In venereal cases the usual moderate charges in cities are, $10 for the first consultation, and $5 for each subsequent one, without credit. The average doctor is preeminently easy in financial transactions and uniformly charitable when necessity invites; but from these notoriously untrustworthy patients, whose diseases are those of election, the fee is very properly expected to be forthcoming at each visit.
Without treatment one cannot hope to be cured, and must either present himself at the doctor's office, or else be visited, sometimes once daily, sometimes two or three times a day; and if the expenses for medical treatment, sanitation, loss of time from work, etc., be taken into account, he will be fortunate if he does not have a bill which amounts to several hundreds of dollars. Of course, the average gonorrhceal patient does not pay anything like this amount; but if the case be complicated, or if syphilis happen to be the form of the venereal disease, the expenses sometimes amount to many thousands of dollars, which are distributed over the years of a lifetime.
Should the patient not be able to afford payment, he must attend a dispensary for genito-urinary diseases, where he will be thrown into contact with an aggregation of the 1 For fuller explanation, see chapter on Gonorrhoea filthiest and most disgusting specimens of humanity, and he will be required to take his seat and rank himself alongside of men whom a clean man touches only from necessity. The expense of keeping a mistress is often greater than what would suffice to support a family; but even that method is not safe.
THE FACTOR OP THE DOCTOR'S SKILL.
Many patients look up to their doctor as a sort of sage, blindly placing the most implicit confidence in him, and never giving a thought to the possibility that he can do wrong. It is not for the writer to speak disparagingly of a calling to which he belongs, and which he admires with the deepest reverence; but doctors are human, and make many an error.
No physician is properly qualified to treat venereal diseases who is not skilful in microscopy and bacteriology; for the criterion of cure, which can be told only by the microscope, is most essential in giving information when to stop and how long to continue treatment. A great number of doctors pronounce the cases cured far too early, to the lasting harm of their patients.
In many cases patients are over-treated or maltreated by doctors, and in a majority of cases they themselves are "lacking", as Finger says, "in a quality which cannot be supplied by the apothecary, viz., patience".
A large number of foolish men are deluded by the advertisements of charlatans, who not only rob them of all the money they can and give them bad treatment, but also, what is even worse, prevent them from receiving good treatment.
It is well known by physicians that only a very small proportion of venereal patients receive anything like adequate attention, partly on account of prescriptions which are carelessly given over the druggist's counter, partly from the mischief done by the press in receiving harmful advertisements, and partly owing to the desire among patients to cease treatment as soon as possible. Thus the medical profession is handicapped, and cannot begin to grapple with these diseases while such ignorance and apathy are prevalent.