The Third Great Plague: A Discussion of Syphilis for Everyday PeopleStokes, John H. (John Hinchman)
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The Third Great Plague: A Discussion of Syphilis for Everyday People
Stokes, John H. (John Hinchman)
Syphilis
Engagements nowadays may well be thought of as equivalent to marriage
when the question of syphilis is considered. They not infrequently offer
innumerable opportunities for intimacies which may or may not fall short
of actual sexual relations. Attention has been called to this situation
by social workers among wage-earning girls. It has been a distressingly
frequent experience in my special practice to find that the young man,
overwrought by the excitement of wooing, has exposed himself elsewhere
to infection and unwittingly punished the trustfulness of his fiancee by
infecting her with syphilis through a subsequent kiss. The publication
of banns before marriage is worth while, and unmistakable testimony as
to the character and health of the parties concerned might well be
exchanged before a wooing is permitted to assume the character of an
engagement. It is of little use to say that a Wassermann and a medical
examination should be made before marriage, when the damage may be done
long before that point is reached.
+Medical Examination for Syphilis before Marriage.+--How shall we
recognize syphilis in a candidate for marriage? The prevailing idea is
to demand a negative Wassermann test. Assuredly this is good as far as
it goes, but it is not so reliable as to deserve incorporation into law
as sole sufficient evidence of the absence of syphilis, as has been done
in one state. From what has been said, it is plain that a single
negative Wassermann is no proof of the absence of syphilis. The subject
must be approached from other angles, and when syphilis may be
suspected, the question should be decided _by an expert_. A thorough
general or physical examination is desirable, and if this reveals
suspicious signs, such as scars, enlarged glands, etc., it is then
possible to investigate the Wassermann report more thoroughly by
repeating the test, sending it to another expert for confirmation. In
some cases it may even be necessary to insist that the patient submit to
a special test, called the provocative test, in which a small injection
of salvarsan is used to bring out a positive blood test if there is a
concealed syphilis. These are, of course, measures which are seldom
necessary except in patients who have had the disease. Much depends on
the attitude of the patient toward the examination and his willingness
to cooeperate. A resourceful physician can usually settle the question of
a person's fitness for marriage, and the result of a reliable
examination offers a reasonable assurance of safety.
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