“All these women have made a false step in their past; they have a small black spot upon their name, and they go in company as much as possible, so that the spot may be less conspicuous. They have the same origin, the same appearance, the same prejudices as good society; but they no longer belong to it, and they form that which we call the half-world (demi-monde), which floats like an island upon the ocean of Paris, and draws towards itself, assumes, and recognizes, everything which falls from the firm land, or which wanders out or runs away from the firm land, without counting the foreign shipwrecked individuals who come no man knows whence.“Since the married men, under the protection of the legal code, havehad the right to banish from the bosom of the family a woman who has forgotten her duty, the morals of married life have undergone a revolution which has created a new world—for what becomes of all these expelled, compromised women? The first of them who found herself shown the door, bewailed her fault, and hid her shame in retirement; but—the second? She sought the first one out, and as soon as there were two of them, they called the fault a misfortune, the crime a mistake, and began to make excuses for one another mutually. Having become three, they asked one another to dinner; having become four—they danced a quadrille. Now round these women there grouped themselves young girls also who had begun their life with a false step; false widows; women who bore the name of the lovers with whom they lived; some of those rapid ‘marriages’ which had lasted as liaisons of many years’ duration; finally, all the women who wished people to believe that they were something else than they really were, and did not wish to appear in their true colours. At the present day this irregular world is in full bloom, and its bastard society is greatly loved by young men. For here love is less difficult than in circles above—and not so expensive as in circles below.”
“All these women have made a false step in their past; they have a small black spot upon their name, and they go in company as much as possible, so that the spot may be less conspicuous. They have the same origin, the same appearance, the same prejudices as good society; but they no longer belong to it, and they form that which we call the half-world (demi-monde), which floats like an island upon the ocean of Paris, and draws towards itself, assumes, and recognizes, everything which falls from the firm land, or which wanders out or runs away from the firm land, without counting the foreign shipwrecked individuals who come no man knows whence.
“Since the married men, under the protection of the legal code, havehad the right to banish from the bosom of the family a woman who has forgotten her duty, the morals of married life have undergone a revolution which has created a new world—for what becomes of all these expelled, compromised women? The first of them who found herself shown the door, bewailed her fault, and hid her shame in retirement; but—the second? She sought the first one out, and as soon as there were two of them, they called the fault a misfortune, the crime a mistake, and began to make excuses for one another mutually. Having become three, they asked one another to dinner; having become four—they danced a quadrille. Now round these women there grouped themselves young girls also who had begun their life with a false step; false widows; women who bore the name of the lovers with whom they lived; some of those rapid ‘marriages’ which had lasted as liaisons of many years’ duration; finally, all the women who wished people to believe that they were something else than they really were, and did not wish to appear in their true colours. At the present day this irregular world is in full bloom, and its bastard society is greatly loved by young men. For here love is less difficult than in circles above—and not so expensive as in circles below.”
From the last sentence we see that the original idea of the “half-world” was not so wide as that of the present day; above all, the former notion did not, as it does at present, include the idea of prostitution. The ladies of the half-world of Dumas were “not so expensive” as ordinary prostitutes. Our modern demi-mondaines are characterized by the fact that their price is high. They are prostitutes for the upper ten thousand. And yet they have this in common with the other demi-monde—that they do not, like prostitutes properly speaking, give themselves indifferently to anyone able to pay the price, but they lay stress on the social position of their lover for the time being, and upon his character as a “gentleman.” They can even exhibit something of the nature of love. The modern half-world can most aptly be compared with the Greek hetairism. It forms a characteristic constituent of modern “high life.” Whether this especially manifests itself on the racecourse, at first nights at the theatre, in great charitable bazaars, at masked balls, at fashionable seaside resorts, at Monte Carlo, at floral festivals, and the like, there also we encounter the half-world; and its members, in respect of beauty, toilet, distinguished appearance, cultivation, and conversation, are in no way to be distinguished from the ladies of high society. Certain types of the demi-monde realize, in fact, the ideal of the Greek hetairæ; but even more than these, the modern demi-mondaine represents elaborated enjoyment. These women are thoroughly cultivated, the true law-givers of fashion, the arbiters in every question of taste. Mondaines and demi-mondaines are in outward appearance hardly to be distinguishedone from the other; at least, this is the case in Paris, where a witty writer defined the distinction between them in this way—that the former received their lovers only in the daytime, the latter also bynight.[310]It is only the connoisseur who is able to detect the “half-world aroma,” that indefinable quality which gives the demi-mondaine such an exceptional value in the eyes of thejeunesse dorée.
From what circles do the recruits of the half-world come? The ladies of the theatre, the stars of the variety stage and of the ballet, send their contingent; the aristocracy is also represented in their ranks; but many a distinguished lorette or “fille de marbre” is of low origin, and yet understands admirably how to adapt herself rapidly to all the demands of high life, to drive her dog-cart as smartly as the most genuine Countess, and in Longchamps, Karlshorst, Ostend, or Trouville, to play the part of the fine lady.
The one distinction between them—and it is the distinction of half a world—is the fact that this fashionable life of the demi-monde is not provided out of their own means, but out of the pockets of one, or more often of several, rich galants.
The type of the “grande cocotte” is encountered in its genuine and unadulterated form only in Paris. Here the demi-mondaine plays a great part in public life. The time of the earlier mistresses of princes, with their political intrigues and their far-reaching spheres of influence, is indeed over—a Lola Montez, an Aurora Königsmark is to-day no longer possible; and yet the Parisian demi-mondaine maintains influential relationships with the new great power of our time—the power of thepress. The journalists who are in the service of the demi-monde are by George Dahlen termed the “Press-Fridoline,” because “their pens are paid, not with ducats, but with more or less enviable hours of love in distinguishedboudoirs”;[311]and Victor Joze also describes the advertisements—paid for by a night of love, or perhaps only by a smile—which the writers of Paris give in the newspapers to the distinguished cocottes of the Quartier Marbœuf or of the Avenue du Bois de Boulogne, in order to attract the attention of Indian nabobs, Russian Grand Dukes, or American millionaires, to this or that fashionable beauty. This is characteristic of Paris. In other great capitals marketable gallantry does not seek publicity in this way, but pursues a more hidden course.
For what the German, and especially what the Berliners, termthe “half-world” is very different from the type we have just described of the true Parisian demi-mondaine. Our half-world (the half-world of Berlin) is recruited for the most part from intelligent prostitutes, who are to be found chiefly in the public gardens, in the Zoological Gardens, in the Lehrter Ausstellungspark, and in the leading restaurants. Hereevery eveningthey seek new prey, every evening they sell their charms to a new lover for a definite sum of money; whereas the true lady of the half-world never has at any time more than one or two admirers, who provide for all the expenses of her life, and she never—at any ratein public—practises professional prostitution, as do the women just described.
Finally, there is yet another type, which must not be confused with the demi-monde. This is theinternational prostitute, who journeys from one place to another, has indeed often the appearance of a distinguished lorette, but leads a much more insecure, unstable life than the true demi-mondaine, and often combines with prostitution the profession of an adventuress. Now she is in Paris, now in London, now at Biarritz, now at Monte Carlo (the principal field of her activity), now in Constantinople, Smyrna, St. Petersburg, or Berlin. Sometimes she undertakes a voyage of discovery to the New World. Germany provides a not insignificant percentage of these international cocottes. Such wanderers are especially well known in the circles of officers and of speculators on the Bourse; by these they are not seldom “recommended,” after the manner in which a traveller is given letters of introduction. They may even be “raffled for,” as recently happened in an officers’ mess in Munich, and so pass to the share of the fortunate (generally much to be commiserated) winner. Abroad they prefer to adopt French or exotic names.
[243]Here, in the phrase “man at length become self-conscious,” we have the animating idea of this work, as it is of all fruitful efforts at the amelioration of the human lot. See the admirable development of this idea in E. Ray Lankester’s Romanes lecture, “Nature and Man”; and also in H. G. Wells’s later writings, more especially “A Modern Utopia” and “New Worlds for Old.”—Translator.[244]That this opinion is false, I have proved incontestably as regards syphilis in my book, “The Origin of Syphilis” (Jena, 1901). For the European and Asiatic world, syphilis is a specifically modern disease, not more than 400 years old.[245]Venice, 1534.[246]“La Lozana Andaluza” (“The Gentle Andalusian”), by Francesco Delicado. Traduit pour la première fois, texte Espagnol en regard par Alcide Bonneau, 2 vols., Paris, 1888. Regarding this work, see my book “The Origin of Syphilis,” vol. i., pp. 36-43.[247]Cf.also the interesting work of Salvatore di Giacomo, “Prostitution in Naples in the Fifteenth, Sixteenth, and Seventeenth Centuries, based on Unpublished Documents,” revised in accordance with the German translation, and provided with an introduction by Dr. Iwan Bloch (Dresden, 1904).[248]Reprinted in his “Satyræ Medicæ XX.,” pp. 528-549 (Leipzig, 1722).[249]Cf.my work on “Rétif de la Bretonne,” p. 504et seq.(Berlin, 1906).[250]The contents of this work are enumerated in my above-mentioned book, pp. 505-512.[251]A. J. B. Parent-Duchatelet, “De la Prostitution dans la Ville de Paris,” third edition, 1857 (Paris, 1836).[252]F. F. A. Béraud, “Les Filles Publiques de Paris” (Brussels, 1839, 2 vols.).[253]Dr. Michael Ryan was an acquaintance of Arthur Schopenhauer, who in June, 1829, sent Ryan a copy of his book “Theoria Colorum.”Cf.Eduard Grisebach, “Schopenhauer: the History of His Life,” p. 168 (Berlin, 1897).[254]M. Ryan, “Prostitution in London, with a Comparative View of that of Paris and New York” (London, 1839).[255]Cf.in this connexion also the report from other sources given in my “Sexual Life in England,” vol. iii., pp. 315-319, 440-447 (Berlin, 1903).[256]W. Tait, “Magdalenism: An Inquiry into the Extent, Causes, and Consequences of Prostitution in Edinburgh,” second edition (Edinburgh, 1842).[257]R. Wardlaw, “Lectures on Female Prostitution; its Nature, Extent, Effects, Guilt, Causes, and Remedy,” third edition (Glasgow, 1843).[258]F. I. dos Santos Cruz, “Da Prostituiçao na Cidade de Lisboa” (Lisbon, 1841).[259]“Estabelecimentos de Beneficencia para as Consultas Gratuitas,” pp. 203-206.[260]A. Potton, “De la Prostitution et de ses Conséquences dans les Grandes Villes, dans la Ville de Lyon en Particulier” (Paris and Lyons, 1842).[261]E. A. Duchesne, “De la Prostitution dans la Ville d’Alger depuis la Conquête” (Paris, 1853).[262]“Die Prostitution in Berlin und ihre Opfer” (Berlin, 1846).[263]C. Röhrmann, “Der sittliche Zustand von Berlin nach Aufhebung der geduldeten Prostitution des weiblichen Geschlechts”—“The Moral Condition of Berlin after the Abolition of Tolerated Prostitution of the Female Sex” (Leipzig, 1846).[264]F. J. Behrend, “Prostitution in Berlin, and the Measures it is Desirable to Adopt against Prostitution and against Syphilis,” etc. A work based on official sources, and dedicated to His Excellency the Minister von Ladenberg (Erlangen, 1850).[265]H. Lippert, “Prostitution in Hamburg” (Hamburg, 1848).[266]A. J. Gross-Hoffinger, “The Fate of Women and Prostitution, in Relation to the Principle of the Indissolubility of Catholic Marriage, and especially in Relation to the Laws of Austria and the Philosophy of our Time” (Leipzig, 1847).[267]Josef Schrank, “Prostitution in Vienna in Historical, Administrative, and Hygienic Relations” (Vienna, 1886, 2 vols).[268]“The Moral Corruption of Our Time and its Victims in their Relationship to the State, to the family, and to Morality, with especial Reference to the Conditions of Prostitution in Leipzig” (Leipzig, 1854).[269]W. M. Sanger, “The History of Prostitution” (New York, 1859).[270]J. Jeannel, “Prostitution in Large Towns in the Nineteenth Century, and the Abolition of Venereal Diseases.”[271]W. Acton, “Prostitution in its Various Aspects,” second edition (London. 1874).[272]Hügel, “The History, Statistics, and Regulation of Prostitution” (Vienna. 1865).[273]L. Martineau, “La Prostitution Clandestine” (Paris, 1885).[274]O. Commenge, “La Prostitution Clandestine à Paris” (Paris, 1897).[275]V. Augagneur, “La Prostitution des Filles Mineures” (Paris, 1888).[276]L. Fiaux, “La Police des Mœurs en France et dans les Principales Villes de l’Europe” (Paris, 1888); “Les Maisons de Tolérance, leur Fermeture,” 3me édition (Paris, 1862); “La Prostitution ‘Cloitrée’” (Brussels, 1902).[277]Yves Guyot, “La Prostitution: Étude de Physiologie Sociale” (Paris, 1882).[278]A. Blaschko, “The Problem of Prostitution,” published in theBerliner Klin. Wochenschrift, pp. 430-435 (1892); “Syphilis and Prostitution from the Hygienic Standpoint” (Berlin, 1893); “Hygiene of Prostitution and of Venereal Diseases” (Jena, 1900); “Prostitution in the Nineteenth Century” (Berlin, 1902); “The Dangers to Health resulting from Prostitution, and the Contest with these Dangers” (Berlin, 1904).[279]C. Lombroso and G. Ferrero, “Woman as Criminal and Prostitute.”[280]B. Tarnowsky, “Prostitution and Abolitionism” (Hamburg, 1890).[281]C. Ströhmberg, “Prostitution: a Socio-Medical Study” (Stuttgart, 1899).[282]E. Dühren (Iwan Bloch), “The Sexual Life in England,” vol. i., pp. 201-445 (Charlottenburg, 1901).[283]E. von Düring, “Prostitution and Venereal Diseases” (Leipzig, 1905).[284]Goethe, in the poem “Der Gott und die Bajadere,” has very beautifully described the ennoblement of gross love by means of ideal love.[285]Henry Murger, in his “Vie de Bohème,” also alludes to the “incomprehensible” fact that “persons of standing who sometimes possess spirit, a name, and a coat cut according to the fashion, out of their love for the common will go so far as to raise to the level of an object of fashion a creature whom their very servant would not have chosen as a mistress.”[286]C. Lombroso, “Woman as Criminal and Prostitute,” p. 550.[287]Friedrich Hammer, “The Regulation of Prostitution,” published inThe Journal for the Suppression of Venereal Diseases, vol. iii., No. 10, p. 380 (Leipzig, 1905).[288]H. Kurella, “A Contribution to the Biological Comprehension of Physical and Psychical Bisexuality,” published in theZentralblatt für Nervenheilkunde, 1896, vol. xix., p. 239.[289]Syphilis is not to be forgotten.[290]This modified Lombrosism is advocated by B. A. H. Hübner in his interesting work concerning prostitutes and their legal relations (Monatsschrift für Kriminalpsychologie, 1907, pp. 1-11). He found that among sixty-four insane prostitutes, under observation in the Hertzberg Asylum in Berlin, not less than 59·45 % were already intellectually defective at the time they had come under police control as prostitutes.[291]C. Lombroso, “Recent Advances in the Study of Criminals.”[292]Schrank observes (“Prostitution in Vienna,” vol. ii., p. 216) that striking physical peculiarities do not appear to be either more or less frequent among prostitutes than they are among the generality of the population.[293]G. Keben, “Prostitution in its Relation to Modern Realistic Literature” (Zurich, 1892).[294]Oda Olberg, “Poverty in the Domestic Industry of Making Ready-made Clothing” (Leipzig, 1896).[295]Anna Pappritz, “The Economic Causes of Prostitution” (Berlin, 1903).[296]Pfeiffer, “Poverty and Overcrowding in Great Towns and in Relation to Prostitution and to Venereal Diseases,” published inThe Journal for the Suppression of Venereal Diseases, 1903, vol. i., pp. 135-144.[297]P. Kampffmeyer, “Poverty and Overcrowding in Great Towns,” etc., published inThe Journal for the Suppression of Venereal Diseases, 1903, vol. i., pp. 145-160; “Bad Housing Accommodation in Relation to Prostitution and ‘Night-Lodgers’; the Necessary Legal Reforms,”op. cit., 1905, vol. iii., pp. 165-229.[298]E. v. Düring, “Prostitution and Venereal Diseases.” p. 11.[299]Cf.the description of the astonishing development of the French procurement of that day which is given in my “New Researches concerning the Marquis de Sade,” pp. 88-98 (Berlin, 1904). The Marquis de Sade, in his novel “The One Hundred and Twenty Days of Sodom,” has very fully described the traffic in girls of his time. Incredible revelations of this traffic, of the almost absolute power of the procuresses, and of their relations to the police, led in October, 1906, to an action against the procuress Regine Riehl, who, under the mask of a dressmaker’s shop, had for years conducted a brothel, in which the girls were entirely robbed of their freedom, were subjected to corporal punishment, and never received payment for their “work.”Cf.A. Blaschko,The Journal for the Suppression of Venereal Diseases, 1906, vol. v., pp. 427-433; also Karl Kraus, “The Riehl Trial” (Vienna, 1906).[300]The literature of the “White Slave Trade” is extensive. I shall mention a few works only: Alfred S. Dyer, “The Trade in English Girls” (Berlin, 1881); the celebrated work of Alexis Splingard, “Clarissa, from the Dark Houses of Belgium,” with an introduction by Otto Henne am Rhyn, fourth edition (Leipzig, 1897); Otto Henne am Rhyn, “Prostitution and the Traffic in Girls” (Leipzig, 1903); Julius Kemény, “Hungara—Hungarian Girls in the Market: Revelations regarding the International Traffic in Girls” (Buda-Pesth, 1903).Cf.also the extensive references inThe Journal for the Suppression of Venereal Diseases, 1904, vol. ii., pp. 207-212 (Report of the Jewish Commission for the Suppression of the Traffic in Girls). Regarding the traffic in girls in Holland,cf.J. Rutgers, “Sketches from Holland,”ibid., 1906, vol. v., pp. 531-355.[301]Cf.regarding the conditions in South America, the report of Major D. Wagner, Secretary of the German National Committee for the Suppression of the Traffic in Girls, published inThe Journal for the Suppression of Venereal Diseases, 1900, vol. v., pp. 378-382.[302]Léo Taxil, “La Corruption Fin-de-Siècle,” p. 169et seq.(Paris, 1894).[303]Louis Fiaux, “Les Maisons de Tolérance: leur Fermeture,” troisième édition, pp. 169et seq., 248, 250, 251 (Paris, 1892).[304]According to recent statistical data, from 80 to 90 % of barmaids (in Germany) are infected with venereal diseases, so that they perhaps represent the most dangerous class of prostitutes.[305, 306]“Animierkneipen.”—Kneipesignifies a drinking-saloon or pothouse, equivalent to the Frenchcabaret. TheAnimierkneipeis a beer-saloon at which the attendants are women (Kellnerinnen), who are engaged on the termsdescribedin the text, and whose function, therefore, is to attract the male customers of the place, to incite them (animieren) to drink freely, and to play the part of prostitutes when required. Thus they correspond toles inviteusesof the similar drinking-saloons in Paris.—Translator.[307]H. Seyffert, “Die Animierkneipen und ihre Geheimnisse” (“Animierkneipen and their Secrets”), published inFreie Meinung, 1906, Nos. 26 and 27. See also “Impropriety at Inns with Female Attendants in Prussia, with especial Reference to the Conditions in Cologne” (1891).[308]O. Rosenthal, “Alcoholism and Prostitution,” p. 46 (1905).[309]Cf.the elaborate descriptions by Hans Ostwald, “Berliner Tanzlokale” (Berlin and Leipzig); regarding the earlier dancing-rooms of London, see my “Sexual Life in England,” vol. i., pp. 324-334.[310]Victor Joze, “Paris-Gomorrhe. Mœurs du Jour,” p. 173 (Paris, 1898).[311]Georg Dahlen, “Sketches of European Society,” p. 126 (Berlin, 1885).
[243]Here, in the phrase “man at length become self-conscious,” we have the animating idea of this work, as it is of all fruitful efforts at the amelioration of the human lot. See the admirable development of this idea in E. Ray Lankester’s Romanes lecture, “Nature and Man”; and also in H. G. Wells’s later writings, more especially “A Modern Utopia” and “New Worlds for Old.”—Translator.
[244]That this opinion is false, I have proved incontestably as regards syphilis in my book, “The Origin of Syphilis” (Jena, 1901). For the European and Asiatic world, syphilis is a specifically modern disease, not more than 400 years old.
[245]Venice, 1534.
[246]“La Lozana Andaluza” (“The Gentle Andalusian”), by Francesco Delicado. Traduit pour la première fois, texte Espagnol en regard par Alcide Bonneau, 2 vols., Paris, 1888. Regarding this work, see my book “The Origin of Syphilis,” vol. i., pp. 36-43.
[247]Cf.also the interesting work of Salvatore di Giacomo, “Prostitution in Naples in the Fifteenth, Sixteenth, and Seventeenth Centuries, based on Unpublished Documents,” revised in accordance with the German translation, and provided with an introduction by Dr. Iwan Bloch (Dresden, 1904).
[248]Reprinted in his “Satyræ Medicæ XX.,” pp. 528-549 (Leipzig, 1722).
[249]Cf.my work on “Rétif de la Bretonne,” p. 504et seq.(Berlin, 1906).
[250]The contents of this work are enumerated in my above-mentioned book, pp. 505-512.
[251]A. J. B. Parent-Duchatelet, “De la Prostitution dans la Ville de Paris,” third edition, 1857 (Paris, 1836).
[252]F. F. A. Béraud, “Les Filles Publiques de Paris” (Brussels, 1839, 2 vols.).
[253]Dr. Michael Ryan was an acquaintance of Arthur Schopenhauer, who in June, 1829, sent Ryan a copy of his book “Theoria Colorum.”Cf.Eduard Grisebach, “Schopenhauer: the History of His Life,” p. 168 (Berlin, 1897).
[254]M. Ryan, “Prostitution in London, with a Comparative View of that of Paris and New York” (London, 1839).
[255]Cf.in this connexion also the report from other sources given in my “Sexual Life in England,” vol. iii., pp. 315-319, 440-447 (Berlin, 1903).
[256]W. Tait, “Magdalenism: An Inquiry into the Extent, Causes, and Consequences of Prostitution in Edinburgh,” second edition (Edinburgh, 1842).
[257]R. Wardlaw, “Lectures on Female Prostitution; its Nature, Extent, Effects, Guilt, Causes, and Remedy,” third edition (Glasgow, 1843).
[258]F. I. dos Santos Cruz, “Da Prostituiçao na Cidade de Lisboa” (Lisbon, 1841).
[259]“Estabelecimentos de Beneficencia para as Consultas Gratuitas,” pp. 203-206.
[260]A. Potton, “De la Prostitution et de ses Conséquences dans les Grandes Villes, dans la Ville de Lyon en Particulier” (Paris and Lyons, 1842).
[261]E. A. Duchesne, “De la Prostitution dans la Ville d’Alger depuis la Conquête” (Paris, 1853).
[262]“Die Prostitution in Berlin und ihre Opfer” (Berlin, 1846).
[263]C. Röhrmann, “Der sittliche Zustand von Berlin nach Aufhebung der geduldeten Prostitution des weiblichen Geschlechts”—“The Moral Condition of Berlin after the Abolition of Tolerated Prostitution of the Female Sex” (Leipzig, 1846).
[264]F. J. Behrend, “Prostitution in Berlin, and the Measures it is Desirable to Adopt against Prostitution and against Syphilis,” etc. A work based on official sources, and dedicated to His Excellency the Minister von Ladenberg (Erlangen, 1850).
[265]H. Lippert, “Prostitution in Hamburg” (Hamburg, 1848).
[266]A. J. Gross-Hoffinger, “The Fate of Women and Prostitution, in Relation to the Principle of the Indissolubility of Catholic Marriage, and especially in Relation to the Laws of Austria and the Philosophy of our Time” (Leipzig, 1847).
[267]Josef Schrank, “Prostitution in Vienna in Historical, Administrative, and Hygienic Relations” (Vienna, 1886, 2 vols).
[268]“The Moral Corruption of Our Time and its Victims in their Relationship to the State, to the family, and to Morality, with especial Reference to the Conditions of Prostitution in Leipzig” (Leipzig, 1854).
[269]W. M. Sanger, “The History of Prostitution” (New York, 1859).
[270]J. Jeannel, “Prostitution in Large Towns in the Nineteenth Century, and the Abolition of Venereal Diseases.”
[271]W. Acton, “Prostitution in its Various Aspects,” second edition (London. 1874).
[272]Hügel, “The History, Statistics, and Regulation of Prostitution” (Vienna. 1865).
[273]L. Martineau, “La Prostitution Clandestine” (Paris, 1885).
[274]O. Commenge, “La Prostitution Clandestine à Paris” (Paris, 1897).
[275]V. Augagneur, “La Prostitution des Filles Mineures” (Paris, 1888).
[276]L. Fiaux, “La Police des Mœurs en France et dans les Principales Villes de l’Europe” (Paris, 1888); “Les Maisons de Tolérance, leur Fermeture,” 3me édition (Paris, 1862); “La Prostitution ‘Cloitrée’” (Brussels, 1902).
[277]Yves Guyot, “La Prostitution: Étude de Physiologie Sociale” (Paris, 1882).
[278]A. Blaschko, “The Problem of Prostitution,” published in theBerliner Klin. Wochenschrift, pp. 430-435 (1892); “Syphilis and Prostitution from the Hygienic Standpoint” (Berlin, 1893); “Hygiene of Prostitution and of Venereal Diseases” (Jena, 1900); “Prostitution in the Nineteenth Century” (Berlin, 1902); “The Dangers to Health resulting from Prostitution, and the Contest with these Dangers” (Berlin, 1904).
[279]C. Lombroso and G. Ferrero, “Woman as Criminal and Prostitute.”
[280]B. Tarnowsky, “Prostitution and Abolitionism” (Hamburg, 1890).
[281]C. Ströhmberg, “Prostitution: a Socio-Medical Study” (Stuttgart, 1899).
[282]E. Dühren (Iwan Bloch), “The Sexual Life in England,” vol. i., pp. 201-445 (Charlottenburg, 1901).
[283]E. von Düring, “Prostitution and Venereal Diseases” (Leipzig, 1905).
[284]Goethe, in the poem “Der Gott und die Bajadere,” has very beautifully described the ennoblement of gross love by means of ideal love.
[285]Henry Murger, in his “Vie de Bohème,” also alludes to the “incomprehensible” fact that “persons of standing who sometimes possess spirit, a name, and a coat cut according to the fashion, out of their love for the common will go so far as to raise to the level of an object of fashion a creature whom their very servant would not have chosen as a mistress.”
[286]C. Lombroso, “Woman as Criminal and Prostitute,” p. 550.
[287]Friedrich Hammer, “The Regulation of Prostitution,” published inThe Journal for the Suppression of Venereal Diseases, vol. iii., No. 10, p. 380 (Leipzig, 1905).
[288]H. Kurella, “A Contribution to the Biological Comprehension of Physical and Psychical Bisexuality,” published in theZentralblatt für Nervenheilkunde, 1896, vol. xix., p. 239.
[289]Syphilis is not to be forgotten.
[290]This modified Lombrosism is advocated by B. A. H. Hübner in his interesting work concerning prostitutes and their legal relations (Monatsschrift für Kriminalpsychologie, 1907, pp. 1-11). He found that among sixty-four insane prostitutes, under observation in the Hertzberg Asylum in Berlin, not less than 59·45 % were already intellectually defective at the time they had come under police control as prostitutes.
[291]C. Lombroso, “Recent Advances in the Study of Criminals.”
[292]Schrank observes (“Prostitution in Vienna,” vol. ii., p. 216) that striking physical peculiarities do not appear to be either more or less frequent among prostitutes than they are among the generality of the population.
[293]G. Keben, “Prostitution in its Relation to Modern Realistic Literature” (Zurich, 1892).
[294]Oda Olberg, “Poverty in the Domestic Industry of Making Ready-made Clothing” (Leipzig, 1896).
[295]Anna Pappritz, “The Economic Causes of Prostitution” (Berlin, 1903).
[296]Pfeiffer, “Poverty and Overcrowding in Great Towns and in Relation to Prostitution and to Venereal Diseases,” published inThe Journal for the Suppression of Venereal Diseases, 1903, vol. i., pp. 135-144.
[297]P. Kampffmeyer, “Poverty and Overcrowding in Great Towns,” etc., published inThe Journal for the Suppression of Venereal Diseases, 1903, vol. i., pp. 145-160; “Bad Housing Accommodation in Relation to Prostitution and ‘Night-Lodgers’; the Necessary Legal Reforms,”op. cit., 1905, vol. iii., pp. 165-229.
[298]E. v. Düring, “Prostitution and Venereal Diseases.” p. 11.
[299]Cf.the description of the astonishing development of the French procurement of that day which is given in my “New Researches concerning the Marquis de Sade,” pp. 88-98 (Berlin, 1904). The Marquis de Sade, in his novel “The One Hundred and Twenty Days of Sodom,” has very fully described the traffic in girls of his time. Incredible revelations of this traffic, of the almost absolute power of the procuresses, and of their relations to the police, led in October, 1906, to an action against the procuress Regine Riehl, who, under the mask of a dressmaker’s shop, had for years conducted a brothel, in which the girls were entirely robbed of their freedom, were subjected to corporal punishment, and never received payment for their “work.”Cf.A. Blaschko,The Journal for the Suppression of Venereal Diseases, 1906, vol. v., pp. 427-433; also Karl Kraus, “The Riehl Trial” (Vienna, 1906).
[300]The literature of the “White Slave Trade” is extensive. I shall mention a few works only: Alfred S. Dyer, “The Trade in English Girls” (Berlin, 1881); the celebrated work of Alexis Splingard, “Clarissa, from the Dark Houses of Belgium,” with an introduction by Otto Henne am Rhyn, fourth edition (Leipzig, 1897); Otto Henne am Rhyn, “Prostitution and the Traffic in Girls” (Leipzig, 1903); Julius Kemény, “Hungara—Hungarian Girls in the Market: Revelations regarding the International Traffic in Girls” (Buda-Pesth, 1903).Cf.also the extensive references inThe Journal for the Suppression of Venereal Diseases, 1904, vol. ii., pp. 207-212 (Report of the Jewish Commission for the Suppression of the Traffic in Girls). Regarding the traffic in girls in Holland,cf.J. Rutgers, “Sketches from Holland,”ibid., 1906, vol. v., pp. 531-355.
[301]Cf.regarding the conditions in South America, the report of Major D. Wagner, Secretary of the German National Committee for the Suppression of the Traffic in Girls, published inThe Journal for the Suppression of Venereal Diseases, 1900, vol. v., pp. 378-382.
[302]Léo Taxil, “La Corruption Fin-de-Siècle,” p. 169et seq.(Paris, 1894).
[303]Louis Fiaux, “Les Maisons de Tolérance: leur Fermeture,” troisième édition, pp. 169et seq., 248, 250, 251 (Paris, 1892).
[304]According to recent statistical data, from 80 to 90 % of barmaids (in Germany) are infected with venereal diseases, so that they perhaps represent the most dangerous class of prostitutes.
[305, 306]“Animierkneipen.”—Kneipesignifies a drinking-saloon or pothouse, equivalent to the Frenchcabaret. TheAnimierkneipeis a beer-saloon at which the attendants are women (Kellnerinnen), who are engaged on the termsdescribedin the text, and whose function, therefore, is to attract the male customers of the place, to incite them (animieren) to drink freely, and to play the part of prostitutes when required. Thus they correspond toles inviteusesof the similar drinking-saloons in Paris.—Translator.
[307]H. Seyffert, “Die Animierkneipen und ihre Geheimnisse” (“Animierkneipen and their Secrets”), published inFreie Meinung, 1906, Nos. 26 and 27. See also “Impropriety at Inns with Female Attendants in Prussia, with especial Reference to the Conditions in Cologne” (1891).
[308]O. Rosenthal, “Alcoholism and Prostitution,” p. 46 (1905).
[309]Cf.the elaborate descriptions by Hans Ostwald, “Berliner Tanzlokale” (Berlin and Leipzig); regarding the earlier dancing-rooms of London, see my “Sexual Life in England,” vol. i., pp. 324-334.
[310]Victor Joze, “Paris-Gomorrhe. Mœurs du Jour,” p. 173 (Paris, 1898).
[311]Georg Dahlen, “Sketches of European Society,” p. 126 (Berlin, 1885).
“In co-operation with alcoholic intoxication and with tuberculosis, syphilis plays in our day the part which in the middle ages was played by bubonic plague.”—Alfred Fournier.
Prostitution the focus, not the cause, of venereal diseases — Philosophy of venereal diseases — Their age — Time and place of their first appearance — The origin of syphilis — Practical importance of the proof of the recent character of syphilis — The theologico-animistic theory of venereal diseases — Refutation of this theory — Blameless infection (syphilis innocentium) — The notion of specific infective disease — Scientific campaign against venereal diseases — Syphilis as a specific disease of modern times — Description of its symptoms, its course, and its termination — Consequences of syphilis to the family, to the offspring, and to the race — Congenital syphilis of the first and second generations — Racial degeneration in consequence of syphilis — The age at which infection with syphilis occurs in man and in woman — The soft chancre (chancroid) — Gonorrhœa — Change in our views regarding the dangers of gonorrhœa — Urethral gonorrhœa in the male — Acute and chronic stages — Complications — Gonorrhœa in women — The “diseases of women” — Blindness due to gonorrhœa.
Appendix: Venereal Diseases in the Homosexual.
The central problem of the sexual question is, as I pointed out at the commencement of the previous chapter, the suppression of prostitution and ofvenereal diseases, the former evil being the principal focus of the latter. I say the principal “focus,” not the “cause.” For, if all prostitutes werehealthy, we could leave prostitution quietly alone—leaving out of consideration the moral depravity to which it gives rise—and venereal diseases would spontaneously disappear.
This opinion I advance at the beginning of the chapter on venereal diseases because, even at the present day, there is a remarkable species ofphilosophy, or rather theology, of venereal diseases, which propounds the most extraordinary hypothesis regarding theirorigin.
For example, the Alsatian writer Alexander Weill, in his confused work “The Laws and Mysteries of Love,” writes:
“Why should we bother our heads about the cure of syphilis? If anyone wishes to get rid of any evil, he must first of all ascertain its causes in order to remove these. If the cause of it is removed, the evil disappears spontaneously. If the snake has been killed, its poison no longer does any harm. But how can we put an end to the causes of syphilis, when this disease is spontaneously renewed and increased day by day by means of neglected prostitution, and by our social laws which combine to oppose the monogamy of youth and the increase of population? If to-day we could cure all patients suffering from syphilis,to-morrow the same disease would return in a new form, for it would be recreated by the same irregularities that first led to its production(!) It is absolutely useless to employ iodide of potassium and mercury, for every new infringement of natural laws would again bring into being new incurable diseases, which can only be avoided by those who have firmly resolved to observe these laws strictly.”
“Why should we bother our heads about the cure of syphilis? If anyone wishes to get rid of any evil, he must first of all ascertain its causes in order to remove these. If the cause of it is removed, the evil disappears spontaneously. If the snake has been killed, its poison no longer does any harm. But how can we put an end to the causes of syphilis, when this disease is spontaneously renewed and increased day by day by means of neglected prostitution, and by our social laws which combine to oppose the monogamy of youth and the increase of population? If to-day we could cure all patients suffering from syphilis,to-morrow the same disease would return in a new form, for it would be recreated by the same irregularities that first led to its production(!) It is absolutely useless to employ iodide of potassium and mercury, for every new infringement of natural laws would again bring into being new incurable diseases, which can only be avoided by those who have firmly resolved to observe these laws strictly.”
Weill, indeed, goes so far as to maintain that every man whosimultaneously, or rather in brief succession, has intercourse with two healthy women, acquires syphilis, even although both these women remain faithful to him, because “any kind of libertinism in sexual intercourse suffices by itself to give rise to this disease!”
According to this view, which is shared by many members of the laity, venereal diseases, and, above all, the worst of them, syphilis, would be as old as sexual licentiousness itself—that is,as old as the human race, and an inalienable associate of that race.
In my book on “The Origin of Syphilis” I have disprovedthis view. I have answered the question, so important alike on general philosophical and on social-hygienic grounds, regarding the true nature of syphilis, and have proved that syphilis (and also the other venereal diseases) had a definitelocalandtemporalorigin; that syphilis has not existed since the beginning of time; and that some day, when certain definite conditions are fulfilled, the disease will disappear.
The history of syphilis is a matter of profoundpracticalimportance. From that history we learn with certainty that the most dangerous and most dreaded of the venereal diseases has, for the European world, and for the “old world” in general, the character of apure chance comer; and we learn thatretrospectively—regarded from the point of view of our present experience—at the time when the disease first began to flourish, it might perhaps have been nipped in the bud.
It is hardly possible to overestimate thepracticalimportance of the recognition of this fact—that for the old civilized world syphilis represents a historical phenomenon, that it has a history, a beginning, or, as Voltaire half-ironically remarks, a genealogy.
Is there not a deliverance, a redemption, in the idea that for the old world there was a time in which syphilis did not exist; that this time, in comparison with the time which has elapsed since syphilis first appeared, was almost infinitely long; and that for this reason, when we look out into the future, the history of the lues venerea assumes the character of a simple episode in the history of European civilized humanity?
At the same time, the definite acceptance of this view would be an urgent warning to all those obscurantists of both sexes who imagine that the problem of the diffusion of venereal diseases can be solved exclusively by religious and moral considerations, and who thus confuse the simplest and clearest relationships, place everything upon an insecure foundation, and exclude every possibility of a successful campaign against syphilis.
Even to-day it unfortunately happens that many continue, as of old, to believe that sexual intercourse is a sin for which a punishment has been provided, and that this punishment is a venereal disease—for example, syphilis. Tylor, the celebrated English anthropologist, has proved that this idea has developed out of theanimismextending back into prehistoric times, which regarded all illnesses as the work of demons. We are still influenced by this doctrine, this gloomy, demoniacal conception in respect of everything sexual. I need hardly remind the reader of the ideas of Tolstoi, and of his disciple, the unhappy Dr.Weininger, a disciple exceeding even his master in respect of fanatical condemnation of sexual intercourse. Until recently the laws regulating our German system of workmen’s insurance against illness continued to exhibit definite traces of our legislators’ adhesion to this view. The majority of physicians and historians who said that syphilis was as old as sexual intercourse itself, who employed the phraseubi Venus ibi syphilis, were unconsciously influenced by this idea, that venereal diseases are to be regarded as a mark of the Divine wrath.
This theological theory, as we may call it, of the origin of syphilis is opposed by certain incontrovertible facts, which suffice to show its utter nullity and untenability.
The mere fact that there exists ablamelessinfection with syphilis (syphilis innocentium), that, for example, in certain districts of Russia as many as 90 % of the cases of this disease are acquiredquite independentlyof sexual intercourse, by simple contact, shows the absurdity of this superstitious idea.
In the second place, it is a widely known fact that quite frequently persons who are still entirely uncontaminated, blameless initiates, become infected with syphilis on the very first occasion in which they have sexual intercourse, whilst greater experience and more exact knowledge of the threatening dangers induce notorious debauchees to adopt effective measures of protection (which, however, would be useless if syphilis were really a divinely decreed punishment for licentiousness of this kind!).
In the third place, the occurrence of syphilisin little children—partly owing to inheritance, partly, however, acquired in the way already mentioned by casual contact—affords a striking refutation of the above idea, which, unfortunately, still dominates and fascinates a large circle of people.
We could adduce further arguments against this view, but what we have said should suffice to show clearly the untenability of such a superstition. The syphilis of one individual is not the consequence of sexual intercourse, but the consequence of another case of syphilis in another individual—that is to say, syphilis is aspecific infective disease, transmissible only by means of its peculiar specific virus, and this transmission can be effectedwithout any sexual intercourse, by means of contacts of other kinds.Syphilis arises only from syphilis.
We have, therefore, to attackthisdisease precisely in the same manner as the other venereal diseases. As a Portuguese physician has most aptly remarked, to the tyranny of syphilis we must oppose the tyranny of human reason. The principal aim of acampaign against venereal diseases will be theorganizationof the means offered to us by reason and experience to cope with the disease. The knowledge of these means must be diffused in ever-wider circles of humanity, and care must be taken that every individual is fully and clearly informed regarding the importance and the dangers of syphilis and the other venereal diseases.
Here also history is our teacher, our lamp of truth, and promises us complete success as the result of our campaign against venereal diseases.
The results of my investigations regarding the origin of syphilis all point to asingleextremely important fact—namely, that in the case of syphilis, and as regards the “old world,” we have to do with aspecific disease of modern times, which made its first appearanceat the end of the fifteenth century, and of the previous existence of which, even in the most distant prehistoric times, not the minutest trace remains. This view was held by very eminent physicians, even before the publication of my own critical work, based upon entirely new sources of study. Among these authorities I may mention Jean Astruc and Christoph Girtanner, in the eighteenth century; in the nineteenth century, the Spanish army surgeon Montejo, and of German physicians, above all, Rudolf Virchow, A. Geigel, von Liebermeister, C. Binz, and P. G. Unna. The great philosopher Arthur Schopenhauer held the sameview.[312]
Ricord, the celebrated French syphilologist, spoke once of a romance of syphilis which still remained to be written. I should rather compare it with adrama, the separate acts of which arecenturies. Of this drama,fouracts have already been played. At the present moment we find ourselves at thebeginningof thefifthact. Thus, we have anentirecentury before us, in which, with all the powers placed at our disposal by scientific medical research, by practical therapeutics, and by hygiene in association with social measures, we must work to this end, that this fifth act shall also be thelast, as it is in the case of a proper drama.
The history of syphilis has remained so long obscure, because, until the time of Philipp Ricord—that is to say, until the beginning of the second half of the nineteenth century—the three venereal diseases,syphilis, orlues, the so-calledsoft chancre(venereal ulcer or chancroid), andgonorrhœa, were regarded as essentially one disease; whereas we know to-day that syphilis is a specific infectivedisease of aconstitutionalcharacter, which permeates the whole body, and must be absolutely distinguished from the other venereal diseases, these latter being purelylocalin character. This earlier belief in the identity of all venereal infections, an error held even by so great an authority as John Hunter, who was misled by falsely interpreted experiments, renders it necessary that the historical side of the question should be considered also from this point of view.
If gonorrhœa and chancroid were of a syphilitic nature, then certainly syphilis must have existed from very early times. It would not be difficult to refer to syphilis some descriptions and accounts of diseases of the genital organs given by the ancient and medieval writers. It was the progressive enlightenment regarding the essential differences between the three venereal diseases which first proved the untenability of such opinions; we were further assisted by the knowledge ofpseudo-venerealandpseudo-syphiliticdiseases which we have obtained from modern dermatology. Moreover, in the old world syphilitic bones belonging to ancient or medieval times haveneverbeendiscovered.[313]The first syphilitic bones date fromafter the time of the discovery of America. They appear, above all,after the outbreak of the great epidemic of syphilis which followed the Italian campaign of King Charles VIII. of France, in the years 1494 and 1495; it was then that syphilis first became diffused in the old world.
In my work on “The Origin of Syphilis” (Jena,1901),[314]I have adduced proof, basing my views upon the criticism of older opinions, and assisted by the utilization of very abundant new sources of material, that syphilis was first introduced into Spain in the years 1493 and 1494 by the crew of Columbus, who brought it from Central America, and more especially from the island ofHayti; from Spain it was carried by the army of Charles VIII. to Italy, where it assumed an epidemic form; and after the army was disbanded the disease was transported by the soldiers to the other countries of Europe, and also was soon taken by the Portuguese to the Far East, to India, China, and Japan. At the time of its first appearance in the old world, syphilis was extraordinarilyvirulent. All the morbid phenomena produced by the disease had a more rapid and violent course than at the present day; the mortality was much higher; the consequences, even when a cure was effected, were much more severe. This virulence of syphilis at the time of its first introduction can only be explained, in accordance with our modern views of the nature and mode of appearances of the disease, by the fact that the nations of the old world (who,nota bene, wereallattacked with equal intensity) had, until that time, beencompletely freefrom syphilis.All classesof the people andall nationswere visited by syphilis to an equal extent and with the same violence.
Even to-day we observe everywhere, when syphilis is introduced into regions which have hitherto beenfreefrom the disease, that it has the same acute course, the same violence of morbid manifestations, that characterized its first appearance in Europe. In the four centuries that have elapsed since its introduction into Europe there has occurred a gradualmitigationof the syphilitic virus, or rather a certain degree of immunization of European humanity against the disease. Speaking generally, syphilis has to-day—in comparison with that earlier time—a relatively mild course. To this point we shall returnlater.[315]
The two other venereal diseases,gonorrhœaandchancroid, unquestionably existed in Europe in the days of antiquity. But they also arespecific infective diseases, and are only produced by the virus peculiar to each, just as syphilis has its own peculiar virus.
Ricord (1800-1889), in the years 1830 to 1850, proved the completediversityof syphilis and gonorrhœa, established the doctrine of the three stages of syphilis—primary, secondary, and tertiary—and, finally, taught us to distinguish thesoft, non-syphilitic chancre(chancroid) from thehard, syphilitic chancre. Virchow, in his celebrated essay on “The Nature of Constitutional Syphilitic Affections” (Virchow’s Archiv, 1858, vol. xv., p. 217et seq.), then threw a clear light on the peculiar course of constitutional syphilis and on the causes of the occasional disappearance and sudden reappearance of the morbid phenomena. Hitherto, however, our knowledge of venereal diseases had rested on an extremelyinsecure foundation; andthe truly scientific study of the subjectmay be said to have begun in the year 1879, with Albert Neisser’s epoch-making discovery of thegonococcusas the specific exciting cause of gonorrhœa. In the years 1889 to 1892 there followed the discovery of thebacillus of chancroidby Ducrey and Unna, by means of which discovery the complete distinction between the soft and the hard chancre was definitely proved; and, finally, the three years 1903 to 1906 were characterized byremarkable discoveries, the full importance of which is not as yet fully realized,regarding the nature of the syphilitic virus. In the year 1903 Eli Metchnikoff succeeded in transmitting syphilis from human beings toapes, and thus laid the foundation for progressive research regarding syphilis by means of experiments on animals; this was carried further by Lassar, by the inoculation of the syphilitic virus from one ape to another, and also by A. Neisser in his experimental researches inJava;[316]and in March, 1905, the Berlin protozoologist Fritz Schaudinn, since prematurely lost to the world of science, published his first studies on the probable exciting cause of syphilis, the so-called “spirochæte pallida.” Numerous subsequent investigations have established the connexion between this spirilla-form, belonging to the order of protozoa, and syphilitic disease. In this way we have been brought notably nearer to the discovery of the certain cure of syphilis and to the discovery of means of immunization against the disease. In this direction quite new views are opening before oureyes.[317]Numerous ideas suggested by recent discoveries in the province of syphilitic research are described in the admirable essay by J. Jadassohn, “Contributions to Syphilology,” published in the German “Archives for Dermatology and Syphilis,” 1907.Cf.also the account of the recent doctrines regarding syphilis by P. G. Unna and Iwan Bloch, “Die Praxis der Hautkrankheiten,” pp. 548-592 (Vienna and Berlin, 1908).
When some day humanity has been freed from the “sexual plague,” from the hydra of venereal diseases, and when a monument is erected to the liberators, four names will there be commemorated: Ricord, Neisser, Metchnikoff, and Schaudinn!
After these preliminary remarks on the nature of venereal diseases, I proceed to a short description of them, and Ibegin with the most dangerous of all the venereal diseases,syphilis.[318]
The first manifestations of syphilis make their appearance about three or four weeksafterinfection, at the place at which infection has occurred, and this is not in every case the genital organs. It is true that syphilis is most commonly transmitted by means of sexual intercourse, but frequently also by contacts of other kinds—for example, bykissing; by gynecological or surgical examinations and operations; bydrinking from a glasswhich has previously been used by some one suffering from syphilis; by the use of uncleansed pocket-handkerchiefs, towels, and bedding, which have been used by a syphilitic patient; by the use of tobacco-pipes, wind-instruments, tooth-brushes, tooth-picks, a glass-blower’s mouthpiece, etc., belonging to strangers;by an uncleansed razor; by the nasty habit of licking the point of a pencil; by moistening postage-stamps with the tongue; by sucking the wound in circumcision;by the suckling of the infant at the breast of a syphilitic wet-nurse,etc.[319]In England the custom, when taking a judicial oath, of kissing the Bible has repeatedly sufficed to transmit syphilitic infection.
In certain districts in which the level of civilization is a low one—as, for example, in some parts of Russia and of Turkey—as many as 50 to 60 % of all infections occur independently of sexual intercourse.
All thedischargesfrom syphilitic lesions in all three stages of the disease are infective. The infective character of the tertiary stage of syphilis was formerly doubted, but has recently been proved beyond dispute.Bloodalso, although more rarely, can prove infective. On the other hand, thepuresecretions—that is, the physiological secretions, not contaminated by morbid products—such as the saliva, tears, and milk, are not infective. Syphilis is, however, very frequently transmitted by means of thesemen.
Infection occurs in places in which there is a solution of continuity of the skin or mucous membrane, such as a scratch or a superficial wound, through which the virus can enter. In this way an apparently healthy syphilitic patient—when, for example, he gets a small abrasion on the penis (or, in the case of a woman, in the vagina)—can transmit syphilis if the other individual also has a similar abrasion through which infection can occur.
As we have said, it is not till the lapse of two to four weeks after infection has occurred that the first manifestations of syphilis appear, in the form of a small vesicle or nodule in the infected area; less often merely an abraded area of a peculiar red colour. Gradually this nodule or area enlarges, and becomes continuallyharderat the base, whilst the surface often undergoes ulceration, and secretes extremely infective pus (the so-called “hard chancre” or “primarylesion”[320]).
This induration is in most cases a certain sign that the syphilitic virus has already entered the body; at least, it has only been possible in a few very rare cases, by excision or cauterization of the hard chancre, to prevent syphilis from entering the blood. Almost always, notwithstanding such endeavours, the manifestations of general infection of the body soon appear.
From the place of infection—that is, from the place at which the hard chancre forms—the syphilitic virus next passes by way of the lymph-stream into the inguinal glands, so that these, in the third or fourth week after the appearance of the hard chancre, begin to swell and to become hard. This swelling of the inguinal glands is painless (the so-called “indolent bubo”), in contrast to the painful swelling which accompanies the soft chancre. From this region the poison now proceeds by way of the bloodvessels and lymph paths on its wanderings all over the body, the individual stages of which can be detected by swellings of the lymph-glands of the axilla, the elbow, the neck, etc. Sometimes other symptoms of general infection are noticeable; above all, the appearance offever(never earlier than forty days after infection),painsin the muscles, joints, nerves, also severe headaches, a general feeling oflassitude,pallor, and a falling-off in the nutritive condition.
These are the forerunners of the so-calledsecondarystage of syphilis, which now manifests itself by the appearance of a multiformskin eruption, rendering the diagnosis of syphilis absolutelycertain. For this reason, in doubtful cases of ulceration of the genital organs the patient should inspect his skin very carefully every day for several weeks or months, and keep watch for the appearance of red spots or nodules. This syphilitic eruption on the skin is also in the later periods one of the most certain and most characteristic insignia of the disease.
The eruption commonly appears first on the trunk, in the form of rose-coloured spots (the so-called “roseola syphilitica”), spreads thence over the whole body, and in many cases, simultaneously with or shortly after the spotted eruption,nodulesappear on the skin, and marked thickenings form on the mucous membranes, especially at the anus, in the mouth, and on the tongue (the so-called “plaques muqueuses,” or “condylomata”). The patient’s attention is spontaneously directed to these lesions by painful sensations in the mouth or by itching of the anus. Often it is these painful sensations, associated with a violent inflammation of the tonsils and pharynx (the so-called “angina syphilitica”), which first lead the patient to consult a doctor, after all the earlier symptoms have passed by unnoticed! As characteristic forms of the secondary syphilitic changes in the skin must, therefore, be mentioned the so-called “corona Veneris,” by which distinguished name is denoted an eruption on the forehead, especially along the margin of the hair, which by members of the laity is easily confused with other affections of the skin common in this locality; the so-called “collier de Venus,” orleukoderma syphiliticum, a peculiar pigmentation of the skin on the throat and the back of the neck in the form ofbrownpatches withwhiteintervening areas. This symptom,which occurs almost exclusivelyin women, is an absolutely certain sign of syphilis. Equally characteristic is the so-called “syphilitic psoriasis,” the appearance of peculiar patches and thickenings on the palms of the hands and the soles of the feet; characteristic also is the syphiliticloss of hair, by its sudden onset and by the patchy way in which it occurs. Not rarely do we seepurulenteruptions on the skin in this secondary stage of syphilis.
The syphilitic eruption of the skin is only an external manifestation of a disease affecting the entire body, for the internal organs also suffer. The affection of the liver manifests itself by jaundice; that of the brain and the meninges by headaches and byweakness of memory, which is often well marked at this stage; that of the spleen by swelling; that of the kidneys by the appearance of albumin in the urine; that of the bones by very painful inflammatory swellings; that of the eyes specially by the well-knownsyphilitic iritis(60 % of all inflammations of the iris are syphilitic in nature!).
If the disease remains untreated, the appearances just described become more general and continually more severe; and after some time, quite new morbid symptoms are superadded (often as early as the third year, on the average five to ten years after infection, but also later), resulting from the transformation of the syphilitic morbid process into thetertiarystage. To these new manifestations belong the appearance of largenodulesin the skin and other organs, which sooner or later undergo ulceration, the so-called “syphilitic gummata”; their ulcerative destruction may entail the greatest disfigurement or danger to life—for example, perforation of the hard palate; sinking of the bridge of the nose (the syphilitic “saddle-nose”); ulcerative destruction of large portions of the bones of the skull, of the intestine, of the liver, the lungs, the testicles, the bloodvessels (especially dangerous are gummous diseases of the bloodvessels of the brain), the brain, and the spinal cord.Apoplectic strokesoccurring in comparatively young persons andnervous paralysisof the most various kinds, as well as suddendeafnessandblindness, are in most cases referable to syphilitic disease. Many chronic diseases of the liver, kidneys, and nervous system, are consequences of previous syphilis; alsocalcification of the arteries, the very dangerous dilatation of the great bloodvessels, especially of the aorta (aneurism of the aorta), are very often of syphilitic origin.
By the researches of Alfred Fournier and Wilhelm Erb, we know to-day that two severe diseases of the central nervous system—tabes dorsalisorlocomotor ataxy, andgeneral paralysis of the insane(paralytic dementia)—are almost always (in about 95 % of the cases) referable to earlier syphilis. Among 5,749 cases of syphilis encountered in his own private practice, Fournier observed no less than 758 cases of brain syphilis, 631 cases of tabes, and 83 cases of softening of the brain. Tabes and general paralysis of the insane are all the more dangerous because they are no longer, properly speaking, “syphilitic” diseases, and therefore they cannot be cured by antisyphilitic treatment; they are severe degenerative changes of the central nervous system, which has been, as it were, prepared for their occurrence by the previous syphilis. These belong to the class of the so-called “parasyphilitic” diseases in which antisyphilitic treatment has little or no good effect.
Even more tragic are the consequences of syphilis to thefamily, theoffspring, and therace.Syphilis in married life,congenitalsyphilis, and thedegeneration of the race by syphilis—these are the tragic manifestations which come under consideration in this connexion.
In his admirable work on “Syphilis and Marriage,” Alfred Fournier, the greatest living authority on syphilis in all its manifestations and relationships, has described the momentous influence exercised by syphilis in conjugal life; and in his recently published work, “Syphilis a Social Danger,” he has dealt also with congenital syphilis and racial degeneration. He found that, on the average, among 100 women suffering from syphilis, 20 had been infected by their husbands, either at the very commencement of married life, or in its later course, or finally through the offspring after conception. Divorce on the ground of syphilitic infection by the husband is at the present day of frequent occurrence.
The transmission of syphilis to the child byinheritancemay be effected either by the father or the mother; when both the father and the mother are syphilitic, it occurs with absolute certainty. The various possibilities of transmission, and the contingent immunity of mother or child, as they are expressed in Colles’s law (Baumès’s law), and in Profeta’s law, cannot here be further dealt with. If the mother has herself been infected with syphilis, or if she was previously syphilitic, either the child is not carried until term, abortion or miscarriage ensuing, or, finally, it is born with symptoms of congenitalsyphilis.[321]
The frequent occurrence of premature births and still-births in any family suggests strong suspicions that they are due to syphilis. Thegeneral mortalityof the children in a family is regarded by Fournier as an important sign to the physician of congenital syphilis. Syphilitic infection of the father gives rise to a mortality in the children of 28 %; syphilis in the mother causes a mortality in the children of 60 %; when the disease affects both parents, the mortality among the children amounts to 68 %. Absolutely astounding is the mortality of the children of syphilitic prostitutes; it amounts to from 84 to 86 %.
Children bornalive, suffering from congenital syphilis, are generallyweakly,[322]of deficient body-weight; have often a flaccid,wrinkled skin, covered with typical syphilitic eruptions, and frequently with great purulent vesicles, especially on the palms of the hands and the soles of the feet (“pemphigus syphiliticus”); the internal organs also, the spleen, the liver, and the bones, exhibit morbid changes. Characteristic is the syphilitic affection of the upper air-passages, especially the syphilitic “cold in the head” (syphilitic rhinitis—“snuffles”), of new-born congenitally syphilitic children. Congenital syphilis further gives rise to severedisturbances of developmentand to phenomena to which Fournier has given the name of “late syphilis” (“syphilis hereditaria tarda”), because they first make their appearance in the later years oflife.[323]Permanentdebility,arrest of development,stigmata of degeneration, in the form of variousmalformations—as, for example, notching of the edge of the upper central incisor permanent teeth (a symptom first described by Jonathan Hutchinson), malformations of the nose, the ears, and the palate, dwarfing, deaf-mutism, malformations of the external and internal reproductive organs,rickets,[324]epilepsy, and mental weakness—are the consequences of congenital syphilis. Tarnowsky, Fournier, and Barthélémy have traced the consequences of congenital syphilis into the second and third generation, and so have discovered an important cause of racial degeneration. Syphilis in the grandfather can still exercise its disastrous influence in the grandson, and give rise to the above-mentioned stigmata ofdegeneration.[325]Indeed, congenital syphilis of the second generation often appears with the same severity as that of the first generation; and, like acquired syphilis, congenital syphilis in women can cause a predisposition to miscarriages and still-births.
According to statistics obtained by Edmond Fournier, relating to 11,000 cases of syphilis (10,000 men, 1,000 women) from theprivate practice of his father, Alfred Fournier, regarding the age at which infection occurs, it appears that inmenit most commonly occurs between the ages of twenty and twenty-six years (the maximum number of infections during the twenty-third year); inwomen, between the ages of eighteen and twenty-one; 8 % of syphilitic males and 20 % of syphilitic females were infected before the age of twenty years. Syphilis is to a considerable extent at the present day a disease ofinexperienced youth. This fact is important in relation to the problem of prevention and the problem ofenlightenment.[326]
Of much less importance than syphilis is the purely localsoft chancre, or chancroid, which never results in general infection. Chancroid is produced by a specific exciting cause, a chain-forming bacillus (streptobacillus),Bacillus ulceris cancrosi, which is found in the pus secreted by the ulcer.One or two daysafter infection, a small pustule forms at the site of inoculation, generally on the external genital organs. This pustule soon bursts, and a deeply hollowed ulcer makes its appearance, which usually undergoes rapid increase, and frequently, owing to the infective character of the pus, gives rise to new chancres in the neighbourhood of the original one, so that the soft chancre is commonly multiple. When suitably treated with antiseptic powders and cauterization, chancroid usually heals quickly; there are, however, very dangerous varieties of chancroid—for instance, theserpiginouschancre, which continues to creep irresistibly forward; and thephagedænicorgangrenouschancre, which puts the skill of the physician to the utmost test. A less dangerous but extremely disagreeable complication of chancroid is inflammation of the inguinal glands, most commonly only on one side; this painful “bubo” (painful in contrast with the painless syphilitic bubo) has a well-marked tendency to suppuration. If this occurs, and the pus finds its way to the surface, fistulas and new chancrous ulcers are liable to occur at the place where it opens. By rest in bed, the inunction of iodide ointment, the application of cold compresses, the injection into the bubo of a solution of nitrate of silver, and the internal use of iodide of potassium, this unfortunate course may be prevented.
A remarkablechange of viewshas, in the course of the lastthirty years, taken place in respect of the nature and importance ofgonorrhœa.[327]Whereas formerly this was regarded as a comparatively harmless disease, we know to-day that gonorrhœa in the male, and still more in the female, gives rise to tedious dangers and painful morbid phenomena, and is the source of unspeakable sorrows, and of the miserable ill-health of numerous women, and that it is the chief cause ofsterilityin both sexes.
Gonorrhœa is principally adisease of the mucous membrane, and is, in this way, distinguished from syphilis, which is a general disorder, diffusing itself by way of the bloodvessels. In rare cases, indeed, gonorrhœa can exhibit general morbid manifestations, the so-calledgonorrhœal rheumatism, gonorrhœal affections of the spinal cord and of the heart, and gonorrhœal nervous troubles, all of which are so rare, that for practical purposes they can be left out of consideration.
The typical seat of gonorrhœa is themucous membrane of the urinary and the genital organsof the male and the female; in the male affectingchieflythe urinary organs, and in the female affecting chiefly the genital organs. The cause ofgenuinegonorrhœa is always infection, the transmission from one human being to another of the purulent inflammation produced by thegonococcusdiscovered by Neisser in 1879.Simple urethral inflammationswith a purulent discharge also occur in which no gonococci are found. These arise also from infection, but their actual exciting cause has not yet been discovered. Not less obscure is the relationship of many of the irritants giving rise to simple urethral catarrh—for example, that which is active during menstruation—to the supposed exciting cause. In any case, these simple catarrhs have a very mild course, and undergo a cure after a few days or weeks, spontaneously or as a result of treatment with mild injections.
Quite otherwise is it with genuine gonorrhœa. In the male it begins from two to six days after the infective intercourse, with a burning sensation on passing water, itching at the urethral orifice, which very easily becomes reddened, and this is soon followed by the discharge, either spontaneously or as a result of pressure on the urethra, of a thick fluid, at first mucous, later purulent, and then of a yellow or a greenish colour. Inflammation, discharge, and pain, the latter especially in association with urination, increase during the subsequent weeks; in addition, in a good many cases there are slight fever, lassitude, and mentaldepression, and the patient is tormented, especially during the night, by violent, painful erections. In exceptional cases there are hæmorrhages from the urethra (the so-called “Russian clap”). In some cases the disease terminates favourably; this is especially observed after the first attack of gonorrhœa. As early as the third week the above symptoms become less severe, and in the fourth or sixth week after infection the whole morbid process may come to an end, the discharge ceases, the urine becomes clear once more, and, in fact, definite cure of the gonorrhœa ensues.
But the number of those who are so fortunate is comparatively small. In the majority of cases, there are other morbid phenomena and complications; the gonorrhœa becomes “subacute,” and later “chronic.” Ricord wrote many years ago: “When anyone has once acquired gonorrhœa, God only knows when he will get well again!” Happily, this pessimism is no longer fully justified at the present day; but it is a fact that in the majority of caseseven to-daygonorrhœa is a very obstinate, wearisome illness, a long-continued burden, not only for the patient, but also for the doctor. The gonococci proliferate in the deeper layers of the mucous membrane, and pass upwards into theposteriorpart of the urethra, this latter migration being manifested especially by frequent and painfulstrangury; further, thebladder, theprostate gland, and theepididymismay be attacked. Bilateral epididymitis has often serious consequences as regards the procreative capacity. In about 50 % of the cases incapacity for fertilization (impotentia generandi) has resulted.
If the gonorrhœa becomes chronic, thickenings occur in isolated portions of the urethral mucous membrane; the urine remains turbid for a long time; the discharge, it is true, becomes scantier, but shows itself with the most annoying persistency every morning as soon as the patient leaves his bed, in the form of the so-called“bon jour” dropsin the meatus; there are also troubles connected with the prostate (painful sensations, especially during defæcation), and symptoms of stricture of the urethra may occur. Very often, also, relative impotence and severe sexual neurasthenia are observed, as consequences of chronic gonorrhœa. Worst of all is thelong duration of the infectivity. There is always the danger that somewhere or other some gonococci may remain hidden, and, given an opportunity, may start the process all over again, or may transmit the infection to another person. Zweifel reports a case in which a man actually infected a woman thirteen years after he had first acquired gonorrhœa!