APPENDIX I. (Page 91)
The following testimony is by Dr. T. Gaillard Thomas, a recognised gynæcological authority of New York.
‘Until the last twenty years specific urethritis was regarded, in the male, as an affection of the most trivial import, as rapidly passing off, leaving few serious sequelæ, and offering itself as an excellent subject for jest and good-natured badinage. About two decades ago, Dr. Emil Noeggerath published a dissertation upon this affection, which will for ever preserve his name in the list of those who have accomplished good for mankind, and give him claim to the title of benefactor of his race. This observer declared, first, that out of growing young men a very large proportion prior to marriage have specific urethritis; second, that this affection very generally causes urethral stricture, behind which a “latent” or low-grade urethritis is for many years prolonged; third, that even as late as a decade after the original disease had apparently passed away the man may transmit it to a wife whom he takes to himself at that time; and fourth, that the disorder affects, under these circumstances, the ostium vaginæ and urethra, and thence passes up the vagina into the uterus, through the Fallopian tubes, where it creates specific catarrh, and by this disease produces oöphoritis and peritonitis, which becomes chronic, and often ends in invalidism, and sometimes even in death. For this essay Dr. Noeggerath was assailed by ridicule and by contradiction. The matter has now been weighed in the balance, and admitted to its place among the valuable facts of medicine.
‘My estimate of specific urethritis as a factor in the diseases of women—and I take no peculiar or exaggerated views concerning the matter—will be vouched for by all progressive practitioners of gynæcology to-day. Specific vaginitis, transmitted to virtuous women by men who are utterly ignorant of the fact that the sins of their youthful days are at this late period bringing them to judgment, is one of the most frequent, most active, and most direful of all the causes of serious pelvic trouble in women—one which meets the gynæcologist at every turn, and one which commonly proves incurable except by the dangerous procedure of cœliotomy.
‘Think for a moment of the terrible position in which a high-minded, upright, and pure man finds himself placed without any very grave or unpardonable fault on his part. At the age of nineteen or twenty, while at college, excited by stimulants, urged on by the example of gay companions, and brought under the influence of that fatal trio lauded by the German poet—“Wein, Weib, und Gesang”—the poor lad unthinkingly crosses the Rubicon of virtue! That is all! On the morrow he may put up the prayer, “Oh, give me back yesterday!” But yesterday, with its deeds and its history, is as far beyond our reach as a century ago, and returns at no man’s prayer.
‘Four or five years afterward this youth goes to the marriage bed suffering, unknowingly, from a low grade of very slight latent urethritis, the sorrowful memento of that fatal night, which has existed behind an old stricture, and a result is effected for the avoidance of which he would most gladly have given all his earthly possessions.
‘All this sounds like poetry, not prose; like romance, not cold reality. But there is not a physician in this room who does not know, and who will not at once admit, that every word that I have uttered is beyond all question true, and even free from exaggeration.
‘I mentioned, in speaking of the grave duties demanded by puberty, that one of the important functions of the physician in regard to the development of the girl during the thirteen years which precede it, is to instruct her and her guardians how to prepare her for the approaching issue. In language no less strong I would here insist upon the physician’s duty to instruct men in all stations of life as to the importance of a “clean bill of health” in reference to gonorrhœa, both acute and chronic, before the marriage contract be entered upon.
‘Until a very late period the plan universally followed has been this: The man about to be married went to his physician, told him the history of a gonorrhœa, and asked if, now that all discharge appeared to have ceased, any danger would attend his consummating the tie. The physician would ask a few questions, examine the virile organ carefully as to discharge, and, if the “outside of the platter” appeared clean, give his consent to the union. The evil which has resulted from this superficial and perfunctory course has been as great as it has been widespread. To-day the question of stricture, a slight, scarcely perceptible “latent gonorrhœa,” with its characteristic “gonococcus,” is looked into, and not until all trace of disease is eradicated is permission given for the union. A marital quarantine is as necessary to-day in social life as a national quarantine is for contagious diseases in general.
‘Few men, however eager for matrimony they may be, would run the great risks attendant upon precipitancy if they only knew of them clearly and positively. In no field of medicine is the old adage, “Prevention is better than cure,” more important than in this one. If physicians would do their duty fully in the matter, how many unfortunate women now languishing from “pyosalpinx” would in the next generation be saved!’
APPENDIX II. (Page 101)
The following important Memorandum lately issued is full of promise of a noble future in the British army.
Memorandum by the Commander-in-Chief.
‘It will be the duty of company officers to point out to the men under their control, and particularly to young soldiers, the disastrous effects of giving way to habits of intemperance and immorality; the excessive use of intoxicating liquors unfits the soldier for active work, blunts his intelligence, and is a fruitful source of military crime.
‘The man who leads a vicious life enfeebles his constitution, and exposes himself to the risk of contracting disease of a kind which has of late made terrible ravages in the British army.
‘Many men spend a great deal of their short term of service in the military hospitals, the wards of which are crowded with patients, a large number of whom are permanently disfigured and incapacitated from earning a livelihood in or out of the army.
‘Men tainted with this disease are useless to the State while in the army, and a burden to their friends after they have left it.
‘Even those who do not altogether break down are unfit for service in the field, and would certainly be a source of weakness to their regiments and discredit to their comrades if employed in war.
‘It should not be beyond the power of company officers to exercise a salutary influence in these matters, more particularly over the younger men. Many of these join the army as mere lads, and are taken away early in life from the restraints and influences of home. They should be encouraged to look to their superiors, both officers and non-commissioned officers, but more especially to the officers commanding their troops, batteries, and companies, for example and guidance amid the temptations which surround them.
‘The Commander-in-Chief expects officers and non-commissioned officers to be always ready and willing to afford them sympathy and counsel, and to spare no effort in watching over their physical and moral welfare.
‘Officers should do their utmost to promote a cleanly and moral tone amongst the men, and to insure that all rowdyism and obscenity in word or action is kept in check. In no circumstances should public acts or expressions of indecency be tolerated, and if in any case there is reason to suspect that immorality is carried on in barracks or other buildings which are under the control of the military authorities, vigorous steps should be taken by surprise visits or otherwise to put a stop to such practices. All persons implicated in them, whatever may be their rank or position in the Service, should be punished with the utmost severity.
‘Nothing has probably done more to deter young men who have been respectably brought up from entering the army than the belief, entertained by them and by their families, that barrack-room life is such that no decent lad can submit to it without loss of character or self-respect.
‘The Commander-in-Chief desires that in making recommendations for selection for promotion regard should be had to the example set to the soldier. No man, however efficient in other respects, should be considered fit to exercise authority over his comrades if he is of notoriously vicious and intemperate habits.
‘The Commander-in-Chief is confident that officers, non-commissioned officers, and men in the Queen’s service will spare no pains to remove from the army the reproach which is due to a want of self-restraint on the part of a comparatively small number of soldiers, and that officers of all ranks will do their utmost to impress on their men that, in the important considerations of morality and temperance, soldiers of Her Majesty’s army should, as befits their honourable calling, compare favourably with other classes of the civil population.
‘War Office,
‘April 28, 1898.’