Though I feel that these facts justify and more than justify our alarm, yet I would not be held to disregard, nor to be unthankful for, the vastly better tone which is to be found in official documents dealing with this subject at the present time as compared with their tone at an earlier period. I look upon the assurances given in Lord George Hamilton's despatch as a very remarkable proof of the progress made by the principles laid down by Mrs. Butler and Sir James Stansfeld, and if we want additional proof of this I would refer you also to the General Order of the late Commander-in-Chief in India, General Sir George White, from which I have already quoted, and the comments thereupon in the Army and Navy Gazette (August 14th, 1897), in which it is said that:
The time has happily now gone by when the soldier was treated as a being governed chiefly by animal passions. There is no reason, medical or otherwise, why a soldier should not maintain a perfectly strict morality, and if the co-operation of all grades of regimental officers, as requested by Sir George White, be secured, the happiest results would follow.
It is unfair to the army and the taxpayer as well as to the moral soldier, that licentious and self-indulgent men should be considered as much as they have been. They are a source of weakness and expense with which Sir George White may be trusted to deal well and wisely.
I have been dealing up to the present mainly with the past history of this question, and I now ask your attention to the new rules for dealing with the sanitary condition of the army in India. These new rules aim at treating venereal disease in the same way as all other contagious disorders, such as small-pox, measles, etc., that is, by isolation during the period of infection. At first sight, this may appear most sensible and useful; but there are grave practical difficulties in the way of carrying it out, and so far as I have read the speeches, articles, and letters of the advocates of the new rules, I have seen no attempt to grapple with these difficulties. They were explained very clearly by Lord Lister in his speech in the House of Lords; he spoke as a defender of the C. D. Acts, but however we may differ from him on this point, this does not vitiate his criticism, as a leading member of the medical profession, on the principle of the new rules, which is to treat venereal disease like any ordinary infectious disorder. This is impossible, as Lord Lister explains, for two reasons:
1. Any person of ordinary intelligence, let alone a doctor, can perceive the symptoms of fever, small-pox, etc., within a very short time of their first inception; in these cases, therefore, the disease being obvious, immediate isolation is easy. But with venereal disease, the case is totally different. In the early stages of the complaint, the man or woman affected may present every appearance to ordinary observation of complete health, and yet may be at the same time a most dangerous source of contagion. Therefore, the isolation of every infected person from the moment, and throughout the period of infection, is a manifest impossibility.
2. The second difficulty refers to the very prolonged period of infection in the case of venereal disease. If a man has small-pox or scarlet fever, he is either dead or cured and absolutely free from infection in the course of a comparatively short time, at the longest six weeks or two months; and during this time, he can be completely isolated from ordinary life. But it is almost impossible to say when a person who has ever had venereal disease ceases to be a source of contagion. It differs from all other diseases most markedly in this, in its far-reaching and long-continued effects on the constitution. The period of infection may last not merely for months, but for years, and isolation under these circumstances becomes a practical impossibility. Lord Lister said it was one of the most difficult things a surgeon ever...
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Though I feel that these facts justify and more than justify our alarm, yet I would not be held to disregard, nor to be unthankful for, the vastly better tone which is to be found in official documents dealing with this subject at the present time as compared with their tone at an earlier period. I look upon the assurances given in Lord George Hamilton's despatch as a very remarkable proof of the progress made by the principles laid down by Mrs. Butler and Sir James Stansfeld, and if we want additional proof of this I would refer you also to the General Order of the late Commander-in-Chief in India, General Sir George White, from which I have already quoted, and the com- ments thereupon in the Army and Navy Gazette (August 14th, 1897), in which it is said that :----
The time has happily now gone by when the soldier was treated as a being governed chiefly by animal passions. There is no reason, medical or otherwise, why a soldier should not maintain a perfectly strict morality, and if the co-operation of all grades of regimental officers, as requested by Sir George White, be secured, the happiest results would follow.
It is unfair to the army and the taxpayer as well as to the moral soldier, that licentious and self-indulgent men should be con- sidered as much as they have been. They are a source of weak. noss and expense with which Sir George White may be trusted to deal well and wisely."
I have been dealing up to the present mainly with the post history of this question, and I now ask your attention to the new rules for dealing with the sanitary condition of the army in India. These new rules aim at treating venereal disease in the same way as all other contagious disorders, such as small-pox, measles, etc., that is, by isolation during the period of infection. At first sight this may appear ruost sensible and useful; but there are grave practical difficulties in the way of carrying it out, and so far as I have read the speeches, articles and letters of the advocates of
IS
the new rules, I have seen no attempt to grapple with these difficulties. They were explained very clearly by Lord Lister in his speech in the House of Lords; he spoke as a defender of the C. D. Acts, but however we may differ from him on this point, this does not vitiate his criticism, as a leading member of the medical profession, on the principle of the new rules, which is to treat venereal disease like any ordinary infectious disorder. This is impossible, as Lord Lister explains, for two reasons :--
I.
Any person of ordinary intelligence, let alone a doctor, can perceive the symptoms of fever, small-pox, etc., within a very short time of their first inception; in these cases, therefore, the disease being obvious, inmediate isolation is easy. But with venereal disease the case is totally different. In the early stages of the complaint the man or woman affected may present every appearance to ordinary observation of complete health, and yet may be at the same time a most dangerous source of contagion. Therefore the isolation of every infected person from the moment, and throughout the period of infection is a manifest impossibility.
4. The second difficulty refers to the very prolonged period of infection in the case of venereal disease. If a man has smail-pox or scarlet fever he is either dead or cured and absolutely free from infection in the course of a com- paratively short time, at the longest six weeks or two months; and during this time he can be completely isolated from ordi- nary life. But it is almost impossible to say when a person who has ever had venereal disease ceases to be a source of contagion. It differs from all other diseases most markedly in this, in its far-reaching and long-continued effects on the constitution. The period of infection may last not merely for months, but for years, and isolation under these circum- stances becomes a practical impossibility. Lord Lister said it was one of the most difficult things a surgeon ever
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