Prophylaxis, of course, means prevention, and it has been a large part of the purpose of the present study to deal with syphilis from the standpoint of prevention and cure. The material of this chapter is, therefore, only a special aspect of the larger problem.

Repression of Prostitution.—By the moral prophylaxis of syphilis is meant the cultivation of such moral ideals as will contribute to the control of a disease which is so closely associated with sexual irregularities. Since public and secret prostitution serve as the principal agencies for the dissemination of the disease, it follows that anything tending to decrease the amount of disease in prostitutes, on the one hand, or to diminish the amount of promiscuous sexual activity, on the other, will retard the spread of syphilis. Systems based on the first ideas, aiming rather to control the disease in public women by inspection of their health and activities than by suppressing prostitution, have failed because the methods of control ordinarily practised are worthless for the detection of infectiousness. So-called regulation has, therefore, given way very largely in progressive communities to the second ideal of repressing or[Pg 157] abolishing the outward evidences of vice as far as possible. In behalf of sanitary control of prostitution, leaving out of the question its moral aspect, it must be admitted that Neisser, probably the greatest authority on the sexual diseases, believed that, as far as syphilis is concerned, the use of salvarsan as a means of preventing infection from prostitutes has never had a satisfactory trial. In behalf of abolition it would seem that systematic stamping-out of the outward evidences of vice, the making of immorality less attractive and conspicuous, is, in theory at least, a valuable means of diminishing the extent and availability of an important source of infection.

Educational Influences.—To do something positive against an evil is certainly a more promising mode of attack than to use only the negative force of repression of temptation. Education of public opinion offers us just such a positive mode of attack. Men and women and boys and girls should first be taught sexual self-control even before being made aware of the risk they run in throwing aside the conventional moral code. Teach honor first and prudence next. The slogan of education in sexual self-restraint is the easiest to utter and the most difficult to put into practice of all the schemes for the control of sexual diseases. A large part of the difficulty of making education effective arises from one or two situations which are worth thinking over.

Economic Forces Opposing Sexual Self-control.—In the first place, while continence, or abstinence from sexual relations, is a valuable ideal in its place,[Pg 158] it cannot be indefinitely extended with benefit either to the individual or to the race. The instinct to reproduce is as fundamental as the instinct of self-preservation and the desire for food. A social order which disregards it or defies it will meet defeat. To an alarming extent the tendency of the present economic system is to create unsocial impulses by making the normal gratification of sexual instinct in marriage and the assumption of the responsibility of a family more and more difficult. The cost of living is steadily rising without a corresponding certainty on the part of a large proportion of young men that they can meet it for themselves, to say nothing of meeting it for wife and children. The uncertainties of a \'job\' are often serious enough to discourage the rashest of men from depending on a variable earning power to help him do his share for the advancement of the race. It will be an impossible task to convince even naturally clean-minded, healthy young men and women that they should live a life of hopeless virtue because it is part of the divine order that they should be so held down by hard times and small earnings as to make marrying and having children an unattainable luxury. Continence and clean living as preparations for decent and reasonably early marriage and the raising of a healthy family are the highest of ideals, and ought to be preached from every housetop. Continence as a life-long punishment for the impossible demands of an oppressive social and economic order gets as little attention as it deserves. First, let us make a clean sexual life lead with greater certainty to some of the rewards that make life[Pg 159] worth living and we shall then have a more substantial basis for making continence before marriage other than empty words. If every father, for example, could say to his sons and daughters that if they showed themselves clean men and women he would back them in an early marriage, there would be an appreciable decrease in the amount of young manhood which is now squandered on indecency. If every employer, or the state itself, would give a clean marriage a preferred position in the social and economic scale, and, by helping to meet the cost of it, recognize in a substantial way the value to the race of a family of vigorous children, an important factor in youthful sexual laxity would be robbed of its power. No one will assert that such remedial proposals are of themselves cure-alls for present evils, but they must have at least an emphatic place in the future of moral prophylaxis.

The Teaching of Sexual Self-control.—First then, make the social order such that sexual self-control yields a reward and not a punishment. Second, teach sexual control itself, since it is one of the fundamental means of attack on the problem of syphilis. How can such control be taught? Information about the physical dangers of illicit sexual indulgence is of course of value, and should be spread broadcast. But taken by itself, the fear of disease, especially if it enters the individual\'s life after the age when he has already experienced the force of his sexual instincts, is a feeble influence. The person who has nothing but the knowledge that he is taking great risks between him and the gratification of his[Pg 160] sexual desires will take the risks and take them once too often. One cannot begin to teach the boy or girl of high school age that sexual offenses mean physical disaster, and expect to control syphilis. The time to control the future of the sexual diseases is in the toddler at the knee, the child whose daily lesson in self-control will culminate when he says the final \'No\' to his pa............