Upon these facts the writer of these pages remarked in his annual report to the Board of Governors for 1856:

"The ratio of venereal disease on the gross number of patients treated in 1854 was 37-4/10 per cent.

The ratio of the same disease in 1855 was 58-7/10 "

Showing an increase in the year 1855 of 21-3/10 "

The ratio of venereal disease on the gross number of patients treated during 1856 was 73-1/10 "

Showing an increase in 1856, as compared with 1855, of 14-4/10 "

Or an increase, as compared with 1854, of 35-7/10 "

This steady increase, 21-3/10 per cent. in one year, and 14-4/10 per cent.

in the next, or 35-7/10 per cent. within two years, may be considered an incontrovertible proof of the progress of this malady in the city of New York. The fact that the people regard the Penitentiary Hospital as a _dernier resort_, an inst.i.tution to which nothing but the direst necessity will compel them to apply, justifies the conclusion that the cases treated are but a fraction of the disease existing, and its increase here may be taken as a sure indication of a corresponding or larger increase among the general population."[399]

Again, on the same subject in 1857:

"In my last report I took the opportunity to submit to your Honorable Board facts proving the increase of venereal disease, and I then gave the ratio of that malady on the gross number of patients treated as 73-1/10 per cent. In the year 1857 the ratio was 65-2/10 per cent.; but this reduction of 7-9/10 per cent, must be considered in connection with the fact that other diseases, much beyond the general average, have been treated in the last year, so that a larger number of venereal cases will yet show a smaller percentage. The cases of phthisis pulmonalis (consumption), which have advanced from 58 in 1856 to 159 in 1857, sufficiently explain that the decrease of venereal affections is apparent and not real."[400]

An investigation beyond the statistics upon which these remarks were based, and including the Penitentiary Hospital, Alms-house, Work-house and Penitentiary, had shown that of the total number admitted to these several inst.i.tutions 59-1/2 per cent. had suffered or were suffering from venereal disease at the time the inquiry was made. Of this proportion 45 per cent.

of the total were suffering _directly_ at the time of investigation, and 19 per cent. were suffering _indirectly_, or, in non-professional language, were laboring under diseases more or less consequent on the syphilitic taint.

The following detailed statistics of venereal disease treated in the Penitentiary Hospital for four years ending December 31, 1857, will be found to embrace many subjects which have been alluded to in these pages.

1854. 1855. 1856. 1857.

Total number of patients treated 4058 2657 2083 3158

Cases of primary syphilis 606 660 650 882 " of secondary and other forms of syphilis 935 919 989 1208 ---- ---- ---- ---- Total of syphilitic diseases 1541 1579 1639 2090 NATIVITIES: Natives of United States 410 489 531 673 Foreigners 1131 1090 1108 1417 ---- ---- ---- ---- 1541 1579 1639 2090

AGES: Under 16 years 65 72 77 68 From 16 " to 20 years 481 457 472 593 " 21 " to 25 " 490 481 494 631 " 26 " to 30 " 314 304 311 423 " 31 " to 40 " 128 151 165 190 " 41 " to 50 " 42 99 101 157 " 51 " and upward 21 15 19 28 ---- ---- ---- ---- 1541 1579 1639 2090

EDUCATION: Good 175 227 231 175 Imperfect 787 794 830 1161 Uneducated 579 558 578 754 ---- ---- ---- ---- 1541 1579 1639 2090

From the total number of venereal patients under treatment 1541 1579 1639 2090 Deduct those discharged each year 1253 1316 1389 1710 ---- ---- ---- ---- Leaving to add to the next year's account 288 263 250 380

Of the numbers discharged the following is the RESULT OF TREATMENT: Cured 874 1051 1201 1491 Relieved 370 263 183 213 Not relieved 7 1 Died 2 2 5 5 ---- ---- ---- ---- 1253 1316 1389 1710

DURATION OF TREATMENT: 5 days and under 13 16 17 83 6 " to 10 days 57 36 68 102 11 " to 20 " 80 59 81 131 21 " to 30 " 154 121 137 187 1 month to 2 months 293 333 453 528 2 months to 3 months 304 443 340 328 3 " to 4 " 220 245 207 260 4 " and upward 132 63 86 91 ---- ---- ---- ---- 1253 1316 1389 1710

Some few remarks may be made on the subject of primary syphilis. The proportion of the cases of this malady to the gross number of patients treated was in

1854 14-9/10 per cent.

1855 25-2/10 "

1856 31-2/10 "

1857 27-9/10 "

By the term "primary syphilis," non-professional readers will understand the commencement of the disease, or symptoms which are the direct consequence of an impure connection, in contradistinction to "secondary syphilis," which is the comparatively remote result of infection; never appearing until after the primary symptoms are well developed, and frequently not until all traces of them are removed. He will thus see that every case of primary syphilis is in itself a proof of recent intercourse with a diseased person. These cases, then, have increased from 15 per cent. in 1854 to 31-1/4 per cent. in 1856, and 28 per cent. in 1857. The remarks recently quoted explain how 882 cases in 1857 make a smaller percentage than 650 in 1856. The fact of this increase compels us to but one conclusion, and that is a very important and suggestive one, namely, that _commerce with prost.i.tutes in 1857 was attended with nearly twice the risk of infection incurred in 1854; and, of course, the health of abandoned women has deteriorated in the same proportion_. This is not said with any wish on the part of the writer to be considered an alarmist. The facts are those which have come under his personal observation: the inference is but a plain and natural deduction.

But the Hospital, although the chief, is not the only inst.i.tution on Blackwell's Island where patients are treated for venereal disease. The Alms-house, Work-house, and Penitentiary have each a share of sufferers from this malady, to what extent will be shown by the annexed table:

1854. 1855. 1856. 1857.

Alms-house 33 173 85 52 Work-house 65 31 5 56 Penitentiary 176 234 430

Bellevue Hospital, New York City, also under charge of the Governors of the Alms-house, is not professedly available to venereal cases. By a report from the Medical Board of that inst.i.tution, which will be found in the next chapter, it is seen that they estimate "not far from 10 per cent. of the inmates of Bellevue Hospital are admitted for affections which have their origin remotely in venereal disease." These data are sufficient to fix the numbers thus treated as follows:

Year. Total number 10 per cent for of patients. venereal cases.

1854 7033 703 1855 6697 670 1856 6392 639 1857 7676 768

In regard to the Nursery Hospital on Randall's Island, it is stated by Dr.

H. N. Whittlesey, the Resident Physician, that "nine tenths of all diseases treated in this hospital during the past five years have been of const.i.tutional origin, and for the most part hereditary. The exact proportion which hereditary syphilis bears to this sum of const.i.tutional depravity can not be stated with accuracy." It is an estimate far within the bounds of probability to a.s.sume that one half of the diseases referred to by Dr. Whittlesey are complicated with or by syphilitic taint, and the numbers in the Nursery Hospital will therefore stand as follows:

Year. Total number 50 per cent. for of patients. venereal cases.

1854 2199 1100 1855 2310 1155 1856 1275 638 1857 1469 734

Following the inst.i.tutions in charge of the Governors of the Alms-house is the New York State Emigrants' Hospital on Ward's Island, New York City, under the direction of the Commissioners of Emigration, in the reports whereof the following cases of venereal disease are noted:

1853 657 1854 732 1855 856 1856 511 1857 559

The New York Hospital, Broadway, next claims attention. The reports for the under-mentioned years give the number of venereal cases as follows:

1852 478 1853 338 1856 372 1857 405

These embrace the princ.i.p.al public hospitals of New York. There are other inst.i.tutions, such as St. Luke's Hospital, St. Vincent's Hospital, the Jews' Hospital, etc., but they are of recent origin, and their practice will not form an element in this calculation.

The dispensaries of the city relieve yearly a large amount of sickness. In the New York Dispensary, Centre Street, the cases of venereal disease are reported as follows:

1855 1154 1856 1393 1857 1580

This gives an average of about three per cent. of all the patients treated.

The Northern Dispensary, Waverley Place, does not publish any detailed report of the diseases treated, and to make an estimate it will be necessary to a.s.sume that the proportion is the same as in the New York Dispensary, namely, three per cent. By this rule the following results are obtained:

Year. Total number 3 per cent. for of patients. ven. cases.

1850 19,615 588 1851 20,680 620 1852 21,941 658 1854 14,075 422 1855 12,378 371 1856 11,797 354 1857 10,895 327

The Eastern Dispensary, Ludlow Street, does not give any detailed report of the diseases treated, and the same approximation will be made as previously:

Year. Total number 3 per cent. for of patients. ven. cases.

1855 25,612 768 1856 21,017 630

To the Demilt Dispensary, Second Avenue, the same system of approximation will be applied:

Year. Total number 3 per cent. for of patients. ven. cases.

1852-3 2,197 66 1853-4 9,006 270 1854-5 14,034 421 1855-6 20,004 600 1856-7 20,684 620 1857-8 26,785 803

The Northwestern Dispensary, Eighth Avenue, subjected to the same rule gives

Year. Total number 3 per cent. for of patients. ven. cases.

1854 9,264 277 1855 11,581 347 1856 11,477 344

Cases of venereal disease are treated in the Clinical Lectures at the three medical colleges of New York City. From the New York University Medical College the following report of patients has been obtained. It is undoubtedly much too low an estimate.

1855 47 1856 53 1857 69