Case LXXIX: Syphilis in Marriage

A married woman learns that her husband is suffering from syphilis. Must and can she continue to live with him as his wife? He declares solemnly that he has not contracted the disease by any fault of his own.

In consequence of the immorality prevalent in large towns, cases of this kind frequently occur, and may have very disastrous results, so that a detailed discussion of the subject seems necessary.

If the husband has contracted this loathsome disease through actual adultery, he has lost all right to the debitum conjugale and consequently the wife may refuse to live with him. This is the doctrine taught by all writers on moral theology and canon law; they base their opinion upon Matth. v, 31, 32, and xix, 9.

In dealing with the case before us, we are not concerned with the details of the adultery, nor with the question whether sodomitic and bestial intercourse have the same effect, and therefore we may set aside these matters.

The man declares that he has contracted syphilis by no fault of his own. Is this statement credible? Physicians are now agreed in believing that people may possibly, though not probably, become infected with syphilis in an innocent manner. Dr. Surbled writes as follows: " The infection can be conveyed directly through the mouth, the breast, or any other part of the body where the mucous membrane is exposed; but there are many indirect ways of becoming infected; for instance, by drinking out of a glass or smoking a pipe used by a sufferer from syphilis, or by wearing his clothes. Midwives are by their occupation exposed to the danger of catching this disease, and so are medical men.... However, it is only in exceptional cases that syphilis is caught in any of these ways, and they do not suffice to overthrow the general theory that " syphilis is a serious disease, brought on by immorality, and, as a rule, only those who voluntarily lead a vicious life display its unpleasant and shameful symptoms." (La morale dans ses rapports avec la medecine, II. 92, 93, ed. 10.) Other physicians write in a very similar way.

We may assume therefore that the husband's assertion is hardly credible, unless he can bring forward some proof of his innocence. If he adheres to his statement, his wife ought not to refuse him the debitum conjugale on the ground that he has probably committed adultery, because his undoubted right to the debitum can not be contested on the ground of what is only a probability. It is true that when a question arises of the loss of the debitum conjugale in a case of adultery, only a moral certainty as to the facts of the case is required, but it can hardly be said to exist here.

There are, moreover, other reasons besides adultery which release any one from the debitum; we may sum them up shortly, and say that the debitum need not be granted if it would result in any considerable injury to mind or body. The moralists teach that a separation from bed and board is allowed where otherwise there would be great danger of sin.

With regard to bodily injuries Berardi writes: "The debt may habitually and reciprocally be refused: (1) If the wife would undergo danger of death in childbirth, so that if she became pregnant again, in the judgment of physicians she would certainly or probably die. (2) If the wife suffered from incipient cancer of the uterus, so that after intercourse she would be subjected to a copious discharge of blood. (3) If she underwent intercourse with very acute pain that recurred each time. (4) If the husband suffered from venereal disease so that he had ulcers or discharges on his genital organs; for then not only the wife herself but also the offspring would be infected in a pitiable manner, with great danger that abortion would follow and baptism itself could not be administered.... (5) If the husband or wife had an organic defect of the heart; for then intercourse is always very harmful and can even produce death suddenly and in the act itself. (6) If husband or wife suffered from pulmonary consumption to such a degree that, continually feverish, they were approaching the final stage of the disease and were already spitting blood" (Praxis Confessar., I. 1042).

Capellmann-Bergmann writes very decidedly on the subject of syphilis: " Syphilis is so serious, disgusting and shameful a disease, that in my opinion the copula ought always to be forbidden, if only one of the conjuges suffers from it. In this disease the danger of the healthy person being infected at the copula is very great, as long as any external symptoms exist. Even when syphilis is latent in the husband, and there are no external symptoms of it, the wife may be infected as soon as impregnation occurs. For the infected person to demand the copula would be a horrible outrage upon the healthy partner, on whose part it would be in my opinion madness, rather than charity, to incur so great a risk of being infected with such a disease. I cannot even regard a periculum incontinentiae as a causa honestas in this matter. I may be thought to speak too strongly, but whoever has seen the awful consequences of this disease will agree with me. I think that there is not a single medical man who would not share my opinion. The consequences to the offspring resulting from such a copula are most disastrous. The children are almost always syphilitic, like their parents, even when in the parents the disease is latent. Abortion and premature births are of common occurrence, and children carried to the full time often die most miserably before they are more than a few months old. Thousands of children are thus called upon to expiate the sins of their fathers, and often die without baptism." (Pastoralmed., 192, ed. 14.)

From the purely medical point of view there may be full justification for these statements, but moral theology requires us to recognize certain distinctions and limitations, which may be summed up as follows:

(1) If one conjux shows symptoms of syphilis, a trustworthy physician must be consulted, and asked to decide whether the syphilis is hereditary or acquired. If the former, the patient is of course not to blame, but the confessor ought, if not actually to insist upon, yet at least urgently to recommend, continence, because hereditary syphilis may be communicated to the offspring of a marriage, although it is not directly infectious.

(2) If syphilis has been acquired after marriage, inquiries must be made to ascertain whether it has been contracted in an innocent or guilty manner. If the latter, the innocent partner has the right to refuse copula carnalis. The same right exists also in the former case, but for another reason. St. Thomas has laid down the principle: Vir tenetur uxori debitum reddere in his quae ad generationem spectant, salva tamen prius personae (propriae) incolumitate (Suppl. qu. 34, art. 1), i.e., if to grant the debitum would involve serious danger to one's own health, it may be refused. Periculum incontinentiae and any quarrels that might resuit from the refusal are not enough to force the innocent partner to grant the debitum conjugale, as they only amount to a necessitas gravis, and no one is bound in such a case to assist his neighbor cum maximo proprio incommodo.

The decretal of Alexander III. (c. 2 X. IV. 8), which is sometimes quoted on the subject, need not be understood to impose such an obligation. It contains the words: But if it should happen that the husband or wife becomes leprous and the sick party demands the carnal debt from the healthy party, what is demanded must be rendered by the general precept of the Apostle; no exception to that precept is found in this case, but at the time when it was issued copula cum leproso was not considered likely to cause the disease in a healthy person. Many medieval writers pointed out this fact when commenting on the decretal. (Cf. S. Thomas, l. c. ad IV, Sanchez, de matrim., lib. IX. disp. 24, n. 17, Cajetan, Victoria, Soto, Ledesma, etc.). Therefore it may be laid down as a general rule that the healthy partner is not bound to grant the debitum conjugale. Certain limits may be assigned to the right to refuse it. There is still a good deal of obscurity with regard to the therapeutics of syphilis; and the disease, after apparently being cured, sometimes breaks out again, but still medical men as a rule believe that the danger of infection ceases after a definite period. Professor E. Lesser (Klin. Wochenschr., No. 23, 1902) says: "The danger of infection is connected with the secondary period, and does not continue more than five years." Consequently the innocent partner is perhaps bound to grant the debitum conjugale, if the other has shown no symptoms of syphilis for a considerable time.

(3) The innocent partner must refuse the debitum if to grant it would cause unjust injury to a third person, and especially to their own children. It frequently happens that there are children requiring education, or aged parents needing support, or that mother and child would both perish if she became pregnant as a result of granting it. In these and similar cases the innocent partner would not be justified in risking infection, as thus an absolute wrong would be inflicted upon others. In my opinion it would objectively be grievously sinful for the mother of little children to grant the copula to a syphilitic husband, as she would expose her children to the danger of becoming orphans, and should she again be pregnant, the child would certainly also suffer from syphilis, and would probably die before its birth, and so be deprived of baptism. It would be absolutely cruel for a mother to treat her children thus. The case is different if from conjugal intercourse the only sufferer is the innocent partner. Under certain circumstances copula might not only be allowed in this case, but might even be very meritorious. For instance, if a good wife has reason to hope that by her self-sacrifice in granting the copula to her disgusting and syphilitic husband she may preserve him from worse evils, or even bring about real amendment of life, it would be a meritorious work to allow conjugal intercourse, and not madness, as Capellmann calls it in the passage quoted above. Her husband is in necessitate gravi spirituali and it is permissible, and even meritorious, to save one's neighbor from such a state, even at the risk of one's own life.

It is, for instance, highly meritorious if a missionary ministers to lepers, although he incurs great danger of infection.

Of course a woman granting the copula under such circumstances would take all possible care, in accordance with medical advice, so as to avoid infection, since it is a duty incumbent upon every man to protect his own health as far as he can.

Several eminent theologians, such as Sanchez, Petrus, Soto and others, teach that in such cases the copula is permissible and meritorious. Cajetan, however, says: If a healthy husband or wife disregards the danger of personal infection from contagion out of love for the spouse, that person is not only excused from sin but, if acting from charity, merits. We see daily in our times (it does not say much for the morality of that period!) spouses not abandoning each other with respect to bed and dwelling because of so great and contagious an evil as the disease commonly called the French disease. (Com. in II. II. qu. 154, art. 1, n. 14.) This malum gallicum was nothing but syphilis.

In practise a confessor ought to be very cautious when such a case comes under his notice, and he ought to express no decided opinion without knowing that of a trustworthy physician.— Dr. Prümmer, OP.