PREVENTION OF SYPHILIS 59 



seem to have made little advance since 1496, when the Parlia- 

 ment of Paris decreed that all persons found infected with syphilis 

 should leave the city within 24 hours. 



The British Royal Commission urged the provision of ample 

 facilities for free diagnosis of these diseases and for free treat- 

 ment when necessary. Such measures have already been at- 

 tempted in a few instances in our own country and their ultimate 

 success on a large scale is insured. The New York City Health 

 Department in a single year examined 59,614 specimens of serum 

 for the presence of syphilis and three-fourths of these were re- 

 ceived from private physicians. A few public health institutions 

 are doing splendid work in the operation of a department for the 

 diagnosis of venereal diseases and the giving of personal advice. 

 The Oregon State Board of Health is undertaking, an extensive 

 correspondence with persons in all parts of the state who write 

 for information in response to venereal disease placards posted in 

 appropriate places. The provision of ample facilities for the 

 free treatment of syphilis in the way of hospital service when 

 necessary, of proper medication, and of the extension of Social 

 Service hospital work is something which we have only begun to 

 touch upon, but which will undoubtedly come in time. The 

 fact that no facilities have hitherto been provided for the care 

 of syphilitics either at public expense, or in the private practice 

 of physicians and hospitals, is a disgrace to our civilization and a 

 menace to our health. The medical prevention of syphilitic in- 

 fection after exposure to it is possible and succeeds in the great 

 majority of instances if attended to within a few hours after ex- 

 posure. The use of self-applied medical treatments has been 

 fairly successful in military life, but as shown by Dr. Snow it is 

 of doubtful value in civil life, since the intelligence required to 

 apply medical preparations properly is lacking in those who need 

 it most — immature boys, drink-befuddled men, defective girls, 

 and the average prostitutes. These classes constitute the bulk 

 of the citizens who become exposed to infection and since the 

 personal supervision of a physician is necessary in most cases, 

 it might best be required in all. Private physicians, dispensary 

 officers and the health department staff are the persons quahfied 

 to employ medical treatment designed to prevent infection after 

 exposure to it. Avoidance of exposure constitutes the best and 

 only safe preventive measure before exposure. 



