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Title: Sex problems of man in health and disease
        a popular study in sex knowledge

Author: Moses Scholtz

Release date: October 10, 2024 [eBook #74554]

Language: English

Original publication: United States: Stewart & Kidd Company

Credits: Richard Tonsing, Donald Cummings and the Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive/American Libraries.)


*** START OF THE PROJECT GUTENBERG EBOOK SEX PROBLEMS OF MAN IN HEALTH AND DISEASE ***





               SEX PROBLEMS OF MAN IN HEALTH AND DISEASE
                    A Popular Study in Sex Knowledge


                                   _By_
                          MOSES SCHOLTZ, M. D.,

 _Chief of Clinic and Clinical Instructor in Dermatology and Syphilology,
 Medical Department University of Cincinnati; Fellow of American Medical
 Association, Ohio State Medical Society, Medical Academy of Cincinnati,
             Society of Moral and Sanitary Prophylaxis, etc._

[Illustration: [❦]]

                              CINCINNATI:
                         STEWART & KIDD COMPANY
                                  1916




                          COPYRIGHT, 1916, BY
                          MOSES SCHOLTZ, M. D.

                         _All Rights Reserved_

                          COPYRIGHT IN ENGLAND




                                PREFACE


The scourge of the social evil and its baneful and disintegrating
influences on the moral and physical structure of modern society has
come to be recognized more and more by the public opinion as one of the
most burning social problems of to-day. A new battle cry of social
purity and conservation of manhood and womanhood has resounded on the
battlefield of social endeavor, and a new crusade, under the banner of a
young but vigorous movement of eugenics, has been started for a morally
pure and physically strong young generation.

The most effective method of waging this campaign against evil forces of
vice and moral contamination would be to start an aggressive movement in
two different directions of social endeavor. One is the campaign of
social legislation and reforms for the purpose of eradicating
deeply-lying causes of economic, social, or political character, which
originate and foster various manifestations and forms of the social
evil, to change gradually the underground from which all evil forces are
arising, and to raise the moral tone of society as a whole.

The other way is to attack the monster of social evil by reaching the
individual offender and by protecting him from the pitfalls and dangers,
through moral persuasion and by arming him with the necessary knowledge
of sex life in health and disease.

It is agreed on all sides that the keynote of this educational movement
should be a campaign of sex education and moral prophylaxis. The young
generation, both boys and girls alike, should be taught from an early
age the proper biological and social function of sex, and trained in an
open and healthy attitude toward sex problems. The prudish and
hypocritical attitude of society is universally regarded as the main
cause of all-pervading diffusion of the social evil, furthered by a most
flagrant ignorance on one hand and a morbid curiosity produced by this
attitude on the other.

A discussion as to which weapon at our command in this propaganda should
be considered most effective, and which particular of the stock
arguments commonly used in the campaign for sexual morality is to be
preferred, seems to the writer perfectly irrelevant and non-essential.
Whether we appeal to the nobler and higher instincts of manhood, or to
the reason and intelligence of the man by enlightening him on the
biological function and significance of sex, or try to instill the fear
of the evil consequences of sexual transgression, none of these
arguments should be emphasized more than another, but all should be
presented with equal force and emphasis. The degree of influence which
any of these motives, single or combined, may exert on a man varies not
only with the different type of man, but even in the same individual the
force of these appeals will vary in different moods and under different
circumstances.

One essential condition for the success and effectiveness of the
propaganda of sexual hygiene and morality is a concrete, practical, and
natural presentation of the subject, without abstract theorizing or
ill-disguised sermonizing, which bores and rather repels an
unsophisticated and untrained in intellectual reasoning average street
man or boy—the real would-be beneficiaries of this crusade.

It is the writer’s firm conviction, based on many years of
genito-urinary practice and mingling with men and boys of different
classes, that each one of them is only too eager for sex knowledge; but
this knowledge has to be presented in a concrete, matter-of-fact
fashion, comprising and explaining various problems and facts of sexual
life in health and disease as they arise daily in the life of the
average man or boy. In this way, and in this way only, in the writer’s
opinion, a man of the masses can be reached.

                                                    MOSES SCHOLTZ, M. D.

  _Cincinnati, 1916._




                           Table of Contents.


 INTRODUCTION—IMPORTANCE OF SEX IN THE LIFE OF AN INDIVIDUAL,         11

                             SEX IN HEALTH.
  1. STRUCTURE AND FUNCTION OF THE SEXUAL ORGANS,                     19
  2. SEXUAL CONTINENCE AND ITS NATURAL SELF-REGULATION,               25
  3. CONTROL OF SEXUAL INSTINCT,                                      27
  4. PSYCHOLOGY OF SEX,                                               29
  5. PHYSIOLOGICAL BASES OF SEX,                                      34
  6. INFLUENCE OF MIND ON SEXUAL INSTINCT,                            40

                     SEX IN DISEASE (Sex Pathology).
  1. NON-VENEREAL INBORN DISEASES OF SEX ORGANS,                      46
  2. NON-VENEREAL ACQUIRED DISEASES OF SEX ORGANS,                    47
  3. MASTURBATION (SELF-ABUSE),                                       50

                           VENEREAL DISEASES.
                             _General Part_:
  1. DOUBLE STANDARD OF MORALS,                                       59
  2. THE DANGERS OF IGNORANCE,                                        64
  3. SELF-DOCTORING AND MEDICAL QUACKS,                               67
  4. PROSTITUTION,                                                    71
  5. PRACTICAL PREVENTION (PROPHYLAXIS) OF VENEREAL INFECTION,        76

                             _Special Part_:
  1. GONORRHEA,                                                       80
     _a._ ITS IMPORTANCE,                                             81
     _b._ DIAGNOSIS-RECOGNITION,                                      82
     _c._ CLINICAL COURSE,                                            84
     _d._ COMPLICATIONS,                                              86
  2. CHRONIC GONORRHEA-GLEET,                                         90
     _a._ GONORRHEA OF THE PROSTATE GLAND,                            91
     _b._ GONORRHEAL STRICTURES,                                      94
     _c._ GONORRHEAL RHEUMATISM,                                      96
  3. TREATMENT OF GONORRHEA,                                          97
  4. TREATMENT OF GONORRHEAL COMPLICATIONS,                          102
  5. GONORRHEA AND MARRIAGE,                                         106
  6. TESTS FOR THE FINAL CURE OF GONORRHEA,                          108

                       FUNCTIONAL SEXUAL DISEASES.
  1. IMPOTENCE—LOSS OF MANHOOD,                                      115
     _a._ PSYCHIC IMPOTENCE,                                         115
     _b._ IRRITATIVE IMPOTENCE,                                      117
     _c._ PARALYTIC IMPOTENCE,                                       119
  2. STERILITY—INABILITY TO HAVE CHILDREN. ITS RELATIONSHIP TO
       GONORRHEA AND SYPHILIS,                                       121
  3. SEXUAL NEURASTHENIA—NERVOUS WEAKNESS AND IRRITABILITY,          125

                               CHANCROID.
 ITS COURSE AND COMPLICATIONS,                                       129

                                SYPHILIS.
  1. DIAGNOSIS-RECOGNITION,                                          134
  2. CLINICAL COURSE,                                                136
  3. HEREDITARY SYPHILIS,                                            144
  4. TREATMENT OF SYPHILIS,                                          146
  5. SYPHILIS AND MARRIAGE,                                          150
  6. TESTS OF THE CURE OF SYPHILIS,                                  152

 CONCLUSION,                                                         155

 QUESTIONNAIRE,                                                      157




                              INTRODUCTION


No greater and more sacred ambition can stir the heart of a boy or youth
than to grow up into a perfect manhood, to become strong enough
physically and mentally to meet any demands on his strength that life
may put upon him. Equally so, no more important nor more sacred duty
lies on a grown-up, fully developed man than to keep this treasure of
physical and mental equipment bestowed upon him by generous Nature
intact and unimpaired.

Unfortunately, while most men and boys have good intentions and right
ambitions, many of them, by weakness of character, light-mindedness, but
mostly thru ignorance, yield to evil temptations, to ugly and morbid
habits, to self-destructive practices, only to find themselves, after a
few years of “sowing wild oats,” as “damaged goods,” physical and mental
wrecks, without strength or ambition to live, worn out and sapped by
chronic diseases. It can be truly said that no other scourge blights as
many happy homes, destroys as many brilliant careers, undermines as much
vitality of body and spirit as does abuse of the sexual system. If it
were possible to express in figures and money value the total amount of
loss of money, time, physical suffering, mental anguish, blighted
happiness, and permanent invalidism; if it were possible to summarize
all the misery and suffering, all the decay and waste of human bodies
and souls, caused directly or indirectly by diseases of sexual origin,
the world would be staggered and shocked by the immense sacrifice it
brings to the Moloch of sex ignorance.

What does sex mean to the average man and youth? What idea does he have
of the function of sex in the human body and its significance in human
life? To a youth, sex means a mysterious force that makes itself felt by
vague desires and impulses, by an irresistible attraction toward the
opposite sex, by its undefinable impulses in his whole being—his body,
his mind, his feelings. But before he has time to clear up the mystery
of his body, some companions more experienced in life’s vulgarities
initiate him almost by force in the physical mysteries of the sexual
relationship, ordinarily under the most vicious and vile surroundings,
which initiation leaves in him invariably a lasting and intense
aftertaste of shame and disgust. More sensitive and refined natures
instinctively recoil after this harrowing experience, and exert their
best and sincerest efforts to avoid temptations and keep their bodies
and feelings fresh and clean. Others yield again to the stronger will of
the older debased companions, and gradually develop a habit of
indulgence in brutal and degrading passions, with the subsequent train
of venereal diseases, impairment of physical and mental strength, and
gradual withering of all moral noble features of manly character. And
yet under proper instructions and the right attitude of mind, no man or
boy should fail to realize that sex is the most precious treasure he
possesses, the squandering and abuse of which is sheer madness and
self-destruction.

Think of a boy fourteen to sixteen years old on the threshold of
manhood, and watch the changes going on in his whole being at this
period of transition. Watch this most wonderful transformation, how a
frail, little, helpless skeleton shoots into a large-boned frame with
powerful muscles; how his squealing, girlish voice deepens into a low,
manly, vibrating tone, and the smooth skin of the face and genital
organs begins to show a hairy growth. Equally great changes take place
in the boy’s mentality and feelings. A childish helplessness and
insecurity gives place to self-assurance and assertiveness, coming from
the inner feeling of growing power and ability to protect himself.
Childish, care-free, everlasting joy gives way to a new feeling of
growing responsibilities and duties, to plans and ambitions to strive
for glory and success in life. The feeling of inner force and energy
stirs him to ever-new activities, spurs him to ever-new achievements.
Nothing is too hard for a youth standing on the threshold of manhood, no
job is too big for him, no ambition is too high to realize. This is the
time when the character and personality of a boy assume their permanent
shape that forecasts the success or failure of his whole future life.
And then comes the last and crowning change in growing manhood. He
begins to feel an indefinite longing, vague and dreamy romantic
impulses, and rapid changes of mood begin to disturb his repose. A new
attitude toward the opposite sex gradually makes itself felt, and a
woman acquires in his mind and feelings a new meaning and a new light.
Womanly beauty and perfection, of which he has been unaware and
unconscious, begins to exert on him all-powerful and irresistible
attraction, and with further bodily and mental growth, he gradually
reaches full maturity and enters the stage of highest consummation of
normal manhood—love, marriage, and happy family life.

What magic power has brought about these changes from a helpless child
to a strong, able-bodied man, ready for an active and happy life? This
wonderful power is sex. Sex is the magic source of life, which not only
reproduces life, but also keeps up the divine spark of vitality in the
human body and controls and stimulates its growth and healthy
development. _Sexual glands that every healthy child gets from its very
inception, thru their internal secretions, act as a source of life and
energy in the body, stimulating its growth and influencing its general
condition._ And just as killing frost or withering heat stunts and
dwarfs a young plant, so any abuse or lack of care of the sexual system
will dwarf and stunt the growing boy, physically, mentally, and morally.

But even after a man has reached a full state of physical development,
his sexual system exerts the same all-powerful influence over his body
and mind. His own health and happiness, as well as the happiness of his
wife and children, are most intimately and deeply dependent on the
healthy and normal condition of his sexual system.

So it can readily be seen that sex is the greatest treasure Nature has
bestowed upon men, and that the sexual organs are just as important for
health and happiness as are any other organs of the body. For this
reason every boy and man should know how to take care of these most
vital organs in health and disease. In a word, he should have all
necessary knowledge to protect and to keep intact his priceless
heritage—healthy and noble manhood.




 Anatomy and Physiology (Structure and Function) of the Male Generative
                                 Organs


To get a clear idea of the sexual system of a man, it is necessary first
to learn the structure and function of sexual organs; that is, to get a
brief acquaintance with their anatomy and physiology.

This is just the very purpose of this book, to give to intelligent and
self-conscious boys and men this necessary knowledge, to give them
guidance and information, which they need on different occasions, to
solve and clear up their many doubts and questions that come up in the
intimate recesses of their minds and which arise on different
experiences of sexual life.

The sexual system of a man consists of the _penis_, two _testicles_ with
two _seminal ducts_, two _seminal vesicles_, and one _prostate gland_.
The _penis_ is a composite structure, as it has a double function of
sexual and urinary organ. It consists of _three cavernous, erectile
elastic bodies_ capped in front by a head part—two of them on the sides
and one underneath. These bodies contain numerous spaces, collapsible in
the time of quiescence, but in time of sexual excitement, in the state
of _erection_, those spaces fill up with blood and render the penis
turgid and hard. Underneath the side cavernous bodies, piercing thru the
lower cavernous body, goes the _urethral canal_, which starts from the
bladder and reaches the external opening. The _urethra_ has a double
function: it carries urine from the bladder out of the body and it
serves as a carrier for natural sexual secretions. The _testicles_ are
the most important sexual glands, as they produce human living
cells—embryos—so-called _spermatozoa_. The testicles, two in number, are
pigeon egg sized bodies, suspended by the spermatic cord in a sac called
the scrotum.

The natural seminal secretion, semen, or _sperma_, after its production
in the testicle, is carried out thru a _long seminal duct_, which, when
unraveled, measures about twenty feet long, but in a natural condition
is twisted and folded on itself many hundred times, forming a
bundle-like swelling in the back of the testicle—_epididymis_. This
detail is good to remember, as epididymis plays a very important part in
venereal diseases.

The seminal duct goes thru the spermatic cord a long way and passes thru
the _inguinal_ canal, located in the groin and enters the seminal
vesicles, which are located in the rear of the base of the urinary
bladder. The _seminal vesicles_ are the reservoir tanks for the _seminal
fluid_, which resemble small pouch pockets, where it is stored up and
accumulated before it is _ejected thru the ejaculatory duct_ into the
deep part of the urethral canal and then carried outward, spontaneously
in a _wet dream_ or actively in sexual intercourse. The seminal vesicles
also produce their own viscid fluid-secretion, which probably preserves
the spermatozoa in time of storage.

The _spermatic cord_ serves as a cable connecting the testicles with the
rest of the body, and contains the _seminal duct_, nerves, and blood
vessels that give vitality and blood supply to the testicles.

Last, but not least in importance among organs of the male sexual
system, is the _Prostatic Gland_. The prostatic gland resembles in form
a chestnut, and is located deep under the urinary bladder, right between
the seminal vesicles. This gland is very rich in muscles, which surround
the deep part of the urethral canal, where it starts from the bladder,
and takes an active part in closing up and opening the bladder in time
of urination. The Prostate Gland is also very rich in nerves, which
connect it with almost every part of the body. For this reason, as will
be seen in the chapter on sexual diseases, the healthy condition of the
Prostate Gland is absolutely necessary for a normal and happy life. The
Prostate Gland also produces a very important sexual secretion well
familiar to all—a grayish white milky emulsion with characteristic
sweetish odor and alkaline reaction. This secretion is very important,
as it preserves and stimulates the vitality of the _sperma__tozoa_
before they reach the female embryo _ovum_ for the purpose of
_fertilization_.

Thus it can be seen that the _seminal secretion_ a man loses, either
during a wet dream or in sexual intercourse, is not a simple, but a
composite fluid, consisting of secretions of the testicles, prostatic
gland, seminal vesicles, and also numerous mucous glands of the urethral
canal.

The most important element of the seminal fluid is the secretion
produced by the testicles and containing spermatozoa. _Spermatozoa_, or
human embryos, are microscopically small living cells, which resemble
very much in appearance tadpoles. They consist of a pear-like head,
thread-like tapering neck and tail, and thousands of them can be seen in
a drop of sperma under a microscope, as rapidly moving and swarming
around little worms.

Let us consider now briefly the function of sexual organs. The structure
and mutual adjustment of the parts in time of function clearly indicate
that the main purpose and vital function intended by Nature for these
organs is procreation and transmission of life. Every single organ of
the sexual system is constructed and provided with wonderful creative
power and natural appliances, all to one purpose—to preserve and to
facilitate the transmission of the living spermatozoa to a meeting place
of its mate of fertilization and conception—the female embryo—ovum. This
is the reason why sexual organs are also called _generative_ organs.
This must also be the reason why Nature has timed the awakening of the
sexual impulse with the period of the greatest development of all the
faculties of the human body and mind, so as to render a man mature and
prepared to shoulder the heavy responsibilities of husband and father.
Unfortunately, under modern economic and social conditions the physical
and mental maturity does not coincide with the _economic_ and social
readiness to take up the obligations of family life, and marriage is
often forcibly deferred to many years after the physical age of
maturity. This brings under discussion the most important practical
question of sex continence.


                           SEXUAL CONTINENCE.

The question whether sexual relationship is a natural necessity and
whether a man can abstain from sexual indulgence and remain in perfect
health is commonly debated in bachelors’ quarters, and seems to have
been decided by popular opinion in the negative. But a glance at the
scientific bases of this problem and every-day experience of every
unbiased man is sufficient to show that nothing could be further from
the truth.

Sex is a _biological_, not a _physical_ function; that is, the
evacuation of the seminal fluid out of the body is intended by Nature
for the purpose of fertilization only, and is not necessary for the
physical well-being of the individual. The general stimulating and
vitalizing effect of the internal secretions of the sexual glands is
best obtained and subserved by retaining these fluids in the body; that
is, by abstaining from free sexual intercourse. That this is so can be
readily substantiated by practical observation; whenever a man
undertakes to perform some mental or physical task, he has to lead an
abstinent and moderate life to get out the maximum of his efficiency.


                POLLUTION (_Night Emission—Wet Dream_).

Nature has wisely provided man with a wonderful self-regulating
appliance, which fact explodes the popular belief about danger to health
in overaccumulation of the seminal secretions in the body. Whenever such
accumulation of the seminal fluid takes place in a healthy man, and he
begins to feel a certain nervous tension and blood-flushes, Nature opens
her safety valve and the overdistended seminal vesicles by pressure
bring in motion the nervous muscular apparatus of the sexual organs, and
this accumulated surplus comes out at night in sleep as a “wet dream”
night emission, medically called “pollution.” The best proof that this
phenomenon is normal, natural, and purposeful can be seen in the fact
that the morning after it the man loses all the disturbing sensations of
nervous tension and at once regains his freshness and vigor. _A man may
have these emissions once or twice a month, even once a week, and he
does not have to worry about it in the least_, provided that after each
night emission he feels fresher and more vigorous than before it.


                CONTROLLING FACTORS OF SEXUAL INSTINCT.

In discussing sexual abstinence and its possible injurious effect on
health, some very important facts bearing on the question should be
brought out.

First, the popular idea that sex is as much a physical necessity as are
other instincts of self-preservation, such as hunger, thirst, or sleep,
is fundamentally wrong. Hunger, thirst, etc., are imperative at all ages
and under all circumstances. The lack of their satisfaction for a very
few days leads to wasting, destruction of the body, and physical
suffering. The sexual impulse awakens only at a certain age, lasts a
certain period of time, and gradually goes down, leaving the physical
welfare of the body undisturbed.

_Individual Variations._—Another extremely important difference is that
hunger, thirst, sleep, and other bodily instincts are implanted in every
human being, and individual natural differences in regard to these
instincts are so insignificant as to be negligible. (We wish to
emphasize the word “natural” in its true sense, as in actual life many
people develop so many different habits as to the quality and quantity
of food and drink and in their ignorance call them their “nature.”) How
different it is with the sex function. People are so different as to
their sexual capacity and preferences, commonly called “temperament,”
that no hard or fast rules can be enjoined on the average man or woman,
and not even approximate limits can be given in an individual case.
There are many so-called _frigid_ natures, particularly among women, who
feel not the slightest attraction for the members of the opposite sex,
and are able to go for years and even thruout life without any active
desire for sexual relationship. On the other hand, there are some
individuals who, either thru heredity or thru personal unbridled
indulgence, are so obsessed by sexual passion that their mind remains
shut off to every refined and moral influence, and they turn into low,
beastly slaves of their brutal passions. What is sexually exciting and
attractive to one man, leaves another man perfectly indifferent, and may
be disgusting and repulsive to a third. Surely an instinct that is so
changeable and so widely differs with different people is not a physical
necessity of our body, and can be held in abeyance for a long period of
time.


                           PSYCHOLOGY OF SEX.

It has been pointed out above that besides its primary and main
biological function of the transmission of life, sex also has a powerful
stimulating and vitalizing influence on the development of the
individual, which is particularly conspicuous in time of adolescence and
approaching puberty. But the influence of sex is not only limited to the
physical sphere; in fact, its influence on the psychology and mentality
of the individual is equally powerful, far-reaching, and lasting thru
the greater part of life. Sex unquestionably is the greatest emotional
power in human life, the greatest and strongest single factor
controlling human feelings and emotions. From a mere physical animal
instinct of procreation as it is manifested in the animal world, in the
man Nature has transformed and has exalted sex into the highest
all-pervading function of human life, has spiritualized and beautified
this physical impulse into a most ennobling and ecstatic passion of the
human soul—the passion of love.

Love between a man and woman and its consummation in marriage and
formation of the unit, the family, is the highest expression and
development of the primitive sex instinct; it is the only form of
expression of the sexual impulse intended by Nature and sanctioned by
religion and the social code of morals. Sex, in its spiritualized and
purified form of love, has ever been the dominating and controlling
factor in the history of the human race. Love has furnished more to the
content of the emotional life of human kind than any other emotional
force. Love has been at all times the source of inspiration to the
greatest creative geniuses of all arts, be it music, literature, drama,
pictures, etc. Nothing thrills an average man or woman as much, nothing
strikes a vibrating response of a human heart as quickly as an
artistically presented romance of love. The only instinct that rivals in
intensity the love between man and woman is mother’s love, which is also
based on the sex impulse, tho of a wider import. Mother love is, as it
were, a continuation of the biological function of sex, a Nature’s
provision to protect and to raise the offspring begotten in love.

The power of sex for good or evil in human life is unlimited. A
spiritualized sex impulse—love—ennobles the man and renders him
responsive to the best and highest sentiments, inspires him to noblest
deeds of devotion and self-sacrifice. The sex impulse, not exalted by
the divine touch of love, and left unbridled in its primitive form,
becomes a destructive and brutalizing force, that not only inflicts the
physical punishment of disease and loss of sexual power, but also
destroys the best and noblest elements of manhood.

The fact that every man and boy suffering from a venereal disease or a
disorder resulting from bad sexual habits feels ashamed, degraded, and
deeply disgusted with himself, is due not only to the fear of public
disgrace and ridicule, but it is essentially a feeling of guilt against
his own physical and moral self.

Besides the emotional sphere, _sex exerts an equally far-reaching
influence on the sphere of mentality_. The faculties of intellect and
reasoning are not affected directly by the sexual impulse, but
indirectly the intellectual capacity is greatly dependent upon sexual
characteristics of the man. A man leading a normal sexual life, that is,
being continent if he is below the age of full sexual maturity, and,
being married, if he is above the age, commands the best conditions of
intellectual efficiency. His mind being undisturbed and unshaken by
periodical waves of sexual excitement, of casual indulgences and nervous
exhaustions following sexual excesses or abuses, remains steadily in a
state of perfect repose and continual freshness, which renders him
capable of the greatest mental concentration and vigorous sustained
mental effort.

In the case of a married man, the state of mental energy and efficiency
is still more increased by a powerful incentive and stimulation felt by
every normal man to exert his best efforts and to strive to the best of
his ability for the welfare and good name of his family. Strange as it
may seem to some, the sexual impulse and feeling has had the greatest
influence on the development of morals and social ethics. The popular
old-time idea that the sexual organs and feeling are something shameful,
disgusting, and loathsome is based on a gross ignorance and on a crude,
vulgar, and narrow-minded interpretation of the great natural provision.
Whatever shameful, immoral, or degrading there may be about the sexual
feeling and function is put into it by the ignorant, vicious, and vulgar
mental attitude and unclean thoughts of man.

Surely the impulse and organs of the human body, designed by the Great
Creator for the highest function of human life—that of transmission of
life—cannot be shameful, nor vulgar, nor immoral. The broad and
intelligent interpretation of sex raises it above a mere animal
instinct, ennobles and purifies it from any element of low and brutal
passions, and by instilling in the man a feeling of sacredness and moral
obligation on his part towards the future family, renders the sex
problem a subject worthy of reverence and earnest study.


                THE PHYSIOLOGICAL BASES OF SEX IMPULSE.

For a clear understanding of the natural mechanism by which a sexual
impulse is originated, set in motion, and brought to its natural
climax—_ejaculation_ (emission of the seminal fluid)—it is necessary to
explain briefly the nervous apparatus controlling this sexual function.
The main nervous center directly controlling and setting in motion every
successive step in the sexual act is located in the lumbar (loin) part
of the spinal cord. This is the center of _erection_. This center can
operate under certain circumstances spontaneously, without active
control of the will or consciousness, but ordinarily it is under full
and absolute control of the brain centers forming sexual ideas and
impulses. The center of erection can be stimulated or excited either by
_impulses from the sexual brain center_, which is by far the most
frequent way of the two of forming sexual desire, or it can be
stimulated by _impulses from the genital organs_. The most common causes
producing erection thru impulses from the genital organs are: a
mechanical friction or tickling of the genital organs (intentional, as
in self-abuse, or accidental and spontaneous); irritative influences in
various diseases of the genital organs; pressure on the nerves by the
bladder distended with urine (particularly on awakening in the morning);
the seminal vesicles overfilled with seminal fluid, or even the blood
congestion caused by lying on the back. All these causes, with the
exception of a deliberate masturbation (self-abuse), can produce an
erection without active participation of the consciousness or will
power: they belong to the realm of subconscious acts, but their
intensity never grows sufficiently strong to bring about a natural
resolution of the sexual reflex thru the ejaculation of the seminal
fluid. The only exception is the sexual irritation produced by the
seminal vesicles overdistended with secretion; in this case it comes to
a resolution thru a “wet dream,” or night emission. The very fact that a
_healthy, normal man never has wet dreams in the daytime in a waking
state_ conclusively shows that under normal circumstances a natural
sexual feeling is never so intense or imperative as to consider it as a
natural necessity, calling for gratification. The _ordinary active state
of mind and concentration of attention on the regular pursuits of life
is sufficient to keep vague sexual impulses in the realm of the
subconscious._ It is only the active participation of mind and the
concentration of attention on these impulses that brings them out on the
surface of consciousness. Once this vague impulse or idea is perceived
by the mind as a sexual idea or emotion, if the will power of the man is
not strong enough to push it back again and to submerge the impulse in
the realm of the subconscious, the imagination steps in and, by
conjuring up various lascivious and sensual images and dreams,
stimulates and fans up the flickering light of the original impulse into
a mighty, all-devouring, irresistible flame of sexual passion,
overpowering all reasoning and self-control of the man. Once it has
yielded and has permitted the sexual subconscious impulse into the field
of consciousness and attention, the mind becomes less resistent, more
sensitive and susceptible to all sexual stimulation, the imagination
runs riot, and every sensual impression is not only not resisted, but
eagerly sought for. The slightest stimulating impression that leaves a
man with normal acting mind perfectly indifferent and cold, or even
evokes a feeling of disgust, such as vulgar, indecently-dressed women,
suggestive stories, ribald songs, etc., sets such a man on fire and
renders him a helpless slave to an animal passion.

And yet how easy it would have been to stem this tide of passion in the
beginning, just with the slightest effort of will power, by not allowing
these vague impulses to come into the realm of consciousness, and by
concentrating the attention on some purposeful occupation or healthy
pleasure.

Thus it can be readily seen that the sexual impulse can never
spontaneously intrude itself into the consciousness of a man, and that
the _sexual desire grows in intensity and becomes overwhelming only with
the active participation of the man’s mind and the connivance of his
will power._ This fact is of tremendous practical importance for the
problem of sexual continence and its solution.

When the mind is clean, and the attention is purposefully occupied, all
danger of temptation and sexual missteps is eliminated. The _main center
of the sexual desire lies in the brain and in the mind, and not in the
body._ No “natural physical necessity” will be felt if one has full
control of his mind. _A mere abstinence from the physical act of sexual
intercourse does not make a man moral, nor is it physically healthy or
worthy of his great effort of self-control._ His mind is torn asunder by
a constant internal struggle between wildly-running imagination and will
power, his mental repose is disturbed, his mental or physical efficiency
is impaired. _There is only one rational, scientifically correct
effective way to control a sexual instinct; that is, to control the body
by controlling the mind first._ The easiest and most certain manner of
obtaining this control of the mind is by keeping the mind busy and
engaged by active, purposeful, and healthy interests. These interests by
themselves, as it were, automatically, will keep the attention and all
the faculties of the mind engaged, and thus in a natural way, without
any special effort, the sexual impulses will be kept in the realm of the
subconscious, as inner vague feelings, not interfering with the man’s
comfort and efficiency nor disturbing his mental repose.

These theoretical contentions are fully borne out by practical
observations in regard to the influence of the mind on the sexual
instinct.


           THE INFLUENCE OF THE MIND ON THE SEXUAL INSTINCT.

Practical experience shows that no other function of the body is so
absolutely controlled by the nervous system and more dependent on the
state of the mind than the function of sex. All other instincts and
functions of the body, like hunger, sleep, digestion, breathing, etc.,
are controlled to some extent by mind influences. Different feelings and
emotions, like fright, worry, sorrow, etc., check and retard all
functions for a while, but they cannot retard them for a long time, and
surely cannot stop them altogether. How different it is with the sexual
impulse. Different mental states can not only subdue the sexual impulse
for many, many months, but they can completely check it for an
indefinite period of time. The every-day experience of any man will show
that when a man’s mind is occupied by any healthy and normal interest,
when he is absorbed by mental or physical work, when his energy and
attention are used up in a purposeful and productive occupation, no
lascivious thought enters his mind, no sexual impulse disturbs his
repose. It is only when the mind is idle, and the body did not work off
its surplus of energy, that the fancy runs riot and a man is bent on
mischief. Take one hundred cases, when a man or boy breaks loose and
takes a plunge into the quagmire of prostitution, analyze the
circumstances and influences that bring about this misstep, and you will
find that in ninety-nine of these hundred cases the hero of this
adventure is more of a victim than an active, deliberate perpetrator.
Usually it is first a case of overeating rich, stimulating food that
heats the blood and clouds clear judgment, the imbibing of sweet wine or
alcoholic liquors still more excites and intoxicates our hero; heavy
smoking adds its effects to ever-increasing dulling of intellect and
checks the normal feeling of self-control and discrimination; vulgar
jokes and smutty stories still more stir up sensuality; add to it
vicious and stupefying influence of low-grade dancing halls, and as a
last and finishing touch, the powerful effect of “gang-spirit”—the hue
and cry of the crowd of “boys,” and you will easily see how our hero is
swept away like a frail vessel by a mighty tide into the abyss of
prostitution. This picture of every-day life plainly shows that under
ordinary circumstances boys and men do not get into mischief unless
their minds are idle and their judgment is clouded, unless their nerves
are high-strung and their senses are inflamed by intoxicating and
stimulating influences. This fact carries in itself a very valuable and
encouraging lesson to those clean-minded and refined boys who make
sincere and earnest efforts to overcome all possible temptations and to
carry securely the treasure of their untainted manhood thru the trying
and stormy period for a happy family life in the future.

In a nutshell, this lesson reads: Keep your mind busy and your body
working; do not overeat; avoid alcoholic and stimulating liquors; be a
moderate smoker; avoid vulgar and vicious company; keep away from
degrading and low temptations that you know will drag you down into the
abyss of vice and shame, and you will find that it is not so hard to
keep in the straight path, _if only you do not take any chances from the
very start._ There is _no better antidote for a young man against the
annoyance of sexual excitement than athletic work and an athletic mode
of life._ Any and all physical sports and games, particularly outdoor in
the fresh air, moderate eating and sleeping in a hard bed in a cool
room, active and busy life and avoidance of narcotic, stimulating or
body-weakening habits and drinks will make you physically strong and
will render the problem of sexual continence an easy and natural task
for a _long period of time_.

Such is in brief words the structure and function of the sexual system
of a man, and such are the practical conclusions and advices based on
these theoretical facts. It is the writer’s hope that his words of
enlightenment and counsel may keep some of the boys away from the
“danger zone.” Yet it is natural to expect that in spite of the best
warnings and the best intentions of the boys themselves, there will
always be such, who, thru lack of will power, light-mindedness, or
vicious influences of the older companions, will succumb to the impulse
of the moment and will trespass the forbidden territory of “sowing wild
oats.”

Mainly for these victims of their own indiscretions the writer devotes
the second part of this book—“The Pathology of the Sexual System.” Let
them know the dangers they are courting, let them know the possible
influence it may have on their own health and the health and happiness
of their future family. Should they be unfortunate enough to contract a
venereal disease, it is to their own interest to know all the possible
complications and developments of these diseases; to prevent, thru
intelligent handling of their cases, all the evil consequences and to
protect themselves from a damage that so often follows ignorance,
neglect, and indifference to the sickness.




               Pathology (Diseases) of the Sexual System


Before entering into detailed consideration of the pathology, i. e.,
diseases of the sexual organs, it should be stated that while the bulk
of these diseases is of venereal character—that is, acquired thru some
abuse of the sexual function or thru unclean intercourse—there is a
large number of diseases that may develop on and affect the sexual
organs without any fault or indiscretion on the part of the patient.
First, the sexual organs, like any other part of the body, can be the
seat of different inflammations, tumors, accidental injuries, etc., and
in the case of any grave general sickness the sexual system is naturally
involved and suffers to a greater or smaller degree. Second, the sexual
organs present very often congenital (inborn) defects of development,
varying to an enormous degree in individual cases. There are also
several non-venereal acquired diseases. Most of these conditions are
practically unknown to the public, and quite often the afflicted victims
are terror-stricken and driven to despair thru ignorance of the true
nature of their case, laboring under the idea that their condition is
due to a venereal infection or some indiscretion on their part. For this
reason, we shall briefly consider these conditions.


      CONGENITAL (INBORN) NON-VENEREAL DISEASES OF SEXUAL ORGANS.

Among congenital non-venereal abnormal conditions possibly the most
common is the _long and tight prepuce_, which in a good many cases gives
rise to many nervous complaints and minor disorders. It is relieved
usually by operation or _circumcision_, which has been adopted by the
Jews and Mohammedans as a religious procedure. As to the sanitary
advantages of circumcision, discussed so often, it must be admitted that
while it is not necessary in all cases, in general it is undoubtedly a
useful procedure. It does not lessen any chances of venereal infection,
which can be seen from the fact that the Jews proportionately contract
Gonorrhea as often as the Gentiles; but it does undoubtedly lessen the
chances of infection with Chancre, soft or hard, and in cases where
Chancre is contracted, the treatment in a circumcised case is a good
deal easier than in the non-circumcised.

Another congenital abnormality of practical interest is an “_undescended
testicle_.” It is not known commonly that the testicles are not formed
in the scrotum, that they descend there before the birth of the child
from the abdominal cavity. But in some cases the testicle does not
descend until later years of childhood, or does not descend at all. In
these cases the retention of the testicle takes place either in the
abdominal cavity or in the groin (inguinal canal). In this location
particularly it is likely to cause pain and distress, and it can even
atrophy and dry up from pressure of the tissues, if not relieved by
operation.


                    NON-VENEREAL ACQUIRED DISEASES.

There are a number of non-venereal acquired diseases that may occur on
sexual organs. Among these should be mentioned, first, _Varicocele_.

Varicocele is a very common condition in young men, and is manifested by
dilation and enlargement of the veins that go thru the earlier described
spermatic cord to the testicle. It occurs mostly on the left side, and
is felt like a snake-like cord twisted on itself, producing an
unpleasant, dragging-down, heavy sensation, and occasionally real
_neuralgic pains in the testicles_.

Varicocele is usually a harmless condition, passes away by itself as a
man grows older, and, if annoying, can be relieved by a snugly-fitting
suspensory bandage.

Another very common condition which occurs in the sexual organs is
_Herpes_. Herpes occurs as grouped in a circle, small superficial
vesicles or blisters on any part of the sexual organs. It is perfectly
harmless and dries by itself in a few days, but it has a peculiar
tendency to recur again and again, particularly after an intercourse,
even a clean one. The cause of its appearance is to be sought in a
certain nervous debility, local or general, but different local
conditions, like a long and tight prepuce, predispose a man toward its
outbreak.

Herpes very often affects men who have had some venereal disease in the
past, particularly Gonorrhea, and naturally those men become very uneasy
and worried by breaking out of Herpes, fearing this may be a relapse or
some after development of the old disease. It is true, tho, that a man
afflicted with herpes is very much predisposed to Chancroidal infection,
and as herpes often resembles the beginning of Chancroid, the opinion of
a competent physician should be secured to make proper diagnosis.

It is also of practical interest to know that a number of various skin
diseases can start from and be limited to the sexual organs, appearing
as red spots, patches, warts, etc. These cases, by being mistaken for
venereal infection, often give rise to unnecessary worry and wrong
treatment.


                       MASTURBATION (SELF-ABUSE).

Before entering into a consideration of the venereal diseases proper, we
shall consider a sexual disorder which is extremely important on account
of its widespread character, but the origin of which is just the
opposite to venereal diseases, as it is due not to sexual intemperance,
but to sexual continence. This disorder is masturbation or self-abuse,
and it is rather a sexual vice or bad habit than a disease. Self-abuse
is so widespread that some medical writers claim that every man has been
masturbating at some time or other in his life. The chief danger of the
masturbation habit lies in the fact that its victims are not only
adults, but children as well; in fact, children constitute the main bulk
of its victims. The habit of masturbation takes its roots ordinarily
very early in childhood, even babyhood. It is a well-known fact that
babies and small children, in their search for amusement and through
innocent curiosity as to different parts of their own body, like to
handle their sexual organs. They easily detect a very vague and pleasant
sensation resulting from it. This gives them the impulse and stimulation
to repeat this action, and thus is formed the first link of the chain of
the habit that may prove later to be a curse of the child’s life. This
is the reason why mothers should watch any tendency to bad habits in
children from a very early age, at the time when the formation of the
habit can be checked more easily. Should the child escape the danger of
masturbation habit early in life, the second equally dangerous period of
temptation is the school time. It is a peculiar and most dangerous
feature of the masturbation habit that its victim feels a strong impulse
and gloats in a beastly satisfaction if he succeeds in initiating a
younger and innocent boy into his habit. This is why one or two vicious
boys in a class can demoralize and mislead in their vice the whole class
of younger boys. The school age up to adolescence and puberty is the
time when the masturbation vice rages in its greatest fury, and then it
gradually begins to abate. Getting older, the boys learn in some way,
mostly from quack literature, how destructive and dangerous is this
habit, and most of them gradually drop it, never to resume. But some of
them become so enslaved to the habit that they cannot resist its lure,
and this is the class to which mostly belong the adult masturbators.
Masturbation has been extensively exploited by the quack medical
literature, which claims that the habit inevitably leads to most
terrible and destructive diseases, such as paralysis, insanity,
tuberculosis, loss of sexual power, etc. These statements are far too
sweeping and exaggerated. Discussing the dangers and evil consequences
of the masturbation habit, we have to consider separately the effects of
it on children on one hand, and on adolescents or adults on the other.

The physical dangers and evils naturally cannot be as serious with the
adults as with the children. First, because the adults know its evil
effects and use self-control to limit their self-indulgence to the
minimum; second, the physical loss of seminal fluid with each
ejaculation can be easier and with less danger spared by a grown-up
body, as the vitalizing fluid of the sexual glands is not needed so
urgently any more for the growth and development of the body, so the
damage to an adult from the habit of masturbation is mostly limited to
his nervous system and to his mental and moral forces.

This fact easily explains why the masturbation habit is so destructive
and dangerous to younger children. They are unconscious of the evil
character of their habit, and helplessly yield to the lure of impulse;
neither can they exert any self-control. On the other hand, every drop
of sexual fluid they lose means that much of vitality and life energy
taken away from their growing body; it means that much loss of the
natural source of their physical health and development. It is natural,
therefore, that excessive and persistent masturbation in younger
children may lead to physical exhaustion, may blunt their bodily growth
and dwarf their mentality, may lead to development of epilepsy, idiocy,
and other mental diseases; in a word, it may blight the child’s life
forever and render him a physical and mental invalid. The older the
victim of masturbation the smaller is the physical damage resulting from
this habit, and the more this damage is transferred to his nervous
system, mentality, and moral character.

The changes that take place in the personality of a habitual masturbator
are a natural result of slowly-accumulating influences, exerted by the
habit on its victim.

There are two cardinal features in the psychology of every masturbator
which give us a keynote toward understanding his character, and serve as
a starting point for all subsequent changes in his personality. The
first is that every masturbator of age knows that he is doing something
wrong; that he is committing a shameful act against his manhood and
against Nature. As a result, he reproaches and pledges himself to shake
off this degrading habit. But his will power is weak and temptation is
strong, and he again and again fails in his efforts and falls back in
the clutches of his master. This internal conflict gradually unnerves
him and puts an indelible stamp of shiftlessness and weakness on his
whole being. A feeling of guilt and shame makes him morose, seclusive,
depressed, and unsociable. Particularly characteristic it is for an
inveterate masturbator to avoid the company of all girls, and those
pleasures and games that are so attractive to normal and healthy boys. A
masturbator gets bodily weak, flabby, and unfit for any muscular
exertion or physical work. The changes in his nervous system and
mentality are still more striking. He becomes shiftless and restless,
and at the same time shows signs of nervous weakness and irritability.
He sleeps bad and feels in the morning more tired and broken up than
before going to bed; he is subject to headaches; he gets easily tired,
and is unable to concentrate his attention for any sustained mental
effort. His personality also changes markedly; he becomes deceitful,
self-retired, cowardly, and grouchy. His physical appearance reflects
well the internal conflict and the slow sapping of his physical and
mental strength; his look is haggard and dejected; the eyes are dull and
deeply encircled with blue rings underneath; his hands are cold and
clammy; his gait is slow, feeble, and uncertain. In a word, strong,
happy, and full of life a boy can in a few years or even months be
transformed under a loathsome mastery of the masturbation habit into a
wreck and a mere shadow of his former self. There is no more sad and
pathetic picture than that of an inveterate masturbator, who wants and
cannot break his slavery to the habit. Such cases can be redeemed back
to health by a long and tedious treatment. Much easier, and, in fact,
the only proper way to fight the scourge of masturbation is by spreading
knowledge of its dangers among the boys.

The prevention of the formation of the habit can best be affected thru
the same physical training of the boys that has been above recommended
to check unnecessary and premature sexual excitement. Give to a boy whom
you suspect or know to be in danger of forming the habit of masturbation
a friendly help; take him out into the fresh air for games and physical
sports; distract his attention by physical and mental pleasures;
regulate his diet and mode of life; even bring him into companionship
with clean and refined girls, and you may save him from a slow waste and
destruction of his physical and mental health and save his manhood for a
healthy and happy family life.




                           Venereal Diseases


Venereal diseases present a unique and most difficult problem of our
days. To realize fully the enormous scope and difficulties of the
control of venereal peril, several social factors bearing on this
problem must be considered. Such are: The attitude of society to the
sexual problem; double standard of morality; prevailing ignorance on the
subject on the part of the public; self-medication and medical quacks;
the sources of venereal infection, and the best methods of its control.


                       THE CONSPIRACY OF SILENCE.

Medically, venereal diseases belong to the oldest and best worked out
class of diseases, tho their treatment only recently, due to the new
discoveries, has been put on a definite and secure basis. Socially,
their tremendous importance for the health, morals, and happiness of a
community is just being disclosed to society, which heretofore, in its
prudish and ostrich-like attitude, attempted to solve the problem of
venereal peril by ignoring it and suppressing free discussion or
preventive education along these lines. Naturally, the evil unchecked,
tho driven underground by a prohibition of publicity, has spread to such
a monstrous size that society could not any more feign not to see it and
to continue the old policy of “conspiracy of silence.”


                       DOUBLE STANDARD OF MORALS.

Among factors bearing on the causes of sexual intemperance and venereal
peril, possibly none stands out as clearly and prominently as the
so-called double standard of morals. We all know that society has
adopted and hypocritically approved a double code of sexual morality for
men and women. What is considered to be natural and permissible for a
man is an offense of morality and a crime punishable by social disgrace
for a woman. No man is willing to marry a girl whom he knows or suspects
to be of loose sexual morals, and no self-respecting man will tolerate
that the fair name and honor of his sister be attacked or ruined even by
a word, not to say in fact. And yet the same man, in full sincerity and
in accord with his conscience gives to himself a free license of “sowing
wild oats” before his marriage. In fact, many men believe that it is not
only permissible, but even desirable for a young man to work off a
surplus of his physical manhood before he settles down to family life.
How a squandering of the best physical and nervous energy in
dissipation, how a waste and perversion of the highest spiritual and
moral instinct of love by a degrading purchase of the body of a
prostitute, how a polluting of the young and pure blood with venereal
poisons can make a man a better husband and father is beyond human
reason and common sense to comprehend; but the superstitions and
barbaric notions of the good old days are dying hard, and thousands of
young men sacrifice their manhood to the deep-rooted traditions and to
the slavery of established social habits.

How this double code of sexual morality has developed is probably to be
explained by a combination of several factors. First, a historically
developed subjection of the woman to man naturally has led to the
domination of man’s ideas and laws, and to the interpretation of
different facts bearing on the relationship between man and woman in
favor of the man. To justify his own license of sexual intemperance and
deny the same freedom to a woman, it was easy for a man to declare that
the sexual necessity for a woman is not as imperative as for a man, and
therefore a woman shall be chaste and pure until the marriage, while the
man may suit himself in this regard. There is no scientific proof
whatsoever that a woman differs in any way from a man in regard to the
sexual instinct. It is true that woman, as an average, is purer, more
temperate, less attracted by mere animal, brutal passion, and often
seeks or tolerates a physical gratification only as the means to get
with it a man’s love and affection. On the other hand, a man is more
brutal and violent in seeking and satisfying his physical passion, less
able to control his sexual impulse, less affectionate and less
sentimental in his expression of love. But this comparative moderation,
modesty, and better self-control can be more easily explained by woman’s
training thru many generations in clean and moral habits of thought and
living, by the fewer chances of exposure to evil influences, by less
stimulation and intoxication thru liquors and tobacco, and last, but not
least, thru fear of public disgrace. The man, being master of the
situation, has never tried to develop self-control and will power in
subduing his physical passion, and has cloaked his sexual intemperance
and indulgence with a fancied natural necessity. The double moral
standard as it is practiced to-day has brought untold misery and has
ruined lives of millions of young women who were so unfortunate as to
make a first misstep and yielded to temptation. While the male seducer
goes on unmolested and unnoticed on his gay round of life, the girl, his
helpless victim, has to face all the fury of public disgrace and
contempt. Many of them commit suicide, others try to hide their disgrace
by a criminal operation and die or cripple their health for life. Many
more, in despair and revolt against the injustice and hypocrisy of
public opinion, enter the gates that swing only one way to slow decay
and untimely death, the gates of prostitution.

There is no more miserable existence, no more hopeless, no more body and
soul-wrecking life than that of a white slave. It is no accident that
practically all of the prostitutes are drinking and smoking, and that
the majority of them are also drug fiends. In fact, that should rather
be credited in their favor, as it shows that with clear judgment and
normal senses they cannot endure this degradation and life-long slavery,
and, since they do not see any possibility of breaking their chains and
redeeming their lives, they drug themselves to forget their misery. Yet
even continual drugging cannot dull the agony of their hopeless
existence, and many of them welcome death at their own hands, usually
thru poison. There is no other occupation or human walk of life where
the suicide rate is as high as among the slaves of prostitution, neither
is there any class of population where physical decay and premature
death is as common as among the women of the underworld. Let a man or
youth who enters a house of prostitution know that by doing so he is not
only purchasing a lottery ticket for the prize of a venereal disease,
which he seldom misses, but that also with each visit to a fallen woman
he drags her down one step lower on the down-grade path of a social
abyss. And if he can do this with full knowledge of the social
consequences of his act with a clear mind and cool judgment, let him
know that he is a man in name only, and that morally he is much more to
be despised and branded with social contempt than the painted creature
he is ashamed to recognize on the street the morning after.


                       THE DANGERS OF IGNORANCE.

There are three main venereal diseases which constitute the roots of the
giant tree of the venereal peril, and from which almost all venereal
disorders spring out like branches and twigs. They are Gonorrhea,
Syphilis, and Chancroid. The first two easily overshadow in widespread
distribution and dangers of complications the third member of the
venereal triad, so that Chancroid can be considered by far the least
dangerous of the three.

A conservative estimate of the spread of venereal diseases, in the
writer’s opinion, would be that from every hundred men, at least ninety
have had at one time or another a venereal infection; that from every
hundred cases of venereal diseases, not half of them receive a thorough
and scientific treatment, not half of the patients are aware of the
seriousness of their condition and possibilities of different
complications, and only a minority of them bring the treatment to a
complete and permanent recovery. Any physician doing genito-urinary work
both in a clinic, hospital, or private practice knows that most of the
patients take treatment only until they cure up their pains, sores, and
other symptoms of the disease, and not until they are completely cured.
As it were, they dismiss the physician; the physician does not dismiss
them. As a result of this unsystematic and superficial treatment, the
original disease recurs again and again, only each time it penetrates a
little deeper into the system and requires a longer period of time for a
complete cure, with less chances for success. Thousands and thousands of
men develop serious and deep-reaching complications, sapping their
vitality and undermining their strength, complications which would never
have happened if the disease had been treated from the start, thoroughly
and to the finish. Still another result of this indifferent and reckless
attitude is that thousands of men, believing themselves cured, take upon
themselves the grave responsibility of entering marriage, taking a pure
and fresh girl, the girl they love and revere with all their hearts,
trusting and unsuspecting of the terrible danger hovering over her head.
The disease-producing germs that have been weakened and stunned but not
killed by insufficient treatment, falling on a virgin and fertile soil,
take on a new lease of life, and with the fury of a devastating tornado
attack and ruin their new victim. A young bride often before the
honeymoon bliss is over is struck down with an acute infection, a
mutilating operation follows, and in a few months a beautiful, healthy
girl is transformed into a permanent invalid and nervous wreck, deprived
forever of beauty, health, and joy of life. This terrible tragedy is not
an exceptional case, it is not an overdrawn statement, it is an
every-day occurrence in medical practice, and every day adds its new
victims of men’s folly, criminal indifference, and recklessness born of
ignorance.


                  SELF-MEDICATION AND MEDICAL QUACKS.

That the average boy or man has not the slightest idea about all the
possible complications that may develop from a venereal infection is
best shown by their attitude in time of such venereal mishap. What is an
average boy doing when he discovers that he is a victim of a venereal
mishap? The very first thing he does is to confide his shocking surprise
to one of his companions, who he knows has already had a similar
experience. The experienced friend first gives him a hearty laugh over
his bad luck, and then assuming a wise look, pats him on the shoulder
and confidently tells him not to worry, as he “will fix him all right.”
He gives him a few general instructions, the kind he used to follow in
his own previous experience, and sends him to the drug store for a
certain kind of pills, capsules, or solutions for injections. If there
be no such friend at hand, some other amateur “expert” is consulted;
sometimes it is a barber, or even a bartender friend who gives an advice
to drive out the sickness by copious drinking of beer. A grade higher in
quality, but equally poor and uncertain in results is a consultation
with the neighboring druggist, who, not having any more knowledge about
the developments of diseases than the average layman, takes up the case
with the supreme confidence of an authority and hands over the counter
the best advertised pills or solution for injections. The best that can
happen to the beneficiary of these consultations is, that he will not
see at once any improvement, or that he will feel worse, then he will go
to a competent physician and will start regular treatment. But woe to
him if he will feel some symptomatic relief, some checking of the
discharge or the pains. This is the time when he is the real loser.
Fooled by the temporary improvement and by clearing up of the symptoms
of his disease into belief that he is cured or pretty nearly cured, and
encouraged in his belief by his equally ignorant and often unscrupulous
adviser, the patient resumes his former mode of life and discontinues
what little precaution or treatment he has been using. The natural
result of it is that a few weeks later, after some indiscretion like
drinking alcoholic liquors or dancing, the whole sickness comes back as
strong and violent as in its very beginning. Again he resumes his
treatment and care, and acute symptoms again quiet down until, under a
new provocation, the disease will break out once more. Thus trusting and
ignorant victims of venereal mishap, wasting time and often considerable
money on their amateur doctoring, let the roots of the sickness
untouched, allow it to penetrate deeper and deeper into the body and
develop some deep complication or permanent damage of the sexual system,
which is either incurable or at best requires many months of the most
painstaking treatment.

Probably the most pitiful of all venereal patients are those
unfortunates who either have no friends in whom they could confide, or
who, thru a false feeling of shame, do not care to have a personal
consultation, and resort to a treatment by mail thru one of the quack
medical concerns. In no other class of diseases, in fact in no other
walk of life, is human ignorance, suffering, and fear so cruelly and
unscrupulously abused and penalized as in venereal diseases.

Shielded from criminal persecution by the secret manner of dealing with
their trusting patrons, secure in their shady operations by the fear of
disgrace, and a reluctance on the part of their victims to bring to
publicity the fact of their venereal infection, these human vultures ply
their extortionate trade on thousands and thousands of men. Most
extravagant claims, guarantees of cure, regardless of what the sickness
is, most blatant, alluring advertisements and offers of free
examinations—these are the stock of trade used by these leeches waxing
fat on human ignorance and degradation. Fortunately, in recent years the
attention of State and Federal government has been called to the use of
the mail by these benefactors of suffering humanity for extortionate
purposes. Energetic steps have been taken to curtail and abolish this
criminal correspondence game and to close up many of these
establishments. Public opinion is aroused on the subject, and it demands
that the newspapers refuse and eliminate all fraudulent and alluring
ads. of quack medical institutions. In the meantime the campaign of
information and enlightenment should be carried on, and every young man
should be informed that reckless and indifferent treatment of venereal
diseases, self-doctoring, cures by correspondence, and “sure cures” by
medical quack institutes may prove as disastrous as the disease itself.


                             PROSTITUTION.

Considering the sources of venereal infection and the best possible
methods of control of venereal peril, one strikes at once the sinister
problem of prostitution. Prostitution is undoubtedly the main source of
venereal infection, but the term prostitution should be taken broadly.
There are two kinds of prostitution: one is openly organized in
red-light district, tolerated by society, and regulated by the police;
and another, secret, clandestine, practised by thousands of women and
girls in large towns, women who do not make a living from the “life of
shame,” but secretly indulge in illicit sexual intercourse for a side
income or presents, while trying to keep up an appearance and social
standing of a “respectable” woman. Which kind of prostitution is more
dangerous to morals and health is not settled.

Many medical and social authorities believe that a woman secretly
prostituting herself is more dangerous and more liable to spread
venereal infection than an open registered prostitute, just because she
is secret, and does not have to submit to medical inspection at any
time. Yet it must be admitted that the medical inspection of houses of
prostitution has failed to bring about the expected results and to give
protection from venereal infection. It is well established that every
prostitute is infected with gonorrhea or syphilis, and mostly with both,
and that they practically at all times carry this disease in active or
latent form. The degree to which they can transmit a venereal infection
to a man depends mostly on the stage of the disease in the prostitute at
the time of her visit by a man; that is, one time danger is greater than
at another, but _at no time the perfunctory medical examination given to
prostitutes as it is conducted under police regulations can give the
slightest guarantee of safety from venereal infection_. All it can
establish and claim is that no acute or active symptoms or lesions have
been found on examination, and that there is no urgent necessity to move
this woman to the hospital as an evident and prolific source of venereal
infection. In other words, medical inspection can single out and isolate
a few of the most flagrant and most evident cases of venereal diseases,
but the women not excluded by medical examination from plying their
trade are just as able to carry over venereal infection to a man as
their sisters removed to the hospital. In fact, the reduction in the
number of venereal infections because of isolation of a few most
flagrant cases is so slight, and the increase in the number of venereal
infections due to increase in numbers of exposures by men, who are
misled into a feeling of security by alleged medical inspection, is so
great that many medical authorities and sanitarians consider medical
inspection of houses of prostitution useless and even harmful.

As mentioned above, a “secret” prostitute and private lady friend is not
a bit more safe and secure from transmitting venereal infection, and in
many cases, contrary to the expectations and beliefs of men, are much
more dangerous and treacherous in this respect. It is almost humorous,
if it were not so pathetic, to see how dumbfounded and shocked are these
youthful transgressors of the forbidden path, when a physician declares
that the exceptional favors of their lady friend resulted in a bad case
of gonorrhea or chancre. They are sincerely indignant at the reflection
on the honor of their affinity, and are almost ready to doubt the
competency of the physician, until a microscopical examination and the
subsequent course of the disease convinces them of the sad truth. On
occasions of this character a man as a rule is always inclined to blame
the woman and accuse her of gross deception. Such attitude is entirely
wrong, and is based on the ignorance of clinical facts. The truth of the
matter is that while a man can always tell when something is the matter
with him, and can always notice or perceive some evidence of the
venereal disease, such as a discharge, pains, sores, etc., a woman
hardly ever is aware of her disease. In fact, women feel pains,
discomfort, and suffer acute distress only in the acute stage of
venereal diseases, at the very beginning of the infection. But after
this acute period is over, they may sincerely believe themselves well,
as no pain or any symptom unusual for them calls their attention to it.
Therefore the noble indignation of these trespassers on forbidden ground
is unjust and unwarranted, and the only party to blame is their own
ignorance and lack of self-control.

The only sure way to avoid a venereal exposure is to avoid the exposure
and to keep away from the danger zone.


                  PRACTICAL PROPHYLAXIS (PREVENTION).

Different methods have been suggested to minimize the chances of
venereal infection. One of them is the use of rubber protectors,
“condom,” but the protection they give is far from certain, as they
occasionally tear, and also the infection may be implanted in parts
beyond the protected area.

The United States Army and Navy, as well as some European governments,
have introduced some preventive ointments for syphilis and injections
for gonorrhea, but these preventive measures to be effective must be
applied at once after the exposure, and in a most thorough and careful
manner.


                           VENEREAL DISEASES.

As mentioned before, there are three venereal diseases, which constitute
the main bulk of venereal cases, and which are at the bottom and the
cause of most venereal disorders. They are Gonorrhea, Syphilis, and
Chancroid. These diseases are produced each by a different and separate
kind of germ; they develop independently one from another, and they can
never change one into another. But they can coexist in one patient; i.
e., a man can get at the same time gonorrhea and Chancroid. If this
double infection takes place, then both diseases have to be treated at
the same time. The fact that a man has already one disease in a chronic
form does not prevent him from getting another. Equally so, the fact
that a man has already once had a venereal disease does not prevent him
from contracting it a second time, nor does it make it less likely to
occur. This is particularly true in the case of gonorrhea and Chancroid,
but much less in syphilis, in which an infection for a second time is
rather rare.


    PROGNOSIS (PREDICTION AS TO THE FUTURE DEVELOPMENT) OF VENEREAL
                               DISEASES.

The popular mind usually estimates the danger, seriousness, and probable
duration of any disease by the amount and intensity of pains, by the
violence and rapidity of its development, and by the degree of
disability that the sickness inflicts on a man. Nothing could be farther
from the truth than this belief in the case of general internal
diseases, and still more in regard to venereal diseases. The most
destructive, most malignant incurable diseases in most of the cases
begin slowly, insidiously, without acute and severe pain, hardly
attracting the attention of the patient, and for a long time not
interfering at all, or very little, with his working capacity. Often the
patient wakes up and takes notice of the disease only after it has
gotten deeply into his system and holds him in its clutches, never to
release him. On the other hand, many acute diseases, that start with a
high fever, violent pains, and other alarming and terrifying symptoms to
the patient, under intelligent care pass away just as quickly as they
come, and leave the patient without any permanent damage. This is
particularly true in regard to venereal diseases. _Do not judge the
seriousness and dangerous nature of a venereal disease by the amount of
pain and discomfort it brings to you._ In no other respect are the
venereal patients as much misled and fooled as in this, and no other
mistake brings as much unnecessary and preventable suffering and
financial loss. Only a competent physician, after a careful observation
and repeated examination with the special methods, can give a correct
estimation as to the danger and probable duration of the disease.

Remember also that the best and most learned specialist cannot promise
you a perfect cure in a specified time, but he can give you only a
probable duration of the disease, liable to be changed by many
unforeseen circumstances; and keep away from a man who “guarantees a
sure cure” in so many weeks or months. The treatment of venereal
diseases can never be forced and hurried thru in a certain period of
time, and those patients who insist on a doctor’s pushing the treatment
in forced marches always strike a bad bargain and are doomed to
disappointment by a relapse of the disease or the development of serious
complications.


                               GONORRHEA.

Gonorrhea, commonly termed a clap, is unquestionably the most widespread
of venereal diseases. So common it is, so insidious and deceiving in its
appearance, that most men fail to realize its serious and often
dangerous nature and regard it as a trifling affection. How often one
hears boys repeat this hackneyed and silly expression, “I would rather
have a clap than a bad cold.” What childish recklessness, what arrogant
ignorance, and how terribly it is punished and regretted later on!

The more medical and social workers study the clinical and social
ravages produced by gonorrhea and its complications, the more they are
impressed by its enormous and far-reaching destructive power on human
health and happiness. It is a wellestablished opinion among the medical
scientists at the present time that the total amount of damage and
suffering to individuals and to society at large produced by gonorrhea
falls not far below that produced by Syphilis, which is justly known as
a black scourge of humanity. Gonorrhea is considered now a very serious
disease, requiring, for a complete and permanent recovery, long and
painstaking treatment. The complications of gonorrhea are numerous and
far-reaching. _Ninety per cent of inborn blindness in children_ in
institutions for the blind are _due to Gonorrhea_, and tens of thousands
of little sightless victims are a pitiful evidence of the disastrous
consequences following the neglect or indifferent handling of Gonorrhea
cases. It is also known that possibly half of all operations performed
on women are due to neglected or unrecognized cases of Gonorrhea, and
thousands and thousands of young women become permanent invalids thru
the ignorance or indifference of their husbands. Only a Genito-Urinary
specialist, who sees how many of these cases are mistreated or untreated
because they are regarded by the patients as trifling and not worthy of
any particular attention, who sees how these cases, once the sickness
takes deep roots in the body, drag on for months and months in spite of
the best treatment; only a physician can realize to the full extent how
seriously and carefully each case of Gonorrheal infection must be
handled. The respect and fear of Gonorrhea comes to young men only after
a sad and distressing experience as an afterthought. How much better it
would be as a forethought. It is the writer’s hope that the following
lines will serve as a torch of knowledge, shedding light and guiding to
safety the traveler through the darkness and dangers of sex ignorance.


                 DIAGNOSIS (RECOGNITION OF GONORRHEA).

Gonorrhea is an inflammation of the lining of the urethral canal,
produced by a certain kind of germ called _Gonococci_. These germs are
so small that millions of them can be found in one drop of pus (matter),
and they can be seen under a microscope grouped in pairs, and resembling
in shape the halves of coffee beans put together. Gonorrhea is also
called a _specific urethritis_, which means an inflammation of the
urethra caused by a specific germ, to be distinguished from a _simple
non-specific urethritis_, produced by other germs not Gonococci.

There is a great difference in seriousness and possibilities of
developing various dangerous complications between real Gonorrhea, i.
e., specific and simple non-specific urethritis. Simple urethritis is a
mild and harmless catarrh of the urethra, which ordinarily clears up in
from one to two weeks with a very simple treatment and even without
treatment. Simple urethritis never leads to any deep or dangerous
complications, never goes into the blood of the patient, and does not
carry over affection to the wife and children. Unfortunately, from every
hundred cases of urethritis, the majority of them, not less than ninety
per cent, are real Gonorrhea, and the balance of ten cases are simple
urethritis. For a man who has contracted a venereal affection of this
character it is of greatest importance to determine whether his case is
a simple urethritis or real Gonorrhea; but this is not as simple as
could be desired, and as most of the patients believe it is. It is
absolutely impossible to differentiate between real Gonorrhea and simple
urethritis by the clinical appearance of the case or to estimate the
seriousness and duration of the case by the visible symptoms, such as
the amount of discharge, intensity of pains, etc. Not only the patient,
but _even the physician can not establish the presence of Gonorrhea in
the case without a microscopical examination_. A man who claims to be
able to estimate the nature and seriousness of the case from the looks
of things is either an ignoramus or impostor, or both.


                 CLINICAL COURSE OF AN ACUTE GONORRHEA.

The first signs of Gonorrhea usually appear not before two and not later
than five days after unclean intercourse. This is the so-called
_incubation period_—a period that differs in length in various diseases.
The first thing that attracts the patient’s attention is a slight
itching or tickling feeling and a sense of heat in the end of the penis.
From twelve to twenty-four hours later a swelling is noticed at the
opening of the urethral canal, and a whitish discharge begins to ooze
from the canal. This discharge begins to increase rapidly in thickness
and amount, and soon a greenish yellow thick pus begins to flow
profusely. Correspondingly, the swelling and inflammation increase more
and more, and urination becomes more difficult and painful, very often
so agonizing that the patient holds the urine as long as he possibly
can. _Usually it takes from one to two weeks until the sickness reaches
its climax, then for a week or two it stands at the same height, and
from the third or fourth week it begins to go down_, the discharge
diminishes in amount, turns to creamy white, then becomes thinner,
slimy, the urine becomes clearer and clearer, and _in five to six weeks
from the beginning of the disease the patient recovers completely_. This
is the course of a somewhat normal case of Gonorrhea, with smooth,
regular development and without any complications. _A man must consider
himself very lucky if he recovers from Gonorrhea in five to six weeks
completely._ Only a small minority of all Gonorrhea cases run so
smoothly, probably not more than 25 to 30 per cent. The majority of the
cases, sometimes in spite of the best treatment and the best care,
develop different complications, which increase the duration of the
disease for a much longer period.


                      COMPLICATIONS OF GONORRHEA.

In the beginning of Gonorrhea the inflammation is limited to the front
part of the urethral canal, but in many cases the inflammation goes in
deeper and spreads to the rear part of the urethral canal nearer to the
bladder.


                            DEEP GONORRHEA.

Acute deep Gonorrhea is usually brought about by some indiscretion on
the part of the patient, such as violent physical exercise like running,
jumping, dancing, or it may be also produced by drinking of alcoholic
liquors or by strong and improperly done injections at the hands of
self-doctoring patients. It develops usually from the third or fifth
week from the beginning of the sickness. The first symptom of acute deep
Gonorrhea is the increase in frequency and painful urination. The most
characteristic feature is that the _pains are not felt in the beginning
or during the act of urination, but right at the end of it_, due to
spasmodic contractions of the deep urethral muscle on highly inflamed
parts. Another distressing feature is the frequency and urgency of
urination, so that the patient cannot hold back his urine for a moment,
but has to void it immediately. One more symptom that often misleads the
patient into the belief that he is getting better, while in reality the
opposite is true, is a rather _sudden stoppage of the discharge_, which
has been rather free. At the same time quite often a drop or two of
bloody discharge appears at the close of urination, accompanied with the
intense spasmodic pains mentioned above. This combination of symptoms
makes the acute deep Gonorrhea a most distressing and alarming
complication to the patient, and frequently he wakes up for the first
time on this occasion to a full realization of the serious and dangerous
nature of Gonorrhea. Acute deep Gonorrhea, under intelligent care,
subsides and quiets down in two to three weeks, but for a complete cure
it takes from six to eight weeks more, so that all together these cases
take from two to three months. The importance of Acute Deep Gonorrhea
lies mainly in the fact that it indicates that Gonorrhea Germs have
penetrated deep into the system, opening a gateway for other deep and
serious complications.


        GONORRHEAL INFLAMMATION OF THE TESTICLE (EPIDIDYMITIS).

The nearest place for Gonorrheal germs to invade from the deep Urethra
is that part of the testicle which consists of the twisted and folded on
itself spermatic duct; this part is called the _Epididymis_, which means
the _appendix of the testicle_. Epididymitis starts usually quite
abruptly, from three to five weeks from the beginning, after some
physical exertion, like too fast or too much walking, running, jumping,
dancing, wrestling, etc. It starts with a high fever, headache, feeling
of heat and weight, and agonizing pain in the testicle. Every motion and
walking becomes impossible and the patient has to take to bed. The
testicle in its rear part becomes swollen, sometimes to twice or even
more its normal size, and hard. Under proper care, the acute symptoms of
pain and swelling _subside in two to three weeks_ and the patient is
able to resume his work, but a part of the swelling and hardness remains
and can be felt for many, many months, until it gradually disappears
thru slow absorption; yet in some cases a small, hard nodule remains
forever. The main danger of Epididymitis is just in this very
possibility, that the spermatic duct may be partially or completely
obstructed and blocked permanently by the inflammation, in consequence
of which no spermatozoa can go out from the testicle of this side, and
_if Epididymitis occurs on both sides_, which happens often, then
obliteration of the spermatic ducts is complete; in other words, _the
man can never have children—he becomes sterile_.


                           GONORRHEAL BUBOES.

Among acute complications of Gonorrhea should be mentioned also buboes,
very much dreaded by the patients, who are pleased to call them, for
some reason, “blue balls.” Buboes are a swelling of the glands in the
groin, which can be felt as hard and tender knots. Gonorrheal buboes are
very harmless, usually go down promptly under treatment, and very seldom
form an abscess.


                       CHRONIC GONORRHEA (GLEET).

_A case of Gonorrhea that lasts longer than three months is called
chronic._ There is a number of different conditions that may keep
Gonorrhea up for many months and even years. Chronic Gonorrhea differs
from acute by the absence of pains, swelling, or any other violent or
acute symptom. The discharge is either very slight, just a drop in the
morning (so-called _good morning drop_) or none at all. Frequently a man
feels no discomfort of any kind and does not notice anything abnormal,
except possibly a slight pasting and glueing of the urethral canal, in
which cases only a close examination of the urine will show that it is
full of shreds; but a large majority of the cases of chronic Gonorrhea
is accompanied with more or less copious discharge, commonly called
Gleet.

Chronic Gonorrhea may be limited either to the front part of the Urethra
or to the deep rear part.


      PROSTATITIS (GONORRHEAL INFLAMMATION OF THE PROSTATE GLAND).

A most frequent cause of Chronic Gonorrhea is the extension of the
Gonorrheal infection into the Prostate Gland, which, as mentioned above,
lies deep between the Urethra and the bladder. Once Gonococci have
penetrated into the deep recesses of the Prostate Gland, they secure
there a very strong foothold, and it is very hard to reach and dislodge
them with an ordinary treatment. Gonococci may lay dormant in the
Prostate Gland, producing very few active symptoms and very little
annoyance and discomfort to the patient, who may consider himself well,
or pretty near well, and suddenly, after some indiscretion like dancing
or use of alcoholic liquors, the germs take a new lease of life and
precipitate an acute outbreak of Gonorrhea. The patients as a rule
believe that they have contracted a fresh case, while in reality it is a
case of reinfection from their own prostate gland. These cases of
rekindling of old Gonorrheal prostatitis can repeat themselves many,
many times, until the true cause is discovered, and the Prostate Gland
is cleaned up thoroughly.

A chronic Gonorrheal Prostatitis is an extremely common infection.
Probably not less than half of the Chronic Gonorrhea cases are due to
the involvement of the Prostate Gland. The tissue of the Prostate Gland
is extremely rich in nerves, and its chronic inflammation, thru the
pressure and irritation of different nerve endings, produces pains and
discomfort, not only locally in the genital organs, but also far away in
different parts of the body. Locally, the _symptoms of chronic
prostatitis are a whitish, milky discharge from the urethral canal_,
particularly _after urination or defecation_ (stool), and _a
deeply-seated feeling of weight or deep burnings_. From distant pains
produced by the irritation of the nerve endings, most common are pains
in the legs, in the back, in the region of the stomach, and headaches.
In fact, very often patients come complaining of pains in different
parts of the body, without having the slightest suspicion that the cause
of it all is their infected Prostate Gland. One of the most distressing
features of chronic Gonorrhea prostatitis is its powerful, depressing
influence on the patient’s spirit and mentality. No other complication
of Gonorrhea wears down a man’s courage, self-assertiveness, and joy of
life, none of them makes a patient so disheartened, worried, and
despairing of recovery as does chronic Prostatitis. Gonorrheal
Prostatitis, under the best treatment, takes usually several months for
a complete cure, and the task to keep up a patient’s courage and
confidence in his recovery taxes as much the physician’s skill as the
treatment itself.


                         GONORRHEAL STRICTURES.

Next to Gonorrheal Prostatitis in frequency and practical importance
should be mentioned stricture. In fact, in many cases it is much more
dangerous, as the old neglected stricture can never be cured completely,
while prostatitis, even in the old cases, almost always can be brought
to a satisfactory condition.

The stricture is a scar, forming gradually and slowly after an uncured
Gonorrhea. Usually these scars are a result of row patches in the
urethral canal that quite frequently develop during a chronic Gonorrhea.
These patches, so-called _granulation patches_, what the public calls
“wild flesh,” are a common source of pains and persistent discharge,
lasting for many months. These granulation patches can be discovered
only thru a special instrument called _urethroscope_, which introduces
electric light in the urethral canal and makes possible a clear and
exact inspection of its entire surface. If these patches are not
discovered or not properly treated, they may heal up slowly by
themselves, but not in a natural way with the restoration of the normal
size and smooth lining of the canal. They will heal up with a scar that
has a peculiar ability to shrink and to contract. As a result of it, the
normal (lumen) channel of the urethral canal is interrupted, twisted,
and obstructed, partially or completely, which leads to a retention or a
stoppage of urine. The granulation patches are soft in the beginning,
and can be cured without difficulty in very few weeks or months; but
after they have turned into a stricture the treatment is immeasurably
harder and longer. In fact, the _very old strictures cannot be cured
completely, but only relieved temporarily_.

The main danger of a stricture is its slow and insidious development. It
takes many months for a granulating patch to turn into a fresh
stricture, and it takes years to form an old stricture. For months and
years a patient may have no discomfort nor symptoms sufficient to call
his attention to his condition, and by the time he begins to feel some
annoyance and to notice some disturbance, the stricture is already old
and incurable. Therefore it is highly important for any man who has had
the misfortune to contract Gonorrhea to secure a positive assurance that
he is in no danger of developing a stricture later. The active symptoms
of stricture are: (Gleet), a _slimy discharge, particularly in the
morning; frequency of urination and a slow, dribbling, weak stream of
urine_; but, as mentioned above, these symptoms develop long after the
stricture is formed, and no man should wait for their development.


                         GONORRHEAL RHEUMATISM.

The last, and by no means a rare complication of Gonorrhea, is
rheumatism. Gonorrheal Rheumatism usually sets in abruptly at any time
in the course of disease, and commonly attacks ankle, wrist, knee, or
elbow joints. Clinically, it strikingly resembles a common acute
rheumatism, but the treatment which is efficacious for the common
variety of rheumatism is perfectly useless in Gonorrheal. Gonorrheal
Rheumatism is a very serious complication; it causes a good deal of
suffering, it takes many weeks or months for a complete recovery, and in
many cases leaves behind stiff joints and permanent disability.


                        TREATMENT OF GONORRHEA.

We shall proceed now to describe briefly the general principles and
methods of the treatment of Gonorrhea and its complications, as we
believe that the intelligent understanding of these methods will help
men afflicted with Gonorrhea to avoid blunders of self-doctoring and
exploitation by ignorant impostors and unscrupulous medical quacks. The
acquaintance with scientific methods of treatment of Gonorrhea
considered the best at the present time should prove conclusively to
these men that to protect themselves against dangerous complications and
permanent injurious aftereffects of Gonorrhea, they should not trust
their health either to friends ever ready with advice nor to the
alluring and highsounding promises of quacks; it would show that _there
is no short cut to a cure of Gonorrhea_; that this cure can be effected
only by systematic and persistent treatment at the hands of a competent
physician.

The first point of importance to remember in the treatment of Gonorrhea
is that Gonorrhea is essentially a local disease, and that it penetrates
into the blood in the whole system very seldom; in fact, only in one
complication, Gonorrheal Rheumatism. This fact readily explains why the
_main treatment of Gonorrhea is local_, and why the internal treatment
with drugs is of secondary importance, and in many cases can be omitted
altogether. Yet the public at large seems to believe as religiously as
ever in the magic power of different potent drugs, such as “blue”
capsules, cubeba, copaive balsams, santal oil, etc. This medical
superstition unfortunately is encouraged and kept up by manufacturers
and dispensers of these drugs for commercial reasons, as well as by many
healers disqualified by the law or the lack of special training and
equipment.


                     TREATMENT OF ACUTE GONORRHEA.

The very first request a gonorrheal patient addresses to a physician is
to stop the discharge as soon as he can. Should the physician comply
with this request, he would show by doing so not only a complete
ignorance of the subject, but he would also do a great deal of harm to
the patient himself by driving the disease inside instead of outside.
The popular fear of a discharge is based on the ignorance of the fact
that the discharge in Gonorrhea, like many other symptoms, such as
fever, cough, vomiting, etc., in other diseases, are not harmful by
themselves, and that in a certain stage of the disease they serve a
useful purpose of helping the human body to get rid of the different
poisons and disease-producing germs. So in Gonorrhea the thick, greenish
yellow discharge helps along the Nature to throw off and to eliminate
Gonococci, and until this purpose is accomplished, to check a discharge
is not only unnecessary, but absolutely harmful. Therefore, _in the
early stage of Gonorrhea_ intelligent treatment calls for injection with
antiseptic drugs that kill Gonococci and rather _stimulate a discharge
than check it_. Only later, in from three to four weeks, when the
character of the discharge shows that all Gonococci are already
eliminated, and that therefore the discharge has outlived its
usefulness, only then the physician is justified in giving injections
with the binding or astringent drugs, that check and gradually stop the
discharge.

Ignorance or a deliberate violation of this rule in a foolhardy attempt
to make a short cut to a cure has caused, in thousands and thousands of
cases, a penetration of Gonorrhea into the deeper organs and has led to
numberless complications and injurious aftereffects.

_The injections_ can be started usually at once, with the exception of
the few very acute cases, where the swelling and pains are so severe
that it is necessary to wait a few days before starting the injections.
It is in these cases particularly that the use of the internal drugs,
usually mild antiseptics, is advisable until local treatment can be
started. In making injections, one point should never be overlooked:
this is, to _urinate each time before making an injection_; failure to
do this has driven many gonorrheas into the deeper parts.


                DIET AND A GENERAL REGIME IN GONORRHEA.

The dietetic and general regime in an acute Gonorrhea is just as
important as the medical treatment. In the _first three to four weeks as
much rest and quiet as a patient can possibly secure_ is a very
important condition to prevent injurious complications. Too much or too
fast walking, running, jumping, dancing, wrestling, etc., should be
absolutely prohibited. A well-fitting suspensory bandage should be put
on at once. That alcoholic liquors are tabooed is pretty well known to
the public, except a very few tyros that still believe that beer can
drive out the disease. All stimulating drinks, like coffee, chocolate,
strong tea, and sharp seasoned food should be avoided until the acute
stage is over. Drinking of plenty of plain water should be encouraged,
as the resulting copious urine provides a natural and most efficient
drainage and elimination of the dirt of the urethral canal. Less meat
and more milk and cereals is the best diet for an acute stage of
Gonorrhea. There is no objection to moderate smoking. It stands to
reason that any sexual excitement or stimulation is extremely harmful
and aggravates the condition immensely. Absolute cleanliness must be
insisted upon, and the patient must be careful not to spread the disease
by soiling with gonorrheal discharge different articles of personal use
that may be used by others. He must be careful also not to carry over a
gonorrheal poison with the soiled fingers into his own eyes, as
_gonorrhea of the eye is a most dangerous disease_ that often leads to
complete blindness.


                 TREATMENT OF GONORRHEAL COMPLICATIONS.

The closing stage of acute Gonorrhea is the only time when a patient can
be allowed to take a part in the treatment by making injections at home
after careful and personal instruction by a physician. All the rest of
the course of Gonorrhea and its various complications can be handled by
a physician only, as it requires a special equipment and a special
technic.

Deep gonorrheal inflammation forbids any instrumental treatment. With
the first symptoms pointing to its development, all injections must stop
until the acute stage is over. The patient is advised to rest, and is
given some soothing internal medicine. After two or three weeks the
local treatment may be resumed.

Similarly to it is treated Acute Epididymitis (inflammation of the
testicle). With the first signs of its development, all injections must
stop, and the patient has to stay in bed until all acute swelling and
pains are gone, which takes usually from two to three weeks. Locally,
cold in the form of ice bags, or heat with the hot-water bottle, are
used. They are both good, but in either case the applications have to be
kept up persistently. Their selection depends upon individual preference
and feeling of relief experienced by the patient. Locally, different
ointments are used to reduce and soften the swelling.

Deep Gonorrhea can be cured only by deep injections, with a special
instrument called _instillator_, of a few drops at a time of strong
germicide drugs.

Extremely useful also and commonly used are _irrigations_ with a
fountain syringe of large quantities of antiseptic and soothing
solutions, which fill up the bladder and effect a thorough flushing of
the whole urethral canal. These irrigations are used under most variable
conditions, and are often used preceding or concluding instrumental
treatment. Their efficacy depends on the systematic and persistent use
and a careful and exact grading of the strength of the solutions.

_Granulating patches_ or row spots mentioned above as the source and
origin of strictures can be _treated_ only by _the urethroscope_
described before, by localizing them and touching them up with
cauterizing medicines. This treatment is supplemented by _stretching
with the steel sounds_ and irrigations. The _treatment of strictures_ is
very similar to this, and mainly consists of _stretching_ with gradually
increasing in size _sounds and irrigations_.

Finally, _Prostatitis is treated mainly by massage of the prostrate
gland_, which is done by a finger inserted per rectum. This massage,
made once or twice a week, is one of the most valuable parts of the
treatment of chronic Gonorrhea, because in no other way can pus and
gonococci be eliminated and carried out from the deep recesses of the
gland as thru massage. Prostatic massage is usually followed by
instillations or irrigations.


       PROGNOSIS (PROBABLE DURATION AND CURABILITY OF GONORRHEA).

_Treatment of all deep chronic complications of Gonorrhea takes usually
from two to six months_, and sometimes longer if the case is neglected.
Patience and persistence in treatment is an absolutely indispensable
condition for success, and patients who take treatment for a while and
then drop it because, in their opinion, their case is incurable are
throwing away their only chance of cure. The fact of the matter is that
chronic Gonorrhea, if treated properly and patiently, can be considered
a thoroughly curable disease. The incurable cases make up not more than
5–10% of the total number of cases properly treated, and these few
exceptions are usually neglected old strictures, which of all Gonorrheal
complications are the hardest to cure.


                        GONORRHEA AND MARRIAGE.

After the treatment of chronic Gonorrhea is completed; after all visible
signs and symptoms have cleared up; after the patient has resumed, with
the permission of his physician, his usual mode of life, a momentous
question comes up before the patient—when can he marry with an absolute
assurance that he will not transmit his sickness to his wife; in other
words, when can it be stated that he is absolutely cured? That the
answer on this question may mean happiness or misery in life for the
patient is realized and recognized by all intelligent people. But it
seems to be unknown and commonly overlooked that to give a positive and
definite answer to this question is a matter of great responsibility and
of greatest difficulty, even to the most experienced and highly-trained
specialist. Only those who know how treacherous are gonococci, what
ability they have to lie dormant for many months or even years in the
deep recesses of the body and then on some provocation to waken up to
new activity, only those know how hard it is to get the system rid of
them, and how difficult it is to be sure of their complete elimination.
And yet almost in all cases a physician is able to tell with reasonable
certainty whether the patient is able to get married without danger of
transmitting the infection, but to arrive at such a definite conclusion
a physician must undertake a whole series of different examinations and
special tests, as only repeated, persistent, negative tests for
Gonococci can be accepted as conclusive. A man who comes to a physician
and insists that the physician should render his verdict at once demands
the impossible, and the hasty conclusion he will force out is not worth
much.


                 URINALYSIS (EXAMINATION OF THE URINE).

The first step in a series of examinations to form an idea of the
localization, intensity of gonorrheal infection and to gauge the results
accomplished by the treatment is an examination of the urine. Even a
plain inspection of the urine gives to the experienced eye of the
physician a pretty good idea of the localization and intensity of the
case. To get the best results, the patient must call early in the
morning with the very first urine kept in the bladder over night, for
the reason that the frequent voiding of urine during the day continually
washes out the secretion, and thus masks the true picture of the
sickness. The physician inspects the urine after it has been voided in
two or three glasses—so-called _two and three glasses test_.

A systematic and repeated examination of the urine is one of the most
important and healthful procedures in the treatment of Gonorrhea, and no
intelligent physician can do without it. In this regard, a word of
warning should be addressed to the gonorrheal patients. Let no one fall
into the error of playing physician in his own case and try to look at
his own urine at home, drawing his own conclusions. This is surely one
of the occasions where a little knowledge is worse than none. No matter
how intelligent a patient may be in other respects, his attempts to
gauge his condition by the appearance of his urine will end disastrously
in blunders, causing unnecessary worry and striking terror into his
heart without reason.

Among the most common mistakes of this character is to regard the long
shreds swimming in the urine for pieces of tissue which come, they
imagine, from their decaying organs, while the shreds are nothing but
the harmless mucous so-called _gonorrheal threads_, and the longer these
shreds are and the more terrifying they appear to the patient the more
harmless they are.

Another common and unnecessary scare is due to a cloudy, dirty-looking
urine, often full of _sandy-like sediment_ which in reality is not a
result of the sickness, but is produced by harmless salts from certain
food or drugs. These two examples should be sufficient to show that for
the best interests of the patient the interpretations of the symptoms of
the disease should never be attempted by themselves, but should be left
entirely to the physician.

The next step after the inspection of the urine is a _microscopical
examination of the discharge or a sediment from a urine_. This test is
the _most significant of all_. If a physician finds under the microscope
typical gonococci even once from so many times, the patient cannot be
pronounced cured and free from infection, no matter how well he feels
and how successful are all other tests.

If a microscopical examination of the discharge and of the sediment of
the urine is negative, i. e., gonococci are not found, then the
physician must secure thru massage a _secretion of the prostrate gland_
and seminal vesicles and _examine_ these fluids _under a microscope for
gonococci_. Even this is not sufficient, and the search for hidden
gonococci can be made still more effective by a _bacteriological test_,
which consists of producing an artificial growth of gonococci from a
discharge. This test is extremely sensitive, but it is complicated. To
assure still greater positiveness of the judgment, a so-called
_provocative test_ can be used. The patient is allowed not only to
return to his normal mode of life and unrestricted regime, but for
experiment’s sake is even allowed an excessive indulgence in stimulating
food and drink. Here should be mentioned the so-called “beer test,”
which is based on the fact that beer has a peculiar irritating and
stimulating influence on gonococci, bringing them from the deep recesses
to the surface, where they can be easily found on microscopical
examination.

If all these tests are uniformly negative, then the patient can consider
himself cured and free from infection, and can be allowed to marry. But
_if a single one of these tests are positive, that is, shows the
presence of gonococci, and the rest of the tests are negative, then the
case is still under suspicion and requires further watching or
treatment_.

It is proper to state, tho, that in certain cases a man may be allowed
to marry even before he is perfectly cured from all after-results or
complications of Gonorrhea. This is particularly true in regard to
strictures, chronic prostatitis, or hard nodules remaining in the
testicles after Epididymitis. The reason for this allowance is that the
contagious stage of Gonorrhea does not last always thruout the whole
course of the disease. Quite often the gonococci are dying out before
the after-results and different inflammatory conditions (that were
originally started by gonococci, but later were kept up by other germs
always present in the genito-urinary tract) are cured. Therefore if a
physician, after having tried all the above-described tests, is
satisfied that there are no more gonococci present and detectable, and
that the condition as yet uncured, such, for example, as a stricture
which carries no germs and precludes every possibility of transmitting
infection, then he can conscientiously allow the patient to get married,
if marriage, for some personal reasons, can not be delayed. At the
present stage of medical science the tests establishing the fact of
perfect cure of Gonorrhea is a time-consuming and complicated procedure,
but considering the responsibility involved both for the patient and the
physician, no intelligent man should fail to go through it, if it should
fall to his lot to do so.




                      Functional Sexual Diseases.


After briefly reviewing the problem of Gonorrhea in its different
aspects, we shall discuss certain conditions which stand in very near
relation to Gonorrhea. There are: _Impotence_, known under the common
name of loss of manhood; _sterility_, loss of procreative power; and
_sexual neurasthenia_, nervous debility developed on sexual ground.
While these conditions may also develop independently without any
Gonorrhea in the history, from other abuses and irregularities in the
sexual sphere, yet in a very large number of cases they do develop, if
not because of Gonorrhea, at least after it; in other words, Gonorrhea,
by weakening general and specially sexual nervous apparatus, creates a
certain predisposition for their development.

These diseases are worthy of serious consideration, as they are very
widespread and are the cause of many unhappy homes, of untold family
tragedies, and of much individual and moral suffering. These diseases do
not cause physical pains, neither are they dangerous to life, but men
afflicted with them feel so miserable, suffer such agonies of moral
anguish, are so depressed in spirit and so despaired of life that they
would prefer any acute pain or welcome any operation to relieve their
misery.


                               IMPOTENCE.

Impotence, as mentioned above, is an inability to perform a normal
sexual intercourse. The indispensable physical condition for a normal
sexual intercourse is an erect position (erection of the penis) and a
normal period of time before a seminal ejaculation takes place; hence
Impotentia can be manifested either by partial or total power of
erection, or premature ejaculation, or both. According to various causes
leading to loss of erective power, three various kinds of Impotence
should be considered—psychic, irritable, and paralytic.

_Psychic impotence_ is a very peculiar condition strikingly illustrating
a powerful influence of the mind over bodily functions. It usually
attacks young men in perfect health who are of a worrying and brooding
disposition, particularly so over sexual matters. They may have on their
conscience the guilt of having indulged in masturbation years ago, or
they may have had a gonorrheal infection some time before. As a result
of this brooding over the sins of their youth, they work themselves into
a suggestion that they have ruined their system and have lost their
sexual power, and such is the power of self-suggestion that in spite of
perfect health and the absence of any abnormal condition, all attempts
at normal intercourse end in dismal failure, which in the case of
newly-married people is naturally a very grave and distressing
occurrence. Ordinarily these cases get well after a certain period of
time under the influence and care of a physician without any local
treatment, but under general tonic regime. The main danger of these
cases is that this class of cases fall particularly easy prey to medical
quack healers, who exploit the ignorant and terror-stricken victims to
the limit of their ability to pay, by intensifying their fear and curing
them from non-existing terrible diseases.


                         IRRITATIVE IMPOTENCE.

The second type of _Impotence_, _irritative_, is the most frequent of
all. In this condition the power of erection may or may not be affected,
but the main distressing feature is a _premature ejaculation of seminal
fluid_, which may take place even before a man approaches the woman.
This condition is caused by over-stimulation and over-irritation of the
sexual nervous apparatus, and is mostly the result either of an old
habit of masturbation (self-abuse) or a chronic inflammation in the deep
urethra left after previous Gonorrhea. This class of patients is also
suffering from _frequent night emissions_ and _general nervosity_. They
constitute the most pitiful and miserable group of all venereal cases.
Weak and haggard-looking from loss of seminal fluid, broken in spirit as
well as in body, they are haunted by a feeling of despair and utter
annihilation; they are full of disgust with themselves, and are
frequently incapable of pursuing their occupation. This class of men, as
all the Impotentia cases, also fall easy prey to medical quacks, as they
are often ashamed to go to a regular practitioner and family physician,
and prefer to go to a stranger. Fortunately these cases are not
difficult to cure, though it takes usually several months to effect a
permanent cure. The treatment will vary according to the cause producing
this hyperirritability of the nervous apparatus. It may require
treatment of the deep urethra, prostate gland, or general tonic regime.


           SPERMATORRHEA (INVOLUNTARY LOSS OF SEMINAL FLUID).

A common and one of the most distressing features of irritative
impotence is _Spermatorrhea_, i. e., an involuntary loss of the seminal
fluid, outside of night emissions. These seminal losses occur either as
periodical oozing of a few drops at the end of urination and defecation,
or as continual oozing as a result of muscular weakness and insufficient
contraction of prostatic ducts. This continually oozing fluid is usually
prostatic secretion, and is due to the existing chronic prostatitis. The
cure of this condition is effected thru the treatment of the prostate
gland.


URORRHEA (WETNESS FROM DRIBBLING AND OOZING OF CLEAR WATERY DISCHARGE).

It should be mentioned here that there is another condition resembling
very much the above-described Spermatorrhea, a condition that scares the
patients very much, who think they are suffering from seminal losses.
This condition, Urorrhea, is very harmless, as the secretion oozing in
these cases is plain water and mucus, due to excessive blood congestion
in time of sexual excitement. But the difference between these two
fluids and two conditions can be established only by a physician on
microscopical examination, and should not be left to the judgment of the
patient himself.


                          PARALYTIC IMPOTENCE.

The last variety of impotence, Paralytic, presents a condition opposite
that just described, and instead of irritation and over-stimulation of
the nervous sexual apparatus, it shows its weakness and exhaustion down
to complete paralysis.

It is understood that every man reaching a certain age gradually
declines in vigor of sexual power. This age of sexual decline varies
considerably with different people, from the ages of 45–70, depending on
general health, and still more on the mode of life. This much is sure:
that _men who have led a regular and moderate sexual life and have
married early retain their sexual power a good deal longer than men who
have dissipated and indulged in various excesses_.

Paralytic impotence may mean either complete loss of erection or
partial. Most common causes of paralytic impotence in young men are a
persistent and excessive masturbation habit and excessive sexual
indulgence. The earlier in life these vicious habits and excesses are
started and the longer they last, the harder and harder is the cure of
the resulting sexual exhausting impotence. In fact, these cases are the
most difficult of all to cure, and many of them are incurable. Men
suffering with paralytic impotence present a truly pitiful picture. They
lose every ambition in life, lose their energy and force of personality,
lose mental and physical vigor and endurance, and become mere wrecks and
shadows of their old selves. If boys and young men could only see these
victims of their own ignorance and folly as the physician sees them in
their desperate and hopeless fight to regain their lost manhood, surely
thousands and thousands of young, happy lives could be saved to
themselves and to society.

The treatment consists in general and local tonic treatment.


                STERILITY (INABILITY TO HAVE CHILDREN).

The foundation of society is a happy family and home life. The
foundation of a happy home life is children. No home can be happy
without the sunshine of the little ones, who are the dearest gifts of
Nature to mankind. No marriage can be happy unless it fulfills its
natural mission and reaches its full fruition by perpetuating the race
of the parents thru children. The children are the greatest and most
powerful incentive and inspiration for a man to work and to strive for a
greater success in his chosen line. Children are a life mission and a
life interest of a woman; they are the strongest and purest bonds of
love between a man and a woman. Gloom and emptiness prevail in a home
that is not blessed with children; there is no living interest and no
natural attraction in such a home, and a childless couple is doomed to
seek outside distractions and interests to fill up the natural void in
their existence and to forget their heart-hunger.

No man who looks forward to a happy family life in the future can ignore
the question and shirk the responsibility of producing healthy children.
And yet so many men, thru light-mindedness or ignorance in younger
years, are responsible for the tragedy of a barren home later in life,
when it is too late to retrace their steps and to redeem their sins of
youth. Public opinion commonly puts the blame on the woman for being
childless, and only in exceptional cases considers the possibility of
the man being responsible for it. How unjust and how far from the truth!
The inability to bear children, medically known as _sterility_, in a
very large number of cases, at least half, is directly or indirectly due
to a man’s disease or an inborn defect. Leaving aside a rather small
group of cases, where a woman is unable to bear children due to some
inborn defect or disease, the largest class of cases of sterility is due
to venereal poisons, Gonorrhea, or Syphilis contracted from their
husbands. In Gonorrhea, due to chronic inflammation of organs of
procreation or mutilating operations—necessary in these cases—no
conception is possible. In Syphilis, conception is possible, but a woman
is unable to bear living children.

In the cases of direct _male sterility_, the woman is perfectly healthy,
and the fault lies with the man alone. It may be due either to some
inborn anatomical defect, or, what is infinitely more common, to some
venereal disease. In these cases, the male embryos-spermatozoa are
either absent or unable to travel in normal channels and to penetrate in
the female organs. This inability may be due to a different cause; _the
most common cause_ of all is Gonorrhea, or, more exactly, a _gonorrheal
epididymitis_. As mentioned above, Epididymitis, if uncured, often
leaves behind hard nodules which obliterate and obstruct the spermatic
channel, partially or completely, thus blocking and preventing
spermatozoa from passing from the testicles, where they are produced
thru the urethral canal out of the body. A man who has had Epididymitis,
with the complete obstruction of the spermatic channel only on one side,
may yet have children, but if the obstruction is on both sides, he
becomes absolutely sterile.

Another cause of male sterility, tho not as common, are strictures,
which, by obstructing and twisting the urethral canal, may divert or
weaken ejaculation of spermatozoa in such a way as to make conception
impossible. It may happen also that tho all channels for the passage of
spermatozoa are free, the spermatozoa themselves, due to a sexual or
general exhaustion, are either missing or are of such low vitality as to
give no hopes for living or healthy children.

Every man with a history of a venereal disease should have his seminal
secretion examined under microscope before his marriage, to test its
vitality. The knowledge of these facts and the application of these
principles in practical life by the average man could save thousands of
happy homes and prevent as many divorces.


                          SEXUAL NEURASTHENIA.

The last complication to be developed in the course of Gonorrhea, but
not by any means the last in importance, is sexual neurasthenia; i. e.,
a chronic state of nervous and mental weakness and irritability.
Possibly no other condition illustrates so well how far and
deep-reaching is the influence of Gonorrhea on the whole system, tho it
is a local disease; how thoroughly it affects the entire mental and
nervous system of a man; how much moral anguish and suffering it
inflicts on its victims. The reason for such a powerful effect of
Gonorrhea on the human mind and emotions has been explained before by
the fact that the genito-urinary tract and different sexual glands which
are usually affected by Gonorrhea are richly supplied with nerves and
are most intimately and abundantly connected thru these nerves with the
highest centers of the nervous system, controlling the mental and
emotional activities.

It has been mentioned already that the nervous weakness can be brought
about by various sexual abuses and irregularities, such as the
masturbation habit, sexual excesses, or over-stimulated and ungratified
desire, but the cases following in the wake of chronic Gonorrhea and its
complications are so numerous, so persistent, and distressing as to
deserve special prominence and consideration.

Sexual Neurasthenia develops as a rule slowly, and it comes either
during the treatment or long after Gonorrhea has been cured. The
predisposition to this condition is created by excessive worrying and
brooding over the disease, and the basis of sexual Neurasthenia
constitutes an idea slowly formed and fixed in the mind of the patient
that he is “full of disease,” and that his condition is incurable. As a
result of this self-suggestion and constant concentration of his mind on
different parts of the body, he feels, or rather he thinks he feels, an
endless variety of different painful and morbid sensations. There is not
a single spot on his body, there is not a single kind of pain or
discomfort that should not be complained of by this class of patients.
It does not matter whether his case is improving or even cured and does
not show a single positive symptom of the disease, the patient cannot be
won over to the cheerful view of his condition. No amount of argument or
persuasion on the part of the physician avails to shake off his gloom
and despair. If the physician, after a careful examination, states to a
sexual neurasthenic that he does not need any more treatment, the
patient accuses the physician of being indifferent, and not taking
sufficient interest in his case and goes elsewhere. If the physician
yields to the pleadings of the patient and keeps up an active treatment,
that makes matters only worse, and still more confirms the patient of
the deep and dangerous character of his condition. The only way to break
the eternal chain of fear and anxiety, which is the main basis of sexual
neurasthenia, is to turn the mind of the patient away from his sickness
by stopping treatment, sending him away, if possible, from old
associations and surroundings, and by building up his general and
nervous system. The treatment of this condition lasts several months,
but they all recover in due course of time.

This class of patients, in their frantic search for a cure from the
imaginary sickness, are naturally more exposed to the danger of drifting
away into the hands of medical quacks, and are more exploited than any
other class of venereal patients. A sympathetic attitude on the part of
the physician and evidence of his sincere and earnest interest in the
condition of the patient is the only thing that slowly gains the
confidence of sexual neurasthenics, brings them back courage, ease of
mind, and restores them to a healthy and happy life.




                               Chancroid


Now before going over the greatest of all venereal scourges, Syphilis,
we shall briefly consider the third and the least dangerous of the
venereal diseases—Chancroid.

Chancroid is also called a _soft chancre_, to differentiate it from
_hard chancre_, which is the initial sore of Syphilis.

_Chancroid usually appears from two to five days after exposure_, seldom
longer. It may develop on the skin of any part of the sexual organs. It
starts as a small red spot or pimple, which rapidly breaks down and
forms a round ulcer, painful on touch, with undermined borders and
profusely secreting pus surface. Chancroid may start at once as a
multiple ulcer or it may grow in numbers after it has started as a
single sore. The number of Chancroids may reach five, ten, or even more.
The peculiar characteristic of Chancroid is that its poison can be
transferred from one place to another by contact, and it is a common
clinical fact, particularly in uncleanly and careless people, that a
single Chancroid or ulcer may duplicate itself on the skin surface that
comes in contact with the Chancroid.

_Chancroid is usually painful_ and disables a man to a smaller or
greater extent, so for this reason it is seldom neglected. Under proper
care, Chancroid _heals up in from three to six weeks_. Only in
exceptional cases, due to low vitality and general debility of the
patient, or due to unusual virulence (intensity) of the Chancroidal
poison, the Chancroidal ulcer assumes a gangrenous character, and in
spite of the best treatment, shows a tendency to spread and to destroy a
large area of tissue. But even in these rare cases, after a few weeks or
months, the ulcerated area gradually heals up without leaving any
permanent systemic damage.

The only complication Chancroid has is a development of bubo, an abscess
of inguinal (groin) glands. _Buboes_ develop in about half the
Chancroidal cases, and are treated by incision on general surgical
principles. The average duration of a bubo is from three to four weeks,
and the total duration of the average Chancroid and bubo from six to
eight weeks.

While Chancroid brings more pain and distress and disables a patient
more than many Gonorrheal complications and average Syphilitic cases, in
reality, Chancroid is the least harmful of all venereal diseases, as it
has a self-limited duration, never penetrates into the blood, does not
lead to any deep or constitutional complication, and does not affect
whatsoever the second generation.




                                Syphilis


Syphilis is one of the oldest diseases in human history. Its ravages and
destruction of health and life thruout many centuries up to our days
have been such that it has been called a “black plague,” in distinction
from the great “white plague,” tuberculosis. It is hard to say which one
of the scourges of humanity is superior in its destruction and wrecking
of humanity. While tuberculosis apparently carries away more lives in
their prime and selects victims principally among the young at the very
height of individual happiness and social usefulness, Syphilis surpasses
its terrible rival in its universal character of distribution, in the
easier mode of infection, and more lasting presence of the poison in the
human body. No country or climate is free from the scourge of Syphilis.
No age, no station of life gives protection from its infection. Syphilis
claims its millions of victims in all parts of the universe. It has
populated cemeteries with untold numbers of bodies of still-born babies
and infants who died in the early months of life; it has filled the
insane asylums of the world with thousands of hopelessly insane men and
women; it has crowded the institutions for the incurable and defective
with paralytic adults and children crippled mentally and physically from
birth.

The individual suffers as much from the ravages of Syphilis as society.
Lucky is the man who can say that he is perfectly cured from Syphilis
after two or three years of the most thorough treatment. Lucky is the
man if he can be sure that later in life, after he may have forgotten
all about his primary infection, the dormant germs of Syphilis lurking
in the deep recesses of his body will not attack his most vital organs,
as arteries, heart, or brain, and will not strike him down to permanent
invalidism or slow but hopeless agony of an incurable disease.

Great as the latest medical discoveries in the recognition and treatment
are, the course of the disease is so insidious and treacherous, and the
treatment requires such persistence and patience and such expenditure of
time and money, that probably no more than half of the syphilitic
patients carry out to the end the treatment and period of medical
observation, and thousands and thousands of them are sure to be stricken
down later in life with the above mentioned terrible after-complications
of Syphilis, and are doomed to premature invalidism, paralytic diseases,
and insanity.


                  DIAGNOSIS (RECOGNITION) OF SYPHILIS.

In every disease an early and correct diagnosis is an essential
condition for a successful treatment. This is particularly true in
Syphilis. The early recognition of Syphilis can prevent a development of
most dangerous complications, can forestall the destruction of most
vital nervous centers and organs.

The recognition of Syphilis is beset with peculiar difficulties, due to
the fact that Syphilis has a remarkable tendency to imitate in
appearance all possible diseases. This simulation is rendered
particularly effective because Syphilis has universal and all-pervading
distribution in the human body, and not a single part, organ, or tissue
is free from the invasion of syphilitic poison. Until lately the
diagnosis of Syphilis was based on the rather uncertain basis of
clinical experience, but the latest medical discoveries have put it upon
a more definite foundation, and rendered it immeasurably more certain.

The first step in this direction was the discovery by a French
scientist, Shaudin, of a germ producing Syphilis, a germ that he has
called _Spirocheta pallida_. Spirocheta under the microscope looks very
much like a corkscrew, and can be easily demonstrated in all fresh
Syphilis sores. A finding of Spirocheta at once and absolutely
establishes a diagnosis of Syphilis. Another valuable method by which a
doubtful or latent case of Syphilis can be recognized is a _blood test_,
known by the name of its discoverer as _Wasserman Test_. This is a very
complicated test, requiring a highly-developed technic, and it can be
properly done only in specially equipped laboratories.

The Wasserman test is not as absolutely sure and positive as finding of
Spirocheta, yet it is very useful, and indeed indispensable in many
cases of latent Syphilis, i. e., Syphilis that does not show any active
symptoms like sores, breaking out, etc.

There is one more way to test the blood for Syphilis—_luetin test_,
discovered by a Japanese scientist, Noguchi. Luetin test is made by
injection in the skin of a certain substance, and also is very useful in
old and latent cases of Syphilis. Recognition of Syphilis by the
appearance and character of the sores and skin eruptions is in many
cases very difficult, and can be done in doubtful cases only by a
physician specially trained in this class of diseases.


                      CLINICAL COURSE OF SYPHILIS.

The clinical course of Syphilis is usually divided, for the sake of
convenience of presentation, into three periods.


                      PRIMARY PERIOD OF SYPHILIS.

The first manifestation of Syphilis in the human body is a primary
syphilitic sore, so-called _hard chancre_. This chancre _appears usually
two or three weeks after exposure_, and this is a very important point
to remember. Most men think that every venereal disease shows up a day
or two after intercourse, and if a week passes without any signs of
infection, they congratulate themselves upon having escaped the penalty
of the transgression. Therefore when, two or three weeks after the
exposure, they notice a small pimple or nodule on the genital organs,
they ascribe it to some accidental cause, and never think of the
possibility of it being of a venereal nature. This error of judgment is
rendered particularly easy by the fact that the initial syphilitic sore
has such a harmless, insignificant appearance, and is commonly so free
from any pain, discomfort, or acute distress, that the patient, as a
rule, ignores it, believing it will pass away by itself, or applies some
ordinary salve. Only after they see that this “pimple” does not
disappear, and gets harder and bigger in size, only then they become
alarmed and consult a physician. This is the reason that so many
patients present themselves to the physician when the syphilitic poison
has already spread all over the body and has broken out in a general
eruption.

A deceiving appearance and mild clinical course of primary syphilitic
chancre that gives to a patient a false feeling of security cannot be
too strongly emphasized and warned against. The following injunction
seems to be well indicated to all men taking chances with venereal
infection: _Beware of the little, painless, insignificant pimple on the
genital organs, that comes up two or three weeks after exposure and
shows a tendency to become firm and hard on touch._

Primary syphilitic chancre may look like a plain pimple or swelling
without any sore on it, or it may present a greasy-looking ulcer with a
very slight discharge, but all syphilitic chancres have _one
characteristic feature_ always present; this is a hard, almost wooden
feel and _firm consistence on touch_.


                           SYPHILITIC BUBOES.

Shortly after the appearance of primary chancre the patient notices a
swelling of the glands in the groin on one or both sides, which feel
like hard nuts, _syphilitic buboes_. These buboes never turn into an
abscess, and remain hard for many, many months, until, under treatment,
they slowly go down.


                             MIXED CHANCRE.

The fact that a man two or three days after an exposure begins to show a
sore of Chancroidal type does not mean that he is already safe from
developing a syphilitic chancre besides. In fact, it is a quite common
occurrence that after development of typical Chancroid, in a week or two
this sore begins to change in appearance and turns gradually into a
syphilitic chancre. In other words, this man has contracted a double
infection of both chancres, only their appearance takes place at
different times, according to the difference in the length of time of
their periods of incubation. The treatment of these mixed cases is
naturally of more complicated character.


                     SECONDARY PERIOD OF SYPHILIS.

The secondary period of Syphilis begins with the first evidence that the
syphilitic poison has spread all over the body, and that Syphilis from a
local sore has become constitutional-blood disease. It takes usually
about _six weeks_ from the time of appearance of the primary chancre
until the development of the constitutional symptoms. The very first
symptom of the constitutional syphilis is a general rash, which has such
a peculiar appearance that no competent physician has any difficulty in
recognizing its nature. Together with the skin eruption, so-called
“_mucous plaques_” can be seen in the throat, on the tongue, lips, etc.
Very often syphilitics of the secondary period suffer from attacks of
fever and get rapidly run down and wasted. In fact, an experienced
physician can recognize a syphilitic by a peculiar paleness and general
appearance suggesting slow waste of the body by some chronic poison.

The most common complaints in the secondary period of Syphilis are:
Severe headaches and boring pains in the bones, particularly at night;
different skin eruptions and patches of mucous plaques around the mouth
or genital organs. These mucous plaques contain millions of active
spirochetae, and for this reason the _secondary period of Syphilis is
the most dangerous period for transmission of the infection_. The
secondary period may last from a few months to one to two years,
depending on the gravity of the case and the character of treatment.


                      TERTIARY PERIOD OF SYPHILIS.

The tertiary period of Syphilis is the longest in duration and the most
dangerous stage of the disease. It gradually succeeds the secondary
active period of Syphilis and lasts, if not treated thoroughly, for many
years, and sometimes thru the entire life.

The main characteristic of this period is that its lesions (sores) are
fewer, but they are very deep and penetrate to the most vital and
important organs, such as blood vessels, heart, spinal cord, and brain.
This is the time when syphilitic germs, after a long period of apparent
cure of the disease, suddenly renew their destructive activity and
strike down their victim with some permanently crippling and incurable
chronic disease. It has been mentioned before that Syphilis does not
spare a single part or organ or tissue of the body. Anywhere, in the
deepest recesses of the most vital and life-bearing centers of the body,
a tumor of tertiary Syphilis can form, so-called _Gumma_, that has a
natural tendency to break down, forming an ulcer and leading to a
terrible destruction of tissues.

We shall not tire the reader by a detailed description of the possible
results of this destruction of the body; it is sufficient to say that
death is a welcome relief to the crippled, palsied, and insane victims
of advanced Tertiary Syphilis. We shall mention only two diseases that
are definitely proven to be after-results of Syphilis—diseases that are
both incurable and that count as their victims countless thousands of
men all over the world.

The first, a _progressive paralysis_, a chronic, progressively
increasing insanity, that draws out for many years and invariably ends
fatally, after a long agony of physical and mental decay and waste.

The second disease is _Locomotor Ataxia_, a chronic, slowly-spreading
decay of the spinal cord, in which are located the most important nerves
controlling the sensation and locomotion of the body. As the result of
the slow death of these nerves, a man is gradually transformed into a
helpless and hopeless paralytic, doomed to stay bedridden for life.

Any and all complications of Tertiary Syphilis can arise and strike down
a man in a most insidious and unexpected manner. The most dangerous and
deceiving feature of syphilitic lesions is that they develop painlessly
and without acute distress or discomfort to the patient, who becomes
aware of the disease only after a considerable amount of tissue is
destroyed and irreparable damage has been done. No man who has a
syphilitic chancre is safe from a possibility of development of
complications of Tertiary Syphilis unless his blood, after repeated
tests, has been pronounced pure and free from syphilitic poisons.


                          HEREDITARY SYPHILIS.

Nowhere else are the ravages of Syphilis more destructive and cruel; no
other disease punishes the offspring for the sins of its parents so
ruthlessly and wantonly; no other scourge inflicts its terrible
retribution on the second generation at such a tender age as hereditary
Syphilis. Hereditary Syphilis is undoubtedly the saddest and most
gruesome chapter in the long black record of Syphilis.

The offspring _may inherit Syphilis from his father_ thru sperma
(semen), _from his mother_ thru ovum and blood circulation, or it may
get infection _from both parents_ at once. Most of the cases are due to
infection from the father. Fortunately, experience has shown that the
older the case of Syphilis is, and the better it has been treated, the
more chance the offspring has to escape a syphilitic heredity, and the
milder will the infection be if it be inherited.

If a man in the active stage of Syphilis marries a healthy woman,
whether she herself be infected or not, she will not bear living
children for a certain period of time. The first two or three years she
will miscarry in the early months of pregnancy, a truly merciful
provision on the part of nature, as death is certainly preferable to the
drawn-out agony of the little creature, mutilated and crippled from
birth. A little later the wife of a syphilitic is able to carry children
to a full term, but they are born with the indelible stamp of loathsome
heredity on their dwarfed bodies. The appearance of such children is as
pitiful as it is repulsive. Wizened, old-looking faces, stunted bodies,
numerous sores and skin eruptions, bone deformities, soft joints, due to
decaying of bone ends and skulls distended with water; these and many
other defects are the legacy these innocent victims come into the world
with. Naturally, the vitality of such children is so low that many of
them die in early infancy. Yet some of them can be saved by an early and
thorough treatment. The farther it goes the more healthy-looking
children are born, the fewer evidences of syphilitic heredity they
present, and the later in life these evidences develop. Gradually, as
the father or both parents receive proper treatment, their offspring
born are more and more healthy and free from taint. _There is no
question whatsoever that syphilitic parents, one or both, can have,
after they have cured themselves, perfectly healthy children, physically
and mentally free from any blood taint or possibility of later
relapses._


                         TREATMENT OF SYPHILIS.

It is remarkable that while modern science has introduced hundreds of
new drugs for different diseases, Syphilis, with one exception, is still
treated with the same drug that was used centuries ago; _this drug is
mercury_; the only thing that has changed is the method of
administration. Mercury, or rather its different salts, are used now in
a number of ways. It can be used internally, in powders, pills, and
mixtures; hypodermically, intradermically, thru inunctions (rubs into
the skin), intramuscularly, and even intravenously. Which particular
method and which particular salt of mercury is to be preferred, depends
on the judgment of the physician and the character of the case. The main
condition of the success of treatment is not the selection of this or
the other method of treatment, but in the thoroughness, persistence, and
systematic use of it.

Mercury is proven to be an excellent germicide, and it cures Syphilis by
killing its germs—Spirochetae.


                             SALVARSAN—606.

Until very recent days mercury was our only anchor sheet in the fight
against Syphilis, but in 1910 the great German scientist, Professor Paul
Ehrlich, discovered that a certain chemical combination of arsenic,
called by him _Salvarsan_, has a wonderful germicide effect on
Spirocheta of Syphilis. Salvarsan is known also as 606, and its latest
modification, Neo Salvarsan, is known as No. 914, because Ehrlich had to
re-examine 605 different combinations of arsenic before he has developed
and adopted 606, and he had to re-examine 913 combinations before he has
adopted No. 914. At the time of its discovery the greatest enthusiasm
prevailed, and it was claimed and expected by many that one injection of
Salvarsan would be able to kill all the spirochetae in the body, and
thus bring about a complete cure of Syphilis. Unfortunately, subsequent
experience has shown that these expectations were unfounded. Salvarsan
is a great remedy and one injection of it may heal up very rapidly most
destructive syphilitic lesions, but neither one injection nor two nor
three can with certainty produce a perfect and absolute cure of
Syphilis.


               GENERAL TREATMENT AND REGIME IN SYPHILIS.

The consensus of opinion of the most reliable and competent of medical
observers at the present time is that the best results in the treatment
of Syphilis are obtained by combined use of mercury and salvarsan,
beginning with a few injections of Salvarsan and following up with a
thorough mercurial treatment. The great usefulness and striking healing
properties of Salvarsan in Syphilis are particularly to be appreciated,
because mercury is not tolerated by many patients beyond a certain
limit. Push beyond this limit, mercury produces symptoms of
_mercurialism_—chronic mercurial poisoning, manifested by swollen and
painful gums, bad smell from the mouth, stomach disorders, diarrhea,
etc., which may prove serious and even dangerous. One of the most
important measures of prevention of mercurialism in a patient undergoing
mercurial treatment is to keep the mouth and teeth in a clean and
healthy condition.

One more drug should be mentioned, which, besides mercury and Salvarsan,
is used more than any other drug in the treatment of Syphilis. This drug
is Potassium Iodide, which is very useful and surpasses anything else in
its remarkable quality to absorb deep-seated syphilitic tumors (gummata)
of the tertiary period.

Besides these three drugs, which are called _specific_, because their
action is almost infallible, there are very few drugs used in Syphilis,
mostly tonics to build up and strengthen the system, weakened by
syphilitic poison. The general regime in Syphilis is much more liberal
than in Gonorrhea, both as to choice of food and drink and as to the
permissible amount of physical exercise or pleasure. This is
particularly true in the late tertiary period of Syphilis. In the acute
secondary stage of the disease, moderation and a regular mode of life is
absolutely essential for the favorable course of the disease. The use of
alcoholic liquors at this stage is absolutely prohibited, but it is
tolerated in moderation if no active symptoms are present. Smoking and
chewing are also prohibited if any sores or patches are present in the
mouth. As mentioned before, these mouth patches, as the sores of this
period, are highly contagious, and the patient, for the sake of others,
must have his own table utensils and all articles of personal use. He is
also cautioned to avoid in every possible way a close physical touch
with others.


                         SYPHILIS AND MARRIAGE.

The question, when can a syphilitic marry? is as momentous and difficult
to answer as a similar question in Gonorrhea; in other words, this
question means, When can a syphilitic be declared perfectly cured and
free from any danger of transmitting the infection to his wife and
children? Until very recent years, before the three great discoveries in
the realm of Syphilis had been made (the discovery of Spirocheta,
Wasserman blood test, and Salvarsan), the physicians adopted from
experience a rule which proved to hold good in the majority of cases.
This rule reads that no syphilitic should be allowed to marry before
three years passed since the time of primary infection. This rule was
adopted on the assumption that the effects of three years’ treatment and
the natural weakening of the virulence (intensity) of the syphilitic
poison with the age of the disease give a reasonable assurance of safety
to the wife and offspring. It is true that in most of the cases the
family was fairly well protected by the long duration of observation
period, and remained free from the infection, yet the physician had no
exact and definite basis for such prediction, and while the family was
well, some of these men developed many years later various dangerous and
incurable complications of the advanced Tertiary Syphilis. Fortunately,
now, in the light of new knowledge at our command about Syphilis, we are
able to gauge the condition of the patient as to the degree of his cure
of Syphilis in a very exact and definite manner. One test, tho, is not
conclusive, particularly if it be negative. Positive Wasserman test is a
fairly good evidence that syphilitic germs, spirochetae, are still
present in the body in a dormant, if not an active, state, but a
negative test, to be conclusive, must be repeated several times,
covering a long period of time under various conditions, such as before
and after a course of treatment. It should be remembered that while
different active lesions in Syphilis are controlled and cleared up under
modern methods of treatment very rapidly, a perfect elimination of
spirochetae from the system is much more difficult, and it is always a
time-consuming procedure. There are many cases of Syphilis where, after
the primary general rash, sore throat, and other symptoms of the early
secondary period, no other active symptoms of any kind develop
subsequently, so that the actual manifestations of Syphilis are limited
to a very few weeks or months, but even in these cases should a blood
test be persistently negative for a period of half a year’s time, at
least another half year should elapse before a final blood test is made.
In the mildest and most thoroughly treated cases, a year’s time should
be the shortest waiting period for giving a permission of marriage. In
many more cases, probably in the majority, this period must be extended
to two or three years, and in a few cases of malignant or destructive
character, even much longer than this.

Thus the modern methods of treatment have shortened enormously the
period of active manifestation of Syphilis, and have placed in our hands
powerful means to control and to check the most malignant and
destructive syphilitic lesions, but the period of quarantine in regard
to marriage is not shortened very much, though its estimation is made
immeasurably more certain, definite, and reliable.

Syphilis can be considered at the present time as _perfectly curable and
readily amenable to treatment_, provided a correct and early diagnosis
is made and a thorough, systematic, and persistent treatment is
administered.




                              Conclusion.


The foregoing pages are offered to the reader with the purpose of
presenting a short and popular exposition of the subject of sex
knowledge, immense in its scope and tremendous in its social importance,
and to give in the simplest and briefest possible terms the most
fundamental and important facts from a practical viewpoint of the sex
life in health and disease. The conclusions to be drawn will naturally
vary with the mental and moral capacity of the reader.

The writer does not want to force his personal opinion on the reader,
and his intention is to present only the facts of the sex life as they
are viewed by medical science of our day, and as they appear from his
personal observation. The writer reserves, however, a privilege to
define his position and attitude on the question of social purity. His
views, based upon personal and theoretical grounds, would be:

First.—That sexual abstinence can be enforced with perfect ease and
without any harmful consequences until the full development of physical
and sexual maturity, which is about from 22–25 years of age.

Second.—That venereal diseases and various sexual disorders are entirely
too big a price to be paid for a momentary impulse.

Third.—That the only proper and normal solution of the sexual problem
for a man above the age of sexual maturity is—marriage.

Fourth.—That the sexual “_necessity_” in young men under the age of
sexual maturity is _always_, and in men sexually mature, _frequently_, a
self-suggested notion, artificially stimulated by indulgence and
environment, and allowed to grow and persist thru the lack of
self-control.

Fifth.—That the amount of social waste and individual damage caused by
venereal diseases can be reduced to a minimum by spreading among men and
maturing boys the elementary knowledge of the facts of sex life in
health and disease.




                             Questionnaire


Question 1.—Is sexual continence harmful to health?

Answer.—At the age before full sexual maturity, that is, up to 22–25
years, sexual continence is not only not harmful, but even advisable and
extremely effective in keeping up the physical and mental freshness and
full vigor of a growing body. After full sexual maturity is reached, a
regular sexual life thru marriage is desirable, but even at this age
sexual continence can be kept up for many months without the slightest
harm to the individual whatsoever, provided he keeps away from
unnecessary stimulating and exciting influences.

Question 2.—Are the pimples on the face of young men an indication of
the necessity of sexual intercourse?

Answer.—Not at all. The pimples on the face of young people is a
harmless skin disease known under the name of _Acne_, and is due to the
surplus of fat secreted by the young skin, but it has nothing to do with
the sexual function. It is just as much and to an equal degree spread
among people indulging in sexual intercourse as among those who are
continent. Acne is often a result of eating too much sweets and other
heavy food. It is treated by regulation of the diet and local
applications.

Question 3.—How often can a wet dream occur without being injurious to
health?

Answer.—There is no definite dividing line and exact time limit between
normal and abnormal wet dreams. In sexual life, individual differences
vary more than in any other function of the human body. Some men get wet
dreams once in 1–2–3 months; some once in 2–3 weeks. The figures are
immaterial. The only safe rule to measure injuriousness of a wet dream
is by its effect on the general health and spirit. _If a man, after a
night emission, feels just as fresh and strong or even better than
before it, it is normal; if not, it is abnormal._

Question 4.—What may the habit of masturbation lead to?

Answer.—In a young child (the younger the more disastrous the results),
persistent masturbation can lead to perfect physical and nervous
exhaustion, and even serious organic diseases. In older boys and men, it
affects mainly the nervous system and mentality.

Question 5.—Is every discharge from the urethral canal a sign of
venereal disease?

Answer.—Not necessarily. It depends on the character and quality of the
discharge. A white, yellow, or greenish thick discharge—pus—is always an
indication of a venereal, or at least a genito-urinary disease (bladder,
kidney, etc.), but a clean, watery, or slimy like white of an egg
discharge may occur in perfect health as a result of sexual excitement,
or it may remain as a harmless temporary phenomenon, due to
overtreatment of the urethral canal in any venereal disease. The exact
condition, of course, can be recognized only by a physician after a
careful examination.

Question 6.—What can Gonorrhea lead to if not treated?

Answer.—Most common complications of Gonorrhea are: (1) Epididymitis
(inflammation of the testicle), with the possibility of sterility later
on. (2) Chronic Prostatitis, leading often to nervous weakness and
irritability (Neurasthenia). (3) Stricture, the most dangerous
complication of all. (4) Gonorrheal Rheumatism, affecting different
joints. (5) Gonorrheal infection of the eye.

Question 7.—Can Gonorrhea turn into Chancroid or Syphilis?

Answer.—No, it cannot. All three diseases are produced by different
germs, and for this reason none of these diseases can turn into any
other. It may happen, tho, that a double infection takes place, when two
diseases may coexist.

Question 8.—Can chronic Gonorrhea (Gleet) be cured?

Answer.—Unquestionably so, tho in some neglected or mistreated cases it
takes many months to effect the complete cure. The only complication of
Gonorrhea that may prove incurable if neglected is a stricture, yet it
can be always improved or relieved.

Question 9.—How can a real Gonorrhea be distinguished from a simple
catarrhal Urethritis?

Answer.—The only sure way to differentiate these two conditions is by
finding Gonococci under the microscope.

Question 10.—How long does it take to cure a Gonorrhea?

Answer.—There is no way whatsoever to predict the exact duration of an
individual case. In average, the cases of _acute Gonorrhea, without any
complications, lasts from 5–6 weeks_, and these constitute a very small
minority of all cases of Gonorrhea. _The largest majority of Gonorrhea
cases_ develop one of the complications and _last from 2–3 months_. The
_cases that turn into chronic, last from 6–12 months_.

Question 11.—How soon can a man who has been suffering from Gonorrhea
marry without danger of infection to his future family?

Answer.—Not before the physician, after a most careful and repeated
examination by all known methods and tests, can positively establish
that there are no more Gonococci present in the patient. All other
symptoms do not bear on the contagiousness of the case, and
contraindicate marriage only if they affect the general condition of the
man.

Question 12.—What is the difference between soft and hard chancres?

Answer.—Soft and hard chancres are produced by different kinds of germs,
and are _entirely different diseases_.

Soft Chancre or _Chancroid_ always remains a local disease, and leads
only to one complication—to abscess of the glands in the groin, a
Chancroidal bubo.

_Hard Chancre_ is a primary syphilitic sore and always penetrates into
the blood, becoming a _constitutional disease_. Syphilitic buboes are
hard and never produce an abscess.

Question 13.—Can Syphilis be cured perfectly?

Answer.—Undoubtedly so, tho to be sure of it, a long time of observation
after treatment is concluded and thoro testing are necessary.

Question 14.—How long does the contagious period of Syphilis last?

Answer.—The most contagious period of Syphilis is the secondary period,
when a syphilitic has the most active lesions—mucous patches in the
mouth or around the genital organs.

The tumors—gummata of the tertiary period—are considerably less
contagious.

Question 15.—How long does it take to cure Syphilis?

Answer.—No case should be declared cured before _at least one year_ has
elapsed, even tho no active lesions are noticeable. Most cases take
between two and three years to render their blood free from syphilitic
poison.

Question 16.—When can a syphilitic marry?

Answer.—_Not before repeated blood tests have shown a persistent freedom
from Syphilitic poison_, which, as pointed out in previous questions,
takes from two to three years.




                                 Index.


 Abstinence, sexual. (See Continence.)

 Acquired non-venereal diseases, 47

 Alcohol in Gonorrhea, 101

 —— —— Syphilis, 150

 Athletic vs. sexual continence, 43


 Bacteriological test in Gonorrhea, 110

 Beer test in Gonorrhea, 111

 Blood test (see Wasserman test.), 152

 Blindness from Gonorrhea, 81

 Buboes in Gonorrhea, 90

 —— —— Chancroid, 130

 —— —— Syphilis, 138


 Centers of erection, 35

 Circumcision, 46

 Chancroid, 129

 Condoms, 76

 Continence, sexual, 25

 Corpora cavernosa, 20


 Dangers of ignorance, 64

 Double standard of morals, 59

 Diagnosis. (See recognition.)


 Ejaculation, premature, 117

 Ejaculatory ducts, 21

 Epididymis, 21

 Epididymitis, 88

 Erection, 20


 Frigidity, sexual, 28

 Functional sexual diseases, 114


 Generative. (See sexual.)

 Gleet. (See chronic Gonorrhea.)

 Gonococci, 102

 Gonorrhea—
   Clinical course of, 84
   Chronic, 90
   Complications of, 86
   Curability of, 105
   Duration of, 86
   General regime in, 106
   Importance of, 80
   Of the eye, 102
   Recognition of, 82
   Symptoms of, 85
   Treatment of, 97

 Gonorrheal threads, 109

 Granulation patches, 94

 Gummata, 142


 Hard chancre, 136

 Hereditary Syphilis, 48

 Herpes of sexual origin, 144


 Impotence, psychic, 115

 —— irritative, 117

 —— paralytic, 119

 —— natural, 120

 Inborn non-venereal diseases, 46

 Incubation period in Gonorrhea, 84

 —— —— —— Chancroid, 129

 —— —— —— Syphilis, 137

 Individual variations of sex instinct, 27

 Injections in Gonorrhea, 100

 Instillations in Gonorrhea, 104

 Irrigations in Gonorrhea, 104

 Internal secretions of sexual glands, 16


 Love vs. sex, 30

 Locomotor Ataxia, 143

 Luetin test, 136


 Marriage and Gonorrhea, 106

 —— —— Syphilis, 150

 Masturbation (see self-abuse.), 50

 —— in adults, 52

 —— in children, 51
   Dangers of, 52
   Psychology of, 54

 Medical quacks, 67

 Mentality and sex, 32

 Mercury, 146

 Mercurialism, 149

 Microscopical test in Gonorrhea, 110

 Mind control of sex, 40

 Mixed chancre, 139


 Neuralgic pains in the testicle, 48

 Neurasthenia, sexual, 125

 Night emission, 26


 Ointments, preventive, 50

 Onanism (see self-abuse.), 50


 Penis, 19

 Pollution (see wet dream.), 26

 Potassium iodide, 149

 Prepuce, tight, 46

 Prognosis. (See prediction.)

 Progressive paralysis, 142

 Prostate gland, 22
   Massage of, 105

 Prostitution, 71
   Open, 72
   Clandestine, 74
   Medical examination in, 73

 Provocative test in Gonorrhea, 111


 Questionnaire, 157


 Recognition of Gonorrhea, 82

 —— —— Chancroid, 129

 —— —— Syphilis, 134

 Rheumatism, Gonorrheal, 96


 Salvarsan, 147

 Self-abuse, 50

 Self-medication, 67

 Seminal ducts, 20

 Seminal secretion, 23

 Seminal vesicles, 21

 Sex—
   Importance of, 16
   Impulses and ideas of, 35
   Instinct in men and women, 30
   Physiological basis of, 34
   Psychology of, 29

 Soft chancre. (See Chancroid.)

 Specific drugs, 149

 Sperma. (See seminal secretion.)

 Spermatozoa, 20, 23

 Spermatorrhea, 118

 Spirochetae, 147

 Sterility, 121
   Causes of, 123, 144

 Steel sounds, 104

 Strictures, 94
   Symptoms of, 96

 Syphilis, 132
   Curability of, 157
   General regime in, 148
   Primary period in, 136
   Secondary „ „, 140
   Tertiary „ „, 141
   Prediction in, 141
   Recognition of, 134


 Testicles, 20
   Undescended, 47

 Tobacco in Gonorrhea, 102

 —— —— Syphilis, 150


 Urethral canal, 20

 Urethritis, simple, 82

 —— specific, 82

 Urethrorrhea, 119

 Urethroscope, 94

 Urinalysis, 108


 Varicocele, 48

 Venereal diseases, 77
   Practical prevention of, 76
   Prediction in, 78

 606. (See salvarsan.)

------------------------------------------------------------------------




                          TRANSCRIBER’S NOTES


 Page           Changed from                      Changed to

   80 always strikes a bad bargain and always strike a bad bargain and
      are                              are

  118 may require treatment or the     may require treatment of the
      deep urethra                     deep urethra

 ● Typos fixed; non-standard spelling and dialect retained.
 ● Enclosed italics font in _underscores_.





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