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people among its inhabitants. An attack of indigestion may equally cause a tactical opportunity to be missed in the field or a fortune to be lost on the Stock Exchange. In battle certain precautions are taken to minimise the occurrence of wounds and death, although these are inevitable in warfare. They are the means used to attain the end in view, namely, the reduction of one's opponent to such a state that he is incapable of further resistance. Victory is secured by that belligerent who can inflict sufficient wounds, death, and suffering upon his enemy. The destruction of the opponent's morale is the prelude to his defeat.
In the army, just as in civil life, disease is bound to occur to a greater or less extent. But, while wounds are inevitable, disease is in some degree accidental. It can with proper care and organisation be minimised so as to be almost negligible. It is the prevention of this unnecessary wastage of man-power by disease that has such a direct bearing upon the maintenance of morale. Specially far-seeing and thorough measures have to be taken to prevent disease during warfare, for the conditions under which the troops live are particularly prone to cause ill-health. Any disease occurring in an army is important; and its importance varies directly with its incidence. If it is a preventible malady and at the same time a common one, and if sufferers from it are rendered non-effective for a considerable time, then, as a factor predisposing to loss of morale and to defeat, it is very powerful. Any such disease afflicting an army must be tackled vigorously. Special efforts must be directed against it; and the Medical Service must be enthusiastic and energetic in its work. Furthermore, strong supportmoral, legislative, and financial-must be forthcoming from the Government.
Some time must elapse before full figures are available concerning the prevalence of venereal disease in the army during the whole of the war. In the mean time, however, an indication of the state of affairs may be gleaned from the following statistics, which refer to British troops in France alone during one year—1917 :Number of cases of gonorrhoea
71,000 Number of cases of syphilis .
21,000 Number of cases of soft chancre
The importance and seriousness of this total scarcely requires comment. It must be borne in mind that all these diseases are entirely preventible. In face of such a total for one year it would be vain to claim that the measures taken to combat the venereal menace were remarkably successful. It were equally vain to surmise what would have been the total had no measures been adopted.
The question now arises as to how such a figure can be accounted for. Granted the existence of a certain amount of venereal disease in the community, what are the conditions which give rise to its increase ? A full consideration of these would involve the use of more space than is at one's disposal; but, in a word, they are those things which, acting together or separately, cause a proportion of the population greater than normal to expose themselves to infection. The arsenal from which fresh stores of the disease are drawn already exists in the civil community. Any increase of the normal amount of promiscuous sexual connexion--that is, if more individuals indulge in it-will be followed by a corresponding increase in the amount of venereal disease. Those things, therefore, which conspire to produce an increased desire among an increased number of people for sexual gratification-and, from the exigencies of communal life, this is usually non-marital-are the chief predisposing causes of venereal disease. Any increase in the facilities for obtaining such gratification will also predispose. There is no mystery as to why venereal disease increases during war. It is a series of well-defined and recognisable causes which combine to produce this effect.
The things which act as stimuli to illicit and promiscuous intercourse are many and can only be stated briefly. It is a fact that the accompaniment of any communal excitement or emotionalism lowers the threshold of sexual morality. The national excitement at the commencement of a great war and during its course has the undoubted effect of relaxing the moral standards which have been erected during more peaceful days. It is a phase of this excitement which results in men flocking to join the colours. The soldier starts off on his military life in a frame of mind very different from his
normal one during the humdrum days of peace. He is affected to a certain extent by the national war hysteria ; and his moral equilibrium, which is a product of peaceful environment, is somewhat out of gear and is more susceptible to disturbing influences. The separation from home life and the loss of the conventions and refinements of civilisation; the change of scene to a foreign country; the hard work, the discomforts, the danger, all conspire in no small measure to direct his thoughts, when on leave or in billets outside the battle area, to having a good time. The orchestra is played fortissimo; the loud pedal is pressed down hard ; and the theme of the symphony is too often Alcohol and Venery. This is a perfectly natural and comprehensible sequence of events. It is the usual and normal response elicited upon the application of certain stimuli. In war-time the stimuli are stronger than normal, and the conditions are such that the response is more easily evoked.
To the soldier a series of such stimuli are applied ; and he is an individual whose powers of resistance are weakened and the barriers of whose normal temperance of conduct have been lowered. The worship of the warrior—the hero-by the female is not confined to any one species. It is just as strong in the human as in the lower grades of animal life. The desire of the soldier to shine in the eyes of the opposite sex is by no means un
The surroundings are often such that female companionship is only available in the form of the prostitute, regular or clandestine. Moreover, that particular element of femininity has, in order to secure custom, to tout for trade. This necessarily takes the form of the application of sexual stimuli to the male. A vicious circle is established.
In brief, then, during war there are increased incentives to sensuality and likewise increased opportunities to indulge in it. These incentives are always present in peace-time civil life ; in war-time they are more powerful, and they act upon the soldier with especial force. The soldier is thus, from the very nature of his conditions of life, apt to place himself in the environment most likely to result in venereal infection. These considerations account in some measure for the prevalence of venereal disease among troops; they show why troops
are specially liable to become infected. They are predisposing causes.
The view put forward here is that the principal cause of the high figures quoted above is that the anti-venereal measures taken were inadequate, and that this inadequacy is the result of the non-appreciation of the problem. It is consequent upon the failure to grasp the fact that powerful mental processes and emotions are the mainsprings of venereal propagation. The mental and psychological factor enters into the question of venereal disease to a greater extent than, and in a different fashion from, what is generally realised. The emotional element dominates it. The majority of other diseases
re of the nature of accidents; no mental state is responsible for the infection of a man with measles. Other diseases are merely physical disorders; and nothing but physical conditions predispose to their acquirement. Venereal disease is different. True, it is in itself a physical disorder, but certain psychological conditions predispose to it, principally an intemperate desire for sexual intercourse. This is an essential point which is seldom grasped. Thus it is that methods which are successful in combating the propagation and spread of other maladies entirely fail when applied to venereal disease. In the latter case we have the powerful driving force of the most intense and deeply rooted human emotion, acting in circumstances forcing the individual into the zone of infection. Only to a very slight extent can this emotion be controlled or inhibited; but the too frequent consequences of giving way to it are not inevitable. They are accidental and can assuredly be
To a certain extent it has been realised that there are two aspects to the problem-one sanitary, the other moral. Two schools, narrow-minded and fanatical, have arisen ; and a vast amount of unnecessary antagonism has been created. It is only by a proper co-ordination of the two that progress can be ensured. The measures adopted during the war were partly those advocated by one school and partly those advocated by the other. The great fault has been that the advocates
. of each have placed implicit reliance upon their own particular panacea, and have derided or regarded as
unnecessary the measures suggested by the other. The cleric was obsessed by the great moral predisposing causes, and, in his efforts to counteract their influence, was averse in some degree from giving any support to the dissemination of knowledge, especially along the lines of prophylaxis. His slogan was Perfect morality
' will banish venereal disease.' The adherent of the purely sanitary school was inclined to regard his clerical colleague as being an incompetent muddler, and seldom sought his advice and support.
The measures adopted during the war for dealing with venereal disease were various. In the first place, an attempt was made to spread knowledge regarding sexual matters and disease. This was done by means of lectures and pamphlets. The whole proceeding, however, was characterised by lack of enthusiasm and driving power. The National Council for the Combating of Venereal Disease did its utmost; and what it did was extremely valuable. The great majority of other propagandists—regimental medical officers and chaplainsfailed to realise the seriousness of the matter, and they neither appreciated the power of the weapons lying ready to their hands nor understood the manner of their employment. The authorities were equally in the dark regarding the gravity of the situation. The tremendous loss of man-power that ensued was apparently unforeseen. Anti-venereal measures were looked upon as merely a 'side-show' of the Medical Service. Treatment of the disease, when it did occur, was regarded as being of much more moment. The delivery of mails to the troops was no doubt of great importance, but not so great as the keeping of them free from venereal disease. Had half the organisation, support, and money expended on the Army Postal Service been given to an AntiVenereal Service, it would have been a very profitable national investment.
While admitting to the very fullest degree that the raising of the standard of morality is the ideal solution and one which must be striven for strenuously and continuously, yet it must in common-sense be pointed out that the millennium of complete morality is a long way off. After nearly two thousand years of the inculcation of Christian ethics, we find the venereal