VENEREAL DISEASES IN THE DOMINION. SPEECH DELIVERED BY THE MINISTER OF PUBLIC HEALTH (THE HON. G. W. RUSSELL) IN SUPPORT OF THE SECOND READING OF THE WAR REGULATIONS BILL, IN THE HOUSE OF REPRESENTATIVES, ON WEDNESDAY, 19th, JULY, 1916.

Appendix to the Journals of the House of Representatives, 1916 Session I, H-38

xx, —-38.

1916. NEW ZEALAND.

VENEREAL DISEASES IN THE DOMINION. SPEECH DELIVERED BY THE MINISTER OF PUBLIC HEALTH (THE HON. G. W. RUSSELL) IN SUPPORT OF THE SECOND READING OF THE WAR REGULATIONS BILL, IN THE HOUSE OF REPRESENTATIVES, ON WEDNESDAY, 19th, JULY, 1916.

Laid on the Table of the House of Representatives by Leave.

The Hon. Mr. Russell (Minister of Public Health). —Sir, I understand the member for Christchurch East has desired that I should speak, following the Hon. Mr. Herdman, so that the House may hear my proposals regarding the treatment of venereal diseases at once. If it is the wish of the House 1 am prepared to proceed. Hon. Members. —Hear, hear. The Hon. Mr. Busshll,—Sir, one of the proposals in clause 3 is that power shall be given to the Governor in Council to make regulations for the suppression of prostitution and the prevention of venereal disease. Sir, the importance of this subject as affecting (1) men enlisting for military service, (2) the civilian population, (3) the women of the country, and (4) the children of the future is so great that I make no apology for placing before the House a fully considered proposal with regard to the treatment of it, this being a portion of my responsibility as Minister of Public Health of the Dominion. That venereal disease is rampant in this country may be proved by the following facts: During the six months ended April, 1916, eighty-eight soldiers were admitted to Featherston Camp and 191 soldiers to Trentham Camp suffering from gonorrhoea, a total of 279. During the same period three were admitted at Featherston and four at Trentham suffering from the more severe disease of syphilis. Other forms of venereal disease at Trentham accounted for six other patients, making a total of ninety-one at Featherston and 201 at Trentham, a grand total for six months of 292. Of those treated at Trentham eleven were returned soldiers. A return recently furnished to me showed that at a certain quarantine station in one of our harbours there were then segregated ninety soldiers, who, having caught venereal disease, mostly at the camps, had been segregated for treatment there, and were being held until they were cured of this disease and could safely be returned among the civilian population. An Hon. Member. —Did not most of them come from Egypt? Hon. Mr. Russell. —Certainly not. lam sorry to say nearly the whole of them were from the camps. I hope honourable members will allow me to continue, and subsequently I will endeavour to deal with any new points at a later stage of the debate. Of the soldiers who had been segregated in quarantine practically a few only were returned soldiers. The whole of the others had been sent from the camps. The question I put to the House and to the country is this : whether these men who are suffering should be segregated, and the women who have communicated venereal disease to them should be allowed to remain at large pursuing their nefarious traffic, and communicating disease to other foolish men who may come within their meshes. I do not for one moment suppose that our soldiers are any more susceptible to the evils caused by diseased prostitutes than are the civilian population. The certainty is that what is going on amongst our soldiers is also going on amongst civilians. Whereas the men in camp are medically examined from time to time and brought under the control of medical officers, the civilians who have become diseased are free to pursue their evil course, and may proceed in turn to communicate disease to women with whom they may come into sexual contact. Therefore in stating what has happened to the soldier population I have merely lifted one corner of the veil which covers the hideous cancer which is eating into the body politic of this country. Nor is New Zealand worse than any other country. Probably on account of the general healthiness of this country it is a great deal better than the average of civilized countries. Let me say it, is interesting to note that venereal disease was unknown in Europe until the time when Christopher Columbus returned to Spain from America in the year 1493. It is generally believed that some of those with him brought this form of disease back from the New World. At any rate, it began in Spain and swept over

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Europe, and since then it has been endemic throughout Europe and in practically all other countries. During the last twenty-five years public attention has been concentrated upon these diseases. For the purpose of regulating vice the Contagious Diseases Act was on our statute-book for a number of years. It was in operation in the City of Christchurch for some time, and women who were known to be prostitutes were required to submit themselves periodically for examination, when, if found to be diseased, they were held in the "Lock" hospital. I was personally assured many years ago by experienced men like, the late Police-Inspector Pender that while that Act was in force a very great improvement took place in the health of the community. Public opinion, however, was against a law which was so liable to abuse, and its operation in Christchurch was suspended, while a few years ago it was finally wiped off the statute-book of the Dominion. I wish to say at once I have no desire to bring again into force the obnoxious provisions of the Contagious Diseases Act. I think, however, that there is a duty cast upon Parliament to take some steps.by which the evils arising from these diseases may be combated, and by which those who for commerce place themselves beyond the pale of pure and virtuous womanhood will, if found suffering from these diseases, be held by the State until they are free from danger to the community. I see no reason why a person suffering from measles, or scarlet fever, or even smallpox, should be segregated while others who suffer from these most awful diseases should be allowed at their own sweet will to mix amongst the healthy members of the community and be able to go on communicating these diseases. And here let me say that, while I advocate the segregation of the diseased female prostitute, I equally hold that men who are in the habit of visiting houses of ill fame or who are known to be promiscuous in their relations with women should be treated on exactly the same line if found to be suffering from these diseases. As honourable members arc aware, the two principal venereal diseases are (1) gonorrhoea and (2) syphilis. The figures I have already given indicate that gonorrhoea is much more the prevalent of the two. Although this is the minor disease, it has disastrous effects, especially in the cases of new-born children. It is a frequent cause of chronic suffering and sterility in women, as well as the chief source of blindness occurring as the result of ophthalmia in new-born infants. Its channel of communication is through the sexual organs. The more severe form of disease, syphilis, is commonly transmitted from the parent to the unborn child, resulting frequently in abortion or miscarriage, in still-births, premature births, and the diseases which so frequently cause mortality in the first, month after birth. Inherent syphilis in later years may cause blindness, deafness, and various bone, skin, and visceral lesions in the infected child. It is now recognized that the two diseases, locomotor ataxia and general paralysis of the insane, are directly of syphilitic origin, and that aneurism and other diseases of the heart are indirectly the result of it. Looking at the figures for our own country for the year 1914, I find that in that year there were the following deaths: From syphilis, 16; gonococcus infection, 4; locomotor ataxia, 10--general paralysis of the insane, 44. The death figures, however, express only a very small portion of the misery, anguish, and sorrow brought about by these diseases. Were sexual contact the only means of disseminating syphilis the case might not be so bad nor the problem so difficult. I could tell .honourable members of cases which have come under my notice in public institutions where pure and innocent women have had their lives shattered by becoming infected with this disease in carrying out their duties. I could tell also of cases of innocent little ones wdiose lives have been destroyed by servant women in the house infecting the children in their charge with this awful disease. It is known that the disease is communicated in lavatories, privies, and barbers' shops, by the use of towels, the kissing of children, the smoking ' of infected pipes, and in other ways. And probably there is not a man amongst us but knows of cases where innocent wives have had their lives made one long sorrow by having disease communicated to them by those who had at the altar promised to cherish and keep them for life. Surely it is a duty which this House owes to the country that some steps should be taken for the purpose of dealing with this awful red scourge. I have received communications from some of the women's associations in New Zealand, in which it, has been stated that they protest against those diseases being dealt with by regulations. My answer is that the matter is too intricate for legislation, and in this I ask the country, and especially the women of New Zealand, to trust the combined wisdom of the Police and Health Departments, the experts, and, above all, the National Cabinet, who have as high a respect for the sacrcdness of womanhood, including their own wives and daughters, as can be looked for. Some of the women's associations have also informed me that they protest against any action being taken by Parliament which will create a sense of_ false security, enabling young men to sin with impunity. I cannot subscribe to any such doctrine as that —namely, that we should allow such a condition of things to remain as now exists in order that those who place themselves within the zone of danger in this matter may suffer penalties which do not end with them, but which they may transmit to the innocent and unborn children of whom they may be the parents. lam not the Minister of Morals, but the Minister of Health, and in that capacity I desire to face this question and tell the House exactly what I think should be done in connection with this matter. On. this point I quote the following sentence from a report written by Dr. R. W. Johnstone for the London County Council. He said, "Without attemnting to go into the subject, at length, it may be said that even if venereal diseases were spread by sexual intercourse alone, which is not the case, a retribution which falls upon innocent women and children, and with equal force upon the raw youth or girl as upon the vicious and abandoned, is not remarkable for its justice." Sir, recently there has been published to the world the Final Report of the Royal Commission of Great Britain on Venereal Diseases, which

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contains a mass of information upon this subject. This I have carefully studied, and the policy I propose is largely' based upon the report of that very able Commission. I shall now indicate what I think should be done in. this country for the purpose of grappling with these diseases. I have already indicated that I do not propose anything in the nature of a renewal of the Contagious Diseases Act. (1.) I do, however, propose to take power to enact by regulations an amendment of the Police Offences Act, that the one-woman brothel shall be placed upon the same footing as a, brothel which has more than one inmate. As the statute law stands at present, there must be two women residing in a house and conducting immoral lives in order to constitute the place a brothel. By the by-laws of the Cities of Auckland and Wellington, a one-woman brothel comes under the law, and 1 propose to make that provision general throughout the Dominion. (2.) That every woman who is proved to be leading an. immoral life shall, on conviction upon a charge of vagrancy, be subject to medical inspection, and if found to be diseased shall be detained until cured of that disease. (3.) That every man who is convicted of consorting with known prostitutes and is found to be diseased shall in the same way, on conviction as a vagrant, be held by the State until cured of the disease. To clear up all doubt, let me say these are the only classes I propose to segregate—namely, male and female prostitutes. The procedure would be as follows: (a) Arrest as a vagrant having no lawful means of support; (b) conviction; (c) medical examination; (d) if proved to be diseased the prisoner would be held until cured. (4.) The great difficulty, however, is found in dealing with casual or clandestine prostitutes of both sexes. This class is undoubtedly far more numerous than those who have given their lives up to immoral courses. How to reach these and bring them under the healing influences of medical science of their own volition is one of the most difficult problems attaching to this question. The British Commission is opposed to notification of the disease, and, although syphilis has become notifiable for about 33 per cent, of the total population of England and Wales, I am satisfied that any attempt to make venereal diseases notifiable in New Zealand would result in driving these diseases underground, and the very order for notification would thus defeat its own object. T think, therefore, that the course to be followed should be on the following lines :— (1.) That it be made a, criminal offence for any person but, a legally qualified medical practitioner to treat venereal diseases. This should have the effect of preventing quacks and chemists of any class whatever from medicating patients or endeavouring to diagnose these diseases. I cannot stress too heavily the importance of early treatment, which is regarded by all the authorities as of the most importance in order that in the earliest stages, by bacteriological examination, by the Wasscrmann and Noguchi tests (which I need not explain), the patient maybe acquainted with his or her real condition. Where matters of such serious importance are involved as the future health of a man or woman and their offspring, quacks of any kind or incompetent and untrained persons should be strictly forbidden from attempting to treat or heal. (2.) The next step should be the establishment of clinics for treatment of venereal diseases. Here 1 do not advocate the establishment of separate institutions. These from their very nature would, if established, prevent persons from going to them for treatment. The mark of shame would be placed at once upon every one who was seen to approach the building night or day. The only way is for venereal disease to be treated at our public hospitals as one of the ordinary diseases for which they exist, and in view of the importance of this matter 1 propose to ask the House to enable me to pay subsidies to Hospital Boards of 75 per cent, instead of 50 per cent, towards the cost, of the treatment of venereal diseases. This, I may say, is being done in England at, the present time, and I think we cannot do better than follow their example. If.by these means we can secure that persons who have any doubt as to their condition will present themselves for examination I see no reason why we should not assist them in the earlier stages of the disease to have it treated and healed. If possible, my policy would be female doctors for women and male doctors for men at these institutions. To be effective the hospital clinics established for this purpose should be open in the evening as well as during the day. (3.) Another and most important aspect of this matter is an educational campaign. There can be no doubt that an enormous amount of good can be done in this direction. With this end in view I propose to print from the report of the Royal Commission, in all their hideous nakedness, the descriptions and evil results of venereal diseases. With the assistance of the medical profession of New Zealand, which I feel sure will be willingly granted me, I propose to have lectures by male and female doctors available for the different sexes, in order that full information may be given of the danger of promiscuous intercourse, and that those who may be suffering may be induced to visit the hospitals for treatment. I think also that the Bishops and clergy of the Dominion may well be invited to assist in the educational work, and that in our high schools and to the children of tho higher classes in the primary schools (to quote the words of the Royal Commission) "more careful instruction should be provided in regard to moral conduct as bearing upon sexual relations." Head teachers should also be encouraged to have private interviews with pupils before they leave school in order to give moral instruction and offer warnings against probable temptations. Advantage should also be taken of the evening classes at our technical schools, and especially should the professors at our universities be enlisted as agents in the educational propaganda. I propose also that it should be made obligatory upon all doctors who treat syphilis and gonorrhoea in institutions or privately to hand cards of instruction and warning to their patients. These cards I propose to print, at the Government Printing Office, and to make them available to every medical man either in private practice or in hospital service who applies for them. Special effort should be made to carefully train students in our training colleges to enable them to deal with these subjects. I hope to secure the assistance of the Press of the Dominion

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in this work of education In America the employment of persons affected with venereal diseases in food-handling establishments is forbidden in many States, especially in bakeries, ice-cream establishments, and meat-shops; also in seventeen States provisions have been made to prevent the spread of syphilis in barber-shops by forbidding the exercise of the trade to persons with the disease, requiring the sterilization of tools and knowledge on the part of the barber of the most common manifestations of skin-disease, &c. In various States certificates showing the absence of communicable disease on the part of applicants are made a condition to the issue of a marriage license. In seven States the marriage of persons with venereal disease in a communicable stage is interdicted, while in lowa the sterilization of syphilitic persons in public institutions is required. The matters mentioned are all important, and propose in the regulations to protect the public health by forbidding persons affected with disease being employed in handling food or coming in contact with the public in any way that may spread venereal disease. 1 have now, during the short time at my disposal, made a general statement to the House regarding this important matter, possibly the most important subject I have ever spoken on in this House. 1 have referred honourable gentlemen to the remarkable proof that lies at hand regarding the condition of some of the men at our camps. I repeat that I cast no reflection on those men, because it so happens that the conditions under which they are living enables their condition in this matter to be at once known. I say that the men who in the camps have contracted this disease are probably quite as good men as the same number of civilians, and therefore that this disease which has shown itself in the camps has spread itself through the civilians of the country. 1 ask the House to understand that this great problem is not to be trifled with. While 1 am Minister of Public Health I am not going to allow the question of delicacy to close my mouth when I am dealing with problems of this kind, and if this House had been as full of women as it was in the earlier stages of the evening I would not have changed a word of the speech I have delivered, The only way we can deal with this matter will be by taking the gloves off. We must realize that instead of leaving it to be dealt with underground and hiding it from our eyes, like the ostrich which puts its head in the sand, the best thing is for us as public men and legislators to face it and try to grasp the trouble and deal with it. I am prepared to hear the opinions of honourable gentlemen with regard to the matter during the debate that will take place, and I assure them that every suggestion that can be made that will assist the Government in coming to a wise decision upon this matter will be considered carefully; but i do say without hesitation that it is a duty we owe to ourselves, it is a duty we above all owe to the unborn children of this country, that we should do the best we can to stamp this disease out. It may not be possible to do it in its entirety, but we must do all we can. And here I want to say, with regard to the possibility of the disease being planted in New Zealand from Egypt and other places, that I can assure honourable gentlemen that under the Public Health Department the most careful examination has been made with regard to every troopship, and there has been no case where a man. has returned whose condition as a venereal patient has been made known to the Public Health Department where that man, even though he may ostensibly have appeared to be cured, has not been sent into quarantine until such time as we were sure there was no possibility of the Eastern forms of this disease being transplanted into this country. Possibly there may be some who have escaped. I have told the House that amongst those manifesting the disease at Trentham eleven were returned soldiers. It is just as possible for returned soldiers to get venereal disease after returning to New Zealand as any other soldier. I wish to give this assurance to the House, that all the information I have received is to the effect that there has been no evidence in New Zealand since the men started coming back of the grosser forms of venereal disease which afflict the East. I thank honourable members for the courtesy they have shown in listening to- my speech. I have gone into this matter with the greatest care, and I desire to assure the women of this country that I recognize the responsibility whioh has been placed upon me, and to assure them that it will be my great desire to uphold the sacredness of the pure and virtuous womanhood of New Zealand.

.By Authority : Marcus F. Marks, Government Printer, Wellington.—l9l6.