Chapter II Syphilis as a Social Problem

The simple device of talking plain, matter-of-fact English about a thing has a value that we are growing to appreciate more and more every day. It is only too easy for an undercurrent of ill to make headway under cover of a false name, a false silence, or misleading speech. The fact that syphilis is a disease spread to a considerable extent by sexual relations too often forces us into an attitude of veiled insinuation about it, a mistaken delicacy² which easily becomes prudish³ and insincere. It is a direct move in favor of vulgar thinking to misname anything which involves the intimacies⁴ of life, or to do other than look it squarely in the eye, when necessity demands, without shuffling⁵ or equivocation⁶. On this principle it is worth while to meet the problem of a disease like syphilis with an open countenance⁷ and straightforward⁸ honesty of expression. It puts firm ground under our feet to talk about it in the impersonal⁹ way in which we talk about colds and pneumonia¹⁰ and bunions and rheumatism¹¹, as unfortunate, but not necessarily indecent, facts in human experience. Nothing in the past has done so much for the campaign against consumption as the unloosing of tongues. There is only one way to understand syphilis, and that is to give it impartial¹², discriminating¹³ discussion as an issue which concerns the[Pg 16] general health. To color it up and hang it in a gallery of horrors, or to befog it with verbal turnings and twistings, are equally serious mistakes. The simple facts of syphilis can appeal to intelligent men and women as worthy¹⁴ of their most serious attention, without either stunning¹⁵ or disgusting them. It is in the unpretentious spirit of talking about a spade as a spade, and not as "an agricultural implement¹⁶ for the trituration of the soil," that we should take stock of the situation and of the resources we can muster¹⁷ to meet it.

The Confusion of the Problem of Syphilis with Other Issues.—Two points in our approach to the problem of syphilis are important at the outset. The first of these is to separate our thought about syphilis from that of the other two diseases, gonorrhea, or "clap," and chancroids, or "soft sores," which are conventionally linked with it under the label of "venereal diseases."[2] The second is to separate[Pg 17] the question of syphilis at least temporarily from our thought about morals, from the problem of prostitution, from the question as to whether continence is possible or desirable, whether a man should be true to one woman, whether women should be the victims of a double standard, and all the other complicated issues which we must in time confront. Such a picking to pieces of the tangle¹⁸ is simply the method of scientific thought, and in this case, at least, has the advantage of making it possible to begin to do something, rather than saw the air with vain discussion.

[2] The three so-called venereal diseases are syphilis, gonorrhea, and chancroid or soft ulcer¹⁹. Gonorrhea is the commonest of the three, and is an exceedingly prevalent disease. In man its first symptom is a discharge of pus from the canal through which the urine passes. Its later stages may involve the bladder, the testicles, and other important glands²⁰. It may also produce crippling forms of rheumatism, and affect the heart. Gonorrhea may recur²¹, become latent, and persist for years, doing slow, insidious²² damage. It is transmitted largely by sexual intercourse²³. Gonorrhea in women is frequently a serious and even fatal disease. It usually renders women incapable²⁴ of having children, and its treatment necessitates²⁵ often the most serious operations. Gonorrhea of the eyes, affecting especially newborn children, is one of the principal causes of blindness. Gonorrhea may be transmitted to little girls innocently from infected toilet seats, and is all but incurable²⁶. Gonorrhea, wherever it occurs, is an obstinate²⁷, treacherous²⁸, and resistant²⁹ disease, one of the most serious of modern medical problems, and fully³⁰ deserves a place as the fourth great plague.

Chancroid is an infectious ulcer of the genitals, local in character, not affecting the body as a whole, but sometimes destroying considerable portions of the parts involved.

Let us think of syphilis, then, as a serious but by no means hopeless constitutional disease. Dismiss chancroid as a relatively³¹ insignificant³² local affair, seldom a serious problem under a physician's care. Separate syphilis from gonorrhea for the reason that gonorrhea is a problem in itself. Against its train of misfortune to innocence³³ and guilt³⁴ alike, we are as yet not nearly so well equipped to secure results. Against syphilis, the astonishing progress of our knowledge in the past ten years has armed us for triumph. When the fight against tuberculosis³⁵ was brought to public attention, we were not half so well equipped to down the disease as we are today to down syphilis. For syphilis we now have reliable and practical methods of prevention, which have already proved their worth. The most powerful and efficient of drugs is available for the cure of the disease in its earlier stages, and early recognition is made possible by methods whose reliability³⁶ is among the remarkable³⁷ achievements of medicine. It is the[Pg 18] sound opinion of conservative men that if the knowledge now in the hands of the medical profession could be put to wide-spread use, syphilis would dwindle³⁸ in two generations from the unenviable position of the third great plague to the insignificance³⁹ of malaria⁴⁰ and yellow fever on the Isthmus⁴¹ of Panama. The influences that stand between humanity and this achievement are the lack of general public enlightenment on the disease itself, and public confusion of the problem with other sex issues for which no such clean-cut, satisfactory solution has been found. Think of syphilis as the wages of sin, as well-earned disgrace, as filth⁴², as the badge of immorality⁴³, as a necessary defense⁴⁴ against the loathesomeness of promiscuity⁴⁵, as a fearful warning against prostitution, and our advantage slips from us. The disease continues to spread wholesale⁴⁶ disaster and degeneration while we wrangle⁴⁷ over issues that were old when history began and are progressing with desperate slowness to a solution probably many centuries distant. Think of syphilis as a medical and a sanitary⁴⁸ problem, and its last line of defense crumbles⁴⁹ before our attack. It can and should be blotted⁵⁰ out.

Syphilis, a Problem of Public Health Rather than of Morals.—Nothing that can be said about syphilis need make us forget the importance of moral issues. The fact which so persistently⁵¹ distorts our point of view, that it is so largely associated with our sexual life, is probably a mere⁵² incident, biologically speaking, due in no small part to the almost absurdly simple circumstance that the germ of the disease cannot grow in the presence of air, and must therefore[Pg 19] find refuge, in most cases, in the cavities and inlets from the surface of the body. History affords little support to the lingering belief that if syphilis is done away with, licentiousness⁵³ will overrun the world. Long before syphilis appeared in Europe there was sexual immorality. In the five centuries in which it has had free play over the civilized⁵⁴ world, the most optimistic cannot successfully maintain that it has materially bettered conditions or acted as a check on loose morals, though its relation to sexual intercourse has been known. As a morals policeman, syphilis can be obliterated⁵⁵ without material loss to the cause of sexual self-restraint, and with nothing but gain to the human race.

It is easier to accept this point of view, that the stamping out of syphilis will not affect our ability to grapple with moral problems, and that there is nothing to be gained by refusing to do what can so easily be done, when we appreciate the immense amount of innocent suffering for which the disease is responsible. It must appeal to many as a bigoted⁵⁶ and narrow virtue⁵⁷, little better than vice¹ itself, which can derive⁵⁸ any consolation⁵⁹ in the thought that the sins of the fathers are being visited upon the children, as it watches a half-blind, groping child feel its way along a wall with one hand while it shields its face from the sunlight with the other. There are better ways of paying the wages of sin than this. Best of all, we can attack a sin at its source instead of at its fulfilment. How much better to have kept the mother free from syphilis by giving the father the benefit of our knowledge. The child who reaped his[Pg 20] sowing gained nothing morally, and lost its physical heritage. Its mother lost her health and perhaps her self-respect. Neither one contributes anything through syphilis to the uplifting of the race. They are so much dead loss. To teach us to avoid such losses is the legitimate⁶⁰ field of preventive medicine.

On this simplified and practical basis, then, the remainder of this discussion will proceed. Syphilis is a preventable disease, usually curable when handled in time, and its successful management will depend in large part upon the co?peration, not only of those who are victims of it, but of those who are not. It is much more controllable than tuberculosis, against which we are waging a war of increasing effectiveness, and its stamping out will rid humanity of an even greater curse. To know about syphilis is in no sense incompatible⁶¹ with clean living or thinking, and insofar as its removal from the world will rid us of a revolting scourge⁶², it may even actually favor the solution of the moral problems which it now obscures.

1 vice   

n.坏事；恶习；[pl.]台钳，老虎钳；adj.副的

参考例句：

• He guarded himself against vice.他避免染上坏习惯。
• They are sunk in the depth of vice.他们堕入了罪恶的深渊。

2 delicacy   

n.精致，细微，微妙，精良；美味，佳肴

参考例句：

• We admired the delicacy of the craftsmanship.我们佩服工艺师精巧的手艺。
• He sensed the delicacy of the situation.他感觉到了形势的微妙。

3 prudish   

adj.装淑女样子的，装规矩的，过分规矩的；adv.过分拘谨地

参考例句：

• I'm not prudish but I think these photographs are obscene.我并不是假正经的人，但我觉得这些照片非常淫秽。
• She was sexually not so much chaste as prudish.她对男女关系与其说是注重贞节，毋宁说是持身谨慎。

4 intimacies   

亲密( intimacy的名词复数 )； 密切； 亲昵的言行； 性行为

参考例句：

• He is exchanging intimacies with his friends. 他正在和密友们亲切地交谈。
• The stiffness of the meeting soon gave way before their popular manners and more diffused intimacies. 他们的洒脱不羁和亲密气氛的增加很快驱散了会场上的拘谨。

5 shuffling   

adj. 慢慢移动的, 滑移的 动词shuffle的现在分词形式

参考例句：

• Don't go shuffling along as if you were dead. 别像个死人似地拖着脚走。 来自英汉文学 - 嘉莉妹妹
• Some one was shuffling by on the sidewalk. 外面的人行道上有人拖着脚走过。 来自英汉文学 - 嘉莉妹妹

6 equivocation   

n.模棱两可的话，含糊话

参考例句：

• These actions must be condemned without equivocation. 对这些行为必须毫不含糊地予以谴责。 来自辞典例句
• With caution, and with some equivocation, Bohr took a further step. 玻尔谨慎地而又有些含糊其词地采取了更深入的步骤。 来自辞典例句

7 countenance   

n.脸色，面容；面部表情；vt.支持，赞同

参考例句：

• At the sight of this photograph he changed his countenance.他一看见这张照片脸色就变了。
• I made a fierce countenance as if I would eat him alive.我脸色恶狠狠地，仿佛要把他活生生地吞下去。

8 straightforward   

adj.正直的，坦率的；易懂的，简单的

参考例句：

• A straightforward talk is better than a flowery speech.巧言不如直说。
• I must insist on your giving me a straightforward answer.我一定要你给我一个直截了当的回答。

9 impersonal   

adj.无个人感情的，与个人无关的，非人称的

参考例句：

• Even his children found him strangely distant and impersonal.他的孩子们也认为他跟其他人很疏远，没有人情味。
• His manner seemed rather stiff and impersonal.他的态度似乎很生硬冷淡。

10 pneumonia   

n.肺炎

参考例句：

• Cage was struck with pneumonia in her youth.凯奇年轻时得过肺炎。
• Pneumonia carried him off last week.肺炎上星期夺去了他的生命。

11 rheumatism   

n.风湿病

参考例句：

• The damp weather plays the very devil with my rheumatism.潮湿的天气加重了我的风湿病。
• The hot weather gave the old man a truce from rheumatism.热天使这位老人暂时免受风湿病之苦。

12 impartial   

adj.(in,to)公正的，无偏见的

参考例句：

• He gave an impartial view of the state of affairs in Ireland.他对爱尔兰的事态发表了公正的看法。
• Careers officers offer impartial advice to all pupils.就业指导员向所有学生提供公正无私的建议。

13 discriminating   

a.有辨别能力的

参考例句：

• Due caution should be exercised in discriminating between the two. 在区别这两者时应该相当谨慎。
• Many businesses are accused of discriminating against women. 许多企业被控有歧视妇女的做法。

14 worthy   

adj.(of)值得的，配得上的；有价值的

参考例句：

• I did not esteem him to be worthy of trust.我认为他不值得信赖。
• There occurred nothing that was worthy to be mentioned.没有值得一提的事发生。

15 stunning   

adj.极好的；使人晕倒的

参考例句：

• His plays are distinguished only by their stunning mediocrity.他的戏剧与众不同之处就是平凡得出奇。
• The finished effect was absolutely stunning.完工后的效果非常美。

16 implement   

n.(pl.)工具，器具；vt.实行，实施，执行

参考例句：

• Don't undertake a project unless you can implement it.不要承担一项计划，除非你能完成这项计划。
• The best implement for digging a garden is a spade.在花园里挖土的最好工具是铁锹。

17 muster   

v.集合，收集，鼓起，激起；n.集合，检阅，集合人员，点名册

参考例句：

• Go and muster all the men you can find.去集合所有你能找到的人。
• I had to muster my courage up to ask him that question.我必须鼓起勇气向他问那个问题。

18 tangle   

n.纠缠；缠结；混乱；v.(使)缠绕；变乱

参考例句：

• I shouldn't tangle with Peter.He is bigger than me.我不应该与彼特吵架。他的块头比我大。
• If I were you, I wouldn't tangle with them.我要是你，我就不跟他们争吵。

19 ulcer   

n.溃疡，腐坏物

参考例句：

• She had an ulcer in her mouth.她口腔出现溃疡。
• A bacterium is identified as the cause for his duodenal ulcer.一种细菌被断定为造成他十二指肠溃疡的根源。

20 glands   

n.腺( gland的名词复数 )

参考例句：

• a snake's poison glands 蛇的毒腺
• the sebaceous glands in the skin 皮脂腺

21 recur   

vi.复发，重现，再发生

参考例句：

• Economic crises recur periodically.经济危机周期性地发生。
• Of course,many problems recur at various periods.当然，有许多问题会在不同的时期反复提出。

22 insidious   

adj.阴险的，隐匿的，暗中为害的，（疾病）不知不觉之间加剧

参考例句：

• That insidious man bad-mouthed me to almost everyone else.那个阴险的家伙几乎见人便说我的坏话。
• Organized crime has an insidious influence on all who come into contact with it.所有和集团犯罪有关的人都会不知不觉地受坏影响。

23 intercourse   

n.性交；交流，交往，交际

参考例句：

• The magazine becomes a cultural medium of intercourse between the two peoples.该杂志成为两民族间文化交流的媒介。
• There was close intercourse between them.他们过往很密。

24 incapable   

adj.无能力的，不能做某事的

参考例句：

• He would be incapable of committing such a cruel deed.他不会做出这么残忍的事。
• Computers are incapable of creative thought.计算机不会创造性地思维。

25 necessitates   

使…成为必要，需要( necessitate的第三人称单数 )

参考例句：

• The increase in population necessitates a greater food supply. 人口的增加需要更多食物供应。
• Your proposal necessitates borrowing money. 你的提议使借款成为必要。

26 incurable   

adj.不能医治的，不能矫正的，无救的；n.不治的病人，无救的人

参考例句：

• All three babies were born with an incurable heart condition.三个婴儿都有不可治瘉的先天性心脏病。
• He has an incurable and widespread nepotism.他们有不可救药的，到处蔓延的裙带主义。

27 obstinate   

adj.顽固的，倔强的，不易屈服的，较难治愈的

参考例句：

• She's too obstinate to let anyone help her.她太倔强了，不会让任何人帮她的。
• The trader was obstinate in the negotiation.这个商人在谈判中拗强固执。

28 treacherous   

adj.不可靠的，有暗藏的危险的；adj.背叛的，背信弃义的

参考例句：

• The surface water made the road treacherous for drivers.路面的积水对驾车者构成危险。
• The frozen snow was treacherous to walk on.在冻雪上行走有潜在危险。

29 resistant   

adj.(to)抵抗的，有抵抗力的

参考例句：

• Many pests are resistant to the insecticide.许多害虫对这种杀虫剂有抵抗力。
• They imposed their government by force on the resistant population.他们以武力把自己的统治强加在持反抗态度的人民头上。

30 fully   

adv.完全地，全部地，彻底地；充分地

参考例句：

• The doctor asked me to breathe in,then to breathe out fully.医生让我先吸气，然后全部呼出。
• They soon became fully integrated into the local community.他们很快就完全融入了当地人的圈子。

31 relatively   

adv.比较...地，相对地

参考例句：

• The rabbit is a relatively recent introduction in Australia.兔子是相对较新引入澳大利亚的物种。
• The operation was relatively painless.手术相对来说不痛。

32 insignificant   

adj.无关紧要的，可忽略的，无意义的

参考例句：

• In winter the effect was found to be insignificant.在冬季，这种作用是不明显的。
• This problem was insignificant compared to others she faced.这一问题与她面临的其他问题比较起来算不得什么。

33 innocence   

n.无罪；天真；无害

参考例句：

• There was a touching air of innocence about the boy.这个男孩有一种令人感动的天真神情。
• The accused man proved his innocence of the crime.被告人经证实无罪。

34 guilt   

n.犯罪；内疚；过失，罪责

参考例句：

• She tried to cover up her guilt by lying.她企图用谎言掩饰自己的罪行。
• Don't lay a guilt trip on your child about schoolwork.别因为功课责备孩子而使他觉得很内疚。

35 tuberculosis   

n.结核病，肺结核

参考例句：

• People used to go to special health spring to recover from tuberculosis.人们常去温泉疗养胜地治疗肺结核。
• Tuberculosis is a curable disease.肺结核是一种可治愈的病。

36 reliability   

n.可靠性，确实性

参考例句：

• We mustn't presume too much upon the reliability of such sources.我们不应过分指望这类消息来源的可靠性。
• I can assure you of the reliability of the information.我向你保证这消息可靠。

37 remarkable   

adj.显著的，异常的，非凡的，值得注意的

参考例句：

• She has made remarkable headway in her writing skills.她在写作技巧方面有了长足进步。
• These cars are remarkable for the quietness of their engines.这些汽车因发动机没有噪音而不同凡响。

38 dwindle   

v.逐渐变小（或减少）

参考例句：

• The factory's workforce has dwindled from over 4,000 to a few hundred.工厂雇员总数已经从4,000多人减少到几百人。
• He is struggling to come to terms with his dwindling authority.他正努力适应自己权力被削弱这一局面。

39 insignificance   

n.不重要；无价值；无意义

参考例句：

• Her insignificance in the presence of so much magnificence faintly affected her. "她想象着他所描绘的一切，心里不禁有些刺痛。 来自英汉文学 - 嘉莉妹妹
• It was above the common mass, above idleness, above want, above insignificance. 这里没有平凡，没有懒散，没有贫困，也没有低微。 来自英汉文学 - 嘉莉妹妹

40 malaria   

n.疟疾

参考例句：

• He had frequent attacks of malaria.他常患疟疾。
• Malaria is a kind of serious malady.疟疾是一种严重的疾病。

41 isthmus   

n.地峡

参考例句：

• North America is connected with South America by the Isthmus of Panama.巴拿马海峡把北美同南美连接起来。
• The north and south of the island are linked by a narrow isthmus.岛的北部和南部由一条狭窄的地峡相连。

42 filth   

n.肮脏，污物，污秽；淫猥

参考例句：

• I don't know how you can read such filth.我不明白你怎么会去读这种淫秽下流的东西。
• The dialogue was all filth and innuendo.这段对话全是下流的言辞和影射。

43 immorality   

n. 不道德, 无道义

参考例句：

• All the churchmen have preached against immorality. 所有牧师都讲道反对不道德的行为。
• Where the European sees immorality and lawlessness, strict law rules in reality. 在欧洲人视为不道德和无规则的地方，事实上都盛行着一种严格的规则。 来自英汉非文学 - 家庭、私有制和国家的起源

44 defense   

n.防御，保卫；[pl.]防务工事；辩护，答辩

参考例句：

• The accused has the right to defense.被告人有权获得辩护。
• The war has impacted the area with military and defense workers.战争使那个地区挤满了军队和防御工程人员。

45 promiscuity   

n.混杂，混乱；（男女的）乱交

参考例句：

• Promiscuity went unpunished, divorce was permitted. 乱交挨不着惩罚，离婚办得成手续。 来自英汉文学
• There is also no doubt that she falls into promiscuity at last. 同时无疑她最后也堕入性乱。 来自互联网

46 wholesale   

n.批发；adv.以批发方式；vt.批发，成批出售

参考例句：

• The retail dealer buys at wholesale and sells at retail.零售商批发购进货物，以零售价卖出。
• Such shoes usually wholesale for much less.这种鞋批发出售通常要便宜得多。

47 wrangle   

vi.争吵

参考例句：

• I don't want to get into a wrangle with the committee.我不想同委员会发生争执。
• The two countries fell out in a bitter wrangle over imports.这两个国家在有关进口问题的激烈争吵中闹翻了。

48 sanitary   

adj.卫生方面的，卫生的，清洁的，卫生的

参考例句：

• It's not sanitary to let flies come near food.让苍蝇接近食物是不卫生的。
• The sanitary conditions in this restaurant are abominable.这家饭馆的卫生状况糟透了。

49 crumbles   

酥皮水果甜点( crumble的名词复数 )

参考例句：

• This cake crumbles too easily. 这种蛋糕太容易碎了。
• This bread crumbles ever so easily. 这种面包非常容易碎。

50 blotted   

涂污( blot的过去式和过去分词 )； （用吸墨纸）吸干

参考例句：

• She blotted water off the table with a towel. 她用毛巾擦干桌上的水。
• The blizzard blotted out the sky and the land. 暴风雪铺天盖地而来。

51 persistently   

ad.坚持地；固执地

参考例句：

• He persistently asserted his right to a share in the heritage. 他始终声称他有分享那笔遗产的权利。
• She persistently asserted her opinions. 她果断地说出了自己的意见。

52 mere   

adj.纯粹的；仅仅，只不过

参考例句：

• That is a mere repetition of what you said before.那不过是重复了你以前讲的话。
• It's a mere waste of time waiting any longer.再等下去纯粹是浪费时间。

53 licentiousness   

n.放肆，无法无天

参考例句：

• Without law, liberty also loses its nature and its name, and becomes licentiousness. 没有法律，自由也同样名实具亡，就是无法无天。

54 civilized   

a.有教养的，文雅的

参考例句：

• Racism is abhorrent to a civilized society. 文明社会憎恶种族主义。
• rising crime in our so-called civilized societies 在我们所谓文明社会中日益增多的犯罪行为

55 obliterated   

v.除去( obliterate的过去式和过去分词 )；涂去；擦掉；彻底破坏或毁灭

参考例句：

• The building was completely obliterated by the bomb. 炸弹把那座建筑物彻底摧毁了。
• He began to drink, drank himself to intoxication, till he slept obliterated. 他一直喝，喝到他快要迷糊地睡着了。 来自《简明英汉词典》

56 bigoted   

adj.固执己见的，心胸狭窄的

参考例句：

• He is so bigoted that it is impossible to argue with him.他固执得不可理喻。
• I'll concede you are not as bigoted as some.我承认你不象有些人那么顽固。

57 virtue   

n.德行，美德；贞操；优点；功效，效力

参考例句：

• He was considered to be a paragon of virtue.他被认为是品德尽善尽美的典范。
• You need to decorate your mind with virtue.你应该用德行美化心灵。

58 derive   

v.取得；导出；引申；来自；源自；出自

参考例句：

• We derive our sustenance from the land.我们从土地获取食物。
• We shall derive much benefit from reading good novels.我们将从优秀小说中获得很大好处。

59 consolation   

n.安慰，慰问

参考例句：

• The children were a great consolation to me at that time.那时孩子们成了我的莫大安慰。
• This news was of little consolation to us.这个消息对我们来说没有什么安慰。

60 legitimate   

adj.合法的，合理的，合乎逻辑的；v.使合法

参考例句：

• Sickness is a legitimate reason for asking for leave.生病是请假的一个正当的理由。
• That's a perfectly legitimate fear.怀有这种恐惧完全在情理之中。

61 incompatible   

adj.不相容的，不协调的，不相配的

参考例句：

• His plan is incompatible with my intent.他的计划与我的意图不相符。
• Speed and safety are not necessarily incompatible.速度和安全未必不相容。

62 scourge   

n.灾难，祸害；v.蹂躏

参考例句：

• Smallpox was once the scourge of the world.天花曾是世界的大患。
• The new boss was the scourge of the inefficient.新老板来了以后，不称职的人就遭殃了。