THE ALL-AMERICA CONFERENCE ON VENEREAL

TH

DISEASES.

By Lt. Col. T. F. Ritchie,

Assistant Chief of the League's Department
for Combating Venereal Diseases.

HE All-America Conference on Venereal Diseases held at Washington D. C. from December 6 to 11, 1920, was the first Regional Conference organised in response to the recommendations of the historic meeting at Cannes in April 1919. That Congress heralded the entry of the allied Red Cross societies into new fields of enterprise, namely, the combating of those various social diseases which have for too long menaced the health, happiness and prosperity of the nations of the world. Prominent among these diseases is the group known as venereal diseases and in this particular field the delegates of the Cannes Conference recommended holding in various parts of the word regional conferences to consider and discuss the methods by which these diseases might best be combated and finally eliminated.

Characteristically and very appropriately, the United States of America was the first to answer the call and this was fitting, for no other nation has planned and put into effect a more comprehensive and far reaching attack on the venereal diseases than the great Republic of the West. Over 400 delegates attended the AllAmerica Conference, representing practically every State in the Union, the Dominion of Canada and the countries of South America. Distinguished foreign delegates were Sir Arthur Newsholme from England and a deputation of physicians from CzechoSlovakia. In this great gathering were to be found leaders in every phase of the social hygiene movement both men and women and among the delegates were comprised not only eminent medical men, pathologists and clinicians, but also social workers, legal authorities, ministers of religion and educators. It will be seen, therefore, that every phase of the many-sided attack on the venereal diseases was represented. The conference was organised under the auspices of the United States Public Health Service, the United States Social Hygiene Interdepartmental Board, the American Social Hygiene Association and the American Red Cross. The Administrative Committee consisted of Dr. William F. Snow, Chairman, with Dr. Storey, Assistant Surgeon, General C. C. Pierce, and Dr. Livingston Farrand as members.

The proceedings of the Conference were opened by the President, Dr. William H. Welch of Johns Hopkins University, in an impressive speech emphasising the need of measures for social betterment and indicating the principles on which such measures

should be based. After this, the various vice-presidents delivered addresses dealing with the anti-venereal activities of the various countries they represented.

Of special note among these, one might mention the forceful and striking addresses of Dr. J. A. Amyot, Deputy Minister of Health of Canada, and Dr. Angelo Vasconcelos of Mexico.

Dr. Gordon Bates of the Canadian Council for Combating Venereal Diseases contributed a very lucid account of the extensive campaign against venereal diseases which is being carried on in the Dominion of Canada.

Sessions of the general body of delegates were held daily in the mornings and afternoons in the Auditorium of the New National Museum, while the General Conference Committee held its meeting in the Hall of Nations at the Washington Hotel. Every evening a general assembly of the delegates took place in the Auditorium of the New National Museum.

At the morning and afternoon sessions, subjects of general interest were presented by selected speakers and were discussed by the delegates. A symposium of views on medical measures was presented by Dr. J. H. Stokes, Dr. E. L. Keyes, Dr. C. C. Norris, Dr. G. H. McCoy and Dr. J. H. Lawrence. Another symposium was that devoted to law enforcement and measures of rehabilitation. In this, Mrs. Martha P. Falconer, acknowledged authority, spoke on the Reformatory Institution, and Mr. Bascom Johnson spoke on methods of law enforcement. Interesting contributions were made by Mr. Samuel P. Trasher of Chicago and Mr. Frederic H. Within of New York on "vice investigations". Dr. William A. White of Washington, the eminent authority on psychopathology, dealt with the psychological aspects of educational work intended for the enlightenment of the general public. Mr. B. C. Roloff of Chicago gave an interesting account of the work of a well-organised clinic for the treatment of venereal diseases. Perhaps, however, the discussion which aroused the greatest interest among the delegates was that which dealt, by means of affirmative and negative arguments, with the subject of "Medical Prophylaxis as a Civilian Measure". The affirmative was argued by Dr. George Walker of Baltimore, who advanced an imposing array of statistics from his experience with the American Expeditionary Forces in France, in support of his arguments. Colonel Percy Ashburn, Medical Corps, U. S. Army, supported the negative. No discussion by the delegates took place on the subject, but one gathered that the argument of Colonel Ashburn appeared to receive the approval of the majority of the delegates. Certainly both sides of this thorny question were very clearly and fully put before the delegates. These and kindred discussions, however, by no means represent the sum total of the work accomplished by the All-America Conference. The chief interest of that remarkable gathering lay in the proceedings of the General Conference Committee. Prior to the As

sembly of the Conference, the Administrative Committee had drawn up a series of questions relative to the many problems which have arisen in connection with the subject of combating venereal diseases and a special committee was charged with the duty of framing suitable replies to these questions in the form of resolutions which could be adopted by the Conference as a whole. This General Conference Committee consisted of over 100 members selected by Dr. William H. Welch from those delegates who, by reason of their experience, could speak with special authority on the problems submitted to them. The General Conference Committee were divided into twelve sub-committees, each of which had special problems to consider. The sub-committees worked all morning on their special problems and each afternoon the replies were considered, discussed, and where necessary, amended by the General Conference Committee as a whole. In the evening, the draft resolutions which had been arrived at in this manner were submitted to the general assembly of the delegates for approval and adoption as formal resolutions of the Conference. The draft resolutions were not always accepted in their original form by the delegates. Frequently they were warmly debated and were sometimes referred back for amendment by the General Conference Committee. Many interesting and even exciting debates resulted in this procedure. A few of the resolutions there adopted may be quoted, in order to show the nature and scope of the work accomplished by the conference. It is understood that the proceedings of the Conference will shortly be published and it is certain that they will prove of the greatest interest and value to all those who are engaged in combating the venereal diseases in various parts of the world. In regard to education with respect to the venereal diseases, it was resolved that: "Fear should not be deliberately stressed as a deterrent. The element of fear should appear only to the extent that it is inherent in the presentation of the facts themselves. Any morbid tendencies resulting from such unavoidable fear should be corrected by positive and constructive teaching as to the prevention and cure of the disease." A psychological factor was discussed in the following resolution: "Although there is danger that superficial and erroneous interpretation of the Freudian psychology in regard to the repression of the sex instinct may be detrimental to the successful development of the programme for the control of the venereal diseases, a more thorough-going, complete and scientific interpretation tends to aid such a programme in that it places the emphasis on the practical means for guiding the sex instinct into socially useful and constructive activities." Measures of rehabilitation are indicated by the resolution: "The establishment of reformatories with standard equipment for examination, classification, training, recreation and parole is the most useful method of rehabilitating the old offender."

Of medical interest, one may quote the following: "The blood Wassermann reaction should not be used as a sole guide to the

duration of a syphilitic infection. The blood Wassermann reaction should not be used as the sole evidence of the effectiveness of a particular drug or method of treatment. The blood Wassermann reaction should not be used as the sole evidence of cure, no matter how many times repeated." The committee concluded that the complement fixation test has not yet been shown to be of value in the diagnosis of doubtful cases of gonorrhoea. The general advantages of combining venereal disease clinics with other clinics. were enumerated by the Committee. In respect to law enforcement, it was resolved that: "The establishment and maintenance of high standards of sex conduct is the best protection of the public health from venereal diseases. ...... That, up to the level of the highest standards which can be sustained by public opinion, laws penalising the promotion of and the indulgence in illicit sex relations constitute sound and practicable public health measures.'

Many other subjects are covered by the resolutions, such as the importance of social service and recreational facilities in the antivenereal campaign. The General Conference Committee showed characteristic American energy in carrying out the task allotted to it and in replying to the formidable list of questions submitted. It was not ununsual to find some sub-committee sitting late at night in the endeavour to solve a knotty point or to harmonise divergent. views. Certainly, the work of the sub-committees was no sinecure, but the kindly forethought of Dr. W. F. Snow and Dr. Allen Winter, Executive Secretary, provided some alleviation of their labours by arranging automobile drives for their benefit to various points. of interest and bringing them back to the hotel for lunch. The committee members thus obtained some much needed fresh air and punctual attendance at the afternoon session was also ensured.

Many exhibits and demonstrations were arranged for the delegates, such as visits to the United States Laboratory for testing. arsphenamine and similar compounds, the United States Naval Hospital and the Army Medical Museum, where a wonderful collection of wax models was on view. The field car of the American Social Hygiene Association attracted the attention of many delegates. This car had just returned from a very successful tour of North Carolina. It carries a complete self-contained cinema outfit by which educational motion pictures can be displayed anywhere.

The All-American Conference was undoubtedly a most remarkable gathering and the universal opinion of the foreign delegates was, that it had been a most successful and memorable meeting. Much of its success was due to the novel organisation outlined above, by which definite and authoritative resolutions were arrived at after free discussions, in which any of the delegates who chose could take part. There can be no doubt that the proceedings of the All-America Conference will not only provide data as to the progress which has so far been attained in the combating of the venereal diseases, but also will indicate the next steps to be taken

in the campaign. The value of such Regional Conferences cannot be overestimated, and it is of interest to note that a conference for North-Western Europe has been arranged under the auspices of the L. O. R. C. S. The place of meeting will be Copenhagen and the Red Cross Societies and Governements of the Scandinavian countries and Great Britain will take part in it. Later in the autumn of this year, it is hoped that the Latin Conference, comprising France, Belgium, Spain, Portugal, Italy and Switzerland, will show that the Western Powers of Europe are responding to the call of the Cannes Conference.