BUILDING OUR BOYS

A Word to Parents.—Within recent times the subject of sex hygiene has been freely discussed by members of the medical profession and through them the general public has been made more or less acquainted with the problem. It has therefore acquired a degree of genuine interest which speaks well for the future of the eugenic ideal. Eugenics is based to a very large extent upon the principles underlying sex hygiene.

As a result of this widespread interest and investigation, we have discovered that the only method that promises actual progress, is to talk plainly and to tell the actual truth. The day of the prude has passed. To attempt to achieve results in the education of youth in sex problems, without giving, facts, is wasted effort. To give facts we must explain each problem so that its principles may be clearly understood and its meaning grasped. To point out the duty of youth is not sufficient. They must be shown why it is to their best interest to live the clean life. In every department of education we are beginning to appreciate that to achieve results it must be based upon the individual equation. This is why we have found it necessary to assert that it is the duty of parents to make sex hygiene a personal matter and to acquaint their children with the facts relating to this problem. It has been discovered, however, that a very large percentage of parents are inadequately informed on these subjects, in fact they know practically nothing about the actual facts which they are supposed to teach. I shall try to tell the story in a way which every parent will understand.

When a boy reaches the age of puberty he is susceptible to sexual desire. If he has not been told the story of his growth from boyhood to man's estate he will either begin to abuse himself, or he will be later enticed to commit himself to intercourse with some unclean female and he will acquire a disease as a result.

Inasmuch as it has been asserted that practically every boy has been addicted to self-abuse at some time, and that eighty per cent. of all males, between the ages of sixteen and thirty years, are victims of venereal disease, it would seem justifiable to assume that the boys who are informed of the facts in time are the boys who constitute the percentage who escape. This, of course, may not be literally true, but it is a reasonable assumption.

While self-abuse is a pernicious habit and may be attended with serious consequences, it is not a disease and, as will be explained later, it can be cured. It is therefore a menace to the individual, not to the race, and consequently need not concern us at the present time. On the other hand the venereal diseases are not to be considered as individual problems since they affect the welfare of the race. The venereal diseases which we will consider are gonorrhea and syphilis.

The Social Evil.—It has been estimated that there are more than ten millions of people in this country to-day suffering from the effects of venereal diseases. In New York city alone, there are two million victims suffering from the direct or indirect consequences of these diseases. It has been authoritatively asserted that, out of every ten men between the ages of sixteen and thirty, eight have, or have had, one or other of these diseases. When it is remembered that these diseases are not merely temporary incidents, but that they may be regarded as practically incurable in the vast majority, because of antagonistic social conditions and ignorance, and that they are highly infectious, we may begin to realize how important they are from the standpoint of race regeneration.

Statistics of these conditions are never reliable because much of the evil is hidden and lied about. It is quite probable,—if the estimates were based upon absolute knowledge—that the extent of the prevalency of these diseases would be greatly increased rather than reduced. It is however a fact, that the combined ravages of the Great White Plague, leprosy, yellow fever, and small-pox, are merely incidents compared to the effects which the venereal diseases have had upon mankind. It is useless to think that these diseases can be driven out of the land. Any hope of this nature is the impression of the dreamer. By a propaganda of education, by the spread of the eugenic idea and ideal, we may, however, reasonably hope to minimize the evil and, at least, to protect the innocent.

The Sources of Immorality.—It is a fallacious idea to assume that the sources of immorality are confined to the large cities. This is far from the truth. In smaller towns and country places the diseases are quite common and conditions there tend to the spread of the contagion in a more intimate and a more harmful way. The individuals who are most likely to become affected are those most liable to succumb to temptation and whose home ties are of the best. There are many instances on record where one or two loose women spread the infection all over the country communities, infecting boys and men alike. No one can estimate what the final effect of such an epidemic may mean or how many innocent individuals may have their lives wrecked as a direct consequence. It is because these consequences are the product of ignorance in a very large percentage of the cases that there is such urgent need for enlightenment. It is at least our plain duty to tell the boy the actual facts—to post him with reference to consequences. The more thoroughly we instruct him in the elementary facts relative to the venereal diseases, the safer he will be from temptation, and if he possesses this knowledge and acquires disease, he will be more likely to immediately seek competent aid and advice.

WHAT ARE THE CONSEQUENCES OF VENEREAL DISEASE TO THE BOY HIMSELF?

Gonorrhea or "Clap."—This is the most frequent of the venereal diseases. It is also the most serious. It is an unfortunate fact, that in the past,—and even to-day—boys have been told that gonorrhea is no worse than "a bad cold." This lie has been responsible for much evil and a great amount of unnecessary suffering and misery.

Gonorrhea is caused by a germ, obtained, as a rule, during intercourse with an infected person. This germ is called gonococcus. It thrives on any mucous membrane; it is not, therefore, limited to the sexual organs. For this reason it may attack any part of the body where mucous membrane is. It is particularly liable to damage, sometimes seriously and permanently, the eye. It may be spread from one person to another, or from any infected article to a person in numerous ways. The innocent may thus suffer as a result of the carelessness of the vicious.

The Symptoms of Gonorrhea in the Male are slight itching and burning of the mouth of the urethra. This is noticeable at any time from the third to the fourteenth day after exposure. These symptoms become more pronounced and a slight discharge appears. The patient is compelled to urinate frequently and it is painful and difficult. The discharge increases, it becomes thicker and looks like ordinary yellow pus. If the case is a severe one, the discharge may be blood stained, and if this symptom is present urination is more painful and more frequent.

In about ten days the disease reaches its height; it remains stationary for a number of weeks and then slowly, seemingly, gets better. The discharge grows thinner, less in quantity and lighter in color. It may refuse, despite the most careful and efficient treatment, to stop altogether; it is then known as "gleet." If the discharge stops completely the patient is apparently cured, as far as any external manifestation of the disease is concerned. In seventy-five per cent. of the cases, however, this apparent cure is no cure at all, as will be seen later.

Certain complications are likely to arise in the course of gonorrhea. The infection itself may be of such an acute or virulent type, that it invades the deeper structures of its own accord and despite the most careful, competent treatment; or if the treatment is not adequate or skillful it may be forced backward; or through neglect in not beginning the right kind of treatment in times, a simple infection may grow in degree into a serious disease, and invade the more important structures. In this way are produced disease of the bladder, prostate gland, seminal vesicles, testicles, and of the kidneys. Gonorrheal rheumatism may follow, and even disease of the lining membrane of the heart, and death.

When disease of the deeper parts occur the patient is frequently incapacitated and compelled to go to bed. He may have chills, fever and sweats, intense pain and the passage of bloody urine. He may have to be operated upon, and his general health may be permanently wrecked. So long as the germs are present there is danger despite the most scientific treatment. It is not the quality of the treatment that is at fault, it is the presence of the germs; and since it is impossible to pursue any certain method of eradication, we must continue treatment—as long as the germs are present—and hope for favorable results. The infection may last for many years. The germs having found entrance into the small tubes in the interior organs they can only be dislodged with difficulty, if at all. These pockets of germs may be excited to renewed activity by sexual intercourse, or by injury to the parts, and may reinfect the patient at any times. In a very considerable number of these cases where the deeper structures are involved, the patient may recover from the acute or painful period of the disease, only to find that he is sterile. There are many such cases, and the most vindictive individual who may believe that every who sins should be punished will admit that sterility, as the price of a moment's forgetfulness, is a terrible fee to pay.

Syphilis, or the "Pox," is an infectious, germ blood disease. It is most frequently acquired through sexual intercourse.

It may be acquired by direct contact with a diseased person. In order to render such contact effective, it is essential that the skin of the healthy person be abraded, or the contact may be directly on a mucous membrane, as the mouth in the act of kissing.

It may be acquired by using any article which has been used by a syphilitic, as a drinking cup, or towel.

It may be acquired through hereditary transmission.

Surgeons frequently contract syphilis while operating on, or examining patients who have the disease. Dentists may convey it by means of instruments which have not been rendered aseptic, or thoroughly clean. Using a towel which has been used by a syphilitic has many times conveyed the infection to an innocent party. For this reason the roller towel has been done away with, and some states have legislated against its use in hotels and other public places. To use dishes, spoons, tobacco pipe, beer glasses, etc., which have been used by one having the disease is an absolutely certain way of being infected. Cigars which may have been made by a syphilitic will infect whoever smokes them with the virus of the disease. Syphilis has been known to have been caught from using the church communion cup. The public drinking-cup has been a prolific source of syphilitic dissemination to innocents. Legislators are just waking up to the danger that lurks in this institution and it will no doubt be done away with, not only in public places, but on all railroad and steamboat lines.

An infected mother can transmit syphilis to her child. If the father is affected, but not the wife, the child may escape.

Syphilis attacks every organ in the human body. The actual degree of infection has no relation to the size or character of the external manifestations. The external evidence may be minute and insignificant, while the internal extent and ravages of the disease may be tremendous and of large proportions. Many men when asked regarding incidents of the long ago, may state, "Oh, yes, I had a chancre twenty-five years ago, but it was a very small affair and soon healed up and was cured." Yet that same little chancre, that made only a mild impression on the man's mind, may, and most probably will, be the direct cause of that man's death.

It is not possible to tell with absolute certainty that an individual is suffering with syphilis by any known test. The most recent one—the Wassermann test—is not absolute by any means.

The first symptoms, or what is known as the initial lesion of syphilis, is the chancre.

The Chancre is a small, hard tumor, or it may be a small ulcer with a hard base, or it may simply appear as a thin small patch on any mucous membrane. It is not painful, it can be moved if taken between the fingers, showing it is not attached to the deep structures, and when it is so moved it is not tender or sore. Any little lump which ulcerates located on the genitals must be regarded with suspicion. Boys and men should not be satisfied with any offhand statement that, "it is nothing." It may be a chancre, and it may be exceedingly serious if not properly diagnosed.

Systemic, or constitutional symptoms, begin to show themselves any time from the sixth to the tenth week after the appearance of the chancre.

Eruptions of the Skin characterize every case of syphilis. They occur in all degrees from the mild rash to the foul ulcer. The ulcerative process is very often extensive and loathsome.

Mucous Patches and Ulcers affect the mucous membranes. The mouth and throat are favorite locations for these lesions. They occur in the anus and rectum, and may be mistaken in that region for other serious conditions. Men who drink and smoke suffer as a rule severely from mucous patches in the mouth and throat.

Syphilis attacks the blood vessels and the lymphatic glands. These cases may have been unrecognized, and may have existed for many years. A man may die from a rupture of a blood vessel in the brain during middle life as a consequence of a forgotten, supposedly cured case of syphilis many years before.

The Interior Organs may be attacked by syphilis. As a result we get disease of the liver, heart, stomach, kidneys, lungs, and other parts. It has been suggested that many diseases affecting these organs, for which treatment proves unsatisfactory, may have had their origin in a former syphilis.

The Brain and Spinal Cord are quite often the seat of syphilitic affections. A tumor, known by the name of "gumma," is the result. The blood vessels of the entire nervous system may be affected and, as a consequence, we often see cases of paralysis, apoplexy, epilepsy, locomotor ataxia and death.

The Nose, Eye, Ear, Throat, are frequently very seriously compromised as a result of the syphilitic poison. Deformity, caused by rotting of the bones of these parts is not infrequent. Loss of voice, or smell, or hearing, or sight, may result.

The Hair and Nails may fall out. The bones may ulcerate and rot. The organs of procreation usually participate in the degenerative process. Virility is destroyed, and impotence is quite common after a severe attack.

WHAT THE BOY WITH VENEREAL DISEASE MAY CAUSE IN OTHERS

Gonorrhea.—When the average boy acquires gonorrhea he frequently does not know, for many weeks, that he is the victim of a dangerous, infectious disease. He appreciates probably, that it relates to the sexual indiscretion he was guilty of, and feels that it is something to be ashamed of. He therefore hides his condition, confides in no one, and blindly hopes it will get better somehow or at some time. Meantime the disease, which may have been mild at the beginning, is gradually gaining ground and strength, and his neglect may eventuate in lifelong misery. No means are taken to guard against spreading the infection, the discharge may lodge on his fingers and he may infect his eyes and may lose his sight because he did not know that the discharge is one of the most dangerous fluids known. It may get on water-closet seats and infect others. Eventually he is compelled to seek aid, and he may, after a long period, be freed from the immediate consequences of his folly. At a later date he marries, and as previously explained, he infects his wife. This is the beginning of much of the domestic infelicity that is so prevalent to-day, and, inasmuch as it is a subject that should be thoroughly understood by every woman and mother, I shall carefully and clearly explain its significance and its consequences.

Let us first, however, briefly consider what may occur to others if the boy is unfortunate enough to acquire syphilis. Again the boy fails to comprehend the nature of his affliction. There is imminent danger of the members of his household becoming infected. He uses the same dishes, spoons, towels, and utensils, any one of which may convey the disease to his father, mother, sister, or brother. He may use the common drinking glass in school, college, or office, and spread the disease in this way. He may kiss any member of his family, or a baby, and infect them. He may have his hair cut, or be shaved, and the virus may be spread around in this way if the barber does not sterilize the article used,—which he never does. He may drink at a soda fountain, or at a saloon, and the next individual to use the same glass may acquire the disease. He is a menace to the individual, to the community, and to the race. Wives often acquire syphilis from their husbands.

The Infected Wife.—It has been previously stated that eight out of every ten males between the ages of sixteen and thirty, have had or have, gonorrhea or syphilis. Seventy-five per cent. of these cases have not been cured. About thirty-five per cent. of these are destined to infect wife, or wife and children, and in all probability many others.

If a young wife acquires infection from her husband, she is exactly in the same condition as the diseased boy,—she does not know what ails her, so she wastes precious time in unprofitable worry. Why should she know what the trouble is? She came to the marriage bed pure, and clean, and healthy. Her previous education did not include instruction which would even help her to guess what the trouble might be. She is simply conscious of new distressing conditions which she does not understand. She may try to believe that these conditions are incidental to the change in her life. Shortly, however, the discharge, which she has had for a number of weeks, and which she thought was only a leucorrhea, or "the whites," becomes so profuse and nasty that she begins douching. This procedure simply blinds her to the true nature of the affection, and in the end she is driven, ashamed and reluctant, to consult a physician. She may be informed that her condition is bad, and that it will be necessary that she submit to a course of treatment. After a time the physician may succeed in tiding her over the immediate consequences of the gonorrheal infection she innocently acquired. She may soon after become pregnant, and she may miscarry as a result of the old trouble, or she may carry the child the full period. When the child is born it may be blind and this defect is a consequence of the old infection to the mother from the father. If the mother is syphilitic the child most likely will inherit all the horrible possibilities of transmitted blood-poison.

Pregnancy frequently "lights up" any old, gonorrheal infection in the female, so this young wife fails to completely recover after the confinement. She is able to be about, but her strength refuses to be restored. It may be months later when she begins to suffer pain and to realize that she is quite sick. She develops a fever and may have a chill. The physician discovers that she has pus in her tubes and there is danger of peritonitis or general blood poisoning. The old germs have been roused and are active. Unfortunately they are located where it is impossible to dislodge them without resorting to a serious operation. It is now a problem of saving her life. She is taken to the hospital and her womb, tubes, and ovaries, are removed—she is unsexed.

Young wives are being operated on every day, in every city in the civilized world for just such causes. It is a notorious fact, that, in every city in the world, the number of operations that are daily being performed on women, is increasing appallingly. Every surgeon knows that eighty per cent. of these operations are caused, directly or indirectly, by these diseases, and in almost every case in married women, they are obtained innocently from their own husbands. It is rare to find a married woman who is not suffering from some ovarian or uterine trouble, or some obscure nervous condition, which is not amenable to the ordinary remedies, and a very large percentage of these cases are primarily caused by infection obtained in the same way.

When a girl marries she does not know what fate has in store for her, nor is there any possible way of knowing, under the present marriage system. If she begets a sickly, puny child,—assuming she herself has providentially escaped immediate disease,—she devotes all her mother love and devotion to her child, but she is fighting a hopeless fight as I previously explained when I stated that one-half of the total effort of one-third of the race, is expended in combating conditions against which no successful effort is possible. Even her prayers are futile, because the wrong is implanted in the constitution of the child and the remedy is beyond her power to find. These are the tragedies of life, which no words may adequately describe, and compared to which the incidental troubles of the world at large are as nothing.

If the conditions are not as bad as those depicted above, the original infection may have rendered her sterile. If the germs reached the womb and tubes, the inflammatory process may close these tubes, with the result that conception is impossible. In these cases the woman has to bear the stigma and disgrace of a childless union, though she is not the guilty party. Many husbands are sterile, however, as a result of venereal disease. It is claimed that eighty per cent. of childless marriages are caused by sterility of the male partner. Curiously and unfortunately these men never suspect themselves. The wife is the delinquent member, in their estimation. She is the victim of jest and suspicion, and later of jibes and insults. Many women have had their lives rendered miserable and unhappy because of this suspicion. They are compelled by their husbands to submit to examination and unpleasant and painful treatment and operations with the intention of rectifying a defective condition that does not exist. Many conscientious physicians refuse to treat women patients against whom the charge of sterility is made, before subjecting the husbands to thorough examination, and, since eighty per cent. of childless marriages are due to sterility in the male, this is a just and reasonable course to pursue.

During the course of all this domestic trouble and tragedy, the young wife's health has suffered—she scarcely enjoys one day of good health. Her mental condition is even worse. She submits to innuendo and insult under the impression that she is the unwitting cause of all the domestic wretchedness and often wishes she had never entered the marriage state. We must remember that these conditions wreck ideals and homes, and that they frequently render inefficient both husband and wife. The economic business of marriage becomes a failure, ambition is crushed and hope dies in the heart.

If the mother has been inoculated with the virus of syphilis her existence is equally wretched; her health is ruined; her efficiency is forever mortgaged. If she becomes pregnant she will most likely abort and she will go on aborting for years, in the effort to bring children into the home, accusing herself meantime and submitting to the reflections which are heaped upon her, while the real culprit is the husband. He assumes an injured and innocent attitude and behaves as if he had been imposed upon by marriage with a woman who cannot carry out her marital contract.

If she gives birth to a child or children, they are syphilitic. They may be deformed, or they may be feeble-minded or idiots. They may live at home for years, always ailing, always sick. They may develop epilepsy, St. Vitus' dance, skin disease, or mental vagaries, and they may have to be put into institutions for the feeble-minded, or they may die by inches at home.

Is the Husband to Blame?—If a boy had gonorrhea a number of years before entering the marriage state, was treated for it by a physician, until all symptoms had disappeared and had enjoyed apparent good health in the interim, and had never been told any of the facts regarding probable consequences, is it just to blame him if he infects his wife? It is certain no man would willingly subject his bride to the risk of infection, with all its horrible consequences. These conditions exist as a result of the prudish attitude of society in the past toward all questions affecting sex hygiene. We have not told all the truth to the boy. Whatever knowledge he may have had was gained from companions, or from individuals who knew the garbled facts only. There is of course no excuse for the man who acquires disease after marriage and conveys it to his wife or children. This is a very different situation and one which should merit the severest condemnation and punishment. We are, however, only interested in the boy at present and will not take up the reader's time with a discussion of the "social evil" from this standpoint.

Building a Man.—When the boy is about fifteen years of age certain changes begin to manifest themselves. He grows more rapidly, a growth in which his whole system participates. His bones grow bigger and stronger, his muscles increase in size, even his heart, and lungs, and liver, and his digestive system accommodate themselves to this transformation; the voice changes and hair begins to grow on his face. The mental process also keeps pace with the new order of things. He thinks differently and he sees from a new viewpoint. Nature is making a man out of a boy.

These changes were not understood in the past, but we are beginning to appreciate the reason for this evolutionary process. We have discovered that the cause depends upon certain active changes which take place in the sex organs. About this time the testicles begin to be active. For years these glands have been preparing themselves for this work, so they first grow rapidly, increasing in size until they are about eight times bigger than they were before this time, then they begin to pour into the circulation a secretion which stimulates changes in all other parts of the body and is directly responsible for the wonderful change that is evident in the stature of the boy's body.

This substance or "internal secretion" must not be confused with the semen. The internal secretion is simply the substance which nature employs in the developing process and is responsible for the degree of growth and quality of manhood which the boy manifests. The semen, on the other hand, is the procreative or fertilizing fluid which enables a man to beget offspring. When a boy understands this process it aids him in appreciating the importance of his sex organs and a little thought enables him to understand that if he abuses these organs he will seriously interfere with his own development. This process goes on for a number of years, until the boy reaches maturity. Any act or habit which weakens the quality of this secretion will deplete his powers and render him physically and mentally inefficient. To make a man, nature must be permitted to work in her own way. You cannot improve on her methods nor can you break her laws with impunity.