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a great deal could be accomplished along the lines that the various States and municipalities are doing in the establishment of their free clinics for the treatment of these venereal diseases. It is only in certain cases that it is necessary to hospitalize them. I think it would tend to offset the question of breaking employment and increasing the economic burden involved in asking a man to go to a hospital if we could establish treatment for these cases in our regional offices.

Senator SHORTRIDGE. If you could arrest the disease, you would not only benefit the man, but ultimately save the Government money.

Doctor McDERMOTT. That is the point.
I should be very glad to answer any questions.

Senator CONNALLY. Let me ask you if it is not true that in many stages of this disease it could be treated at home, and the man could go ahead and pursue his occupation and simply take treatments without going to the hospital, and without taking him away from his family, and it could be done quite as effectively as hospital treatment, could it not?

Doctor McDERMOTT. I think in many cases that should be done.

Senator CONNALLY. That is the way they do it in civil life. They get a doctor, and he gives them treatment over a long period,

Doctor McDERMOTT. The great difficulty, as I see it, is that the bureau's hands are tied in further liberalizing the situation.

Senator CONNALLY. Exactly. But we are here to untie them if we can.

Mr. RANKIN. Doctor, if this presumptive period is extended, these men would be put on the roll and would get an average of $43 a month, would they not? Is that not right, General Hines?

General HINES. Yes.
Doctor McDERMOTT. What do you mean?
Mr. RANKIN. The presumptive period for all these men.
Doctor McDERMOTT. I really do not know anything about it.

Mr. RANKIN. I will say for the record that that was the statement of General Hines before the House committee.

The CHAIRMAN. That is another question, is it not?

Mr. RANKIN. It costs $120 a month to hospitalize one of these men, does it not?

Doctor McDERMOTT. I believe so.
General HINES. I will state that that is correct.

Mr. RANKIN. So, by refusing to put these men suffering from these chronic diseases, including the men you refer to, on the roll, and forcing them to go to the hospital, instead of paying them $43 a month, you spend $120 a month, do you not?

Doctor MCDERMOTT. I would like to have the general explain that.

General Hines. That is not correct. By the time these men go to the hospital, they have to go to the hospital, and therefore by connecting the disease with service you make the cost $80, $90, or $100 compensation plus $120 for hospitalization. I would like to touch upon one point or suggestion Doctor McDermott made. It seems very plausible, but we should keep in mind that if we attempt to give out-patient relief to men suffering from social diseases, such as he is suggesting, most certainly, then, we should extend out-patient relief to all other men of the World War, and that becomes a much

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greater problem than the problem of hospitalizing all veterans of the World War. So, we ought to give some consideration to the question of whether we are prepared to set up clinics to take care of the entire potential load of the World War veterans. We have not gone quite so far in that direction with any of them up to this time, except the service-connected cases. We have out-patient clinics for the service-connected cases, but we have not extended those to the nonservice-connected cases.

The CHAIRMAN. General, supposing a soldier contracted syphilis in 1924. The war was over then, for six years. He contracts that disease. Can he go to the hospital?

General Hines. Yes, sir. No matter when he contracts it

The CHAIRMAN. No matter when he contracts it, whether it was in the service or not?

General Hines. That applies to veterans of all wars, regardless of disabilities. The only restriction is as to whether a bed is available or not.

Senator COUZENS. In that connection, General, based upon the statement you have just made, would it be more economical to proceed along those lines than to take care of them after they become totally disabled?

General Hines. I doubt it, Senator, although it would be difficult to say offhand. But it seems to me that the number of men we would have to treat would be many more than finally reach our hospitals, because I have a feeling that a number of them now are taking advantage of the free clinics in communities wherever there are free clinics, and until we are prepared to treat all veterans alike, in out-patient treatment of that character, that would seem to be the proper place for that to be done. But the question of paying them compensation, it seems to me, rests entirely upon the question of whether we again wish to depart from the principle of service-connected disabilities. Congress put into the present law the provision for taking care of them and paying them compensation, clearly on the proposition that they would be a charge upon some community. The Federal Government, having the facilities, is probably best able to take charge of them.

A question was asked about percentages, and I thought I could probably find the answer to that.

Senator CONNALLY. Before you get to that, I would like to ask about a statement you made a while ago. I do not quite agree with your statement there that if you give these cases out-patient treatment, you would have to treat all veterans of the war. That would mean a veteran of the war that contracted an illness any time. These are only cases where this thing was contracted during service. You are already compensating everybody else. You are already compensating the service-connected cases.

General Hines. How are we going to determine when they did contract it?

Senator CONNALLY. You determine it in the case of everything else.

General Hines. I think we would have greater difficulty.

Senator CONNSLLY. You determine when a man gets tuberculosis, or psychiatric trouble, and every other ailment on earth.

General Hines. Of course, if they contracted this disability in service, the record we would have would be where they were treated in hospitals. We would have that.

Senator CONNALLY. They might not have been treated.

General Hines. In the case of a man who was not treated, we would have great difficulty in showing when it was contracted.

Senator CONNALLY. Let me ask the doctor a question there. Has not medical science got this thing down to the point where you can examine a man and determine approximately when he contracted it?

Doctor McDERMOTT. You are speaking of syphilis?
Senator CONNALLY. Yes.

Doctor McDERMOTT. The history is a very important factor, Senator, in determining the onset of the disease. It is true that we divide it into the primary, secondary, and tertiary stages, but we sometimes run across a case of what we call precocious syphillis, where the period of consecutiveness does not prevail, and it will run almost from the primary into the tertiary stage. We find that because of the opprobrium attached to these diseases, our medical histories and our medical examinations, perhaps, are not as complete as they might have been during service. I think it is a fact that if any soldier ever admitted that he had a venereal disease he would probably be scanned a little more carefully than if he denied ever having had a venereal disease.

Senator CONNALLY. You have records of 330,000.

Doctor McDERMOTT. Three hundred fifty-seven thousand, nine hundred sixty-nine treated primarily for social disease and 383,706 cases in which primary treatment was for another disease but where a venereal disease was also present.

Senator CONNALLY. That shows that many were actually treated. You would have records of those. You would know whether those particular ones got it during service or not?

Doctor McDERMOTT. My idea, from the humanitarian standpoint, in contradistinction to all other diseases, is this, that we are dealing with a very insidious and subtle foe. It is readily communicable. A syphilitic may act as a prey on many an innocent individual. For example, I know in my own State that according to statistics instituted some years ago by the board of health, a surprising and amazing number of syphilitics were working in lunch houses and in restau

We do not know just when we are brushing elbows with them. Senator SHORTRIDGE. Ďoctor, is not this a fact, scientifically, that that disease may be communicated without sexual intercourse?

Doctor McDERMOTT. Yes. That is one of the reasons that led to the campaign for the eradication of the old community towel and the old community glass—that and tuberculosis. The same thing applied, of course, to syphilis. The knife, fork, spoon, cup, saucer, and so forth, are vehicles of conveyance.

Senator CONNALLY. It is an infection that gets into the blood and goes all through the body.

Doctor McDERMOTT. My real thought in the matter was that because of its dire possibilities, and its subtle and insidious workings in conveying it to the public in general, that in the case of the soldier it would be well to bring it before the Congress for consideration as to whether they should leave it up to the various municipal or State health departments, or private individuals to look after.

It is a problem that certainly demands a very high toll annually, from the standpoint of health.

Senator CONNALLY. Let me ask you, Doctor, if, in the Army, the cook had syphilis and communicated it in some way to the men of his mess, under this law, they could not get any compensation, could they?

Doctor McDERMOTT. No; they could not. Incidentally, I do not know whether the committee knows it or not, but this is a fact, that a soldier in the service whose wife may have had syphilis and may have communicated it to him is marked "misconduct," and he falls under this same stigma.

The CHAIRMAN. There are very few of those. You need not worry about them.

Doctor McDERMOTT. I do not know how may there are, but I know those cases do occur, and are not as infrequent as you might suppose.

Senator CONNALLY. A man frequently gets it from somebody else's wife.

General Hines. Bearing upon the question Senator Connally asked me, I notice that Colonel Ayres, the statistician of the War Department, whose work is taken as an authority on data of all kinds in connection with the war, says here on page 130 of his book that of each 100 cases of venereal disease recorded in the United States, 96 of them were contracted before entering the Army. Ninety-six cases out of every 100 were contracted before they entered the Army, and only four afterwards.

Mr. ŘANKIN. In connection with the question asked by Senator La Follette a while ago, and the question I asked Doctor McDermott, if these 18,000 tubercular men and these 23,000 neuropsychiatric men who would come under the provisions of this amendment of mine were put on the roll by this bill, they would draw, on the average, $43 a month, would they not, from the Government?

General HINES. When they are out of the hospital.

Mr. RANKIN. Yes. They all have the right, under the present law, to go to a hospital.

General HINES. Yes.

Mr. RANKIN. If they do go to the hospital now, it will cost the Government an additional $120 a month. So, if they are given compensation and permitted to stay at home, instead of costing the Government $120 a month, it will only cost $43.

General Hines. That is not correct, Congressman. If these men are in the hospital now, they are in the hosiptal because they need hospital treatment, and it will cost us $120 per man per month, plus whatever compensation they get while they are in the hospital. If you give them compensation, instead of getting $43 a month, which is the average of the compensation paid, they will draw temporarytotal, or $80, $90, or $100 or more a month, when they are in the hospital, so that would not be exactly right. If they are out of the hospital, and so far recovered that they can leave the hospital, they would draw whatever compensation their disability entitles them to, and, on the average, it would be $43.

Senator GEORGE. General, can you approximate the number of cases where compensation might be otherwise allowed if it were not how many

for this wilful misconduct provision in the law? In other words,

General Hines. At one time we made an estimate, Senator, but that would be somewhat out of date. I recall that during the investigation we estimated that about 8,000 of those cases would then be compensable, but I have an idea there would be many more at this time.

Senator GEORGE. You think it would show an increase?
General HINES. Yes. I can look that up.

Senator GEORGE. No. I thought perhaps you had that information.

General Hines. I recall the figure of 8,000 quite distinctly, because we discussed the matter at that time at quite some length, in connection with the matter of the revision of the World War veterans' act.



Dostor McDERMOTT. The purpose of the bill now before the committe is to equalize benefits to a very large class of really disabled veterans within the financial ability of the Government to do so, by presuming that a large number of diseases are due to service if shown to have existed prior to January 1, 1925. I am not here as intercessor for a premium to be placed upon vice, not as a proponent for Government concurrence in evil acts. I merely wish to call the attention of the committee to a few facts regarding a class of exservice men which is not covered in the proposed bill, and which will continue to present a pathetic appeal to you, and to the bureau, if nothing is done for them.

If the purpose of the present committee hearing is to end discrimination, and by law and upon legal premises establish justice, then it would seem that there is a large class up to the present time left out and still to be done a legal injustice; namely, the unfortunate veterans suffering from so-called misconduct diseases. These veterans responded with equal alacrity to the mandate of the Congress when the call to arms went forth. From the farm, the shop, the factory, the mill, the office; yea, even from the school, they came forth in the mighty assemblage of the man power of the Nation.

To-day a committee of that Congress is in session to consider some measure of relief from a grateful Government for those showing disabilities directly or presumptively residual to war.

Since it is apparently the purpose of this Congress, more than any other yet assembled, to study and discuss in detail the various problems arising from the wounds of war, and how best to establish equality among those who served, it will not seem amiss to mention a few facts regarding the so-called misconduct disease class. I propose to deal only with facts and let you gentlemen draw your own conclusions, and in doing so I submit that the Government is not charged with the duty of administering moral law but no one disputes its right to grant mercy and clemency when the Government chooses to extend

Very likely some of you gentlemen in the remote past have stood before the bar of justice to intercede for some unfortunate accused. You were inspired to take this stand, no doubt, because of certain


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