-organized commercial business; rowdyism, white
slave traffic, drunkenness, etc., that is to say, everything that favors
the development of crime, social degradation and diseases not only
terrible because of individual consequences, but also for the grave
consequences for posterity. And it is obvious and incontestable
that the State and Society should be interested in the repression
plan, because less expense and an increase of individual productive
capacity are involved in undertaking a real preventive campaign
against venereal diseases, than in supporting the sick and seeing
the number increase daily.

The work done at this Regional Conference offers encouraging
prospects to the highest degree.

Facing the problem in its fullness and complexity and on a human
and scientific level, which proposes really and effectively to reduce
the prevalence of venereal diseases, the deliberations of the Conference
inspire confidence that we shall reach, in time, the best and fullest
solutions possible. The tree which we see full of life, and abundant
with leaves and fruit was first a tiny and delicate seed. Work,
cooperation and good will are the climate and environment most
propitious. How splendid for the Americas this fine example of
solidarity, whose beginnings were so small, overflowing with fertile
fruits to protect our health, to make our individual heritage more
sacred and valuable, and without which all right and liberties are
mere illusions.

202 JOURNAL, OF SOCIAL HYGIENE

Afternoon Sessions — School of Tropical Medicine
PUERTO EICO DOES HER PART IN THE FIGHT

GROUP I. KNOWLEDGE IS A STRONG WEAPON

Presiding: DR. TOMAS BLANCO, Director of Health Education, Puerto Bico

Department of Health

Discussion Leader: CAPTAIN Jos6 CHAVES, MC, U. S. Army
Secretary: Miss ALICE H. MILLER, Health Education Specialist, U. S. Public

Health Service, District No. 6, San Juan, P. E.

REMARKS BY THE CHAIRMAN

In the strenuous battles for the control of public health problems,
knowledge is a strong weapon. So are prophylaxis and treatment,
so is legislation. Since it is obvious that meaningful legislation, useful
prophylaxis and proper treatment must be based on clear understand-
ing of the scientific factors involved, therefore knowledge takes
precedence as a basic element in all other means of combat. But
like every weapon, the efficacy of knowledge — or of the dissemination
of knowledge — depends more on the intelligent application we make
of it, and on the willingness and readiness to use it correctly and
ably, rather than on the strength and reliability of the weapon itself.

In the same way that a law can be only as effective as the dis-
position of the people to comply with it or the determination of
the community to support it, knowledge in itself — the mere accumu-
lation of bare facts and cold data — is powerless unless honestly,
earnestly and deftly put into service, and in such a consistent and
repeated manner as to create eventually a good measure of automatic
responses in accordance with the information gained. In other words,
knowledge must influence behavior, behavior must be guided by
knowledge, if our purpose is not to be frustrated, if our efforts are
not to be wasted. The extent of learning 's immediate, practical value
depends on the degree to which it is incorporated as part of the
personality, and thus helps in the formation of habits, customs and
traditions.

In a broader scope than it directly concerns us now, this is a
cultural process by which it may be said that knowledge becomes
wisdom.

Our practical aim and justification for divulging public health
information among the people is not simply to acquaint them with
abstract and idle knowledge ; but to attain results in actual conduct.
Therefore, the subtle differences between convincing and persuading,
between instructions and education must be borne in mind; an
attempt must be made to influence or to alter what we might call
the people's background — the sum total of their notions, their expe-
rience, their training, their norms and cultural patterns, — in all
that concerns the prevention and treatment of disease and the control

PROCEEDINGS REGIONAL CONFERENCE 203

of epidemics, — as the best grounded method of conditioning their
behavior in public and private health matters.

If the above is accepted, immediately it becomes evident that the
health educator must possess certain gifts and acquired qualifications
to be able to carry on his work successfully.

I will not try to enumerate a list of the ideal desirabilities in
the health educator — that would be rather tedious and somewhat
beyond the point; but we may set down one qualification as basic:
in order to instruct without misleading, he, himself, must have
sufficient knowledge and clear understanding of the matter on hand.
Rather than run the risk of broadcasting misinformation and spread-
ing confusion, either ignorance must be humbly avowed, or else all
discussion postponed until sound information on the subject is
learned. Complete and absolute silence is the only other alternative.
This is so obvious as to be axiomatic, and so it sounds uncalled for;
but unfortunately, amongst us, it is not altogether unnecessary to
mention it.

In order to be convincing, the health educator must not only be
truthful and sincere, but must sound plausible also and, above all,
he must make himself plain: he must be well understood. So, he
must have as perfect a command over his means of expression as
possible, and be particularly well acquainted with the resources of
the vernacular. This implies, among other things, a capacity to
adapt his attitude and his language to the age and the intellectual
or educational level of his audience. In order to be persuasive,
he must give due care to the psychological approach; and in so
doing he must not only be apt but also deft. He must be able to
appeal to both the altruistic instincts of the human herd and the
egocentric impulses of the human individual in such a way as to
elicit the desired, harmonious, constructive response. But he must
not preach in a vacuum. Any effort to persuade and educate defeats
its own purpose and is bound to cause disillusion and even despair,
if contact with reality is lost. Extravagant hopes must not be
aroused; useless and harmful fears must not be fostered. Remedies
beyond the means of the audience should not be prescribed, and
advice that is materially impossible to follow should not be given.
As the Spanish proverb runs : ' ' One must not demand pears from
the elms." So, the relative facilities and opportunities offered by
the country and the organized community must be carefully taken
into consideration, because public health problems are sometimes
dependent, in too large a measure, on stubborn socio-economic evils
that no amount of pure health education alone can defeat.

Knowledge is indeed a strong weapon, but the stronger the weapon,
the abler, the wiser should be the hands that wield it. And it is
wisdom to realize that the ultimate goal of our educational campaign
is to exercise a formative influence on the character and behavior of
the individual and a favorable conditioning of the background of
the group.

204 JOURNAL OF SOCIAL HYGIENE

ACTION ON THE HOME FRONT

ELENA BONILLA, K.N.

Health and Hygiene Specialist, Agricultural Extension Service,
University of Puerto Eico

We celebrate today a regional conference on social hygiene, with
the purpose of coordinating the ideas and efforts of all the institutions
and agencies here represented, to put to flight one of our most
powerful enemies — venereal disease.

It is not necessary to repeat that our nation is involved in a world
conflict and that everyone, no matter who he is, should contribute in
one way or another to help win the final Victory.

It is a well known fact that our fighting people must be healthy.
Special attention and care are offered to our enlisted men, to eliminate
all those diseases that are a menace to their health and to their energy.

Experience has taught us that keeping our army healthy is as
important as keeping the health of civilians. Well known to us are
the words of President Roosevelt, when he said that this is a conflict
where we are all involved and that every individual is responsible, as a
citizen, for maintaining the principles of liberty and democracy. The
National Executive also stated that the final victory depends on the
health and wealth of the Nation.

It is our duty — men, women and children — to help and further all
efforts to prevent venereal disease. Puerto Rico has done and will
continue doing its part to control this Enemy No. 1 — and to defend
the armed forces stationed here.

We can say that this war taught us the need of coordinating all our
power to struggle against this enemy. There are two ways of fighting
this enemy: the curative — that is to eradicate the disease where it
exists, and the preventive — which tries to avoid its spreading further.

Ignorance is the strongest ally of our enemy, venereal disease.
Just a few years ago, it was a hard task to make a public speech
about syphilis or gonorrhea. They were considered a secret, a mys-
tery, and a dishonor. This was one of the reasons why those
suffering from these diseases preferred to keep it secret. Others
consulted quacks in the hope that they were going to be cured.
Instead, they ruined their health completely.

Today, all health agencies are working hard to spread appropriate
knowledge wherever it is needed. We are teaching our people to
get away from the risk of this evil and convincing them of the exist-
ence of this harm. To a great number of people, venereal disease
has no meaning at all. We have to teach them, we have to interest
them in keeping their bodies and their minds healthy. It is our duty
to remind everyone of the responsibility to contribute with his share to
maintain a healthy and strong nation.

All private and government agencies are trying to educate our

PROCEEDINGS REGIONAL CONFERENCE 205

people how to eliminate those murderous diseases. Th^re is no doubt
that if we speak of the ' ' spirocheta, " or " Treponema Pallida ' ' people
will not understand us. But we can explain the existence of a
germ that, when it attacks the human body, destroys not only the
blood, but the health in general.

I know that not a single parent remains indifferent before the pros-
pect of having abnormal children. They do not like to play a part in
the Bible prophecy, "The sins of the fathers are visited on the chil-
dren." They are anxious to learn how to keep well and have healthy
families.

The Agricultural Extension Service Agency, which I have the honor
to represent in this conference, is carrying on an educational cam-
paign on Social Hygiene. This campaign against venereal disease, is
being carried on all over the island, in the rural areas, cooperating
with other agencies which educate our people living in the urban zones.

The Agency I represent here works hard and enthusiastically
among the rural groups in its efforts to combat venereal diseases.
With this aim, we celebrate annually during the entire month of
February an intensive campaign against syphilis and gonorrhea. Our
country people are ignorant, most of them not only do not know the
way these diseases are acquired, neither do they know how to protect
themselves, nor how to seek treatment and cure if they are diseased.
During the campaign each Home Demonstration Agent and Agricul-
tural Agent tries to teach these facts. They prepare radio talks, hold
meetings, exhibit motion picture films, visit all the organized groups
teaching in one way or another what to do to prevent infection and
where to go for treatment. Trained leaders help the Agents and
educational material, supplied by the Insular Health Centers, is dis-
tributed. Also the blood of 4-H boys and girls is examined.

Our health campaign continues throughout the year, because there
are other than social hygiene phases included in our program.

To give you an idea of the work accomplished by the Agricultural
Extension Service during the last year I must say that 79 meetings
were held with an attendance of 2,137. We distributed among our
rural people 2,437 copies of bulletins and mimeographed educational
material regarding these diseases.

I have observed that the lack of knowledge among our rural people
is due to the fact that they are not given the attention needed. It
must not be forgotten that 60 per cent or more of the population of
the island lives in the country areas. It is the patriotic and civic
duty of all the agencies to spread knowledge wherever needed but
it is an even higher patriotic duty to teach our country people. They
need our help more than anybody else because they do not have the
opportunity to learn that town people do. The aim of the Agricul-
tural Extension Service is to raise the standard of living of the
rural families.

Side by side with the educational campaign we have arranged that
more than 100 young girls and boys, 4-H members, have had their

206 JOURNAL OF SOCIAL HYGIENE

blood examined at the Health Centers. It is a pity to have to say
that because of scarcity of personnel and material, due to the war
situation, it was impossible to examine the blood of all members
belonging to the 4-H Club in Puerto Kico.

We do not lose any opportunity to instruct our country people to
make use of the services rendered by other agencies and by the
Department of Health through the Health Units. We want the
people to realize the importance of their being in contact with
the health centers to maintain and improve their health.

The Agricultural Extension Service has been working hard and will
continue working to help our people to live sane and healthful lives.

It is the duty, not only of the government agencies, but a duty of
every citizen to help to maintain a healthful nation, especially during
these war days. We need a healthy army and we must all strive to
maintain the health of ourselves and our families.

POWER OF THE PRESS

EMILIO E. HUYKE
Eepresenting the Puerto Eicon Newspaper Association

No other organization can be more interested in a meeting of this
kind, than a Newspapermen's Association; no other profession
can be more eager to share the responsibilities with the doctor in a
fight against social diseases, than the newspaperman; no other pro-
fession can be more willing to devote its full efforts to the realization
of the plans set forth by the medical profession to fight such diseases,
than Journalism, because when the history of this fight is written,
it will be necessary to specify that the greatest share of the blame
for the lack of information on the dreaded diseases, and of the
consequences of such ignorance, belongs to Journalism and to the
newspapermen of the world.

Such is the " Power of the Press." A power that can be used
actively in a positive way, to further the good, or used passively,
in a negative manner, to further the evil. Once in the history of
Journalism was the newspaper misled to believe that it served better
its purposes and duties, if it kept away from its readers what we
now agree should have been discussed freely. It was not that the
newspaper refused to discuss such problems, but that it worked in
accordance with the ideas of the society it served. The ideas of
that society were that a high sense of morality, as interpreted then,
prevented even the indirect mention of such diseases.

But there have been many other instances where the newspaper
broke away from its charted course to discover new horizons, and
the truth is that regardless of the interpretation given to what the
newspaper really is, here was an opportunity to become a guiding
light in the darkness of ignorance, and a powerful weapon in the
hands of the medical profession, — to fight an enemy more powerful

PROCEEDINGS REGIONAL CONFERENCE 207

and more destructive than ninety per cent of the best known dangers
the youth of the world faces, one generation after the other.

In this specific instance the newspaper kept its course, and once,
twice, and as many times as attempts were made to break the greatly
misunderstood Code of Ethics of Journalism, the newspapers refused
to discuss venereal disease problems.

Time has elapsed and many things in life have changed since then.
The Code of Ethics of Journalism has also changed.

Simon Michael Bessie in his history of the New York Daily
News, says:

"No better illustration of the News' editorial vigor could be
found than that offered by its recent series of articles on syphilis
which won a 1936 Pulitzer Prize in journalism for their author.
. . . While other newspapers persisted in hiding the problem
behind a veil of euphemism (social disease), and printing as little
as possible about the matter, the News ran several well documented
articles and gave tremendous impetus to the long overdue move-
ment for the eradication of a cancer which exists largely because
the press has refused to aid in stirring the public from apathy."

The year 1936 was only the beginning. In later years, when the
printing of a photograph taken at an execution created certain furor
and again what should, and what should not be printed was discussed,
the Reverend Charles Francis Potter wrote :

"When you come to think of it, why not have cameras? Why
not have moving pictures and sound films? If these executions
are supposed to have a deterrent effect on other criminals, why
not exhibit all over the country a vivid record of the entire pro-
ceeding ? If it is all right for the public to read a printed account,
why is it wrong for the public to be given the story by a more
accurate medium? Ah, that's the trouble! The photographs could
be too vividly accurate. Written accounts can be toned down."

The beginning of World War II brought a new interpretation to
newspaper work. Written accounts may be made brief, but they
cannot be toned down. The written account, as life itself, must be
real. The newspaper must use in an active way its great power.
The "Power of the Press" must be used in a positive way. It is
now that the newspaper offers itself as a powerful weapon in
the hands of the medical profession.

We are most fortunate because it isn't too late. And the Power
of the Press, we all agree, can succeed in serving Society in this
campaign.

EDITOR'S NOTE: An important contributor to the program of
Group I was MR. FRANCISCO ACEVEDO, Radio Commentator for San
Juan's Station WKAQ, and Chairman of the Education and Pub-
licity Sub-Committee of the Puerto Rico Committee on Social Pro-
tection. His subject was Two Million People Listen and Learn, and

208 JOURNAL, OF SOCIAL HYGIENE

his extensive radio audience will join with the Editors in regret-
ing that circumstances prevented preparation of a manuscript for
inclusion in these Proceedings. In brief, he said: Radio plays one
of the most important parts in any program of education. Nearly
every home in Puerto Rico had access to or owns a radio. The
people who are responsible, then, for giving programs on health
must know the facts and must be sure that these programs are
scientifically correct. Dramatic sketches by far lead the other types
of programs in the popular appeal they carry. The time of the day
that programs are given will have an important bearing upon the
number of listeners. Radio stations are always willing to give time
for health broadcasts.

The talks and discussion in Group I were supplemented by the
showing of the Spanish version of the American Social Hygiene
Association's film, With These Weapons — the Story of Syphilis.

An adjunct also to this session was the exhibit of posters, placards,
charts and other graphic materials, plus a supply of pamphlets and
leaflets for distribution, which was arranged by Dr. Blanco and
Miss Miller as Chairman and Secretary of the session.

GROUP II. MEDICAL DIAGNOSIS AND TREATMENT ARE STRONG WEAPONS

Round Table Discussion Presenting Viewpoints of Various
Agencies Responsible for Venereal Disease Control

Presiding: DR. Jos6 N. GANDARA, Assistant Commissioner of Health, Puerto Rico
Discussion Leader: DR. PABLO MORALES OTERO, Director, School of Tropical

Medicine, San Juan, P. B.
Secretary: DR. ERNESTO QUINTERO, Chief, Bureau of Venereal Disease Control,

Puerto Bico Department of Health

REMARKS BY THE CJIAIRMAN

It is a great honor to have participated in the first Regional Con-
ference on Social Hygiene ever held in Puerto Rico, to have the
opportunity of welcoming so many distinguished guests and partici-
pants, and to hear of the work being carried on elsewhere in venereal
disease control.

As evidence of the important part which medical knowledge plays
in the control of these diseases I might point to such developments
as the curricula in public health nursing which have contributed to
make the expansion of our venereal disease clinics possible, and the
development of new methods of therapy for syphilis which hold a
promise that in the not too distant future this dreaded disease may be
cured within a period of days or weeks instead of months and years.
Or I might mention that valiant group of physicians, many of them
already skilled in combatting syphilis and gonorrhea in the general
population, who as the venereal disease control officers of our armed
forces, with the aid of their colleagues still serving the civilian com-
munity, have spearheaded a program which has materially reduced
the venereal disease rate of the armed forces.

PROCEEDINGS REGIONAL CONFERENCE 209

But it is hardly necessary to go so far afield. I note with pleasure
that the attendance of our group meeting, in which the power of
medical diagnosis and treatment as strong weapons was discussed,
comprised not only 34 doctors, 32 nurses and six social workers, but
in addition more than 30 participants representing other special
points of view important to the welfare of the community. Papers
read and discussions presented by doctors, nurses and sociologists all
pointed out how vital and basic a strong medical program is in
venereal disease control and how it can be implemented and sustained
by means of other kindred and friendly disciplines.

This group meeting shows again how eagerly our whole society
awaits a chance to work for a community in which good health has
become an accepted part of the life of all men and women, and
which freedom from venereal disease will be one of the basic freedoms.

The Chairman wishes to express his deep appreciation and grati-
tude not only to the members of this group, to Doctors Pablo Morales
Otero and Ernesto Quintero who carried out the duties of Discussion
Leader and Secretary so ably, but also to all the distinguished and
socially minded persons attending the meetings who phrased these
central thoughts so clearly and who will implement them in their
several spheres.

KOLE OF THE PRIVATE PHYSICIAN

C. E. MUNOZ MACCORMICK, M.D.
President, Puerto Rico Medical Association

The view that syphilis is an ancient disease which has existed
among civilized peoples since the dawn of history is strongly sup-
ported by the bony changes, typical of the disease, found in mum-
mies ; by the early Egyptian and Assyrian inscriptions and by claims
that a Chinese medical treatise written more than 20 centuries before
the Christian Era contains direct reference to the disease. The great
epidemics of syphilis which occurred during the middle ages were
mere recrudescences of an already endemic disease. The fact that
the spread of one such epidemic throughout Italy in 1493 coincided
with the return of Columbus from one of his trips to America gave
rise to the theory that syphilis was introduced into the civilized world
by his sailors and spread thereafter by the soldiers of Charles III.

The venereal origin of syphilis was not generally recognized early
in the Middle Ages. Later on it became to be regarded solely as a
venereal disease and was not differentiated from other venereal con-
taminations. In the Nineteenth Century it was studied because of its
dermatological interest and it was not until the early part of the
Twentieth Century that the conception of syphilis was greatly broad-
ened and it came to be considered as a general disease with protean
manifestations. This was after the discovery in 1905 by Schaudinii
of the treponema pallidum as its causative agent, and later on,

210 JOURNAL OF SOCIAL HYGIENE

in 1913, by the contribution of Noguchi to our present knowledge of
neurosyphilis.

The fact remains that syphilis and other venereal diseases are
known to humanity as incapacitating and devastating social burdens
since ancient days. Up to relatively recent times syphilis was con-
sidered as the product of sexual corruption ; the fruit of sin ; a stigma
of moral degeneration. Thus, it was kept as a secret disease and it
was outrageous even to dare talk in public about such a filthy malady.

Fortunately, things have changed and the road to success has been
laid wide open to all institutions and organizations interested in the
control of this disease, with its complete eradication as an ultimate
goal, through a better and more comprehensive attitude on the part of
society as a whole, giving course to the all important factor, basic,
fundamental, in the fight for social hygiene : education. Thus,
the private physician today is placed in a more advantageous posi-
tion than heretofore to render effective cooperation in the fight for
the eradication of these diseases, since he is now able to educate his
patients frankly without restrictions of any sort because of possible
resentment on the part of the public.

The Puerto Rico Medical Association as an entity, and some of its
prominent members individually, have been contributing to this cam-
paign practically since its foundation, and even long before that, our
physicians in Puerto Rico, in collaboration with prominent citizens
interested in the sociological aspects of venereal diseases had laid
plans for tackling this difficult problem. Available records show that
approximately half a century ago, Dr. A. Vazquez Prada, in a com-
mittee with Federico Degetau and Manuel F. Rossy, made recom-
mendations for the control of prostitution in the city of San Juan, in
an effort to lower the incidence of venereal diseases, which then, as
now, had created a problem among the armed forces. It is interest-
ing to see how well oriented they were in their recommendations,
which followed more or less the same trend of thoughts that prevail
among us today.

When they were still devoid of the facilities for free discussion in
public about this disease, many distinguished members of our Asso-
ciation, challenging criticism and opposition, have come forth in the
fight for education and proper orientation of the general public. Now,
with the facilities of coordinated action among public agencies inter-
ested in this problem, the work of the private physician, which con-
tinues to be of paramount importance in the solution of same, has
been, in my opinion, rendered less difficult and more effective. The
private physician is now in a position where he can freely discuss this
disease with his patients, in private, or with the general public as a
whole.

The importance of darkfield examinations of any cutaneous lesion,
no matter how remotely suspicious of syphilis it may be, can be
explained and urged and the facilities for carrying out examinations
are available throughout the island. The importance of immediate
institution of proper treatment can be enforced by explaining the com-

PROCEEDINGS REGIONAL CONFERENCE 211

plications and ultimate results of syphilis and gonorrhea. Facilities
are available for adequate therapy to all social strata and freely
accessible to the indigent classes, thus doing away with the possibility
of deficient treatment because of financial embarrassment. Prophy-
laxis, one of the most important weapons to be used in the eradication
of venereal diseases, can now be brought to an utmost degree of <
effectiveness through proper education of our youth.

I am not going to enter into detailed considerations of the thera-
peutics of the disease or its sociological aspects nor of its sanitary
control, because these topics will be properly dealt with by experts in
the matter gathered here today.

However, there is one point which because of its extreme impor-
tance, I wish to consider very superficially and leave it in your minds
for study. It is extremely difficult for the private physician, in a
great number of instances, to follow up their cases properly or to
compel patients to finish the course of treatment indicated for their
condition. A very intimate cooperation between the Department of
Health, through its social workers, and the private physician is essen-
tial to do away with or minimize these difficulties. We all know that
the tendency of our people is such as to abandon treatment as soon as
sufficient improvement has been attained and they are rendered
symptomless, and this, logically, will bring about latent manifesta-
tions of the disease and result in detriment to our effort.

Medicine is frequently called the noble profession, because it is the
profession that tries to render its services unnecessary through educa-
tion and prophylaxis. The private physician being true to these
precepts, will no doubt continue to give his full cooperation to this
cause, and even more so now when not only are we fighting the disease
entities because they are incapacitating and devastating burdens to
society, but because they have become a nuisance and hindrance to our
war effort. Let us all join whole-heartedly and unyieldingly in this
crusade against venereal disease.

FIGHTING VENEREAL DISEASE AMONG MILITARY PERSONNEL

LIEUTENANT COLONEL B. D. HOLLAND, M.C.

Department Venereal Disease Control Officer, U. 8. Army,
Antilles Department

The primary concern of the military forces, with reference to
venereal disease, as in any disease, is the effect which such diseases
have on the combat efficiency of the fighting troops, and inasmuch
as the goal of the military forces is victory, the army strives both
to prevent venereal disease and to restore to duty in as short a
time as possible those soldiers who do become infected. The strong
weapons, diagnosis and treatment, are thus used by the army to
supplement that most powerful of all weapons against venereal
disease, prevention.

212

JOUKNAL OF SOCIAL HYGIENH

Let me cite briefly the measures used by the army to prevent
venereal disease:

1. Prophylactic materials, including condoms and individual chemical
prophylactic packets are made available to the soldier and all soldiers
are instructed in their use.

2. Stations are operated by trained personnel of the Medical Department
in our army camps and in civilian communities as well, for the
purpose of administering chemical prophylaxis and also, under certain
conditions, administration of sulfathiazole by mouth. Therefore
soldiers who have engaged in extra-marital sexual relations may secure
prophylaxis in addition to the individual prophylaxis just referred to.
Special care is taken to insure that intoxicated soldiers receive a
thorough prophylactic treatment on return to their stations.

3. Soldiers are educated concerning the nature of all forms of venereal
disease, the mode of their spread, and the dangers attendant upon
sexual promiscuity and excessive indulgence in alcohol. The value of
prophylaxis is emphasized. Use is made of lectures, radio transcrip-
tions, films, pamphlets, posters, data obtained in epidemiological
reports, and demonstrations to properly instruct our troops not only
in the methods of prophylaxis, but also the aftermath which may
follow infection by a venereal disease.

4. Disciplinary control is exercised over those soldiers whose past record
and general behavior indicate that they are prone to contract venereal
disease.

5. Wholesome recreation and entertainment are provided for the troops
in garrison.

6. Commanding officers of all grades are charged with the responsibility
of the control of venereal disease.

7. Medical officers are assigned at army posts and stations as full-time
venereal disease control officers and are constantly on the alert to any
conditions which may raise the venereal disease rate in regions under
their jurisdiction.

8. All cases of venereal disease among soldiers are investigated epidemi-
ologically. This is done for the purpose of furnishing civilian health
agencies with such information concerning the infected woman as will
permit them to locate her and place her under treatment, and for the
purpose of discovering and coping with factors which cause soldiers
to contract venereal disease.

9. Cooperation is also extended by the military to the civilian police in
an effort to discourage the activities of prostitutes and procurers in
the vicinity of military reservations and installations.

10. Certain areas and establishments, outside of military reservations, which
are actual or potential sources of venereal disease hazard are declared
"off limits" for the armed services.

All these measures have achieved worthwhile results as is shown
by the fact that the venereal rate among the soldiers in the Puerto
Rican Sector, for 1943, is but three-quarters as high as the rate
for 1942.

Having presented this background, I shall briefly discuss the
diagnosis and treatment in use in our military establishment.

All men called for induction into the army are subjected to a
thorough-going physical examination, including serological tests for

PROCEEDINGS REGIONAL CONFERENCE 213

syphilis. This examination serves to uncover venereal disease if
such be present.

Each month soldiers are subjected to a thorough physical inspection
which usually reveals any case of venereal disease not previously
reported by the infected individual.

Moreover, soldiers are impressed with the seriousness of venereal
disease in terms of effect to their health. They are shown the
folly of self-treatment and urged to report at once should they
develop any symptom which might indicate a venereal disease. Under
the present regulations there is no punishment imposed upon the
soldier for contracting a venereal disease or for failure to take
prophylactic treatment after intercourse. Therefore the soldier
has nothing to lose and everything to gain by promptly reporting
his infection. He will lose but little time from duty inasmuch as
treatment is administered on a duty status and, therefore, lose but
little pay, for soldiers hospitalized for venereal disease forfeit all
pay and allowances during the period they are absent from duty
due to such an infection.

The army insists that soldiers report their venereal infections
promptly in order that scientific treatment may be undertaken
early and the soldier restored to full fighting efficiency in the shortest
possible time.

Soldiers are provided with the best of medical care and may avail
themselves thereof at any time. The latest laboratory tests and
technics are employed in the diagnosis of venereal disease. Venereal
diseases are treated in the army by the latest approved methods,
adapted to the needs of the military service. The Surgeon General
of the Army avails himself of the assistance of the National Research
Council and promulgates scientifically correct instructions to guide
medical officers in the treatment of these diseases. The medical
officer is allowed the necessary freedom in modifying the prescribed
forms of treatment to meet the needs of individual cases.

The sulfa drugs (sulfathiazole and sulfadiazine) are the main
agents used for the routine treatment of gonorrhea. Local treatment
is not used in acute uncomplicated cases. Uncomplicated cases
are given one course of the sulfa drug on a duty status. Compli-
cated cases and those not cured by one course of the drug, on a
duty status, are hospitalized and another course of a sulfa drug
is given. If the case has not been cured by two courses of sulfa
drugs, as shown by demonstration of the gonococci in exudates by
means of smears and cultures, when possible treatment with penicillin
is then instituted. Results achieved with the sulfa drugs have been
not altogether encouraging. A considerable proportion of cases
have to be treated with penicillin. Spectacular success has been
achieved with this drug. Most cases can be classed cured. This
has been established not only by the disappearance of symptoms,
but by negative follow-up cultures. The few cases which do not
respond to penicillin are then subjected to fever therapy. In all

214 JOURNAL OF SOCIAL HYGIENE

cases of gonorrhea the infected soldier is subjected to a serological
test for syphilis.

Syphilis, if primary, secondary or latent, is treated with ma-
pharsen and bismuth subsalicylate on a 26 weeks' schedule, 40 doses
of mapharsen and 16 of bismuth. Cases of tertiary syphilis, cases
showing special complications and cases manifesting untoward reac-
tions to the drugs used are given various forms of treatment, pur-
suant to the instructions of the Surgeon General and modified to
meet the special needs of the individual case. The progress of the
treatment is followed by serological examinations of the blood and
spinal fluid and by careful physical examinations including x-ray
and electrocardiographic examinations when indicated clinically.

Cases of chancroid and lymphogranuloma venereum are treated
with sulfa drugs, generally sulfathiazole and sulfadiazine, and granu-
loma inguinale with tartar emetic and fuadin. Such local treatment
is administered as may be necessary. Examinations for syphilis
are made in all such cases routinely.

Soldiers suffering with venereal disease are restricted while in
the infectious stage, as a public health measure, and are not released
from restriction until treatment is well established and infectiousness
controlled.

Careful records are maintained in the army in the management
of venereal disease, both in order to insure the excellence of the
professional care rendered as well as to compile scientific data to
evaluate and to improve present procedures.

It can be said, then, that every effort is being made and every
proven method capable of being used in the military service is
employed by the army to prevent, diagnose and treat venereal
disease. I have limited my remarks to the army, but all the armed
forces are equally as alert to provide efficient preventive measures
and methods of dealing with venereal disease.

THE LOCAL PUBLIC HEALTH OFFICIAL

JACK C. HALDEMAN
P. A. Surgeon, U. S. Public Health Service, District No. 6

One of the most important advances in medical science during the
last quarter century has been the demonstration of the fact that
prevention of disease must occupy a position of paramount importance
if we are to fully realize the benefits of scientific knowledge.

Whereas the private physician and the medical officer of the armed
services are primarily interested in the health of the individual or
a specific group of individuals, the public health worker is primarily
interested in the health of the entire community he serves and is
faced with the responsibility of initiating a program with this in view.

PROCEEDINGS REGIONAL CONFERENCE 215

Under the American system the ultimate responsibility for carry-
ing out the attack is placed in the hands of the local health depart-
ment, the personnel of which are aided by the planning and consulting
services of personnel attached at higher administrative levels. Under
this system the success or failure of the program depends largely
upon the ability, initiative and resourcefulness of the people in the
field doing the actual work. This implies that sufficient authority
must be vested in them to effectively utilize these qualities. Due
to the importance of the local health unit in the public health picture
it is felt desirable to limit the discussion in this paper to matters
relating to local health work and to factors affecting its efficient
operation.

An indispensable prerequisite to efficient operation in a health
unit, as in any organization, is the maintenance of high morale
among its personnel. Stability of the personnel structure is a most
important factor in this, but tenure of office should be contingent
solely upon meritorious service. The personal desires of the
employees concerned should receive major consideration when trans-
fers become necessary and these should be kept at a minimum.
Also the primary loyalty of the personnel must be directed to the
community being served and to the administrative head of the specific
health unit in which they serve. This of necessity requires that
the administrator be given an important voice in the selection of
personnel employed, subject of course to limitations imposed by
merit systems and administrative guides established by higher
authority.

The venereal disease program of a health unit is one that is of
utmost importance and one that necessitates careful local planning.
One of the most important considerations in this is the controllability
of the venereal diseases through the discovery and early treatment of
the infectious person.

Two methods are usually utilized in case finding. One deals with
routine examination of specific population groups such as selectees
or industrial groups. The other method deals with the epidemiological
investigation of persons having had intimate contact with infectious
cases of venereal disease.

If maximum good is to be obtained from personnel engaged in
contact tracing, priority must be given to the following types of
contacts :

1. Marital or extra-marital sexual contacts of infectious cases.

2. Children born to mothers with syphilis.

3. Brothers and sisters of cases with congenital syphilis.

A similar priority is established in case holding. The early case
of syphilis which lapses from treatment is a danger to the community,
whereas, the late-latent case is not.

216 JOURNAL, OF SOCIAL HYGIENE

Although the clinic load gives an indication of the volume of work
being done by a health unit, a more reliable index of the efficiency
of case holding activities from a public health standpoint are monthly
reports relative to the number of infectious cases under treatment
and the per cent of lapses in treatment among such cases. Data
relative to pregnant women under treatment might also well be
added to this list.

The case-finding and case-holding activities of the field staff can
easily be nullified if recognition is not given to some of the following
common reasons given by patients for failure to continue treatment
until they are rendered non-infectious:

1. Failure to explain the nature of the infection and to stress the importance
of treatment from both personal and public health aspects.

2. Clinic quarters inadequate for or inaccessible to the people to be served.

3. Lack of enough sessions at convenient hours to meet the needs of the
community.

4. Dirty and unattractive quarters.

5. Lack of privacy.

6. Rough or discourteous handling.

7. Frequent change in personnel — particularly those who give medication by
injection.

8. Poor therapeutic technique in the clinic resulting in unnecessary pain.

9. Long intervals spent in waiting rooms.

It has been said that "A sharp needle, a cheerful attitude and an
expressed interest in the patient's well being" are the best case-
holding techniques known.

A number of points merit consideration in a discussion of clinic
management. What is the average number of patients that can
be seen per clinic, and the average number of new patients? What
should be the number and distribution of personnel according to
clinic function? The experience in the Continental United States
has been that more economical use can be made of professional
personnel when a three hour clinic session is geared to handle two
to three hundred patients. Experience has shown that even in rural
areas some hundred or more patients can be easily attended by one
physician if the proper provision is made for the flow of patients
through the clinic, and if the services of non-medical personnel are
properly organized. An analysis of the work-flow in any given
clinic, utilizing a diagram of floor plan of available space and arrows
to indicate clinic flow, will frequently indicate the inevitable con-
fusion resulting from bottle-necks or back-tracking on the part of
.patients.

It is commonly stated that a desirable clinic arrangement cannot
be obtained due to lack of sufficient clinic space. This is unfortu-
nately true in some cases. However, in many health departments
there is space available which is allocated to some other activity

PROCEEDINGS REGIONAL CONFERENCE 217

but which is not being used during the hours venereal disease clinics
are held.

Treatment room bottle-necks are often traced to insufficient equip-
ment. In the case of arsine oxide treatments, time is saved by mixing
the drug in quantity in advance of the rush and loading 20 to 30
syringes and having an additional supply of dry syringes for taking-
routine blood tests.

A critical analysis of duties performed by professional personnel
is indicated in view of the acute shortage of physicians and nurses.
Duties not of necessity requiring professional skill can be turned
over to non-professional clinic attendants or lay helpers. This
increase in the responsibility placed on non-professional personnel
emphasizes the importance of taking special care to select people
with the highest possible qualifications for these positions.

The subject of records presents a controversial subject. Persons
better informed than I scoff at my statement that a simple single
clinic record is sufficient to meet the needs of the clinician and prefer
separate forms for different diseases. Additional records are of
course necessary for administrative purposes, but in my opinion,
these can be kept simple and few in number. Items need not be
allowed to stay on required reports which do not form the basis of
administrative action. It would seem that the bulk of " paper- work ' '
could best be performed by clerks, allowing nurses and other
professional personnel to concentrate on more important activities.

It is felt that data collected primarily in the interest of research
is best obtained 011 special forms for use in selected areas. In that
way the forms can be discontinued at the termination of the special
study, whereas, items placed on routine forms for such purposes
remain after their usefulness has ended.

Laboratory technicians tell us that some of the causes of delay
in obtaining reports of results of laboratory tests may be prevented
in the local health department. In the case of blood specimens,
hemolysis is often prevented by seeing that water is not present
in syringe or test tube. A decrease in the number of unsatisfactory
specimens has been reported in areas where blood samples pending
shipment are kept in an ice-box and where local arrangements have
been made with transportation facilities which expedite the delivery
of specimens to the laboratory.

Reference to educational and epidemiological interviews, treatment
methods and staff education have been of necessity omitted in this
discussion of clinic management but are obviously important.

Among non-clinical activities of the health department the informa-
tive program for physicians and other scientific personnel is recom-
mended as an important part of the venereal disease program. The
lag in time between the discovery, of new drugs or techniques in
treatment and their general application is unnecessarily prolonged.
The treatment of early syphilis is being revolutionized by the intro-

218 JOURNAL OP SOCIAL HYGIENE

duction of the so-called ' ' intensive " or " modified intensive ' ' methods
of treatment, and we should also be prepared to make full utilization
of penicillin when it becomes generally available.

In venereal disease as in other communicable disease the duty of
the health official in protecting healthy people from exposure to
infected persons is clear. A person who is infected with a venereal
disease should not be allowed to make sexual contacts for the same
reason that a smallpox case would not be allowed in a public meeting.
The public health worker, therefore, recognizes that the toleration
of prostitution is epidemiologically unsound and consequently actively
encourages and supports the law enforcement program of the proper
law enforcement authorities.

The interest shown by public health workers in the meeting today
and the part they played in making it possible, is a manifestation
of the type of interest necessary if the social and economic aspects of
the venereal disease problem as well as the medical aspects are to be
succssfully attacked.

SOCIOLOGY AND THE COMMUNITY

JOSE COLOMBAN EOSAEIO

Professor of Sociology, University of Puerto Eico

sociology can render a twofold service in the field of public health,
since, after all, public health problems are as genuine social problems
as any others that you can select from the sociological catalogue.

Sociology considers social problems as they exist in the total web
of social evolution; and in this way keeps people from isolating
each problem for study ; a procedure which is bound to create numer-
ous and dangerous misconceptions. For example, if we observe
prostitution as a separate problem, we might conclude that it is
the result of the evil instincts of certain girls, or as the work of
unprincipled whiteslave traders who victimize innocent young ladies,
or just classify it as one more sign of our declining civilization.

Examining this phenomenon sociologically, we discover that
prostitution, everywhere and everytime, since Sodom in the year
1500 before Christ till San Juan, in the year 1944 of our Lord,
has always been connected with the following circumstances :

1. Lack of economic security which deprives numerous girls of the common
necessities that the other girls in their group possess.

2. Parental ignorance, which, with its misunderstandings and injustices, and
cruelties impels numerous girls to follow any path that leads away from home.

These two factors create the supply end of prostitution. The
demand is created by:

1. The many married men who find at home neither companionship, nor
understanding, nor sexual adjustment, and proceed to purchase some of these
goods at the prostitution market.

PROCEEDINGS REGIONAL, CONFERENCE 219

2. The many single young men who in an urban society have to postpone
their marriage beyond the time when marriage would normally take place
in a rural society.

If we envisage prostitution in this way, we would not consider
the prostitute as a delinquent; since she is merely the provider
and dealer in economic goods which are in great demand by all sorts
of honorable gentlemen in urban groups everywhere. We would
try to enlist her cooperation in the campaign to control venereal
diseases; instead of treating her as a criminal, and so arousing her
resentment and her antagonism against our work.

This is an example of how the sociological method of attacking
social problems might be radically different from the plans used
by persons without the benefit of sociology.

I said at the beginning that sociology can offer a twofold service.
So far, I have described how sociology, by presenting the social
problem in the total web of social evolution, can help formulate a
more efficient method of attack.

The second weapon that sociology can offer to combat public
health problems consists in its comprehension of human nature; for,
after all, in attacking public health problems, we are dealing with
human beings; and human beings are essentially human minds;
that is, aggregates of attitudes, emotions, sentiments, and social inher-
itance with a little reasoning added to the mixture for good measure.
You can conceive of venereal diseases being completely stamped
out by the proper attitudes of the community toward the disease,
without the use of a single drug or doctor to cure the people infected ;
but you cannot conceive of these diseases being eradicated without
the proper attitudes on the part, of the people, no matter haw many
doctors and drugs you have at your disposal. In other words,
the attitudes of the community in the struggle against social prob-
lems are as important, at least, as the totality of all other
contributing forces.

Everywhere we see evidences of the absolute need of simultaneous
treatment of the body and the mind of the patients; the latter part
being within the sphere of persons with sociological training; people
who understand human nature; and who are able to influence its
reactions. This truth is particularly evident in dealing with the
problem of venereal diseases where the long treatment, and the sense
of shame attached to the disease create additional obstacles for the
smooth working of any combat measures.

I can summarize the point of view of sociology in connection with
the community and venereal diseases by stating that :

First: We must train the community to see the problem in its
proper perspective, without any moral or prudish implications.

Second: We must place, side by side with the physician, people
with sufficient knowledge of human nature to back up medical work
through the creation and cultivation of the most helpful attitudes
on the part of the community.

220 JOURNAL, OF SOCIAL, HYGIENE

Third: We must emphasize prevention rather than cure; and this
cannot be done in any other way than by a permanent, aggressive
campaign of education. In this campaign we must get the enthu-
siastic cooperation of the newspapers, the high school and university
students, the political leaders, the teachers, the pharmacists, the
doctors, the ministers of religion and the prostitutes. It is a sad
circumstance that we can say for Puerto Rico, parodying Hornell
and Ella Hart's words for the United States l that if a young woman
selects, at random, as a sex partner, a young man between twenty
and twenty-four years of age in one of our cities, she takes about
one chance in six that she will expose herself to a young man who
is, or should be, under treatment for a venereal disease.

Fourth: There is no doubt that venereal diseases are the result
of promiscuous sex relations; but promiscuous sex relations are the
result of unadjustments in family life; unadjusted marriages, unad-
justed boys and girls in their families, plus insufficient or inadequate
information of venereal diseases in the community as a whole.

We cannot cope with the problem of family relations without
upsetting the whole social web; but we can, without further com-
plications, take up the question of inadequate information. We can,
through the proper sociological approach, make the community as
conscious of the dangers of syphilis as they were a few months ago
of the dangers of the far less dangerous aerial bombings; and we
can make the community as active and cooperative in heeding our
advice about evading syphilis as they were active and cooperative
in following our instructions about the blackouts. Unless we take
sociology into consideration, medical diagnosis and treatment are
not strong weapons.

ROLE OF THE PUBLIC HEALTH NURSE

CELIA GUZMAN

Instructor in Public Health Nursing, School of Tropical Medicine,
San Juan, P. B.

Her role in the control of venereal diseases depends on her prepa-
ration, on the policies of the agency which she represents and on
her knowledge and attitude about syphilis and gonorrhea.

Her preparation

Education in the public health and social aspects of gonorrhea
and syphilis control should begin in the early days of student
training. It is our duty to direct our efforts to improve and enrich
these courses in our School of Nursing. Furthermore, the public
health nurse who works in this program of control, needs to meet
the essential requirements for public health nursing plus a thorough

i The Medical Woman 's Journal, Nov., 1942. Article : Legal and Social
Aspects of Syphilis in Relation to Marriage and the Family, by Wendy Stewart,
LL.B., M.D., pp. 355 sg.

PROCEEDINGS REGIONAL CONFERENCE 221

knowledge of these diseases. At present greater emphasis than
previously is being placed on teaching the public health aspects
of venereal diseases in the undergraduate schools of nursing in
Puerto Rico as well as in the post graduate course for Public Health
Nursing in the School of Tropical Medicine.

Policies of the agency which she represents

What are the policies of the organization in regard to her duties
and responsibilities? What is she allowed to do? How much can
she accomplish? Until very recently the public health nurse had
been given very little responsibility in the venereal disease program
in Puerto Rico, and the work was carried out mainly by field agents
and medico-social workers Not so at present; our public health
nurses are actually taking a part in the program.

Her knowledge and attitude about venereal diseases

Her attitude should be objective and free from moral implication;
she must be sympathetic and sincere in the acceptance of the patient
and his disease. After hearing a diagnosis of venereal diseases,
the patient more than ever needs assurance that his morals and
character are not criticized.

DUTIES AND RESPONSIBILITIES OF THE PUBLIC HEALTH NURSE IN THE

PROGRAM OF CONTROL

The Public Health Nurse in the clinic

In places where, according to the policy of the organization, the
nurse gives the treatment under supervision of the medical officer,
it is advisable to have a clinic nurse. She should not be included
in the rotating system, she needs to have high skill, she needs to
become a nurse technician. Because of the shortage of public health
nurses at present, inactive nurses could be employed as clinic nurses,
provided they meet the minimum requirements for public health
nursing studies. Later on they might be interested in following
this field.

Nevertheless, there should be at least a public health nurse in the
clinic as she has an important job to perform. Case-finding, case-
holding, and education are her weapons and her greatest contribution
to the control program. She interviews the newly diagnosed patients
with the purposes of obtaining information of all contacts, of keeping
the case under treatment and of educating the patient, thus leading
him to see his responsibility for treatment and his responsibility
toward the community.

The interview is a difficult situation to cope with as the nurse faces
a patient who may be distressed, worried and perhaps ashamed of
having a disease usually contracted by intimate contact. Yet she
expects him to tell her about his intimate contacts.

In educating the patient, the nurse keeps in mind that telling
things which are not scientifically correct just for the purpose
of impressing him with the need of treatment is unsound.

222 JOURNAL OF SOCIAL HYGIENE

The nurse's approach and technique are not the only factors which
contribute to case-holding and case-finding. The general atmosphere
should be such that it seems a cordial invitation for the patient
to return. Provision for privacy, good technique, sharp needles,
painless treatment, application of the Golden Rule. "A little less
rush and more attention to detail" should be our slogan. An
indifferent physician, an irritable nurse, a snobbish clerk, are all
perfectly good excuses to stop treatment as soon as one feels better.

In spite of our philosophy of ' ' approach, " " establishing rapport, ' '
"winning the patient's confidence," we will not be successful in
case-holding and case-finding, until we have a better ratio of pro-
fessional personnel to patient, to provide for satisfactory interviewing
and satisfactory clinic management. Because of the lack of public
health nurses at present we have to think of ways and means to
save the nurses' time. During the duration, many activities formerly
performed by her will have to be delegated to non-professional
workers. If the nurses were released from many clerical and house-
keeping duties they could have more time for the important job of
finding the source of infection and holding the case under treatment.

The Public Health Nurse in a generalized program

The nurse in a generalized program who is constantly alert to
the different problems of her families, has a valuable contribution
to make in the control of venereal diseases. She has countless
opportunities to find new and unsuspected cases if she is alert to
abnormal symptoms in the various members of the families that
she visits in tuberculosis service, maternal hygiene, infant and pre-
school In her rounds of her district she has opportunity to persuade
the patients to remain under treatment long after they claim to
feel well.

As a health worker, and with free access to a large number of
families, she has an unequalled opportunity to disseminate widely
the facts regarding venereal diseases.

The Public Health Nurse as a member of the community

As a member of the community she holds a strategic position.
Through mothers' classes, midwife groups, parent-teacher associa-
tions and civic groups, she teaches about venereal diseases as poten-
tial hazards, helps them to understand their responsibility as citizens,
helps them to know for sure if responsible authorities in the com-
munity are meeting their obligations.

As a professional and as a loyal citizen she realized that the
control of venereal diseases is essential to win the war; that toward
this objective she has a responsibility, the responsibility of helping
to break down chains of infection to help conserve manpower.

To summarize: The part that the public health nurse plays in
the education of the public and in the control of venereal diseases
depends chiefly upon the leadership that she gets from the medical

PROCEEDINGS REGIONAL, CONFERENCE 223

officer. The Health Officer points out the way; the nurse follows
at the pace that he has set.

BAILEY, FLORENCE G. "Interviewing the Syphilis Patient." P, H. N., v. 35,

Jan. 1943, p. 47. .
BALDOCK, EDGAR C. "Case Finding with Gonorrhea Patients in a Clinic for

Venereal Diseases." Venereal Disease Information, v. 22, June 1941,

pp. 202-206.
BURKE, MARY A. "Extra Familial Contact Tracing." P. E. N., v. 22, June

1941, p. 15.
CEAIN, GLADYS L. ' ' Creating and Maintaining the Interest of Social Workers

in a Program for the Control of Gonorrhea and Syphilis." Venereal

Disease Information, v. 18, Nov. 1937, Eeprint No. 77.

"The Public Health Nurse in the Control of Syphilis and

Gonorrhea." P. H. N., May, July, Aug. 1937, Eeprint.
DUNN, MARY I. "The Clinic Interview." P. H. N., v. 31, No. 12, Dec. 1939,

p. 682.
GREENE, AMY W. "A Study of Patients ' Eeaction to the Diagnosis of Syphilis. ' '

Hospital Social Service, v. 27, 1933, p. 645.
INGRAHAM, LOUISE, AND STOKES, JOHN H. ' ' The Philosophy of Case Holding. ' '

Venereal Disease Information, v. 18, No. 5, May 1937, Eeprint No. 65.
MCPHILIPS, JULIA. "The Principles of Case Finding." Venereal Disease

Information, v. 18, Sept. 1937, Eeprint No. 74.
PEARCE, DONNA. "The Major Public Health Battle Front." P. H. N., v. 35,

No. 1, Jan. 1943, p. 8.
PEARCE, LOUISE. "The Outlook for Syphilis Control." Venereal Disease

Information, v. 20, Aug. 1939, Eeprint.

PIERCE, C. C. "Syphilis and Gonorrhea Control." Venereal Disease Informa-
tion, v. 22, Feb. 1941, pp. 43-52.
U. S. P. H. S. "V. D — War Letters," Nov. 22, 1943 and Nov. 29, 1943.

"V. D.— Education," Circular No. 20, Nov. 29, 1941.

— "Outline for Institute — Place of the P.H.N. in the Syphilis
Control Program," B-2211.

WATERS, LENA R. ' ' The Social Worker and the Nurse in Genito-Inf ectious
Disease Control." Venereal Disease Information, v. 22, Nov. 1941, pp.
395-401.

' ' The Organization and Function of Follow-Up Service in Venereal

Disease Clinics." Venereal Disease Information, v. 19, July 1938, Eeprint
No. 93.

REMARKS BY THE DISCUSSION LEADER
DE. MOBALES OTERO

It is apparent from the papers read this afternoon that we have a
tremendously difficult problem before us. It is encouraging, though,
to see how interested are all the groups represented here and how
awakened is their disposition to find a solution.

There are certain facts that have come out of this discussion that
should be stressed as they will be of material help in solving this
problem. It has been said that the facilities for diagnosis and treat-
ment should be extended. In this regard, a simplification of clinical
records with a sufficient number of physicians to care for this large
section of the population are valuable suggestions. It seems to be a
consensus of opinion that such personnel should feel a sense of security
and that as few changes as possible be made among them. Cooperation
between the private physician and the local health services should be

224 JOURNAL OF SOCIAL HYGIENE

a closer one, especial emphasis to be laid on the necessity for improv-
ing the system of case reporting and the follow-up of the same.

Other points are the necessity for a live program to arouse com-
munity interest. In this, the sociologist is a great inspiration since
he deals so closely with human relations. He stresses prevention
rather than cure, training the community to see the problem in its
true light so that it can accept its full share of the responsibility, and
thus help the physician to fulfill his task and the victims to reha-
bilitate themselves.

The obvious need for well-trained personnel with firsthand knowl-
edge of community problems is also emphasized. Education in all
aspects of this field is important — in other words, close collaboration
between the community, the physician and his coworkers, and the
victims themselves. With the proper education and due considera-
tion to social problems, medical diagnosis and treatment should be
very strong weapons in the fight against venereal disease.

GROUP III. GOOD LAWS AND LAW ENFORCEMENT ARE STRONG WEAPONS

Presiding: DR. R. AKEILLAGA TORRENS, Speaker, Puerto Eico House of

Representatives
Discussion Leader: HON. MART!N TRAVIESO, Chief Justice, Supreme Court of

Puerto Eico
Secretary: THEODORE ESLICK, Social Protection Representative for Puerto Eico

NOTE: A speaker in this session whose paper was not available was MR.
MANUEL RODRIGUEZ RAMOS, then Acting Attorney General for Puerto Rico, and
shortly afterward appointed as Dean of the Law School, University of
Puerto Rico.

It is to be regretted that a transcript is not available of the vigorous dis-
cussion which took place at this session, in which the large audience took an
active part, and which led to a number of revisions in the legislation subsequently
sponsored by the Committee on Social Protection.

STATEMENT BY

PHILIP F. HERRICK
United States District Attorney, San Juan, P. E.

There are just a few points which I should like to mention. I
have listened with interest to the speech of Attorney General Rod-
riguez Ramos. I agree emphatically with him that we cannot simply
legislate venereal disease out of existence. The problem is more
complicated than that. We must have good laws, understandable
laws, public support, and vigorous enforcement.

It has been aptly said that "Making the laws understandable
is as important as making the laws." At the present time the
Social Protection Committee in Puerto Rico is engaged in drafting
a code of laws which will be designed to suppress prostitution and
venereal disease. We need such a code in Puerto Rico at this time.
Under the laws as at present written, for instance, it is not even
an offense for a prostiti^te to solicit. The Committee has worked

PROCEEDINGS REGIONAL CONFERENCE 225

hard and has produced a draft of a proposed code. This draft
is not perfect. No draft, and for that matter no law, is ever perfect.
There is need for haste in connection with this proposed legislation,
but there is also need for deliberation. I hope the legislature will
consider the matter carefully and that hearings will be held which
will give everyone a chance to express his views. Although few
will deny the necessity for the new code as a whole, there are
certain controversial features which will undoubtedly be opposed.

There is one provision of the proposed draft which I should like
to see expanded. That provision requires the prison authorities to
give a physical examination for sex offenders in order to determine
whether or not they are infected with venereal disease. I see no
reason why such provision of the law should be limited to sex
offenders. It seems to me that such examination would be salutary
for all prisoners and, indeed, for as many persons as can be brought
within the scope of the laws. The recent requirement by the Insular
Government that prospective insular employees be examined is a
long step in the right direction.

The new laws must have public support. No chain is stronger
than its weakest link, and no law is stronger than the public support
back of it. We have seen, in the prohibition law, how impossible
it is to enforce a statute which does not carry the support of every-
body. In order to obtain public support for the new laws, there
is a crying need for education. It seems to me that problems of
this kind should be taught to high school children, and in addition
they should be aired over the radio, in the papers, and in special
motion pictures.

There is always of course the need for vigorous enforcement.
I am particularly interested in Act No. 14, and should like to see
it enforced to the hilt. It is said that enforcement of this law
would simply drive the prostitutes out of the places where they
now congregate into the parks and alleys, but experience in other
places has shown that even though some prostitution may occur in
such places, the number of contacts is definitely decreased.

The impact of the Federal laws, which it is my duty to enforce,
is not particularly great in this field. There is the Mann Act, which
has been and is being enforced vigorously in the Federal Court.
Several prosecutions are pending even at this time. The Mann
Act was designed primarily to eliminate "rings," which I am
glad to say we do not have in Puerto Rico. There are, however,
a number of owners of houses of prostitution who have and who will
feel the enforcement power of the Federal Court under the Mann
Act.

The requirements of the Naturalization Act are also an important
medium in this regard. No person may become a citizen of the
United States if he is a person of bad moral character. A prosti-
tute or a keeper of a house of prostitution is a person of bad moral
character, and he or she must leave that field for five years before
becoming eligible for American citizenship.

226 JOURNAL, OF SOCIAL HYGIENE

There is also the so-called May Act, but this has not yet been
applied in Puerto Rico and has been applied so infrequently on the
continent that we are not yet prepared to say that its effect is
important at this time.

As I say, the impact of the Federal laws in this field is not great,
but at the same time we stand ready to assist the local enforcement
authorities in any possible way. I have nothing but the best of
wishes for the success of the social protection program in Puerto
Rico.

SOCIAL PROTECTION IN VENEREAL DISEASE CONTROL

ELIOT NESS
Director, Social Protection Division, CWS, Federal Security Agency

The subject on which I have been asked to speak to you today
has certain controversial aspects. Doubtless many of you in this
audience have thought, and perhaps said, in honest conviction, that
repression of commercialized prostitution and sexual promiscuity,
or prevention of prostitution and promiscuity, — along with efforts
to rehabilitate girls and women involved in these problems, — are
impractical. That such objectives cannot be accomplished. That if
they could be, they would not do the job.

I do not intend today to be controversial. But the facts are, that
when the Social Protection Division of the Federal Security Agency
was organized in April, 1941, two and a half years ago, each of
these so-called "impractical," "non- workable" processes became a
part of the Division's program. In the Eight-Point Joint Agree-
ment, set up in 1939 as the basis for our national venereal disease
control program, the medical and public health authorities gave
pointed recognition to the importance of social protection in making
this program work.

As Director of the Social Protection Division, and as a former
law enforcement officer, I am going to outline just how we went
about putting this program into effect. I shall try to evaluate what
has been accomplished on the Continent. I believe these
accomplishments can stand on their own merits.

Last August, Charles P. Taft, then the Director of the Office of
Community War Services, of which the Social Protection Division
is a part, spoke before the International Association of Chiefs of
Police. He told the members of that organization just what social
protection was up against at the beginning of its program.

To quote his words : "It ran the risk of ridicule for trying to stop
the unstopable. It risked being called the promoter of an anti-
vice crusade, before its actual accomplishment could show a true
picture of its objectives. It had a tremendous handicap in the
misunderstanding among many police officers, public officials, and

PROCEEDINGS REGIONAL CONFERENCE 227

leading citizens of the public health facts about venereal disease
and prostitution."

Mr. Taft was right. Yet in the less than three years of our
existence, 662 cities and towns on our mainland have closed their
former segregated prostitution districts. And in those same two
years and some months the Army venereal disease rate for the Con-
tinent has been knocked from 42 per thousand per year to 25 per
thousand; the overall Navy venereal disease rate has gone from
80 to 33.

This was no overnight, flash-in-the-pan job. We had to start with
a process of education among police officers and other local officials
who were responsible for doing the actual day to day work of putting
the repression program across.

Hundreds of times we had to answer this fallacy, "Why not keep
prostitutes in a segregated area and control venereal disease through
periodic medical examinations and treatment of those infected ? ' ' But
we know the answer to that question — and the answer isn't on the
affirmative side of the segregation argument.

Dr. F. C. Gillick, Passed Assistant Surgeon of the United States
Public Health Service, has summed up the opinion of the medical
profession on this point in terse and down-to-earth terms. "A phy-
sician who certifies prostitutes as non- venereal or non-infectious,"
he says, "is either intentionally dishonest or grossly incompetent.
A prostitute can transmit gonorrhea, syphilis and other venereal
diseases without becoming self-inf ected. " Dr. Gillick goes on to
say, "The average prostitute (in a house of prostitution) to meet
her financial obligations, must accommodate about 20 men per day.
It does not take a mathematical genius to figure out what a prolific
spreader of venereal disease an infected prostitute can be. The
average . . . amateur prostitute, at -best, only contacts from 3 to 5
men a night. Her method is slower. Both are dangerous and
practically 100 per cent infected."

Some skeptics told us, too, that closing the red light district
would make prostitution "spread all over town." Yet the prac-
tical police officer knows that tolerated red light districts never
really segregate, that they stimulate prostitution activity generally,
and that many prostitutes continually operate outside the ' ' district. ' '

We based our stand on this knowledge. Subsequent experience
has proved that we were right. In San Antonio, Texas, for example,
after the red light district was closed, the Department of Public
Safety kept spot maps to discover whether prostitution really did
spread to other parts of the city. At the end of a four month's
period there had been only eight cases of venereal disease found
within the former red light district, but 95 per cent of cases discovered
were within a one-mile circle of what had been this old district.
The prostitutes had not scattered. And the rate of venereal infec-
tions in the San Antonio area is now only a fraction of what it
was prior to the city's repression program.

228 JOURNAL, OF SOCIAL HYGIENE

Today, with the closing of those 662 red light districts, com-
mercialized prostitution has been largely wiped out on the mainland.
But in communities where the districts still exist, it is still the
greatest source of venereal disease and must be eliminated. It was
said that "it couldn't be done." I say, "It has been done, and
the work will continue until it is all done."

During wartime thousands of people are subjected to higher emo-
tional tensions and fewer social restraints. It is inevitable that
increased sexual promiscuity should be one result of wartime con-
ditions. One of our very real problems even before the war began,
such promiscuity is our No. 1 venereal disease problem now — the
greatest source of present venereal infections in the United States.

For obvious reasons, it is more difficult to do an effective job of
preventing or repressing promiscuity than of eliminating the red
light district. Repression of promiscuity requires the development
of definite and specialized techniques for the law enforcement
officer, backed by sound laws intelligently administered by the courts.
It requires the active cooperation of health departments and social
agencies. In the final analysis, it requires good community
organization on a foundation of educated, informed public opinion.

Last year saw the publication of what I believe to be the most
authoritative information to date on law enforcement in the social
protection field. The National Advisory Police Committee on Social
Protection brought out a pamphlet called Techniques of Law Enforce-
ment Against Prostitution. Its title, perhaps, is an inadequate
description of the contents, for a large part of the pamphlet deals
with techniques used by law enforcement in attacking the more
difficult and involved problem of promiscuity.

And last year, too, saw the development of prevention in the social
protection field of policing. Police know that crime prevention,
effectively administered, is better than crime repression. It is more
efficient. It pays off in dollars and cents. Humanly speaking,
prevention is constructive, but never destructive.

This is especially true in the social protection field. Our mainland
police — yes, and our courts, too — have been willing to put this
idea to the test in working with hotels, taxicabs, taverns and bars,
tourist camps, and all those private enterprises that might wittingly
or unwittingly foster prostitution and promiscuity. They have seen
the prevention idea work.

By and large, we have found private commercial enterprise not
only willing, but eager, to cooperate in the social protection program.
Perhaps it is moved by practical as well as patriotic motives, but
it has been extremely effective as a co-partner of law enforcement
and health agencies. Many individual bar and tavern and taxicab
operators were honestly mistaken as to the extent of their own
control powers. But as soon as they knew, they began to act.
National business organizations have gone on record supporting our
program. The American Hotel Association and the National

PROCEEDINGS REGIONAL CONFERENCE 229

Association of Taxicab Owners and Cab Operators are but two
among many.

But I want to impress upon all of you -the fact that none of
these organizations has stopped with a simple passing of resolutions.
These groups have reached directly down to their local members,
stimulated them to greater vigilance, helped them to institute self-
policing measures that have often left the police free to concentrate
upon other phases of social protection enforcement.

To be sure, here as always there are certain persons who refuse
to cooperate or who give lip service that is never translated into
action. But we have force tactics to use when other measures fail.
Here, as in a hundred other ways, Army and Navy cooperation,
often through the "off limits" or "out of bounds" orders, is
an effective weapon. Under local laws and ordinances, abatement
proceedings, revocation of licenses and like control measures can
be and are used. Operation of taxicabs is subject now to rules
imposed by our wartime Office of Defense Transportation. Yes,
the weapons are there — to be used when we need them.

We have still on the Continent some earnest — but misguided —
persons who, in spite of the facts behind the Social Protection pro-
gram, and the facts that prove it is effective, continue to "view with
alarm." They shake their heads at the increased numbers of those
arrested for promiscuous activity. They point trembling fingers at
the doubled and tripled rate of venereal disease clinic or hospital
admissions. They are convinced that venereal disease is increasing
by leaps and bounds, among our civilian population. There was
never a more perfect example of trees blotting out the view of
the forest.

Why shouldn't scientific policing, selective law enforcement, work-
ing in a program law enforcement believes in, and that has been
geared directly into the war effort, result in increased arrests for
violations against the law?

Why shouldn't good new laws, or good old laws brought up to
date, combined with effective court action, be responsible for
conviction of a greater number of law violators?

Why shouldn't our venereal disease hospitals and clinics have
more patients now that the Army and Navy contact reports give
local health departments a basis for case finding never before equalled
in their history? And now that we have public education on
venereal disease bringing more and more people in to doctors and
clinics to seek voluntary treatment?

I could go on and on. But I'm sure you get my point. We're
glad that those figures have increased — not because we believe it
means a vast increase in our civilian venereal disease rate, but
because we are convinced that it leads to a decrease in venereal
disease now and in the future !

230 JOURNAL, OF SOCIAL, HYGIENE

As we have seen our program in operation on the Continent,
however, we have become more and more impressed with one fact —
in venereal disease control it is not enough to repress prostitution
and promiscuity through law enforcement — it is not enough to offer
medical treatment and cure to infected persons. Perhaps you've
heard of the "revolving door" theory. Well, that means that we
have done only part of our job if girls and women who are appre-
hended are only made to serve a term of detention, or given medical
treatment until non-infectious or cured, and then released to ga
back to the same conditions that were the actual foundations of
their troubles.

Wiping out prostitution and promiscuity is a broad community
problem. Conditions that encourage prostitution and promiscuity,
and thus encourage the spread of venereal disease, must be attacked
at their source. That's a big job, but it certainly isn't a job that
will ever be done by shaking the head and saying ' ' It can 't be done. ' '
No one pretends to believe that malaria can be wiped out by swatting
mosquitoes. No — swamps have to be drained, stagnant water has
to be oiled, things have to be done to attack the disease at its source.
The things that must be considered in attacking prostitution and
promiscuity at the source may sound different — things like economic
conditions, to name one — or employment opportunities — or housing
conditions. Basically, though, they are right there in the same
class with the swamps and the stagnant water. We are convinced
that we are doing an effective job, step by step, in attacking the
sources of venereal disease on the mainland. We believe that it
can be done in Puerto Rico.

I want to commend the Insular Officials and those fine citizens
of the island who have been instrumental in setting up your Social
Protection Committee and in lending other support to the program
here. Your new Rapid Treatment Centers are other evidence of
constructive work that is being done in Puerto Rico toward control
of venereal disease. These are big steps in the right direction.

There's one story I would like to tell. It's a true story, though
I can't give "who" and "where" except to say that it was told
to me by one of our Army officers stationed on foreign territory.

This officer and the officers responsible to him were really con-
cerned over the venereal disease problem. By and large, they
and the men under them were doing an excellent job of keeping
the rate down under singularly adverse circumstances. But a
certain number of infections kept showing up — and most of the
men infected reported contacts made at a house close to the camp
but, of course, situated beyond the area of military control.

The officer in charge of this camp went to the health officials.
They admitted that they could do nothing to force the "citizens"
in that house to have a medical examination or to quarantine
them for treatment.

PROCEEDINGS REGIONAL CONFERENCE 231

He then went to the police officials who stared at him rather
blankly and said there was no law under which the house's inmates
could be arrested and convicted.

The officer's hands were tied. Infections continued to come from
the house across the road from the Army camp.

Then one night a fire broke out in the house and burned it to
the ground. The women who had lived there moved away. The
infections stopped.

What would have happened if the police and the health depart-
ment had had the authority and the will to take action? How
many infections might have been prevented? Multiply that one
experience by the thousands of other similar situations that aren't
solved accidentally by fire or earthquake or other catastrophes and
see what you have.

Then remember this: We are making social protection succeed
on the mainland. And we will keep making it work in a fight to
the finish against venereal disease.

STATEMENT

COLONEL LOUIS EAMiEEZ BEAU
Chief, Insular Police Department, San Juan, Puerto Eico

Law is the sole expression of authority in matters of public interest.
Laws should be just, intelligible, applicable to the place and time of
their promulgation. They should be fearless, honest, and in their
application make no difference as to rank or wealth of person. l

How many of us can praise ourselves in the belief that we are
just? To formulate laws of social hygiene we should go as deep
in the customs of people as it is possible to go, and seek the underlying
causes of immorality.

Much has been said about the principles of morality and ethical
conduct. These principles should be translated to our children by
the church, in the school, in the home, or wherever they may be.
There are too many homes where the important teachings of morality
are neglected. Our social standard in Puerto Rico is the same
as that of any other people on the American Continent. We have
good and bad people. Unfortunately we have a greater number of
poor people than we have wealthy ones. This may be possibly due
to our economic conditions, chiefly caused by the lack of industries.

Despite the impoverished condition of our people we expect them
nevertheless to maintain their homes in such manner as to inculcate
in their children every moral principle. Poverty, though debasing
some, has nevertheless been the soil from which some of our greatest
men have arisen.

To poverty, however, can be ascribed the cause which has led
many a girl, and even whole families, to a life of crime and prostitu-

232 JOURNAL OF SOCIAL HYGIENE

tion. Though these cases may be in a minority, they stand out as
a splinter might from a log of good wood.

It must be obvious that there is a close relation between prostitu-
tion and venereal diseases. Prostitution is an ancient evil, and today,
as in the past, it would be difficult to find a community all of whose
members were in accord in respect to the methods that should be
used to eradicate it.

All decent people and communities, however, will probably agree
that the pimps, panderers, white-slave dealers, and all others who
knowingly share in the earnings of a prostitute are far more
despicable than is the prostitute herself.

What is a prostitute? A prostitute is a woman who practices
indiscriminately lewdness for hire, and makes her living through
this means. A large percentage of prostitutes are in type either
stupid, moronic, or otherwise mentally defective. Many suffer from
venereal disease and are a serious problem and danger to society,
filling our prisons and insane asylums. Upon this point there can
be no question of difference. A prostitute may be broadly classified
as a street- walker, inmate of a disorderly house, or a "call-girl"
who works in connection with appointment houses or houses of
assignation.

At present Puerto Rico has no law by which we can reduce prosti-
tution in our midst, and we are, therefore, powerless. An effective
law should be formulated to control and eradicate prostitution.
With such a law in our statute books, we who are called upon to
enforce laws will have a strong weapon with which to attack this
menace and wipe it out in our communities.

We believe that it is necessary that every girl arrested be sub-
mitted to a physical examination to determine whether she has a
venereal disease or is a carrier of such disease.

In order to execute rationally such a proposed law it will be
necessary to enact certain additional ones to the end that some of
these girls may not only be rehabilitated but educated in a voca-
tion by which they may earn their living. Many are at present ignor-
ant of any means of self support and this lack in many instances has
led to a life of prostitution. We further believe that these cases
should be handled by a special court having special knowledge of
this subject, and working in conjunction with welfare associations
and probationary officers, and others having public interest at heart.

PROCEEDINGS REGIONAL, CONFERENCE 233

GEOUP IV. YOUTH HAS PRIORITY

Chairman : MRS. MAR! A PINTADO DE RAHN, Director, Department of Social
WorTc, University of Puerto Rico.

Discussion Leader: MR. ELOY ESTRADA, President, Insular League of Parent-
Teacher Associations.

Secretary: Miss EAFAELA ESPINO, Executive Secretary, Puerto Rico Committee
on Social Protection.

REMARKS BY CHAIRMAN

This Regional Conference on Social Hygiene offers another oppor-
tunity to bring out in the open and confront a difficult situation,
which is now aggravated by the war and which concerns all of us
deeply. Our common responsibility for the welfare of youth becomes
greater than ever in the light of the increasing threat of venereal
disease, prostitution and their disastrous sequelae.

Youth indeed has the right to be considered — to have priority as
we say in war terminology — in the campaign of civic groups against
the enemies of health, both physical and mental. Young people
should have priority in clearing away difficulties which may keep
their lives from being healthy and happy. There should be no
halfway measures in adjusting the sociological and educational
aspects of family life so that they may guarantee the kind of economic,
mental and emotional security which will permit boys and girls to
develop, under proper guidance and encouragement, socially
acceptable and useful activities.

The speakers on this program on the subject Youth Has Priority
will present facts, points of view and plans for the future in various
aspects of work for the welfare of youth in the Island of Puerto Rico.

THE CHILD IN THE HOME

MISS BEATRIZ LASSALLE
Former Director, Bureau of Social Welfare, Insular Department of Health

It is a well known fact that many different factors can affect,
and do affect, the conduct of the individual. Also it has now been
proved that much of adolescent behaviour as well as that of adults
has roots in the impressions which have been retained from the first
childhood years.

Every child enters the world endowed with certain hereditary
characteristics. How much these are to predominate in his future
life depends a great deal on the daily environment which governs his
infancy, his food, the people around him whom he will soon begin to
imitate; the habits and ideals of his home. State and law can
adopt as many measures as they may wish to achieve their economic
goals for the protection and care of children, but the fact remains
that nothing can make up for the lack or loss of a home in a child's
first years.

234 JOURNAL OF SOCIAL HYGIENE

These facts justify our constant effort to preserve the home intact
when there is one — or to try to substitute for it as may be possible
when through misfortune home life fails or has been destroyed —
and to keep watch, that new homes are started under the best con-
ditions of health, physical and moral, and on sound economic founda-
tions which guarantee the security and strength of the family,
indispensable factors for the best growth and education of the child.

Never, at any time has it been easy to fulfill the duties of parents,
but in the present day it is more than ever difficult and disturbing.

Life in the last twenty-five or thirty years has been characterized
by an amazing tendency towards new things and towards change;
change in the political order, in the economic order, in the social
order ; in educational methods ; in dietary habits ; in fashions of dress,
ways of amusing ourselves, etcetera. Naturally, the home is greatly
affected in its structure and in its function by these continual changes.
Many innovations have been introduced that seem contrary to our
habitual custom of thinking, feeling and living. "The home is in
danger ! " is cried everywhere, and parents, smarting under the impli-
cation that this accusation involves them, react in their turn by
blaming youth of today for lack of affection for the home, refusal to
obey, bad taste in noisy parties (and especially dancing), exaggerated
frankness, and many other things. Parents blame, too, the school,
the teachers, the government, and in fact, everything and everyone
but themselves.

I consider this reaction a very poor defense which needs discus-
sion. Let us look at the situation. Is it not true that parents of
today cannot rightfully confine their responsibility solely to what
happens inside the family group at home? What better thing can
they do — these fathers and mothers — than to concern themselves out-
side the home with all that affects it ? To delegate this responsibility
to the schools, the public health officials, the social service workers,
and rest confident that all is in good hands, would be convenient, no
doubt, but it would hardly be the best way to discharge the duties
which are especially our own as parents. Parents are on duty twenty-
four hours a day. There is no time off for them, because they must be
concerned with anything which may affect the home at any time —
either their own homes or those of their neighbors — f or the relation to
those around us, no matter in what circle we may move, is closer
than one might realize at first thought. To think of shifting parental
responsibility to the government for the guidance and protection of
children and young people, is to take the view that parents, in the
eyes of the government, do not have the same rights as do other
citizens to look after their own affairs.

Let us consider living conditions and economic resources as prin-
cipal factors in the organization of a home and how the lack of
proper conditions brings crisis to the family. A dwelling consisting
of one room which the whole family occupies, no matter what the
number of children nor their ages, is insufficient for human needs as
they exist in our present society. Children living in such conditions

PROCEEDINGS REGIONAL CONFERENCE 235

naturally have to find on the street the privileges and fun which they
are denied at home. Naturally they are out from under the watchful
eye of their mother, who has to care for hex family in that crowded
room, and they easily fall into the evil habits which idleness fosters in
those who indulge in it.

There is now being started among us in Puerto Rico a movement
to improve living conditions of those who have limited economic
resources. We presume that parents as such will give attention to
this vital matter in our changing social order, and will support this
effort by their endorsement and their vigorous action.

We have said that children of these poverty stricken and unwhole-
some dwellings have to play in the streets. What does the street
have to offer them? Where are the recreational parks, the play-
grounds to welcome these little fugitives? Who provides facilities
for these children to play, a need as compelling to them as is that for
food? Not having a place to play is a tragedy for any child. How-
ever, here again our parents have delegated their duty. Play is
organized in the school — they think — under the supervision of well-
trained teachers, and so the child's necessity is supplied. But the
question of finding diversion in the hours out of school, when play is
equally needed, is something different, and it is on the parents that
the blame falls for failure to provide a place.

The Associations of Parents and Teachers have done good work in
furnishing lunches for school children, this plan having become a
permanent and efficient feature of our school system. The PTA could
well undertake a similar campaign in regard to playgrounds in the
various neighborhoods. I am not urging the construction of school
athletic parks, with race tracks and other sport equipment. Although
physical exercise is part of the education of all children, many do
not like strenuous games, nor are they strong enough to partici-
pate in them. I am thinking, rather, of playgrounds, places to while
away leisure hours — to learn leisure pastimes which can be turned to
good account later in the life of the child, in the questions perplexing
the home. What do our future citizens do when they leave the house,
after a meal, or on Saturday when there are no classes. With
whom do they meet? Where do they go? Of what do they talk?
These are questions of great importance to parents. They have come
to call this "the dangerous age" and a period of difficult problems.
They fear the results of the liberty which their children will naturally
acquire as they grow older. If it can be understood that the busi-
ness of learning how to use leisure hours begins much before ado-
lescence— although the word "leisure" could scarcely apply to the
small child — many of the so-called problems of this later stage of
child life would be easily solved.

Adolescence is not a problem by itself, although during this period
sexual manifestations may occur which cause profound worry to par-
ents, especially the mother, and the sexual conduct of the adolescent
often determines his later adjustment to life. But if his intimate
relations with his friends are satisfactory, if he has learned to make

236 JOURNAL OF SOCIAL HYGIENE

good use of his leisure hours, and if he has found wholesome avenues
of escape for his energies and interests, he will not be in great
danger of misusing his sexual impulses. These things ought to be the
object of serious consideration by parents. The best method of educa-
tion is by example, and if the child, big or little, notices that one or
the other of his parents finds more pleasure in recreation outside the
family circle than in their home, or that they seek sensational
amusements, he will be apt to follow his parents' lead.

No one is to be more admired than the parents who can say that
they have the entire confidence of their children, and between whom
true friendliness and camaraderie exist. This valuable fruit ripens
only by careful cultivation, but the trouble which one goes to is very
little compared with the satisfaction received from the results. It is
worth any price if children can learn the benefits to be derived from
knowing how to use their leisure hours wisely.

Someone has said, very sagely, that to learn how to play well
is as valuable as to .learn how to work. And the earlier this is
learned, the better and the easier.

I speak again of the Associations of Parents and Teachers because
I have much faith in them and I know that they are in a position
to exert the influence which circumstances demand. Fortunately
there is no debate between the school and the home as to who has
the responsibility for the education and care of the child of school
age. Parents and teachers know that the work of one group com-
plements that of the other and that close cooperation of both is indis-
pensable to real progress in education. The parents cannot delegate
all their responsibility to the teacher, but neither can they permit
that the teacher alone observes the rules and methods of the school.
It is clear that teachers as specialists should always have the deciding
voice in pedagogical matters, but they should not fail also to listen
to what parents have to say, especially as to preferences regarding
the kind of education which they think their children ought to have.
The meetings between the two groups ought not to consist only of
discussions on the manner in which parents should cooperate in
order that children may better learn their multiplication tables,
or their geography lessons, or how they may be of more help in
the class room. There should be also consideration of how the school
can best serve the community and can develop better future citizens.

Parent Teacher Associations in my opinion have greater respon-
sibility regarding the education of parents than the regular schools
for adults. And the annual PTA programs should include informa-
tive courses and discussions on aspects of child education in which
parents can participate and bring to notice ideas which at times
may escape the attention of the teacher specialist.

At present we have an example before us in Puerto Rico in which
the joint action of parents and teachers has to be put to test.
I refer to the inclusion of religious education in our schools. It
appears that we all are agreed that a knowledge of religion rounds

PROCEEDINGS REGIONAL CONFERENCE 237

out the education of the child, and that a person without religion
of some kind lacks a necessary element of happiness. Good. We
accept this basic principle and it only remains to decide how we
are going to supply this item in our educational system. With no
thought of controversy — we have enough in other matters— I am
going to venture the hope that parents and teachers may discuss
this question calmly and impartially, taking plenty of time, in order
to avoid regret later. Ardent defender as I am of all that affects
the child for good and teaches him to practice the religion that his
parents choose for him, I admit serious doubts as to how the
instructor in the school-room can undertake such teachings. It is
to be hoped however, that the solution of this problem will not take
as long as some others which have for many years claimed public
attention, and in the end have been settled only in regard to questions
of pedagogical nature.

In these and other questions which relate to children there can
be no possible delegation of duty on the part of the parents. It
is necessary for them to act for themselves in order to avoid the
undesirable exercise of undue authority by individuals or groups
which though well intentioned may be far removed from the demo-
cratic ideals to which we all wish to hold.

I trust that I have not discouraged those who have had the kind-
ness and patience to listen to me. In closing, I want to repeat:
That family life should be a harmonious and well-ordered educational
experience. Discussion in the family circle of problems which per-
tain to the home will always throw light on ways of solving them.
For success, firm decision on the part of the parents is needed,
linked with a true sense of responsibility to the community in
which they live and to the country whose citizenship they enjoy.

Miss Lassalle's paper was followed by an excellent discussion of The Child in
School: His Physical Health, by Dr. Dolores Pinero, Director, School Hygiene
Section, Bureau of Maternal and Child Health, Puerto Rico Department of
Health. The Editors regret that the manuscript was not available for inclusion
in the Proceedings.

MENTAL HEALTH FOR OUR CHILDREN

DR. LUiS MANUEL MORALES
Director, Department of Mental Hygiene, University of Puerto Rico

Mental defects constitute a serious public health problem in the
civilized world. Statistics recently compiled in the United States,
for example, show that of each 1,000 adults there are 150 suffering
from some type of mental disease. Ten per cent of all the popula-
tion are said to be at some time of life temporarily or permanently
affected by mental trouble. Since the war, many thousands of boys
have been classified as unfit for military service because they are
victims of mental or nervous diseases, and one-third of all those

238 JOURNAL, OF SOCIAL, HYGIENE

who have been discharged for health reasons from the armed forces
have been because of neuropsychiatric disturbances.

The true extent of this problem in our island is not known. We
are just on the point of trying to measure it by means of a census
that will be made by the Insular Department of Health; but there
is no reason to think that these difficulties are less here than in other
civilized countries. Assuming that such is the case, then it is prob-
able in Puerto Rico today there would be about 200,000 persons
suffering in greater or less degree from mental disorder.

Let us be clear that in speaking here of mental disorders we do not
refer to the condition commonly known as ''insanity." Mental
diseases which prevent the individual from adapting himself to his
social environment in such a way that society or the law dubs him
"crazy," constitute only a small proportion of the ills afflicting
those with personality troubles. In other words, one can be mentally
ill without being "crazy."

From the biosocial point of view there are three levels of adjust-
ment to the rules and customs which govern human relations. These
three levels of social conduct, which are similar to those used by
medicine and its psychiatric branches to classify such types, are
*' normal," "neurotic" and "psychopathic."

The "normal" individual is one whose desires, longings, emotions,
thoughts and conduct in general are compatible with accepted social
standards sanctioned by the group of which this individual forms a
part. Between the normal individual and his surroundings there
are no serious nor prolonged conflicts. The changes to which his
surroundings may be subject do not seriously affect his social adjust-
ment. The conduct of the normal man is considered by his associates
as reasonable, logical and easily understood.

The "neurotic" has not been able to adapt himself well to his
surroundings. His ambitions, his tendencies, his ideas, his emotions
are often incompatible with those which are held by the majority
of people who make up the community in which he lives. This incom-
patibility develops into the mental conflicts which appear in the
form of preoccupation, morbid ideas, chronic fatigue, absurd and
unfounded fears, obsessive thoughts and compulsions. The neurotic
manages to maintain relations partially acceptable with his social
surroundings. He can generally control his behavior to an extent
that will be sufficiently in accord with social conditions. His conduct
may be peculiar, but for the most part it is understandable by
his fellowmen. The neurotic is capable enough of self criticism, and
is also capable of recognizing his own problems, but is unable to
solve them.

The ' ' psychopathic ' ' — the insane, as he is common called — is totally
unable to become adapted to his social group. His conduct is irra-
tional, absurd and incomprehensible when judged by general stand-
ards. Not only is his behavior strange and abnormal, but the insane

PROCEEDINGS REGIONAL, CONFERENCE 239

person is incapable of controlling his actions in order to adjust
them to social norms. The difference between the thoughts, desires,
sentiments, emotions and interests of the psychopathic and the normal
person is such, that the former tries to escape from reality, or to
deny it as accepted by the normal man. This strange form of life,
this imprisonment in the world of fantasy, and this more or less
complete denial of reality, assume such proportions that they cannot
be modified by appealing to reason, nor logic, nor feelings, nor by
persuasion, nor by force.

All types of abnormality are psychological problems, but only
those of the latter group, the psychopathies, and a small proportion
of neurotics, are hospitalized, or isolated in special institutions. The
large majority of those who form the second level of adaptation are
not sufficiently "abnormal" to justify their internment. Therefore
thousands of persons, who, apparently well, live in every civilized
community, endure lives bitter with emotional upsets, morbid ideas,
and a multitude of neurotic symptoms which make them and their
kind very unfortunate.

Mental infirmities are not due to any specific cause. There are
innumerable factors, biological, physiological, constitutional, psycho-
logical and environmental, which enter into the production of morbid
mental reactions. But science proves that many of these are avoid-
able. And when the causative factor cannot be avoided, it is pos-
sible in a great majority of cases to prevent the pathogenic agent
from causing damage by the use of prophylactic measures. The
study of how these maladjustments may be avoided, whether they
are slight or serious, and in whatever level of conduct alienated
from the normal — in that of the neurotic or that of the insane — is
the scientific discipline which is known by the name of mental hygiene.

Mental hygiene is the doctrine which teaches the individual to
cultivate his mental health. Its principles should be applied from
the cradle, and have the maximum of effect when they are inculcated
during infancy and early childhood. It is precisely during these
first years of life that habits of thought, feelings and action are
formed which determine the conduct of the individual for the rest
of his life. And it is then, if one does not proceed wisely, that it
is easy to plant the seeds of an abnormal mentality.

Abnormal mentality in children can be classified, for practical
purposes, as of two types, that is: abnormality of character, and
abnormality of intelligence. The abnormalities of character are seen
in children who exhibit changes of personality and of conduct because
of factors which are not essentially intellectual defects. Abnormali-
ties of intelligence are seen in individuals whose intellectual functions
have not been normally developed.

Abnormalities of character are susceptible to treatment through
specialized techniques which are put in practice in medical-psycho-
logical and psychiatric centers by personnel especially skilled in the
application of these techniques for the orientation of children.

240 JOURNAL OF SOCIAL HYGIENE

Intelligence can be estimated by aptitude and ability tests, and
classified in accordance with standards already established and
accepted by science. Within the ranks of these children with
abnormal intelligence exist three types with different needs, which
require special establishments, that is: (1) hospital establishments
or asylums for children not susceptible to instruction (idiots) and
subject to hygienic care; (2) educational establishments for children
of a slight or medium degree of imbecility, but who can be taught
useful and easy work; and (3) auxiliary schools for the education
of mentally weak children susceptible to a higher education when
it is carried on under special conditions. (Lafora)

In Puerto Kico, children who are suffering from mental abnormali-
ties are, at least, as numerous as in any other civilized country.
This great battalion of unadapted children constitutes a serious
problem which requires solution with great urgency. These thousands
of children, who, today, in the home and in the school, interfere
with discipline and affect the conduct of normal children, tomorrow,
when the damage has become irreparable, will populate the asylums
and jails and fill the psychiatric clinics.

In speaking of mental hygiene for our children there immediately
arise various questions which we must answer in accord with reality.

1. We already know the interest that health, educational and
medical authorities take for the health of our children. We ask :
Are the people of Puerto Rico as much concerned about the mental
health of their children as with bodily health?

2. A hundred and two years ago Dr. Seguin founded in Paris
the first school for abnormalities of the intelligence, indicating rules
which have been followed advantageously in almost all countries of
the civilized world. What measures have been put in practice in
this Island for the protection and education of our thousands of
children with abnormal intelligence?

3. More than a quarter of a century ago "Child Guidance Clinics"
were functioning with great success on the continent. They are
community mental hygiene centers where personnel well adapted
for this work take care of problems of child behavior; and educate
children and adults of the community to cultivate healthy habits
of thought, feeling and action. What has been done in Puerto Rico
comparable to the indispensable service given by these clinics? If
there is any service of this nature in the island ; is it efficient ? is it
well organized? is it equipped with sufficient capable personnel,
who have the skill and experience required to assume the respon-
sibility for such delicate work? How many of the thousands of
children throughout the island who need these services can be
taken care of?

In this audience there are those who can answer these questions,
because there are persons who for many years have been much inter-
ested in finding the solution to these problems. But I fear that

PROCEEDINGS REGIONAL CONFERENCE 241

the answers will not make us feel very proud of the help we are
offering to our children in regard to their mental health. And as
long as effective and efficient measures are not taken in order to
be able to answer these questions satisfactorily, mental infirmities
will continue to make havoc among our people.

Puerto Rico's only hope of salvation depends on the education
wrhich is given our children. Education is also the most powerful
instrument for cultivating mental health. Let us not overlook this
essential factor on which the future of our country depends in
great measure.

SOME WAYS OUT

MISS CELESTINA ZALDUONDO
Director, Division of Public Welfare, Insular Department of Health

The solution of a problem should be in accordance with its cause.
Delinquency — in this case sexual delinquency, which is of special
interest to us now in the war emergency because of its influence in
the spread of venereal infections — is not the product of any single
factor. Our observations in this field lead us to believe that in the
greater number of cases a complex situation is found, where diverse
factors producing antisocial conduct are brought into play.

Economic privations alone do not cause prostitution. There are
many poor girls who earn a living by other means. Neither are
lack of affection and understanding on the part of parents and bad
examples in the home the sole cause of prostitution. We all know
girls, rejected and misunderstood by their parents, and girls with
parents of dissolute habits, who have yet set for themselves patterns
of conduct acceptable to society. Lack of recreational facilities
does not make a girl a prostitute. We. know of thousands of girls
who live all their lives in communities without amusement facilities,
and who nevertheless do not transgress. Not even lack of religion,
alone, takes them into prostitution.

But when these and other causes, which singly may not produce
delinquency, are combined and exert influence on the same subject,
the result is almost always a new carrier of venereal diseases.

What can be done, then, about this problem? The prevention of
prostitution, as we have seen from the facts which I have mentioned,
is far from being an easy thing — and the evil is so intimately linked
with the whole grave situation in our Island, at least in respect to
some of the elements which cause it, that the prospect for the next
few years is ominous.

All measures taken to > increase and insure earnings in Puerto
Eican homes by increasing opportunities for employment and more
adequate remuneration for it, as well as social security and public
assistance when such provision is lacking, will lessen somewhat the
attraction of prostitution for our young girls. In almost all of

242 JOURNAL OF SOCIAL, HYGIENE

the studies which have been made in the Island, the most powerful
factor among those which combine to cause sexual delinquency,
is that of economic privations. Insufficient earnings have close
relationship with deficiencies in lodgings. Crowded living conditions
and forced proximity to neighbors of dubious character sometimes
hinder normal development of our youth. The government projects
now planned for reclaiming ground in order to eliminate the slums
and the construction of sanitary living quarters at low cost should
be supported by all those who are interested in checking the menace
of prostitution.

The crowding which prevails in the life of the poor permits
children to be familiar with the sexual act from a very early age,
and consequently it seems a common thing to them. At the same
time, since they learn about such matters in this precocious way,
they lack sufficient intellectual and emotional maturity to under-
stand the results of misuse of sex instinct, or to prevent them,
in the case of girls, from entering prostitution, in case they do not
meet men with whom they can marry and set up homes.

As a means of solving the economic problems of poor families,
young girls start to work as domestic servants at a very early age.
Scarcely any of them reach the fourth grade in school. This lack
of academic and vocational training of course leaves these girls
a very limited choice of occupations, and so they have to turn to
poorly paid domestic service. Long working hours, low wages, and
the sort of semi-slavery into which domestic service on our island
has grown, lends little attraction to this means of livelihood. It
cannot compare with the financial profit and personal freedom
enjoyed by the majority of prostitutes in Puerto Rico.

In order to prevent the continuation of this situation, and to
keep girls from going into prostitution to make money, it is necessary
to increase the number of academic and vocational schools, and
to enforce the law compelling attendance at school — which is now
a dead statute. In addition, ways of officially regulating domestic
work should be investigated, and higher wages and better working
conditions should be demanded for the aid of domestic servants.

The education of parents regarding the basic needs of their
children will do much toward preventing unhappiness and rest-
lessness among children who are brought up in homes where they
do not receive affection or where discipline is at times too lax and
at others, too strict, so that they do not want to remain at home,
and run away, taking the first step down towards a life of prostitu-
tion. When parents are not interested in their children 's welfare, their
companions, and what they are thinking and seeing, a barrier is
established between the two generations and when the home does not
provide what the children want, they turn somewhere else, which
may have very bad consequences.

The provision of recreational facilities, that children in their
leisure hours may have healthy fun under good supervision, should

PROCEEDINGS REGIONAL CONFERENCE 243

not be further postponed in Puerto Rico. All those who are inter-
ested in preventing prostitution should support the efforts of the
Commission on Recreation and Sports and spur it on so that the
necessary facilities may be established in all communities, including
the rural sections. When we speak of recreational facilities we
do not mean merely parks for athletic games, but community centers
which offer various activities of interest to youth and where they
may find fun which today is only found in bars and night clubs —
which very often open the way to prostitution.

When one has acquired a true concept of religion, it helps to
guide and control conduct. It is very important that the churches
work with the schools and with civic and religious organizations
in fulfilling their mission of developing a deep and genuine Chris-
tianity, so that not even the lure of more money or other material
things can cause our youth to turn away from right living.

This religious influence ought to penetrate into the heart of our
homes. A home of loose habits, in which the mother changes marital
partners frequently, cannot help impressing on young people the
idea that life is only as she shows it to be, and the worst thing
about this is that though there may be outside influences which
exercise better influences on these youth, it will be this home situation
which will largely determine his conduct.

If we try to help a child when we first notice symptoms of unde-
sirable conduct, and arrange for psychological-social study, which
will throw light on the different factors which may lie behind such
actions, it is quite possible that we can, by applying necessary
measures, halt the development of a new recruit to prostitution.
The child guidance clinics for whose establishment we have been
laboring for a long time are a valuable aid in the prevention of
juvenile delinquency.

Child welfare services are also an essential part of a program
to prevent prostitution. Social workers can help to guide parents
toward more intelligent attitudes. Sometimes parents do not under-
stand their children, and their failure to do so lays the foundation
for openly antisocial developments in children's attitudes. On the
other hand, there are children who, not understanding the circum-
stances of their parents, make unreasonable demands on them and
are rebellious and protesting at the same time, representing problems
of conduct which in the case of girls often leads to prostitution.
The opportune aid of well-trained social workers can help to remedy
situations such as these.

On occasion it is necessary to take a child away from home, some-
times temporarily, and in other cases, permanently. When because
of inadequate or faulty surroundings, especially because of immo-
rality of the parents, it is necessary to 'do this, the social worker
must look for another home for the girl where she can have a normal
life. When a girl's behaviour begins to present conduct problems,
a social worker can help much in guiding her and supervising her

244 JOURNAL, OF SOCIAL, HYGIENE

in a suitable home, or possibly by finding another better suited,
or even placing her in the right kind of institution.

Before closing, I wish to say, in agreement with Mr. J. Edgar
Hoover, of the Federal Bureau of Investigation, that the problem
of juvenile delinquency is really that of adult delinquency, and
not delinquency of the children. In all the situations that we have
seen here the cause as much as the remedy is in the hands of
adults, both as individuals, and as a collective group. It is no
less than our duty then to give our young people opportunity for
decent and happy lives. Happy children are not candidates for
delinquency.

YOUTH IN CRISIS: NEW HORIZONS FOR OUR GIRLS IN TROUBLE

A Study of a Group of Adolescent Girls Interned in Venereal
Disease Hospitals in Caguas, Puerto Rico

MRS. DOLOKES G. DE LA CARD
Chief, Bureau of Medical-Social Services, Insular Department of Health

I am glad to present before this group, which has come together
today to discuss social hygiene from the point of view of our youthful
population, a study of a group of adolescent girls interned in
venereal disease hospitals in Puerto Rico. It is the intention to
present the results of this study, in the light of figures appli-
cable to our total population of adolescent girls, so that the prob-
lems confronting not only this group but also our society may be
considered.

I must state that this study is not the first regarding this prob-
lem which has been undertaken in Puerto Rico. Among several
others I will cite the one made by Judge A. Alvarado in Arecibo
in 1935, one undertaken by the Social Service Office of Cr^ian
Defense, and another by Dr. Maria Cristina Barreras and Miss
Celestina Zalduondo.

The Division of Medical-Social Services of the Insular Health
Department made this study for the purpose of determining social
characteristics and personal problems of patients who are minors.
Only girls 18 years of age or under were included. This study
is part of another more inclusive one of all patients in those hos-
pitals (a total of approximately 300) which the Division of Medical-
Social Services made at the request of the Puerto Rico Committee
on Social Protection, with the object of obtaining information to
serve as a base for planning and developing a program of social
rehabilitation for this group.

The Division of Medical-Social Services desires publicly to thank
the Office of Community War Services of the Federal Security
Agency for its valuable cooperation in this work, and to acknowledge

A Game • San Jose Plaza • San Juan

YOUNG AMERICAN CITIZENS

Students • Central High School • San Juan

Photograph from Puerto Rico Trade Council

AT A MILK STATION

the background, Mrs. Rexford G. Tugwell, who has been active in securing the establishment and provision of these

stations throughout the Island.

Photograph from Insular Department of Public Information

After Sunday School • San Jose Church • San Juan

Newsboy

Sentry-Box • City Wall • San Juan

At the University
Waterfall . El Yunque

Gate • The Arsenal • San Juan

Outside Sixto Escobar Baseball Park • San Juan

Plaza at Ponce

Entrance • University of Puerto • Rio Piedras

Arsenal Patio . U. S. P. H. S. Office in Background

USO • San Juan

The Tree " • Townsend Square • San Juan

Library • University

Cristofer de Colon Plaza • San Juan

Archway • School of Tropical Medicine
Plaza • Humacao

Sifills: Grave Pellgro a la
Fortaleza Nacional

Recomeiidara dos pro

cto

ILU5TRHDO

1

I'R I f'ni'ct'ttf Dixptinc Partey

COOPERATION FROM THE PUERTO RICAN PRESS

A selection from the newspaper and magazine publicity which was generously

accorded by both Spanish and American press, and which helped greatly to increase

public knowledge of social hygiene.

PROCEEDINGS REGIONAL CONFERENCE 245

gratefully the interest and earnest participation of Miss Francisea
Bon and Miss Gracia Nadal, Supervisors of Medical-Social Work.

The time at our disposal for the presentation of this work being
short, we have tried to summarize as much as possible the results
of the study, giving only the outstanding points.

Following are the most common characteristics found in the group :

The 105 patients included in the study are girls from 14 to 18
years old, although the majority fall in the 18-year group. Fourteen
of these girls claim they are not prostitutes. (For purposes of this
study we must consider a prostitute as a woman who devotes her-
self to sexual commerce.)

More than half of the group are white girls and 70 per cent of
them single. By "single" we mean that they have never been
legally married.

It was found that before entering the hospital practically all
the patients lived in the* urban zone or in places very near military
posts. A third of the group lived in houses of prostitution, and
the remainder lived with their families, in rented houses, or boarding
houses.

Information obtained from the medical records of the hospitals
shows that the great majority of patients suffer from gonorrhea
and about a third from syphilis. It was found that more than
a fourth of the group was suffering from more than one venereal
disease.

We find that only a minority of these girls lived with both parents
during their childhood and adolescence, and the great majority
came from homes where one or both parents were missing.

According to their own statements economic conditions in their
homes were very bad, in a large percentage of the group. Four-fifths
of the group reported the existence of serious social problems in
the family. The most frequent were drunkenness and desertion.
Among other problems reported were promiscuity, delinquency and
dependence, as the most important.

In general it was found that the education of these girls was
very limited, the majority having had no more than third grade
schooling. Only 25#per cent said that they had had any vocational
instruction, principally sewing or embroidery.

Four-fifths of the group stated that they had worked before
they became prostitutes, most of them in domestic service. The scale
of wages for this work varied from those who worked for board and
clothes only to those who earned $7.00 weekly doing other work.
Three-quarters earned only $2.00 a week. Perhaps due to lack
of opportunities for employment, and lack of knowledge of other
kinds of work, the great majority showed a preference for poorly

246 JOURNAL, OF SOCIAL, HYGIENE

paid work, such as domestic service and sewing, when questioned
regarding a choice of possible future occupations. This shows the
great necessity for vocational orientation, which will help them
to a better selection of occupations according to their individual
limitations.

The average age in this group for the first sexual experience was
15 years; although a sixth reported having had sexual relations
before 14 years. In half of the cases this occurred through seduction
and in more than a third by rape.

Ten per cent of the group said they had been initiated in prosti-
tion before the 15th year. Thirty per cent had entered this life •
at 17 years of age. Half of these girls had been in prostitution
about a year. Analyzing the reasons inducing them to enter this
life, we find that the influence of friends (especially girl friends),
the attitude of their families and other persons, was as decisive as
economic reasons. A third said they had entered the life in search
of diversion and adventure. Once started in prostitution, the influ-
ence of owners of houses of prostitution is 'an important factor for
their continuance. Sixty-nine per cent said that the money they
obtained was the principal reason for continuing in prostitution.

The gre#t majority of these girls frequent bars in search of
clients. Another group found their clientele in houses of prosti-
tution. Of the group who solicit in bars, almost all have their
sexual contacts in hotels nearby or in the building where the bar
is located.

The fact that members of the Armed Forces constitute three-
quarters of these girls' clients is evident proof of the great influence
the War has had in the increase in prostitution in Puerto Rico.

Half of these young girls, on being asked about their plans,
expressed their intention of returning to prostitution after leaving
the hospital, in spite of the fact that many of them expressed disgust
for this kind of life and fear of the risks it would bring to them.
More than a third intend to give up prostitution, and it is this
group which is most in need of our help to carry out their plans.

A large majority of the group have committed other offenses,
although only a third have been in jail. The most common offenses
in the group have been assault and battery and disturbance of the
peace.

The average weekly earnings from prostitution among this group
is $25 although 5 per cent claim that they earn more than $100
a week. A fourth of the group received more than $50 weekly. It
should be noted that there is a tendency on the part of these young
girls to exaggerate slightly their earnings, in order to justify this
kind of life. And while the majority state that they do not
make direct payments in money to the owners of the houses of
prostitution they frequent, they do pay them indirectly by exorbitant
prices for meals and other accommodations which are provided in the
houses where they live.

PROCEEDINGS REGIONAL CONFERENCE 247

Medical-social workers who conducted the interviews expressed
case by case their impressions about the possibilities of rehabilitation
of these patients, basing their opinion on such factors as age, edu-
cation, working experience, time spent in prostitution, and attitude
toward this kind of life. The 14 patients who claimed they were
not prostitutes were included among the possibilities for rehabili-
tation, considering that many of them were equally in need of
orientation as regards vocational rehabilitation.

The possibilities for rehabilitation of 45 per cent of the group
were considered as excellent, good, or unnecessary. Only 27 per cent
of the group was considered as presenting apparently little or no
opportunity for rehabilitation. The possibilities for rehabilitation
of the other 30 percent were considered fairly good.

i Folio wing we give some examples of cases and their respective
classifications: The reaction of the patient to her mode of living
and the impression of the social worker about possibilities of social
rehabilitation have been copied exactly from model forms used in
the study.

1. Example of a few with whom it is believed rehabilitation worlc will not "be
necessary :

"The patient is 16 years old and studied up to the fifth grade in elementary
school. She is married and lives with her husband. She came to the hospital
from the Public Health Unit, where she went for medical treatment for a
gonococcal infection.

2. Example of a case whose possibilities for rehabilitation are considered

excellent :

' ' The patient is 17 years old. She studied up to the eighth grade of elementary
school and also had training as a nurse 's aide. She has been in prostitution for a
year, obtaining average of $20 weekly."

Reaction of the patient to her mode of living:

"The patient says that she does not wish to continue in prostitution. Her
desire is to get work as a nurse's aide in a hospital, but not in a venereal
disease hospital, because there she would not be allowed to go out to shop or to
visit her mother."

Impression of the social worlcer:

"Very good possibilities for rehabilitation. The patient wants to work and to
quit prostitution. Apparently she feels great affection for her mother."

3. Example of a case whose possibilities for rehabilitation are considered good:

"A girl 16 years old, with second grade elementary school education, witH
knowledge of hand embroidery. She has been in prostitution six months and
earned $50 a week."

Reaction of the patient to her mode of living:

"She intends to quit prostitution. She is ashamed to carry on this kind of
life. She now lives with her grandmother whom she supports. She plans to
look for work as soon as she leaves the hospital."

Impression of the social worlcer:

"The patient says that she is not now in prostitution. Apparently she is
sincere. She is an attractive and congenial young girl. She gives the impression
of being weary and ashamed."

248 JOURNAL OF SOCIAL HYGIENE

4. Example of a case whose possibilities for rehabilitation are considered fairly
good :

"This one is a patient 14 years old. She reached the eighth grade and has
some knowledge of dressmaking. She has been in prostitution six months and
has an average earning of $100 weekly in this activity."

"The patient stated that she liked the adventure of this kind of life. She
plans to return to another house of prostitution. She does not want to return to
'Castle Inn,' because from there girls are very often sent to the venereal
disease hospital."

Impression of the social worker:

"The patient is almost a child. She has been in prostitution but a short
time, but since she has started on this life she has been hospitalized several
times. Her family want to have her at home, but she likes to enjoy herself and
cannot do so at home. She needs orientation and guidance. Apparently she has
possibilities for rehabilitation."

5. Example of a case whose possibilities for rehabilitation are practically nil:

Age: 16 years.

Education: Fifth grade elementary school. Never has worked.

Period of time in prostitution: 1 year..

Earnings obtained in prostitution: $75 a week.

Eeaction of the patient to this kind of life: She is well satisfied with her present

manner of living.

Impression of the social worJcer:

' ' The patient is not interested in any work or in quitting prostitution. Appar-
ently there are no possibilities for rehabilitation in this case."

So we present here briefly to you a resume of the results of this
study, bringing to your attention the problem which prostitution
presents for Puerto Rico, especially in this group of minors and
adolescents. It is urgent that preventive measures be taken, in
order to prevent the entrance day after day of more young girls into
prostitution, which constitutes a menace to the moral and physical
health of our youth.

This is not the responsibility of any agency in particular, but of
all the groups and private or public agencies interested in public
welfare. The facts obtained from this study prove that a large
proportion of these girls are in a favorable condition for possible
rehabilitation, and that a coordinated program of services could
save them. The venereal disease hospitals have already made pro-
visions for a program of recreation and vocational orientation in the
hospital, but this is not sufficient. The period of hospitalization of
these patients is generally much too short to assure their permanent
social rehabilitation. We believe that it is the responsibility of the
community to continue this work.

It is now, in war time, that we must assemble all our forces and
mobilize all our available resources to protect our youth in time of
crisis.

We should like to instill in your minds today the optimism which
animates us as social workers toward a possible solution of this
great social problem, and we should like to inspire the necessary

PROCEEDINGS REGIONAL CONFERENCE 249

action in order that our ''youth in crisis" may very soon be able
to look toward new horizons where they will find more security,
protection and happiness.

GENERAL SESSION

Presiding: DR. FERNOS ISERKT

Reports of Group Chairmen or Secretaries

%

Resolutions

(For general resolutions growing out of the Conference, as presented by the
Resolutions Committee appointed by the Conference Chairman, please see pages
264r-266. Resolutions drawn up by the Group Sessions were embodied in
the general resolutions.)

Conference Summary

Dr. Snow gave a quick review of some of the highlights of the
day's events, congratulated the Conference Committee on their suc-
cess, and urged all present to attend the evening session to be held
at 8 :30 at the Central High School.

He also mentioned the Executive Session of the Conference to
be held next day, as the closing event, which provided oppor-
tunity for those concerned with venereal disease control in the
Caribbean Area to report current progress and to discuss further
plans for continued joint effort.

250 JOURNAL, OF SOCIAL HYGIENE

Evening Session — Central High School Auditorium

THE NATIONS UNITE FOR VICTORY OVER
VENEREAL DISEASE

Presiding: DR. CARLOS E. MUNOZ MACCORMICK, President, Puerto Eico Medical
Association

REMARKS BY THE CHAIRMAN

Distinguished Guests; Ladies and Gentlemen: The Puerto Rico
Medical Association rejoices at the success and accomplishments of
this Regional Conference on Social Hygiene, for two main reasons :
in the first place, for approximately half a century, members of our
profession in cooperation with prominent citizens interested in the
sociological aspects of venereal diseases have been working in the
control and eradication of this social burden. A united effort of all
agencies concerned, under proper leadership, as it has prevailed
throughout this conference, constitutes a decisive movement toward
the achievement of our final goal. Secondly, the interchange of ideas
under our auspices, between outstanding members of our profession
from various parts of the country and from Latin-American repub-
lics, is one of the basic and fundamental policies in the program of
our Association.

Thus, it is to me extremely gratifying, both personally and in my
official capacity as president of the Puerto Rico Medical Society, to
have been honored with the request to preside at this evening session
and to enjoy the unique privilege of presenting to you our distin-
guished guests tonight.

Let this be the cornerstone for a sound firm foundation of friend-
ship and understanding between the medical and allied professions of
your respective countries and ours. Let us all join together in making
the best use of the geographical, racial, social and cultural char-
acteristics of our beloved Island of Puerto Rico in behalf of an
indissoluble everlasting solidarity in the Western Hemisphere.

An impressive feature of the Evening Session was the award of Honorary
Life Memberships in the American Social Hygiene Association to DR. A. FERNOS
ISERN of Puerto Eico and DR. ENRIQUE VILLELA of Mexico, as reported in detail
in the March JOURNAL OF SOCIAL HYGIENE. The citations were made by SURGEON
GENERAL PARRAN, acting as Chairman of the ASHA Committee on Awards, and
were presented to the audience in printed form, with photographs of the recipients,
both of whom made appreciative and eloquent responses.

The evening program also included two intervals of music which added much
to the enjoyment of the occasion. Through the kindness of MAJOR GENERAL
WILLIAM E. SHEDD, Commanding Officer for the IT. S. Army, Antilles Depart-
ment, an Army Band rendered a half-hour concert previous to the addresses,
and midway in the program the University of Puerto Rico Chorus of forty
voices, under tne direction of MR. AUGUSTO EODRIGUEZ, and by permission of
CHANCELLOR JAIME BENITEZ, sang a number of selections.

PROCEEDINGS REGIONAL CONFERENCE 251

A HEALTH TASK FOR TODAY — AND TOMORROW

THOMAS PARRAN, M.D.
Surgeon General, U. S. Public Health Service, Washington, D. C.

During the past week, I have enjoyed for the first time Puerto
Rico's gracious hospitality and natural beauties. In these lovely
surroundings, the good company, and the salubrious climate I have
been far removed from the serious purpose which brings us together
this evening.

There is a shadow on this island — the same shadow which has
only just begun to lift across the length and breadth of the main-
land. The task which the Puerto Rico Conference on Social Hygiene
has been discussing today is a heavy one. Indeed, the all-out fight
against the venereal diseases is of fairly recent origin in the Western
Hemisphere. But you are not alone in your determination to rid
the people of Puerto Rico of these most destructive and pestilent
diseases. The campaign against syphilis and gonorrhea is being
waged in every State; and, as in Puerto Rico, it is being waged
with the full support of the medical profession, the health authorities,
and the Government of the United States. Today, we look forward
with assurance to the not far distant time when our entire nation
will be free from the venereal diseases.

Evolution of Venereal Disease Control

A few short years ago we could not entertain the hope I have just
expressed. In fact, it is well to remember that all of our weapons
against syphilis and gonorrhea have been forged within the lifetime
of most of us. Forty years ago we did not know the cause of syphilis ;
we had no means to secure an accurate diagnosis; and we had no
cure. Our weapons against gonorrhea are even more recent.

The ravages of syphilis among our troops in World War I, and
the costly aftermath, showed the health forces that the Nation faced
a continuing danger. With limited funds and grim determination,
the U. S. Public Health Service fifteen years ago began the search
for better weapons of control that could be applied to the total
population. A Cooperative Clinical Group — specialists in the then
newer knowledge of syphilis — was formed to assist in forging these
weapons. In five great university clinics, careful records of every
case of syphilis were kept for a period of eight years. Outstanding
specialists studied these records, comprising 75,000 cases, and together
they outlined for private physicians and public health clinics the
best available systems of treatment for syphilis in all of its protean
manifestations.

In the meantime, the Public Health Service and the American

252 JOURNAL OP SOCIAL HYGIENE

Society of Clinical Pathologists sought the answer to another impor-
tant question: What is the adequate diagnostic test for syphilis?
More than a dozen types of serologic tests were evaluated — tests
which had been developed since 1906 by Wassermann, Kahn, and
others. Standards were set for the performance of tests in State,
municipal, and commercial laboratories. Yearly appraisals since
1937, plus Federal financial aid, have brought up the standard of
performance in public laboratories so that today reliable blood
tests and spinal fluid tests for syphilis, and culture tests for
gonorrhea can be obtained in every State and territory.

While these improved methods for diagnosis and treatment were
in the making, we had not overlooked the necessity for intelligence
of the enemy's strength. Estimates of the prevalence of syphilis
and the attack rate, made in the early 1930 's, indicated that in
the course of his lifetime, one in every 10 Americans would acquire
syphilis. No age, race, no class was spared. The cruel loss of
infant life among the offspring of syphilitic mothers was revealed.
The high rates of infection among young males showed further the
need for prevention and control. By 1940, the risk had dropped
to one in sixteen.

In 1936, the time seemed propitious to launch a new public educa-
tional program against syphilis, for by then we had good weapons and
sufficient knowledge to invite the people to join in the fight for their
own lives and health. (At that time, we had no effective means for
the control of gonorrhea. ) The Public Health Service and the Ameri-
can Social Hygiene Association took the leadership in this campaign.
Throughout the country, among the rank and file of our people, there
rose a determination to stamp out syphilis.

Our strategy was simple in 1936. It was the same as it is today.
Find the cases of syphilis — by tracing down sources of infection and
by mass blood testing (with special attention to pregnant women,
applicants for marriage licenses, and youth groups). Second, treat
the cases, especially those in the early infectious stages. Third, reduce
exposure to infection through education in clean living (moral
prophylaxis) and through eradicating the worst foci of disease —
organized vice.

It is the fortuitous and unique feature of the anti-syphilitic drugs
that the infectious patient can be rendered non-infectious while he is
under treatment and long before his disease is cured. Thus, we can
set up a chemical quarantine which breaks the chain of infection. It
was with this strategy, plus stringent laws penalizing the transmission
of syphilis, that the Scandinavian countries, in 1935, before our new
campaign started, reduced their annual syphilis rate to about 0.2 per
1,000 population, as compared to an estimated 3.3 per 1,000 in the
United States. In other words, we had more than ten times as much
syphilis as Norway, Sweden, and Denmark.

The cost of mass blood testing and treatment was far beyond the
budgets of State and local health departments. But a start was made

PROCEEDINGS REGIONAL CONFERENCE 253

in 1936 with Federal funds provided through Title VI of the Social
Security Act. Two years later the Federal Government assumed a
direct share of responsibility for the conquest of syphilis and gonor-
rhea in the passage by the Congress of the National Venereal Disease
Control Act, assuring financial and technical aid to the health authori-
ties until we shall have rid the Nation of these plagues. Each year
since 1939, the Congress has appropriated to the Public Health
Service increasing amounts for this national campaign. The funds
provided for the six years 1939—1944 inclusive total 45 million, 430
thousand dollars. The 1944 appropriation, largest of all, was 12
million, 367 thousand dollars.

Puerto Rico has shared in the distribution of Federal venereal
disease control funds. An increased allotment has been made each
year. The total for the six years 1939 to 1944, is one million, 110
thousand dollars. The allotment to Puerto Rico for 1944 is $383,000,
of which $118,400 is specifically for war emergency control of the
venereal diseases. Added to this are funds for an Island-wide system
of rapid treatment.

In increasing substantially the appropriations for venereal disease
control during the present war, the Congress has recognized an his-
torical truth. War and venereal disease have marched together
through the ages. The psychology of war breeds disruption of nor-
mal controls; military and industrial expansion sets in motion great
masses of people — who take with them and spread their venereal infec-
tions. Traditionally, troops are followed by prostitutes and by men
who organize and profit by this traffic in human flesh.

This war has been no exception to historical experience, and Puerto
Rico has suffered these new threats no less than the States, especially
our Southern States, in many of which the war-spread of venereal
infection was superimposed upon high peace-time rates and low-
powered programs of control.

The performance of routine blood tests for syphilis begun in 1940
in connection with Selective Service proved to be of great importance
in locating most all of the hidden syphilis among 15 million of our
young men, and in bringing under treatment those found to be
infected. Examination of the first two million men revealed the
presence of syphilis in 45 selectees and volunteers per 1,000. For
the entire male population between 21 and 35 years of age, the
adjusted rate is 48 per 1,000 — (24 per 1,000 among white males, and
among Negroes, 272).

The highest combined rates were found in five Southern States, all
of which had rates of 100 or more per 1,000. It is significant that
the syphilis rates in these States were about ten times as high as in
New Hampshire, North Dakota, Wisconsin, Vermont, Utah, and Min-
nesota, where vigorous control programs have been in effect many
years. Recent estimates based on Selective Service findings show
that Puerto Rico's prevalence rate among young males is 120 per
1,000 — somewhat higher than Florida, Georgia, Louisiana, Mississippi,
and South Carolina, the States with the highest rate on the mainland.

254 JOURNAL. OF SOCIAL HYGIENE

Special War Problems and Mobilization

War forced our attention upon an essential phase of venereal disease
control — namely, the breaking up of organized prostitution. Sup-
ported by the May Act which makes prostitution a Federal offense
in military areas designated by the Army or the Navy, the police and
courts in some 500 United States communities have attacked com-
mercialized vice forthrightly. Many States — seven in 1943 — have
revised their laws dealing with prostitution; 29 now have adequate
anti-vice legislation. The Social Protection Division organized in the
Office of Community War Services has exercised fine leadership in
bringing State and local governments to the vigorous enforcement of
laws against prostitution. In this we have had the backing of the
Federal Bureau of Investigation and strong support from the Army
and the Navy. As a result, surveys made by the American Social
Hygiene Association in critical areas show that commercialized vice
has been greatly reduced; in many communities where brothels for-
merly flourished, prostitution as an organized business no longer
exists.

Finally, in the midst of war, science has brought us new weapons
which are being tried and proved in our intensified attack on syphilis
and gonorrhea. About four years ago, we began to study the value
of several new methods for the intensive treatment of syphilis.
Developed by American clinicians, these methods greatly shorten the
length of time required for cure. Continued research has also proved
that the sulfonamide drugs — notably sulfathiazole and sulfadiazine —
are a safe, quick, and effective cure for the majority of gonorrhea
cases. Even more recently — within the past six months in fact — we
discovered that penicillin is even more effective in the cure of gonor-
rhea. And, as though in answer to the world 's greatest medical need,
research still in the experimental stage indicates that penicillin may
be the magic cure for syphilis — safer, swifter, and more effective than
the arsenicals.

The Results of the Campaign

What have been the results of these years of planning and hard
work in the venereal disease control campaign? Perhaps the best
answer is found in the simple statement: "Since the outbreak of
war there has been no overall increase in venereal infection on the
mainland." This reverses all previous records of any nation at war.
Dr. Ray Lyman Wilbur, President of the American Social Hygiene
Association, said to me a few months ago : ' ' How fortunate it is that
we were geared up to deal with the venereal diseases before the war
started. Without that backlog of organized control and increased
treatment facilities, venereal diseases would have become epidemic
under the pressure of war." Word comes from across the seas that
in countries where control had not been strong, or where war had
wiped out control work, syphilis and gonorrhea are again rampant.
Yes, we have held the line so far. The real victory will be when we
can say : ' ' We have turned the tables ; the trend of venereal infection
is downward."

PROCEEDINGS REGIONAL CONFERENCE 255

Some of the figures recording progress in the past few years are
impressive. Annual Federal appropriations have increased since 1940
by 1,127 per cent; State and local appropriations by 24 per cent.
The number of venereal disease clinics in 1936 was barely 700 ; at the
close of 1943, more than 3,700 were in operation — an increase of 428
per cent. In Puerto Rico, the number increased from 13 in 1939 to
47 in 1943. Annual blood tests for syphilis — some 31 million last
year — increased by 200 per cent between 1940 and 1943. The distri-
bution of anti-syphilitic drugs by State health departments increased
50 per cent in the same period.

Twenty per cent more cases of syphilis were reported to State
Health departments and 26 per cent more patients were admitted to
clinics in 1943 than in 1942. Present indications are that these
increases reflect intensified case-finding more than an actual increase
in the number of infections.

Civilians with gonorrhea are seeking treatment from physicians and
clinics in far greater numbers than in the past. Without adequate
means for appraising the prevalence of gonorrhea, it is safe to say
that each year three to five times as many people acquire this infec-
tion as acquire syphilis. Since the advent of the sulfa drugs as a
means of mass control, annual clinic admissions for treatment of
gonorrhea have doubled.

The policy of the War and Navy Departments from the outset has
been to cooperate with the Public Health Service and the civilian
authorities in the control of venereal infection, including the repres-
sion of prostitution. On the mainland, we have had the fullest
cooperation from Army Service Commands and Naval Districts. The
military authorities realize that alone they cannot control venereal
disease among their personnel ; vigorous measures in the civilian popu-
lation also are essential. In fact, cooperative studies by Army
Service Commands on the mainland and the Public Health Service
indicate that "reduction in infection rates among military personnel
reflects parallel increases in case-finding, treatment, and repression of
prostitution among civilians in communities adjacent to army camps.

The Problem in Puerto Rico

Puerto Rico's venereal problem parallels in many respects the situ-
ation in some of our Southern States. Poverty and disease are inter-
dependent. Together, they foster public ignorance of the causes and
prevention of venereal infection. Here, too, living conditions in a
densely populated area favor the spread of disease. Here, too, as in
our Southern States, the home front problem has been aggravated by
war — specifically by the presence of large military forces ; forces from
a distance; forces not in combat. Each of these factors contributes
to the spread of venereal disease.

Puerto Rico, too, has experienced a shortage of physicians as have
other war areas on the mainland. The available doctors have been
under pressure to take care of emergency illness. They have had less
time to devote to the less visible urgency of venereal disease control.

256 JOURNAL. OP SOCIAL HYGIENE

In addition, Puerto Rico has inherited the Latin tradition of tolerat-
ing commercialized prostitution — a policy which every medical
investigation has proved to be a deterrent to the control of venereal
diseases.

We do not have sufficient knowledge of the prevalence and incidence
of venereal infection in Puerto Rico, but the estimates based on
Selective Service tests as well as objective circumstances indicate as
I have said that the syphilis rate probably exceeds that in the most
heavily infected Southern States.

A high rate should not be a discouragement, however; for it is a
principle of disease control that a greater reduction in total cases and
a greater percentage reduction can be accomplished by determined
effort against a highly prevalent disease than when cases are scarce.
In other words, the first 75 per cent reduction is the easiest. This
has been shown in the sharp decline of typhoid fever and infant
mortality during the early years of the public health attack in the
United States, followed by a leveling off and retarding of the rate of
decline in later years when methods of control were actually better.

A Program for Puerto Rico

No physician can make a diagnosis and prescribe treatment for a
patient without having all the facts in his possession and without
making a thorough examination. So it is impossible for me, a
stranger in Puerto Rico, to come in from the outside and in a few
short days prescribe a program for ridding the Island of venereal
diseases.

You are fortunate indeed to have as your health leader Dr. Fernos
Isern, who is giving such aggressive and competent leadership to the
whole health program here in Puerto Rico. I wish also to express
appreciation to your medical profession which is devoting itself so
fully to the advancement of public health. And I may also say I
think you are fortunate in having as your consultant my able col-
league, Dr. Vonderlehr, who during the period 1934^42 was in charge
of the U. S. Public Health Service Division of Venereal Diseases.
He is here in Puerto Rico to render every assistance which the Public
Health Service has to offer to your Insular Health Department in
dealing with this and other problems. The active program of control
which these experts have planned can be carried to a successful con-
clusion only if you who represent the forward-looking people of
Puerto Rico put your shoulder to the wheel and push — hard.

The tried and true methods of control which have lifted the shadow
of venereal disease wherever they have been applied with determina-
tion and vigor, will be just as effective here if they are applied with
equal will and vigor. The strategy is the same — find and treat the
cases of syphilis and gonorrhea in the civilian population, stamp out
the sources of infection.

I know this is an over-simplification of the problem. One of the
first essentials is to know the size of the task which confronts you.
A good law requiring blood tests for both parties before marriage is

PROCEEDINGS REGIONAL CONFERENCE 257

an excellent means of locating cases in vulnerable age groups, as well
as of providing an index of the prevalence of syphilis. Likewise, a
law requiring a blood test for every pregnant woman makes it pos-
sible to prevent congenital syphilis as well as to cure the infected
mothers. Thirty States now require premarital tests of both partners ;
and 30 require prenatal tests. Routine blood testing for all hospital
patients is another valuable dragnet. Mass blood test campaigns on a
voluntary basis have proven successful in revealing cases and in edu-
cating the public to the importance of the problem. The recent
Executive Order of the Governor requiring blood tests for Insular
employees is in consonance with modern practice both in government
and industry.

Good treatment facilities are the foundation of any effective con-
trol program. The treatment of syphilis and gonorrhea requires
expert medical personnel. Not only is the technique of administering
anti-syphilitic drugs a medical procedure, but close observation of the
patient, checking his reactions to treatment, and interpretation of
laboratory findings demand the attention of the physician. Mobile
clinics staffed by full-time trained personnel have been used with great
success to reach isolated communities in Southern States with prob-
lems similar to those in Puerto Rico. Special training facilities for
physicians, nurses, and laboratory technicians can be made available
through the Public Health Service. Adequate laboratory facilities
also are necessary.

Public education and participation are basic in venereal disease
control. All groups of the population must be reached, by every
means at our disposal, and particularly, they must be reached in
ways and terms that will be understood by every group, whatever the
educational level.

Finally, let me say frankly that no program of venereal disease
control will succeed unless it includes the repression of commercial-
ized prostitution. Regulation of commercialized vice, in the long
run, has never brought about reduction in disease rates. The tenuous
control of prostitutes, by means of routine medical examinations,
serves no purpose save to give their customers a false sense of security.

I understand that the Social Protection Committee of Puerto Rico
will propose to the 1944 Legislature bills for the control of venereal
disease and for repression of commercial prostitution. I cannot over-
emphasize the urgent need for adequate laws and their vigorous
enforcement. Moreover there must be a public sentiment to back up
the law, the police, and the courts, as well as provision for medical
care of infected prostitutes and for their social rehabilitation. The
penalties in the law should be primarily directed against those who
organize the business, who exploit, advertise, transport the girls who
are merely pawns in this man's racket. These young girls, — one-half
of whom are under 18 years of age, one-third under 16, — frequently
are sick, usually ignorant. They should have our sympathetic concern
and the benefit of our best scientific and social resources.

258 JOURNAL, OP SOCIAL HYGIENE

Public support for adequate laws should be assured here if the
participation of so many organizations, official and civic, in this Con-
ference gives an indication of continued interest. It is to the Social
Protection Committee particularly that the authorities will look for
the creation of public sentiment and cooperation essential to any
program of repression and venereal disease control.

The control of venereal disease in Puerto Rico, as in other States
and Territories, is not only a local problem ; it is also a Federal respon-
sibility. This is true not only in time of war when the health of our
troops and our home front are essential to victory, but equally in the
years of peace until the job is done. Disease knows no political
boundaries. The health of one state or of one nation depends to an
increasing extent upon the health of all. The venereal diseases are
endemic throughout the world and epidemic in large areas; their
spread is augmented by modern transport. Unchecked, they cast a
deep shadow of human misery across the land. They are still our
number one health problem, and an important social problem as well.
They undermine family life; maim and kill innocent children.
Science has given us the weapons for effective control, and even
eradication, if in this Island, in this nation, we have the determination
and will to use them fully. The cost will be much less than the cost
of inaction.

I can only present to you the facts as I see them. In our democ-
racy, it is only you the people who have the power to act.

PUERTO Kico's PLACE IN THE NATIONAL VENEREAL DISEASE
CONTROL PROGRAM

DE. ANTONIO FEEN6S ISERN

Commissioner of Health for Puerto Eico, Chairman of the Committee on Social
Protection and Chairman of the Regional Social Hygiene Conference

In the fight for liberty, which, when it seems to have terminated
in victory, begins anew in pursuit of a greater liberty and a more
resounding victory, there is before us an enemy which we must
conquer, because if we should permit it to continue fighting us we
would be neglecting one of the forces which, without doubt, produces
effects as deadly as those of our present enemies in this war for
world-wide liberty and democracy.

It has fallen upon me to preside at this Regional Conference on
Social Hygiene, the first to be held in Puerto Rico, under the auspices
of the Department of Health, the American Social Hygiene Asso-
ciation, the Puerto Rican Committee for Social Protection, the
Division of .Social Protection, the U. S. Public Health Service, with
the cooperation of the Army and Navy and with the motto: "Unite
Against Venereal Diseases — Venereal Disease Delays Victory."

PROCEEDINGS REGIONAL CONFERENCE 259

Many official, civic, social and labor organizations are represented
at this conference. The presence among us of our distinguished
guests, not the merits of its Chairman, gives us the measure of its
importance. As Chairman of this Conference, as Commissioner of
Health, as President of the Social Protection Committee of Puerto
Rico, I have set forth before this assembly the question: What is
Puerto Rico's participation in the national program for the control
of venereal diseases?

What is the nature of participation? What is the interest of
Puerto Rico in that participation ? What is the necessity for Puerto
Rico's acceptance of participation? And in order to answer these
questions, the nature of the struggle must be made clear, to begin
with. This struggle is scientific, social, moral and human — above all
human. Nothing is more humane than to serve and protect and
promote the health and the life of humanity itself.

Of the long and painful struggle for the existence of mankind
over the face of the earth, we do not know the beginnings from a
strictly historical viewpoint; but should we explain them according
to the religious teachings or according to the teaching of anthro-
pology, looking into the sacred books of religion or into the conse-
crated books of science, we find how man has striven always to
subdue inferior forms of life for the sake of enhancing our superior
form of life, within the zoological realm. Now empiricism and at
other times experimentations have been giving man the weapons for
his defense.

Let us take a leap from the prehistorical level to the frontiers of
contemporary history and we find Jenner, inoculating the vaccine
virus to protect us from smallpox ; a step ahead and we find Pasteur
pointing to the eye-piece of the microscope which multiplies the
human vision to discover the infinitely tiny, but infinitely powerful,
forms of life; another step onward and the spirochete of syphilis
is identified and Wassermann establishes the serologic reaction to
discover syphilitic infection. In the midst of all this we find the
new science of public health organizing and growing a full fighting
technique in the manner of warfare strategy in the face of an enemy.

Within our own time, within the very years of our life, the tech-
nique of warfare has undergone numberless changes. An army
waging battle today with the armament and technique of merely
twenty-five years ago, the time since the first World War, would
be defeated beforehand. Armaments have had to be revised, renewed,
transformed; techniques likewise.

In a similar way, the struggle for the public health is revised,
renewed, transformed.

In the history of public health the world over, Puerto Rico, modest
in many aspects of its life, has no reason to be so modest for the

260 JOURNAL OF SOCIAL HYGIENE

part it has played. When the establishment of vaccination was
still under discussion and was resisted in the civilized nations of
Europe, Puerto Rico during the first year of the 19th century was
experimenting with and establishing vaccination. Puerto Rico was
one of the first countries in the new world to establish vaccination
against smallpox. Dr. Oiler, Head Surgeon of the garrisoned Puerto
Rican regiment of that time, imported vaccine serum from the then
Danish Virgin Islands. Shortly after the Spanish- American War,
Puerto Rico, through the voice of Dr. Ashford, warned the world
that these fertile lands of tropical and sub-tropical America were
infected with an anemia-producing worm which was devitalizing their
population. With Ashford 's discovery the work of curing the new
world, and even Europe, of hookworm disease, received a tremendous
impulse. Hardly had the world known that Salvarsan cured syphilis,
when Salvarsan treatment for syphilis began in Puerto Rico.

It was not enough to know that there was syphilis; it was not
enough to know that syphilis was caused by the spirochete; it was
not enough to know that it was transmitted by sexual contact; it
was not enough to know that it was curable with Salvarsan and
with the different chemical products later developed. There
remained still the need to organize against syphilis as we organize
against uncinariasis, as we organize against smallpox, as we
organize against infectious diseases in general. Another chapter
in the work of the science of public health had to be -added, to be
called: " Control and Suppression of Syphilis in Mankind." That
chapter is now written and we know a few fundamental things:
We know that syphilis is transmitted from man to woman and from
woman to man and that there is no intermediary agent. We also
know, however, that there are men and women, we must regretfully
declare, more women than men — who, on account of a grievous failure
by society, unconsciously — let us plead in their favor — living in ignor-
ance and squeezed by poverty, are bent on spreading syphilis and
the other venereal diseases. And methods have been tried and
palliatives have been experimented with between both evils. All
have failed.

The attempt to maintain prostitution in the heart of society and
keep that society free from venereal diseases, has failed. Consider-
ing the realities of social life, prostitution cannot exist without
venereal diseases. This is the problem that we are facing now in
Puerto Rico.

Here is the real problem: Do we want to free our people from
venereal diseases ? Do we want to protect the child from the terrible
heritage of syphilis? Do we want to spare the mother the anguish
of bringing death to her child when she believes she is giving him
life, and protect her after the pangs of motherhood and the bloody
drama of childbirth, from finding that all ends in a frustrated
life and in a coffin instead of a cradle? Do we want to free young
men from the harrowing bitterness suffered upon learning that kisses
and caresses carry with them to a beloved woman as a penalty,

PROCEEDINGS REGIONAL CONFERENCE 261

infection of her blood with one of the most dangerous and deadly
diseases afflicting humanity? Do we want to protect the family
from the loss of the parent at a time when his efforts and his care
are most needed to protect his offspring? Do we want to preserve
the man who at the summit of accumulated experience and triumph
of life, falls stricken by syphilis? Do we want to spare society the
loss of great men who when their counsel is at its best are beaten
down by this scourge? Do we want to avoid the sorrowful sight
of the countless tragedies preying upon the insane syphilitics who
fill our hospitals? And above all, do we want in this hour of strife
a healthy, vigorous army, capable of confronting the enemy hordes?

If that is what we want, we must organize against syphilis.

Puerto Rico through the years has held a point of vantage in the
struggle for the public health; in shedding the blood of its sons in
the defense of liberty and democracy Puerto Rico has always occupied
the vanguard, in the first World War and in this second World War.
Puerto Rico cannot now be guilty of an unpardonable backwardness,
negating integrity and its will to strive for public health, by being
able to offer to this struggle not the red blood of her vigorous sons
but the sickly blood of hospital inmates.

Puerto Rico's participation in the struggle against venereal dis-
eases must be on a par with its participation in the military effort.
With the same decision that inspired its sons in rallying to the
colors, forming in the ranks and going to Europe to vanquish i,he
enemies of liberty and democracy, they must enter the ranks in
the anti-venereal front, thus guaranteeing that our men will be able
to hold high the colors in the battlefield, and that our men, women
and children can also hold the flag aloft on the home front, so
essential for the support of the combat forces.

Such is the participation that Puerto Rico is bound to take in
the national fight against venereal disease. We must decide it now
and fulfill our responsibility.

Let us examine the various phases of this fight.

First of all, we must spread knowledge. Let us all understand
that syphilis is among us and how it is propagated. The enemy
known, half the battle is won.

In the second place, we must have the resources and the skill
in order to make the correct diagnosis of syphilis. - The medical
profession of Puerto Rico is well prepared to do this.

Due to lack of economic resources among so large a proportion
of our population, the Health Department has established a Public
Health Unit in each town of Puerto Rico, where anyone can be
examined for syphilis without cost.

We have the resources of our laboratories. The Health Depart-
ment maintains eight laboratories in the Island where blood tests
are made.

262 JOUE1STA1, OF SOCIAL HYGIENE

We have also field agents who after localizing a syphilitic case,
invite to the clinic those persons who on account of their relations
with the first patient, may be suspected of having the disease. We
have established two hospitals where at present 500 cases of venereal
diseases are hospitalized. Two more hospitals with a capacity for
500 more cases are now being prepared. Buildings are being pur-
chased for accommodating 750 more cases. For those cases under
observation, houses of detention are being provided.

But this is not all. Still more must be achieved. A Committee
of Social Protection has been set up in which the following are
cooperating: The Departments of Health, Justice and Education,
the Social Service Agencies, the Army and Navy, the U. S. Public
Health Service, the Federal Social Security Agencies, the Federal
District Attorney, labor, religious and civic organizations, and public-
spirited citizens. We jointly drew up an inclusive program embracing
all the aspects of the fight against venereal diseases. The work has
been distributed among five sub-committees: One on Education in
Venereal Diseases, one on Treatment of Venereal Diseases, one on
Legislation, one on Law Enforcement, one on Rehabilitation.

Besides the knowledge and the treatment, a number of laws and
their enforcement are necessary, since to reduce venereal diseases we
must deal with a social problem: That of prostitution.

There is no sense in attacking venereal diseases on the one hand
and on the other hand permitting their spread. As long as prostitu-
tion exists, venereal diseases will thrive. _If prostitution is allowed
free scope, venereal diseases will have free scope. And "regulated"
prostitution means "regulated" dissemination of venereal diseases.
In short, in one form or another, with prostitution they will be
propagated.

Repression of prostitution is, therefore, the cornerstone in the fight
against venereal diseases. And to repress prostitution we must
know its causes.

What are the causes of prostitution?

Prostitution is a trade, a business. Why are the people involved
in it, despite its social connotations? In the first place, for economic
reasons. The trade yields profits, even if only for a few years,
as long as there is beauty to peddle, youth to sacrifice and love
to simulate.

It is a lucrative business, lucrative for those plying it, and lucrative
for those exploiting those who ply it.

And then we ask: Are not there other trades yielding the same
economic benefit without those social connotations? And we are
obliged to answer : There are not many. There may be none within
the general economic situation. But if there should be, they are
not within the reach of those plying the trade of prostitution. And
they are out of reach because those occupied in prostitution come

PROCEEDINGS REGIONAL CONFERENCE 263

mostly from homes where poverty keeps the stomachs empty, the
bodies slovenly, the spirit discontented; because there was no hope
of a better life; because all doors being closed to normal legitimate
expansion, an exit was sought, as a sort of escape from misery and
frustration, through the trapdoor of prostitution. Poorly established
homes, broken families, ignorant, illiterate parents, drunkenness,
poverty and squalor, that is the soil producing those derelicts, who,
dazzled by the glamor of easy living, flutter swiftly like dazzled
moths into the flaming dunghills of prostitution.

And what do we need then, in the face of this problem? In the
first place, let us tackle the economic problem in a threefold way:
Eradication of slums, provisions for proper education and
employment.

After the economic aspect, we ought to use the instruments of
law to punish whoever incites to prostitution.

And when it has not been possible to prevent the evil, then let
us lift up those who are found in prostitution, cure them of disease,
rehabilitate them vocationally and return them to the fold of society,
even if granting them belatedly what was denied them earlier when
the whole tragedy could have been prevented.

Such is the purpose of our program. Within the national fight
against venereal disease, Puerto Rico's task consists in keeping in
line and marching steadily onward to develop the program drawn
up by the Committee on Social Protection. We are in the ranks
with the banners of health unfurled. The victorious outcome is in
sight over the battlefields of Europe. The coming dawn of liberty
shall illumine all the expanse of the earth. This shall also mean the
liberation of the human body from the depredation of disease.

264 JOURNAL. OP SOCIAL HYGIENE

EESOLUTIONS

presented by the
CommUtee on Resolutions of the Regional Conference on

Social Hygiene
held on February 9, 1944, San Juan, Puerto Rico

and approved by the

Puerto Rico Social Protection Committee
on March 16, 1944

RESOLUTION NO. I
PROTECTION OF THE PUBLIC HEALTH

Whereas, there is need for standards by which health authorities
may decide who are reasonably suspected of having venereal diseases,
(syphilis, gonorrhea infections, chancroid, lyphogranuloma venereum,
granuloma inguinale, etc.) ; and

Whereas, the powers of the health officer in reference to the control
of communicable diseases in general should not be abridged when
applied to the control of the venereal diseases ; and

Whereas, voluntary examination and treatment have proved suc-
cessful, when with this medical treatment are united the social forces
of rehabilitation :

Therefore, it is hereby resolved: That the Conference recommends
continued study and extension of effective voluntary examinations
and treatment services, but, in view of the importance of preventing
further increases of venereal diseases and reducing opportunities for
their transmission, also recommends the following formulation more
precisely defining those who may be reasonably suspected of having
venereal diseases and the mode of procedure in regard to them ;

(a) All persons who are known to the health officer to have been
exposed to a venereal disease may be reasonably suspected of having
such a disease and shall be examined. In carrying out this procedure
the results of such examinations should be confidential and should
not be used as evidence in any trial for violation of laws against
prostitution.

(b) All persons who have been convicted of recent sex offenses
involving promiscuity may be reasonably suspected of having venereal
diseases.

(c) The functions of the health officer in prevention, diagnosis and
treatment of venereal diseases, should not be confused and hampered
by imposing upon him duties involving directly or indirectly police
law enforcement, or matters properly pertaining to the courts.

PROCEEDINGS REGIONAL CONFERENCE 265

RESOLUTION NO. II,
SOCIAL PROTECTION FOR YOUTH

RESOLVED :

1. That the establishment and maintenance of high standards of
sex conduct are the best protection of public health from venereal
diseases.

2. That up to the level of the highest standards which can be
sustained by public opinion, laws penalizing the promotion of, and
indulgence in, promiscuous sex relations constitute sound and prac-
ticable health measures.

3. That the public support of such laws and law enforcement is and
should be largely dependent upon the following considerations:

(a) That such laws be designed particularly to eliminate prosti-
tution and to protect the youth from this evil.

(b) That these laws and their enforcement should not be discrimi-
natory and in all cases should apply equally to men and women.

(c) That the courts be given and exercise a wide discretion to pro-
nounce sentences calculated to rehabilitate the offenders and to deter
potential offenders as well as to protect society.

(d) That the functions of police and courts in preventing and
curing delinquency be not confused and hampered by imposing upon
them duties involving directly or indirectly the diagnosis and treat-
ment of venereal diseases.

RESOLUTION NO. Ill
PROVISION FOR MEDICAL TREATMENT AND EDUCATION

Whereas, the enforcement of laws against prostitution in order to
be effective and in order to reach its objectives should be supple-
mented by medical measures aimed at rendering non-infectious
sexually promiscuous carriers of disease; and

Whereas, the enforcement of laws for the prevention and treatment
of venereal diseases would equally be dependent on the existence of
adequate medical facilities for that purpose; and

Whereas, society would not fulfill its full obligation if it limits its
activities to the suppression or repression of prostitution and to the
prevention and treatment of venereal diseases, it being evident that,
the prevention of the spread of venereal diseases and of prostitution
largely depends on the social, educational and moral conditions of
the people ; and

Whereas, the value of legislation and law enforcement is limited in
practice by the educational background of the people and the facili-
ties offered for checking the evils intended to be cured, be it resolved:

266 JOUBNAL OF SOCIAL HYGIENE

That adequate facilities for voluntary examination and treatment
of venereal diseases be provided, accessible to residents of all parts of
Puerto Eico, together with a constructive program for re-education,
industrially, morally and socially;

That increased efforts be made through protective and educational
work to eliminate conditions that make for prostitution and disease;
to the end that youth be safeguarded and exploitation of men and
women be prevented.

RESOLUTION NO. IV

IN SUPPORT OF LEGISLATION FOB THE PURPOSES PREVIOUSLY

MENTIONED

Be it Resolved by this Resolutions Committee of the Regional Con-
ference on Social Hygiene:

That in accordance with other resolutions approved by this Com-
mittee of Resolutions of the Regional Conference on Social Hygiene,
this Committee indorses Bill No. 226 and Bill No. 227, as drafted by
the Social Protection Committee of Puerto Rico.

This Resolutions Committee also indorses and urges the develop-
ment and continuance of the proposed system of rapid treatment
centers, as inaugurated by the Health Department, under the auspices
of the Federal Works Administration.

This Resolutions Committee further declares that laws against
prostitution and for the prevention of venereal diseases would be
ineffectual and unenforceable unless the proper medical facilities such
as rapid treatment centers be developed and kept in full operation.

COMMITTEE ON RESOLUTIONS
PUERTO Rico REGIONAL CONFERENCE ON SOCIAL HYGIENE

DE. ANTONIO FEEN6S ISERN DE. WILLIAM F. SNOW (Eepre-

Commissioner of Health, Chairman, sented by Miss Jean B. Pinney at

Eegional Social Hygiene Confer- the meeting of March 16th)

ence and of The Puerto Rico Chairman, Executive Committee,

Committee on Social Protection American Social Hygiene Associa-

DE. JOSE N. GANDARA tion, New York

Assistant Commissioner of Health, DE CARLOS MUSTOZ McCORMICK

Insular Department of Health, president, Puerto Rico Medical Asso-

Puerto Rico ciation

DE. TOMAS BLANCO _._ r>ar.Ar> n^a^A TVTAATTYDV

Chief, Office of Health Education, DR OSCAR COSTA MANDRY

Insular Department of Health, Director, Bureau of Public Health

Puerto Rico Laboratories, Insular Department

DR. R. ARRILLAGA TORRENS of Health, Puerto Rico

Member of the House of Representa- MRS. MARIA P. RAHN

tives, Manati, Puerto Rico Chairman, Sub-Committee on Social

DE. EENESTO QUINTERO Rehabilitation, The Puerto Rico

Chief, Bureau of Venereal Disease Committee on Social Protection;

Control, Insular Department of Director, Department of Social

Health, Puerto Rico Work, University of Puerto Rico

PBOCEEDINGS BEGIONAL CONFEKENCE 267

GREETINGS AND MESSAGES RECEIVED FROM THE OTHER
AMERICAN REPUBLICS •

Numerous letters and cablegrams were received by the Conference
Chairman, Dr. A. Fernos Isern, expressing interest and good wishes
for the success of the meetings. The following are excerpts :

La Paz, Bolivia, February 14, 1944

Your kind invitation to join in the Conference on Social Hygiene held in
San Juan on February 9th has been received.

I regret that it arrived too late for us to send a message to be read during
the Conference sessions, but may I now offer my best wishes and hearty
congratulations on the success of this event.

DR. HECTOR ALIAGA SUAREZ

Director General of Health

Bogota, Colombia, February 10, 1944

I should have liked to send a delegate to this important Conference, but the
invitation did not arrive in time to arrange for this. I look forward, however,
to seeing the report of the Conference, and learning the developments regarding
venereal disease control, in which this country is much interested.

Best wishes for the success of the Conference's work.

DR. ALFONSO OROZCO

Secretary General of Labor, Health

and Social Security

San Jose, Costa Eiea, February 4, 1944

Costa Eica is vitally interested in the subject of the Regional Conference on
Social Hygiene, and we greatly regret that transportation difficulties will prevent
a delegate attending from here. We have, however, asked Dr. E. Martinez Eivera
of San Juan to represent us.

The invitation to join in this meeting is greatly appreciated.

DR. SOLON NUNEZ
Secretary of Public Health and Social Protection

Ciudad Trujillo, Dominican Republic, March 4, 1944

. . . The Social Hygiene Conference was a genuine success, covering in an
excellent way the problems relating to control of the venereal diseases in the
Caribbean area. I feel sure that the Conference will be of great assistance
to me in my future work. . . .

DR. L. F. THOMEN

Assistant Secretary of Health and

Public Assistance

Quito, Ecuador, February 9, 1944

We considered the possibility of sending a delegate to this important meeting,
but transportation difficulties prevented. Please accept our best wishes for a
brilliant success, and the hope that the Conference deliberations and resolutions
may have a lasting effect on health progress.

DR. LEOPOLDO N. CHAVEZ

Minister of Hygiene and Health

San Salvador, El Salvador

May I express my appreciation of the invitation received to the Conference on
Social Hygiene in San Juan, and assure you of my interest in this event.

VICTOR ARNOLDO SUTTER

Director General of Health

268 JOURNAL OP SOCIAL HYGIENE

Tegucigalpa, Honduras, February 4, 1944

The invitation to the Conference has been received and is much appreciated.
I regret that it will«not be possible for us to participate, but you have our best
wishes for a great success both in the events and the permanent progress which
should come out of the Conference deliberations.

DR. P. H. ORJDONEZ DIAZ

Director General of Public Health

Mexico, D. F.

Best wishes for the success of the Social Hygiene Conference, which we believe
will be especially valuable at this time.

DR. GUSTAVO BAZ
Secretary of Health and Assistance

Managua, Nicaragua, February 3, 1944

Lack of time to arrange for transportation will prevent the attendance of
a delegate to the Conference, but I want to send my congratulations and
best wishes for the success of this meeting. I shall look forward to hearing
the report of the sessions.

The occasion should be a memorable one.

DR. Luis MANUEL DEBAYLE

Director General of Health

Panama, February 9, 1944

We would have liked to send a delegate to the Social Hygiene Conference,
but at the last moment it proved impossible. Please accept our best wishes
for the success of this event, and the assurance that we are greatly interested
in this campaign.

DR. GUILLERMO G. DE PAREDES

Director of Health

Asuncion, Paraguay, February 8, 1944

We regret that it was not possible for Paraguay to be represented at this
important meeting, and are honored by the invitation. The Conference should
make a valuable contribution to health improvement and welfare in the Americas.

DR. GERARDO BUONGERMINI

Minister of Health

Caracas, Venezuela, February 3, 1944

I take this opportunity to send you greetings and to express my deep satis-
faction that the Social Hygiene Conference is being held, together with the
hope that it may be highly successful.

Traditionally, my country has held to the principle that united action of the
American people towards the solution of our common problems will bring good
results. The Conference theme is inspired with this ideal, and since the venereal
diseases are among the heaviest afflictions of the people, I can do no less than
offer full cooperation in the plans which may be developed by the Conference
in the broad field covered.

DR. FELIX LAIRET, HIJO
Minister of Health and Assistance

f\

Vol. 30 May, 1944 No. 5

Journal

of

Social Hygiene

Social Hygiene in Wartime. XIV»
Some Current Efforts toward Rehabilitation

CONTENTS

A Study of 280 Patients in the Venereal Disease Isolation Hospitals of Puerto Rico 269

The San Francisco Separate Women's Court Richard A. Koch 288

Rehabilitation in Action: A Social Hygiene Society Cooperates
with a Rapid Treatment Center in Aiding Venereal Disease

Patients Lucia Murchison 296

Who Are the Juvenile Delinquents? Winifred Overholser 304

Editorial: " This Way Out . . .? " 309

National Events Reba Rayburn 311

News from the 48 Fronts Eleanor Shenehon 317

Notes on Industrial Cooperation Percy Shostac 322

The American Social Hygiene Association presents the articles printed in the
JOURNAL or SOCIAL HYGIENE upon the authority of their writers. It does not
necessarily endorse or assume responsibility for opinions expressed or statements
made. The reviewing of a book in the JOURNAL OF SOCIAL HYGIENE does not
imply its recommendation by the Association.

EDITORIAL BOARD
O.-E. A. WIHSLOW, Chairman

RAY H. EVERETT WILLIAM F. SNOW

JOSEPH K. FOLSOM JOHN H. STOKES

EDWARD L. KEYES JOHN C. WARD

JBAN B. PINNIY, EDITOR
WILLIAM F. SNOW, EDITORIAL CONSULTANT

The JOURNAL OF SOCIAL HYGIENE is supplied to active members of the American
Social Hygiene Association, Inc. Membership dues are two dollars a year. The
magazine will be sent to persons not members of the Association at three dollars
a year ; single copies are sold at thirty-five cents each. Postage outside the United
States and its possessions, 50 cents a year.

Entered as second-class matter at post-office at Albany, N. Y., March 23, 1922.
Acceptance for mailing at special rate of postage provided for in Section 1103,

Act of October 3, 1917, authorized March 23, 1922.
Published monthly (nine issues a year) for the Association by the Boyd Printing

Company, Inc., 372-374 Broadway, Albany, N. Y.

Copyright, 1944, by The American Social Hygiene Association, Inc.

Title Registered, U. 8. Patent Office.

PUBLISHED MONTHLY EXCEPT JULY, AUGUST AND 8EPTEMBEB
AT 372-374 BROADWAY, ALBANY 7, N. Y., FOB

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

EDITORIAL OFFICES and NATIONAL HEADQUARTERS
1790 BROADWAY, 19, NEW YORK CITY

WASHINGTON LIAISON OFFICE
Room 609, 927 15th St., N.W., Washington 6, D. C.
JEAN B. PINNIY, Director in Charge
RIBA RAYBURN, Office Secretary

FIELD OFFICES

ATLANTA, GEORGIA. 506-508 Citizens and BALTIMORE, MARYLAND. Care of Baltimore

Southern National Bank Building. Serv- Community Fund, 22 Light Street,

ing Alabama, Florida, Georgia, Missis- Serving Delaware, Maryland, Pennsyl-

sippi, North Carolina, South Carolina and vania and Virginia.

Tennessee. KENNETH R. MILLER, Field Bepresenta-

CHARLES E. MINER, Field Bepresentative. tive, Home address 260 Bridge St., Drexel

COLUMBUS, OHIO. Care National Confer- r ' ,,*• w _, „. , , v om-tntilt<a

a a • i IIT i oo TT'~i, a<->^«4. MRS. .bDNA W. ± ox, field Jiepresentative.

ence of Social Work, 82 High btreet.

Serving Indiana, Kentucky, Ohio and

West Virginia. CHICAGO, ILLINOIS. Room 615, 360 North

WADE T. SEARLES, Field Eepresentative, Michigan Avenue. Serving Illinois, Michi-
gan and Wisconsin.

OMAHA NEBRASKA. 736 World Herald WARREN H. SOUTHWORTH, Field Bepre-

Buildiiig. Serving Colorado, Iowa, Kan- sentative,
sas, Minnesota, Missouri, Nebraska, North
Dakota, South Dakota and Wyoming.

GEORGE GOULD, Assistant Director, DALLAS, TEXAS. Cliff Towers. Serving

Division of Legal and Social Protection Arkansas, Louisiana, New Mexico, Okla-

Services, in Charge. homa and Texas.

BASCOM JOHNSON, Director in Charge.

AKB ?TT' U*A?- 4°2 Mclntyre MRS. GERTRUDE R. LUCE, 0$c* Ssoretarj,.
Building. Serving Arizona, Idaho, Mon-
tana, Nevada, Utah, California, Oregon

and Washington. SAN FRANCISCO, CALIFORNIA. 45 Second

GEORGE GOULD (see above), temporarily Street.

in dharge. W. F. HIGBY, Field Consultant;

Journal

of

Social Hygiene

VOL. 30 MAY, 1944 NO. 5

Social Hygiene in Wartime. XIV.
Some Current Efforts toward Rehabilitation

FEBRUARY, 1944

Report on a study of prostitution conducted by the Bureau of
Medical Social Services of the Puerto Rico Department
of Health at the request of the Puerto Rico
Social Protection Committee

War has brought the venereal disease problem to a sharp focus
because of its undermining effects on the defensive structure of the
nation. Statistics presented by the Puerto Rico Department of Health
on the incidence of the venereal diseases among civilians and reports
made by military authorities on the rates of these diseases among the
armed forces have contributed to arouse interest in the study and
control of prostitution — which is the largest reservoir of venereal
diseases. The particular acuteness of the situation in Puerto Rico
points up the need for drafting plans to curb these diseases with their
debilitating effect on military manpower and civilian population.

269

270 JOURNAL OF SOCIAL HYGIENE

With the purpose of focusing the efforts of public and private
organizations on an island-wide program for the control and pre-
vention of venereal diseases, the Puerto Rico Social Protection Com-
mittee was organized in October, 1943, on the initiative of Dr. Antonio
Fernos Isern, Commissioner of the Insular Department of Health,
and Mr. Conrad Van Hyning, Territorial Director, Community War
Services, Federal Security Agency. To study specialized phases
of the Committee's objectives, appropriate sub-committees were
appointed, one of which is the Social Rehabilitation Sub-Committee.
This sub-committee found that no adequate information was avail-
able to guide the development of a rehabilitation program for pro-
miscuous girls or prostitutes. Accordingly, it was recommended that a
study be conducted to reveal the characteristics and background of
girls confined for treatment in the Venereal Disease Isolation Hos-
pitals. The study was undertaken by the Bureau of Medical Social
Services of the Department of Health, at the request of the Com-
missioner of Health who is also Chairman of the Social Protection
Committee.

The Bureau of Medical Social Services felt that the opportunity
offered by this study should also be used to gather factual information
bearing on practices and patterns of prostitution in Puerto Rico, and
that the schedules used for recording interviews with patients should
be designed for use as the basis of further case work with the indi-
viduals, as well as for gathering the data for this study.

The study covers such information and characteristics of patients as
the following: age, race, civil status, religion, physical handicaps,
medical diagnosis, sources of infection, social background (including
type of childhood and adolescence home, location, economic situation,
family composition), social problems, education, training, work his-
tory, vocational choices, sex history and circumstances, factors leading
to prostitution, length of time in prostitution, influence of friends and
facilitators, places of soliciting and sex contacts, types of customers,
income, attitude of patient toward way of living and worker's impres-
sion of rehabilitation possibilities.

The Bureau presented to the Rehabilitation Sub-Committee pre-
liminary findings based on tabulation of 200 schedules, on January 14,
1944. The present report is based on analysis and tabulation of
schedules of 280 patients at Caguas and Troche Isolation Hospitals.
These findings, though more complete, are not significantly different
from those of the preliminary report.

PATIENTS IN THE VD ISOLATION HOSPITALS OF PUERTO EICO

271

The 280 patients constitute over half of the normal population of
the hospitals, and unquestionably constitute an adequate sample of the
group as a whole.

At the end of this report, a summary, notes on methods used in
conducting the study, the staff participating, and a sample of the
schedule, have been appended.

1.

FINDINGS
Characteristics of the group as revealed by this study follow:

One-eighth of the 280 patients claim they are not prostitutes
and in most cases this seems to be true.

2. Diagnoses

From 275 available medical records it was found that 95 per
cent of the patients are under treatment for gonorrhea. One-
third are under treatment for at least one other venereal disease,
usually syphilis. The relative frequency of the venereal diseases
under treatment are:

Number
Infections Under

Treatment Relative
Disease (215 patients) Frequency

Gonorrhea 261 70

Syphilis 102 27

Lymphogranuloma venereum 6 2

Chancroid 2 1

371 100

3. Age Distribution

Percentage

Age Number Distribution

14 yrs 3 1

15 yrs 5 2

16 yrs 16 6

17 yrs 32 11

18 yrs.* 50 18

19 yrs 39 14

20 yrs 36 13

21 yrs 16 6

22 yrs 20 7

23 yrs 21 7

24 yrs 13 5

25 yrs 12 4

26-30 yrs 11 4

Over 30 yrs 3 1

Not given 3 1

280

100

More girls are 18 than of any other single age group, and over
half of the total are under 21. Very few are over 25.

* Heavy type in this and subsequent tables indicates the classification con-
taining the largest number, and therefore the most typical.

272

JOURNAL OF SOCIAL HYGIENE

4.

7.

Residence

At time of admission to hospital the residences of the patients
were as follows :

In the seven largest municipalities** on the Island..

In municipalities adjacent to largest municipalities. . .

Neither in nor adjacent to the largest municipalities,
but near military establishments (note also Section
28)

Other municipalities

47
10

Per Cent
66
14

17
3

5. Color

280

100

Color

White . . .
Mulatto . .
Colored . .
Not given

Number

157

74

45

4

280

Percentage
Distribution

56

27

16

1

100

6. Civil States

Number

Single 174

Married (legally)

Married (consensually)

Separated

Divorced

Widowed

Not given

28

30

13

27

6

2

280 100

Physical Handicaps

Relatively few serious physical handicaps are found. There
were 10 girls (3 per cent of total) with scarred faces. This may
not appear to be a handicap, but some of the girls feel it marks
them for life as prostitutes, and it is therefore a real barrier to
rehabilitation. Six (2 per cent) have defective sight. One is a
hunchback and five others have some other physical handicap.

8. Previous Commitments to Hospitals

Half of the 280 patients have been committed to a venereal
disease hospital at least once before. For 9 per cent, the present
commitment is at least their fourth.

Present commitment the first

Once before

Twice before

Three times before

Over three times before

Not given

Number

139

68

34

19

7

13

Per Cent
50
24
12

7

2

5

280

100

** Puerto Rico is divided into 77 "municipalities" which are roughly
equivalent to "counties" in the States.

PATIENTS IN THE VD ISOLATION HOSPITALS OF PUERTO RICO 273

9. Childhood of 80 per cent was spent in a home with at least one
parent. In adolescence only 43 per cent were in a home with at
least one of their parents ; 37 per cent were in foster homes ; and
the remainder were married or living in homes where they worked.

10. Thirty-nine per cent of the girls felt that the economic situation
in their childhood homes was adequate. This is a subjective
evaluation, of course, and actually it is probable that the economic
situation did not provide an adequate living in most cases.

11. All but 34 per cent of the 280 patients reported at least one
serious social problem in their families. Percentagewise, these
are as follows :

Per Cent

Alcoholism 37

Desertion 22

Dependency 13

Promiscuity 11

Criminal history 8

Other 9

100

12. Sixty per cent maintain good relations with their families
(though in some cases the family does not know the girl is in
prostitution). An additional 11 per cent maintain good relations
with foster families. Only 21 per cent report strained rela-
tions with their families. Eight per cent have no family ties.

13. Education

Sixteen per cent of the group have had no education at all.
Over half have not advanced beyond third grade. Distribution of
the 280 by grade of school attained follows :

Grade Number Per Cent

None 46 16

1st grade 18 6

2nd grade 34 12

3rd grade 49 18

4th grade 37 13

5th grade 30 11

6th grade 13 5

7th grade 25 9

8th grade 20 7

Over 8th grade 8 3

280 100

14. Previous l^ocational Training

Over half of the 280 patients have had at least some vocational
training. In this respect the total group is distributed as follows :

Per Cent

Needlework or sewing 25

Domestic service 19

Other 7

None 49

100

274 JOURNAL OF SOCIAL HYGIENE

15. Job of Previous Maximum Earnings

Many of the girls had done more than one kind of work. For
over half, their maximum earnings outside of prostitution were in
domestic service.

Number for Whom
Type of Work
Provided Best

Previous
Type of WorTc Earnings

Domestic service 157

Sewing (dress making) 19

Needlework (embroidery, etcetera) 19

Other 36

No previous work 49

280 100

16. Distribution of earnings from work outside of prostitution was
as follows :

Per Cent

Never worked 17

Subsistence only 2

Under $2 per week 29

Over $2 but under $3 25

Over $3 but under $5 14

Over $5 but under $10 12

$10 or over 1

100
Two dollars was the most typical weekly wage.

17. Vocational Choices of Patients

Sixteen per cent of the patients had no vocational choice out-
side of prostitution. Considering both first and second vocational
choices of the remainder, the distribution is as follows :

Per Cent

Domestic service 33

Seamstress 28

Needlework 14

Nurses aid 12

Beautician 3

Salesgirl 3

Clerical worker. 3

Other . 4

100

Of those who would choose domestic service, 26 per cent speci-
fied laundry work, and 29 per cent specified cooking.

The high percentage interested in work as nurses aides is doubt-
less a reflection of their experience in the venereal disease hos-
pitals. This, together with the low percentage mentioning some
of the better paying types of work, such as beautician, sales
person, etcetera, leads to the observation that these girls need
vocational guidance in the selection of possible fields of work,

PATIENTS IN THE VD ISOLATION HOSPITALS OF PUERTO RICO

275

and a vocational training program should probably not be very
much conditioned by the patients' present choices.

18. Sex History; Age at First Menstruation

Age
Under 11 yrs

11 yrs

12 yrs

13 yrs

14 yrs

15 yrs

16 yrs
Over 16 yrs

Not given

Number
12
33
77
71
42
26

7

6

6

Per Cent

4
12
28
26
15

9

2

2

2

19. Age at First Sex Experience
Age

Under 12 yrs

12 yrs

13 yrs

14 yrs

15 yrs

16 yrs

17 yrs

18 yrs

19 yrs

20 or over
Not given

280

Number
11
23
39
35
67
53
17
15

6

7

7

100

280
20. Circumstances of First Sex Experience

Marriage (including consensual) .........

Rape (including statutory, i.e., seduction
under 14 years of age) ................

Seduction .............................

Other .................................

Number
72

77
123

8

Per Cent
25

28

44

3

280

100

21.

Age at Which Patient Was Initiated into Prostitution

Excluding the 36 patients who are not prostitutes, the remain-
ing 244 are distributed below by age at which they were initiated
into prostitution :

Age
Under 14 yrs

14 yrs

15 yrs

16 yrs

17 yrs

18 yrs

19 yrs

20 or over.
Not given .

Number
14
17
28
33
36
27
31
52

Per Cent

6

7

12
14
15
11
12
21

2

244

100

276 JOURNAL OP SOCIAL HYGIENE

22. Length of Time in Prostitution

Excluding the 36 patients who are not prostitutes, the 244
prostitutes are below distributed by length of time in prostitution :

Length of Time Number Per Cent
Under one year

(Over 3 months but under 1 year) 73 27

(Under 3 months) 19 8

One year 54 23

Two years 25 11

Three years 18 8

Four years 13 5

Five years 12 5

Over five years 25 10

Not given 5 2

244 100

The most typical patients have been prostitutes about one year
and over two-thirds of them for less than two years.

23. Factors Leading to Prostitution

Excluding 36 who are not prostitutes, most patients mentioned
several of the factors given below. It is noted that influence of
friends and relatives is more often cited than the economic factors
leading to prostitution. By age group, it is the younger girls
who get into prostitution without influence or by introduction of
friends, and in general the economic pressures apply more
severely to the older women.

Factor Percentage

Economic Frequency Weight

Economic 132 19

Love of personal adornment 75 10

Desertion 29 4

Dependency 12 2

Total economic pressure factors 35%

Influence of Others

Influence of friends 138 20

Attitude of parents 52 8

Attitude of husband 31 4

Influence of neighbors 17 2

111 treatment at home. . 69 10

Total influence of other factors .... 44%

Other Factors

Love of excitement and adventure.... 87 12

Lack of adequate recreation 60 9

21%

100

24. By Whom Induced to Enter Prostitution

Excluding the 36 not prostitutes, and 53 patients who said no
other persons induced them to enter prostitution, the persons
introducing the remainder to prostitution are classified below :

PATIENTS IN THE VD ISOLATION HOSPITALS OF PUERTO EICO 277

Number Per Cent

Friends 152 (of these 118 were specified as girl friends,

13 as men, of whom 4 were policemen,

21 friends, sex unspecified) 80

Procurers 33 (13 pimps, 18 madams, 2 not specified).. 17

Others 7 (includes relatives, 2) '3

100

Note that friends are almost five times as frequently cited as
procurers. It appears therefore that operations of procurers are
not on a large scale ; that most prostitutes get into that business
because they wish to, and are introduced to it by girl friends.
(Of course, it is possible that some of the "girl friends" might
be regular procurers.)

25. Factors Determining Continuation After First Entering

Prostitution

Again excluding the 36 not prostitutes, the relative importance
of factors that prostitutes give for remaining in prostitution are
the following :

Percentage

Frequency Weight

Income 165 36

Rejection by family or social groups

(family, 82) 101 22

Influence of procurers, bar operators

and other ' ' facilitators " 87 19

Fondness for dancing, liquor, etc 39 9

Hypersexuality 34 8

Influence of friends. . 29 6

100

For comparison with data on persons influencing girls to enter
prostitution, the similar factors influencing them to stay in pros-
titution may be considered separately.

Percentage

Frequency Weight
Eejection by family or social group.. 101 47

Influence of procurers 87 40

Influence of friends . 29 13

100

Thus it is seen that influence of procurers becomes a much
more important factor in keeping girls in prostitution than it
was as a factor inducing them to begin it. In Section 24 above, it
is shown that only 17 per cent of the persons whose influence
led to initial prostitution were procurers, while it is noted above
that procurers constitute 40 per cent of persons influencing
women to remain prostitutes.

26. Place of Soliciting

Bars far overshadow other places of soliciting, but most girls
solicit at other places also.

278 JOURNAL OF SOCIAL HYGIENE

Percentage

Place

Frequency

Weight

Bars

165

46

Hotels

51

14

Night clubs

39

11

Streets

38

10

Houses of prostitution

29

8

Parks

15

4

Own room or home

13

4

Other

12

3

100

27. Place of Sex Contacts

Percentage

Place

Frequency

Weight

Hotels

119

31

Houses of prostitution

81

21

Bars

74

19

Own room ,

50

13

Boarding house

28

7

Open spaces ,

13

3

Taxicabs

9

2

Own home

7

2

Other places

9

2

100

Thus while most soliciting is in bars (Section 26 above), more
sex contacts take place in hotels.

28. Customers: Armed Forces or Civilians

Of 237 prostitutes who gave this information, customers of
35 per cent were from the armed forces, 33 per cent had both
military and civilian customers and 31 per cent had civilians
only. This is indirect evidence that members of the armed
forces probably constitute well over half of the customers in
current prostitution.

29. Reaction of Patients to Prostitution

Of the 244 patients who are prostitutes, 18 did not give their
attitude towards it. The remaining 226 have been classified as
follows :

a.
b.

1
Likes prostitution and does not wish to quit ....
Dislikes prostitution but does not intend to
Quit .

number
55

27

Percentage
24

12

c.

Would quit for job with earnings equalling those
from prostitution

2

1

d

Would quit for adequate earnings

35

15

e

Would quit for a man to care for her

16

7

f

Would quit for a man plus adequate job

6

3

Intends to quit, but has no plans

47

21

h

Intends to quit, has a plan

38

17

100

Considering patients' attitude alone, it would seem to be those
classified d, e, f, and g, comprising 46 per cent of the prostitutes
(36 per cent of the total hospital population) with which the

PATIENTS IN THE VD ISOLATION HOSPITALS OF PUERTO EICO 279

Committee should find the best opportunities for rehabilitation.
The 17 per cent who have some kind of plans may also need
help to make the plans succeed.

30. Delinquencies of Patients

Sixty-five per cent of the 280 patients, 183, have previously
been arrested, some for several offenses. These delinquencies are :

Percentage

Frequency Weight

Disorderly conduct 74 40

Alcoholism 60 33

Assault and Battery 35 19

Other (includes gambling 7, pros-
titution of minors 2, drug addic-
tion 3) 14 8

100

31. Average Weekly Earnings from Prostitution
(222 prostitutes who gave information)

Number Per Cent Number Per Cent

Under $5

2

1

$35

to

$39.

99

5

2

$5

to

$9

.99

10

4

40

to

44.

99

17

8

10

to

14

99

27

12

45

to

49.

99

5

2

15

to

19.

,99

29

13

50

to

74.

99

29

13

20

to

24

.99

34

15

75

to

99.

99

11

5

25

to

29

.99

28

13

100

or

over

8

4

20

tn

24-

QQ

17

fl

222 100

Most typical earnings are about $20-$25 per week, though the
arithmetic average is $35. Earnings of $50 a week or more were
claimed by 22 per cent of the prostitutes who gave this informa-
tion. The interviewing staff noted a tendency to exaggerate, and
point out that figures do not take account of exorbitant board,
etcetera, paid by some prostitutes.

32. Of the 222 prostitutes who gave budget data, over half (116)
contribute to their families, 10 per cent contribute to procurers,
and 25 per cent customarily save some money.

33. Workers' Impressions as to Rehabilitation Prospects

The social workers conducting the interviews made brief state-
ments as to their impression of the rehabilitation possibilities
of the patients. Their opinions, together with other factors
such as age, education, previous work, length of time in prostitu-
tion, etcetera, have been used in classifying the patients as to
rehabilitation prospects. The 36 claiming not to be prostitutes
are included, as some appear to be in need of help and are
interested in training.

Number Per Cent

Rehabilitation not necessary 18 6

Prospects excellent 9 3

Prospects good 101 39

Prospects fair 69 24

Prospects poor 49 17

Prospects practically none 34 11

280 100

280 JOUKNAL OF SOCIAL HYGIENE

An example of information pertinent to each type of classi-
fication follows:

Example of Classification — "Rehabilitation Not Necessary"

Age: 20

Education: 8th grade

Not a prostitute

Worker's impression as to rehabilitation possibilities:

"Patient is not a prostitute, she is supported by her husband with whom
she lives. She went to the Public Health Unit when she found out by
husband that she had been infected by him and was sent to Hospital from
there. She is alert."

Example of Classification — " Excellent"

Age: 17

Education: 8th grade plus some training as a nurses' aide

Length of time in prostitution : 1 year

Average income from prostitution : $20 per week

Reaction of patient to her present way of living :

"She says she does not want to go in prostitution. She wants to work
as nurse 's aide in a Hospital but not in the V.D. Hospital because they don 't
let her go out to do her shopping and to see her mother."

Worker 's impression :

"Very good candidate for rehabilitation. Wants to work and quit
prostitution. Seems to care a great deal for her mother."

Example No. 1 of Classification — "Good"

Age: 16

Education : 2nd grade, some training in embroidery

Length of time in prostitution : 6 months

Average earnings from prostitution : $50 per week

Patient's reaction to her present way of living:

"Intends to quit. She is ashamed of this kind of life. Stays now with
her grandmother who supports her. Planning to look for a job."

Worker 's impression :

' ' Says she is out of the business. Seems sincere. Very young and
attractive girl. Ashamed and tired of being persecuted. Planning to look
for work."

Example No. 2 of Classification — "Good"

Age: 17

Education : 8th grade, some training in handicraft and housework

Length of time in prostitution : 5 months

Average earnings from prostitution : $25 per week

Reaction of patient to her present way of living :

' ' She would like to earn her living working in something else. She is
afraid her family might reject her now."

PATIENTS IN THE VD ISOLATION HOSPITALS OF PUERTO RICO 281

Worker 's impression :

' ' Patient is cooperative. Seems to be able and capable of learning a
trade. Is willing to do so. Seems intelligent."

Example of Classification — ' ' Fair ' '

Age: 14

Education : 8th grade, some training in sewing
Length of time in prostitution : 6 months
Earnings in prostitution: $100 per week
Reaction of patient to her present way of living :

"Patient loves excitement of this kind of life. Planning to go back to
some other bar, not Castle Inn because in there girls are sent to V.D.
Hospitals very frequently."

Worker 's impression :

"Very young girl. Has been a short time in present business since
most of time she has been in the V.D. Hospital. Her family would like to
have her, but she loves excitement. Needs guidance and orientation.
Seems a possible candidate for rehabilitation. ' '

Example of Classification — "Poor"

Age: 18

Education : 3rd grade ; no previous work

Length of time in prostitution : 2 years

Average earnings from prostitution : $20 per week

Reaction of patient to her present way of living :

"Patient says she likes her present way of living but as she does not
like to come to the V.D. Hospital she will go home to live with her
family again."

Worker 's impression :

' ' Apparently very low intelligence. It seems that the possibilities for
rehabilitation are very slight. ' '

Example of Classification — "Practically None"

Age: 19

Education : None ; training in laundry work
Length of time in prostitution : 5 years
Earnings in prostitution : $80 per week
Reaction of patient to present way of living :

"She likes this kind of life. When she is out of circulation she is bored
and has to go back to it again. ' '

Worker's impression:

' ' Likes present way of living. She admits she cannot go on without it.
Has tried to get out of it but has to come back again. Does not seem
inclined to any vocational training."

SUMMARY

The patients of the isolation hospitals, which may be assumed to be
representative of Puerto Rican prostitutes as a whole, are a young

282 JOUKNAL OF SOCIAL HYGIENE

group. Over half are under twenty-one, and only ten per cent are
over twenty-five years old. Almost all of the patients under treat-
ment have gonorrhea and about a third have syphilis. Over half
are classified as white: another fourth as mulatto. One-fifth are
married (half of these consensual ly). Very few have physical handi-
caps. Half of them have been previously committed to hospitals for
venereal disease treatment, several as many as four times. History
of broken homes, inadequate economic situations, and social problems
are very prevalent in the background of these girls (though 60 per
cent maintain good relations with their families).

Over half have not more than third grade education; one-eighth
have none at all. Vocational training, if any, and previous work
history, is typically in domestic service or needlework where earnings
averaged about two dollars per week. First sex experience was at
less than fifteen years of age in 40 per cent of the cases, usually by
seduction, though over a fourth were raped (including all seductions
where the girl was under 14 as rape). Over half of the prostitutes
were initiated into prostitution when under 18 years of age and most
typically they have been in prostitution for less than one year, indicat-
ing a fairly rapid turnover, although almost a third have been pros-
titutes for at least three years.

Most girls declare they got into prostitution because they wanted to,
and the majority were introduced into it by girl friends. Only 17
per cent were recruited by procurers, though the influence of pro-
curers or "facilitators" on keeping prostitutes in the business after
they once start appears considerable. Love of excitement and adven-
ture is an important factor especially among the younger girls.

Most soliciting is in bars and night clubs. Most common places of
actual sex contact are hotels, houses of prostitution and bars. Sixty-
five per cent of the patients have previously been arrested. The chief
charges have been disorderly conduct and alcoholism, the former of
which is the usual charge made when arrests are actually for prostitu-
tion, as prostitution itself is not against existing law.

There is evidence that the armed forces constitute more of the cus-
tomers than the civilian group. This is especially true of the younger
girls, and it is they who cite much higher earnings from prostitution
than the group as a whole. Average weekly earnings from prostitution
are $35, though one-fifth claim earnings of over $50 per week.

Over a third of the group state that they intend to continue pros-
titution upon release from the hospitals. Only 17 per cent have some
more or less definite alternative plan.

CONCLUSIONS

On the basis of patient 's attitude ; plus social worker 's impression
as to rehabilitation possibilities based on education, previous back-
ground, length of time in prostitution, etcetera, it appears that social
rehabilitation prospects are good for about one-third to one-half of

PATIENTS IN THE VD ISOLATION HOSPITALS OF PUERTO EICO 283

the group, if provided with facilities for training, guidance, social
case work and employment.

On the basis of attitude of patients toward prostitution, the follow-
ing classifications should be fair prospects for rehabilitation:

Per Cent

Intend to quit prostitution and have a plan .... 17
Intend to quit prostitution but have no plan .... 21
Would quit prostitution if could secure adequate

earnings elsewhere (or man to live with) 25

As to social worker's impression after interview, the following
proportions are classified as ' ' good ' ' or better rehabilitation prospects :

Per Cent

"Good" rehabilitation prospects 39

' ' Excellent ' ' rehabilitation prospects 3

Rehabilitation not necessary 6

It is the opinion of the staffs of the Bureau of Medical Social
Services and the Office of Community War Services, Federal Security
Agency, that a well planned vocational guidance and training pro-
gram must in most cases be supplemented by social case work in order
to provide the individual attention necessary to achieve reasonable
success in the rehabilitation of any substantial proportion of the
women now engaged in prostitution in Puerto Rico.

METHOD OF STUDY

The study was developed by the following steps :

1. Study of other research projects related to the problem.

2. Consultation with organizations and persons experienced in research of
this type.

3. Preparation of a tentative schedule which was discussed and refined by the
entire supervisory staff of the Bureau of Medical Social Services.

4. The tentative schedule was then tested by interviews with a small random
sample of hospital patients, which led to further revision, and presentation for
approval to the Social Rehabilitation Subcommittee. (A sample of the final
schedule is attached to this report.)

5. Interviews were conducted by eleven regular medical social workers and
eight medical social work supervisors, with 280 patients of Caguas and Troche
Hospitals, on various dates between December 20, 1943, and January 14, 1944.

6. To reduce to a minimum the differences in interpretation and appraisal by
the workers, detailed written instructions were given followed by a group dis-
cussion or institute.

7. Interviews with patients were preceded by interpretation and explanation of
the purpose of the study to gain their cooperation. They were assured that
information would be held in confidence, and that the Agency hoped to be able to
help them. Most of the girls were quite willing to discuss their situations with
apparent frankness and sincerity, and most of them seemed to feel the interviews
provided high relief from the boredom of hospital life.

284

JOURNAL OF SOCIAL HYGIENE

8. Only one interview was had with each patient, usually without verification of
the statements made by the patient (except consultation with hospital staff or
medical records for some of the patients stating they were not prostitutes, or not
recalling periods of previous commitment, etc.). There was no time limit for the
interview. They probably averaged two hours per patient. The interviews
were, of course, conducted in Spanish.

Specimen of Schedule

DEPARTMENT OF HEALTH
DIVISION OF PUBLIC HEALTH
BUREAU OF MEDICAL SOCIAL SERVICES

Confidential Information
SPECIAL STUDY OF PATIENTS IN V.D. HOSPITALS

V.D. Hospital at , P.R.

I. Identification Data:

A. Name B. Address

C. Place of Birth (Specify)

(Town) (Street) (Barrio)

D. Age. . . E. Race F. Civil Status

G. Religion H. Physical Handicaps (if any)

II. Medical Data (To be obtained from medical record) :

A. Diagnosis:

1. On admission 2. Final

B. Medical Recommendations

C. Source of Infection : D. Previous Commitments to V.D.

1. Natural Hospital

2. Promiscuity

3. Prostitution

III. Social background,:

A. Childhood (1 to 12 yrs.) B. Adolescence (12 to 21 yrs.)

1. Where spent : 1. Where spent :

(Town) (Town)

(Street) (Street)

(Barrio) (Barrio)

2. With whom: 2. With whom:

C. If patient was not brought up in natural home, explain why

D. Type of home she had:

During Childhood During Adolescence

(1 to 12 yrs.) (12 to 21 yrs.)

1. Years in this home

2. Family composition

3. Economic situation

4. Living space Persons Persons

Rooms Rooms

PATIENTS IN THE VD ISOLATION HOSPITALS OF PUERTO RICO 285

5. Social problem, in
family :

a. Alcoholism

b. Criminal history

c. Promiscuity

(specify)

d. Desertion

(specify)

e. Dependency

(specify)

f. Other (specify)

E. Actual relations of patient:

1. With natural family

2. With foster family

IV. Educational and Occupational History:

A. Grade completed B. Other training .

C. Work experience:

1. Type of work:

a

b

c

2. Weekly salary:

a

b

c

3. Place and time in occupation:
a

b

c

D. Vocational choices (if any) : a.

b.

V. Sexual History:

A. Age at time of:

1. First menstruation

2. First sex experience

a. Circumstances:

(1) Marriage

(2) Rape

(3) By whom

3. Seduction

4. Other (specify)

B. Age at which patient was initiated in prostitution.

C. Length of time in prostitution

1. Continuous 2. Intermittent .

D. Circumstances which led patient to become a prostitute:

1. Economic

a. Dependents:

(1) Own children (2) Other children.

(3) Adults

b. Poor jobs

(1) Low wage

(2) Ill-treatment in jobs (specify)

2. Attitude of husband

3. Attitude of parents

4. Influence of neighbors

5. Influence of friends

6. Lack of adequate recreation

7. Ill-treament at home

8. Dependency

286 JOURNAL OF SOCIAL HYGIENE

9. Desertion

10. Love for excitement and adventure

11. Love for personal adornment

E. By whom induced to present activity

1. How

F. Factors determining patient's continuation in this activity:

1. Income

2. Hypersexuality

3. Rejected by:

(a) Family group

(b) Social group

(c) Community

4. Influence of procurers

Other facilitators (specify)

5. Health problem in family (specify)

6. Other factors (specify)

G. Place of soliciting:

1. Bars 5. Night Clubs

2. Streets 6. Others (specify)

3. Hotels

4. Parks

H. Place of contact:

1. House of prostitution 7. Streets

2. Own home 8. Taxicabs

3. Own room 9. Open spaces . . . .

4. Hotels 10. Koadhouse

5. Boarding house 11. Others (specify)

6. Bars

I. Customers:

1. Contacts mostly with members of the armed forces . .

2. Civilians

3. Both

J. Reaction of patient to her present way of living

VI. Delinquencies other than prostitution:

A. Alcoholism E. Drug addict

B. Disorderly conduct F. Gambling

C. Assault and battery G. Larceny

D. Prostitution of minors (1) At what age.

VII. Confinement in Jail :

A. At what age ....

B. For how long

C. Seasons .

VEIL Present Life:

A. Living arrangements (explain)

B. Economic condition:

1. Income from prostitution:

a. Earnings last week

(1) Date of week

b. Average weekly earning

c. Minimum weekly earning

2. Income from other sources (specify sources) :

Amount Source

a

b. .

PATIENTS IN THE VD ISOLATION HOSPITALS OF PUERTO RICO 287

3. Distribution of last week's income:

a. Bent

b. Food

e. Clothing

d. Recreation

e. Transportation

f. Contribution to family expenses

g. Contribution to procurers

h. Contribution to others (specify)

i. Savings (specify)

IX. Worker's Impressions About Patient's Possibilities for Rehabilitation:

(Signature)
(Date)

MEMBERS OF THE SOCIAL REHABILITATION SUB-COMMITTEE OF
THE PUERTO RICO SOCIAL PROTECTION COMMITTEE

MBS. MARIA PINTADO DE RAHN, Chairman

Mas. DOLORES G. DE LA CARO MRS. PETRO A. PAGAN DE COLON

Miss CELESTINA ZALDUONDO Miss FELICIDAD CATAL

MR. LLOYD LEZOTTE Miss SARA RODRIGUEZ CHACON

MR. CONRAD VAN HYNINQ MRS. VESTA VESOSKE

MR. WINSTON RILEY MR. PEDRO SAN MIGUEL

MR. PAUL EDWARDS MR. MANUEL A. PEREZ

MR. ADRIAN DORNBUSH MR. HERMAN MONSERRATE

STAFF PARTICIPATING IN THE PROJECT

MRS. DOLORES G. DE LA CARO,
Chief, Bureau of Medical Social Services

Medical Social Work Supervisors, Bureau of Medical Social Services

Miss SELENE ROIG Miss MONSERRATE GONZALES OLMO

Miss GRACIA NADAL MRS. OLIMPA T. ZENO

Miss FRANCISCA Bou MRS. LUISA V. DE JESUS

Medical Social Workers, Bureau of Medical Social Services

MRS. JOSEFA V. GARCIA MRS. ANA MARIA MANGUAL

Miss JACINTA MURIEL MRS. NORA RAMIREZ

MRS. VIRGINIA CANTING Miss JUMTH TORREGROSA

Miss LYDIA DAVILA MRS. ISABEL NAZARIO DE CARPINTERO

MRS. ELENA R. DE PORRATA MRS. ARACELIS SANABRIA DE VAZQUES

Others

MISS ROSARIO CUCURELLA MlSS GEORGINA PASTOR,'

Field Agent Supervisor, Supervisor of Field WorTc, Medical Social

Bureau of V.D. Control WorTc, University of Puerto Rico

Miss MARGOT CORDERO, Social Worker Aide

Analysis of Data and Report Preparation by

MRS. DOLORES G. DE LA CARO MR. ROBERT C. UNKRICH, Assistant

Miss FRANCISCA Bou Territorial Director, Community War

Miss GRACIA NADAL Services, Federal Security Agency

THE SAN FRANCISCO SEPARATE WOMEN'S COURT *

KICHARD A. KOCH, M.D.

Chief, Division of Venereal Diseases, San Francisco Department of
Public Health

The San Francisco Separate Women's Court was established in
1943 to provide an adequate and enlightened social facility which
could be used as an intake center for women arrested for vagrancy,
prostitution, disturbing the peace and related misdemeanors. Estab-
lishment was indicated because of the inadequate facilities existing
and community awareness as to social responsibility in this regard.
Action was achieved by the coordinated efforts of the various official
and non-official agencies such as the California Social Hygiene Asso-
ciation, the Division of Social Protection of the Federal Security
Agency, the Community Chest, the War Department, the Navy
Department, the Mayor's Office, the City Administrator's Office, the
Police Department, the Sheriff's Department, the District Attorney's
Office, and the Public Health Department. The latter agency acted
in the capacity of a coordinator and attempted to organize the pro-
gram into a workable form.

Facilities Existing Prior to Establishment of Court

Prior to establishment of the Separate Women's Court facilities
for handling women arrested for offenses of this kind were, in the
large, similar to facilities existing for this purpose in most western
communities.

Before advent of the gonococcic culture technique for diagnosis of
gonorrhea, female vagrants were held under observational quarantine
for 12 to 18 hours during which time gonococcic spreads were prepared
and examined and serologic examinations for syphilis were performed.
The women were generally arrested during the evening hours and
placed in the city prison in a large tank about 30 ft. square. When
overcrowding existed, which was the rule rather than the exception,
manjr of these women slept on blankets on the cement floor of this
tank. First offenders mingled with habitual offenders and young
women were indiscriminately housed with the older group. Sub-
sequently juvenile delinquents were transferred to the juvenile court
for disposition.

The examining physician of the health department secured neces-
sary cervical and serologic specimens the morning following the

* Bead before the Third Annual Oregon State Conference on Social Hygiene,
February 4, 1944.

288

THE SAN FRANCISCO SEPARATE WOMEN'S COURT 289

alleged vagrant's arrest. The spreads were examined the same
morning at the examining clinic of the prison and reports as to
existence of gonorrhea were prepared for the jurist within 2 hours
of the examination. Usually 15 to 25 women were examined in a
period of from one-half to one hour. Serologic examinations were
performed in all cases but results of these examinations were not
available by the time the alleged vagrant appeared before the jurist.

By 10 or 11 o'clock the morning following their arrest (unless
a holiday intervened) these women, in a group, appeared before
the jurist. It was customary for him to scan the health department
examination reports of the women assembled and to mete out jail
sentences to all those found to have gonorrhea. The remainder of
the group were dismissed routinely unless the jurist recalled a name
or a face that might have appeared before him in the immediate
past. In such an eventuality he sometimes offered a word or two
of judicial or fatherly advice and perhaps assigned a fine of $5
to $25 to the most recalcitrant offender. Under this procedure
all those found to have gonorrhea as diagnosed by a positive spread
were sent to jail. Those who had a negative spread were dismissed.
No effort was made from a social point of view to assist any of
these women except those under eighteen years of age who were sent
to the juvenile court for disposition.

During the period of this procedure about 75 per cent of the
female vagrants could be classified as confirmed prostitutes or street
walkers who made their appearance usually at maximum intervals
of three months.

With the advent of gonococcic culture technique it became neces-
sary to hold arrested women under observational quarantine for
three days rather than overnight. This situation aggravated the
problem of housing and heightened the evils of the whole procedure.
Our health workers frequently reported the change in social outlook
that took place during this observational quarantine period in persons
arrested for the first time. On first being questioned by the doctors
most seemed willing to discuss their problem and amenable to
guidance, but after two or three days in prison environment they
seemed to become hardened, revengeful towards society, and unwilling
to accept any official assistance, which, as a matter of fact, due
to the non-existence of social services, was only to a minute degree
available. Most observers thought that one exposure of a woman to
this prison environment was enough to place her, in many instances,
beyond future social adjustments.

An effort was made to correct judicial inadequacies that had
developed under the program at the city prison. Women were being
sentenced to jail for having a venereal disease. They were not being
sentenced for committing a misdemeanor — prostitution and related
offenses. A joint meeting was held with all jurists, both of the
municipal court and the superior court, to seek their recognition of
this injustice. They agreed that confirmed prostitutes would be given
jail sentences whether diseased or not, and that in the future fines

290 JOURNAL OF SOCIAL HYGIENE

which were in actuality a municipal form of license would no longer
be imposed.

When this program was inaugurated it soon became apparent
that additional facilities would have to be added to the court struc-
ture. Under the old regime many women found guilty gladly paid
their fines and returned to their former way of life. Under the new
regime these defendants appealed for a writ of habeas corpus rather
than face jail sentences. The municipal courts in California are not
courts of record; consequently the testimony of witnesses was not
available and the superior court, without evidence of adequate proof
of the offenses charged, was frequently compelled to release the
defendant. As a result offenders were again released, their "license
fee" this time being legal costs in obtaining the writ of habeas corpus.
Those who could afford the price could pay for their freedom.

When these prison conditions and the judicial problems involved
became known to various members of the community, a unified effort
was formulated to provide a more enlightened administration. Various
potential sites for a new facility were investigated. It was impossible,
under war conditions, to construct such a facility; the only feasible
plan was to remodel an existing structure. It was decided to estab-
lish a separate court for the judicial determination of these cases
in an environment as far removed from conditions existing at the
city prison as possible.

The major purpose was to remove the court from the old traditions
of the Hall of Justice and from the influence of politics, shyster
lawyers, bail bondsmen, and the large court room, which was a gather-
ing place for the morbid-minded and other undesirable elements.
To emphasize the medical and social objectives of the new insti-
tution and departure from the summary, punitive, and fining pro-
cedures of the old system, it was decided to establish the court in
the civic center area.

The site chosen was a portion of the health center building formerly
used by the psychiatric court. Extensive structural alterations were
necessary, such as providing interviewing rooms, space for a medical
clinic, and adequate plumbing. A small court room, the judge's
chambers, and rooms to house defendants were already in existence.
The site chosen was relatively small and provided facilities for only
thirty-two women, but it offered in addition to removal from the
prison environment and the unhappy precedents of the past, oppor-
tunity for segregation, private interview, and office space for all
personnel concerned with the operation of this new court. Indi-
vidualized protective services were the new goals. The court became
known as Division 2, Department 10, of the Municipal Court. The
entire facility became popularly known as the Separate Women's
Court. It was opened on March 17, 1943.

Organization of the Court

As previously stated, the purposes of the Separate Women's Court
were to provide a facility that would contribute to venereal disease

THE SAN FRANCISCO SEPARATE WOMEN'S COURT 291

control with an organization that would assure equality before the
law of all offenders. It was also planned to provide a humane,
decent, and socially progressive method of operation. Under the
previous program the jurist spent about half-an-hour hearing the
cases of these defendants in a group, while the remainder of his
time was spent in the general women's court, mainly concerned with
domestic problems. No social workers were available to work with
sex offenders and clerical facilities of the health department were
inadequate.

The new facility provides in addition to the small court room,
the examination clinic, private interviewing rooms for social workers,
and office space, sixteen separate rooms, with two beds, a wash basin
and lavatory in each room. The premises are supervised by police
matrons, but the maximum possible privacy exists.

All women are given individual rooms in so far as they are
available and careful segregation is the rule. To provide for the
maximum degree of segregation during the observational quarantine
period, all meals are served in the individual rooms. Food served
is prepared at the San Francisco County Hospital and is of unusually
good quality.

Upon apprehension by a member of the police department, a
statement of the offense, the previous police history, and other
pertinent information is prepared and submitted to the Separate
Women's Court. The morning after arrest the patient is examined
by a physician of the Division of Venereal Diseases. Following
examination the woman appears before the jurist. If, in the opinion
of the jurist, enough evidence exists to hear the case, it is post-
poned for 72 hours in order to provide for social diagnosis, inter-
pretation, and determination of the presence of a venereal disease.
If, in the opinion of the jurist, the evidence presented is insufficient,
the patient is placed under observational quarantine and held under
the quarantine authority of the San Francisco Department of Public
Health. If this type of patient is subsequently found to be infected
with a venereal disease, she is held under treatment quarantine
until non-infectious, according to accepted criteria of cure. If the
patient is found guilty by the jurist, disposition of the case is
predicated upon previous history of the defendant and mitigating
or aggravating circumstances, and may be either a jail sentence or
release to probation custody. Treatment of a venereal disease follows
as a natural sequence.

The social worker interviews each patient during the quarantine
period. An attempt is made to confirm all phases of the history
received from the patient, so far as practicable. Home environment
is checked by field inquiry and telegraphic communication with
properly constituted agencies, and parents or relatives are contacted.
Following social inquiry the patient is given an Otis Self Admin-
istering Mental Test by the department of public health psycholo-
gist and selected cases are given various other special and vocational
aptitude tests.

292 JOURNAL OF SOCIAL HYGIENE

At conclusion of the 72 hour quarantine period the records of the
police department, social workers, health department, and psycholo-
gist are assembled in the patient's folder and become the permanent
record of the court. The social service workers prepare a half page
summary of the entire case which is included in the patient's folder
for convenience of the jurist and the deputy district attorney. This
method of preparing the case offers the jurist the opportunity
of quick and intelligent evaluation of social, psychometric, medical,
and legal aspects. In addition to this progressive service each case
now appears before the jurist individually, and adequate judicial
time is devoted to its complete consideration and constructive
determination.

One major shortcoming of the previous court arrangement has also
been remedied. The Separate Women's Court now has a court
reporter who makes a complete transcript of all testimony presented
during the hearing. As a result of having these records available,
no writ of habeas corpus has been granted by the superior bench
since the court has been in operation.

The personnel of the Separate Women's Court consists of the
following :

1 judge 1 female bailiff

1 doctor 2 culinary workers

1 nurse 1 porter

1 psychologist 1 head matron

1 deputy district attorney 3 matrons

1 court clerk 1 relief matron

1 court reporter 3 probation officers

1 male bailiff 3 clerk stenographers

Cost of physical establishment of the court, including alteration
to the premises, equipment, and supplies was approximately $18,000.
Yearly operation cost for salaries is $56,000, and cost of food and
maintenance is $9,000, a total annual expenditure of $65,000.

Increased personnel represents an increased annual expenditure
for salaries of $32,000;* added cost for maintenance is $3,000, a total
annual additional cost of $35,000.

Statistical Analysis

The Separate Women's Court from March 18, 1943, to January 1,
1944, dealt with 859 women. These cases resulted in 970 hearings
before the bench, representing a similar number of arrests. Thirty-
eight per cent of these arrests were in houses of prostitution, private
addresses, or hotel rooms. Eleven per cent of the arrests were
in bars and taverns, 24 per cent were street walkers, and in the
remainder of cases the place of arrest was not stated.

Judicial disposition of the 970 hearings is of considerable interest.
Four hundred twenty-two (44 per cent) were sentenced to the county
jail; 178 (18 per cent) were given suspended sentences with pro-

* 1 psychologist, 1 court clerk, 1 court reporter, 1 male bailiff, 1 head matron,
3 matrons, 3 probation officers, 2 clerk stenographers.

THE SAN FRANCISCO SEPARATE WOMEN'S COURT 293

bation; 100 (10 per cent) were given suspended sentences under
special conditions; 223 (23 per cent) were dismissed; 36 (4 per
cent) were referred to the juvenile court; and the remainder were
committed to the psychiatric ward of the county hospital or com-
mitted to a state mental hospital.

Some of the dismissed cases were referred to the psychiatric
service of the City Venereal Disease Clinic for assistance and
guidance. This service is available as a voluntary resource to assist
women who are potentially amenable to such guidance and assistance,
and is supplied with funds to assist in the furtherance of desired
objectives.

Seventeen per cent of the women arrested were under 21 years
of age, and 48 per cent were under 25 years. An analysis of the
inmates by race shows that 80 per cent were white, 16 per cent
were Negro, and 4 per cent were Indian and other races.

In so far as the incidence of venereal disease is concerned 219
(25.5 per cent) were found to be infected. Of all the women
examined 56 (6.5 per cent) were found to have syphilis, 159 (18.5
per cent) were found to have gonorrhea, and 18 (2.1 per cent) were
found to have lymphopathia venereum.

Classification of the women by the social service department shows
that 118 (14 per cent) were prostitutes, 25 (3 per cent) were drug
addicts, 314 (37 per cent) were promiscuous, 96 (11 per cent)
were alcoholics, and the remainder could not be definitely classified.
For the purpose of this classification prostitutes were defined as
women who required pay for their sexual act; drug addicts were
defined as those who were sexually promiscuous due to the effect
of drugs, or who were so in order to procure drugs; alcoholics were
defined as those who were routinely sexually promiscuous due to
the effects of alcohol, or in order to procure alcohol ; and promiscuous
women were defined as those who engaged in sexual intercourse
without monetary consideration due to a variety of social economic
and psychological motivations.

It is important to point out that a status of unemployment did
not enter into the problem of sex offenses. Only a negligible per-
centage of the women were unemployed due to inability to find work.
More than 25 per cent of them were either gainfully employed in
a legally accepted occupation or had marital status.

Seventy-five per cent of the women placed on probation satis-
factorily complied with its conditions. Thirty-four violated pro-
bation of which 30 were re-arrested, and 4 were under order for
re-arrest. On January 22, 1944, 248 remained on probation to the
court.

Comment

The San Francisco Separate Women's Court represents an impor-
tant attempt on the part of the municipality to recognize its respon-
sibilities in providing adequate legal, social, and public health

294 JOURNAL OF SOCIAL HYGIENE

services toward solution of the problems of sexual promiscuity and
prostitution. Such an endeavor of necessity requires the cooperation
of many departments of the city government operating as a coordi-
nated and cooperative unit. Such coordination and cooperation
requires effective liaison relations between the different depart-
ments, for if one department should fail in its responsibility or
fail to coordinate its activities with the others, the entire operation
of such a court may become difficult or it may eventually cease to
provide the services it was established to perform. The difficulties
in achieving such coordination of activities is increased by the fact
that the various contributing departments of such a unit have a
wide diversity of social training and professional outlook. The
judicial department and the district attorney's office are concerned
primarily with the legal responsibilities of the court. The jurist
is charged with the responsibility of protecting the legal rights of
the defendant as well as protecting the social and public health
interests of the community.

The members of the police department must detect and apprehend
the offenders and must make a minimum legal case against them
which, because of the very nature of the offenses charged, is usually
difficult to prove. In addition, the police department must provide
for the custodial care of offenders which includes the responsibility
for providing adequate facilities for legal consultation of the
defendants.

The probation department must provide trained social workers
to carry on an adequate social evaluation of the case and a concise
presentation of this evaluation to the deputy district attorney and
to the jurist. The department of public health must provide
adequate medical facilities for the examination and treatment of
the cases. These diverse activities and responsibilities indicate the
need for a coordinator who can cement the parts into a unified
whole. The jurist must liberally interpret the laws under which
the court operates; the district attorney's office must maintain a
strong protective attitude towards offenders; the police department
must be tolerant in its attitude, recognizing the difficulties and short-
comings of existing laws and judicial procedures; the probation
department must attempt to gain the confidence of the woman,
be just and fair in its case evaluations, and not wholly limit itself
to strictly legal requirements in the consideration of a case, rather
it should exceed these requirements, in order to offer the woman a
constructive program of readjustment and a friendly helping hand.

The department of public health must protect the community
from the dissemination of venereal diseases by careful and complete
examinations followed, if indicated, by modern treatment; in addi-
tion to this, through the mental hygiene facilities available, it should
furnish adequate psychometric evaluations to assist the court and
the social workers.

Unfortunately, the Separate Women's Court does not have an
official coordinator charged with the responsibilities of bringing

THE SAN FRANCISCO SEPARATE WOMEN'S COURT 295

together the diversified activities and responsibilities of the court.
However, the chief of the Division of Venereal Diseases has acted
in this capacity and has been assisted by others who have sought
to interpret the court to the community and acquaint the court
with available community resources. The fundamental objectives,
of course, are to provide a facility for venereal disease control and
the redirection of girls and young women who have become involved
in prostitution and promiscuity.

The San Francisco Separate Women's Court represents a sincere
endeavor on the part of the community to do a constructive job
in the control of venereal diseases by establishing a facility to
provide for the adequate legal and social disposition of these women
who markedly contribute to the dissemination of such diseases.
The court is well located in a clean and pleasant environment.
The clients are handled in a friendly, humane, and dignified manner
in order to permit them to maintain and develop self respect.
They are given every assistance possible to find a suitable place in
society.

The court has many shortcomings. The quarters are too small
to meet the needs of adequate detention. Too much of jail-like
environment prevails, giving an impression of punishment rather than
assistance. Recreational facilities and occupational therapy are not
provided and an adequate number of professionally trained per-
sonnel is not available for effective case work and supervision. The
greatest drawback of all is that the only place for quarantine
treatment is the county jail.

It is most important that adequate treatment facilities be pro-
vided in an atmosphere which will permit individualization of the
patient by providing facilities for segregation, recreation, training
opportunities, instruction, occupational therapy, and placement. Such
facilities should be provided in a treatment center apart from jails,
hospitals, or correctional institutions where a complete social and
public health job can be accomplished.

In this important matter the Pacific Northwest has shown the
way by the establishment (assisted by Federal funds) of two inten-
sive treatment centers. One is established as a municipal facility
in Seattle, Washington, and the other is a State facility located
at Grand Mound, Washington. Both of these centers offer excellent
medical, psychiatric, and social redirective services maintained by
a well-organized and professionally trained staff. Plans are under
way to establish a similar facility in Northern California. No
venereal disease control program is completely effective without
such a facility. In my judgment it is just as essential to offer
readjustment services to venereally infected young women as it is
to diagnose and treat their diseases. From the public health stand-
point it is as important to take steps to avoid reinfection as it is
to cure the first infection.

EEHABILITATION IN ACTION *

A SOCIAL HYGIENE SOCIETY COOPERATES WITH A RAPID TREATMENT CENTER
IN AIDING VENEREAL DISEASE PATIENTS

LUCIA MUECHISON

Chairman, Eehabilitation Committee, District of Columbia Social
Hygiene Society, Washington, D. C.

Although steady progress has been made through the years in
efforts to deal with problems arising out of sex delinquency, the
spotlight of war has revealed alarming deficiencies in both public
and private activities designed to solve these problems. Gratifying
advances especially were made in the fight against syphilis and
gonorrhea during the years just previous to the war, but early in
the nation 's mobilization, as young men began to pour into the Army
training camps and Naval bases, and the military medical officers
increased venereal disease control efforts within the reservation, public
health authorities realized that expanding programs and facilities
in the states and communities must be still further augmented and
speeded up to meet the growing needs. In some communities near
large camps or war industries facilities for medical treatment and
detention of infected civilians were practically non-existent, or
extremely limited. At best, such facilities were quite inadequate to
cope with the many-times-multiplied social hygiene problems which
follow in the wake of war.

Before war was declared, while the country was still building its
national defense program, a unified plan had been laid down and a
joint program begun to correct this situation, under the "Eight Point
Agreement ' ' l between the War and Navy Departments, the Federal
Security Agency (on behalf of the U. S. Public Health Service)
and the State Health Departments.

In furtherance of this Joint Agreement, as a logical development in
the campaign against syphilis and gonorrhea and as "a direct and
realistic effort to combat a definite wartime threat to our national

* This paper was prepared as a basis for discussion at a meeting arranged
by the Special Committee on Social Hygiene, National Conference of Social
Work, Cleveland, May 22, 1944.

1 An Agreement ... cm Measures for the Control of the Venereal Diseases in
Areas Where Armed Forces or National Defense Employees are Concentrated,
adopted in May, 1940. For text see Social Hygiene Yearbook, 1942. ASHA Pub.
No. A-438.

296

KEHABILITATION IN ACTION 297

strength," early in 1942, the establishment and operation of hospital
facilities was begun in areas where they were lacking.2

In addition to the increased facilities thus provided, these hospitals
were also planned to serve as bases for application of the newer tech-
niques in treatment of venereal diseases. With Federal funds made
available through the Lanham Act and the Federal Works Agency,
with consultation service and specially trained physicians, nurses and
technical personnel provided by the United States Public Health
Service, forty or more of these hospitals have been set up so far in
various parts of the country. The Rapid Treatment Centers, as they
are known, are usually located in buildings provided by the state or
local health department, or other official agency. Cooperating with
the other agencies concerned, is the Division of Social Protection,
Federal Security Agency, which works particularly from the angle
of social treatment and redirection of infected women and girls who
are brought under observation.

Under the Joint Agreement, the aid of the American Social Hygiene
Association, as the national voluntary agency, and that of the state
and community social hygiene societies, was requested. The present
article undertakes to give an account of the activities of one society's
special committee set up to work with the Rapid Treatment Center
operated by the Health Department of the District of Columbia at
Gallinger Hospital.

The Committee, officially known as the Rehabilitation Committee
of the District of Columbia Social Hygiene Society, was organized in
June, 1943 in preparation for the opening of the Gallinger Center
in July. The District of Columbia Social Hygiene Society through-
out its 26 years of work has always maintained a committee
on social protection as a vital part of the broad social hygiene pro-
gram. The primary purpose of the present Committee, which was
an outgrowth of the Metropolitan Civilian Defense Committee on
Social Protection and Venereal Disease Control, was to aid the admin-
istration of the Rapid Treatment Center in providing social therapy
for the patients to supplement the medical treatment. The Health
Officer of the District of Columbia assured the Social Hygiene Society
that the help of such a committee would be welcomed by the members
of his staff charged with responsibility for conduct of the Rapid
Treatment Center.

With this rather definite assignment the first important thing to
be done was to select the Committee's membership. To insure a well
rounded representation, the following persons were invited to serve :

Secretary of the Family and Children's Division, Council of Social Agencies.
Director of the Family Service Association.

2 For further information on the establishment of Rapid Treatment Centers, see
Social Hygiene Year Book 1942, Appendix 1, and VD War Letter, March 1943.

298 JOURNAL OF SOCIAL HYGIENE

Assistant Director of Catholic Charities.

Assistant Director, Public Assistance Division, Board of Public Welfare.
Director of the Women's Bureau, Metropolitan Police.
Executive Secretary, Travelers Aid Society.

Supervisor of the Protective Service for Children, Board of Public Welfare.
Director of Social Service, Juvenile Court.

Director of the Welfare Department, Washington Federation of Churches.
Case Supervisor, Jewish Social Service.
Director of the U. S. Employment Service, District of Columbia.

Eepresentative of the Regional Office, Social Protection Division, Community
War Services.

Superintendent of the Women's Division, Work House of the District of
Columbia.

Ex-officio members are :

Director of the Bureau of Venereal Diseases, D. C. Health Department.

Medical Social Work Supervisor, Bureau of Venereal Disease, D. C. Health
Department.

Executive Secretary, D. C. Social Hygiene Society.

The Center opened on July 12, 1943, and the Committee began its
work. The members approached their task with open minds, realiz-
ing that much needed to be done in this field, as social therapy has
not kept pace with the speedy progress of medical treatment. It was
thought, before the Committee could define its job, that a thorough
orientation of the purpose and functions of the Rapid Treatment
Center was necessary. This orientation was given by the Director
of the Bureau of Venereal Disease of the D. C. Health Department,
ex-officio committee member, and the first two meetings were given
over to discussion of medical aspects.3

Among the facts brought out were :

Pending the completion of an additional 50-bed hospital wing made
possible through Lanham Act Funds, the Center, with 50 beds, is
located in a renovated building on the grounds of the Municipal
Hospital. It is expected, however, eventually to utilize both build-
ings, making 100 beds available.4 The personnel consists of a medi-
cal officer in charge, nurses, a public health nurse and a placement
officer who is a social worker. The Center provides various forms of
treatment for syphilis with special emphasis on the five-day treat-
ment for those patients who are physically able to take this type of
therapy. The experience indicates 30 to 50 per cent of the patients

8 The Committee has had the privilege of having recent meetings at the Center
where patients could be observed taking treatment.

4 (The second 50-bed wing was completed and put into service in October,
1943.)

[REHABILITATION IN ACTION 299

admitted are able to do so.5 All planning for these patients should
be based upon rapidity and decisiveness. The schedule of study,
treatment and disposition of patients in the Center must be geared
so that it is completed within ten days. Before a plan of treatment
is decided on, the patient will receive a three-day work-up to deter-
mine the form of treatment most suitable. During this time, social
evaluation will also be started. The ten-day period of stay will be
assigned as follows: three days for observation, five days for the
intravenous injections, ninth day spinal puncture, with patient dis-
charge on tenth day. Records show that this treatment produces at
least 85 per cent "cures." The schedule is strenuous and, while the
Center has the authority to isolate the patient, it cannot force treat-
ment. Treatment of the type advisable is explained to the patient
with the hope that he will submit to whatever course seems best for
him. Patients must give written consent before treatment is started.
The mortality rate for the five-day treatment is about one in 300.

The Center will also treat gonorrhea with sulfa drugs and the
newer penicillin when necessary, if it can be obtained. It is expected
that this drug will also be made available later for the treatment
of syphilis.

Admission to the Center is through the Bureau of Venereal Dis-
ease of the Health Department and patient-sources are the Women's
Bureau of the Police Department, venereal disease clinics, voluntary
admissions, private physicians and the isolation of those individuals
who are known to be promiscuous. Since the present object of the
Center is to halt the spread of disease by treating as many infectious
persons as possible as rapidly as may be, only patients in the early
active stages can be accepted. Residence or financial need of the
patient are not considered as criteria of admission.

As this is written, patients treated at the Gallinger Center number
over 800, and on the ten-day schedule the turnover naturally has been
great. However, realizing that the Center's responsibility does not
stop with the completion of medical treatment, the placement officer
has attempted to conduct admission interviews to screen if possible
the types of social problems.

These interviews show that many patients do not want help of any
kind, many are already known to social agencies, many want help but
are not good material for rehabilitation purposes. Consistently the
population of the Center has been composed of the younger age
group, — the early teens to twenty-five years. Because of the limited
psychological service available, routine psychometrics cannot be given.
However, the few that have been tested reveal I. Q.'s ranging from
50 to 70. The professional staff at the hospital believe that approxi-

6 For patients unable to pursue the five-day treatment course, other methods,
including the standard long-time treatment, are adopted. The latter patients of
course do not require hospitalization, are usually ambulatory and so can be
treated through the regular clinics and out-patient dispensaries, and the social
therapy can use the routine slower technics.

300 JOURNAL OF SOCIAL HYGIENE

mately half of the group of 800 that has been treated, are of low grade
mentality.

The placement officer early was faced with the problem of obtain-
ing emergency relief for the group of patients who have no resources
and no place to go upon discharge. Then there is the group of
patients who are employable, but need shelter and some new clothing
to tide them over until the first pay is received. Still another group
of patients includes the young boys and girls admitted with infec-
tious primary syphilis, who need supervision and protective services.
For the most part the history of these adolescents reveals that they
are a mentally dull group. The unmarried mother presents a problem
in that many do not want to accept institutional care but want to
place their babies so that they can return to work. The non-resident
who is unwilling to return to his own community also presents the
need of emergency relief and service.

How to make a plan that would assure the patient upon discharge
that his immediate problem would be met was a challenging experi-
ence for the placement officer. When this work was started the
intake policies of the social agencies, both public and private, were
not flexible enough to accept referrals from the Center without first
having the patient interviewed by their own intake worker. The
Center has sometimes held beds for patients so that they might go
to the agency for the intake interview. It was also found that emer-
gency relief from the Public Welfare Department was not available
sooner than approximately three weeks following hospital discharge
due to legal restrictions based on the establishment of need and
residence.

The Committee soon realized that, if the social agencies were to
be of assistance to the patients discharged from the Center, the intake
policies would have to be stepped up to keep pace with the speed of
the medical program. Also it was evident that the social agencies in
the community have the ultimate responsibility in this problem. The
question of referrals was discussed in the whole committee but it
was felt that a smaller group, representing the private case-working
agencies, public welfare and children's protective services should get
together and work out ways and means of meeting this problem. The
secretary of the Family and Child Welfare Division of the Council of
Social Agencies was asked to call the group together. The problem
was presented to the Steering Committee of the Family and Chil-
dren 's Division of the Council of Social Agencies, which approved the
study of the problem and requested the secretary to assemble the
group. Several meetings were held by this sub-committee, and from
these meetings the agencies have developed a better understanding of
the Center 's problems and the intake of the agencies has become more
flexible, as evidenced by such facts as : the Travelers Aid Society will
now accept referrals by telephone and give emergency assistance
pending investigation ; the Catholic Charities and Jewish Social Serv-
ice will send a worker to the Center to interview the patient; the

REHABILITATION IN" ACTION 301

Family Service Association has been accepting referrals by telephone
and if financial assistance is needed, the patient upon discharge is
seen immediately at the agency and assistance given.

Due to legal limitations, the Public Assistance Division of the Board
of Public Welfare cannot give emergency assistance; therefore, the
Committee has recommended that the Center placement officer be
given a petty cash fund to be used pending investigation by the Divi-
sion or in other emergency situations.

The Committee's work soon showed that the two big needs of
patients were for emergency relief on discharges and protective serv-
ices for the adolescent dull-minded group. The Committee, meeting
with the placement officer at the Center, was most helpful in working
out referral procedures and the procedures for handling cases active
with an agency. It was suggested that the following kinds of infor-
mation would be important and necessary for the agency to have :

1. Patient's reaction to treatment and his feeling about his illness.

2. The need of follow-up at the Clinic and the intervals at which it should
occur (these intervals will usually be one month).

3. The need for examination of other members of the family.

4. The limitations as to the type of work the patient can perform.

5. Social and financial information pertinent to eligibility.

6. The possibility of emotional and physical handicaps growing out of the
disease such as sterility or mental illness.

The Committee agreed, for the time being, on this type of informa-
tion with the thought that as the Center and the agencies had experi-
ence in working together, further procedures could be worked out.

It may be of interest to know that among 168 cases admitted in
April, 1944, the placement officer was able to be of service to 139
patients. The following statistical report gives a break down of
some of the services given:

Number of cases carried over from March 21

Number of new patients interviewed 118

Total number of cases 139

Number of psychometric tests 7

Number of cases carried cooperatively with other agencies 51

Referrals to other agencies 9

Field visits 3

Collateral visit with relatives 23

Referred to United States Employment Service 33

Authorization to return to home community 1

At the first meeting of the Committee, the Director of the U. S.
Employment Service of the District of Columbia stated that it would
be possible for members of the staff of the D. C. Employment Center

c Ub*"ci

302 JOURNAL OF SOCIAL HYGIENE

to hold interviews in the Rapid Treatment Center before the dis-
charge of patients. He estimated that throughout the country be-
tween 25 and 40 thousand in this group would be an additional
source of labor supply, which can be diverted into productive chan-
nels of employment. The most important factor for the Employment
Center is, of course, expressed in terms of physical capacity of the
patient for work. This practice of interviewing patients at the Center
has been most helpful.

The Committee representative from the Federation of Churches
pointed out that religion often played a great part in rehabilitation
and suggested that the chaplain assigned to the Municipal Hospital
be urged to work out a program for the Center. The Committee wel-
comed this suggestion and requested that the chaplain be asked to
conduct a religious program.

In spite of the fine adjustment that most patients were found to be
making to the hospital routine, the placement officer and the medical
officer in charge believed there was a real need for a recreation pro-
gram, and recreation rooms in which to carry on the activities. Unfor-
tunately public money was not available for recreation personnel or
program. The executive secretary of the Social Hygiene Society sug-
gested that certain city clubs might be interested to equip and
decorate a recreation room and offered to investigate the matter.
Many practical suggestions were received. It is gratifying to report
that two rooms (one in the women's dormitory and one in the men's)
have been attractively re-decorated, the necessary money being fur-
nished by the Social Hygiene Society from a special fund, and suit-
ably furnished and equipped. Pictures were donated by the Director
of Children's Division of the Public Library. The Hotel Lafayette
collects used but current magazines and arrangements have been made
for regular delivery to the Center. The Variety Club of Washington
has given a radio and is supplying games of all kinds. The Council of
Church Women have made a donation to purchase material for a
sewing project. A sewing machine was loaned by the Women's Divi-
sion of the Work House. The Public Library contributed a fine col-
lection of children's books, through the Strong Memorial Fund for
handicapped children, and plans to make a donation of adult books
from their used collection.

As the project grows, it demonstrates more clearly than ever that
effective rehabilitation is dependent upon the cooperation of everyone
in the community and that the opportunity for service is limitless.

The Committee plans to work out procedures for follow-up of the
patients referred to the social agencies and the U. S. Employment
Service. It is hoped that an institute can be given soon for case
workers of the agencies actively working with the problem.

KEHABILJTATION IN ACTION 303

The Committee is convinced that the problem requires an all-com-
munity approach with especially active participation by agencies
offering welfare and protective services. The members realize that
their work has only begun; but results to date convince them that
they have evolved a practical pattern for correlating medical and
social therapy and helping to restore sick and mistaken human beings
to useful places in the social order.

. . . "Supervision after discharge is one of the most vital parts of
the whole institutional program, particularly for the type of offender
who, in addition to being a law violator, has also been a social outcast.
The social worker responsible for guiding this offender back to a new life
must be able to deal with her feeling of insecurity, her difficulty in evading
old haunts and companions, the lure of easy money, and her difficulty in
forming new relationships. Frequently there is so much rejection by the
family group that other living arrangements are essential. There are the
questions of a job, of clothes, of recreation and a social life to be faced.
More fundamental, however, than all of these, is the relationship between
the after-care worker and her client. Understanding and acceptance of
the woman's problem, insight, patience, courage and resourcefulness — and
I would like to repeat and emphasize — courage and resourcefulness in
dealing with it, will go far toward rebuilding and redirecting the offender 's
life pattern. ..."

From Rehabilitation of the Female Sex Offender, a
paper given at the New York Social Hygiene Con-
ference, February 2, 1944, by MARIE DUFFIN, Social
Protection Division, Federal Security Agency.

WHO ARE THE JUVENILE DELINQUENTS?*

WINFEED OVERHOLSER, M.D., Sc.D.
Superintendent, Saint Elisabeths Hospital, Washington, D. C.

At practically every stage in the world's history the older genera-
tion has been much concerned over the conduct of the younger
generation, and has felt that the oncoming youth were headed
directly for perdition. It is well to remind ourselves of this fact in
order to maintain a certain amount of perspective when, as at present,
we hear that there exists an "alarming" increase in juvenile delin-
quency. Is there a juvenile crime wave? Probably not. There seems
little doubt from the statistics that there has been during the past two
years a substantial increase in the number of offenses committed by
juveniles, at least in certain age groups. A certain amount of cau-
tion has to be exercised, however, in interpreting these statistics.
Delinquency is a term which covers a large variety of types of anti-
social behavior, types which vary substantially in severity, just as
in the case of adults, murder and violation of the automobile laws are
technically both crimes, although of considerably different social
significance. The types of offense which seem to have shown the
largest increases in general are particularly sex delinquency among
girls, truancy, running away from home, and larceny of the more
aggressive type.

The reasons for these increases in offenses are variously enumerated,
depending upon the primary interest of the enumerators. The social
worker is inclined to blame broken homes and decreased supervision ;
the recreation worker lack of recreational facilities; the housing
expert explains the situation in terms of housing; the clergyman in
terms of lessened influence of the church; the educator as a problem
of curriculum. Various groups have made studies and are now so
engaged, but in these groups one is very likely to find one type of
expert overlooked, namely, the psychiatrist. It is as a psychiatrist
that I appear before you, and perhaps I may be pardoned if I say a
few words concerning the interest of the psychiatrist, not only in
delinquent behavior, but in behavior of all sorts. The psychiatrist is
a physician who, perhaps more than in any other specialty, looks upon
the individual as a whole. To him the child or the adult is an indi-
vidual with certain wants, needs, and instincts, faced with various
situations, frustrating or facilitating, and exhibiting his ability, or
lack of it, to deal with stresses and adjust himself to varying situa-
tions in various ways. He is concerned, in other words, with the
forces operating upon the individual, whether these be social or
economic or religious, and at the same time he is interested in the
person upon whom these influences are at work. He does not hold

* Address before Social Hygiene Society, Washington, D. C., February I, 1944.

304

WHO ARE THE JUVENILE DELINQUENTS? 305

the whole answer, but neither does the clergyman, nor the recrea-
tionist, nor the social worker. The problems of delinquency need to
be dealt with by all of these groups working together and supple-
menting each other's skills and approaches.

To psychiatrists everyone is possessed of certain drives, needs,
instincts, or whatever we wish to call the driving forces. The infant
has no conscience but soon learns that certain practices and
abstinences are expected of him. His conscience, in other words, is
acquired from the social situation in which he is brought up. His
capacity for learning may be great or slight. In one instance we
speak of him as being bright or intelligent and in the other case as
stupid or moronic. As life becomes more complicated, as it does for
all persons as they grow older, he is called upon to adjust himself
to more and more difficult situations and the possibilities of adjust-
ment become greater and greater. The normal type of adjustment
brings the greatest emotional gratification and at the same time con-
forms to the requirements of the community. Instead, however, of a
normal means of emotional gratification we may find a neurotic one,
a perverse one, or a delinquent one. The gratification of needs is the
principal drive in any behavior.

With the advent of adolescence, aggressiveness becomes consider-
ably more marked, as does the sex drive. If the child feels that he is
wanted at home, if the atmosphere of the home is one of calm and
affection, the child will feel reasonably secure and there will be less
call for aggressive behavior for the purpose of attracting attention.
Much of the behavior of adults, whether delinquent or otherwise,
stems from their early years in the home and the attitude of the
parents toward them. In a very real sense juvenile delinquency is
an outgrowth of disharmony and insecurity in the home situation.

With the development of aggressive drives and the new attitude
toward the opposite sex which come about as a result of adolescence,
problems of adjustment become considerably more difficult. It is not
strange, therefore, that we find evidence that maladjustment is more
frequent in those of lower intelligence. There are figures which
indicate that in Bristol, England, for example, the increase in
juvenile delinquency in 1942 as compared with 1941 was a sixfold
one among the dull and borderline, whereas there was actually a
reduction of nearly one-fourth among the children of average in-
telligence. These problems of adjustment are magnified considerably
by war conditions; we may consider, then, what some of these con-
ditions are and to what extent the community must bear its responsi-
bility for the child's shortcomings.

One of the significant war factors is one of those which is rela-
tively intangible, namely, the accentuation of the instinctive drives,
particularly those of sex and aggression. A nation which does not
have a spirit of aggressiveness cannot wage successful war, and this
atmosphere must pervade the entire community, civilian and military
alike.

306 JOURNAL OF SOCIAL HYGIENE

Aggressiveness is a normal part of the make-up of every individual ;
in time of war it should be directed outwardly against the enemy.
It is no accident that the suicide rate falls considerably during war-
time; aggression is turned on one's self more in times of peace than
of war. At the same time there is a considerable amount of insecurity.
It is recognized that many will be killed or maimed and there is a
feeling that perhaps it is better to seize what is present than to wait
for what is hoped for but may never come. It is not at all improbable
that the large number of early and rather hurried marriages, as they
would be considered in normal times, are manifestations of this feel-
ing of present insecurity and even of some doubts as to the nature
of the society which will survive the war. In wartime life is lived
at a higher pitch. The glory is greater, the grief is greater, too.
Tensions are accentuated; it is therefore particularly important that
suitable outlets be found in such a time.

The development of competitive sports in the schools should prob-
ably be encouraged, but emphasis should be laid upon the importance
of holding to the rules of the game. This is a valuable antidote
toward the tendency of a wartime society to lower standards and
relax the rules. In many families the tension is increased, particu-
larly when the decision has to be made as to whether the father will
enter the armed service or stay in civilian life, whether the mother
will take up work, or what will be done. All too often these matters
are under discussion and consideration without the children's being
consulted or told what is going on. The children feel this tension,
realize that something which may threaten their security is being
considered, and not infrequently may react with some form of
aggressive behavior, such as shoplifting. Many parents fail to realize
that children sense contemplated changes and that they should be
kept advised as to what is being considered. All too often it is for-
gotten that children are people.

Another point of value to children and adults in these times is
the feeling that one is participating in the activity of the group,
especially, in activity related to the war. The various civilian defense
projects were of great use in this respect, and such things as scrap
paper collections make children feel that they are playing a part (as
they really are) in the common defense.

Many homes are broken by the war; broken, that is, in the sense
that the father or older brother, or both, are away in military
service. The women's services have been wise in not permitting
women with young dependents to enter them. This rule tends to
keep the home together at a crucial time in the child's life. Even
now it is quite possible that from the point of view of the main-
tenance of the home, there is more employment of women than there
should be. There are all too many children who hardly see their
parents from one end of the week to the other. Both may be working,
leaving home early in the morning and perhaps not coming back until
long after the child is home from school. Supervision is necessary
for adolescent children, and this cannot always safely be entrusted
to the public schools, valuable as those organizations are.

WHO ARE THE JUVENILE DELINQUENTS? 307

I am one of those who is old fashioned enough to think that the
home is a useful institution, and to lament the fact that too many
persons shunt on to the public schools, and on to other social organi-
zations, responsibilities which they, themselves, should assume. Such
persons are likely to be the first to criticize and to say that the
schools and other organizations are "falling down" on the job.
Projection of this sort is quite necessary sometimes to preserve one's
own self-respect and those who complain the most loudly are often
the most to blame.

A great deal of the sex delinquency of adolescent girls is to be
laid directly at the door of faulty supervision on the part of parents.
There are many well-organized activities going on for the benefit of
service men and it would be far preferable if some of these young
girls should be allowed to serve as hostesses at some of these well-
operated affairs for service men rather than that they should be
loitering about in dark corners unsupervised, as is, to a considerable
extent, the case. It should always be borne in mind in discussing
this matter of sex delinquency among adolescent girls that a very
considerable influx of rather young and entirely unattached women
has occurred as a result of the expansion of some of the Govern-
ment departments, and the increased private employment oppor-
tunities in the glamorous capital of the nation. There is some doubt,
from the statistical point of view, whether the increase in known
sex delinquency among girls is substantially greater in proportion
to that particular age group in the general population than is the
case in peacetime. Certainly there is every reason to think that
from the recent development of the venereal disease program in the
city the venereal rate is actually less than was the case two or
three years ago ! This is not said in defense and certainly should
not be taken as an excuse for relaxing any of the activities, but
rather as a reason for seeking to accomplish still more along the
same line.

In Washington, as probably in every city, there are advantages
and disadvantages, some of them peculiar to this area. Notable on
the debit side is the large number of persons in the city who look on
themselves not as bona fide citizens of the District of Columbia, but
as citizens of one State or another temporarily living in Washington.
This rootlessness and the rather substantial turnover of population
inevitably have a deleterious effect upon the civic spirit, as witness the
difficulty in achieving the quota of the Community War Fund. Among
the younger group of Government employees, however, the situation
has shown improvement as compared with a year ago; the turnover
is less and the provision of recreational facilities has been very grati-
fyingly developed. Our Police Department is well oriented toward
the preventive aspects of their duty. The development of the Police
Boys' Clubs, for example, is an extraordinary thing which reflects
great credit upon the Police Department. The same may be said of
the Women's Bureau and its very active protective measures. Our
Juvenile Court has recently been provided with a psychiatric clinic
which adds substantially to its ability to separate the treatable from

308 JOURNAL OF SOCIAL HYGIENE

the nontreatable who come before that court. There are those of us
who hope that the school system may be likewise provided with
psychiatric facilities before too long a time has elapsed. There are
numerous settlement houses, parks and playgrounds, most of which
could well use more funds. These are times in which the provision
of additional personnel is difficult. Trained people are needed in the
Services, and in the Red Cross, and to fill vacancies as they occur is
difficult enough even without trying to obtain new positions. In
wartime, however, above all other times, so-called economies in the
field of protective services and welfare services, in relief, in the pro-
vision of nursery schools, and in the various other public functions
which contribute to the supervision, development and the training
of children, turn out to be an expensive luxury for the future
welfare of the children.

. . . What is it like to be a girl of thirteen or sixteen or a young woman
of eighteen in this war year of 1944? It seems doubtful that we who are
charged with some responsibility to teach, protect, correct or rehabilitate
really can "understand" the adolescent girl of 1944. . . . There has been
so much talk about a relatively small minority of girls that it appears
as if all girls and young women had thrown overboard all of the restraints
and self-disciplines which our present cultural patterns have set up as con-
stituting acceptable conduct. Actually, we know that the promiscuous girls,
the runaways, indeed the whole group that is characterized as "victory
girls", "bobby-sock girls", etcetera, represent but a handful out of our
nearly ten million girls between thirteen and twenty, the majority of whom
are carrying on their school work and family life in constructive fashion.
There are, however, certain problems common to girls in those years
between thirteen and twenty which become intensified in their effect on
the small minority with whom we as adults have some responsibility for
guiding, protecting, and even correcting against their wills. Only as we
comprehend the effect of modern civilization on the attitudes of the whole
group of girls can we begin to see the infintely difficult and painful
problems of the smaller group. ... In the face of these new aspects
. . . it seems essential that all governmental and voluntary agencies
sit down around a table, admit their ignorance of many factors and pool, in
all humility, such wisdom and resources as they can. This to the one end
that each young woman who strays off on the alluring path of adventure,
from whatever motivation, shall be given a chance to find a more satis-
fying mode of life.

From Girlhood 1944, an article by MARGUERITE MARSH,
Associate Director, Contributors Information Bureau,
Welfare Council, New York City.

EDITORIAL

"THIS WAY OUT . . . ?"

Of the social hygiene problems which war throws into sharp focus,
none is more frequently encountered nor more difficult of solution
than those which concern the woman sex offender. Always a potential
carrier of venereal disease, and a symbol of society's failure to
protect her and the community where she dwells, in wartime she
is an actual hindrance to victory. She takes up the time of the
courts and crowds the jails. She often recruits to her trade others
who might be grinding gears, filling shells or otherwise contributing
to war needs, and most of these are young girls — and boys. More
often than not she is infected with syphilis or gonorrhea, or both,
and so she spreads disease and keeps service men and industrial
workers out of the ranks. For her healing must be made available
the time of nurses, doctors and clinic workers, drugs, instruments
and hospital beds which might be used to advantage otherwise. The
same is true of those to whom she passes on her infection. In short,
her activities may definitely be classed as sabotage. And in wartime
there are so very many of her !

War has high-lighted these facts, and one more stands out clearly :
It is of little use to spend money and time to round up these victims
of an ancient evil, nor to rid them of their syphilis and gonorrhea,
unless at the same time an effort is made to get rid also of the
underlying conditions responsible for their plight, and to help them
back to individual normalcy. The "revolving door system," as it
has been called — arrest — conviction — jail sentence — treatment if
infected — release — leads only to further misdemeanors, arrest again,
and the same procedure over and over, with no permanent gains.
The new "rapid treatments" which constitute such a boon to suf-
fering mankind, unless they are balanced with adequate retraining
and rehabilitation towards decent employment and ways of life,
only make it possible for the revolving door to whirl faster.

Splendid progress has been made during the past three years in
community action against the increased menace of wartime commer-
cialized prostitution. The Federal Security Agency's Division of
Social Protection reports over 650 towns and cities which have insti-
tuted effective law enforcement against this racket. The campaign
against clandestine or "free-lance" prostitution — a chief source of
venereal infection among the armed forces — is also making progress.

309

310 JOURNAL OF SOCIAL HYGIENE

On the preventive side, home-towns have become aroused over con-
ditions which lead to sex delinquency, and are providing better
recreation and other safeguards for young people. But we have
hardly made a beginning in the present war period on the job of
salvaging those who come to harm when these safeguards break
down or are not set up soon enough for early protection. More
intensive study, more widespread effort, and more trained workers
are needed. Especially is needed more thorough public understand-
ing of the problem and what can be done about it. Citizen opinion
seems to range all the way from an over-sentimental attitude that
the woman or girl who becomes involved in prostitution is "more
to be pitied than censured" to the hard-boiled view that she is a
criminal, to be punished as the penal code provides. In either case,
many seem to believe that nothing much can be done to restore or
retrain her.

The truth, of course, is somewhere in between these extremes, and
must be gauged largely by the individual situation. While a gen-
eral program can be laid out for all, human salvage in this field
does not proceed successfully by assembly line methods. It is a
person-by-person job — genuine casework of the most delicate and
painstaking kind, whether in the court, the medical center or the
community. And success depends much, as in other endeavors for
human health and welfare, on how well public understanding and
cooperation backs up the effort of the trained workers with funds
and facilities as needed.

The studies, methods and projects reported in this number of the
JOURNAL are examples of the ways in which some American com-
munities are undertaking solution of these salvage problems in the
present difficult days. Neither the situations described nor the
remedies proposed are unique or new. But, with many similar efforts
in other localities, they indicate encouragingly that there is, as Jane
Addams once said "a new conscience" about these matters, and a
disposition to follow up with action where that conscience leads.

As the articles testify, some who infringe on the moral and civil
law deliberately choose to continue in the same way when released
from custody. Others must be constantly guided and protected if
they are to keep out of trouble, and frequently fail. But a con-
siderable number, if given a chance, are both willing to make a new
start, and capable of attempting it. For these especially, the com-
munity should see that the road back to right living is free from
obstacles or barriers, and that the signs read plainly ''this way
out . ."

NATIONAL EVENTS

EEBA EAYBUEN
Washington Liaison Office, American Social Hygiene Association

National Conference of Social Work at Cleveland. — The National
Conference of Social Work which in 1943 assembled through a series
of regional meetings, due to wartime transportation limitations,
resumed its schedule of holding a national meeting in 1944, at
Cleveland, May 21-27. Sessions of particular interest to social
hygiene workers were listed among the regular events, and the
American Social Hygiene Association, as an associate group prepared
a special program. The ASHA meeting occurred on May 25 at
8:00 P.M. in the assembly room of the Hotel Hollenden and was
open to members of the Conference and interested friends of social
hygiene in the community. A large group of national, state, and
Cleveland agencies joined in sponsorship. The program was as
follows :

Subject: New Contributions of Powerful Allies to Social Hygiene.

Presiding: MRS. STANLEE T. BATES, Chairman, Social Protection Committee,
Welfare Federation of Cleveland.

Speakers: Labor and Management Join in a Notable Demonstration Program
for the Defeat of Venereal Diseases — PEBOY SHOSTAC, ASHA Consultant on
Industrial Cooperation.

Pharmacy Mobilised Against VD — IVOR GRIFFITH, Phar.D., Sc.D., President,
Philadelphia College of Pharmacy.

Negro Groups Expand Their Participation in the Fight Against the Venereal
Diseases — PAUL B. CORNELT, M.D., Head of Department of Bacteriology,
Preventive Medicine and Public Health, Howard University.

One of the Special Committees planning regular sessions of the
71st Annual Meeting of the National Conference of Social Work
was the Committee on Social Hygiene, of which Ray H. Everett,
Executive Secretary of the District of Columbia Social Hygiene
Society, is chairman. The Committee scheduled the following
programs for two meetings, on Social Hygiene and Social Protection:

May 22, 11 A.M.

Sex Delinquency as a Social Hazard — ELIOT NESS, Director, Division of
Social Protection, Federal Security Agency.

Purposes and Methods of Individual Treatment — KATHARINE F. LENROOT,
Chief, Children's Bureau, U. S. Department of Labor.

Discussion Leader — LUCIA MURCHISON, Navy Eelief Society. (See page 296.)

May 23, 11 A.M.

Policewomen's Part in Social Protection — ELEANORE HUTZEL, Chief, Women's
Division, Department of Police, Detroit.

311

312 JOURNAL OF SOCIAL HYGIENE

Social Worker — What Are Ton Doing about Better Laws and Law Enforce-
ment?— BASCOM JOHNSON, ASH A Field Representative and Associate Director.

Discussion Leader — HENRIETTA ADDITON, Superintendent, Westfield State
Farm for Women, New York.

The Association sponsored a consultation and exhibit booth in
the Exhibit Hall of the Public Auditorium. Consultants were in
attendance daily from 9-10 A.M. and from 1-2 P.M. throughout the
period of the conference.

Penicillin Made Available for Civilian Use. — The War Production
Board announced early in May that a limited distribution of peni-
cillin for civilian use would be initiated through the use of 1,000
hospitals all over the country which have been selected to serve
as depots for the distribution. An Office of Civilian Penicillin Dis-
tribution has been established in Chicago with Dr. John N. McDonnell
as director. The depot hospitals, selected by an advisory panel
including representatives from the WPB, U. S. Public Health Service,
and the American Medical Association, will be expected to recognize
requests of other hospitals and to furnish penicillin for their purchase
according to the need and the available supply. First shipments
of penicillin under this plan were expected to be received by some
of the hospitals by May 10.

Meanwhile the study of penicillin in relation to control of syphilis
and gonorrhea- continues, with results which indicate that this drug
may prove the most potent agent yet developed toward eradication
of these infections.

Caribbean Commission Makes Recommendations for Unified. VD
Control Program. — At a West Indian Conference held at Bridge-
town, Barbados, March 20-31, the Anglo-American Caribbean Com-
mission's Subcommittee appointed to consider Health Protection and
Quarantine made a report and recommendations for venereal disease
control in the Caribbean countries which mark another advance in
efforts toward a unified campaign against syphilis and gonorrhea
in this important area.*

Appearing as Section C of the Subcommittee's full report, the
statement and recommendations read as follows:

"C. Venereal Disease Control.

16. We consider that Venereal Disease Control is an urgent necessity in
the Caribbean area and that the various territories which have not yet done so
should proceed to institute Venereal Disease control programmes which should

* See JOURNAL OF SOCIAL HYGIENE, October, 1943, page 453, for report and
recommendations of a Joint Meeting of the Commission with the Interdepart-
mental Venereal Disease Committee, June 28-30, 1943. Following this meeting
a statement of U. S. Government Policy with reference to Venereal Disease
Control in the Caribbean Area was issued by the Committee, and subscribed
to by the Secretaries of War and Navy, the Federal Security Administrator,
by the Surgeons General of Army, Navy and Public Health Service, the Director
of Community War Services, and by the officers and representatives of these
agencies having charge of Caribbean activities.

NATIONAL EVENTS 313

include propaganda and education for the prevention and early treatment of
venereal diseases.

17. It is felt that, in preparation for the starting of these programmes,

the various territories should proceed with

«

(a) the securing and training of personnel under the following headings:

1. Medical officers.

2. Nurses — male and female.

3. Laboratory technicians.

4. Case workers.

5. Educational officers.

6. Kecord and statistical clerical staff.

(b) the provision of adequate accommodation, equipment and drugs.

18. We note that the Trinidad Venereal Disease Control programme is
about to be started jointly by the United States and Trinidad Governments
and that arrangements have been made to provide special facilities for the
training of the above mentioned personnel from all parts of the area.

19. We urge that the various territories should proceed with the selection
of candidates for this training as soon aa possible in order that their respective
programmes may be started without unnecesary delay.

20. We also recommend that, as far as possible, in all local programmes
there should be adopted uniformity of methods of diagnosis and treatment;
of laboratory methods; of record keeping; and of legislation.

21. We further recommend that there should be periodic meetings of the
Venereal Disease Control Officers of the various areas for exchange of ideas
and information.

National Health Council Elects Officers. — The election of Mrs.
Eleanor Brown Merrill, Executive Director of the National Society
for the Prevention of Blindness, as President of the National Health
Council for 1944 was recently announced. Mrs. Merrill succeeds
Dr. George S. Stevenson, Medical Director of the National Committee
for Mental Hygiene. The council, with headquarters at 1790 Broad-
way, New York, is a clearing house for twenty voluntary health
organizations, including the American Social Hygiene Association.
Other officers for 1944 are :

Vice-President, Dr. Walter Clarke, Executive Director, American Social Hygiene
Association, who succeeds Dr. Kendall Emerson, Managing Director, National
Tuberculosis Association; Secretary, Professor Maurice A. Bigelow, President,
American Eugenics Society; Treasurer, Dr. William F. Snow, Chairman, Execu-
tive Committee, American Social Hygiene Association. Dr. G. Poard McGinnis,
Director of Medical and Health Services, American Bed Cross, was elected
to the Board of Directors.

The National Health Council maintains the National Health Library,
which contains more than 6,000 volumes and 30,000 pamphlets
dealing with public health, sanitation and related subjects. More
than 500 professional journals and technical periodicals are received
regularly from all parts of the world ; and the library issues a weekly
bulletin, Health Articles of the Week, giving brief descriptions
of current magazine articles relating to health problems. It also
prepares an annual guide for publication in the book list of the
American Library Association as an aid to public libraries in the
selection of books on health subjects.

314 JOURNAL OF SOCIAL HYGIENE

Active member agencies in the National Health Council include
the following:

American Eugenics Society, American Heart Association, American Public
Health Association, American Red Cross, American Social Hygiene Association,
American Society for the Control of Cancer, American Society for the Hard
of Hearing, Conference of State and Provincial Health Authorities of North
America, Maternity Center Association, National Committee of Health Council
Executives, National Committee for Mental Hygiene, National Organization
for Public Health Nursing, National Society for the Prevention of Blindness
and the National Tuberculosis Association.

Associate member agencies are:

American Association of Medical Social Workers, American Diabetes Asso-
ciation, American Nurses' Association, Foundation for Positive Health, Lay-
men's League Against Epilepsy and the Planned Parenthood Federation of
America.

The U. S. Public Health Service and the U. S. Children's Bureau are
advisory members.

Dr. Parran Reappointed Surgeon General. — Dr. Thomas Parran,
who has served with distinction as Surgeon General at the head
of the U. S. Public Health Service for the past eight years, was
recently nominated for a third term of four years by President
Roosevelt and his reappointment immediately confirmed by the Senate.
Dr. Parran is a member of the ASHA Board of Directors and the
Chairman of its General Advisory Committee.

Professor Winslow to Edit American Journal of Public Health. —
The American Public Health Association has announced the appoint-
ment of Professor C.-E. A. Winslow as editor of the American
Journal of Public Health, succeeding Dr. Harry S. Mustard. The
new editor, who is also Chairman of the Editorial Board of the
JOURNAL OF SOCIAL HYGIENE, took over with the April issue.

In 1942, Professor Winslow, who is Anna M. R. Lauder Professor
of Public Health at Yale University, received a certificate for
forty years continuous membership in the American Public Health
Association. He served as President of the APHA in 1926 and
has filled many other offices in the organization.

Dr. George Baehr Completes OCD Assignment. — Mt. Sinai Hos-
pital, New York, has announced the appointment of Dr. George
Baehr, formerly Chief Medical Officer of the Office of Civilian
Defense, as Director of Clinical Research. Dr. Baehr, a member of
the ASHA Board of Directors and Executive Committee, formerly
served the hospital as Chief of the Medical Staff. He resigned his
OCD post on March 1, after rendering distinguished service. In
his new capacity he will coordinate clinical research activities, the
work of the laboratory, and the development and use of clinical and
laboratory facilities at Mt. Sinai Hospital.

Fellowships in Health Education Announced. — Fellowships for
graduate work in health education, leading to a Master of Science

NATIONAL EVENTS 315

degree in public health, are being offered by the U. S. Public Health
Service through funds made available by the W. K. Kellogg Foun-
dation. The fellowships, which will be available for the Fall college
quarter of 1944, are similar to the eighteen fellowships awarded
in the fall of 1943. Applications for the fellowships must be in
the Office of the Surgeon General of the U. S. Public Health Service
by August 1. Following is the official announcement of the fellow-
ships, including the requirements for eligibility and the description
of what they offer:

The need for qualified personnel who have a thorough understanding of
both public health and education is being increasingly recognized. The shortage
of trained health educators which exists, as well as a contemplated demand
growing out of future expansion of health education activities both in this
country and abroad is the chief concern of the sponsors of the fellowships.

What do fellowships provide?

Training. — Twelve months in public health education. This training includes
nine months of academic work in public health and public health education
and three months of supervised field experience. Upon successful completion
of the course the candidate is eligible for a master's degree in public health
education.

Financial aid. — The fellowships provide a stipend of $100 a month for
twelve months, full tuition, and travel for field experience. Candidates must
pay their travel to and from the university at the beginning and end of training.

When are fellowships effective?

Fellowships will be available for the fall college quarter of 1944.

Who is eligible?

Fellowships are available to qualified American women between the ages of
19 and 40 years, inclusive. Men cannot be considered because of the demand
for manpower for military service.

Educational qualifications. — A Bachelor of Science degree, or its equivalent,
from a recognized college or university. Although standardized training as
a qualification for fellowships cannot be specified in a field as new as public
health education, it is desirable that the • candidate present a background
including as many as possible of the following areas of knowledge and skill:

1. A basic cultural education, including skills in the use of the English language

2. Basic science education in the physical and biological sciences

3. Training in education and educational psychology

4. Social science education to provide an appreciation of the importance
of respect for human personality and government

Personal qualifications. — One of the qualities needed for community edu-
cation is the ability to work effectively with people; therefore, creative ability,
leadership, sound judgment and adaptability are essential qualities for the
health educator to possess, plus good health and a pleasing appearance.

What fields are open to the health educator?

Local, State and Federal health departments as well as schools and voluntary
agencies are employing health educators to assist in the development of com-
munity and school health education programs. It is the recommendation of
leading public health authorities that a health educator be added to every local
health department in the country. Other health educators will be needed abroad.

316 JOURNAL OF SOCIAL HYGIENE

How is application for fellowships made?

Application forms may be obtained from the Surgeon General, U. S. Public
Health Service, Washington (14), D. C. Applications must be accompanied
by a transcript of college credits and a small photograph. Completed application
must be in the office of the Surgeon General not later than August 1, 1944.

Summer Courses. — The following information has been received
concerning summer courses of interest to social hygiene workers:

Harvard School of Public Health: A series of lectures and seminars on
venereal disease control held during the period of May 30 to June 15 as
announced by Dr. Edward G. Huber, Acting Dean of the Harvard School of
Public Health. Dr. Walter Clarke, ASHA Executive Director and Clinical
Professor of Public Health Practice at Harvard, conducted the course which
is known as Venereal Disease Control A2. It was given Mondays, Wednesdays,
and Fridays, and on Thursday, June 1st from 2:00 to 4:00 P.M.

Lectures given during the first hour of each session, covering epidemiology,
case holding, health education and public health administrative aspects. During
the second hour, problems individualy assigned for study and reporting was
discussed in a seminar. During, or at the end of the course, a one-week
field trip to study venereal disease control programs in operation was available
for interested students.

Special students, not candidates for a degree in Public Health, are admitted
to the course by special permission of the instructor. Those interested in
future sessions are advised to write the Secretary, Harvard School of Public
Health, 55 Shattuck Street, Boston, Massachusetts, for a copy of the catalogue;
and to write Dr. Walter Clarke, American Social Hygiene Association, 1790
Broadway, New York, 19, New York, giving a statement of training and
experience for admission as special students.

Mills College, California: The American Institute of Family Relations will
again offer a workshop in Family Life Education at Mills College, Oakland,
California, from June 30th to July 22nd.

Dr. Eoswell H. Johnson, Director of the Institute's Department of Personal
Services, and Mrs. C. Brooks Fry, Assistant to the General Director, will be
in charge. Mornings will be taken up by three periods of lectures, and afternoons
will be open to discussion groups. For details and terms, write the Director
of Summer Sessions, Mills College, Oakland, California.

University of Utah: Dr. Orson Whitney Young of the Weber Health Asso-
ciation has been invited to give a course on Social Hygiene, as part of the
University's extension division work.

For further information, write the Utah Social Hygiene Association, Mclntyre
Building, Salt Lake City, Utah.

University of Pennsylvania: Dr. John H. Stokes announces the second
course in Health and Human Relations to be offered by the Institute for the
Control of Syphilis, University of Pennsylvania in cooperation with the U. S.
Public Health Service, June 26 to July 28. Public Health Service funds
provide scholarships for a limited number of teachers for the course which
is fully accredited by the University of Pennsylvania and Temple University.

NEWS FROM THE FORTY-EIGHT FRONTS

ELEANOR SHENEHON
Director, Community Service, American Social Hygiene Association

Alabama: Birmingham — Representatives of high schools and col-
leges of the State of Alabama met with health authorities on May 4th
apid 5th in Birmingham for a conference on sex education called
by Doctor B. F. Austin, State Health Officer, and Mr. E. B. Norton,
State Superintendent of Education. The group in their discussions
explored the general outlines of courses in sex education at the col-
lege and high school levels and the desirability of establishing teacher
training courses in social hygiene in the normal schools of the state.
Among those who addressed the gathering were Doctor Maurice A.
Bigelow, Educational Consultant of the American Social Hygiene
Association and Doctor Walter Clarke, the Association's Executive
Director.

Georgia: The Georgia Social Hygiene Council recently arranged for
a series of meetings throughout the state at which Mrs. T. Grafton
Abbott of the American Social Hygiene Association spoke on youth
problems. Dates and places visited include :

May 9 — Athens May 12 — Brunswick

May 10 — Columbus May 15 and 16 — Savannah

May 11 — Macon May 19 — Eome

Many of these meetings were co-sponsored by City or County
Health Departments. Mrs. Charles D. Center, Social Hygiene Con-
sultant of the Georgia State Department of Public Health and Execu-
tive Secretary of the Georgia Social Hygiene Council, accompanied
Mrs. Abbott on her trip through the state.

Indiana: Indianapolis — The Indianapolis Social Hygiene Associa-
tion recently made the city of Indianapolis a gift of the property
housing the 150-bed city isolation hospital for the treatment of girls
and women infected with the venereal diseases. The property includes
the three buildings housing the hospital, their furnishings, and the
land on which they stand. The hospital was deeded to the city at a
formal ceremony at the office of Mayor Tyndall. Officers of the
Indianapolis Social Hygiene Association include Mr. Harold B. West,
president and Mrs. Evans Woollen Jr., vice president. Mrs. Meredith
Nicholson Jr. is the Association's Director.

Nebraska: North Platte — Word has just reached national headquar-
ters of the organization of the North Platte Social Hygiene Commit-

317

318 JOURNAL OF SOCIAL HYGIENE

tee, with Mr. Donald T. Swaim of that city as chairman and a mem-
bership representing a number of interested North Platte groups. A
future issue of the Journal will carry further word of the plans and
program of this newest member of the social hygiene family.

New Jersey: Newark — The New Jersey Tuberculosis League held its
annual spring conference in Newark on April 20th. Tuberculosis and
social hygiene shared the spotlight, as for several years past. The
morning session was divided into section meetings on these two great
health problems. Mrs. Asher Yaguda, President of the Woman's
Auxiliary to the Medical Society of New Jersey, presided over the
Social Hygiene Section. The program of this section follows:

The Incidence and Control of Venereal Disease in New Jersey in
Wartime — Glenn S. Usher, M.D., Chief, Bureau of Venereal Disease
Control, State Department of Health.

Social Protection in New Jersey — L. Van D. Chandler, Health Offi-
cer, Department of Health, Hackensack ; Chairman, Social Protection
Committee of New Jersey.

Education for Human Relations and Family Life — Wilson G. Guth-
rie, M.D., Director, Health, Safety, and Physical Education, State
Department of Public Instruction.

How Venereal Disease Affects Family Life — Sophia J. Kleegman,
M.D., Assistant Clinical Professor of Obstetrics and Gynecology, New
York University College of Medicine.

The large luncheon meeting was presided over by Doctor Stephen

A. Douglass, President of the New Jersey Tuberculosis League. After
a word of welcome by the Honorable Vincent J. Murphey, Mayor of
the City of Newark, Mr. Percy Shostac, Consultant on Industrial
Cooperation on the staff of the American Social Hygiene Association,
spoke on Health Education for Industrial Workers. He was followed
by Doctor H. McLeod Riggings, Medical Director of the Triboro Hos-
pital of Jamaica, who discussed Some New Developments in the Con-
trol of Tuberculosis. The final speaker was Mrs. T. Grafton Abbott,
Educational Consultant of the American Social Hygiene Association,
who spoke on ' ' Youth Problems in Wartime. ' '

New York: New York City — The Consultation Center, a division of
the Jewish Social Service Association of New York, with offices at
1819 Broadway, has recently celebrated its second anniversary. The
Center offers case work service to any one in the Metropolitan area
who can pay a moderate fee for help with personal or family prob-
lems. During its second year of life it helped approximately a thou-
sand families, good evidence that the service it offers is needed and
welcomed.

North Carolina: Marriage and Family Conservation Conference.—

B. N. Duke Auditorium, North Carolina College for Negroes, was

NEWS FKOM THE FORTY-EIGHT FRONTS 319

the scene of the Third Annual Conference on Conservation of
Marriage and the Family, on April 14. Mrs. Gladys Hoagland
Groves, Director, Marriage and Family Council, Inc., Chapel Hill,
North Carolina, served as Director of the Conference, and morning,
afternoon and evening sessions were scheduled. Forums for high
school and college students were held in the morning, under the
direction of Miss Diana S. Dent, Head of Home Economics Depart-
ment, with Dr. E. C. Hamblen, of Duke University Medical School,
speaking on the subject An Endocrinologist Looks at Marriage and
Family Life. Dr. John Hope Franklin, of the Department of
History, presided at the afternoon session, and seven round table
group meetings on the subject Helping Young People Today discussed
the topics In College, In High School, In Grade School, Before School,
In Community, At Home, At Church. Later, Edward Stainbrook,
of Duke University Medical School, spoke on the subject of Preven-
tion and Treatment of Juvenile Delinquency. High point of the
program was the evening session with Dr. Albert L. Turner, Dean
of the Undergraduate School, presiding, and President J. W. Sea-
brook, of Teachers College, Fayetteville, North Carolina, addressing
the Conference on Marriage and Family Life in Wartime.

Charles E. Miner, ASHA Field Representative for the South-
eastern States, attended the Conference.

Ohio: Social Hygiene in Scioto County. — Miss Magdalen Sommer,
Executive Secretary of the Scioto County Tuberculosis and Health
Association, Portsmouth, reports an active program for the Associa-
tion's Social Hygiene Committee during the past year. Outstanding
projects included:

Eight educational articles published in the newspapers, four radio programs
(fifteen minutes each) and two fifteen-minute radio drama transcriptions, eighteen
talks, eight showings of the film Fight Syphilis, the distribution of literature,
and three window displays which were shown for a period of about six weeks.
One of these in a small window consisted only of posters and pamphlets, but
the others, where space permitted, included two models dressed in surgical
gowns and masks and instruments and supplies used in treatment, as well as
posters and pamphlets.

The Committee also has officially endorsed and made plans to
promote passage of local legislation regarding inspection of food
and examination of food handlers for venereal disease.

Officers and members of the Committee are :

Chairman: Dr. C. W. Wendelken, Judge Ealph A. Stevens, (President of the
Scioto County Association), Miss Mary Wilking, Mrs. V. W. Scott, Mrs. Dorothy
Shela, Kobert J. MeNamara, John W. Purdum, Mrs. C. M. Fitch, Mrs. William
Nageleison, Kev. Koger Turrell, Captain A. B. Hill, Philip A. Bauer, William
A. Atlas, Howard A. Berndt, Eichard C. Ross, and Judge Emory Smith.

South Carolina: Charleston — Mrs. T. Graf ton Abbott, Educational
Consultant of the American Social Hygiene Association, was guest

320 JOURNAL OF SOCIAL HYGIENE

speaker at a meeting sponsored by the Charleston Social Protection
Committee on May 4th, when she spoke on Youth in Wartime. Invita-
tions were issued by Mayor Henry \V. Lockwood, Honorary Chair-
man of the Committee, Mr. Jesse W. Orvin, Chairman, and Doctor
Leon Banov, County Health Officer.

While in Charleston Mrs. Abbott also addressed the Charleston
Welfare Council and a luncheon meeting of the Charleston Kiwanis
Club.

South Carolina: State Bar Association Adopts Resolution for Educa-
tion and Repression of Prostitution. — At Columbia, South Carolina,
on March 16, the State Bar Association adopted the following
important resolution in support of the compaign against venereal
disease and prostitution:

WHEREAS, The Social Protection Division of the Federal Security Agency, The
War Department, The Navy Department, The United States Public Health
Service, State and Territorial Health Officers, The American Social Hygiene
Association, the American Bar Association and other State Bar Associations,
are engaged in a campaign for the control of Venereal Diseases which embraces:

FIRST: A vigorous suppression of prostitution, and a decrease of the oppor-
tunities for contact with infected persons.

SECOND: The elimination of all who traffic in, profit from or have a hand
in the business of commercialized prostitution.

THIRD: An investigation and elimination of all sources of infection by an
early diagnosis, adequate treatment and isolation and quarantine, when necessary
and medically advisable, of infected persons.

FOURTH: State and Local Eesponsibility for accomplishing the program's
objectives with the cooperation and assistance of the Federal Government.

NOW, THEREFORE BE IT RESOLVED:

FIRST: That the South Carolina State Bar Association endorse the foregoing
program for the State of South Carolina.

SECOND: We invite attention of all law enforcement officers in South Carolina
to the fact that the National Sheriff's Association and the International
Association of Chiefs of Police have endorsed this program and are actively
cooperating with the Federal Government in it.

THIRD: We endorse a comprehensive statewide educational program which
will advise and acquaint the general public with the nature, seriousness and cost
of the venereal diseases, having as its objective the eradication of said diseases.

H. S. Reeves, Social Protection Representative for South Carolina,
reports excellent cooperation from other state and community groups.
Officers of the Bar Association are: President, Roach S. Stewart, of
Lancaster; secretary, Charles I. Dial of Columbia, and executive
committee, C. T. Graydon, R. Beverly Herbert and Chrisie Benet of
Columbia.

Texas: Corpus Christ! — The formation of a permanent social
hygiene committee was announced on April 29th by Mr. Harold M.
Barnes, Director of the Corpus Christi Council of Community Agen-
cies. Members of the Committee are Dr. W. P. Scarlett, C. E. Burnett,

NEWS FROM THE FORTY-EIGHT FRONTS 321

Carl W. Crow, Dr. Jack Derzavis, Dr. Mclver Furman, Mrs. Alice
Hagerdorn, the Rev. W. Oliver Harrison, Mrs. Eugene Kipp, Roy
Klett, Dr. R. S. Lloyd, E. M. LaCona, Paul Martineau, Bob Mc-
Cracken, Mrs. Ruth McDonald, Tom Quigley, C. C. Sampson, George
Schauer, Mrs. C. M. Winther, Ed. P. Williams, Comdr. Frank Ellis,
and Mr. Barnes.

The new Committee will undertake a survey of community conditions, needs,
and facilities in the field of social hygiene for their guidance in planning a
program designed to meet those needs. Special consideration will be given to
case finding and holding, to health education, to the repression of prostitution,
and to a program of information for young people, to be carried out through
home, school and church.

Other recent social hygiene history in Corpus Christi includes a very successful
Social Hygiene Day luncheon meeting held at the Plaza Hotel there on February
llth, which was attended by a number of the city's most distinguished citizens,
including the Mayor, the Commissioner of Health, the Chief of Police, the Jus-
tice of the Peace, the Juvenile Court Judge and many others. The speakers were
Captain John E. Poppen (MC) USN, Senior Medical Officer, U. S. Naval Air
Intermediate Training Command, Corpus Christi, Texas; William P. Scarlett,
Surgeon, U.S.P.H.S, Director in Charge of Venereal Disease Control for Nueces
County, Corpus Christi City-County Health Unit; Judge Paul Martineau, Juvenile
Court Justice; and Lieutenant Jack L. Derzavis (MC)V(S), U.S.N.E.

Utah: The Utah Social Hygiene Association just sponsored a series
of meetings throughout the state at which Doctor Harriet S. Cory,
Executive Director of the Missouri Social Hygiene Association, and
Commander Benton V. D. Scott (MC), U. S. Navy, Venereal Disease
Control Officer, 12th Naval District, San Francisco, shared the
honors as visiting speakers on social hygiene problems. Arrange-
ments were made for their appearance at the following times
and places :

May 8-9 — Salt Lake City, where a number of meetings were held and where
Commander Scott broadcast over station KDYL.

May 10 — Provo, where a dinner meeting was arranged.

May 11 — Ogden, where both Doctor Cory and Commander Scott spoke at
a meeting sponsored by the Weber Health Association.

May 12 — Salt Lake City again, where Commander Scott addressed the Junior
Chamber of Commerce.

May 12 — Brigham City, where Commander Scott and Doctor Cory both
appeared. Members of the medical profession, social and welfare workers, health
department executives, law enforcement officers, military and naval personnel, and
the general public were invited to take part in this impressive schedule of
meetings on social hygiene problems.

Mr. Elias L. Day, Secretary of the Utah Social Hygiene Associa-
tion, reports that Doctor Orson Whitney Young of the Weber Health
Association of Ogden, has been invited by the University of Utah to
give a course on social hygiene as part of their extension division
program. The Weber Health Association carries on an active social
hygiene program.

NOTES ON INDUSTRIAL COOPERATION

PERCY SHOSTAC
Consultant on Industrial Cooperation, American Social Hygiene Association

INDUSTRY FIGHTS VD

The exciting news on the ASHA industrial front is the series of
seven articles Unite Against VD prepared by Dr. Walter Clarke for
the labor press. This series is now appearing in at least 60 trade
union papers with an estimated total circulation in the neighborhood
of three million. Multiply this circulation by seven (the seven
articles) and we get approximately 21 million individual messages
to strengthen our campaign against the venereal diseases.

Dr. Clarke's series is appearing in union papers in 24 different
states from Texas to Wisconsin, from New York to California. Five
union papers for mine workers are running the articles in Harrisburg
and Hazleton, Pennsylvania; in southern Illinois and in Morgan-
town, West Virginia. The national CIO News is carrying the pieces
as are the official national papers of the unions covering shipbuilding,
mill and smelter workers and maritime workers. Negroes are receiv-
ing the messages through the Dining Car Worker. Two labor papers
with newspaper stand circulation, the Cleveland Citizen and the
Kenosha Labor, have opened their columns to us.

To reach this great number of industrial workers under the favor-
able auspices and endorsement of their respective unions at a cost
of mimeographing 14 pages of copy and spending a few dollars in
postage is certainly an economical method of operation. It is a
method, however, that can only succeed if the material presented is
interesting in style and vital in content. The pieces by Dr. Clarke
are brief, factual, lively, and always angled from a trade union
point of view.

The articles are being followed up by a series of seven illustrations
which are offered as a mat service without cost. Any reader of the
JOURNAL OF SOCIAL HYGIENE who can place the series (with illustra-
tions) in a union publication is invited to write us. They are being
sent to all social hygiene societies and are being followed up by our
field staff.

The Unite Against VD series is the opening gun of a three-prong
offensive against syphilis, gonorrhea, prostitution and youth problems
in the industrial field. In this drive we hope to enlist great numbers
of our country's thirty million industrial workers and their families.
That's a large order and we're planning our strategy carefully.
Already our field staff, armed with a procedure manual based on
the Fort Greene Industrial Health Committee project, is exploring
the possibility of helping to initiate similar committees in at least
one industrial community in each of the Service Commands.

322

NOTES ON INDUSTRIAL COOPERATION

323

CIO flews

Pablished Weekly

Congress of Industrial Organizations

Philip Murray .......... President James B. Carey. ....... Secretary-Treasurer

April 24, 1944

No. 17

Unite Against VD

Co to Good Doctor,
Not Quack, for VD

By WALTER CLARKE, M. D.

(Third of a series of articles OH venereal disease by the Executive
Director of the American Social Hygiene Association, a national volun-
tary health agency closely teamed up with the Army and Navy in tht
wartime campaign to combat syphilis and gonorrhea and all condition*
favoring their spread.)

It cannot be stressed too often
In this series of articles that good
health is not served up on a silver
platter. You must take a lively in-
terest in your own well being and
do something about it. You should
seek the most benefit to yourself
and your family from the health
program of your local health de-
partment and of your trade union.
You should go to your private doc-
tor for regular physical check-ups.

People do not expect bone frac-
tures to mend by jthemselves. They
immediately go to a doctor. There
is every reason to act- in this sen-
sible manner when gonorrhea Is
contracted. Medical authorities
can put to use their effective
method of treating gonorrhea only
when people come to them for ex-
aminations and treatments.

SIGNS OF TROUBLE

Gonorrhea, which is mainly •
local disease of the sex organs, Is
caused . by a germ known as the
gonococcus. It strikes at least
three times as many people as
syphilis and, is highly contagious
until completely cured. Cured once,
it can b* contracted again and
again. • A burning sensation on
passing water; followed by a- dis-
charge within two to ten days after
infection .are the usual first- symp-

Found and treated In Ito early
•tages, gonorrhea can be cured
in almost all cases, and the dan-
ger of serious complications to
avoided. People set gonorrhea
through sexual relations -with
•omeone who te Infected. Neg-
lected gonorrhea often prevent*
men ,and women from having
children. It can also lead to
aerious Internal disorders.
Gonorrhea is able to do so much
damage because of its deceptive
nature. After its acute stage, It
tends to pass into a quiet period,
often leading to the mistaken be-
lief that the danger of infection
has passed. Only * doctor — after
thorough tests — can tell whether
gonorrhea has been cured.

EFFECTIVE TREATMENT
By use of the sulfa drug, great
advances have been brought about
in, the treatment and cure of
gonorrhea. Today, where these
drugs are administered by a physi-
cian, early cases of gonorrhea can
be cured within one to two weeks.
But it takes much longer to make
sure that a cure has really been
achieved. Furthermore, these
drugs may cause serious damage —
even death— if used without the
supervision , of, a physician.

324 JOURNAL OF SOCIAL HYGIENE

A second manual, nearing completion, with the title The Trade
Unions vs. VD — A Program of Education and Action Against
Syphilis and Gonorrhea, will soon be in the hands of more than a
thousand national unions as well as state and city central labor
bodies of the AF of L and CIO. This trade union manual which
will include samples of literature, posters and available films, etc.,
will present a three-point program : organize, educate, participate,
and is expected to get wide trade union support. It will be suggested
to the unions that (1) they organize health and welfare committees
in their locals and in the plants where they work; (2) that an
educational campaign, directed by the health and. welfare committees
and, following the concrete suggestions in the manual, be carried
on among their members and finally that (3) the unions participate
in the community fight against VD by working with local social
hygiene societies, using their influence for law enforcement, social
hygiene education and in the legislative field.

The third prong of our offensive will operate through management.
A series of articles are in preparation, very similar to those now
appearing in the trade union press but suitable for house organs
and plant publications. Likewise we are readying a manual for
management which follows the same general lines as the one for trade
unions including the three-point basic program : organize, educate,
participate, and emphasizing the importance of employee-management
sponsorship of the program through a joint health and safety
committee in every firm.

Our plans are big. They have to be if our message is to make
a real dent in the largest segment of our population.

\

Vol. 30 June, 1944 No. 6

Journal

of

Social Hygiene

Eleventh Annual Library Number

CONTENTS

Education, the Soldier and the Home Moe Frankel 325

A Public Library Works with Community Agencies .... Aubry Lee Graham 329

A Library and a Social Hygiene Society Cooperate Pauline J. Fihe, Viola Wallace

and Jean Thomas 333

" I Want to Draw a Book on ..." Aimee Zillmer 336

Editorial — War and the Journal's Annual Library Number 339

National Events Reba Rayburn 340

News from the Forty-eight Fronts Eleanor Shenehon 349

Notes on Industrial Cooperation Percy Shostac 356

Book Reviews:

Books of General Interest 360

Books on Sex Education, Marriage and Human Relations 362

Books on Law Enforcement, Legislation and Social Protection 363

Books on Medical and Public Health Activities 371

Publications Received — In the Periodicals 376

Health Articles of the Week . . 384

The American Social Hygiene Association presents the articles printed in the
JOUWCAL or SOCIAL HYGIENE upon the authority of their writers. It does not
necessarily endorse or assume responsibility for opinions expressed or statements
made. The reviewing of a book in the JOURNAL OF SOCIAL HYGIENE does not
imply its recommendation by the Association.

EDITOBIAL BOARD
C.-E. A. WINSLOW, Chairman

EAT H. EVEEETT WILLIAM F. SNOW

JOSEPH K. FOLSOM JOHN H. STOKES

EDWARD L. KEYES JOHN C. WABD

JEAN B. Prmnrr, EDITOE
WILLIAM F. SNOW, EDITOBIAL CONSULTANT

The JOUENAL OF SOCIAL HYGIENE is supplied to active members of the American
Social Hygiene Association, Inc. Membership dues are two dollars a year. The
magazine will be sent to persons not members of the Association at three dollars
a year ; single copies are sold at thirty-five cents each. Postage outside the United
States and its possessions, 50 cents a year.

Entered as second-class matter at post-office at Albany, N. T., March 23, 1922.
Acceptance for mailing at special rate of postage provided for in Section 1103,

Act of October 3, 1917, authorized March 23, 1922.
Published monthly (nine issues a year) for the Association by the Boyd Printing

Company, Inc., 372-374 Broadway, Albany, N. Y.

Copyright, 1944, by The American Social Hygiene Association, Inc.

Title Eegistered, U. 8. Patent Office.

PUBLISHED MONTHLY EXCEPT JULY, AUGUST AND SEPTEMBER
AT 372-374 BROADWAY, ALBANY 7, N. Y., FOB

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

EDITORIAL OFFICES and NATIONAL HEADQUARTERS
1790 BROADWAY, 19, NEW YORK CITY

WASHINGTON LIAISON OFFICE
Room 609, 927 15th St., N.W., Washington 5, D. 0.
JEAN B. PTNNEY, Director in Charge
BEBA RAYBUEN, Office Secretary

FIELD OFFICES

ATLANTA, GEOEGIA. 506-508 Citizens and BALTIMORE, MARYLAND. Care of Baltimore

Southern National Bank Building. Serv- Community Fund, 22 Light Street,

ing Alabama, Florida, Georgia, Missis- Serving Delaware, Maryland, Pennsyl-
sippi, North Carolina, South Carolina and vania and Virginia.

Tennessee. KENNETH R. MILLER, Field Eepresenta-

CHARLES E. MINER, Field Eepresentative. five, Home address 260 Bridge St., Drexel

COLUMBUS, OHIO Care National Confer- gj |*'NA w> F FMd Eepre8entative.

ence of Social Work, 82 High Street.

Serving Indiana, Kentucky, Ohio and

West Virginia. CHICAGO, ILLINOIS. Room 615, 360 North

WADE T. SEARLES, Field Eepresentative. Michigan Avenue. Serving Illinois, Michi-

gan and Wisconsin.

OMAHA, NEBRASKA. 736 World Herald WARREN H. SOUTHWORTH, Field Eepre-

Building. Serving Colorado, Iowa, Kan- sentative.

sas, Minnesota, Missouri, Nebraska, North

Dakota, South Dakota and Wyoming.

GEOROE GOULD, Assistant Director, D^S, TEXAS. Cliff Towers. Serving

Divition of Legal and Social Protection Arkansas, Louisiana, New Mexico, Okla-

Servioet, in Charge. h°ma aQd Texas.

inn BASCOM JOHNSON, Director in Charge.

SA^T.i^AKB ?**.' UTAH' i M ™yre MRS. GERTRUDE R. LUCE, Office Secretary.
Building. Serving Arizona, Idaho, Mon-
tana, Nevada, Utah, California, Oregon

and Washington. SAN FRANCISCO, CALIFORNIA. 48 Second

GEORGE GOULD (see above), temporarily Street.

in dharffe. W. F. Hiomr, Field ConruHont.

A NEW EXHIBIT

The new American Social Hygiene Association exhibit which made
its debut at the National Conference of Social Work, Cleveland, Ohio,
in May, has since appeared in Buffalo at the Biennial Nursing Con-
vention, and in Chicago at the conference of the American Home
Economics Association. Standing five feet tall and five feet wide,
the exhibit is developed in attractive coloring, and the legends read,
from top to bottom: "... to help keep soldiers, sailors and airmen at
their posts and fit to fight ... to help preserve the family and
protect youth in wartime ... to help keep workers fit to produce the
instruments of war."

o-

CH

02 K

o£
o?

li

Journal

of

Social Hygiene

VOL. 30 JUNE, 1944 NO. 6

Eleventh Annual Library Number

EDUCATION, THE SOLDIER, AND THE HOME *

MOE FRANKEL
Director, American Red Cross, Antilles Department

The purposes of the Red Cross Services to the Armed Forces and
its staff are four fold :

(1) To give round-the-clock service to the men and women of the Armed
Forces wherever they may be.

(2) To link the servicemen and women with their home communities and
families and constant two way flow of service.

(3) To represent the American people in their desire to provide human com-
fort and aid to the Armed Forces.

(4) To fulfill the charter obligations of the American Red Cross in war time.

A successful discharging of these four purposes depends on the
people we represent and that success is in direct relationship to the
quality and degree of education possessed by these people. That
the demand for this education exists can be made evident by the
few following statements. Today armed forces are considered a
better fighting machine than that of the last war, because of the
level of education of the men and women who make it up. The
standard of living of any country is in direct ratio to the level of
education. You have heard in previous talks the demand from the
services for educational material and must realize that many of the
men are anxious to prepare for life after the war by availing them-
selves of the educational facilities offered.

* A paper given before a Conference of Librarians of the Antilles Department,
U. S. Army, San Juan, Puerto Rico, April 11-13, 1944. (See p. 353.)

325

326 JOURNAL OF SOCIAL HYGIENE

One of our prime functions is to serve as a buffer for the "gripes"
and complaints of men who are dissatisfied with their lot. We feel
that by giving them an opportunity to get this off their chests,
their troubles may eliminate themselves in just talk. It is not
sympathy that they desire in most cases. A timely suggestion or
a new thought might change the entire complexion of things.
Directing them to magazines or books, or helping them in securing
material to follow up some interest they have expressed may be all
that is necessary. Army Institute Courses have been helpful and
Nayy courses for advanced ratings still remain the most popular
form of recreation or leisure-time activity on bases.

The necessary part education must play in this war can best be
brought out by quoting some pertinent facts recently released by
the Army and Navy. Neuropsychiatric disabilities accounted for
discharge of almost half of 474,000 enlisted soldiers returned to
civilian life lately. Admiral Ross T. Mclntire expressed concern
over these discharges, particularly those occurring in the first six
months of service. Regimentation and non-adjustment occur to
make many normal civilians into useless service men. Many of
these men could have been useful if in some way their interests
had been directed to some sort of self education. I can state that
directing a person to some interest which obviously will prove to
be a benefit to the individual in question has given meaning to
time which previously prevented adjustment and was aimless.

Let me take a look at the soldier in reference to the requests-
which come into the Red Cross offices for aid. One fact stands out
very clearly. In A.W.O.L. requests the soldier in question is usually
found to have less formal education than the average for the Army.
Those soldiers who receive C.D.D. or Section 8 discharges follow
the same pattern. The more self-reliant soldier will request infor-
mation but he will reserve the right to make a decision and take
necessary action. His background enables him to do this. He is
not easily upset nor emotionally unstable. His education has given
him the mental discipline necessary to meet the unexpected. On
the other hand the exact opposite exists where there is lack of under-
standing or clear thinking. The slightest deviation from the norm
puts such a soldier in a whirlpool, grasping at every straw which
may miraculously help him. He is the one who falls prey to the
unethical interests and usually winds up by cutting a wide swath
through the wheat field of Army or Navy regulations.

A self-reliant serviceman, a confident serviceman, a well-adjusted
serviceman, and an intelligently courageous serviceman is an edu-
cated serviceman, either through formal means or self-education.
An interesting experiment is taking place right now in the Reha-
bilitation Camp that has been set up on the island here. As a result
of several conferences between the Officer-in-charge and the Red
Cross man at the station, a program of education is going on.
Spanish and English textbooks were provided so that the corre-
sponding foreign language could be learned. Through the coopera-

EDUCATION, THE SOLDIER, AND THE HOME 327

tion of the Department Library, a good supply of Victory books
were made available so that the boys would have access to reading
material. These boys will return to the Army in many instances
as better soldiers. Here again education will prove its worth as the
superior cure to punishment.

This war will be victorious because many men realize why they
are in it. This fact is exemplified by a picture appearing in Time
Magazine months ago showing an American soldier taking refuge
from the raid underneath an Army truck reading a Time article on
Backgrounds of War.

As stated, the Ked Cross service to link the serviceman and woman
with their home communities and families is a constant two-way
flow of service. Let me set the picture up for you with a few
examples. A soldier visits one of the Red Cross offices and exhibits
a letter just received from home. The news is upsetting, either
sickness of some member of the family, financial difficulty, legal
charges against the serviceman, or just the ordinary petty difficulties
which occur in the home, magnified by some one to assume major
importance.

Through the medium of the Chapter, which we shall call our
educational unit, these disturbances can be solved with dispatch.
But more important for this conference than an explanation of
what procedures are used would be the correlation existing between
the problems that arise and the educational level of the family.
It can be stated without any hesitation that there is a direct ratio
existing. The same situation exists at home as with the individual
soldier. He is usually a direct counterpart of what one will
encounter at the other end of the problem. These problems arise
because families are poorly prepared from the standpoint of experi-
ence and background to foresee the results of their action or deter-
mine a course for the future which will adequately solve their need.
An example can be cited. Through an ambulatory patient word had
come to a Red Cross hospital worker that one of the new patients
was terribly worried about some sort of family problem. This
soldier was a young man of about twenty-three years, who was so
upset by a letter he had received from home that at first he could
not speak. At the conclusion of her visit, the worker had obtained
the following information:

Because of transfers from one hospital to another the soldier
had not received any pay for five months past, and had not been
able, therefore, to send any money home to his family, which con-
sisted of a mother, father, commonlaw wife and their two small
children. The total income for the family group was $37.50 per
month, or the dependency benefits received by the soldier's mother,
for the soldier had been misinformed and did not know that the
other dependents were entitled to benefits. The family had one
acre of land, but they could not make ends meet and being unable
to cope with the situation further, had written to this sick soldier
telling of illness and privation in the home. The Red Cross was of

328 JOURNAL OF SOCIAL HYGIENE

course ready to handle such a situation. The local chapter in the
home community was informed and went into action immediately.
The ill members were taken for medical treatment and medicines
were provided. A cash grant was made to the family for the rest
of the month's expenses. The Hospital Worker contacted the Sick
and Wounded office on the problem of the pay due the soldier.
In subsequent interviews the soldier expressed his desire to marry
his commonlaw wife and with the help of his Army Chaplain per-
mission was secured. Again the Chapter's assistance was sought
in obtaining the necessary certificates and licenses for marriage
and the documentary evidence to support the allowance application
for the wife, children and father. These were executed and put
through the proper channels, and the story thus given a happy
ending, but all the suffering, physical and mental, could have been
avoided, had this family only known the resources of the community.

It is necessary therefore for some sort of education to be carried
on in the home if the soldier is to be spared such distressing experi-
ences. Through the many trained workers of the ARC solutions
are found not by the worker but by the family with the help of the
worker. Steps are taken to assure non-reoccurrence, sometimes
by carrying on a training program in the home or by suggesting
literature which will provide the information. Add to this forms
of direct education carried on by chapters, such as First Aid and
Water Safety courses, Home Nursing, Nutrition, and Nurses Aid
work. In many instances visiting nurses are made available to
families. Of necessity the groups reached are small. Mass edu-
cation is beyond the ARC scope of activities.

But the need for this type of service is sufficient to point out
that many families now requiring aid from outside agencies would
not require this aid if their education met accepted standards.

The goal of this country has always been an educated citizenry.
The services today are moulding the men who will direct the
country tomorrow. Amidst all the expenditures for destruction
today, it is fitting that the government recognize that the future
depends on education. That is why we have these libraries estab-
lished in the midst of war. It is these libraries which carry out the
thought expressed by Benjamin Franklin in his "Information to
those who would remove to America" to wit "In Europe birth has
indeed its value, but is a commodity that cannot be carried to a
worse market than to that of America, where people do not inquire
of a stranger, 'what is he?' but 'what can he do?' Let us hope
that every American soldier will have a constructive answer to this
when this war is over.

A PUBLIC LIBRARY WORKS WITH COMMUNITY

AGENCIES

;

AUBEY LEE GRAHAM
Public Relations Assistant, Public Library of Washington, D. C.

The public library is an adult education agency, usually tax-
supported, which serves both groups and individuals with books,
pamphlets, and visual aids, and advice about them.

In the social hygiene field — which though only one, is an important
one, of the fields served — the public library supplies books and
pamphlets on sex education, preparation for marriage, child and
maternal care, juvenile delinquency, venereal diseases, social case
work, family life, recreation, housing, and related subjects.

The library works with agency staffs, with individuals sent to
the library by the agencies, and refers persons to the proper sources
for help. Some of its most effective work is done through close
cooperation with established agencies. Some examples of these are
reported by the Sociology Division of the Public Library in the
nation's capital, as examples of how such cooperation can result
in better service to the community.

The D. C. Social Hygiene Society and the Public Library pre-
pared a joint exhibit at the Annual Scientific Assembly of the
D. C. Medical Society. A bibliography listing books on sex education,
marriage and venereal diseases was compiled for distribution at the
exhibit and books and pamphlets were displayed, before a background
of posters stating the functions of the two agencies as they related
to cooperation with the medical profession.

This exhibit was also lent later to the Jewish Community Center
to accompany a lecture by the Society's Executive Secretary.

Before the Young Women's Christian Association gave its course
on Marriage and the Family, the instructor conferred with the
Library's Sociology Division head about suitable books. The Library
then sent the books to the Y.W.C.A. to make them readily accessible
to the class members.

The American Women's Voluntary Services uses selected library
books in their training course for child care aides.

The D. C. Board of Public Welfare borrows library books for
staff use.

329

330 JOURNAL OF SOCIAL HYGIENE

Library books are used at the D. C. Jail, in connection with the
in-service training of the custodial staff. The collection deals
largely with prison administration, leadership, and personality
adjustment, and is intended to supplement lectures on these subjects.

The head of the Sociology Division served as chairman of the
Central Neighborhood Council and became better acquainted with
neighborhood problems and ways in which the Library could cooperate
with social workers who are dealing with the problems.

The Washington Citizens' Council on Planning and Housing
invited a representative of the Library to attend its meetings; as
an agency for adult education for better community living and one
providing literature on housing, it was logical that the Library
be represented.

Several local Parent-Teacher Associations asked the Library to
recommend books on sex education.

The Haskins Bureau asked for a list of books for an 18-year-old
girl on "life and the mistakes of youth." Another newspaper col-
umn, 'Mary Haworth's of the Washington Post, suggested that a
reader ask for books on the facts of life, with immediate response.

The influence of newspaper and magazine stories is often noted
in increased circulation of books on the subject concerned, but the
Library staff was somewhat startled recently to find ninth grade
students — the guinea pigs themselves — asking for reading matter
on juvenile delinquency, following newspaper and magazine
publication of stories on increase in this problem.

Leaders in guidance work in the D. C. Public Schools used library
material on juvenile delinquency, the subject of their study program
for the year; thereafter almost daily requests for this material
were noted.

The D. C. Health Department asked for a special supply of books
on pre-natal care and child care and training, for use with city wide
classes for prospective mothers. The Library bought the books,
took them to one meeting of each class, and lent them, without
red tape.

At the Christian School in the Nation's Capital, a six weeks' course
sponsored by the Washington Federation of Churches, materials on
marriage and child care were exhibited in connection with lectures
on family life, and books and pamphlets were also displayed to
supplement lectures on delinquency and housing.

Personnel workers from the War Department conferred with the
Library staff about appropriate books for young people on marriage.
A friend of a twenty-year-old soldier called to secure a suitable
book on courtship and its problems to help the soldier's romance
proceed more satisfactorily.

A PUBLIC LIBRARY WORKS WITH COMMUNITY AGENCIES 331

The Librarian in charge of book selection for the ship and shore
libraries of the Navy, requested a list of recommended books on
marriage, and a list based on titles in several existing bibliographies
and specially annotated, was prepared.

Because of the dubious character of the many socalled "sex books",
the Washington Library has consulted with the Social Hygiene
Society for many years regarding acquisitions in that field. When
any doubt exists as to the desirability of new purchases, the volumes
in question are carefully checked as to scientific accuracy and exact-
ness of statement. Hence the book-lists prepared and sponsored
jointly by the Library and the Society have a high reputation for
authenticity and good judgment. Thousands of these "teamwork"
book-lists have been put to good use by parent-teacher associations
and other organizations. Constant liaison is maintained and referrals
are numerous, both from the Library to the Society and vice versa.

The Sociological Section of the Library has no ' ' lock-box complex ' '
but it takes pains to emphasize the normal and constructive social
hygiene literature and to keep books on abnormal sexual psychology
for serious students and away from minors and the morbidly curious.

Referrals

The referral task of the Library is a responsible one. Under no
circumstances does the library staff do actual counseling. When a
person needs more advice than can be obtained in books, he is referred
to persons competent to handle the matter.

There was the case of a fourteen-year-old girl who asked for books
for her sister who was contemplating suicide. The librarian made
an appointment for the girl at the Life Adjustment 'Center where
it developed that the "sister" was actually the girl herself.

A young boy came to the Sociology adviser for help. His story
was incoherent — full of accounts of objects seen where none existed,
extreme fear of people and things, and confusion in general. He,
too, was referred.

It is difficult for the average person to know where to go when
in personal trouble. The accessibility of the public library, its long
hours of service — usually twelve hours daily — and its impersonality —
if one wishes to browse among its books there are no questions
asked — seem to attract many who lack the courage, money, or
information to seek professional advice. At the same time, an adviser
usually is at hand to assist those who seek help. You can help
such individuals by making sure that the Library knows the resources
of the agency and by making it easy to call on the agency and to
refer persons to it.

332

Other Ways in Which the Local Library Can Be Helped to Serve

the Community Better

The library, can be helped, too, by inviting the librarian to come
or to send a staff member to special meetings of the organization.
It is only by acquaintance with the work and program that the
librarian can provide the books and other materials to help in it.
Call for books when needed and urge that they be made available
in sufficient quantities to meet the needs of individual readers.
Where library resources are not as great as the agencies might wish,
special requests may help to focus attention on the need for more
books in the field and provide impetus for acquiring them.

Call to the attention of your local librarian the films of the
American Social Hygiene Association, so he in turn can recommend
them, along with books, to individuals or groups interested in
improving health and social conditions in the community.

These are a few suggestions only. Not all libraries are large
enough to have a Sociology Division directed by a person with train-
ing and experience in social work. But all public libraries distribute
books and try with varying degrees of effectiveness to contribute to
the well-being of the community. By asking the public library's
cooperation the distribution of books in all fields can be made more
effective.

"If your boy or girl cornea to you with a question or problem, listen quietly
and without batting an eyelash, no matter if it makes the eold chills run up
and down your spine. Your boy or girl, in bringing a problem of morals to
you, is paying you the greatest tribute that you as a parent will ever receive.
And if your boy or girl doesn't bring up the subject, I suggest that you
do it. Then talk the situation over frankly and without emotion, without
censure — man to man, or woman to woman. Your youngster needs now, as never
before, your love and understanding and the straightest thinking of which you're
capable. Maybe you won't know all the answers. But you can give your boya or
girls what you do know — what you've experienced and observed. Give them
facts upon which they'll have a chance to decide wisely."

— From an article, Does Tour Daughter Ihink
She's in Love?, by GLADYS DENNY SCHTTLTZ,
condensed by the Reader's Digest from
Better Homes and Gardens.

A LIBRARY AND A SOCIAL HYGIENE SOCIETY
COOPERATE *

PAULINE J. FIHE, Head
VIOLA WALLACE, Assistant
JEAN THOMAS, Assistant

Readers' Bureau, Cincinnati Public Library

For too many years, sex was a horrid word, spoken softly in
the home, and certainly kept undercover in the public library. Yet,
the library is the place to which the individual, seeking accurate,
impersonal and wisely presented information, should be able to turn.
Since the establishment of the Readers' Bureau of the Public Library
of Cincinnati in 1925, advice has been sought constantly by parents,
teachers and others in charge of children, in answering sex questions
and in solving the problems which naturally present themselves to
youth from the age of understanding through adolescence up to
the pre-marital age. The informal, friendly atmosphere of Readers'
Bureau has encouraged people to make requests across the desk
which they might hesitate to do in more impersonal, hurried sur-
roundings. Experience, too, has enabled the Readers' Advisers to
penetrate the surface of a casual request, and to bring to light the
real demand which reticence forbade the patron stating in his
initial request.

To meet adequately these requests for recommended readings on
sex education, the Readers' Bureau has always felt the need of a
graded reading list which had received the approval of an authority
in the field of social hygiene. In Cincinnati we are fortunate in
having the active cooperation of the Cincinnati Social Hygiene
Society, an affiliate of the American Social Hygiene Association. We
asked the Executive Secretary, Mr. Roy E. Dickerson, widely known
for his many writings on sex education, to collaborate with us on
such a list. The work was begun in the summer of 1943, with an
exhaustive combing of all available literature in the field of sex
education. The books were examined from the viewpoint of accuracy
of information, method of presentation, and whether or not they
contained anything controversial or contrary to teachings of the
church, home, and school. After minute revision, Graded Read-
ings in Sex Education was published. To quote Mr. Dickerson, "This
is a highly selective reading list, not a bibliography. It is not
intended to include even all the good books in this field. It is
designed rather, to make it possible for a reader to make a quick
choice, without being confused by many titles. Special attention
has been given to pamphlets."

* A paper prepared for the Wilson Bulletin for Librarians, and reprinted
here by permission.

333

334 JOURNAL OF SOCIAL, HYGIENE

Even before publication we were using Graded Readings in the
proof stage; to advise readers who came to us with their problems.
The ink was scarcely dry on the initial printing of ten thousand
copies before one thousand were given out at the Southwest District
Conference of the Ohio Congress of Parents and Teachers. Since
the publication date, March thirty -first, 1944, the list has met enthu-
siastic reception. It was distributed to Elementary, Junior, and
Senior High School teachers of health, biology, social sciences,
physical education, and kindred subjects, in the Cincinnati Public
Schools. Copies were sent to all ministers through the Cincinnati
Council of Churches.

We felt that social workers would be interested in such a working
tool, and the various social service agencies of the city welcomed it
gladly. They cover a wide field, ranging from Associated Charities
and United Jewish Social Agencies, to the public relief divisions,
probation officers, child protective associations, et cetera. Another
interesting channel of distribution was to the five hundred parents
enrolled in the Home Study Course in Sex Education, initiated last
year by the Cincinnati Social Hygiene Society, and sponsored by
the Cincinnati and Hamilton County Councils of the Parent-Teachers
Associations. The list received nation-wide distribution through
Mr. Dickerson, who mailed copies to all societies and affiliates of
the American Social Hygiene Association in the United States. We
consider, however, that the surface has been barely scratched.

This reading list is intended for parents, adults, teachers, coun-
selors, and kindred persons, rather than for miscellaneous distribu-
tion. We would not, for example, give it in its entirety to high
school students. The needs of this age level are met by a reprint
of the section, "For the upper teens," which has been distributed
through several youth-serving agencies, such as the preinduction
health education program of Cincinnati's public high schools in
which twenty-five hundred seniors were enrolled.

A reference set of the books included in this list is kept in the
Readers' Bureau, so the patron may examine the books recommended
and make his personal choice. Circulating copies are readily available
in the main library and all branches, a number of which are housed
in public school buildings.

Insofar as we can ascertain, Graded Readings in Sex Education
is the first printed list published under the joint collaboration of
a, social hygiene society and a library. We submit it in hope it
may be as useful to other libraries as we are finding it in Cincinnati
and Hamilton Count v.

EDITOE'S NOTE: It is to be regretted that wartime lack of space prevents
publication here of this list, which is arranged under the following headings;
(books and pamphlets listed separately) : For Parents; For Children up to
Ten or Eleven; For Boys and Girls Ten or Eleven to Fourteen (inclusive) ;
For the Upper Teens; Thinking Ahead to Marriage; Marriage and the Family;
Prenatal Life and Care; Supplementary Readings.

LIBRARY AND SOCIAL HYGIENE SOCIETY COOPERATE 335

Another excellent recent list is from another Ohio city, Cleveland, where
the Cleveland Public Library, the Cleveland Division of Health, Bureau of
Venereal Disease Control, and the Family Health Association collaborated in
preparing a four-page bibliography, Community Protection through Social
Hygiene Education. This list is arranged under the headings, The Human
Body ; When Children Ask; Step by Step in Sex Education; Attaining Maturity;
Marriage for Moderns, and Plain Words about Venereal Disease.

Copies of the above lists may be secured by writing to any of the agencies
named.

' ' Most Americans want to play square with the boys and girls who will follow
them. Most American communities want to do a good job for their young
people. Playing square with them, doing a good job for them calls for truly
cooperative effort all the way along the line. Children have at least twelve
hours of intense activity every day. School takes a small part. Modern homes do
not provide many chores that are experience builders nor many tasks that are
appealing. Playgrounds are too remote. Streets are too handy, and streets lead
down town where there are the most lights and excitement . . . the most
places to do useless, if not harmful things. Cooperative effort to beat these
conditions means real work by lots of people, not mere lip service to the nice
phrase "let's prevent juvenile delinquency." Merchants and budget officers of
public departments have to be as willing to back facilities for recreation, as to
back public works. When the folks of any town or city are ready to put their
hearts into the job of meeting the needs of the young people, it can be done. We
are in the mood to blame someone else, the teacher, the preacher, or the parent
rather than blame ourselves for an environment that needs to be moulded for
children if these children are to develop as good and constructive citizens. Chil-
dren want to be a part of what goes on around them. Places where they fit in
easily are important if they are to have a sense of responsibility and of
participation.

The war is tearing us apart clear down to the foundations. Our children are
now a prime war casualty. There is so much to do in building anew, in rehabilita-
tion, in readjustment, that every boy and girl of these days should feel he is a
part of the constructive community building."

BAY LYMAN WILBUR,

Chancellor, Stanford University, and President,
American Social Hygiene Association, in a radio
symposium, one of the "Here's to Youth"
series, of the National Broadcasting Company,
April 15, 1944.

"I WANT TO DRAW A BOOK ON . . ."*

AIMEE ZILLMEE
Lecturer on Social Hygiene, Wisconsin State Board of Health

Parent: " I'd like to have a book — a book about — I don't really
know what to ask for! but you know what I mean — I want — my
child is beginning to ask embarrassing questions."

Librarian: " You mean a sex hygiene book? "

Parent: " I guess that's what you call them, but my little girl is

so young. I just want to answer her questions and don 't want a sexy
book."

Librarian: "I am sure that we have something that will help
you." And so they have !

Twenty-two libraries visited, librarians interviewed — libraries in
towns ranging from less than 5,000 to libraries serving a population
of more than one half million — constitute the basis of this article.

Are social hygiene books available? Are they easily accessible
to those concerned? Are they too easily accessible to those not
concerned? How are they listed? Are they used? These and
similar questions are waiting an answer. The impression gotten by
visits of the author of this article, could hardly be called a study —
rather a picture. The picture, by the way, of how it appears to
the lay person, rather than to one trained in the library methods.
And that was the object !

Libraries Are Really Schools

We are always saying, and believing, or hoping, that parents are
the child's best social hygiene teachers. The library is really a
voluntary, not compulsory, school for adults. It is for this reason
that we consider the libraries an important part of the social
hygiene educational program. The libraries are there to be used.
Practically all librarians will get the best books available but would
like a fair guarantee of their use. Because a little reticence on the
part of parents exists, when it comes to asking for these books, the
use of excellent books in many well stocked libraries is not always
sufficient to justify their purchase. It is not fair to say, " If one
person is helped by the book, the purchase is justified ! " There are

* Eeprinted from the Wisconsin State Board of Health Bulletin, January-March,
1944.

336

337

the books; there are the children to be guided; there are the con-
scientious parents — and Wisconsin boasts a large proportion of such
parents. " You can lead a horse to water, but — ."

Hence this study! The libraries visited, served towns totaling a
population of 1,065,065. We hope the comments prove helpful to
librarians and parents, linking the two ; the one having the supply,
the other the demand.

What We Were Looking For
We visited the libraries to see

1. Which of the best social hygiene books they had?

2. Which they lacked.

3. Which books were asked for most often ?

4. Were many books antiquated?

5. Where were the books located?

6. How were they listed?

7. Were parents natural or reticent about asking for books?

Answering Question 1, we found that most libraries had a good
number of the best books — a number proportionate to their popula-
tion. The books were well distributed as to type (education, mar-
riage, health), and as to age group. It was interesting to note that
in cities where the proportion of college parents was large, there
were few social hygiene books in the library. In each such instance
the librarian volunteered that the parents probably bought the
books — at least she thought it likely. I wonder ! After all, a social
hygiene book is not like a book of poetry, a classic, or a cook book.
It is more a reference book, and a library is a good place for it.

In re Query 2, we found many libraries lacking books on venereal
diseases. That was not surprising, since until recently, few were
written for the laity; and latterly, there has been a flood of free
literature on the subject. Many had files of such free literature.

Which books were asked for most? "Books on marriage" is the
answer to Question 3, and a wise choice they were. They included
books that covered all phases of married life. My notes on this part
of the findings read : " File on marriage worn and dirty." And
again, "Librarian says, Marriage cards must be re-typed once a
year."

Question 4. One librarian visited volunteered this honest remark :
" Most of our books are old and good for a bonfire." But only one
other library visited had outmoded books — relics of 1911.

Do They Hide the Books?

With regard to the other objectives of our study, to learn where
most books were located, how listed, and whether parents are reti-
cent about drawing them, our findings are unsettled and perhaps
slightly unsatisfactory. On the first two points, there is no set
policy. Generally the books are a little difficult to get. My notes
on the location of social hygiene books read :

338 JOURNAL OP SOCIAL HYGIENE

Books on closed shelf ; must ask for them at desk.

Books on balcony — on open shelves; but balcony restricted.

Books on reserved shelf, behind glass, so titles can be seen.

Must ask for specific book.

Books in librarian's office; must ask for at desk. (Under this system books

are little used.)
Books in locked case.
Books on open shelf, out of reach of children in "Parents Reading Room"

(This seemed most nearly the correct way of handling such books.)

As to the listing of books, there seemed no particular method,
the listings running from the single word " sex " (with no cross
reference) to listing and cross references such as marriage, family,
divorce, sex, sex hygiene, social hygiene education, sexual ethics,
venereal disease, birth control. Social hygiene, marriage, and
venereal disease seem to be satisfactory and sufficient headings.

By and large, parents are timid about asking for books. I hardly
think that it is an embarrassment concerning the subject, but rather
a queer and an unnecessarily conspicuous feeling that results from
the cumbersome way of securing a desired book. It is the same
result that occurred when a half dozen copies of very good and
approved marriage books were put on the open shelves in a college
dormitory library. When there was only one book, it was stolen,
or at least sneaked off; when there were a half dozen copies, they
were taken from the shelf and read in the open library. This diffi-
culty about drawing books is surmounted by a variety of happy
solutions devised by resourceful librarians. In one city, the librarian
prepares a little colored folder listing books the library has on the
various subjects to be discussed during the year by parent groups,
including sex hygiene books. One librarian sees that the books
applicable to a subject discussed are in full view at the meeting
places. Another librarian has given the doctors of her city a list
of marriage books available at her library, books written for the
laity and covering more than the physical side. Another librarian
sends marriage book lists to young brides, and book lists on child
guidance to young mothers.

All the above observations were discussed with an outstanding
Wisconsin librarian. The problem, she admitted, was ho\v to get
the book from the library to the persons who want to use it dis-
creetly. She suggested it might be helpful to place a sign near the
sex hygiene books, or a note on the fly leaf of each book reading
something like this: "Do not hesitate to have this book checked
at the desk." Or if a book was " lifted " and not really stolen, an
added statement might read : " If you failed to check this book
when taking it out, do not hesitate to have it checked on return."

Eager to serve wisely and in good taste is how I would sum-
marize the findings of this study of social hygiene books made avail-
able to the public through Wisconsin public libraries. The Social
Hygiene Department counts on these libraries as its community
outposts.

EDITORIAL

WAR AND THE JOURNAL'S ANNUAL LIBRARY NUMBER

War pressures and trends of the times are plainly seen in this,
number of the JOURNAL OP SOCIAL HYGIENE — the eleventh annual
issue devoted to library interests. Wartime duties of the editorial
staff, as well as of writers to whom we would naturally turn for
articles and book reviews, are responsible for delayed appearance and
omission of some features and items which would usually be included.
Wartime limitations on paper and printing are shown in the lesser
number of publications received for review, and in the fact that
some of those received were in miniature size, often in paper covers
and sometimes in mimeographed form. Wartime problems are
apparent in the increased number of publications dealing with efforts
for prevention of prostitution and sex delinquency. Wartime
advances in medicine and public health have made necessary new
editions of a number of standard works. On the other hand, pre-
occupation with war emergency difficulties seems to have prevented
the usual generous contribution of writers on the long-range aspects,
of social hygiene, ordinarily grouped under Books on Sex Education,.
Marriage and Human Relations, though advance notices of publica-
tion of a number of promising ones have been received. These are
needed more than ever for postwar guidance, and the JOURNAL looks
forward to their advent.

The fast-changing scene of a country at war is also illustrated by
the fact that many of the publications reviewed in this issue which
would in normal times be published in book form have appeared as
pamphlets or as articles in periodicals. Some of these, with suitable
revision and amplification, will doubtless be published between boards
after the war is over, as permanent records and reference mate-
rial. Meanwhile, for the sake of simplicity and uniformity with
other Library Numbers, and because so many of these temporary-style
publications are really book-material, the Editors have kept to the
usual style of interest group Book Review headings. For the same
reasons, considerably more space than would under ordinary circum-
stances be assigned to pamphlet publications has been devoted to.
reviews of some of these. This we believe will meet with the approval
of librarians generally, and especially of those who are concerned
with special collections of literature on health and welfare.

The importance and opportunity of the library, whether public or
special, in social hygiene matters, steadily grow, and the JOURNAL
urges all social hygiene groups to make full use of the help available
for public education from this source. The Editors will be glad to
receive information concerning other community education efforts
conducted in cooperation between libraries and social hygiene societies,
and workers, such as those reported in the articles in this number by
Mrs. Graham, Miss Fine and her helpers, and Miss Zillmer.

Please send us also any suggestions which may occur to you regard-
ing desirable features for future Library Numbers of the JOURNAL, or
in fact for publication at any time.

339

NATIONAL EVENTS

EEBA RAYBURN

Washington Liaison Office, American Social Hygiene Association

American Library Association Plans for War Areas. — Plans for
aiding foreign libraries after the war and activities being carried
on toward that end during the present time are outlined in a recent
release from the American Library Association telling of a $100,000
grant from the Rockefeller Foundation which will make possible
the purchase of books of permanent value for future shipment to
libraries in war areas. The books, representing significant contribu-
tions to research and scholarship in the United States since the war
began, are to be held in reserve for distribution when transportation
returns to normal. Some important books published during the war
are already out of print and many more will be before transporta-
tion channels are reopened. The grant is an extension of funds
amounting to $250,000 provided by the Foundation for the pur-
chase of periodicals to be sent to foreign libraries after the war.
Both projects are administered by the A.L.A. International Rela-
tions Board through its Washington Office.

The A.L.A/s international activities have expanded considerably
since the beginning of the war and as part of the government's
information program books on all aspects of cultural, political and
economic thought are being sent to libraries in Latin America.
American libraries of information are open to the public in Mexico
City, Managua, Nicaragua, and Montevideo, Uruguay, with plans
under consideration for an American library in China. Information
libraries in Europe, Asia and Africa are operating under the OWL
The A.L.A. helps to operate library schools in Quito, Ecuador, Lima,
Peru, and Sao Paulo, Brazil, and aids students coming from other
countries to study in American library schools.

U. S.-Mexico Border Public Health Association Meets. — The Second
Annual Meeting of the United States-Mexico Border Public Health
Association was held in El Paso, Texas, and in Ciudad Juarez, Chi-
huahua, Mexico, May 30- June 1. Morning sessions were devoted
to formal presentation of papers on health subjects of mutual
interest and afternoons were devoted to simultaneous meetings of
three round tables on venereal diseases, sanitation and tuberculosis.
Of special interest to social hygiene workers were the discussions
on venereal diseases and social protection:

Venereal Disease Control Program Along the Border of the State of Sonora,
Dr. Francisco Arriola, Federal Health Department, Nogales, Sonora; Venereal
Disease Lay Workers Program, Walter Joslin, Senior Investigator, California
State Health Department, Los Angeles, California; Rapid Treatment Centers,

340

NATIONAL EVENTS 341

Dr. Melford S. Dickerson, Director, Venereal Disease Control, Texas State Health
Department, Austin, Texas; Border Venereal Disease Control Activities, Dr.
Luis Castaneda, Supervisor, Venereal Disease Clinics on the Mexican Border;
and The Development of the Venereal Disease Control Program of the City-
County Health Unit of El Paso, Dr. M. R. Vinikoff, Director, Venereal Disease
Control Division, City-County Health Unit, El Paso, Texas.

Presiding at the venereal disease round table were the heads of Federal venereal
disease control programs of the two countries, Dr. Enrique Villela, Mexico City,
and Dr. J. E. Heller, Washington, D. C., on May 30; and on May 31 Dr. Jose
Ortega Bustamente, Ciudad Juarez, Chihuahua, and Dr. W. B. Prothro, El Paso,
Texas.

Mr. Bascom Johnson, ASHA Director in charge of the Dallas Field Office,
attended the conference.

Dr. Frederico Ortiz Armengol, Health Officer of the State of Chihuahua,
Mexico, succeeded Arizona State Health Officer, Dr. Lewis H. Howard, as presi-
dent of the Border Public Health Association; and Dr. V. M. Ehlers, Sanitary
Engineer of the Texas State Health Department, was named president-elect, to
take office next year. Dr. Donald Davey, Venereal Disease Officer for Southern
California, and Dr. Victor Ocampo Alonzo, Chief of Coordinated Health Service
of the State of Sonora, Mexico, were elected vice-presidents. Dr. A. Baz Dresch
of the Juarez Health Department was named Secretary, succeeding Dr. Joseph
Spoto, Traveling Representative, Pan American Sanitary Bureau.

U. S. Chamber of Commerce Makes Community Health Awards. —
Award of 1943 National Health Honor Roll standings to 53 city
and county units was announced late in April by Eric A. Johnston,
president of the United States Chamber of Commerce, which with
the American Public Health Association, sponsors this nation-wide
merit award program for community health advancement.

The awards are made on the basis of attainments of high standards
of excellence in protecting public health in wartime, with emphasis
placed on specific measures to control communicable diseases, such
as venereal diseases, tuberculosis, and children's diseases. Further
important elements are safeguards in maternity care, child health
and welfare, effective health education, sanitation, industrial health
programs and other health services. The large number of entries
was judged by a committee of ten leading authorities who spent
weeks grading reports from communities throughout the United
States. Chairman was Dr. John T. Phair, Chief Medical Officer of
Health, Toronto, Canada.

The report also included a statement by two members, Dr. George
P. Darling of the National Research Council and Dr. John A. Ferrell
of the Rockefeller Foundation, that both wartime health problems
and postwar planning for industrial and community welfare had
been considered. Pronouncing the Health Evaluation Schedule
used in this contest "one of the best tools for postwar planning,"
these health authorities said that its use would give every com-
munity exact knowledge of where it stands in health and hospital
facilities in connection with adjusting itself to post-war conditions.
Maintaining that cities which make this inventory are steps ahead
of non-participating communities in postwar planning, they asserted

342 JOURNAL OF SOCIAL HYGIENE

that " communities which arm themselves with a definite plan based
on the Honor Roll Health Evaluation Schedule will obviously be
in the best position to obtain promptly trained technicians and
additional facilities after the war."

The 53 winning cities and counties which will be awarded
engraved plaques are as follows:

Arkansas: Little Eock.

California: Los Angeles County, Pasadena, San Jose, Santa Barbara County.

Connecticut: Greenwich, Hartford, Stamford.

Georgia: Glynn County.

Illinois: Evanston, La Salle-Peru-Oglesby, Peoria,

Kentucky: Fayette County, Louisville -Jefferson County, Madison County.

Maryland: Baltimore.

Massachusetts: Newton.

Michigan: Allegan County, Barry County, Calhoun County, Detroit, Dickinson (
County, Eaton County, Ingham County, Jackson, Mason County, Menominee
County, Midland County, Saginaw County, Van Buren County.

Minnesota : Roche ster .

Mississippi: Coahoma County, Jones County, Lauderdale County, Leflore
County, Washington County.

New Jersey: Hackensack, Newark.

Mew York: Schenectady.

North Carolina: Forsyth County.

Oregon: Jackson County.

Pennsylvania : Reading.

South Carolina: Spartanburg County.

Tennessee: Davidson County, Gibson County, Mem phis -Shelby County.

Texas: Austin-Travis County, El Paso City-County, Houston.

Virginia: Arlington County.

Wisconsin: Madison, Milwaukee, Racine.

National Congress of Parents and Teachers Holds Conference on
Childhood and Youth. — With the theme All Children Are Our
Children, the National Congress of Parents and Teachers met in
their 48th Annual Convention, May 22-24 at the Pennsylvania Hotel
in New York. The three days were crowded with general meetings,
forums, panel and general discussions, dramatizations and interest-
ing presentations of all kinds. Mrs. William A. Hastings, president
of the Congress, presided at the general sessions. On May 22, an after-
noon general session was devoted to Parent Education and the Citizens

NATIONAL EVENTS 343

of Tomorrow, with talks by Mrs. Evelyn Millis Duvall, Mrs. Sidonie
Gruenberg, and others. This was followed by meetings of various
workshop groups on such subjects as publicity, legislation, and
special programs of the various age groups.

On May 23, a general session in the morning was addressed by
John W. Studebaker, United States Commissioner of Education, who
spoke on Problems of Postwar Education. Symposiums on various
subjects were presented in the afternoon, among them, one on
Keeping Children Healthy and Safe, which included as participants
Dr. Marion Hotopp, National Chairman, Health and Summer Round-
Up of the Children ; Joseph Miller, National Chairman, Mental
Hygiene; Mrs. Bess N. Kosa, National Chairman, Social Hygiene;
and Mrs. L. K. Nicholson; National Chairman, Safety. A resource
panel for this group included Dr. Walter Clarke, ASHA Executive
Director, and Dr. Mayhew Derryberry, Chief, Field Activities in
Health Education, U. S. Public Health Service.

An evening general session included greetings from Canada,
China, Russia and South America ; and an address on Child Care in
Tomorrow's World, by Miss Mary Craig McGeachy, Director of Wel-
fare and Relief for UNRRA.

Women's Clubs Adopt Resolutions.— The Annual Convention of the
General Federation of Women's Clubs, held in St. Louis on April
25—28, adopted and reaffirmed a number of resolutions supporting
a well-rounded program for the welfare of children and young
people. The Convention ratified a resolution adopted by its Board
of Directors in June 1943 concerning Juvenile Delinquency, as
follows :

WHEREAS, The problem of the rapidly mounting rate of juvenile delinquency
is confronting every community in the United States; and

WHEREAS, This condition is a responsibility of the forces of the home, the
school, the church and the community ; therefore be it

RESOLVED, That the General Federation of Women's Clubs in convention
assembled, April 1944, urges the formation of committees within the individual
clubs, districts and states of the Federation, which shall work toward the
coordination of effort of all organizations and agencies of the community inter-
ested in the welfare of children and youth to combat juvenile delinquency through
the establishment of such community services as a survey shall prove to be
necessary in the local communities.

Presented by:

MRS. HORACE B. RITCHIE, Chairman, Public Welfare Department. I

MRS. HIRAM C. HOUGHTON, JR., Chairman, Education Department.
MRS. EDWIN I. POSTON, Chairman, American Home Department.
MRS. GUSTAV KETTERER, Chairman, War Service Department.

Resolutions previously adopted and reaffirmed by the Convention
included one on education and crime prevention, as follows:

WHEREAS, The American home is the keystone of the nation in the preserva-
tion of moral, ethical and spiritual values; and

344 JOURNAL OF SOCIAL HYGIENE

WHEEEAS, American women can and must assume the challenge presented
by the alarming increase of juvenile delinquency to safeguard American youth,
upon whom the future of the nation depends; and

WHEREAS, A well-coordinated and thoroughly integrated crime prevention
program demands the wholehearted cooperation of the home, the churches of all
denominations, the schools, as well as the social, civic and commercial agencies
in the community with the full participation and assumption of responsibility
by youth itself; therefore be it

RESOLVED, That the General Federation of Women's Clubs in convention
assembled, April 19'44, calls upon the national, state and local authorities to make
available on the community level, practical assistance in the form of school
character-building programs; sex and marriage counseling courses; vocational
guidance; psychiatric and psychological clinics; properly supervised recreational
facilities for all age groups, including adult and youth forums for the develop-
ment of civic responsibility and patriotism; proper control over commercial enter-
prises which are harmful to youth ; adequately-staffed socialized juvenile and
adolescent courts and socially-trained police and probationary officers; and be it
further

RESOLVED, That the General Federation of Women's Clubs requests its
membership to use every available means at its command to secure the adoption
and implementation of this program throughout the nation for the protection
of American youth.

Presented by:

MRS. HIRAM C. HOUGHTON, JR., Chairman, Education Department.
MRS. HORACE B. RITCHIE, Chairman, Public Welfare Department.

New resolutions presented and approved, support the development
of nursery schools ; continuance of school lunch programs ; support
of the U. S. Children's Bureau; and a statement about the use of
policewomen, worded as follows :

WHEREAS, The employment of policewomen has shown its value in those
communities where the system has been given a fair trial; and

WHEREAS, The point of particular value in the use of policewomen haa been
in the treatment of women and children who are in conflict with the law; there-
fore be it

RESOLVED, That the General Federation of Women's Clubs in convention
assembled, April 1944, expresses its approval of the system of employing police-
women and its support of plans to extend the system to all municipalities where
there are cases involving any considerable number of women and children.

Presented by:

MRS. HORACE B. RITCHIE, Chairman, Public Welfare Department.

United States Office of Education Has Consultant in Social Hygiene.
— Lester A. Kirkendall has been temporarily assigned from the
United States Public Health Service to the United States Office of
Education, to serve as Senior Specialist in health education in the
Division of Physical Education and Health Activities. He will be
available as consultant on social hygiene, human relations, sex
education, and related subjects, to schools, teacher training insti-
tutes and other educational agencies and organizations. The need

NATIONAL EVENTS 345

for a service of this kind has been attested by many requests from
state and local school officers, and by resolution of the National
Conference for Cooperation in School Health Education.

Mr. Kirkendall holds M.A. and Ph.D. degrees from Columbia Uni-
versity and his interest in education and social hygiene has been
varied. He has served as principal of elementary and secondary
schools; as teacher of education and personal counselor in univer-
sities; and as educational consultant with the VD Institute of
Raleigh, North Carolina.

Dr. Sawyer Appointed to UNRRA. — The appointment of Dr. Wilbur
A. Sawyer of New York as Director of Health for the United
Nations Relief and Rehabilitation Administration was recently
announced by Director General Herbert H. Lehman. Dr. Sawyer,
who has been Director of the Rockefeller Foundation's International
Health Division for the past nine years, will be assigned to Wash-
ington in charge of the Health Division of UNRRA and will be
responsible for planning and directing health and medical activities.

Chautauqua Summer Schools Offer Social Hygiene Courses. — Con-
tinuing their custom, the New York University Division of Chautau-
qua Summer Schools at Chautauqua, New York, offers a number of
courses dealing with social hygiene subjects for its forty-fourth
session, July 10th to August 18th. Doctor Mabel G. Lesher gives
three which are of special interest:

I. EDUCATION: Course 9. Education for Family Life I — This course aims to
meet the increasing demand for educators, nurses, social and religious
leaders trained in the field of sex-character education or education for
family life as recommended in the 1941 Yearbook of the American
Association of School Administrators. It is designed (1) to give an
appreciative understanding of the normality and potential value of the
creative force of sex in the life of every normal individual from infancy
to adulthood; (2) to enable parents to answer the child's questions and
to aid in the development of wholesome habits and emotional attitudes
as essential preparation for the oncoming changes of adolescence; (3) to
offer concrete methods for the guidance of youth in the adjustment of
his physical, emotional and social problems; (4) to present detailed
elementary and secondary school programs and illustrated classroom
talks on the high school level. A special reference library will be
available.

Course 10. Education for Family Life II — A discussion group study of
the social problems of the late adolescent and the adult. It includes
essential factors in preparation for marriage as effected by changing
economic and educational conditions and by the changing standards of
behavior, greatly accelerated in wartime; also, needed adjustments of
the unmarried and readjustment in family and social relations in the
postwar period. Eeports, opinions of recognized authorities, access to
latest studies and specific questions for class consideration will char-
acterize the course.

Note: Courses 9 and 10 offer a complete unit in that aspect of Social
Hygiene known as Education for Family Life. Course 9 is not an
essential for Course 10.

346 JOURNAL, OF SOCIAL HYGIENE

VIII. PHYSICAL EDUCATION:

1. Personal Hygiene — Deals with the personal health problems of the class.
Guidance is given in solving these problems on the basis of what is known
at the present time about the best ways of living. This course not only
presents the factual knowledge essential for healthful living; but it also
emphasizes methods of motivation of the adolescent for the application
of this knowledge in his daily living.

U. S. Public Health Service Act Signed. — Legislation adopted by
Congress, " To consolidate and revise the law relating to the Public
Health Service," was signed by the President 011 June 30. Known
as the Public Health Service Act, the new Public Law 410 of the
78th Congress, 2nd Session, broadens the scope of the Service, and
brings together in one place all the legislative authority for its
activities. Among new features of the Service under this act
will be : a tuberculosis control program with authorization for a
$10,000,000 appropriation for the first year, including both TJSPHS
activities and grants-in-aid to states; authorization of up to
$20,000,000 a year for aid to general public health activities in
the states ; commissioning of Public Health nurses. In approving
this legislation, the President issued a statement commending the
Public Health Service which reads in part as follows:

The Public Health Service Act is an important step toward the goal of better
national health. A constituent of the Federal Security Agency since 1939, the
United States Public Health Service is one of the oldest Federal agencies — and
one in which the people have great confidence because of its excellent record in
protecting the health of the nation. ... In establishing a national program of
war and post-war prevention, we will be making as sound an investment as any
government can make; the dividends are payable in human life and health.

Surgeon General Thomas Parran issued a formal statement shortly
after the President had signed the act, outlining some of the benefits.
" I am deeply gratified," he said, " that the House and the Senate
have passed the Public Health Service Act without a dissenting vote.
We are conscious of the large obligations imposed by the public
trust invested in the service. This law facilitates the discharge of
this responsibility under both wartime pressures and the continuing
demands of peacetime."

Dr. Parran said that the new law would enable the Public Health
Service to make further Federal grants-in-aid for research in dis-
ease ; would strengthen the commissioned corps of Public Health
officers; would provide for the commissioning of Public Health
nurses; and confirm the broad foreign and interstate quarantine
powers of the Service.

Negro College Social Hygiene Day Contest Winners. — Congratula-
tions are in order for the following colleges, winners of the contest
on Social Hygiene Day projects, in a field of contestants comprising
thirty-three Negro colleges: first place, Louisiana Negro Normal
and Industrial School, Grambling, Louisiana; second, Jackson Col-
lege, Jackson, Mississippi; third, Wilberforce University, Wilber-
force, Ohio ; fourth, St. Augustine's College, Raleigh, North Carolina.

347

The reports were judged on the basis of the amount of activity
carried on, the extent to which the program covered all phases of
social hygiene problems, the amount of student participation in the
planning and execution of the program and the number of people
apparently reached. In the latter connection those programs which
reached out into the community were given extra credit. Original
dramatic skits, poster contests and quiz contests were among the
more novel features in some of these programs.

The contest was sponsored by the American Social Hygiene Asso-
ciation and the National Student Health Association. The prizes
awarded were in the form of books on social hygiene for the college
libraries, to be selected by the colleges from an approved list in
amounts to the value of $40 for the first place, $30 for second place,
$20 for third place, and $10 for fourth place. All entries in the contest
received a year's subscription to the JOURNAL OF SOCIAL HYGIENE.

Honorable mention in the contest was awarded to six other
entries: Wiley College, Marshall, Texas; West Virginia State Col-
lege, Institute, West Virginia ; Johnson C. Smith University, Char-
lotte, North Carolina ; Dillard University, New Orleans, Louisiana ;
Morgan State College, Baltimore, Maryland ; and Southern Christian
Institute, Edwards, Mississippi.

National Women's Advisory Committee on Social Protection
Meets. — The second general meeting of the Committee was held on
May 25th in the National Auditorium, Washington, D. C., with
nearly all the thirty and more member organizations represented.
Morning and afternoon sessions were held, with Mr. Eliot Ness,
Director of the Division of Social Protection, presiding, and Mr. Mark
McCloskey, Director, Community War Services, Mr. Judson Hardy,
Public Information Specialist, U. S. Public Health Service, as guest
speakers. Chief business of the day was the reading and revision of
the new manual for women's groups, Meet Tour Enemy — Venereal
Disease, which has been prepared during the past year by a special
sub-committee headed by Mrs. Horace B. Ritchie, and which is now in
process of publication by the Division of Social Protection. Plans
for distribution by the member organizations were also discussed
and it is expected that the publication will have a wide circulation,
especially among women's groups newly cooperating in the social
protection program.

Attending the meeting were:

Dr. Helen Gladys Kain, American Medical Women's Association; Mrs.
DeForest Van Slyck, Association of Junior Leagues of America, Inc. ; Mrs. Boy
C. F. Weagley, Associated Women of American Farm Bureau Federation;
Mrs. Horace B. Ritchie, General Federation of Women's Clubs; Miss Eleanor
Fowler, Congress of Women's Auxiliaries of the CIO; Mrs. George E. Pariseau,
Girls ' Friendly Society of the U.S.A. ; Dr. Janet Fowler Nelson, National
Board of the Y.W.C.A.; Mrs. Frederick R. Scott, National Board of the
Y.W.C.A. ; Misa Margaret T. Lynch, National Council of Catholic Women; Mrs.
Gerson B. Levi, National Council of Jewish Women; Mrs. J. Austin Stone,
National Women's Trade Union League of America; Mrs. Samuel McCrea

348 JOURNAL OF SOCIAL HYGIENE

Oavert, United Council of Church Women; Miss Alice Scott Nutt, Assistant
Director of Research, Social Service Division; Miss Jean B. Pinney, American
Social Hygiene Association; Miss Elizabeth H. Godwin, Consultant on Family
and Child Welfare, Bureau of Public Assistance ; Miss Bertha McCall, National
Traveler's Aid Association; Mrs. Mildred F. Eslick, Associate Public Health
Nurse Consultant, United States Public Health Service; Mrs. Pearl Case Blough,
USO Service for Women and Girls; Miss Florence Taaffe, Joint Army and Navy
Committee on Welfare and Recreation; Mrs. Norma F. Wulff, Vice President,
Cleveland Safety Council and Board of Education; Mrs. Zilpha Franklin, Director
of Information, Federal Security Agency; Mrs. Delie Kuhn, Director of Informa-
tion, Community War Services; Mrs. Ruth Sadler, Miss Marie Duffin, Miss Cecelia
McGovern, Social Protection Division.

American Medical Association Journal Urges Teaching of Biology
in High Schools. — The Journal of the American Medical Association
for June 3 urges its membership to cooperate in backing a two-year
course in biology in all high schools, as an aid to the general health
of the country through the dissemination of knowledge concerning
human biology. A recent report on instruction in biologic subjects,
by a committee appointed by the Union of American Biological
Societies, indicated serious deficiencies both in the teaching itself
and in the training of teachers.

' ' The medical profession, M says the Journal, ' ' cannot be indifferent to wide-
spread public ignorance of biologic facts and principles. The health of a people
must rest in part on well disseminated knowledge of man's biologic friends and
enemies, of a sound nutrition, of man's own bodily functions, of how and what
he inherits, and of the sure relation between cause and effect. Much experience
has shown that comprehension of these and other related matters is usually not
obtained through short exposures to formal training in the various biologic sub-
jects in our schools. ' '

A year ago the Medical Association's Reference Committee on
Hygiene and Public Health adopted the following resolution in sup-
port of this type of cooperation :

That the American Medical Association through its Bureau of Health Educa-
ton encourage close cooperation between the constituent state medical associa-
tions and component county medical societies and the teachers of science in
their respective communities to the end that intelligent instruction in science and
biology be given the youth of America.

NEWS FKOM THE 48 FKONTS

ELEANOE SHENEHON
Director, Community Service, American Social Hygi-ene Association

Arkansas Pharmaceutical Association Holds Annual Meeting. — The
62nd Annual Convention of the Arkansas Pharmaceutical Associa-
tion occurred June 13th and 14th at Arlington Hotel, Hot Springs.
Mr. Bascom Johnson of the ASHA staff was a speaker on the subject
Pharmacy Fights VD, reporting progress under the Joint Committee
of the ASHA and APHA and outlining the present program and
recent developments.

California : San Diego's First Annual Health Education Week. — The
San Diego Social Hygiene Association was one of some forty-five
organizations taking part in that city's First Annual Health Educa-
tion Week, May 12 to 21, organized by the USO Industrial and
co-sponsored by the Community Chest Health Council. The theme
of this program was Community Mobilization for Health Education.
Mr. Royal Thomas, USO Industrial director, served as secretary of
the Health Education Week Committee.

Health education about the venereal diseases was of course an
important part of this overall health program. Through the cour-
tesy of the San Diego Gas & Electric Company the San Diego Social
Hygiene Association obtained the use of a large display window in
which they arranged the effective exhibit shown in the photograph.
The sign Free Literature Inside attracted many people to visit and
select from the display of literature arranged in the show room.*

Other events of the week were film showings, radio broadcasts, talks,
health themes and contests in the schools — in fact all the devices
which can be used to bring the importance of Victorious Health — the
slogan of the Week — to the attention of the public. Congratulations
to the USO and the Community Chest Health Council and to all
those who worked with them to make a success of this event.

District of Columbia Social Hygiene Society Reports on Year's
Work. — Ray H. Everett, Executive Secretary of the Society, in the
May issue of Social Hygiene News and Views, tells the story of a busy
twelve months with many important results. The "stark statistics,"
as Mr. Everett says, include:

Lectures — Health, Sex Education and Law Enforcement 141

Total Attendance 11,397

Personal Service (Consultation on casework basis) 1,613.

Education by Publicity •

Radio Broadcasts

Newspaper Articles (inches of space) 1,379

Pamphlets Distributed 19,770

Books Lent 787

Exhibits 23-

* See frontispiece photograph.

349

350 JOURNAL OF SOCIAL HYGIENE

But, as the report points out :

' ' Many of the Society 'a most important and effective activities can 't be made
into statistics. A single conference with key officials may be far more useful to
Washington's welfare than the distribution of a thousand pamphlets; testimony
before Congressional committees and data inserted in the Congressional Record
may prove decidedly more resultful than a lecture to scores of individuals; our
two prostitution surveys aided importantly in efficient law enforcement; and other
committee and individual projects have been similarly valuable. ' '

Translating these statistics into action, the report tells of adjust-
ment of family problems aggravated by war, teamwork among agencies
and workers for better health, and general encouraging progress in
the Capital City. Important social hygiene events of the year with
which the Society has been concerned included :

Establishment of a 100-bed Rapid Treatment Center for Venereal Diseases at
Gallinger Hospital, and assistance with rehabilitation of patients.

Continued cooperation of Washington pharmacists — "All druggists are sup-
plied with the Society's pamphlets for distribution and many of them send
perplexed customers to our offices for counsel. Five such clients were referred
to us one recent week."

Library and reference services, both in cooperation with the D. C. Public
Library and directly — "One day brought us queries from two members of Con-
gress, the Corporation Counsel's Office, two editors, and Haskins' Information
Service. ' '

Improvement in public school social hygiene teaching ' ' both in quality and
quantity" and as well in parent-teacher association activities.

As to the prostitution racket:

' ' Steady police pressure and better teamwork of courts, prosecutors, and police
against commercialized prostitution have produced notable improvement in Wash-
ington status this past year. Recent undercover studies evidence a great decrease
in solicitation and other aspects of "the vice racket." The District of Columbia
now is numbered among the nation's cleaner communities in so far as commer-
cialized prostitution is concerned. But another difficult problem — that of the
'amateur pickups' or socalled Victory Girls — still is far from being solved. It's
not primarily a police problem but, as has so often been pointed out, an all-
community job on which home, school, church, and social agencies must continue
to work. It 's a task not only ' for the duration ' but for a long time thereafter. ' '

In building bulwarks against delinquency, Washington has made definite
progress —

' ' Recreation and police authorities have increased their aid to youth ; churches
and other character-building forces have stepped up their efforts ; the D 'Alesandro
hearings furnished a considerable degree of publicity and direction; and parent-
teacher associations have used their forums and meetings to support the entire
program. Many from the Society's Board and committees have served on and
with these advisory groups and have furnished expert testimony on items in our
field. All in all, both in understanding and in doing, Washington has made real
strides towards securing a more wholesome atmosphere for its growing youth. ' '

Officers and board members of the Society are:

President, H. H. Hazen, M.D.; 1st Vice President, Rhoda J. Milliken; 2nd Vice
President, Albert W. Atwood; Secretary, Mrs. Lawrence Martin; Treasurer,
George W. Creswell, M.D.

Board members : Birch E. Bayh, R. G. Beachley, M.D., James V. Bennet,
Fay L. Bentley, Mrs. Evelyn Bright Buckley, Edith Seville Coale, M.D., Paul B.
Comely, M.D., Mrs. Henry Grattan Doyle, Lewis C. Ecker, M.D., Mrs. P. C.
Ellett, V. L. Ellicott, M.D., Dorothy Boulding Ferebee, M.D., Russell J. Fields,
M.D., James Harold Fox, William P. Herbst, M.D., M. W. Ireland, M.D., F. H.
Kenworthy, Elizabeth Kittredge, M.D., Robert Scott Lamb, M.D., Mrs. Julius
Lansburgh, William J. Mallory, M.D., Benjamin M. McKelway, Watson B. Miller,
Beatrice Mullin, Ella Oppenheimer, M.D., Winfred Overholser, M.D. Mrs. Eleanor
Patterson, Merlo J. Pusey, Mrs. Stanley Reed, Vincent Saccardi, Esther Scott,
D. L. Seckinger, M.D., Mrs. Walter S. Ufford, Lida J. Usilton, R. A. Vonderlehr,
M.D., Mrs. Eleanor N. Walker, W. W. Wheeler, Mrs. W. W. Wheeler, G. C.
Wilkinson.

NEWS FROM THE 48 FRONTS 351

Committee members and consultants: Mrs. M. Virginia Allan, Mrs. Susan Baker,
Lillian Bischoff, Gertrude Bowling, Rev. ' Warren G. Bowman, Eoacoe Brown,
M.D., Sarah Brown, M.D., W. A. Browne, M.D., Inez L. Cadel, W. W. Cardoza,
M.D., Mrs. Mildred Carr, Morris Chase, M.D., Valerie Chase, Virginia Clary,
Margaret Cummings, Hugh J. Davis, M.D., A. Madorah Donahue, Linn C. Drake,
Charles F. Farmer, C. Wendell Freeman, M.D., Roland Gable, M.D., Bea Gelbman,

F. G. Gillick, M.D., Donald Gray, Elizabeth Harvey, E. B. Henderson, Clara
Herbert, A. Katharine Davis, Gwen Hurd, Melvin P. Isaminger, J. Bay Jacobs,
M.D., Frank Jones, M.D., Grace G. Keech, Mrs. Chastina Kendall, Mrs. Mildred
Kilinsky, Gertrude Koeneman, Mrs. Blanche LaDu, Wilbur LaRoe, Mrs. Frank
Linzel, Margaret Ludden, Mrs. Marjorie N. Mayer, Rev. Francis McPeek, Lucia f
Murchison, Florence Murray, James A. Nolan, Mrs. H. Norman, Mrs. Katharine
Norton, Mrs. Virginia O'Dell, Sidney Olansky, M.D., Mrs. Margaret Osterman,
Mrs. Josephine Prescott, Mrs. Alice Sheldon, Alexine Tanner, Wm. Charles White,
M.D., Theodore Wiprud, Linda Woods.

Kentucky Association Holds Annual Meeting. — The Kentucky Social
Hygiene Association held its annual meeting at the Brown Hotel in
Louisville on June 7th. A luncheon meeting presided over by Dr.
L. E. Smith, the Association's President, was followed by a business
session and the election of officers for the , coming year, after which
Mrs. T. Grafton Abbott, Educational Consultant for the American
Social Hygiene Association, spoke on Youth Problems in Wartime.
Members of a panel discussing the problems set forth by Mrs. Abbott
included Mr. H. V. Bastin, Superintendent Ormsby Village; Mrs.
Hugh R. Leavell, Chairman, Council of Social Agencies; Lt. William

G. Kiefer, Superintendent, Crime Prevention Bureau; Mrs. Theresa
Mason, Chief Probation Officer; and Miss Elizabeth Wilson, Coordi-
nator, Louisville Service Club.

Doctor John R. Pate was elected President of the Association, with
Mr. H. V. Bastin and Mrs. J. E. Glass as first and second Vice
Presidents respectively. Miss Margaret Flynn was elected Secretary
and Miss Doris Chandler, Treasurer.

Massachusetts Society for Social Hygiene Holds Annual Meeting. —

June 23 was the date of the Society's annual get-together and busi-
ness meeting, held at the College Club in Boston. Principal speaker
was Ray H. Everett, Executive Secretary of the District of Columbia
Social Hygiene Society, his subject being Current Adventures in
Social Hygiene. This was the second public meeting of 1944 for
the Society, an unusually successful Social Hygiene Day Confer-
ence having been held in February.

Dr. George Gilbert Smith, who reported on the year's activities, was re-elected
president of the society and others named officers were Mrs. Harry C. Solomon of
Jamaica Plain, vice-president; Mrs. Evangeline H. Morris of Wellesley Hills,
secretary, and William Wadsworth of Concord, treasurer.

Named to the executive committee were the Rev. Paul Harmon Chapman,
Winchester; Dr. Oscar F. Cox, Brookline; Dr. Ernest B. Howard, on military
service; Dr. John B. Hozier, Brookline; Dr. Harold L. Leland, Lowell; Dr. Robert
Sterling Palmer, on military service, and Mrs. Eva Whiting White, Boston.

Directors, Mrs. Augustus Hemenway, Readville; Mrs. William A. Hinton,
Canton; Reuben L. Lurie, Brookline; Dr. Alonzo K. Paine, Boston; Richard C.
Paine, Brookline, Clifton T. Perkins, Melrose; the Rev. Dr. Palfrey Perkins,
Boston; Gilbert H. Roehrig, Auburndale; Miss Marion E. Rowe, Cambridge;
Dr. A. Warren Stearns, Billerica; Dr. Edward C. Sullivan, Springfield, and Mrs.
White.

352 JOUENAL OF SOCIAL HYGIENE

The Society lias recently added to its staff as Assistant Execu-
tive Secretary Miss Frances R. Hecht, who comes to the social
hygiene field following case work in the Boston Dispensary Skin
Clinic and Massachusetts Memorial Hospital with basic training in
medical social work at Simmons College. Mrs. S. W. Miller con-
tinues as Executive Secretary, with Dr. Helen I. D. McGillicuddy
as Educational Secretary, Lester W. Dearborn as Chief Consultant
and Mrs. Katharine W. Lewis, Office Secretary.

Michigan Establishes Bureau of Venereal Disease Control. — The
work of venereal disease control previously conducted by the Michigan
State Department of Health through its Bureau of Epidemiology
has now been established as a separate bureau. The new bureau is
under the direction of two representatives assigned by the U. S.
Public Health Service — Dr. Nobel W. Guthrie, as Director, and Dr.
John Lincoln, Assistant Director. P. A. Surgeon Weber of the
USPHS, previously in charge of the Michigan State VD Program,
has been transferred to a new assignment in the State of California.

Dr. William DeKleine, formerly of the American Red Cross, is the
newly appointed Commissioner of Health, succeeding Dr. H. Allen
Moyer, deceased.

New York: Institute at Skidmore College. — The State Committee on
Tuberculosis and Public Health of the New York State Charities Aid
Association held an institute for new staff members at Skidmore Col-
lege, Saratoga Springs, on June 9th-30th. During this period those
in attendance from both County Tuberculosis and Health Associations
and the State Committee had an opportunity of reviewing the latest
information and materials on the eradication of tuberculosis and the
venereal diseases.

Mr. George J. Nelbach, Executive Secretary of the State Committee, presented
the plan and purpose of the institute. Other speakers included Mr. Frederick D.
Hopkins, Executive Secretary, Doctor William A. Doppler, Director of Industrial
Relations, and Mr. Holland Hudson, Director of Rehabilitation, all of the
National Tuberculosis Association; Dean Margaret Bridgman of Skidmore Col-
lege, Miss Kathryn Starbuck, the College Secretary, and Doctor Claire Amyot,
the College Physician; Doctor James H. Lade, Director of the Division of
Syphilis Control, and Doctor Edward X. Mikol, Division of Tuberculosis Control,
both of the New York State Health Department; Doctor George Baehr, Member
of the State Public Health Council and of the ASHA Board of Directors, Mr.
Robert Osborn, Assistant Executive Secretary, and Mrs. Marie Warner Anderson,
Christmas Seal Sale Director, both of the State Committee. Miss Hazel Hart of
the State Committee was Director of the Institute.

Registrants also attended sessions of the Annual Conference of Health Officers
and Public Health Nurses held in Saratoga Springs on June 27th and 28th and
made field trips to the Saratoga County Tuberculosis Hospital and to the Mount
McGregor Sanatorium of the Metropolitan Life Insurance Company. A showing
of health movies was arranged by Miss Hanora McDonald, Executive Secretary
of the Saratoga County Tuberculosis and Public Health Association, who also
joined with Mrs. Iva Holmes of Fulton County, Mrs. Iva Thompson of Schenec-
tady County, Mrs. Marian Fahey of Washington County and Miss Dorothy Yeakel
of Washington County in putting on a round table program of Tips to New
Workers.

NEWS FROM THE 48 FRONTS 353

Oklahoma Social Welfare Association Holds War Conference. — So-
cial Hygiene was a featured subject at the Oklahoma Association's an-
nual meeting held in Oklahoma City June 14th to 17th. A session of
the health section Avas held on the subject of Social Hygiene After the
War, Mr. Bascom Johnson, ASHA Director in charge of the Dallas
Office, delivering the principal address. He developed the subject
on the basis of four questions : ( 1 ) What ought the program to be ?
(2) What is it now? (3) What are we likely to lose if we relax?
(4) What must we do to keep and add to our gains? Chairman of
the session was Mr. L. M. Jones and discussants were:

Dr. Charles B. Taylor, Oklahoma City-County Venereal Disease Clinic; Mrs.
Eileen Harrison Wilson, Social and Mental Hygiene Director, Oklahoma County
Health Association; Mr. John Cantrell, State Department of Health; Mr. C. O.
Rogers, American Social Hygiene Association; Mr. John Hall, American Social
Hygiene Association.

Following Mr. Johnson's speech the Health Section went on record
as supporting expansion of a state-wide social hygiene program with
a view to securing

"a. Venereal disease to be defined, by law, as infectious and communicable,
and therefore subject to quarantine as other contagious, infectious and com-
municable diseases now are. VD is not now so defined." Presented by John
Cantrell, State Health Department.

" b. A premarital law, demanding freedom from venereal disease before issuance
of license."

"c. Prenatal examination law to assure healthy births.

"d. Eevitalization of the State Social Hygiene Association to sponsor such
bills, and others as needed, and to aid in such revisions, innovations, etcetera, as:

1. Crime prevention bureau as part of police department, to include Women's
Police Division.

2. Detention Home for Juveniles under qualified trained supervision.

3. Children's Court or its equivalent, apart from other court, manned by well-
qualified judge and competent, trained probation officers, serving under Civil
bervice, and not answerable to politicians.

4. Stimulation of Congressmen and State Legislators to see that Federal and
btate appropriations are maintained after the war, and not lopped off in
the post-war economic retrenchment urge.

5. Sex education in schools, to be taught by qualified teachers, as a part of
long-range program for prevention and control of venereal disease.

6. Punishment of parents guilty of willful neglect which contributes to iuvenile
delinquency and anti-social traits."

Puerto Rico: U. S. Army Librarians of Antilles Department Hold
Conference.— Books for the Citizen Soldier: the library's part in
returning the soldier to private life a better equipped citizen, was
the subject of a three-day Conference held in San Juan, Puerto
Kico April 11-13 under the auspices of Army Special Services and
the direction of Miss Agnes D. Crawford, Department Librarian
Librarians of the Department 's staff from various posts in the
Caribbean Area joined with Puerto Rican librarians and represen-

354 JOURNAL OF SOCIAL HYGIENE

tatives of other agencies in hearing a notable group of speakers,
which included Lt. Col. Ray L. Trautman, Director of the Army
Library Service, Washington, D. C., who spoke on The National Army
Library Program, Dr. Jose M. Gallardo, Puerto Rican Commissioner
of Education, on Education Problems Inherent in Bilingualism and
Mr. Arturo Morales Carrion, Director, University of Puerto Rico
Exchange Center, on Puerto Rico — A Stepping Stone Between Two
Cultures.

Other topics and speakers were : Morale, the Soldier and His
Future, Col. G. C. Bunting of Personnel ; Training the Soldier to
Think, Col. S. E. Stancisko, of Plans and Training; Informing the
Soldier, Lt. Eugenio Rivera, Special Service Officer, Camp O'Reilly;
British Libraries in the Caribbean, Dr. Helen Gordon Stewart,
Librarian; Shifting Library Emphases in the Caribbean, Miss Craw-
ford; Interesting the Spanish Speaking Soldier in Reading, Miss
Luz M. Antique, Base Librarian ; Contemporary Latin American
Authors, Mrs. Katherina Keelan Lopez, Post Librarian; Supply
Procedures, Major George G. Friedman, Executive Special Service
Officer and Special Service Supply Officer; Importance of Coordi-
nating All Morale Agencies, Lt. Col. Selby H. Buck, Department
Special Service Officer; Education, the Soldier and the Home, Mr.
Moe Frankel, Director, Red Cross, Antilles Department (see page
325) ; Recreation for the "Off-Duty" Soldier, Mr. Conrad Van
Hyning, Director Caribbean Area, Community War Services, and
The University Library Goes to War, Mr. Thomas Hayes, Librarian,
University of Puerto Rico.

Capt. John P. McKnight, Assistant Special Service Officer, Antilles
Department, served as co-ordinator for the events, which were held
at the auditorium of the Puerto Rico Athaneum, with luncheon
sessions each day at the USO building. Miss Jean B. Pinney
attended for the ASHA.

Texas: Dallas Extends VD Educational Campaign. — With the
slogan The People Must Know — VD Must Go, the Dallas Venereal
Disease Educational Program which swung into action early in
March, under auspices of the Dallas Chamber of Commerce is being
extended indefinitely in some of its aspects. Like New Orleans,
St. Louis and other cities where similar programs have been
undertaken, Dallas finds that the demand for lectures, films and
educational materials stimulated by the intensive compaign calls for
continued service.

The Dallas Program, of which William S. Henson is chairman
and Z. E. Black, Secretary, utilizes a wide variety of educational
methods and literature. Outdoor billboards, both large size and
smaller ones stationed at various sidewalk locations, headed the list
of display advertising, with numerous smaller advertisements appear-
ing in Dallas newspapers. The local papers also ran special feature
articles, editorials and news items concerning the campaign. Boy
Scouts stuck some 1500 small stickers Stamp Out Venereal Diseases on

NEWS FROM THE 48 FRONTS . 355

parking meters, and these also were affixed to dressers and mirrors
in hotel bedrooms and bathrooms, on vending machines, et cetera.
Larger gummed stickers printed in red, white and blue, urging the
reader to seek treatment "if you think you have been exposed" were
widely distributed in washrooms and toilets in war industries, hotels,
bus and railway stations, courthouse, city hall, business establish-
ments, including the Negro district. A small folder, entitled News
about Syphilis and Gonorrhea, was enclosed with 50,000 bills sent
out by the Dallas Water Department.

Active in the campaign were a large number of community and
group agencies, including churches, Sunday schools, high schools,
parent-teacher associations, and Dads' Clubs. At the close of the
first month, over 25,000 persons had attended lecture or film programs
and over 325,000 pieces of literature had been distributed. Church
groups and agencies were particularly vigorous in participation, a
special religious committee heading this effort. The Dallas Council
of Church Women was the first organization to request a speaker
and film.

The Program is being conducted in cooperation with the local
Health Department, the Texas State Health Department, U. S. Public
Health Service and Dallas County Medical Society.*

Washington: Social Hygiene Societies Hold Annual Meetings. — The

Washington State Social Hygiene Association and the Seattle-King
County Social Hygiene Society held a joint annual dinner meeting —
the first for both these new groups — on Thursday, June 29th, at
the Gowman Hotel in Seattle. Guest speakers were Lt. Commander
A. N. Johnson, V.D. Control Officer, 13th Naval District; Capt. H.
Swerdloff, V. D. Control Officer, Fort Lawton; and Dr. Harold L.
Lawrence, Surgeon, United States Public Health Service. Miss
Honoria Hughes, Executive Secretary of both the state and the county
societies, was in general charge of arrangements.

* See frontispiece photograph.

NOTES ON INDUSTRIAL COOPERATION

PERCY SHOSTAC
Consultant on Industrial Cooperation, American Social Hygiene Association

"SOMETHING NEW HAS BEEN ADDED" TO THE NATIONAL SCENE

Something new was added at the 71st National Conference of
Social Work — labor participation. In the opinion of most of those
present in Cleveland during the week of May 21 to 27, the extensive
participation of labor at the sessions promises new vitality in the
health and welfare field. With such an attitude keynoting the
Conference, the ASH A 's program for reaching large groups of indus-
trial workers in cooperation with the trade unions fitted very well
into the picture.

At a well attended special meeting on "New Contributions of
Powerful Allies to Social Hygiene" the Association's industrial pro-
gram, outlined in the May issue of the JOURNAL, was presented along
with reports on activities among pharmacy and Negro groups.
Throughout the week, the Association's lively exhibit was constantly
besieged by interested delegates, who carried away with them quan
tities of social hygiene literature. Meanwhile, ASHA representatives
attended a number of Conference sessions, renewed many old friend-
ships, and made many new acquaintances especially among labor
people.
\

Among the speakers listed in the 95 page official conference pro-
gram, the names of at least 20 labor leaders appeared. Fourteen
of the scheduled meetings concerned themselves with labor attitudes
and were participated in by trade unionists as speakers or principal
discussants. A general session held at the Cleveland Music Hall
on the evening of May 24th with an attendance of 3,000 was devoted
to The Social Responsibility of Labor in Postwar Society with Mat-
thew Woll, chairman of Labor League for Human Rights (AF of L
National War Relief Committee) and Irving Abramson, chairman
of the National CIO War Relief Committee, as speakers. Of six
sessions listed under the general division of social action, five were
addressed by one or more labor people and labor was represented
in the divisions of group work, case work and community organization.

In these various meetings it was asserted that labor and social work
are striving for the same objectives; that organized labor, spokesman
for thirteen million members and their families and also the articulate
representative for all men and women who work, must have a voice
in the planning and policy making of welfare and health agencies now
and during the postwar period ; that labor and the voluntary agencies
working together for common ends can make a powerful team for

accomplishment.

356

NOTES ON INDUSTRIAL COOPERATION 357

Elizabeth Wisner, Dean of the School of Social Work, Tulane Uni-
versity, and president of the Conference, was outspoken in voicing
similar opinions. Douglas P. Falconer, executive director of United
Seamens Service said that social welfare a'nd health work had been
missing the boat, that it would not come to maturity until it had
established a vital working relationship with organized labor.

To complete the Cleveland picture, it is interesting to note that
the Labor League for Human Rights under the chairmanship of
Abraham Bluestein was holding its annual national staff meeting
during the Conference sessions. We were fortunate in being able
to present the ASIIA industrial program before the 35 staff members
of the AF of L National War Relief Committee. This group, operat-
ing throughout the country, enthusiastically promised to do its utmost
to help launch our trade union program against VD.

IN THE ''OLD DOMINION"

The feeling that we got at the National Conference of Social Work
of being in the groove in our work with the trade unions, was
heightened in Virginia when we participated in a two-day conference
on industrial health (June 8 and 9) arranged by the Richmond
Community Council in that city under the leadership of Dr. Fred
J. Wampler, Professor of Preventive and Industrial Medicine at
the Medical College of Virginia. The dinner session of this Con-
ference, at which we presented the industrial health committee plan
based on the Fort Greene, Brooklyn demonstration, was an impressive
gathering, with more than 175 present: industrialists, plant physi-
cians, representatives of the Community Council and the health and
welfare agencies and labor.

Our presentation pointed out that some of the methods the Ameri-
can Social Hygiene Association is developing in the industrial field
are based on experiences gathered in recent years by the large fund-
raising organizations; the need for employee management teamwork,
the need to work with the trade unions, and the effectiveness of a
single drive for all purposes which in the health field would mean
the effectiveness of including VD as part of a comprehensive health
education program. These ideas were well received but were helped
considerably by the endorsement and backing of the two discussants
who followed : E. B. Pugh, Regional Director for the CIO and T. B.
Farmer, Virginia Regional Director for the Labor League for Human
Rights (AFofL).

Richmond is not as yet a strong trade union town but the labor
movement is growing and is already an important factor in the
local welfare and health set up. The CIO, AF of L and Railroad
Brotherhoods are working together harmoniously on many issues
and, organized into a special committee, played an important part
in the last fund-raising campaign of the Richmond War and Com-
munity Fund. The Labor Herald, official weekly newspaper of
the local AF of L has just completed publication of Dr. Clarke's
series of seven articles Unite Against VD. All the labor groups are

358 JOURNAL, OF SOCIAL HYGIENE

anxious for us to start our Labor vs VD campaign and are heartily
in favor of an industrial health committee in Richmond. Good
relations exist between organized labor and the local Tuberculosis
Society, the Cancer Foundation and the public health people. In
fact social workers, nurses, and workers with public and voluntary
health agencies all showed a sympathetic awareness of the importance
of the trade unions which was quite in line with the conclusions drawn
at the Cleveland National Conference, i.e., that organized labor is
adding something new to the health and welfare picture.

ON THE WEST COAST

In the March issue of the Social Hygiene News we described the
Bay Area Union Health Conference held in San Francisco on Janu-
ary 16th. This Conference which gave consideration to health
problems from the trade union point of view was sponsored by the
California Social Hygiene Association, the San Francisco Medical
Society and Public Health Department and other health organiza-
tions, and was attended by numerous representatives of AF of L, CIO
and Railroad Brotherhoods. At the session free blood tests were
provided by the San Francisco Health Department and an exhibit
on venereal diseases was displayed.

We are happy to report that breaking the precedent of so many
excellent conferences, the problems and decisions reached at this
one were not filed for reference and left to gather dust. The Northern
California Union Health Committee was established and is now carry-
ing out the resolutions and recommendations adopted at the Bay
Area Conference. This California Union Health Committee will
act as a clearing house for material and information ; through union
committees already in existence will integrate and make available
to unions the work of large lay organizations and medical agencies;
will release weekly health articles to union publications reaching
200,000 people; will facilitate the work of labor with management
and government agencies upon health education projects; will act
as an over-all service committee in matters of health and safety for
union men and women.

The fight against the venereal diseases will not be neglected by
this promising group in California. The first item on its program
is concerned with the initiation and sponsorship by all trade unions
of mass examinations for syphilis and mass x-ray surveys for tubercu-
losis. The program, in addition to its resolutions on public health,
includes items on nutrition, on health insurance and on industrial
health. In the words of Dr. Ray Lyman Wilbur, Chancellor, Stan-
ford University and President of ASH A, " This eifort is a pioneer
activity on the part of the unions directed toward better health
and participated in by the important health organizations of the
community. ' '

Concurrent with the formation of the Northern California Union
Health Committee a labor school has been organized in San Francisco-

NOTES ON INDUSTRIAL COOPERATION 359

which among other subjects will emphasize the part that the trade
unions must take in providing health protection for their members
and the community.

That the West Coast is on its toes in regard to the health pro-
tection of its industrial workers is further attested to by the notable
VD educational program for shipyard workers being carried on
in Portland, Oregon, under the leadership of David L. Piper, Admin-
istrative Assistant, U. S. Public Health Service with Division of
VD Control, Oregon State Board of Health. Four major Portland
shipyards employing some 85,000 workers are currently participating
in this project. The readily available materials, i.e., pamphlets,,
posters, washroom cards, etc., are being generously employed, but
the focal point of the campaign is the endeavor to assemble the workers,
in conveniently small groups for open discussions of the problem.

We understand that a two-person team of VD educators 'has to
date reached a large proportion of the participating employees. The
most practical method of getting to the workers was found to be
through the training courses given by the shipyards to new employees
and to those desiring more skilled jobs. It is particularly interesting
that the Portland shipyards cooperated in establishing these VD
educational periods on company time as part of their training classes,
paying the workers the regular 95 cents an hour while attending
the programs.

The programs last from 45 minutes to an hour, with attendance
varying from 40 to 80. Each session begins with a general introduc-
tory talk by a woman health educator, and is followed by the long
version of the U. S. Public Health Service film, Fight Syphilis.
A male health educator then invites questions, and a general forum
discussion is so directed as to stress the advisability of blood tests
and the facilities for obtaining treatment and prophylaxis.

BOOK REVIEWS

Books of General Interest

PROCEEDINGS OF THE NATIONAL CON-
FERENCE OF SOCIAL WORK — 1943,
Selected Papers Seventieth Annual
Meeting War Regional Conferences,
New York, St. Louis, Cleveland.
Columbia University Press, New
York. Editorial Committee: Flor-
ence Hollis, New York City ; Edwin
Fells, Chicago ; Cordelia Trimble,
Washington, Chairman ; Howard R.
Knight; Kussell H. Kurtz; Fred
K. Hoehler, members ex officio.
491 pages.

As stated in the Foreword of the
Proceedings, the selection of papers for .
this volume Avas made under exceptional
circumstances. Difficulties of wartime
transportation brought about the divi-
sion of the usual large meeting into
three regional events in 1943, and at
the last moment it was found necessary
to cancel the final series, scheduled for
Cleveland. Other difficulties, such as
wartime restrictions on paper and print-
ing, naturally applied to the Proceed-
ings and some of the papers have had
to be presented in less than their origi-
nal length. However, the volume is all
the more appreciated and the Editorial
Committee has done an excellent job
in bringing together the 45 papers pub-
lished. Among those which will espe-
cially interest social hygiene workers
are:

The Impact of the War on Marriage
Relationships, Florence Hollis; Helping
to Prevent Sex Delinquency, Elsa Cas-
tendyck ; The Prevention and Treat-
ment of Juvenile Delinquency in War-
time, Mary L. Gibbons; Organizing the
Community for Health Protection in
Wartime, Dean A. Clark, M.D.; /Social
Problems Created by the Mobilization
of Manpower in a War-Industry Com-
munity, W. Earl Prosser; Problems of
a Postwar World, Max Lerner ; Over-all
Postwar Community Planning, Elwood
Street.

The arrangement of these papers
under a series of explicit headings helps
in attracting the eye. Among these
are: Manpower to Win the War; Social
Work and War; Social Security — Now
and After the War; Social Worlc and

Postwar Planning. A series of appen-
dices describing the Conference Pro-
grams, the Officers and Committees for
1943 and 1944, the General Secretary's
Report, and Constitution and By-laws
together with a list of contributing
authors and a comprehensive general
index complete this useful reference
volume.

JEAN B. PINNET

HEALTH INSTRUCTION YEARBOOK — 1943.
Compiled by Oliver E. Byrd, Ed.D.
Foreword by Ray Lyman Wilbur.
Stanford University Press. 308 pp.
$3.00.

This is the first in an intended an-
nual series of yearbooks for the ' ' use
of teachers of hygiene, school nurses,
school administrators, and all others
who desire to know of the develop-
ments in the field of health. ' ' Com-
piled by the Director, Division of
Health Education, of the Stanford
University School of Health with a
foreword by Stanford 's Chancellor, it
is a textbook for reference use in deal-
ing with current experience, discovery,
and research in the fields of public
health, medicine and allied services.

The Table of Contents lists twenty
divisions of interest. The chapters
are in turn divided into a total of 300
abstracts dealing with a range of
subjects from Improved Health Condi-
tions in 1930-1940 Decade to American
Health Developments During 1942.'

To the public health worker in-
terested in social hygiene as well as
the teacher, information of value which
can be put to practical use is to be
found in sixty-two different pages of
special reference to venereal disease
control, syphilis, gonorrhea, health of
Negroes, Army health, Navy health,
industrial health, Wassermann test, sex
education, and family health. These
references exceed those on any other
subject, followed, as was to be ex-
pected, by tuberculosis, mental health,
dental care, food and nutrition, cancer,
and care of the eyes, ears and feet.

360

BOOK REVIEWS

361

The information given is brief with
the source reference indicated in a
bibliography. The book should be a
library ' ' Must ' ' for any individual or
organization vitally concerned with up-
to-date knowledge in a field in which
development is rapid and fresh facts
and opinions are needed to enrich dis-
cussions of current health issues.

RAYMOND H. GREEN MAN

AMEN, AMEN. By S. A. Constantino.
New York, Harper, 1944. 186 pages.
$2.00.

In this slender volume a young Navy
flier sets forth his views on God, the
hereafter, ethics, sex, labor relations,
and a variety of other subjects. Using
current idioms and modern advertising
punch-lines to expound his philosophy,
he crusades for a renaissance of Chris-
tianity and a more general adherence to
the Ten Commandments and the Golden
Rule. Some of his abstruse reasoning
is pointed up by such everyday inci-
dents as the baking of a cake, or Joe
DiMaggio knocking a two-bagger.

There is a forthrightness and sin-
cerity in the book that makes it read-
able and interesting. We are not
enough of a dialectician to attempt
picking flaws in his efforts to rational-
ize phenomena which many think meta-
physical, but we are wholly with the
author in his thesis that the U. S. and
the rest of the world stand to gain im-
measurably through cooperative think-
ing and living. He has a message well
worth your reading.

His chapters on sexual promiscuity
and the venereal infections are potent
jeremiads, exhorting his readers to right
living, both as a deterrent to unhappi-
ness and disease, and as the decent
thing to do for societal and individual
improvement. At times his tones are
strident, but so are the jazz and jitter-
bug social cacophonies that he is argu-
ing against.

RAY H. EVERETT

PROCEEDINGS OP THE HEALTH AND WEL-
FARE INSTITUTE, CLEVELAND, OHIO,

FEBRUARY 25, 1944. Compiled by
the Department of Public Rela-
tions, Welfare Federation of
Cleveland. 206 pages. $1.00.
Mimeographed.

Over 2,000 persons attended this one-
day meeting arranged by Clevelanders
for Clevelanders, the second annual

event of its kind in that city. Looking
over the list of topics, it is easy to
understand the Institute's success. A
few: The Service Man in War and
Peace; Accent on Youth; Postwar
Planning for Community Welfare; Job
Placement for the Returning Service
Man; Returned Service Men in Civilian
Life; Maintaining Mental Equilibrium;
Children in Wartime; The Leisure
Time of the Child and Youth; Every-
day Problems Affecting Juvenile De-
linquency; Developing Interracial Un-
derstanding in Cleveland; Women in
Industry After the War ; Better Neigh-
borhoods and How to Get Them.

Of special interest to social hygiene
workers will be the accounts of the
session on Health in Wartime and
Afterwards, which included an ad-
dress by Dr. Roy L. Kile, on Venereal
Diseases — No. 1 Health Problem in
Wartime, the panel discussion on What
Everyone Should Know About Health,
with Howard Whipple Green as chair-
man and twelve five-minute papers by a
carefully chosen group, and the round-
table on Sex Education — Wise or
Otherwise, with Mrs. Elva Horner
Evans as chairman. Participants in all
sessions were workers actually on the
job in Cleveland, who knew the prob-
lems they were discussing from first
hand experience.

A special feature of the Institute
was the Annual Luncheon Meeting of
the Cleveland Welfare Federation, at-
tended by 1,200, and addressed by
Robert P. Lane, Executive Director,
Welfare Council of New York City,
who took for his subject, Divided We
Stand Still — United We Move Forward.

Several pages of Conclusions requir-
ing action or attention complete a de-
cidedly worthwhile record of an out-
standing community event.

JEAN B. PINNEY

HEALTH EDUCATION ON THE INDUSTRIAL
FRONT. The 1942 Health Educa-
tion Conference of the New York
Academy of Medicine. Columbia
Union Press, 1943, 63 pages, $1.25.

This well printed little volume, with
an introduction by Dr. lago Galdston,
gives permanent form to the five papers
delivered at the 1942 Health Education
Conference of the New York Academy
of Medicine and includes the address
of welcome by Dr. Malcolm Goodridge

362

JOURNAL OF SOCIAL HYGIENE

and the introductory comments by Dr.
Donald B. Armstrong. The papers
highlight some of the industrial health
and hygiene problems in war produc-
tion industry and present practical ex-
periences and the medical approaches
in the fields of nutrition promotion,
the control of physical illness, the re-
striction of mental disabilities and the
limitation of accidents. Dr. Leonard
Greenburg, Executive Director, Divi-
sion of Industrial Hygiene, New York
State Department of Labor, mentions
gonorrhea as one of the communicable
diseases which are "no longer a chal-
lenge to the ability of the health officer,
but rather to the finance board of the
community." Dr. Lydia G. Giberson,
Psychiatrist for the Metropolitan Life
Insurance Company, in an excellent
essay on Mental Problems and Morale
in Industry lists sufferers from syphilis
as well as brain tumor, epilepsy and
cerebral accidents, as belonging to the
group in which accidents are most

likely to occur. It is regrettable that
the problem of VD control in industry
was not given specific consideration
despite the conference 's one day time
limitation.

The publication of this book is
symptomatic of the growing concern
of the medical profession, public health
officials and health educators with the
need for better health among industrial
workers. Perhaps because this New
York Academy conference took place
in 1942 the emphasis was almost ex-
clusively on the medical aspects of the
problems discussed. No educational
programs are outlined. The importance
of employee and trade union participa-
tion in achieving health consciousness
in industry is not brought forward.
This is something new that is being
added in 1944 and which, in our
opinion, holds the key to progress in
the industrial health field after the war.

PERCY SHOSTAC

Books on Sex Education, Marriage and Human Relations

TEACHERS FOR OUR TIMES, A State-
ment of Purposes by the Commis-
sion on Teacher Education, Ameri-
can Council on Education, Wash-
ington, D. C., 1944. 200 pages.
$2.00.

This book is announced as the first
in the series of final reports of the
Commission on Teacher Education. The
volume is organized under four chap-
ters, as follows: Chapter I — The Ameri-
can Teacher, Extent of the teaching
profession; characteristics of the teach-
ing profession; institutions that pre-
pare teachers; certain emphases of
preservice education; aspects of educa-
tion in service; the Commission's pur-
pose. Chapter II — Our Country, Our
People, The American faith; national
problems and demands they make upon
us; some implications for the indi-
vidual ; summary. Chapter III — Our
Children, Our Schools, America's chil-
dren; scope of our schools; responsi-
bility of our schools; American schools
for our times; summary. Chapter IV —
Teachers for Our Times, Participants
in teacher education; problems of goal
setting; qualities needed in teachers;
conclusion. Throughout, the Commis-
sion undertakes to deal with two ques-
tions : first, what is the social signifi-
cance of teaching and teacher educa-
tion ? and second, what are the qualities
that should be sought for in teachers

who are to guide the nation's young
people during the generation that lies
ahead? Teacher education cannot be
planned except in the light of purpose,
the purpose of teacher education is to
produce good teachers, excellence in a
teacher is relative to the tasks that he
ought to perform, and those tasks
should be determined with reference to
the changing needs of children and the
society in which the teaching is to be
done.

The Commission, established early in
1938, completed most of its field work
by June 1942 and the reports now in
preparation are the results of the par-
ticipation through the three-year period
of some fifty colleges, universities, and
public school systems in a cooperative
study of teacher education. Members
of the Commission are: E. S. Evenden,
Chairman; Ralph W. Tyler, Vice Chair-
man ; Harold Benjamin ; Harry M.
Gage ; Charles W. Hunt ; Fred J. Kelly ;
Shelton Phelps ; Payson Smith ; Mildred
English, Helen Hay Heyl; Harold E.
Jones; Lewis Mumford; W. Carson
Ryan; Alexander J. Stoddard; Frank
W. Thomas; George F. Zook, ex officio;
and Karl W. Bigelow, Director. Mr.
Bigelow served as interpreter of the
views of the Commission in Teachers
for Our Times.

JEAN B. PINNEY

BOOK REVIEWS

363

A GUIDE FOB A MAN AND WOMAN
LOOKING TOWARD MARRIAGE. By
Boy A. Burkhart. Heathside Press,
Flushing, L. I., N. Y. 1943. 62
pages. 10 cents.

The author, an eminent Ohio minister
and Marriage counsellor, is well known
for his book, From Friendship to Mar-
riage, and other writings. This new
booklet sustains the promise of the
previous works and adds a useful item
to the literature on this important sub-
ject. The style is popular and intended
to catch the attention of lay readers,
but the scientific basis is sound and the
facts accurate. Attractive format and
care with printing details makes this
little guide well worth inclusion in pub-
lic library collections.

M. A. BIGELOW

THE FAMILY TODAY: A CATHOLIC
APPRAISAL. Family Life Bureau,
National Catholic Welfare Confer-
ence. Washington. 1944. 164
pages.
Twenty-three papers presented at a

Conference on the Family, held at the

Catholic University of America on
Feb. 29, March 1, 2 are published in
this volume. While religious considera-
tions are to the fore, there are some
good statistical summaries on birth
rates and population trends, divorce
and juvenile delinquency, which will be
useful to all students.

One of the most interesting papers,
by Rev. Thomas P. Ryan, describes the
Diocesan Matrimonial Clinic, estab-
lished 18 months ago at Wichita, Kans.
Its personnel (all Catholic) includes a
doctor,- lawyer, priest, banker, psychia-
trist, registered nurse, and social
worker. Most of its clients have been
non-Catholics and local courts as well
as social agencies and professional men
are referring persons to it. Services
are free; the procedures used are de-
scribed in some detail.

(Eeview reprinted from the Monthly
Service Bulletin of the American Insti-
tute of Family Relations, Los Angeles.)

Books on Law Enforcement, Legislation and Social Protection

PREVENTION OP PROSTITUTION. A Study
of Measures adopted or under con-
sideration particularly with regard
to minors by the League of Nations
Advisory Committee on Social Ques-
tions. League of Nations Publica-
tions IV Social 1943 IV 2. Official
No. : C. 26, M. 26, 1943 IV.

This is a 160-page report with two
annexes, totaling 22 additional pages.
It was completed and ' ' considered by
the Committee" just prior to the out-
break of the present war with the ex-
ception of the final chapter 6 entitled
Conclusions and Recommendations. This
final chapter was prepared by Mr. S.
Cohen (since deceased), General Secre-
tary of the British Jewish Association
for the Protection of Girls, Women and
Children, corresponding member of the
Committee, who acted as Rapporteur
for the Committee.

' ' When a plan of work was drawn
up in 1938, the Committee decided that
a study should be undertaken with
the collaboration of the International
Labour Office and of two experts who
had taken part in the work of the
Advisory Committee. The present docu-
ment therefore includes a chapter
(Number 3) supplied by the Interna-

tional Labour Office on the moral pro-
tection of young women workers and
chapters (2 and 5) supplied respectively
by Dr. Tage Kemp on the physical and
psychological causes of prostitution and
Dr. Cavaillon on the reduction of de-
mand. A paper read by Dr. Kemp at
a meeting of the Advisory Committee
in 1939 on certain practical results
arising out of scientific investigations
carried out by himself and other Scandi-
navian scientists is given as Annex I. ' '

A footnote at the beginning of chap-
ters 2 and 5 states that "the responsi-
bility for the signed chapters of the
report is borne by their authors."

Chapters 1 and 4 are entitled Intro-
duction and The Protection of Young
Girls and Women Against Immediate
Causes of Prostitution, respectively.

Chapter 1 is a review of the Develop-
ment of Prostitution and measures for
attacking it since the beginning of this
century, a general statement of the
causes of prostitution and of the meas-
ures which have been found useful in
preventing it. Little or no attempt is
made in this chapter to document or
support the various statements of fact

364

JOURNAL OF SOCIAL HYGIENE

made therein or concerning the conclu-
sions reached regarding causes of pre-
ventive measures. No reference, for ex-
ample, is made to the findings of the
International Commission to Study the
Traffic in Women and Girls in Europe
and the Americas, conducted by the
League of Nations in 1924-5, nor to
the influence of those findings on the
subsequent adoption of International
Conventions. The causes and preven-
tive measures discussed are mainly those
which have been found to exist or to
have been tried in Europe. For this
and other reasons, social hygienists in
the United States will find this discus-
sion somewhat academic, though inter-
esting, and foreign to their experience.

Chapter IV deals with measures
against Souteneurs (pimps), Means of
Propaganda and Enlightenment, Age of
Consent, The Eole of Women Police
in Preventing Prostitution, Eailway-sta-
tion Missions, Dangers Facing Unmar-
ried Mothers, and Eegulations Prevent-
ing the Registration of Minor Girls and
Their Admission to Brothels.

Here again many of the conditions
and measures discussed are typical of
and adapted to Europe rather than of
and to the United States of America.
This is particularly true as regards the
sections dealing with Souteneurs and
the registration of minor girls as prosti-
tutes. There is, however, much food for
thought for Americans in the other sec-
tions of the chapter.

Chapters 2 and 5 deal on the one
hand with the physical and psychologi-
cal causes which influence women to
enter prostitution and the means of
combating them, and on the other hand
with the male demands for prostitution
and what can be done to reduce these
demands.

The authors of these two chapters
are more hopeful of a solution than
most scientific men who have studied
and written on this subject, though the
conditions which they lay down as
necessary prerequisites for success do
not exist completely anywhere today,
and may not come into existence for
many years. The following quotations
from these two chapters are of special
interest :

Dr. Kemp, in speaking of the effect
of chronic physical diseases which he
finds so common among prostitutes, has
this to say : ' ' When a woman who is
poor, with no one to support her, and
no health or invalidity insurance, de-

velops a serious chronic physical dis-
ease, her situation is a difficult one, and
she may be forced into prostitution.
Compulsory health and invalidity in-
surance, as well as unemployment
insurance, must therefore rank as
effective preventive measures against
prostitution. ' '

Dr. Cavaillon, referring to the influ-
ence on the demand for prostitutes of
the encouragement by the state of early
marriages, stated: "It is no use en-
couraging marriage unless, at the same
time, young couples are assured that
the community will help them to bear
the burdens of marriage. Provision
must be made for birth bounties, and
especially for family allowances; and
a 'family policy' must be adopted.
Such a policy, however, will not have
the slightest effect unless it is com-
prehensive, covering all points and all
questions— agricultural credit funds,
tax abatements for large families,
national encouragement, benefits for
women in childbed and for nursing
mothers. In France alone, before Sep-
tember 1939, the expenditure of the
State, Departments and communes,
amounted to 3,000 million francs, to
which must be added another 3,000 mil-
lions disbursed by trade and industry.

Chapter 3 was drawn up by the
International Labour Office and deals
with measures which exist or are
needed for the moral protection of
young women workers during Placing,
at the Work Place, from the dangers
of unemployment, and during their
leisure hours.

One measure which is interesting
and may be novel to many Americans
was adopted by the International
Labour Conference in 1933, and has
been ratified by five countries to date.
"It consists in the complete abolition
of all fee-charging employment agen-
cies conducted with a view to profit
. . . together with strict supervision
of employment agencies not conducted
for profit but charging an entrance
fee or other contribution to cover
their costs. ' '

Chapter 6, Conclusions and Eecom-
mendations, was not, as has been said
above, considered by the Committee.
It is not known to this reviewer
whether its author, Mr. Cohen, saw
the other chapters of the report be-
fore he wrote his chapter. It would
seem that he had not because his
arrangement of material and his con-
clusions and recommendations are not

BOOK REVIEWS

365

in entire harmony with those of the
Committee though the difference is not
always marked.

He announced at the beginning of
his chapter that prostitution has
shown a tendency to decrease since
the beginning of the present century,
and then proceeded to discuss its
causes — first its social causes and the
consequences of the removal of some
of them, and then the individual
causes "concurrently responsible for
the downfall of prostitutes." In con-
clusion he called attention to the
more direct measures that should be
taken to reduce prostitution ' ' such as
the mental examination of minors,
the intervention of social services in
venereal disease dispensaries and hos-
pitals, the provision of assistance for
unmarried mothers, the strengthening
of women police forces, and the rais-
ing of the age of consent."

He concluded with the following
optimistic forecast: "Without ventur-
ing to foreshadow a state of society
in which prostitution is unknown, one
may look forward to a period during
which it will be progressively reduced
as a result of increasing conscious-
ness by the individual of his responsi-
bility towards society, of a further
development of social services, and of
deliberate effort on the part of the
authorities to lessen the incidence of
prostitution. One may look forward
to a world in which prostitution will
have diminished to such an extent that
it will be regarded as a relic of an
uncivilised age, and as a pathological
phenomenon rather than as a problem
which demands a predominant place
in public consideration."

BASCOM JOHNSON

' ' To MAINTAIN LAW AND ORDER . . . ".
Prepared by the National Law and
Order Committee, Executive Sec-
tion, American Legion. Judge
Bichard Hartshorne, Chairman. 20
pages. Free on request to Ameri-
can Legion Headquarters, Indian-
apolis, Indiana.

This pamphlet sets forth the na-
tional law and order program of the
American Legion and urges compre-
hensive Legion participation in na-
tional, state and community programs
aimed toward better medical, legal and
rehabilitative measures in social hy-
giene. Using as an introduction and
basis for action the Resolution adopted
by the National Executive Committee

at Indianapolis on November 18, 1942,
which calls for Department and Post
support of law enforcement and legis-
lative activities for venereal disease
control and repression of prostitution,
the Committee states the facts, outlines
a program, and indicates What the
Legion Can Do to cooperate with Army,
Navy, Division of Social Protection,
Public Health Service and other agen-
cies concerned with these problems in
wartime.

Appendices include: Tables showing
USPHS figures on prevalence of syph-
ilis among Selective Service Candi-
dates; the 1942 supporting statement
of the House of Delegates of the
American Medical Association, and the
American Social Hygiene Association's
three maps showing State Laws against
Prostitution, Premarital Examination
Laws and Prenatal Examination Laws.
BAY H. EVERETT

UNDERSTANDING JUVENILE DELIN-
QUENCY. Children's Bureau, U. S.
Department of Labor. Publication
300. 1943. 52 p. Superintendent
of Documents, U. S. Government
Printing Office, Washington, D. C.
10 cents.

This pamphlet is a replacement of
Bureau Publication No. 215, issued in
1932 and entitled Facts about Juvenile
Delinquency. In a foreword Miss Kath-
arine Lenroot, Bureau Chief, says
' ' The report was written by Mrs. Edith
Karlin Lesser of the Social Service Di-
vision under the general supervision
of Elsa Castendyck, director of special
services and research section, Social
Service Division. It deals with the
questions of what causes delinquency,
how wartime conditions aggravate some
of the underlying factors, and what can
be done in prevention and treatment. ' '

The text starts with a realistic de-
scription of the predicament in which
three boys with different backgrounds
and physical and mental make-ups find
themselves when haled into juvenile
court for stripping tires off a '42
sports roadster.

The next 15 pages, following these
illustrative cases, deal with the nature,
extent, and causes of juvenile delin-
quency. It is pointed out that there
is no adequate measure of the extent
of such delinquency, as the only sta-
tistics relate to the number passing
through juvenile courts, whereas there

366

JOURNAL, OF SOCIAL HYGIENE

are many thousands of difficult and
maladjusted children whose behavior
problems are handled by other agencies
and never get into court. In summary,
it is said: "Such statistics as are
available have shown no alarming ten-
dency to increased 'juvenile crime' as
newspapers perennially claim ; ' ' and
again ' ' all that the available figures
indicate, however, is that in some com-
munities juvenile delinquency has in-
creased and generally the rate of in-
crease is greater for girls than for
boys."

Of those passing through the courts
the boys, for the most part, are
charged with ' ' stealing ' ' and ' ' acts of
carelessness and mischief," whereas the
girls — in the ratio of 1-6 to the num-
ber of boys — are charged with "run-

ning away,

' being ungovernable, ' '

and "sex offenses."

Among the causes of juvenile de-
linquency then discussed there are
listed the usual ones: Inadequate or
broken homes, criminal parents or
brothers and sisters or companions;
schools geared to the mentality of
the average child and unable or un-
willing to provide special training for
the dull or to hold the interest of the
bright — result truancy for both the
"kindergarten of crime."

The deteriorated neighborhood ' ' with
the greatest amount of social ills —
poverty, disease, neglect, family strife,
desertion, mental disorders" — in short,
alums stand high on the list of breeding
places for delinquency and crime.

In conclusion, however, it is pointed
out that there is no one cause of delin-
quency. ' ' There are many contributing
causes, and for each child they vary
in significance. To understand the de-
linquent behavior of an individual child
it is necessary to learn all about him.
We must know about his physical and
mental make-up. We must know about
the social and psychological forces
that have played upon him from the
time he was born. Above all, we must
know how he feels about things, if we
are to understand what makes him
the kind of person he is and what
prompts him to do the kind of things
he does."

The next 30 pages of the pamphlet
deal with the Prevention and Treatment
of Delinquency under the titles, — Pres-
ervation of family life, The role of the

church in prevention, The role of the
school in prevention, Protection from
harmful community influences, Recrea-
tion and leisure-time agencies, Child
guidance clinics, Social services, The
police, The Juvenile court, Foster-
home care, Institutional care.

The pamphlet ends with some prac-
tical suggestions for the community
and its citizens. (See page 501, No-
vember, 1943 JSH for quotes.)

BASCOM JOHNSON

CONTROLLING JUVENILE DELINQUENCY:
A COMMUNITY PROGRAM. Chil-
dren's Bureau, U. S. Department
of Labor. Publication 301. 1943.
27 p. Superintendent of Docu-
ments, U. S. Government Printing
Office, Washington, D. C. 10 cents.

This pamphlet is one of three recom-
mended by the Children's Bureau Com-
mission on Children in Wartime, at a
meeting at the White House on Feb-
ruary 4, 1943.

"It is addressed particularly to com-
mittees of State and local defense
councils and councils of social agen-
cies; to other community groups as-
suming active responsibility in pro-
moting basic service for children and
youth; to private national agencies
and associations with programs bearing
upon some aspect of delinquency pre-
vention and treatment; and to Federal
agencies with responsibilities relating
to juvenile delinquency."

After a three-page introduction which
states the problem and the contribu-
tion to it of wartime conditions, the
material is presented in two parts:
Part I, consisting of 21 pages, defines
the goals for community action, and
Part II (two and a half pages) outlines
very briefly the procedure for action.

Part I: The goals for community
action, it is stated, should include
"(1) Strengthening of resources
needed by all children, (2) Protection
of groups of children especially vulner-
able to delinquency, (3) Control of
harmful influences in the community,
and (4) Services for the delinquent
child and the child with behavior
problems. ' '

Part II: The procedures for action,
it is declared involve "all in the com-
munity who are concerned with chil-

BOOK REVIEWS

367

dren's problems or conditions which
affect children." An organization
with leadership placed on a "commit-
tee of the local defense council,
council of social agencies, or other
organization that has broad responsi-
bility for problems related to children
and youth" is regarded as a prere-
quisite.

"The function of such a group
should be to study the problem of
juvenile delinquency, to stimulate the
activities of other committees or groups
with responsibility in special fields im-
portant in prevention and control of
juvenile delinquency, to plan for es-
sential services not already fully avail-
able, and to assist in the fullest pos-
sible coordination of these services."

The plan agreed upon should be put
into action by "getting the facts with
respect to juvenile delinquency in the
community, the services available to
deal with it, and the gaps that need
to be filled, in the light of the goals
for community action outlined in
Part I."

There should follow an analysis of
4 ' the facts and charting the course to
be taken, in the light of the findings,
to strengthen existing resources and
develop new resources needed."

Finally, there must be action ' ' on
the facts by proceeding promptly and
effectively to stimulate widespread com-
munity interest and mobilize support
for specific services and facilities for
the prevention and control of juvenile
delinquency. ' '

BASCOM JOHNSON

SURVEY MIDMONTHLY. Special Number
on Juvenile Delinquency. March,
1944. New York, 30 cents.
This special number is "designed
to stimulate community planning and
action to deal with wartime delinquency
and provide a framework for continued
action during the postwar period."
It describes how community resources
and other specialized services work,
and how they may be used in an
organized effort. Austin H. Mac-
Cormick, former New York City Com-
missioner of Correction, in the lead
article, The Challenge to All of Us,
points out that no such wide cam-
paign of control and prevention as is
taken for granted in public health
methods has been brought to bear on
this problem. A four-point attack

would include (1) getting the facts,
(2) organizing the service to meet
gaps of various kinds, (3) enforcing
the law, and (4) building character.

Bradley Buell, executive editor, in
How to Begin, outlines a series of
working conferences by a defense coun-
cil or other community organization .
to take stock and plan for control of
delinquency problems. . . . Eliot Ness,
director of the Division of Social Pro-
tection, in New Bole of the Police
describes briefly some of the con-
structive ways in which police can
aid — through cooperation with health
departments and other agencies,
through regular enforcement of laws,
and through the use of policewomen
. . . Four Grown-Ups and a Child
by Kathryn Close, associate editor,
introduces the four adults who are the
most important influences on children,
and discusses the forces tending to
improve these influences: efforts in
parent education are enumerated; the
handicaps and opportunities of the
teacher in developing good citizens
are discussed; the importance of the
religious leader in giving the children
"something to believe in" is related
to the availability of such leadership,
and of religious training; and the
problems of the group leader in recre-
ation, especially because of the in-
creasing use of volunteer workers, are
outlined.

In a study of war impacted com-
munities, A Look at Ten Communities,
Genevieve Gabower, consultant in the
Social Service Division of the U. S.
Children's Bureau, finds a common
fault to be a stagnant community
attitude toward all of the problems
occasioned by the increased industrial
activities and population, although
many are becoming aware that bad
conditions affect the whole com-
munity. Chief causative factors in
juvenile delinquency seemed to be:
lack of parental supervision and ade-
quate housing ; shortage of school
facilities and personnel; employment
of children with insufficient protection;
inadequacy of social resources, in-
cluding lack of jail, police, health,
social welfare, and recreation facili-
ties. . . . Sheldon and Eleanor Glueck,
noted criminologists of Harvard Law
School, in What Do We Know About
Delinquency, stress the fact that
props to good behavior are naturally
weakened by the social stress and
strain resulting from the war. Since

368

JOURNAL OF SOCIAL HYGIENE

so little is known about what makes
one child become delinquent, while
others under the same general environ-
mental circumstances do not, we must
adopt measures as in public health
that seem to tend to prevent delin-
quency. As a measuring rod, we can
ask whether the needs of the child
for learning self-management and for
adequate outlets for the basic instincts
are being provided. ... In Federal
->nd State Action, Katharine Lenroot,
Chief of the U S. Children's Bureau,
points out that added federal aid is
needed, especially in the expansion of
services through state and local public
welfare departments. The govern-
mental agencies for children's services,
both state and federal, are described,
with some mention of how the various
agencies work together.

Good Ideas at Work, gives briefly
suggestions on "how they do it" from
thirty communities, including ideas on
the neighborhood approach, youth par-
ticipation, referral services and general
programs.

KEBA RAYBURN

JUVENILE-COURT STATISTICS, 1940-42.

Social Statistics. Supplement to
THE CHILD, December 1943. Chil-
dren's Bureau, U. S. Department
of Labor.

JUVENILE- COUET STATISTICS, 1943, Pre-
liminary Statement Children 's
Bureau, U. S. Department of
Labor.

An estimated increase of 31 per
cent in the number of juvenile delin-
quency cases disposed of by repre-
sentative juvenile courts in 1943 over
the 1942 figure is reported in this
Preliminary Statement, based on tele-
graphic reports from 145 courts over
the country, cooperating with Chil-
dren's Bureau in an annual review
of juvenile court cases. In 111 courts
reporting to the Children's Bureau, the
number of cases disposed of increased
in 1943 over 1942. In four counties
n which large cities are situated, the
number of cases was more than
doubled, and increases of 50 per cent
or more were not uncommon in other
courts. A slightly greater increase,
in boys' than in girls' cases was
indicated in 1943, a reversal of the
situation during the two previous years.
Boys' cases represent more than four-
fifths of the total.

The report warns that some in-
creases in juvenile delinquency cases
may be entirely the result of changes
of court procedure; and that the cases
represent all types of "alleged" de-
linquency from the most serious to the
most trivial. Included is a table show-
ing cases disposed of by 53 courts
serving areas with a population of
100,000 or more for the period from
1937 through 1943. A similar table
for 83 courts in the 1940-42 report
compares areas where population has
increased with areas where it has de-
creased, finding the number of cases
disposed of increased 18 per cent in
the former and only 9 per cent in the
latter. A series of tables in the
1940-42 report uses material from 26
courts, which reported on individual
cases, showing the regional distribu-
tion, and numbers and percentages by
age, sex, and race; the chief reasons
for reference to the court; the disposi-
tion made ; previous court experience ;
and sources of reference to the court.
KEBA RAYBURN

THE PRISON WORLD, Special Number
on the Woman Offender of Today,
March-April 1944. The American
Prison Association and National
Jail Association. New York.

Since articles in this number mention
many times the problems of sex offenses
and prostitution, and since the emphasis
throughout is on what can be done to
restore the woman offender to useful
life, mention here is indicated. The
topics of the seventeen articles and the
names of their authors guarantee a
publication packed full of information :

So You Can't Do Anything About
Prostitution?, by Marie Duffin, Social
Protection Representative, Federal Se-
curity Agency; We Don't Carry Night-
sticks!, by Ehoda J. Milliken, Director,
Women's Bureau, Metropolitan Police
Department, District of Columbia ;
These Are Our Jails, by Nina Kinsella,
Administrative Assistant to the Direc-
tor, Federal Bureau of Prisons; Prob-
lems of Administration, by Helen
Ilironimus, Warden, Federal Reforma-
tory for Women, Alderson, West Vir-
ginia; Aims of Classification, by Dr.
Miriam Van Waters, Superintendent,
Reformatory for Women, Framingham,
Massachusetts; Medical and Psychiatric
Services for Women Offenders, by
Augusta F. Bronner, Ph.D., Consulting
Director, Judge Baker Guidance Clinic,
Boston, Massachusetts; All Women Of-
fenders Are Not Criminals, by Edwina

BOOK REVIEWS

369

Mitchell, Associate Member, Board of
Pardons and Paroles, Alabama; The
Institutional Employment Program, by
Helen de Corse McArthur, Superintend-
ent, Women's Prison, Jessups, Mary-
land; How Can We Educate the
Female?, by Marion F. Gallup, Superin-
tendent, Indiana Women's Prison;
Girlhood 1944, by Marguerite Marsh,
Associate Director, Contributors In-
formation Bureau, Welfare Council,
New York City; Reflections on Institu-
tional Discipline, by Edna Mahan,
Superintendent, State Reformatory for
Women, Clinton, New Jersey; Proba-
tion and Parole, by Helen D. Pigeon,
Acting Executive Secretary, American
Parole Association; Her Readjustment
to Society, by Miss Franklin R. Wilson,
Superintendent, State Industrial Home
for Women, Muncy, Pennsylvania;
Penology as a Career for Women, by
Elizabeth Munger, Superintendent, Con-
necticut State Prison and Farm for
Women, Niantic, Connecticut ; Girls Do
Not Learn About Crime in Prison,
by Henrietta Additon, Superintendent,
Westfield State Farm, Bedford Hills,
New York; Specific Aspects of Crime
Prevention, by Elizabeth E. Prescott,
Superintendent, Wisconsin Industrial
Home and Prison for Women, Taychee-
dah, Wisconsin.

In an introductory editorial the edi-
tors of Prison World say : "... in
these pages we portray some of the
present efforts to cope with the prob-
lem with whatever facilities exist. We
are setting forth what our institutions
are doing, what they want to do and
what should be done for and with the
woman offender of today. Our authors
share their experiences, their findings
and opinions of the woman offender
while she is under their care. ... It
is our task to study and treat the
woman offender, to retrain her and try
to give her an insight into the factors
that are involved in any genuine at-
tempt on her part to readjust herself
to life and its responsibilities. There
is the problem — not a mere academic
query — of whether society will accept
her when she returns. Will the woman
offender be given an opportunity to
become a normal member of the com-
munity? The correctional process is
thus but one rung in a long ladder
that must be ascended by every offender
who is trying to make the climb to
normalcy. ' '

JEAN B. PINNEY

WHAT ABOUT Us? A Eeport of Com-
munity Recreation for Young
People. Office of Community War
Services, Federal Security Agency,
Washington, D. C. 41 pages. Free.

This pamphlet, prepared by the OC
WS, Division of Recreation, describes
the efforts and experience of some 700
cities and towns in providing organized
recreation for boys and girls. Problems
that confront the city, town and village
are outlined and the programs under-
taken in the search for solutions of
these problems aje reported upon. War
recreation committees, now existing in
over 1,300 communities, are proving to
be one successful means of providing
community-wide recreation facilities.
Good programs offer boys and girls the
chance to join in war services as well
as to play. The work of boys and girls
in salvage programs, war bond selling,
civilian defense, and similar war serv-
ices is cited. One outstanding volunteer
job is protecting the nation's forests,
and the pamphlet describes how in the
San Bernardino National Forest, Cali-
fornia, 75 high school boys served as
civilian defense forest fire watchers
during the summer.

As a guide for communities under-
taking such programs, a detailed outline
of the recreation plan in Milwaukee,
Wisconsin, is included. An appendix
includes various detailed information of
special fields in such projects.

JEAN B. PINNEY

SUMMARY OF STATE LEGISLATION RE-
QUIRING PREMARITAL AND PRE-
NATAL EXAMINATIONS FOR VENE-
REAL DISEASE, Second Edition by
George Gould. Revised to 1944,
from Original Edition by Aneta E.
Bowden and George Gould, 1941,
American Social Hygiene Associa-
tion—New York, Pub. No. A-522.
40 pages. 25 Cents.

The first edition of this useful pam-
phlet issued three years ago has been
brought up to date to include the rapid
advance in adoption by the states of
laws to protect marriage and childhood
from syphilis. Since 1935, \ when Con-
necticut pioneered in this type of legis-
lation, thirty states have adopted laws
requiring examinations for syphilis be-
fore issuance of a marriage license.
Laws to discover syphilis in expectant
mothers have made even more rapid
progress. Thirty states now have laws
of this type, the first law having been
passed in New York in 1938.

The present summary is presented
particularly for the convenience of

370

JOURNAL OF SOCIAL HYGIENE

groups and persons interested in and
concerned with the history and require-
ments of such laws and especially for
those who may be contemplating new
laws of this type or revisions of exist-
ing laws. The text, in addition to the
historical data and charts concerning
these laws, describes in detail legisla-
tive requirements in the different states
and gives examples of typical lawa
which have been found to work satis-
factorily. A new helpful feature is a
table of the legal waiting periods in
relation to marriage licenses in the
various states. Up to date maps arc
included.

Dr. John R. Heller, Chief of the
Division of Venereal Diseases, U. S.
Public Health Service, writes an intro-
duction to the pamphlet.

JEAN B. PINNEY

JUVENILE DELINQUENCY AN» THE COM-
MUNITY IN WARTIME. 1943 Year-
book of the National Probation
Association. Marjorie Bell, Edi-
tor. New York. 307 pages.
Cloth, $1.75; paper, $1.25.
The NPA Yearbook is an annual
event anticipated and appreciated by
all who are dealing with problems of
probation, parole and delinquency pre-
vention. The current volume is con-
cerned with one of the most difficult
problems in the war emergency.

Nine parts make up the 1943 Year-
book. The first seven contain papers
given at the 37th Annual Conference of
the National Probation Association at
St. Louis, in April, 1943, and at other
conferences during the year. Part
VIII contains a digest by Charles L.
Cnute, Executive Secretary of the
NPA, and Frederick M. Killian, of
Legislation and Court Decisions affect-
ing Probation and Parole and Juvenile
Courts for the year 1943. Part IX is a
report of the activities and organiza-
tion of the NPA during the current
year, and an outline of its program for
the future.

The twenty-one papers published in
Parts I to VII constitute two-thirds
of the book and well represent "cur-
rent opinion on the treatment and pre-
vention of delinquency and crime" as
increased and complicated by the war.
Among them are: American Culture
and the Treatment of the Offender, by
Donald R. Taft, Professor, Department
of Sociology, University of Illinois,
Champaign; The Juvenile Court in a
War Industries Area, by Max Spelke,

former Judge, Juvenile Court, First
District, Connecticut; Using Proba-
tioners and Parolees as Manpower in
the Military Service, by Joseph H.
Hagan, Administrator of Probation
and Parole, Rhode Island; Toung
Camp Followers, by Whitcomb H.
Allen, Regional Supervisor, San An-
tonio, Texas, Social Protection Divi-
sion, Community War Services; Com-
munity Cooperation in Social Treat-
ment of the Prostitute and Promiscu-
ous Girl, by Raymond F. Clapp, Asso-
ciate Director, Social Protection Divi-
sion, Community War Services, Federal
Security Agency; Children in Jail, by
Roy Casey, Inspector, Federal Bureau
of Prisons; The Bar and Crime Preven-
tion, by Harold K. Krowech, Chairman,
Juvenile Crime Prevention Committee,
State Bar of California; Psychiatric
Aspects of Criminal Behavior, by Ed-
mond F. Sassin, Psychiatric Consultant,
Social Planning Council, St. Louis.

Though social hygienists will be pro-
fessionally concerned mainly with the
programs and activities outlined in
Part III, new and practical approaches
to the problems of delinquency and its
prevention which apply to social hy-
giene as well are included in Parts V
and VI. These and also the other
parts will repay careful reading.

BASCOM JOHNSON

TKCHNIQUES OF LAW ENFORCEMENT IN
THE TREATMENT OF JUVENILES ANI>
THE PREVENTION OF JUVENILE DE-
LINQUENCY. A Manual for the
Guidance of Enforcement Officers
in Dealing with Juvenile Offenders
and in Establishing a Delinquency
Prevention Bureau within the Law
Enforcement Agency. Compiled
by the National Advisory Police
Committee to the Federal Security
Administrator, in Consultation
with the United States Children's
Bureau. Division of Social Pro-
tection, Office of Community War
Services, Federal Security Agency.
U. S. Government Printing Office,
Washington, 1944. 60 pages.

In 1943 the National Advisory Police
Committee 's Sub-committee on Law En-
forcement compiled and sponsored for
publication by the Division of Social
Protection the useful report Techniques
of Law Enforcement against Prostitu-
tion. This second Techniques compila-
tion has been prepared by the Sub-
Committee on Prevention, of which

BOOK KEVIEWS

371

Chief Joseph T. Owens, of Eome, N. Y.,
is Chairman, and was reviewed and
approved by the full Committee early
in the year. Since then it has had
wide distribution, copies having been
mailed to chiefs of police, county
sheriffs and state enforcement agencies
throughout the country. The manual is
intended to serve as a guide to the
enforcement officer in dealing with ju-
venile offenders, and in setting up a
delinquency prevention bureau within
the law enforcement agency concerned.
Following an introduction stating the
purpose of the report, the text is di-
vided into four parts: Part I, Law
Enforcement Responsibility, discusses
What the Patrolman Can Do to Pre-
vent Delinquency, and Locating Trouble
Spots. Part II, Dealing with the In-
dividual Offender, covers the topics
Questioning a Child; Warning and
Notification; Custody and Detention;
Fingerprinting Juveniles; Special Prob-
lem— the Young Girl. Part III, Con-
trolling Conditions, deals with Licensed
Establishments; Dance Halls; Bars;
Restaurants, Clubs and Cabarets; Candy
Stores; Movies; Unlawful Employment

of Minors, and Curfew. Part IV, A
Juvenile Bureau Treats of Personnel;
Offices; Introducing the Juvenile Bu-
reau; Locating Delinquency; Relation-
ship with the Juvenile Court; and Re-
lationship with Other Agencies. In
Part IV also are short statements con-
cerning the organization and functions
of the Social Protection Division, the
Children's Bureau, and a Summary of
Suggested Reading. Members of the
NAPC are also listed for convenient
reference.

Chief Owens says in a foreword
' ' The manner in which the officer han-
dles the child in his first difficulty with
police may be the making or breaking
of the youngster's future life. For this
reason, it is imperative that every offi-
cer, from the chief or sheriff down to
the newest rookie or deputy, have an
understanding of how juveniles should
be interviewed and treated. ' '

The new booklet should be a real
aid in preventive efforts.

JEAN B. PINNET

Books on Medical and Public Health Activities

Unless otherwise indicated, reviews are by WALTER CLARKE, M.D.,

Executive Director, American Social Hygiene Association

kins universities with 5 each. The
remaining contributors are scattered
among 27 medical schools and numerous
distinguished research institutions.

Cecil's Medicine is divided into the
following major parts: The Infectious
Diseases, Diseases of Doubtful or Un-
known Origin, Diseases of Allergy, Dis-
eases Due to Physical Agents, Diseases
Due to Chemical Agents, The Intoxica-
tions, Deficiency Diseases, Diseases of
Metabolism and Diseases of the Diges-
tive System, Eespiratory System and
each of the other systems of the body.
Each major part is divided into the
appropriate sections and each section
has been written by a well known
authority. A useful feature of each
section is a short bibliography.

In this authoritative work what is
there of interest to physicians, nurses
and public health workers engaged in
any social hygiene activity? First in-
terest will be found in the section deal-
ing with Infectious Diseases for here
are found up-to-date discussions of
syphilis, lymphogranuloma venereum
(here referred to by one of its many
other names — lymphogranuloma ingui-

A TEXTBOOK OF MEDICINE, Sixth Edi-
tion, edited by Eussell L. Cecil,
M.D., and Foster Kennedy, M.D.,
of Cornell University Medical Col-
lege. W. B. Saunders Co. of Phila-
delphia and London. 1566 pages.
Illustrated.

The sixth edition of this popular
textbook will be welcomed by teachers
of medicine, medical students and prac-
titioners throughout the English speak-
ing world, for Cecil's Medicine is al-
most if not quite as well known in Great
Britain and the British Dominions and
Colonies as it is in the United States.
More than 150 authors, each thoroughly
conversant with his field of medicine
and all but a few connected with schools
of medicine, collaborated in the prepa-
ration of this textbook. Those not so
connected are members of the medical
staff of well known research institutions
and hospitals. It is interesting to note
that the medical schools with largest
representations are Harvard, with 24
contributors, College of Physicians and
Surgeons of Columbia University, with
22, Cornell with 14, New York Univer-
sity and Minnesota University with 7
each and Pennsylvania and Johns Hop-

372

JOURNAL OF SOCIAL HYGIENE

nale) and gonococcal infections. These
discussions, however, emphasize the "
medical aspects of these diseases. Thus
gonococcal infections deal mainly with
endocarditis, meningitis, nephritis and
other more or less rare manifestations
of gonococcal infection rather than with
such banal conditions as urethritis and
cervicitis. Chancroid and granuloma
inguinale, being rarely systemic dis-
eases, are omitted.

The section on Syphilis was written
by Dr. Jas. S. McLester of Alabama
University and former President of the
American Medical Association. After
giving a brief account of the early
manifestations of the disease, he de-
votes most of his discussion to a de-
scription of the damage done by syph-
ilis to the various vital structures of
the body, then goes on to present the
essentials of diagnosis and treatment
including under the latter head a brief
mention of massive arsenotherapy.

In a textbook of this character syph-
ilis appears in the discussions of many
systemic diseases including those of the
cardiovascular, central nervous and di-
gestive systems. Syphilitic aortitis,
aneurysm, and aortic valvular disease,
tabes dorsalis, general paralysis of the
insane, syphilitic cirrhosis and many
other conditions are discussed, illus-
trating the fact that this disease at-
tacks all structures of the body. That
is why it appears in this textbook in
about 30 discussions in addition to that
of Dr. McLester.

Cecil's Medicine is well printed, well
indexed and sufficiently illustrated. It
is the sort of book any physician, medi-
cal student, nurse or public health
worker will be proud to possess and
will find much satisfaction in using.

OSLER'S PRINCIPLES AND PRACTICE OP
MEDICINE. By Henry A. Christian,
A.B., A.M., M.D., LL.D., Sc.D.,
F.E.C.P. D. Appleton-Century Co.,
New York. 1600 pages. $9.50
(15th Edition.)

The rapid pace of progress in medical
science can hardly be better illustrated
than by the fact that only eighteen
months after the publication of the
14th edition of Osier 's Medicine, it has
become necessary to publish a 15th
extensively revised edition. The phe-
nomenal advances in the treatment of
diseases is not limited to such inno-
vations as sulfonamide therapy and
even more recently, the almost miracu-
lous effects of penicillin: stimulated to
some extent by the war, very rapid
progress has taken place in many

branches of medicine as well as of
surgery. The need to make authorita-
tive knowledge of these advances avail-
able to the medical services of our
armed forces and those of our allies
is among the reasons for the prompt
issuance of this 15th edition of Osier 's
Medicine.

It was interesting to note that the
14th edition marked the semicentennial
of this authoritative book which is used
at least as widely in Great Britain and
the British Empire generally as it is in
the United States. The scientific and
literary distinction of Sir William Os-
ier 's original work has been maintained
by the eminent physicians and authors
who have edited the numerous editions
of this book which have appeared since
the death of the original author. Dr.
Henry A. Christian, Hersey Professor,
the Theory and Practice of Physic,
Emeritus, Harvard Medical School, is
certainly among the most distinguished
of these editors.

It is of interest to note that the 15th
edition of Osier's Medicine is only
about one half the size of the earlier
editions used by tens of thousands of
British and American medical students
and physicians. This reduction in bulk
has been achieved through the use of
"Bible" paper but without substan-
tially affecting the actual number of
words in the text.

As always Osier's Medicine deals
with syphilis as a medical problem.
One can depend upon finding here sound
and practical information and guidance
in dealing with this protean disease
which affects virtually every structure
of the human body.

So distinguished a book needs no
recommendation from this or any other
reviewer. It goes almost without say-
ing that every physician who can read
English would prize a copy of Osier's
Medicine.

THE MANAGEMENT OP NEUROSYFHILJS.
By Bernhard Dattner, M.D., Jur.D.,
Associate Clinical Professor of
Neurology, New York University
Medical College. Grune & Stratton,
New York, 1944. 420 pages. $5.50.

This monograph will prove to be of
interest and value to physicians espe-
cially those interested in neurology or
syphilology. Its most distinguished
characteristic is its complete coverage
of the world literature dealing with the
subject of neurosyphilis ; the book con-
taining references to nearly 600 indi-

BOOK EEVIEWS

373

vidual articles and books. The author
and collaborators draw upon their very
extensive experience in all phases of
the diagnosis and management of neu-
rosyphilis. The author's style is pleas-
ing and the book is well indexed.

The book is divided into two major
parts — the first dealing with the tech-
nics of withdrawal and examination of
spinal fluid : interpretation and evalua-
tion— and the second with methods of
treatment: application and results.
Each chapter is divided into sections;
the concluding paragraph of each giv-
ing a brief practical summary of the
preceding discussion. It is the re-
viewer's opinion that most neurologists
and syphilologists will find little with
which to disagree in these important
conclusions.

It is hoped that this book will find
a place among the reference volumes
in syphilis clinics and in the offices of
private physicians.

CLINICAL DIAGNOSIS BY LABORATORY
EXAMINATIONS. By John A. Kol-
mer, M.D., Professor of Medicine,
Temple University. Published by
D. Appleton Company, New York
and London. 1239 pages. Illus-
trated.

Kolmer's Clinical Diagnosis is one
of the most satisfactory and useful
books which has come to the attention
of this reviewer in a good many years
of following the medical literature in
his field. The author has presented his
vast material in a form to make it
usable at a moment's notice by physi-
cians and students who refer to it. A
most practical feature of the book is
the presentation in tabular form of the
normal laboratory findings side by side
with abnormal or pathological findings
in various conditions — a great aid to
those of us whose memories for details
are undependable.

Kolmer is best known in the English
speaking medical world for his work
as a serologist. His modification of the
complement fixation test for syphilis is
one of the most widely used blood tests
for this disease in the United States.
But the author is known, though per-
haps less generally, as a bacteriologist
and pathologist of distinction and a
productive research worker in many
fields of medicine.

Part One of Kolmer's Clinical Diag-
nosis consists of 21 chapters devoted to
discussions of the Clinical Interpreta-
tion of Laboratory Examinations. Part
Two deals, in 11 chapters, with the
Practical Application of Laboratory Ex-

aminations in Clinical Diagnosis. Part
Three entitled Technic of Laboratory
Examinations consists of 9 chapters.

In each part there is material of in-
terest to students of syphilis, gonor-
rhea, chancroid, granuloma inguinale
and lymphogranuloma venereum, to
mention only the most important
"venereal" diseases. Not only are
there presented methods for studying
the causal organisms and their effects
upon the body but also for determining
qualitatively and quantitatively the
presence in the body of drugs used in
the treatment of these infections. The
methods of laboratory examination are
lucidly presented and the findings in
normal and abnormal conditions are
associated so that the reports of labora-
tory procedures can be correctly inter-
preted by the physician faced with the
practical problems of diagnosis and
treatment. In the field of venereology
— to use a British expression — Kolmer 's
book will prove extremely usef ulT

This book contains numerous line
drawings and photographic reproduc-
tions illustrating techniques, and a few
handsome colored plates showing re-
actions in which color is a factor in
interpretation. A valuable feature of
this book is the remarkably complete
index which fills the last 130 pages of
the book.

A STUDY OF FACT AND ATTITUDE
ABOUT GONORRHEA AS DEMON-
STRATED BY QUESTIONNAIRE STUDY.
By Marie Di Mario Wann. New
York, submitted in partial fulfill-
ment of the requirements for the
degree of Doctor of Philosophy in
the Faculty of Philosophy, Colum-
bia University, 1943. 68 pages.

The material was made available
through a joint study of the United
States Public Health Service and the
American Social Hygiene Association
known as the Venereal Disease Educa-
tion Evaluation Project. It was car-
ried on by questionnaires distributed
at the New York World's Fair of
1940, and this thesis is an analysis of
the responses evoked. It was an effort
to determine the attitudes and informa-
tion of the general public on the sub-
ject of gonorrhea as to its seriousness,
the kind of advice one should seek in
the event of suspected infection, ade-
quacy of facilities for its control, social
and family situations involved, and
technical knowledge of symptoms and
cure.

Gonorrhea was generally considered
a serious disease, with a physician the

374

JOURNAL OF SOCIAL HYGIENE

acceptable source of information and
treatment; 97% indicated willingness
to assist infected co-worker to get treat-
ment, but only 76% would regard it
safe to retain an infected employee
about the home; 86% thought that
those who have had gonorrhea should
be allowed to marry upon a doctor's
approval; only 74% believed that previ-
ously infected and treated persons
should have children; 82% said that
gonorrhea strikes all classes and kinds
of people; 70% believed gonorrhea
attacks large numbers of people ; 94%
said medical treatment is usually suc-
cessful; 97% said untreated gonorrhea
may result in serious damage to health.

The study throws light upon the
question ' ' Are the educational methods
now in use effective in conveying the
attitudes and information necessary to
the eventual control and prevention of
gonorrheal infection ? ' '

HARRIET S. CORY, M.D.
Executive Director, Missouri Social
Hygiene Association

THE PRINCIPLES AND PRACTICE or IN-
DUSTRIAL MEDICINE. Edited by
Fred J. Wampler, M.D. Baltimore,
The Williams & Wilkins Company,
1943. 579 p. $6.00.

This book, edited by Fred J. Wamp-
ler, M.D., of the Medical College of
Virginia, is the work of the editor and
32 contributors including physicians
and others well known in the fields
of public health and industrial medi-
cine. The subjects dealt with range
all the way from the administrative
aspects of industrial health, hygiene
and medicine to specific medical prob-
lems such as industrial poisoning,
traumatic shock and tuberculosis. The
chapter on Venereal Disease Control in
Industry was written by Dr. Otis L.
Anderson of the U. S. Public Health
Service, a man highly qualified to
present this subject. There is an
interesting chapter on a very timely
subject, namely Women In Industry by
Dr. Molton H. Kronenberg and Ken-
neth Morse. The chapter descriptive
of The Nurse in Industry by Joanna
Johnson, E.N., discusses the duties
and qualifications of industrial nurses.

The index is adequate, the type and
format are satisfactory. This book
should be of use to any physician, nurse
or industrial safety engineer who de-
sires to read an authoritative general
book in this field.

SOME DANGEROUS COMMUNICABLE DIS-
EASES. A Special Unit of Study
in Health Education for Senior
High Schools and Junior Colleges.
A manual for Teachers and Stu-
dents; Plan and Script by Maurice
A. Bigelow, Ph.D. Edited by:
Jean Broadhurst, Ph. D.; Walter
Clarke, M.D. ; Jacob A. Goldberg,
Ph. D.; William F. Snow, M.D.
American Social Hygiene Associ-
ation. 1943. 32 pages. 10 cents.
(Part II of the Manual has been
reprinted as a Handbook for
Students. 24 pp. 10 cents.)

Among current practical teaching
aids in health education we can heartily
recommend these two pamphlets,
planned for use with lantern slides
or reflecting cards but adaptable to
lecture and textbook methods. With
Bigelow as planner and essayist and
with Broadhurst, Clarke, Goldberg and
Snow as the editorial board, one can
be assured of scientific accuracy and
pedagogical soundness.

Syphilis and gonococcal infections
have been the step-children of health
teaching since its inception. Now,
with thousands of parents alive to
the dangers of these two major 'health
menaces, and with the old time tabus
against public discussion rapidly being
smashed, educators are coming to
realize that no worthy course in health
and physical education can omit teach-
ing regarding these ' ' diseases of
youth. ' '

The pamphlets summarize known
facts about ' ' germs ' ' — bacteria, vi-
ruses, and parasites, but their special
emphases are on tuberculosis, syphilis
and gonorrhea. The text is concrete,
direct and interesting. Suggestions are
made for amplification if teaching
time is available, and supplementary
reading is outlined.

Our only disagreement with the emi-
nent author and editors would be con-
cerning the text of paragraphs or
slide 43 referring to the use of sulfa
derivitives in the treatment of gon-
orrhea. "The drug sulfathiazole prop-
erly given by competent physicians
will cure most cases within ten days,"
they say. According to Pelouze and
other ranking authorities, many of
these so-called "cures" are not bacteri-
ologically cured. Perhaps future edi-
tions of the two manuals will see fit
to modify this statement.

All in all, however, health education
owes a real debt to these collabora-

BOOK REVIEWS

375

tora for their timely and valuable
contributions.

KAY H. EVERETT

THI SEAMEN'S HANDBOOK FOR SHORE
LEAVE. Eighth Edition. By Mrs.
Henry Howard. New York, Ameri-
can Merchant Marine Library
Association. 350 pp. $1.25.

In war as in peace seamen remain
our perennial travelers. The Seamen's
Handbook for Shore Leave, since 1919
when the first edition appeared, has
been accepted by the men who man our
ships as an essential part of their care-
fully selected equipment. By arming
our fighters in dungarees (including
their officers in uniform) with a ' ' con-
cise, practical guide to the seaports of
the world, giving full information for
comfort, recreation and safety ashore,"
the Handbook is contributing its part
toward the wartime task of ' ' deliver-
ing the goods". Eemembering the
sacrifices which have been and are
being made to keep this lifeline intact,
it is fitting that this book be dedicated
to the heroic Merchant Seamen of the
World Wars.

An amazing amount of useful infor-
mation is packed into the 350 pages of
this closely printed, excellently bound
volume designed to fit into a jacket
pocket. In addition to the location
and all oher necessary information
about venereal disease clinics and hos-
pitals in every foreign and domestic
port, the Handbook lists American
consulates, amusements, dental clinics,
inexpensive hotels, legal aids, laundries,
seamen's homes, banks and agencies,
physicians, and points of interest. It
carries warnings about local conditions
in various ports, a glossary of common
words and phrases in French, German,
Italian and Spanish and a great deal
of other useful information. It is
interesting to note that in the informa-
tion given on American ports there
is a complete listing of all the seafar-
ing trade unions with their addresses
and telephone numbers. The present
edition also lists the residential clubs,
hotels and recreational centers of the
United Seamen's Service and carries a
short article on its aims and purposes
by Douglas P. Falconer, its national
executive director.

The present (eighth) edition of the
Handbook is receiving extensive dis-
tribution through shipping companies,
unions and by individual purchase. The
War Shipping Administration has or-
dered 50,000 copies for distribution to

its trainees and the Navy has ordered
more* than 3,000 to use for their armed
guard on the merchant ships. Through
special donations many copies are being
given to convalescent seamen in Marine
hospitals. Mrs. Henry Howard, the
compiler and editor, deserves commen-
dation for her 25 years of devoted
work in preparing this unique contribu-
tion for smoother sailing by the men
who go down to the sea in ships

PERCY SHOSTAC

SHORE CONVOY FOR MERCHANT SEA-
MEN. Third Edition. United Sea-
men's Service, N. Y. 64 pp. Free.

Our Merchant Seamen are today's
fighters and tomorrow's peacetime
mariners. They are essential to our
war effort and to our peace. The high
casualties suffered by merchant marine
personnel focused attention on the spe-
cial needs of this long neglected group.
As a result the United Seamen's Serv-
ice was organized in 1942 through the
cooperation of the \Var Shipping Ad-
ministration, the maritime unions, the
shipbuilders, the ship operators, the
public and the President. Through the
establishment of medical admitting of-
fices, residential clubs, hotels and rec-
reation centers in domestic and foreign
ports, USS fulfills a function for sea-
men somewhat similar to that provided
by USO for our armed forces.

Shore Convoy is a handy little di-
rectory listing health services open to
seamen without cost, U. S. Public
Health Service marine hospitals and
clinics, War Shipping Administration
offices, and the various facilities of the
USS at home and abroad. In addition
concise information is given on such
subjects as repatriation, training and
upgrading, selective service status, war
risk insurance, Red Cross canteens and
other facilities, and personal service
for seamen.

Attractively printed in two colors
and of convenient pocket size, Shore
Convoy is said to be in the hands of
every merchant seaman and recruit.
Distributed without cost through the
maritime unions, the War Shipping
Administration and the ship operators,
first and second editions of 200,000 are
now exhausted and the third edition is
now coming off the press in a run of
100,000. USS is to be congratulated
on tliis excellent example of the way in
which many needs of the men who man
our ships are being met.

PERCY SHOSTAC

PUBLICATIONS RECEIVED

IN THE PERIODICALS
Marriage and Family Relations

ALLIED YOUTH. Published monthly, except August, by Allied Youth, Inc.,
National Education Association Building, Washington 6, D. C. 10^ a copy.

HEALTH EDUCATION JOURNAL. Central Council for Health Education. April,
1944. Difficulties of sex enlightenment, p. 81. Anna Freud.

— April, 1944. Sex education — a Bristol experiment, p. 91. G. H. Sylvester, B.A.
JOURNAL OP HOME ECONOMICS. 36:2 94-5. February, 1944. Wartime Health

Conference. Marjorie Heseltine.

— May, 1944. Democracy in family life. Mary S. Lyle.

— May, 1944. Workshop methods in family life education. Benj. A. Andrews.

— June, 1944. Education for living. Ruth Bonde.

— June, 1944. Family life education in Idaho. Lucille Magruder and Julia

M. Harrison.
JOURNAL OF EDUCATIONAL SOCIOLOGY. February, 1944. 17:323-37. Family

situations and child behavior: a proposed frame of reference. J. H. S.

Bossard, Ph.D.
HEALTH AND PHYSICAL EDUCATION. 14:10 515-16 and 557-558. December,

1943. Psychological considerations in planning an educational program for
adolescent girls. Lillian Cottrell, M.D.

MENTAL HYGIENE. (New York City). 28:55-63. January, 1944. A factor
in the sex education of children. G. E. Gardner, M.D.

OREGON HEALTH BULLETIN. State board of health. February 2, 1944. 22: 9-11.
The. family and its daughters. Adolph Weinzirl, M.D.

PARENT'S MAGAZINE. (New York City). 18:16-17, 66:67. January, 1944.
Are they too young to marry? K. W. Taylor.

NATIONAL PARENT-TEACHER. March, 1944. One church did this. The Kev.
Clayton L. Potter, p. 25.

VENEREAL DISEASE INFORMATION, 25:197-203, July 1944. Some general con-
siderations affecting present-day sex and sex education problems. John
H. Stokes, M.D.

Health Education

ALASKA'S HEALTH. (Juneau). 2:5-7. May, 1944. What is health education?

Allen Freedman, M.D.
AMERICAN JOURNAL OF PUBLIC HEALTH. (New York City). 34:446-51, May,

1944. Preparation of health education personnel for the war and post-war
periods. R. E. Grout, Ph.D., H. R. Leavell, M.D., Dr. P.H.

COLLEGE HEALTH REVIEW. March, 1944. Health education now and in the

post-war period. Jennie L. Douglass, M.A.
DALLAS. (Dallas, Texas). 23:213-24. February, 1944. V.D. — No. 1 home front

problem.
FLORIDA HEALTH NOTES. State board of health. (Jacksonville). 35:180-82.

November, 1943. Florida's school health program. Elizabeth Fretwell.
HEALTH EDUCATION JOURNAL. Central council for health education. (London;.

1:146-52. October, 1943. Health education in the United States of America.

C. E. Turner.

— October, 1943. The place of sex in life. E. F. Griffith.

— April, 1944. A practical experiment in health education, p. 78. Mabel

B. Ross.

— April, 1944. The human approach to visual education, p. 61. Otto Neurath.

— April, 1944. Physical education in the future, p. 86.

JOURNAL OF HEALTH AND PHYSICAL EDUCATION. (Washington, D. C.). 15:
21-22, 30-32. January, 1944. A modern health and physical education
program. Herbert Wey.

376

PUBLICATIONS RECEIVED 377

— January, 1944. 15:3-4, 35-36. Health education and physical fitness in the

college program. R. E. McConnell.

— March, 1944. Physical educators and high school sex education. .Lester

A. Kirkendall.
- May, 1944. Planned Health Film Production. Adolf Nichteinhauser, M.D.

JOURNAL-LANCET. (Minneapolis). 64:115-18, April, 1944. Problems, oppor-
tunities and obligations confronting health educators. C. E. Lyght, M.D.

JOURNAL OP SCHOOL HEALTH. (Buffalo). 13:258-61. December, 1943. Sex
problems and the teacher. A. R. Timme, M.D.

MEDICAL EECORD. February-March issues. 157 : 138, 140, 142. Venereal dis-
ease public educational program and the public health agencies. Herman
Goodman, M.D.

PUBLIC HEALTH NURSING. 36:3 135-6. March, 1944. A suggestion for good
school health programs. John Oppie McCall, D.D.S.

— May, 1944. New health -films. Supplement to the list Health Films. Section

on health and medical films, American Film Center, 45 Eockefeller Plaza,
New York 20, New York. 6 pp. 10^.

SCIENTIFIC MONTHLY. (Washington, D. C.). 57:497-99. December, 1943.
Why public health education? R. A. Thomas.

TRAINED NURSE AND HOSPITAL REVIEW. (New York City). 112:35-36. Jan-
uary, 1944. Venereal disease quiz. This quiz on gonorrhea is the second
of a series of six on venereal disease. Isobel Collins, E.N.

Social Protection

AMERICAN JOURNAL OF ORTHOPSYCHIATEY. (New York City). 14:128-35.
January, 1944. Phychiatric problems in training school for delinquent
girls. M. C.-L. Gildea, M.D.

— January, 1944. The "opportunity" class: a study of children with problems.

J. W. Beckmann, M.D.

— January, 1944. The defective delinquent : a definition and a prognosis. L. A.

Lurie, M.D., Sol Levy, M.D. and F. M. Eosenthal.

AMERICAN JOURNAL OF PSYCHIATRY. (New York City). 100:347-50. Novem-
ber, 1943. Law enforcement aspects of the delinquency problem. E. P.
Coffey.

— January, 1944. 100:452-55. Sociological changes predisposing toward juvenile

delinquency. D. A. Thorn, M.D.
AMERICAN JOURNAL OF SOCIOLOGY. (Chicago). 49:199-208. November, 1943.

Delinquency and its outcome in court and college. A. L. Porterfield.
AMERICAN SOCIOLOGICAL EEVIEW. (Menasha, Wis.) 9:178-84, April, 1944.

Juvenile delinquency and economic trend. David Bogen.
CHANNELS. National publicity council for health and welfare services. (New

York City). 21:1-6. October-November, 1943. Our children at war; what

the public should be told about them. Viola Paradise.
CHILD. U. S. Children's Bureau. April, 1944. 8:152-56. State committees

on children in wartime.
CHILDHOOD EDUCATION. (Washington, D. C.). 20:157-63. December, 1943.

Delinquency prevention and the role of love. Fritz Redl, Ph.D.
COLLIER'S. June 10, 1944. Job for a lady. Vera Connolly, p. 18. Detroit

Police Women.
FEDERAL PROBATION. 7:4 19-23. October-December, 1943. A worlcing philosophy

for the probation and parole officer. L. Guy Brown, Ph.D.

— January-March, 1944. New horizons in rehabilitation. John A. Kratz.

— January-March, 1944. Some aspects of the psychology of the offender.

John M. McGinnis, Ph.D.

— April— June, 1944. The art of disinterested friendship in the treatment of

juvenile delinquency, G. Howland Shaw.

— October, 1943. 1:165-72. Delinquency in peace and war. Cyril Burt.
HEALTH. Health League of Canada. (Toronto). 11:10-11,27. Autumn, 1943.

Teen age tragedy: a vital program of recreation points way to control
of teen-age delinquency. Christian Smith.

HYGEIA. April, 1944. 22:268-69, 296, 298, 300. Wartime problems of children.
F. L. Beals.

378

THB JOURNAL OF TUB AMERICAN PUBLIC WELFARE ASSOCIATION, 2:4, 96-100,
April, 1944. How a state welfare department can aid community efforts
in delinquency control and treatment. William J. Ellis.

JOUKNAL OF HOME ECONOMICS. April, 1944. Helping young people solve their
problems. Mary Van Deusen. p. 209.

— May, 1944. Teen town. Alice Sowers.

JOURNAL OF CRIMINAL LAW AND CRIMINOLOGY. January-February, 1944. 34:
291-302. Juvenile delinquency in Britain during the war. M. E. Bathurst.

— January-February, 1944. 34:311-14. Some criminology implications of the

returning soldier. P. V. Wagley, M.D.

JOURNAL OF CRIMINAL PSYCHO-PATHOLOGY. (Monticello, N. Y.). 5:289-301.
October, 1943. Group sex conferences as a diagnostic therapeutic and peda-
gogic method. A description of the technique of group sex discussions as
used on the adolescent ward of Bellevue psychiatric hospital. F. J. Curran,
M.D., B. V. Strauss, M.D. and B. F. Vogel, M.D.

MEDICAL WOMAN'S JOURNAL. January, 1944. Some thoughts on prostitution and
its problems. A. L. Wolbarst, M.D.

NATIONAL PARENT-TEACHER. (Chicago). 38:4-6. December, 1943. Can your
community control delinquency? M. A. Elliott.

PARENT'S MAGAZINE. (New York City). 18:26, 30, 32. January, 1944. Pri-
ority for young America. Problem of juvenile delinquency. Claude Pepper.

PENNSYLVANIA'S HEALTH. State Department of Health. January, 1944. 5:4-5,
12-13. The delinquent girl as a wartime problem. N. B. Carson.

POLICE CHIEF'S NEWS LETTER. (Washington, D. C.). 10:11, 1-2-3. .November,
1943. Juvenile delinquency and crime prevention developments and activities.

— December, 1943. Children's bureau calls conference on delinquency problems.

— December, 1943. Illinois officials meet to study social protection problem.

— January, 1944. A police and school attack against juvenile delinquency.

Charles J. Monks, Passaic, N. J.

PROBATION. National Probation Association. (New York City). 22:12-14.
October, 1943. Muskegon moves ahead. Program for dealing with juvenile
delinquency and child neglect.

— December, 1943. There are children in our jails. Charles L. Chute.

— December, 1943. It is certainly something. Mary Edna McChristie.

— December 1943. The pubertal struggle against the instincts. Joseph Lander.
• — April, 1944. Delinquency prevention after the war. W. J. Harper.

— April, 1944. Digging at the roots of prostitution. E. J. Lukas.

SCHOOL AND SOCIETY. (New York City). 59:350-51, May, 13, 1944. Delin-
quency— a by-product of the school. W. C. Kvaraceus.

SOCIAL SERVICE EEVIEW. (Chicago). 18:26-^1, March, 1944. Juvenile delin-
quency from the standpoint of the state. Marietta Stevenson.

SOCIAL STATISTICS. Supplement to CHILD. U. S. Children's Bureau. December,.
1943. 8:1-14. Juvenile court statistics. 1940-42.

STATE GOVERNMENT. (Chicago). 16:230-32. November 1943. Juvenile delin-
quency in wartime: survey of state and state-local programs to control
and prevent delinquency reveals high degree of inter-agency cooperation.

SURVEY MIDMONTHLY. March, 1944. Juvenile delinquency — (symposium). The
challenge to all of us, by A. H. MacCorrnick. How to begin, by Bradley
Buell. New role of the police, by Eliot Ness. Four grown-ups and a
child, by Kathryn Close. Good ideas at work — a look at ten communities^
by Genevieve Gabower. What do we know about delinquency? by Sheldon
a-nd Eleanor Glueck. Federal and state action, by K. F. Lenroot.

SOCIAL HYGIENE. Issued by Social Hygiene Committee. New York City TB
Association. March, 1944. Eehabilitation of the female sex offender.
Marie Duffin.

UNDERSTANDING THE CHILD. (New York City). 13:20-21, April, 1944. A
school administrators' program for delinquency prevention.

Legislation

AMERICAN JOURNAL OF NURSING. April, 1944. The Wagner-Murray-Dingell

Bill. p. 326.
FEDERAL PROBATION. 8:1, 3-10, January-March, 1944. A judge discusses the-

proposed Federal Corrections Act. Judge Paul J. McCormick.

PUBLICATIONS RECEIVED 379

MBDICAL CARE. Committee on research in medical economics. (New York City).

3:303-13. November, 1943. Insurance companies and the Wagner Bill.
K. G. Clark.

— February, 1944. 4:52-69. Wagner bill section: Pros and cons on the

Wagner-Murray-Dingell Bill, and a list of references on the bill and its
background^

— February, 1944. 4:12-16. Medical freedom and the Wagner Sill. A. M.

Butler, M.D.

PUBLIC HEALTH REPORTS. U. S. Public Health Service. (Washington, D. C.).
59:539-40, April 21, 1944. Court decision on public health.

STATE GOVERNMENT. March, 1944. p. 300. State legislation requiring pre-
marital examinations for venereal diseases.

— March, 1944. p. 305. Marriage laws requirements.

Industrial Problems

CANADIAN JOURNAL OF PUBLIC HEALTH. (Toronto). 34:494r-501. November,

1943. Venereal disease education in industry. H. C. Ehodes and D. K. H.
Cleveland, M.D.

HEALTH EDUCATION JOURNAL. Central Council on Education. (London). April,.

1944. Health education in industry, p. 54. Joan K. McMichael.
ILLINOIS MEDICAL JOURNAL. (Chicago). 84:399. December, 1943. Sug-
gested activities of county industrial health committees. Adapted from an
outline prepared by the Committee on industrial health, Ohio state medical
society. E. C. Sage, M.D.

INDUSTRIAL BULLETIN. New York State Department of Labor. (Albany). 22:
466-68. December, 1943. Recommendations on how the health of workers
can be better protected. Leonard Greenburg, M.D.

INDUSTRIAL MEDICINE. (Chicago). 13:105-10. January, 1944. Wartime
industrial hygiene — abstracts of Proceedings of the Industrial hygiene
section meetings, wartime public health conference and 72nd annual business
meeting, American Public Health Association, New York, October 12-14+
1943. Reported by C. O. Sappington.

— January, 1944. An effective preventive medical program at an army-operated

industrial plant. E. W. Probst, M.D., and L. D. Lewis.

— January, 1944. The physical examination.

— January, 1944. The married woman workers : some of the employment and

health problems facing wartime employers, and suggestions for meeting them.

— January, 1944. Follow-up and periodic examinations of employees. H. H.

Fellows, M.D.

— February, 1944. A survey of the effects on menstruation of working in a war

plant. Morey Parkes, M.D.

— April, 1944. 13:302-6. Venereal diseases in industry: their control as a

public health function. R. A. Koch, M.D.

— April, 1944. 13:349-50. Gynecological examinations in industry. F. D.

Gibson, M.D.

— May, 1944. Industrial Hygiene : Highlights in State Health Department

actwities.

— May, 1944. Workers' participation in a health-safety program. J. J.

Bloomfield.

JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. March 11, 1944. 124:683-87.
Health maintenance program for women in industry. M. R. Burnell, M.D.

— March 11, 1944. 124:692-97. Specific problems of women in industry.

H. C. Hesseltine, M.D.

— May 27, 1944. Sixth Annual Congress on Industrial Health; Report of chair-

man of Council on Industrial Health, American Medical Associaton. S. J.

Seeger, M.D.
LANCET. February 12, 1944. 245:223-25. Fitting industry to human needs:

the contribution of medicine to industrial well-being. T. A. L. Davis, M.D.
NEW ENGLAND JOURNAL OF MEDICINE. (Boston). 229:1003-7. December

30, 1943. Medical progress : industrial hygiene. I. R. Tabershaw, M.Dl

and Bowditch, Manfred.

380 JOURNAL OF SOCIAL HYGIENE

NEW ORLEANS MEDICAL AND SURGICAL JOURNAL. March, 1944. 96:388-94.
The industrial hygiene program today. J. G. Townsend, M.D.

OHIO STATE MEDICAL JOURNAL. (Columbus). 39:1035-45. November, 1943.
Ohio state medical association. Committee on industrial health. Funda-
mentals in the organization and operation of an industrial health program
by a county medical society: an outline.

OREOON HEALTH BULLETIN. Oregon state board of health. January 19, 1944.
22:3-4. A venereal disease educational program for shipyard workers.
D. L. Piper.

PUBLIC HEALTH NEWS. New Jersey state department of health. (Trenton).
26:357-61. December, 1943. Industrial hygiene service facilities. W. G.
Hazard.

Public Health and Medical

AMERICAN JOURNAL OF DISEASES OF CHILDREN. 66:611-14. December, 1943.

Acquired syphilis in infants and in children: report of three cases. G. W.

Creswell, M.D., Elizabeth Seech, M.D. and W. L. Murray.
AMERICAN JOURNAL OF NURSING. February, 1944. 44:104-6. , Venereal disease

in wartime. Theodore Eosenthal, M.D.

— July, 1944. 44:673. Community health service project. Eva Johnson, E.JN.

— July, 1944. 44:649-651. Wartime public health nursing service: Recom-

mended minimum.

AMERICAN JOURNAL OF PUBLIC HEALTH. December, 1943. The evolving pattern
of tomorrow's health. 1. Joseph W. Mountin, M.D.: Prerequisites to
improved public health. 2. C.-E. A. Winslow: The post-war city. 3. H. F.
Vaughn: The health department of the future. 4. E. M. Atwater: The
health worker of the future.

— December, 1943. Planning today for public health administration tomorrow.

Felix J. Underwood, M.D.

— December, 1943. Penicillin therapy in sulfanamide-resistant gonorrhea in

men. C. J. Van Slyke, M.D., B. C. Arnold, M.D. and Maurice Buchholtz, M.D.

— December, 1943. Penicillin treatment of early syphilis — a preliminary report.

John F. Mahoney, M.D., E. C. Arnold, M.D. and M. Buchholtz, M.D.

— January, 1944. A new interest in Chemoprophylaxis. (Editorial).

— February, 1944. The proposed Canadian National Health Bill. J. J. Heagerty,

I.S.O., M.D., C.M., D.P.H.

— February, 1944 From social security to public health in Chile. Hernan

Eomero, M.D.

— February, 1944. The evolving pattern of tomorrow 's health : future of

public health in the Western hemisphere. Felix Hurtado, M.D.

— February, 1944. Present status of gonorrhea control. Nels A. Nelson, M.D.,

M.P.H.

I — February, 1944. Present status of health insurance in the United States.
Nathan Sinai.

— March, 1944. Correlation of "in vitro" sulfonamide resistance of the

gonococcus with results of sulfonamide therapy. Charles M. Carpenter,
M.D., F.A.P.H.A. and Helen Ackerman.

— March, 1944. State support of industrial hygiene services — an urgent

necessity. W. F. Draper, M.D.

— March, 1944. Vital and health statistics in the federal government. S. D.

Collins, Ph.D.

— 'May, 1944. The problem of falsely 'doubtful and positive reactions in the1
serology of syphilis. J. A. Kolmer, M.D.

— May, 1944. The United States Chamber of Commerce Public Health Pro-

gram. Howard Strong.

AMERICAN JOURNAL OF SYPHILIS. March, 1944. The control of venereal disease
in the army. T. B. Turner, M.D., and W. A. Brumfield, Jr., M.D.

— May, 1944. Canada's First National Venereal Disease Control Conference.

D. H. Wiliams, M.D.
BETTER TIMES. (New York City's Welfare News Weekly.) February 25, 1944.

The effect of venereal disease on fertility. George W. Kosmak.
BRITISH MEDICAL JOURNAL. February 26, 1944, A national health service:

government proposals — the White paper summarized.

PUBLICATIONS RECEIVED 381

— Supplement. March 18, 1944. p. 47-53. The White paper — an analysis.

British medical association.
BULLETIN. U. S. Army medical department. April, 1944. p. 108-10. A new

technique of prophylaxis in venereal disease. T. G. Tousey, M.D. and others.
CALIFORNIA'S HEALTH. State department of public health. (Sacramento).

1:80-81. December 15, 1943. Recommendations regarding the teaching

of facts concerning the venereal diseases at the secondary-school level.

Adopted by the National conference for cooperation in health education,

New York, April 28, 1943.

— February 15, 1944. 1:112-15. Causes of rejection and incidence of defects;

local board examinations of selective service registrants in peacetime;

an analysis of reports of physical examination from 21 selected statesn

Period November 1940 to September 1941.
CALIFORNIA AND WESTERN MEDICINE. (San Francisco). 59:258-65. November,

1943. Voluntary health plans in California. J. R. Mannix.
CANADIAN JOURNAL OF PUBLIC HEALTH. (Toronto). November, 1943. The

social aspects of our syphilis problem. Grant Fleming, M.D., D.P.H.

— November, 1943. Social security and health education, presidential address.

Adelard Groulx, M.D.

— January, 1944. Britain's development of preventive medicine. Sir A. S.

MacNalty.

— January, 1944. International public health: the work of the health organisation

of the League of Nations in wartime.

< — January, 1944. The venereal disease control program in the U. IS. J. R.
Heller, Jr.

— February, 1944. 35:55-58. Administration of a provincial venereal disease

control program. Elphege lalande, M.D., D.P.H. and Jules Archambault,
M.D.

— April, 1944. Venereal disease control.

CANADIAN MEDICAL ASSOCIATION JOURNAL. (Montreal). 49:423-26. November,
1943. Preventive medicine in the new order. F. W. Jackson, M.D., D.P.H.

COMMITTEE ON RESEARCH IN MEDICAL ECONOMICS. (New York City). 3:331-39.
November, 1943. Four national health bills compared. M. M. Davis and
Eose Ehrlieh.

COLLEGE HEALTH REVIEW. March, 1944. National Negro Health Week — the
health of our children. Martha M. Eliot, M.D.

EDUCATION FOR VICTORY. U. S. Office of Education. (Washington, D. C.) 2:
20-21, April, 1944. The army's physical fitness needs. H. W. Kent.

FEDERAL PROBATION. 8:1, 29-33. January-March, 1944. Poor health — a per-
sistent problem in supervision. William C. Nau.

FLORIDA STATE BOARD OF HEALTH. (Jacksonville). 35:183-87, 192. November,
1943. The school health service. E. F. Hoffman, M.D.

— February, 1944. 36:21-48. Venereal disease control in Florida, 1944. R. F.

Sondag, M.D.

HEALTH EDUCATION JOURNAL. April 1944. Education in venereal diseases in
the Colonies, p. 67. A. G. H. Smart.

— April, 1944. A constructive outlook on pregnancy, p. 58. WC. W. Nixon.
HEALTH NEWS. New York state department of health. (Albany). 20:207-8.

December 13, 1943. The management of venereal contacts. J. H. Lade, M.D.

— February 21, 1944. 21:31-32, Health conditions in New York state — 1943.
HOSPITALS, (Chicago). 18:23-26, April, 1944. Why not an American Blue

Cross? J. R. Mannix.

HYGEIA. (Chicago). 21:854-55, 889-90. December, 1943. Inter- American
cooperation in health work. A. R. Dreisbach, M.D.

— February, 1944. Health coordination — American plan. WT. W. Bauer, M.D.

— April, 1944. 22:274-75, 300, 302. The development of pencillin in medicine.

H. W. Florey and E. Chain.

— May, 1944. A comprehensve school health plan. Mary Farnham.

ILLINOIS MEDICAL JOURNAL. March, 1944. 85:132-37. Wartime consideration

of syphilis. P. A. O'Leary, M.D.
INDUSTRIAL MEDICINE. (Chicago). 13:396-99. May, 1944. Civilian health

in wartime. W. F. Draper, M.D.

382 JOURNAL OF SOCIAL HYGIENE

JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. (Chicago). 124:133-37.

January 15, 1944. Management of the venereal diseases in the Army.
T. B. Turner, M.D., and T. H. Sternburg, M.D.

— April 15, 1944. Penicillin treatment of sulfonamide resistant gonococcic

infections in female patients. Alfred Cohn, M.D., William E. Studdiford,
MJX and Isaak Grunstien, M.D.

— May 6, 1944. p. 125:22-23. Penicillin therapy of gonorrhea in men.

Charles Ferguson, M.D. and Maurice Buchholtz, M.D.

— May 27, 1944. The reconditioning program: the Army's answer to the

manpower shortage. F. P. Boeckman.

— May 27, 1944. Rehabilitation and reemployment. (Editorial.)

— July 1, 1944. Studies on the action of penicillin. C. Phillip Miller, M.D.f

William Wallace Scott, M.D., Velma Moeller, B.A.

— July 8, 1944. Penicillin in the treatment of ophthalmia neonatorum. Jerome

J. Sievers, M.D., Lislie W. Knott, M.D., Herman M. Soloway, M.D.
JOURNAL OF THE IOWA STATE MEDICAL SOCIETY. (Des Moines). 33:556.

December, 1943. Iowa plan for combatting venereal disease in operation.
JOURNAL OF THE MISSOURI STATE MEDICAL ASSOCIATION. (St. Louis). 41:8-9.

January, 1944. Syphilis: five-day and other treatments. A. W. Neilson.

— January, 1944. Syphilis: public health aspects. J. F. Bredeck, M.D., D.P.H.
KENTUCKY MEDICAL JOURNAL. April, 1944. 42:102-7. The administrative

control of syphilis. R. E. Teague, M.D.
MARYLAND STATE DEPARTMENT OF HEALTH. Monthly bulletin. February, 1944.

15:93-97. Genitoinfectious disease as a measure of sexual promiscuity tn

a community. N. A. Nelson, M.D.
MEDICAL RECORD. (New York City). 157:345-49. June, 1944. The effect of

syphilis on the pregnant woman and her offspring. K. F. Miller, M.D.
MEDICAL WTOMAN'S JOURNAL. (Cincinnati). 50:293-300. December, 1943.

The premarital medical consultation; clinical premarital procedures as

an aid to biologic and emotional adjustments of marriage. M» P. Warner, M.D.
MODERN HOSPITAL. (Chicago). 62:75-76. January, 1944. Practical ways to

promote public health. Public health and community services of the Flint-

Goodridge hospital, New Orleans, Louisiana. J. L. Proeope.

— February, 1944. Small country makes great strides in health and hospital

oare. Public health and hospital services in Iceland. O. J. Ofeigsson, M.D.,

and Porter McKeever.
MOTHER. American committee on maternal welfare. January, 1944. 5:9-11.

The Pan-American sanitary bureau and its work in the field of maternal

and child welfare. H. S. Gumming, M.D.
NATIONAL NEGRO HEALTH NEWS. U. S. Public Health Service. (Washington,

D. C.) 11:11. July-September, 1943. State health officer discusses Negro

health weeTc in Alabama. B. F. Austin, M.D.
NEW ORLEANS MEDICAL AND SURGICAL JOURNAL. March, 1944. 96:385-88.

Maternal and child welfare wi New Orleans. E. E. Arnell, M.D., and

J. M. Wliitney, M.D.
NEW YORK STATE JOURNAL OF MEDICINE. October 1, 1943. The extent of the

syphilis problem at the beginning of World War II. B. A. Vonderlehr,

M.D., and Lida J. Usilton, M.A. p. 1825.

— October 1, 1943. Venereal disease control as applied to the Army. William

Bisher, Major (MC), U. S. A. p. 1832.

— October 1, 1943. Venereal diseases — a Navy problem. Leo A. Shif rin, Lt.

Comdr. (MC), U.S.N.E. p. 1829.

— March 1, 1944. 44:493-95. Report of an outbreak of gonorrhea at a boys'

school. E. S. Westphal, M.D.
NURSING TIMES. (London.) 40:293-94. April 29, 1944. The ideal health centre.

— 40:299. A real health centre.

OKLAHOMA STATE HEALTH DEPARTMENT. 1:151-4. December, 1943 and sub-
sequent months. Venereal Disease Control Division — News Letter.

OREGON HEALTH BULLETIN, OREGON STATE BOARD OF HEALTH. February 2, 1944.

22:4,12. Tracer of missing patients. W. H. Aufranc, M.D.
— February 9, 16, 1944. 22:3,3—1. Venereal disease delays victory. J. K.
Heller, M.D.

— March 29, April 5, 1944. 22:3-4, 3. The control of venereal disease in Oregon.

W. H. Aufranc, M.D.

PUBLICATIONS RECEIVED

383

PENNSYLVANIA'S HEALTH, STATE DEPARTMENT OF HEALTH. (Harrisburg.)
4:4-5,12-13,16. December, 1943. The relationship of federal, state and
local health agencies in an integrated program. R. C. Williams, M.D.

— January, 1944, 5:3,11. Wartime control of venereal disease in the state of

Pennsylvania. E. S. Everhart, M.D.

PUBLIC ADMINISTRATION CLEARING HOUSE NEWS BULLETIN. Release No. 1.
April 10, 1944. Richmond, Virginia, operates modern rapid-treatment center
for venereal diseases.

PUBLIC HEALTH NEWS, NEW JERSEY STATE DEPT. OF HEALTH. February, 1944.
27:12-15. "National roundup" of selectees known or suspected of being
infected with syphilis. G. S. Usher, M.D.

PUBLIC HEALTH NURSING. 36 : 1 3-11. January, 1944. The duration and there-
after for public health nursing. Louis I. Dublin, Ph.D.

— 36:122-23. Recent developments in the appraisal of public health work.

George T. Palmer, Dr.P.H.

— 36:139-43. Relationships of health agencies. Dorothy E. Wiesner, Mar-

garet M. Murphy.

— • June, 1944. Public health nurse and social worker in a venereal disease pro-
gram. Alice M. Kresge and Dorothy H. Brubaker. p. 269.

PUBLIC HEALTH REPORTS, U. S. PUBLIC HEALTH SERVICE. March 17, 1944.
59:367-71. Prevalence of communicable diseases in the United States,
January 30-February 26, 1944.

— February 16, 1944. Prevalence of communicable diseases in the United States.

59:236-42.

— March 17, 1944. 59:376-80. Notifiable diseases, year 1943.

— April 14, 1944. 59:499-502. Prevalence of communicable diseases in the

United States, February 27-March 25, 1944.
PUERTO Rico JOURNAL OF PUBLIC HEALTH AND TROPICAL MEDICINE. (New York

City.) 19:148-52. September, 1943. The training of medicosocial workers.

Maria Pintado Rahn.
— 19 483-91. March, 1944. Studies on syphilis in Puerto Rico, III. O. G. Costa-

Mandry, M.D. and Janer.
ROCKEFELLER FOUNDATION — REVIEW FOR 1943. The development of penicillin.

p. 8.
SCIENCE. February 11, 1944. 99:114-16. Public health in the U.S. S.R. C.-E. A.

Winslow, M.D.
SOUTHEEAN MEDICAL JOURNAL. March, 1944. 37:179-82. Health problems

ahead. Thomas Parran, M.D.
STATE GOVERNMENT. March, 1944. p. 290. The provision of adequate medical

care. Allan M. Butler, M.D.
VENEREAL DISEASE INFORMATION, U. S. Public Health Service. (Washington,

D. C.) 24:358-63. December, 1943. A study of attitudes and informational
levels with respect to gonorrhea. An analysis of responses to questionnaires
on gonorrhea distributed at the New York World's Fair in 1940. Marie
Di M. Wann, Ph.D.

— 24:12355. Penicillin treatment of early syphilis : A preliminary report. J. F.

Mahoney; R. C. Arnold and Ad Harris.

— January, 1944. 25:1-2. Serial examinations in the epidemiology of gonococcal

infections. S. D. Allison, M.D., W. L. Zink, M.D., and W S. Ito, M.D.

— 25:9-13. Improvement of present methods of extrafamilial contact tracing.

M. A. Burke.

— 25:3-8. Venereal disease and selective service. R. H. Eanes, M.D.

— February, 1944. 25:35-41. Criteria of cure in gonorrhea. R. A. Koch, M.D.,

E. N. Mathis, M.D., and J. C. Geiger, D.P.H.

— 25:42-45. Progress in the wartime management of gonorrhea. P. 8.

Pelouze, M.D.

— March, 1944. 25:76-80. Gonorrhea: the epidemic we face. P. S. Pelouze, M.D.

— May, 1944. An evaluation of the blood-dye diluent for the transportation of

material from gonococcic infections. S. E. Sulkin, J. C. Willett.

— June, 1944. 25:167-70. A technic of follow-up of selective service registrants

with syphilis in Philadelphia. Alice M. Kresge, R.N.

WISCONSIN STATE BOARD OF HEALTH QUARTERLY BULLETIN. (Madison.) 7:12-13.
October-December, 1943. Wisconsin's record of venereal disease control.
Milton Trautmann, M.D.

A Time-Saving Guide for Busy Health Workers

HEALTH ARTICLES OF THE WEEK

A Classified Selective Index

to Current Periodical Literature

Some of the regular subject

headings
Cancer

Child Welfare
Communicable Diseases
Delinquency
Dental Hygiene
Eyesight Conservation
General

Health Education
Health Insurance
Health Work in Schools
Heart Diseases
Industrial Diseases
Industrial Hygiene
Industrial Nursing
Maternal Welfare
Mental Hygiene
National Defense and War
Nursing
Nutrition

Occupational Therapy
Physical Education
Public Health Nursing
Rehabilitation
School Nursing
Sex Education
Social Hygiene
Tuberculosis
Venereal Diseases

From 500 health periodicals, the trained
staff of the National Health Library com-
piles Health Articles of the Week to guide
busy health workers to the most significant
among all the scientific papers and reports
that are being published.

Health Articles of the Week offers these
advantages:

— a classification of material under the
subject heads listed to the left

— the inclusion of the extremely useful
information in the numerous state,
county and city publications that
are outside the scope of other index-
ing services

— a four-page mimeographed format
which can be scanned in a minimum
of time

— preparation by staff workers spe-
cially schooled in the field of public
health

Originally planned to meet the needs
of members of the National Health Coun-
cil, Health Articles of the Week is now
available, on a non-profit basis, to organi-
zations and individuals in the whole field
of public health, and we invite the oppor-
tunity to provide a free sample copy and
subscription information.

The fill-in and return of the coupon
below will bring these data by return mail.

For free sample copy and
further details fill in and
return this coupon today

NATIONAL HEALTH LIBRARY,
1790 Broadway, New York 19, N. Y.

You may send me, without cost or obligation, a
sample copy of the current issue of Health Articles
of the Week, together with information concerning
subscription costs.

Name

Address

City and state

\

Vol. 30 October, 1944 No. 7

Journal

of

Social Hygiene

The Social Hygiene Campaign in the Other
American Republics

"Not less important than the military cooperation and the supplies
needed for the maintenance of our respective economies, has been the
exchange of those ideas and of those moral values which give life and
significance to the tremendous effort of the free peoples of the world."

Franklin D. Roosevelt

CONTENTS

A Message from President Ray Lyman Wilbur Opposite Page 385

Editorial — Nations United for War and Permanent Peace .... William F. Snow 385

Letters from Major General G. C. Dunham, Institute of
Inter- American Affiairs; Dr. Hugh S. Gumming, Pan
American Sanitary Bureau; Surgeon General Thomas

Parran, United States Public Health Service 387-8

The Social Hygiene Campaign in the Other American
Republics

Argentina Milio Fernandez Blanco . . 390

Brazil L. Campos Mello 394

Colombia Annual Report, Ministry of Health 398

Costa Rica Jos6 Amador Guevara. . . 402

Dominican Republic L. F. Thomen 404

Haiti Jules Thebaud 407

Honduras Pedro Ordonez Diaz 412

Mexico Central Technical Office . . 414

United States-Mexico Border Cooperative Venereal

Disease Program Joseph S. Spoto 418

Nicaragua Luis Manuel Debayle .... 423

Panama Arturo Tapia 427

Paraguay A paper prepared by the Venereal, Syphilis and Skin Dispensary 431

Venezuela Felix Lairet Hijo 434

National Events Reba Rayburn 438

News from the 48 Fronts Eleanor Shenehon 445

Notes on Industrial Cooperation Percy Shostac 447

The American Social Hygiene Association presents the articles printed in the
JOTTKNAL or SOCIAL HYGIENE upon the authority of their writers. It does not
necessarily endorse or assume responsibility for opinions expressed or statements
made. The reviewing of a book in the JOURNAL or SOCIAL HYOISNK does not
imply its recommendation by the Association.

EDITORIAL BOABD

C.-E. A. WlNSLOW, Chairman

RAY H. EVERETT WILLIAM P. SNOW

JOSEPH K. FOLSOM JOHN H. STOKES

EDWARD L. REYES JOHN C. WARD

JMAN B. PISNKY, EDITOR

KEBA RAYBURN, ASSISTANT EDITOR
WILLIAM F. SNOW, EDITORIAL CONSULTANT

The JOURNAL OF SOCIAL HYGIENE is supplied to active members of the American
Social Hygiene Association, Inc. Membership dues are two dollars a year. The
magazine will be sent to persons not members of the Association at three dollars
a year; single copies are sold at thirty-five cents each. Postage outside the United
States and its possessions, 50 cents a year.

Entered as second-class matter at post-office at Albany, N. Y., March 23, 1922.
Acceptance for mailing at special rate of postage provided for in Section 1103,

Act of October 3, 1917, authorized March 23, 1922.
Published monthly (nine issues a year) for the Association by the Boyd Printing

Company, Inc., 372-374 Broadway, Albany, N. Y.

Copyright, 1944, by The American Social Hygiene Association, Inc.

Title Registered, U. 8. Patent Office.

PUBLISHED MONTHLY EXCEPT JULY, AUGUST AND SEPTEMBER

AT 372-374 BROADWAY, ALBANY 7, N. Y., FOR

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

EDITORIAL OFFICES AND NATIONAL HEADQUARTERS
1790 BROADWAY, 19, NEW YORK CITY

WASHINGTON LIAISON OFFICE
Room 609, 927 15th St., N.W., Washington 5, D. 0.
JEAN B. PINNEY, Director in Charge
REBA RAYBURN, Office Secretary

FIELD OFFICES

ATLANTA, GEORGIA. 506-508 Citizens and SALT LAKE CITY, UTAH. 402 Mclntyre

Southern National Bank Building. Serv- Building. Serving Arizona, Idaho, Mon-

ing Alabama, Florida, Georgia, Missis- tana, Nevada, Utah, California, Oregon

sippi, North Carolina, South Carolina and and Washington.

Tennessee. GEORGE GOULD, temporarily in charge.

CHARLES E. MINER, Field Representative.

MRS. EDNA W. Fox, Field Representative. BALTIMORE, MARYLAND. Care of Baltimore

Community Fund, 22 Light Street.

COLUMBUS, OHIO. Care National Confer- Serving Delaware, Maryland. Pennsyl-

ence of Social Work, 82 High Street. vania and Virginia.

Serving Indiana, Kentucky, Ohio and

West Virginia. DALLAS, TEXAS. Cliff Towers. Serving

CHICAGO AND ILLINOIS. Room 615, 360 North Arkansas, Louisiana, New Mexico, Okla-

Michigan Avenue. Serving Illinois, Michi- homa and Texas.

gan and Wisconsin. BASCOM JOHNSON, Director in Charge.

WADE T. SEARLES, Field Representative. MRS- GERTRUDE R. LUCE, Office Secretary.

OMAHA, NEBRASKA. 736 World Herald HAN FRANCISCO, CALIFORNIA. 45 Second

Building. Serving Colorado, Iowa, Kan- Street.

sas, Minnesota, Missouri, Nebraska, North W. F. HJOBT, Field 0<m*uJ*<m*.
Dakota, South Dakota and Wyoming.

GEORGE GOULD, Assistant Director, ,<> Rico. P. O. Box 4101.

Division of Legal and Social Protection KENNETH R. MILLER, Field Bepre$enta-

Sfrviccs, in Charge. -fire.

Chihuahua o^^fg ^<SsffTliurT»ra pal

'•*** ^.J Gulf of Mexico

rvcap

<&*

„ Caribbean Sea -

WSA^ ..<<?

INDIES

. <

AMERICA

.

GAIAPAGOS Is:

--pCOSTA RlfA

Buetuvvenl
PopaySn

Paita^

JUAN FERNANDEZ i

/C.CORRIENTE5

tiiaBlanca
rtilf of San Matins

Stra it of Magella n

Punta Arenas

riERRADEl FuEGO

A MESSAGE FROM PRESIDENT WILBUR

The most striking feature of the venereal diseases is the way in
which they have survived throughout many centuries and have
spread themselves to practically all parts of the world, because of
their long life in the human carrier and the way in which those
carrying these diseases have moved about over a wide range.

Now, with this world-wide war and the great shifts in populations
through the movements of armies and of refugees, this process
has been speeded up and the venereal diseases are practically
universal. We realize that they will gain a spread throughout the
whole human family far beyond anything we have known before
and that they are the problem of all human organizations.

Fortunately this comes at a time when we have better ways of
controlling these diseases than ever before and when through
government and voluntary agencies we can check their spread by
medical treatment and also by accepting public responsibility for
the control of those features of society which offer the greatest
opportunity for the contamination of our youth. It is also more
possible now to get a world-wide understanding and a world-wide
attack upon all the phases of venereal diseases, with the develop-
ment of sound social agencies. In this, as they are developing
more and more interest in public health, our Latin American
neighbors can be particularly helpful.

It is hoped that this special edition of the Journal of Social
Hygiene will start new procedures by all elements in the population
interested in the control of disease and in the protection of
youth.

Ray Lyman Wilbur, M.D.

President

American Social Hygiene Association

Office of the Chancellor
Stanford University, California

Journal

of

Social Hygiene

VOL. 30 OCTOBER, 1944 NO. 7

"Not less important than the military cooperation and the supplies
needed for the maintenance of our respective economies, has been the
exchange of those ideas and of those moral values which give life and
significance to the tremendous effort of the free peoples of the world."

Franklin D. Roosevelt

EDITORIAL

NATIONS UNITED FOB WAE AND PEKMANENT PEACE

Brilliant and inspiring and terrible are the international strategy
and coordinated operations of war recorded in the pages of current
history. Equally important to the peoples of the world will be
the peacetime plans and teamwork which must be brought to fruition.
For both victors and vanquished life will go on. However the forms
of political and social organization may vary, the family, handing
life on from generation to generation, will remain the corner-stone
of each nation. No part of the foundations in which these corner-
stones are set will be more vital than the health and well being of
all the people, — for the diminishing generation of the aged, with
their knowledge and experience of the past, — for the vigorous, self-
reliant generation at the peak of its power and influence, — for the
growing generation of childhood and youth, loyal, filled with ideals
and dreams of a great future for themselves and humanity.

In no field of health and welfare are greater gains to be won and
greater losses to be avoided, than in the conquest of the venereal
diseases, and the conservation of moral tradition and family life.
To accomplish this task we must have community, state, national
and international cooperation. And there must be understanding
and active participation of religious, educational, and social welfare
groups, as well as of the health, medical, legal and social protective
agencies.

The American Social Hygiene Association has enjoyed always the
privilege of working with all of these agencies, both voluntary and
official, and in many countries. The present wartime emergency
has naturally drawn the nations of our hemisphere more closely
together — but this is nothing new in social hygiene. As long ago
as 1920, the Association joined in sponsoring an All American
Conference on Venereal Diseases in which were enrolled 3,000 persons
of prominence, representing every scientific, religious, social and

educational interest in North and South America, and which was

385

386 JOURNAL OF SOCIAL HYGIENE

attended at its sessions in Washington by 450 delegates, from these
countries, and also from Europe. Ever since then, the influence
of that Conference has stimulated international interchange of infor-
mation and concerted activity. In recent years, and especially since
the beginning of war, international cooperation in venereal disease
control has been steadily building under the encouragement and
support of the Pan American Sanitary Bureau and the Coordinator
of Inter- American Affairs in the U. S. Office of Emergency Manage-
ment, working with governmental agencies in other countries. Con-
sideration of venereal disease problems by the Anglo-American
Caribbean Commission at its meetings in Washington with the Inter-
departmental Venereal Disease Committee and in the West Indies
with numerous government officials; the joint activities in Trinidad
and elsewhere in the Caribbean Area of the British Army and British
Health Services with the U. S. Army and Public Health Service;
and the examination of mutual objectives and applicable methods
through the Regional Conference on Social Hygiene held in Puerto
Rico in February of this year, — all such projects make for a united,
steady forward march towards national and world health, — for today
and tomorrow.

This issue of the JOURNAL OF SOCIAL HYGIENE, with its interesting
descriptions of developments and future plans for social hygiene
work among the other American republics, is fresh evidence that
we stand now, as we have stood always, on common ground in this
as in many other respects, and that all of these countries recognize
the need for vigorous voluntary agencies to support official programs.
Year by year it becomes more plain that the Constitution of the
American Social Hygiene Association states, in brief, the major
purposes toward which such voluntary groups should direct their
efforts :

"The purposes of this Association shall be to acquire and diffuse
knowledge of the established principles and practices and of any new
methods, which promote or give assurance of promoting, social health;
to advocate the highest standards of private and public morality; to
suppress commercialized vice, to organize the defense of the community
by every available means, educational, sanitary, or legislative, against the
diseases of vice; to conduct on request inquiries into the present condition
of prostitution and the venereal diseases in American towns and cities; and
to secure mutual acquaintance and sympathy and cooperation among the
local societies for these or similar purposes."

Announcing these purposes at the First Annual Meeting, in 1914,
Charles W. Eliot, first president of the new organization, said :

' ' These being its objects and aims, and its conception of public service
. . . the Association invites men and women in every part of the country,
who are of this mind, to support this work."

As we look towards the end of war and the coming of lasting
peace among the nations, men and women "who are of this mind"
in every part of the globe must join in safeguarding the health
and stability of family life, as potent factors in world unity and

world strength.

WILLIAM F. SNOW, M.D.

Chairman, 'Executive Committee, American

Social Hygiene Association

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 387

A LETTEE FEOM THE OFFICE OF THE COORDINATOR OF INTEE-
AMEEICAN AFFAIRS

OFFICE OF THE COORDINATOR OF INTER-AMERICAN AFFAIRS

THE INSTITUTE OF INTER-AMERICAN AFFAIRS

COMMERCC DEPARTMENT BUILDING
WASHINGTON. D.C.

October 20, 1944

Dr. William F. Snow

Chairman, Sxecutive Committee

American Social Hygiene Association, Inc.

927 - 15th Street, N. W.

Washington, D. C.

Dear Doctor Snowj

The publication of a special Latin American edition
of the Journal of Social Hygiene provides important im-
petus to the grovriLng recognition of the need for inter-
national cooperation in this field. In social hygiene as
in othar phases of public health work, the exchange of
ideas, knowledge and experience is fundamental for effec-
tive disease control.

The efficacy of hemispheric cooperation in the con-
trol of venereal diseases and in other public health ac-
tivities is now being demonstrated by the work of the
Inter-American Cooperative Health Services now operating
as an integral part of the Ministry of Health in each of
18 other American republics. With the cooperation of the
Paa American Sanitary Bureau and the United States Public
Health Service, an extensive venereal disease control pro-
gram is under way on the United States -Mexican border; the
Services are also establishing and strengthening similar
laboratory and clinic work in seven of the other countries.
The Services serve to supplement and extend the work of
National Departments of Health which have in many countries
been carrying on work of outstanding quality in many as-
pects of disease control.

The Journal of Social Hygiene is to be commended for
recognition and publication of details of venereal disease
control activities in the other Americas in the interest of
improved understanding and dissemination of knowledge con-
. corning work in this field*

Sincerely yours,

Dr. G. C. Dunham

Major General, U. S. Army

Executive Vice President

A LETTER FROM THE DIRECTOR OF THE PAN AMERICAN SANITARY BUREAU

OR. HUGH S. GUMMING VICEDIKICTOR

OR. JORGE BEJARNO

OFICINA SANITARIA PANAMERICANA

DR. C. E. PA2 SOLDAN ( CONKjruO*

PAN AMERICAN SANITARY BUREAU
LIMA. Ptnu DR VICTOR SUTTER

DR. LUIS GAITAN REPARTICAO SANITARIA PANAMERICANA SAN ,A, VADOR

OFFICE SANITAIRE PANAMERICAIN DR. HENRIQUE CLAVEAUX

DR. M. MARTINEZ. BAEZ MONTEVIDEO. URUGUAY

MIXICO. O.F. WXSHINGTON.D.C..E.U.DEA.

SECRETARIO DR. EDWARD C. ERNST

OR. ARISTIDES A. MOLL

October 11, 1944

Dear Miss Pinney: }

I am delighted to learn that the material
for the Latin American edition of the Journal of Social
ffygiene embodies the best thought and progress from
our sister Republics and am sure that the hemispheric
dissemination of this information will be of significant
value. Venereal disease control in the other Republic*
will receive a real impetus through this publication and
an appreciation of the newer activities in this program
will be a most desirable result.

i Sincerely yours,

Hugh S. Gumming
Director

Miss Jean B. Pinney

Editor. Journal of Social Hygiene

927 15th St., N.fl.

Washington, D.C.

The Pan American Sanitary Bureau is an independent international public health organiza-
tion. It was created by the Second International American Conference (1901-1902), organ-
ized by the First Pan American Sanitary Conference (1902), and reorganized by the
Sixth (1920). It is governed by a Directing Council elected, together with the Director,
at each Pan American Sanitary Conference. The Bureau is supported by annual quotas
contributed pro-rata by all the American Republics. It is interested primarily in the
prevention of the international spread of communicable diseases, and also in the main-
tenance and improvement of the health of the people of the 21 America Republics. Under
the provisions of the Pan American Sanitary Code (1924), it has become the center
of coordination and information in the field of public health, in the American Republics.
It also acts as a consulting body at the request of national health authorities, carries on
epidemiological and scientific studies, and publishes a monthly Bulletin, as well as other
educational material. Pan American Health Day is celebrated annually on December 2
in all American Republics.

A LETTER FEOM THE SURGEON GENERAL OF THE PUBLIC HEALTH SERVICE

ADDRESS T
O. S. PUB

FEDERAL SECURITY AGENCY
U. S. PUBLIC HEALTH SERVICE

WASHINGTON 14
(BETHESDA STATION)

October 6,

Miss Jean B. Pinney,
Editor, Journal of Social Hygiene,
American Social Hygiene Association,
927 Fifteenth Street, N. ».,
Washinfton 5, D. C.

Dear Miss Pinney:

In publishing a special number devoted to reports of social
hygiene ard venereal disease control work in the Latin-American
republics, the Journal of Social Hygiene is furthering the purposes of
international cooperation and understanding in venereal disease control.

Venereal disease is both a community and an inter-community
problem. Mo city, State, or nation can secure lasting control of any
communicable disease so long as new infections can be brought in from
other areas. The importance of international cooperation in the control
of venereal disease is gaining increasing recognition, particularly in
the exchange of identifying reports which assist in tracing and placing
under treatment persons to whom or from whom new infections have spread.
The Public Health Service now exchanges such contact reports which
health agencies of all nations in the world with which the United States
rcaintains diplomatic relations.

Social hygiene and venereal disease control workers through-
out the Western Hemisphere should find encouragement and practical
inspiration in the reports from the several countries represented in the
special Latin-American number of the Journal of Social Hygiene.

Sincerely yours,

Surgeon General.

THE SOCIAL HYGIENE CAMPAIGN IN THE
OTHER AMERICAN REPUBLICS

EDITOR'S NOTE: The articles and statements included under this
heading, as JOURNAL readers will know, report on but a small part
of the social hygiene programs in action in our neighbor republics.
A full record would show, in each of the twelve countries represented
here, many other efforts towards protection of homes and communi-
ties from the venereal diseases, towards education of young people
for successful marriage and family life, towards provision of safe
environment for childhood and youth to grow up in — in fact towards
the good way of life that right-thinking, true-hearted people the
world over desire for themselves, their children, and their nations.
At a later time the Editors hope to publish additional information
concerning some of these other endeavors, as well as concerning the
programs of countries not represented in the present series. Mean-
while, grateful acknowledgment is made to the authors and to all
who have helped to make this compilation possible, with especial
thanks to the U. S. PUBLIC* HEALTH SERVICE, the OFFICE OF THE
COORDINATOR OF INTER-AMERICAN AFFAIRS, the PAN AMERICAN
SANITARY BUREAU and the PAN AMERICAN UNION, for the loan of
texts and illustrations, and for assistance generally in assembling the
material and translating from the Spanish, French and Portuguese.

ARGENTINA

PROFESSOE MILIO FEENANDEZ BLANCO, M.D.

Chief of the Dermatovenereological Section, National Administration

of Public Health and Social Welfare

Toward the end of 1936, the Argentine
Congress approved Law No. 12,331 for pre-
vention of the venereal diseases which, after
the drafting of the necessary regulations,
went into effect June 29, 1937.

Under the plan for organizing the preven-
tion and treatment of these diseases through-
out the nation, there was established in the
National Department of Hygiene, a bureau
with the following duties:

1. To exercise general supervision and
coordination of the venereological services
in all the hospitals, dispensaries, and lab-
oratories of the country (national, provin-
cial, municipal, or private), and to maintain
relations with all the agencies concerned

with the problem, in order to watch over and to ensure the success

390

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 391

of this work. All the hospitals should provide beds for these diseases
according to the need.

2. To distribute free drugs and equipment, as well as educational
materials and scientific information through conferences, films,
et cetera, especially in an effort to provide sex education for young
people.

3. To carry out medical and social studies of the problem.

4. To organize social services, with trained workers and specialists
charged with the duty of locating the foci of infection.

5. To encourage growth of antivenereal centers.

Obligation was also laid on all institutions or organizations (of
any kind whatsoever) having a personnel of more than 50 persons,
to create for them a free treatment service, the only amount
collectible from the patient being the actual cost of the drugs.

Infected persons, during the period in which their disease is in
a contagious state, are obliged to undergo treatment, and if they do
not do so voluntarily, they may be compulsorily hospitalized.

The manufacture of antivenereal drugs by both official and pri-
vate companies, is to be arranged and encouraged, and no taxes
or customs duties are to be enforced on the products destined for
this use.

A premarital health certificate is required from bridegrooms, to
be secured within seven days preceding the marriage, the certificate
being issued free of charge. The examination is to be made by a
physician authorized by the National Bureau of Public Health and
Social Welfare, and the certificate may be refused if active lesions
of syphilis, or signs of gonorrhea, chancroid, lymphogranuloma
venereum, or leprosy are found. In necessary cases the examining
physician may request any serologic test, all the laboratories operated
by the National Bureau of Public Health and Social Welfare
providing this service free of charge.

Article Fifteen prohibits, throughout the Republic, the establish-
ment of houses or districts where prostitution is conducted or encour-
aged; this is really an abolitionist law suppressing the licensing or
legalization of prostitution and does not prohibit prostitution itself,
as some have mistakenly interpreted it to do.

Finally, the law contains several sections establishing punishment
and fines for those who refuse to observe its rulings and provides
an appropriation for law enforcement.

The regulations set forth the manner in which the campaign is
to be coordinated between the venereological services of the country,
the therapeutic standards to be followed ; and the manner of keeping
record of treatments of each patient (in a special notebook) ; and
give sample forms for the monthly statistical reports to be sent
by the various services to the Central Section for study and filing.

392 JOUENAL OP SOCIAL HYGIENE

On the educational side a venereological museum of wax models
has been set up, including 300 items; two sound moving pictures
about gonorrhea and syphilis have been produced and are regularly
exhibited in the Federal Capital and the interior of the country;
educational pamphlets and posters are distributed; lectures and
conferences are held.

For the better enforcement of the premarital certificate require-
ment, there have been opened in addition to the hospital laboratories
six serologieal centers strategically located across the country where
competent personnel, selected by competitive examination, carry out
the analyses or reactions.

Finally there is a consultant-Advisory Commission, made up of
professors on the Medical Faculty, which among other duties, advises
on procedure and methods fon diagnosis, treatment and prophylaxis
of the venereal diseases throughout the country, in order to secure
the standardization of these efforts, and strives to bring about the
orientation of antivenereal propaganda and the diffusion of sex
education.

It has now been six and a half years since this law was passed.
Its benefits are undoubted, in spite of the obvious difficulties sur-
rounding its application. It really has two fundamental objectives:

1. The requirement of the male premarital certificate, which is
carried out with strictness and efficiency ; and

2. The abolition of regulated prostitution — a theme which deserves
a separate chapter. This measure has eliminated the traffic in women,
at least in part, and thus is changing the unfortunate concept hitherto
held concerning our country in this respect.

The procuress or brothel-keeper and the innumerable ramifications
of her activity have been wiped out; the number of casual sexual
contacts has been reduced and consequently the probability of infec-
tion. Statistics prove that the venereal diseases have decreased
notably, both in the civil population of the Capital, in the interior,
and in the army. The crimes of violation, rape and lewd abuses that
it was feared would break out have not increased in comparison
with conditions before the law went into effect. These facts show
clearly that in this respect the law is beneficial in spite of the fact
that such abolitionist measures have constituted an abrupt change
in custom. Without question, the duty of striving to educate young
people in these matters during adolescence cannot be put aside;
to this end the addition of certain instructive material in the second-
ary school programs has been studied, with the object of making
known to the young people simple and elemental information about
these subjects.

The requirements of the premarital certificate aroused certain
misgivings in the beginning. Statistics, nevertheless, attest that the
number of marriages has not diminished but has increased, even in
comparison with the increase of the population, and that the number
of illegitimate children has not increased.

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 393

To sum up, this legislation is not perfect, but neither are most
laws. The time elapsing since the law was approved has brought
out some faults, more chargeable to its application than to its basic
intention, and which could be corrected without much trouble. All
those who have no interests directly damaged by the law, agree unani-
mously that the Argentine Law for prevention of the venereal dis-
eases, constitutes a valuable acquisition for the public health of
the country, that it should not be done away with, but on the
contrary, that it deserves most vigorous support from the authorities.

Area — 1,080,000 square miles Population— 13,709,238

Capital — Buenos Aires; population 3,500,000 Language — Spanish

Unit of currency — The paper peso, worth 26 cents in U. S. currency.

People — -In addition to the Indians who have been absorbed into the population,
the mainly Spanish stock has assimilated many immigrants from Italy, England,
Scotland, Ireland, Germany, Austria, France, Poland, Eussia, Switzerland and
other American countries. The amalgamation of peoples and of cultures is more
complete than in the United States.

Climate and Physical Characteristics— There are four well-diversified geo-
graphical regions: a humid, subtropical northern region; a semi- arid, semi-
mountainous northwest; the south of plateaus and mountain slopes and lakes;
and the great central pampa, a region of rich agricultural plains. The climate
is temperate, slightly milder than the United States, with seasons in reverse.

Government — Federal in form, modeled on that of the United States. Each
of the 14 provinces has its own government, with its own constitution, governor
and other officials, a two-chamber legislature, and provincial judicial and
educational system. Ten territories, with governors appointed by the President,
constitute more than 40 per cent of the total area of the country, but only
about 5 per cent of /the population. The President, who wields much power, is
elected for a 6-year term by an Electoral College. Congress consists of a Senate
of 30 members chosen by a special body of electors for nine years; and a House of
Deputies of 158, elected by direct vote for four years.

Education — National and provincial governments cooperate in maintaining the
school system, which includes 14,000 elementary schools with 1,800,000 pupils,
and about 250 high schools. Literacy is estimated at 88 per cent generally,
with a higher rate for the cities. There are nearly 100 normal schools, and
24 universities, the largest of which is the University of Buenos Aires with
15,000 students.

Public Health — The National Department of Health, under the Ministry of the
Interior, carries on health work, and is given authority to intervene in public
health matters in the provinces and municipalities, especially in connection with
such national problems as malaria, plague, and venereal diseases. Some of the
provinces have well developed health departments, and an enormous amount of
health and welfare work is carried on by the larger cities. The national
government maintains welfare stations or health centers in the national territories,
as well as maternal and child welfare centers, venereal disease dispensaries,
tuberculosis sanatoria, leprosaria, vacation colonies for children, and other
welfare institutions throughout the country.

Societies

Liga Argentina de Profilaxia Social, Corrientes 980, Buenos Aires.

Sociedad Argentina de Dermatologia y Sifilografia, General Urquiza 609, Buenos

Aires.
Sociedad Argentina de Venereologia y Profilaxia Social, Buenos Aires.

394

JOURNAL OF SOCIAL HYGIENE

BRAZIL

L. CAMPOS MELLO, M.D.

In Charge of the Antivenereal Campaign, National Department
of Health of Brazil

Syphilis, gonorrhea and other infections coming under the heading
of venereal diseases, present in Brazil and particularly in its larger
cities, as is also the case to a varying degree in all countries of the
Americas, a problem which demands the careful attention of the
public health services and of all agencies interested in one or more
of the aspects of this important health problem.

Besides the characteristics which make venereal disease one of
the most important problems of public health medicine in peacetime,
other difficulties arise in times of war which make it even more diffi-
cult. Some of the factors which favor the spread of such diseases
in war conditions are : the mass calling of military reserves, fre-
quently recruited from remote sections and small cities and taken
to larger cities or nearby training barracks; the larger migration of
laborers, experts, farmers, rubber explorers and miners, all over
the country; long stays away from families thereby exposing them
to attractions heretofore unknown. All this is facilitated by higher
salaries being received by the men and also by the increase in
prostitution.

For a long time the State Departments of Health in Brazil have
been actively fighting venereal diseases. The campaigns, however,
have been conducted generally without a definite or uniform program.

In 1942 the Federal Government resolved, through the National
Department of Health of the Ministry of Education and Health,
to establish a national campaign, on a progressive plan, based on
agreements with the State Departments of Health, and enabling
them, with the aid of drugs, laboratory material and technical guid-
ance furnished by the Federal Government, to undertake the com-
prehensive program for venereal disease control which had been
planned by the Federal Government.

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 395

Money was set aside for the initiation of the campaign in 1942 and
three States were chosen as a trial ground for the work. After mak-
ing agreements with the State Departments of Health of Espirito,
Santo and Alagoas, the campaign was begun. Local budgets were
supplemented by federal grants and the program was put into effect
under the federal standards previously approved, but adapted to
local conditions.

The above mentioned federal standards may be summarized in
part as follows:

1. The State Departments of Health must have, as an assistant
to the Director General a trained venereologist, to centralize,
coordinate and control the State campaign.

2. In the sanitary districts having venereal dispensaries in their
Health Centers, the State Departments of Health shall make the
reporting of venereal diseases compulsory by the number system.

3. Steps shall be taken to impart sex education in high schools
and colleges through the proper agencies.

4. The State Departments of Health shall make the police authori-
ties enforce the provisions of the Criminal Code on prostitution,
white slavery, pandering, et cetera, offering no cooperation nor
encouragement to any medico-police reglementation system, having
its basis in law or fact, and bringing about the immediate abolition
of the carnets used for the periodical examination of prostitutes.

5. Health education against venereal diseases shall be carried on
extensively and continuously.

6. The State Departments of Health shall cooperate with the
health services of the armed forces with a view to preventing and
treating venereal diseases among the troops and to exchanging
information on cases and infection foci.

7. Sample serological surveys on the basis of the "One Day
Census" shall be made.

8. The use of individual preventive methods, facilitating their sale
in drug stores and other places, shall be encouraged.

9. Preparation and maintenance, directly or by properly author-
ized persons, beds for interning and treating cases of venereal diseases
which require hospitalization.

10. Provision, through the Health Centers, of premarital exami-
nations, explaining in full their advantages.

11. Strict control of advertisements and quality of products used
in the treatment of venereal diseases, as well as sharp repression
of quackery.

12. Monthly statistics shall be sent in by each dispensary with
data as set forth in the official form.

396 JOURNAL OF SOCIAL, HYGIENE

13. Closer relationship shall be established between the various
services of the Health Centers with the venereal disease service,
in order that all may cooperate in the campaign.

14. The federal standards under which the Nursing Services of
the Health Centers will work on case-finding, case-holding and
follow-up of defaulting cases, in cooperation with the venereal
disease dispensaries, shall be adopted.

15. The program of cooperation between the services of Periodical
Examinations of Health, of Prenatal Hygiene, Child Hygiene, Pre-
school Age Hygiene, of Otorhinolaryngology, Ophthalmology, Lab-
oratory, et cetera, of the Health Centers shall be adopted, so that
the working hours will harmonize with those of the, Venereal Disease
Services.

16. Venereal dispensaries shall be organized within the require-
ments prescribed as to materiel, personnel and operation, and shall
adopt the required diagnosis nomenclature, treatment schemes and
clinical diagnosis and laboratory standards.

17. The above program shall be adopted in the Health Units of
the small cities and rural areas.

18. Organization, especially in the cities having military camps,
of preventive centers for the use of both the military and the civilian
population.

These are points included in the detailed federal standards for
the campaign against venereal diseases in cooperation with the State
Departments of Health, and which from time to time are to be
changed according to the results of experience.

Since 1942 efforts have also been made with the Health Depart-
ments of the Army and Navy, to synchronize the campaign among
civilians with the work of medical authorities of the armed forces.

This year, with increased resources, the venereal disease campaign
is being carried on in the above-mentioned States, as well as started
in the States of Rio Grande do Sul, Parana, Rio Grande do Norte,
Para, and Rio de Janeiro, taking in seven of the twenty States in
the country.

The other States, while not yet receiving federal aid, are never-
theless working against venereal diseases, and during 1944 should
be embraced in the national program, when the first course for
venereologists will be given, with a view to preparing experts for
the dispensaries of the Health Centers.

According to available data the campaign against venereal diseases
in Brazil will be greatly broadened during the next few years as a
necessary measure.

SOCIAL HYGIENE IN" THE OTHER AMERICAN REPUBLICS 397

FACTS ABOUT BEAZIL

Area— 3,286,170 square miles Population — 41,565,083

Capital — Rio de Janeiro; population 1,585,234 Language — Portuguese

Unit of currency — The cruzeiro, worth 6 cents in U. S. currency.

People — An amalgamation from many countries, the main stock was originally
Portuguese, but a constant flow of immigrants, chiefly Italian, Portuguese,
Spanish, German and Japanese, with many others from a great variety of
nationalities, has made a blended population, most of whom are well assimilated.
More than 70 per cent of the people are engaged in agricultural occupations.

Climate and Physical Characteristics — The three general regions have distinctive
climates: the tropical Amazon basin has high temperatures and humid atmo-
spheric conditions; the northeastern states, partly scrubland and desert, are warm
and dry, occasionally suffering from drought; the southern and central coastal
regions are cooler and have moderate but adequate rainfall. The country's
area is greater than that of any other republic of the Western Hemisphere,
covering 47 per cent of the South American continent.

Government — Established as the United States of Brazil in 1889, the con-
stitution adopted in 1891 was modeled largely on that of the United States.
There are 20 states having their own governments and legislatures, and five
territories. The National Parliament includes a Chamber of Deputies and a
Federal Council and meets each year on May 3 for four months. The president,
selected by an Electoral College or by plebiscite for a six-year term, is given
large powers by the constitution, and is assisted by a cabinet of ministers,
including a Minister for Education and Public Health. Since 1934, suffrage has
been extended to all men and women over 18 years of age.

Education — Elementary and rural education with 2,670,000 children in 36,661
schools, is controlled by the states, but influenced to some extent by the Federal
government through subsidies, with a growing tendency toward federal centrali-
zation. The Ministry of Education, with advice from a National Council of
Education composed of leading educators, supervises all secondary, university,
commercial and remedial education. There are nine institutions of higher
learning, offering advanced work in engineering, law, medicine, dentistry, fine
arts, education and business. Research institutes and professional schools of
mining, agriculture and military and naval science are maintained either by
federal or state governments. There are more than 1,250 libraries in the country,
many serving outlying rural areas.

Public Health — Chief health problems are malaria, intestinal parasites, leprosy,
trachoma, water-borne diseases, plague and yellow fever. Also important are
the high infant death rate, tuberculosis, venereal diseases, malnutrition, and
in some regions tropical diseases. The large cities have good physicians and
equipment, but the interior suffers from a dearth of doctors, nurses and hcfspitals.
The National Department of Public Health cooperates with state governments
in campaigns against the various diseases; in maintaining dispensaries and health
centers; and in health education. The Institute of Inter- American Affairs has
aided in the establishment of two large laboratories, at Belem and in the Rio
Doce Valley; and several smaller ones where routine clinical examinations
are made.

Societies — Circulo Brasileiro de Educacao Sexual, Rio de Janeiro.
Socieda de Brasileira de Dermatologia, Rio de Janeiro.

398 JOURNAL OF SOCIAL HYGIENE

COLOMBIA

A Statement Eeprinted from the 1943 Annual Beport of the Ministry of Labor,
Health and Social Welfare

Among all the health campaigns, that against venereal disease has
benefited most through the new scientific progress and development
of treatment. Today it is possible to cure syphilis in its first two
stages within a period of from 10 to 30 days. With regard to gonor-
rhea, the advent of the sulfanilamides has brought about a complete
therapeutic revolution. For these reasons, the Government, inter-
ested in developing the campaign, called a conference of the pro-
fessional workers connected with health and welfare agencies in
Colombia and a meeting was held in the Samaritan Hospital. Various
interesting conclusions were adopted concerning treatment, the social
campaign, provision of drugs, sex education, provision of equipment,
blood tests, and other details.

There was brought out the need for Colombians to understand
fully the dangers of venereal diseases, how they are transmitted,
and how they may be avoided and treated, putting an end to the old
system of treatment which made the external lesions disappear and
gave the patient a false illusion of improvement while the infections
were following their course, later causing disturbances in the nervous
system and vital organs with disastrous results.

The Government should press forward powerfully and scientifically
with the necessary measures to defend the community, isolating
infectious cases, tending the sick, controlling as far as possible
those who spread infection and establishing standards for dealing
with prostitution in a way that will be least dangerous to society.

No complete statistics as to the number of syphilitics in Colombia
have yet been compiled, but the number must be huge, since we
have not had adequate health regulations, since the lack of knowledge
among the people concerning the source of infection is great, and
since we have lacked the education and public information which
would point out the dangers of this evil and the benefits and facilities
of treatment.

We must confess that so far our campaign has been cold and unim-
aginative as regards human welfare. While we have done a great

SOCIAL HYGIENE IN" THE OTHER AMERICAN REPUBLICS 399

deal in investigation and in medication, we have done very little
along the lines of the social campaign. The prostitutes have been
herded into the clinics by the police ; have been made to live in filthy
surroundings, unhabitable hovels without running water and without
sewage facilities. This has made them feel neglected and forgotten
by the State, so that those who become diseased shun the institutions
which combat these diseases. We need, in order to fulfill our duty
to society and to carry out our work in a more Christian and humane
spirit, to see that these women have a chance to be accurately in-
formed how to protect themselves against these diseases, and as to
the treatments which should be followed, if they become infected,
lest they reach a stage in which medical science can be of no avail.

To accomplish this the antivenereal activities in the Capital and
Departments and in the large cities ought to have attached to
the hospital wards necessary facilities for education and rehabilita-
tion— recreation rooms, sewing rooms, school rooms, — and sufficient
provision for nourishing food as well as for attention from the medical
and administrative staff.

If this plan can be put into effect with arrangements for suitable
personnel and necessary drugs to maintain continuous treatment
and laboratory service for complete investigation and blood tests;
if we can train public health nurses, one of the great needs of the
country; if sex education can be increased, — or, rather, begun, — the
problem of the venereal diseases will be reduced fifty per cent. The
progress of disease to the third stage, with the serious complications
that require surgical aid and leave the patient in a critical condition
will be avoided. We will also help to prevent criminality which in
fifty per cent of cases is influenced by syphilis ; and the population of
our hospitals for the insane will be reduced, inasmuch as according
to statistics, sixty per cent of the insane are so because of syphilis
and other venereal diseases; twenty per cent because of alcoholism,
and the rest because of other infections, toxic conditions and neuro-
pathic tendencies.

From the cold facts, Congress may see the importance of granting
increased economic aid and moral support to the campaign against
the venereal diseases, which to date has been waged solely out of
departmental funds, permitting neither complete treatments nor
educational work.

BUDGET

The budget of the Venereal Disease Section for the year 1942
was $110,577 of which $40,000 was assigned from the general budget
and $70,577 assigned from the budget of the Department of Coordi-
nated Health Services. Of the $40,000, $38,570 was expended and the
rest was transferred for expenses of the Minister of War.

The appropriation for the expense of the Antivenereal Section
during the year 1943 was $120,000, plus $62,558.04 from funds of
the Department of Coordinated Health Services.

Antivenereal Institutions': During the year 1942, 86 Antivenereal
Services were functioning.

400 JOURNAL OF SOCIAL HYGIENE

Persons Attending: The total number of persons attending the Anti-
venereal Services was, during the year, 200,394. In the prophylactic
stations 49,172 persons attended.

Hospitalization: In 62 of the 86 institutions, 23,753 persons were
hospitalized ; the other 24 lacked facilities for this purpose.

Prophylactic Stations: During the year 44 prophylactic stations
functioned. Of these 18 were supported with funds of the Anti-
venereal Section and the other 26 by the Departments and Munici-
palities.

Improvements: Eesolution No. 282 was put into force, regulating
prostitution throughout the national territory. 25,000 educational
booklets were printed.

EDITOR'S NOTE: This report is supported by a detailed account of
venereal disease control work as carried on in the departments of
Antioquia, Atlantico, Bolivar, Boyaca, Caldas, Cauca, Cundinamarca,
Huila, Magdalena, Narifio, Santander del Sur, Santander del Norte,
Tolima, and Valle, and the territories. In each case the number of
patients and the chief characteristics of the work are reported.

The general health and sanitation campaign being carried out by
Colombia in cooperation with the Office of the Coordinator of Inter-
American Affairs of the United States will be of considerable influ-
ence in venereal disease control. The report further says that the
administrating agency, ''Cooperative Inter- American Health Ser-
vice, ' '* under the Ministry of Labor, Health and Social Welfare, uses
funds, equipment, and personnel furnished by the two countries
(to an amount not to exceed one million U. S. dollars or Colombian
pesos, respectively). Its venereal disease control work, as described
in the report of the Minister, includes venereal disease diagnosis and
treatment in coastal health centers operated primarily as part of the
malaria eradication program; treatment of these diseases by the
malaria and yaws units on the Pacific coast; aid to venereal disease
institutes in several Departments (among them Caldas, Magdalena,
Santander del Sur, and Valle) ; venereal disease control in mining
and other industrial areas; and indirectly, the assistance to the
School of Public Health Nursing set up by the combined efforts
of the Government of Colombia, the Rockefeller Foundation, the Pan
American Sanitary Bureau, the Office of the Coordinator of Inter
American Affairs and, the National University.

(* The Department of Coordinated Health Services referred to in the main
text is not the above; but rather an administrative agency for funds supplied
by the federal, departmental and municipal government on a grant-in-aid basis
for local health projects. Some of these centers also receive aid from the
Cooperative Inter American Health Service . . . It is a little difficult to
separate responsibility in Colombia; because all possible cooperation is enlisted,
including that of private companies. In Bucaramanga the Venereal Disease Dis-
pensary is to be built with funds from the Department of Santander del Sur
and the Cooperative Inter American Health Service, on a site donated by the
local Eotary Club, and no doubt the national government will be helping main-
tain it.)

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 401

FACTS ABOUT COLOMBIA

Area — 448,794 square miles Population — 8,701,816

Capital — Bogota; population 400,000 Language — Spanish

Unit of currency — The gold peso, worth 57 cents in U. S. currency.

People — The country was settled by Spaniards beginning in 1525, and the people
are mainly Spanish and Spanish-Indian, with some Indian tribes in isolated
parts entirely unassimilated. Spanish culture dominates, though French influence
has been important in the intellectual life. Agriculture and mining are important
occupations.

Climate and Physical Characteristics — Just south of the Republic of Panama,
Colombia is the only South American country to overlook both the Pacific Ocean
and the Caribbean. Neighbors on the east are Brazil and Venezuela, and on
the south, Ecuador and Peru. Three great ranges of the Andes run north
and south through the country, making transportation a major problem. The
high tablelands between the mountains enjoy a cool and pleasant climate. Only
two per cent of the land is cultivated, with 23 per cent used for grazing, and
50 to 60 per cent in forests. There are also rich mineral deposits.

Government — Established as a republic in 1819, the government is vested in
a Federal Congress and President. The Congress consists of the Senate of 57
members elected for terms of four years, and the House of Representatives, of
119, elected every two years. The president is elected by direct vote of the
people every four years.

Education — Education is free but not compulsory. Since 1931 the educational
budget was increased fivefold in a six-year period, and according to law must
reach a minimum of 10 per cent of the total national budget. The National
University, founded in 1573, is in Bogota, and there are four other universities.

Public Health — The National Public Health Department, whose budget in a
recent year amounted to over seven million pesos, has increased its activities
during recent administrations. Including expenditures by the various departments
and municipalities, and by such organizations as the Inter- American Cooperative
Service and Rockefeller Foundation, over twenty million pesos are spent annually
for health and welfare purposes. Principal health problems include malaria,
intestinal parasites and waterborne diseases, tuberculosis, venereal diseases, yaws,
and smallpox. Facilities for prenatal and maternal care, tuberculosis, and other
purposes are being expanded. There are 238 hospitals with ] 9,562 beds, 2,322
practicing physicians, a cancer institute, the National Institute of Medical
Research devoted especially to leprosy investigation, an Institute of Epidemiology
and Research, a laboratory for yellow fever studies operated in cooperation
with the Rockefeller Foundation, and three schools of medicine at Bogota,
Medellin and Cartagena. A model school of nursing has been opened recently
in Bogota with the cooperation of the Pan American Sanitary Bureau and
other organizations.

402 JOURNAL OF SOCIAL HYGIENE

COSTA RICA

JOSE AMADOE GUEVARA, M.D.

Chief, Venereal Disease Control Department, Ministry of Public Health
and Social Protection

The following data may be recorded regarding the campaign to
combat venereal diseases in Costa Rica : *

1. The Department of Venereal Disease Control is the technical
organization charged with all antivenereal activities.

2. The Antivenereal Social League, recently founded, is a voluntary
organization which cooperates with the Chief of the Venereal Disease
Control Department in his activities. The League was created for
the purpose of promoting united effort of the public in health and
social campaigns.

3. A joint campaign is now being organized, in which the Ministry
of Health, the Costa Rica Social Security Board, the Inter- American
Cooperative Public Health Service and the Pan American Sanitary
Bureau will cooperate.

4. The National Congress will soon adopt a Sanitary Code which
will provide for dealing with the venereal problem in a modern and
scientific way.t

You may count on our full cooperation.

*From a letter of September 14, 1943, to Dr. William F. Snow, American
Social Hygiene Association.

t EDITOR 's NOTE : These laws were adopted in March, 1944.

FACTS ABOUT COSTA RICA

Area — 23,000 square miles Population — 687,354

Capital — San Jos6; population 72,270 Language — Spanish

Unit of currency — The colon, worth 18 cents in U. S. currency.

People — About 80 per cent of the people are whites of Spanish origin, with
14 per cent mestizos (mixed white and Indian), four per cent Negroes, and
less than one per cent pure Indian. Agriculture, chiefly coffee, bananas and
cacao, is the source of livelihood directly or indirectly for almost the entire
population.

SOCIAL HYGIENE IN" THE OTHER AMERICAN REPUBLICS 403

Climate and Physical Characteristics — Area is about that of West Virginia,
bounded by Nicaragua on the north, Panama on the south, the Caribbean on
the east and the Pacific on the west. The climate varies from the hot zone
of the coastal and river plains, through the pleasant temperate weather of the
central plateau where most of the population is concentrated, to the cool, dry
mountain heights.

Government — The power of government is primarily national, with governors
of the seven provinces deriving their power from the authority of the president,
who is elected directly by the people for a term of four years. The Constitutional
Congress is composed of 47 Deputies elected for four-year terms, half every two
years, by manhood suffrage. The Congress convenes on May 1 in ordinary
session of 60 days each year. Voting for all elective offices is direct, secret
and since 1936 compulsory. The president is responsible for the execution of
the laws and other duties, and is assisted by a Cabinet of secretaries-of -state
for the nine executive departments, two of which are Public Health and
Education.

Education — A centralized school system is headed by the Department of
Public Education. The annual appropriation for education, which for 1943
amounted to almost eight million colones, represents about 21 per cent of the
national budget. Costa Eica is the fourth most literate of the 20 Latin
American republics. About 81,000 students attend the 800 schools, of which
700 are maintained by the government. Elementary education is free and com-
pulsory for children between seven and fourteen years. A decree of June
1944 provides that English be taught in all primary schools. A school of
special instruction was recently established for physically handicapped and
mentally retarded children. Graduates of the elementary schools may enter
the School of Fine Arts, the School of Agriculture, the School of Commerce
or one of several secondary schools. Graduates of secondary schools may attend
a School of Social Service, or may do advanced study at the School of Education,
which offers secondary education also. The National University of Costa Eica,
with 730 students, includes schools of law, pharmacy, agriculture, education,
art, engineering, sciences, liberal arts and dentistry.

Public Health — The public health budget for 1942 amounted to 2,844,878.14
colones or about $483,629, and the 60 municipalities are required to devote
20 per cent of their income to public health work. There were 22 health
units throughout the country in 1942, each with a small maternity ward,
and 24 children's clinics. There are 23 hospitals and clinics in the principal
towns, with a total of 3,232 beds. It is estimated that there are 150 physicians
in Costa Eica. There are a Central Laboratory, and a number of branch
laboratories connected with the health units. In San Jose there is a school
of nursing. The Institute of Inter- American Affairs is cooperating in the
installation of laboratory facilities in health centers in Orosi, Tres Eios, Nicoya,
Villa Colon, Turialbe, Orotina, and Santa Maria.

Societies— Liga Social Antivenerea de Costa Kica, San Jose. There are a
number of local branches.

404 JOUKN'AL OF SOCIAL HYGIENE

DOMINICAN REPUBLIC

L. F. THOMEN, M.D.
Assistant Secretary of National Health and Public Welfare

The venereal disease problem is one of those most seriously con-
cerning the Dominican Government, and in recent years great efforts
have been made to improve the national health services and the
institutions of public welfare.

While we have not yet established in the organization of our
Department of Health, a centralized system for guiding the campaign
against syphilis and gonorrhea, these infections are combatted through
various medical institutions in which diagnosis and treatment are
offered free of charge to persons infected with these serious social
diseases. Some of these institutions are devoted exclusively to venere-
ology, but the activities of those which give attention to this specialty
among other clinical services are not yet governed by a central
organization charged with direct control.

The public welfare services of the Dominican Republic at present
number eleven national hospitals for civilians, all of which provide
anti-venereal treatment for both ambulatory and resident patients.
The offices of the seventeen Health Physicians who work in the
Provincial Health Districts into which the country is divided, furnish
ambulatory treatment of individuals affected with venereal disease,
and medical care is also given such patients in the thirty-eight rural
clinics of the Health Campaign, which extends systematically through-
out the country.

In Trujillo City— a Health District of 125,000 inhabitants— the
Department of Public Health conducts a venereal disease clinic for
men and an anti-venereal hospital for women, with a capacity of
twenty patients. Both services are in charge of specially trained
physicians, who are assisted by a sufficient number of trained
personnel.

In addition to these two special centers, in three other large cities
of the country the Municipal governments of the respective com-

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 405

munities maintain small anti-venereal clinics which are in charge of
physicians of the Department of Health.

The official statistics regarding the principal venereal diseases
reported in our country in the year 1943, show a total of 25,788 cases
of syphilis, with an incidence of 14.8 per 1,000 inhabitants, and 5,637
cases of gonorrhea with an incidence of 3.0.

The Sanitary Legislation in force in the Dominican Republic pro-
hibits prostitution, considered a source of venereal disease. At the
same time penalties are provided for persons who transmit these
diseases. The State is obligated to provide free treatment for such
persons, and they are compelled by law to submit to treatment. If
necessary, they may be hospitalized by compulsion of the health
authorities, with the aid of the police, for protection of the public
health. In addition, legislation regarding duties of the police, pro-
vides that they shall search out and investigate the secret centers
of prostitution, which they are charged with suppressing as foci of
immorality and vice. The strongest defense of the family against
the social evil and transmission of disease to children is our law
adopted in the year 1943, which requires premarital health certifi-
cates throughout the Republic.

We are glad to say that the Dominican Army has brought venereal
diseases under control almost entirely among the members of the
Republic's armed forces. As a requirement for acceptance, all who
intend to enlist for military service, and also for the National Police,
are obliged to submit to a rigorous physical examination and to prove
themselves free from syphilis or other venereal diseases. Following
admission to service, military or police, any infection which appears
will be discovered in one of the frequent physical examinations which
are conducted in accord with the disciplinary regulations of our
military bodies. In addition, servicemen and members of the police
are obliged to observe strict prophylaxis in their sexual relations.

The Department of Public Health of the Dominican Government
recognizes the necessity and the advantages which lie in the central-
ization of the antivenereal campaign in an officially directed organi-
zation, and has under way a project for the establishment of a
Division of Social Hygiene within this Department In preparation
for this we have sent physicians on scholarships to the United States,
where they are studying venereology as a specialty and gaining the
necessary technical knowledge concerning organization, so that a plan
of compaign suited to the needs of our country may be recommended.
In this plan will be included the establishment of a medical center
for the diagnosis and treatment of the venereal diseases, more hos-
pitals exclusively for patients suffering from these diseases, reor-
ganization of the venereal clinics, establishment of laboratories
especially for serving these clinics, and a campaign for public edu-
cation, including information concerning scientific prophylaxis follow-
ing sexual relations.

406 JOURNAL OF SOCIAL HYGIENE

FACTS ABOUT THE DOMINICAN REPUBLIC

Area — 19,332 square miles Population — 1,768,162

Capital — Ciudad Trujillo; population 71,297 Language — Spanish

Unit of currency — U. S. money is principal circulating medium.

People — Of Spanish culture, the people are about two-thirds mestizo (Spanish
and Indian), about 20 per cent Negro and about 13 per cent white. Nearly
five-sixths of the population is rural.

Climate and Physical Characteristics — Occupies the eastern two -thirds of the
mountainous island of Hispaniola, some fifty miles southeast of Cuba and an
equal distance west from Puerto Eico. Temperature averages about 78° with
little variation. Rainfall is usually heavy.

Government — The present constitution, that of 1934, provides for separation
of powers into legislative, executive and judicial branches, prohibiting the
delegation of functions by any. Legislative power is vested in the Congress,
composed of a Senate and a Chamber of Deputies, all elected by direct vote
for four-year terms. There is one senator from each of the 15 provinces and
the Federal District, and one Deputy for each 30,000 persons, or at least
two from each province. Executive power is in the president and vice-president,
elected by direct vote for terms of four years, assisted by various cabinet
officers. Suffrage is extended to all male Dominicans who are married or have
reached 18 years, and individual rights of life and property, freedom of speech
and peaceful association, of teaching and personal security, are guaranteed by
the constitution.

Education — A National Council of Education, composed of four members
appointed by the president, controls the educational system. The country is
divided into 33 school districts in two administrative areas called intendencias.
There are 859 primary schools, of which 788 are government-supported, with
over 160,000 pupils, and education in agricultural pursuits is stressed. The
nine secondary schools have approximately 1,800 students. There are about
50 vocational and night schools, and nine teachers' colleges. The University
of Santo Domingo, chartered in 1538, has 700 students training in philosophy,
law, medicine, pharmacy and chemical sciences, dental surgery, exact sciences,
agronomy and veterinary medicine.

Public Health — The National Department of Health is headed by a cabinet
member, and funds devoted to public health and welfare in 1939 amounted
to 478,600 pesos, or 4.1 per cent of the national budget. The Republic was
the first country in the Americas and probably in the world to make diphtheria
immunization compulsory. Two types of organizations administer the program
of health education, immunization, and preventive work against venereal disease,
tuberculosis and malaria: public dispensaries, and sanitary brigades which travel
over the country.

407

HAITI

JULES THEBAUD, M.D.
Director General, National Service of Health and Public Welfare

Demographic and Social Aspects:

The Republic of Haiti has an area of 28,676 square kilometers and
an estimated population, according to studies made by the section
of biostatistics of the National Health Service of Haiti, of 3,000,000
inhabitants or a density of 139 people per square kilometer. Under
the inadequate conditions in which registration of births and deaths
are made, and which indeed have brought about the reorganization
of the Service charged with this work, a birth rate of 14.4, and a
death rate of 4.4 have been recorded.

The rural population of the Republic is estimated at 2,400,000
and the urban at 600,000.

The rural groups are located chiefly in the plains, whose surface
covers not more than 2,500 square kilometers, a little more than a
tenth of the country's whole area.

The lack of rapid means of communication, not only between
the rural groups but also between the rural areas and the towns,
helps to safeguard the integrity of the country people and to protect
them in a great measure from the vices of civilization against which
the efforts of social hygiene are directed. To this may be added the
partial survival of polygamy which, although it is illegal, is accepted
among the country people as constituting true marriage, and which
naturally limits promiscuous sexual activity among them. Also
emphasis is placed on preservation of ancient and prudent tradi-
tions, and these maintain in the heart of the country family an
atmosphere of morality, a true barrier set up against prostitution
and other sophisticated customs which tend to corrupt morals in^
their sexual aspects.

On the other hand, social hygiene problems are acute among the
urban group.

The principal cities, to the number of a dozen, Port-au-Prince,
Cap-Haitien, Cayes, Jeremie, Jacmel, Port-de-Paix, St. Marc,
Gonaives, Maragoane, Petit-Goave, and quite a number of other
towns of lesser importance are strung out along the coast and are
ports open to foreign commerce.

408 JOUKNAL OF SOCIAL HYGIENE

Nearly all of these towns are built in valleys at the foot of rather
high mountains. The middle ground and the heights are occupied
chiefly by the aristocracy and the middle classes. The greater part
of the city's population lives at the foot of the towns and along the
shores, often under most unhealthful conditions. The population
is made up of sailors, fishermen, small merchants, porters, and
peddlers, who live in general promiscuity. To a great extent these
impoverished people come from the rural sections and slowly abandon
their country ways. But they become easy prey to the corruption
of the city.

Also, in the crowded hovels, which permit no privacy, the sexual
act is despoiled, often, of all sentiment and becomes an ordinary
routine affair. One naturally finds in these districts the sources
of prostitution. It is chiefly in persons of that profession that syphilis
and gonorrhea are found.

Special Conditions:

A common aspect of the social hygiene problem is found particu-
larly in Haiti, in that the gulf which in the social order separates
the rural and city masses from the aristocracy does not exist in
the fields of sexual relations.

From that point of view there is a decided mingling between
apparently distant social classes. To each family is attached a domes-
tic staff composed in the greater part of women from the lower class.
Often enough these girls happen to tempt the sexual appetite of
the sons of the family, and they are no more particular about sex
relations with others outside the family. From this situation there
is great danger of infection and a new field of spread for syphilis
and gonorrhea, if these members of the servant staff suffer from
these diseases.

The situation is aggravated also by the fact that there are in
the principal cities a certain number of uncontrolled houses of
prostitution.

The recent introduction of certain commercial enterprises in Haiti,
the industrialization projects now under study, and the economic
developments which spring from them are factors encouraging means
of communication between the towns and the country and thus aiding
in an increase of the venereal diseases among the rural people.

Social and Medical Measures: »

These are the problems. Now let us consider the duties of the
agencies charged with social hygiene control in Haiti, from the double
viewpoint of prevention and cure.

The important subject of social hygiene, for financial reasons,
still remains more or less mingled with the general group of problems
which relate to public health. It is not yet the duty of a separate
bureau, with social service workers to search out the carriers of
infection, report them to the Sanitary Police, and place them in

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 409

contact with agencies which can provide necessary treatment; to
follow up those who are inclined to stop their visits to the clinics;
and to confer with employers on behalf of sick employees. In this
respect, the work is differently organized than in the United States
and in the other Latin American countries.

At present the task of combating the venereal diseases rests with
the National Service of Public Health and Social Welfare, organized
in 1919. It has under its direction ten Health Districts, and a
total of ten hospitals, nine asylums, and 124 rural dispensaries and
clinics. Therefore the campaign against these diseases is conducted
at present on a double front, in the cities and in the rural districts.

In each hospital there is a dispensary for men and women, where
are maintained consultation and treatment services for ambulatory
cases. All the hospitals have wards, semi-private and private accom-
modations for patients whose conditions necessitate hospitalization.

In the rural districts, the treatment of venereal diseases is con-
ducted by the doctors and nurses in the dispensaries and clinics.
The nine asylums, situated some kilometers away from the District
headquarters, also join in the campaign against venereal diseases.
Syphilis is responsible for a large percentage of causes of certain
disabilities, and needy persons are kept in these institutions until
they are able to work again. Here are the statistics of our Health
Districts, taken from the Bulletin of the National Health Service
for the period 1941-42 :

SYPHILIS GONORRHEA

Cases under Observation Cases under Observation

Syphilis, s.a.i 89,145 Gonorrhea 5,002

Acquired syphilis 3,445 Gonorrheal (conjunctivitis) .... 952

Congenital syphilis 581 Gonorrheal orchitis 51

Syphilitic gummas 506 Gonorrheal cystitis . . 105

Syphilitic ulcers 28,415 Gonorrheal urethritis . . 179

Bone afflictions 5,037 Vaginitis 12

Vulvitis 5

Ophthalmic gonorrhea 44

CHANCROID
Cases under Observation

Chancres, s.a.i 11,380

Phagedenic ulcer 934

These statistics need interpretation, for they give only a slight
idea of the extent of venereal diseases in Haiti, and are not correlated
with actual social and biostatistical findings. To complete these
figures, it would be necessary to add those of the Hospital of St.
Francois de Salles, and of the Asylum Frangais, two charitable insti-
tutions in Port-au-Prince which take care of a great number of
indigent patients infected with venereal diseases. It would be desir-
able also to take note particularly of the role played in the cities
by private physicians treating these diseases. Syphilis and gonorrhea
are still shameful diseases in the eyes of city-bred Haitians, and
the great majority of city-dwellers seek the help of private physicians

410 JOURNAL OF SOCIAL HYGIENE

to treat these infections. On the other hand, a good number of
patients try to treat themselves, often by dangerous or uncertain
means, or, as in the rural areas, with home remedies.

From the point of view of treatment, the campaign against the
venereal diseases has made notable progress, but it would not be
possible to say the same concerning preventive medicine. Aside
from the advice and information given patients at the time they
receive treatment from the physicians in hospitals, rural clinics and
dispensaries, and asylums, or in charitable institutions or by private
practitioners, it is hardly possible to say that education exists.
Because of the lack of a special section charged with social hygiene
work, the education of the masses is not organized.

Neither is the repression of prostitution as yet established. How-
ever, in the Haitian National Guard, the Health Service maintains
a strict supervision, with the idea of revealing what service men
are infected with venereal diseases. The sick soldiers are properly
treated, being provided with a card by means of which they are
followed until their treatment is completed.

All these different angles enter into a project now being studied
to set up a Section for Social Hygiene. That project is part of
a great health program being undertaken by the Direction Generale
of the National Health Service, with the help of the Haitian Gov-
ernment, of the American Sanitary Mission and of the Pan American
Sanitary Bureau.

In addition to two Health Centers which are actually functioning,
many others are being built in connection with the training of visiting
nurses. In their duties as liaison representatives, they will coordinate
their activities with those of the Sanitary Police, with a view of
finding venereal infections in the suburban groups, of tracking down
the sources of these infections, of providing counsel and putting
the infected persons in contact with the agencies whose duty is to
treat and cure.

FACTS ABOUT HAITI

Area — 10,700 square miles Population — 3,000,000

Capital — Port-au-Prince; population 125,000 Language — French

Unit of Currency — The gourde, worth 20 cents in U. S. currency.

People — Haiti is the only French-speaking republic in America. Nine-tenths of
the population is engaged in agriculture. Possibly as many as ninety per cent
of the inhabitants are Negro, with about ten per cent mulatto.

Climate and Physical Characteristics — Occupying the western third of the island
of Hispaniola, about 50 miles southeast of Cuba, and ranking next to Cuba
in size among the West Indies, Haiti consists largely of two peninsulas pro-
jecting westward, giving the country an extensive seacoast for its area. Tem-
perature averages 70° to 85° with slight variation between summer and winter.
Wet seasons occur in spring and fall.

Government — A constitutional republic with the three customary branches —
legislative, executive and judicial. Administration of local governments or

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 411

communes is under direct control of the President, elected by the people for a
term of five years, and a maximum of two terms. The Constitution provides
suffrage for men and women over 21 years. The people elect a Chamber of
Deputies of 37 members apportioned among the arrondissements into which the
five departments of the Eepublic are divided. The Senate consists of 21 members,
eleven elected by the Chamber and ten appointed by the President. As the
National Assembly, the two houses convene in separate sessions annually on
January 15 for three months.

Education — The Constitution makes primary education obligatory, but the
system is handicapped by lack of funds and trained teachers. Urban education
is under the Ministry of Public Instruction, and rural education under the
Ministry of Agriculture. While the urban system, patterned on the French,
has stressed eradication of illiteracy and classical education, rural schools follow
American influences in attempting to establish a school-community bond and
to meet specific pupil needs. A movement is under way to reorganize urban
education to adapt it to local conditions. About 64,500 children are enrolled
in primary schools and 5,364 in secondary schools. There are also 10 vocational
schools, 4 private commercial schools, one normal school for training women
teachers, the Normal Section of the Practical School of Agriculture for training
men teachers in the rural schools; and separate professional schools in law
(under the Department of Public Instruction), engineering (private), Medi-
cine (under the Public Health Service), the Military School to train officers
in the National Army and police force, the Ecole Apostolique which trains for
the Catholic priesthood, and the School of Ethnology (private).

Public Health — -The greatest health problems of the country are malaria,
yaws, waterborne diseases, venereal diseases, and intestinal parasites. Tubercu-
losis figures are high. The National Public Health Service, organized in 1919,
under the Ministry of Interior, had for the fiscal year 1939-40 an appropriation
equivalent to $508,000. The country is divided into health districts, and medical
service is available through 11 hospitals, two asylums, a Communal Hospital
and a health center at Port-au-Prince, and in rural clinics. The American
Sanitary Mission in Haiti, which is the name of the cooperative service of the
Institute of Inter-American Affairs there, operates a malaria laboratory in
Port-au-Prince.

412

JOURNAL OF SOCIAL HYGIENE

HONDUEAS

DE. PEDEO H. OED6tfEZ DIAZ *
National Director of Public Health

Adequate importance has not yet been placed on social hygiene
among health activities in our country. The same procedures regard-
ing venereal diseases are still practiced as have been going on for
many years, although we realize that new methods can do much to
prevent and control these diseases, and that they are a cause of
degeneration of the race, and a cruel inheritance for posterity.

Fortunately we are now joining in the development of a campaign
with the Inter-American Public Health Service, and have in process
of planning an organization of efforts to find and treat venereal
diseases, which we hope will eventually bring satisfactory results.

This campaign, however, is not far enough along to permit any
useful description of its organization or methods, or to provide any
statistics as to the extent of the problem in Honduras. After a year
or so of work we shall be better able to report progress. The prob-
lem certainly merits the greatest care and attention, as upon its
solution depends to a great degree the welfare of humanity. Venereal
diseases at this time should more than ever be combated, since
science now is able truly to make them disappear from the face of
the earth.

FACTS ABOUT HONDUEAS
Area — 46,332 square miles

Population— 1,109,833

Capital — Tegucigalpa; population 47,223 Language — Spanish

Unit of Currency — The lempira, worth 49 cents in U. S. currency.

People — The influence of the inhabitants before Spanish invasion, that is the
Aztecs and other Indian peoples, is still strong in the culture. About nine per
cent of the people are Indians, 85 per cent mestizos, some three per cent white
and three per cent of other races. Agriculture, stockraising and mining are
predominant industries.

'Abstracted from a letter of November 20, 1943, to Dr. William F. Snow,
American Social Hygiene Association.

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 413

Climate and Physical Characteristics — Third largest of the Central American
countries, Honduras is also the most mountainous. It borders Guatemala on
the west, Nicaragua on the southeast, and El Salvador on the southwest, with
the Caribbean Sea lying along its 440-mile north shore, and the Gulf of
Fonseca (Pacific Ocean), rimming it for 40 miles on the south. The climate
is tropical along the coasts and cooler in the high interior. The rainy season
begins in May and continues until the middle of November.

Government — There are seventeen departments, each headed by a governor
appointed by the President. The Constitution which went into effect in 1936,
substantially a revision of the 1924 Constitution, provides for legislative power
to be exercised by a Congress of Deputies elected for six-year terms, one for
each 25,000 inhabitants, by popular vote. The President and Vice President
are similarly elected for six-year terms, and a Cabinet assists the President
with administration of the government. Certain definite regulations are laid
down by the government respecting labor; and the family, as the fundamental
unit of society, is provided with effective aid for maternity and the protection
of minors.

Education — Primary education is free and compulsory for children between
seven and 15 years. An enrollment of approximately 42,200 is in 900 primary
schools. Upon completion of the five-year primary course, a secondary school
course of five years follows, with special training preparatory for professional
courses in law, medicine, pharmacy, or engineering; and with teacher training
offered in 16 secondary schools. There are separate, national vocational schools
for boys and girls, and a National Commercial School. Higher education is
obtainable at the Central University of Honduras, which has schools of law,
medicine, pharmacy, and sciences. A campaign against illiteracy is carried
out in the night schools, barracks and prisons. The educational system is
under the direction of the Minister of Education.

Public Health— Public health work is carried out by the Minister of Interior,
Justice and Health, through the National Department of Health, with its divi-
sions of Child Welfare, Tropical Diseases, Sanitary Engineering, Sanitary Police,
Venereal Disease Control and Laboratories. Among principal activities of the
Department are work against malaria and intestinal parasitoses, including
treatment ; smallpox vaccination ; child welfare clinic and milk station ; national
tuberculosis sanatorium; inspection of food; inspection of industrial premises;
improvement of water supplies; examination and treatment for venereal dis-
eases; and health education. There are 12 hospitals in Honduras, with something
over 1,000 beds, a school of medicine in the Central University, and a school
of nursing.

The Inter-American Cooperative Health Service in Honduras has undertaken
22 major health projects, in helping to support and extend the work of the
National Department of Health. A technical field party has aided in estab-
lishing clinics for tuberculosis, venereal diseases, communicable diseases, and
maternal and child health; in improving water supplies and waste disposal; in
setting up health centers and first aid dispensaries; and in health education
through motion pictures, pamphlets and other means. Three doctors have been
sent to the United States for graduate study, and other personnel are being
given training. A new building is being constructed in the capital to house
a health center, the four chief clinics, and the National Department.

414 JOURNAL OF SOCIAL HYGIENE

MEXICO *

Up to 1920 activities for the control of venereal diseases were limited
to weekly inspection and registration of prostitutes in Mexico City
and some of the State capitals. A few of these women were kept
briefly where they received perfunctory treatment. This, as can
be well understood, was not enough to make a non-infectious case out
of an infectious one, much less to prevent relapses of infection.

In 1920 the first anti-venereal dispensary was established, in Mex-
ico City, to fulfill the need which was being felt more and more,
of facilitating the treatment of numerous sufferers among the civilian
population. These had been neglected and stigmatized, hiding their
sufferings in their shame, and thus becoming active and efficient
carriers of disease.

Success was immediate, and the benefits so evident that soon a
second dispensary of the same type was established. One can safely
say that the foundation of these two dispensaries marked in Mexico
the beginning of a new health policy as regards the prevention of
venereal diseases, as well as the beginning of the real campaign
against this evil to humanity. By placing this work on the same
epidemiological basis as other communicable diseases, improvement
and development were enabled.

Little by little the number of dispensaries was increased in the
Capital, and in 1926, when the work of the Department of Health
was extended throughout the country, similar treatment centers were
established in all the more densely populated centers.

Organization and Administration

At present there are 60 specialized anti-venereal clinics distributed
among the principal cities of the Eepublic, with 430 Health Centers
for smaller towns and 130 in rural areas. These last two services
have a general program, part of which is devoted to activities in the
campaign against venereal diseases.

All the work of the campaign is under the direction of a Central
Office with a full-time specially trained physician in charge.

* A paper prepared by the Central Technical Office of the Campaign against
Venereal Diseases, of the National Department of Health, Versalles, No. 49,
Mexico City, Mexico.

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 415

Hospital Facilities

The Hospital Morelos in Mexico City has long been the chief facility
for care of infectious cases. At present this institution is undergoing
reorganization and alterations so that it can more adequately carry
on this work. In the States, arrangements have been made with
local authorities to set aside beds in city or municipal hospitals in
every zone, for the interning of urgent cases.

Basic Outline of the Program

Each Antivenereal Service directs its work towards the following
objectives :

a. Control of cases during infectious period;

b. Adequate treatment to prevent relapses of infection ;

c. Prevention of congenital infections;

d. Discovery of new cases and follow-up of patients under treat-

ment;

e. Educational activities.

Drugs are provided free of charge. Methods of treatment for
syphilis are according to the standards formulated by the Clinical
Cooperative Group; for gonorrhea, those of the American Neisserian
Medical Society are used.

The principal venereal clinics have the necessary laboratory equip-
ment for microscopic examinations, and during the last few years
the darkfield examinations, have been emphatically insisted upon, so
that at the present time, many of the Services make them as a routine
practice. For serological tests there is a chain of regional laboratories
to which blood samples are sent.

Growing attention is being paid to the investigation of contacts
and a small corps of public health nurses with special venereal dis-
ease control training is available for the necessary field work.

Since venereal disease control is a comparatively new effort among
us, many difficulties are encountered, but the preliminary results
are favorable and encourage continuance with enthusiasm until the
anticipated goal is reached.

Educational Program

The educational program, which is now being intensified, is for
the purpose of bringing to the general public information concerning
the dangers of venereal diseases. Outside of the ample financial
resources made available to the different services as mentioned above
for educational work, they have been urged to adopt the following
routine: At least once or twice a week a 5- or 10-minute lecture
shall be given while the patients are in the waiting-room, before
treatment begins; a paragraph or two from an approved pamphlet
shall be read to them, followed by explanation and comments in the
simplest words, and if possible showing illustrative photographs, or
other graphic materials.

Educational leaflets and colored posters are used, and efforts are
being made to increase the use of silent and sound films.

416 JOURNAL OP SOCIAL HYGIENE

With the cooperation of the National University, of the National
Association of Venereology and of the Mexican Society of Derma-
tology, the Central Office arranges yearly student and postgraduate
courses in venereal disease control.

During the National Health Week, ' ' Antivenereal Day" is
celebrated.

During the year 1944 a training center has been established for
instruction regarding treatment and control of the venereal diseases.
This is conducted in Mexico City and as its name implies, has as
its objective the inculcation of the fundamentals in the work of the
antivenereal campaign. This is principally for the personnel of the
Department of Health and Welfare, but is also available to the per-
sonnel of other official departments or institutions as well as to
private physicians.

The center has developed three types of activities :

a. Dispensary

b. Laboratory

c. Specialized training per se

It is thought of as in-training service, that is, as a unit which uses
the practical tasks of the dispensary and laboratory to provide part
of the specialized training which is its fundamental objective.

The center will sponsor semi-annual medical conferences to discuss
diagnosis, laboratory techniques, treatment methods, preventive
methods, educational techniques, social problems, etcetera, concerning
the venereal diseases. It is hoped that these meetings will attract
the special attention of private physicians and officials connected in
one way or another with the problems and programs of the venereal
campaign, so that they may become interested and lend their cooper-
ation for the accomplishment of its objectives.

i
Legislation

In the Federal District and the Territories, the weekly registra-
tion and inspection of prostitutes has been abolished since 1940 ; and
also since that time the Penal Code has prescribed punishment for
knowingly infecting others with a venereal disease, for the solici-
tation of prostitution, exhibitionism, the conduct of bawdy houses
or other business connected with prostitution, or for contributing to
the delinquency of minors.

Various States of the Republic are adopting similar legal measures
within their own jurisdictions, and thus we are able to say that the
campaign for the elimination of prostitution is under way. In this
field of work, however, there is a tremendous task ahead, because
some of the other States are recalcitrant and continue to hold out for
the system of licensed or regulated prostitution.

There is a Federal health regulation which includes the following
provisions :

SOCIAL HYGIENE IN THE OTHER AMERICAN" REPUBLICS 417

Compulsory reporting of cases by private physicians; compulsory
treatment; enforced hospitalization where necessary; premarital
examinations as a legal requisite for marriage; compulsory appli-
cation of the Crede Method for all newly-born infants ; the obligation
of various federal, State and municipal authorities, as well as Labor
Unions, to cooperate in the antivenereal campaign by establishing
clinics or aiding in the maintenance of them.

International Cooperation

To deal with war emergency problems, a cooperative program along
the Mexican-United States Border was established in 1941, for the
more vigorous combating of venereal diseases. Because of war con-
ditions, these infections were finding new and propitious means for
their spread. This program, under the auspices of the governments
of the two nations, has been progressing favorably under close,
friendly, and mutual cooperation

The best results have been obtained in the City of Juarez, Chi-
huahua. Municipal authorities there have lent their aid to the
program by taking proper steps toward .repression of prostitution,
and the City of Juarez is serving in many ways as a model and
example for the rest of the country, including the Capital.

One of the most satisfactory results of this program of inter-
national cooperation has been in regard to educational work.

Various carefully selected groups of medical health officers have
received fellowships from the Pan American Sanitary Bureau in
order to take postgraduate work in the U. S. Public Health Service
Medical Center at Hot Springs National Park, Arkansas, and at
Johns Hopkins University. Some laboratory experts have been sent
to the U. S. Public Health Service Research Laboratory for Venereal
Disease Control, at Staten Island, New York; and a group of public
health nurses were sent to the School for Nurses at San Antonio,
Texas. This splendid cooperation has already shown good results.

Also definite advances have been made in the field of scientific
publications, thanks to the Bulletin Information sobre Enfermedades
Venereas and to the pamphlet, Programa Minimo de Trabajo para
Dispensaries Antivenereos, edited by the Pan American Sanitary
Bureau, published in Mexico, and distributed throughout the Amer-
icas. Posters, moving pictures, and other popular educational
materials are also being used in the campaign.

Cooperation of Private Physicians

The laboratories of the Health Department without exception
attend to the requests of private physicians for free laboratory
examinations for the diagnosis of venereal diseases.

It may be added, however, that up to this time, it has not been
possible to get private physicians to cooperate fully as regards the
reporting of venereal cases. Efforts towards this end continue.

418 JOURNAL OF SOCIAL HYGIENE

The National Association of Venereology

This medical society, made up of physicians, official and private,
specializing in this subject, and having members throughout the
country, collaborates fully in the campaign and publishes bi-monthly
the Archives Mexicanos de Venereo-Sifilis y Dermatologia.

Conclusion

In this report effort has been made to give a picture of the present
principal features of the antivenereal campaign in Mexico. For the
sake of brevity, and since the purpose has been to tell about the work
in general, many details have been omitted.

UNITED STATES-MEXICO BORDER COOPERATIVE
VENEREAL DISEASE PROGRAM

JOSEPH S. SPOTO, M.D.

Surgeon, U. S. Public Health Service, Traveling Representative,
Pan American Sanitary Bureau

In the winter of 1941 the attention of the U. S. Public Health
Service was called to the fact that with the increase in our defense
and war efforts there was a corresponding increase in the inter-
mingling of the civilian and military populations along the United
States-Mexico Border and with it an accompanying increase in the
venereal disease rates, especially among the military personnel
stationed along the border.

Due to the international nature of the problem the matter was
referred to the Pan American Sanitary Bureau. A joint study
made between representatives of the Federal Health Department of
Mexico and the U. S. Public Health Service revealed that most of
the larger communities on the United States side of the border
offered fairly adequate facilities for the control of the venereal
diseases. On the Mexican side of the border the facilities available
were very inadequate. Commercialized prostitution was more flagrant
on the Mexican than the United States side of the border. It was
also recognized that the control of the venereal diseases among the
civilian as well as the military population on either side of the
border would not be practical without a coordinated cooperative
control program on both sides of the international boundary. On
February 5, 1942, a cooperative venereal disease control program
was initiated between the Pan American Sanitary Bureau, the U. S.
Public Health Service, and the Federal Health Department of
Mexico. In order to coordinate the activities and assist with the
development of the venereal disease program on the border, the Pan
American Sanitary Bureau established a regional office in El Paso,
Texas.

During the first year of this cooperative endeavor 17 Mexican
physicians were designated by the Federal Health Department of
Mexico for the purpose of receiving postgraduate training in the

SOCIAL HYGIENE IN THE OTHER, AMERICAN REPUBLICS 419

United States in the control of the venereal diseases. Upon com-
pletion of their training period, nine were assigned to the venereal
disease clinics along the Mexican border and eight were assigned
to other venereal disease control centers in Mexico. Up to the
present time a total of thirty-two physicians, fourteen nurses and
three laboratory technicians have completed their post-graduate
training in the United States.

During the present calendar year a demonstration and teaching
center was established in Mexico City for the purpose of training
the personnel employed in the venereal disease control program in
Mexico. The center is fully equipped including a serologic and bac-
teriologic laboratory. The teaching staff is composed of well trained
individuals within their particular fields. It is anticipated that new
employees, as well as all physicians, nurses, social workers and
laboratory technicians now employed in the venereal disease control
program in Mexico, will in the course of time spend a training
period of several months in the center. Besides overcoming the
language difficulty experienced by the Latin-American trainees in
the States, this center will offer the opportunity of training a larger
number of individuals, per year, than could be trained through
the available fellowship funds provided by voluntary and official
agencies.

There has been a marked improvement in the quality as well as
the quantity of work done on the Mexican side of the border. Besides
the enlargement of the existing treatment facilities, new centers
have been established. The clinics are well equipped and drugs and
supplies are furnished in sufficient quantities. A laboratory has been
established in Ciudad Juarez, Chihuahua; and by the end of the
present calendar year another will be installed in Nuevo Laredo,
Tamaulipas, Mexico. The Federal Health Department of Mexico
has more than doubled the personnel assigned to the venereal disease
control centers on the border.

We are grateful for the splendid cooperation received from state
and local ' officials on both sides of the border. Practically all
Mexican border communities have made provisions for the isolation
of infectious cases in their municipal hospitals. They have also
assisted considerably in the program by providing needed additional
space and in some instances, additional personnel for the treatment
centers. An outstanding contribution by state and local officials
on the United States side of the border was the performance of
the vast majority of the serologic tests for syphilis for the Mexican
clinics until the laboratory in Ciudad Juarez was made available.

The El Paso office of the Pan American Sanitary Bureau has
served as the connecting link in the liaison activities carried on
between the health agencies of the United States and Mexican sides
of the border. All contacts and sources of infection, especially
among military personnel, are reported to this office, which in turn,
makes the information available to the control officer in the com-
munity of its origin. A constant effort is being made to improve

420 JOURNAL OF SOCIAL HYGIENE

the epidemiologic studies made in the border clinics. The liaison
established between the United States and Mexican local officials
has, insofar as the venereal diseases are concerned, erased all
international boundaries.

As a means of better coordination of the health activities on the
border, a conference was called by the Pan American Sanitary
Bureau of health officials on both sides of the border, which was
held in El Paso, Texas, and Ciudad Juarez, Chihuahua, Mexico,
in June of 1943. As an outgrowth of this conference the United
States-Mexico Border Public Health Association was organized, for
the purpose of continuing the interchange of knowledge, as well
as cooperating in the establishment of coordinated and cooperative
public health activities along the border. The Association held its
second annual meeting May 30-June 1, 1944. The first two meetings
of the Association have been crowned with marked success and with
their continued enthusiastic support and splendid cooperation many
public health improvements along the border will undoubtedly result.

The educational activities emanating from the El Paso office of
the Pan American Sanitary Bureau have included the publication
of a bulletin entitled Information Sobre Enfermedades Venereas
(consisting of Spanish translations of articles appearing in Vener-
eal Disease Information, published by the U. S. Public Health
Service), and the publication of minimum standards for venereal
disease control activities entitled Programa Minima para Dispensaries
Antivenereos which has been established as a minimum program
by the Federal Health Department of Mexico. Ten different posters
have been printed and are now in the process of distribution. Films
and lantern slides have been made available to the various groups
for educational purposes. Conferences and lectures have been held
by members of the staff among professional and lay groups.

It is felt that this cooperative effort has served as a stimulus
for the development of a program for the repression of prostitution
in Mexico. The first border community, and incidentally the first
community in Mexico, to institute a repression program was Ciudad
Juarez, and a rigorous repression program has been maintained.
The immediate lowering of the venereal disease rates in troops sta-
tioned in cantonment areas near Ciudad Juarez exemplified the
benefits of such a program.

On September 18, 1942, the President of the Eepublic of Mexico,
Manuel Avila Camacho, addressed a letter to the Governors of the
States and Territories, and to Executives of the nation, requesting
that the repression of prostitution replace the legalization and regula-
tion of prostitution. Several states in the Mexican Republic have
complied with this request. Of the border states, the State of Sonora
was the first to institute repressive measures, closing all houses of
prostitution in the border communities on September 2, 1943.

In this connection, at the United States-Mexico Border Public
Health Conference in June of 1943, at which time the United

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 421

States-Mexico Border Public Health Association was organized, the
following resolution was adopted :

A RESOLUTION IN RE REPRESSSION OF PROSTITUTION
(Adopted at Juarez-El Paso Conference, June 15-16, 1943

WHEREAS : Vigorous repression of prostitution in all of its forms has
been repeatedly demonstrated to be an effective measure for reduction of
the incidence of venereal diseases among the armed forces;

AND WHEREAS: This policy has been promulgated on the north side
of the Border by the Army, Navy, Public Health Service, Social Pro-
tection Division and the American Social Hygiene Association; and on
the south side of the Border by President Avila Camacho himself;

THEREFORE BE IT RESOLVED:

1. That the Mexico-United States Border Health Conference now in
session urges faithful compliance with this policy not only with respect
to organized houses of prostitution but also the practice of prostitution
through any other avenues whatsoever such as honky tonks, taverns,
tourist courts, hotels, etc.

2. That necessary laws be enacted and energetically enforced by the
State and/or local authorities concerned in order to assm-e adequate
repression of prostitution which will include specially severe penalties
upon those who facilitate ihe practice of prostitution such as taxicab
drivers, bell-boys, hotel-keepers, and others who may be aiding and
abetting this practice, as well as suitable penalties upon prostitutes
themselves.

3. That consistency demands repression of prostitution in ALL localities
on both sides of the Border regardless of race or color.

4. That this Conference will appreciate an unqualified adherence to the
policy herein set forth as an important contribution toward prompt and
certain victory.

State laws legalizing and regulating prostitution have served as
a serious handicap in our cooperative control program. The Mexican
people are realizing that the archaic procedure of periodic exami-
nation of the prostitute in an attempt to diminish the number of
infections has met with total failure. It is only through the elimi-
nation of the brothels and the maintenance of a rigorous repressive
program that the number of sexual contacts with infected individuals
can be diminished. We believe that in the course of time more
states will recognize the value of repressive measures.

422 JOURNAL OF SOCIAL HYGIENE

FACTS ABOUT MEXICO
Area — 758,258 square miles Population — -19,546,135

Capital — Mexico City Language — Spanish

Population, including Federal District, 1,749,916

Unit of Currency — The peso, worth 21 cents in U. S. currency.

People — Mexican civilization goes back to 1000 A.D., and the influence of the
ancient Toltec and Aztec culture, though the people are both progressive and
modern, is still strong in most phases of Mexican li'fe. Although the greatest
wealth is in minerals, rubber and petroleum, agriculture is the basic industry,
more than sixty per cent of the people living in rural communities. There is
wide variety of customs and dialect among the states which make up the
Republic.

Climate and Physical Characteristics — The area is roughly seven-eighths the
size of that part of the United States east of the Mississippi. Two mountain
chains traverse the country northwest-southeast, forming between them a number
of valleys and plateaus, of which the great central plateau is the dominant
feature. The climate varies with altitude, from a mean temperature in the
lowlands of 80° to 90°, to 70°-80° in the temperate plateau of average 6,000
feet elevation, and about 60° in the cool regions over 8,000 feet.

Government — The Republic of Mexico is divided into 28 states, a Federal
District, and three territories. The Constitution of 1917, similar to one of
1857 except for important provisions concerning social welfare, labor and the
land, provides for internal sovereignty of the states, and for a Federal govern-
ment of the usual three branches. Congress consists of a Senate whose members
are elected, two from each state, for terms of six years; and a Chamber of
Deputies, elected one for every 100,000 inhabitants, for three-year terms. None
of these officials may be elected for consecutive terms, nor may the President,
who is chosen by direct, popular vote for a six-year term, return to office.
The President's function is to promulgate and execute the laws of Congress,
with the help of a cabinet of 11 secretaries of state for various departments,
and five autonomous departments.

Education — Primary education is free and compulsory. More than 1,000 schools
are supported by the Federal Government in urban communities in addition to
several thousands in rural districts, while the states maintain about 5,700 in
the cities and a larger number in the villages. It is estimated that almost
one million children attend the city primary schools and nearly that number
are registered in rural schools. Students enrolled in government secondary schools
number about 8,000, with some 4,000 in private schools. The National Prepara-
tory School in Mexico City, and a number of institutes in the states provide
pre-professional training. Courses in teacher training for primary schools are
given in 12 federal, 39 state, and 26 private schools. The National University
has schools of philosophy and letters, architecture, plastic arts, music, law,
economics, commerce and administration, medicine, dentistry, veterinary science,
engineering and chemistry. There are several other centers of higher education
and vocational schools of advanced grades.

Public Health — The National Department of Health cooperates with the states
through the "Cooperative Health Services" in a variety of activities carried
on by traveling sanitary brigades, local health units, and special types of
units in the ejidos or collective agricultural communities. Appropriations for
public health work increased from 3,466,759 pesos in 1925 to 16,500,000 in 1939.
Among the most serious health problems are malaria, tuberculosis, intestinal
parasites and waterborne diseases, infant mortality, venereal diseases, and
leprosy.

Societies

Asociacion Nacional de Venereologia, Hospital Morelos, Mexico, D.F.
Sociedad Mexicana de Dermatologia, Mexico, D.F.

Sociedad Mexicana "Jose Torres" de Profilaxia Sanitaria y Moral, 8a del
Naranjo No. 216, Mexico, D.F.

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 423

NICARAGUA

LUIS MANUEL DEBAYLE, M.D.
National Director of Health

Social hygiene, with its broad and close relation to the very lives
of human beings and its never-changing, precise, and scientific prin-
ciples, is a battle-front of vital importance which must be defended.
For the destruction of nations and of races never starts from without
but from within. The health of the individual, the essential basis
of human happiness and progress, is one of the indispensable founda-
tions to the structure of a society, or of a nation.

United as we are in the Americas by a common destiny and by
an ardent desire for liberty which the American ever has in his
veins, we should also be closely united in the sound aim of giving
health and life to the people who make up this Hemisphere, which
may later be the refuge of elements who may come from the other
side of the seas, seeking peace in work, and happiness in life.

The Government of the Republic of Nicaragua, realizing that the
development of health work is of primary importance and that
venereal diseases are a social scourge, has enacted laws regulating the
campaign against these diseases, including the following basic
regulations :

1. The Government of Nicaragua does not recognize prostitution
as a professional means of livelihood and all persons engaged in such
business are subject to legal penalties.

2. All persons suffering from venereal diseases, (syphilis, gonorrhea,
chancroid, lymphogranuloma venereum, Nicolas, and Favre's dis-
eases) in the contagious stage, are obliged to submit to treatment
either by private physicians or in one of the public clinics.

3. Each physician attending a case of venereal disease is obliged
to report such case to the Director General of Health, and if the
patient abandons treatment, this also must be reported.

4. People suffering from venereal disease who cannot pay are to
be treated free in the dispensaries of the Public Health Service.

5. There is a special Section in the Public Health Service, known
as "Venereal Disease Control" and which maintains a constant cam-

424 JOURNAL OP SOCIAL HYGIENE

paign for health education, research, and treatment. In addition
a bill has been placed before the Legislature dealing with Pre-marital
Medical Certificates, as shown below, which soon is to be enacted
in this country.

This, in short, is "what is being done at the present time in Nic-
aragua and which we hope to improve upon in the future, by estab-
lishing free clinics where infection foci are found.

This struggle for health is ardous and difficult, and is not a one-
or two-year job. It has to be carried on constantly and over a long
period of time, above all in our country where great efforts are being
made to make the people health-conscious. The publication of
materials on such subjects in the JOURNAL OF SOCIAL HYGIENE is of
great cooperative importance in these campaigns and demonstrates
the altruistic spirit and high ideals of the American Social Hygiene
Association, in taking an interest in the health of all the people of
the American Continent.

PEOPOSED LAW TO ESTABLISH PEE-MAEITAL HEALTH
CEETIFICATES IN NICAEAGUA

Art. 1 — There is hereby established the obligatory Pre-marital Medical Cer-
tificate, without which the justices or pastors of churches in the country cannot
authorize performance of marriages.

Art. 2 — Exeepted from the provisions of Art. 1, are:

a. Persons who live more than ten leagues from a duly authorized
physician.

b. Those having maintained common-law marriages and wishing to be
legally married, and

c. When one of the contracting parties is at the point of death.

In these cases, the contracting parties, under oath to tell the truth, shall
swear before the respective Judge or pastor, who is to perform the ceremony,
whether or not they suffer from one or more diseases which would prevent their
marriage. The official functioning at the marriage shall send such data to the
Public Health Service.

Art. 5 — The following are prohibited from marrying:

a. Syphilitics

b. Those suffering from other venereal diseases

c. Tuberculers

d. Lepers

e. Epileptics, imbeciles and insane, and

f. Alcoholics; addicts of ether, morphine, heroin and cocaine; vagrants,
prostitutes, pimps and owners of bawdy houses.

Art. 4 — Only physicians legally authorized to practice their profession in the
country may issue Health Certificates, and only after having made all labora-
tory examinations necessary (Wassermann, Kahn, etcetera, tests), and having
determined that the person in question cannot transmit one of the diseases
given in Art. 3, or cause injury to descendants and therefore to the community
in which he lives.

Art. 5 — In doubtful cases, physicians who issue the pre-marital certificate can
only be released from responsibility by consulting with and presenting all data
to the Public Health Service.

SOCIAL HYGIENE IN" THE OTHER AMERICAN REPUBLICS 425

Art. 6 — The pre-marital certificate shall be issued in triplicate by the phy-
sician, one being kept in the physician's files, one given to the person applying,
and the third sent to the Public Health Service, not later than the third day after
being issued.

Art. 7 — Following is the form to be used for the Pre-marital Certificate:

"PEE- MARITAL MEDICAL CERTIFICATE"

The undersigned, Physician-Surgeon, legally authorized to practice his pro-
fession in the Eepublic, duly registered in the Public Health Service under
No , and under oath to tell the truth,

Certifies :

That having made a careful examination of whose

identity has been established and whose photograph, finger prints and signature
are on the margin, and after having used the examination methods recommended

for such cases by medical science, including tests for diagnosing

syphilis, results of which are attached, as issued by the Laboratory authorized
by the Public Health Service, has found that he does not suffer from the diseases
as given in Art. 3 of Legislative Decree dated , which might inca-
pacitate him legally for marriage.

This present Certificate and attached Keport shall become invalidated after 15
days from the date of issue.

I issue this Certificate and attached Eeport, in , on the day

of the month of in the year

(signature) Physician- Surgeon

Art. 8 — Infractions of this law, considered a criminal misdemeanour, shall be
punished administratively by a fine of from FIVE to FIVE THOUSAND
COEDOBAS, according to damage caused or danger to which someone may have
been exposed, in the judgment of the Public Health Service.

Art. 9 — The Public Health Service shall be charged with the enforcement of
this law.

FACTS ABOUT NICAEAGUA

Area — 57,915 square miles Population — 1,013,946

Capital — Managua; population 118,448 Language — Spanish

Unit of Currency — The cordoba, worth 20 cents in U. S. currency.

People — Of Spanish and Indian descent, the people are primarily dependent on
agriculture, cultivating only 5 per cent of an estimated 20 million acres of fertile
land. About half the population is concentrated in the Pacific Coast region.

Climate and Physical Characteristics — About the size of Wisconsin, Nicaragua
lies south of Honduras and north of Costa Bica, between the Pacific Ocean and
the Caribbean Sea. The climate is tropical, with a mean temperature of 78°
for the Pacific region, somewhat cooler in the mountains, and the characteristic
tropical dry and rainy seasons.

Government — For purposes of administration, the republic is divided into 15
departments and a National District, with heads appointed by the President.
The national government is divided into the usual three branches with their
separate functions. Legislative power is vested in a Congress of two houses —
the Chamber of Deputies and the Senate — which convenes on April 15 each year
for 60 days. The Senate is composed of 15 senators elected by direct popular
vote for six-year terms, plus the ex-Presidents, who are senators for life. Deputies
are elected by direct popular vote for six-year terms, one for each 30,000 inhab-
itants, with an equal number of alternates elected simultaneously, and at least one
deputy from each department. The President, similarly elected for six years, is

426

JOURNAL OF SOCIAL HYGIENE

responsible to Congress, and is entrusted with the government and administration
of the state.

Education — Primary education is free and compulsory for all children six to
thirteen years of age. The educational system is highly centralized, under the
Ministry of Public Instruction and Physical Education. The six-year course
of elementary instruction makes teaching in agriculture for boys and home
economics for girls compulsory. English is compulsory from the fourth grade
through the first three years of secondary school. Public and private primary
schools have a combined enrollment of some 61,000. There are 12 institutes
or secondary schools with an enrollment of 1,253 students. Vocational education
and higher education are offered in 15 commercial schools, two agricultural
colleges, a Montessori school for kindergarten teachers, and three universities
with varied graduate schools.

Public Health — Public health work is under the supervision of the Bureau of
Health, created in 1937, and directly responsible to the President. The Bureau
maintains clinics, including those for venereal diseases, carries on educational
work, and must approve plans for institutions, sanatoriums, etc. School services
include health examinations, medical and dental clinics, and courses in hygiene
given in cooperation with the Ministry of Education. A visiting nurse service
furnishes prenatal and obstetrical care; and dental, medical and hospital care
are provided free when necessary. All cities are required to appropriate' at
least 10 per cent of their revenues for health work. There are some 130 physi-
cians, 45 dentists, and 16 hospitals with 1,300 beds. The National Institute
of Health furnishes a central laboratory service, with 15 branches, and also
engages in research. Most important health problems are intestinal parasitoses,
waterborne diseases, malaria, tuberculosis, and venereal diseases.

LASIFILIS

ffffff Sfff MTADA

TRATAMIfNTO

IHMEDIA70
Y AD ECU ADO

SIGN-FICA PREVEKIR
COMPLICACIONES Y
CUR AC ION SEGURA.

EDUCATIONAL PLACARDS PREPARED BY THE MEXICO
DEPARTMENT OF HEALTH AND WELFARE

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 427

PANAMA

AETUEO TAPIA C., M.D., M.P.H.

Chief of the Division of Genito-Infectious Diseases, Department of
Health, Republic of Panama

The increased number of military personnel, the defense activities
and the economic prosperity brought on by the war have created
conditions favoring the spread of venereal diseases in the Republic
of Panama. The problem is complicated by the fact that the popu-
lation in Panama is made up of a heterogenous group of Panamanians,
North Americans and foreigners attracted to the Isthmus by its
growing prosperity.

The health authorities of the Republic and of the Canal Zone
have united for the purpose of solving the problem, which interests
the Panamanians as much as it does the North American military
and civilian residents.

The cost of the campaign is being divided equally between the
governments of Panama and the United States through the Office
of the Coordinator of Interamerican Affairs.

The facilities for diagnosis and treatment of the venereal diseases
have been augmented. In the city of Panama, a new Clinic has
been constructed with all modern improvements. The treatment of
all cases is done by medical specialists in these diseases. The Clinics
which formerly existed continue functioning.

The Quarantine Hospital set up in Panama has been expanded.
There are now 235 beds and there will soon be accommodations
to receive 40 more. Since it is the only Hospital of its kind in
the Republic of Panama, it is not large enough for the need and
the erection of a new wing is contemplated.

Construction of a new Clinic in the city of Colon has been started.
This Clinic will help to solve the problem of the overflow among
patients going to the General Hospital. Mobile units are being
organized to provide treatment for thickly populated but remote
parts of the country.

Realizing that sexual promiscuity is the principal factor in the
spread of syphilis and gonorrhea, the Panamanian Government,

428 JOURNAL OF SOCIAL HYGIENE

through the Ministry of Government and Justice and its representa-
tives has started a campaign for improvement of moral standards.
The houses of assignation, hotels of doubtful reputation and similar
places are being closed, and clandestine prostitutes arrested. The
Ministry of Foreign Relations has instituted the deportation of
many women who, attracted by prosperous conditions, have come
to the Isthmus to practice prostitution. On the efficient carrying
out of this phase of the program depends to a large extent the
whole outcome of the campaign.

The newspapers have extended prompt cooperation in this project.
The health authorities publish articles explaining the different aspects
of the problem, and the press helps in this also. Meetings and
conferences of various groups are held periodically, by members of
the staff of the Department of Health, and illustrated by lantern-slides
and motion pictures.

The Department has commenced to establish contacts with different
civic organizations and is seeking their cooperation.

It is altogether too early to predict the results of these efforts. It
is difficult to collect statistics which may adequately serve as a guide.
Also, the problem of venereal diseases has always existed on the
Isthmus, and it has increased since 1940. The Department of Health
realizes that it is not possible to obtain spectacular results, but is
confident that with the cooperation of all agencies interested the
problem can eventually be solved.

As of August 1944 the following additional activities are reported :

1. Preparation and extensive distribution of pamphlets on
gonorrhea, syphilis, congenital syphilis and other venereal diseases.

2. Meetings, with film showings and pamphlets distributed, in the
principal towns and in each district of the capital city. This is
done with the help of Civilian Defense, the Junior Chamber of
Commerce and civic organizations.

3. Serological examinations of the population, by means of the
visiting nurses, who go from house to house obtaining samples
of blood.

4. Organization of a service, also in charge of the visiting nurses,
for case holding and epidemiological investigations of contacts.

5. Free clinic service, particularly blood tests of patients who
cannot pay, as part of routine physical examinations.

6. Distribution to the medical profession of recommendations for
venereal disease treatment in accordance with the most recent medical
knowledge.

7. Preparation of a treatment card which is given to each patient,
to help in holding cases and keeping them coming for treatment
although they change residence.

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 429

8. Establishment of two night clinics where treatment is given
free of charge. It is planned to have one of these clinics in each
district of the city.

9. Expansion of facilities for diagnosis, treatment and hospitaliza-
tion of professional prostitutes.

10. Establishment of routine examinations of groups suspected of
high venereal disease incidence : i.e., cabaret hostesses, restaurant
employees and women whom the police suspect of sexual promiscuity.

11. Cooperation with the police and Foreign Relations authorities
regarding the elimination and control of prostitution.

12. Campaign with the provincial authorities for repression of
tolerated districts in both city and rural areas.

13. Expansion and intensification of information regarding vener-
eal disease statistics, especially regarding careful diagnosis of the
disease (whether latent syphilis, primary syphilis, etc.). We are
meeting with excellent success regarding the increase of reports
by institutions, official and unofficial, and by the physician special-
ists. This is occurring to such a degree that we believe we are
rapidly getting an idea of the real extent of venereal disease in
this country.

FACTS ABOUT PANAMA

Area — 34,169 square miles Population — 631,637

Capital — Panama; population 111,893 Language — Spanish

Unit of Currency — The silver balboa, valued at about $1.00.

People — Greatest influence on life in Panama is her strategic location at a
crossroads of the world. Although the soil and climate are favorable for
agriculture, so many of the people engage in commerce, industry and the tourist
trade, that much of the necessary foodstuffs which could be produced there
must be imported.

Climate and Physical Characteristics — Panama is an isthmus, connecting North
and South America, but running east and west, with Costa Rica on its western
border and Colombia on the east. The Caribbean is to the north and the
Pacific on the south; and the Panama Canal and the Canal Zone, extending five
miles on either side of the Canal, separate the east from the west. Two ranges
of mountains traverse the length of the country, and the east contains vast
stretches of tropical jungle. The climate varies from the tropical heat of
the coastal areas to the refreshing coolness of the interior plateaus.

Government — There are seven provinces, each with its legislature which meets
every year in December, and a governor appointed by and responsible to the
President of the Republic. The National Assembly, composed of one chamber,
meets on January second of every odd-numbered year, and is made up of
deputies elected from the provinces by direct popular vote for six-year terms.
The President, likewise elected by popular vote for a six year term, is assisted
in administering the government by a Cabinet composed of Ministers of
Government and Justice, Foreign Relations, the Treasury, Education, Health
and Public Works, and Agriculture and Commerce.

Education — Primary education is compulsory for children 7 to 15 years of age,
and the law requires the State to maintain a primary school in every community

430 JOURNAL OF SOCIAL HYGIENE

having 30 or more school-age children. In 1942 there were 55,358 children
in 549 primary schools. Following the primary course of six years come three
years of preliminary work in secondary school, after which the student decides
whether to finish in a liceo, which corresponds roughly to a senior high school,
or in a trade, normal, nursing, commercial or agricultural school. Secondary
schools in fine arts, drama and music have also been established. The National
University of Panama, established in 1935, has increased' its enrollment from
175 to 900, and has schools in arts and sciences, law, education, engineering,
public administration and commerce, and pharmacy.

Public Health— Most important health problems are malaria, tuberculosis,
intestinal parasites, and venereal diseases. Because of the Canal and the
preventive measures which made its building possible, Panama has had the
good fortune of furnishing a practical object lesson as to what public health
measures may achieve in the campaign against preventable diseases. It has
some of the best equipped hospitals and laboratories on the continent. There
are about 200 physicians, 85 dentists, 16 hospitals with about 3,500 beds,
two asylums, a leper colony with 105 patients, and a hospital for the insane.

Social Hygiene Films in Latin America

Some thirty-five prints of Spanish versions of the U. S. Public Health
Service film Fight Syphilis,* and of the American Social Hygiene Asso-
ciation's Con Estas Armas (With These Weapons — the Story of Syphilis),
are now in circulation in the other American republics, through the Health
and Medical Film Unit of the Motion Picture Division, Office of the
Coordinator of Inter-American Affairs. In addition, some of the Latin
American countries have produced their own films, along with other
materials, for education of the public regarding the dangers of venereal
diseases, and generally speaking films are regarded among the good
neighbor countries, as in the United States, as among the most effective
educational tools.

Prints of Con Estes Armas are deposited at the following locations:
The American Embassies at Buenos Aires, Argentina; Santiago, Chile;
Bogota, Colombia; Habana, Cuba; Mexico City, Mexico; Lima, Peru;
Montevideo, Uruguay; Caracas, Venezuela. The American Legations at
La Paz, Bolivia; San Jose, Costa Kica; Quito, Ecuador; Guatemala City,
Guatemala; Tegucigalpa, Honduras; Managua, Nicaragua; Asuncion,
Paraguay; San Salvador, El Salvador; Trujillo, Dominican Eepublic.
Also at the United States Consular Offices at Valparaiso, Chile; Barran-
quilla, Colombia; Le Ceiba, Honduras; Monterrey, Mexico; Guadalajara,
Mexico; Guayaquil, Mexico.

The Association is now working on a Spanish version of the one-reel
talking film Plain Facts About Syphilis and Gonorrhea, which it is hoped
may also be of service in the social hygiene educational programs in
Latin America.

* This film has also been translated in Portguese for Brazilian use.

SOCIAL HYGIENE IN" THE OTHER AMERICAN REPUBLICS 431

PARAGUAY *

We meet again at this reunion of the crusaders against venereal
diseases in America, with our usual optimism and with minds open
to useful suggestions which may be presented at this assembly, and
which each year obliges each one of the countries represented to
examine its health conscience as regards the struggle against venereal
diseases.

With pride we can announce here, that in Paraguay, for some
time, preventive measures paralleling those of treatment have been
carried on in all medical activities for individual and group welfare.
And not merely by coincidence has the highest health authority of
the Nation during this administration added to its title of Ministry
of Public Health that of Social Welfare. The results of this expansion
will soon be evident in our objective, the conquest of the venereal
diseases, because we know that besides health problems many eco-
nomic and social questions are ever present in this campaign.

Generally and briefly we may report:

In our country, "Anti-venereal Day" is celebrated, year after
year, with the usual educational program, especially the activities
of the Department of Health Education and Information of the
Ministry of Public Health, established in 1941. This Department
has a daily radio broadcast hour, distributes the Health Bulletin
and various other publications, leaflets and posters, illustrated and
printed in simple language suitable for the general public.

In January 1942, the Division of Syphilis and Leprosy was created
and put in charge of venereal disease control, statistics and the
investigation of sources of infection.

In May of the same year the Interamerican Cooperative Service
was created, attached to the Ministry of Public Health, which takes
charge of the grants-in-aid received from the United States as a
token of continental solidarity. Thanks to this Service many Par-
aguayan doctors are receiving fellowships abroad to perfect them-

* A paper presented by the Venereal, Syphilis and Skin Dispensary at the Ninth
Annual Celebration of Anti-venereal Day in the Eepublic of Argentina (September
1943).

432 JOURNAL OF SOCIAL HYGIENE

selves in all medical and public health specialties, among them, the
prevention of syphilis.

Through the Schools of Public Health Nursing and Social Work,
which have a large, carefully chosen group of students, the principles
of preventive medicine will be spread among all social classes.

In June 1942, a premarital examination, which is required of both
parties and is not only for syphilis but for any other infectious or
contagious disease, was made obligatory throughout the country.

Since May 1941 there has been a law making it obligatory to report
all infectious or contagious diseases. Since October 1942 this law
has been supported by a departmental resolution, recommending that
all attending physicians inquire as to the origin of infection, that
carriers may be treated.

With this brief summary, we wish to speak of the institution which
more specifically struggles against syphilis and other venereal dis-
eases; that is the Venereal, Syphilis and Skin Dispensary. This
Dispensary, which was founded under the name of the Venereal
Syphilis Prevention Institute, has had 25 years of uninterrupted
activity. Its doors were not closed even during the hazardous days
of our last war !

Step-child of so many administrations throughout the years, this
clinic will very soon take its place in the same palatial building
which will house the Ministry of Public Health and Social Welfare,
the construction of which advances apace.

During the first half of this year (1943) 972 new patients have
received treatment in the main Dispensary, and 9,670 injections have
been given. However, not only routine work is done in service, but,
by ruling of the Ministry of Public Health and under the direction
of Prof. Insaurralde, the Dispensary has an experimental section
for the modern rapid treatment of primary and secondary syphilis.
The University of Chicago methods (fever-therapy and arseno-therapy
combined) are used. Because of the minimum material resources
required, this treatment, when finally verified and accepted, will
place in many hands a new technique to shorten the treatment of
syphilis and make it less tedious for the patient and less expensive
for the private individual and for the public funds.

FACTS ABOUT PAEAGUAY

Area — 177,104 square miles Population — 1,014,773

Capital — Asunci6n; population 172,423 Language — Spanish

Unit of Currency — The guarani, worth 32 cents in U. S. currency.

People— Paraguay has produced a distinctive and homogeneous racial type,
based on an original admixture of Guarani Indian and Spaniard, which has
assimilated thoroughly the European immigrants who have come there.

Climate and Physical Characteristics — One of the two landlocked nations of
Latin America, in the heart of the South American continent, Paraguay is

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 433

bordered on the northwest by Bolivia, on the northeast by Brazil, and on the
south by Argentina. The eastern part, where most of the population concentrates,
has dense tropical or sub-tropical forests alternating with cleared areas, grasslands
and low plateaus. The Gran Chaco or western region consists of an almost
unforested flat grassy plain 250 to 300 feet above sea level, largely inundated
during the rainy season. The climate is sub-tropical, the average annual
temperature being between 70° and 74°. /

Government — The national government has an Executive Power vested in the
President, chosen by direct general election for a term of five years, and his
Cabinet; and a unicameral legislative body, the House of Eepresentatives. One
representative is elected for each 25,000 inhabitants for a term of five years,
and the House convenes every year from April 1 to August 31. Citizens are
guaranteed the right of suffrage, which is compulsory for all men over 18 years
of age. The country is divided into 12 Departments, each governed by a
Delegate of the Executive Power, responsible to the Ministry of Interior.

Education — Primary education is compulsory and provided by the State, which
also provides secondary and university education largely at public expense.
Approximately 100,000 pupils attend the 1,500 public and 100 private elementary
schools, which are administered by a Director General of Schools. Schools
designated ' ' class one ' ' prepare students for admission to secondary and normal
schools. There are seven normal schools, four public secondary schools with
an enrollment of 2,631, and five private secondary schools with 900 students.
The university has facilities for the study of law, engineering, medicine, dentistry,
pharmacy and surveying. Foreign languages, music and art are taught in the
Ateneo Paraguayo, and the government maintains schools of commerce, radio-
telegraphy, agriculture, military science and aviation.

Public Health — Important health problems are intestinal parasitoses, dysentery,
typhoid and other gastro-intestinal diseases, malaria, tuberculosis, venereal dis-
eases and leprosy. The Pan American Sanitary Bureau recently furnished the
aid of a technical adviser in the reorganization of the health department.
The budget for the Ministry of Public Health has been greatly increased in
recent years, and in 1940 it amounted to about $147,300. There are in Paraguay
about 150 physicians, 65 dentists, 14 government hospitals with about 3,000
beds, 18 dispensaries with some 1,100 beds, three dental clinics, three asylums,
and 8 private hospitals and sanatoriums. The rural sanitation service has health
centers in more than 100 towns and villages.

434

JOURNAL OF SOCIAL HYGIENE

VENEZUELA

DR. FELIX LAIEET HIJO
Minister of Health and Social Welfare

The antivenereal campaign in Venezuela was regularly established
in 1938, with its organization and direction under the Venereological
Division of the Public Health Service in the Ministry of Health and
Social Welfare.

In close collaboration with the Ministry of Health and Social
Welfare, the Military Health Service is in charge of the campaign
among the forces of the national army.

From its beginning, the campaign has been progressively expanded
by creation of new services, training and employment of additional
specialized personnel, cooperation with other municipal and state
organizations, and steadily increasing budget appropriations.

In 1938 the campaign began work with nine specialized services
of which four were located in the Capital city, Caracas, and the
others assigned to various locations in the Republic, under the Medi-
cal Chiefs of the Health Units, who, however, without auxiliary
personnel were able to accomplish only a minimum of antivenereal
work.

Since this time excellent progress has been made. Today we are
able to rely upon 24 specialized services staffed by 24 syphilologists
and seven urologists. In 25 towns, which because of sparse popu-
lation and limited venereal problems, do not require special anti-
venereal services, the Medical Chief of the Sanitary Unit in his
weekly program of work devotes two days, at least, to venereal
disease. All the services are also staffed with trained personnel who
assist the doctors in the clinic, administer the treatment as ordered,
look after the records, search out new patients and sources of infection,
and follow up patients who do not return regularly for treatment.

The population reached by these services totals 898,334 inhabitants.

The campaign in rural Venezuela is still a very modest effort.
The rural health physicians have a variety of duties, mostly treat-
ment, and carry on a minimum public health program, of which a
part relates to venereal work. They do not have assistants but

SOCIAL HYGIENE IN THE OTHEE AMERICAN REPUBLICS 435

are furnished with free drugs and supplies for the treatment of
patients.

The budget assigned to the antivenereal campaign in 1938 was
548,980 Bolivars (about $163,870. EDITOR) equivalent to 5 per cent
of the amount assigned to the Public Health Service and 2.8 per cent
of the General Health Budget The appropriation has been increased
until today it is 1,000,000 Bolivars ($298,500) representing 8 per
cent of the Budget of the Public Health Service and 4.8 per cent
of the General Health Budget.

The antivenereal campaign is not set up as a separate independent
campaign from that of other public health services. It is a part of
the general health program and each Antivenereal Service forms an
integral part of the local Health Services, which in Venezuela are
designated as Units. In each Health Unit, in each type of cam-
paign, all personnel takes part in the work of all the health activities
conducted. In the antivenereal campaign, in addition to the Unit
personnel, there is available the assistance of the health inspectors
for supervision of Health Certificates; of the visiting nurses, for
referring suspected cases encountered in their home visits; of the
laboratory for the serological reactions; and of the maternal-infant
health services for the prevention of congenital syphilis. According
to the plan drawn up by the Division of Venereal Diseases the cam-
paign works to diminish the incidence of the venereal diseases by
means of treatment, which is obligatory, according to the anti-
venereal law.

Through this program there are attained :

a) Treatment of infections until non-infectious; This, in the case
of syphilis, is obtained with the administration in sequence of 20
arsenical ampules, and 20 of a heavy metal (bismuth).

b) The prevention of late syphilitic lesions, which according to
data compiled by the American Cooperative Clinical Group is obtained
with this minimum treatment.

c) The prevention of congenital syphilis by means of prenatal
treatment, especially the arsenicals, for pregnant women.

d) Clinical cure: with 30 arsenical injections and 40 of bismuth
as a minimum.

By these means we endeavor to diminish one of the important
causes of death, as brought about by late syphilis; particularly
syphilis of the nervous system or cardiovascular system.

In order to achieve these objectives we have proceeded as follows:

1. Search for new cases by means of examination of health groups
(clinical examination and blood tests), the health certificates required
of all food handlers being of great value in this respect.

2. Investigation of sources of infection and contacts of recently
infected patients.

436 JOURNAL OF SOCIAL HYGIENE

3. Follow up by visiting nurses of patients lapsing treatment.

4. Investigation and strict control of the principal sources of
contagion.

Inasmuch as in our country the prostitute constitutes the prin-
cipal source of venereal infection, strict control is exercised over
these women. All those who become infected must submit to treatment
and the healthy ones are under continued supervision. (Clinic visits
every two weeks and blood tests every month.)

The reports and statistics of each of the Antivenereal Services are
centralized in the Venereological Division and a monthly summary
of activities is sent in by each Health Unit. In this way the Divi-
sion is in a position to gauge the intensity of the venereal problem
in the Republic ; and to direct and to advance the campaign efficiently.

Thus a plan of action has been set up for all the Antivenereal
Services of the Republic, establishing methods of work, standardizing
schedules of treatment (for recent syphilis or infections of less than
two-year duration; for late syphilis; and for syphilis in pregnancy
and infancy) ; and supplying every type of drug. Through this
plan we have been able to keep patients under treatment, even though
they move from one part of the country to the other. The "treat-
ment card" which must be provided to patients under the Anti-
venereal Law has been of substantial benefit in this respect.

The work of public education is directed by the Division utilizing
all possible methods.

That knowledge regarding venereal problems may reach all physi-
cians, the Division has founded the Boletin de Venereologia and
crowned its labors with the celebration in Caracas, in February 1943
of the first Venezuelan Conference on Venereology and Dermatology.
The first volume of the proceedings has already been published and
distributed in all American countries by the Ministry of Health and
Social Welfare.

At present, considering the short time since the work was organized,
it is impossible to make an exact evaluation of the results obtained,
but observing the steady increase in activities, and the growing
number of new patients, as well as the improvement in attendance
on treatment, we believe that this difficult fight against a stubborn
foe goes well.

For example, we present the following data:

a) The admission of new cases with recent or infectious syphilis
in the course of the present year has exceeded by 38.2 per cent those
received during the previous year.

b) The total number of patients registered with recent syphilis
has reached 15,123; the monthly average of patient attendance has
been improved by 10 per cent over the former year; the number of
prostitutes actually under supervision has risen to 8,314.

SOCIAL HYGIENE IN THE OTHER AMERICAN REPUBLICS 437

c) The most favorable result of all is seen in the marked increase
in "cases rendered non-infectious" and in "clinical cures" achieved
during the current year ; double those of the previous year.

FACTS ABOUT VENEZUELA

Area — 352,170 square miles Population — 3,943,239

Capital — Caracas; population 203,342 Language — Spanish

Unit of Currency — The bolivar, worth 30 cents in U. S. currency.

People — Although oil is the chief export, agriculture and stock-raising are the
chief occupations, with 75 per cent of the people engaged in raising and marketing
crops. The average density p0r square mile is only 11.2, with most of the
population concentrated in the northern states.

Climate and Physical Characteristics — Lying in the northern extreme of South
America, entirely within the Torrid Zone, Venezuela is bordered on the north
and northeast by the Caribbean Sea, on the east by British Guiana, on the
southeast by Brazil, and on the west and southwest by Colombia. Pour principal
regions are : the Guayana Highlands in ' the south, largely unexplored ; the
central plains or llanos, used principally for grazing; the mountainous region,
which is temperate, most densely populated, and the chief agricultural section;
and the narrow strip along the coast which is the source of oil. The climate
is tropical in the central llanos and coastal regions, and temperate in the
higher parts.

Government — Twenty states, two Federal territories, a Federal Dependency
and the Federal District comprise the United States of Venezuela, which has a
federal form of government under the Constitution of 1936, with governmental
functions distributed among the Union, the states and the municipalities. Legis-
lative power is vested in a Congress of two houses: a Chamber of Deputies
elected by conventions representing the municipalities, which elect one deputy
for each 35,000 inhabitants, and an equal number of alternates; and a Senate
composed of two senators from each state. Both are elected for terms of four
years, and Congress convenes annually for at least 90 days. The President is
elected by Congress for a five-year term, and is charged with execution of laws
passed by Congress and administration of federal affairs generally, with the
assistance of a Cabinet of ten Ministers, including a minister of National
Education and a Minister of Health and Social Welfare.

Education — Primary education is compulsory for children between seven and
fourteen years; and education is centralized under the control of the Federal
Government. There are over 5,500 primary schools of rural and urban types
enrolling 360,000 pupils. Rural education is carried on through pedagogical
missions assigned to given areas where they conduct Welfare Institutes, with
activities ranging from teaching to sanitation and road-building. There are
48 secondary or normal schools, and 19 normal schools giving teacher training,
plus three rural normal schools with curricula adapted to the needs of agri-
cultural communities. The Central University in Caracas, and the University
of the Andes in Merida have schools of medicine, political science, physical
sciences, mathematics, dentistry, pharmacy and others. Special schools offer
higher education in agriculture, commerce and modern languages.

Public Health — The Ministry of Public Health and Social Welfare is in charge
of all health work, with divisions of mother and child welfare, school hygiene,
yellow fever, malaria, venereal diseases, tuberculosis, epidemiology and social
welfare. Most intensive work is being done in the fields of malaria control;
tuberculosis, maternal and child welfare, venereal diseases, and health education.
Maternal and infant hygiene is handled through health centers throughout the
country; and special hospitals, sanatoriums, and dispensaries are being used
or planned for tuberculosis, maternal and child care, and venereal diseases.
Also connected with public health work are the Cancer Institute and the Institute
of Hygiene and Tropical Medicine.

NATIONAL EVENTS

EEBA EAYBUBN
Washington Liaison Office, American Social Hygiene Association

U. S. Public Health Service Holds National Conference on Postwar
Venereal Disease Control. — Another National Venereal Disease
Control Conference will be conducted under the auspices of the
U. S. Public Health Service in St. Louis. Missouri, November 9,
10 and 11, when leading experts from the United States and other
countries will consider international and postwar venereal disease
control and other specialized subjects. State and local health
officers, venereal disease control officers, practicing physicians, and
all others engaged in venereal disease control, including social
hygiene executives and other community leaders, are invited to
attend the sessions in the St. Louis Medical Society Building at
3839 Lyndell Court. This will be the third national venereal dis-
ease control conference sponsored by the USPHS, the first having
been held in 1936 in Washington and the second in 1942 at Hot
Springs, Arkansas.

With Surgeon General Thomas Parran in the chair, and following
greetings from Federal Security Administrator Paul V. McNutt,
Missouri, Governor Forrest Donnel and other officials, a three-day
program packed full of vital and interesting talks and discussion
will be presented, including:

The purposes and problems of the Conference presented by Surgeon General
Parran and Medical Director John E. Heller, Jr., USPHS 5 discussion of Army
and Navy venereal disease control programs; papers on penicillin therapy by
Dr. J. E. Moore, Dr. John H. Stokes, and Medical Director J. F. Mahoney;
a symposium on International Control of Venereal Diseases with representatives
from England, Canada, Mexico and Norway; section meetings which will be
reported to the entire group, on Diagnostic and Therapeutic Procedures in
Gonorrhea, Diagnostic and Therapeutic Procedures in Syphilis, Epidemiology,
and Education and Community Action.

Later issues of the JOURNAL will report more fully on these sessions.
Voluntary agency representatives at the conference have been
invited to attend a dinner on the evening before the first session,
Wednesday, November 8, at 6 :30 P.M. at the Coronado Hotel, as
guests of the American Social Hygiene Association.

Congress Appropriates $12,500,000 for VD Control. — For the year
beginning July first 1944 Congress appropriated $12,500,000 for
venereal disease control to be expended through the U. S. Public
Health Service and Federal grants to the states. The Appropriation
Bill for the Department of Labor and Federal Security Agency,
which included the items comprising this sum was passed by the
Senate and House and signed by the President on June 28. After
brief discussion of the VD control allotments in the Subcommittees,
under the able chairmanship of Senator McCarran and Representa-
tive Butler B. Hare respectively, unanimous approval was given

438

NATIONAL EVENTS

439

this amount as requested in the President's budget. The $12,339,000
provided under the provisions of the LaFollette-Bulwinkle Venereal
Disease Control Act of 1938 was supplemented by travel allowances
and various items coming under other headings in the Federal
Security Agency funds to bring the total to $12,500,000, which is
the same as last year's appropriation.

Introduced at the House hearings was the interesting table shown
below, giving the various bases for allotments to the states during
the 1943-44 fiscal year including in the last column the minimum
amount required to be matched by state and other appropriations.

Allotment of venereal disease control funds for fiscal year ending June SO, 1944

Venereal disease
problem basis Amount

Population ,. * x Financial to be

State Total basis General War need need basis matched

Total $10,276,200 $2,369,200 $2,343,200 $3,229,200 $2,334,600 $4,666,700

Alabama .....

427,800

50,500 112,100 140,900
1,400 23,200 1 2,900
6,300 22,400 18,400
29,200 35,800 42,500
142,400 96,800 155,700
20,700 18,500 29,100
31,700 12,000 30,100
5,300 6,800 8,600
16,000 45,600 40,400
40,300 94,700 148,700
58,700 127,000 177,800
6,100 5,300 17,600
7,800 11,300 9,100
146,200 128,800 90,000
56,800 37,100 60,000
43,900 17,900 15,800
33,200 20,700 43,500
50,500 68,400 128,000
42,700 82,500 135,400
13,900 9,100 14,900
37,500 33,600 58,500
74,600 20,400 9,800
95,400 42,200 70,200
46,300 30,300 7,000
39,100 107,500 181,300
58,200 38,500 50,000
7,400 14,900 4,100
20,100 14,000 19,100
2,500 7,400 5,200
8,700 5,600 5,700
78,000 43,900 39,600
9,600 14,100 20,200
229,300 136,100 119,200
62,200 95,300 140,300
10,500 8,600 2,100
134,700 76,700 76,100
37,600 52,600 74,300
22,200 17,700 42,700
178,200 73,600 77,500
28,900 49,100 118,400
11,600 4,600 10,300
35,900 72,600 133,600
9,700 15,200 7,400
48,100 75,400 88,100
114,200 172,800 264,100
9,600 16,200 19,900
5,900 4,300 3,800
39,300 47,500 144,200
500 3,400 7,700
31,300 14,200 40,500
30,800 31,100 34,500
53,900 20,100 16,100
3,800 7,700 8,300
to California to be earmarked for

to Illinois to be earmarked for

124,300 162,600
3,400 24,600
6,000 28.900
71,500 64,900
34,700 235,000
17,700 39,200
5,300 43,600
900 12,100
300 51,900
46,600 135,000
121,600 178,500
12,800 11,400
8,500 19,000
60,800 257,500
45,900 95,900
40,200 62,300
37,300 54,400
106,700 118,900
71,900 125,200
12,300 23,000
15,000 48,000
24,300 95,000
51,800 137,100
41,600 76,600
127,000 146.500
53,200 99,700
5,200 22,400'
23,300 35,100
500 9,900
7,000 14,200
10,100 121,900
16,400 21,900
45,700 365,400
122,100 157,500
14,600 19,100
65,400 205,400
61,500 93,200
13,100 41,500
103,600 251,800
185,800 78,000
4,500 16,200
86,800 108.500
13,400 24,900
97,700 123,400
145,500 287,000
8,900 25,900
5,800 10,200
46,700 86,700
3,000 3,900
13,700 47,500
43,400 61,900
46,900 75,000
2,400 11,500
the support of the

the support of the

Alaska

40,900

Arizona

, . . . 53,100

Arkansas . . . ,
California1 . . .

179,000
429,600

Colorado

86.000

Connecticut 79,100
Delaware 21,600
District of Columbia 102,300
Florida 330.300

Georgia . . . . ,

485,100

Hawaii ,

... 41 800

Idaho ,

, . . . 36,700

Illinois2

, . . . 425,800

Indiana

199,800

Iowa

117 800

Kansas

134,700

Kentucky . . . ,

353 600

Louisiana ....

332,500

Maine

50,200

Maryland ....

, . . . 144,600

Massachusetts .
Michigan
Minnesota . . .
Mississippi . . .

129,100
259,600
125,200
464,900

Missouri .....
Montana

199,900
31 600

Nebraska ....
Nevada

76,500
15.fiOO

New Hampshire. . . 27,000
New Jersey ...--- 1 71 fioo

New Mexico . . ,

, . . . 60 300

New York

530 300

North Carolina
North Dakota .
Ohio

419,900
35,800
342,900

Oklahoma ....

226 000

Oregon

... 95,700

Pennsylvania .
Puerto Rico . .
Rhode Island. . ,

432,900
382,200
31,000

South Carolina.
South Dakota . ,
Tennessee ....

328,900
45,700
309,300

Texas

696 600

Utah

... 54,600

Vermont . . . . ,
Virginia
Virgin Islands . .
Washington . . ,

19,800
277,700
14,600
99,700

West Virginia. .
Wisconsin ....

139,800
137 000

Wyoming)

22,200

1 The sum of
regional central
2 The sum of
regional central

$24,950 allocated
tabulating unit.
$25,000 allocated
tabulating unit.

440 JOUKISrAL OF SOCIAL HYGIENE

Rapid Treatment Centers Use Penicillin for Early Syphilis. — Large-
scale use of penicillin in the treatment of early syphilis is being
undertaken by the U. S. Public Health Service and a number of
State health departments, according to Dr. J. R. Heller, Jr., chief
of USPHS Venereal Disease Division. Selected patients with early
syphilis will receive penicillin in rapid treatment centers, of which
there are more than 50 in the United States. Thirty-six centers in
18 states are already participating in the penicillin program. To
date approximately 20,000 patients have been admitted to the centers
and have been treated for syphilis and gonorrhea with new intensive
methods. Penicillin already has been used successfully at the rapid
treatment centers for treating gonorrhea cases that did not respond
to sulfa drugs.

Studies of the effectiveness of penicillin in the treatment of syph-
ilis will be conducted by the Public Health Service in cooperation
with the National Research Council. The program of penicillin
therapy for syphilis in the rapid treatment centers is a research
as well as a treatment program.

" If these studies prove that penicillin is as effective as everyone
hopes," said Dr. Heller, " we will be armed with a powerful new
weapon in the national fight against syphilis. The effectiveness of
penicillin in the treatment of syphilis has not been fully evaluated.
However, evidence of its possibilities, following the original treat-
ment of syphilis patients by PHS physicians at Staten Island in
1943, is sufficient to warrant its large-scale use in the interest of
public health.

" It is of interest that about one-third of all the syphilis patients
admitted to rapid treatment centers are infected also with gonor-
rhea. Penicillin has already proved its value in treating gonorrhea.
If it should prove equally as effective in treating syphilis it would be
possible, for the first time in medical history, to treat patients with
both these venereal diseases with a single drug."

In studies conducted by the Army, the Navy, and the USPHS in
collaboration with the Penicillin Panel of the National Research
Council, more than 1,000 patients with syphilis in all stages have been
treated with penicillin. The drug has an immediate effect on syphilis
of all types; but additional time must pass before permanence of
results can be judged. Most of the patients selected for penicillin
treatment in the PHS program will be persons with early untreated
syphilis who can be reexamined regularly for a period of six months
or a year. Two schedules of penicillin therapy are being considered
in the USPHS program — a four-day schedule and an eight-day
schedule.

State rapid treatment centers to which USPHS physicians have
been assigned to supervise the medical program, and which are
already participating, include :

San Diego, Calif.; Denver and Pueblo, Colo.; Ocala, Wakulla, and Jackson-
ville, Fla.; Pineville and New Orleans, La.; Ann Arbor, Mich.; Meridian and

NATIONAL EVENTS

441

McLain, Miss.; Albuquerque, N. M. ; Charlotte, N. C. ; Rush Springs, Okla. ;
Columbia, S. C. (three centers); Nashville, Chattanooga, and Memphis, Term. ;
San Antonio, El Paso, and Waco, Texas; Richmond, Va. ; Seattle and Grand
Mound, Wash.; and Washington, D. C.

Federal rapid treatment centers participating, include:

Birmingham, Ala.; Hot Springs, Ark.; Pensacola, Fla. ; Savannah and Augusta,
Ga.; Greenwood, Miss.; St. Louis, Mo.; Durham, N. C. ; Norfolk, Va. ; Charleston,
W. Va.

In May the USPHS released a map showing the location of various
types of rapid treatment centers assisted by Lanham Act Funds.
(See map, page 442.) Following is a list of these centers as of
April 1944, including names of the respective medical officers in
charge :

Alabama :

Mid-South Medical Center, South
Park Unit, 301 South Park Road,
West End, Birmingham.
P. A. Surgeon (R) Ivan E. Martin.

Slossfield Unit, 2500-20th Street,

North, Birmingham.

P. A. Surgeon William B. Perry.

Arizona:

Phoenix Venereal Disease Quarantine

Hospital, 205 East Madison Street,

Phoenix.

P. A. Surgeon (R) Paul M. Armour.

Colorado:

Rapid Treatment Center, Denver
General Hospital, 935 Bannock
Street, Denver 4.
Surgeon (R) W. L. Chadwick.

Pueblo Rapid Treatment Center, 29th

and Court Streets, Pueblo.

P. A. Surgeon (R) D. W. Dykstra.

District of Columbia:

Venereal Disease Rapid Treatment
Center, Gallinger Hospital, 19th and
Massachusetts Avenue, S. E., Wash-
ington, D. C.
P. A. Surgeon (R) Sidney Olansky.

Florida:

Wakulla Rapid Treatment Center

No. 1, Wakulla.

P. A. Surgeon (R) George H. Smullen.

Ocala Rapid Treatment Center No. 2
, (White), P.O. Box 577, Ocala.
Surgeon (R) Alfred E. Troncelliti.

Jacksonville Rapid Treatment Center
No. 4, Duval County Hospital, 2000
Jefferson Street, Jacksonville.
P. A. Surgeon (R) Nathaniel Jones.

Gulf Coast Medical Center, P.O. Box

2128, Pensacola.

Surgeon (R) Ford S. Williams.

Georgia:

Southeastern Medical Center, Oat-
land Island, Route No. 2, Savannah.
P. A. Surgeon Clarence A. Smith
(4-15-44).

Piedmont Medical Center, #1

edge Road, Augusta.

Surgeon (R) Forest C. Hunter.

Mill-

Illinois :

Chicago Intensive Treatment Center,
2449 South Dearborn Street, Chicago.
Surgeon (R) H. W. Kendell.
(Address Dr. Herman N. Bundesen.)

Indiana :

Venereal Disease Isolation Hospital,
Fletcher Sanitorium, 1140 East Mar-
ket Street, Indianapolis.
Dr. H. M. Beatty.

Iowa:

Rapid Treatment Center, St. Joseph
Mercy Hospital, Sioux City.

Rapid Treatment Center, Broadlawns
Hospital, Des Moines.

Rapid Treatment Center, University
Hospital, Iowa City.

Kentucky :

Rapid Treatment Center, Louisville
City Hospital, Louisville.

Louisiana :

Leesville Quarantine Hospital, Lees-
ville.
P. A. Surgeon (R) Carl G. Kuehn.

Minnesota:

Women's Detention Home, Minne-
apolis.

Mississippi:

Delta Medical Center, P.O. Box 937,

Greenwood.

P. A. Surgeon (R) Francis D. Wilder.

442

JOTJBNAL OF SOCIAL HYGIENE

NATIONAL, EVENTS

443

Public Health Rapid Treatment Cen-
ter, Matty Hersee Hospital, Meridian.
Asst. Surgeon John F. Flynn.

Public Health Treatment Center,

McLain.

P. A. Surgeon (R) Milford M. Green-

baum.

Missouri:

Midwestern Medical Center, 3630
Marine Avenue, St. Louis 18.
Surgeon Leland J. Hanchett.

Nebraska:

Intensive Treatment Center, 1702
Grace Street, Omaha.

New Mexico:

New Mexico Intensive Treatment
Center, 1305 East Gold Avenue, Al-
buquerque.

Asst. Surgeon (R) Herbert M.
Leavitt.

New York:

Bellevue Hospital Rapid Treatment

Center, New York.

Surgeon (R) Cornelius T. Stepita.

North Carolina:

Rapid Treatment Center, Box 1968,

Charlotte.

P. A. Surgeon (R) Howard P. Steiger.

U. S. Public Health Service Medical
Center, P.O. Box 1729, Durham.
P. A. Surgeon Evert A. Swensson.

Oklahoma :

Oklahoma State Rapid Treatment
Hospital, Rush Springs.
Surgeon (R) C. A. Shumate.

South Carolina:

Quarantine Hospital No. 1 (colored),

Route 3, Box 990, Columbia.

P. A. Surgeon (R) Maynard C.

Shiffer.

Quarantine Hospital No. 2, Route 2,

Box 480, West Columbia.

P. A. Surgeon (R) Andrew P. Sackett.

Quarantine Hospital No. 3, Route 2,

Box 102 -A, Columbia.

P. A. Surgeon Clarence A. Smith.

South Dakota:

Rapid Treatment Center, c/o County
Health Officer, Rapid City.

Rapid Treatment Center, c/o City
Hall, Sioux Falls.

Tennessee:

West Tennessee Isolation Hospital,
c/o Shelby County Hospital, Mem-
phis 12.

Asst. Surgeon (R) Edward M. Eck-
berg.

Middle Tennessee Isolation Hospital,

Route 6, Nashville.

P. A. Surgeon (R) E. T. Duncan.

Silverdale Isolation Hospital, Route
2, Box 501, Chattanooga 6.
Asst. Surgeon (R) Robert L. Wood-
ward, Jr.

Texas :

Quarantine Hospital, 2827 Louisiana
Avenue, El Paso.

Asst. Surgeon (R) Vernon L. Hagan.
Health Department, Health Center
Building, Mineral Wells.

Riverview Hospital, 102 Dwyer Ave-
nue, San Antonio.
Asst. Surgeon Chester M. Sidell.

Park View Rapid Treatment Center,

Corpus Christi.

Surgeon (R) William P. Scarlett.

Utah:

Utah Detention Quarters, 115 South
State Street, Salt Lake City.

Virginia:

Richmond Rapid Treatment Center,
108 West Gary Street, Richmond 20.
Asst. Surgeon Edward W. Kunckel.

Washington:

Seattle Treatment Center, 9236 Ren-
ton Avenue, Seattle.
Asst. Surgeon (R) Fred W. Harb.

Washington Infirmary, Route 1, Box

700, Centralia.

Surgeon (R) Lennert B. Mellott.

West Virginia:

Kanawha Valley Medical Center, 151
Twelfth Avenue, South Charleston.
P. A. Surgeon Robert D. Wright.

444 JOURNAL OF SOCIAL HYGIENE

EVENTS— PAST AND FUTURE

October 2 ASHA Associate Group Meeting on Industry vs. VD, in connection
New York with the Annual Meeting of the American Public Health Association
(see p. 447). 8:30 P.M., Salle Moderne, Hotel Pennsylvania.
Presiding: Dr. Victor G. Heiser. Speakers: R. E. Gillmor, Dr. W. L. Weaver,
Abraham Bluestein, Percy Shostac.

October 3-5 Second Wartime Public Health Conference and 73fd Annual

New York Business Meeting of American Public Health Association, New

York, Hotel Pennsylvania. Associate Group Meetings, October 2.

October 3-5 First White House Conference on Rural Education, Washington,
Washington D. C. Planned and financed by the National Education Asso-
ciation to bring together 200 leaders of groups whose interests
are linked with rural American life. Topics to be considered: interdependence
of rural and urban economics; health of rural young people; extension of
complete educational opportunity to farm children now denied it; and post-war
conversion plans of farm school.

October 6-7 Annual Conference of Social Hygiene Executives, Town Hall Club.
New York Guests of ASHA.

October 9-10 ASHA Semi- Annual Staff Conference. Headquarters Offices, 1790
New York Broadway, New York 19.

October 23-29 Seventh Annual Better Parenthood Week. Suggestions and
materials available from Better Parenthood Week Committee,
52 Vanderbilt Avenue, New York 17, N. Y.

November 5-1 1 American Education Week. Sponsored by National Educa-
tion Association, American Legion, U. S. Office of Education,
National Congress of Parents and Teachers. Material and suggestions may be
secured from National Education Association, Washington 6, D. C. General
Theme : Education for New TasTcs. Daily topics : Nov. 5 — Building Worldwide
Brotherhood; Nov. 6 — Educating All the People; Nov. 7 — Improving Schools
for Tomorrow; Nov. 8 — Developing an Enduring Peace; Nov. 9 — Preparing
for the New Technology; Nov. 10 — Enriching Our Cultural Heritage; Nov. 11 —
Bettering Community Life.

November 9-1 1 National Conference on Postwar Venereal Disease Control,
St. Louis, Missouri. Auspices of U. S. Public Health
Service.

Saturday, December 2, 1944

PAN AMERICAN HEALTH DAY

Wednesday, February 7, 1945

SOCIAL HYGIENE DAY

NEWS FROM THE FORTY-EIGHT FRONTS

ELEANOE SHENEHON
Director, Community Service, American Social Hygiene Association

Connecticut: Connecticut State Health Department Completes
Laboratory Evaluation Study. — The Connecticut Health Bulletin for
August, 1944 reports that :

"Directors of laboratories have been informed of the efficiency of their
serological tests. At the recommendation of the Advisory Committee who
have guided the study, a representative of this Department will contact laboratory
heads to determine how the facilities of this Bureau may be applied in each
individual case to effect improvement where necessary. The follow-up work
will be most important but is time-consuming. Visits wrill be made at the
earliest possible moment but there are more than 30 of the 48 laboratories
evaluated where arrangements for follow-up work must be made. Meantime,
approximately 24 of the laboratories will participate in another study scheduled
for this fall and a like number in one to begin in the spring."

The Department states for the month of July of 16,374 blood tests made
for syphilis only 1,932 were positive and of 511 examinations made for gonorrhea
only 60 infections were reported.

District of Columbia: D. C. Society Has Full-Time Health Edu-
cator.— Ray H. Everett, Executive Secretary of the District of
Columbia Social Hygiene Society, has announced the recent appoint-
ment of Mrs. Grace Lando as Educational Assistant, succeeding Mrs.
M. Virginia Allen, who resigned after two years of service in the
same post.

Mrs. Lando is a Public Health Nurse with varied experience. A graduate
of Frankford Hospital in Philadelphia, she later received the Certificate in
Public Health at the University of Pennsylvania, where she studied under
Dr. John L. Stokes. Her previous assignments have included work with a
settlement house and the Visiting Nurse Society in Philadelphia, with the
Baltimore County Health Department on loan from USPHS, doing epidemiological
work mainly and with two industrial plants operated by Central Administrative
Service.

Nebraska: Midwest Conference on Interagency Relationships in
Venereal Disease Control. — Carrying out the national pattern at
the regional level, a third conference of representatives from the
Army and Navy, Federal Security Agency and ASHA was called
jointly with representatives of State health departments in United
States Public Health Service District No. 7, in Omaha on April 25th,
to discuss matters of mutual interest.

Among topics taken up were Army Morbidity Reports and Suffi-
cient Sexual Contact Information. Special discussion was given to
the subject of Community Venereal Disease Councils and the part
they could play in " 'spark plugging' community interest in the
control program" as an ''avenue of public interpretation," and in

445

446 JOURNAL OF SOCIAL, HYGIENE

providing a sounding board to which both civilians and military
could take their problems and obtain understanding and mutual
support. ' '

Attending the meeting were :

J. J. Harbart, U. S. Coast Guard, District Venereal Disease Officer; Melba M.
Foltz, Paul D. Jones, and Charles L. Leopold, Social Protection Kepresentatives,
Kansas City, Missouri; Howard F. Feast, Social Protection Representative,
Denver, Colorado ; Mrs. Winifred H. Ferguson and Martin J. Lahart, Social
Protection Eepresentatives, Minneapolis, Minnesota; Charles J. Hahn, Jr., Repre-
sentative, Law Enforcement Section, Social Protection Division, Washington,
D. C. ; George Gould, Assistant Director, Division of Legal and Protective
Services, American Social Hygiene Association, and in charge of ASHA Field
Offices at Omaha and Salt Lake City, Utah; Captain H. Kaplan, Internal
Security Section, Seventh Service Command; Lieutenant Colonel James Gordon,
MC, Venereal Disease Control Officer, Seventh Service Command; Captain Hugh
C. Clark, MC, Station Hospital, Lowry Field, Denver, Colorado ; Dr. L. O. Weldon,
Liaison Officer, U. S. Public Health Service, Seventh Service Command; Dr. H. G.
Irvine, Minnesota State Department of Health; Dr. R. A. Frary, Nebraska
State Department of Health; Dr. M. Sorenson, U. S. Public Health Service,
Kansas State Department of Health; Dr. W. C. Woofter, U. S. Public Health
Service, Iowa State Department of Health; R. R. Wolcott, U. S. Public Health
Service, Missouri State Department of Health; A. B. Price, Surgeon, U. S. Public
Health Service, Kansas City, Missouri; Lieutenant (j.g.) W. K. Hall, Medical
Corps, U. S. Navy, Kansas City, Kansas; Lawrence A. Brennon, U. S. Public
Health Service; J. K. Holpern, Pt. Surgeon, U. S. Public Health Service.

New York City: Social Hygiene Division, New York Tuberculosis
and Health Association Has New Staff Member. — Dr. Jacob A.
Goldberg Secretary of the Division has announced the appointment
of Miss Charlotte Smith to assist with the community program.

Replacing Mrs. Ruth Wells who resigned in June, Miss Smith comes to the
Division with a rich background of education and experience in social hygiene.
For the past few years she has been public health nurse with the Pennsylvania
State Department of Health, where she organized social hygiene programs in
various parts of the state. She is a graduate of the University of Pennsylvania
Hospital, and studied at the University of Pennsylvania and under Dr. John
H. Stokes.

Virginia: State Social Hygiene Council Sponsors Workshop in
Health and Human Relations at Radford College. — The first Work-
shop for Teachers in Health and Human Relations to be held in
the State of Virginia occurred at Radford College from July 17th
to August 5th. Working with the Virginia Social Hygiene Council,
chief sponsor of the project, the Virginia State Department of Edu-
cation and the State Department of Public Health provided adminis-
trative and financial assistance. Teachers from nearly twenty
schools in every part of the State were in attendance and faculty
was provided by national, state and local agencies.

The work plan began with a study of the need, in the light of the
present and the future, for activities in health and human relations
in schools and consideration of methods now in use. This was
followed by a study of the Virginia Curriculum to discover oppor-
tunities for incorporation. Recommendations were later drawn up
and passed on to the sponsoring agencies on this point.

NOTES ON INDUSTRIAL COOPERATION 447

Directed by Dean M 'Ledge Moffett of Radford College, the course
was conducted by Dr. Lester A. Kirkendall of the IT. S. Office of
Education, James S. Owens of the Regional Social Protection Divi-
sion Office, and Kenneth R. Miller, Field Representative of the
American Social Hygiene Association. A number of guests visited
the classes and field trips were features of the course.

The Virginia Social Hygiene Council was organized in 1943 and
includes in its membership a group of distinguished persons rep-
resenting agencies interested in various phases of social hygiene.
John W. Goldsmith, Radford attorney, is president ; Abner W. Robert-
son, Richmond, is secretary, and other members are state and local
officials, educators, physicians and laymen. In addition to teacher
training, the Council's program includes promotion of better use
and understanding of State laws regarding venereal diseases, public
education and development of community groups throughout the
State.

It is believed that this summer 's Workshop will do much to advance
the participation of schools and teachers in community venereal dis-
ease control work and other social hygiene activity. It is hoped
that the Workshop can be continued next year so that more attention
can be given to the development of study outlines, work units and
extra curricular activities in detail.

NOTES ON INDUSTRIAL COOPERATION

PERCY SHOSTAC
Consultant on Industrial Cooperation, American Social Hygiene Association

NEW INDUSTRIAL PROGRAM GETS UNDER WAT

MEETING

The ASHA's campaign to enlist management and the trade
unions in a program of education and action towards the control
of VD was auspiciously launched on October 2, at the Association's
Industry vs. VD meeting at the Hotel Pennsylvania in New York.
The meeting was held in connection with the Second Wartime Public
Health Conference and the 73d Annual Business Meeting of the
American Public Health Association.

An audience of several hundred public health officers, physicians,
industrialists and labor people, heard how important it is to bring
the VD message to industrial workers, a group which with their
families includes at least half of our total population. Activities
and progress in VD education and control in industrial and union
groups were reviewed, and the ASHA program was presented. The
speeches aroused so much interest that it is planned to publish them
in some later number of the JOURNAL.

Dr. Victor G. Heiser, consultant, committee on industrial health,
National Association of Manufacturers, presided. The speakers were

448 JOURNAL OF SOCIAL HYGIENE

R. E. Gillmor, president, Sperry Gyroscope Company, Inc.; Dr. W.
L. Weaver, medical director, du Pont Rayon plant, Richmond, Va. ;
Abraham Bluestein, executive director, Labor League for Human
Rights, AFL, and Percy Shostac.

MATERIEL

The October 2 gathering was the occasion for public presentation
of the ASHA's two new manuals: Industry vs. VD prepared for
use by management and The Trade Unions vs. YD designed for
union programs.

The manuals, as previously mentioned in Notes on Industrial
Cooperation (May JOURNAL), outline a three-point program against
the venereal diseases stressing the value of shop health and safety
committees for enlisting support and participation of the workers.
The* importance of cooperation with community activities to combat
VD and the conditions which favor their spread, is also highlighted.
Flap envelopes in both manuals contain samples of pamphlets,
including the new Why a Blood Test and The Prostitution Racket,
a film list, reproductions of suitable posters and other material.
The manuals were designed to present in one packet or kit all the
essentials for a complete VD control program for a firm or a union.
Copies are available upon request to those who want to help further
the program.

RESPONSE

The October 2d meeting was preceded by a mailing of 10,000
invitation-announcement cards to friends of the Assosiation, public
health officials, physicians and nurses in industry, VD control officers,
business men and trade unionists. This mailing was intended pri-
marily to publicize the Association's industrial program and only
incidentally to build an audience. In response to a brief notice
announcing that the two new manuals would soon be forthcoming,
almost 200 requests for copies were received from firms, state and
local health offices and trade unions. Just as encouraging was the
reaction of the newspapers to the meeting; topnotch metropolitan
coverage was given in a full column news-story on October 3 and
a vigorous editorial on October 4, in the New York Times. The
Baltimore Sun followed with an editorial and items appeared in
various papers throughout the country. The Association's new
program in industry was indeed auspiciously launched.

This response of the press and the public left no doubt that
industry is interested and willing to do something about the venereal
disease problem. However, to launch a program and to carry it
into successful operation are two different matters. Certainly the
latter cannot be accomplished on a mail order basis alone. In the
next issue of the JOURNAL a progress report will be made on the
program in action.

fubttc LIW"J
Kansas Cltj, »*

Vol. 30 November, 1944 No. 8

T 1 C ' 'Vv

Journal *•<

of

Social Hygiene

A Review of
Principles and Progress in Social Hygiene Legislation

CONTENTS

A Challenge to Community Workers Bascom Johnson 449

Twenty Years' Progress in Social Hygiene Legislation George Gould 456

Requirements of Existing State Laws:

Laws against Prostitution 470

Premarital Examination Laws 472

Prenatal Examination Laws 477

Forms and Principles of State Social Hygiene Laws 479

Social Hygiene Legislation Considered in 1943-44 in the States, Territories and District
of Columbia 494

Editorials:

If Your State Needs New Social Hygiene Laws 496

Your Part in the Legislative Campaign 497

National Events Robert W. Osborn and Reba

Rayburn 499

News from the 48 Fronts Eleanor Shenehon 508

Notes on Industrial Cooperation Percy Shostac 511

Publications Received 514

National Social Hygiene Day
February 7, 1945

The American Social Hygiene Association presents the articles printed in the
JOURNAL OP SOCIAL HYGIENE upon the authority of their writers. It does not
necessarily endorse or assume responsibility for opinions expressed or statements
made. The reviewing of a book in the JOURNAL OF SOCIAL HYGIENE does not
imply its recommendation by the Association.

EDITORIAL BOARD
C.-E. A. WINSLOW, Chairman

RAY H. EVERETT WILLIAM F. SNOW

JOSEPH K. FOLSOM JOHN H. STOKES

EDWARD L. KEYES JOHN C. WARD

JEAN B. PINNEY, EDITOR
EEBA RAYBURN, ASSISTANT EDITOR
WILLIAM F. SNOW, EDITORIAL CONSULTANT

The JOURNAL OF SOCIAL HYGIENE is supplied to active members of the American
Social Hygiene Association, Inc. Membership dues are two dollars a year. The
magazine will be sent to persons not members of the Association at three dollars
a year ; single copies are sold at thirty-five cents each. Postage outside the United
States and its possessions, 50 cents a year.

Entered as second-class matter at post-office at Albany, N. Y., March 23, 1922.
Acceptance for mailing at special rate of postage provided for in Section 1103,

Act of October 3, 1917, authorized March 23, 1922.
Published monthly (nine issues a year) for the Association by the Boyd Printing

Company, Inc., 372-374 Broadway, Albany, N. Y.

Copyright, 1944, by The American Social Hygiene Association, Inc.

Title Registered, U. S. Patent Office.

PUBLISHED MONTHLY EXCEPT JULY, AUGUST AND SEPTEMBER
AT 372-374 BROADWAY, ALBANY 7, N. Y., FOR

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

EDITORIAL OFFICES AND NATIONAL HEADQUARTERS
1790 BROADWAY 19, NEW YORK CITY

WASHINGTON LIAISON OFFICE
Room 609, 927 loth St., N.W., Washington 5, D. C.
JEAN B. PINNEY, Director in Charge
REBA RAYBURN, Office Secretary

FIELD OFFICES

ATLANTA, GEORGIA. 506-508 Citizens and SALT LAKE CITY, UTAH. 402 Mclntyre

Southern National Bank Building. Serv- Building. Serving Arizona, Idaho, Mon-

ing Alabama, Florida, Georgia, Missis- tana, Nevada, Utah, California, Oregon

sippi, North Carolina, South Carolina and and Washington.

Tennessee. GEORGE GOULD, temporarily in charge.

CHARLES E. MINER, Field Eepresentative.

MRS. EDNA W. Fox, Field Eepresentative. BALTIMORE, MARYLAND. Care of Baltimore

Community Fund, 22 Light Street.

COLUMBUS, OHIO. Care National Confer- Serving Delaware, Maryland, Pennsyl-

ence of Social Work, 82 High Street. vania, an<j Virginia.

Serving Indiana, Kentucky, Ohio and JOHN HALL. Field Eepresentative.

West Virginia.

AND DALLAS, TEXAS. Cliff Towers. Serving

CHICAGO, ILLINOIS. Room 615, 360 Nortii Arkansas, Louisiana, New Mexico, Okla-

Michigan Avenue. Serving Illinois, Michi- homa and Texas.

gan and Wisconsin. BASCOM JOHNSON, Director in Charge.

WADE T. SEARLES, Field 'Representative. MRS. GERTRUDE R. LUCE, Office Secretary.

OMAHA, NEBRASKA. 736 World Herald SAN FRANCISCO, CALIFORNIA. 45 Second

Building. Serving Colorado, Iowa, Kan- Street.

sas, Minnesota, Missouri, Nebraska, North W. F. HIGBY, Field Consultant.
Dakota, South Dakota and Wyoming.

GEORGE GOULD, Assistant Director. SAN JTTAN, PUERTO Rico. P. O. Box 4101.

Division of Legal and Protective Services, KENNETH R. MILLER, Field Bepresenta-

in Charge. tive.

Journal

of

Social Hygiene

VOL. 30 NOVEMBER, 1944 NO. 8

A Review of
Principles and Progress in Social Hygiene Legislation

A CHALLENGE TO COMMUNITY WORKERS *

BASCOM JOHNSON

Director, Division of Legal and Protective Services
American Social Hygiene Association

If I were a community worker instead of a lawyer and some one
asked me the question, "What are you doing about better social
hygiene laws and law enforcement?", I should reply with another
one or perhaps two or three about as follows: Why should I do
anything about them? If I received a satisfactory answer to that
one proving that good social hygiene laws, well enforced, would aid
me to attain my objectives as a community worker, I would still
want to know what I could do about them, and how.

In attempting to answer these questions which I have put in your
mouths, I will first list these better laws that social hygienists think
important, and this may aid you in determining, perhaps without
any argument from me, whether their passage and enforcement would
help you to do a better job.

* Eevised from a paper delivered before a session on Social Hygiene and Social
Protection at the National Conference of Social Work, as arranged by the
Conference's Special Committee on Social Hygiene, Bay H. Everett, Chairman,
at Cleveland, Ohio, May 23, 1944.

449

450 JOURNAL OF SOCIAL HYGIENE

These laws fall into two main categories : repressive and preventive.

The repressive laws are aimed mainly at reducing the number and
activities of persons who stimulate the sexual appetites of man, or
who exploit these appetites for gain, while trafficking in the poverty,
weakness, or misfortunes of women.

The preventive laws attempt to eliminate conditions which force
or influence women into prostitution. They include also public health
laws designed to prevent the spread of the venereal diseases.

In the first category are laws against pimps, procurers, traffickers
in women and girls, operators of houses of prostitution, and the
whole unsavory crew of go-betweens and facilitators of prostitution.

There are, in addition, repressive laws aimed at the direct partici-
pants in prostitution — namely, the prostitutes and also (in some
nineteen states) their customers. These latter laws, it must be con-
fessed, have been limited in too many places, to use as venereal
disease case-finding machinery for health departments rather than
as instruments for the repression of prostitution for the general
welfare of the people as a whole.

In the second category come laws which provide compulsory health
or sickness insurance, laws for the protection of minors, laws pro-
viding strict supervision over commercial employment agencies or
abolishing them as necessary, and the public health laws above
referred to.

I include in preventive laws those providing compulsory health or
sickness insurance because health studies of prostitutes made both
in this country and abroad show that many of them have suffered
from chronic diseases and abnormalities from adolescence, which
entailed reduced working capacity.

Dr. Tage Kemp, Director, University Institute for Human Genetics,
Copenhagen, in a chapter which he contributed to a recent League
of Nations Publication, entitled Prevention of Prostitution* makes
this comment on page 46:

"It may be taken that only about one half the total number of
prostitutes have a normal earning capacity for ordinary work and
many of them are totally disabled. ' ' He continues : ' ' When a woman
who is poor, with no one to support her, and no health or invalidity
insurance, develops a serious chronic disease, her situation is a difficult
one and she may be forced into prostitution. Compulsory health
and invalidity insurance as well as unemployment insurance must
therefore rank as effective preventive measures against prostitution. ' '

Laws abolishing or providing strict supervision of commercial
employment agencies are included as preventive measures because
of studies in which I participated in this country and abroad for
the League of Nations, of conditions and agencies, which contribute
to the international traffic in women and girls.

* Prevention of Prostitution, a study of measures adopted or under considera-
tion particularly with regard to minors. League of Nations Advisory Committee
on Social Questions. Official Pub. No. C.26.M.26. 1943. IV.

A CHALLENGE TO COMMUNITY WORKERS 451

The international convention adopted in 1933 by the International
Labor Conference and ratified up to 1943 by five countries provides
the most radical regulation of this kind.

It consists in the complete abolition of all fee-charging employment
agencies conducted with a view to profit subject to certain limitations.
For those interested in further details, I recommend reading Chap-
ter 3 of the League of Nations publication above referred to, which
was contributed by the International Labor Office.

In this last-named group are public health laws giving power to
state health departments to make rules and regulations regarding
the control of the venereal diseases which have the force and effect
of laws; laws which require health officers to examine and treat,
under quarantine if necessary, persons who, they have reasonable
grounds for believing, have an infectious venereal disease; those
requiring physicians, superintendents of hospitals, dispensaries, or
charitable institutions and others to report such cases to health
departments; those requiring premarital and prenatal examinations
for syphilis, and those requiring periodical examinations of certain
occupational groups such as children's nurses, masseurs, barbers, or
others who come into intimate physical contact with others; laws
or regulations which prohibit infected persons from engaging in the
occupations listed just above.

Assuming, for the sake of argument, that the enforcement of such
laws does help to reduce the volume of prostitution and the number
of prostitutes on the one hand, and the spread of the venereal dis-
eases on the other, would these reductions lighten the burdens of
community workers or help them in any way to attain their
objectives ?

You know so much more about your burdens and objectives than
I do that I hesitate to answer these questions for you.

I suggest, however, that prostitution as a serious social disorder,
and syphilis and gonorrhea as dangerous communicable diseases,
incapacitate their devotees and victims for useful and productive
living, — sometimes for short periods, sometimes for life.

I suggest, for example, that you have had among your clients,
whether you know it or not, many broken down prostitutes who
were incapable of self-help and therefore permanent millstones about
your necks. I suggest, also, that many of the homes and families
you have sought to keep together or rehabilitate were broken, perhaps
irrevocably, because the father, mother, daughter, or son had drifted
into or become patrons of prostitution, or had acquired one of the
venereal diseases which was not recognized or treated in time to
prevent seriously incapacitating effects.

I suggest that a number of your men and women clients have
married with uncured syphilis which they never knew they had or
thought was cured, and have therefore infected their marital partners
unintentionally. I suggest that a number of such married persons

452 JOUKNAL OF SOCIAL HYGIENE

have carelessly or unwittingly created children, born dead, crippled
or blind because they were not required to have examinations for
syphilis before marriage or because the mothers were not required to
have examinations for this disease during pregnancy.

If it is true, as I have suggested, that invalidism and death,
incapacity to perform any useful labor, broken homes and families
are often caused by prostitution and the venereal diseases, and that
you are interested professionally in preventing and reducing such
disasters, the question remains : Do such laws, well enforced, actually
help to reduce prostitution and prevent the spread of the venereal
diseases ?

The record is quite clear as regards prostitution. Since Abraham
Flexner made his classic study of Prostitution in Europe, in 1912,
down through the years to the present day, it has been proven beyond
doubt that prostitution can be and has been, in many places and
at various times, greatly reduced by the passage and enforcement of
repressive laws. The American Social Hygiene Association has
checked and counter-checked these results by a long series of investi-
gations. The Army and the Navy, the United States Public Health
Service, State and local police and health departments agree. We
must accept these findings as conclusive.

Evaluation of the influence of health laws and their enforcement
on the reduction of the venereal diseases is difficult. There are
many factors which may contribute to the results. Among them
are the reduction of prostitution as a source, the establishment of
free clinics, the increased use of prophylactics and the effects of
health education projects. Moreover, there is no satisfactory way
of estimating the possible or probable number of exposures or infec-
tions occurring in a community. Nor can we be sure how generally
reporting of cases is being observed in many areas. We cannot,
therefore, prove statistically that the increases or reductions that
apparently have taken place in some communities have actually
occurred. It is, however, profitable to watch the rise and fall of
both military and civilian data.

We know from experience that when civilian prostitution laws and
quarantine are enforced against promiscuous and infectious civilian
women, the venereal disease rates among the exposed armed forces
immediately drop. It is probable that the same thing occurs among
civilian men, and could be expected to occur among civilian women
if infectious, promiscuous civilian men were quarantined in the same
way. We shall never know, with any degree of accuracy, however,
what progress we are actually making in venereal disease control
among civilians until the reporting laws are generally observed
and full cooperation in adequate diagnosis and record keeping are
secured.

Regardless, however, of whether venereal diseases are increasing
or decreasing among civilians during the present war, most public
health men would agree, I think, that any increase which may exist

A CHALLENGE TO COMMUNITY WOEKEES 453

would be far greater if the powers of health departments and the
public health measures and appropriations, all based on or derived
from the statutes, were wiped out.

This brings me to my final question : What can community
workers do about the passage and enforcement of good laws, and how?

Every two years, approximately, 44 States have legislative sessions.
Next year, 1945, is a big legislative year. There will come up in
the legislatures of many of these states bills in both of the categories
above described — that is, repressive laws and preventive laws. A
number of these states need new laws or improvements in their
existing ones.

Many of the cities in these States, as well as in others which
already have good laws, will find that it is desirable to incorporate
the provisions of the State laws in their municipal ordinances.

If community workers are well informed and convinced of the value
to the public of good social hygiene laws, and appear in their support
before committees of the legislature to whom such bills are sent
for consideration, their chances of passage are greatly increased.
This applies not only to substantive laws but to bills calling for
appropriations to police departments, courts, health departments,
and other agencies of government.

I don't need to remind you that few laws can be enforced or
administered without adequate equipment and personnel. One of
the byproducts of this and all other wars has been the starvation
of our official administrative agencies. Many of the best men and
wromen are drafted for war service. We must see to it that this
starvation does not continue into the post-war period. There is
real danger that this may happen if the events of 25 years ago are
any criterion. There was a serious letdown in all official social and
health activities after World War I. This was a human reaction
but disastrous in many ways, particularly in the field of social
hygiene. Red-light districts reopened in many cities where they
had been kept tightly closed during the war. Many health depart-
ments abolished their divisions of venereal disease control. Appro-
priations for this work and for clinics were discontinued or sharply
reduced; women police and probation officers were discharged; quar-
antine hospitals and detention houses were in many cases eliminated.
The result was that the growth of social hygiene activities was slowed
down in many places, and some of the gains were lost. One of the
permanent gains was the creation of the Venereal Disease Division
of the United States Public Health Service, which today is a strong
section of the backbone of the national campaign.

That Division and the annual appropriations made by the Congress
each year since 1937 to the Public Health Service, for aid to the
states for venereal disease control activities, seem fairly secure. This
Federal assistance, however, is conditioned on the availability of
state, county and community funds to match it in whole or in part,
except in the case of special war related expenditures. If you want

454 JOURNAL OP SOCIAL HYGIENE

these funds in your States to be continued, the members of Congress
and of your state and local appropriating bodies need to know how
you feel and on what evidence you base your opinions. This applies
also to the retention of appropriations which are now available for
other related activities and for the establishment and operation of
the so-called Rapid Treatment Centers in many communities.

These are but a few of the examples of what community workers
can do to maintain our present status. Over and above this main-
tenance of the status quo, I suggest we might take advantage of
public interest in such matters during this war, as we did during
the last one.

Juvenile delinquency, including sex delinquency, is much in the
public eye. Newspapers, magazines, the pulpit and the lecture
platform resound with loud cries and wails concerning the lost gen-
eration. Many good suggestions have been made to remedy or
alleviate the situation. Some of them have been put into operation
on a limited scale. Most of them depend on the availability of
trained personnel for the education and protection of youth. This
means money for training and salaries of teachers, juvenile judges,
women police, probation officers, and others.

Isn't it timely, therefore, and intensely practical for us to ask
from Congress Federal grants-in-aid to the States to help them
attack this problem? These Federal grants could require that State
legislatures appropriate funds to match them in whole or in part,
just as was done and is being done with Federal grants to the
States for the control of the venereal diseases.

The Federal agency to distribute these grants under appropriate
regulations might perhaps be the Children's Bureau or the Social
Protection Division, if this Division is continued or the Office of
Education or other administrative unit of the government.

Isn't it equally practical and necessary to continue in some form
the Federal participation and cooperation with the States and local
communities in their attack on prostitution? The Federal May Act,
Public Law No. 163, adopted against prostitution on July 11, 1941,
is a war measure which expires, unless reenacted, on May 15, 1945.
While it has been actually applied only in Tennessee and North
Carolina, it has been immensely effective in stimulating effective
action by many other State and local governments. We also have
the Federal Mann and Bennett acts which are permanent, and aimed
at the elimination of interstate and international traffic in women
and girls.

Following the precedent of the last war, during which, as previ-
ously mentioned, there was created in the Public Health Service the
Division of Venereal Diseases which has survived and has performed
most useful service in cooperation with State health departments,
why not make permanent the Federal Division of Social Protection
to continue cooperating with the States in their attack on prostitu-
tion? If for any reason it is deemed necessary or expedient to

A CHALLENGE TO COMMUNITY WORKERS 455

abolish this Division when peace is declared, why not establish in
the Department of Justice or in some other appropriate government
unit a division dedicated to cooperation with States and municipalities
in the attack on prostitution? Such a division, within a permanent,
popular and highly efficient Federal agency would insure continuity
of attack and the maintenance of steady gains against this
ancient evil.

To recapitulate — community workers should have an interest and
do have a stake in the passage and enforcement of good social hygiene
laws. They also have a special responsibility for the operation of
some of these laws. No one else is so well equipped to discharge this
responsibility. I refer to the preventive and rehabilitative gaps in
both the program against prostitution and that against the venereal
•diseases.

It may be that new techniques will have to be developed for deal-
ing satisfactorily with reluctant "victory girls." It may be that
these young girls are reluctant because of conditions attendant on
their arrest and confinement in jails when they ought to have been,
if confined at all, confined in modern detention places for juveniles.
Wherever the latter proves to be the ease, community workers might
well be found in the forefront of workers who are attempting to
secure such places from their local governments.

' ' The final end of Government is not to exert restraint but
to do good."

EUFUS CHOATE

in a speech before the United States Senate, July 2, 1841

TWENTY YEAES' PROGRESS IN SOCIAL HYGIENE

LEGISLATION

DEVELOPMENTS IN THE ADOPTION OF STATE LAWS FOB THE PREVENTION
AND CONTROL OF THE VENEREAL DISEASES AND FOR

REPRESSION OF PROSTITUTION
FROM THE YEAR 1925 TO NOVEMBER 1, 1944

GEOEGE GOULD

Assistant Director, Division of Legal and Protective Services,
American Social Hygiene Association

For forty-four states* the year 1945 will be a "legislative year."
Popular interest in the nation-wide campaign against syphilis and
gonorrhea and for the repression of prostitution, and the genuine
public concern that sound and effective legal safeguards shall be
set up to protect the family and the community from these hazards
to health and happiness, will stimulate the introduction of a good
number of social hygiene bills in the state legislatures during the
1945 sessions. Thirty-six states considered social hygiene legislation
of one type or another during 1943, and 17 states passed and put
into effect new laws or amendments for improvement of old laws.
A number of states holding regular or special sessions in 1944 fol-
lowed suit, and indications are that J.945 will see law-makers in many
of the states which have not yet provided full legal protection in
this way for their citizens, taking steps to do so.

This means that careful study should be given to state and com-
munity social hygiene needs and any legislative plans for meeting
them, well ahead of the time that legislatures meet. All who are
interested in health and welfare should join in seeing that any new
social hygiene laws proposed, or any amendments of existing laws,
are adequate for the purposes intended, and enforceable.

For the aid and interest of groups contemplating new social hygiene
laws, including the legislators themselves, and also for the reference
of officials concerned with operation of such laws, this twenty-year
review of progress has been compiled. The American Social Hygiene
Association's Division of Legal and Protective Services will be glad
to supply further information on request, and is glad to place its
thirty years of study and experience at the service of all agencies
endeavoring to obtain sound and satisfactory laws.

* Also for the Territories of Alaska and Hawaii and the Insular Dependencies
of Puerto Rico, the Virgin Islands, and, in normal times, the Commonwealth
of the Philippines. Also, since Congress meets every year, for the District of
Columbia.

456

457

Generally speaking, there are four types of laws relating to social
hygiene, which are of special current interest to the public. They are :

1. Laws for the repression of prostitution

2. Premarital examination laws

3. Prenatal examination laws

4. Venereal disease control laws and state or local board of
health rules and regulations.

The essential or principal provisions of these laws should be known
as widely as possible.1

LAWS AGAINST PROSTITUTION

Although, during the early part of the twentieth century, there
were a number of states with fair laws against the activities of
exploiters of prostitution and of prostitutes, it was not until 1919
that the first legislation penalizing the male customers of prostitutes,
was placed on state statute books. Ten states,2 at that time adopted
new laws 3 based on the provisions of a standard form of law known as
the Vice Repressive Law, which had been drafted by the Federal
government and presented for enactment to the state legislatures.
The Vice Repressive Law provided a new definition of prostitution,4
making as an element of the offense, not merely the giving but also
the receiving of the body for hire, as well as the giving or receiving
of the body for indiscriminate sexual intercourse without hire. Other
provisions of the law prescribed penalties for solicitation for prostitu-
tion on the part of either party, as well as for the other activities
of the immediate parties, and of third parties to prostitution including
go-betweens. The law also punished the professional or occasionally
disorderly house keeper and made it an offense to occupy, enter,
or remain in any house, premises, or conveyance for the purpose
of prostitution. Furthermore, it eliminated fines and provided
indeterminate sentences in order to afford opportunities for
rehabilitation.

By 1925, forty-four states 5 had laws penalizing the keeping, setting
up, or maintaining of disorderly houses. Forty-four states6 made
compulsory prostitution a crime ; and forty-five states 7 had forbidden
pandering or procuring of a female for prostitution. Twenty-seven 8

1 See Forms and Principles of State Social Hygiene Laws, pp. 479-494.

2 Connecticut, Delaware, Maine, Maryland, New Hampshire, North Carolina,
North Dakota, Ohio, Ehode Island and Vermont. (New Jersey, New Mexico
and Wyoming passed similar legislation in 1921 and 1922.)

8 For copy of provisions of this law see page 479.

* No statutory definition prior to 1919 can be found. Prostitution was not
an offense at common law. In the absence of a statute the courts followed the
dictionary definition, which states that prostitution is common lewdness of a
woman for hire.

B Arkansas, Kentucky, Louisiana and South Carolina had no laws. (In
Kentucky, a common law offense; and in Louisiana, unlawful outside limits
fixed by city.)

« Georgia, Mississippi, North Carolina and South Carolina had no laws against
this activity.

T Georgia, Mississippi and South Carolina had no laws against this activity.

8 Arizona, Arkansas, Connecticut, Delaware, Georgia, Idaho, Kentucky
(female), Louisiana, Maine, Maryland, Michigan (female), New Hampshire,

458 JOURNAL OF SOCIAL HYGIENE

provided punishment for transporting another for such purpose,
while living off the earnings of a prostitute had been made unlawful
in thirty-five states.9 These so-called "white slave laws" are
directed against the panderer, the procurer, the madam or other
person who detains a female in a house of prostitution, the individual
who transports another within the state for immoral purposes, or
other person who receives any of the proceeds of prostitution, or
who lives on the earnings of a prostitute. By "compulsory prostitu-
tion" is meant the placing or keeping of a woman in a house of
prostitution or forcing her to lead the life of prostitution. By
"pandering" is meant procuring a female inmate for a house of
prostitution, inducing her to become such an inmate, encouraging
her to remain there, or offering or agreeing to do so.

The Injunction and Abatement Law, first passed in Iowa in 1909,
is a civil action, brought in the name of the state by the attorney
general, district attorney, or by a private citizen, and provides
for the closing of houses of prostitution as public nuisances by courts
of equity. The owner, keeper of, or employees in a house of prosti-
tution, or the agent who rents or takes care of the property, all or
any one of them, may be declared guilty of maintaining a nuisance.
Upon proof of the existence of the nuisance, a permanent injunction
is issued against its continuance, the personal property used in con-
ducting the nuisance is ordered sold, and the premises closed unless
bond is given to assure the lawful use of the property in the future.
Violation of the order of injunction or abatement is made a contempt
of court and is punishable by fine or imprisonment. Prior to January
1, 1917, only 27 states had enacted the Injunction and Abatement
Law, but by 1925 forty-one 10 had enacted such legislation. Many
points of difference relating to minor details of legal procedure are
found in these laws. The principle which they share in common is
that they give individual citizens in any community the right to
prevent by injunction the continued operation of houses of lewdness,
assignation, or prostitution as nuisances, without having to prove
that such individual citizens suffered special damages different from
those suffered by them in common with the public.

In 1925 nine states11 did not penalize the act of engaging in
prostitution by either the prostitute or her customer, while 23 states 12

New Jersey (female), New Mexico, New York, North Carolina, North Dakota,
Ohio, Pennsylvania (female), Bhode Island, South Dakota, Texas (persons in
military service during World War I), Utah, Vermont, Virginia, Wisconsin
and Wyoming.

» Florida, Georgia, Iowa, Kansas, Mississippi, New Mexico, North Carolina,
Ohio, Oklahoma, Rhode Island, South Carolina, Tennessee and Texas had no law.

10 Arkansas, Missouri, Nevada, Oklahoma, Ehode Island, Vermont and West
Virginia had no such laws. (Tennessee and Texas laws dealt only with injunc-
tion.) New Jersey's law was declared unconstitutional in 1919 but another law
was enacted at a later date. Maryland 's Injunction and Abatement Law, enacted
in 1918, terminated in November 1920.

11 Arizona, Arkansas, Kentucky, Nevada, Oregon, Pennsylvania, South Carolina,
Tennessee and West Virginia.

12 Alabama, California, Colorado, Florida, Georgia, Idaho, Illinois, Iowa,
Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri,
Montana, Nebraska, New York, Oklahoma, Texas, Utah, Virginia and
Washington.

PROGRESS IN STATE LAWS AGAINST PROSTITUTION

As early as 1909 some states
saw the need to protect family
and community from the moral
and health hazards of commer-
cialized prostitution. Pressure
of this problem during the First
World War and the years soon
after spurred wide-spread leg-
islative action, so that, by 1925,
all states had some type of law
to combat this evil.

Existence of these laws and
improvement in community con-
ditions made necessary com-
paratively little new legislation
from 1925 to 1941; but mobili-
zation— both military and in-
dustrial— in the national defense
effort of 1939-41, and the
plunge into World War II,
with a gfeat increase in prosti-
tution activitiesaround strategic
communities, again stimulated
a drive for better laws.

As of November I, 1944,
twenty-nine states and the Dis-
trict of Columbia have accept-
able laws, with only two states

having laws considered " in-
adequate."

Law enforcement officials,
with the backing of public opin-
ion, since 1941 have used these
laws to close over 650 " red-
light districts " or other prosti-
tution activities, thus safe
guarding youth and reducing
the chances of exposure to
venereal diseases.

Good laws against prostitu-
tion and promiscuity will be
more than ever needed in the
restless postwar years.

Is your state well equipped in
this respect?

States having adequate laws
against most aspects of
prostitution

States having adequate laws
against most aspects of
prostitution except the ac-
tivities of customers of
prostitutes

States having laws against
some activities of prosti-
tutes and their exploiters

States having laws against
activities of exploiters of
prostitutes but inadequate
laws against prostitutes

19 25

13«22
4FJ 9

460 JOURNAL, OP SOCIAL HYGIENE

had enacted laws punishing the woman only. Thirteen states 13 had
adequate laws punishing both the prostitute and her male customer
for engaging in prostitution, and the remaining three states of
Indiana, South Dakota and Wisconsin had laws against this activity,
though they were not adequate. No law against soliciting for prosti-
tution existed in 20 states ;14 and statutes in eleven other states 15
applied only to prostitutes. The remaining 17 states had laws
which attempted to penalize both sexes for solicitation for prostitution.

A review of state laws dealing with various aspects of prostitu-
tion 16 now in force (November 1, 1944) shows the District of Col-
umbia and all states except Arizona and Nevada with legislation
which makes it a crime for any person to keep, set up, maintain, or
operate a house of prostitution. Nevada prohibits the keeping of a
house of ill-fame on a principal city street or near a church or school ;
and Arizona declares it a felony for any person to maintain or operate
a house of ill-fame on a principal city street or outside the limits
provided by the ordinances of any city or town.

All states and the District of Columbia prohibit pandering or pro-
curing a female for the purpose of prostitution, while living off the
earnings of a prostitute is unlawful in all but the seven states of
Iowa, Kansas, New Mexico, North Carolina, Ohio, Oklahoma and
Rhode Island. Compulsory prostitution is punishable in the District
of Columbia and all states except North Carolina, and the states of
Alabama, California, Colorado, Illinois, Indiana, Iowa, Kansas,
Massachusetts, Minnesota, Nebraska and Washington do not declare
the transportation of either a female or any other person for
prostitution unlawful.

As of November 1, 1944, no Injunction and Abatement Law of
any kind exists in Maryland, Nevada, Oklahoma and Vermont. In
Arkansas a house of prostitution is declared a public nuisance which

is Connecticut, Delaware, Maine, Maryland, New Hampshire, New Jersey, New
Mexico, North Carolina, North Dakota, Ohio, Ehode Island, Vermont and
Wyoming.

i* Alabama, Arizona, Arkansas, California, Florida, Idaho, Indiana, Iowa,
Kentucky, Michigan, Mississippi, Missouri, Nebraska, Oklahoma, Pennsylvania,
South Carolina, South Dakota, Tennessee, Texas and West Virginia.

is Colorado, Georgia, Illinois, Kansas, Louisiana, Massachusetts, Minnesota,
Montana, Nevada, Utah and Washington. (In New York the courts interpret
the word person in the law against soliciting for prostitution, as woman.)

is Supplementary legal measures also effective against prostitution are : laws
empowering the attorneys general to supervise or supercede local law enforce-
ment officials when the latter are incapable or unwilling to deal with this problem ;
laws subjecting liquor licensees to suspension or revocation of their licenses if
they permit prostitution or related disorderly conditions to exist on their premises ;
laws providing for the supervision and revocation of the licenses of taxi-cabs,
dance halls and other forms of commercial amusements used for the purposes
of prostitution, lewdness, or assignation, and for the supervision and revoca-
tion of the licenses of boarding houses, rooming houses, hotels, and restaurants
for any violation of the laws against prostitution, lewdness, or assignation
(if municipalities have legislative powers to permit passage of an ordinance
on this subjecct no state law is recommended) ; laws providing for the removal
from office of any municipal or county official who neglects, or refuses to
enforce laws of this character (Ouster Law) ; and laws prohibiting other sex
offenses, such as fornication, abduction, seduction and contributing to the sexual
delinquency of children.

TWENTY YEARS' PROGRESS IN SOCIAL HYGIENE LEGISLATION 461

may be abated under the law for the suppression of public nuisances,
but the law is inadequate. At the present time only Arizona and
Nevada do not penalize the act of engaging in prostitution, whereas,
in 1925 there were nine states which did not have such laws. The
District of Columbia and forty-six states now attempt to make it
unlawful for the prostitute to engage in prostitution whereas only
25 states had such legislation in 1925. Of the 46 states, the nineteen
states of Arkansas, Connecticut, Delaware, Florida, Kentucky, Maine,
Maryland, New Hampshire, New Jersey, New Mexico, North Carolina,
North Dakota, Ohio, Oklahoma, Rhode Island, Tennessee, Texas,
Vermont and Wyoming also penalize the customer and in nine states 17
of the 46 the legislation against such activities by either sex is not
entirely adequate.

In 1925 there were 20 states with no law against soliciting for
prostitution, and there are still 11 states18 which do not now penalize
solicitation for prostitution or immoral purposes by either the male
or female. Of the remaining 37 states, 32 attempt to penalize solicita-
tion by either the prostitute or her customer. The laws of the five
states of Colorado, Minnesota, Nevada, New York and Utah apply
to the woman only, but this indicates progress, for twenty years ago
there were 11 states with this limited type of legislation.

Excellent legislative progress was made in the enactment of laws
against prostitution by a number of state legislatures during 1942
and 1943. Arkansas, Florida, Kentucky, Oklahoma, Tennessee and
Texas adopted new repression laws, making a total of nineteen states 19
which now have adequate legislation against most of the aspects
of this evil. Ten states 20 and the District of Columbia now have
good legislation against most phases of prostitution, with the excep-
tion of those provisions concerning the activities of customers of
prostitutes. Of these ten states, Georgia, Louisiana, Mississippi, South
Carolina and West Virginia secured their excellent laws in 1942 and
1943. The 17 states of Alabama, California, Colorado, Idaho, Illinois,
Indiana, Iowa, Kansas, Massachusetts, Minnesota, Missouri, Montana,
Nebraska, Oregon, Pennsylvania, South Dakota and Washington have
laws against some of the activities of prostitutes and their exploiters,
while Arizona and Nevada have laws only against the activities of
exploiters of prostitutes and very inadequate laws against prostitutes.

PREMARITAL EXAMINATION LAWS

A study of the statute books in 1925 shows that a number of
states had laws restricting the marriage of venereally infected per-
sons, even though the legislation was limited or inadequate. Indiana
(for transmissible disease), Michigan, New Jersey, Oklahoma (a

IT Georgia, Indiana, Massachusetts, Mississippi, Pennsylvania, South Carolina,
South Dakota, West Virginia and Wisconsin.

is Alabama, Arizona, California, Idaho, Indiana, Missouri, Nebraska, Oregon,
Pennsylvania, South Dakota and Virginia.

is Connecticut, Delaware, Maine, Maryland, New Hampshire, New Jersey, New
Mexico, North Carolina, North Dakota, Ohio, Ehode Island, Vermont and
Wyoming are the other 13 states.

20 Georgia, Louisiana, Michigan, Mississippi, New York, South Carolina, Utah,
Virginia, West Virginia and Wisconsin.

PROGRESS IN STATE LEGISLATIC

/Vthough by 1925 a number
of states had adopted limited
legislation to safeguard mar-
riage from the venereal dis-
eases, it was not until ten years
later that Connecticut passed
the type of law known as the
" premarital examination law,"
f-he essential provisions of which
are now in operation is so many
states. The majority of states
require a physical examination,
including an approved blood
test for syphilis, of both bride
and groom, and a certificate
from the examining physician
as prerequisite to marriage.

Other states were quick to
see the advantages of such a
law. By 1938, nine states had
adopted new legislation of this
type.

By 1940, twenty states had
passed new premarital examina-
tion laws, or amended existing
laws for better operation.

O PROTECT MARRIAGE FROM SYPHILIS

By the end of 1942, twenty-
six states had made provision
to protect health in marriage
by means of social hygiene
legislation.

Social hygiene and other vol-
untary groups have given
strong support to public health
officials in securing adoption of
these laws, and in promoting
general understanding of their
benefits.

In 1943 and 1944, four more
states adopted the new type of
law, with five others which
already had made provision to
some extent for such protec-
tion, so that, as another " leg-
islative year" begins, only
thirteen states and the District
of Columbia, have yet to
safeguard family health in this
way.

How does your state stand?

issuhf 'license15 bl°°d

f°r syphilis of both bride and groom before

- , - -=. by physician for venereal diseases, or

groom on?1ertineates showing freedom from such diseases, usually of

nrato«,,^?Hbi!lnfonnfrriagre of Persons Infected with venereal diseases,
marriage licenses without regard to venereal disease

464 JOURNAL OF SOCIAL HYGIENE

felony), and Vermont declared it a misdemeanor for venereally
infected persons to marry. New Hampshire and Maine prohibited
the marriage of syphilitics. Nebraska, New York, North Carolina
(applicable to males only), Pennsylvania (for "communicable dis-
ease"), Virginia (from male applicant if bride under 45 years),
and Washington (for male only) required affidavits from applicants
for marriage license stating that they were free from venereal dis-
eases. In Utah marriages between persons afflicted with venereal
diseases were declared void. It can readily be seen that such laws
were ineffective because of the difficulty in proving the infected
individual was actually infected, or had knowledge of the venereal
infection at the time of the marriage.

Alabama, Louisiana, and Wisconsin specified an examination by
a physician of the prospective groom only for freedom from venereal
diseases and made it unlawful for the licensing authority to issue
a marriage license to any male applicant who failed to present a
medical certificate showing that he was free from venereal disease.
North Dakota, Oregon, and Wyoming required the male applicant
to present a medical certificate attesting his freedom from an infec-
tious venereal disease. In 1929 Texas enacted a law providing that
the man must secure from a physician a certificate of freedom
from venereal disease before a marriage license could be issued.
Shortly afterward California made it a misdemeanor for any person
to marry while infected with a venereal disease in a communicable
stage; and Delaware required a sworn statement from each of the
applicants to be presented to the licensing authority showing freedom
from such a disease. Washington in 1929 repealed its premarital law
discussed above. Such laws were limited because they did not
apply to both sexes and they did not require blood tests.

The first law requiring a premarital blood test for syphilis of both
applicants and a medical certificate showing freedom from such
disease in communicable form as a prerequisite to the issuance of
a marriage license was passed in Connecticut on May 23, 1935. Two
years later Illinois, Michigan, New Hampshire, Oregon, and Wis-
consin 21 passed similar laws or amendments ;22 and in 1938 Kentucky,
New Jersey, New York and Rhode Island enacted such legislation.
(The Kentucky premarital examination law was repealed but was
reenacted on February 28, 1940.)

Nineteen hundred and thirty-nine and 1940 were big years in
this type of social hygiene legislation. Ten additional states 23
passed laws or amendments to their existing statutes making, in
1940, a total of twenty states24 which required premarital blood
test for syphilis of both the prospective bride and groom. This

21 In Wisconsin law states physical examination is applicable to males.

22 A majority of these laws required a premarital medical examination.

23 California, Colorado, Indiana, North Carolina, North Dakota, Pennsylvania,
South Dakota, Tennessee, Virginia and West Virginia.

24 California, Colorado, Connecticut, Illinois, Indiana, Kentucky, Michigan,
New Hampshire, New Jersey, New York, North Carolina, North Dakota, Oregon,
Pennsylvania, Ehode Island, South Dakota, Tennessee, Virginia, West Virginia
and Wisconsin.

465

represented nearly as much legislative activity for the protection of
family health as had taken place during the previous 25 years.

During the legislative years 1941 and 1943 ten more of the
states 25 passed laws of this type, making a total to date of
thirty states26 which now require of both partners premarital
blood tests for evidence of freedom from syphilis as prerequisites
to issuance of marriage licenses. Most of these states require also
a medical examination 2T and presentation of physicians ' certificates
showing freedom from such disease in communicable form, before
the licensing authorities may issue marriage licenses to the applicants.
Massachusetts and Virginia permit, however, marriage of the appli-
cants even though one or both may have syphilis in an infectious
stage, but the physician discovering evidence of syphilis must inform
both applicants to the marriage of the nature of the disease and
the necessity of medical treatment therefor. Massachusetts repealed
its premarital law of August 2, 1941 and enacted a new one on
June 12, 1943. During this period, to get smoother operation, about
fifteen states amended their premarital laws. In 1943 South Carolina
passed a bill requiring a physician's certificate of freedom from
venereal disease of both bride and groom but it was vetoed by
the Governor. Of the 30 states, eight states28 also require medical
examination and necessary tests for gonorrhea, and eleven other
states29 in the group require examination "for communicable
diseases, including venereal diseases."

The general purpose of this legislation is not to prevent, but to
postpone marriage while the disease is in a communicable stage
(except Massachusetts and Virginia). The passage of these laws
by thirty states within a nine year period (1935 to 1944) is an excel-
lent record in the history of health legislation but there are still
eighteen states 30 with no adequate legislation for preventing syphilis
in marriage.

PRENATAL EXAMINATION LAWS

In 1938 New Jersey, New York, and Rhode Island passed the first
laws requiring serological tests for syphilis of expectant mothers as
a further step in the protection of the family from venereal dis-
eases. These laws attempt to prevent congenital syphilis by directing

25 Idaho, Iowa, Maine, Massachusetts, Missouri, Nebraska, Ohio, Vermont,
Wyoming and Utah.

2« California, Colorado, Connecticut, Idaho, Illinois, Indiana, Iowa, Kentucky,
Maine, Massachusetts, Michigan, Missouri, Nebraska, New Hampshire, New
Jersey, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania,
Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, West Virginia,
Wisconsin and Wyoming. (For Suggested Form of Premarital Examination
Law, see page 483.)

27 Missouri and Virginia require physical examination when blood test for
syphilis is positive.

28 Illinois, Michigan, North Carolina, Oregon, Tennessee, Utah, Wisconsin
and Wyoming.

29 Colorado, Idaho, Illinois, Kentucky, Michigan, North Carolina, Oregon,
Tennessee, Utah, Wisconsin and Wyoming.

so Alabama, Arizona, Arkansas, Delaware, Florida, Georgia, Kansas, Louisiana,
Maryland, Minnesota, Mississippi, Montana, Nevada, New Mexico, Oklahoma,
South Carolina, Texas and Washington.

PROGRESS IN STATE LEGISLATIO

The first state law to protect
mothers and babies from the
deadly effects of syphilis was
passed by the New York State
Legislature in March, 1938.

Known as the " baby health
bill," sponsored by the New
York Post, the American Social
Hygiene Association a.nd nu-
merous state and community
agencies, both voluntary and
official, the passage of this
forward-looking legislation
touched off a fuse in health
progress. Before that year's
legislative sessions had ended,
the states of New Jersey and
Rhode Island had adopted
similar laws.

Law-makers across the coun-
try were prompt to respond to
public opinion by adopting
such obviously valuable legis-
lation. As in the case of the
premarital examination laws,
succeeding years have seen
rapid action.

By 1940, nineteen states had
made provision for this type of
child health protection.

The law, in its usual form, provides that a licensed physician or
other authorized person making an examination of an expectant
mother is required to make a blood test for syphilis within a specified
time of the first examination. Syphilis, unlike most diseases, may be
transmitted to a child before birth, directly from an infected mother.
Thousands of babies are born dead, or die young, because of syphilitic
infection, but if the disease is discovered in the mother during preg-
nancy, and treatment provided, nine out of ten such infected babies
are born healthy.

466

O PROTECT BABIES FROM SYPHILIS

Seven more states adopted
prenatal examination laws dur-
ing 1941 and 1942.

As with the premarital ex-
amination laws, voluntary social
hygiene and cooperating agen-
cies have vigorously supported
health officials in securing pas-
sage of this legislation and in
public education regarding the
saving in health and happi-
ness to be gained from full
observance.

Now, in 1944, nearly two-
thirds of the 48 states have pro-
vided this fine sort of health
protection for their coming
generations. The Territory of
Hawaii also made such provi-
sion in 1943, and plans are on
foot in some of the other 18
states and the District of Co-
lumbia for similar safeguards.

Does your state have a pre-
natal examination law?

flGTJRE III

t V, , States requiring prenatal blood test for syphilis

States not requiring prenatal blood test for syphilis

467

468 JOURNAL OF SOCIAL HYGIENE

every physician, midwife, or other person authorized by law to attend
pregnant women, to make or cause to be made a standard blood
test of every such woman for submission to an approved laboratory
for the testing for syphilis, and to state on the birth certificate
whether such a test was made, if made, when, and if not made,
the reason why. During 1939 and 1940 similar legislation was passed
in sixteen other states.31

As of November 1, 1944, thirty states 32 seek to insure healthy
babies by protecting them from syphilis. Eleven of these states 33
passed such legislation during 1941 and 1943. It is good to note
this spectacular progress in such beneficial legislation in a period of
six years. There are still, however, eighteen states 34 which need
laws of this character.

VENEREAL DISEASE CONTROL LAWS AND REGULATIONS
Adequate laws and state board of health regulations 35 for the
control and prevention of venereal diseases,36 are the legal instru-
ments which enable the health authorities to deal effectively with
syphilis and gonorrhea,37 as public health problems. Good social
hygiene legislation should include provisions declaring venereal dis-
eases to be contagious, infectious, communicable, and dangerous to
public health, and requiring also the reporting of such diseases and
ophthalmia neonatorum by physicians and others, the examination
by health officers of persons reasonably suspected of being veiiereally
infected, and their detention pending completion of the examination,
follow-up of sources of infection and the contacts of infected indi-
viduals. Health officers should be authorized to provide treatment
for infected persons and to quarantine or isolate infectees if necessary
for the protection of the public health.

Another principal provision should empower the state boards of
health to make and amend venereal disease control regulations, declar-
ing them to have the force and effect of law. If health authorities
are to bring venereal diseases under permanent control, the laws
should also prohibit (1) any person other than a licensed physician
from treating a case of venereal disease, (2) the advertisement of
venereal disease remedies or cures, and (3) the sale of drugs or

si California, Colorado, Delaware, Illinois, Indiana, Iowa, Kentucky, Louisiana,
Maine, Massachusetts, Michigan, North Carolina, Oklahoma, Pennsylvania, South
Dakota and Washington.

32 California, Colorado, Connecticut, Delaware, Georgia, Idaho, Illinois, Indiana,
Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Missouri,
Nebraska, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon,
Pennsylvania, Ehode Island, South Dakota, Utah, Vermont, Washington and
Wyoming. (For Suggested Form of Prenatal Examination Law, see page 487.)

33 Connecticut, Georgia, Idaho, Kansas, Missouri, Nebraska, Nevada, Oregon,
Utah, Vermont and Wyoming.

s* Alabama, Arizona, Arkansas, Florida, Maryland, Minnesota, Mississippi,
Montana, New Hampshire, New Mexico, North Dakota, Ohio, South Carolina,
Tennessee, Texas, Virginia, West Virginia and Wisconsin.

35 For principal provisions of such laws and regulations, see page 488.

86 Good premarital and prenatal examination legislation and strong prostitution
laws are additional effective legal weapons for the control of this problem.

37 Chancroid, granuloma inguinale and lymphogranuloma venereum are also
venereal diseases.

TWENTY YEARS' PROGRESS IN SOCIAL HYGIENE LEGISLATION 469

medicinal preparations for the treatment of venereal diseases, except
on the prescription of a licensed physician. Furthermore, the law
should attempt also to prevent ophthalmia neonatorum by requiring
the physician or other authorized person in attendance on a con-
finement to apply prophylactic treatment, as specified in the regula-
tions, to the eyes of newborn infants. Finally, other provisions
should penalize individuals who violate any of the venereal disease
control laws or regulations or who knowingly infect or expose others
to their infections.

The venereal diseases had been made reportable either by statute
or regulations of state board of health in only thirteen states 38 prior
to January 1, 1917. Due to World War I and Federal advice, forty-
three states 39 by 1919 had made venereal diseases reportable and
forty-five states 40 required compulsory examination of suspected
persons and quarantine of those who were deemed by state health
officers to be threats to the public health. All the states and the
District of Columbia as of November 1, 1944 have made legal
provisions covering these requirements.

In 1921, twenty-three states 41 had laws or regulations forbidding
the advertising of cures for venereal disease. By 1925 five additional
states 42 had enacted similar legislation. As of November 1944,
therefore, 28 states and the District of Columbia have laws pro-
hibiting the advertisement of cures or remedies for venereal diseases.
Twenty-six states 43 do not now have statutes prohibiting the sale of
remedies for venereal diseases without a physician's prescription,
whereas in 1921 there were thirty states44 which had no laws or
regulations of state boards of health against the sale of remedies for
venereal diseases except on a physician's prescription.

During the past few years and especially in 1943 a number of
states strengthened their venereal disease control laws particularly
in relation to the reporting, treatment, quarantine, follow-up and
finding of persons with an infectious venereal disease. Experience
has proved that such legislation is an essential and important factor
in maintaining a smoothly functioning venereal disease control
program.

88 Calif ornia, Colorado, Connecticut, Indiana, Idaho, Kansas, Louisiana,
Michigan, North Dakota, Ohio, Vermont, Virginia and Wisconsin.

8» Idaho, Nevada, Pennsylvania, Rhode Island and Virginia had no such laws.

40 Idaho, Massachusetts, and Nevada had no such laws.

41 Alabama, California, Colorado, Georgia, Iowa, Kentucky, Massachusetts,
Michigan, Minnesota, Montana, Nebraska, New York, North Carolina, North
Dakota, Ohio, Pennsylvania, South Dakota, Texas, Utah, Virginia, Washington,
West Virginia and Wisconsin.

42 Idaho, Maine, Nevada, Vermont and Wyoming.

« Arizona, Arkansas, Connecticut, Delaware, Florida, Illinois, Kansas, Mary-
land, Massachusetts, Michigan, Mississippi, Missouri, Nevada, New Hampshire,
New Jersey, New Mexico, North Dakota, Ohio, Pennsylvania, Khode Island,
South Dakota, Tennessee, Texas, Vermont, Virginia and Wyoming.

44 Arkansas, California, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois,
Indiana, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Mississippi,
Nevada, New Jersey, New Mexico, North Dakota, Ohio, Pennsylvania, Rhode
Island, South Dakota, Tennessee, Texas, Vermont, Virginia, Washington and
West Virginia.

470

JOURNAL OF SOCIAL HYGIENE

""a

&l

^^ ••—!••->

•— ,-^-> C

JOf gJUVfollUOJ iO 90VJJ -131(10

du v u-i 'Smuivwg JLO 2uu9)ug

Mf yjuvfoauoj JLO
duy ui Suipisa

SB

H

uotjn)
-ysotj fo ysnofj ?ui&t}n33Q

uoijnj
luiatxay

2 » >

> »

-n)i]sojj jof <Cpog

>e

uof Sutjiyijog %

O /0 SJUlUJVg ffQ iiUMtJ

W
H
P
H

H

CO

O

(25

fc

O

«

H

O
3

w

in

W

H
CJ

H

CO

^

jof
*o Suuapuvj

wj ojvutyj v liuijjcxfsuvjj,

uotjnjtjsojj
fuy Suiqvj. to

uotinjtjfojj jof ayuvfoauoj io
dyvjj wifjo &uy ojut auo/Cuy
9(11303^ oj Su

-ijsojj jofayuvfonuoj jo 30&IJ
o 3S

o asnojj v 2wt

-UWJUtOffl MO '3UISV3J 'SUIUOIQ

fo asnojj v ?ut

uoijnj X-.

1

I Jill nillf ill iff II Hiii

q^^cSaaps SOSS^^MW^SS^SSS

REQUIREMENTS OF STATE PROSTITUTION LAWS

471

w_^_

._ a o c

.— .-,..-, c c

>ȣ

Federal Legislation against prostitution exists: The Mann Act prohibits interstate
The Bennet Act penalizes importation of aliens for prostitution and provides for
May Act prohibits prostitution within such reasonable distance of military and/or
or Navy shall determine to be needful to the efficiency, health, and welfare of the

n.
law

isor
r th

agr
aba

tut
es)
f l
th

rch
bu
Or

t
e

a
ma

rostit
l stat
rm o
s of

, chur
ion,
New
e and
cing
stitut
in t

titut
and

wing
tion.
The
and/

s.

w on
several
dard for
islatures
nts.
schools,
rostituti
only in
female
for plac
for pros
person
rancy.
on pros
uisance

hire

th
ro
tut
of

ate Laws t
men for pr
in prostitu
retaries o

Abatemen

ndard for
gislatures
sive Law (
tment to t
ishable as
of ill-fame
laces used
cy by stat
d forcible
eiving of
by women
terpret th
unishable
who is a
clared a p

prostituti
or prostit

St
wo
ng
Se

NOTE: I
and intern
deportatio
naval esta
Army and
— Reme
t — Vice
f
I — Major
a
a — Keep
) — Unla
c — Law
)— Offen
e — Law
t — Law
g — Law
h— Court
i — Offen
3 — Law
)— Hous
p
— Unla
— Unla
— Law

472 JOURNAL OF SOCIAL HYGIENE

EEQUIEEMENTS OF STATE PREMARITAL EXAMINATION LAWS t

STATE

DATE OF LAW

SCOPE OF EXAMINATION

TEST REQUIREMENTS
FOR SYPHILIS

SEROLOGIC LABORATORY REPORTS ON
OUT OF STATE FORMS ACCEPTED

Approved

Effective

Syphilis

Gonorrhea

Other Venereal Diseases

Days
Valid

Approved
Blood
Tests

o
1

ft

Serologic Laboratory Test

Physical Examination

Microscopic Test

California*

June 5,
1939

Sept. 19,
1939

yes

yes

no

no

no

30

Kolmer, Eagle, Craig
Fix., Kahn, Kline,
Hinton, Eagle Precip.

yes
(11)

Colorado

Apr. 10,
1939

Oct. 10,
1939

yes

yes

yes

no

yes

30

Kahn official, others
accepted

yes
(24)

Connecticut* ....

May 23,
1935

Jan. 1,
1936

no

yes

no

no

no

40

Wassermann, Kahn,
Kline, Hinton, or any
standard serologic test

yes
(24)

Idaho

Feb. 11,
1943

Apr. 30,
1943

yes

yes

yes

no

yes

30

Standard serologic test

yes

Illinois*

June 23,
1937

July 1,
1937

yes

yes

yes

yes

yes

15

Standard serologic test

yes

Indiana ........

March 9,
1939

March 1,
1940

yes

yes

no

no

no

30

Kolmer, Eagle Fix.,
Kahn, Kline, Hinton,
Eagle Precip., Mazzini

no

Iowa

Apr. 5,
1941

Apr. 9,
1941

ye«

yes

no

no

no

20

Standard serologic test

yes
(7)

Kentucky*

Feb. 28.
1940

Jan. 1.
1941

yes
(53)

yes

(53)

yes

no

yes

15

Kolmer modification of
Wassermann test,
Kahn, Kline, Hinton,
Eagle

yes
(24)

Maine*

Apr. 10,
1941

July 25.
1941

yes

yes

no

no

no

30

Standard serologic test

yes
(17)

Massachusetts! . .

June 12,
1943

June 12,
1943

yes

yes

no

no

no

30

(49)

Standard serologic test

no

Michigan*

July 20.
1937

Oct. 29,
1937

yes

(53)

yes

(53)

yes

yes
(28)

yes
(51)

30

Any test performed in
a State Health Dept.
Laboratory

yes
(24)

Missouri

Apr. 13.
1943

Jan. 1,
1944

yes
(31)

yes

no

no

no

15
(54)

Standard serologic test

yes
(26)

Nebraska

Mar. 23.
1943

Aug. 29,
1943

yes

yes

no

no

no

30

Standard serologic test

no

New Hampshire.

Aug. 12,
1937

Oct. 1.
1938

yes

yes

yes

no

no

30

Wassermann, Kahn or
other standard sero-
logic test

no

New Jersey

May 3.
1938

July 1,
1938

no

yes

no

no

no

30

Wassermann, Kahn or
other standard sero-
logic test

yes

t As of November 1, 1944. See page 476 for Supplementary Notes.

REQUIREMENTS OP STATE PREMARITAL EXAMINATION LAWS 473

SEROLOGIC REPORTS

LICENSE

MEDICAL CERTIFICATES

FREE

ACCEPTED FROM ANY

ACCEPTED FROM ANY

H

a

fl

1

td

N.Y.C. 1

ratories

lunicable

ATES ON
ACCEPT

c/ilE

sjo

s

H STATE
HEALTH

M °

fJt/5

H

Other State Dept. of
Health Laboratory

Territorial Dept. of
Health Laboratory

D.C. Health Dept. I
Of Health Lab

U.S.P.H.S., Army or
Navy Laboratory

Issued When Not Com

Prerequisites Waived

MEDICAL CERTIFI
OF STATE FORM

Out of State Licensed
Physician

Commissioned U.S.P
Army or Navy Medica

State Laboratory Test
Physicians

Physical Examinations
to Patients

RESULT FILED WI
DEPARTMENT OF

PENALTY

yes
(8)

yes

yes

yes

yes

yes
(40)

yes
(ID

yes
(2)

yes
(20)

yes

no

yes
(47)

yes

yes

(4)

yes
(14)

yes

yes

yes

yes
(40)

yes
(24)

yes
(6)

yes

yes
(36)

no

yes

no

(14)

yes

no

D.C.

(15)

yes

yes

yes

yes

yes

yes

no

no

yes

only

(40)

(24)

(2)

(47)

yes
(12)

yes

yes

yes

yes

yes
(40)

yes

yes

yes

yes
(36)

yes
(46)

yes

(47)

yes

yes

yes

yes

yes

yes

yes

no

yes

no

yes

no

no

yes

(37)

(30)

(38)

(32)

(33)

yes

yes

D.C.

yes

yes

yes

no

yes

yes

yes

no

yes

yes

only

(40)

(48)

yes

(7)

yes

yes

yes

yes
(37)

yes
(32)

yes

(7)

yes
(7)

yes

yes

no

yes
(47)

yes

yet

no

no

yes

yes

yes

no

no

yes

yes

no

yes

yes

(18)

(32)

(47)

(40)

yes

no

D.C.

yes

yes

yes

yes

yes

yes

yes

yes

yes

yes

only

(39)

(33)

(17)

(25)

(25)

(36)

(41)

(48)

(41)

(50)

yes

yes

D.C.

yes

(52)

yes

no

yes

yes

yes

no

no

yes

only

(34)

(19)

yes

no

yes

yes

yes

yes

yes

yes

yes

yes

no

no

yes

(8)

(37)

(32)

(24)

(9)

(38)

(40)

yes

no

no

yes

yes

yes

no

no

no

yes

no

yes

yes

(4)

(35)

(33)

(26)

(36)

(26)

(14)

yet

no

no

yes

yes

yes

no

yes

yes

yes

yes

yes

yes

(40)

(2)

(41)

(47)

yes

no

D.C.

yes

yes

yes

no

yes

yes

yes

no

yes

yes

only

(40)

yes

yes

yes
(10)

yes

yes

no
(21)

yes

yet

yes

yes

no

no

yes

474 JOURNAL OF SOCIAL HYGIENE

KEQUIREMENTS OF STATE PEEMAEITAL EXAMINATION LAWS t

STATE

DATE OF LAW

SCOPE OF EXAMINATION

TEST REQUIREMENTS
FOR SYPHILIS

SEROLOGIC LABORATORY REPORTS ON
OUT OF STATE FORMS ACCEPTED

Approved

Effective

Syphilis

Gonorrhea

Other Venereal Diseases

Days
Valid

Approved
Blood
Tests

Physical Examination

Serologic Laboratory Test

a
.S
ta
a

W
1

R

<S

Microscopic Test

New York*

Apr. 12.
1938

July 1,
1938

yes

yes

no

no

no

30

Kahn, Wassermann, or
test approved by State
Health Commissioner

yes

New York City*.

Apr. 12.
1938

July 1.
1938

yes

yes

no

no

no

30

Complement - Fixation
or Kahn

yes

(24)

North Carolina*.

Apr. 3,
1939

Apr. 3.
1939

yes

yes

yes

yes

(28)

yes

30

Kolmer, Eagle Fix.,
Kahn, Kline, Hinton,
Eagle Precip.

no

North Dakota*. .

Mar. 13.
1939

July 1,
1939

no

yes

no

no

no

30

Complement - Fixation
and Flocculation

yes

Ohio

May 16,
1941

Aug. 18,
1941

yes

yes

no

no

no

30

Standard serologic test.
(Eagle, Hinton, Kline,
Kahn and Kolmer)

no

(22)

Oregon*

Mar. 12,
1937

Dec. 1.
1938

yes

yes

yes

yes
(28)

yes

10

Kolmer and Kahn

yes
(11)

Pennsylvania

May 17.
1939

May 17.
1940

yes

yes

no

no

no

30

Two tests — Comp le-
ment — Fixation and
Flocculation

no

Rhode Island

Mar. 29.
1938

Apr. 28,
1938

yes

yes

yes

no

no

40

Wassermann, Kahn or
other standard sero-
logic test

no

South Dakota. . .

Mar. 10.
1939

July 1.
1939

yes

yes

no

no

no

20

Standard serologic test

yes
(24)

Tennessee*

Mar. 10.
1939

July 1.
1941

yes
(53)

yes
(53)

yes

yes
(28)

yes
(29)

30

Eagle. Hinton. Kahn,
Kline. Kolmer

yes

(24)

Utah

Feb. 28,
1941

July 1,
1941

yes

yes

yes

yes
(28)

yes

15

Standard serologic test

no

Vermont*

Apr. 10.
1941

July 31,
1941

yes

yes

no

no

no

30

Any test; if Floccula-
tion positive, Comple-
ment-Fixation required

yes

Virginia

Feb. 28,
1940

Aug. 1,
1940

yes
(31)

yes

no

no

no

30

Standard serologic test

yes
(55)

West Virginia....

Feb. 25,
1939

May 26,
1939

yes

yes

no

no

no

30

Standard Complement
Fixation or Floe, test

no

Wisconsin*

June 29,
1937

July 31.
1937

yes
(27)

yes

yes
(27)

yes
(27)
(28)

yes
(27)

15

Standard serologic test

yes
(16)

Feb. 1,
1943

May 21,
1943

yes

yes

yes

yes

(51)

yes
(51)

30

Standard serologic test

no

t See page 476 for Supplementary Notes.

SEROLOGIC REPORTS

LICENSE

MEDICAL CERTIFICATES

FREE

ACCEPTED FROM ANY

ACCEPTED FROM ANY

H

a

£j f"\

•

Q

*H

HK

Other State Dept. of
Health Laboratory

Territorial Dept. of
Health Laboratory

D.C. Health Dept. & N.Y.C.
Of Health Laboratories

U.S.P.H.S., Army or
Navy Laboratory

Issued When Not Communicable

Prerequisites Waived

MEDICAL CERTIFICATES Ol
OF STATE FORMS ACCEP

Out of State Licensed
Physician

Commissioned U.S.P.H.S.,
Army or Navy Medical Ofl&cer

State Laboratory Tests to
Physicians

Physical Examinations
to Patients

RESULT FILED WITH STA1
DEPARTMENT OF HEALT]

PENALTY

yes

no

yes

yes

yes

yes

yes

yes

yes

yes

no

yes

yes

(23)

(40)

(42)

yes

yes

yes

yes
(23)

yes

yes

(33)

yes
(24)

yes

yes

no

no

yes
(42)

yes

(40)

yes

no

yes

yes

yes

yes

no

no

yes

yes

yes

no

yes

(4)

(20)

(41)

(41)

yes

(12)

no

no

no

yes

yes

(40)

no

no

no

no
(43)

no

yes
(48)

yes

no

no

no

yes

yes

no

no

no

yes

yes

no

yes

yes

(22)

(22)

(23)

(39)

(22)

(22)

(23)

(41)

(47)

yes

no

no

USPHS

yes

no

yes

no

yes

yes

(45)

no

yes

only

(37)

(11)

(20)

(41)

(38)

(39)

yes

yes

yes

yes

yes

yes

no

no

yes

yes

no

no

yes

(10)

(39)

(40)

(36)

(41)

yes

no

yes

yes

yes

yes

no

no

yes

(44)

yes

no

yes

(5)

(40)

(41)

yes

(4)

yes

yes

yes

no
(56)

yes

(32)

yes

(24)

yes

yes

yes

no

yes

yes

yes

yes

D.C.

yes

yes

yes

yes

yes

yes

yes

yes

no

yes

(3)

only

(39)

(32)

(24)

(36)

(41)

(40)

yes

yes

yes

yes

yes

yes

no

yes

yes

yes

no

yes

yes

(13)

(13)

(40)

(13)

(41)

(47)

yes

no

yes

yes

yes

yes

yes

yes

yes

yes

no

no

yes

(14)

(40)

yes
(12)

yes

yes

yes

(52)

(52)

no

yes

(2)

yes

yes
(41)

yes
(41)

yes
(48)

yes

yes

yes

D.C.

yes

yes

yes

no

no

no

(36)

(36)

no

yes

only

(40)

yes

yes

no

yes

yes

yes

yes

yes

yes

yes

yes

no

yes

(4)

(16)

(37)

(40)

(16)

(16)

(36)

(41)

(16)

(38)

yes

yes

yes

yes

yes

no

no

no

no

yes

no

yes

yes

(12)

476 JOURNAL OF SOCIAL HYGIENE

Supplementary Notes

* Law amended.

t Former premarital law repealed.

(2) From physicians licensed in U.S. territory also.

(3) Laboratories of author — serologists: Eagle, Hinton, Kahn, Kline, Kolmer, also.

(4) Also from any laboratory approved by any state health officer or state dept. of health.

(5) Local laboratories approved only by arrangement with R.I. State Health Dept.

(6) Physician should indicate on certificate state in which he is licensed.

(7) Applicant from state which has premarital examination law must comply with own state law in lieu
of Iowa's. Certificate must be signed and notarized by physician. Iowa non-resident form required
for residents of state with no premarital examination law.

(8) Ottawa, Toronto, and Quebec provincial laboratories also. (Calif, accepts from all provincial labora-
tories.)

(9) Premarital examinations to include all venereal diseases; blood test alone not sufficient.
HO) From Phila. and Baltimore Health Dept. laboratories also.

(1 1) From other states with similar permarital examination laws. (For Calif, examinations and test must
be performed within 30 days prior to issuance of license.)

(12) From state health dept. laboratories which are approved. (Va. accepts from those state dept. of health
laboratories which participate in U.S.P.H.S. serologic survey.)

(13) From states and territories which reciprocate with Utah.

(14) From laboratories approved by U.S.P.H.S. accepted, also.

(15) Reports from V.D. Research Laboratory, U.S. Marine Hospital, Staten Island, N.Y., signed by com-
missioned medical officer, acceptable.

(16) Original laboratory report from out of state laboratory must be submitted with physician's statement
and endorsement of laboratory by out of state health officer.

(17) During present emergency and six months thereafter out of state forms accepted if forms have same
statements as those of Maine.

(18) From U.S.P.H.S., Army and Navy laboratories located in Ky. and approved by Ky. State Dept. of
Health only.

(19) Examination and medical certificate by physician on active duty in Army or Navy acceptable.

(20) Reports of examinations of men in armed services by their medical officers accepted. (In Ore. only
during war and 30 days after termination thereof.)

(21) Only when criminal charge of bastardy, rape or fornication is preferred and defendant consents to marry
such female.

(22) Applicants who were former residents of a state with premarital law similar to Ohio, may, however,
present certificate from out of state official who issues marriage licenses, certifying premarital law
complied within that state by applicants.

(23) U.S.P.H.S., Army and Navy laboratories approved for blood tests for men in the armed services only.
(In Ohio acceptable at discretion of Probate Judge.)

(24) Accept such forms providing they contain same information which appears on own forms. (Notariza-
tion of such forms necessary for use in Ky.)

(25) If a graduate of a Grade A medical school.

(26) Regulations regarding forms to be used and filing of laboratory results not issued as yet.

(27) Male only.

(28) At physician's discretion.

(29) If history of chancroid.

(30) State Dept. of Health approval.

(31) If initial blood test indicates evidence of syphilis.

(32) On physician's affidavit of pregnancy.

(33) On woman's statement of pregnancy. (In Mo. on physician's certificate of pregnancy or imminent
death.) In 111. on woman's affidavit that she is the mother of the child if a copy of the birth record
of the illegitimate child is not available.)

(34) No certificate required in cases of pregnancy or imminent death.

(35) Report of negative blood test and affidavit by applicant saying he is free from syphilis, also accepted
for license.

(36) On request of physician. (In Mo. also on request of patient; in W. Va. by going to county health dept.)

(37) Only if blood test negative.

(38) Positive requires State Dept. of Health approval.

(39) Law grants right of appeal.

(40) By court order. (In Neb. affidavit of pregnancy or any person's statement of imminent death; in
Colo, by he_alth dept. only.)

(41) Free to patient if unable to pay.

(42) Submitted to district, county or city dept. of health.

(43) Maximum fifty cent charge.

(44) Reasonable.

(45) Maximum five dollars.

(46) Maximum two dollars.

(47) By laboratory. (In Conn, if positive and performed at State Dept. of Health laboratory.)

(48) By physician.

(49) Examination and laboratory tests shall be made not more than 30 days before marriage license is issued.

(50) Maximum three dollars.

(51) As indicated by physical examination.

(52) Law does not prohibit marriage in any case. If syphilis diagnosed, physician must notify other applicant.
Infected applicant must take treatment as approved by state health commissioner.

(53) Darkfield when necessary.

(54) Marriage license void if not used within 10 days from date of issuance.

(55) Providing result of test is indicated.

(56) License issued if patient has received minimum of 40 treatments, if infection is over 4 years duration
and if attending physician's judgment is that disease is non-infectious.

REQUIREMENTS OF
EEQUIEEMENTS OF

STATE PRENATAL EXAMINATION LAWS 477
STATE PRENATAL EXAMINATION LAWS t

STATE

DATE OF LAW

BLOOD TEST REQUIREMENTS

RESULT FILED WITH STATE
DEPARTMENT OF HEALTH

REQUIREMENTS
FOR BIRTH
CERTIFICATE

PENALTY

Approved

Effective

Serologic
Test

Standard Serologic Test

Laboratory Approved
by State Dept. of Health

Serologic Test Free

If No Test Taken
To Be Noted

Date of Test To
Be Noted

Test Result Not To
Be Recorded

Mandatory

At First Examination

May 9,
1939

Sept. 19,
1939

yes
a

ij

yes
q

yes

no

yes

yes

s

yes

yes

yes
t

Colorado

Apr. 10.
1939

Apr. 10,
1939

yes

a

ij

yes
q

yes

yes

X

yes

yes

yes

yes

yes

t

Connecticut

June 18.
1941

July 1.
1941

yes

yes
o

yes
q

yes

yes

X

(2)

yes
s

yes

yes

yes

Mar. 8,
1939

Mar. 8.
1939

yes

yes

yes
q

yes

yes

X

(2)

yes
s

yes

yes

no

Georgia

Mar. 18,
1943

July 1,
1943

yes

yes
o

yes

q

yes

yes
rv

no

yes
s

yes

yes

yes

Idaho

Feb. 5.
1943

Apr. 30,
1943

yes
a

yes
j

yes
q

yes

yes

X

yes

yes

yes

yes

yes

t

Illinois

July 21.
1939

July 21.
1939

yes

yes

q

yes

yes

X

(2)

yes

yes

yes

no

Indiana

Feb. 18.
1939

Jan. 1,
1940

yes

e

P

yes

q

yes

yes

(4)

(5)

yes
s

yes

yes

no

Iowa

May 17,
1939

July 4.
1939

yes

k

yes

yes

yes

yes

yes
s

yes

yes

no

Kansas

Mar. 22,
1943

July 1,
1943

yes
c

k

yes

m

no

no

yes
s

yes

yes

yes

Kentucky

Mar. 18.
1940

June 12,
1940

yes

1

q

yes

yes

X

yes

yes

s

yes

yes

yes

Louisiana

July 12,
1940

July 31.
1940

T

yes

yes
y

h

yes

(4)

(5)

yes

(3)

yes

no

Maine

Apr. 20.
1939

July 20,
1939

T

n

yes
q

yes

yes

X

yes

no

no

no

no

Massachusetts . . .

Aug. 3,
1939

Nov. 1,
1939

yes

yes

yes

yes

no

no

no

no

no

no

Michigan

May 16,
1939

May 16.
1939

yes

yes

yes
q

yes

yes

X

no

yes

s

yes

yes

no

Missouri

July 28,
1941

Oct. 10,
1941

yes
d

yes
w

yes

yes

yes

X

no

yes
s

yes

yes

yes

Nebraska

Mar. 25,
1943

Aug. 29,
1943

yes

yes

yes
q

yes
q

yes

yes

yes

yes
s

yes

yes

no

Nevada

Mar. 28,
1941

July 1,
1941

yes

yes

yes

yes

X

no

no

no

no

no

New Jersey

Mar. 30,
1938

Jan. 1,
1939

yes

yes

yes

q

yes

yes

no

yes

yes

no

no

New York

Mar. 18,
1938

Mar. 18,
1938

yes

yes

yes

q

yes

yes

(2)

yes
s

yes

yes

no

t As of November 1, 1944. See page 478 for Supplementary Notes.

478

STATE

DATE OF LAW

BLOOD TEST REQUIREMENTS

RESULT FILED WITH STATE
DEPARTMENT OF HEALTH

REQUIREMENTS
FOR BIRTH
CERTIFICATE

PENALTY

Approved

Effective

Serologic
Test

Standard Serologic Test

Laboratory Approved
by State Dept. of Health

Serologic Test Free

<*.£

V V

Test Result Not To
Be Recorded

Mandatory

a
.S

"rt

a

£

£

3

North Carolina. . .

Apr. 3.
1939

Jan 1,
1940

yes
g

g

q

yes

yes
rz

no

yes

yes

no

yet

Oklahoma

Mar. 10,
1939

July 28.
1939

yes

c

yes

yes
q

yes

yes

X

no

yes
s

yes

yes

no

Mar. 7,
1941

June 13,
1941

yes

ij

yes
q

yes

yes
xz

no

yes

s

yes

yes

no

*

Pennsylvania ....

June 24,
1939

June 24,
1940

T

yes

j

yes

q

yes

yes

rx

no

yes

s

yes

no

yes

Rhode Island ....

Apr. 22.
1938

Apr. 22.
1938

yes

0

yes

yes

no

no

no

no

no

ye.

South Dakota. . . .

Mar. 8.
1939

June 6.
1939

yes

yes

yes

yet

yes

X

yes

yes

s

yes

yes

no

Utah

Feb. 28.
1941

May 13.
1941

yes

a

yes

yes
q

yes

yes

X

yes

yes

yes

yes

yet

Vermont

Apr. 10.
1941

July 31.
1941

yes

u

yes
q

yes

no

(5)

yes

s

yes

yes

no

Washington

Mar. 16.
1939

Jan 2,
1940

yes

yet

yes

q

yes

yes

X

no

no

no

no

no

Wyoming

Feb. 20.
1941

Apr. 21.
1941

yet

a

ij

yes

q

yes

yes

X

yes

yes

yes

yes

yet
t

SUPPLEMENTARY NOTES

a Except when woman refuses request for specimen.

b If no objection by the woman.

e At woman's request or with her consent.

d If woman gives consent.

e Except if woman opposed to medical examination

on grounds of spiritual means.
f Unless a test was taken by another physician during

the pregnancy,
g Upon request of woman,
h Tests accepted from laboratory duly operated

(see y) or in hospitals approved unconditionally

by American College of Surgeons.
i Test to be taken at first visit,
j Or within 10 days after. (In Idaho and Pa. within

15 days after.)
k Within 14 days.
1 Or as soon as possible,
m Blood specimens sent to private laboratories, State

Dept. of Health laboratory at Topeka, or other

laboratories cooperating with State Dept. of Health,
n During gestation.
o Within 30 days of first professional visit. (Ga. and

Conn, within 30 days of first examination.)

p At diagnosis.

q Tests must be approved by State Dept. of Health.

r If patient unable to pay.

s If test not taken, reason to be stated.

t Except if woman refused request.

u If possible, prior to 3rd month of gestation.

v Charge of not more than $1.00.

w Within 20 days thereof.

x To physician requesting such from State Dept. of

Health laboratories.

y As approved by the American Board of Pathology,
a No charge to be made to any patient by the

physician for services in taking blood specimen.

(2) If positive, to be reported. (In Conn, if positive
and performed in State Dept. of Health laboratory.)

(3) Not required by law but date is asked on birth
certificate blank.

(4) Performed free of charge in State Dept. of Health
laboratories.

(5) State laboratory tests only.

FORMS AND PRINCIPLES OF STATE SOCIAL
HYGIENE LAWS

Prepared by

DIVISION OF LEGAL AND PEOTECTIVE SEEVICES
AMEEICAN SOCIAL HYGIENE ASSOCIATION

The form of laws suggested here is similar to that adopted
by many states for repression of prostitution and for the preven-
tion and control of venereal diseases, and contains adequate provi-
sions for effective use. Before any such bills are introduced, they
should be carefully examined by some attorney reasonably expe-
rienced in the special fields concerned in the particular state, in
order that such changes may be made therein as will bring them
into harmony with the legal usage and procedure in that state.
State constitutions should be examined for requirements as to scope
and title of state laws, such as constitutional requirements: (1) that
a statute deal with only one subject; (2) that all subjects of
a statute be expressed in its title; (3) miscellaneous state
constitutional provisions.

ESSENTIAL PROVISIONS OF STATE LAWS FOE EEPEESSION OF

PEOSTITUTION WITH A BEIEF INTEEPEETATIVE SUMMABY

OF THEIE USE IN DEALING WITH THIS PEOBLEM

Provisions Interpretation

Section I. It shall be unlawful for any
person, corporation, or association:

(a) To keep, set up, maintain, or oper-
ate any house, place, building, other
structure or part thereof, or vehicle,

trailer, or other conveyance for the j /a\ ^^ /|j\

purpose of prostitution, lewdness, or

assignation ; Third parties, such as keepers, owners

and operators of houses of prostitu-

(b) To knowingly own any house, place, tion, madams, and the like, use every
building, other structure, or part thereof, means to exploit prostitutes and their
or vehicle, trailer, or other conveyance customers for profit. These legal
used for the purpose of lewdness, as- provisions penalize such persons and
signation, or prostitution, or to let, declare their activities to be crimes.*
lease, or rent, or contract to let, lease,

or rent any such place, premises, or
conveyance or part thereof, to another
with knowledge or reasonable cause to
believe that the intention of the lessee
or rentee is to use such place, premises,
or conveyance for prostitution, lewdness,
or assignation;

*A civil action (Injunction and Abatement Law) may also be brought in a
court of equity to close a house of prostitution as a public nuisance.

479

480

(e) To offer, or to offer to secure, an-
other for the purpose of prostitution, or
for any other lewd or indecent act;

(d) To receive or to offer or agree to
receive any person into any house, place,
building, other structure, vehicle, trailer,
or other conveyance for the purpose of
prostitution, lewdness, or assignation, or
to permit any person to remain there
for any such purpose;

(e) To direct, take, or transport, or to
offer or agree to take or transport, or
aid or assist in transporting, any person
to any house, place, building, other
structure, vehicle, trailer, or other con-
veyance, or to any other person with
knowledge or reasonable cause to believe
that the purpose of such directing, tak-
ing, or transporting is prostitution,
lewdness, or assignation;

(f) To procure a female inmate for a
house of prostitution; or to cause, in-
duce, persuade, or encourage by promise,
threat, violence, or by any scheme or
device, a female to become a prostitute
or to remain an inmate of a house of
prostitution; or to induce, persuade, or
encourage a female to come into or
leave this state for the purpose of prosti-
tution, or to become an inmate in a
house of prostitution; or to receive or
give, or agree to receive or give any
money or thing of value for procuring,
or attempting to procure any female to
become a prostitute or an inmate for a
house of prostitution;

(g) To knowingly accept, receive, levy
or appropriate any money or other thing
of value, without legal consideration,
from the proceeds or earnings of any
woman engaged in prostitution.

Section II. It shall further be unlawful
for any person:

(a) To engage in prostitution, lewdness,
or assignation;

(b) To solicit, induce, entice, or procure
another to commit an act of lewdness,
assignation, or prostitution, with himself
or herself;

(c) To reside in, enter, or remain in any
house, place, building, or other structure,
or to enter or remain in any vehicle,
trailer, or other conveyance for the
purpose of prostitution, lewdness, or
assignation.

I-(c), (d) and (e)

These provisions penalize the persons
who receive others into any place or
vehicle for prostitution and define
and make illegal the activities of
go-betweens such as the bellboys,
taxi-drivers, and others who bring
for a monetary consideration, the
prostitute and the customer together.

I-(f) and (g)

Provisions dealing with the activities
of panderers and procurers of women
for the purpose of prostitution are
commonly called "white slave" laws.
The penalties should be severe if the
traffic in women and girls is to be
curbed. These provisions attempt to
attack this vicious racket at its heart.

II— (a) to (c)

Prostitution activities of the man and
woman are made, by these provisions,
unlawful and illegal.

FORMS AND PRINCIPLES OF STATE SOCIAL HYGIENE LAWS 481

Section III. That the term "prostitu-
tion" shall be construed to include the
giving or receiving of the body for
sexual intercourse for hire, and shall also
be construed to include the giving or
receiving of the body for indiscriminate
sexual intercourse without hire. The
term "lewdness" shall be construed to
include any indecent or obscene act.
The term "assignation" shall be con-
strued to include the making of any
appointment or engagement for prosti-
tution or lewdness or any act in further-
ance of such appointment or engagement.

Section IV. It shall be unlawful to aid,
abet, or participate in the doing of
any of the acts enumerated in Sections
I and II.

Section V. That in the trial of any
person charged with a violation of any
of the provisions of Section I of this
Act, testimony concerning the reputation
of any place, structure, or building and
of the person or persons who reside in
or frequent the same and of the defend-
ant shall be admissible in evidence in
support of the charge.

Section VI. That any person who shall
be found to have committed a single
violation of Section II of this Act shall
be deemed to be guilty in the third
degree. That any person who shall be
found to have committed two or more
violations of Section II of this Act
within a period of one year next pre-
ceding the date named in an indictment,
information, complaint, or charge of vio-
lating Section II shall be deemed to be
guilty in the second degree. That any
person who shall be found to have com-
mitted a violation of Section I of this
Act shall be deemed to be guilty in the
first degree.

Section VII.

(a) That any person who shall be
deemed to be guilty in the third degree
as set forth in Section VI, may be sub-
ject to commitment to a reformatory
institution for not more than six months ;

Provided, that the sentence imposed,
or any part thereof, may be suspended,
and provided, further, that the defendant
may be placed on probation.

(b) That any person who shall be
deemed guilty in the second degree, as
set forth in Section VI, shall be subject
to commitment to a reformatory insti-
tution for an indeterminate period of not
more than three years in duration, and
the Board of Managers or Directors of

III

Under this provision, the promiscuous
man who has intercourse with a
promiscuous woman can be punished
as well as the woman. Another im-
portant principle is that it places
sexually delinquent boys and girls,
who are serious problems at this time,
under the control of the courts which
can use their powers for the redirec-
tion or rehabilitation and retraining
of such boys and girls.

IV

This provision makes it possible to
deal with many technical evasions of
responsibility for the acts enumerated.

According to this provision courts
admit evidence of the reputation of
a place or house, as well as that of
the inmates and frequenters, to sup-
port the charge of violating Section I
of this Act.

VI and VII— (a) to (e)

These provisions emphasize the prin-
ciples that:

(a) no prostitute shall be fined;

(b) commitment should be to insti-
tutions suitable for rehabilita-
tion, including treatment for
the venereal diseases, rather than
to jails or other penal institu-
tions ;

482

JOUENAL OF SOCIAL HYGIENE

the reformatory institution shall have
authority to discharge or place on parole
any person so committed after serving
therein for a minimum period of three
months and to require the return to the
said institution for the balance of the
maximum term of any person who shall
violate the terms or conditions of the
parole ;

Provided, that the court or judge im-
posing sentence may in his discretion
place the defendant on probation for a
period of not less than one year, nor
more than three years.

(c) That any person who shall be
deemed to be guilty in the first degree,
as set forth in Section VI, shall be
subject, for a term of not more than
three years, to imprisonment in or com-
mitment to any state, city or county
penal or reformatory institution, which
is or may hereafter be authorized to
receive persons convicted of criminal
offenses;

Provided, that in case of a commit-
ment to a reformatory institution the
commitment shall be made for an inde-
terminate period of time of not more
than three years or not less than six
months in duration, and the Board of
Managers or Directors of the reforma-
tory institution shall have authority to
discharge, or place on parole, any person
so committed after the service of a
minimum term of six months, or any
part thereof, and to require the return
to the said institution for the balance
of the maximum term of any person who
shall violate the terms or conditions of
the parole.

(d) That the suspension of sentence or
the release on probation or parole of
any person infected with a venereal
disease shall not prevent the imposition
of such terms and conditions as may
be made by the health officer in order
to prevent the spread thereof, nor limit
the authority of the health officer to
require persons convicted under this act
of offenses involving sexual promiscuity
to be examined for venereal diseases.

(c) the terms should be indetermi-
nate up to three years with pro-
vision for discharge or parole of
inmates at discretion of the
Board of Managers of the in-
stitution and for return thereto
of violators of parole for the
balance of maximum terms.*

* The court in which a prostitute is convicted should notify the local health
officer immediately following such conviction and should not discharge from
custody on probation or otherwise any such prostitute until the health officer
has had opportunity to examine her for venereal disease, or to take such further
action concerning her as he deems necessary for the protection of the public
health; and prostitutes placed on probation by the court or paroled from
institutions should be under the care and supervision of women probation or
parole officers only.

FORMS AND PRINCIPLES OF STATE SOCIAL HYGIENE LAWS 483

(e) That no girl or woman who shall
be convicted under this Act shall be
placed on probation or parole in the
immediate care or charge of any person
excepting a woman probation officer.

Section VIII. That all courts of record
shall have jurisdiction to try all cases
involving violation of any of the
provisions of this Act.

Section IX. That all state laws and city
ordinances or parts thereof in conflict
with the provisions of this Act be and
the same are hereby repealed.

Section X. That the declaration by the
courts that any of the divisions, sections,
subsections, sentences, clauses, phrases,
or requirements of this Act is for any
reason unconstitutional, such decision
shall not affect the validity of the re-
maining portions thereof which the legis-
lature hereby declares it would have
passed even if it had known that one
or more of such divisions, sections,
subsections, sentences, clauses, phrases,
or requirements might be declared
unconstitutional.

VIII

This provision enables all courts of
record to hear all cases involving
violations of this Act.

Declaration by the courts that any
provision of this Act is unconstitu-
tional shall not affect any other
provision.

PEINCIPAL PEOVISIONS OF A STATE PEEMAEITAL EXAMINATION

LAW WITH A BEIEF INTEEPEETATIVE SUMMAEY

OF APPLICATION*

Interpretation

Provisions

Section 1. Before any person, who is
or may hereafter be authorized by law
to issue marriage licenses, shall issue
any such license, each applicant therefor
shall file with him a certificate from a
duly licensed physician which certificate
shall state that the applicant has been
given such examination, including a
standard serological test, as may be
necessary for the discovery of syphilis,
made not more than thirty days prior
to the date of issuance of such license,
and that, in the opinion of such physi-
cian, the person either is not infected
with syphilis, or if so infected, is not
in a stage of this disease which is or
may become communicable to the marital
partner. Any person who by law is
validly able to obtain a marriage license
in the (name of the state) is validly
able to give consent to any examination
and tests required by this Act. In sub-
mitting the blood specimen to the lab-

* Based on the California Premarital Examination Law. A more comprehensive
statement on the status and operation of this legislation is found in the Summary
of State Legislation Eequiring Premarital and Prenatal Examinations for
Venereal Diseases, 2nd Edition, Publication No. A-522, 25 cents postpaid,
American Social Hygiene Association, 1790 Broadway, New York 19, N. Y.

This provision requires each appli-
cant for a marriage license to pre-
sent to the licensing authority a
certificate from a licensed physician
stating a premarital examination,
including a standard serological test
for syphilis, was made within a cer-
tain period of time, which showed
freedom from infectious syphilis, as
a prerequisite to the issuance of such
license.

484

JOURNAL OF SOCIAL HYGIENE

oratory the physician shall designate that
this is a premarital test.

Section 2. The certificate shall be ac-
companied by a statement from the
person in charge of the laboratory mak-
ing the test, or from some other person
authorized to make such reports, setting
forth the name of the test, the date it
was made, the name and address of
the physician to whom the test was sent
and the name and address of the person
whose blood was tested, but not stating
the result of the test. Except as herein-
after provided, the certificate of a
physician and the statement from a
person in charge of a laboratory or
from a person authorized to make reports
for the laboratory shall be on a form
to be provided and distributed by the
(name of the state) Department of
Public Health to laboratories in the state
approved by the (name of the state)
Department of Public Health. This
form is hereinafter referred to in this
Act as ' ' the certificate form. ' '

Section 3. Certificate forms provided
by other states having comparable laws
will be accepted for persons who have
been examined and who have received
serological tests for syphilis outside of
(name of the state) ; provided, such ex-
aminations and tests are performed not
more than 30 days prior to the issuance
of a marriage license. Certificates pro-
vided by the United States Army or
Navy will be accepted for military
personnel; provided, such certificates are
signed by a medical officer commissioned
in the United States Army or Navy ;
and provided, the certificates state the
examinations and serological tests for
syphilis were performed not more than
30 days prior to the issuance of the
marriage license.

Section 4. For the purpose of this Act
a standard serological test shall be a
test for syphilis approved by the (name
of the state) Department of Public
Health, and shall be performed by the
state department of public health on
request, free of charge. An approved
laboratory shall be the laboratory of
the (name of the state) Department of
Public Health, or a laboratory approved
by the (name of the state) Department
of Public Health, or any other laboratory
the director of which is licensed by said
State Department of Public Health ac-
cording to law. In case of question
concerning accuracy of tests prescribed
in this Act, it shall be mandatory upon
the State Department of Public Health
to accept specimens for checking purposes
from any district in the state.

The physician's certificate, under this
provision, must be accompanied by
a laboratory report giving the name
and the date of the blood test made,
which must not state the result.

3

Medical certificates and serologic
laboratory reports on out-of-state
forms will be accepted from other
states with similar premarital exami-
nation laws; also certificates for
military personnel when executed by
Army or Navy physicians, provided
such examinations and tests are per-
formed not more than 30 days prior
to the issuance of the marriage
license.

This provision defines standard sero-
logical test for syphilis to mean a
test approved by the state department
of health, and performed by the state
department of health or by an
approved laboratory.

FORMS AND PRINCIPLES OF STATE SOCIAL HYGIENE LAWS 485

Section 5. The (name of the state)
Department of Public Health shall issue
a "Laboratory Eeport Form" to be
distributed upon application to all lab-
oratories approved to do tests called for
in this Act. Any laboratory doing tests
called for in this Act shall prepare the
report in triplicate. The original of
this report shall be transmitted by the
laboratory doing such test together with
the certificate form to the certifying
physician. The duplicate reports shall
be forwarded at weekly intervals to the
(name of the state) Department of
Public Health. The triplicate shall be
retained by the laboratory on file for
five years and shall be open during that
time for inspection by any authorized
representative of the (name of the state)
Department of Public Health.

Section 6. The judge of the (name of
proper) court in the county in which
the license is to be issued is hereby
authorized and empowered, on joint ap-
plication by both parties to a marriage,
to waive the requirements as to medical
examinations, laboratory tests, and cer-
tificates and to order the licensing
authority to issue the license applied
for, if all other requirements of the
marriage laws have been complied with,
and if the judge is satisfied by affidavit
or other proof that an emergency or
other sufficient cause for such action
exists and that the public health and
welfare will not be injuriously affected
thereby. In any case where such ex-
aminations and tests have been made
and certificate or certificates have been
refused because one or both of the
applicants have been found to be in-
fected with syphilis, the judge shall
nevertheless be authorized and empow-
ered on application of both parties to
such marriage to order the licensing
authority to issue the license, if all
other requirements of the marriage laws
have been complied with and if the
judge is satisfied by affidavit or other
proof that an emergency or other suffi-
cient cause for such order exists and
that the public health and welfare will
not be injuriously affected thereby. In
every such case, however, the clerk of
the court shall transmit to the (name
of the state) Department of Public
Health a transcript of the record and
the order thereon for such follow-up in
said department as is required by law
or deemed necessary by said department
for the protection of the public health.
The order of the court shall be filed by
the licensing authority in lieu of the
certificate form. The court when it is

This provision provides for the filing
of reports of premarital laboratory
tests by the laboratory performing
the blood tests with the state
department of health.

6

This provision is designed to permit
marriages of infected persons in
special cases, by order of the proper
court.

486

JOURNAL OF SOCIAL HYGIENE

This provision contains a penal
clause, making it a misdemeanor for
any misrepresentation of essential
facts and for any other violation of
the provisions of the Act.

deemed necessary may, to the extent
authorized by law or rules of court,
order all proceedings instituted under the
provisions of this Act to be confidential
and private. There shall be no fee for
these court proceedings. The certificate
forms and the court orders shall be filed
in the office of the county clerk.

Section 7. Any applicant for a mar-
riage license, physician, or representative
of a laboratory who shall misrepresent
his identity or any of the facts called
for by the certificate form prescribed
by this Act; or any licensing officer who
shall issue a marriage license without
having received the certificate form or
an order from the court, or who shall
have reason to believe that any of the
facts on the certificate form have been
misrepresented, and shall nevertheless
issue a marriage license; or any person
who shall otherwise fail to comply with
the provisions of this Act, shall be
guilty of a misdemeanor. Certificates,
laboratory statements or reports, appli-
cations and court orders, in this Act
referred to and the information therein
contained, shall be confidential and shall
not be divulged to or open to inspection
by any person other than state or local
health officers or their duly authorized
representatives. Any person who shall
divulge such information or open to in-
spection such certificates, statements, re-
ports, applications or court orders,
without authority, to any person not
by law entitled to the same shall be
guilty of a misdemeanor.

Section 8. The sum of ($ )* is

hereby appropriated out of any money
in the state treasury not otherwise ap-
propriated, to be expended by the (name
of the state) Department of Public
Health for printing, necessary expenses
relative to checking and approval of
laboratories, clerical and technical assist-
ance involved in administration of this
Act and any other expenditures neces-
sary for carrying out the provisions and
purposes of this Act. All claims against
this appropriation shall be submitted for
approval and audit to the (name of
the state) Department of Public Health,
and shall be paid in accordance with law.

Section 9. Nothing in this Act shall
impair or affect existing laws, rules,
regulations or codes made by authority
of law, relative to the reporting by
physicians and others of eases of syphilis
discovered by them.

* California appropriated $20,000.00 for two years for carrying out the
provisions of this law when it was passed in 1939.

8

This provision provides for appro-
priation to state department of health
in the administration of this Act.

FOEMS AND PRINCIPLES OF STATE SOCIAL HYGIENE LAWS 487

10

Declaration by the courts that any
provision of this Act is unconstitu-
tional shall not affect any other
provision.

Section 10. If any section, subsection,
sentence, clause or phrase of this Act
is for any reason held to be unconstitu-
tional, such decision shall not affect the
validity of the remaining portions
thereof. The Legislature hereby de-
clares that it would have passed this
Act, and each and every section, sub-
section, sentence, clause and phrase
thereof, irrespective of the fact that
any one or more other sections, sub-
sections, sentences, clauses or phrases
be declared unconstitutional.

Section 11. This Act shall take effect
on (a day specified at least three months
after its passage).

C

PRINCIPAL PROVISIONS OF A STATE PRENATAL EXAMINATION

LAW WITH A BRIEF INTERPRETATIVE SUMMARY

OF APPLICATION *

Provisions Interpretation

Section 1. Every physician attending
pregnant women in the (name of the
state) for conditions relating to their
pregnancy during the period of gesta-
tion and/or at delivery shall, in the
case of every woman so attended, take
or cause to be taken a sample of blood
of such woman at the time of first ex-
amination, and shall submit such sample
to an approved laboratory for a standard,
serological test for syphilis. Every other
person permitted by law to attend preg-
nant women in the state, but not per-
mitted by law to take blood samples,
shall cause a sample of blood of such
pregnant woman to be taken by a
physician duly licensed to practice medi-
cine and surgery and have such sample
submitted to an approved laboratory for
a standard serological test for syphilis.

Section 2. For the purpose of this Act
a standard serological test shall be a
test for syphilis approved by the Di-
rector of Health of (name of the state),
and shall be made at a laboratory ap-
proved to make such tests by the
Director of Health of (name of the
state). Such laboratory tests as are
required by this Act shall be made on
request without charge at the Depart-
ment of Health of the (name of the
state) .

NOTE: This form of law does not have a penalty clause but 13 of the 30
states which now have prenatal examination legislation do penalize violations.

This provision requires every physi-
cian or otherwise authorized attend-
ant on a pregnant woman to take
and submit a sample of blood to a
laboratory for a test for syphilis.

This provision defines a standard
serological test for syphilis to mean
a test approved by the state depart-
ment of health, and performed by
the state department of health or an
approved laboratory.

* Based on the New Jersey Prenatal Examination Law. A more comprehensive
statement on the status and operation of this legislation is found in the
Summary of State Legislation Requiring Premarital and Prenatal Examinations
for Venereal Diseases, 2nd Edition, Publication No. A-522, 25 cents postpaid,
American Social Hygiene Association, 1790 Broadway, New York 19, N. Y.

488

JOURNAL OF SOCIAL HYGIENE

3

Each birth certificate must state,
whether test was made, and if not,
why. (Kesult of test must not be
shown.)

Section 3. In reporting every birth and
stillbirth, physicians and others required
to make such reports shall state on the
certificate whether a blood test for
syphilis has been made upon a specimen
of blood taken from the woman who
bore the child for which a birth or
stillbirth certificate is filed and the
approximate date when the specimen was
taken.

Section 4. The sum of ($ ) t,

or so much thereof as may be necessary,
is hereby appropriated to the State
Department of Health to cover the
additional clerical, printing and other
expenses in carrying out the provisions
of this Act.
Section 5. This Act shall take effect on
(a specified time).

D

PRINCIPAL PKOVISIONS OF LAWS AND EEGULATIONS FOR THE

CONTROL AND PREVENTION OF THE VENEREAL DISEASES

WITH A BRIEF INTERPRETATIVE SUMMARY OF THEIR

USE IN DEALING WITH THIS PROBLEM*

(The following outline suggests the principal provisions which should be
embodied in state laws and regulations to enable the health authorities to deal
effectively with the venereal diseases, as public health problems.)

This provision provides for appro-
priation to state department of health
for the administration of the Act.

Provisions

(A) Penal, Correctional and Custodial
Institutions Law

Statute: Should authorize health
officers or deputies to examine or
cause to be examined for commu-
nicable diseases, including venereal
diseases, as defined in public health
law, or state venereal disease regu-
lations, the inmates of penal, cor-
rectional and custodial institutions.

Corresponding Begulation: Should
prescribe methods for such exami-
nation.

(B) Premarital Examination Law
Statute: Should require applicants
for marriage licenses to have pre-
marital examinations by physicians,
blood tests by approved labora-
tories, and certificates by the
examining physicians showing
freedom from infectious syphilis,
as prerequisites to the issuance of
such licenses.

State Boards of Health should be
authorized and directed to pre-
scribe examinations and blood tests

Interpretation

(A)

These provisions empower health au-
thorities to cooperate with various
institution officials in the treatment
of inmates for venereal disease.

(B)

These provisions require applicants
for marriage licenses to have exami-
nations by physicians, including blood
tests for syphilis, and the presenta-
tion of medical certificates to licens-
ing authorities showing freedom from
infectious syphilis as prerequisites to
the issuance of such licenses.

t New Jersey appropriated $15,000.00, or so much as might be necessary, for
carrying out the provisions of this law, when it was passed in 1938.

* Approved by the medical staff of the American Social Hygiene Association
including Dr. William F. Snow, Chairman, Executive Committee and Dr. Walter
Clarke, Executive Director.

FORMS AND PRINCIPLES OF STATE SOCIAL HYGIENE LAWS 489

and to approve laboratories meet-
ing requirements.

This provision has usually been
adopted as an amendment to the
state marriage law.

Corresponding Regulation: Should
prescribe such examinations and
blood tests.

(C) Prenatal Examination Law

Statute: Should require doctors in
attendance on pregnant women to
make examinations, and have blood
tests made, by approved labora-
tories, for syphilis in such women.

State Board of Health should be
authorized and directed to pre-
scribe such examinations and blood
tests and to approve laboratories
meeting requirements.

Each birth certificate shall state
whether such test was made. If
such test was not made, the reason
shall be given.

This provision has sometimes
been adopted as an amendment to
the state birth registration law.

(C)

These provisions require doctors in
attendance or otherwise authorized
attendants on pregnant women to
take blood tests for syphilis on such
women for submission to approved
laboratories for testing for syphilis.

Corresponding Regulation: Should
prescribe such examinations and
blood tests.

(D) Public Health Law

I. Definitions of venereal diseases
Statute: Defining "venereal dis-
eases" to include syphilis, gon-
orrhea, chancroid, granuloma
inguinale and lymphogranuloma
venereum; and declaring them to
be contagious, infectious, com-
municable and dangerous to public
health.

Corresponding Regulation : In
states where it is not unconstitu-
tional (under theories such as
illegal delegation of legislative
power) for health authorities to
prescribe the categories of dis-
eases contagious, infectious, com-
municable and dangerous to public
health or to determine what dis-
eases fall within such statutory
categories, this result may be
accomplishable by regulation.

II. Prescriptions T>y physicians

only

Statute: Prohibiting any person

other than a licensed physician

from treating or prescribing for a

case of venereal disease.

Corresponding Regulation: None

These provisions declare venereal dis-
eases to be communicable and dan-
gerous to the public health. On
this foundation the venereal disease
control program is based.

(D)-II

Only a qualified medical doctor can-
prescribe for or treat venereal disease.

490

JOURNAL OF SOCIAL HYGIENE

III. Advertising venereal disease
remedies

Statute: Prohibiting the advertise-
ment of cures or remedies for
venereal diseases.

Caution: The provisions should not
prevent such advertisements in pro-
fessional medical, pharmaceutical
and public health publications;
nor announcement of authorized
medical and clinical services and
facilities.
Corresponding 'Regulation: None

IV. Sale of appliances, remedies,
et cetera.

Statute: Making it unlawful: (a)
to display, sell, or dispose of appli-
ances, drugs or medicinal prep-
arations for the prevention or
treatment of venereal diseases ex-
cept in registered pharmacies and
as may be provided for in medical
practice acts; (b) for pharmacies
or anyone else to sell remedies or
drugs for venereal diseases ex-
cept on prescription by a licensed
physician.

Caution: Special exceptions should
be provided to save acts other than
medical practice acts considered
desirable — such as the Kentucky
statute (Oh. 55, L. 1938).

Corresponding Regulation: None

V. 'Reporting

Statute: Eequiring the reporting
of venereal diseases and ophthalmia
neonatorum by physicians, or,
where no physician is in attend-
ance, by others who have knowl-
edge of such cases to state and/or
local health departments.

Corresponding Regulation : Pre-
scribing form and method of such
reporting and various authorities
to which reports must be made.

VI. New-torn infants

Statute: Requiring physicians and
other authorized persons to apply
prophylactic treatment as specified
in the regulations, to the eyes of
new-born infants to prevent oph-
thalmia neonatorum, and to report
to health officers the performance
of this procedure.

Corresponding Regulation: Pre-
scribing nature of such treatment
and reporting.

(D)-m

This provision prohibits the adver-
tising of remedies for the cure of
venereal diseases.

(D)-IV

This provision prohibits the sale or
disposal of appliances or medicinal
preparations used in venereal disease
control except in registered pharma-
cies or as provided in state medical
practice acts. The sale of remedies
by drug stores and others is prohibited
without a prescription.

(D)-V

These provisions require venereal dis-
eases to be reported by physicians or
other qualified persons.

(D)-VI

Requiring physicians and other au-
thorized persons to apply prophylactic
treatment to the eyes of new-
born infants for the prevention of
blindness.

FORMS AND PRINCIPLES OF STATE SOCIAL HYGIENE LAWS 491

VII. Examination and detention
of suspects

Statute: Authorizing and directing
health officers to examine persons
reasonably believed to be infected
with a venereal disease, and to
detain such persons pending com-
pletion of examination and also to
ascertain and follow up sources of
infection and contacts of infected
individuals.

Corresponding Regulation: Pro-
viding nature and character of
such examination; places where
examinations may occur; by what
medical officers such examinations
shall be conducted; for prompt
reporting of results of such exami-
nations; and for investigation of
alleged sources of infection and
contacts.

VIII. Provision of treatment for
the venereally infected

Statute: Authorizing and directing
health officers to provide treatment
for infected persons when necessary
in the public interest.

Corresponding Regulation : Pre-
scribing nature, character, extent
and places of such treatment.

IX. Quarantine or isolation of
infectees

Statute: (a) Eequiring infectious
persons to submit to treatment or
to quarantine if necessary for the
protection of the public health;
(b) Authorizing and directing
health officers to isolate or quaran-
tine persons infected with a vener-
eal disease whenever such action is
in the opinion of the health officer
necessary for the protection of the
public health.

Corresponding Regulation : Pre-
scribing nature, character, extent
and place of such treatment,
quarantine and isolation.

X. Infectees in certain occupations
Statute: Authorizing health offi-
cers to restrain, when necessary in
the public interest, any person with
a venereal disease from engaging
in any occupation involving inti-
mate contact with other persons,
or the public.

Caution: If designation of such
occupations is regarded, in a state,
as a non-delegable legislative func-
tion, such designation should be
included in the statute itself.

(D)— VII and VIII

These provisions empower and direct
health officers to examine and detain
persons reasonably believed infected
with venereal disease and to provide
treatment for those found infected.

(D)-IX

These provisions empower and direct
health officers to quarantine persons
infected with venereal disease and
also require such persons to submit
to treatment or quarantine when
necessary for the protection of public
health.

These provisions give power to health
officers to restrain a venereally in-
fected person from engaging in any
occupation involving intimate contact
with the public.

492

JOURNAL OP SOCIAL HYGIENE

Corresponding Regulation: Pre-
scribing nature, character and
extent of such restrictions.

If such designation of occupa-
tions is regarded as properly
delegable to health officers these
may make the designation by
regulation.

XI. Issue of certificate of freedom
from venereal diseases
Statute: Prohibiting the issuance
of certificates of freedom from
venereal diseases by physicians or
health officers except in accordance
with state laws or the regulations
of the state board of health.

Corresponding Regulation: None
recommended, specifically. Further-
more, the public policy in the
United States is categorically op-
posed to issuing any such certifi-
cates for purposes of prostitution.

(D)-XI

This provision prohibits the issuance
of certificate of freedom from vener-
eal disease, except in accordance with
state laws or state department of
health regulation.

XII. Exposure of another to vener-
eal disease by an infectee
Statute: Penalizing any individual
for infecting another with, or ex-
posing another to, a venereal
disease, with knowledge of, or
reasonable grounds to suspect the
existence of such disease.

Corresponding Regulation: None

(D)— XII

This provision penalizes an infected
individual for knowingly infecting
another with or exposing another to
his infection.

XIII. Public education as to
venereal disease

Statute: Authorizing and directing
the state and local health authori-
ties to promote public understand-
ing of the venereal diseases and
the means for their control and
prevention.

Corresponding Regulation : Pre-
scribing nature and character of
methods of public education aimed
to promote such public understand-
ing and means for control and
perhaps for providing material
therefor.

Caution: Care should be taken not
to contravene existing state laws
regarding social hygiene education.
Also not to restrict such activities
to health authorities.

Declaring it to be the duty of
every physician who examines or
treats a person to give or arrange
for instruction of such persons for
preventing the spread of such dis-
eases and regarding the necessity
of treatment until cured.

(D)— XIII

These provisions authorize and direct
state health authorities to educate the
public concerning the venereal dis-
eases and methods for their control.

FORMS AND PRINCIPLES OF STATE SOCIAL HYGIENE LAWS 493

XIV. Power to make and amend
venereal disease health regulations
Statute: Authorizing and directing
the state board of health to promul-
gate, establish and amend such
regulations, rules and/or proced-
ures as it may from time to time
deem necessary for carrying out
existing or new venereal disease
legislation, for the prevention and
control of the venereal diseases,
and for the discovery, treatment
and quarantine of persons infected
therewith; and declaring that such
rules, regulations and procedures
shall have the force of law.

Corresponding Regulation: None

(E) General penal provisions

Statute: Should penalize, as mis-
demeanors, the violations of any
of the above-listed provisions, in
either the marriage law; birth reg-
istration law; penal, correctional
and custodial institutions law; or
public health law.

Such penal provisions, in a given
state, may seem more properly in-
corporable into the penal law, with
cross reference to the other laws.

Corresponding Regulation : None

•(F) Separability Clause

Statute: The various statutes en-
acted or amended in pursuit of
these suggestions should each con-
tain a specific provision to the
effect that judicial adjudication,
as unconstitutional, of any portion
or portions of said acts shall not
invalidate the remaining provisions.

Corresponding Regulations: None

(G) Repealer

Statute: Each such statute should
also contain a specific provision
that all laws or parts of laws in
conflict with its provisions be, and
hereby are, repealed.

Corresponding Regulation: None

(D)— XIV

This provision gives power to the
state board of health to make and
amend regulations, which shall have
the force and effect of law.

(E)

Violations of the laws or regulations
of the state department of health are
penalized as misdemeanors.

(F)

Declaration by the courts that any
provision of this Act is unconstitu-
tional, shall not affect any other
provisions.

494

JOURNAL OF SOCIAL HYGIENE

•«

V

0> «

)

Ef

> >

»

«o 0

0 0

3

3 i

1* IH !

H

|i

Sj

.1 .1

=

ll

0> <1) i

-*J -4-J H

S

^ c^

PH CO PH OS 1

Xtn

o o *

O O> O 0) C

2 01

^^ T^ 02

T3 *H ""CJ ^ *"5

3 g

*. ^Z

**J co**J co "*

Sell
^ <jj

»— OS £

03 1 S3
M C« g «•

4 tt<4 fl <4

os os o

it

OS S *"* ^

»H rH r-

4

S w

O ^ ^j -*j> a;

<

•+

S "S

t^p t~~ tQ f <^ ~

I

3 >

^^ —^ X) P

3 O

<i R 5 c

O a 73 73 *

' i

S &

co O ^ g g "g

n
e

i .§

^^ ^ ^

^ HH o "^ 'n *C

7

3 73

O S»i73(H73S
,_ W a •*» 8-J3 9s

Z S g CO rj CO O
j C_, -"S HH "O hH <0

(
. 1

> °
li "ft
J O

7

3 73

_^ r"^ ^ ^ ft-^1

4

1 ^

rv^ f^ QJ MA o M« ^ u

r*"1 ^J_H "^ vi w v? w CO

1

HH HH OS OS OS

,3

0

S "" OS ^

H O2 «H «H IH

^

4 rH

0 3

HH W ^,

' •+

2

CQ 3

O J

3

Hjp /^l ^

1^i M 00

-*J Qj

2

o z §

•5 01

JTT: vl e 73

ce t

1

^ *N KH

-U Q.

*y • ^ e ^

g.n ?

i

<H CC -g § 73

S 2 1

3 73 7

o pa is £73

•2 '

'M $ :

" 5? -+J -«•

HH i— i § e ~ "-

HMt f * C 2
, PH £ •§ HH «

^ o a

C -P •*

« s c

S-0 K

- co ft t
3 cc 0 C
0373 7

J L— i ™
^"^ ^^ H -4J
^ J"j P^ CO O

f «
u
eo 3 e-

s o eo c

^H Q2 ^i* C

1 G ^ r

O S ^

OS C

s os o

4 r-< »-

g H

" ^S -p -1J

VH (H -4J •" ' •+

5 -1J

SOCIAL HYGIENE

:N THE STATES,

Premarital
Examination Laws
1943 — Introduced bu
not passed
1943 — Introduced bu
not passed
1943 — Introduced bu

o o s .73 :

«W «t-l -»J ^

§ § '1

Hill i1"

pi " *w " 3 S S F

§ ft g P,^ S 73 7

73 g o g S*J-sf|l

%** fc^ fe^ g-g §^f

CtJ rM pQ Ct3 . .

ft -e I -je ft1""1 ^
o | o s

+> -P 73

oco geo ECO Oeo C P

CT*< «3Tt< cc^ C^ PTJ
OS OS OS OS O

not passed
1943 — Introduced bu
not passed

1QA3 A/1rv^t«/1

s «

co O O> O 01 ^ co

ft<! S <J S I ft

<*«
TjtC<*
os ci

„

ft
o

73

1

i

1

II

g g ft ft

coc

o co co

C-^TK
O O5

ic
e

C

S *
|

>,

> 3
>r* .B *

«

ii i

-•I

SOCIAL HYGIENE LEGISLATION

495

.8 §

73 'S

I £73
&»fi 2
7?£*§
og i *

$«•$
sS g

^^

.i

&00

•§

1

B _5 fi _H

• I— I »PH ^ .r-

CS

« «

73 73

rr-j O> O/

; s; -*e •*»

i S ft 05 ft 03

cn O eu O d)

0573 Jj73 b

^ g<! g

-» f g I 3

ieo ceo §

i<* C-* S

03 03

I I g

i JJ g W

' 05 03

-f a

«

CO*

-

rt

3

£73
•+J o

e OQ
£ *

•g -g

"^ "ft
O O

-s

o o

I
I

•g.

8-gl

73 ,2

c o 73

H 1 S 3^

M § a-0 .

« o w^co Sw_g

' 03

-Si

« g

bu

ed

-*J
^

73

o>

V

i

~-

-«

IS

6? -

23 -^ rG

-8

ti

EDITORIAL

IF YOUE STATE NEEDS NEW SOCIAL HYGIENE LAWS . . .

If new social hygiene laws are needed to protect family health
and welfare in your state, and to improve community conditions —
or if old laws need to be strengthened — you can perform a patriotic
duty by joining with other good citizens to see that the next session
of your legislature has an opportunity to consider such legislation.

Strong and workable laws, vigorously enforced, against prostitu-
tion and the venereal diseases, provide excellent insurance against
the moral hazard and the spread of infection. Communities
which have backed up their law enforcement and health officials in
the observance of such laws have seen this proved over and over
again during the war years, as VD rates among nearby servicemen
and war workers took a quick and steep drop after "redlight dis-
tricts" were closed,* or other sources of infection were cleaned out.
States which have set out to protect present-day marriages and future
generations from syphilis by laws requiring premarital and prenatal
examinations for this disease, are learning that through these laws
many infections which might otherwise run their courses undiscovered
until too late, are being found and checked. States which considered
their legal provisions good for finding and treating infected persons
in the general population are realizing that better laws mean better
results, in terms of more patients brought under treatment and
kept under treatment until cured. There is in fact a new and wide
recognition among forward-looking people that these protective and
repressive laws are part of the essential framework of our national
health structure.

And the benefit to health — national, community and family — is
but one of the good effects of these laws. Where well-drawn laws
for protection of health and welfare are well observed, other laws
are apt to be well observed — which means orderliness and good man-
agement. It goes without saying that good laws and law observance
show that home, church, school and all other good elements are
working with the law enforcement and public health officials in
bringing this about — which means that there is unity and cooperation.
Then, too, where there is vigorous action to drive out prostitution

* The Federal Security 's Division of Social Protection reports that since 1940
federal and state laws and city ordinances against commercialized prostitution
have enabled officials to close up such hotbeds of infection in over 650 communities
•where wartime conditions had permitted them to spring up.

496

EDITORIAL 497

and to protect the people from VD by cleaning up its sources of
spread, the number of new infections is bound to be less, and the
cost for medical care proportionately low both to the personal pocket-
book, and to the public budget for tax-supported hospitals, clinics
and laboratories — which means saving and economy. Most profitable
result of all, the existence and observance of good social hygiene
laws guarantee strong safeguards thrown around the growing gen-
eration of Americans upon whose soundness and integrity national
strength and progress depend, in war or in peace.

Looking at the record of recent years, it seems that a majority
of state law-makers have become convinced of these facts, and have
recognized the extent of the opportunity for public service. The
score to date:

Twenty-nine states now have workable laws against prostitution,
and some states have laws to help persons who are victimized
in their efforts to return to normal and useful lives.

Most states now have serviceable laws for prevention and control
of syphilis and gonorrhea.

Thirty states have special laws to protect marriage from
syphilis.

Thirty states have special laws to protect mothers and babies
from syphilis.

How does your state stand f

Study the maps and charts and the history of progress in legisla-
tion in this issue of the JOURNAL, and plan to help, if new laws are
needed in your state, when your legislature meets.

And remember always, good laws are only the first step. To pro-
duce results the laws must be intelligently used and well enforced.
Help in your state and community to promote understanding and
observance of the social hygiene laws you have and better ones when
they are enacted and support your police officials, your courts and
judges, and all other officers concerned, with strong, informed public
opinion and united effort of every community agency and institution,
and of every citizen.

YOUR PART IN THE LEGISLATIVE CAMPAIGN

If your state is one in which new social hygiene laws, or amendment
of old laws, is needed, begin now to plan for action. Possibly some
qualified organized group is already planning to introduce legisla-
tion. If so, they will welcome your interest and support. Programs
of action which have often been successful in securing sound social
hygiene laws have included activities like the following :

498 JOURNAL OF SOCIAL HYGIENE

1. A social hygiene society, medical society, bar association, parent-
teacher association or similar interested group studies the require-
ments of existing laws and the needs to be met. Sometimes two or
three groups will make this a joint project, but responsibility for
carrying out the details of the program usually must be delegated to
one group or a central joint committee, with all other interested
agencies constantly consulted and kept in touch.

2. Special advice is sought from (a) medical and nursing organiza-
tions as to the scientific and administrative practicability of the leg-
islation as drawn up; (b) of legislators and Statute Commission,
or Legislative Council, if there is one in your state, or the state's
Attorney General as to the form which the law must take to meet the
desired ends. Drafts of the laws are submitted to the state health
department and the social protection and welfare official and voluntary
agencies for their advice and approval.

3. Popular support for the legislation is worked up in advance of
its introduction. This includes: publicity which will inform the
general public, by radio, newspapers and meetings; petitions and
letters from constituents to their legislators; resolutions in support
of the legislation by the various interested agencies ; personal contact
with legislators to secure advice and assurance of support in advance.

4. A high level of wide public interest will demonstrate that the
citizens really understand the purpose of the legislation and want
it passed. To this end the testimony of informed and impartial
witnesses is helpful and welcomed by legislative committees working
on the new laws; thorough study beforehand enables supporters of
the legislation to meet all arguments and to suggest adjustments and
changes which the legislators may think necessary, without the law
losing force.

Finally, the records of most states show that those who have not
succeeded the first time, HAVE TRIED AGAIN ! When a legislature
has failed to enact suitable laws when first presented, the time before
the next session has been used to keep on developing public interest
and support, making passage at the next session more likely, and
also helping to create public understanding and observance of the
laws when they are passed.

NATIONAL SOCIAL HYGIENE DAY
Wednesday, February 7, 1945

Write to

Social Hygiene Day Service

AMERICAN SOCIAL HYGIENE ASSOCIATION

1790 Broadway, New York 19, New York

for program and publicity suggestions and other helps

in preparing your observance

NATIONAL EVENTS

EEBA RAYBURN
Washington Liaison Office, American Social Hygiene Association

National Venereal Disease Committee Meets. — Two meetings of
the new National Venereal Disease Committee have been held in
Washington, July 27 and September 29, when conditions and activi-
ties to date were reviewed and consideration given to ways of main-
taining the present gains against venereal diseases during the postwar
demobilization period. The Committee, recently appointed by Fed-
eral Security Administrator McNutt "to plan new programs in
the fight against venereal diseases and their spread," includes
representation from medicine, nursing, public health, the press,
education, and church groups, as well as the Army, Navy, U. S.
Public Health Service, Federal Security Agency, and the American
Social Hygiene Association.

In making plans for the demobilization period, it was pointed
out that no man would return to civilian life from the armed
forces with a venereal disease infection that has not been cured or
rendered non-infectious. Representatives of both Army and Navy,
however, emphasize that high VD rates may be expected after the
war unless the present program is maintained and strengthened.

In commenting on the upward trend in Army VD rates in con-
tinental United States in the last three months, Lt. Col. Thomas
H. Sternberg (MC), USA, said that the average rate per 1,000 is
now 30 whereas the average rate per 1,000 over the past year was 26.
Commander W. II. Schwartz MC-USN, said that the Navy rate for
the continental United States also showed a slight increase during
the same period. In spite of this trend, both the Army and the
Navy reported substantial decreases in days lost because of venereal
disease, a fact attributed to the use of penicillin in the treatment
of the infections and the resulting reduction in the time required
for treatment with the use of this drug.

Factors entering into the rise of VD cases as reported by the
armed services include: (1) increased reporting of infections with
the advent of penicillin and the short period required for treatment ;
(2) a shortage of trained VD men in this country after the departure
of more trained men for overseas duty; (3) the possibility of laxity
induced by over-reliance upon new methods of treatment.

Members of the National Venereal Disease Committee include:

The Rt. Rev. Howard J. Carroll, general secretary, National Catholic Wel-
fare Conference; Dr. Belmont Farley, National Education Association,
Washington, D. C. ; Dr. T. K. Lawless, dermatologist and consultant, Provident
Hospital, Chicago; Mrs. Mabel K. Staupers, executive secretary, National
Association of Colored Graduate Nurses; John A. Sengstacke, president, Negro
Publishers' Association, managing editor, Chicago Defender; Bishop R. R.
Wright, Jr., executive director, Fraternal Council of Negro Churches, Wilber-

499

500 JOURNAL OF SOCIAL HYGIENE

force, Ohio; Dr. Mordecai Johnson, president, Howard University, Washington,
D. C. ; Medical Director John B. Heller, Division of Venereal Disease, U. S.
Public Health Service; Dr. William F. Snow, American Social Hygiene Associa-
tion; Kev. Alphonse M. Schwitalla, S.J., St. Louis University School of Medicine;
Lt. Col. Thomas H. Sternberg (MC), USA; Commander W. H. Schwartz (MC),
USN; Dr. Felix J. Underwood, Mississippi State Board of Health; Ealph McGill,
editor, Atlanta Constitution; Watson B. Miller, assistant administrator, Federal
Security Agency; Kev. Eoswell Barnes, associate general secretary, Federal
Council of the Churches of Christ in America; Mark A. McCloskey, director,
Office of Community War Services; and Eliot Ness, consultant, Social Protection
Division.

Physical Fitness Year Is Planned by Joint Committee. — A year's
campaign for physical fitness, beginning September 1st, has been
planned by the Joint Committee on Physical Fitness, represent-
ing the American Medical Association and the National Committee
on Physical Fitness. A conference in Washington on July 27 and
28 worked out a program, with more than 100 leaders in all the
fields concerned taking part. Dr. William F. Snow participated
as a Medical Consultant. The September issue of Hygeia, The
Health Magazine in an editorial Keep Fit and Like It, describes
the physical fitness status of the country as viewed by the Committee,
and outlines the goals adopted at the Conference, as follows:

1. Help each American learn physical fitness needs.

2. Protect against preventable defects.

3. Attend to correctable defects.

4. Know how to live healthfully.

5. Act to acquire physical fitness.

6. Set American standards of physical fitness at high levels.

7. Provide adequate means for physical development.

American Public Health Association Holds Second Wartime Con-
ference.— The 73rd Annual Meeting and Second Wartime Confer-
ence of the American Public Health Association which convened in
New York, October 2 to 5 at the Hotel Pennsylvania, drew a large
attendance from all over the country and was of unusual interest
and value. The program included as usual scientific section meetings
and forums, general and business sessions and meetings of related
organizations. Events of special interest were:

First General Session, October 3, 8:30 P.M.: Presiding: President Felix J.
Underwood, M.D. Addresses of Welcome: Mayor Fiorello H. LaGuardia, Com-
missioner of Health Ernest L. Stebbins, M.D., of New York City, State Commis-
sioner of Health Edward 8. Godfrey, Jr., MJX, and Leverett D. Bristol, M.D.,
Chairman, Health Advisory Committee, U. 8. Chamber of Commerce. Speakers:
Eaymond B. Fosdick, LL.D., Public Health as an International Problem; John
J. Sippy, M.D., APHA President-elect, Local Responsibility in Public Health
Administration.

First Special Session, October 4, 9:30 A.M.: Today's Global Frontiers in
Public Health. Presiding: Thomas Parran, M.D. Speakers: Major General
George C. Dunham (MC), for South America; Szeming Sze, M.D., for China;
Melville Mackenzie, M.D., for Great Britain; Dr. Parran and Dr. James A.
Crabtree for the United States.

NATIONAL EVENTS 501

Public Health Education Section, October 3, 2:30 P.M.: What the Health
Officer Expects from the Health Educator and Vice Versa. Panel Leader:
H. O. Swartout, M.D. Participants: W. W. Peter, M.D., W. W. Bauer, M.D.,
Louisa J. Eskridge, Helen Martikainen, D. A. Dukelow, M.D.

Public Health Education, October 4, 2:30 P.M.: Health Education Praxis.
Presiding: Charles E. Lyght, M.D. Discussion: Mary B. Connoly, Charles F.
Wilinsky, M.D., Capus Waynick, Director, VD Education Institute. Speakers:
Harry E. Kleinschmidt, M.D., Savel Zimand, Charles M. Carpenter, M.D.

Epidemiology Section, October 4, 9:30 A.M.: Including address on Venereal
Disease Epidemiology in Wartime, by John B. Heller, Jr., M.D., head of Venereal
Disease Division, U. S. Public Health Service.

Industrial Hygiene, Public Health Education, and Public Health Nursing
Section, October 5, 9:30 A.M.: A Demonstration of Cooperative Effort for
Health Education Workers on the Job. Presiding: Herbert G. Dyktor, Mayhew
Derryberry and Marion H. Doublas, R.N. Speakers: Jacob H. Landes, M.D.,
The Plan of the Fort Greene Industrial Health Committee; Louis Hollander,
Organised Labor's Cooperation in the Plan; L. Holland Whitney, M.D., Manage-
ment's Cooperation; Kenneth D. Widdemer, Community Cooperation; Charles
F. McCarty, M.D., Organised Medicine's Cooperation; Philip E. Mather, Eole
of the National Voluntary Agency. Discussion: Leverett D. Bristol, M.D.,
Victor G. Heiser, M.D., and Mary E. Delehanty, R.N.

American Social Hygiene Association, October 2, 8:30 P.M.: Industry vs.
V.D. — A Program of Education and Action. (See pages 477-8, October JOURNAL
OP SOCIAL HYGIENE.)

APHA Officers for the enusing year were as elected as follows: President,
John J. Sippy, M.D., Stockton, California; President-elect, Milton J. Rosenau,
M.D., Chapel Hill, N. C.; Vice-Presidents, Malcolm R. Bow M.D., Edmonton,
Alberta; Carlos E. Paz-Soldan, M.D., Lima, Peru; Marion W. Sheahan, R.N.,
Albany, N. Y.; Treasurer, Louis I. Dublin, Ph.D., New York; Chairman of
the Executive Board, Abel Wolman, Dr.Eng., Baltimore.

Conference of Social Hygiene Executives in New York. — Another
in the series of conferences of social hygiene executives from all
parts of the country occurred October 6 and 7, directly following
the meetings of the American Public Health Association. The
sessions, which were held at the Town Hall Club, included speakers
and discussions as follows:

Friday, October 6, Morning Session: Social Hygiene Problems of the War
and Postwar Period; George J. Nelbach, Executive Secretary, Committee on
Tuberculosis and Public Health, New York State Charities Aid Association,
presiding. Speakers included Dr. Walter Clarke, ASHA Executive Director;
Bascom Johnson, Director of ASHA Legal and Protective Services; Dr. Harriet
S. Cory, Executive Secretary, Missouri Social Hygiene Association; Charles E.
Miner, ASHA Field Representative; Dr. Jacob Goldberg, Secretary, Social
Hygiene Committee, New York Tuberculosis and Health Association; general
discussion followed.

Luncheon Session: Dr. William F. Snow, Chairman, ASHA Executive Com-
mittee, presiding. Speakers included Commander Walter H. Schwartz (MC),
Officer in charge, Venereal Disease Control, Division of Preventive Medicine,
Bureau of Medicine and Surgery, U. S. Navy; Lt.-Col. Thomas H. Stern-
berg (MC), Chief, Venereal Disease Division, Preventive Medicine Service, Office
of the Surgeon General, U. S. Army Service Forces; Eliot Ness, Consultant,
Social Protection Division, Federal Security Agency; and Medical Director
John R. Heller, Jr., Chief, Venereal Disease Division, IL S. Public Health Service.

502 JOURNAL OF SOCIAL HYGIENE

Afternoon Session: Dr. Harriet S. Cory, presiding. Speakers: George Gould,
Assistant Director, ASHA Division of Legal and Protective Services, 1945: A
Legislative Year; Mrs. Meredith Nicholson, Jr., Executive Secretary, Indianapolis
Social Hygiene Association, A Voluntary Social Hygiene Program in Indianap-
olis; Kenneth R. Miller, ASHA Field Representative, Social Hygiene Programs
for Tuberculosis and Health Associations; Dr. Charles F. Marden, ASHA Field
Representative, Participation of Negroes in a Social Hygiene Program; Miss
Alma Jackson, Hartford Tuberculosis and Public Health Society, A "Health
in Action" Program in Hartford.

Saturday October 7, Morning Session: Mrs. Charles D. Center, Executive
Secretary, Georgia Social Hygiene Council, presiding. Speakers: Wade T.
Searles, ASHA Field Representative, The Organization of the Ohio State Social
Hygiene Council; Frances R. Hecht, Massachusetts Society for Social Hygiene,
The Social Hygiene Program in Massachusetts; Lawrence Arnstein, Executive
Secretary, California Social Hygiene Association, California Unions Cooperate
in the Social Hygiene Program; Percy Sliostac, ASHA Consultant on Industrial
Cooperation, led discussion on this topic; Dr. Adolph Weinzirl, Director, Divi-
sion of Social Hygiene Education, University of Oregon Medical School, Social
Hygiene Education in Oregon; Professor Maurice A. Bigelow, Educational
Consultant and Chairman, ASHA Committee on Education, led the discussion
on social hygiene education; Dr. William F. Snow gave the Conference Summary.

Robert W. Osborn, Assistant Executive Secretary, Committee on
Tuberculosis and Public Health, New York State Charities Aid
Association, expresses the spirit and gist of the Conference in some
notes prepared for SCAA local committee executives.

"IN TIME OF WAR PREPARE FOR PEACE ..."

"When in danger of losing hard-won ground, press the attack more vigor-
ously and resourcefully than before; in other words, apply the time-honored
axiom in fighting circles, 'an attack is the best defense.'

"This was the common tie of discussion at a 'family gathering' of the
American Social Hygiene Association in New York City, October 6-7, 1944.
This was the annual occasion when the ASHA invites state and local social
hygiene executives throughout the country to meet with the headquarters and
field staff to review progress and next steps in venereal disease control. With
the end of World War II in the foreseeable future, haunting the discussion
were ghosts of 1919-1921, when the bottom fell out of World War I VD controls
with a thud that rivaled the stock market crash of 1929.

"So, from the Conference 'invocation' by Dr. Walter Clarke to the closing
'benediction' by Dr. William F. Snow, the emphasis was on 'Don't let it
happen here again,' and that is where the attack-is-the-best-defense angle
applies to the campaign. It was pointed out that now is obviously the time
to consolidate the strongest and most accented features of public interest in
and support of venereal disease control measures and to project them into the
post-war period. 'In time of war prepare for peace,' was a warning sounded
by Bascom Johnson.

"These conferences always have been most stimulating and worthwhile, this
one especially so, not entirely because of what was said, but because of who
said it, since the opportunity was given to meet intimately with interesting
personalities, who are engaged officially and non-officially in the VD control
field from various sections of the nation. Following are but brief notes taken
on the proceedings.

"DR. WALTER CLARKE: Advances in chemotherapy are particularly promising.
Successful treatment of gonorrhea with penicillin is possible in one day through
the use of 20,000 Oxford units injected intramuscularly, 6 doses at intervals
of 3 hours. Syphilis treatment requires about 8 days with the injection of
20,000 units at 3-hour intervals. No toxic effects observed. The spirochete
is eliminated in about 12 hours, and lesions heal quickly. Treatment so new

NATIONAL EVENTS 503

that final outcome is not yet known. Best results are obtained with early
cases although there are hopeful results in treatment of late cases, too.

"Thus, public education is needed more than ever as VD treatment facilities
improve. Improved case finding and tracing of contacts (just as in TB) must
be sought. The public must be told of treatment procedures so as to establish
a strong base of public interest and support to hold our gains. We are
greatly dependent on Federal financial assistance in the program and we must
be alert for any curtailment that would wreck present control machinery.
Increased State and local efforts to stabilize the program through local tax
funds would be a safeguard against a loss in Federal aid.

"BASCOM JOHNSON: Since there has been a marked gain during wartime in
law enforcement against prostitution, continued application in peacetime is
needed to prevent a return of commercialized prostitution. Why has the public
supported the program? Why have Congress and the Army and the Navy
done so? It has been under the compulsion of war, so it is essential that 'in
time of war we should prepare for peace,' as applied to VD control methods.
Any failure of doctors to report cases would contribute to a relapse in effort.
We have been fighting prostitution mainly as a public health menace. It has
not been sufficiently sold to the public as an anti-social condition to insure
peacetime barriers against the evil.

"The pressure of the Army and the Navy now is very important in law
enforcement. Will this influence continue after the war?

"The Federal May Act expires in 1945. Will it be renewed? It should
be because it places Congress on record against commercialized prostitution
and constitutes a positive threat against the underworld.

"COMMANDER WALTER H. SCHWARTZ, U. S. Navy: The Navy VD rate, after
the all-time lows of 1942-3, has in recent months advanced steadily in the
continental United States, in all but the Third District. There has been a
decrease overseas except in Honolulu. Right now we are lagging behind Great
Britain in a public education advertising campaign.

" LIEUT. COL. THOMAS H. STERNBERG, U. S. Army: An important favorable
index in Army control of VD has been the steady downward decline of days
lost because of VD. While VD infection rates remain about the same, improve-
ment in days lost through earlier reporting and treatment has greatly diminished
the problem. The President has signed an amendment to the Articles of War
doing away with penalties for servicemen found to have venereal disease, except
that the infected man must report for treatment. There can be no post-war
claim on the Government for disabilities if he fails so to report. Some of
our problems: (1) our best medical personnel for the control of VD are now
overseas; (2) the advances in treatment probably will make the prevention
of exposure more difficult, by lessening fear of consequences; and (3) loss of
interest by civilians and law enforcement must be guarded against.

' ' The following are important points in the separation of men from Army
service: (1) routine blood tests will be taken before discharge; and (2) all
infected cases will be retained for treatment. Syphilis cases will be identified
to health officers.

"We must face the fact that with demobilization, Army and Navy influence
will be diminished. Then law enforcement will not be easily obtained. Keep
up the good work. Build a strong foundation for post-war control.

"ELIOT NESS: The speaker lived up to the good notices on his speaking and
personality. He praised the ASHA as a voluntary agency which has official
force in dealing with VD problems. The enlistment of police cooperation in
stamping out commercialized prostitution was cited. These officials, he said,
are now appreciative of the moral aspects as well as the public health aspects
of repression. The undercover surveys were praised. Improved public
administration should be our goal. That is the way to get sustained results.

504 JOURNAL OF SOCIAL HYGIENE

"DR. JOHN E. HELLER, JR., USPHS: Kesults to date have been excellent
in VD control, but a somber note is injected when we consider what may
happen to our efforts after the war. Case holding, under chemotherapy, is no
longer a serious problem, but case finding early, just as in tuberculosis,
should be the main concern. Sexual promiscuity must be educated against
and every effort made to enhance character building.

"Experiments are being conducted in the variables of time and dose of
penicillin treatment. Some conjectures on amount of treatment needed to
substantially eradicate syphilis follow: Two years ago it was estimated there
were 200,000 cases of syphilis of which probably not more than 25 per cent
completed treatment. It is probable that there are 230,000 cases reported
annually of which about 60 per cent are being treated. To keep abreast of
new cases and to clear up the reservoir of old cases, 85 to 90 per cent must be
treated to eradicate the disease."

Mr. Osborn also refers to the October 2 meeting sponsored by the
ASH A as an associate group of the APHA on Industry vs. VD, (see
Notes on Industrial Cooperation, October JOURNAL and pp. 511-513,
this issue) as "a running start in a new nation-wide effort to enlist
the aid of industry and labor in VD control," and says:

During the discussion on Friday and Saturday numerous references were
made to cooperation being given by management and employees organizations,
and special mention was made of recommended procedures which will be found
neatly packaged in the new ASHA Manuals by Percy Shostac, ASHA Consultant
on Industrial Cooperation, Industry vs. VD, and The Trade Unions vs. VD. This
is "big league" stuff.

Concluding, Mr. Osborn emphasizes the principles which must
motivate the social hygiene program, if progress is to continue in
the postwar world :

"In his Conference Summary, Dr. Snow made a plea for the moral, ethical,
and philosophical aspects of social hygiene education, enlisting family, church,
school and community forces in the effort. Our greatest period of opportunity
is before us, he said, with no place for the timid soul. He concluded: 'Action,
not reaction, should be our common goal. We have successfully met and
overcome so many real and imaginary situations in this work that we can
confidently face the future without fear of losing ground. Let's keep on
trying also to enlist youth more actively in the organization, administration
and promotion of our program.' '

Eleanor Shenehon, Director of ASHA Community Service, assisted
by other staff members, arranged and conducted the Conference.
Among those attending were :

California: California Social Hygiene Association, San Francisco, Lawrence
Arnstein, Executive Secretary.

Connecticut: Hartford Tuberculosis and Public Health Society, Hartford,
Dr. Muriel F. Bliss, Executive Secretary; and Alma Jackson.

District of Columbia: Social Hygiene Society of the District of Columbia,
Mrs. Grace Lando, Educational Assistant.

Georgia: Georgia Social Hygiene Council, Atlanta, Mrs. Charles D. Center,
Executive Secretary.

Indiana: Indianapolis Social Hygiene Association, Mrs. Meredith Nicholson, Jr.,
Director.

NATIONAL EVENTS 505

Massachusetts: Massachusetts Society for Social Hygiene, Boston, Frances

Hecht, Assistant Executive Secretary.
Cambridge Tuberculosis and Health Association, Mabel M. Brown, Executive

Secretary.
Hampden County Tuberculosis and Health Association, Paul G. Macurda,

Executive Secretary.
Harvard Medical School, Cambridge, Dean and Mrs. Edward G. Huber.

Missouri Social Hygiene Association, St. Louis, Dr. Harriet S. Cory, Executive
Director.

Nebraska: State Department of Health, Omaha, Don Warner, State Director

of Education.
Lincoln Department of Health, Division of Venereal Disease Control, Mrs.

Florence Walt, Assistant Educational Director.
Community Welfare Council, Omaha, Margaret Porter and Josephine J.

Albrecht.

New Jersey Tuberculosis League, Newark, Ernest D. Easton, Executive Secretary.
Middlesex County Tuberculosis and Health League, New Brunswick, Marie
Klause, Executive Secretary; Rose Golosoff, Health Education Worker.

New York: State Committee on Tuberculosis and Public Health, New York

City, George J. Nelbach, Executive Secretary; Mrs. Margaret Anderson,

Secretary, Heart Division; Robert W. Osborn, Assistant Executive

Secretary; Hazel A. Hart; Helen E. Watkins.
Broome County Tuberculosis and Public Health Association, Binghamton,

Dorothy Denniston, Executive Secretary.
Buffalo and Erie County Tuberculosis Association, Buffalo, Janet A. Scott,

Secretary.
Columbia County Tuberculosis Eradication Association, Hudson, Mrs. Neale

Parsons, Executive Secretary.
Delaware County Tuberculosis and Public Health Association, Walton, Mrs.

Mai-garet Watson, Executive Secretary.
Dutchess County Health Association, Poughkeepsie, Mrs. Cynthia Sweet,

Executive Secretary.
Fulton County Tuberculosis and Public Health Association, Johnstown, Mrs.

Iva W. Holmes, Executive Secretary.
Montgomery County Tuberculosis and Health Association, Amsterdam, Helen

C. Brennan, Executive Secretary.
Newburgh Public Health and Tuberculosis Association, Margo Mason,

Executive Secretary.
New York Tuberculosis and Health Association, New York City, Social

Hygiene Committee, Dr. Jacob A. Goldberg, Secretary; Charlotte Smith,

Assistant.
New York Bureau of Marriage Counsel and Education, Dr. Valeria H.

Parker, Director.
Niagara County Tuberculosis and Health Association, Niagara Falls, Carl

0. Lathrop, Executive Secretary.
Orange County Health Association, Middletown, Grace D. Cole, Executive

Secretary.
Oneonta County Tuberculosis and Public Health Association, Mary M. Jones,

Acting Executive Secretary.
Rochester and Monroe County Tuberculosis and Health Association, Rochester,

Marie Goulett, Executive Secretary.
Rockland County Tuberculosis and Health Committee, New City, Eleanor

V. Green, Executive Secretary.
Yonkers Tuberculosis and Health Association, Mrs. Marie F. Kirwan,

Executive Secretary.
Wayne County Tuberculosis and Public Health Association, Newark, Louise

G. Campbell, Field Demonstrator.
Neighborhood Health Development, Inc., New York City, Mrs. Laura Chase

Farley; Kenneth Widdemer, Secretary; Mrs. Ora G. Weir, Field

Supervisor.

506 JOUKNAL OP SOCIAL HYGIENE

North Carolina: Venereal Disease Education Institute, Raleigh, Capus Waynick,
Director.

Ohio: Bureau of Health Education, Division of Health, Department of Public

Health and Welfare, Cleveland, Mrs. Bertha Ashby Hess, Chief.
The Dayton Social Hygiene Association, Mrs. Florence J. Sands, Executive

Secretary.
Toledo Social Hygiene Association, Arthur R. Siebens, President.

Oregon: Medical School, University of Oregon, Portland, Mrs. George Moorhead,
Field Secretary; Division of Social Hygiene Education, Dr. Adolph Weinzirl,
Director.

Pennsylvania: Public Charities Association of Pennsylvania, Mental Hygiene
and Public Health Division, Philadelphia, Dr. Arthur H. Estabrook,
Secretary; Clyde E. Arbegast, Health Education Secretary.
Visiting Nurse Association, Reading, Mrs. Anna Barlow, Director.

Utah: Salt Lake City, L. C. Romney, Commissioner of Public Safety.

Officers and staff of American Social Hygiene Association: Mrs. T. Graf ton
Abbott, Educational Consultant; Professor Maurice A. Bigelow, Educational
Consultant; Bailey B. Burritt, Secretary and member of the Board of Directors;
Blake Cabot, Director, Division of Public Information Service; Cynthia F.
Chasan, Assistant in charge of Publications, Division of Public Information
Service; Dr. Walter Clarke, Executive Director; David Cohn, Assistant, Divi-
sion of Public Information Service; Mrs. Miriam E. Doll, Administrative
Assistant; Mrs. Edna M. Fox, Field Representative (and her husband, Brigadier
General Leon A. Fox, Field Director, American Typhus Commission) ; George
Gould, Associate Director, Division of Legal and Protective Services; John
Hall, Field Representative; May Hansen, Financial Assistant; Bascom Johnson,
Director, Division of Legal and Protective Services; Paul Kinsie, Associate
Director, Division of Legal and Protective Services; Dr. Charles F. Marden,
Field Representative; Kenneth R. Miller, Field Representative; Charles E.
Miner, Field Represenntative ; Mrs. Betty A. Murch, Assistant to the Executive
Director; Reba Rayburn, Assistant, Washington Liaison Office and Assistant
Editor, JOUBNAL OF SOCIAL HYGIENE; Wade T. Searles, Field Representative;
Percy Shostac, Consultant on Industrial Cooperation; Dr. William F. Snow,
and Mrs. Snow; Rebecca Stiller, Assistant in Charge of Films and Exhibits,
Division of Public Information Service; Mrs. Robert N. Tuller, Assistant
Director, Division of Community Service.

ASHA Staff News. — Following the Executives' Conference, on
October 9 and 10 field representatives and general staff of the ASHA
gathered for their semi-annual conference at national headquarters,
1790 Broadway, New York. Each field representative briefly reviewed
activities in his particular area, while heads of divisions and directors
of special projects at headquarters made brief reports, followed by
discussion. Special attention was given to the question of holding
ground gained so far and making further progress during the
postwar period.

Following the conference on October 11, field representatives
started out to take up their assignments.

Bascom Johnson, Director of Legal and Protective Services, returned to take
charge of the Dallas Office, where Mrs. Gertrude R. Luce had preceded him on
September 15th as Office Secretary. Miss Jean B. Pinney returned to Wash-
ington, D. C., to continued service as Director in Charge of the Washington
Liaison Office and Editor of the JOURNAL OF SOCIAL HYGIENE, with Miss Reba
Rayburn as Office Secretary and Assistant Editor. Charles E. Miner is again
in charge of the Atlanta Office, with Mrs. Edna W. Fox, who was on leave
during the summer months, acting as field representative in North and South

NATIONAL, EVENTS 507

Carolina. George Gould, Assistant Director, Division of Legal and Protective
Services, left for Omaha to take over the ASHA Field Office there. Mr. Gould
also acts at present as Field Representative for the states served by the Salt
Lake City Office.

Among new assignments are:

Kenneth R. Miller, formerly in charge of the Baltimore Office, left on
October 18th for San Juan, Puerto Rico, for a stay of several months. Aside
from continuing the cooperation begun by Dr. Snow and Miss Pinney last
spring with the Puerto Rico Committee on Social Protection and the St. Thomas
(V.I.) Committee on Social Protection, Mr. Miller expects to be available for
service as possible to other countries in the Caribbean Area.

John Hall, who joined the staff last Spring, and covered the Dallas Office
during the summer months, is assuming Mr. Miller's former assignment, with
headquarters at 22 Light St., Baltimore.

Another comparatively new staff member, Dr. Charles F. Marden, on special
assignment as a field representative, is spending several weeks in Texas,
Arkansas, Oklahoma and other states in that part of the country.

Dr. Warren H. Southworth, in charge of the Chicago office for some months,
resigned October 1 to become a member of the faculty of the University of
Wisconsin. Wade T. Searles, who has headquarters in Columbus, Ohio, for
the area covered by the Army Fifth Service Command, has assumed responsibility
for the Chicago office also.

Mrs. T. Grafton Abbott, formerly educational consultant, who resigned during
the summer to become Mrs. James W. Sever of Boston, attended the Executives'
Conference.

EVENTS— CURRENT AND COMING

December 2 Pan American Health Day. Celebrated throughout the American
Republics by meetings and other observances. In Washington,
D. C., the Pan American Sanitary Bureau was host to a public meeting, in the
Hall of the Americas, Pan American Union, with Mrs. Franklin D. Roosevelt,
Surgeon General Thomas Parran, FSA Administrator Paul V. McNutt and
others as speakers.

January 26 Public Health Nursing Day. Know Your Public Health Nurse.
Auspices of National Organization for Public Health Nursing,
Inc., 1790 Broadway, New York 19, N. Y.

February 7 National Social Hygiene Day. ASHA Annual Meeting in Chicago
with regional and community meetings throughout the nation,
including Alaska, Hawaii, Puerto Rico and the Virgin Islands. Canada will
also observe the Day, both nationally and in the Provinces.

NEWS FROM THE 48 FRONTS

ELEANOE SHENEHON
Director Community Service, American Social Hygiene Association

Connecticut: State Teachers Association Convention Includes
Social Hygiene Speaker on Program.— On October 27, 1944, at the
request of the program committee, Dr. Mabel Grier Lesher,
Instructor on Methods and Materials of Social Hygiene Education,
Rutgers University, and Chairman of the Advisory Committee on
Social Hygiene Education of the New Jersey Department of Public
Instruction, addressed the Biology Section of the Annual Convention
of the Connecticut State Teachers Association on the topic The Role
of the Educator in the Field of Social Hygiene. The meeting was
held in the New Haven High School.

Other speakers included Dr. Grace Mooney, State Medical Asso-
ciation, who spoke on the Problems in Public Health, and Hon.
Fred Faulkner of the Connecticut Juvenile Court, on the topic
Rehabilitation of the Adolescent.

Although human biology is included in the courses for both boys
and girls in the New Haven High School, in other districts repre-
sented according to the teachers present little is being done in this
field. Definite recognition of the need for undertaking effort in
this direction was acknowledged and a real desire for training
in teaching methods and organization at the secondary school level
was manifest. Also there was vocal expression that the topic be
presented to the entire State Teachers' Association at some
future date.

Idaho: State Home Economics Association Contributes to Better
Home Life in Wartime. — In the Journal of Home Economics for
June, 1944, Miss Lucille Magruder, President of the Idaho Home
Economics Association and a member of the faculty of the Uni-
versity of Idaho, and Mrs. Julia M. Harrison, Chairman of the
Idaho Home Economics Association's Committee on Family Life
Education and Consultant in Family Life Education for the State
Board of Vocational Education, report an important recent project.

With the objective of promoting good home life in wartime, a two
or three day family life education institute was held in each of
the four cities of Moscow, Idaho Falls, Pocatello and Boise. The
IHEA helped to secure leadership for the Institutes, to formulate
plans, and offered some financial assistance. The local committees
decided upon specific objectives, made final selection of leaders
and planned the programs.

Programs were built around the theme Youth, Recreation and
Family Living in Moscow, Idaho Falls and Boise, while Pocatello,
confronted especially with problems of an influx of military personnel

508

NEWS FROM THE 48 FRONTS 509

and industrial workers, called its program Youth in Crisis. Sponsor-
ship was shared among the Idaho Association and local, civic,
religious, health, welfare, youth, fraternal and educational groups.

It is believed that through these Institutes communities have
become more aware of the importance of family and community
life, that parent education has been extended and that many home-
making teachers of Idaho will incorporate more on family and social
relations into their programs.

Out-of -state leaders for the Institutes were: Mrs. Buena M. Maris, formerly
with the Extension Service, now dean of women of Oregon State College, but
on leave to supervise women's activities for an industrial plant in Washington;
Ferdinand A. Bahr, field recreation representative for the Federal Security
Agency, Office of Community War Services, Salt Lake City; Howard Feast,
regional social protection representative for the Federal Security Agency Office
of Community War Services, Denver; and Dr. Elmer G. Peterson, president of
the Utah State Agricultural College.

Ohio: Cleveland Holds VD Institute and Physicians' Refresher
Course. — With the slogans U. S. Needs Us Strong and Man Health
Is Man Power, a double program for physicians and community
leaders was held during the month of October in Cleveland. Spon-
soring agencies were the Joint Social Hygiene Committee of the
Academy of Medicine and Cleveland Health Council, the Social Pro-
tection Committee of the Cleveland Welfare Federation and the
Division of Health, Cleveland Department of Public Health and
Welfare.

The Physicians' Eefresher Course was given at two afternoon sessions on
October 4th and October llth at the Cleveland City Hospital and the Lakeside
Hospital. Speakers included Dr. Koger Heering, Dr. C. G. LaEocco, Dr. H. V.
Lund, Dr. J. E. Rauschkolb, Dr. P. S. Pelouze. The Committee in charge
of the Refresher Course was made up of Dr. Fred W. Dixon, Chairman, Health
Education Committee, Academy of Medicine; Dr. Robert N. Hoyt, Secretary, the
Joint Social Hygiene Committee; Dr. Roy L. Kile, Surgeon (R) U.S.P.H.S.,
Venereal Disease Control Officer, Cleveland Division of Health.

The two-day Venereal Disease Institute program ran from the morning of
October 30th through the afternoon of October 31st. Sessions were held on
the subjects of Venereal Diseases and Their Significance, Law Enforcement,
Medical and Information Services, Information Channels, Availability of Welfare
Services and The Venereal Disease Control Program. The program closed with
a panel discussion on How the Church Can Strengthen the Program with Dean
Leonard Mayo, leader.

The Executive Committee for the Institute included Mrs. Stanlee T. Bates,
Chairman, Social Protection Committee of the Welfare Federation and the
Civilian Defense Council ; Miss Ruby I. McCallum, Secretary, Social Protection
Committee of the Welfare Federation and the Civilian Defense Council ; John
M. Ragland, Promotion, Specialist in Social Protection, Federal Security Agency,
Washington, D. C. ; Clayborne George, Chairman, Health Committee, Central Areas
Council; Dr. Robert N. Hoyt, Secretary, Joint Social Hygiene Committee of the
Academy of Medicine and the Cleveland Health Council, Venereal Disease Coor-
dinator, Cleveland Division of Health; Dr. Roy L. Kile, Surgeon (R) U.S.P.H.S.,
Venereal Disease Control Officer, Cleveland Division of Health; Dr. C. G. LaRocco,
Chairman, Joint Social Hygiene Committee of the Academy of Medicine and
the Cleveland Health Council, Senior Instructor in Dermatology, School of
Medicine, Western Reserve University; Dr. J. E. Wallace, President, Cleveland
Medical Association ; John F. Williams, Regional Social Protection Representative,
Region 5.

510 JOURNAL OF SOCIAL HYGIENE

Pennsylvania: Annual Institute on Marriage and Home Adjust-
ment at State College. — The School of Education of the Pennsyl-
vania State College, with the cooperation of the Division of Sociology
of the School of Liberal Arts and the Division of Health Education
of the Pennsylvania State Department of Health, held a three day
Institute at the State College on October 23rd, 24th and 25th.

The Conference theme this year was War Marriage and Its Problems, the
program being divided into three parts: Preparing for Marriage, Counseling
Married Couples and Preserving the Family. Some forty Institute leaders
included outstanding experts in various phases of marriage, whose task it was
to analyze problems of war and post war marriage to consider some of the
steps that may help solve them.

The Planning Committee in charge of the Conference comprised Clifford E.
Adams, Chairman, Miss Laura W. Drummond, Bruce V. Moore and George E.
Simpson. The Institute Proceedings will be published subsequently.

South Carolina: State Conference of Social Work Appoints Social
Hygiene Committee and Holds Meeting. — Miss Adele J. Minahan,
Secretary of the South Carolina Conference of Social Work,
announces that a Social Hygiene Committee has been appointed by
the Conference to correlate and consolidate the lively interest in
social hygiene problems that already exists in a number of cities
in the state.

The new Committee held an important session in Columbia on
October 26 in connection with the annual meeting of the Conference,
which was held October 25-27 as a "war conference to discuss how
social work can make its greatest contribution toward winning the
war and establishing a just and lasting peace."

Mr. Alan Johnstone, General Counsel of the Federal Works Agency,
Washington, D. C., and a member of the ASHA Board of Directors,
was the keynote speaker at the opening Conference session on October
25th in the hall of the House of Representatives, State House. He
spoke on the subject, "Four Decades in South Carolina." Miss
Eleanor Shenehon, Director ASHA Division of Community Service,
spoke at the luncheon meeting, October 26th, on the subject Social
Hygiene in Wartime — And After. Miss Shenehon also participated
in a panel discussion on community organization.

Members of the new Committee are: Mr. W. H. MeElveen, State Board of
Health, Chairman; Mrs. Eosamond Wimberly, Converse College, Spartanburg;
Dr. John W. Moore, Superintendent of City Schools, Florence; Mr. Harold
Beeves, Field Eepresentative, Social Protection Bureau for South Carolina,
Charleston, and Dr. A. L. Geisenheimer, President of the Council of Social
Agencies, Charleston.

NOTES ON INDUSTRIAL COOPERATION

PEKCY SHOSTAC
Consultant on Industrial Cooperation, American Social Hygiene Association

INDUSTRIAL PROGRAM MOVES FORWARD

As described in the October issue of the JOURNAL, the ASHA's
new program in industry was inaugurated in New York at the meet-
ing, "Industry vs. VD, " held on October 2 in connection with the
Annual Conference of the American Public Health Association.

As indicated last month, this national effort to enlist workers in
the struggle against the venereal diseases and the conditions favoring
their spread is based on the use of our two new manuals, Industry
vs. VD, outlining a program under management auspices, and The
Trade Unions vs. VD, for programs initiated through union channels.
Since our staff is limited and wartime travel difficult, preventing
visits to the thousands of firms and organizations whose aid is being
sought, the manuals were prepared to serve so far as possible in
lieu of personal contact. They are compact working kits giving
detailed organizational directions and including samples of material
for programs in firms or trade union bodies.

While mail-order promotion without adequate follow-up is often
a wasteful procedure, obviously the first step in reaching 30 million
workers must be the distribution of printed matter to the top lead-
ership of the firms and unions whose aid must be enlisted for action.
A fundamental characteristic of the industrial population is that
every individual worker is a part of a functioning group — his firm
or his union. As R. E. Gillmor, president of Sperry Gyroscope
Company, so well said at the October 2 meeting, ' ' Industries . . . are
the only social group where the dissemination of information can
be direct, where the participation of the group itself can be enlisted
and where medical services for diagnosis and proper advice can
be given."

During the month of October, the principal emphasis has been
on distribution of the manuals. JOURNAL readers may like to know
the disposition of the major portion of the ten thousand manuals
which made up the first printing, as shown below:

MANUALS DISTRIBUTED
Industry Trade Union

To Manual Manual EemarTcs

Health Advisory Council, Cham- 2000 Sent to local chambers with

ber of Commerce of the instructions to interest local

United States. industries.

Individual firms, unions, educa- 150 50 Most of these requests received

cators, health officers. through notice in invitation-

announcement to October 2
meeting.

511

512

JOUKNAL OF SOCIAL HYGIENE

Industry Trade Union

To Manual Manual EemarTcs

International unions, state and 1500 Mailed with request that local

city bodies and labor press unions be interested,

editors of American Federa-
tion of Labor, Committee on
Industrial Organizations and
railroad brotherhoods.

National Conventions of CIO
and AFL, November 20, 1944.

Labor League for Human Eights
(AFL National War Relief
Committee) .

CIO National War Eelief Com-
mittee.

Mine, Mill & Smelter Workers
Union.

Textile Workers Union of Amer-
ica, CIO.

Connecticut State Health De- 500
partment in cooperation with
Committee on Social Protec-
tion, Connecticut War Council.

Texas Department of Health.. 18

State Health Department of 50
New Jersey.

Arkansas State Health Depart- 600
ment.

United States Public Health 200
Service National Postwar VD
Control Conference, St. Louis,
November 9-11.

State and important local health 150
officers and VD division heads.

Affiliated Social Hygiene So- 170
cieties.

ASHA Field Staff. 100

October 2 Meeting (Held in 150
connection with APHA Con-
ference).

500 To be distributed from ASHA
exhibits at both conventions.

40 Program and manuals to be
promoted among local unions
by field staff.

35 Program and manuals to be
promoted among local unions
by field staff.

550 For local unions.

100 Sent by national office to list
of selected locals.

1100 Industry manual sent to se-
lected firms in state; trade
union manual to be distrib-
uted to delegates at CIO and
AFL state conventions.

18

50 To be distributed and followed
up by educator of VD Control
Bureau. Eequest for several
hundred more anticipated.

Purchased by State Department
of Health.

200 Distributed to health officers and
other conferees.

150 To be sent, it is hoped, under
joint sponsorship of ASHA
and VD and Industrial Hy-
giene Divisions of USPHS.

170 Sample copies sent to executive
secretaries with request to
promote program in firms and
unions. Heavy requests for
additional copies anticipated.

100 Staff to promote programs in
firms and unions and cooper-
ate with Social Hygiene
Societies and other groups.

150 Manuals distributed at this
meeting account for many
requests for material.

TOTAL

4,088 4,713

NOTES ON INDUSTRIAL COOPEEATION 513

FOLLOW-UP

The listings above disclose the principal sources for the personal
follow-up so often necessary to initiate actual programs. Indications
already show that the promotion and "selling" job at local levels
will be undertaken by the field staffs of the AFL and CIO War
Relief Committees and by individual union leaders, by state and
city health officers, and by the ASHA field staff and our affiliated
Social Hygiene Societies.

Both the union relief organizations seem determined that organized
labor should take a vigorous stand in the campaign and promise
to carry the program into trade union locals. The Mine Mill and
Smelter Workers and the Textile Workers Union of America are
the first internationals to use large quantities of the manual and
to urge participation on the part of their locals. Further progress
should result from the ASHA exhibits officially scheduled at the
AFL and CIO national conventions this month.

The response already received from the New Jersey, Connecticut,
Arkansas and Texas state health departments, which it is hoped
will include follow-up by health educators, is given further encour-
agement by the attitude of the United States Public Health Service.
Late in October, in Washington, Dr. Clarke met with Dr. J. B.
Heller, Jr., Medical Director, Chief, Venereal Disease Division and
Dr. James P. Townsend, Medical Director, United States Public
Health Service, National Institute of Health. As a result of this
conference it seems likely that both Dr. Towynsend's and Dr. Heller's
divisions will sponsor the two manuals and will further their
distribution through state and local channels.

Our own field staff and our affiliated social hygiene societies must
assume the heaviest responsibility if the program is to develop the
deep and spreading roots needed. It is they who must catalyze
interest and spur groups into action; they must "sell" the program
to firms and trade unions in their territories, enlist the participation
of local chambers of commerce, and keep interest growing among
state and local health officials.

If we may forecast the harvest from straws already in the wind
there should be further progress to report in the December JOURNAL.

514 JOURNAL OF SOCIAL HYGIENE

PUBLICATIONS RECEIVED
IN THE PERIODICALS

Of General Interest

BULLETIN OF THE MASSACHUSETTS SOCIETY FOR SOCIAL HYGIENE, October, 1944.
Current Adventures in Social Hygiene, Ray H. Everett.

— October, 1944. Annual Review, George Gilbert Smith, M.D.

Marriage and Family Relations

BULLETIN OF THE MASSACHUSETTS SOCIETY FOR SOCIAL HYGIENE, October, 1944,

Straight Talk on Sex Education, Lester A. Kirkendall.
THE CATHOLIC FAMILY MONTHLY, June, 1944. The Family and the Home.

— June, 1944. The Family, The State and the Church.

— June, 1944. How the Parish Can Prepare Youth for Marriage, Eileen M.

Schmid.

— June, 1944. Marriage and Family Briefs, Mary L. Gorman.

JOURNAL OF HOME ECONOMICS, June, 1944. Education for Living, Ruth Bonde.

— June, 1944. Family Life Education in Idaho, Lucille Magruder and Julia

M. Harrison.

— October, 1944. A Factor in the Sex Education of Children, G. E. Gardner.
MARRIAGE AND FAMILY LIVING, May, 1944. Growing Edges in Family Life

Education, E. M. Duvall.

— May, 1944. Medical Aspects of War Time Marriages, N. R. Kavinoky, M.D.

— August, 1944. Panel Discussions: Education for Family Life in the Com-

munity, Family Life Education for High School Students, Family Counselling,
Guidance Today, Home-School Cooperation, Eeligion and the Family.

— August, 1944. Postwar Problems of the Family, Ernest W. Burgess.

— August, 1944. War and the Family, C. G. MacKenzie.

NEW ADVANCE (Toronto, Canada), October, 1944. Does High School Education

Prepare Ton for Marriage?, Joseph Lichstein.
VENEREAL DISEASE INFORMATION (Washington, D. C.), July, 1944. Some General

Considerations Affecting Present-Day Sex and Sex Education Problems*,

J. H. Stokes, M.D.

Health Education

AMERICAN JOURNAL OF PUBLIC HEALTH, June, 1944. Block Organization for
Health Education, H. Y. MeClusky, Ph.D.

— October, 1944. Early Days of the Public Health Education Section, H. E.

Kleinschmidt, M.D.

BOOKLIST (Chicago), May 15, 1944. Health Books for Public Libraries, 1943.
CANADIAN JOURNAL OF PUBLIC HEALTH (Toronto), May, 1944. Venereal-disease

Education in High School, H. C. Rhodes and P. M. C. Capelle.
CHANNELS, NATIONAL PUBLICITY COUNCIL (NYC), July-August, 1944. History

of a Health Column, Ruth Neely.

— July-August, 1944. Two-way Trade with the Library, O. M. Peterson and

W. E. Thompson.
THE CLINIC BULLETIN (San Francisco), August, 1944. Syphilis-Gonorrhea.

— September, 1944. Why the Spinal Test?

FLORIDA HEALTH NOTES, Negro Health Education Number, June, 1944.
HEALTH (Toronto, Canada), Summer, 1944. Manitoba Battles VD, James

McLenaghen.
HEALTH BULLETIN, North Carolina State Board of Health, September, 1944.

The Teachers Dilemma in the Health Education Program, W. J. Hughes,

M.D., and L. R. Swift, M.D.
HEALTH EDUCATION JOURNAL (London), July, 1944. Film Notes.

— July, 1944. Health Education in Scotland, Rt. Hon. Thomas Johnston, M.P.

— July, 1944. Health Education Through School Biology, Hugh P. Ram-

age, M.A.

PUBLICATIONS RECEIVED 515

— July, 1944. Public Opinion and Venereal Diseases, I. E. McCraeken, M.D..

D.P.H.

— October, 1944. Fresh Air on Venereal Disease, Rev. George Kendall, O.B.E.,

C.F. (Ketd.).

— October, 1944. Marriage Guidance, David R. Mace, M.A.

JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, July 22, 1944. Physical
Fitness: Its Evaluation and Significance, J. E. Gallager, M.D., and Lucien
Brouha, M.D.

— July 22, 1944. Physical Fitness Program, C. A. Wilzbach, M.D.

JOURNAL OF HEALTH AND PHYSICAL EDUCATION, October, 1944. Health Education

in Eural Schools, Nina B. Lamkin.
PUBLIC HEALTH NURSING, July, 1944. Eecent Developments in Treatment of

Syphilis in Eelation to Patient Education: I. The General Perspective,

John H. Stokes, M.D.; II. The Specific Application, Alice M. Kresge and

Dorothy H. Brubaker.
PUBLIC HEALTH NURSING, September, 1944. Coordinating Health Education,

L. E. Kerr, M.D.

Social Protection

FEDERAL PROBATION (Washington, D. C.), April-June, 1944. Some Problems of
the Anti-social Ex-service Man, L. S. Selling, M.D., Dr.P.H.

— April-June, 1944. Wartime Needs of Children and Federal Eesponsibility,

J. W. Polier.

— July-September, 1944. A Dilemma — And an Opportunity — For the Schools,

Elise H. Martens, Ph.D.

— July-September, 1944. Juvenile Delinquency in a Democracy, Martin L.

Reymert, Ph.D.

— July-September, 1944. Some Basic Factors in the Treatment of Juvenile

Delinquency, Simon Doniger, Ph.D.

— July-September, 1944. Unwholesome Environment — A Problem in Supervi-

sion, Peter Stanne.
HEALTH (Toronto, Canada), Spring, 1944. Eecreation for War WorTcers, A. A.

Burridge.
INDIANA STATE BOARD OF HEALTH MONTHLY BULLETIN, August, 1944. Indiana's

Eepression of Prostitution in Venereal Disease Control, J. H. McDougall.
JOURNAL OF CRIMINAL LAW AND CRIMINOLOGY (Chicago), May, June, 1944.

The Eelation of Juvenile Courts to Other Agencies, W. G. Long.

— July-August, 1944. Juvenile Delinquency and Adult Disorganisation, Hans

von Hentig.
THE JOURNAL OF HEALTH AND PHYSICAL EDUCATION, October, 1944. Problems

of Youth in Peace and War, Eleanor L. Hutzel.
MENTAL HYGIENE (NYC), July, 1944. The Moral OutlooTc of the Adolescent

in War Time, P. A. Bertocei.

— July, 1944. Prediction of Behavior of Civilian Delinquents in the Armed

Forces, A. J. N. Schneider, M.D., C. W. LaGrone, Jr., E. T. Glueck and
Sheldon Glueck, Ph.D.

POLICE CHIEFS' NEWS LETTER, July, 1944. How Kansas City Is Meeting Its
Child and Youth Problems, Lou Smyth.

— July, 1944. Youth and Parental Cooperation in Crime Prevention, B. J.

Edgar Hoover.
PUBLIC WELFARE (Chicago), June, 1944. Michigan's Youth Guidance Program,

E. F. Fauri.
QUARTERLY JOURNAL OF STUDIES ON ALCOHOL (New Haven), March, 1944.

Youth, Alcohol and Delinquency, F. W. McPeek.

Legislation

CONNECTICUT HEALTH BULLETIN, June, 1944. Directions for Complying with
the Connecticut Marriage License Law 'Requirement, Friend Lee Mickle,
M.S., Sc.D.

PUBLIC HEALTH (London), June, 1944. Legislative Measures Against the Spread
of Venereal Diseases in Sweden, R. J. M. Hallgren, D.P.H.

516 JOURNAL OF SOCIAL HYGIENE

Industrial Problems

JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (Chicago), July 22, 1944.

Physical Fitness in Industry, W. P. Jacobs.
CHANNELS, National Publicity Council, September, 1944. An Industrial Health

Committee Grows in Brooklyn, Percy Shostac.
HEALTH (Toronto, Canada), Spring, 1944. VD Control in Industry, D. H.

Williams.

INDUSTRIAL MEDICINE (Chicago), June, 1944. Venereal Disease: Report.
JOURNAL OF THE MEDICAL SOCIETY OF NEW JERSEY, June, 1944. Venereal

Disease Control in Industry, G. S. Usher, M.D.
PUBLIC HEALTH NURSING, October, 1944. The Nurse in Industry Organises

Against VD, Percy Shostac.

Public Health and Medical

THE AMERICAN JOURNAL OF NURSING, September, 1944. Health Supervision for
G. I. Joe, I. Army Nurses Tackle Health Problems in the ETO ; II. ABC
Services in England, Mary Beard, E.N.; 177. AEC Services in the
Mediterranean Theater, Ruth Young White.

— September, 1944. A National Health Service for England, Scotland and

Wales, Pearl Mclver, E.N.

AMERICAN JOURNAL OF PUBLIC HEALTH (NYC), September, 1944. Preliminary
Report on a National Program for Medical Care.

— September, 1944. Gonorrhea Contacts — Criteria for Management, James H.

Lade, M.D., F.A.P.H.A.

— October, 1944. Epidemiological Study of Lymphogranuloma Venereum,

Employing the Complement-fixation Test, P. B. Beeson, M.D., and E. S.
Miller.

AMERICAN JOURNAL OF SYPHILIS, September, 1944. Contact Investigation in
Gonorrhea, N. W. Ghithrie, M.D.

— September, 1944. Beview of 2,144 Courses of Bapid Treatment for Early

Syphilis, E. W. Thomad, M.D., and Gertrude Wexler, M.D.

— September, 1944. Syphilis in Gonorrhea Patients and Contacts, N. W.

Guthrie, M.D.
ANNALS OF INTERNAL MEDICINE, May, 1944. Becent Advances in U. S. Public

Health Service Methods, F. V. Meriwether, M.D.
BRITISH MEDICAL JOURNAL (London), May 20, 1944. Sulphonamide Prophylaxis

of Gonorrhea.

— July 15, 1944. Venereal Disease in Sweden.

BULLETIN, U. S. ARMY MEDICAL DEPARTMENT, July, 1944. Sulfathiazole for
the Prevention of Gonorrhea, P. G. Reque, M.D., and Daniel Bergsma, M.D.

— August, 1944. Experimental Use of Penicillin in Treatment of Sulfonamide-

resistant Gonorrhea, R. J. Murphy, M.D.

— October, 1944. Penicillin, I. Prolonged Action in Beeswax-peanut Oil Mixture ;

II. Single Injection Treatment of Gonorrhea, Capt. Monroe J. Romansky, MC,
U.S.A., and Technician Fourth Grade George E. Rittman, Med. Dept., U.S.A.

Postwar Problems and Plans

CHILD, U. S. Children's Bureau (Washington, D. C.), May, 1944. International

Labor Office Proposals for Post-war Youth.
HARVARD PUBLIC HEALTH ALUMNI BULLETIN, May, 1944. Post-war Objectives,

Earnest Boyce.
HEALTH (Toronto, Canada), Summer, 1944. World Alliance Against Disease,

Arthur Wauters.
PARENTS' MAGAZINE (New York City), July, 1944. What's Ahead for the

Teens?, R. C. Taber.
PUBLIC HEALTH REPORTS, July 14, 1944. Planning for Health Education tn

the War and Post-war Periods, J. W. Studebaker.
July 21, 1944. 7. Planning for Health Education in the War and Post-war

Periods, J. C. Knox, M.D.
july 21, 1944. 77. Planning for Health Education in the War and Post-war

Periods, H. B. Robins, M.D.

\

Vol. 30 December, 1944 No. 9

Journal

of

Social Hygiene

Social Hygiene Day Number

CONTENTS

Promiscuity as a Factor in the Spread of Richard A. Koch and

Venereal Disease Ray Lyman Wilbur 517

The Challenge to Law Enforcement L. R. Pennington 530

The Policewoman's Role in Social Protection Eleanor L. Hutzel 538

Canada's Four Sector Program in Action Donald H. Williams 545

An Answer to a Challenge June Johnson 549

Pharmacy in the Wartime Educational Campaign Robert P. Fischelis 554

Editorial: Towards V-Day in the War on Venereal

Diseases 557

Call for the Annual Meeting — American Social Hygiene Association 559

National Events Reba Rayburn 560

Some Forecasts of Social Hygiene Day Programs Eleanor Shenehon 569

So You're Going to Hold a Social Hygiene Day Meeting! Program Suggestions from

the Social Hygiene Day Service 571

Notes on Industrial Cooperation Percy Shostac 573

Book Reviews and Publications Received 576

Index — Volume 30, Journal of Social Hygiene 583

National Social Hygiene Day
February 7, 1945

The American Social Hygiene Association presents the articles printed in the
JOURNAL OF SOCIAL HYGIENE upon the authority of their writers. It does not
necessarily endorse or assume responsibility for opinions expressed or statements
made. The reviewing of a book in tho JOURNAL OF SOCIAL HYGIENE does not
imply its recommendation by the Association.

EDITOBIAL BOARD

C.-E. A. WINSLOW, Chairman

EAY II. EVERETT WILLIAM F. SNOW

JOSEPH K. FOLSOM JOHN H. STOKES

EDWAED L. KEYES JOHN C. WARD

JEAN B. PINNEY, EDITOR
EEBA BAYBURN, ASSISTANT EDITOR
WILLIAM F. SNOW, EDITORIAL CONSULTANT

The JOURNAL OF SOCIAL HYGIENE is supplied to active members of the American
Social Hygiene Association, Inc. Membership dues are two dollars a year. The
magazine will be sent to persons not members of the Association at three dollars
a year ; single copies are sold at thirty-five cents each. Postage outside the United
States and its possessions, 50 cents a year.

Entered as second-class matter at post-office at Albany, N. Y., March 23, 1922.
Acceptance for mailing at special rate of postage provided for in Section 1103,

Act of October 3, 1917, authorized March 23, 1922.
Published monthly (nine issues a year) for the Association by the Boyd Printing

Company, Inc., 372-374 Broadway, Albany, N. Y.

Copyright, 1944, by The American Social Hygiene Association, Inc.

Title Registered, U. S. Patent Office.

PUBLISHED MONTHLY EXCEPT JULY, AUGUST AND SEPTEMBER
AT 372-374 BROADWAY, ALBANY 7, N. Y., FOR

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

EDITORIAL OFFICES AND NATIONAL HEADQUARTERS
1790 BROADWAY 19, NEW YORK CITY

WASHINGTON LIAISON OFFICE
Room 609, 927 15th St., N.W., Washington 5, D. C.
JEAN B. PINNEY, Director in Charge
REBA RAYBURN, Office Secretary

FIELD OFFICES

ATLANTA 3, GEORGIA. 506-508 Citizens and SALT LAKE CITY 1, UTAH. 202 Ness

Southern National Bank Building. Serv- Building. Serving Arizona, Idaho, Mon-

ing Alabama, Florida, Georgia, Missis- tana, Nevada, Utah, California, Oregon

sippi, North Carolina, South Carolina and and Washington.

Tennessee. GEORGE GOULD, temporarily in charge.

CHARLES E. MINER, Field Representative,

MRS. EDNA W. Fox, Field Eepresentative. BALTIMORE 2, MARYLAND. Care of Baltimore

Community Fund, 22 Light Street.

COLUMBUS 15, OHIO. Care National Confer- Serving Delaware, Maryland, Pennsyl-

ence of Social Work, 82 High Street. vania and Virginia.

Serving Indiana, Kentucky, Ohio and JOHN HALL. Field Eepresentative.

West Virginia.

AND DALLAS 8, TEXAS. Cliff Towers. Serving

CHICAGO 1, ILLINOIS. Room 615, 360 North Arkansas, Louisiana, New Mexico, Okla-

Michigan Avenue. Serving Illinois, Michi- homa and Texas.

gan and Wisconsin. BASCOM JOHNSON, Director in Charge.

WADE T. SEARLES, Field Eepresentative. MRS. GERTRUDE R. LUCE, Office Secretary.

OMAHA 2, NEBRASKA. 736 World Herald SAN FRANCISCO 5, CALIFORNIA. 45 Second

Building. Serving Colorado, Iowa, Kan- Street.

sas, Minnesota, Missouri, Nebraska, North W. F. HIGBY, Field Consultant.
Dakota, South Dakota and Wyoming.

GEORGE GOULD, Assistant Director. SAN JUAN, PUERTO Rico. P. O. Box 4101.

Division of Legal and Protective Services, KENNETH R. MILLER, Field Eepresenta-

in Charge. tive.

FtCHT Vt> ON THE

jwo/rr

CANADA'S FOUK SECTOR PROGEAM IN ACTION

One of a series of six full-page advertisements published by Canadian newspapers and maga-
zines to ;iid in the current educational campaign sponsored by the Department of National
Health and Welfare with the cooperation of numerous voluntary agencies, including edu-
cational and church organizations and industrial and business groups. (See pages 545-548 for
description of this program by Lt. Col. Donald H. Williams)

The Challenge

of
Venereal Disease

By IT.-COt, D. H. W1LU&MS

Chief. Division ot VmntsuMl Disease Control

Hidden Costs in Industry

Recent sS«dtes oi mdu^nttl tiivoit^cs show an
«v«t«g« oi 2.98% Syphilis

SOCIAL HYGIENE

EDUCATION IN
TWO LANGUAGES

an air squadron a year, figKf Con-
ado'j sKaf* of the SJciiy fcallfe an<f
tfcc

Pourquoi
les tolerer

Examples of articles and literature used in Canada's campaign to Fight VD on the Four
Sector Front — Health, Welfare, Legal and Moral. The pamphlets shown here in the French
versions are also published in English. Good design and attractive colors add to their
effectiveness. Pourquoi les tolerer will be recognized as a French edition of the ASHA
pamphlet Why Let It Sum?, discussing the case against the red-light district.

/

Journal
of

Social Hygiene

VOL. 30 DECEMBER, 1944 NO. 9

Social Hygiene Day Number

PROMISCUITY AS A FACTOR IN THE SPREAD OF
VENEREAL DISEASE *

RICHARD A. KOCH, M.D.

Chief, Division of Venereal Diseases, Department of Public Health,
City and County of San Francisco, California

AND

RAY LYMAN WILBUR, M.D.

Chancellor, Stanford University; President, American Social
Hygiene Association

Venereal diseases are one of the greatest preventable human
tragedies. The reason we fail to conquer them is our prudery and
our failure to face the over-all problems, their causes and background.
The sex urge is as fundamental as that of hunger and thirst, and
in our sensate society that urge has led to promiscuity.

Sexual promiscuity is the most vital factor in the spread of
venereal diseases. If sexual promiscuity were eliminated from our
national life, venereal diseases as a natural course would disappear
from our state without the necessity of medical intervention. Vener-
eal disease control is concerned inseparably with the physical and
social aspects of our national life. It is thus concerned with the
moral fiber of the community, the church, the home, and with those
factors and agencies, official and non-official, which strengthen that
moral fiber, as well as with those factors that tend to weaken it.
We must remember that while we cannot control the morals of people
by legislation, we certainly can control the environment of youth.
Venereal disease control, therefore, is related to church activity,
school activity, parent educational programs, youth agencies, recrea-
tional activities, law enforcement, protective care of girls and boys,

* An address given on November 10, 1944 before the National Postwar
Conference on Venereal Disease Control at St. Louis, Missouri, under the
auspices U. S. Public Health Service, Venereal Disease Division.

517

518 JOURNAL OP SOCIAL, HYGIENE

training in leadership, and a long-range public health educational
program.

This diversity of factors related to the control of venereal dis-
eases is not characteristic of the venereal diseases alone. The control
of typhoid fever is not exclusively a medical problem. Its control
is related to the control of the sanitary environment and to the
vast ramification of engineering feats that are necessary to effectuate
this control. The control of tuberculosis is not a medical problem
alone. Its control is related to the provision of improved housing
conditions through slum clearance ; to the provision of adequate parks
and playgrounds; and to the development of a general concept of
a healthy social life providing sufficient recreation, freedom from
overcrowding, balanced nutrition, and an understanding of family
hygiene. There are many non-medical factors used also in the
control of malaria, yellow fever, cholera, dysentery, plague, and
other communicable diseases.

Unquestionably, venereal disease control is of a more personalized
nature than the control of the other communicable diseases. Perhaps
for this reason the venereal diseases to a large degree have defied
control. It is for us to recognize the diversity of the problems
involved and to effectuate programs directed towards their solution.

The non-medical problems related to venereal disease control are
those that relate to sexual promiscuity. Promiscuity in the male
has always been more or less condoned as long as such promiscuity
was not blatantly forced upon the public. Just as the satisfaction
of hunger and thirst is commercialized by the food establishments
by the preparation of attractive food materials, so also is the satis-
faction of the sex urge likely to be commercialized. Such commer-
cialization, if the community permits, involves the establishment of
houses of prostitution with the result that where such houses exist
a high percentage of venereal disease is certain to be found. It
has been shown that if commercialized prostitution is actively
repressed, a decline in the incidence of venereal disease follows.
Prostitution of course is a system intended to serve male promiscuity.
It is intolerable in a democratic society.

In our past history, promiscuity of the female has not been accepted.
We are only a few decades away from the days when a promiscuous
woman would find her door painted with tar as the sign of dis-
approval of her moral looseness. If we attempt to trace the acute
development of female promiscuity in contemporary times, we need
search no further than World War I, when women gained more
freedom outside the home, and the passage of the Nineteenth Amend-
ment in 1920, when women gained the same political privileges and
freedom held by men.

As woman has become more prominent in the business world
and has accepted greater freedom outside of the home, she, also to
some degree, has accepted the same masculine freedom in relation
to sex. A few years ago the largest percentage of venereal diseases
came from prostitutes, but since repression of commercialized prosti-

PROMISCUITY IN THE SPEEAD OP VENEREAL DISEASE 519

tution the promiscuous girl has come to be considered the major
source of venereal infection. Therefore today the problem of venereal
disease control is chiefly that of the promiscuous girl and not of the
prostitute. Not only is this a wartime problem, but with the lowering
of moral conduct and the loosening of old controls and safeguards,
more and more, the promiscuous girl as the spreader of venereal
disease will be a definite postwar problem.

Those who have worked in this field know that if ever venereal
diseases are to be eradicated the control must be related not only
to medicine and public health but also to welfare, church, law
enforcement, education, and public understanding, and that it must
be supported by all agencies private and governmental.

The solution of the problem of promiscuity does not lie in the
hands of the medical profession. It will be corrected only by
cultural changes in society. Surgeon General Thomas Parran has
written :l

It is my opinion that too often in the past health officers have neglected
their direct medical responsibilities in controlling syphilis and have diluted
their efforts by attempting to function in the whole field of social hygiene.
The repression of prostitution is primarily the responsibility of the law
enforcement agency. The teaching of sex hygiene is primarily the function
of the parent and educator, secular and religious. As a good citizen,
the health officer should work wholeheartedly with both. As a public
servant, he should do his own job and endeavor to coordinate it intelligently
with both.

The official health agency, being directly concerned with the control
of all communicable diseases must act as a community catalyst in
bringing about a public awareness of the over-all community problems
pertaining to the dissemination of venereal diseases.

A STATISTICAL ANALYSIS

We found among 8,027 persons examined in a pre-war serologic
survey among labor unions in northern California 2 that the inci-
dence of positive serologic findings among the employed was 3.7 per
cent, whereas among the unemployed it was 5 per cent. In a summary
of studies made from 1935 to 1940, Doctor Walter Clarke 3 reported
syphilis was more prevalent in the relief (unemployed) groups than
in the employed groups. We further found 2 in the northern Cali-
fornia area group the incidence of positive serology to be 3.8 per
cent in the resident and 6.3 per cent in the non-resident or transient,
a difference of incidence indicating that those who live transient,
migratory lives are more prone to promiscuity and have a higher
incidence of syphilis than those who live a resident, non-transient life.

In the serologic examination of 14,354 new employees of a San
Francisco War Industry (Table I) which represent, in the large,
a transient population, or at least a population which did not have
its roots deeply established in a communal environment, we found
1,590 (11.1 per cent) to have a positive serology; 685 (6.0 per cent)
whites and 905 (30.6 per cent) Negroes. These statistics again illus-
trate the high incidence of syphilis among the relatively promiscuous

520

JOURNAL OF SOCIAL HYGIENE

transient. On the other hand, examination of 3,610 workers from
the same industry before the introduction of large masses of migra-
tory workers (Table I) showed 214 (5.9 per cent) to have a positive
serology; 108 (3.7 per cent) whites and 106 (15.5 per cent) Negroes;
thus again is illustrated the lower incidence of syphilis in the resident,
less promiscuous class of our population. Further analysis of this
table shows the low incidence of positive serology in our more stable
population.

Occupational status is related to social stability and the establish-
ment of a permanent home. In various industrial surveys in the
San Francisco area 4 out of a total of 7,147 workers, whose occupation
was known, the incidence of positive serology was as follows :

Unskilled laborers 5.0 per cent

Semiskilled laborers 4.6 per cent

Skilled laborers 3.7 per cent

Office workers 4.3 per cent

Professional workers 1.1 per cent

The incidence of syphilis decreased with increase of employment
stability.

TABLE I

SEKOLOGIC FINDINGS IN EMPLOYEES OF SAN FRANCISCO

INDUSTRIES

Serologic survey of permanent em-
ployees in four old established
San Francisco manufacturing
firms.

Serologic survey of a San Fran-
cisco war industry prior to the
employment of a large number
of migratory workers.

Serologic survey of the migratory
workers employed by the afcove
war industry.

Serologie survey of employees in
a transient war service.

White
Negro

Total

White
Negro

Total

White
Negro

Total

White

Negro

Total

Total
1,187

1,187

2,924
686

3,610

11,400
2,954

2,142
859

3,001

Number

Positive

31

31

108
106

214

685
905

14,354 1,590

166
256

Percentage

Positive

2.6%

2.6%

3.7%
15.5%

5.9%

6.0%
30.6%

11.1%

7.8%
29.8%

422

14.1%

The Psychiatric Service of the San Francisco City Clinic offers
figures related to promiscuity. Patients referred to this service in
1943 were those who had been interviewed by public health nurses
.and doctors and found to be sexually promiscuous, not prostitutes,
and generally under 22 years of age. Promiscuity was denned as
sex delinquency of a non-commercial character. It included a girl
"who might receive clothes, meals, a gift, or even money, if such
returns did not constitute her conscious reason for resorting to sexual

PROMISCUITY IN THE SPREAD OF VENEREAL DISEASE 521

promiscuity, and who did not confine her attention to one or
two male friends.*

Of 168 patients on whom complete psychiatric case studies were
done, 63 per cent came from currently broken homes; 83 per cent
reported familial conflicts, some being at the point of open breaks
with their families while others blamed their families for their situa-
tion, with a wide range of difficulties between the patients and
their parents. An analysis of 158 of these 168 patients whose records
were known showed that 18 per cent had been previously in cor-
rectional schools or had juvenile court experience. Almost all of
these 168 patients indicated they had been affiliated with some
religious group in childhood. A large majority had ceased attendance
at Sunday school or church before or during adolescence. Most
of these patients did not adhere to any form of organized religion
at the time of the interview. Many of the patients who claimed
affiliation with a church had recently come from small communities
where the church was a social and recreational center as well as
a place of worship. Statistics on 163 patients of the psychiatric
service show 39 (23.9 per cent) claimed no present church affilia-
tion, although almost all of these had had some previous church
or Sunday school affiliation. The chief recreations of this group
of patients studied by the psychiatric service were commercialized,
such as frequenting bars, dance halls, and cheap movies, reading
"pulp" romances and detective stories, and visiting beach
concessions habitually as a means of meeting men.

The women examined at the San Francisco Separate Women's
Court since its establishment in March 1943 offer important case
study statistics.

TABLE II

STATISTICAL EVALUATION AND CLASSIFICATION OF 1,402 CASES

APPEARING BEFOEE THE SAN FRANCISCO SEPARATE WOMEN 'S

COURT, MARCH, 1943, THROUGH SEPTEMBER, 1944

Number Per Cent

of Cases of Cases

Prostitutes 311 22.2

Promiscuous women 751 53 . 5

Alcoholics 283 20 . 2

Drug addicts 57 4.1

Total cases 1,402 100.0

Repeat investigations 278

Total investigations 1,680

Classification of the women by the social service department shows
that 311 (22.2 per cent) were prostitutes, 751 (53.5 per cent) were

* This definition conforms with the definition of promiscuity in the report
of the Committee on Sex Delinquency in Young Girls, which met in New York,
November 23 and 24, 1942, at the invitation of the American Social Hygiene
Association; Bascom Johnson, Chairman.

522 JOURNAL OF SOCIAL HYGIENE

promiscuous women, 283 (20.2 per cent) were alcoholics, and the
remaining 57 (4.1 per cent) were classified as drug addicts. For
the purpose of this classification, prostitutes were defined as women
who required pay for their sexual act; promiscuous women were
denned as previously mentioned; alcoholics were defined as those
who were routinely sexually promiscuous due to the effect of alcohol
or who were so in order to procure alcohol; and drug addicts were
defined as those who were sexually promiscuous due to the effect of
drugs or who were so in order to procure drugs.

This study shows the important place the promiscuous woman now
occupies in venereal disease control, especially when it is pointed
out that about 60 per cent of all venereal disease reported in San
Francisco is contacted through the media of bars and taverns.

Table III illustrates part of the social background of the women
appearing before the San Francisco Separate Women 's Court. These
women were referred to the Court following arrest for alleged
vagrancy or prostitution.

TABLE III

TABULATION OF HOME LIFE, EELIGION, AND EECORD OF AEEESTS

FOB 1,402 WOMEN APPEAEING BEFOEE THE SAN FEANCISCO

8EPAEATE WOMEN'S COUET

Number Per Cent

Broken home 794 56 . 7

Home with parents 382 27. 2

Unknown. 226 16.1

Total 1,402 100.0

'Church affiliation 1,184 84.5

No religion 218 15.5

Total 1,402 100 . 0

Eecord of previous arrest 635 45 . 3

No known record 742 52 . 9

Unknown 25 1.8

Total 1,402 100.0

Note that of the 1,402 women, 794 (56.7 per cent) came from
broken homes, a broken home or an unhappy home background
being defined as any breaking up of the solidarity of the home by
(1) death of one or both parents when the child was 18 years of
age or under; (2) divorce or separation of the parents; (3) removal
of the child from home, i.e., placed in boarding school, work home,
foster home, et cetera; and (4) illegitimate child of mother. Strik-
ingly similar findings of Doctor Rachlin 5 show 52 per cent of 249
women studied at the Midwestern Medical Center in St. Louis,
Missouri, came from broken homes.

* Ninety of the group with church affiliation were questioned concerning active-
ness of affiliation. Of these, 22, or 24.5 per cent had active affiliation, while
68, or 75.5 per cent were inactive.

PROMISCUITY IN THE SPREAD OF VENEREAL DISEASE

523

Although in this group 1,184 (84.5 per cent) stated some religious
affiliation, in the majority of instances this was only an expression
of faith. Detailed analysis of 90 of these patients showed 68 (75.5
per cent) to be religiously inactive.

The large numbers of first offenders 742 (52.9 per cent) is of
significant importance also as a reflection of the social condition of
our times. This figure coincides with the number of promiscuous
women (53.5 per cent) as shown in Table II.

Evaluation of the mental level of women appearing before the
Separate Women's Court is of importance in an adequate consid-
eration of the problem of promiscuity. These figures are a result
of the study of Doctor Mary C. Van Tuyl, Separate Women's
Court psychologist. The tests used were the Otis Beta B group
test and Wechsler individual test adult scale, as we were concerned
with the best measure of intelligence quotient possible for the
particular patient.

Chart I is a graphic description of the mental level by race for
553 women appearing before the Separate Women's Court from

CHART I

DISTRIBUTION OF MENTAL LEVEL BY EACE FOB 553 WOMEN

APPEARING BEFORE SEPARATE WOMEN'S COURT

FEBRUARY 21-SEPTEMBER 22, 1944

Total — 553

White— 394

Negro — 138

40- •

-65 65- 80- 91- 111 +
79 90 110

D BD DN N S

-65 65- 80- 91- 111 +
79 90 110

D BD DN N S

-65 65- 80- 91- 111+ Mental
79 90 110 Level

D BD DN N S

D — Defective DN — Dull normal

BD — Borderline N — Normal

defective S — Superior

From Records of the Separate Women's Court
Includes 21 persons of races other than White and Negro.

524

JOURNAL OF SOCIAL HYGIENE

February 21 to September 22, 1944. It is of interest to point out
that 61 per cent of the white cases and only 34 per cent of the
Negro cases fell within the grouping "dull normal and normal."
It should be further pointed out that in the whites 67 per cent
are above the defective and borderline defective level. Of the total
cases 57.8 per cent are of a mental level of dull normal or better,
the evidence thus showing the. subjects, on basis of intelligence, to
be amenable to redirectional care.

Chart II shows the per cent distribution of infection within the
various mental level groupings. It is of interest to note the small
fluctuation of venereal disease incidence in the various mental levels
of the white women ; while this fluctuation is more marked in Negro
women, the difference is not great. One might, therefore, consider
that mental level was not necessarily related to the incidence of
venereal disease in this class of patient.

CHART II

PEE CENT OF INFECTION BY MENTAL LEVEL AND RACE,

FOB 532 WOMEN APPEARING BEFORE SEPARATE WOMEN'S COURT

FEBRUARY 21— SEPTEMBER 22, 1944

White— 394

Negro— 138

TOTAL -65

65-
79

80- 91- 111 +
90 110

TOTAL -65 65- 80-
79 90

D BD DN N S

D — Defective
BD — Borderline
defective

91- 111 +
no

Mental
Level

D BD DN N S

DN — Dull normal
N — Normal
S — Superior

From Records of the Separate Women's Court

PROMISCUITY IN THE SPREAD OF VENEREAL DISEASE

525

Chart III by a graph relates the mental level groups found in
the women at the Separate Women's Court with the expectancy
curve found in a normal population as reported by Wechsler.6
According to the expectancy curve, 50 per cent of a normal popu-
lation falls within the limits of the normal mental level (91 to
110 I.Q.) ; in our population only 32 per cent of the total cases
fell within this normal range. This figure is 18 per cent below
the normal expectancy. The incidence of border-line defectives in
our group was 21.3 per cent above the expectancy in the normal
population.

CHART III

NORMAL EXPECTANCY AND MENTAL, LEVEL OF 553 WOMEN

APPEARING BEFOEE SEPARATE WOMEN'S COURT

FEBRUARY 21-SEPTEMBER 22, 1944

50-

40

30 '

20

10

Below 65 65-79
D BD

D — Defective
BD — Borderline defective
BN— Dull normal

80-90
DN

N — Normal
S — Superior

91-110

N

111+ Mental Level
S * Weehsler

Normal Expectancy *
Actual

From Records of the Separate Women's Court

These figures tend to point out that the problem of promiscuity
is to some degree related to low mental intelligence, as compared
to the average population, but the evidence is not strikingly con-
clusive. The group in the main, from a mental level point of view,
is amenable to redirectional treatment.

526 JOURNAL OF SOCIAL HYGIENE

GENERAL CONSIDERATIONS

The medical profession now has new and lethal weapons with
which to combat venereal diseases. While the old weapons were
effective, the new ones are likely to be even more so. We should
be forewarned, however, that penicillin is not likely to be a panacea
for the cure of both syphilis and gonorrhea. As the sulfonamides
have failed to meet general expectations, so penicillin may fail. A
rigid criterion of cure in both diseases is indispensable to adequate
treatment and control. Pelouze 7 has warned that patients who are
free from symptoms are not necessarily cured. The public health
doctor is not entitled to assume cure. He has a medical respon-
sibility to the community. Even in the practice of mass medicine
individualization is indispensable for proper medical care and proper
public health safeguards. Consideration should be given also to
the possibility that with quicker and less arduous treatments,
promiscuity, and consequently venereal diseases, may increase.

Stokes8 in speaking about the new weapons for venereal disease
treatment states:

That some of the anticipated beneficence may be wishful thinking will almost
certainly prove to be the case; for quick and easy cure is turning out as
Pelouze has indicated for gonorrhea, to be less of a device for the control
of infection than an incentive to epidemicity through incitement to exposure.
Venereal disease dissemination takes place in the period between infection and
the institution of treatment control. It is not the patient under treatment
who spreads disease but the promiscuous individual before and after treatment.
In other words, we must move against promiscuity rather than, or in addition
to, disease.

We must as a matter of necessity widen our view to include
the magnitude and ramifications of our problems in venereal disease
control. We must face the expanding front of social factors leading
to the dissemination of venereal disease. The social problem of
venereal disease knows no geographic or class boundary lines. The
venereal disease control officer must be more than a public health
doctor. He must coordinate his work intelligently with other
agencies. He must do more than treat the sick. He must realize
that the avalanche of new venereal disease cases that will continue
to descend upon him cannot be controlled by medical treatment
alone. Prevention is the health officer's business no matter where
it leads him. He has to be a social guide and work on the environ-
ment of disease; that is a large part of his business. We must
follow the spirochete and gonococcus wherever they go; we have
to get the remedy whether medical or social. We cannot do it by
just running around with a luer syringe.

It is necessary as well to get at the root of the social problem
that produces the recruits for new cases of venereal disease. The
parent, the church, the school, and the social agency play a vital
and important role in an adequately coordinated venereal disease
control program, and all of these factors relate back to the kind
of a social state the people wish to develop.

PROMISCUITY IN THE SPEEAD OF VENEREAL DISEASE 527

Analysis of a great number of new female cases shows that the
new recruits to venereal disease seldom come from well-organized,
tranquil homes; they come from broken homes, homes where the
daughter has been left to drift with little parental guidance or
assistance. In some instances, the parent has directly contributed
to the daughter's delinquency, but in the majority of cases the
factors are those of neglect. Therefore, these factors which con-
tribute to juvenile delinquency also contribute to exposure and to
the spread of venereal diseases.

The church and school must take a more active lead in reaching
parents. It is the moral fiber of the nation, developed by its religious
concepts, which has thus far kept venereal diseases from becoming
more prevalent than they are. This moral fiber must be strengthened
in a positive and direct way, because when one deals with promis-
cuity, one is dealing with conduct and behavior. Venereal disease
is only one of the casualties that come from anti-social or irrespon-
sible social behavior. Venereal disease is essentially a problem of
youth. This is supported by the fact that the majority of new cases
of venereal disease are contracted by boys and girls between the
ages of fifteen and twenty-five.

Therefore, the parents must be reached and brought to a realiza-
tion of their obligations to rear the child in an environment that
will build and strengthen a strong moral character. This parent
education can be achieved through social and religious education
in health and human relations. Such a program is, of course, beyond
the scope of any one agency.

To present a military analogy, the program should be defense
in depth against venereal disease — in our case, depth in prevention
by establishing social standards that will create cultural obstacles
to promiscuity, and consequently, to exposure to venereal disease.
In cases where these obstacles fail, it is necessary to depend upon
medical diagnostic and treatment safeguards. Defense in depth
is outlined as follows:

1. Establishment of the family as a secure cultural unit.

2. Achievement of a religious and socially moral outlook -with adequate
religious training of the child in his moral obligations to his God,
his parents, his country, and himself.

3. Establishment of a coordinated health education program in the
public schools.

4. Establishment of community recreational facilities.

5. Adequate parental knowledge of child development guidance.

6. Progressive social hygiene instruction of the child by the parent.

7. Continued social guidance to post-adolescent youth by the church and
state through the recognition of their responsibility to assist the
post-adolescent to a firmly established, socially balanced, adult life,
assisted by trained and adequately staffed social agencies.

8. Recognition on the part of health agencies of their responsibility
in guiding the public through health education to recognize the
foregoing concepts as indispensable to adequate public health.

528 JOURNAL OF SOCIAL HYGIENE

9. Adequate social treatment and redirectional care for those who have
failed to maintain an accepted social course. This treatment should
be made available through community agencies offering assistance in
social redirection to the post-adolescent through competent and effec-
tive service for the individual as a person with a distinct and specific
psychic makeup and problem.

10. Active, intelligent, continuous, and diligent repression of commer-
cialized prostitution in its many and devious manifestations and
relentless prosecution of the facilitator.

11. Adequate public health education regarding the problems, symptoms,
nature, and method of prevention and treatment of venereal diseases.

12. Free diagnosis readily available in the community for all those
suspected of having a venereal disease.

13. Adequate and readily available treatment and physical quarantine
for those who are unwilling to submit voluntarily to medical care.

14. Free treatment for those who cannot afford to pay for treatment.

15. Active venereal disease case finding and case holding adequately sup-
ported by public funds to provide an effective control program by
the health department.

16. Recognition on the part of public health workers of the strategic
leadership to be given by the health department in building a defense
in depth against venereal disease.

The pride of today's medicine is prevention. Treatment for

venereal disease may be effective, but the disease and the source

of its origin leave scars on the personality and conscience that
never heal.

We must always bear in mind the menace of these diseases to
the home and to that one divine attribute of man, the power to
produce babies — the future of the race. Promiscuity is the worst
enemy of the family and the home. Babies diseased at their birth
are the greatest of all indictments against any man or woman
participating in their creation. The illegitimate boy has been fed
into the armies of Europe for centuries. The illegitimate girl with-
out family protection has gone to the bottom of society. Promiscuity
will decrease to a marked degree if we can make every boy and girl
feel that the greatest happiness on earth can come from honorable
marriage and that it is worth while to lead a continent and
restrained life.

Our boys and girls need help and knowledge to face this promiscuity
that is rotting the family tree at its very roots. There is no family
immunity to these diseases.

If the health department takes a negative attitude toward the
larger and necessary aspects of venereal disease control, or enter-
tains a defeatist or cynical disregard for it, we will fail. If the
community is not told the job is more than the medical profession
alone can do, we will fail. If the results of promiscuity are to
be controlled only by medical treatment, we will fail. But, if we
marshal all the community resources in a united front, and take
our place on the headquarters staff with the ministers, the sociologists,

PROMISCUITY IN THE SPBEAD OF VENEREAL, DISEASE 529

the educators, the peace officers, the prosecutors, and the jurists,
we cannot fail.

Nothing less will win the battle against promiscuity and venereal
disease.

REFERENCES

1. Parran, Thomas: Shadow on the Land. New York. Spec. Ed. Sec.

Printing 1938, 222 p. American Social Hygiene Association.

2. Koch, E. A., Merrill, M. H. : Serologic Survey Among Labor Unions in

Northern California. Venereal Disease Information, 23:317-322, 1942.

3. Clarke, Walter: Syphilis, Gonorrhea, and National Defense Industries.

Journal of Social Hygiene, 27:169-174, 1941.

4. Koch, B. A.: Venereal Disease in Industry. Industrial Medicine, 13:302-306,

1944.

5. Eachlin, H. L. : A Sociologic Analysis of 304 Female Patients Admitted

to the Northwest Medical Center, St. Louis, Mo. Venereal Disease
Information, 25:265-271, 1944.

6. Wechsler, David: The Measurement of Adult Intelligence. The Williams

and Wilkins Co., 2nd Ed., 1941.

7. Pelouze, P. S. : Gonorrhea: The Epidemic We Face. Venereal Disease

Information, 25:76-80, 1941.

8. Stokes, J. H.: Some General Considerations Affecting Sex and Sex

Education Problems. Venereal Disease Information, 25:197-203, 1944.

The Spearhead Must Be Prevention

The attempt to stamp out syphilis and gonorrhea by "finding and
treating" alone is as impractical as trying to control malaria by dosing
with quinine, without getting rid of swamps and mosquitoes. Nor is it
enough to put commercialized prostitution out of business, unless efforts
are made to lessen other forms of sexual promiscuity. Especially, must
be stopped before it starts youth's drift toward such quicksands.

More than any other factor, promiscuous sex relations spread VD today —
from man to woman, from woman to man, from boy to girl, and from girl
to boy. Army and Navy reports show a great majority of infections trace-
able to "free" girls, or "pickups." Often these youngsters are hardly
in their teens, seldom are they past them.

Thus, the attack by public health measures, law enforcement and citizen
action is outflanked and its achievement in part defeated by sexual promis-
cuity, stemming from individual and public casualness towards moral
values, and to a great extent involving persons too immature to recognize
the danger or to realize the consequences.

Much of this "sex delinquency" comes out of home and community
conditions disturbed by the war. More is due to failure to provide the
instruction and guidance necessary for knowledge and character-strength
to withstand the stress and strain of living in today's world. Needed, too,
are more facilities for wholesome recreation, and other outlets for young
energies.

Until such bridgeheads enable safe passage from uncertain adolescence
to experienced maturity, sexual promiscuity will continue to threaten the
efficiency of Army, Navy and war industry, and to shadow the health and
happiness of thousands of young men and young women.

The chief responsibility for taking steps to solve this problem lies with
home, church, school and youth-serving agencies.

from Calling All Communities!

ASHA Pub. No. A-575, announcing National

Social Hygiene Day for 1945

THE CHALLENGE TO LAW ENFORCEMENT *

L. R. PENNINGTON

Inspector, Federal Bureau of Investigation, U. 8. Department
of Justice, Washington, D. C.

Ever since Mr. John Edgar Hoover became the Director of the
FBI in 1924, he has worked continuously and untiringly toward a
cooperative program for law enforcement agencies. Shortly after
Mr. Hoover's appointment as Director, the FBI became the repository
on a national scale of criminal fingerprint records which had pre-
viously been kept at Leavenworth Penitentiary and by the Inter-
national Association of Chiefs of Police. The records received in
1924 included approximately 800,000 prints. On February 11, 1944,
there were on file in the Bureau's Identification Division 78,916,494
fingerprint cards. Contributing law enforcement agencies totaled
12,369.

Identifications were made on 64.68 per cent of the criminal arrest
fingerprint cards forwarded to the Identification Division in 1943.
During the same period, fingerprint cards were received at the rate
of 93,540 daily. Of the total prints forwarded to the FBI, 5,172,746
are civil prints sent to the Bureau by citizens for identification
purposes. Through the facilities of the Identification Division, 11,976
fugitives were identified in 1943. This more than doubles the 5,706
identifications made in the fiscal year 1942.1 Through the facilities
of the Identification Division, police agencies are kept fully informed
of the criminal records of individuals taken into custody.

Again, through the facilities of the FBI Laboratory which are
at the disposal of police agencies, criminals who a decade ago would
have gone scot-free are daily being identified and convicted.

Examinations are being made almost daily for police departments
by ballisticians to determine whether a certain gun was used as the
lethal weapon in the commission of a murder. Collections of blue
prints of auto tire treads, various types of bullets and cartridge
cases, typewriting specimens of every make of domestic typewriter
and many of foreign manufacture, handwritings of many chronic
criminals, paint samples, and many other collections of scientific
specimens are used by FBI technicians to assist police agencies
throughout the country.

* A paper given before the Southeastern Regional Conference on Social
Hygiene, Atlanta, Georgia, February 23, 1944; and revised for publication in
this number of the JOURNAL.

t As of December 10, 1944, the Identification Division had a total of 93,500,000
fingerprint cards, from contributing agencies totaling 12,500. These include
5,300,000 civil prints. Identifications were made on 70.25 of the criminal
arrest fingerprint cards forwarded in the fiscal year 1944, and 13,729 fugitives
were identified, through the facilities of the Division.

530

THE CHALLENGE TO LAW ENFORCEMENT 531

As a further means of cooperation, Mr. Hoover in 1935 initiated
the FBI National Police Academy, whose graduates now total 816 *
officers. These men represent police personnel of over 100,000.
Returning to their agencies, they have for the most part initiated
schools to assist in raising police standards throughout the country.
The FBI has, when requested, assisted in preparing the programs
and loaned technical experts to assist in the police training schools.

In response to President Roosevelt's directive in 1939, calling upon
the FBI to take charge of and to coordinate National Defense
activities, conferences were initiated throughout the country, that
our police agencies might be fully informed concerning the National
Defense Program. In 1941, 1,000 such conferences, representing
7,000 law enforcement agencies, were held. In 1942, the number
of conferences increased to 1,394, representing 9,000 agencies. In
1943 there were 1,604 such conferences, representing 9,900 law
enforcement agencies. The particular problems of this Conference
were regularly discussed at these meetings.

As all of you no doubt know, the first Federal legislation adopted
to curb exploitation of women for purposes of prostitution was the
so-called Mann Act, which was passed by the Congress in 1910 and
signed by President William Howard Taft on June 25th of that
year. This Act provides for the punishment of any person who,
in interstate or foreign commerce, transports a woman or girl for
the purpose of prostitution, debauchery, or with other immoral
intent. The control of commercial organized vice rings operating
on an interstate basis is the primary objective of this law, and it
does not cover the problem of local prostitution. However, the
Courts have held that certain transportations not of a commercial
nature but occurring under aggravated circumstances, such as the
involvement of a minor, are within the purview of the Mann Act.
Prosecution is aimed primarily toward the promoter or propagator
of the business and not at the prostitute and her client.

The professional procurer makes the business of trafficking in
women his total source of income and his preferred way of life.
He appeals to young and frequently ignorant victims, and, through
the false lure of entirely fictional wealth and easy living, effects the
transition of the juvenile delinquent into the hardened prostitute.
The arrest records as reflected by the criminal files of the Identifica-
tion Division of the FBI clearly show that, once inured to the life
of prostitution, successful rehabilitation of these girls is so unusual
as to be unique.

Particularly noteworthy concerning the illegal "business" of
prostitution is the fact that it invariably is allied with the whole
underworld. During the "crime era" in the 1930's when organized
gangs of killers and extortionists were rampant in this country,
the major figures and leaders were found to be frequenters of prosti-
tution haunts. The Dillingers, the "Pretty Boy" Floyds, the Harvey

* By December, 1944, officers graduated from the FBI National Police Academy
total 968.

532 JOUBNAL OP SOCIAL HYGIENE

Baileys, and their accomplices maintained close alliance with the
madams, procurers, and prostitutes throughout the country. Today,
the petty gambler, racketeer, and "con" man not only find the
brothel and its inmates a means of entertainment and relaxation,
but often utilize the house of prostitution, in communities where
these sore spots are still permitted to exist, as centers of activity
through which others in the same line of business may keep in touch
with their movements. In every city and town, the madam, the
pimp, the procurer, the prostitute know and associate with personnel
involved in every other category of crime.

Juvenile delinquency, one of the major problems in our country
today, concerning our whole population, and one which is of par-
ticular moment to the law enforcement officer, is an important factor
in the propagation and maintenance of the business of prostitution.
Young, inexperienced girls, because of mental limitations or because
of dissatisfaction with their home patterns of life, are fair and
better than fair game for the prostitution promoter. It is an axiom
clearly shown by factual record that the female juvenile delinquent
of today is most often the professional prostitute of tomorrow.

The approach of the professional procurer is disarming and
friendly. In the beginning he utilizes every psychological means of
persuasion from the offer of a glowing theatrical career to protesta-
tions of love. After the confidence of his victim is gained, she is
often transported from her home surroundings to another locale,
where the second phase of her education as a prostitute begins. It
is here that she is introduced to the actual life of prostitution and
where the degree of trust developed by the procurer is augmented
by the factors of fear and duress. As previously stated, the girl
who has become experienced as a prostitute as a rule never learns
another way of life.

Since Pearl Harbor, organized prostitution has been greatly
reduced throughout the United States. Spurred by patriotism and
backed up by public opinion, law enforcement officials have hit
hard at the ''business" wherever it has tried to set up shop, and
the results may be seen in "red-light districts" closed in more than
650 communities, and in the fact that today a low proportion of
venereal disease infections among the armed forces may be consid-
ered chargeable to prostitutes. Nevertheless, in spite of this fine
record, the FBI still runs across flagrant examples of the white
slave traffic which have persisted here and there. Some of these
are described below. They are cited not because they are commonly
found now, but because they are examples of conditions which
existed in many places before the war, and which are sure to exist
again after peace is declared, unless our laws against prostitution-
local, state and national — are rigidly enforced.

The words "white slavery" are indeed suitable to describe operations uncov-
ered by FBI Agents at Wheeling, West Virginia, in 1942. Young girls were
being procured by a group of panderers on the streets and in taverns in
Wheeling. In many instances, they were lured with the promise that employ-

THE CHALLENGE TO LAW ENFORCEMENT 533

ment as waitresses at a good salary would await them if they would accompany
the procurers to Campbell, Ohio. They were furnished with money to hire a
taxicab to drive them across the Ohio River and, upon their arrival in Campbell,
were taken to the Campbell Hotel, a bawdy house. It was here they learned
for the first time that their jobs as waitresses consisted of prostituting themselves
for any and all customers. Evidence introduced at the trial of the case indicated
that drugs were frequently used to aid in convincing these girls, in case they
were reluctant to take up the trade. Once convinced, the victim was made to
carry on her activities as a virtual prisoner.

The Campbell Hotel, a two-story brick building, in many respects resembled
a prison, inasmuch as there was only one entrance and the windows were barred.
The entrance was carefully guarded at all times to prevent the girls from
leaving without permission of the panderers or the madam. If the victim left
the premises without permission, a $35 fine was assessed against her. The
"business" had been worked out so thoroughly that a punch-card system
was used for recording the volume of trade handled by each girl, and thus
the madam made certain of her fifty per cent out of the victim's earnings.
This cut was increased by high charges assessed against the girls for room
rent, laundry, and medical examination. As most of the girls at the Campbell
Hotel were placed there by panderers associated with this group, the balance
of their earnings went to the panderer. In January, 1943, a United States
Grand Jury at Wheeling, West Virginia, returned indictments against the
panderers. They received sentences varying from two to five years.

In the spring of 1942, the FBI instituted an investigation of violations of
the White Slave Traffic Act in eastern Pennsylvania which resulted in. the
conviction of twenty-two individuals engaged in trafficking in women. Investi-
gation centered around Beading, Pennsylvania, where many of these persons
had been engaged in prostitution for a long period of time. Several houses
of prostitution maintained close liaison. Many of the procurers, whose activities
were uncovered, freely exchanged girls with other groups. Many of the girls
were brought from New York City, a number were transported to the vicinity
of the race track at Havre de Grace. Maryland, and quite a few were juveniles.
The sentences in most cases were relatively light.

In July, 1942, members of the Cleveland, Ohio, Police Department relayed
to the FBI a tip received from a former prostitute, which brought to light
one of the most vicious vice rings yet uncovered. Pete Morei, well known as
"King of the White Slavers" in the Cleveland area, with others, not only
controlled the procurement, training, distribution, and discipline of women for
his trade in Ohio, but also farmed them out into other states as well. Young
girls, some of high school age, were recruited.

A typical case is that of a young girl. We will call her Marjorie Adams.
She was only 16 when she met Morei, and, two years later when she was
hospitalized for an operation, he volunteered to pay a portion of her hospital
expenses. He did in fact contribute $140 for this purpose. Hardly a charity,
however, was this contribution by Morei but rather a shrewd investment. On
her release from the hospital, Marjorie was told by Morei that he expected
her to pay the hospital bill by working as a prostitute. Morei also prevailed
on Marjorie's sister to work in the same capacity to help repay him.

After working briefly in houses of prostitution in Sandusky and Akron, Ohio,
Marjorie was sent by Morei to Lorain, Ohio. Here she worked for a period
of approximately seven months and turned over substantially all the proceeds of
her prostitution to Pete. When interviewed by Special Agents of the FBI,
Marjorie stated she earned a minimum of $75 weekly during the period. In
September, 1942, the entire group involved in this ring was brought to trial
and received substantial sentences.

That these activities take many forms and involve men and women of various
occupations and incomes is illustrated by the long and lucrative career of
Dr. Anna Swift, purveyor of prostitution on a grand scale, which was culminated
on June 17, 1943, following an intensive investigation by Special Agents of
the FBI. Anna Swift drifted into the business of prostitution by way of the

534 JOURNAL OF SOCIAL HYGIENE

legitimate path of a professional masseuse. Shortly after coming to the United
States from her home in Brunswick, Canada, in 1906, she became a governess.
Later, she conceived the ambition of entering the massage business. She served
her apprenticeship with a New York concern and from 1912 to 1914 operated
as a professional masseuse in New York and Paris. From 1914 until July, 1940,
she operated the Danish Institute in New York, posing as a masseuse, but was
actually manager and owner of one of the most elaborate of brothels.

Her life during this period was interrupted sporadically, but only for short
periods, by ten arrests under local prostitution statutes, and her total jail
sentences for these violations amounted to six months.

In April, 1941, after serving 90 days in the Women's House of Detention,
Anna Swift left New York and secured a home in a fashionable residential
section in Maryland near Washington, D. C. She continued to operate her
business, seeking to reach the monied clients available in Washington's higher-
class hotels with the aid of bellboys and other personal contacts in the city.
In carrying out her business, she sent her girls across the District line in
violation of the White Slave Traffic Act.

At the height of her activities in New York, Anna Swift maintained one
of the most luxurious establishments of its kind. She kept complete records
of all her clients and went to the extent of having prospective customers
investigated by private detective agencies, both for the purpose of ascertaining
their financial status, as well as to avoid being involved with the law by evidence
obtained through an undercover officer. Her house, though actually little used
for professional massage purposes, was equipped with the very finest para-
phernalia of the business, and the most up-to-date electrical apparatus and
furnishings were maintained there.

Catering always to the well-to-do, the personnel of her house was periodically
changed and fees paid by her substantial clients were consistently in the
$25 to $50 range.

In passing sentence on June 17, 1943, Judge Matthew McGuire of the District
Court for the District of Columbia remarked: "I have read the report of the
Federal Bureau of Investigation in this case. It is one that you would hesitate
to read twice. This case is commercialized vice of the rankest, deepest and
lowest form. This woman is charged with a crime that is a stench in the
nostrils of decent people in a civilized community. She is a hypocrite and I am
going to send her away."

During the fiscal year 1943, and the first seven months of the
current fiscal year beginning July 1, the FBI was responsible for
751 convictions involving violations of the White Slave Traffic Act.*

Early in 1941, the Congress of the United States began taking
into consideration possible steps toward legislation which would limit
and control the practice of prostitution in areas adjacent to military
establishments and convenient to the military personnel. The pre-
occupation of Congress with this matter was motivated by the devel-
opment and enlargement of the military forces and the concentration
of large contingents of soldiers and sailors at established or newly-
developed camps, stations, or cantonments. An additional develop-
ment was the influx of a large number of workers to industrial
centers for the production of war materials. The health of these
large numbers of citizens, both military and civilian, was of great
concern, and the possibility of the moral and physical breakdown
which would follow the spread of prostitution and venereal infec-

* Convictions on such charges for the fiscal years 1943 and 1944, and for the
first four months of fiscal year 1945 come to 1,023.

THE CHALLENGE TO LAW ENFORCEMENT 535

tions was given considerable attention by Congress. This attention
resulted in the introduction by Congressman Andrew Jackson May
on January 20, 1941, of a bill calculated to repress prostitution in
the military areas. The bill became Public Law No. 163 on
July 11, 1941.

The May Act is invoked by the respective branches of the military
service on the basis of information, recommendations, and requests
from military and civilian sources. For example the Army, in
considering the possibility of invoking the Act, has followed this
approximate procedure: A Post Commander, aware of a rising
venereal disease rate among his personnel, confers with local police
authorities, acquainting them with details and requesting their par-
ticular assistance in eradicating vice conditions in the area adjacent
to his military establishment. If, within a reasonable time, the
situation is not eradicated, the Post Commander refers the matter
to his Corps Area Commander, who then requests the Social Protection
Division of the Federal Security Agency to have a survey made of
vice in the area. If the condition is then not corrected, the May
Act is invoked by the Secretary of War, restricting a certain area
within the vicinity of a camp, and the FBI is requested to conduct
an investigation.

Two areas which have been declared restricted illustrate this pro-
cedure: the first at Camp Forrest, Tennessee, and the second at
Fort Bragg, North Carolina. In the initial investigation conducted
in the Camp Forrest area, the threat of Federal enforcement resulted
in the cleaning out of many centers of vice in central Tennessee
and brought about an overnight exodus of prostitutes to points out-
side the area in which the Act was put into effect. In Nashville,
vigorous action by the Police Department resulted in the closing
of houses of prostitution, honky-tonks and taverns. Following the
enforcement of the May Act in this area, venereal disease infections
among servicemen registered an amazing drop — from 61 per thousand
to sixteen per thousand. At Fort Bragg, North Carolina, this Act
was invoked on May 21, 1942, with similar results. The activities
of Special Agents of the FBI in these two areas, up to January 31,
1944, brought about 784 convictions of prostitutes and procurers.

However, experience everywhere, including areas in which the
May Act has been invoked, shows that withdrawal of FBI agents
for urgent duty elsewhere, and a letdown in state and local law
enforcement and court action is followed by an increase in prostitu-
tion activities and venereal disease rates. In cleaning out such areas
it does not appear that a "sob sister" or psychological approach
will capably handle the situation. It is only by vigorous and con-
tinuous enforcement of the law that you can hope to succeed.
United action throughout the nation by all agencies, governmental
and voluntary, is essential for protection of the health, welfare and
efficiency of our armed forces, industrial workers and other citizens
against this "business" which exploits both women and men.

There are broader aspects of this problem relating to sexual

536 JOURNAL OF SOCIAL HYGIENE

promiscuity which demand consideration. I wonder how many
people, when speaking oil juvenile delinquency, realize fully that
adult delinquency is responsible. Look at the record of 1943. Dur-
ing this year, age eighteen predominated in the frequency of arrests
for both sexes and was followed in frequency by ages seventeen,
nineteen, twenty-two and twenty. For males, however, age seventeen
predominated, this being the lowest age for boys since 1932. While
arrests for boys under twenty-one years of age declined 7.6 per
cent in 1943, arrests of seventeen-year-olds increased 27.7 per cent.

Arrests of girls under twenty-one for offenses against common
decency increased 56.9 per cent. Arrests of girls eighteen years
of age increased 54.3 per cent, while for the age of nineteen, the
increase was 52.9 per cent. At age seventeen for both sexes, there
was an increase in arrests amounting to 30 per cent in 1943. For
age seventeen and lower ages, the combined increase for both sexes
was 26.3 per cent. For girls under twenty-one, during 1943, there
was a 74.8 per cent increase in prostitution and commercialized vice,
for other sex offenses 51.6 per cent, for disorderly conduct 67 per
cent, for drunkenness 30 per cent, and for vagrancy 59.6 per cent.

There are many contributory factors in the upswing in juvenile
crimes. There is a general spirit of "after me the deluge." In
many instances, homes have been broken up, with one parent in
the service and the other in a war plant. Many young people now
employed in war plants are receiving enormous salaries. Never
having been taught how to handle money or realize its value, they
now spend it through frequenting night clubs, buying liquor, visiting
houses of prostitution, and similar activities.

In order to cope with the situation, it must be fully brought home
to civic organizations, parent-teacher associations, schools, and
churches. At present, though winning on the war front, we are
losing on the home front. If immediate and drastic steps are not
taken to curb the craze among our youths, this drift to delinquency
will become a veritable tidal wave of crime that might well undermine
'the very foundation of our great Nation.

A few public-spirited citizens throughout the country have recog-
nized the dangerousness of present conditions and have taken steps
to curb the temptations of youth by organizing clubs of various
types which offer clean, wholesome entertainment to the grade-school
and teen-age youths. But this is not enough. Complacent citizens
must be aroused from their lethargy and ' ' don 't- want-to-be-bothered ' '
attitude. They must be jarred into shouldering their civic and
domestic responsibilities. And one excellent way of accomplishing
this is by rigid and strict enforcement of all laws or ordinances
pertaining to juveniles, laws pertaining to the restriction of vice
in communities, and especially gambling and liquor laws.

Violations of vice laws, gambling laws, and liquor laws are some-
times so flagrant in our communities that youth cannot avoid having
knowledge of the violations. Such an open disregard for law on
the part of adults cannot fail to develop in youth a cynical attitude

THE CHALLENGE TO LAW ENFORCEMENT 537

toward law and order. It is of vital importance that police officers,
prosecuting attorneys, juries, and judges in every community in
the land see that violators receive their just deserts. A policy of
strict enforcement is necessary if we are to maintain the majesty
of the law.

Many citizens -are sidestepping the problem in much the same
manner as they are sidestepping any responsibility in the conduct
of the war. They are selfishly interested only in their own petty
inconveniences. They have no one near and dear to them involved.
We are living in an era where all citizens must pull together for
God and Country. If government, religion and morality break down,
it is only a brief step to national disintegration and dissolution.

The Community Is on the Firing Line

It is right that the community should take up arms in the battle against
VD, for it is as true today as ever that soldiers, sailors and war workers
become infected with syphilis and gonorrhea not while in camp, on ship
or at the shop bench, but while they are off-duty in civilian surroundings.

Here, then, is where the conditions which favor spread of VD infections
must be fought relentlessly, with skill and courage. And in our democracy,
a community will have no better program for the control of venereal
diseases, the repression of prostitution and for the training of youth to
live full and useful lives, than the citizens of that community want and
are willing to support.

As a responsible member of your community, do you Jcnow what your
hometown needs to do? And is it being done?

The broad social hygiene attack, geared to wartime and postwar needs,
should include:

Medical and Public Health

Adequate facilities to find, diagnose and treat venereal infections.

Legal and Protective

Adequate laws, and law enforcement, to repress prostitution, to protect
marriage and babies from infection and to safeguard youth and their
environment.

Education and Public Information

Information concerning the nature of the venereal diseases, their cause,
means of spread, treatment and cure. For personal protection and to build
sound public support for all measures needed for prevention and control,
including repression of prostitution, all should know the facts.

Education for young people regarding the normal function of sex in
life, and training for happy marriage and successful human relations.

Your community may need to do more along some of these lines, and
remember —

Your Community Is You

from Catting All Communities!

ASHA Pub. No. A-575, announcing National

Social Hygiene Day for 1945

THE POLICEWOMAN'S BOLE IN SOCIAL PROTECTION*

ELEANORE L. HUTZEL

Chief of Woman's Division, Department of Police,
Detroit, Michigan

Although the first policewoman was appointed in 1907, it was
not until the period of the first World War that there was any gen-
eral acceptance of the need for women with police powers to deal
with youth. The lay women's organizations, interested in providing
this service, recognized from the beginning the need for skilled social
workers in this field. Social workers, however, worked in ways which
seemed strange to police officers, with the result that the natural resist-
ance to the appointment of women to work in a men's organization
was strengthened by inability to understand the methods and objec-
tives of women who were appointed. The fact that public social
work of any type during the early nineteen hundreds was considered
by social workers as less desirable than work in private agencies,
made it difficult to recruit the most desirable workers, so that the
urgency of the first World War was needed to give impetus to
appointment of policewomen and make a patriotic appeal to interest
qualified women. Most cities which appointed policewomen during
this period retained them, but there were not a great many new
appointments until World War II brought renewed emphasis on
youth problems.

In different parts of the country one finds police departments
which have employed policewomen so long that most of the men
have no conception of a department without women officers; and
policewomen's bureaus which have been so long accepted in the
community program of youth service that their work is no more
commented on than that of other established agencies. Police chiefs
also have come to appreciate the need for officers with special skills
to work with youth, as evidenced by their recent request that the
Federal Children's Bureau assist them in setting up national schools
for the better training of officers doing this type of work.

During the past ten years, there has been a marked trend in
police departments toward broader service, and policewomen's
bureaus have become "youth protective bureaus" or "crime preven-
tion bureaus," with both men and women police officers. The action
of the International Association of Chiefs of Police in attempting
to standardize service to youth in police departments is heartening,
because of the recent increase in problems of juvenile delinquency.
Heartening especially because whether other workers in the youth
field recognize it or not, the fact remains that police officers are a
part of service to youth and effort, therefore, should be directed
to making it an efficient service.

* A paper given before a session on Social Hygiene and Social Protection at
the National Conference of Social Work, as arranged by the Conference >s Special
Committee on Social Hygiene, Eay H. Everett, Chairman, at Cleveland, Ohio,
May 23, 1944.

17 ' 538

POLICEWOMAN'S EOLE IN SOCIAL PROTECTION 539

The figures most frequently used in discussing juvenile delin-
quency are figures on Juvenile Court complaints. To give you some
idea of the difference between Juvenile Court complaints and police
contacts, I mention the following:

In 1943, in Detroit, policewomen contacted 8,936 girls between 10 and 17
years of age. During the same period, 450 complaints were filed in Juvenile
Court on girls in this age group. The Juvenile Court complaints were for
the entire area of Wayne County, and the police contacts for the City of
Detroit, which alone makes the difference even more marked.

These figures show the extent to which the police enter into work
with youth problems. Their work is peculiarly significant and their
contact important because so often the police officer is the first youth
worker with whom the child makes contact, and in many cases, the
only one, since a high percentage of contacts are adjusted by the
police (fifty per cent in Detroit, and more elsewhere).

I accepted the subject assigned to me with the understanding that
social protection should be interpreted in a broad enough sense to
cover the conduct problems presented by all teen age girls, and not
be limited to any specific group, because the policewoman works
with the larger group. ^

In discussing the work of policewomen, necessarily I must be
influenced by my own experience in organizing and directing a group
of women officers over a period of twenty years, during which time
the number has increased from 16 to 64. Of the 22 officers appointed
since 1940, all but two are college graduates, most of whom majored
in sociology. These two are nurses with experience in public
health nursing. Ten of the 22 were trained for social work, nine
for teaching, and one for secretarial work. Appointment is by com-
petitive examination. The fact that our initial salary is high, $2,829,
has made it possible for us to interest women with some background
of experience in their respective fields.

Policewomen work both with individuals and with community con-
ditions which present hazards to youth. Once accepted by the men
officers, the policewomen find themselves a part of an organization
which is reaching into every part of the city, during every hour of
the day, every day of the week. It requires but little effort to develop
in the men of the department a feeling of obligation to concern
themselves with youth in hazardous situations, and to be on the
lookout for conditions which are harmful. The men officers will
do this with greater enthusiasm if there is within the department
a special bureau to which they can refer the problems coming to
their attention, since they necessarily feel themselves inadequate to
meet these problems.

The first duty of the policewoman is identification of the young
person who is in a hazardous situation, and because her numbers
in any police department are small, she must extend herself in any
way that she can. Men officers are her first resource, but there
are many others and a considerable part of her success depends on
her ability to secure this help.

540 JOURNAL OF SOCIAL HYGIENE

The inexperienced young girl, coming to a new community, gen-
erally does not go to an organized agency for advice or direction.
The Information Center in a Public Library is rarely consulted.
Some come with letters from their pastors and make church con-
nections, many more do not. These young girls consult the bus
driver, a fellow traveler or the person who gave them a lift on the
road. They go to centrally located cheap hotels or rooming houses.
They attach themselves to seemingly more experienced girls whom
they meet in eating places, in public parks, at work, or who sit next
to them in a movie theatre. These, therefore, are the people whom
the policewoman must learn to know. Bus drivers, taxi drivers and
truck drivers must be contacted in groups and, when the opportunity
presents, individually; employees in terminal stations; attendants
in public rest rooms ; news stand operators ; managers and waitresses
at eating places; operators of rooming houses, hotels, theatres, dance
halls, cabarets and bowling alleys, all serve as resources and the
policewoman must enlist their help in protecting young girls from
undesirable experiences, if she is to succeed in serving those she
most needs to help.

Much of the educational work which brings about this cooperation,
is carried on as a part of otller activities. A good contact while
making search for a missing girl; a word of appreciation when it
has been earned; an extra few minutes to explain what the police-
woman is trying to accomplish; a report back that a girl has been
successfully planned for, take little extra time, but bring good results.
When policemen are picking up and are bringing young runaways
to the woman's bureau before they are reported as missing, when
officers observe and report danger spots in the areas in which they
work, when girls, obviously young and unprotected, are reported
to the woman's bureau by landlords, taxi drivers, employers, wait-
resses or older girls, then the director of a policewoman's bureau
can feel that good resources are being built up, and that youth in
the community is being given some measure of protection.

Along with the development of these resources, however, the police-
woman must make her own observations. Because much of this
observation must be made at night, and because it does not work out
well to keep officers on night duty continuously, a certain rotation
in personnel is inevitable. Since, however, it is agreed that in this
work of identification, officers should be assigned in teams, it is pos-
sible to provide some continuity. Maps are developed on which
questionable places and points where youth congregate are indicated ;
note books, in which helpful information of a permanent and also
of a temporary character is kept, are prepared and kept up to date
for each area. This work of going out to find girls who may be in
dangerous situations is so intangible and its success depends so
much on the individual, that a high type of worker is required
as well as good leadership and close supervision. This type of work
under no circumstances can be done satisfactorily unless the officer
is so well trained that she feels security in her sure knowledge of
how to handle any situation which may arise and has assurance

POLICEWOMAN'S ROLE IN SOCIAL PROTECTION 541

of the full support of her superiors. The ability to make quick
decisions, to meet efficiently any emergency, to deal understandingly
with disturbed people under difficult circumstances is required of
every policewoman.

Recently, in Detroit, we have been experimenting with teams
made up of a policewoman and a policeman. These officers work
during the late night hours, coming on duty at 10 :00 in the evening
and working until 6 :00 in the morning. They are assigned to'The
central part of the city, to public parks and areas especially fre-
quented by young people. The experiment resulted from the fact
that almost invariably the contacts are with boys and girls and a
man and woman police team seemed better suited. The men officers
are not especially trained, but are carefully chosen and selected
because of skills which they have evidenced in handling youth. The
two teams with which we began the experiment last summer, at the
request of men executives, have been expanded to four, and we all
feel well satisfied with the results obtained.

The second duty of policewomen in protecting boys and girls is
to inspect places of commercial recreation, and particularly to con-
cern themselves with violations of laws which protect youth. Efficient
managers, who operate desirable places, should be commended and
supported; inexperienced ones who are making effort should be
given help ; wilful violators should be prosecuted objectively, but
with determination and intelligent use of every resource. In this
field also the policewoman must constantly endeavor to extend her
usefulness by educating managers to an understanding of the fact
that it is to their advantage to operate within the law. An operator
who conforms only when he thinks he may be observed has the
opportunity to do much harm before he is finally eliminated, but
a licensee who has learned that it is to his advantage to operate a
decent place, will do so at all times and much will have been gained.

The third thing for policewomen to concern themselves with is
prosecution of individuals who exploit women for immoral purposes.
The reports of FSA Division of Social Protection show encouraging
progress in suppression of commercial prostitution. Nevertheless,
policewomen know that they must be constantly alert to prevent
individuals who have found commercial prostitution a profitable
business from re-establishing themselves. The policewoman must
learn to recognize procurers and panderers. This is accomplished
by arranging for her to look at arrested persons in the police show-up,
the purpose being to make it possible for the policewoman to watch
these individuals if she sees them under suspicious circumstances.
In cities where all young girls contacted by policemen are turned
over to policewomen, information is frequently obtained which leads
to prosecution of individuals who have committed crimes against
them. The men who made the contact and the policewoman then
find it desirable to collaborate in the preparation of the criminal
case, because the policewoman will have won the confidence of the
girl and her cooperation in prosecution will depend on maintaining

542 JOUENAL OF SOCIAL, HYGIENE

this confidence. Gradually, policewomen become very skilful in the
preparation of these difficult cases and their help is eagerly sought.

With the suppression of commercial prostitution, the problems
growing out of pick-up contacts, where there is no money transaction,
have come to the front. Kecords of the Woman's Detention Quarters,
where all arrested women in Detroit are held, show that only about
one-half as many women were referred to the Department of Health
for examination in 1943 as in 1942. This is due to fewer commercial
prostitutes arrested. It is a known fact that many former prosti-
tutes are now employed in industry. With the lesser number of
cases, however, the incidence of infection has increased, indicating
that the younger girl, the clandestine type prostitute, is less
experienced in protecting herself.

Many different efforts are being made in different cities to control
this problem. My own feeling is that fairly good results are obtained
from the type of patrol service which I have described. A part of
this service, of course, must be constant prosecution of individuals.
t who contribute to the delinquency of, or are immoral with a girl
in the age group which is legally protected. When members of the
military services are involved in these practices, efforts to control
the situation must be cooperatively developed with the military
authorities and their police divisions. A knowledge of military rules
and regulations and the position of members of the armed forces
who violate civilian laws, as well as provisions for handling these
problems, is necessary for every police officer, man and woman.

I have discussed methods of contacting girls and prosecution of
individuals who commit crimes against them, but have said nothing
so far about the girls contacted. These girls come to our attention
either through identification by the police officers, as I have indi-
cated, or are brought to our attention by members of their families,
employers, friends, interested citizens, social workers, teachers or
sometimes the girl comes herself to ask for help. Our intake is
about 1,200 cases a month. I am going to use two cases to illustrate
how we work with these girls, because I think it will give a clearer
picture than I could give in any other way.

The first case came to our attention early this month, when two policewomen
were checking rooming houses in a cheap transient area. They observed a girl
who appeared young, going into one of the houses. The landlady of this house
was a person whom the policewomen were working with, but of whose coop-
eration they were not yet sure. They stopped and asked whether there were
any girls with whom the land-lady would like them to talk. The woman said
that there were no young girls in the house. When the policewomen asked
to speak to the girl who had just come in, they were assured that she and
her friend were 18 or 19 years of age. The woman was sure because she had
questioned them carefully since they had looked young. She said that both
girls were employed, but that only one was there because the other one had
gone home for the week-end. They had been there several days. The police-
women insisted on talking with the girl who proved to be 15 years of age.
She said that she did not know where her friend was, but was sure that she
was coming back. The first girl was taken into custody and the landlady, con-
siderably disturbed, agreed to telephone policewomen if the other girl came bacck.
She carried out her agreement and policewomen found a second 15 year old
girl and brought her to the office of the woman's bureau.

543

It was learned that the girls were runaways from a small town in Ohio,
and both were held in the Juvenile Detention Quarters. They told policewomen
that they ran away because one girl was unhappy in a home where there
was a stepmother and the other wished to escape continuing in school. They
arrived in Detroit with twenty-five cents between them, asked someone at the
bus station to direct them to a good, clean place to stay, and were directed
to one of Detroit's most expensive downtown hotels, which was a few blocks
from the bus station. They gave their twenty-five cents to the porter who
carried their bag into the hotel and registered in an $8.00 room. One girl
said she was so worried she was unable to sleep, but the other enjoyed a good
night's rest and then ordered breakfast sent to their room.

After breakfast, the girls went out and walked about for some time, trying
to make up their minds what to do. They finally approached a middle aged
man on the street. They told him their situation and asked his help. He gave
them the money to pay their hotel bill, went back to the hotel with them
and took them in his car to the rooming house where policewomen found them.
He sent one girl into the rooming house to inquire about rooms and then gave
them ten dollars to pay a week's rent and buy food. He took them out to
dinner once after this, inquired about their efforts to secure employment, but
made no advances. They told him they were eighteen years old. Physical
examination showed that neither girl had had any sexual experiences. The man
was later identified as a responsible business man. The girls easily got work
and were getting along so well that one of them went back to try to get
some of her clothes. She succeeded in doing this without contacting her family.
Both girls were released to their fathers who came for them. Because there
were no case treatment agencies in the small town in which the girls lived, a
policewoman, who is an experienced social worker, spent a great deal of time
with the girls and their fathers, and in as far as possible in the limited time,
a real effort was made to adjust the problems.

The hotel was warned, employers warned in regard to hiring without working
papers, the man who befriended the girls was made to see his mistake, and
we feel sure that another time he will bring a girl to the woman's bureau.
These girls were returned to their homes without serious harm having come
to them. The very capable one, who was the leader and who had wanted to
escape school, left Detroit determined to go to college so that she could become
a policewoman. Had not policewomen contacted them, however, they could
hardly long have escaped harmful experiences, and had there been no policewomen
there would have been no other agency to make such a contact.

The second case came to us recently at 3:00 o'clock one morning, when a
mother reported that her sixteen year old daughter, who, with a seventeen year
old girl friend, had gone out to a theater, had not returned home. These
girls were not as fortunate as were the girls in the previous case. Policemen
found them in the early morning hours in a downtown alley. They were very
intoxicated and could not be interviewed for several hours. Later, they told
policewomen of having loitered around a downtown bar. They were approached
by two men. The seventeen year old said she knew them, but this was not
true. The girls accepted the invitation of the men to go to have a drink, the
sixteen year old led on by the seventeen year old. Neither could tell where
they went because they took a taxi there. During the evening, they drank in
other places. Later, they drank in the men's rooms. The girls' recollection
of the evening was so vague that it was evident that they were early under
the influence of alcohol. They could not recall how they got to or left the
men's rooms, and could give no information which would help the police in
identifying either the men or the places to which they went.

The seventeen year old was known to policewomen and had previously been
referred by them to a case treatment agency. After consultation with the
agency worker, a complaint was filed in Wayward Minor Court. The sixteen
year old girl's parents reported no previous difficulty. Seemingly, this girl
was influenced by the friend whose acquaintance she had recently made. An
unfortunate result of the experience was that the sixteen year old developed
a venereal infection. The parents of this girl are intelligent and interested
and are making effort to deal wisely with a very disturbed and depressed

544 JOUEJSTAL OP SOCIAL HYGIENE

daughter. The policewoman is in touch with the family, and if it seems
necessary, later, the help of professional case workers will be requested.

Any of the 8,936 teen age girls contacted by policewomen last
year could equally well have been used to illustrate the work. Each
girl presents her own problems and wherever capable, well qualified
policewomen are doing good work, each girl is approached as an
individual and her problem worked out on a case work basis.
Venereal disease is considered as just one of these problems, the
treatment of which requires knowledge of additional resources.

Case work is short time interviewing, diagnosing of needs and
adjustment or referral of problem. Policewomen work both with
case treatment agencies and with group work agencies. It is required
of them that they have comprehensive knowledge of treatment facili-
ties. In-training programs are directed toward developing the finest
techniques in interviewing and a wide knowledge of resources.
Interviews must often be conducted under difficult and handicapping
conditions, with urgent need to establish early good rapport because
arrests and prosecutions are involved and such action cannot await
favorable interviewing conditions.

The conflicts and misunderstandings which occur between police-
women and case workers in some cities, are not necessarily due to
the fact that the policewomen in that city are not trained social
workers, but may well be due to the fact that their work takes
place on such different levels. A policewoman contacts a girl and
refers her for case treatment service.

She may see the girl stimulated by alcohol and sexual excitement.
The case treatment worker sees the girl under quite different cir-
cumstances. Where there is the mutual respect and understanding,
which grows out of frequent case conferences, the interpretation of
the policewoman is of help to the case worker, and the evaluation
of the case worker, after her longer contact, is accepted by the police-
woman. Where there is not this respect and understanding the
service is greatly handicapped.

Nineteen hundred and forty -three recorded a large increase of
juvenile delinquency. The Detroit woman's bureau figures for the
ten to seventeen year age group show a 62.6 percentage of increase
over 1942. It is encouraging, however, that the first three months
of 1944 do not show an increase over 1943.

The policewomen know that these youth problems are not new;
that they are deep rooted in our social structure. They also appre-
ciate that times of stress and dislocation increase these problems and
color them with their own complexion. They see, in today '& problems,
youth uprooted, sensitive to the tension of adults, blinded by the
offer of high wages, conscious that all of life's experiences may
need to be crowded into a few years. They are, therefore, under-
standing of and patient with conduct which is so often in conflict
with established procedures. They are close to the suffering, how-
ever, and for this reason they must regret that there was not greater
forethought so that some of the hurt and waste might have been
avoided.

CANADA'S FOUR SECTOR PROGRAM IN ACTION

LT.-COL. D. H. WILLIAMS, E.C.A.M.C.

Army Venereal Disease Control Officer, Department of National Defense; Chief,

Division of Venereal Disease Control, Department of National Health and

Welfare; Director, Division of Venereal Disease Control,

Provincial Board of Health, British Columbia; Advisor

to the British Government on Venereal Disease

Control for the Anglo-American

Caribbean Commission

With the creation, early in 1943, of a federal Division of Venereal
Disease Control within the Department of Pensions and National
Health,1 the need for a basic national plan became an urgent
consideration.

Since it was apparent that the success of a venereal disease control
program would depend largely upon strong community support, the
problem resolved itself to finding a cooperative plan of action for
the principal community influences. Thus was conceived the "four
sector Canadian front against venereal disease" which, it was envis-
aged, would unite with a singleness of purpose, the health, welfare,
legal and moral forces of the nation.

The function of each sector was — and is — of course, to take the
offensive with the weapons peculiar to its own particular method of
attack. In Canada's National Health and V.D. Control 2 this is
described briefly, as follows :

"Waging unrelenting war on the health sector, with the weapons of
modern medical science and public health procedure, will be the physicians,
nurses, health departments, university medical training centres and hos-
pitals. Leading the attack on the welfare sector will be social workers
and welfare agencies armed to battle squalor, overcrowding, inanition,
neglect and insecurity. Directing a vigorous, unrelenting, sustained action
on the legal sector are the courts, the legal profession and police agencies,
whose action seeks out and brings to justice those who, for personal gain
purvey to men's weaknesses. On the moral sector the battle is led by
the churches and homes of Canada, strengthening the moral fibre of our
nation and upholding the sanctity of marriage and family life. ' '

At the first national venereal disease control conference held at
Ottawa in December, 1943, the "four sector front" was adopted
officially by the representatives of the provincial and federal health
departments.

The federal Division of VD Control, it should be noted, does not
engage in local-level activities, but channels all services and materials
through the provincial departments of health. The provinces assume
complete responsibility for the development of VD control measures
in their respective jurisdictions.

iBeeently changed to "Department of National Health and Welfare."
2 From "Canadian Journal of Public Health," June, 1943.

545

546 JOURNAL, OF SOCIAL HYGIENE

How the "Four Sectors" Operate
Health Sector

The health sector has six chief objectives:

1. Wholesome, dignified health education concerning syphilis and
gonorrhea.

2. Adequate diagnostic and treatment facilities for all persons
suffering from venereal disease.

3. The suppression of quackery and charlatanry in the treatment
of venereal disease.

4. Early adequate prenatal care including blood tests for expectant
mothers to prevent the tragic infection of babies.

5. General health examination including blood tests for syphilis
before marriage.

6. Contact tracing.

During the past year and a half, particularly, the provincial
authorities have devoted considerable effort to developing this
"six-point strategy."

Education has received unprecedented attention. In many of the
larger centers in Canada, aggressive campaigns have been carried
on by Junior Boards of Trade in cooperation with provincial and
local health departments. As a result of these intensified programs,
most Canadian citizens are now aware of the gravity of the venereal
disease problem. Long-range, education-for-action programs will
capitalize fully this favorable public interest. (See frontispiece.)

Diagnostic and treatment facilities, through private physicians
and clinics, are being constantly improved and expanded. Profes-
sional education is making available to the busy doctor, in a variety
of time-conserving forms, news of current developments in the
medical and public health fields.

In addition to prenatal and premarital blood testing, which are
high-lighted in all VD education, more and more emphasis is being
placed on pre-employment and periodic blood tests as part of a
sound industrial hygiene program, and in order to uncover hidden
syphilis. Industrial workers in every part of Canada, are currently
viewing the film Fight Syphilis — the circulation of which has been
arranged by the Industrial Circuit of the National Film Board.
Reports indicate that the interest in this film is very high, and it
is reasonable to assume that it will help pave the way for a national
acceptance of blood testing as a necessary and normal routine
procedure.

Eecognition of the importance of contact tracing is evidenced by
the fact that the majority of the provincial health departments sent
selected members of their public health nursing staff to two special
three-months courses in epidemiology conducted by the Montreal
School of Social Work. The results have been nothing short of

CANADA'S FOUR SECTOR PROGRAM IN ACTION 547

dramatic in a number of instances. One of the greatest aids to
civilian case-finding has been the Armed Forces policy of reporting
to the provincial authorities all contacts to infected personnel.

Welfare Sector

One of the outstanding examples of the welfare sector in action
is the Council of Social Agencies of Greater Winnipeg. Among the
first voluntary agencies to mobilize its resources on a four-sector
basis, the Council organized a Social Protection Committee with
subcommittees comprising specially qualified consultants in each field.
The recommendations of the Committee were placed before the
appropriate authorities, and for the most part, were acted upon.

The welfare sector is linked so intimately with general socio-
economic problems that the actions of civic authorities, legislators,
and others who influence the welfare of our citizens will determine
much of the progress in this field. For this reason, every effort
is being bent to acquaint key citizens with the basic problems
associated with venereal disease in order that their plans will include
remedial measures.

Legal Sector

Of great significance to the Canadian VD control program, was
the following resolution, passed at the 1944 convention of the Chief
Constables' Association of Canada:

WHEREAS, It is recognized that venereal disease is Canada's greatest
public health problem, and is of such proportions that it seriously affects
the efficiency of the nation both in war and peace, . . .

WHEREAS, The police of Canada are primarily concerned with the law
enforcement aspects of venereal disease control.

THEREFORE, BE IT RESOLVED THAT the Thirty-ninth Annual Convention
of the Chief Constables' Association of Canada, . . . endorses the
present Canadian program against venereal disease.

BE IT FURTHER RESOLVED THAT since it has been proven that commer-
cialized prostitution is the greatest reservoir of venereal disease, this
Association urges that vigorous action be continued against prostitution
in all its aspects.

In most Canadian cities, the sincerity of this viewpoint has been
demonstrated through its practical application to specific problems.
Perhaps the clearest illustration of what determined police and court
action can accomplish in suppressing prostitution is the experience
of Quebec City. In the Fall of 1943 the number of infections being
acquired by army personnel in the Quebec City area was substantially
higher than the average army rate. Following a conference of
armed forces and civic officials, the Quebec City police and courts
adopted stern measures in handling the prostitution problem. Jail
sentences instead of fines became the order of the day. Within two
months the army rate in this area dropped by 50 per cent.

Increasing emphasis is being placed on the role of "facilitation"
in the spread of venereal disease. A recent Canadian Army survey
of sources of infection revealed the following :

-548 JOURNAL OF SOCIAL HYGIENE

(a) Places where pick-ups occurred:

Dance-halls 13 per cent

Restaurants 19 per cent

Streets 24 per cent

(b) Places where exposure occurred:

Hotels 22 per cent

Eooming houses 21 per cent

Homes 17 per cent

With information such as this, the army has made available to
the provincial health authorities a strong weapon with which to
take action against offending premises. Voluntary cooperation is
first sought. If this is not obtained, the threat of suspension or
cancellation of license usually suffices.

As these statistics point out, much of the sexual adventuring and
subsequent venereal infection among young people today is traceable
to casual meeting in irresponsibly-managed recreational, and other,
places. Intensive public education is, therefore, being carried out
to show the undesirability of these ''hot spots," and stress the need
for community action in providing not only wholesome, but
thoroughly enjoyable, substitutes.

Moral Sector

Canada is fortunate in having the active support of its Churches
in the fight against venereal disease. In addition to their roles as
spiritual counselors, they have given much strength to the other
three sectors by spontaneously urging the adoption of premarital
and prenatal blood tests, as well as community control measures,
for the protection of the family group.

The fullest cooperation of parents and schools is, of course, being
sought.

"Four Sector Front" a Practical Plan

The four sector front against venereal disease has been in opera-
tion in Canada for little more than eighteen months. But in that
time it has proved its soundness. Without exception, community
leaders, rallied under the four-sector banner, have responded
magnificently.

The principal stumbling blocks to community action were usually,
in the past, the well-meant assertions that "VD is strictly a health
problem" or "It can only be treated as a moral problem." With
the popularizing of the four-sector concept, few can fail to see that
there is a place for every citizen on the battle-front against VD.
Thus it becomes a truly cooperative undertaking, and as we know,
true cooperation seldom fails.

AN ANSWER TO A CHALLENGE
How A HAWAIIAN SCHOOL UNDERTOOK VD EDUCATION

JUNE JOHNSON

School Health Education Administrator, Board of Health,
Territory of Hawaii

"The new task which Principal Smith has just imposed upon the
English department is a challenge. Shall it go unanswered?"

This was the closing paragraph of an article entitled A Challenge
to English Teachers, in a recent issue of the JOURNAL OF SOCIAL
HYGIENE.1 As I read, in a search for information on work done
in mainland schools in venereal disease education, I hardly thought
that this article would be used later in the year in Hawaii as the
precedent and as the necessary encouragement needed for an English
department of a large rural high school to launch a VD program.

An educational program in venereal diseases this year was started
on the secondary level of Hawaii's schools through the cooperation
of the Board of Health, Territory of Hawaii, and the Department of
Public Instruction. As School Health Education Administrator, I
was assigned to formulate and carry out the program.

A thorough search was made of available VD educational material.
After a careful study of venereal disease education methods carried
out in most states, those in charge of the VD program in Hawaii
recommended that venereal disease work be presented as part of a
study of communicable diseases, and preferably by science or health
teachers. However, because the schools in Hawaii do not follow
a uniform curriculum, even though they are under a central depart-
ment, the insertion of venereal disease instruction had to be carried
out on an individual school basis.

* EDITOR'S NOTE: The Challenge to which this article refers pointed out ways
in which teachers of English literature have opportunity to guide youth, as
they learn, to better understanding of life generally, and of social hygiene
objectives, especially of marriage and family relations, and including health
as affected by the venereal diseases. Perhaps few English teachers, even with
the backing of the departments of health and public instruction, would find it
possible or desirable to undertake a project in venereal disease instruction such
as is described by Miss Johnson here, but the JOURNAL presents it, nevertheless,
as an outstanding example of constructive work, honestly and faithfully done
with the tools and materials at hand, and apparently with excellent results.
In social hygiene education, as in many other efforts today, when ideal condi-
tions and equipment are not available, honor to those who "make do," as
best they can, and get the job done.

i Steen, Alice M., A Challenge to English Teachers, JOURNAL OF SOCIAL
HYGIENE, 27:391 (Nov.), 1941.

549

550 JOUKNAli OF SOCIAL HYGIENE

In the course of approaching the individual high schools on the
island of Oahu, preparatory to introducing venereal disease instruc-
tion, a rural senior high school of 1,200 students, close to Honolulu,
was contacted. Meeting the suggestion that work in venereal dis-
eases be directed toward the maximum number of students in the
most effective way possible, the principal and the school health
worker named their English department as the one best qualified
to obtain optimum results.

After careful consideration, having in mind the precedent men-
tioned above, it was decided that perhaps this approach was not
too impossible or incongruous. It was realized that the search for
and preparation of materials suitable for presentation in an English
class would take much time and thought. It was also realized that
the teachers would need help in securing the necessary background
of knowledge concerning VD. But these difficulties did not seem
insurmountable once the initial decision was made.

Shortly afterwards the Venereal Disease Control Officer, Board
of Health, Territory of Hawaii, spoke to the school faculty, outlining
the seriousness of the venereal disease problem and pointing out the
importance of putting the program into the school. A period of
time was then allowed for reflection on this presentation, while
materials were accumulated for the teachers. When this phase
ended, a meeting was arranged with the English teachers to discuss
the possible approaches, the available teacher and student materials,
and some teaching pitfalls to be avoided. A spirited discussion fol-
lowed in which the attitude of the teachers was revealed as being
frankly dubious and hesitant. The outlook seemed none too
encouraging.

From November to January, the teachers were provided with
plenty of materials for their reading and study and left to their
own devices. At their luncheon meetings and rest-room periods, the
teachers held informal discussions to help them clarify their think-
ing. Ideas began to crystallize and each teacher decided how she
would handle the topic. The school health worker then arranged
for showing of the films, Health Is a Victory and With These
Weapons, as a means of introducing VD education into the English
classes.

Various ways were used by the teachers in the classroom to
develop the work. Some drew upon the historical and literary refer-
ences provided them; others used the mental hygiene and communi-
cable disease relationship; and still others taught it as a health
project. Procedures used to carry out the instruction were lectures,
outlines, readings, discussions, and themes.

When notification came that the project was completed, a meeting
was arranged with the English teachers to hear the outcome. In
view of the initial meeting, I attended this second one with trepida-
tion and consequently was entirely unprepared for their not only
enthusiastic but even effusive response.

AN ANSWER TO A CHALLENGE 551

In the lively discussion which occurred teacher reactions were
given. As the project seemed such a success, it was felt that an
analysis of the teachers' techniques would be worth while. Accord-
ingly, written responses were sought from individual teachers. Stu-
dent opinion was also sampled by oral questioning of casually
selected students, and later by informal unsigned replies from
various classes representing different grade and intelligence levels.

There was only one negative response from the teacher group.
This person was definitely opposed to the work from the beginning
and retained the same attitude throughout.

Excerpts from teacher and student responses:

Presentation of the Material by the Teachers

— "The biggest stumbling block was the approach to the presentation, and
I finally decided that a general course on communicable diseases, with emphasis
on syphilis and gonorrhea, would be the least embarrassing to both myself
and my students."

— ' ' Two lectures on syphilis and gonorrhea were given by the teacher. Eeading
by the class of pamphlets and other materials, was followed by class discussion.
Movies and test completed the work."

— "I used the historical and literary backgrounds, beginning with Columbus
and Henry VIII. Since my class was studying English literature, that approach
seemed most appropriate to me."

— "Approach was made by a preliminary consideration of institutions and
crime conditions and how the disease can play a part as a causative factor.
Comparisons from a mental hygiene angle."

— "We frankly stated why we were presenting facts on VD."

Teaching Techniques That Seemed Worth While

— "I feel that a great responsibility rests on the teacher. She must know
her subject well and give information to the class to supplement their reading."

— "I. An historical outline (with results). II. A paper written by each
student. ' '

— "Lectures, informal, combined with actual life situations. Research reading.
Outline made of the phase of particular interest to each individual. Paper
written and then follow-up with movies. Very satisfactory."

Students' Attitudes
(Given by teachers)

— ". . . I was amazed at the seriousness with which they view the whole
matter. In many cases the boys who were the most troublesome in their general
daily class attitude proved to be the most interested in the subject. Out of
112 students there wasn't one who leered, snickered, or expressed any emotion
other than a serious interest and a desire to learn."

— "Very interested, cooperative and unembarrassed."

— "It was excellent. They were thoughtful, J;hankful and sincere."

— "Inspiring. Easy to carry on the campaign here because we were honest
with our senior high school pupils and they loved the project."

552 JOURNAL OF SOCIAL HYGIENE

Significant Results Observed by Teachers

— "As a general result of this project, I find that there is an increased
interest in and feeling of responsibility about general community affairs. There
is also an increased interest in new medical discoveries and a surprising amount
of interest in military and naval methods of combating tropical diseases."

— "Lack of embarrassment in discussion of VD problems. I feel strongly
there should be follow-up material in ethics, morals, and standards."

— "An aroused interest in VD as a community problem, as well as a personal
one, resulted. ' '

Opinions Regarding the Experiment

— "I would like to say in closing that I ended up by enjoying a project
that I had dreaded and that my own fund of knowledge, both medical and
education, is vastly increased."

— ' ' I think it was exceedingly worth while. ' '

— "Pupils are anxious to gain the confidence of their elders and to gain
knowledge. The attitude of the junior and senior level in the high school
was outstandingly intelligent."

— "I think it is a big step in a modern approach of a formerly hush-hush
subject. ' '

— "It is my opinion that this subject, if it is to be taught in the schools
effectively, should be handled by a specialist, talking to groups segregated as
to sexes, where more freedom will prevail. What educational justification is
there for interrupting an English program in this way just because the federal
government has some extra dollars? Is it education, or just blundering?"

Students' Reactions
(Given by themselves)

These student reactions were gleaned from unsigned, impromptu
papers written at the close of the project. It is interesting to note
that not one negative paper came in from the many student papers
examined.

— "I believe that education is the best process in wiping out this type of
contagious diseases. ' '

— "I think this subject syphilis was one of the most important subjects I
ever learned. It taught me many things that I didn't know in the past. I think
every high school should teach about syphilis. In my opinion, teaching when
they are young is one of the most important steps in preventing syphilis. ' '

— "I think health is just as important as English, history or any other
subject and there should be more lessons of health in our high schools. ' '

— "If students are taught in school about venereal diseases, it would be
better than having the young minds absorbing the things they hear from older
persons who haven't been educated."

— "I don't think it's necessary to separate the boys and girls when this
topic is being discussed because it concerns all of us."

— "I suggest that all high school students have a knowledge of venereal
diseases. They will pass it on to their elders and to their future children, so
thousands will be protected from venereal diseases."

AN ANSWEK TO A CHALLENGE 553

— "The study of venereal diseases should be nationwide and a subject in
the high schools of our country."

— "Students who have parents unable to understand English may easily
translate this and tell it to them."

— "The school did not waste time by using a whole week for the study of
these diseases as knowledge of these facts will help in building better men
and women."

In conclusion, I would say that the principal's faith in the effec-
tiveness of his English department was justified. This trial showed
us that work such as the inclusion of venereal disease material,
which might be considered as extraneous to the English curriculum,
could be taught effectively there. It was gratifying in that it was
successful and bore out the contention of those of us who are working
with the VD program here that the success or failure of school work
in venereal disease education rests largely upon the school staff.
From this trial project, we received many excellent suggestions which
will aid us materially in the developing and strengthening of the
school venereal disease educational program in Hawaii for the
coming year.*

* Among the materials developed as teaching aids are three effective
publications :

VD Manual for Teachers. A mimeographed 90 page handbook, prepared by
Miss Johnson, Samuel D. Allison, M.D., Venereal Disease Control Officer
of the Board of Health; W. Tate Eobinson, Director, Health Education,
Department of Public Instruction, and Elmer J. Anderson, Acting Director,
Public Health Education of the Board of Health. Contents include
I. The VD Program, a general discussion. 17. VD Information, with
references. HI. Teaching Aids, with a suggested outline, and detailed
information regarding films, lantern slides, posters, transcriptions, radio
talks, etc., and where to get them.

The Story of VD. A 28 page pamphlet prepared by the same group for
intermediate school pupils (but equally useful for other groups), showing
by illustrations and brief, simple text that syphilis and gonorrhea are
communicable diseases and how the average person may join in stamping
them out.

VD Information for High School Students. A 32-page pamphlet prepared by«
the same group for use in the senior liigh school. It presents in an illustrated
text the information needed by a student for a well-rounded understanding
of the diseases, syphilis and gonorrhea, and the VD problem.

For further information about these or other materials address Division of
Health Education, Department of Public Instruction, P. O. Box 2360,
Honolulu 4, Territory of Hawaii.

ROBERT P. FISCHELIS

Chairman, Joint Committee of the American Pharmaceutical Association
and the American Social Hygiene Association

Stimulated by the activities of the Joint Committee of the American
Pharmaceutical Association and the American Social Hygiene Asso-
ciation, pharmacists have continued to play a key role in 1944 in
the wartime educational campaign against the venereal diseases.

The importance of the Joint Committee's program to the nation's
wartime and all-time fight against these infections arises primarily
from the fact that pharmacists, practicing their profession in this
country's 50,000 or more drug stores, are in daily contact with
millions of people, a considerable percentage of whom look on the
pharmacist as a friend and counselor in matters of health. It has
been estimated that a considerable proportion of the persons eventu-
ally going to a physician for treatment for syphilis or gonorrhea
first mention their ailment to pharmacists. It is clearly important
that pharmacists should be willing and able to give correct informa-
tion and refer such inquiries to the proper sources of accurate
diagnosis and treatment.

The Joint Committee has now been in existence for some four
and one-half years, t By enlisting the interest and active support
of a constantly increasing number of pharmacists, the Committee
has been able to set national, state and local programs in motion,
and to make substantial progress toward the goals it has set for itself.

A summary of the activities of the Committee since our last annual
report follows:

1. Pharmacists all over the country participated in Social Hygiene
Day programs during the month of February, 1944, by arranging
window displays, distributing literature, speaking on radio forums
and serving on community Social Hygiene Day Committees. In prepa-
ration for this event, complete kits of materials, bulletins and letters
were sent to all secretaries of state pharmaceutical associations, sec-
retaries of state boards of pharmacy, deans of pharmacy colleges,
and editors of pharmaceutical journals. Approximately fifteen state
pharmaceutical journals ran special articles on the social hygiene
programs.

* A report before the House of Delegates, American Pharmaceutical Association,
at the Annual Meeting, Cleveland, Ohio, September 7, 1944.

tin addition to the Chairman, members are: Dr. Walter Clarke, Secretary;
Theodore Campbell, Jr., A. G. DuMez, Adolph Jacoby, E. F. Kelly (deceased),
Charles Kurtzhalz and Dr. Joseph E. Eaycroft.

554

WARTIME CAMPAIGN AGAINST VD 555

Connecticut pharmacists continued the outstanding work started
in Bridgeport over a year ago under the leadership of Mr. Louis
Kazin, who heads the public health activities of the Connecticut
Pharmaceutical Association. The Connecticut Association voted to
extend the Bridgeport program to the entire State and, working
closely with the ASHA, the Connecticut State Health Department
and the Connecticut State War Council, made considerable progress
during the past year.

The New York State Pharmaceutical Association distributed to
pharmacies 400 sets of window displays and 20,000 copies of the
leaflet A Tip from Your Pharmacist. The State Tuberculosis and
Health Association bought the window displays from the ASHA
and sent them to their local societies, who in turn contacted
pharmacists and arranged for these displays to be shown in their
windows.

An outstanding contribution was made in New Jersey where the
State Health Department and the State Pharmaceutical Association,
in cooperation, provided each of the State's 1,800 drug stores with
a counter display card produced by the American Social Hygiene
Association, plus fifty copies of A Tip from Your Pharmacist, and
arranged several broadcasts of a radio forum, under the title "With
These Weapons We Can Win," in which pharmacists took part.

One hundred sets of pharmacy window displays were distributed
by the Philadelphia Department of Health to pharmacists in the city.

The Executive Secretary of the Ohio State Pharmaceutical Asso-
ciation reported that his office distributed 1,100 copies of Target for
Today, a circular high-lighting the objectives of Social Hygiene Day.

In Cleveland, Ohio, fifty druggists in Greater Cleveland requested
posters and pamphlets published by the U. S. Public Health Service
and the ASHA, which were made available through the Venereal
Disease Control Officer, Dr. Roy L. Kile. Some of the larger chain
drug stores agreed to display five-foot exhibits prepared by the
Cleveland Health Museum.

Dr. L. Burkett, acting Executive Health Officer of Flint, Michigan,
ordered 1,000 imprinted copies of A Tip from Your Pharmacist
and 100 pharmacy counter cards which he made available to the
pharmacists in his city.

2. More than half a million copies of A Tip from Your Pharmacist
have been distributed by pharmacists to date, and the demands for
additional copies keep mounting, thanks to the unflagging interest of
the secretaries of state pharmaceutical associations, local health
authorities, individual pharmacists and the public at large.

3. News releases and special stories have been prepared for pub-
lication in state, regional and national pharmaceutical journals. The
ASHA's Annual Report, which included an account of pharmacy's
contribution to the campaign against venereal diseases, was sent with

556 JOURNAL OF SOCIAL HYGIENE

a special letter and news release to state pharmaceutical association
officials, journal editors, pharmacy board secretaries, and deans of
pharmacy schools.

4. Field representatives and officers of the ASHA, augmenting
the efforts of affiliated societies and national headquarters, have
established contact with many state and local pharmaceutical groups
to enlist their support in community social hygiene programs. In
many cases, they have stimulated state and local health officers to
supply educational materials for distribution by pharmacists.
Arrangements were made by the Joint Committee for field representa-
tives to speak at several annual meetings of state pharmaceutical
associations. Dr. Walter Clarke, Executive Director of the ASHA,
gave a talk under the auspices of the Northern New Jersey Pharma-
ceutical Association, at the Kutgers University School of Pharmacy.
Dr. Clarke also spoke at a meeting of the New York Branch of
the American Pharmaceutical Association held at the Fordham
University School of Pharmacy.

5. Dr. Ivor Griffith, President of the American Pharmaceutical
Association, gave an address Pharmacy Mobilized Against VD as one
of three speakers participating in a forum entitled, New Contributions
of Powerful Allies to Social Hygiene, presented by the American
Social Hygiene Association at the National Conference of Social
Work in Cleveland, Ohio, on May 25, 1944. This program, presented
by the Association as an associate group of the Conference, was
sponsored by over thirty national and local health and welfare organi-
zations, and Dr. Griffith 's contribution to the program was considered
an unusually effective presentation of the part that pharmacists can
play in this important field of public health activity.

FUTURE PROGRESS

The activities of the Joint Committee of the American Pharma-
ceutical Association and the American Social Hygiene Association
carried on thus far indicate that the greatest results will be gained
in the future by developing the program along the following lines:

1. Production of new educational materials — leaflet and window display —
to be distributed through cooperation of health departments and
pharmaceutical organizations.

2. Steps to improve and extend the teaching of public health methods
and communicable disease control in schools of pharmacy.

3. Special efforts to stimulate participation of pharmacists in all phases
of Social Hygiene Day activities.

4. Preparation of news releases, graphic material and feature stories
for pharmaceutical publications.

The Joint Committee believes that inclusion of representatives of
pharmacy on Social Hygiene Society boards and committees, and
on official state and local boards of health, health councils, etc.,
would greatly aid in the steady and permanent development of
this work.

EDITOEIAL
TOWARDS V-DAY IN THE WAR ON VENEREAL DISEASES

This year's observance of Social Hygiene Day — February 7,
1945 — takes place at a time when conditions are more favorable than
ever before for rapid advance on that sector of the social hygiene
front which has as its objective the eradication of the venereal dis-
eases— syphilis and gonorrhea — as a public health problem. Public
interest is high, important achievements have been made in the
methods of treating these infections, medical and public health facili-
ties have been increased.

Much of this progress has been made because of the urgent wartime
need to protect the armed forces, industrial workers and youth in
general from the damaging effects of syphilis and gonorrhea. There
now exist the continued need and the possibility not only to maintain
gains already made, but to extend them through to victory and into
the postwar world. Social Hygiene Day will provide an unequalled
opportunity to intensify both current activities and long range
planning upon which the success of your community's social hygiene
program depends.

A fundamental consideration in all such activities and planning is
that, in the final analysis, it is promiscuity which spreads the venereal
diseases. Serious efforts must be made to combat promiscuity. An
effective campaign to eradicate the venereal diseases and promote a
constructive social hygiene program should include all sectors of the
front : medical and public health, law enforcement, welfare and edu-
cational activities, character building, moral, social and religious
influences.

It was with this in mind that the Association, in issuing the call for
observance of Social Hygiene Day this year, put particular stress on
the need to mobilize, in support of community social hygiene pro-
grams, the widest possible representation of all responsible community
forces. Only in this way can the over-all program, which the situation
demands, be implemented.

Elsewhere in this number of the JOURNAL * the Social Hygiene Day
Service outlines various types of programs which will help in this
mobilization. The following notes may also be of help :

As an effective means of rallying wide interest in and support for
your community's social hygiene program, it is suggested that a

» Pp. 571-2.

557

558 JOURNAL OF SOCIAL HYGIENE

town meeting be held. In the planning and carrying out of this
meeting, bring together leaders in the fields of health, welfare, law
enforcement, education and character building. Include other inter-
ested persons such as labor leaders, business men and pharmacists.

The effectiveness of such a town meeting — to which the general
public is invited — can be increased by making it the focal point for
newspaper stories before, during and after the actual day of the
meeting, by publicizing it through spot announcements on the air,
displaying posters in the town, by making it an occasion for dis-
tributing informative leaflets and the showing of films.

In addition to a town meeting it may be possible for you to help
arrange and take part in an all day regional social hygiene
conference.

The churches have always played an important role in preserving
home and family life. Ask the clergymen of your community to
consider delivering a sermon on either Sunday, February 4th, or
Sunday, February llth, on the subject of social hygiene. Offer to
supply background material for their use in preparing an address.

Another means of observing National Social Hygiene Day is to
arrange for speakers at February meetings of clubs and other
organizations in your community.

Particularly during the past year, the Association's experience
indicates that industry — both labor and management — is vitally
interested in many cases in the social hygiene program, and willing
to cooperate. Industrial groups offer a splendid opportunity for
health education; furthermore, they constitute a tremendous poten-
tial source of support for the whole program.

Pharmacists are in a strategic position to bring reliable information
to literally millions of interested persons. We suggest that you, in
cooperation with your health department, contact individual phar-
macists, local and/or state pharmacy organizations and arrange for
distribution of display and leaflet material. You will find pharmacists
receptive to this project.

A large section of the public can be reached during the period of
Social Hygiene Day by arranging radio broadcasts featuring promi-
nent persons in your town.

The Social Hygiene Day Kit of Program and Publicity Aids, avail-
able without charge to groups planning meetings, is intended to
provide you with materials with which you can provide to both
the general public and community leaders, information upon which
they can take action.

In addition to aids for carrying out these program suggestions,
the kit contains many other new publications. Look these over. Make
use of them. Write to us for whatever quantities you need to increase
the effectiveness of your observance of National Social Hygiene Day.*

* Many publications are free of charge. For prices on others, consult A8HA
Pub. A-574, Your Guide to Social Hygiene Day Materials.

EDITORIAL

559

These are suggestions for community action and public information.
These and other activities undertaken by you will do much to
strengthen the year round social hygiene program, and will do much
to bring us nearer to the day when VD will be stamped out.

This year provides a really great opportunity to move forward in
the field of social hygiene. Let's make it register another strong
advance towards

V-DAY OVER VD

AMERICAN SOCIAL HYGIENE ASSOCIATION ANNUAL

MEETING

To the Association's Members:

The Thirty-second Annual Meeting of the American Social
Hygiene Association will be held in Chicago, Illinois, on
February 7, 1945.

Sessions will be held as follows:

Business Sessions

8:30 a.m. Breakfast meeting. Committees and Board of Directors report
on the year's work and Officers are elected for the ensuing
year.
11:00 a.m. Annual Business meeting (the public is invited).

General Sessions

(arranged jointly with the Illinois Social Hygiene League and the Chicago
and Regional Committee on Social Hygiene Day)

12:15 p.m. Luncheon session.
2:30 p.m. Afternoon session.
8:00 p.m. Evening session.

Details of the program, including the accounts of the Commit-
tee on Awards presentation of the William Freeman Snow Medal
for Distinguished Service to Humanity and Honorary Life
Memberships, will appear in the March issues of the JOURNAL
OF SOCIAL HYGIENE and the SOCIAL HYGIENE NEWS.

This call for the Annual Meeting is published with a special
request, this year, for submission of advance comments, recom-
mendations and resolutions from Association members and
friends. The difficulties of travel, and the local responsibilities
of our members during war make it important for the Standing
Committees to seek contact by correspondence with members
who cannot be in Chicago on February 7.

BAILEY B. BUBRITT
Secretary of the Association
1790 Broadway, New York 19, N. Y.

NATIONAL EVENTS

EEBA EAYBUEN
Washington Liaison Office, American Social Hygiene Association

National Conference on Postwar VD Control Meets in St. Louis. —

Nearly a thousand health officers, physicians, nurses and other pro-
fessional workers filled the auditorium and other meeting rooms of
the St. Louis Medical Society, where the various sessions of the
USPHS-sponsored National Conference on Postwar VD Control met
November 9, 10 and 11. Enthusiasm marked the reception of the
addresses by leading experts from this and several other countries,
and the discussions in section meetings which reported to the entire
group at the end of the sessions.

The Conference Proceedings will be published by the USPHS as
a supplement to Venereal Disease Information, with some of the
papers also appearing elsewhere.* The program of the Conference
was as follows:

Thursday, November 9

Registration — 9:00 A.M.
Morning Session— 10:00 A.M. to 12:30 P.M.
Chairman — SURGEON GENERAL THOMAS PARRAN

Messages — DR. C. H. NEILSON, representing State Health Officer of Missouri
DR. J. F. BREBECK, City Health Officer of St. Louis
HONORABLE PAUL v. McNUTT, Federal Security Administrator (read

by Dr. Parran)
Address of Welcome and General Purpose of Conference — SURGEON GENERAL

PARRAN
Problems in Venereal Disease Control of Tomorrow — MEDICAL DIRECTOR J. E.

HELLER, JR.
Army Contributions to Postwar Venereal Disease Control Planning — LT.-COLONEL

THOMAS H. STERNBERG (MC)
Venereal Disease Control in the Navy — COMMANDER W. H. SCHWARTZ (MC)

Afternoon Session — 2:00 P.M. to 4:30 P.M.

Penicillin in Early Syphilis — DR. J. E. MOORE

Penicillin in Late Syphilis — DR. JOHN H. STOKES

Penicillin Therapy in Venereal Disease Control — MEDICAL DIRECTOR J. F.

MAHONEY

Discussion — DR. PAUL A. O'LEARY
Venereal Disease Control in the European Theatre of Operations:

Treatment — COLONEL DONALD M. PILLSBURY (MC)

Prevention — LT.-COLONEL PAUL PADGET (MC)

Evening Session — 8:00 P.M. to 10:00 P.M.

Symposium: International Control of Venereal Diseases
Statement by DR. PARRAN
England — DR. MELVILLE MACKENZIE
Canada — LT.-COLONEL DONALD H. WILLIAMS
France — MAJOR BERTRAM G6u
Mexico — DR. JAIME VILARDE
Norway — DR. T. GUTHE
Puerto Rico — MEDICAL DIRECTOR E. A. VONDERLEHR

* See pages 517-29 for a paper by Dr. Eichard A. Koch and Dr. Eay Lyman
Wilbur.

560

NATIONAL EVENTS 561

Friday, November 10

Morning Session — 10:00 A.M. to 12:30 P.M.

Rapid Treatment — MEDICAL DIRECTOR (E) UDO J. WILE

Epidemiology — DR. J. F. BREDECK; Discussion — MAJOR E. M. HOLMES, JR.

Biologic False Positives — DR. HANS NEURATH; Discussion — SURGEON E. C.

ARNOLD
Promiscuity as a Factor in the Spread of Venereal Disease — DR. EICHARD A.

KOCH; Discussion — FATHER ALPHONSE SCHWITALLA, S.J.
Social Protection — MARK MCCLOSKEY; Discussion — SURGEON EUGENE A. GILLIS

Afternoon Session— 2:00 P.M. to 4:30 P.M.

Section Meetings:

1. Diagnostic and Therapeutic Procedures in Gonorrhea

Chairman — DR. EOGERS DEAKIN. Secretary — SR. SURG. C. J. VAN
SLYKE

2. Diagnostic and Therapeutic Procedures in Syphilis

Chairman — DR. A. W. NEILSON. Secretary — P. A. SURG. (E) HOWARD
P. STEIGER

3. Epidemiology

Chairman — DR. N. A. NELSON. Secretary — LT.-COLONEL EGBERT A.
DYAR (MC)

4. Education and Community Action

Chairman — DR. WILLIAM F. SNOW. Secretary — DR. H. H. HAZEN

Saturday, November 11

Morning Session — 10:00 A.M. to 12:30 P.M.

Report of Chairman for Section on Diagnostic and Therapeutic Procedures in

Gonorrhea — DR. EOGERS DEAKIN
Report of Chairman for Section on Diagnostic and Therapeutic Procedures in

Syphilis — DR. A. W. NEILSON

Afternoon Session — 2:00 P.M. to 4:30 P.M.

Report of Chairman for Section on Epidemiology — DR. N. A. NELSON
Report of Chairman for Section on Education and Community Action — DR.
WM. F. SNOW

ASHA — Missouri Social Hygiene Association Dinner Meeting. —

Voluntary agency representatives who were in St. Louis for the
National Conference on Postwar VD Control were guests on Novem-
ber 8 at a joint dinner meeting of the boards of directors of the
American Social Hygiene Association and the Missouri Social Hygiene
Association. Dr. Richard S. Weiss, president of the Missouri organi-
zation, presided, and informal talks and discussion followed a pleasant
social hour and an excellent meal. Guests included:

Officers, Members of the Board of Directors and Staff of the Missouri Social
Hygiene Association: Mrs. Fred Armstrong, Mrs. Ira L. Bretzf elder, Mrs.
J. Hart Brown, E. Forder Buckley, Judge John W. Calhoun, Dr. Adolph H.
Conrad, Dr. Harriet S. Cory, Dr. F. W. Ewerhardt, Mrs. Ottilie Gildehaus,
Mr. Emmett Grumer, Dr. L. J. Hanchett, Adolf H. Hanser, Gilbert Harris,
M. A. Hellman, Mrs. Alexander S. Langsdorf , Mrs. Thyrza E. Mack, Mrs. Helen
Messick, Walker Pierce, Mrs. Euth Eoach, William Sentner and Mrs. Sentner,
Mrs. Boyd Speer, Mrs. Arthur Stockstrom and Dr. Paul J. Zentay.

Representatives of State and Local Social Hygiene Societies: Dr. H. W. N.
Bennett, Manchester, New Hampshire, Social Hygiene Committee; Mrs. Charles
D. Center, Georgia Social Hygiene Council, Atlanta; Mrs. Elva H. Evans, Family
Health Association, Cleveland, Ohio; Dr. E. G. Frary, Lincoln-Lancaster County
Social Hygiene Association, Omaha, Nebraska; Mrs. F. H. Eeam, Kansas City
Social Hygiene Society ; Dr. Bertha F. Shaf er, Illinois Social Hygiene League ;
Dr. Henry H. Hazen, Social Hygiene Society of the District of Columbia, and

562 JOURNAL, OF SOCIAL HYGIENE

Mrs. Hazen; Medical Director R. A. Vonderlehr, Puerto Rico Committee on
(Social Protection.

Representatives of Neighbor Countries: Lt. Colonel Donald H. Williams,
Chief, Venereal Disease Control, Canadian Army; Dr. Joseph S. Spoto, Traveling
Representative, Pan American Sanitary Bureau; Dr. Jaime Vilarde, National
Department of Health, Republic of Mexico, and representing the National
Anti-Venereological Society of Mexico.

Officers, Board Members and Staff Members of the American Social Hygiene
Association: Bailey Burritt, Blake Cabot, Dr. Walter Clarke, John Hall, Bascom
Johnson, Charles F. Marden, Charles E. Miner, Surgeon General Thomas Parran,
Jean B. Pinney, Wade T. Searles, Eleanor Shenehon, Dr. William F. Snow,
Rev. Alphonse Schwitalla, S.J.

War Department Advisory Council Meets in Washington. — The
third anniversary of the formation of the Advisory Council to the
Women's Interests Section, War Department Bureau of Public Rela-
tions, was observed by a two-day meeting of the Council at The
Pentagon, Washington, D. C., on October 6-7, 1944.

Called together by Major General Alexander D. S'urles, Director,
Bureau of Public Relations, thirty-six representatives of thirty-two
national organizations met in the Secretary of War's Conference
Room to hear a distinguished roster of speakers present some of the
problems facing the Army and the women of the country and to
formulate plans for participation in a program of disseminating
information vital to understanding of military requirements and
home-front cooperation during the months ahead.

The tremendous value of work done in the past and the vital impor-
tance of continued cooperation of organizations of the Advisory
Council was recognized by the presence of the Honorable Henry L.
Stimson, Secretary of War, who took time from his busy schedule
to open the conference. Pointing to the complexity of problems
which will arise from the defeat of Germany and the transfer of
military emphasis to the Eastern theaters, the Secretary urged these
organizations to continue their splendid programs of cooperation
with the War Department and the Army.

Miss Margaret S. Banister, Chief, Women's Interests Section, presided at
the afternoon session on October 6, when speakers included Major General
William F. Tompkins, Director, Special Planning Division, War Department
Special Staff; Brigadier General Hugh J. Morgan, Director, Medical Consultants
Division, Office of the Surgeon General; Colonel George R. Evans, Chief, Classifi-
cation and Replacement Branch, Adjutant General's Office; Lieutenant Colonel
Walter E. Barton, Assistant Director, Reconditioning Consultants Division, Office
of the Surgeon General; and Lieutenant Colonel Timothy A. Melnerny, Speakers
Branch, Bureau of Public Relations. These speakers discussed the progress
of the war with Germany and Japan; the Army's plans for gradual and partial
demobilization at the close of hostilities with Germany; the separation process
which, through counselling and vocational classification, will aid the soldier
in readjusting to civilian life ; and the operation of the Army 's program to
meet the needs of ill and wounded soldiers.

At the dinner session held in the General Officers' Dining Room at The
Pentagon, the Advisory Council was joined by officers attached to the Bureau
of Public Relations. They were: General Surles; Colonel Falkner Heard,
Deputy Director; Colonel J. Noel Macy, Chief of the WAG Group; Colonel
Horace B. Smith, Assistant to the Director for Army Ground Forces; Lieutenant

NATIONAL EVENTS 563

Colonel Arson D. Clark, Acting Assistant to the Director for Army Service
Forces; Lieutenant Colonel Harold B. Rorke, Acting Assistant to the Director
for Army Air Forces; Lieutenant Colonel Douglas Parmentier, Chief of the
News Division, and Lieutenant Colonel Stewart T. Beach, Chief of the Publi-
cations Branch. Also present were: Mesdames Surles, Osborn, Smith, Clark,
Eorke and Beach.

Following dinner Colonel William C. Chanler, Acting Director, Civil Affairs
Division, War Department Special Staff, discussed functions of the Civil Affairs
Administration and Allied Military Government; and Major General Frederick
H. Osborn, Director, Information and Education Division, Army Service Forces,
described the present work of his division and the projected educational, voca-
tional, and recreational program to be initiated during the period of partial
demobilization. The evening's program concluded with the showing of The
Hidden Army, a War Department film depicting the contribution of women
industrial workers to winning the war, and other special War Department films.

The Saturday morning program included addresses by Lieutenant Colonel
Jessie Pearl Eice, Executive, Women's Army Corps, on the integration of WAC
with the Army, and Lieutenant Colonel Stewart T. Beach, Chief, Publications
Branch, Bureau of Public Eelations, who discussed the importance of safe-
guarding military information and the assistance given the Women's Interests
Section by the Advisory Council.

Plans for the year's work suggested by Miss Banister and commended by
the Council's business meeting included:

1. Eegional meetings, to which would be invited state presidents, district presi-
dents or representatives, to be held in the nine Army Service Commands;*

2. Emphasis by all Advisory Council organizations on one Army subject each
month, the subject to be selected by the Women's Interests Section and
materials prepared and forwarded to names on the mailing list; and

3. Expansion of the Women's Interests Section mailing list to include state
editors of organization publications, and state program and radio chairmen.

Following the business meeting, the group went by bus to Gravelly Point and
by motor launch to Boiling Field. Inspection of hospital facilities, typical
of the best provided by the Army, preceded luncheon served in the Officers'
Mess. At the field proper the party saw various training, fighter, and bomber
planes assembled on the main air strip. Later the group proceeded to the new
Air Transport Command terminal at Gravelly Point where a tour of the main
terminal building had been arranged. Colonel Frank H. Collins, Commanding
Officer, Washington National Airport Army Air Base, explained the process
followed by plane passengers in completing their entry into this country.

Organizations and delegates registered for the meeting were: American
Association of University Women — Dr. Kathryn McHale, General Director,
Washington, D. C. ; American Federation of Women's Auxiliaries of Labor —
Mrs. Herman H. Lowe, President, Nashville, Tennessee; American Legion
Auxiliary — Mrs. Charles B. Gilbert, President, Indianapolis, Indiana; American
Eed Cross — Mrs. Hendrick Eustis, Assistant Director, Volunteer Special Services,
Washington, D. C. ; American Social Hygiene Association — Miss Jean B. Pinney,
Associate Director, Washington, D. C. ; American Women's Voluntary Services —
Mrs. Dorothea Lynch, Washington, D. C. ; Army Eelief Society — Mrs. Arthur
W. Page, President, New York, New York; Associated Women of the American
Farm Bureau Federation — Mrs. Charles W. Sewell, Administrative Director,
Chicago, Illinois; Association of Junior Leagues of America — Mrs. Eobert W.
Wilson, Washington, D. C. ; Women's Supreme Council of B'nai B'rith — Mrs.
Maurice Bisgyer, National Secretary, Washington, D. C. ; Congress of Women's
Auxiliaries of the CIO — Mrs. Faye Stephenson, President, Cleveland, Ohio;
Daughters of Union Veterans of the Civil War — Miss Grace Hurd, National

* Three such meetings were held during December at Columbus, Ohio, Chicago
and Minneapolis, and similar conferences will be held in fifteen other cities
before the middle of March, 1945. Social hygiene representatives are invited.

564 JOURNAL OF SOCIAL, HYGIENE

Treasurer, Washington, D. C. ; The Garden Club of America — Miss Aline Kate
Fox, Past President, New York, New York; The Garden Club of America —
Mrs. Gilbert M. Hitchcock, Washington, D. C. ; General Federation of Women's
Clubs — Mrs. LaFell Dickinson, President, Washington, D. C.; General Federa-
tion of Women's Clubs — Mrs. Thalia 8. Woods, Washington, D. C.; Women's
Division, Jewish Welfare Board — Mrs. Lewis L. Strauss, Washington, D. C.;
Ladies Auxiliary to the Veterans of Foreign Wars — Mrs. Alice M. Donahue,
Past President, Director, War Service Committee, Glen Head, Long Island,
New York; National Catholic Community Service — Miss Ann Devine, Washington,
D. C. ; National Conference of Christians and Jews — Mrs. Frank A. Linzel,
Chairman, Washington, D. C.; National Council of Catholic Women — Miss Mar-
garet T. Lynch, Executive Secretary, Washington, D. C. ; National Council
of Jewish Women — Miss Flora R. Kothenberg, Executive Director, New York,
New York; National Council of Negro Women, Inc. — Mrs. Mary McLeod
Bethune, President, Washington, D. C.; Natipnal Council of Negro Women,
Inc. — Mrs. Mame Mason Higgins, Washington, D. C. ; National Council of
State Garden Clubs — Mrs. E. Wesley Frost, President, Fayetteville, Arkansas;
National Council of Women of the United States — Mrs. Ambrose N. Diehl,
Chairman, War Activities Committee, New York, New York; National Education
Associatoin — Miss Eva G. Pinkston, Executive Secretary, Department of Ele-
mentary School Principals, Washington, D. C.; National Federation of Business
and Professional Women's Clubs — Mrs. Marion H. Britt, Legislative Representa-
tive, Washington, D. C. ; National Society Daughters of the American Revolu-
tion— Miss Hazel Nielson, Executive Secretary, National Defense Committee,
Washington, D. C. ; National Travelers Aid Association — Miss Bertha McCall,
General Director, New York, New York; National Women's Christian Temperance
Union — Mrs. Ida B. Wise Smith, President, Evanston, Illinois; National Women's
Christian Temperance Union — Miss Elizabeth A. Smart, Director of Legislation,
Washington, D. C. ; United Council of Church Women — Mrs. Josephine Kyles,
Washington, D. C.; United Daughters of the Confederacy — Mrs. Charles E.
Boiling, Chairman, Patriotic Activities and Civilian Defense Committee, Rich-
mond, Virginia; United Service Organizations — Miss Ethel Mockler, National
Staff, New York, New York; Young Women's Christian Association — Mrs.
Henry A. Ingraham, President, National Board, New York, New York. Other
organizations represented on the Advisory Council to the Women's Interests
Section are: National Panhellenic Congress, National Women's Trade Union
League, The Salvation Army, and the Army and Navy Department, Young
Men's Christian Associations.

United States Junior Chamber of Commerce Announces New Pro-
gram.— The Public Health Committee of the " Jaycees," of which
Alfred E. Kessler of Denver, Colorado, is Chairman, has recently
issued a comprehensive new outline of ways and means by which
this enterprising young men's organization can be of service and
assistance in safeguarding community health. A new illustrated
manual, impressively and attractively printed in sepia and black
under the title Public Health, sets forth project outlines, campaign
methods and carefully selected references for undertaking the lay-
man's part in Health Department activities, service through the
Men's Hospital Volunteer Corps, a program for Industrial Mental
Health, Physical Fitness in Industry, Red Cross Activities, Tuber-
culosis Control, Sanitary Food Inspection, Rat Control, Child Dental
Health and Postwar Medical Planning. A special section is devoted
to cooperation in radio programs regarding health.

Continuing the program of several years standing, the Manual
emphasizes Jaycee cooperation in the campaign against venereal
diseases, and recommends special efforts locally during the last
weeks of January and the first part of February, to coincide with

NATIONAL EVENTS , 565

National Social Hygiene Day. A campaign outline includes sug-
gestions for a speakers' bureau, newspaper publicity, special radio
program and distribution of literature, special displays and film
showings. Sample letters are shown to enlist cooperation of school
heads, clergymen and industrial leaders.

A new feature of cooperation in social hygiene is the announcement
of a Sex Education program, which recommends that Jaycee members
endeavor to fit themselves to give proper sex education to their
children in the home, and cooperate with school, church and other
agencies in any efforts these groups may undertake. A selected list
of books and pamphlets is included, and the reader is invited to
write to the U. S. Office of Education and the American Social
Hygiene Association for additional materials and information.

National Committee for Mental Hygiene Holds Annual Meeting. —

Talks and discussions at the 35th annual meeting of the National
Committee for Mental Hygiene, held in New York, November 8 and
9 at the Hotel Pennsylvania, centered around such topics as Mental
Hygiene of Industry and Reconversion, Rehabilitation and the
Returning Veteran, Race Relations, Services to the Mentally III
Today, Mental Hygiene Considerations in Peace Plans, and Needs
and Opportunities, im, the Mental Hospital Field.

A feature of the annual luncheon meeting on November 9 was the presenta-
tion of the Lasker Award to Lt. Col. William C. Menninger, of Topeka, Kansas,
and currently Chief Consultant in Neuropsychiatry, Office of the Surgeon
General, U. S. Army, Washington, D. C. This award, as recently announced
by Dr. George S. Stevenson, Medical Director of the Committee, has been
established by the Albert and Mary Lasker Foundation, Inc., and comprises
a sum of $1,000 to be given annually through the Committee, at the annual
meeting, for outstanding service in the field of mental hygiene.

The purpose of the award is to recognize significant contributions to the
promotion of mental health and to making the broad field and program of
mental hygiene more familiar to the general public. Each year according to
plans made by a Committee consisting of Dr. Lawrence S. Kubie, Chairman,
Dr. Frederick H. Allen and Nina Ridenour, the award will be made for a
contribution in some special aspect of the field of mental hygiene which
seems to be of most immediate and current significance. The recipient of the
award will be selected by an anonymous jury chosen annually for its competence
to judge accomplishment in a particular field.

In presenting the award this year to Col. Menninger for mental hygiene work
related to the war, the recipient was chosen from among leaders who have
done work in the general enhancement of the mental health of the men and
women of the services, both while in service and during the period of
rehabilitation, so far as developed at the time.

At a meeting of the Board of Directors on December 14, Eugene Meyer, editor
and publisher of the Washington Post, was elected president of the National
Committee.

National Congress of Parents and Teachers Supports Social Hygiene
Program and ASHA. — The following resolution was adopted by
the Board of Managers of the National Congress of Parents and
Teachers at its annual meeting in New York in May, with the

566 JOURNAL OF SOCIAL HYGIENE

request that a copy be sent to the American Social Hygiene
Association :

WHEREAS, The National Congress of Parents and Teachers believes that a
well-planned program of social hygiene instruction should be instituted in the
public school systems of the United States; therefore, be it

RESOLVED, That this Congress support the efforts of Federal, state, and local
educational authorities to institute such a program; and be it further

RESOLVED, That it is the conviction of this Congress that the n«ed for pro-
viding adequate juvenile protection; preventing the spread of venereal infection;
and providing more adequate personal, family, and community living demands
that instruction concerning the psychological, social, and health aspects of sex
development and behavior be planned .and carried into effect; that such
instruction, adapted to various needs and maturity levels, begin with the
pre-school child, continue throughout public school training, and carry over
into the education of adults — particularly parents; and be it further

RESOLVED, That this Congress commend the interest and efforts of the United
States Public Health Service, the United States Office of Education, the American
Social Hygiene Association, and other Federal, state and local governmental
and voluntary agencies working on this problem; that this Congress pledge its
support in any effort to promote a social hygiene educational program so
planned as to result in better family and community living.

The Board of Managers of the National Congress, at its fall session
in Chicago, adopted a program designed to meet critical needs on the
home front and urged local units to work for better human
relationships.

Selectees with Syphilis Rehabilitated for Induction. — More than a
quarter of a million Selective Service registrants who were originally
deferred because of evidence of syphilis have been reclaimed through
treatment, according to a U. S. Public Health Service report in
August 1944. Among the first fifteen million registrants blood-tested,
evidence of syphilis was uncovered in 720,000. Tracing, treating
and induction of a large number of those infected was accomplished
through cooperation among Selective Service Boards, state and local
health departments, the Army and the Navy. Approximately 125,000
have already enlisted or been inducted into the armed forces,
and 140,000 more are available unless otherwise disqualified, the
estimates show.

Estimates of the number of infected men reclaimed are based
on USPHS tabulations of data to June 30, 1943 from 22 states
on 182,607 registrants with evidence of syphilis. (See table.) The
tabulations show that:

Ninety-three per cent of the infected men have been traced by State and
local health departments.

Thirty-eight per cent have been made available for active war duty training
by the venereal disease control program. This includes 18 per cent who have
been inducted into the armed services and 20 per cent declared available for
military duty after follow-up and treatment when necessary. Sixteen per cent
still need further treatment.

Sixteen per cent probably never will be available because their syphilis had
progressed to late stages before it was discovered, or because of other physical
defects.

Eleven per cent have moved from the jurisdiction of the reporting States.

NATIONAL EVENTS

567

H£

Or}

9°

PH,

^t_,-ei«cMtocxioo oooaooococMt^oiowtpco 'Win -*

gj M

oo p^gt^oicooicoto cMiomtooooi^iococMT-Hioio into

O I Sf-iCOOOOrHi— I CMtOOOCOlOt~rHI>.OOl6dblQ
3 j» CO^CO CO 7<! IO <M to 00_ U3 rH CO CM CM rH rH CO

.. +* 00 00 O O O 00
Si p)

O, O> (M-^OOIOCOOO OiOCMlOlOOt^OlCOCOtOtO^tOIMtO
'"^WrHTHCQCQ rH T— fi — IC^i— ICQi— I rH r-tCQi — iOQ Csl
r*j 0} p_i

e ?> ^

cocitoocqm cooopopopoiinrHootoomcooo-*to

^,S rf

•-^ CO <M
.,+i COCOOOt^OJOO

5 a

VI

r? I
8'
^S 1 •

1H*-1-

IH lo'oq" •*

i C5

I «O I
rH rH rH

iOrHintOinOS t-OOrHCOt--(MOlOO5OTHOJintOOO

cvToT r-T co~

CM

COrHCOOOt~lO>nt~rHrHtOaiTt<O>n

_p PI
e t C

I O5 rH »O O5 to »O
i to CM t~ lO b- t-
^ O5^t^ O3CO IO rHrHtOCNl'^CO IOIOCO O^CMrHrHrH O

co~cvf cf cT

^ J3

5^1' tOcOCOlOt- t-05rHtOOi ^C35tOOi<M^WOt>

^ IS^lOCOOirH CO iH ^"^t>-TH OiOiCO

R of

•« « ' -*^

* ^>

1 fel
^ l§

oi

Cq i-H O rH rH t^

to
•^'n'ao'of uo' oo~!-rco"o'to"r-r oo'in'ao' cTio"

00 rH CO OQ W

! '~^ !

o ;

: : o : : : SP ::::::;::::::

o

::::; :o ::::::•;:::::

• ••••:«• : •'• •'i * i -"2 '•

rtfl

•2 § 3 §

-

568 JOURNAL OF SOCIAL HYGIENE

In most cases the names of these have been referred to health departments in
communities to which the registrants moved.

Seven per cent were not located by health departments.

Twelve per cent were classified in a miscellaneous category, including men
who had died, had been placed in mental institutions as a result of syphilis,
or whose records were incomplete.

Health Education Fellowships Awarded by U. S. Public Health
Service. Kellogg Foundation, and National Foundation for Infantile
Paralysis. — Twenty-eight fellowships in health education have
been awarded to men and women in twenty states under a new
program of the National Foundation for Infantile Paralysis and a
continuing grant of the W. K. Kellogg Foundation, the U. S. Public
Health Service has announced. Twenty-two of the fellowships were
provided by the National Foundation, and six will be maintained
by the Kellogg Foundation. Qualifications of candidates were sub-
mitted to an advisory committee of the U. S. Public Health Service.
The persons selecte.d will be assigned to schools of public health at
Yale University, the University of Michigan and the University of
North Carolina. The training will consist of nine months' academic
work and three months of supervised field experience. Eighteen
similar fellowships were awarded last year. Recipients of the
fellowships this year are:

Linnea Anderson, Waverly, Massachusetts; Euth Brossman, Allentown, Penn-
sylvania; Camille Brown, Laramie, Wyoming; Theron Butterworth, New Orleans,
Louisiana; Bessie Creecy, Eich Square, North Carolina; Nell Jane Guthrie,
Oklahoma City, Oklahoma; Mrs. Dorothy B. Hamilton, Washington, D. C.;
Dorothy Ann Huskey, Knoxville, Tennessee; Mrs. Margaret Idema, LaMarque,
Texas; Marion Jensen, Knoxville, Tennessee; Maizie Jean Jones, Boone, North
Carolina; Eae E. Kaufer, Bethesda, Maryland; Mary Lou King, Bradenton,
Florida; Mary Evelyn Leith. Due West, South Carolina; Eaymond Leonard,
Asheville, North Carolina; Edith E. Lindly, Stillwater, Oklahoma; Wilma Mail-
ander, Spalding, Nebraska; Jean McCartney, Elkhart, Indiana; Leila McCormick,
Eowland, North Carolina; Frances Montgomery, Tempe, Arizona; Hazel Mun-
dorff, Clay Center, Nebraska; Gladys C. Omohundro, Norfolk, Virginia; Mrs.
Julia O'Neill, Bushnell, Illinois; Maude Parker, Norfolk, Virginia; Mary H.
Parks, Wichita, Kansas; Jeannette Simmons, West Des Moines, Iowa; Mrs.
Louisa Spell, Athens, Georgia; and Helen Wilson, Grand Forks, North Dakota.

SOME FORECASTS OF SOCIAL HYGIENE DAY PROGRAMS

ELEANOR SHENEHON

Director, Division of Community Service

American Social Hygiene Association

Social Hygiene Day — 1945 — Wednesday, February 7th — is evi-
dently going to provide important opportunity to review accom-
plishments of the past year and plan concrete projects for 1945.
The following references to selected programs and the agencies or
officers in charge are presented to illustrate the variety of ways in
which both large and small cities and areas are going about the
task of organizing their meetings.

Auburn and Lewiston, Maine, are planning to make the interesting experiment
of holding an inter-community Social Hygiene Day meeting in Lewiston for
the two cities. For further information write Mrs. Guilda M. Albert, ' R.N.,
Public Health Nurse, Lewiston, Maine.

The city of Cambridge, Massachusetts, will be host to a Regional Conference
on social hygiene on February 7th under the auspices of the Cambridge Social
Hygiene Committee and the Massachusetts Society for Social Hygiene. Doctor
John R. Heller, Jr., Chief, Division of Venereal Disease Control, United States
Public Health Service, will appear on the program as one of the principal
speakers. This regional meeting will bring in people from Greater Boston
and all of the New England area. For further details write Miss Mabel
M. Brown, Executive Secretary of the Cambridge Tuberculosis and Health
Association or Mrs. S. W. Miller, Executive Secretary, Massachusetts Society
for Social Hygiene, 1146 Little Building, Boston 16, Massachusetts.

The Health Division of the Hartford, Connecticut, Council of Social Agencies,
in cooperation with the Hartford Tuberculosis Association and a number of
other interested groups, will sponsor a Social Hygiene Day luncheon on Tuesday,
February 6th, at which Doctor Heller will also be the principal speaker. Inquiries
should be addressed to Doctor Muriel F. Bliss, Executive Secretary of the
Hartford Tuberculosis and Public Health Society, Inc., 65 Wethersfield Avenue,
Hartford 6, Connecticut.

The New York City Tuberculosis and Health Association will have a series
of sessions covering all phases of social hygiene at the Pennsylvania Hotel
on February 7th as part of its Annual Meeting. Colonel Thomas B. Turner,
Office of the Surgeon General, U. S. Army, Washington, D. C., and Dr. J. Earle
Moore of Baltimore, Maryland, have agreed to appear on this program. Further
information about these plans may be obtained from Doctor J. A. Goldberg,
Secretary, Social Hygiene Committee, New York Tuberculosis and Health
Association, 386 Fourth Avenue, New York 16, N. Y.

The Philadelphia Social Hygiene Day Committee is planning a large and
interesting all-day program for Thursday, February 8th. Doctor Heller and
Mr. Alan Johnstone, General Counsel, Federal Works Agency, have accepted
an invitation to speak at the luncheon session at the Ritz Carlton Hotel. The
evening program will include a presentation of the part of labor in the venereal
disease control program by Mr. Abraham Bluestein, Executive Secretary of
the Labor League for Human Rights, and a report on Philadelphia's " Institute
on Health and Human Relations." Further information may be obtained from
Mr. Charles Kurtzhalz, Secretary, Social Hygiene Day Committee, Philadelphia
Tuberculosis and Health Association, 311 South Juniper Street, Philadelphia.

The District of Columbia Social Hygiene Society is planning its conference
in the National Capitol on February 5th, to meet government schedules. Thia
meeting is also a regional conference drawing into its sessions representatives
of all states of the Union now stationed in the Nation's Capitol and many

569

570 JOURNAL, OF SOCIAL HYGIENE

representatives from nearby states. For information on this meeting write
to Mr. Ray H. Everett, Executive Secretary, Social Hygiene Society of the
District of Columbia, 927 Fifteenth Street, N. W., Washington, D. C.

Lynchburg, Virginia, is planning an intensive program of community informa-
tion centered around the observance of Social Hygiene Day. A committee
appointed to sponsor this program includes representatives of important civic
organizations. This will be Lynchburg's first community-wide Social Hygiene
Day observance. Address inquiries about it to Doctor S. D. Sturkie, Director
of Public Welfare for the City of Lynchburg.

Dr. Percy S. Pelouze, of the USPHS Service and an ASHA Board Member,
is speaker at an important Social Hygiene Day meeting in Columbia, South
Carolina, on Tuesday, February 6th, sponsored by a number of interested
agencies, including state and country social hygiene groups. For further
information write to Mrs. Jules Bank, Secretary of the Richmond County
Social Hygiene Association, 1311 Marion Street, Columbia, South Carolina;
or to Miss Adele J. Minahan of the South Carolina Conference of Social
Work, 1119 Barnwell Street, Columbia, South Carolina.

The Georgia Social Hygiene Council will serve as the principal sponsor for
a regional conference on social hygiene to be held in Atlanta February 19th
and 20th. Doctor Heller has also accepted an invitation to appear as the
principal speaker on this program. For further information write to Mrs. Charles
D. Center, Executive Secretary, Georgia Social Hygiene Council, Room 240,
State Office Building, Atlanta, Georgia.

The Chicago Social Hygiene Day Committee is planning a regional conference
on Wednesday, February 7th, to take the form of a series of joint sessions
with the American Social Hygiene Association, which will hold its annual
meeting in Chicago on the same date. For details of these meetings write
to Doctor Bertha Shafer, Chairman of the Committee, and Executive Director,
Illinois Social Hygiene League, 303 East Chicago Avenue, Chicago 11, or to
the American Social Hygiene Association, 1790 Broadway, New York 19, N. Y.
(See also above.)

The Council of Social Agencies of Omaha will be the principal sponsor of a
dinner meeting to be held in that city February 7th. Emphasis in planning
this program will be placed on the important role of industry and labor in
the total social hygiene program. Information about these plans can be
obtained from Miss Josephine J. Albrecht, Executive Secretary, Community
Welfare Council of Omaha, 736 World-Herald Building, Omaha 2, Nebraska.

The Kansas City Social Hygiene Society is planning a large evening meeting
for Social Hygiene Day, with a nationally known speaker as one of the principal
attractions. For further information write to Mrs. F. H. Ream, Executive
Secretary, Kansas City Social Hygiene Society, Room 404, 1020 McGee Street,
Kansas City 6, Missouri.

The Denver Public Health Council in cooperation with the Division of Venereal
Disease Control of the State Division of Public Health and other sponsors
is working on plans for a meeting to be held on February 9th. Mrs. J. Burris
Perrin has been appointed Chairman of the Social Hygiene Day Committee.
Inquiries should be addressed to either Mr. Gerald M. Porter, Executive Sec-
retary, Denver Public Health Council, 314 Fourteenth Street, Denver 2, Colorado,
or Doctor G. P. Gannon, Director, Division of Venereal Disease Control,
Colorado State Division of Public Health, State Office Building, Denver 2,
Colorado.

Seattle, Washington, will hold its 1945 Social Hygiene Day meeting on
Tuesday, February 6th, under the sponsorship of the Seattle-King County Social
Hygiene Society and the Washington State Social Hygiene Association. Lt. Col.
Thomas H. Sternberg, Director, Venereal Disease Control Division, Office of
the Surgeon General, Washington, D. C., has agreed to appear on this program.
Tentative plans are also being made for a Social Hygiene Week with observances
in the form of community meetings in selected cities throughout the state
of Washington. Inquiries should be addressed to Miss Honoria Hughes,

SOCIAL HYGIENE DAY MEETING

571

Executive Secretary of both Associations, 6147 Arcade Building, Seattle 1,
Washington.

Portland (Oregon) plans for Social Hygiene Day, February 7th, are now
well advanced. Lt. Col. Sternberg will also appear as a principal speaker
on this program. Further information may be obtained from Mrs. Sadie Orr
Dunbar, Executive Secretary, Oregon Tuberculosis Association, 605 Woodlark
Building, Portland 5, Oregon.

Preliminary reports from other sections of the country tell also of Social
Hygiene Day plans in Downington, McKeesport, Chester and Erie, Pennsylvania;
Wilmington, Delaware; Richmond, Virginia; Florence and Greenville, South
Carolina; Milwaukee and Baraboo, Wisconsin; Tulsa and Shawnee, Oklahoma;
Corpus Christi, Fort Worth, Houston and Wichita Falls, Texas; Salt Lake
City, Utah; Los Angeles, California; Little Rock and Fort Smith, Arkansas;
Puerto Rico and Hawaii. Later issues of the JOURNAL and Social Hygiene News
will carry word of additional prograjns as cooperating agencies in all states
swing into action.

SO YOU'RE GOING TO HOLD A SOCIAL HYGIENE
DAY MEETING!

PROGRAM SUGGESTIONS

from the

SOCIAL HYGIENE DAY SERVICE
American Social Hygiene Association

A General Community Meeting-

Subject: Social Hygiene: A Four-Sector Front

Presiding: President of Social Hygiene Society or Chairman of Social

Hygiene Day Committee

Topics 1. The Health Sector: The Attack on the Venereal Diseases

and Venereal Disease Control Officer of State or City Health

Speakers: Department, Army or Navy, or representative of Health

Council or other voluntary health agency.

2. The Legal and Social Protective Sector

Representative of Social Protection Division, Chairman of
Social Protection Committee, Judge, Probation Officer,
Lawyer, Executive of youth-serving or family welfare
agency.

3. The Educational Sector

Superintendent of schools or other educator; representative
of social hygiene society, parent-teacher association or other
group active in this field.

4. The Character Building (or Moral) Sector

Clergyman or other representative of church, educator,
executive of youth-serving agency.
Discussion: Four Sectors — One United Front

Representative of social hygiene society or committee.

Group Meetings

(Women's Clubs, Men's Service Clubs, Parent-Teacher Associations, Church

Organizations, Study and Discussion Groups or Other Special

Interest Groups)

Subject: Social Hygiene in Youth-Serving Programs

Topics: 1. Health Education of Youth as Lifelong Health Protection

2. Education in Human Relations as a Preparation for Life

3. Social Protection as an Element in Community Planning for
Safeguards for Youth

572

JOURNAL. OP SOCIAL HYGIENE

II

Subject: The Church and Social Hygiene

Topics: 1. The Church Builds Character

2. The Church Prepares for Marriage

3. The Church Goes to WorTc on the Moral Sector of Venereal
Disease Control

in

Subject: The Parent and the Teacher in Social Hygiene

Topics: 1. The Parent as the Child's First Guide in Learning About Sex

Relations

2. The Teacher TaTces Up the Taslc of Sex Education Through
Integrated Programs of Health and Human Eelations in the
Schools

3. The Opportunities of Parents and Teachers as Community
Leaders

IV

Subject: Labor and Industry Fight VD

Topics: 1. Industry Recognizes the Need to Combat the Venereal Dis-

eases *

2. The Trade Unions Join the Battle Against VD*

3. The American Social Hygiene Association Plan for Venereal
Disease Control Programs in Industry *

V
Subject: The Contribution of the Neighborhood Pharmacy to the Fight

Against the Venereal Diseases
Topics: , 1. The Pharmacist Cooperates with the Health Department — A

Joint Plan of Action

2. The Corner Drug Store as a Community Center for the Dis-
tribution of Information About Health Problems

3. Public Reaction to Informational Programs Carried Out by
Neighborhood Pharmacies

An All-Day Conference

Any or all of these program elements can be combined to provide
interesting and helpful subject-matter for a meeting of several
sessions planned to draw into its " sphere of influence" all groups
interested in the social hygiene program. Sponsors of such important
meetings frequently extend invitations to persons in nearby com-
munities— or even throughout the state. Your neighbors will be
interested in what you are thinking and planning — and in an
exchange of views about common problems.

Call on the American Social Hygiene Association, 1790 Broadway,
New York 19, for the Social Hygiene Day kit of program and pub-
licity aids to use in planning and publicizing your meeting. Ask
for the announcement folder, Calling All Communities to build
interest in the February observance in your town. Call on the
Association for the new Social Hygiene Day poster to publicize your
meeting and for a supply of the attractive new folder Heartache
House to distribute at your meeting. There is no charge to
sponsoring groups for these materials.

* Sample talk or speech outline available through the American Social Hygiene
Association, 1790 Broadway, New York 19, N. Y.

NOTES ON INDUSTRIAL COOPERATION

PEECY SHOSTAC
Consultant on Industrial Cooperation, American Social Hygiene Association

A TALE OF THREE CITIES

This is a progress report from the field about the American Social
Hygiene Association's industrial program. As Dr. Clarke has said,
the field trip has the same importance for the worker in head-
quarters of a national health agency that duty in a clinic has for
the physician: it gives each the opportunity to test theory in the
light of actual experience. In addition, the trip now being reviewed
helped to accelerate plans for VD education and control by
management, labor and public health groups in several areas.

TWO CONVENTIONS

Delegates to the National CIO Convention in Chicago and the
National AFL Convention in New Orleans, held simultaneously in
November, were greeted by well placed ASHA exhibits. About 500
of these union leaders received our Trade Unions vs. VD manual,
accompanied in most instances with some lively verbal propaganda.
The 1,200 delegates from all over the country, before deliberations
were over, were in possession of one or more of the pamphlets on
display. This thorough-going coverage of the two great labor gather-
ings was certainly aided by the friendly hand extended by the CIO
National War Relief Committee and the AFL Labor League for
Human Rights. Offering a concrete program of education and action,
and better known to the labor movement than during the 1943
conventions, the ASHA made valuable contacts, many of which can
be expected to produce tangible results.

DETROIT

Detroit, capital of the automotive industry and headquarters of
the United Auto Workers, CIO, was a "must" on the industrial field
trip itinerary. The purpose of the visit was to stimulate this largest
union in the United States (approximate membership 1,200,000) into
activity against VD and related conditions. With the approval of
R. J. Thomas, UAW International President; Edward Levinson,
Editor of the Auto Worker; and Dr. Morris Raskin, Director of the
UAW Health Institute, it seems likely that a program will be under-
taken among the thousand or more auto locals throughout the
country. As matters stand right now, there is good reason to believe
that this substantial and significant extension of VD education and
control will be based on our trade union manual, and may very well
be carried on locally in cooperation with the Detroit Health
Department.

That the auto workers' union promises to give leadership in the
trade union fight against VD is not surprising in view of the impres-

573

574 JOURNAL OF SOCIAL HYGIENE

sive work of its Health Institute. This diagnostic treatment and
health education center operated by the union is breaking fresh
ground in looking after the health needs of its members.

CHICAGO

The ASHA is spark-plugging two promising industrial projects
in Chicago ; a community industrial health committee, patterned after
the Fort Greene, Brooklyn, demonstration (see February 1944
JOURNAL), and a VD campaign among the trade unions.

The Chicago Industrial Health Committee, as now planned, is to
be established and administered jointly by the Council of Social
Agencies (which includes the Illinois Social Hygiene League, and
the Tuberculosis Institute of Chicago and Cook County), the Chicago
Health Department and the Chicago Medical Society. The idea is
that trade unions, business associations and voluntary agencies will
serve as a sponsoring group, with an additional body of citizen
sponsors. Participation and financial support will be sought from
firms located in a large industrial section of the South Side, and
also from department stores and other business establishments in
the Loop.

The ball was started rolling in Chicago at two enthusiastic meetings
arranged by the Health Division of the Council of Social Agencies.
Guidance and organizational drive for this comprehensive health
education plan in industry — in which VD will figure prominently —
can be expected from Laurence T. Rogers, Secretary of the Council 's
Health Division; Dr. Frederick W. Slobe, President, American
Association of Industrial Physicians and Surgeons; and the Chicago
Board of Health.

Our second Chicago project proposes a plan for a joint Health
Department-union campaign using our Trade Unions vs. VD manual.
The enthusiasm of Dr. Theodore J. Bauer, the city's VD Control
Officer, coupled with the cooperative attitude of the unions, bodes
well for this undertaking. With a thousand or more trade unions
located in Chicago, it is understandable that Dr. Bauer considers
these groups the best avenue of approach to workers in his territory.

This contemplated campaign may very well add another orchid
to those already rated by Dr. Herman Bundesen, President of the
Chicago Board of Health, and by Dr. Bauer. One cannot talk of
VD control work in Chicago without special mention of the city's
broad and amazingly effective program. This covers not only all
the medical and public health aspects of the problem but ties in
with the work of the police and courts in repressing prostitution
and with the constructive programs of church and welfare agencies
engaged in protecting family life. As a unique feature of the
Chicago plan, attention should also be called to the cooperation with
the Health Department of tavern owners, the bartenders union and
brewers and distillers associations in both educational and law
enforcement activities.

NOTES ON INDUSTRIAL COOPERATION 575

NEW ORLEANS

New Orleans promises to bring forth a full-blown industrial health
committee. As in Chicago, the initial response to the ASHA's pro-
motion efforts came from the Council of Social Agencies. The
Council arranged the first preliminary meeting on organization
attended by Dr. John M. Whitney, Board of Health Director; Miss
Marietta Rocquet, Executive Secretary of the TB Association; Miss
Odile Simpson, Executive Secretary of- the New Orleans Social
Hygiene Association and other leading people in the city! This
meeting was followed by one largely attended by union leaders, and
finally there was a luncheon of leading businessmen arranged by
Dr. Whitney and George H. Gardiner, Secretary of the Association
of Commerce.

The businessmen went all out for an industrial health committee
and offered to finance it. Since Dr. Whitney is determined to have
such a committee, and since he is offering the committee the full-
time services of a health educator from his department, who will
supplement the work of a full-time organizational secretary paid
from the committee's proposed budget, this project definitely seems
to be headed for realization in New Orleans.

CONCLUSIONS

1. Leaders of industry and business are recognizing the value
of health education as a sound investment for themselves and their
employees. When the community industrial health committee plan
is presented to them, they are enthusiastic about it and are appar-
ently willing to support it financially. Cooperation by labor, councils
of social agencies, organized medicine, public health bodies and citizen
groups generally can be expected.

2. Local social hygiene societies have a great opportunity to stimu-
late initial interest in industrial health committees and to see that
VD receives sufficient attention in their programs. The actual forma-
tion and operation of such committees may very well be expected
to be undertaken by the local councils of social agencies in cooperation
with the health departments.

3. Local and state health departments should be counted on to
serve as the focal points for carrying on VD education and the
whole control program with both the trade unions and management.
This is an approach that bears emphasis and development. Local
social hygiene societies can aid in achieving these objectives by
working with and through both industrial groups and health
departments.

Summarizing the lessons of this "tale of three cities" in a sentence,
all that need be said is that health education for industrial workers
is in the air ; the ASHA, by staying on the beam, has an opportunity
to bring its vital message to a large and powerful segment of the
nation's population.

BOOK REVIEWS

MEET Yotra ENEMY — VENEREAL. DIS-
EASE. A manual for women's
groups. Prepared by the Social
Protection Division, Office of Com-
munity War Services, Federal Se-
curity Agency, in consultation with
the National Women's Advisory
Committee on Social Protection.
41 p. Free on request.

This new handbook will be an ex-
tremely effective weapon for use in
the nationwide drive against prostitu-
tion and sexual promiscuity. Prepared
in consultation with the National
Women's Advisory Committee on Social
Protection and carrying the Commit-
tee's endorsement, it is addressed
primarily to women's organizations.
Women's clubs and other groups are
urged to mobilize their forces for the
/ fight against the venereal diseases and
conditions that favor their spread. The
pamphlet defines the scope of the prob-
lem from both public health and social
points of view, describes the role of
the prostitute and her patrons as
promiscuous persons generally as car-
riers of diseases, and discusses the
danger of wartime increase in juvenile
delinquency.

The functions of health department,
police department, courts and social
services in a community program of
prevention and control, together with
the role of the school and church as
character-builders are set forth clearly
and helpfully. The importance of wise
and well-considered laws and ordinances
against prostitution and for the control
of the venereal diseases and the value
of an informed public opinion are given
due weight in the summary of the
total forces to be mobilized against the
"Enemy."

The handbook closes with a well-
planned section giving suggestions for
specific action by women's groups in
support of the social protection pro-
gram, under the headings, Mobilize,
Survey, Enlist, Fight.

The importance of public education
and of coordination with other inter-
ested voluntary groups is stressed.
Social Hygiene Day in February is

suggested as a focal point for a cam-
paign of public information, and
specific ideas are given for publicity
through newspaper and radio in
connection with such observances. An
appendix contains a well-chosen list of
social hygiene pamphlets, posters and
films.

ELEANOR N. SHENEHON

BETTER TIMES. Health Issue in Honor
of Bailey B. Burritt, November 3,
1944. Welfare Council of New
York City.

Seldom does a project for compli-
mentary purposes realize its objective
as well as does this special issue of
Setter Times, dedicated to Mr. Bur-
ritt ' ' with affection and esteem ' ' on
the occasion of his retirement as
Chairman of the Executive Council of
New York's Community Service So-
ciety. From the leading article Mile-
posts of Public Health by Mr. Burritt
himself, the 20 page illustrated issue
is packed full of interesting history,
current events and forecasts of the
future. Dr. George Baehr contributes
Medical Advances Since 1900. Com-
missioner Ernest L. Stebbins asks
What's Ahead in Public Health?
Homer Folks pays a well deserved
tribute in Bailey Burritt and Public
Health. Winslow Carlton, Executive
Director of Group Health Cooperative,
Inc., discusses The Converging Lines
of Public Health and Health Insurance.
A nostalgic symposium is Backward,
Turn Backward ... by Donald B.
Armstrong, Leverett D. Bristol, Louis
I. Dublin, Frank Kiernan, Charles S.
Prest, Ollie A. Randall, Kenneth D.
Widdemer, and Savel Zimand, recount-
ing their experiences as members of
the Burritt staff.

As an agency which has the privilege
of sharing in the benefits which accrue
from Mr. Burritt 's wise guidance, the
American Social Hygiene Association
is in a position to realize the solid
truth of all that Better Times says in
this effort to honor a man who has
been, and is, one of New York City's
and State's most useful citizens. We
claim the privilege of adding to the

576

BOOK EEVIEWS

577

general applause the praise and ap-
preciation of social hygiene workers
throughout the country.

THE EDITORS

THE LONG BOAD, FORTIETH ANNIVER-
SARY REPORT — 1944. National
Child Labor Committee, 419
Fourth Avenue, New York. Pub.
No. 390. 56 pp.

In forty years of work on behalf
of American children, the Committee
has covered a varied scene. Eeporting
by decades, the years 1904-1914 are
reported as A Decade of Fights, De-
feats and a Few Gains; 1914-1925 —
Fighting on Two Fronts — State and
Federal; 1924-1934 — 'Leave It to the
States'; 1934-1944 — Child Labor in a
Decade of Upheavals. Four vigorous
champions of the Committee, Eduard
C. Lindeman, Homer Folks, Samuel
McCune Lindsay and Owen E. Lbvejoy,
contribute Forewords; the two latter
having served as general secretaries to
the Committee for the years 1904-1907
and 1907-1926 respectively.

In perspective, the Committee's work
is seen as influencing steady progress
throughout the years and throughout
the nation. Advances in laws to re-
strict child labor and make education
compulsory have brought about a
marked decrease in children at work
and a marked increase in school at-
tendance. "By 1940 high school en-
rollment had reached the peak figure
of 7,244,000 and the number of em-
ployed children 14 to 17 years old had
decreased to 872,000 or a million and
a half less than had been employed
in 1920." War hasr reversed the trend
reducing high school enrollment by
1,000,000 students and raising the
number of employed 14 to 17 year
olds by a half million, or to a total of
3,000,000. The Fair Labor Standards
Act of 1938 has prevented thousands
of younger children from flocking into
factories as they did in the last war.

The road ahead will be long, too,
it is believed. Thirty states still need
to bring their child labor laws in line
with their compulsory education laws
by establishing a 16 year limit without
exemptions for employment during
school hours. Immediate enactment of
such laws, to be effective after the way,
would not only increase the educational
equipment of these future citizens but
at the same time would keep them out

of competition with adults in the
post-war labor market.

" 'There will be a large group of
children for whom special educational
facilities must be provided, namely,
those among the 3,000,000 young work-
ers of today who left school to work
full time without completing high
school. They will not be equipped by
education, training or skill for post-
war work employment and they will not
be interested in going back to high
school. Unless special programs are
planned for them as well as for veter-
ans and adult war workers, they will be
casualties of the war, facing a future
of poor jobs at low wages.' "

Gertrude Folks Zimand, the Commit-
tee 's General Secretary, and Florence
Taylor, Assistant Secretary, have
planned and carried out this interest-
ing report. The concluding pages are
devoted to the Published Eeeord of
major field studies and other publica-
tions of the National Child Labor
Committee in its forty years history.
JEAN B. PINNBY

A SYNOPSIS OF CLINICAL SYPHILIS. By
James Kirby Howies, B.S., M.D.,
M.M.S. St. Louis, The C. V.
Mosby Co., 1943. 671 p. $6.00.

This beautifully printed, illustrated
and bound volume, by the Professor of
Dermatology and Syphilology at the
Louisiana State University School of
Medicine, covers much the same ground
as the Essentials of Syphilology by
Eudolph H. Kampmeier, A. B., M.D.,
also recently reviewed. Dr. Howies'
text is divided into three sections. The
first deals with general considerations
of syphilis; the second with systemic
and regional syphilis; and the third
with familial and public health aspects
of syphilis.

Section One discusses first the path-
ologic process and other general con-
siderations of syphilis and then goes
on to an exposition of the primary,
secondary, latent and tertiary clinical
and laboratory findings and treatment.
Following this are two chapters on
diagnosis and one each on treatment
and prognosis. As indicated by its
subject, Section Two discusses the an-
atomic distribution of syphilis, together
with diagnosis, therapy and prognosis.
Under Section Three the epidemiology
of syphilis, syphilis in pregnancy, and

578

JOURNAL OF SOCIAL HYGIENE

congenital syphilis are discussed to-
gether with a discussion on the organ-
ization of syphilis clinics.

The appendix presents a brief, his-
torical account of this disease. There
is an excellent, full bibliography and
the book is well indexed.

To a considerable extent Dr. Howies
presents his own personal point of
view and methods of diagnosis and
treatment in this book. With some
of these, other syphilologists will not
entirely agree. The book is best in
its clinical presentations.

WALTER CLARKE, M.D.

ESSENTIALS OF SYFHILOLOGY. By Ru-
dolph H. Kampmeir, M.D. Phil-
adelphia, J. B. Lippincott Co.,
1943. 518 p. $5.00.

Doctor Kampmeier and his collabor-
ators have produced an excellent, prac-
tical book for students and general
practictioners of medicine. The book,
which runs to 518 pages, is well printed
and copiously illustrated. It presents
an orderly discussion of the diagnosis,
treatment and control of syphilis.

After a short introductory chapter,
the authors discuss the biology of
syphilis, the details of examination of
the patient, including serology, and
then go on to a general discussion
of the therapeutic agents and methods
used in the treatment of syphilis.
From this point they proceed to dis-
cuss syphilis by its typical stages and
then according to its anatomical dis-
tribution. Following this is a discussion
of syphilis in pregnancy, congenital
syphilis and syphilis with relation to
marriage. The last fifty pages of the
book are devoted to the public health
aspects of this infection. Throughout
the book the authors make use of case
histories to illustrate practical points.

Although the authors draw princi-
pally upon the experience of Vander-
bilt University Hospital, they adhere
closely in their presentations to gen-
erally accepted principles and to stan-
dard methods. Brief mention is made
of the newer intensive methods of
treatment but with due warning that
these are to be employed only by phy-
sicians especially trained in syphilology.

The index leaves something to be
desired in the matter of completeness.
WALTER CLARKE, M.D.

PUBLICATIONS RECEIVED

IN THE PERIODICALS
Of General Interest

BETTER TIMES, November 3, 1944. Health Issue in Honor of Bailey B. Burritt.
JOURNAL OF THE NATIONAL EDUCATION ASSOCIATION, November 1944. The White
House Conference on Eural Education, p. 189.

Marriage and Family Relations

EDUCATION DIGEST, September 1944. Sex Education in High Schools, L. A.
Kirkendall, Ph.D.

JOURNAL OF HOME ECONOMICS, November 1944. Personal and Marriage Counsel-
ing in Boston, Lester Dearborn.

— November 1944. Marital Counseling: An Evaluation, Roy E. Dickerson.

Health Education

AMERICAN JOURNAL OF PUBLIC HEALTH, August 1944. New Developments in
Health Education, Committee on new developments in Health Education.

Social Protection

COMMUNITY RECREATION BULLETIN, New York, October 1944. Kiwanians Take

Lead in Promoting Center.
GENERAL FEDERATION CLUBWOMAN, December 1944. Juvenile Delinquency, Lewis

E. Lawes.

PUBLICATIONS EECEIVED 579

Industrial Problems

COMMUNITY, Community Chests and Councils, September 1944. Health and
Welfare in the Labor Press, Percy Shostac.

— November 1944. The Nurse in Industry Organises against VD, Percy

Shostac.

Public Health and Medical

AMERICAN DRUGGIST (N.Y.), December 1944. The Facts Behind the Cottier's

Article, Dangerous Magic, p. 62-63.
AMERICAN JOURNAL OF PUBLIC HEALTH, August 1944. The Cooperative Health

Program of the American Republics, G. C. Dunham, M.D., Dr.P.H.
BRITISH MEDICAL JOURNAL (London), July 8, 1944. Gonorrhea in North Africa

and the Central Mediterranean (in British Troops), D. J. Campbell, D.P.H.
CALIFORNIA AND WESTERN MEDICINE (San Francisco), June, 1944. Venereal

Disease Control in Military Scene, J. E. Scholtz, M.D.

— September, 1944. The Problem of Syphilis as Handled in the U. S. Navy,

H. D. Newton, M.D.

CANADIAN JOURNAL OF PUBLIC HEALTH, June, 1944. A Survey of the Incidence
of Venereal Diseases in Toronto in 1943, Gordon Bates, M.B.

— July 1944. Medical Care for All the People, H. E. Sigerist, M.D.

— September, 1944. Records and Statistics in Venereal-disease Control, A. H.

Sellers, M.D., D.P.H.

— October 1944. A Guide for Penicillin Treatment iby the Medical Advisory

Committee on Penicillin.
HARVARD PUBLIC HEALTH ALUMNI BULLETIN, May, 1944. Cooperative Public

Health in the Americas, H. B. Gotaas.

• — May, 1944. Preventive Medicine, J. S. Simmons, M.D., Dr.P.H.
HEALTH (Toronto, Canada), Spring, 1944. Medical Care for All the People,

Henry Sigerist.
JOURNAL OF AMERICAN MEDICAL ASSOCIATION (Chicago), July 15, 1944. The

Public Health Service Act.

— July 22, 1944. National Program for Physical Fitness Revealed and Developed

on the Basis of 13,000,000 Physical Examinations of Selective Service
Registrants, L. G. Eowntree, M.D.

— September 9, 1944. The Action of Penicillin in Late Syphilis Including

Neurosyphilis, Benign Late Syphilis and Late Congenital Syphilis, J. H.
Stokes, M.D., and others.

— September 9, 1944. The Treatment of Early Syphilis with Penicillin: A

Preliminary Report of 1,418 Cases, J. E. Moore, M.D., and others.

— September 9, 1944. Penicillin Treatment of Early Syphilis : II, J. F. Mahoney,

M.D., and others.

— September 16, 1944. The Treatment of Sulfonamide Resistant Gonorrhea

with Penicillin Sodium, Lt. Col. Thomas H. Sternberg and Col. Thomas B.
Turner MC, U.S.A.

— October 14, 1944. Penicillin in the Prevention and Treatment of Congenital

Syphilis, J. W. Lentz, M.D., Norman E. Ingrahan, Jr., M.D., Herman
Beerman, M.D., John H. Stokes, M.D.

— October 28, 1944. Combined Fever and Arsenotherapy, Evan W. Thomas, M.D.,

and Gertrude Wexler, M.S. ,

— October 28, 1944. Intensive Arsenotherapy, A. Benson Cannon, M.D., Jerome

K. Fisher, M.D., Juan J. Eodriguez, M.D., Guila F. Beatie, M.D., and
Eugenia Maechling, Ph.D.

— October 28, 1944. Massive Arsenotherapy for Syphilis, USPHS Evaluation

Cooperating Clinics of N. Y. and Midwestern Groups.

— October 28, 1944. The Treatment of Early and Latent Syphilis, Harry

Eagle, M.D.

— November 4, 1944. Sulfonamide Therapy of Gonorrhea, Euth Boring Thomas,

M.D., William E. Graham, M.D. and George E. Cannefax.

— November 11, 1944. The Dallas Venereal Disease Control Program.
JOURNAL OF HOME ECONOMICS, October, 1944. New Problems in the Control

of Syphilis and Gonorrhea, C. A. Wilzbach.

JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES (Chicago), July
1944. Teaching the Public Health Aspects of Syphilis Control, Henry
Packer, M.D., Dr.P.H.

580 JOURNAL OF SOCIAL HYGIENE

JOURNAL OF THE MISSOURI STATE MEDICAL ASSOCIATION, September 1944.

Venereal Disease Control in Missouri, E. R. Woleott, M.D.
MICHIGAN PUBLIC HEALTH, August, 1944. Eligibility Requirement of Michigan

Bapid Treatment Center, N. W. Guthrie, M.D.
MILBANK MEMORIAL FUND QUARTERLY (N.Y.C.), October 1944. Findings of

Selective Service Examinations, G. St. J. Perrott.
MILITARY SURGEON, August, 1944. Some Aspects of Venereal Disease Control

in the Army, C. S. Hendricks, M.D., and J. D. Winebrenner, M.D.
MINNESOTA MEDICINE, July, 1944. The New Intensive Measures for the Treatment

of Early Syphilis, P. A. O'Leary, M.D.
MODERN HOSPITAL, July, 1944. Health Examinations Can Benefit Hospitals as

Well as Public, C. C. Little.

— July, 1944. A Public Health Doctor's View, E. E. Church, M.D.

MOTHER AND CHILD (London), June, 1944. Social Conditions and Infant

Mortality, B. Woolf, Ph.D.
NORTH CAROLINA MEDICAL JOURNAL, September, 1944. Recent Experiences in

the Intensive Treatment of Syphilis, N. B. Hon, M.D.
NURSING EDUCATION IN SOCIAL HYGIENE, October, 1944. Integrated Material

in Medical and Public Health Courses, Social Hygiene Committee, New

York Tuberculosis and Health Association, New York.

— November 1944. Study Units for Ward Classes.

— November 1944. Study Units in Pharmacology.

— November 1944. Medical Nursing.

PENNSYLVANIA'S HEALTH, State Department of Health, July-September, 1944.

Venereal Disease Quarantine Plan in Pennsylvania, E. S. Everhart, M.D.
PUBLIC HEALTH NEWS, New Jersey State Department of Health, June, 1944.

Penicillin Treatment Plan for Gonorrhea and Syphilis Offered to Physicians

and Hospitals, J. L. Mahaffey, M.D.

— June, 1944. Twenty-five Years of Progress in Maternal and Child Health,

K. F. Lenroot.

PUBLIC HEALTH NURSING, July, 1944. Community Action Against Venereal
Disease, Charlotte P. Smith.

— September 1944. Techniques for Teachers — an experiment in Teacher train-

ing, Geraldine Hiller, E.N.

PUBLIC HEALTH EEPORTS, U. S. Public Health Service, June 23, 1944. Notifiable
Diseases, First Quarter 1944.

— July 7, 1944. Prevalence of Communicable Diseases in the United States,

May Si-June 17, 1944.
SOCIAL HYGIENE, November 1944. New York TB and Health Assn. Syphilis

Control in War Time — Rapid Treatment Centers.
UNITED STATES NAVAL MEDICAL BULLETIN, September, 1944. Penicillin in

Sulfonamide-resistant Gonorrhea: Preliminary Report of 124 Cases, J. G.

Menville, M.D., and C. W. Eoss, M.D.
VENEREAL DISEASE INFORMATION, June, 1944. A Technic of Follow-up of

Selective Service Registrants with Syphilis in Philadelphia, A. M.

Kresge, E.N.

— August, 1944. Outpatient Penicillin Treatment of Gonococcic Infections in

Males, C. J. Van Slyke, Surgeon, S. Steinberg, Passed Assistant Surgeon.

— August, 1944. Prevalence of Gonorrhea Among Syphilitic Patients, A. R.

Cameron, M.D., A. L. Chapman, M.D.

— September, 1944. False Positive Serologic Tests for Syphilis in Several

Members of a Family, Bernard Zuger, M.D., and G. B. Moffat, M.D.

— September, 1944. The Rapid Treatment Center Program of Texas, Melford

S. Dickerson, M.D.

— September, 1944. A Sociologic Analysis of 304 Female Patients Admitted

to the Midwestern Medical Center, St. Louis, Mo., H. L. Eachlin, Surgeon (R).

— October, 1944. The Treatment of Gonorrheal Urethritis in the Male : Special

Reference to the Care of Sulfonamide Resistant Infections with Combined
Fever and Sulfathiazole, Major Eugene Greenwald, MC.

— October, 1944. Venereal Disease Epidemiology in the Army Third Service

Command: Progress Report for Period July Through December, 1943,
E. W. Norris, Senior Surgeon, A. F. Doyle, Major, MC, Fred W. Kratz,
Senior Surgeon, Albert P. Iskrant, M.A.

WAR MEDICINE, August, 1944. Use of Penicillin for Gonorrhea Resistant to
Sulfonamide Compounds, L. W. Eiba, M.D., and others.

Index to Volume 30, 1944

Journal of Social Hygiene

CONTENTS

BY AUTHOR, TITLE AND SUBJECT

A

home

front. Elena

Action on the
Bonilla. 204.
Agricultural Extension Service.

Puerto Kico regional conference on
social hygiene. Examples of spon-
soring agency cooperation. 172.
Alabama.

Birmingham. 317.
American Journal of Public Health,

Professor Winslow to edit. 314.
American Library Association plans for

war areas. 340.

American Medical Association Journal
urges teaching of biology in high
schools. 348.

American Public Health Association
holds second wartime conference.
500.

American Social Hygiene Association.
Annual dinner meeting. 144.
Annual report of Executive Director.

107.
Associate group meeting at National

Conference of Social Work. 311.
Call for the 1945 meeting. 559.
Field offices. 133.
Missouri Social Hygiene Association,

Dinner meeting with. 561.
A new exhibit. Frontispiece. June.
New honorary life members. 149.
Officers and board of directors. 143.
Program and budget for 1944. 128.
Report of the board of directors.

135.
Report of the committee on awards.

140.
Report of committee on credentials.

135.

Report of the nominations committee.
142.

ASH A — continued

Report of the committee on resolu-
tions. 142.

Report of the committee on war ac-
tivities. 140.

Report of the general advisory com-
mittee. 141.

Report of the treasurer. 137.

Staff news. 506.

Summary of corporation report for
1943. 139.

Summary of report of the executive
committee. 136.

Summary of report of the finance
committee. 137.

Thirty-first annual meeting, business
session. 134.

Thirty-first annual meeting number.

March.
Americas go forward together, The.

Luncheon session, Puerto Rico reg-
ional conference on social hygiene.

191-201.
Americas versus the venereal diseases,

The. Charles E. Shepard. 192.
Anderson, Gaylord. Venereal disease

education in the army. 20.
Anglo-American Caribbean Commission.

See Caribbean Commission.
Announcements. 48.
Answer to a challenge, An. June John-
son. 549.
Appropriations. Congress appropriates

$12,500,000 for VD control. 438.
Argentina. Milio Fernandez Blanco.

390.
Arkansas Pharmaceutical Association

holds annual meeting. 349.
Army preventive medicine units stepped

up. 44.

583

584

CONTENTS

Army's campaign, The. The national
campaign for venereal disease control
in wartime. M. C. Stayer. 174.

Award for distinguished service to hu-
manity to Hugh Smith Gumming.
Presentation by Merritte W. Ireland.
101.

B

Baehr, Dr. George. 314.

Bigelow, Maurice A. Sex education in
school programs on health and human
relations. 84.

Biography of a civilian committee on
venereal disease control. M. Leider,
S. Brookins and V. McDaniel. 67.

Blanco, Milio Fernandez. The social
hygiene campaign in the other Ameri-
can republics: Argentina. 390.

Blanco, Tomas. Remarks by the Chair-
man, Group I, afternoon sessions,
Puerto Eico regional conference on
social hygiene. 202.

Bonilla, Elena. Action on the home
front. 204.

Book Reviews. See pages 595-6 for
Index.

Brau, Louis Ramirez. Statement, Group
III, afternoon sessions, Puerto Rico
regioual conference on social hygiene.
231.

Brazil. L. Campos Mello. 394.

Briercliffe, Rupert. Remarks by the
chairman, luncheon session, Puerto
Rico regional conference on social
hygiene. 191.

Brookins, S., M. Leider and V. Mc-
Daniel. Biography of a civilian com-
mittee on venereal disease control.
67.

C

California. Display arranged by San
Diego Social Hygiene Association.
Frontispiece. June.
Promiscuity as a factor in the spread

of venereal disease. 517.
San Diego's first annual health edu-
cation week. 349.

The San Francisco separate women's
court. 288.

Calling all communities. Quotations.
529, 537.

Campaign with special reference to the
Caribbean area, The. R. A. Vonder-
lehr. 183.

Canada's four-sector program in ac-
tion. D. H. Williams. 545, and
Frontispiece. December.
Caribbean Commission makes recom-
mendations for unified VD control
program. 312.
Child in the home, The. Beatriz Las-

salle. 233.

Challenge to community workers: What

are you doing about better laws and

law enforcement? Bascom Johnson.

449.

Challenge to law enforcement, The.

L. R. Pennington. 530.
Chautauqua Summer Schools offer social

hygiene courses. 345.
Choate, Rufus. Quotation. 455.
Clarke, Walter. Teamwork in venereal

disease prevention. 107.
Community is on the firing line, The.

537.
Community Programs.

Biography of a civilian committee on
venereal disease control. M.
Leider, S. Brookins, and V. Mc-
Daniel. 67.

Library and a social hygiene society
cooperate, A. Pauline J. Fihe,
Viola Wallace and Jean Thomas.
333.

Neighborhood war clubs as a channel
for popular education in venereal
disease, The. Shata Ling. 49.
Plan for reaching industrial workers
through industrial health commit-
tees. Percy Shostac. 58.
A public library works with com-
munity agencies. Aubry Lee Gra-
ham. 329.

Rehabilitation in action: a social
hygiene society cooperates with a
rapid treatment center in aiding
venereal disease patients. Lucia
Murchison. 296.

United States Junior Chamber of
Commerce announces new program.
564.

Conference, American Public Health
Association holds second wartime.
500.
Conference of social hygiene executives

in New York. 501.
Conference of Social Work at Cleveland,

National. 311.

Conference on childhood and youth,
National Congress of Parents and
Teachers, holds. 342.
Conference on Conservation of Marriage

and the Family. 318.
Conference on inter-agency relation-
ships in venereal disease control, Mid-
west. 445.
Conference on postwar VD control

meets in St. Louis, National. 560.
Conference on postwar VD control, Na-
tional. 438.

Conference with negro leaders on war-
time problems in venereal disease con-
trol: abstract of proceedings. 76.
Conferences.
Alabama. 317.

National voluntary agency executives
discuss social hygiene problems.
95.

New Jersey. 318.

Proceedings of the Puerto Eico reg-
ional conference on social hygiene.
April.

Rehabilitation to be discussed at Na-
tional Conference of Social Work.
97.

U. S. Army librarians of Antilles
Department hold conference :
Puerto Eico. 353.
Congress appropriates $12,500,000 for

VD control. 438.
Connecticut.

Connecticut State Health Depart-
ment completes laboratory evalua-
tion study. 445.

State Teachers Association Conven-
tion includes social hygiene speaker
on program. 508.

Costa Eica. Jose Amador Guevara.
402.

CONTENTS 585

Gumming, Hugh Smith. Award for dis-
tinguished service to humanity.
101.
Letter, Latin American cooperation.

388.

Nations united for health and wel-
fare in peace and war. 103.
William Freeman Snow Award pre-
sented to. Frontispiece. March.
Current status of venereal disease con-
trol education, The. Thomas Parran.
1.

Debayle, Luis Manuel. The social hy-
giene campaign in the other American
republics : Nicaragua. 423.

de la Caro, Dolores G. Youth in crisis :
new horizons for our girls in trouble.
244.

de Eahn, Maria Pintado. Eemarks by
chairman, Group IV, afternoon ses-
sions, Puerto Eico regional confer-
ence on social hygiene. 233.

District of Columbia.

D. C. Society has full-time health

educator. 445.

A public library works with com-
munity agencies. 329.
Eehabilitation in action: a social
hygiene society cooperates with a
rapid treatment center. 296.

District of Columbia Social Hygiene
Society reports on year's work. 349.

Doak, E. Douglas. The venereal disease
education institute. 12.

Dr. George Baehr completes OCD
assignment. 314.

Dr. Parran reappointed Surgeon Gen-
eral. 314.

Dr. Sawyer appointed to UNEEA. 345.

Dominican Eepublie. L. F. Thomen.
404.

Dunham, Georgia C. Letter, Latin
American cooperation. 387.

Editorials. 93-4, 162-64, 309-10, 339,
385-86, 496, 497, 557-59.

586

CONTENTS

Education.

American Medical Association Jour-
nal urges teaching of biology in
high schools. 348.

Current status of venereal disease
control education. The. Thomas
Parran. 1.

Neighborhood war clubs as a channel
for popular education in venereal
disease, The. Shata Ling. 49.

Sex education in school programs on
health and human relations. Mau-
rice A. Bigelow. 84.

Venereal disease education in the
army. Gaylord Anderson. 20.

Venereal disease education in the
U. S. Navy. C. S. Stephenson and
G. W. Mast. 29.

Venereal disease education institute,
The. E. Douglas Doak. 12.

Venereal disease education process in
the U. S. Navy, The. Howard
Ennes. 40.

Venereal disease health education pro-
ject for Negroes in Texas. Bas-
com Johnson. 72.

The federal program of venereal
disease education. January.

The soldier and the home. Moe

Frankel. 325.

Eleventh annual library number. June.
Eliot, Charles W. Quotation. 148.
Ennes, Howard. The venereal disease

education process in the U. S. Navy.

40.

Events — past and future. 444.
Exhibits and posters.

Canada's four-sector program in ac-
tion. Frontispiece. December.

Display by San Diego Social Hygiene
Association. Frontispiece. June.

Mexico. 426.

A new exhibit. American Social Hy-
giene Association. Frontispiece
June.

Social hygiene day — 1944. 157, 160.

Street display in Dallas. Frontis-
piece. June.

U. S. Army. 25-26.

U. S. Navy. 36, 42.

VD education institute. 17-18.

Federal program of venereal disease

education, The. January.
Fellowships in health education an-
nounced. 314.
Fernos Isern, Antonio. New honorary

life members. 151.
Puerto Rico's place in the national
venereal disease control program.
258.

Fighting venereal disease among mili-
tary personnel. B. D. Holland. 211.
Fihe, Pauline J., Viola Wallace and
Jean Thomas. A library and a social
hygiene society cooperate. 333.
Fischelis, Eobert P. Pharmacy in the
wartime educational campaign
against VD. 554.

Florida. Biography of a civilian com-
mittee on venereal disease control.
67.
Forms and principles of state social

hygiene laws. 479.
Frankel, Moe. Education, the soldier

and the home. 325.
Frontispiece.

Canada's four-sector program in ac-
tion. December.

Map of Pan American countries, and
message from President Wilbur.
October.
Puerto Eico regional conference on

social hygiene. April.
Snow award presented to Hugh Smith
Gumming. March.

Gandara, Jose N. Remarks by the
chairman, Group II, afternoon ses-
sions, Puerto Rico regional confer-
ence on social hygiene. 208.

General Federation of Women's Clubs.
343.

General Magee joins staff of National
Research Council. 97.

Georgia. 317.

Gould, George. Twenty years progress
in social hygiene legislation. 456.

Graham, Aubry Lee. Public library
works with community agencies, A.
329.

CONTENTS

587

Guevara, Jose Amador. The social hy-
giene campaign in the other Ameri-
can republics: Costa Eica. 402.

Guzman, Celia. Eole of the public
health nurse. 220.

H

Haiti. Jules Thebaud. 407.

Haldeman, Jack C. The local public
health official. 214.

Harvard School of Public Health.
Summer courses. 316.

Hawaii. An answer to a challenge.
549.

Health education and health educators.
Editorial. 93.

Health education fellowships awarded
by U. S. Public Health Service, Kel-
logg Foundation, and National Foun-
dation for Infantile Paralaysis. 568.

Health education, Fellowships in, an-
nounced. 314.

Health task for today — and tomorrow,
A. Thomas Parran. 251.

Herrick, Philip F. Statement, Group
III, afternoon sessions, Puerto Rico
regional conference on social hygiene.
224.

Holland, B. D. Fighting venereal dis-
ease among military personnel. 211.

Honduras. Pedro Ordonez Diaz. 412.

Honorary life members, New. 149.

Hutzel, Eleanore L. The policewoman 's
role in social protection. 538.

Huyke, Emilio E. Power of the press.
206.

"I want to draw a book on . . ."
Aimee Zillmer. 336.

Idaho. State Home Economics Asso-
ciation contributes to better home
life in wartime. 508.

If your state needs new social hygiene
laws. Editorial. 496.

Indiana. Indianapolis. 317.

Industry.

Plan for reaching industrial workers
through industrial health commit-
tees. Percy Shostac. 58.
See Notes on industrial cooperation.

Institute of Inter- American Affairs.
387.

Inter-American cooperation. The so-
cial hygiene campaign in the other
American republics. October.

Ireland, Merritte W. Award for dis-
tinguished service to humanity to
Hugh Smith Gumming. 101.

J

Johnson, Bascom. A challenge to com-
munity workers: what are you
doing about better laws and law
enforcement? 449.
Venereal disease health education
project for negroes in Texas. 72.
Johnson, June. An answer to a chal-
lenge. 549.

Juvenile delinquents, Who are they?
Winfred Overholser. 304.

K

Kellogg Foundation. Health education
fellowships awarded by. 566.

Kentucky Association holds annual
meeting. 351.

Koch, Richard A. The San Francisco
separate women's court. 288.

Koch, Richard A. and Ray Lyman Wil-
bur. Promiscuity as a factor in the
spread of venereal disease. 517.

L

Lairet Hi jo, Felix. The social hygiene
campaign in the other American re-
publics: Venezuela. 434.
Lassalle, Beatriz. The child in the

home. 233.

Latin America. The social hygiene
campaign in the other American re-
publics. October.
Laws and law enforcement.

A challenge to community workers:
What are you doing about better
laws and law enforcement? Bas-
com Johnson. 449.
Forms and principles of state social

hygiene laws. 479.
Good laws and law enforcement are
strong weapons. Group III, after-
noon sessions, Puerto Rico regional
conference on social hygiene. 224.

588

CONTENTS

Laws and law enforcement — continued
Puerto Rieo legislative program.

Newspaper clippings. 167.
Requirements of existing state laws.

470.

A review of principles and progress
in social hygiene legislation. No-
vember.

Social hygiene legislation considered
in 1943-44 in the states, territories
and District of Columbia. 494.
Twenty years progress in social hy-
giene legislation. George Gould.
456.
U. S. Public Health Service Act

signed. 346.

Laws against prostitution.
Forms and principles. 479.
Requirements of existing state laws.

470.

Laws, Premarital examination.
Forms and principles. 483.
Requirements of existing state laws.

472.

Laws, Prenatal examination.
Forms and principles. 487.
Requirements of existing state laws.

477.
Laws, Venereal disease control. Forms

and principles. 488.
Legislation. See Laws and law en-
forcement.

Leider, M., S. Brookins and V. Mc-
Daniel. Biography of a civilian com-
mittee on venereal disease control.
67.
Libraries.

Education, the soldier and the home.

Moe Frankel. 325.
"I want to draw a book . . ."

Aimee Zillmer. 336.
Public library works with community
agencies, A. Aubry Lee Graham.
329.

Library and a social hygiene society
cooperate, A. Pauline J. Fihe, Viola
Wallace and Jean Thomas. 333.
Library number, Eleventh annual.

June.

Ling, Shata. The neighborhood war
clubs as a channel for popular educa-
tion in venereal disease. 49.

Local public health official, The. Jack

C. Haldeman. 214.
' ' Looking backward ' ' — and forward.

Editorial. 162.

M

MacCormick, Carlos E. Munoz.

Remarks by chairman, evening ses-
sion, Puerto Rico regional confer-
ence on social hygiene. 250.
Role of the private physician. 209.

McDaniel, V., S. Brookins and M.
Leider. Biography of a civilian com-
mittee on venereal disease control.
67.

Magee, James Carre (MC). 97.

Marriage and Family Conservation Con-
ference. North Carolina. 318.

Marriage and home adjustment, Annual
institute on, Pennsylvania. 510.

Marsh, Marguerite. Quotation. 308.

Massachusetts Society for Social .Hy-
giene holds annual meeting. 351.

Mast, G. W. and C. S. Stephenson.
Venereal disease education in the
U. S. Navy. 29.

Medical diagnosis and treatment are
strong weapons. Group II, afternoon
sessions, Puerto Rico regional con-
ference on social hygiene. 208.

Mello, L. Campos. The social hygiene
campaign in the other American re-
publics : Brazil. 394.

Mental health for our children. Luis
Manuel Morales. 237.

Mexico. Educational placards prepared
by department of health and wel-
fare. 426.

U. S.-Mexico border cooperative VD
program. Joseph S. Spoto. 418.
U. S.-Mexico Border Public Health
Association meets. 340.

Mexico's contribution to the venereal
disease campaign. Enrique Villela.
195.

Michigan.

The neighborhood war clubs as a
channel for popular education in
venereal diseases. 49.
The policewoman's role in social pro-
tection. 538.

CONTENTS

589

Michigan establishes Bureau of Ven-
ereal Disease Control. 352.

Mills College. Summer courses. 316.

Missouri. ASHA-Missouri Social Hy-
giene Association dinner meeting.
561.

Morales, Luis Manuel. Mental health
for our children. 237.

Morales Otero, Pablo. Remarks by dis-
cussion leader, Group II, afternoon
sessions, Puerto Eico regional con-
ference on social hygiene. 223.

Murchison, Lucia. Rehabilitation in
action: a social hygiene society co-
operates with a rapid treatment cen-
ter in aiding venereal disease pa-
tients. 296.

N

National events. 43-8, 95-7, 311-16,
340-55, 438-44, 499-507, 560-68.

National campaign for venereal disease
control in wartime, The. Morning
session, Puerto Rico regional con-
ference on social hygiene. 174—190.

National Committee for Mental Hygiene
holds annual meeting. 565.

National Conference of Social Work.
Cleveland. 311.
Notes on industrial cooperation. 356.

National conference on postwar "VD
control meets in St. Louis. 560.

National Congress of Parents and
Teachers holds conference on child-
hood and youth. 342.

National Congress of Parents and
Teachers supports social hygiene pro-
gram and ASHA. 565.

National Foundation for Infantile
Paralysis, Health education fellow-
ships awarded by. 568.

National Health Council elects officers.
313.

National Venereal Disease Committee
meets. 499.

National voluntary agency executives
discuss social hygiene problems. 95.

National Women's Advisory Committee
on Social Protection meets. 347.

Nations unite for victory over venereal
disease, The. Evening session,
Puerto Rico regional conference on
social hygiene. 250-263.

Nations united for health and welfare
in peace and war. Hugh S. Gum-
ming. 103.

Nations united for war and permanent
peace. Editorial. 385.

Navy and venereal disease control in
the Caribbean, The. Frank W. Rey-
nolds. 180.

Navy venereal disease control officers.
46.

Nebraska.

Midwest conference on inter-agency
relationships in venereal disease
control. 445.
North Platte. 317.

Negro colleges, Social hygiene day con-
test for. 96.

Negro college social hygiene day con-
test winners. 346.

Negro leaders, Conference with, on
wartime problems in venereal disease
control: abstract of proceedings.
76.

Negroes in Texas, Venereal disease
health education project for. Bas-
com Johnson. 72.

Neighborhood war clubs as a channel
for popular education in venereal
disease, The. Shata Ling. 49.

Ness, Eliot.

Social protection in the cooperative

program. 186.

Social protection in venereal disease
control. 226.

New honorary life members. 149.

New Jersey. Newark. 318.

New problems in the control of syp-
hilis and gonorrhea. Carl A. Wilz-
bach. 88.

New York.

Institute at Skidmore College. 352.
New York City. 318.

New York City. Social Hygiene Divi-
sion, New York Tuberculosis and
Health Association has new staff
member. 446.

News from other countries. 98-100.

590

CONTENTS

News from the 48 fronts. 317-21,

349-55, 44,5-47, 508-10.
Nicaragua. Luis Manuel Debayle. 423.
North Carolina. Marriage and Family

Conservation Conference. 318.
Notes on industrial cooperation. 322-

24, 356-59, 447-48, 511-13, 573-75.

Office of the Coordinator of Inter-
American Affairs. Letter. 387.

Ohio.

Cleveland holds VD institute and

physicians' refresher course. 509.

A library and a social hygiene society

cooperate. 333.

New problems in the control of syp-
hilis and gonorrhea. 88.
Social hygiene in Scioto County. 319.

Oklahoma Social Welfare Association
holds war conference. 353.

Ordonez Diaz, Pedro. The social hy-
giene campaign in other American
republics: Honduras. 412.

Osborn, Robert W. National Events.
502.

Overholser, Winfred. Who are the
juvenile delinquents? 304.

Pan American Sanitary Bureau. Letter.

388.

Panama. Arturo Tapia. 427.
Parran, Thomas. 314.

The current status of venereal disease
control education. 1.

A health task for today — and tomor-
row. 251.

Letter. 389.

New honorary life members, Re-
marks. 149.
Penicillin for early syphilis, Rapid

treatment centers use. 440.
Penicillin made available for civilian

use. 312.
Pennington, L. R. The challenge to

law enforcement. 530.
Pennsylvania. Annual institute on

marriage and home adjustment at

State College. 510.

Pharmaceutical association holds an-
nual meeting, Arkansas. 349.

Pharmacy in the wartime educational
campaign against VD. Robert P.
Fischelis. 554.

Physical fitness year is planned by joint
committee. 500.

Pinney, Jean B. Introduction, Pro-
ceedings of Puerto Rico regional con-
ference on social hygiene. 165.

Plan for reaching industrial workers
through industrial health committees.
Percy Shostac. 58.

Policewoman's role in social protection,
The. Eleanore L. Hutzel. 538.

Posters. See Exhibits and posters.

Power of the press. Emilio E. Huyke.
206.

Premarital examination laws.
Forms and principles. 483.
Requirements of existing state laws.
472.

Prenatal examination laws.
Forms and principles. 487.
Requirements of existing state laws.
477.

Proceedings of the Puerto Rico regional
conference on social hygiene. April.

Professor Winslow to edit American
Journal of Public Health. 314.

Promiscuity as a factor in the spread
of venereal disease. Richard A.
Koch and Ray Lyman Wilbur. 517.

Prostitution, Laws against. Forms and

principles. 479.

Requirements of existing state laws.
472.

Public information. Knowledge is a
strong weapon. Group I, afternoon
sessions, Puerto Rico regional con-
ference on social hygiene. 202.

Public library works with community
agencies, A. Aubry Lee Graham.
329.

Publications received. 376-83, 514-18,
578-580.

Publicity. Cooperation from the Puerto
Rican press. Opposite 245.

Puerto Rico.

Map. Frontispiece. April.
Photographs. Between 244—45.

CONTENTS

591

Puerto Rico — continued

IT. S. Army librarians of Antilles De-
partment hold conference. 353.
Young American citizens. Photo-
graph. Opposite 244.

Puerto Rico Department of Education.
Regional conference on social hy-
giene. Examples of sponsoring
agency cooperation. 172.

Puerto Rico does her part in the fight.
Afternoon sessions, regional confer-
ence on social hygiene. 202-249.

Puerto Rico legislative program. News-
paper clippings. 167.

Puerto Rico's place in the national
venereal disease control program.
Antonio Fernos Isern. 258.

Puerto Rico regional conference on so-
cial hygiene:

Examples of sponsoring agency co-
operation. 172.

Greetings and messages received from
the other American republics. 267.
Photographs. Frontispiece. April.
Photographs. Insert between 196-

197.

Program. 170.
Resolutions. 264.

Sponsoring agencies, officers and pro-
gram committee. 168—9.
Proceedings of. April.

Puerto Rico social protection commit-
tee. Resolutions. 264.

Puerto Rico, A study of 280 patients
in the venereal disease isolation hos-
pitals of. 269.

R

Rapid treatment centers use penicillin

for early syphilis. 440.
Rayburn, Reba. See National events.
Rehabilitation.

San Francisco separate women's

court, The. Richard A. Koch. 288.

Selectees with syphilis rehabilitated

for induction. 566.
Youth in crisis : new horizons for our
girls in trouble. Dolores G. de la
Caro. 244.

Rehabilitation of the female sex of-
fender. Quotation. 303.

Rehabilitation, Some current efforts to-
ward. May.

Rehabilitation in action: a social hy-
giene society cooperates with a rapid
treatment center in aiding venereal
disease patients. Lucia Murchison.
296.

Rehabilitation to be discussed at Na-
tional Conference of Social Work.
97.

Requirements of existing state laws.
470.

Resolutions of Puerto Rico regional
conference on social hygiene. 264.

Review of principles and progress in
social hygiene legislation, A. No-
vember.

Reynolds, Frank W. The Navy and
venereal disease control in the Carib-
bean. 180.

Rockefeller Foundation. American Li-
brary Association plans for war
areas. 340.

Role of the private physician. C. E.
Munoz MacCormick. 209.

Role of the public health nurse. Celia
Guzman. 220.

Roosevelt, Franklin D. Quotation. 385.

Rosario, Jose Colomban. Sociology and
the community. 218.

San Francisco separate women's court,

The. Richard A. Koch. 288.
Sawyer, Dr. Wilbur A. 345.
School programs on health and human

relations, Sex education in. Maurice

A. Bigelow. 84.

Schultz, Gladys Denny. Quotation. 332.
Selectees with syphilis rehabilitated for

induction. 566.

Sex education. Alabama. 317.
Sex education in school programs on

health and human relations. Maurice

A. Bigelow. 84.
Shenehon, Eleanor.

Social hygiene day — 1944. 155.

Some forecasts of social hygiene day
programs. 569.

See News from the 48 fronts.

592

CONTENTS

Shepard, Charles E. The Americas

versus the venereal diseases. 192.
Shostac, Percy.

Plan for reaching industrial workers
through industrial health commit-
tees. 58.

See Notes on industrial cooperation.
Snow, William F.

Award for distinguished service to

humanity. 101.
Editorial: Nations united for war

and permanent peace. 385.
The voluntary social hygiene agencies

in wartime. 189.

So you're going to hold a social hy-
giene day meeting! Program sug-
gestions from the social hygiene day
service. 571.

Social hygiene campaign in the other

American republics, The. October.

Social hygiene day contest for Negro

colleges. 96.
Social hygiene day contest winners,

Negro college. 346.
Social hygiene day — 1944. Eleanor

Shenehon. 155.

Social hygiene day number. December.
Social hygiene day programs, Some

forecasts of. 569.
Social hygiene day service, Program

suggestions from the. 571.
Social hygiene executives, Conference

of. 501.

Social Hygiene in Wartime. XII. The
federal program of venereal disease
education. January.
Social Hygiene in Wartime. XIV.
Some current efforts toward rehabili-
tation. May.

Social hygiene legislation considered in
1943-44 in the states, territories and
District of Columbia. 494.
Social hygiene societies. See respective
states under News from the 48
fronts.

Social protection in the cooperative pro-
gram. Eliot Ness. 186.
Social protection in venereal disease

control. Eliot Ness. 226.
Social Protection, National Women's
Advisory Committee on. 347.

Social Protection, Puerto Eico commit-
tee on. Eesolutions. 264.

Sociology and the community. Jose
Colomban Bosario. 218.

Some current efforts toward rehabili-
tation. May.

Some forecasts of social hygiene day
programs. Eleanor Shenehon. 569.

Some ways out. Celestina Zalduondo.
241.

South Carolina.
Charleston. 319.

State Bar Association adopts resolu-
tion for education and repression
of prostitution. 320.
State Conference of Social Work ap-
points social hygiene committee
and holds meeting. 510.

Spoto, Joseph S. The social hygiene
campaign in the other American re-
publics: United States-Mexico border
cooperative venereal disease program.
418.

Stephenson, C. S. and G. W. Mast.
Venereal disease education in the
U. S. Navy. 29.

Stayer, M. C. The national campaign
for venereal disease control in war-
time: The Army's campaign. 174.

Summer courses. 316, 345.

Tapia, Arturo. The social hygiene cam-
paign in the other American repub-
lics: Panama. 427.

Teamwork in venereal disease preven-
tion. Walter Clarke. 107.

Texas.

Corpus Christi. 320.
Dallas extends VD educational cam-
paign. 354.

Street display in Dallas. Frontis-
piece. June.

Venereal disease health education
project for Negroes in Texas. 72.

Thebaud, Jules. The social hygiene
campaign in the other American re-
publics: Haiti. 407.

Thirty-first annual meeting number.
March.

CONTENTS

593

"This way out . . .?" Editorial.
309.

Thomas, Jean, Pauline J. Fine and
Viola Wallace. A library and a so-
cial hygiene society cooperate. 333.

Thomen, L. F. The social hygiene
campaign in the other American re-
publics: Dominican Eepublic. 404.

Towards V-Day in the war on venereal
diseases. Editorial. 557.

Tugwell, Eexf ord G.

Greetings to Puerto Rico regional

conference on social hygiene. 174.

Proclamation by the Governor of

Puerto Rico. Frontispiece. April.

Twenty years progress in social hygiene
legislation. George Gould. 456.

United Nations Relief and Rehabilita-
tion Administration, Dr. Sawyer ap-
pointed to. 345.
U. 8. Army.
See Army.
Venereal disease education in the

army. Gaylord Anderson. 20.
U. S. Chamber of Commerce makes

community health awards. 341.
TJ. S. Junior Chamber of Commerce an-
nounces new program. 564.
U. S.-Mexico border cooperative ven-
ereal disease program. Joseph S.
Spoto. 418.
TJ. S.-Mexico Border Public Health

Association meets. 340.
U.S. Navy. See Navy.

Venereal disease education in the
U. S. Navy. C. S. Stephenson and
G. W. Mast. 29.

Venereal disease education process in
the U. S. Navy, The. Howard
Ennes. 40.
U. S. Office of Education has consultant

in social hygiene. 344.
U. S. Public Health Service. Congress
appropriates $12,500,000 for VD
control. 438.

Dr. Parran reappointed Surgeon Gen-
eral. 314.

Health education fellowships awarded
by. 568.

U. S. Public Health Service — continued
Letter, Latin American Cooperation.

389.
National conference on postwar VD

control meets in St. Louis. 560.
Selectees with syphilis rehabilitated

for induction. 566.
Reorganizes. 43.

U. S. Public Health Service Act signed.
346.

U. S. Public Health Service holds Na-
tional Conference on Postwar Ven-
ereal Disease Control. 438.

University of Pennsylvania. Summer
courses. 316.

University of Utah. Summer courses.
316.

Utah. 321.

Venereal disease control officers. 43—48.

Venereal disease education in the
Army. Gaylord Anderson. 20.

Venereal disease education in the U. S.
Navy. C. S. Stephenson and G. W.
Mast. 29.

Venereal disease education institute,
The. E. Douglas Doak. 12.

Venereal disease education process in
the U. S. Navy, The. Howard
Ennes. 40.

Venereal disease health education pro-
ject for Negroes in Texas. Bascom
Johnson. 72.

Venezuela. Felix Lairet Hijo. 434.

Villela, Enrique. Mexico 's contribu-
tion to the venereal disease cam-
paign. 195.
New honorary life members. 150.

Virginia. State Social Hygiene Coun-
cil sponsors workshop in health and
human relations at Radford College.
446.

Voluntary agency executives discuss so-
cial hygiene problems, National. 95.

Voluntary social hygiene agencies in
wartime, The. William F. Snow.
189.

Vonderlehr, R. A. The campaign with
special reference to the Caribbean
area. 183.

594

CONTENTS

W

Wallace, Viola, Pauline J. Fihe and

Jean Thomas. A library and a social

hygiene society cooperate. 333.
War and the Journal's Annual Library

Number. Editorial. 339.
War Department. See also TJ. S.

Army.
War department advisory council meets

in Washington. 562.
Washington. Social hygiene societies

hold annual meetings. 355.
Who are the juvenile delinquents?

Winfred Overholser. 304.
Wilbur, Ray Lyman, Message from.

Reverse of frontispiece. October.
Wilbur, Ray Lyman and Richard A.

Koch. Promiscuity as a factor in the

spread of venereal disease. 517.
Wilbur, Ray Lyman. Quotation. 148.

Quotation. 335.
Williams, D. H. Canada's four sector

program in action. 545.

Wilzbach, Carl A. New problems in
the control of syphilis and gonorrhea.
88.

Winslow, Professor C.-E. A. 314.

Wisconsin. ' ' I want to draw a book
on . . ." 336.

Women's Interests Section, War De-
partment. 562.

Women's Clubs adopt resolutions. 343.

Your part in the legislative campaign.
Editorial. 497.

Youth has priority. Group IV, after-
noon sessions, Puerto Rico regional
conference on social hygiene. 233.

Youth in crisis: new horizons for our
girls in trouble. Dolores G. de la
Caro. 244.

Zalduondo, Celestina. Some ways out.

241.
Zillmer, Aimee. ' ' I want to draw a

book on . , ." 336.

(Book Reviews — see next page)

CONTENTS

595

BOOKS REVIEWED

BY AUTHOR AND TITLE

Amen, ainen. S. A. Constantino. 361.

American Council on Education, Com-
mission on Teacher Education.
Teachers for our time. 362.

American Legion, National Law and
Order Committee. ' ' To maintain
law and order. ' ' 365.

American Prison Association, The, and
National Jail Association. The
prison world. 368.

B

Bell, Marjorie, editor. Juvenile de-
linquency and the community in war-
time. 370.

Better times — health issue in honor of
Bailey B. Burritt. 576.

Byrd, Oliver E. Health instruction
yearbook. 360.

C

Cecil, Eussell L. and Foster Kennedy.
A textbook of medicine, sixth edition.
371.

Children's Bureau.

Controlling juvenile delinquency : a

community program. 366.
Juvenile-Court statistics, 1940-42.

368.

Juvenile-Court statistics, 1943, pre-
liminary statement. 368.
Understanding juvenile delinquency.
365.

Christian, Henry A. Osier's principles
and practice of medicine. 372.

Clinical diagnosis by laboratory exami-
nations. John A. Kolmer. 373.

Commission on Teacher Education,
American Council on Education.
Teachers for our times. 362.

Constantino, S. A. Amen, amen. 361.

Controlling juvenile delinquency : a com-
munity program. Children's Bureau.
366.

Gould, George. Summary of state
legislation requiring premarital and
prenatal examinations for venereal
disease. 369.

Guide for a man and woman looking
toward marriage, A. L. I. Flushing.
363.

Health education on the industrial

front. The 1942 health education

conference of the New York Academy

of Medicine. 361.
Health instruction yearbook. Oliver E.

Byrd. 360.
Howies, James Kirby. A synopsis of

clinical syphilis. 577.
Howard, Mrs. Henry. The seamen's

handbook for shore leave. Eighth

edition. 375.

Juvenile-Court statistics, 1940-42. Chil-
dren's Bureau. 368.

Juvenile-Court statistics, 1943, pre-
liminary statement. Children's Bu-
reau. 368.

Juvenile delinquency and the com-
munity in wartime. 1943 yearbook
of the National Probation Associa-
tion. Marjorie Bell, editor. 370.

Kampmeir, Eudolph H. Essentials of
syphilology. 578.

Kennedy, Foster and Eussell L. Cecil.
A textbook of medicine, sixth edi-
tion. 371.

Kolmer, John A. Clinical diagnosis by
laboratory examinations. 373.

Dattner, Bernhard. The management
of neurosyphilis. 372.

E

Essentials of syphilology. Eudolph H.
Kampmeir. 578.

Flushing, L. I. A guide for a man and
woman looking toward marriage.
363.

League of Nations Advisory Committee
on Social Questions. Prevention of
prostitution. 363.

M

Management of neurosyphilis, The.

Bernhard Dattner. 372.
Meet your enemy — vd. National

women's advisory committee on

social protection. 576.

596

CONTENTS

N

National Advisory Police Committee.
Techniques of law enforcement in the
treatment of juveniles and the pre-
vention of juvenile delinquency. 370.

National child labor committee. The
long road — fortieth anniversary re-
port—1944. 577.

National Jail Association, The and the
American Prison Association. The
prison world. 368.

National Law and Order Committee,
Executive Section, American Legion.
"To maintain law and order ..."
365.

National Probation Association, 1943
yearbook of the. Juvenile delin-
quency and the community in war-
time. 370.

National women's advisory committee
on social protection. Meet your
enemy — vd. 576.

Osier's principles and practice of
medicine. Henry A. Christian. 372.

Prevention of prostitution. League of
Nations Advisory Committee on So-
cial Questions. 363.

Principles and practice of industrial
medicine, The. Fred J. Wampler.
374.

Prison world, The. The American
Prison Association and National Jail
Association. 368.

Proceedings of the Health and Welfare
Institute, Cleveland, Ohio. 361.

Proceedings of the national conference
of social work, 1943. 360.

Seamen's handbook for shore leave,

The. Eighth edition. Mrs. Henry

Howard. 375.
Shore convoy for merchant seamen.

Third edition. United Seamen's

Service. 375.

Study of fact and attitude about gonor-
rhea as demonstrated by question-
naire study, A. Marie Di Mario
Wann. 373.

Synopsis of clinical syphilis, A. James
Kir by Howies. 577.

Summary of State legislation requir-
ing premarital and prenatal examina-
tions for venereal disease. George
Gould. 369.

Survey midmonthly, March, 1944. Spe-
cial number on iuvenile delinquency.
367.

Teachers for our times. Commission on
Teacher Education, American Coun-
cil on Education. 362.

Techniques of law enforcement in the
treatment of juveniles and the pre-
vention of juvenile delinquency.
National Advisory Police Committee.
370.

Textbook of medicine, A. Sixth edi-
tion. Eussell L. Cecil and Foster
Kennedy. 371.

"To maintain law and order ..."
National Law and Order Committee,
Executive Section, American Legion.
365.

The long road — fortieth anniversary
report — 1944. National child labor
committee. 577.

Understanding juvenile delinquency.
Children's Bureau. 365.

United Seamen's Service. Shore con-
voy for merchant seamen. Third
edition. 375.

W

Wampler, Fred J. The principles and
practice of industrial medicine. 374.

Wann, Marie Di Mario. A study of
fact and attitude about gonorrhea as
demonstrated by questionnaire study.
373.

THE AMERICAN SOCIAL HYGIENE ASSOCIATION

organized in 1913, is the national voluntary agency for social hygiene.

At present, with emphasis on war needs, the Association undertakes

to promote an " 8-point program on the 48 state fronts "...

1. Rally more citizens fo tight syphilis and best safeguard against "bad times in bad
gonorrhea and commercialized prostitution company "• to clean up community condi-
through community action. Train leaders to tions leading to delinquency; to aid victims
guide such action, and teach others. of bad conditions make a new start, particu-

2. Tell the great masses of the people the larly women, girls and young men exploited
truth about these dangerous diseases— how b? the P««//M/on racketeers.

they attack the nation's strength, how they 6> He, hea,fh officerS( physic!anSi pharma.

may be avo,ded, how cured. chfs nurses/ soc;<J/ WQfkers gnd ofhef ffained

3. Aid employers and workers, especially in persons to drive out the venereal disease
war industries, to strengthen manpower and quacks and charlatans; to give sound counsel
stop financial loss and needless suffering by '° infected persons.

striking at syphilis and gonorrhea. , ,, ,

7. Help parents, teachers and church leaders

4. Lessen opportunities for exposure to ve- provide suitable sex education for children
nereal diseases by helping to enforce exist- and youth and practical preparation for
ing laws against the commercialized pros//- marriage, parenthood and family life,
tution racket; advise and assist in securing

better laws where needed. 8- SfudY "otional and community conditions

and programs, official and voluntary, and

5. Help communities to provide " good times keep all concerned informed regarding
in good company " for young people as the progress and results, in peace or in war.

The Association is a participating service of the
National War Fund, Inc.

OFFICERS AND DIRECTORS OF THE ASSOCIATION

Honorary President: EDWARD L. KEYES, M.D.

President: RAY LYMAN WILBUE, M.D.*

Vice-I 'residents

MRS. FRANCES PAYNE BOLTON JOHN H. STOKES, M.D.

Secretary : BAILEY B. BURRITT *

Treasurer: TIMOTHY N. PFEIFFER

Chairman of the Executive Committee: WILLIAM F. SNOW, M.D.

Executive Director: WALTER CLARKE, M.D.
Chairman of the General Advisory Committee: THOMAS PARRAN, M.D.

CHARLES H. BABCOCK ALAN JOHNSTONS

GEORGE BAEHR, M.D.* Ross T. MC!NTIRE, M.D.

ROBERT H. BISHOP, JR., M.D.* RT. REV. ARTHUR R. MCKINSTRY

BAILEY B. BURRITT* JAMES C. MAGEE, M.D.

ALBERT J. CHESLEY, M.D. PHILIP R. MATHER*

Louis I. DUBLIN THOMAS PARRAN, M.D.

KENDALL EMERSON, M.D. PERCY S. PELOUZE, M.D.

ROBERT P. FISCHELIS ALPHONSE M. SCHWITALLA, S.J.

IRA V. HISCOCK WILLIAM F. SNOW, M.D.*
MERRITTE W. IRELAND, M.D.*

COMMITTEE ON WAR ACTIVITIES

PHILIP R. MATHER, Chairman

SEWELL L. AVERY FRED T. MURPHY, M.D.

MERRITTE W. IRELAND, M.D. WILLIAM F. SNOW, M.D.
* Member of Executive Committee.

CONTENTS OF RECENT ISSUES

APRIL, 1944

Proceedings of the Puerto Rico Regional Conference on Social Hygiene
Morning Session: The National Campaign for Venereal Disease Control in

Wartime

Luncheon Session: The Americas Go Forward Together
Afternoon Sessions: Puerto Rico Does Her Part in the Fight

Group I. Knowledge Is a Strong Weapon

Group II. Medical Diagnosis and Treatment Are Strong Weapons

Group III. Good Laws and Law Enforcement Are Strong Weapons

Group IV. Youth Has Priority

Evening Session: The Nations Unite for Victory over Venereal Disease
Resolutions Presented by the Conference Committee on Resolutions
Greetings and Messages Received from the Other American Republics

MAY, 1944

Social Hygiene in Wartime. XIV.
Some Current Efforts toward Rehabilitation

A Study of 280 Patients in the Venereal Disease Isolation Hospitals of Puerto
Rico — Bureau of Medical Social Services, Puerto Rico Department of Health

The San Francisco Separate Women's Court Richard A. Koch

Rehabilitation in Action: A Social Hygiene Society Cooperates with a Rapid

Treatment Center in Aiding Venereal Disease Patients Lucia Murchison

Who Are the Juvenile Delinquents ? Winfred Overholser

Editorial—" This Way Out . . . ? "

JUNE, 1944
Eleventh Annual Library Number

Education, the Soldier and the Home Moe T"raukel

A Public Library Works with Community Agencies Aubry Lee Graham

A Library and a Social Hygiene Society Cooperate

Pauline J. Fihe, Viola Wallace and Jean Thomas

' ' I Want to Draw a Book on . . . " Aimee Zillmer

Book Reviews, Publications Received, etc.

OCTOBER, 1944
The Social Hygiene Campaign in the Other

American Republics

A Message from President Ray Lyman Wilbur
Editorial

Nations United for War and Permanent Peace William F. Snow

Letters from Major General G. C. Dunham, Dr. Hugh S. Gumming and Surgeon
General Thomas Parran

Articles from

Argentina: Milio Fernandez Blanco Honduras: Pedro Ordonez Diaz

Brazil: L. Campos Mello Mexico: Central Technical Office

Colombia: Ministry of Health U. S. Border-Mexico: Joseph Spoto

Costa Rica: Jose Amador Guevara Nicaragua: Luis Manuel Debayle

Dominican Republic: L. F. Thomen Panama: Arturo Tapia

Haiti: Jules Thebaud Paraguay: VD and Skin Dispensary
Venezuela: Felix Lairet Hi jo

NOVEMBER, 1944
A Review of Principles and Progress in Social Hygiene Legislation

A Challenge to Community Workers Bascom Johnson

Twenty Years Progress in Social Hygiene Legislation George Gould

Requirements of Existing State Laws

Forms and Principles of State Social Hygiene Laws

Social Hygiene Legislation Considered in 1943-44 in the States, Territories

and District of Columbia
Editorials :

If Your State Needs New Social Hygiene Laws
Your Part in the Legislative Campaign