SOME CONSEQUENCES OF IGNORANCE AND SILENCE.—PART I.

When the boy arrives at the age of puberty, he is in greater danger than a girl of being not only led astray by companions, but being actually sent into unclean living by those nearest and most interested in his welfare—HIS PARENTS.

The reason of this is that there has been and still is a false idea clinging to many parents that as soon as the boy has seminal emissions, it is a signal that he must have sexual relations or suffer in health.

That the seminal emissions are not harmful and that they grow less frequent as the boy grows older is a fact of which few mothers seem to be aware.

We cannot blame the mothers of the past for not informing their sons of this physical condition, for few of them knew it themselves. Mothers have been as ignorant as the boys of their sex functions as well as other functions of the body.

They accepted sickness, disease, and even death without a question, placing their faith and confidence entirely in the hands of the medical profession, who, like the rabbis and high priests, made a church of their knowledge.

Fortunately this condition of affairs is changing, and the knowledge of the human body, which for ages has been most carefully locked within the medical libraries, is fast taking up its abode in the homes of the people—where it belongs.

It is said that in Japan or China, the duty of a physician is to keep his patients in good health, receiving payment only when they are well.

Certainly this sounds like civilization.

Only a few weeks ago I had occasion to talk to a woman about her oldest son, whom I considered sick from overwork and lack of nourishment. She informed me, however, that this was not so, and whispered confidently that he was 16 years old and “in that age when he needs a woman.” She further remarked that she and “the papa” had talked it over with the result that the father had told the boy, when he had “the desire for a woman,” that he, the father, “would give him money enough to get one.”

Think of that boy's attitude toward women, and the danger to become affected with venereal diseases that he was likely to contract. Yet both parents had the sincerest wish to do their best for that boy; they gave the best advice they knew.

One of the most common errors I have found among people, even those educated in other lines of thought, is that the sexual organs will become useless unless they are used in early manhood. This is considered untrue by the best authorities on the subject, for it is known that the essential organs of reproduction are glands, not unlike the tear glands of the eyes or the milk glands of the breasts. The tear glands do not atrophy even if one does not cry for years, nor the milk glands during the entire period of reproduction. The same can be said of the sexual glands.

Another idea which is fast being uprooted is that the sexual act is an appetite, not unlike that of hunger and thirst, which must be fed by the boy sowing his “wild oats” first before settling down to marriage. It is now a recognized fact that it is no more necessary for a boy to “sow wild oats” than it is for a girl, and women are today demanding of men the same cleanliness of body and mind which men have heretofore considered necessary only in women.

It is now the unreserved opinion of the foremost medical men of the day that a man does not suffer in health from living a continent life, nor is he a “mollycoddle” from so doing.

Hutchinson says: “The belief that the exercise of the sex functions is necessary to the health of the male at any age is a pure delusion, while before full maturity it is highly injurious.”

Ruggles says: “Sexual abstinence is compatible with perfect health and tends to increase virility (which means manhood) through the reabsorption of the semen.”

The ancient Teutons were aware of this, for it is said that it was considered a most shameful thing for their young men to have sexual relations with a woman before their twenty-sixth year. From observation and experience they were convinced that men were not sexually mature much before this age, and no one will dispute they were strong and manly.

Statistics show that 65 per cent. of men infected with venereal diseases (which means diseases due to sexual intercourse) are contracted between the ages of 15 and 21 years; and 25 per cent. are contracted in the 21st and 23rd years.

Writers claim that from statistics they have found men are not sexually mature before the twenty-fifth year and women not before the twentieth year. Yet we find them both reeking with sexual diseases before this age.

According to Sanger's “History of Prostitution,” it is claimed that three-eighths of the prostitutes enter the life before the twentieth year in New York City. It is safe to say this is a conservative estimate, for the more recent investigations in Chicago and other cities show a very much higher percentage. However, this, together with the statistics of venereal diseases mentioned above, show that it is before the boy and girl are sexually mature that there is the greatest difficulty in directing the impulses and controlling the passions.

Chassaignac says that the more healthy and normal an individual is, the better can he not only control his passions, but the less likely is he to be disturbed by continence.

Just one more word on the subject of continence, and that is that it is not at all unusual to find men determined to remain continent until they find their ideal woman. Nor for athletes in training engaged in contests, nor for sailors on long sea voyages, and many others for long periods of time is continence impossible; in fact, they are better for it.

This knowledge was not lost sight of in ancient times.

Reference is made to it in the Bible, in the sending of women prostitutes into the camps of the enemy the night before an expected battle, in order to exhaust or decrease the vitality of the soldiers.

When one finds an individual who realizes the force of the sexual impulses and knows how to conserve them, you usually find a person who does not drain or exhaust these forces, but uses them in creative work.

Every girl should look upon the man who indulges freely in the sexual relations without Social responsibility, as a prostitute far more degraded than the unfortunate girl who is compelled to sell her body to sustain life.

Every girl should know something about the physical makeup of a boy as well as of her own, for upon the well-being of both does the future race depend. To be a real mother a woman must understand a boy's emotions and development, if she would sympathize with him. And when she does understand, she will not send him to buy a woman for physical satisfaction.

It is this ignorance of parents, together with the silence of the medical profession, which is largely responsible for the terrible spread of venereal diseases which exist today.

When a few years ago Dr. Morrow stated that there is more venereal diseases among innocent, virtuous wives, than among prostitutes, this statement should have resounded throughout the walls of every home in the land, instead of which it is kept intact within the covers of large volumes, where only those wearing cap and gown have access to it.

It is claimed that out of 1,000 married men in New York 800 have gonorrhoea, and 90 per cent. of these have not been cured and can infect their wives. The result is that at least three out of every five married women in New York have gonorrhoea.

This seems astounding and exaggerated, but the following quotation is taken from an authority and is considered quite conservative: “Over 90 per cent. of our young men stray from the path of virtue before marriage; 60 per cent. contract venereal diseases which are difficult to cure; more wives than prostitutes have venereal diseases; one-eighth of all diseases in New York hospitals are venereal; 20,000 infected persons walk the streets daily.”

It seems to me that the above facts are sufficient to warrant every girl and boy knowing something about these diseases.

SOME CONSEQUENCES OF IGNORANCE AND SILENCE.—PART II.

The two venereal diseases which I will tell you something of here are those most commonly known to all—gonorrhoea and syphilis.

Gonorrhoea is an inflammation of the urethra (water passage) characterized by redness, swelling, smarting pain on the passing of water, and accompanied by thick purulent (poisonous) discharge, at first creamy in color, and later a greenish yellow. It is considered by the highest authorities as solely a sexual disease in adults, depending almost exclusively upon sexual intercourse as its mode of origin and infection. In children, however, it is not the rule, especially in infants and little girls, who can be infected by the hands of the mother or nurse being soiled with the discharge, also where the fresh discharge is on towels, toilets, etc. It starts an inflammation of the outer delicate parts but seldom enters the urethra.

In former days gonorrhoea was considered an ordinary catarrhal inflammation, “no worse than a bad cold,” the old saying went. It was thought to originate in women with the discharge at the end of the menstrual period, or leucorrhoea; in fact any secretions from the uterus, of an irritating character, were thought to be sources of gonorrhoea. However, with the discovery of the microbe “gonococcus”, in 1879, by Dr. Neisser, it is now an established fact that the disease comes from a source where there is either latent or chronic gonorrhoea, which, of course, means that the gonococcus is present. It is considered a conservative estimate that at least 50 per cent. of the adult population in this country have suffered from gonococcal infection. More men than women have been and are infected.

The first symptoms of the disease appear from three to seven days after infection, and under proper treatment the discharge may disappear in six or eight weeks.

If the man or woman places himself under the care of a specialist within forty-eight hours after infection, the disease is often of much shorter duration. When allowed to become chronic, it is called gleet. Too much emphasis cannot be put upon the danger of placing any one with this disease into the hands of the doctors who advertise so conspicuously, claiming rapid and complete cures for all sexual diseases. Experience has found that thousands of boys and young men, attracted by such alluring promises as only the quack can put forth, have been under such treatment, only to find later that the disease was allowed to remain in the tissues, the discharge only having been dried up. The germs were allowed to continue their work on up into the bladder, kidneys, joints, heart and even to the brain. The germs can live for years in the body hidden away in the gland ducts, the mucous membrane of the organ first attacked being in a normal state, yet when a condition arises when the vitality of the tissues in which the germs are lodged is lowered, or which gives the germs themselves more nourishment or stimulus, such as alcohol or excessive intercourse, they almost always become active again.

In women the small part of the womb (cervix), as well as the urethra, are favorite places of attack. When the disease attacks the cervix a woman may not be conscious of it, and so, unless prominent symptoms attend it, she may infect many persons in the meantime. In man, on the other hand, the disease cannot be present without his knowing there is something wrong, and it should be impressed upon him that it is a moral obligation on his part not to have sexual relations until he has been examined and pronounced cured by a specialist in genito-urinary diseases.

Your general practitioner will always recommend to you a specialist if you ask him to. When the disease attacks the uterus and ovaries it very often blocks the fallopian tubes and prevents the impregnation of the ovum. It is said that over one-third of the childless marriages are due to gonorrhoea in women, innocently contracted from their husbands. Both men and women can become sterile from this disease. The seminal tubes in the man become blocked, thus disabling him from impregnating the ovum.

Again, when the disease attacks the organs of generation, unless speedily attended to, the organs get into a chronic state of inflammation. The disease is, therefore, more difficult to reach, the chances of cure more difficult, and it usually means an operation for the woman.

The great mass of ailing women who trace their misery back to never seeing a well day since marriage, can be classed among those suffering with this disease, as can also that army of women whose illness is classed among “female disorders.”

A curious point to know is that a man may have a hidden or latent gonorrhoea, of which he is not aware, for it gives him no trouble, and may infect a clean, healthy woman during sexual relations, and she in turn, can infect him with the same disease, acting like a fresh infection, giving rise to pain and discomfort. The great majority of infections in women are contracted from men who believe themselves cured, being under the false impression that they are cured because the discharge has ceased.

At a lecture given by a well-known physician in this city last winter, the physician advised every girl whose sweetheart, lover or expected husband had a history of inflammatory rheumatism of the joints, back of him, that as she values her life and future health, not to marry that man without a thorough examination by a specialist in these diseases. He declared: No young man should have inflammatory rheumatism. This statement is considered somewhat exaggerated by some making more recent investigations, yet all seem to agree that a very large majority of cases of inflammatory rheumatism of the joints have the gonococcus present.

If the woman is not made sterile by the disease and is able to carry the child to full term labor, then there is another danger of infecting the child's eyes during the process of labor, when the secretions lodge themselves into the delicate membrane of the eyes. Then, unless quick action is applied, the sight of both eyes can be lost. Over 80 per cent. of blindness in babies is due to this germ. It can be carried into the eyes of both children and adults by any means which can carry the discharge to the eyes. Upon the slightest suspicion that this has been done, medical aid should be summoned at once.

There is one fortunate thing to know, that the germ cannot live for a great length of time outside its natural or proper environment, though it can for years be hidden in the body. It dries up very quickly, and special solutions of both bichloride and permanganate of potash will kill the germs with which the solution comes in contact. There is but one course to follow, that upon any of the symptoms mentioned above, go at once to a reliable physician and follow his instructions closely. And remember that the causes which retard recovery are alcoholic drinks, lack of rest, spicy food and sexual excitement. It is said there is no positive proof against this disease, except continency until marriage and then monogamy.

A story is told of a young Irish physician, who, being asked how he treated gonorrhoea, replied most tersely, “with contimpt.” That this was for a time a general feeling is agreed, but with the knowledge that so many persons, especially women, contract the disease, under the moral, as well as legal, conditions of present society, the feeling has changed. A woman is infected by her husband after the marriage is sanctioned by the state and blessed by the church, neither taking the interest in the woman's future to guarantee to her a clean individual as a husband. Prostitution has been upheld and women segregated for man's sexual use, the government going to the extent of authorizing examinations of the women for venereal diseases to insure man's safety from these diseases. Yet there has been no such protection given either the woman prostitute or the wife that the man's body is free from them. On the other hand, every means to keep a married woman in ignorance of the source of her infection is made by the church, state and society in general. Every law to protect the man's crime is made for his use, while women remain unprotected victims of his guilt. And this, they say, is “to protect the family and the home.”

Dr. James S. Wood tells a story of his experience With a young woman of 25, married five years, when she came to him. The husband admitted having had gonorrhoea previous to marriage. The doctor found her flowing excessively, the cervix badly torn, the uterus sharply bent back and fixed, ovaries bound down and adherent, the tubes thickened; a leuchorreal discharge was present which contained gonococci, and other symptoms which made her sick and miserable. The doctor operated upon her, scraping her womb, sewing the torn cervix, opening the abdomen to remove the thickened appendix and inflamed ovaries and tubes. She convalesced beautifully, and had no bad or unusual symptoms for six months, at which time she returned with a renewed infection. Careful questioning extracted from the husband the confession that he had been “out with the boys,” and had had a recurrence of gonorrhoea. Most of the good which came from the operation was spoiled by this second infection.

This is only one simple example of what is meant by preserving the home and family at the terrible cost of women's lives. Women should protest against the so-called medical secret which decrees that they be kept in ignorance where their health, as well as life, is directly concerned. That there are men in the medical profession in this country, as well as in Europe, who have openly protested against respecting the secret where another life is involved, seems a cheerful signal of a general social awakening in this field.

In the Medical Record, April 20, 1912, Maude Glasgow says: “After suffering for years a woman becomes a feeble, worn-out, nervous woman; her life is a burden The operating table is her only hope, and she leaves it deformed, mutilated and sexless.”

If women voluntarily exposed themselves to diseases which would sap the husband's vitality, making him a dependent invalid, or expose him to the shock of a mutilating operation, or death—would men continue to suffer? Would they allow the medical secret to protect women in this alleged “freedom”? Every girl knows he would neither protect her nor continue to suffer. It is women only who have allowed the double standard of morals to stand so long, giving men the purest and best of their womanhood, but not demanding the same from them. As soon as women realize the danger to themselves and their children which they are likely to incur from men who have lived promiscuously, they will revolt against such standards.

Gonorrhoea differs from syphilis, and though it is not a disease which can be transmitted from the parent to children, as syphilis can, yet it is a subtle, wrecking disease and can do almost as much harm to the individual.

[From New York Call, after temporary suppression of article, “What Every Girl Should Know,” by the postal authorities.]

SOME CONSEQUENCES OF IGNORANCE AND SILENCE.—PART III.

Prominent medical authorities claim that syphilis was not known in Europe before the discovery of America. Others equally as prominent hold that it has existed for many centuries in Europe, but was confused with other diseases such as leprosy. It makes little difference to the girl or boy today just how long or where it came from; the point we do know is that it is here in our homes and workshops, and we should know what it is like and how to avoid it.

A story is told of a French nobleman whose son was about to leave his home to live in a big city. Said the father to the son: “If you are not afraid of God, fear at least syphilis.” This advice might be applied today, for if boys or girls knew, or could see the appalling results of syphilis, they would surely fear it, for it is humanity's most deadly foe.

Syphilis is an infectious disease, caused by a special microbe which is acquired by contagion or heredity.

It is chronic in course, varied and intermittent in character, and the length of time it remains in the body is indefinite.

It is so widespread that no country in the world is free from it, neither is any organ of the body exempt from its ravages.

Let us take a young man indulging in promiscuous sexual intercourse, who cohabits with a syphilitic woman. He notices nothing wrong for about five weeks, when he becomes aware of a pimple on the sexual organs, to which perhaps he pays little attention. This grows and becomes hard at the base and is ulcerated on the top.

About ten days after the appearance of the ulcer (or chancre) the boy notices that the glands of the groins begin to swell, but as there is little or no pain attached he still pays no attention to all this.

After three, or sometimes four weeks the ulcerated opening heals, but leaves the hard lump under the skin. In two or even three months after the time of infection the first general symptoms appear. His bones ache, he is mentally depressed, slightly feverish at night, and a rash appears upon his body and sore spots in the mouth; and throat. These symptoms usually decide him to consult a doctor, who finds him in the second stage of syphilis. This condition lasts usually about two and one-half years, the rash often lasting a short period, and leaving, but to return again.

The blood within and the ulcers on the body contain the poisons of the disease, and for three or four years the poison can be transmitted by contagion, or by heredity.

The third stage is the most destructive, especially to the nervous system, for this disease is recognized as the greatest factor in organic disturbances of the nervous system.

It not rarely is the cause of cerebral and spinal meningitis, paralysis of the legs, paralysis of one side of the body, and that most helpless and terrible disease, softening of the brain and many other diseases which affect the spinal cord, which are seldom ever cured. The majority of those diseased are left with physical or mental infirmities, rendering them public charges.

There have been cases where the third stage did not develop, and as this stage is not distinctly separated from the second stage by a definite line, it may not take place for months, or even years after the first sore appeared. Again, this stage has been averted by careful treatment in the early stages, and it is here the hope of all afflicted lies.

Every case of syphilis begins with the characteristic pimple or chancre, except inherited syphilis. The chancre always appears where the infection enters, and the glands swell in the same vicinity. For instance, if in using a pipe of a syphilitic, whose mouth contains the sore patches, the victim finds the chancre will appear on his lips, mouth or throat, and the glands of the neck will swell.

It is said that almost 10 per cent. of the infections are contracted innocently, especially in European countries, where kissing and other forms of endearment are much indulged in. In this country it is not so common, but more women than men contract it innocently and in this manner.

In women, too, the first symptoms are not so characteristic as in men. She may pay no attention to the chancre for a month, even if she does feel aches in the bones, she thinks she is run down, or thinks she has malaria; even the rash does not alarm her, and often only repeated miscarriages will be the only symptoms she can remember of the early stages. She may continue for years before the disease reaches the third stage. This is not always so, for in every individual the disease differs in character and duration.

Gonorrhoea and syphilis differ in many ways. For instance, the former shows itself in a week or ten days after infection, where syphilis shows no signs for five or six weeks.

Gonorrhoea is considered a purely sexual disease, because infection takes place only in sexual relations (except where the germ gets into the eyes), while syphilis can be contracted in many other ways, through forks, spoons, glasses or cups, towels, sponges, bathtubs, toilets, pipes, dental and barbers' instruments, and kissing.

Gonorrhoea is considered a social danger because of its effect upon the sexual organs, often rendering them sterile. Syphilis is also a social danger, but it has direct effect upon the offspring, and upon future generations because its effects are visited upon the child.

Sixty to eighty per cent. of the syphilitic offspring die at birth or in early infancy. Someone has well said, “The greatest criminal is he who poisons the germ cells.”

In hereditary syphilis there is more difficulty in gathering facts, for the laws which control it are not so well understood, as yet.

There is no sore or chancre in hereditary syphilis, but other symptoms appear which every physician recognizes and of course attends to at birth.

Under proper treatment the danger of the father transmitting the disease to the child should cease in from two to five years, while the danger of the mother transmitting it to her offspring does not end at any definite time, for there have been mothers known to give birth to syphilitic offspring years after all disappearance of their own symptoms.

The strongest features of the disease transmitted to the offspring are the deformities which it imparts to the bones of the head as well as of the body.

It is said on good authority that if a patient, at the end of five years, has been two years without symptoms or treatment, he may be guaranteed for marriage. Though he can never be wholly guaranteed from relapses in his own person. These, however, are considered noninfectious.

The cure of the disease depends upon the individual's environment, constitution and his habits, chiefly as regards alcohol and tobacco.

Alcohol is considered the commonest and most active enemy of the patient's recovery. Men addicted to the use of alcohol are the most difficult to cure.

There seems to be no doubt that if the disease receives the proper treatment there is every hope for the individual to live a normal life. Fouriner, a French authority, says:

“Personally I could cite several hundred observations concerning syphilitic subjects who, after undergoing thorough treatment, have married and became fathers of healthy, good-looking children.” The question, then, to receive some attention is what means are available for the treatment of both syphilis and gonorrhoea.

Dr. Prince A. Morrow says: “Prompt curative treatment is not only in the interests of the patients themselves, but especially in the interests of the others they might infect. But everywhere we are confronted with this situation: There are no special hospitals for this class of diseases; few general hospitals receive them in the early, curable stage; still fewer have special venereal wards; even the dispensary services are not organized with special adaption to the needs of venereal cases; few have night classes, so that working people who go to the dispensary must lose half a day, which often means the sacrifice of their employment. As a consequence they resort to quacks or the use of nostrums (secret or quack medicines). They are not cured, but go on spreading the seeds of contagion.”

This is the condition as far as hospitals are concerned in the matter of venereal diseases. And in relation to private practice the average person's position is still more deplorable. Take, for example, the story of a girl who came under my care some years ago, after having suffered three years with the disease. She had been refused attendance in public hospitals in three different cities while she was working her way to New York. At different times she consulted physicians, only to learn that to be cured she must be treated regularly, and to be so treated would require money. Different estimates were quoted from $150 to $500 for treatment. As the amount of money left over after she had paid her expenses each week was never over $2, the possibility of a cure looked hopeless. She concluded to purchase patent medicines whenever she could, but her condition became worse, until she was picked up by a charitable organization, who cared for her until she died. When I saw her all her hair, eyebrows and eyelashes were gone, her nose and upper lip were almost entirely eaten away, most of her teeth were gone—in fact, to try to describe her condition would be almost impossible.

This is only one case, but there are thousands of syphilitics who are wandering around unable to pay the prices which the physician asks to treat this disease. The same can be said of gonorrhoea, and the same physician who clamors against the prices of the so-called quack, forgets that the price he asks of the public is exorbitant in the extreme. So the only course for the individual to take, if he cannot pay the price, is to remain a menace to society. The physician assumes no responsibility toward society to find out if the patient is under treatment elsewhere; the patient can do as he pleases with his disease when he closes the doctor's door. This, then is the situation as regards society's attitude toward the venereal subject: Society seems to take a different attitude towards other contagious and infectious diseases, such as measles, chicken pox, diphtheria, etc. In these diseases, a physician has some responsibility toward society; he must report each case as it comes to his attention, to the Board of Health, who in turn assume some responsibility by isolating the disease.

If this is necessary in these comparatively simple diseases, how much more important should it be to register and isolate patients suffering from the venereal diseases.