The Battle Against Venereal Disease in Wartime Britain (1914-1918) by Emily Payne
(This articles first appears in Stand To ! 76 April 2006)
Introduction to Venereal Disease in Britain during the First World War
The outbreak of war in August 1914 brought about demands upon Britain beyond the military requirements of international conflict. Manpower and efficiency were vital, and the incapacitation of the workforce or military personnel due to sexual infections posed a threat to national efficiency. Sexual morality and sexual health were considered to be necessary factors for military victory to be possible, while venereal disease presented a dangerous threat to the military and racial strength of the British nation. As such, writings on this subject were extensive. This article identifies the moral and national problems that were perceived to surround sexual activity and venereal disease, and examines attempts to solve these problems, on both the home and military fronts.
Social and political attitudes towards Venereal Disease
Myriad contributory factors meant that venereal diseases could be located throughout the British populace. The social stigma of sexual infection, a shortage of sexual health education, a lack of prophylactic awareness and provision, insufficient treatment facilities, and the double sexual standard for men and women all contributed to the extent of infection. Furthermore, those who were infected could not easily and confidentially obtain the necessary treatments, cures, and knowledge. The necessities of wartime cast a new light on venereal matters, and added a new imperative for addressing the problems. Sexual theorist Havelock Ellis declared that 'these diseases are not only more destructive than war, they are immensely increased by war, and that not only among soldiers, but the civilian population'(1). Indeed, these issues attracted such interest and concern that, for some commentators, they were of comparable importance to the war itself. The venereal problem in Britain was seen to require such urgent attention that venereologists were brought back from the front in order to work in British venereal disease clinics. (2)
Sex had been a topic of concern before the war. Britain had a tradition of state involvement in sexual matters, perhaps most strongly demonstrated by the Contagious Diseases Acts of the 1860s, and perpetuated through the Criminal Law Amendment Act of 1885, and Criminal Law Amendment Bill of 1911. A Royal Commission on Venereal Disease was appointed in 1913, and was intended to investigate and to provide solutions to what historian David Evans describes as 'one of the racial poisons (along with alcoholism and feeblemindedness) that social hygienists saw as linked with racial, economic and imperial decline'.(3) Alongside this, the National Council for Combating Venereal Disease was inaugurated in the same year.
However, while the appointment of the Royal Commission and the founding of the National Council for Combating Venereal Disease had prefigured subsequent concern, the war Brought an unprecedented, and possibly unexpected, level of moral panic. Extant factors, such as the long-established anxiety about high rates of venereal infection in the armed forces, combined with the exigencies of wartime, meant that a new light was cast on sexual behaviour. With the war effort in mind, venereal diseases were seen to be problematic because, as Christabel Pankhurst wrote, 'The sexual diseases are the great cause of physical, mental, and moral degeneracy, and of race suicide'.(4) This belief was highlighted on a grand scale by the war, when 'social order and racial progress were paramount.(5) The printed instructions on boxes of calomel ointment and tubes of potassium permanganate, to be used for disinfection after sex, drew upon the imperatives of military efficiency in wartime as an incentive to use disinfectant, imploring: 'REMEMBER that if you have disease, not only are you doing yourself serious harm by delaying treatment, but YOU ARE HELPING THE ENEMY by rendering our men unfit to fight'.(6)
The Royal Commission on Venereal Disease reported in 1916 that 'in a typical working-class population of London at least 8 to 12 percent, of the adult males and at least 3 to 7 percent, of the adult females have acquired syphilis'.(7) Statistics for other venereal diseases were not included in these results, and, as infection rates for gonorrhoea were known to be higher than those for syphilis, (8) had they been included, the percentages of infected persons would have been much higher’.(9)The Commissioners' report proved to be a cause for concern, particularly in time of war, due to the 'grave economic losses to the State’ (10) incurred through venereal infection, and the loss of working days in both the navy and the army. As such, the Commission's recommendations for sexual health education, and free treatment (11) for all British citizens, were taken seriously. In July 1916, the Local Government Board required the Council of every County and County Borough to implement a scheme for the hospital treatment of venereal diseases (12) and by 1917, 86 out of 145 Councils, covering a population of 23.5 million people, had submitted their schemes for treatment to the Local Government Board.
Fighting Venereal Disease in First World War Britain
In 1913, as a result of the Royal Commission's appointment, the National Council for Combating Venereal Disease was established. This prestigious Council counted among its members physicians, peers, bishops, and high-ranking military officers, many of whom were experienced in dealing with the medical or social problems of venereal disease, and some of whom were simultaneously involved in the investigative work of the Royal Commission. The Council's work acquired a new significance in wartime. It was praised by The Times, in which a leading article congratulated the Council for having 'definitely broken down the barrier of silence', and stated that 'Their energy in educational work is altogether meritorious'.(13)The Council took an unprecedented approach to the problem: it did not isolate a particular social group as its cause; nor did it attempt to solve the problem solely via legal or medical channels: these means had proved largely ineffective theretofore, as they did not directly impact on the majority of the population, and, as such, could be circumvented. Rather, it aimed to educate people about venereal disease, its causes and manifestations; to press for free and confidential treatment for all British citizens, whether for prevention or cure; and to remove the social stigma of seeking medical help regarding sexual matters. By delivering lectures to groups such as Friendly Societies, Mothers' Unions, Girls' Clubs, military establishments, and munitions workers, the matters of sexual diseases and their attendant social problems were brought into large-scale public debate. By March 1916, through working with the military, the Council had delivered 750 lectures, to 500,000 troops.(14)
The first annual report of the National Council for Combating Venereal Disease, published in June 1916, stated that:
It is too soon to attempt to forecast the effects of this terrible war upon the social structure of the nation. We are being tried in the fire, and we must earnestly hope that many of the evils which are manifest ill disappear, and that we shall rise to a purer national life once the war has ended. If that is so, the gallant men who have fallen in the defence of our honour and our liberties will not have died in vain. But the vigour of the race can never be strengthened until we have brought this particular scourge under complete control, and to that great end this Council must work unceasingly.(15)
This bold statement, exploiting the discourses of national struggle and national greatness, exemplified the attitudes of the Council, that the fight against venereal disease was as imperative a cause for the British nation as was the pursuit of the European war. While immorality and sexual ill-health, understood to be demonstrated by both behaviour and medical evidence, were believed to be detrimental to Britain's war effort, this debate remained convincing and ubiquitous. Furthermore, as the experience of total war affected all groups in society and all British citizens, venereal disease similarly affected all social classes: sexual diseases did not only affect the poor or the privileged.
Military measures regarding Venereal Disease in the British Army
The military took a particular interest in preventing and curing venereal disease in service personnel. A handbook on military sanitation stated that 'The well being and efficiency of the British Soldier is the final aim of all Military Sanitation',(16) thereby encompassing both sexual health and military efficiency. Upon enlistment in the British Army, if a man was found to have venereal disease, the National Service Medical Board informed his recruiting officer that he would require hospital treatment upon his military posting, and recommended that he be cured before he could participate in training or active service.(17) Strict orders were imposed by the King's Regulations regarding those soldiers who contracted venereal disease, that 'a soldier suffering from venereal disease is to report himself sick without delay'.(18) Incidences of venereal disease were also seen to have a deleterious effect on the morale of British troops:(19) while positive morale remained essential, the venereal disease rate was required to remain low.
Regular examinations by army doctors, and the army's provision of prophylactics, evinced an awareness by the authorities that, the ideals expounded in the King's Regulations notwithstanding, soldiers would have sex, and some would, as a consequence, become infected:
Sexual intercourse was regarded as a physical necessity for the men. Besides being the medical point of veiw, it became the official army point of view as well, and we were ften told in lectures that it was natural, and all we had to do was to use the safeguards and preventatives which were at our disposal to save us from disease … Hundreds of thousands of men who had led comparatively pure lines until then saw France learned and were even encouraged to go with impure women.(20)
However, the policy of the army, as expressed in terms of law and philosophy, was incongruous. Military law did not punish soldiers who had sex, but did punish soldiers who contracted and concealed venereal diseases: such soldiers could be punished with two years' hard labour under the Army Act, 1881.
The army took active measures to protect the sexual health of its soldiers. Prostitutes in Red Lamp brothels (for the lower ranks) and Blue Lamp brothels (for officers) underwent compulsory regular medical examinations by Royal Army Medical Corps doctors for sexually transmitted disease, and were permitted to work only if they were pronounced clear. By 1917, there were 137 licensed brothels in 35 towns throughout France.(21) The army-approved brothels were not, of course, the only source of infection, and the prevalence of venereal diseases was evidence that methods of prophylaxis were not universally adopted, or were ineffective or unreliable. Records show that 32 out of every 1000 soldiers were found to be infected with VD in 1917.(22) By the end of the war, 416,891 soldiers had been treated for VD.(23) Figures peaked in 1918, with 60,000 British and Dominion soldiers receiving treatment.(24) During the war, between 40,000 and 50,000 British officers and men were constantly out of action due to venereal disease.(25)
The army attempted to create an alternative culture for the soldier to enjoy, consisting of sports and other recreations unconnected with sex.(26) Similarly, the National Council for Combating Venereal Diseases encouraged men to 'keep out of temptation' by 'going in for games and exercises',071 and encouraged the provision of recreational opportunities by such bodies as the YMCA and the Church Army, asserting that:
There is not the slightest doubt that the aimless promenading in darkened street so familiar a feature of all garrison towns is a fertile source of danger to the soldier, and anything that gives him other means of occupying his spare time, is a powerful aid to the avoidance of temptation. (28)
Certain areas were placed 'out of bounds' for troops, so that they would not be exposed to the temptations of brothels.(29) The efficacy of such schemes was in doubt, however. Military historian Gordon Corrigan criticises the British army for its attempts to counteract sexual desires with 'good discipline and healthy exercise' and cites this as a cause for Britain's high VD rates.(30) Historian of medicine Mark Harrison points out that Army policy was, to a certain extent, unsystematic:
When war broke out, there were three relatively distinct positions on VD Control in the British army: sexual continence; medically regulated prostitution; and a more liberal approach associated with the new technologies of prevention. (31)
Venereal Disease on the Home Front
Measures were also adopted to combat incidences of venereal disease on the home front, and the impact that sexual illhealth had on national and military efficiency and the nation's morality. Regulation 40D of the Defence of the Realm Act was one of the last attempts by the government, during the war, to police sexual behaviour and consequently check the spread of venereal infection, and was perhaps an indicator of an increasing moral panic and concern that levels of immorality and of sexual ill-health were out of control. The motivations for the introduction of Regulation 40D were manifold: influences were to be found in the military, the church, interest groups in Britain, and calls from the governments of the Dominion countries. The Defence of the Realm Act itself had been introduced in August 1914, and added to throughout the period of the war. 22 March 1918 saw the advent of Regulation 40D, '21 which stated that:
No woman who is suffering from venereal disease in a communicable form shall have sexual intercourse with any member of His Majesty’s forces or solicit or invite any member of His Majesty’s forces to have sexual intercourse with her …
A woman charged with an offence under this regulation shall of she so requires be remanded for a period (not less than a week) for the purposes of such medical examination as may be requisite for ascertaining whether she is suffering from such a disease as aforesaid … (33)
Interestingly, the regulation was introduced one day after the German army launched its Spring 1918 offensive, on 21 March. By this late stage in the war, and in the light of the Germans' offensive, the issue of manpower, and the quality of British troops, was paramount. Regulation 40D could be seen as a means of ensuring the quality of those troops that were available. This regulation was in addition to DORA Regulation 13A, which had been passed in 1916, prohibiting women convicted of prostitution from the 4 vicinity of military camps.(34) In July 1918, after discussion at the Imperial War Conference, the regulation was amended to apply equally to American troops and the areas in which they were encamped. The Dominion Governments called resolutely for adequate measures to control or prevent venereal infection among Dominion troops. Visitors to Britain from America and the Dominions were, it was alleged, 'scandalised by the conditions' in British towns and military camps.(35) Britain's sense of nationhood, of patriotism and unsullied Britishness was defined alongside the countries of her Empire and her Dominions. Moreover, manpower and efficiency were maxims in time of war:
[Infected soldiers] became, at least for a time, wastage of manpower, and in many cases they returned home to be a perpetual danger to the Dominion from which they came … every women with this disease is a centre of infection and each centre of infection may be as prolific of ‘infectiveness’ and a wastage of manpower as German poison gas. (36)
Regulation 40D, as may have been expected, was met by a tenacious and vociferous opposition from within Britain. Historian of sexuality Jeffrey Weeks writes that it:
Was attacked by moralists and feminists, and was also clearly against common sense, as it made it an offence for a diseased wife to sleep with a soldier husband, even if he infected her in the first place. (37)
Weeks concedes, however, that 'it was a logical effect of the unwillingness of the state to be seen to condone immorality.'(38) In parliament, opposition to the regulation, and criticisms of it, came from MPs from across the political spectrum and with a wide variety of party affiliations,(39) thereby proving it to be an issue relating to morals and ideology, rather than to party politics. Randall Davidson, the Archbishop of Canterbury, wrote that 'this matter is so important and the subject is pressed upon me from so many quarters that it is impossible to let it rest'.(40) Resistance was also expressed by the Bishop of Birmingham and his Diocese, who recognised 'the urgent necessity for checking the ravages of Venereal Disease in the Army', but was 'of opinion that DORA 40D will not fulfil this object, and that it is open to great abuse', and called for the regulation to be repealed.(41) Regulation 40D had a relatively short active life, having been enacted on 22 March 1918, and revoked, along with a whole raft of DORA regulations, by an Order in Council of 25 November 1918.(42) It was revoked 'despite anticipation of an enormous post-war rise in VD', and, as such, is emphatically described by historian Lucy Bland as 'a feminist victory'. (43) However, the fact of its being revoked so immediately after the Armistice serves to illustrate the fact that the regulation was not introduced primarily out of concern for the nation's sexual health, but more specifically as a wartime expedient aimed at maintaining national and military efficiency and securing military victory. The connection of morality and sexual health with the national cause was to be found in legislation, as well as in the popular consciousness.
It is clear that the magnitude of these hitherto private issues was demonstrated by the volume of coverage they received in various public discourses, and, as historian Susan Grayzel observes, it was believed that 'the moral battles had to be won if the war was to be a true victory'.(44) National efficiency, security, and morale were essential for military success, and threats posed to these by sexual impropriety and disease required exposure and elimination. The interest of such a spectrum of individuals, and both official and non-official bodies, in the matter of the moral rectitude and sexual health of the nation, established this matter as being intrinsically linked with the pursuit of the war. Furthermore, the involvement of the state and of the Royal Commission in the matter meant that sexual morality and patriotism were linked not only in the popular consciousness, but also in official British policy. And, while discourses connected the two tenets of military success and racial supremacy, Britain's moral crusade, against sexual depravity and venereal disease, was fought as passionately as was the war itself.
1 Ellis, Havelock, 'Eugenics in Relation to the War', pp. 110 n 127 in Ellis, Havelock, The Philosophy of Conflict and Other Essays in Wartime (London: Constable and Company Ltd., 1919), p.122.
2 See The National Archives, file no. MH 96/1131.
3 Evans, David, 'Tackling the "Hideous Scourge": The Creation of the Venereal Disease Treatment Centres in Early Twentieth-Century Britain', pp. 414-417 in Social History of Medicine, 5, 1992, pp.414-415.
4 Pankhurst, Christabel, The Great Scourge and How to End It (London: E. Pankhust, 1913), p.vi.
5 Davidson, Roger, 'The Culture of Compulsion: Venereal Disease, Sexuality and the State in Twentieth-Century Scotland', pp. 58-75 in Eder, Frank X., Hall, Lesley A., and Hekma, Gert (eds.), Sexual Cultures in Europe: Themes in Sexuality (Manchester: Manchester University Press, 1999), p.58.
6 Rout, Ettie A., Two Years in Paris (London: Ettie A. Rout, 1923), p.l
7 Royal Commission on Venereal Diseases, Final Report: 1916 Cd. 8189 xvi 1, p.16
8 Ibid., p.60.
9 Ibid., p.22.
10 Ibid., p.31.
11 Treatment was to be provided by Counties and County Boroughs, the cost of 75 per cent of which was to be paid for by imperial funds, and the remaining 25 per cent by local rates: Prevention and Treatment o f Venereal Diseases (London: HMSO, 1917), p.2
13 Times, 24 June 1916, p.9, column b, 'The Weakness of Ignorance'.
14 The Wellcome Archives for the History and Understanding of Medicine, file no. SA/BSH
15 National Council for Combating Venereal Diseases, First Annual Report o f the National Council for Combating Venereal Diseases, June 1916 (London: National Council for Combating Venereal Diseases, 1916).
16 Blackham, Colonel Robert ]., Military Sanitation: A Handbook for Soldiers (London: John Bale, Sons & Danielsson Ltd., date unspecified), page number unspecified.
17 The National Archives, file no. NATS 1/769: Memorandum to the Commissioner of Medical Services, London Region, from J. T. Lewtas, for the Chief Commissioner of Medical Services, 20 November 1917.
18 The King's Regulations and Orders for The Army: 1912. Re-printed with Amendments published in Army Orders Up to 1st August, 1914 (publication details unspecified), p.107, paragraph 462.
19 Harrison, Mark, 'The British Army and the Problem of Venereal Disease in France and Egypt during the First World War', pp. 133-158 in Medical History, 39, 1995, pp.145-146.
20 Graham, Stephen, A Private in the Guards  (London: Heinemann, 1928), p.225.
21 Flexner, Abraham, I Remember: The Autobiography of Abraham Flexner (New York: Simon and Schuster, 1940), pp.194- 198; The National Archives, file no. WO 32/5597; both cited in Harrison, op. cit., p.142.
22 DeGroot, Gerard J., Blighty: British Society in the Era of the Great War  (London: Longman, 1998), p.235.
23 Winter, Denis, Death's Men: Soldiers of the Great War  (Harmondsworth: Penguin, 1979), p.150.
24 Mitchell, T. ]., and Smith, G. M., Medical Services: Casualties and Medical Statistics of the Great War (1931), pp.164 and 174, cited in Fuller, J. G., Troop Morale and Popular Culture in the British and Dominion Armies, 1914-1918 (Oxford: Clarendon Press, 1990), p.75.
25 Rout, op. cit., p.22. Rout adds that many of those who were out of action with venereal diseases were claimed to be padres
26 Winter, op. cit., p.152.
27 National Council for Combating Venereal Diseases, A Cause of Military Inefficiency (London: National Council for Combating Venereal Diseases, date unspecified), P-3.
28 May, Otto, The Prevention of Venereal Diseases in the Army (London: National Council for Combating Venereal Diseases, 1916), p.8.
29 The National Archives, file no. WO 32/5597: letter from Field Marshal Haig to the Secretary, the War Office, January 1918.
30 Corrigan, Gordon, Mud, Blood and Poppycock: Britain and the First World War  (London: Cassell, 2003), p.94.
31 Harrison, op. cit., p.139.
32 The National Archives, file no. HO 45/10893/359931; DeGroot, op. cit., p.235
33 The National Archives, file no. MEPO 3/2434
34 Evans, op. cit., p.429; see also Haste, Cate, Rules of Desire: Sex in Britain: World War 1 to the Present  (London: Pimlico, 1994), p.33.
35 See Gotto, Mrs. A. C., The Changing Moral Standard (London: National Council for Combating Venereal Diseases, 1918), p.l.
36 The National Archives, file no. WO 32/4745: Memorandum by Ian Macpherson, Deputy Secretary of State for War, 26 August 1918
37 Weeks, Jeffrey, Sex, Politics and Society: The Regulation of Sexuality Since 1800 (1981) (London: Longman, 1984), p.216
38 Ibid.; see also De Groot, op. cit, p.235; Van Viscount Milner, 8 June 1918. Association grant for research for her PhD Emden, Richard and Humphries, Steve
39 Opponents and critics of Regulation 40D included Hastings Bertrand Lees-Smith (Labour), Sir Henry Seymour King (Unionist), Sir Robert Paterson Houston (Conservative), and Lord Henry Cavendish-Bentinck (Conservative).
40 The National Archives, file no. WO 32 / 4745: letter from Randall Davidson to Ian Macpherson, 14 October 1918.
41 The National Archives, file no. WO 32/111403: Resolution passed by the Birmingham Diocesan Chapter, sent to Viscount Milner, 8 June 1918.
42 The National Archives, file no. HO 45/10894/359931.
43 Bland, Lucy ‘In the Name of Protection: The Policing of Women in the First World War’, pp. 23-49 in Brophy, Julia and Smart, Carol (Eds.), Women-in-Law: Exploration in Law, Family & Sexuality (London: Routledge & Kegan Paul, 1985), p.32
44 Grayzel, Susan R., Women’s Identities at War: Gender, Motherhood, and Politics in Britain and France During the First World War (Chapel Hill and London: University of North Carolina Press, 1999), p.155.
Emily Payne has recently been awarded her doctorate in History by the University of Kent. She was in receipt of a Western Front Association grant for research for her PhD thesis, Private Lives and Patriotism: A Study of Attitudes to Sex and Venereal Disease in Wartime Britain, 1914-1918. She has published a number of articles and reviews, including work in BBC History Magazine, and has appeared on BBC radio discussing historical matters. Emily has a BA and MA from Lancaster University: for her MA thesis, on tobacco smoking and morale during the Second World War, she was awarded the Joseph Hertford Sutton Prize for Modern Social History. She was elected a member of the Royal Historical Society in 2003.