A Positive Method for Prevention of
Venereal Disease"From Shanghai to Shanghai"
The War Diary of
an Imperial Japanese Medical Officer
1937～1941
Aso Tetsuo
Translated by Hal Gold1

A Positive Method for Preventionof Venereal Disease*(Paper Submitted by Dr. Asoto the Army Medical Department)

By Aso Tetsuo, Second Lieutenant, Army Medical Doctor attached to
the 14th Clearing Hospital of the Eleventh Army

Contents
I
Introduction
II Prostitutes
III Syphilis Examinations
IV Alcohol Consumption
V Sexual Abstinence
VI Awareness of Venereal Disease
VII Avoiding a Narrow view of Prevention
VIII Handling Patients
IX Conclusion------------------------------------------* Dr. Aso submitted this paper to a meeting on military medicine in Jiujiang
on June 30, 1939.

2

I Introduction
When a given disease has a high relationship between the interests of the patient andthe interests of persons surrounding the patient, it must be said that the social meaningof that disease increases. In this sense, leaving other forms of acute, communicabledisease aside, venereal disease, whether it occurs in peace or during war, is as serious as
tuberculosis. Thus, it follows that to realize the objective of eradicating this disease, it is
not enough merely to adhere to or continue a portion of all the types of countermeasuresconsidered until now. The overall completion of the plan described here is necessary
beyond dispute.
The objectives in this method are that infected patients will be treated, and healthy
persons will be prevented from becoming infected. Together with treatment andpreventative measures for infected patients and healthy persons respectively it is also
necessary to survey and research the associated social factors. Statistical studies of thefrequency and quantity of diseases as to the sources of infection, different diseases, andthe course of diseases must be meaningful in order to establish future countermeasures.
Since we are dealing with people, some of these surveys and treatments should be
handled actively, others more passively. With a disease that has such a large social
significance as this, it must be asserted that all countermeasures should be carried out
with impartiality.

II Prostitutes
In January of last year, while I was working in the outskirts of Shanghai, I carriedout an order to perform examinations for syphilis on prostitutes who were about tomove into the interior regions of the country.
The examinees consisted of some eighty women from the [Korean] peninsula, andabout twenty from the mainland. Among the women from the peninsula, thosesuspected of carrying venereal disease were exceptionally few. Among those from themainland, even though many did not actually exhibit acute symptoms of the disease, allwere of very dubious character.
Most of them were above twenty years of age, and among them were even some
who were almost forty years of age and who were merely continuing the same line ofprostitution that they had followed for years. A point of interest concerning the womenfrom the peninsula was that besides their young ages, many were new in this line ofwork. Thus, among those in the latter group, in light of the past incident [a reference3

to the Nanjing Incident of December 1937] some among them should be recruited as
though they were auxiliary soldiers without basic training.
Generally, for a higher quality in prostitutes, the younger age level is favorable. In a
survey conducted in the city of Munich, among 2,686 prostitutes examined, 26.5
percent were found to be infected with venereal disease. The disease distribution amongage groups was as follows:
Below 16 years of age
19 persons
16 to 18104
18 to 21239
21 to 30281
In addition, a survey covering three years of minors engaged in prostitution in thesame city showed the following incidence of those who had been infected with venereal
disease:15 years of age
55.0 percent
16 years
61.5 percent
17 years
68.6 percent
This shows a lower prevalence in the younger age groups.
Another survey in Stuttgart, conducted on 565 prostitutes between the ages offourteen and twenty-one, showed a prevalence rate for the group of 55 percent.
In a survey in Munich in 1908, the prevalence rate was 23.5 percent, and in Paris therate was 58.0 percent, Then in 1932 in Fukuoka Prefecture, a survey was conducted ofwomen in four classes of work up to the age of forty. Those in the survey group undertwenty years of age were represented by the following percentages:
Geisha (Geigi)
Licensed prostitutes (Shogi)
Servers in better-class eating/drinking
establishments (Shakufu)
Waitresses in popular-priced restaurants (Jokyu)

56.3 percent
29.1 percent
44.6 percent
46.5 percent

In other words, approximately half the prostitutes surveyed can be said to be undertwenty years of age. [The author apparently included all categories as prostitutes. While
only licensed prostitutes outwardly engaged in the profession, the other three categories
also participated in an open secret status, and were actually included in the prefecture's
4compulsory examinations for venereal disease.]
Thus, it is important to take care of young prostitutes, and those prostitutes who aresent to the war zones should be of young age. While I was conducting syphilis
examinations in a certain region, I often saw surgical scars from inguinal adenitis[bubos or swollen lymph nodes, a common development in advanced venereal disease
and other afflictions] on both sides of the inguinal region, which was tantamount tobranding those women as low-class prostitutes with clear histories of venereal disease. I
dare say that thought should be given to the fact that these women would be ofquestionable value as gifts to the officers and men of the Imperial Army.
Even if we formulate a method for carrying out syphilis examinations, generally athorough weeding out is necessary at the final port of embarkation among prostitutes
who are being sent to the war zones. Taking women who are unable to earn a living on
the mainland and transferring them to the war zones must be termed an absurdity. In asimilar problem, with the present situation here in China, the infiltration of syphilis
among Chinese prostitutes and refugees engaged in unregulated prostitution is alarming.
Under these conditions, the military should be provided with young prostitutes in
comfort stations for exclusive military use and under our supervision, and decisive
measures should be taken with those outside these controls.
In Germany, venereal disease became widespread at one time among the garrison at
Cologne. Even stringent examinations produced no results, and people contracting thedisease were recorded at a high 22 percent. This was caused by the overwhelming
number of unlicensed prostitutes.
Because of this situation, Cologne learned from the examples of England and theUnited States, and established a women's police squad, and thus achieved enforcementof the regulations. Attention must be given here to the fact that some Chinese prostitutes
do not like men to use protective condoms. Those extremes must be eliminated; theresults of such actions are the same as if the fighting strength of the army were erodedby an enemy plot.

III Syphilis Examinations
A major reason for the easy spread of venereal diseases, and the difficulty in their
eradication, is that it is difficult to achieve a complete cure for gonorrhea. In addition,
we may consider what happens once the bacteria invade a woman's lower abdominalorgans. While these are facts, are venereal disease examinations really useless?
According to medical literature, both licensed prostitutes and unlicensed prostitutes
5subjected to so-called syphilis examinations record almost the same rates of infection.
This may support the thinking that syphilis examinations are useless. In respect to this, I
would like to present my views regarding syphilis examinations.
The historical origins of syphilis examinations are old. The order of the Bishop of
Winchester was issued in the entertainment quarters of Southwick, outside of London,in 1162. In 1413 and also in 1469, the city councils of Zurich and Lucerne passed
rulings based on this. Then in 1823, Paris enacted prostitute registration, which ruledthat prostitutes be regulated under the supervision of physicians. This can be regarded
as the establishment of today's venereal disease examinations.
In 1908, however, Hecht proposed from a study of a mere 5 percent or 10 percent of
unlicensed prostitutes that syphilis examinations were useless in discovering diseased
subjects. He was not the only one to declare syphilis examinations useless, and eventoday a considerable number of researchers do likewise. They say that the number oflicensed prostitutes is extremely small compared with the total number of unlicensed
prostitutes. Clarifying the situation with numbers, in Berlin, Cologne, and Paris,
unlicensed prostitutes outnumber licensed prostitutes by seven to ten times. The
situation is probably similar in Japan today.
Also, in the war zones, the occasional appearance of similar unlicensed prostitutes isrecognized, but to focus on the main point, in order for the army to establish special
comfort stations to bring prostitutes under closer control, we should disregard theories
that dispute the value of syphilis examinations.
Furthermore, the latest information from Nuremberg and Bohemia shows thatfrequent syphilis examinations have yielded results. However, even if the examinations
themselves prove successful, if the examination system is not carried out properly, it
will give rise to the advance of other harmful effects. if the expectations are to realize an
overall enhancement of hygiene, it is essential that following the examinations, infected
persons are quarantined and treatment is administered. If this aspect is handled with
halfway measures, the syphilis examinations will be so in name only. I came to realize
this point keenly while working at my duty assignment. Before that time, the army did
not have a unified policy in this matter, and people were sent from outlying areas tohospitals in large cities for treatment only when conditions made this possible. After I
examined the prostitutes, I was transferred away from that duty location for one and ahalf years, and for a long time I did not realize the current situation. If there is anabsolute absence of medical treatment following the examinations, what is the purposeof the examinations? The army must realize that a strictly controlled examination
system is necessary.
6The next item that should be addressed is the risk of incomplete inclusion of persons
for syphilis examinations. This is a question of personal relationships among thoseadministering the examinations, the brothel operators, and recipients of theexaminations. A well-known example of this problem occurred in the city of Vienna. [In1906, a Madame Lille ran a brothel with kidnapped women who were infected withdisease. She bribed police and officials not to interfere with business.] Perhaps there aretimes when people in the background of the hidden, dark world shamelessly wield agreat deal of power. Some people may think that military comfort stations have noconcern with these incidents, but there is much we can learn from them, namely, in
considering problems that would arise when persons responsible for examining andregulating prostitutes make private visits to the brothels, and have sexual contact withthe prostitutes. It would be truly regrettable if they were scheming something while
exercising such abuses of power. Further, those who are led by mere curiosity and haveno judgmental ability would be absurd choices as persons to conduct examinations. I
repeat, examinations of prostitutes and examinations of brothels are necessary.
While I was stationed at a certain duty location, I conducted examinations of
prostitutes and brothels, One of these was an exclusive military comfort station with thebuilding constructed in the style of a barracks. Each room had a place for washing. The
ticket dispensing desk, entrance, exit, and other facilities all approached the ideal. The
other comfort station was in a former Chinese home, where the separation of rooms andwashing facilities was not satisfactory. As expected, after these two brothels wereopened, the number of persons who became infected with disease was extremely low,
and it is worthy to note that the latter mentioned brothel accounted for nearly all of thecases of infected persons.
These examples demonstrate that results can be seen from syphilis examinations at
brothels under army supervision. The results, however, should not produce
overconfidence in the average soldier and cause him to look lightly on the risks
involved with unlicensed prostitutes.

IV Alcohol Consumption
There has been a close association between alcohol and women since olden times.
Alcohol is, according to the old adage, "the best of all medicines." [A Japanese
expression of Chinese origin.] But as a rule, the first stage of the pharmacological effectof alcohol on the human body is behavioral disinhibition and impairment of moral
Judgment. Even those who, under ordinary circumstances and while sober, would not7

be able to seek the company of prostitutes, may end up going to a brothel when under
the influence of alcohol. In addition, alcohol lowers sexual potency, thus the duration ofsexual activity is lengthened. In this way, men bring themselves to exposing their bodies
to the dangers of venereal disease infection. Furthermore, the so-called alcohol moodcauses people to become bolder and neglect preventive measures and preventive
medicine.
Lomholt stated, "Alcohol dislikes protective measures," and it is in fact, true.
Various studies have recently examined the correlation between alcohol and venereal
disease. According to Forel, in a survey of 182 men who contracted venereal disease,76.6 percent did so while under the influence of alcohol. In a study by Langstein of 179
infected women, 43.8 percent became infected while under the influence of alcohol.
Moller conducted a survey of 1,225 infected subjects and found 17.7 percent had
become infected through the influence of alcohol, while Hecht found alcohol-related
infection in 43 percent of approximately 1,000 infected subjects.
A survey of special interest was by Wein, of seven hundred males infected withvenereal disease. He found that 30 percent of single men and 51 percent of married men
had become infected while under the influence of alcohol. Among the males who were
married and had children were those who were discreet enough that they would not haveallowed themselves to be attracted to the adventure if alcohol were not present.
Statistics from the British military on soldiers' entertainment quarters indicate thatrefraining from alcohol dramatically reduced venereal disease. The breakdown per one
thousand hospitalized patients is as follows:Year

1886-1890
1891-1900
1901
1902
1903
1904
1905
1906
1907
1909

Alcohol-related
Venereal Disease
Sickness (persons)(persons)-------------------------------3.1
207.6
2.1
143.7
2.69
5.6
2.6
110.1
1.5
109.1
1.3
1.2
1.7
1.4
0.7

107.6
90.5
99.4
84.4
68.4
8

1901-1909
1906-1909

1.8
1.1

102.6
579.4

This clearly shows that as patients with alcohol-related problems reduce in number,cases of venereal disease likewise decline. As Stoddard shows, since alcohol-prohibition
laws were passed in the state of Massachusetts, the number of venereal disease cases
dropped sharply. And Ikthemann shows that in Leningrad, 25 percent of venereal
disease cases came about as a result of drinking alcohol. Further, a survey of American
military men since 1900 showed that where alcohol was strictly forbidden for sale in
on-base canteens, noncoms and enlisted men resorted to bars and cafes, and an increasein venereal disease was evidenced. If these points are not given serious consideration,
this project will start with promise and end in weak results.
Numerous people have shown the important factual relationship between alcohol
consumption and the spread of venereal disease. Furthermore, once a person contracts
venereal disease, mere observation of the effects of alcoholic consumption would be no
more than a half measure.
From my position, I would like alcohol consumption in the military to be reduced to
the lowest possible level. The fact that the great majority of accidents in the military todate have been caused by the condition termed "under the influence of alcohol"
confirms the findings and strengthens the relationship between alcohol and venereal
disease.
Comfort stations for exclusive use of military personnel should not be consideredamusement facilities, but similar to hygienic, shared toilets. It is a foregone conclusionthat in the military as well as in comfort stations, alcohol should be prohibited. Yet,when I supervised comfort stations, I saw many examples of evidence of alcohol
consumption, a highly regrettable situation. For this reason also, comfort station
operators must be supervised, prostitutes must be supervised, and this type of educationmust be advanced.

V Sexual Abstinence
There are those who claim that sexual abstinence is harmful. They list thephenomenon that occur under restraint of sexual desire and thus proclaim its harm. I
believe that there is a great variance among individuals in sexual desire and vigor.
Those who do not have a strong sexual drive do not require a great deal of will power toexert control. Among some people, however, sexual desire is strong and cannot
9

be controlled by any means. Abstinence, though, will rarely if ever have a harmful
effect. How many examples show that abstinence causes harmful effects such asasthenia [debility] of the nerves of the reproductive organs, prostatic hypertrophy or
epididymitis [swelling of the mass at the back of the testis]?
To put it concisely, the premise for sexual abstinence is to achieve the goal of amore hygienic lifestyle, Our first priority must be to exert efforts and find suitable
methods of recreation to eliminate the idleness that gives rise to sexual desires. I cannotemphasize enough that the problem is influenced by each person's character, personality
beliefs, and other factors, discussions of methods may become somewhat abstract, andtherefore I cannot expand more on the matter here. In my opinion, if we were to launch
a 100-year plan for East Asia, a one-or two-year period of sexual abstinence could not
be considered excessive.

VI

Awareness of Venereal Disease

Generally, to annihilate the enemy one must know the enemy. It is the same in thebattle with venereal disease. One cannot be ignorant of the enemy's military strength orof the strength of a noxious substance. One must not only be aware of himself as anindividual in the military but must also have full awareness of prostitutes.
Lesser worked to improve prostitute supervision. He offered a method of prostitutediscipline through which he brought about a reduction in venereal disease. Considering
this, the benefit was not only to the individual prostitutes but also to their employees,that is, those who normally take a dispassionate view of sexual intercourse and demandnothing more of prostitutes. In this sense, prostitutes in military comfort stations should
always be under supervisory control.
Further, the male employers of the women should be made more aware than thewomen themselves of venereal disease. There is a common saying that "There is no man
without syphilis symptoms and a sexual urge." [A play on the similarity of sounds in theendings of the two terms, kasake and iroke].
Also, in European countries around the sixteenth and seventeenth centuries, syphilis
was not a cause for shame. Men took pride in speaking about their sickness.
Chronic gonorrhea is difficult to treat, and once the spirochaetae invade the cells of
the cerebral nerves, the survival power of the patient is affected. This is more than aquestion of the individual, but concerns the unquestionable cause-and-effect relationshipin lowering the quality of the family, the offspring, and by extension the race. In
consideration of this, even those without a medical education will realize that the10results would be terrifying. Thus the thoroughness of sex education in the military
becomes an important problem. Recently the U.S. military has been distributing
information booklets and pamphlets, with especially strong impressions made throughphotographs and movies. This movement to enlighten people about venereal diseasemust also be considered an important duty that is assigned to hygiene personnel inthe military.

VII Prevention in a Narrow Sense
Before I comment on narrow interpretations of prevention, I should like to makereference to the problem of phimosis [uncircumcised or congenitally constricted
foreskin], which occurs often in the military. There has never been any background of
circumcising large numbers of adult men with phimosis as a preventive measure against
venereal disease, and for this reason comparisons in the incidence of venereal disease
were made between those circumcised for religious beliefs and those not circumcised.
According to a study by Breitenstein conducted among the armed forces in the
Dutch East Indies, fifteen thousand native, circumcised soldiers had a venereal diseaseprevalence rate of 16.0 percent. Among the affected, syphilis accounted for 0.8 percent,while among eighteen thousand uncircumcised European soldiers, the venereal diseaseprevalence rate was 41.0 percent, of which syphilis represented 4.1 percent.
Another survey by Loeb was conducted among 2,468 patients with venereal disease.
Of these, the uncircumcised men had a prevalence rate of chancre [a painless ulcer thatcan develop on the penis, urethra, lips, or eyelids as a primary symptom of infection]and syphilis of 39.1 percent, while the circumcised patients had a prevalence rate ofthese diseases of only 15.0 percent. We can affirm with certainty that the penis in thosewith phimosis is easily susceptible to uncleanliness, and the constantly damp condition
provides favorable breeding grounds for disease bacteria.
For these reasons, as an extension of physical examinations of conscripts, venereal
disease examinations should be administered upon completion of their usual
conscription physical exam, or immediately after their entering the military, andtreatment administered, with a view to achieving the far-reaching plan of the preventionof venereal disease.
Next I would like to take up prevention in the narrow sense as it applies to themilitary. Extreme differences in the prevalence and the types of venereal diseases occur
in the military during times of war and times of peace. For example, in the U. S. Army
the incidence of venereal disease up until the Great War was 16.0 percent. Immediately
11

after mobilization, this rose to 40.0 percent. indeed, it would seem that the increase
arises from an urgency of the battlefield.
Numerous methods of prevention attempted before now are almost similarin bothWestern and Eastern countries; these consist of protective medicines, condoms,
combinations of these methods together, lavage after coitus, and disinfection. I
formulate the plan presented here fully adhering to all methods used to date. Since there
is a wide variety in the compositions and other factors of the medicines used in thesetreatments, I cannot present here details of those materials; the point is that reliablematerials should be selected.
In addition to the medicinals we receive from military hygiene sources, at times weare also supplied with products from commercial sources. In these cases, special caution
is needed. Recently, various cases have been reported in which patients showed an
intolerance of certain types of medicines because of strong topical stimulation [i.e.,externally applied medicines that cause skin irritation or inflammation.]
Recently almost all condoms have been made from vulcanized rubber, withenhanced quality, which is a good trend, but among them are some that deteriorate or
become denatured with long storage. Caution must be exercised here. On the mainland,rubber goods are said to be under government controls. Good quality materials should
be selected not merely for automotive tires but also for condoms, and efforts must be
made to avoid inferior products.
Washing, disinfection, protective agents, germicidal soap, and other substances areused after sexual contact, but as important as these are, other points also demand ourattention. These are inside and outside the houses of prostitution. As a rule, if
disinfection takes place soon after sexual contact, the incidence of disease will diminish.
This is only reasonable. The following shows how these results were demonstrated
in the Dutch Navy.
Time elapsed after intercourse
Incidence of infection-------------------------------------------1 hour
0.08 percent
2 hours
0.55 percent
3 hours
5 hours
7 hours
9 hours
10 hours and over

0.77 percent
1.57 percent
2.17 percent
3.62 percent
7.40 percent
12This clarifies the importance of preventive disinfection following sexual contact. In
the European and American military, disinfection stations are established incommissaries and other locations in cities in the style of public toilets. Also, in somecases they are provided inside military bases and, for the above-stated reason ofdisinfection following sexual contact, I believe they should be provided inside brothelsand even within each room.
Regarding this point, when the Yangjia Japanese Army comfort station opened forbusiness in the spring of 1938, in the vicinity of the former Jungong Road in Shanghai,
its hygiene facilities were ideal.
Disinfection solution at the time was Chameleon Water [potassium permanganate
solution]. I have witnessed how just one location for applying it is provided inside a
brothel, an unsatisfactory situation.
As we have seen, the results of preventive measures have been positively
demonstrated. Results achieved by the U.S. Navy are worthy of our study. Around 1907
disinfection stations were provided at each unit for use on an optional basis. In 1909,
they were provided at numerous locations and their use was enforced. In 1916 adecision was reached that members of the U.S. Navy who were infected with venereal
disease, or those who were hospitalized through their own imprudent behavior, would
not receive pay during the time of their treatment. And the rules for methods ofprevention required that those who did not carry their own portable disinfection kits had
to receive preventive disinfections under the supervision of hygiene corps members
either upon returning to their ship or at a convenient location on the way to the ship.
Through enforcing this method, the number of venereal disease cases dropped from theyear 1910. In addition, in 1917 and 1918, even though it was during the Great War, thenumber of cases declined sharply. This clearly shows the beneficial results of measurestaken by the authorities.
A report by Reid in 1917 showed the incidence of venereal disease among the
garrison at Portsmouth to be 92 per 1,000. Boyden also demonstrated desirable results
using this same system; among 923 men there were no cases of gonorrhea and only one
case of syphilis.
In an example of one army unit in London that used the same system, an incidenceof venereal disease of 95.6 per 1,000 recorded in 1913 was reduced to 35.0 per 1,000 at
the end of 1917. Likewise, among the [British] occupation army in Singapore an
incidence of venereal disease of 15.8 per 1,000 was reduced to 3.4 per 1,000 through theuse of preventive methods.
13And in Italy, Sangiorgi showed how voluntary use of preventive ointments reduced
an incidence rate of 56 per 1,000 in 1906 to 32 per 1,000 in 1923.
These results all show that these methods of prevention are positively effective.
Overconfidence in these measures, however, would be a mistake, and they should notgive rise to a false sense of security.

VIII Handling of Patients
Once a person has contracted venereal disease, thorough treatment should be
administered at the absolutely earliest possible stage of the disease. When I was treating
outpatients at the clearing hospital in Nanjing, patients and hygiene corps
noncommissioned officers frequently requested extra quantities of medicines above theprescribed doses. One of the reasons for this was that men were afraid to report theirsickness to the medical officer attached to their unit. Another reason was that the army
doctors did not like to have medicines consumed in this way for venereal disease
patients in the units under those doctors' supervision. As a result, patients either bought
medicines with their own money or the trend described above manifested itself.
Deciding on a method to treat venereal disease ordinarily presents problems. In thisrespect, there is no other way except to adhere to Medical Directive for Central China
Number 45, as in the past. Also, Medical Directives for Central China Number 5 andDirective of the Surgeon General Number 85 concerning surveys among venereal
disease patients must be strengthened. Organized and statistical methods of observationin each of the above measures are necessary.
In these cases, problems can be expected in regard to the so-called "Privileges ofvenereal-disease-patient soldiers." That is, these men are hospitalized and in a safe place
during battle, Indeed, it is an irritating situation. While their army buddies who are freeof venereal disease and carrying out their duty are exposed to hails of bullets, theinfected make friends with Salvarsan [arsphenamine] and Protargol [silver colloid] andlead an easy life in the hospital. Yet, their daily routine is not beneficial to them. Hecht
proposed that in light cases of infection, and with gonorrhea after symptoms havedisappeared, the men should be sent to the war zone. He stated further that it would not
be difficult to continue injections and treatment while at the front, while Neisser
proposed that men can be treated in the trenches with Salvarsan and mercury, but thiswas not put into actual practice.
Normally one cannon shot in several thousand can be expected to explode in the gun
barrel. As a protective measure a rope is attached to the trigger mechanism during
14

gunnery practice, and this is no problem in actual battlefield conditions. With Salvarsanalso, there is no freedom from risk in one use out of a thousand. But whatever thesituation on the field of battle, there are times when action is demanded of us to avert
problems, and steps must be taken to prevent a deterioration in the fighting strength of
the army.

IX Conclusion
The armies of the world have tested various measures. The opinions of Finger andfourteen other researchers are carried in the records of lectures on skin disorders andvenereal disease issued by army medical groups. They addressed basically the same
issues, and I agree almost completely with their conclusions. However, my belief in thevalidity that each of the measures should be implemented whenever and wherever
possible is at least as firm as the other researchers mentioned. The items addressed
above are listed in the following conclusions.
1. Education in the army concerning venereal disease.
⇒It is essential that this instill an awareness of the true nature of the disease.
2. Education should nurture self-motivation for protective measures.
3. Physical examinations of the genital area.
⇒Special attention should be paid to this during regular monthly physicalExaminations.
4. Limiting of alcohol intake.
⇒As a substitute for alcohol, a better class of recreational facilities is necessary.
Music, moving pictures, books, and physical activities are good. Regarding this, if
methods of presenting 16mm talkies are studied, it should not be too difficult toshow these at different locations near the front lines. I have hopes for theconstruction of army recreational facilities other than brothels.
Through these means, soldiers should be educated into good habits and achieveself-control subconsciously.
5. Fair and accurate syphilis examinations.
⇒It is necessary that brothels and brothel operators also be regulated. Infected
prostitutes must be isolated and treated, For this purpose, specialized hospitals
should be set up within the logistics area. Since some women will have to besent farther to the rear for treatment, the entire organization must be unified.
6. Selection of and enhancing the quality of prostitutes.
15

⇒At the same time, it is necessary to take precautions against unlicensed prostitutes,
and conduct thorough investigations into the sources of communicable diseases.
7. Strict observance of anti-epidemic regulations.
⇒Attaining the objectives set forth in the preceding clauses is dependent uponenhancing military discipline and military anti- epidemic regulations.
From now on, Logistics Headquarters will have to improve its ability to treat
venereal diseases as part of its general anti-epidemic measures, or transfer
part of that function to other hygiene and disease-prevention bodies.
8. Research into all factors presented in this paper, and into the various problems seenfrom different angles in an overall and statistical research, will be of importantvalue in dealing with problems of the future and problems in society.
June 26, 1939
[The following was appended by Dr. Aso on March 18, 1989.]
In this paper, I especially wanted to emphasize recreation facilities other thanbrothels as taken up in Item No.4. This was my first personal request. The atmosphereof Shanghai changed as a logistical area with the exchange of duties from the 101st
Regiment to the 18th Regiment. After that, the soldiers were kept away from music, andthis caused them to chase wild desires. Unbridled sexual acts should be prohibited evenin the war zones.

16