By courtesy of The New York Times
New York's Better Baby
Little Hiss Johanna Wiggers, who won the first prize in New York's Better Babies Contest by scoring 100 points, is the type of little girl that will make the best mothers, and the better race tomorrow. Her score card showed; age, 28 months; weight, 33 lbs. 14 ozs.; height, 35-1/2 inches; circumference of head, 19-1/2 inches: circumference of chest, 20 inches; lateral diameter of chest, 6 inches; diameter of chest from front to back, 4-1/2 inches; length of arm to tip of middle finger, 14-1/2 inches; length of leg to the sole of the foot, 16-1/2 inches; total, 100 points.
The Eugenic Marriage
A Personal Guide to the New Science of Better Living and Better Babies
By W. GRANT HAGUE, M. D.
College of Physicians and Surgeons (Columbia University), New York; Member of County Medical Society, and of the American Medical Association
In Four Volumes
VOLUME II
New York
THE REVIEW OF REVIEWS COMPANY
1914
Copyright, 1913, by
W. Grant Hague
Copyright, 1914, by
W. Grant Hague
TABLE OF CONTENTS
Sex Hygiene for the Boy
CHAPTER XII
BUILDING OUR BOYS
A word to parents—Interest in sex hygiene—The "Social Evil"—Ten millions suffering with venereal diseases in the United States—Immorality not confined to large cities—Venereal diseases common in country places—What are the consequences of venereal disease to the boy?—Gonorrhea, or clap—Symptoms of gonorrhea in the male—Complications of gonorrhea—Syphilis, or the "pox"—How syphilis is acquired—Syphilis attacks every organ in the body—Not possible to tell when cured—The chancre—Systematic, or constitutional symptoms—Mucous patches and ulcers—Syphilis of the blood vessels and lymphatic glands—The interior organs—Brain and spinal cord—The nose, eye, ear, throat—Hair and nails—What the boy with venereal disease may cause in others—The infected wife—A girl's fate when she marries—Young wife rendered sterile—Young wife made to miscarry—Is the husband to blame—Building the man—Age of puberty—"Internal Secretion" Page [139]
CHAPTER XIII
THE PARENTS AND THE BOY
Abuse of the procreative function—The continent life—Provide the environment necessary to the clean life—The period of procreative power—Self-abuse—Masturbation—Treatment of masturbation—Night losses or wet dreams—Causes of night emissions—Sexual excesses—Treatment of sexual excesses—What parents should know about the so-called "social evil" before speaking with authority to the boy—The need of enlightenment in sexual matters—"No one told me, I did not know"—Fake medical treatment of venereal diseases—Sowing wild oats—Should circumcision be advised Page [153]
Sex Hygiene for the Girl
CHAPTER XIV
A MOTHER'S DUTY TO HER DAUGHTER
What a mother should tell her little girl—Where do babies come from—How baby birds and fish come from eggs—How other animals have little nests of their own—The duty of mothers to instruct and direct—What a mother should tell her daughter—Every mother should regard this duty as sacred—Every female child is a possible future mother—Motherhood the highest function of the sex—Health the one necessary essential—Symptoms of the first, or beginning menstruation—The period of puberty in the female—Changes in the reproductive organs at puberty—The female generative organs—The function of the reproductive organs—The age of puberty in the female—The function of the ovary—The function of the womb—Why menstruation occurs every twenty-eight days—The male or papa egg—The function of the spermatozoa—"Tell the whole story"—"How do these spermatozoa get there"—The union of the species—"How can a baby live in there for such a long time"—How the baby gets its nourishment in the womb—Girls must not become mothers Page [173]
CHAPTER XV
PREPARING FOR MOTHERHOOD
Menstruation—Irregular menstruation—Changes in the quantity of the flow—How the womb is held in place—Symptoms of menstruation—Menstruation should not be accompanied with pain—Don't give your daughters patent medicines, or "Female Regulators"—Take your daughter to the doctor—Leucorrhea in girls—Bathing when menstruating—Constipation and displaced wombs—Dress and menstruation—Absence of menstruation, or amenorrhea—Treatment of amenorrhea—Painful menstruation, or dysmenorrhea—Causes of dysmenorrhea—Treatment of dysmenorrhea—Sterility in the female—Conditions which affect the fertility of women—Climate, station in life, season of the year, age, the tendency to miscarry—Causes of sterility in the female—Displacement of womb—Diseases of womb, ovaries, or tubes—Malformations—Lacerations—Tumors— Leucorrhea—Physical debility—Obesity—Special poisons—"Knack of miscarrying"—Miscarriage—Cause of miscarriage—The course and symptoms of miscarriage—What to do when a miscarriage is threatened—Treatment of threatened miscarriage—Treatment of inevitable miscarriage—After treatment of miscarriage—The tendency to miscarriage Page [187]
The Baby
CHAPTER XVI
HYGIENE AND DEVELOPMENT OF THE BABY
What to prepare for the coming baby—Care of the newly-born baby—The first bath—Dressing the cord—Treatment after the cord falls off—A pouting navel—Bathing baby—Clothing the baby—Baby's night clothes—Care of the eyes—Care of the mouth and first teeth—Care of the skin—Care of the genital organs—Amusing baby—Temperature in children—The teeth—The permanent teeth—Care of the teeth—Dentition—Treatment of teething—How to weigh the baby—Average weight of a male baby—Average weight of a female baby—Average height of a male child—The rate of growth of a child—Pulse rate in children—Infant records, why they should be kept—"Growing pains" Page [209]
CHAPTER XVII
BABY'S FEEDING HABITS
Overfeeding baby—Intervals of feeding—How long should a baby stay at the breast—Vomiting between feedings—Regularity of feeding—Why is regularity of feeding important—A baby never vomits—What is the significance of so-called vomiting after feedings—Mother's milk that is unfit for baby—Fresh air for baby—Air baths for baby Page [223]
CHAPTER XVIII
BABY'S GOOD AND BAD HABITS—FOOD FORMULAS
Baby's bed—The proper way to lay baby in bed—Baby should sleep by itself—How long should a baby sleep—Why a baby cries—The habitual crier—The habit of feeding baby every time it cries—The habit of walking the floor with baby every time it cries—Jouncing, or hobbling baby—Baby needs water to drink—The evil habit of kissing baby—Establishing toilet habits—Baby's comforter—What can be done to lessen the evil effects of the comforter habit—Beef juice—Beef juice by the cold process—Mutton broth—Mutton broth with cornstarch or arrowroot—Chicken, veal, and beef broths—Scraped beef or meat pulp—Junket or curds and whey—Whey—Barley water—Barley water gruel or barley jelly—Rice, wheat or oat water—Imperial Granum—Albumen water—Dried bread—Coddled egg Page [235]
Artificial Feeding
CHAPTER XIX
ARTIFICIAL FEEDING
Elementary principles of milk modification—The secret of the efficiency of mothers' milk—Two important factors in successful artificial feeding—Every child is a problem in itself—Proprietary foods of little value as infant foods—Their value is in the milk added to them—The credit belongs to the cow—Difference between human and cow's milk—What "top-milk" feeding means—Utensils necessary for home modification of milk—Artificial feeding from birth to the twelfth month—How to measure "top-milk"—Easy bottle-feeding method—Condensed milk feeding—Objections to condensed milk feeding Page [249]
CHAPTER XX
ARTIFICIAL FEEDING (continued)
How to prepare milk mixtures—Sterilizing the food for the day's feeding—How to test the temperature of the food for baby—When to increase the quality or quantity of food—Food allowable during the first year in addition to milk—Beef-juice—White of egg—Orange juice—Peptonized milk—The hot or immediate process—The cold process—Partially peptonized milk—Completely peptonized milk—Uses of peptonized milk—Objections to peptonized milk—What a mother should know about baby's feeding bottle and nipple—Should a mother put her baby on artificial food if her supply of milk during the first two weeks is not quite enough to satisfy it—Certain conditions justify the adoption of artificial feeding from the beginning—Mothers' mistakes in the preparation of artificial food—Feeding during the second year—Sample meals for a child three years of age—The diet of older children—Meats, vegetables, cereals, bread, desserts, fruits Page [259]
What Mothers Should Know
CHAPTER XXI
THE EDUCATION OF THE MOTHER
What mothers should know about the care of children during illness—A sick child should be in bed—The diet of the sick child—A child is the most helpless living thing—The delicate child—How to feed the delicate child—How to bathe the delicate child—Airing the delicate child—Habits of the delicate child—Indiscriminate feeding—Poor appetite—Loss of appetite—Treatment of loss of appetite—Overeating in infancy—What correct eating means—Bran as a food—Breakfast for a child at school—Lunch for a child at school—Bran muffins for school children—Bran muffins in constipation—Hysterical children—What a mother should know about cathartics and how to give a dose of castor oil—Castor oil—Calomel—Citrate of Magnesium—When to use castor oil—When to use calomel—Vaccination—Time for vaccination—Methods of vaccination—Symptoms of successful vaccination Page [277]
CHAPTER XXII
CONSTIPATION IN INFANTS AND CHILDREN
Constipation—Regularity of bowel function—The function of the stomach—Fermentation—Incomplete constipation—Importance of a clean bowel—A daily movement of the bowel necessary—Constipation in breast-fed infants—Treatment of constipation in breast-fed infants—Constipation in bottle-fed infants—Treatment of constipation in bottle-fed infants—Constipation in children over two years of age—Diet list for constipation in children—Bran muffins in constipation—Treatment of obstinate constipation—Oil injections in constipation Page [303]
CHAPTER XXIII
CONSTIPATION IN WOMEN
Chief cause of constipation in women—Constipation a cause of domestic unhappiness—The requirements of good health—The cost of constipation—Constipation and social exigencies—One of the important duties of mothers—Constipation and diseases of women—Constipation is always harmful—Constipation and pregnancy—Explanation of incomplete constipation—Causes of constipation—Negligence—Lack of exercise—Lack of water—Lack of bulk in the food taken—Abuse of cathartic drugs and aperient waters—Overeating—Treatment of constipation in women Page [315]
SEX HYGIENE FOR THE BOY
CHAPTER XII
"The evil that men do lives after them. The good is often interred with them."
"The pleasure in living is to meet temptation and not yield to it." Elmer Lee, M. D.
BUILDING OUR BOYS
A Word to Parents—Interest in Sex Hygiene—The "Social Evil"—Ten Millions Suffering with Venereal Diseases in the United States—Immorality not Confined to Large Cities—Venereal Diseases Common in Country Places—What Are the Consequences of Venereal Disease to the Boy?—Gonorrhea, or Clap—Symptoms of Gonorrhea in the Male—Complications of Gonorrhea—Syphilis, or the "Pox"—How Syphilis is Acquired—Syphilis Attacks Every Organ in the Body—Not Possible to Tell When Cured—The Chancre—Systematic or Constitutional Symptoms—Mucous Patches and Ulcers—Syphilis of the Blood Vessels and Lymphatic Glands—The Interior Organs—Brain and Spinal Cord—The Nose, Eye, Ear, Throat—Hair and Nails—What the Boy with Venereal Disease May Cause in Others—The Infected Wife—A Girl's Fate When She Marries—Young Wife Rendered Sterile—Young Wife Made to Miscarry—Is the Husband to Blame?—Building the Man—Age of Puberty—"Internal Secretion."
A Word to Parents.—Within recent times the subject of sex hygiene has been freely discussed by members of the medical profession and through them the general public has been made more or less acquainted with the problem. It has therefore acquired a degree of genuine interest which speaks well for the future of the eugenic ideal. Eugenics is based to a very large extent upon the principles underlying sex hygiene.
As a result of this widespread interest and investigation, we have discovered that the only method that promises actual progress, is to talk plainly and to tell the actual truth. The day of the prude has passed. To attempt to achieve results in the education of youth in sex problems, without giving, facts, is wasted effort. To give facts we must explain each problem so that its principles may be clearly understood and its meaning grasped. To point out the duty of youth is not sufficient. They must be shown why it is to their best interest to live the clean life. In every department of education we are beginning to appreciate that to achieve results it must be based upon the individual equation. This is why we have found it necessary to assert that it is the duty of parents to make sex hygiene a personal matter and to acquaint their children with the facts relating to this problem. It has been discovered, however, that a very large percentage of parents are inadequately informed on these subjects, in fact they know practically nothing about the actual facts which they are supposed to teach. I shall try to tell the story in a way which every parent will understand.
When a boy reaches the age of puberty he is susceptible to sexual desire. If he has not been told the story of his growth from boyhood to man's estate he will either begin to abuse himself, or he will be later enticed to commit himself to intercourse with some unclean female and he will acquire a disease as a result.
Inasmuch as it has been asserted that practically every boy has been addicted to self-abuse at some time, and that eighty per cent. of all males, between the ages of sixteen and thirty years, are victims of venereal disease, it would seem justifiable to assume that the boys who are informed of the facts in time are the boys who constitute the percentage who escape. This, of course, may not be literally true, but it is a reasonable assumption.
While self-abuse is a pernicious habit and may be attended with serious consequences, it is not a disease and, as will be explained later, it can be cured. It is therefore a menace to the individual, not to the race, and consequently need not concern us at the present time. On the other hand the venereal diseases are not to be considered as individual problems since they affect the welfare of the race. The venereal diseases which we will consider are gonorrhea and syphilis.
The Social Evil.—It has been estimated that there are more than ten millions of people in this country to-day suffering from the effects of venereal diseases. In New York city alone, there are two million victims suffering from the direct or indirect consequences of these diseases. It has been authoritatively asserted that, out of every ten men between the ages of sixteen and thirty, eight have, or have had, one or other of these diseases. When it is remembered that these diseases are not merely temporary incidents, but that they may be regarded as practically incurable in the vast majority, because of antagonistic social conditions and ignorance, and that they are highly infectious, we may begin to realize how important they are from the standpoint of race regeneration.
Statistics of these conditions are never reliable because much of the evil is hidden and lied about. It is quite probable,—if the estimates were based upon absolute knowledge—that the extent of the prevalency of these diseases would be greatly increased rather than reduced. It is however a fact, that the combined ravages of the Great White Plague, leprosy, yellow fever, and small-pox, are merely incidents compared to the effects which the venereal diseases have had upon mankind. It is useless to think that these diseases can be driven out of the land. Any hope of this nature is the impression of the dreamer. By a propaganda of education, by the spread of the eugenic idea and ideal, we may, however, reasonably hope to minimize the evil and, at least, to protect the innocent.
The Sources of Immorality.—It is a fallacious idea to assume that the sources of immorality are confined to the large cities. This is far from the truth. In smaller towns and country places the diseases are quite common and conditions there tend to the spread of the contagion in a more intimate and a more harmful way. The individuals who are most likely to become affected are those most liable to succumb to temptation and whose home ties are of the best. There are many instances on record where one or two loose women spread the infection all over the country communities, infecting boys and men alike. No one can estimate what the final effect of such an epidemic may mean or how many innocent individuals may have their lives wrecked as a direct consequence. It is because these consequences are the product of ignorance in a very large percentage of the cases that there is such urgent need for enlightenment. It is at least our plain duty to tell the boy the actual facts—to post him with reference to consequences. The more thoroughly we instruct him in the elementary facts relative to the venereal diseases, the safer he will be from temptation, and if he possesses this knowledge and acquires disease, he will be more likely to immediately seek competent aid and advice.
WHAT ARE THE CONSEQUENCES OF VENEREAL DISEASE TO THE BOY HIMSELF?
Gonorrhea or "Clap."—This is the most frequent of the venereal diseases. It is also the most serious. It is an unfortunate fact, that in the past,—and even to-day—boys have been told that gonorrhea is no worse than "a bad cold." This lie has been responsible for much evil and a great amount of unnecessary suffering and misery.
Gonorrhea is caused by a germ, obtained, as a rule, during intercourse with an infected person. This germ is called gonococcus. It thrives on any mucous membrane; it is not, therefore, limited to the sexual organs. For this reason it may attack any part of the body where mucous membrane is. It is particularly liable to damage, sometimes seriously and permanently, the eye. It may be spread from one person to another, or from any infected article to a person in numerous ways. The innocent may thus suffer as a result of the carelessness of the vicious.
The Symptoms of Gonorrhea in the Male are slight itching and burning of the mouth of the urethra. This is noticeable at any time from the third to the fourteenth day after exposure. These symptoms become more pronounced and a slight discharge appears. The patient is compelled to urinate frequently and it is painful and difficult. The discharge increases, it becomes thicker and looks like ordinary yellow pus. If the case is a severe one, the discharge may be blood stained, and if this symptom is present urination is more painful and more frequent.
In about ten days the disease reaches its height; it remains stationary for a number of weeks and then slowly, seemingly, gets better. The discharge grows thinner, less in quantity and lighter in color. It may refuse, despite the most careful and efficient treatment, to stop altogether; it is then known as "gleet." If the discharge stops completely the patient is apparently cured, as far as any external manifestation of the disease is concerned. In seventy-five per cent. of the cases, however, this apparent cure is no cure at all, as will be seen later.
Certain complications are likely to arise in the course of gonorrhea. The infection itself may be of such an acute or virulent type, that it invades the deeper structures of its own accord and despite the most careful, competent treatment; or if the treatment is not adequate or skillful it may be forced backward; or through neglect in not beginning the right kind of treatment in times, a simple infection may grow in degree into a serious disease, and invade the more important structures. In this way are produced disease of the bladder, prostate gland, seminal vesicles, testicles, and of the kidneys. Gonorrheal rheumatism may follow, and even disease of the lining membrane of the heart, and death.
When disease of the deeper parts occur the patient is frequently incapacitated and compelled to go to bed. He may have chills, fever and sweats, intense pain and the passage of bloody urine. He may have to be operated upon, and his general health may be permanently wrecked. So long as the germs are present there is danger despite the most scientific treatment. It is not the quality of the treatment that is at fault, it is the presence of the germs; and since it is impossible to pursue any certain method of eradication, we must continue treatment—as long as the germs are present—and hope for favorable results. The infection may last for many years. The germs having found entrance into the small tubes in the interior organs they can only be dislodged with difficulty, if at all. These pockets of germs may be excited to renewed activity by sexual intercourse, or by injury to the parts, and may reinfect the patient at any times. In a very considerable number of these cases where the deeper structures are involved, the patient may recover from the acute or painful period of the disease, only to find that he is sterile. There are many such cases, and the most vindictive individual who may believe that every who sins should be punished will admit that sterility, as the price of a moment's forgetfulness, is a terrible fee to pay.
Syphilis, or the "Pox," is an infectious, germ blood disease. It is most frequently acquired through sexual intercourse.
It may be acquired by direct contact with a diseased person. In order to render such contact effective, it is essential that the skin of the healthy person be abraded, or the contact may be directly on a mucous membrane, as the mouth in the act of kissing.
It may be acquired by using any article which has been used by a syphilitic, as a drinking cup, or towel.
It may be acquired through hereditary transmission.
Surgeons frequently contract syphilis while operating on, or examining patients who have the disease. Dentists may convey it by means of instruments which have not been rendered aseptic, or thoroughly clean. Using a towel which has been used by a syphilitic has many times conveyed the infection to an innocent party. For this reason the roller towel has been done away with, and some states have legislated against its use in hotels and other public places. To use dishes, spoons, tobacco pipe, beer glasses, etc., which have been used by one having the disease is an absolutely certain way of being infected. Cigars which may have been made by a syphilitic will infect whoever smokes them with the virus of the disease. Syphilis has been known to have been caught from using the church communion cup. The public drinking-cup has been a prolific source of syphilitic dissemination to innocents. Legislators are just waking up to the danger that lurks in this institution and it will no doubt be done away with, not only in public places, but on all railroad and steamboat lines.
An infected mother can transmit syphilis to her child. If the father is affected, but not the wife, the child may escape.
Syphilis attacks every organ in the human body. The actual degree of infection has no relation to the size or character of the external manifestations. The external evidence may be minute and insignificant, while the internal extent and ravages of the disease may be tremendous and of large proportions. Many men when asked regarding incidents of the long ago, may state, "Oh, yes, I had a chancre twenty-five years ago, but it was a very small affair and soon healed up and was cured." Yet that same little chancre, that made only a mild impression on the man's mind, may, and most probably will, be the direct cause of that man's death.
It is not possible to tell with absolute certainty that an individual is suffering with syphilis by any known test. The most recent one—the Wassermann test—is not absolute by any means.
The first symptoms, or what is known as the initial lesion of syphilis, is the chancre.
The Chancre is a small, hard tumor, or it may be a small ulcer with a hard base, or it may simply appear as a thin small patch on any mucous membrane. It is not painful, it can be moved if taken between the fingers, showing it is not attached to the deep structures, and when it is so moved it is not tender or sore. Any little lump which ulcerates located on the genitals must be regarded with suspicion. Boys and men should not be satisfied with any offhand statement that, "it is nothing." It may be a chancre, and it may be exceedingly serious if not properly diagnosed.
Systemic, or constitutional symptoms, begin to show themselves any time from the sixth to the tenth week after the appearance of the chancre.
Eruptions of the Skin characterize every case of syphilis. They occur in all degrees from the mild rash to the foul ulcer. The ulcerative process is very often extensive and loathsome.
Mucous Patches and Ulcers affect the mucous membranes. The mouth and throat are favorite locations for these lesions. They occur in the anus and rectum, and may be mistaken in that region for other serious conditions. Men who drink and smoke suffer as a rule severely from mucous patches in the mouth and throat.
Syphilis attacks the blood vessels and the lymphatic glands. These cases may have been unrecognized, and may have existed for many years. A man may die from a rupture of a blood vessel in the brain during middle life as a consequence of a forgotten, supposedly cured case of syphilis many years before.
The Interior Organs may be attacked by syphilis. As a result we get disease of the liver, heart, stomach, kidneys, lungs, and other parts. It has been suggested that many diseases affecting these organs, for which treatment proves unsatisfactory, may have had their origin in a former syphilis.
The Brain and Spinal Cord are quite often the seat of syphilitic affections. A tumor, known by the name of "gumma," is the result. The blood vessels of the entire nervous system may be affected and, as a consequence, we often see cases of paralysis, apoplexy, epilepsy, locomotor ataxia and death.
The Nose, Eye, Ear, Throat, are frequently very seriously compromised as a result of the syphilitic poison. Deformity, caused by rotting of the bones of these parts is not infrequent. Loss of voice, or smell, or hearing, or sight, may result.
The Hair and Nails may fall out. The bones may ulcerate and rot. The organs of procreation usually participate in the degenerative process. Virility is destroyed, and impotence is quite common after a severe attack.
WHAT THE BOY WITH VENEREAL DISEASE MAY CAUSE IN OTHERS
Gonorrhea.—When the average boy acquires gonorrhea he frequently does not know, for many weeks, that he is the victim of a dangerous, infectious disease. He appreciates probably, that it relates to the sexual indiscretion he was guilty of, and feels that it is something to be ashamed of. He therefore hides his condition, confides in no one, and blindly hopes it will get better somehow or at some time. Meantime the disease, which may have been mild at the beginning, is gradually gaining ground and strength, and his neglect may eventuate in lifelong misery. No means are taken to guard against spreading the infection, the discharge may lodge on his fingers and he may infect his eyes and may lose his sight because he did not know that the discharge is one of the most dangerous fluids known. It may get on water-closet seats and infect others. Eventually he is compelled to seek aid, and he may, after a long period, be freed from the immediate consequences of his folly. At a later date he marries, and as previously explained, he infects his wife. This is the beginning of much of the domestic infelicity that is so prevalent to-day, and, inasmuch as it is a subject that should be thoroughly understood by every woman and mother, I shall carefully and clearly explain its significance and its consequences.
Let us first, however, briefly consider what may occur to others if the boy is unfortunate enough to acquire syphilis. Again the boy fails to comprehend the nature of his affliction. There is imminent danger of the members of his household becoming infected. He uses the same dishes, spoons, towels, and utensils, any one of which may convey the disease to his father, mother, sister, or brother. He may use the common drinking glass in school, college, or office, and spread the disease in this way. He may kiss any member of his family, or a baby, and infect them. He may have his hair cut, or be shaved, and the virus may be spread around in this way if the barber does not sterilize the article used,—which he never does. He may drink at a soda fountain, or at a saloon, and the next individual to use the same glass may acquire the disease. He is a menace to the individual, to the community, and to the race. Wives often acquire syphilis from their husbands.
The Infected Wife.—It has been previously stated that eight out of every ten males between the ages of sixteen and thirty, have had or have, gonorrhea or syphilis. Seventy-five per cent. of these cases have not been cured. About thirty-five per cent. of these are destined to infect wife, or wife and children, and in all probability many others.
If a young wife acquires infection from her husband, she is exactly in the same condition as the diseased boy,—she does not know what ails her, so she wastes precious time in unprofitable worry. Why should she know what the trouble is? She came to the marriage bed pure, and clean, and healthy. Her previous education did not include instruction which would even help her to guess what the trouble might be. She is simply conscious of new distressing conditions which she does not understand. She may try to believe that these conditions are incidental to the change in her life. Shortly, however, the discharge, which she has had for a number of weeks, and which she thought was only a leucorrhea, or "the whites," becomes so profuse and nasty that she begins douching. This procedure simply blinds her to the true nature of the affection, and in the end she is driven, ashamed and reluctant, to consult a physician. She may be informed that her condition is bad, and that it will be necessary that she submit to a course of treatment. After a time the physician may succeed in tiding her over the immediate consequences of the gonorrheal infection she innocently acquired. She may soon after become pregnant, and she may miscarry as a result of the old trouble, or she may carry the child the full period. When the child is born it may be blind and this defect is a consequence of the old infection to the mother from the father. If the mother is syphilitic the child most likely will inherit all the horrible possibilities of transmitted blood-poison.
Pregnancy frequently "lights up" any old, gonorrheal infection in the female, so this young wife fails to completely recover after the confinement. She is able to be about, but her strength refuses to be restored. It may be months later when she begins to suffer pain and to realize that she is quite sick. She develops a fever and may have a chill. The physician discovers that she has pus in her tubes and there is danger of peritonitis or general blood poisoning. The old germs have been roused and are active. Unfortunately they are located where it is impossible to dislodge them without resorting to a serious operation. It is now a problem of saving her life. She is taken to the hospital and her womb, tubes, and ovaries, are removed—she is unsexed.
Young wives are being operated on every day, in every city in the civilized world for just such causes. It is a notorious fact, that, in every city in the world, the number of operations that are daily being performed on women, is increasing appallingly. Every surgeon knows that eighty per cent. of these operations are caused, directly or indirectly, by these diseases, and in almost every case in married women, they are obtained innocently from their own husbands. It is rare to find a married woman who is not suffering from some ovarian or uterine trouble, or some obscure nervous condition, which is not amenable to the ordinary remedies, and a very large percentage of these cases are primarily caused by infection obtained in the same way.
When a girl marries she does not know what fate has in store for her, nor is there any possible way of knowing, under the present marriage system. If she begets a sickly, puny child,—assuming she herself has providentially escaped immediate disease,—she devotes all her mother love and devotion to her child, but she is fighting a hopeless fight as I previously explained when I stated that one-half of the total effort of one-third of the race, is expended in combating conditions against which no successful effort is possible. Even her prayers are futile, because the wrong is implanted in the constitution of the child and the remedy is beyond her power to find. These are the tragedies of life, which no words may adequately describe, and compared to which the incidental troubles of the world at large are as nothing.
If the conditions are not as bad as those depicted above, the original infection may have rendered her sterile. If the germs reached the womb and tubes, the inflammatory process may close these tubes, with the result that conception is impossible. In these cases the woman has to bear the stigma and disgrace of a childless union, though she is not the guilty party. Many husbands are sterile, however, as a result of venereal disease. It is claimed that eighty per cent. of childless marriages are caused by sterility of the male partner. Curiously and unfortunately these men never suspect themselves. The wife is the delinquent member, in their estimation. She is the victim of jest and suspicion, and later of jibes and insults. Many women have had their lives rendered miserable and unhappy because of this suspicion. They are compelled by their husbands to submit to examination and unpleasant and painful treatment and operations with the intention of rectifying a defective condition that does not exist. Many conscientious physicians refuse to treat women patients against whom the charge of sterility is made, before subjecting the husbands to thorough examination, and, since eighty per cent. of childless marriages are due to sterility in the male, this is a just and reasonable course to pursue.
During the course of all this domestic trouble and tragedy, the young wife's health has suffered—she scarcely enjoys one day of good health. Her mental condition is even worse. She submits to innuendo and insult under the impression that she is the unwitting cause of all the domestic wretchedness and often wishes she had never entered the marriage state. We must remember that these conditions wreck ideals and homes, and that they frequently render inefficient both husband and wife. The economic business of marriage becomes a failure, ambition is crushed and hope dies in the heart.
If the mother has been inoculated with the virus of syphilis her existence is equally wretched; her health is ruined; her efficiency is forever mortgaged. If she becomes pregnant she will most likely abort and she will go on aborting for years, in the effort to bring children into the home, accusing herself meantime and submitting to the reflections which are heaped upon her, while the real culprit is the husband. He assumes an injured and innocent attitude and behaves as if he had been imposed upon by marriage with a woman who cannot carry out her marital contract.
If she gives birth to a child or children, they are syphilitic. They may be deformed, or they may be feeble-minded or idiots. They may live at home for years, always ailing, always sick. They may develop epilepsy, St. Vitus' dance, skin disease, or mental vagaries, and they may have to be put into institutions for the feeble-minded, or they may die by inches at home.
Is the Husband to Blame?—If a boy had gonorrhea a number of years before entering the marriage state, was treated for it by a physician, until all symptoms had disappeared and had enjoyed apparent good health in the interim, and had never been told any of the facts regarding probable consequences, is it just to blame him if he infects his wife? It is certain no man would willingly subject his bride to the risk of infection, with all its horrible consequences. These conditions exist as a result of the prudish attitude of society in the past toward all questions affecting sex hygiene. We have not told all the truth to the boy. Whatever knowledge he may have had was gained from companions, or from individuals who knew the garbled facts only. There is of course no excuse for the man who acquires disease after marriage and conveys it to his wife or children. This is a very different situation and one which should merit the severest condemnation and punishment. We are, however, only interested in the boy at present and will not take up the reader's time with a discussion of the "social evil" from this standpoint.
Building a Man.—When the boy is about fifteen years of age certain changes begin to manifest themselves. He grows more rapidly, a growth in which his whole system participates. His bones grow bigger and stronger, his muscles increase in size, even his heart, and lungs, and liver, and his digestive system accommodate themselves to this transformation; the voice changes and hair begins to grow on his face. The mental process also keeps pace with the new order of things. He thinks differently and he sees from a new viewpoint. Nature is making a man out of a boy.
These changes were not understood in the past, but we are beginning to appreciate the reason for this evolutionary process. We have discovered that the cause depends upon certain active changes which take place in the sex organs. About this time the testicles begin to be active. For years these glands have been preparing themselves for this work, so they first grow rapidly, increasing in size until they are about eight times bigger than they were before this time, then they begin to pour into the circulation a secretion which stimulates changes in all other parts of the body and is directly responsible for the wonderful change that is evident in the stature of the boy's body.
This substance or "internal secretion" must not be confused with the semen. The internal secretion is simply the substance which nature employs in the developing process and is responsible for the degree of growth and quality of manhood which the boy manifests. The semen, on the other hand, is the procreative or fertilizing fluid which enables a man to beget offspring. When a boy understands this process it aids him in appreciating the importance of his sex organs and a little thought enables him to understand that if he abuses these organs he will seriously interfere with his own development. This process goes on for a number of years, until the boy reaches maturity. Any act or habit which weakens the quality of this secretion will deplete his powers and render him physically and mentally inefficient. To make a man, nature must be permitted to work in her own way. You cannot improve on her methods nor can you break her laws with impunity.
CHAPTER XIII
THE PARENTS AND THE BOY
Abuse of the Procreative Function—The Continent Life—Provide the Environment Necessary to the Clean Life—The Period of Procreative Power—Self-abuse—Masturbation—Treatment of Masturbation—Night Losses or Wet Dreams—Causes of Night Emissions—Sexual Excesses—Treatment of Sexual Excesses—What Parents Should Know About the So-called "Social Evil," Before Speaking with Authority to the Boy—The Need of Enlightenment in Sexual Matters—"No One Told Me, I Did Not Know"—Fake Medical Treatment of Venereal Diseases—Sowing Wild Oats—Should Circumcision be Advised?
Abuse of the Procreative Function.—Breeders of animals have discovered that to breed from very young stock is not good. The quality and stamina of the progeny is lowered and the vitality of the parent stock is reduced. It is not a good economic proposition.
Boys should therefore be taught that any form of sexual indulgence is harmful before the period of full growth.
Nature did not intend that the procreative function should be exercised by individuals who were not fully developed. The perpetuation of the species must not depend upon the license of immaturity. The instinct of sex-attraction must not be debased to serve a puerile, rather than a holy purpose.
Sexual indulgence in any form, and in any degree, at any age prior to full maturity is a perversion of the primal instinct of race perpetuation. The practice has a more intimate and a more personal association with growing boys, however, than a merely altruistic reference. Any indulgence of this character at this time is physically and mentally injurious. No boy can hope ever to acquire the full measure of his possible development as an efficient working or thinking machine if he wastes his vital forces in unnatural liberties. He should be taught this truth in an emphatic manner by those responsible for his education.
There is a false idea prevalent that a continent life is harmful. So far as continence relates to immaturity, it may be strongly and justly asserted that it is probably the most important factor in the conservation of health and strength. The retention of the procreative fluids, at a time when nature is opposed to their loss, enables the growing economy to utilize them in the conservation of nervous energy and virility. If a boy dissipates these energizing fluids, he deprives his body of the richest products which he is capable of manufacturing at a time when he needs every aid in the building up of a physically and mentally sound and vigorous constitution. There cannot exist a normal development if the body is deprived of the essential ingredients necessary to growth and mental vigor.
There was a time when young men were actually taught that sexual intercourse was necessary to develop full manhood. This was followed by a period of silence, which has practically extended to recent times. Both of these systems are pernicious. We know that sexual intercourse is not necessary to the development of mature normal manhood or womanhood. On the contrary, we know that continence, not incontinence, is an absolute essential to the growth of full sexual, virile maturity, as well as to the growth of efficient and healthy manhood and womanhood.
We must appeal to a boy's reason and show him the personal side of clean living. When he understands that to attain success in every department of human effort,—on the baseball and football fields, in the ring, in gymnastic contents, in examinations, in social intercourse, in trades and professions,—a continent life is the only means possible that promises success, he will give the appeal consideration.
We must employ all the safety devices possible to guard against the inclination of youth to wander. Regular exercise is one of the very best institutions in this respect. If we can instill into our boys a love of manly sports and encourage every effort in this direction, we will be doing much to minimize the growth of any tendency toward incontinence. We must provide the environment necessary to right living. The home should be attractive and we should permit the boy to have privileges even at the expense of the housekeeping decorum. His companions should be made welcome if they are the right kind of intimates, and the parents should enter into the life of the boy and try to look at "things" from his standpoint.
The Period of Procreative Power.—The procreative ability begins at puberty. There is no fixed period at which it may be said to end. From puberty until the period of physical maturity, it grows in vigor and it remains stationary until middle life, when it gradually declines. The standard of virility is unquestionably an individual problem. It depends upon the various factors that contribute to good health and longevity. It may be stated that the boy who abused his procreative function, during the period of immaturity, will not enjoy, during the mature period of his sexual life, a normal standard of vigor, nor will he carry the ability into old age, to the same relative degree, as he would, and as he had the innate promise to do—if he had led a normal continent existence. It may also be stated here that there is no effective remedial measures known, that will "bring back" the procreative ability if it is lost as a result of disobeying natural laws. Drugs and treatments by quacks to cure impotence are impositions and fakes. Money and time spent in the pursuit of this dream is money and time wasted.
Self-Abuse or Masturbation.—By self-abuse is meant the production of the venereal orgasm, with or without emission, by any means other than the natural union of the sexes.
It is a fact that the large majority of boys acquire the habit of self-abuse at some time. This is a very serious reflection upon parent, teacher, and physician, because it is through ignorance of the elementary principles of sex hygiene that this condition continues to exist. If they were warned against the possibility of self-abuse arising in innocent ways, as well as in more reprehensible ways, they would exert their influence against its acquirement. If however a boy discovers accidentally a condition of which he was innocent, and of which he does not know the significance, it is human nature that he should investigate the phenomenon and in the end suffer as a consequence. In the effort to relieve some local irritation he may handle himself and be led into a dangerous practice. He does not know that the practice may have serious results—in fact he does not know he is doing anything wrong. Many boys have practically ruined their physical health and become morally irresponsible because no one—neither parent, teacher, physician, nor friend—told them of their danger. This is unjust, but great strides are being made in this direction and we may reasonably hope, that in the not far distant future, every boy will be plainly told the true facts about himself.
Most boys acquire this habit from other boys, but as we have intimated it is possible to acquire it in what are termed innocent ways. Sometimes the sensation which leads to it is discovered by sliding down banisters; or it may be that climbing trees or poles first awakens the feeling. Very young children are sometimes taught the vice by depraved nurses. Local irritation, as has been stated, may necessitate itching and handling the parts and in this way the vice is begun. The results are the same, no matter how the habit may have originated.
If the habit is persisted in, the muscular system suffers,—the muscles become weak and flabby; the patient develops weariness and languor and loses his mental and physical vigor. He is no longer forceful or energetic, his efficiency is impaired and as a consequence his nervous system begins to show signs of depleted strength. He cannot concentrate his thoughts, he falls behind in his studies, his mental effort is sluggish, he becomes diffident and shy, shuns society, loses confidence in himself, is morbid and emotional and may even think of suicide.
It is astonishing how indulgence in this habit may affect the moral nature of a boy. First of all, he is no longer frank and open. He becomes shifty and suspicious and will not look you squarely in the face. A boy cannot become a slave to this habit without it affecting his mind. He invites debasing thoughts,—the old pure and clean method of thought and living no longer satisfy. His imagination even becomes corrupt and his moral nature and moral sense is perverted until he no longer seems to be able to tell the difference between right and wrong. He has little regard for the truth and if occasion demands it he will lie without appreciating the dishonorable part he is playing. In the end his will power is lost—even the effort to save himself is too feeble to succeed—he is a slave to the habit, his health and strength ruined.
If every boy could realize the possible end of this evil habit he would make an effort to rid himself of it before he becomes its victim and its slave. It may be easy to abandon the practice in the beginning. The longer he continues it, however, the less chance he has of finally mastering it, until, if he persists beyond a certain point, it is a matter of serious question whether he will ever be able to free himself from its grip. If the boy has lost the will power to carry out his resolves, no number of good desires or resolutions will avail. And it is just this will power that the wasting of the semen saps little by little away.
Treatment.—What can we do for these boys? Most of them can do much for themselves by simply stopping the practice. There are, of course, others who need careful management before the habit may be controlled and health restored. It is well to always remember to be tactful and patient and kind to these boys. Many of them are standing on the brink of despair, weak in body and weak in mind. They do not know where to turn to look for a friend—the right kind of a friend. It is a terrible thought that your own boy may be abjectly miserable in his own home because he is harboring a secret that is wrecking his health, and, though he may long for sympathy and a helping hand, neither his father nor mother have invited his confidence or spoken to him about these things. A watchful mother can usually tell when her boy becomes addicted to this habit. He will show it in his manner, he will not be free and open, he will want to be by himself. Later he will show the effects of the abusive treatment he is subjecting himself to in his appearance. He will be sunken-eyed, pimply-faced, pasty-skinned, shiftless, sneaking, silent, unmanly. No mother can fail to note these signs and she should suspect the cause and take steps to tactfully reach him before he has ruined his health absolutely.
We would advise regular exercise of a vigorous kind. Tire out the body so that sleep may be sound. Cold baths, followed by brisk rub-downs; no intoxicants, light meals, plenty of drinking water morning and night. The bowels should be regular every day. He should sleep alone on a hard bed in a well-aired room with light covering. He should keep busy every minute of the day and he should not think of himself at all.
The boy must realize that his salvation rests with himself. After he knows the real danger which the habit carries with it, he must be on his guard every moment to abstain. If he does not he may rest assured that the practice will ruin his health, render him, a business failure and deprive him of all happiness during the rest of his life.
Night Losses or "Wet-Dreams."—A so-called wet-dream is an unconscious emission of semen during sleep. The discharge may or may not be accompanied with an erotic dream.
After a certain age—which may be from the twelfth or fourteenth year—a boy may discover that he has discharged some substance during his sleep. He finds the discharge on his night clothes and it naturally puzzles him greatly. He may be entirely unconscious of the whole proceeding, having slept soundly during the night, or he may wake up to find the fluid actually discharging.
If a boy has not been told of this phenomenon he may regard it as a form of self-abuse of which he may have heard and as a consequence he may worry himself sick, as the night emissions continue to occur from time to time. Many pure-minded boys have been rendered miserable, and their efficiency and health have suffered as a result of just such an experience. It is, therefore, proper that they should fully understand the true significance of these occurrences.
Causes of Night Emissions.—I have explained how nature makes a man out of a boy. During this maturing process the testicles are very active organs—their function is to manufacture or secrete the fertilizing fluid or semen. This maturing process begins actively, as I stated, about the age of fifteen, though in some boys it frequently occurs earlier, sometimes as early as the twelfth year. When the testicle begins to grow at this time they manufacture more semen than the little pockets can hold, so nature adopts the method of permitting the surplus to escape during sleep. These night emissions, therefore, are perfectly natural losses, and need cause absolutely no distress of mind whatever. The frequency with which they may occur depends altogether upon the temperament of the boy. If the boy is a strong, active, athletic boy, they may not be so frequent in him as they may be in a quiet, studious boy. The system of the athletic boy seems to utilize more of this surplus than the quieter existence of the studious boy calls for. If the discharge does not occur oftener than once every two weeks, it may be regarded as normal and natural. Should they become more frequent than this, the boy should inform his mother or father and the family physician should be consulted. It may be that he is in need of a tonic, or special instructions regarding his method of living and his mode of exercising. Whatever the cause may be, it can be corrected, and the best plan is to give it attention as soon as it is noted that the losses are too frequent.
Sexual Excesses.—It is well known to the medical profession that the marital relation is frequently practiced to excess. The same indictment may be passed on what may be termed extra-marital relations. No one has ever formulated a general sexual standard which could be safely regarded as normal. Too many individual conditions of temperament and health enter into the proposition to permit of a standard being formulated. It must, therefore, be regarded as an individual question to be adjusted, if necessary, by the family physician. What may safely be regarded as normal and harmless in one, constitutes, for many reasons, excess in another. When a man performs hard physical or mental labor, his sexual aptitude or capacity is limited, and this limitation cannot be exceeded without risk. Such a limitation may not constitute an excess in a man whose occupation does not call for a great expenditure of physical or mental energy. Any indulgence which produces exhaustion is excessive.
The age of the individual has undoubtedly much to do with his sexual endurance. A young, virile adult will tolerate a sexual expenditure which would seriously affect the health and vigor of an older man.
Environment and inclination are factors in determining the standard of some people. If the marital relations are participated in simply to preserve peace and harmony in the home, they are productive of harm even if indulged in moderately.
The symptoms of sexual excess are much the same as those of self-abuse. To a certain extent, however, they are favorably influenced, because the conditions under which the relationship is practiced are natural, because the participants are matured physically, and because there is no element of worry over the probable effects.
Sexual excess defeats its own purpose, because it engenders a lack of desire and consequently it is to a certain extent a self-limiting process. We must also remember that excess entails consequences just as the breaking of any natural law is followed by retribution of some kind. In these cases we find that discomfort follows excess. The parts become irritated and congested and disease of the prostate gland always follows.
Treatment.—Stop the excess by self-control and self-restraint. Employ all the aids dictated by an intelligent perusal of the laws of sex hygiene. Preserve the general health. It may be necessary to resort to local treatment, because, if the parts have been abused by excessive indulgence, there is always more or less irritation and congestion present. This condition affects the nerves, suggestive reflex sensations are produced by a congested prostate and the patient becomes morbid. It is essential for such patients to consult a physician whose local treatment will stop the sensitiveness in the parts and relieve him so that he may carry out his programme of restoration unhampered by conditions which are only amenable to local treatment.
What Parents Should Know About the So-Called "Social Evil" Before Speaking With Authority to "The Boy."—To be qualified to speak with authority, or convincingly, to a boy upon sex hygiene, the parents must be familiar with, and well versed in the subject. The facts related in the preceding pages must be thoroughly understood. No parent can study these facts intelligently without being impressed with the importance of the subject; without realizing that it is absolutely essential that the fundamental principles of sex hygiene should be taught to the rising generation; without acknowledging the tremendous part for evil which prudery and ignorance play in the education of youth; and without being convinced that most of the evil is the product of ignorance on the part of the boy, and that parents are in a large sense to blame if they fail to impart the necessary knowledge in time.
The need for enlightenment in sexual matters is a product of existing conditions. Civilization and the social environment are developing along a plane which subjects the youth to temptations that practically did not exist in the past. There is a broader and looser code of ethics. Business monopolizes the entire time of the father, and social and political unrest and misdirected ambition distracts the mother. The son or daughter has a wider latitude and a freer reign than they once had. The opportunities for promiscuous intimacies are easier, and the public conveniences and utilities lend themselves to the designs of evil-intentioned and loose-moraled women. The ease of travel, the laxity of laws, the theater, with its unchaste and indecent plays, the moving picture snows, the vaudeville resorts, whose highest priced "talent" is some voluptuous female, who has cultivated the art of draping nudity with suggestiveness and singing immoral songs, all tend to give youth a false impression of the reality of life and to make the path of the degenerate easy and profitable. The rich are growing richer, and their children are pampered and overfed and underrestrained. Time hangs heavily on their hands and their only mental effort is to devise new methods and new ways of satisfying the lust of liberty and overstimulated desire. The poor are growing poorer, and to "keep in the ring," to live and dress beyond their means as many do, it is necessary to have an unexacting standard of morals. In this way the promiscuous libertine is evolved,—the most insidious and dangerous product of present day civilization, and the most pernicious factor in the spread of immoral impulses and indecent diseases.
Parents must accept these institutions and agencies as necessary instruments of evil and adopt measures to nullify their attractiveness. Eternal vigilance is the price of success, but the quality of the vigilance must be dictated by love, not by suspicion and distrust.
When the parent can convince the boy that the knowledge is imparted, not with the intention of depriving him of what he may construe as his natural liberties and rights, but with the single intention of adding to the sum total of his pleasure and success, he will look more kindly upon any proposition that suggests a course of conduct that leads to clean living. Sex hygiene will eventually find a natural place in the scheme of education. It will be taught to male and female alike. In the meantime, however, we must begin by educating the educators—the parents. In the beginning, their task will not be easy. There will be much to overcome, much ignorance, prudery, false modesty, hypocrisy; there will be much vicious teaching and evil example to live down. But we cannot hope to achieve results in the noblest cause, save by patient, intelligent, and persistent effort and by self-sacrifice and a constant enthusiasm. The aim is to tell all,—all the truth,—so that we may never be assailed by the cry, "No one told me, I did not know," from the loved lips of son or daughter gone astray.
The Father and the Boy.—The right kind of father can always find the time and the way to awaken in the heart of the boy the spirit of companionship. No boy living will resent the fellowship of the right kind of father. It depends upon the father! If the spirit of chumminess does not exist between you and your boy, you are at fault, you have made a mistake, you have missed your opportunity, you "did not go about it in the right way and in the right spirit." Try again—it may not be too late.
The father who adopts the habit of taking his boys (and his girls too) out for long walks, at least every Sunday, and who spends an hour with them every evening—is the right kind of father. One who has never tested the merit of walks with children cannot possibly appreciate the enjoyment and benefit that can accrue from them. It is not only the physical good that results, nor the inspiration which one may draw from nature, but the concrete advantages that come from the fellowship with the children are a new and a real experience—this is what counts. You will have opportunities of sewing seeds in their minds that will grow into a harvest that will astonish you. Children in the right mood—and they are in the right mood when they are happy, and they are happy out in the open with an interesting companion—are alert, and responsive, and eager to be told "things," and this mood can be put to marvelous use by the "right kind of father." The father who wanders forth with the fixed purpose of thinking out some business problem during the walk and permits the children to find their own amusement is the wrong kind of father. He must choose to be a child again, he must desire to please them, he must make an effort to be in harmony with them, he must draw on his experience to interest them, he must talk to them entertainingly of every interesting problem which the walk itself suggests or he must formulate a plan and select a subject with a definite educational scheme in view. We can, in a most effective way, begin to build their characters, and, by the right kind of talk and enthusiasm, he can determine their resolves to be honest, truthful, just, clean, sympathetic. He can instill into them, in a thousand different ways, the determination and inspiration to succeed. It is a wonderful and a precious chance, and it will make the "right kind of father" more just, more sympathetic, more optimistic, and it will make him young again and more successful. Try it.
Implant in the hearts of your children a love of home, make the evening meal and hour by the fireside a period of congenial fellowship, when all the little irritable ruffles of the day may be ironed out and swept away. The secret is to be intimate. Tell them the secret of success from your standpoint, how happiness is gained only by being efficient and successful, and that, to be efficient, one must be energetic and healthy. Drum into their ears the truth that life is a battle, and only the brave "win out," and health is the one essential necessity. It is astonishing how such talks will impress young minds. They will remind you of things you said, that made a lasting impression on them, long after you have forgotten the incident.
A father can, in this way, by talking of the future to his boy, convey to him the high hopes he entertains of the great success the boy is going to achieve—you establish a standard in the boy's mind, and he unconsciously hopes to attain that standard. If you have impressed him with the necessity of preserving his health and strength, as an essential to success, he will be slow to yield to any temptation that may interfere with his plans. This reasoning may sound quixotic to some people, but it is the truth. Many a boy has been inspired to success by the knowledge that his mother or father believed in him, and was confident he would be a leader. He strove to justify the pride and confidence of those who held him dear, and he won out.
To retain his health, therefore, is the first impulse to be conveyed to the boy. When he recognizes this truth, it is an easy task to instill a love of exercise, gymnastics, swimming, fresh air, cleanliness and temperance in him. If these are attained, you will have tided him over the tendency to self-abuse, and you will have rendered him less likely to yield to evil suggestion or temptation. His confidence in you will be whole-hearted and implicit. You can do anything with him at the psychological moment. It is now time to talk of more intimate matters. Carefully and tactfully, the father approaches the fundamental truths of sex hygiene.
The selection of a subject for a text as a means from which to advance toward the real facts is sometimes of importance. It must not appear as though the subject was designedly chosen. If it follows in a natural way it will more thoroughly interest the boy and he will have swallowed a large dose of truth before he is impressed with the personal viewpoint. A passing trotting horse has served me a number of times for intimate talks with boys on heredity and kindred subjects. I invite the boy to watch how the horse uses his legs, and how rhythmically and beautifully he places his feet, and how his whole attitude serves the end for which he is exerting himself—to gain speed. Tell the boy the story of how professional breeders have achieved such marvelous results; how for generations the "strain" has been kept clean and pure, how any descendant of a great sire, who showed any habit detrimental to the development of the highest racing qualities—no matter how trivial the disability might be—was cast aside, experience having taught that it does not pay to waste effort and time on any horse whose physical or mental characteristics are not up to the highest standard. Such a horse will not win, and it is only "wins" that count.
Change the subject to human beings. Tell him how the race maintains its standard; but show him the difference between the methods employed. How the horse has his mate selected because of the female's good qualities, so that the offspring may possess like qualities, if not better, and that the selection is made by men who know their business, and have had long experience in the work. How, on the other hand, a young man with no experience is permitted to choose any woman he may fancy irrespective of her qualifications. As a consequence, we have all kinds of children, good and bad, feeble and strong, honest and dishonest, some degenerates from birth, some criminal, and many diseased and inefficient, few of them "winners." It is an easy matter to preach a little sermon from this text. Show him how essential it is to select the mother of one's children wisely, to know if there is disease in the future wife's blood, if her family history is good, if her temperament is suited to his, if her domestic qualities are satisfactory, if her principles are moral and normal, and if she understands and appreciates the true object and function of marriage. Show him also the element of justice involved in the marriage contract; that he must give what he exacts, that if he expects a healthy and normal wife, he must be healthy and normal himself; if he expects purity and cleanliness he must give purity and cleanliness; if he expects to mate with a fit female he must be an efficient and fit male. Remember that every act, deed, thought, and aspiration is regulated by laws which one cannot fool with, or disobey, without reaping a harvest which will conquer, crush and ruin you, no matter how clever or smart you may think yourself.
Show him the wisdom of the breeders' habit of never permitting sexual liberties in a too young stallion. For the same reason the boy must conserve his strength and virility for the marriage state and for the function of procreation.
In a further talk, the father may extend this subject and gradually lead up to the "consequences" of the unclean life. The boy will be ready for this talk and will evince an interest in it that will be encouraging and promising.
The talk about the science of mating the horses he will understand readily and thoroughly, and he will not fail to see the point when you switch to man and apply the same principles. Then when you show how mismating is responsible for poor children quality and how disease accounts for feeble-minded and degenerate offspring, he will be fairly well posted, and he will be ready to imbibe more details, and you will have done much of your duty. His curiosity will be quickened and his interest is awakened. It depends upon the father. If your boy is honest and clean, open and decent, he will not fall without a fight, and while he is fighting he is maturing. If your picture of the consequences of the venereal diseases has been effective and vivid, he will grow up with a healthy horror of them. If your conduct as a father has been wise and exemplary, and if your home has the right kind of environment, and the right kind of mother in it, you have done all a father can do to help the boy over the rough spots. The proper kind of encouragement and the right kind of vigilance, and books which will satisfy the boy's craving for more knowledge along this line is all that is needed to help the boy to "win out."
Fake Medical Treatment for Venereal Diseases.—Parents should in every possible way discourage the use of patent medicines and fake medical methods of curing these diseases. Untold harm has been done to boys and to women by these nostrums.
In every instance the motive underlying the methods of people selling these things is to frighten the patients into the belief that their condition is more serious than it is in order to justify a long and expensive course of treatment.
Their work is carelessly performed, and frequently they are directly responsible for the development of complication and dangerous sequelæ. The promises of speedy cures are false, and, not infrequently, methods of black-mailing have been known to follow an expensive and unsuccessful course of treatment.
There is no class of disease in which the help and honesty of the legitimate medical profession is needed more than in the treatment of the venereal diseases. Parents should see to it that the family physician is prescribing any strange medicine that may appear in the boy's room, and not some unknown individual who may be an impostor and a blackmailer.
Sowing Wild Oats.—Writers of fiction and others of a more serious trend of thought have recognized the sowing of wild oats as an institution which, if it does not merit the full approval of society's moral code, is, at least, tolerated. No serious consequences befall the offender. On the contrary, the libertine is the type of hero who receives the commendatory quips of erotic dames and the questionable interest of hysterical maidens.
Women of easy morals are always willing to espouse the cause of the "black sheep," and to further the matrimonial success of the penitent roué. Many mothers are willing to marry their daughters to the polished villain of society, who is known as a rake and debauchee, if his family connections are desirable. It has been even held that a youth who did not "sow his wild oats" was of doubtful stamina.
That many able men have sown wild oats is indisputable, and that many men who are respectful husbands, have also gone "through the mill" is also true, but this need not blind us to the fact that thousands upon thousands, who could have been successful men of affairs and creditable husbands and fathers, have been utterly ruined, as a result of having sown wild oats. No man is a better man because of a past record of licentious habits. The man who sows and escapes the harvest is lucky. The man who reaps, reaps in abundance. Most men regret the lapses of youth. Most of these lapses would never have occurred if the impulse could have been governed by the reasoning of maturity. These acts are the promptings of an impetuosity which may be entirely foreign to the individual's innate character, but brought out by promiscuous circumstances and the ignorance and license of youth. If we can protect youth, by an adequate knowledge of the consequences, we will furnish the means to tide over the impressionable period. Until a healthy maturity of judgment will assume the task unaided.
The effects of the wild oats' theory are too tragically evident to need any argumentative refutation. The statistics of the prevalency of venereal diseases alone is sufficient; the results of these diseases are more than enough.
Study the records of the jails and prisons, courts and asylums, hospitals and health resorts, think of the hundreds of thousands of diseased and deformed and mentally inferior children, of the multitude of paretics, melancholies, ataxics, maniacs, syphilitics,—all the products of "wild oats,"—and ask if the wild oats' theory is justifiable.
Think of the ruined homes, the wretched lives of fallen women, the hopeless prayers of abandoned wives, the loneliness and misery of parents neglected and forgotten, the "bastards" and fatherless children, the drunkards and criminals and tramps—all weeds of the wild oats' harvest.
Then reflect upon the tragedies, the suicides of the betrayed and of the diseased, the bank thief, the broken hearts of deserted and hungry children, the army of inefficients—around whose necks hang wild oats' medals, the men of big business, who constantly fight the effects of early incontinence and abuse, and the thousands who go to early graves, and then ask, in all justice, if the sowing of wild oats needs justification.
Who supports the thousands of prostitutes? Who made them? Wherever you find pauperism, crime, drunkenness, insanity, idleness, immorality, vice and disease, you will find that the sower of wild oats has traveled the path and left his stain and his footprints there.
Should Circumcision be Advised?—The answer to the above question is "Yes," in every instance. If circumcision is done early,—during the first two weeks of life,—the operation is without danger and practically without pain. In quite a considerable percentage of all males, circumcision is an absolute necessity. For excellent medical reasons, about which your family physician can inform you, every boy should be circumcised.
CHAPTER XIV
A MOTHER'S DUTY TO HER DAUGHTER
What a Mother Should Tell Her Little Girl—Where Do Babies Come From—How Baby Birds and Fish Come from Eggs—How Other Animals Have Little Nests of Their Own—The Duty of Mothers to Instruct and Direct—What a Mother Should Tell Her Daughter—Every Mother Should Regard This Duty as Sacred—Every Female Child is a Possible Future Mother—Motherhood the Highest Function of the Sex—Health the One Necessary Essential—Symptoms of the First, or Beginning Menstruation—The Period of Puberty in the Female—Changes in the Reproductive Organs at Puberty—The Female Generative Organs—The Function of the Reproductive Organs—The Age of Puberty in the Female—The Function of the Ovary—The Function of the Womb—Why Menstruation Occurs Every Twenty-eight Days—The Male or Papa Egg—The Function of the Spermatozoa—"Tell the Whole Story"—"How do These Spermatozoa Get There"—The Union of the Species—"How Can a Baby Live in There for Such a Long Time"—How the Baby Gets its Nourishment in the Womb—Girls Must Not Become Mothers.
What a Mother Should Tell Her Little Girl.—Every little girl should be told the Story of Life by her mother. It should be told in simple language, so that the little girl will understand. Very early in life the little girl will be prompted to inquire of her mother "Where do babies come from?" It is wrong to give an evasive reply to this natural inquiry or to postpone telling the story, because they will be told it by playmates and will receive very wrong and very crude impressions of this wonderful subject.
Every mother knows enough of life to tell her little girl its story in a way that will impress her with the sacredness of God's beautiful reproductive plan. She should begin by telling her a story about how the birds live. How at a certain season of the year they choose a mate and go housekeeping. They build a nest, and when it is all nicely finished, the mother bird lays her eggs. Then the papa and mamma bird take turns and sit on the eggs to keep them warm, and after a time the egg breaks and a little bird is born into the world. They feed the little baby birds until their feathers grow, and when they are old enough they fly away from their home and begin life by themselves.
Many questions will be asked as the mother tells the story in her own words, and the correct answers to these questions will fill in all the difficult-to-understand points. The story of how the fish lay eggs in shallow water so that the sun may keep them warm and hatch them out will interest also. Be careful to impress upon them that there is always a mamma and a papa, a male and a female bird and fish,—that this is necessary because God made it so, and we must obey His wish. When the little girl fully understands the story of the egg bird, and egg fish, the mother can tell how the Creator thought out a different plan for other animals like the dog, horse, lion, elephant, and cow. He knew that it would neither be safe nor possible for these animals to stay at home long enough to sit on eggs and hatch their babies, so he made a nest for them inside of their bodies. There they would be warm and would always be with their mammas no matter what they were doing. So we come to the answer to their question: "Where do babies come from?"
These interesting stories, according to the intelligence and sincerity of the mother, can be taken advantage of, to impress the little girl with the importance of many of the lessons of life. For example, her attention can be drawn to the fact that man and woman are the highest types of living things that God made. No other living thing, animal, or fish, or bird, or tree, or flower, can talk, and think, and reason as man and woman can. Because of this faculty—to think and reason—the human family are always trying to find out what can be done with all the other things God made. We try to find out what the different rocks are good for; what the different trees are good for, and the different kinds of earth, and animals, and birds, and fishes, and everything in the world. We study these, and we learn much, and we are made happier and more comfortable by what we learn. For example, by studying horses, and feeding and breeding them carefully, and training them, and caring for them, we can make stronger horses and better and faster horses; by studying trees, and planting them in soil best suited to them, and giving them plenty of water to drink, we can compel these trees to grow better apples and pears and peaches. In the same way we can produce better strawberries, and oranges, and grapes, and we can grow flowers with sweeter smells and prettier colors. We do all this by training these animals and trees to grow a certain way, to eat certain food, to drink pure water, and we protect them from the cold and sometimes from the sun if it is too hot. Our faculty to think and reason has taught us just what is good for them, and we compel them to obey our laws. As a result they become strong and more healthy. Now show the little girl how important she is; how much more precious she is than a tree, or animal, or flower, and how much more necessary it is that we, mammas and papas, should use our ability to think and reason in her interest. Show her how we have found out all about babies and little girls and how we know just what to do to make strong and healthy, and pure, and good, and clean men and women of all the little boys and girls in the world. Tell her that this is what mother is doing now, training her and compelling her to do the things that will make her a strong and a good mother when she grows older. Let her distinctly understand that it is the duty of mothers to instruct and to correct their little daughters when they do any wrong. Mothers know, because they have had experience in these matters, and they know just how a little girl must live, and dress, and eat, and behave, in order to be strong and pure, and good. So when mother reproves and corrects, it is because she knows that what you are doing to merit a correction is not for your ultimate good. Show them that all young things, and young animals, and young babies, and young girls, must be compelled to obey certain rules and laws, otherwise they would not grow up to be strong and healthy. Sometimes a rose bush grows up among stones and weeds, but it never thrives, it is always more or less sick. It does not grow strong, its flowers are poor little sickly things compared to the roses on a bush that is planted in proper soil, and carefully tended and pruned, and watered. So would the little girl turn out if she grew up in bad company and did not have a mother to guard and guide her,—to prune her when she was growing careless. Everything in this world has a meaning, and when mother tells you that you must not do a certain thing you very much want to do, she has a very good reason for telling you not to do it. You may not know the reason, but you should have confidence in your mother, you should believe that she knows what is best, and that she would not inflict pain or cause you suffering unless she knew it was for your good. The young horse does not understand why a halter is put around its neck and is made to run around in a circle until it is tired. It would much rather enjoy itself in its own care-free, and happy way. And when finally a full set of harness is put on, and it is put into the shafts of a wagon and tied there, and made to pull it and its driver many weary miles the horse does not like it, and he rebels strenuously. He is, however, compelled to obey in the end, and he finally consents to become a useful horse.
It is exactly the same way with every little boy and girl. We are put into this world for a certain purpose, and we must all work. Now parents know this, and they know just how to prepare little girls and boys for this work. They therefore ask them to do many things that are not pleasant or agreeable but which must be done in order to prepare them for the work ahead.
WHAT A MOTHER SHOULD TELL HER DAUGHTER
Your daughter is now about fourteen years of age. She is about to pass from girlhood to womanhood and she should know more of life's story. The mother will now tell her the complete story in the form of little talks, based upon the following facts as texts. Each mother will doubtless add to the story as conditions justify and as the education of the mother and daughter may dictate. A multitude of little side talks can be wisely indulged in to make clear any uncertain or doubtful explanation, and every one of these incidental excursions can be made exceedingly interesting if wisely and opportunely chosen. Always remember, however, to emphasize the sacredness of the story. Do not permit your daughter to get the impression that you are telling her something that simply has to be told, just as you told her the correct way to boil an egg. Let her realize and get the impression that this is the most serious and most wonderfully interesting story in existence, the most important story she will ever hear. Let her understand that motherhood, for which she is now preparing, is the duty God assigned her in this world: that that duty must be carried out, and that she must do nothing, nor leave anything undone, to interfere with its accomplishment. Do not only impress her with the story itself, but let your own explanation be so emphatically serious, that she will deeply appreciate its momentous significance—an occasion to be remembered all her life.
If she gets the proper impression from you at this time she will never treat the subject lightly, or permit it to be promiscuously discussed within her hearing.
Begin by telling her that she is about to enter the most important period of her life. Explain why this is so in the following way, in your own words. If we admit every female child to be a future mother, and motherhood the highest function possible to the sex, then the awakening of the sex organs and the mother instinct, must be the most important developmental episode in the life story of every woman. If this is so, then it follows that every girl should enter this period in the very best physical health possible, in order to reap the best results incident to this evolutionary period. We impress and warn her, therefore, that, as her system is about to undergo important changes, she must be particularly careful of her health. A little mistake at this time may be followed by more serious consequences than if made at any other time in her life. If a girl is to become a mother, certain changes must occur in her body before the nest, of which we previously wrote, can be made ready. God did not overlook anything when He peopled the earth; He therefore wisely planned that these changes in the female should occur at a time when the girl is strong and healthy.
The Period of Puberty in the Female. Symptoms of Beginning Menstruation.—At about the age of fourteen these changes begin to give evidence of existence. They affect the girl's whole system and the mother must be especially patient and sympathetic. Her disposition may change, she may want to be alone, and she may be more or less melancholy. She will be dissatisfied with the things that previously interested her. She will tire easily, and she may have many spasmodic pains from time to time. The wise mother will tactfully see that she takes plenty of nourishing food and systematic exercise, and that she gets enough sleep in a well-aired room. There are other physical changes which are observable at this age. The girl grows taller, the figure broadens out, the hips widen, the bust enlarges, and the waist line increases in size. These are all part of the great change from girlhood to womanhood.
Changes in the Reproductive Organs.—The principal change takes place in the reproductive organs themselves, and it is very essential that she should have a clear mental picture of just what is meant by "reproductive" organs and their location in her body. We mean by this term the group of organs which are concerned in creating and nourishing a child until it is old enough to be born into the world.
The Female Generative Organs.—These organs are the womb or uterus, two ovaries, two fallopian tubes and the vagina. The womb or uterus is the "nest." It is about the size of and is shaped like a pear. It is hollow, however, though its walls are quite thick. The ovaries are about the size of a peach stone and lie at the side of the womb,—one on either side. The fallopian tubes connect the ovaries with the womb. The vagina connects the womb with the outside world,—it is sometimes known as the birth canal. In the very lowest part of the abdomen, or belly, in front, is the bladder, which collects the urine until it is necessary to pass it out. In the back part of this region is the rectum; it collects all the undigested food, etc., from the intestinal canal. Between these two,—the bladder and rectum,—we find the reproductive organs, the womb, ovaries and vagina, described above.
The Function of the Reproductive Organs.—It will be difficult, even for mothers, to acquire a clear understanding of the function of the reproductive or generative organs. It is an exceedingly interesting process, however, and it is well worth a patient, attentive study to clearly understand the brief description we give of it. If you acquire a distinct mental picture of the problem you will be able to tell your daughter a story that will be of intense interest to her, and a tale that is interesting is impressive and is productive of thought and reflection. That is the condition of mind we want daughters to be in when they hear this story.
The human ovaries begin to prepare themselves for their life work when the girl is about eight years of age. When they are ripe, or ready to perform this duty, the girl menstruates for the first time. This is known as the age of "puberty," which implies that she has developed, passed from girlhood into womanhood. After having reached the age of puberty it is possible to become a mother.
The Age of Puberty.—There is no fixed age at which the first menstruation takes place. Some girls develop quicker than others,—a condition that depends upon the health and type of girl. A strong, robust, full-blooded girl will menstruate at an earlier age, than will a sickly anemic girl. The average age is fourteen years, though there is no reason to worry if a girl does not menstruate for a number of years later. In warm climates the age of puberty is from two to four years earlier than in more temperate climates.
The Function of the Ovary.—Just what takes place in each ovary when it is ripe is best explained by likening an ovary to an orange,—though of course the ovary is very much smaller than an orange, as was previously noted. If you make a cut in an orange and squeeze it, you express some of its juice and most likely you will also express one or more seeds. The seeds of the ovaries are called "ovules," and the process by which it expresses them is called "ovulation." Of course there is no actual squeezing of the ovary,—the ovules grow in the ovary, and as they ripen they come to the surface, and when actually ripe, the part of the surface of the ovary to which they come, opens up (like a flower unfolding when in bloom), and they fall out. The ovule we may regard as the human female egg, and one ripens and falls out every twenty-eight days.
When the egg falls out of the ovary it falls into the tube which carries it into the womb. This tube you will remember is called the fallopian tube. The ovule or egg is now in the cavity of the womb where we will leave it for the present.
The Function of the Womb.—While these changes are going on in the ovary, the womb is also preparing itself for its share of the work. The lining or internal surface of the womb is composed of mucous membrane, much the same as the interior lining of the mouth and throat. This lining becomes congested with blood, and is so intensely swollen at the time when the ovule or egg reaches the womb, that it is ready to rupture and bleed all over its surface. Just whether it will rupture and bleed, depends upon whether the egg is going to grow into a child or not. If it is not going to grow into a child, it immediately bleeds freely, and continues to bleed, until the whole lining of the womb and egg is passed out into the outer world. This takes four or five days and constitutes "menstruation." After menstruation is over, the womb begins again to prepare itself for the coming of the next ovule or egg, and as this occurs every twenty-eight days, menstruation is commonly termed the "monthly periods."
Why Menstruation Occurs Every Twenty-Eight Days.—The reason why the womb does this every twenty-eight days is because it is impossible to tell just when the womb will be called upon to nourish and support a child. If it did not get rid of the old blood, it would not be in a healthy condition to nourish and take care of a baby, nor would its interior be ready to supply new fresh blood for the growth of the infant. Hence nature constructs and builds a new "nest" in the interior of the womb each month. It very much resembles the new home into which the bride and groom, go to begin housekeeping.
When you told your little girl the story of life, you particularly drew her attention to the important fact that every living thing is created by the union of a male and female principle, and, therefore, has a mamma and papa. This applies to trees, flowers, vegetables, fish, animals, birds, insects,—every living thing, including human beings. We have seen that the ovule from the ovary is the female egg, or principle. It is the part the female contributes toward the future child. Before a child is possible, however, the ovule must meet the egg from the male.
The Male or Papa Egg.—The male or papa egg is called a "spermatozoa." It reaches the interior of the womb through the lower opening, which you will remember opens into the vagina. Emphasize to your daughter that the female ovule or egg, and the male egg, or spermatozoa, are minute objects, so microscopically small that a hundred million of them could comfortably lie upon a ten-cent piece.
The Function of the Spermatozoa.—God gave the male spermatozoa the power to move. To watch them under the microscope you would imagine you were looking into a bowl of water, in which there were hundreds of little fish all squirming around. But the most wonderful thing about them is, they can only move in an upward direction,—they seemingly cannot move downward, or sideways. If you think for a moment you will understand why God gave them this marvelous property. When the male semen is deposited in the female vagina, there are thousands of these minute, living, moving spermatozoa in it. The womb is above the vagina, and the female egg is in the womb, consequently, to reach this egg, the spermatozoa must travel upward. To travel in any other direction would be fruitless energy. There is only one female egg, but there are thousands of male eggs, or spermatozoa; it is easy, therefore, to comprehend how one of these spermatozoa should exactly be in line with the female egg in its upward path, since there are so many of them. It is only necessary that one should meet the female egg in order to impregnate it.
The shape of the male principle, or spermatozoa, is exactly like a little tadpole, and you no doubt recall that a tadpole has a minute tail, the movement of which enables it to swim around. So has the spermatozoa, and by the incessant movement of this microscopic tail they all move upward as soon as discharged by the male. I told you that God gave the male-germ life. It is necessary now to explain the character of this life. It is very brief; it is estimated that they are active for two hours, and then become inactive, or die. The best way to explain the brief activity to your daughter, is to liken the spermatozoa, to a mechanical toy, which is wound up to go for a certain time. After it runs out it becomes inactive; this is exactly what happens to the little human tadpole. If during this brief life none of them has happened to reach the female egg, pregnancy does not take place and menstruation occurs. On the other hand, if this were not so,—if these spermatozoa were active for a longer period, pregnancy would almost be certain to take place every time the womb was not already occupied with a pregnancy.
Tell the Whole Story.—When a mother reaches this stage of the wondrous tale she will be asked by an innocent girl,—"How do these spermatozoa get there?" or, "You have not told me where these tadpoles came from" or, "I don't understand how these spermatozoa got into the vagina" or, "I don't know why you call these the male egg when they are in mamma." It does not matter how it is expressed, the intent is plain enough. I have said, that an innocent girl will ask this question, the implication being that one who is not innocent will refrain from asking this question. A girl who knows the answer will not ask, because, if she is familiar with this subject before her mother thinks it wise and proper to tell her, she obtained her information from a source which, most likely, insinuated a suggestive, or evil, meaning into the explanation, consequently she would be afraid, or ashamed, to ask the question. An innocent girl, on the other hand, would rightly ask for information which is obviously kept back, and which she has a right to know, since a complete, and intelligent understanding of the story depends upon the elucidation asked. If it is proper to tell part of the story, it is essential to tell all of it. Tell it in your own words in this way:
When God conceived the human race He ensured its perpetuation by designing a method whereby this would be rendered possible: He did more; He wisely decided that the function, involving the very existence of the human race, should be attended with a sentient gratification. He further instilled into the fundamental economy of mankind, sex attraction, which is involuntary, undeniable, and unquenchable. If God conceived the means and the method, no human mind in possession of its faculties should see evil where it does not exist. It was by Him designed that the male organ of reproduction should deposit its germinating fluid in the vagina of the female, and this is accomplished by a union of species.
The one set of reproductive organs is a complement of the other, and essential to the other. It is by this act that the male spermatozoa is enabled to complete the function of fecundation.
If now we assume the male and female element to have met and united, menstruation does not take place. The egg or embryo (the future child) begins to grow, and it remains in the womb for two hundred and eighty days from the day when the male and female egg met. It is quite natural for an intelligent girl to ask her mother to explain, "How a baby can live in there for such a long time," or "What makes it grow if it does not get anything to eat or drink."
How the Baby Gets its Nourishment in the Womb.—These questions can be answered in this way. While the baby is in its little comfortable home it gets everything it needs. You are in your home now. If you wanted a drink, what would you do? Wouldn't you go to the water faucet and draw a glass of water? The water comes to you through a pipe, right into your home, you don't have to go out of the house to get it. And if you wanted light when it is dark you would turn on the gas and light it. It, too, comes into your home through a pipe. Now baby gets its air; and food, and all it needs to drink in just that way. There are two little pipes which go into its nest or home, and then into the baby's body at the navel, and through these pipes fresh blood runs in and out. When mother breathes, her blood sucks up oxygen from the air in her lungs, and the blood carries oxygen to every part of her body. In this way, all parts are supplied with the proper quantity of air. Now the baby is simply a new part of mamma as long as it is in its nest in her body, so it too gets air in this way. When mother eats, the food is taken into her stomach and it is there changed into liquid and so prepared, that when it passes into the intestines, the part of the food that is good for her, is sucked up into the blood, and the blood carries it to every part of her body. It distributes whatever is needed to all parts, and as the baby is a part, it gets its share. The other pipe carries the blood back again, out of the baby for new supplies, and as this is going on all the time, there is no danger of the baby starving in any way, or at any time.
When your daughter understands this, show her how important it is that mothers should be in good health, otherwise the baby will not get good food, it will not be properly nourished and will be born a poor, little sickly child. Little girls, consequently, should try to eat properly, exercise regularly, and do everything their mothers tell them, so that when they become mothers, they will be able to nourish their babies and not bring into the world poor little starved infants.
Girls Must not Become Mothers.—We have previously stated that girls can become mothers when they have reached the age of puberty. God did not intend, however, that girls at the age of twelve or fourteen should become mothers, because their bodies are not strong enough, nor are they fully grown, nor have they the experience, to undertake the physical task and responsibility of bringing a baby into the world. We know this from experience, because we have seen the sickly babies such girls have, and we have seen how much these girl mothers suffer, and how they ruin their health, by trying to do what God did not intend they should do. Even the trees teach us this lesson. An orange tree will bring out buds, which would develop into oranges, when it is two years old. The experienced farmer, however, will pluck these buds off, and will do so every year, till the tree is five years old. If he allowed the tree to bear fruit during its young years, the oranges would not be good, or sweet, or large; so he waits until the tree has grown and is strong and healthy, when its fruit will be large and sweet. An orange tree of this type will have better fruit, and will continue to produce this good variety for many years. A tree allowed to bear fruit when two years old will never have first class oranges, nor will it continue to have, even poor oranges, as long as the other.
CHAPTER XV
PREPARING FOR MOTHERHOOD
Menstruation—Irregular Menstruation—Changes in the Quantity of the Flow—How the Womb is Held in Place—Symptoms of Menstruation—Menstruation Should Not be Accompanied with Pain—Don't Give Your Daughters Patent Medicines or "Female Regulators"—Take Your Daughter to the Doctor—Leucorrhea in Girls—Bathing when Menstruating—Constipation and Displaced Wombs—Dress and Menstruation—Absence of Menstruation, or Amenorrhea—Treatment of Amenorrhea—Painful Menstruation, or Dysmenorrhea—Causes of Dysmenorrhea—Treatment of Dysmenorrhea—Sterility in the Female—Conditions Which Affect the Fertility of Women—Climate—Station in Life—Season of the Year—Age—The Tendency to Miscarry—Causes of Sterility in the Female—Displacement of Womb—Diseases of Womb, Ovaries, or Tubes—Malformations—Lacerations—Tumors—Leucorrhea—Physical Debility—Obesity—Special Poisons—"Knack of Miscarrying"—Miscarriage—Cause of Miscarriage—The Course and Symptoms of Miscarriage—What to do when a Miscarriage is Threatened—Treatment of Threatened Miscarriage—Treatment of Inevitable Miscarriage—After Treatment of Miscarriage—The Tendency to Miscarriage.
MENSTRUATION
We have explained in the previous chapter what menstruation is, its frequency, its significance and its origin. There are a number of its common characteristics with which the mother and daughter should be acquainted.
Irregular Menstruation.—Menstruation may occur once (the first time) and fail to recur the following month or for a number of months. This need cause no alarm as long as the general health remains good. It will come again in its own time. Nervousness may cause a suspension of menstruation. This is quite common in school girls who are driven too hard at school, whose sleep is interfered with, whose appetite is poor and who are allowed too many social indiscretions, as parties, dances, etc., where late hours are observed, all of which should be put aside until school life is over. Sometimes menstruation will temporarily stop if the girl goes away from home on a visit.
Sometimes the quantity will be greater than at other times, and a very scant flow, after it has been free and regular may cause apprehension. Various causes may be responsible for a decrease, catching cold, sitting on cold steps or cold ground, wearing damp clothes, nervousness, mental worry, physical exhaustion, insufficient food and exercise, and anemia, may cause it. For these reasons a girl should be exceedingly careful of her health, she should guard against catching cold. Do not change the underwear until certain that the weather is far enough advanced in season to justify such a change. She should not become exhausted or worry. In all cases of suppression, or of increased flow, a physician should be consulted at once, and girls should be instructed to tell their mothers of any change in the character of the "periods," as soon as it occurs. Mothers should instruct their daughters to rest the first day of their monthly flow, and all during the menstruation they should refrain from any unusual activity. Even play should be moderated and abstained from entirely if there is any pain. In order that the girl fully appreciates why these rules are laid down, it is advisable to explain just how the womb is held in place in her body.
This appears to the writer as being a particular important point. A girl must not be expected to give these matters the serious consideration they merit unless she thoroughly understands the reasons why. An explanation, in the form of even an intelligent talk, will soon be forgotten. If, however, a definite, concrete picture, is impressed upon her; if she actually sees in her mind the process that is going on, she will understand why it is necessary to do as she is told. If the mother will therefore assure herself that the daughter actually knows what is being accomplished in her womb at the menstrual period, she will carry out the instructions more faithfully.
How the Womb is Held in Place.—The human uterus, or womb, is held in its proper place in much the same way as a clothes pin sits on a clothes line. The heavier part is the upper part, and that part is held in place partly by resting on the rectum behind, and the bladder in front. When menstruation occurs, the body of the womb becomes much heavier because of the increased amount of blood in its interior. This added weight increases its liability to tip over, and if any extra strain or effort is made at this time it will become tipped, or as the physician calls it, displaced. If a womb becomes displaced, every menstruation afterward will be painful and prolonged,—sometimes excessively so. A displaced womb becomes congested and unhealthy. It causes leucorrhea or a chronic discharge, makes a nervous wreck of the woman, results in sterility and frequently in a dangerous operation. There are, therefore, ample reasons for watchfulness and care on the part of the growing girl.
Symptoms of Menstruation.—After menstruation is established there should be no actual pain at each period. There are, however, certain undefined feelings,—premonitory symptoms,—which may be explained in the following terms:—A day or two before the date on which the menstruation is expected, the girl will appreciate that "her sickness" is coming. She will not, or should not, complain of pain, but will state that she has a bearing down feeling, is a little more nervous than usual, has no desire to go into company, and wants to be more or less her own entertainer. The "sick" period usually lasts four or five days. The second day is the most important.
Menstruation Should Not be Accompanied With Pain.—If any actual pain accompanies menstruation, either before or after it is established, the mother should at once take the daughter to the family physician. Menstruation is a natural, physiological act and should not be accompanied with actual distress or pain. It is astonishing how many mothers will allow their daughters to suffer needlessly, for months and years, because of the mistaken idea that "since the pain is there, it must be," or because she—the mother—suffered, so also must the daughter suffer. There is no more unfortunate mistake, and many a girl's health and happiness has been blasted because of this misbelief. The cause of the pain is, in a vast majority of the cases, a very simple one, and can be removed in a very brief time.
Should the menstrual period last too long, be too frequent, or be in any way not what it should be, consult your physician. If you are not sure of "what it should be," or if you have any doubt, ask your doctor. Don't let any false pride or feeling of modesty on your part, or on the part of your daughter, dictate your policy under such circumstances. Don't take the advice of your friends or neighbors in a matter so vital. It is too important, and they are not qualified to "guess" any more than you are. Don't, if you have any respect for yourself, or love for your child, begin dosing her with the advertised patent medicines and "Female Regulators" for which so much is claimed, and which seem to "just suit" your daughter's case at this particular time. Take her to the doctor, whose advice you value (or you should not have him as a family physician), who has no interest at stake except to help you and your child, and whose fee is no more than the price of one of these bottles of advertised poison. He is the only one qualified to speak with authority on such a momentous subject, and you will never spend a dollar to better advantage. Warn your daughter not to speak about "her sickness" to other girls.
Especial attention should be paid to cleanliness during this period. The mistaken idea that bathing of any kind at this time may have disastrous consequences is responsible for much of this neglect. If proper care is taken warm sponge baths, in a warm room, will not cause any trouble. Unpleasant odors can be avoided by sponging the parts with a warm solution, into which a mild antiseptic is put, upon changing the cloths.
Leucorrhea in Girls.—It has been stated above that a displaced womb may cause leucorrhea or a discharge. It must be remembered that leucorrhea, or "whites," may occur in girls as well as in married women. It can also result from catching cold during the menstrual period. Another mistaken idea is that girls should not take douches for fear of injuring the hymen. This is erroneous, and while they are entirely unnecessary in a vast majority of cases it is sometimes absolutely essential to douche in order to cure leucorrhea. When they are given, it is advisable to use the small nozzle that comes with every douche bag set.
Constipation and Displaced Wombs.—When the picture is fresh in the mind of the girl, of how the womb is held upright in her body, the mother should speak to her about the serious results that may occur from constipation. If the rectum is full of hardened feces the womb will be pushed out of place, and if under these circumstances straining is necessary to empty the bowel, and if this condition is habitual, constipation may be the actual cause of displacement of the womb.
Dress and Menstruation.—It is also an opportune time to demonstrate to what extent serious results may follow mistakes in dressing. The habit of permitting growing girls to constrict the waist, to bind and pull the abdomen by too tight garters, or too tight corset, is wrong, and no mother should permit it. In another part of the book, this matter is taken up more fully, but if it is explained to the girl while she is considering the subject of menstruation, she may more quickly and more fully appreciate its significance.
Absence of Menstruation—Amenorrhea.—The absence of menstruation after it has been established, does not, as a rule, indicate any disease of the womb or female sexual organs. It is to be regarded merely as a symptom and can be, as previously stated, safely ignored if the general health is good. If the general condition is poor, and the quantity and quality of the blood deficient, it is a provision of nature to suppress menstruation in the interest of the general health. For this reason it is safe to disregard the amenorrhea and build up the bodily strength. This explains why some girls pass the usual age of puberty and show no signs of menstruating. They are poorly developed sexually, through deficiency of blood. If, on the other hand, a girl should have all the symptoms of menstruation every month, but no flow, she should be examined by a physician to determine if there is any obstruction to the escape of blood. Total absence of any symptoms of menstruation extending into adult life, may indicate an absence of the sexual organs. During the first year after puberty it is quite natural for menstruation to be irregular; after the function is thoroughly established there are many causes that may be responsible for its temporary absence.
Causes of Amenorrhea.—Any condition or circumstance which reduces the general health or impoverishes the quality or quantity of the blood and weakens the nervous system, will result in a stoppage of the monthly periods. Among these are insufficient food and exercise, overwork, overstudy, exposure to cold, sitting on cold steps or gold ground, wearing damp clothes, bathing in cold water at the beginning of menstruation, powerful emotions, as great fright, anger, anxiety; acute diseases, such as typhoid fever, cholera, the infectious skin diseases; chronic diseases such as Bright's disease, heart disease, consumption; anemia and chlorosis are very common causes. Obesity or an overfat condition will cause an early suppression of the menses which may result in a fruitless marriage. Displacement of the womb and other local disorders frequently result in scanty or delayed menstruation. Anxiety lest pregnancy may occur in the newly married may cause a delay in the periods. A radical change of climate or sometimes a visit to the country, or changed circumstances may stop the flow for the time being.
Treatment.—The treatment of amenorrhea, or absence of menstruation, will depend on the underlying cause. A careful investigation should be made into the mode of life and the hygienic surroundings of the patient. Her general health and her mental condition should be inquired into. If the patient is not in good health, or is not obtaining exercise in the open air, or if she is a victim of mental worry or of domestic unhappiness, or if any sufficient cause exists for the amenorrhea it must be removed before any treatment may be expected to relieve the condition. If the patient is a married woman the possibility of pregnancy should always be borne in mind, and no radical treatment instituted until this has been excluded. If the absence of menstruation is dependent upon defective development of the sexual organs we cannot expect much from any treatment. The amenorrhea from exhaustive diseases will usually correct itself with, or soon after, the establishment of convalescence. In diseases which tend to death, as in consumption, heart disease, etc., the function is never reestablished. A very common habit of most people is to regard the absence of the monthly periods as the cause of their ill health. It is not, it is the result of the ill health. Get rid of the bad health and the menses will take care of themselves. That form of amenorrhea which is the result of change of climate or surroundings will regulate itself as soon as the victim becomes acclimated or reconciled to the change, or returns home if the visit is of brief duration.
As a general routine treatment, good wholesome food, regular hours, fresh air, sunlight, and judicious exercise, with such other measures as may be suggested by the condition of the blood and nervous system, are the indications in the way of treatment. Anemia and chlorosis (poor blood) should be treated by the administration of iron in some form. Obesity should be reduced by diet, exercise, and such other treatment as may be found efficient and not detrimental to health. Overwork, mental and physical, should be stopped, and sedentary habits changed to a more active out-door life. The acute suppression from exposure to cold, wearing of damp clothes, sitting on cold stones or cold or damp ground, sea bathing in very cold water, is very often associated with an acute inflammation of the womb itself and calls for rest in bed, laxatives to open the bowel, hot application to the lower part of the abdomen and a teaspoonful of Hayden's Viburnum in a glass of hot water every four hours until relieved. The use of the sitz bath is frequently successful if taken at night followed by a laxative and a hot drink.
Painful Menstruation—Dysmenorrhea.—Most, if not all, victims of painful menstruation are of a nervous temperament. Dysmenorrhea is simply one symptom of the general nervous condition. The nervousness may be acquired or it may be the result of heredity. In girls it has been found to be an accompaniment of the overwork and worry of school and student life. Girls who suffer greatly from it while in school are entirely free during vacation from school.
There is a type of painful menstruation known as neuralgic dysmenorrhea. This is simply a local expression of a general neuralgic tendency. It comes under conditions which favor neuralgias in other parts of the body. Girls and women affected with this type of dysmenorrhea are often anemic, hysterical, and not infrequently the victims of malaria, rheumatism, or other diseases which tend to impoverish the blood and reduce nerve vitality. The pain resembles neuralgia elsewhere. It comes and goes, it may last a brief time or a long time, it may be very mild or very severe. The pain bears no fixed relation to the flow, it may proceed, accompany or follow it.
Mechanical dysmenorrhea is that form in which a mechanical impediment exists to the escape of the menstrual fluid. The internal canal may be too small, displacement, growths, either inside or out of the womb, faulty development, or frequently simple congestion will act as an obstruction and cause pain from tension. The pain accompanying mechanical dysmenorrhea is very different from the neuralgic type. It comes on gradually, increases slowly until it is very severe and stops suddenly. A gush of blood from the womb announces the fact that the obstruction has been overcome and the womb has emptied itself; as soon as this occurs the pain ceases.
In the mechanical variety there are frequently clots in the menstrual flow. Inasmuch as this type may be caused by imperfect development of the womb, it is common to find that pain has characterized the monthly periods from the time of the first menstruation. It may, however, as stated above, be caused by growths which had their beginning at a later period.
Treatment.—For the neuralgic variety the treatment should be general. The whole object is to build up the general health. Fresh air, sunlight, out-door exercise, plain, substantial food, regular hours, pleasant surroundings, and such medication as may be indicated, should be the course to follow. The bowels should be kept regular and digestion aided in every way possible, if necessary by rest from school, or work, or by a change of air and scene. If the patient is inclined to malaria she must take quinine and live in a locality free from that tendency. If rheumatic she should take the remedies advised in that disease and avoid colds, wet clothes, or sitting in cold, badly ventilated rooms, churches or theatres. If there are no distinct evidences of special tendencies, general tonics may be given to advantage. These should consist chiefly of iron, arsenic, phosphous, nux vomica, cod liver oil, etc.
The treatment of mechanical dysmenorrhea of course implies removal of the cause. As this necessitates operative procedure, or at least an examination by a physician, it is best left in his hands.
STERILITY
Sterility means the inability to become a parent. A woman who is sterile cannot become a mother. She is for some reason unable to have a baby.
A childless union is frequently the cause of much unhappiness. There is something lacking in the expression "a childless home." It seems a paradox, as home is inherently associated with children and happiness. It has been stated that one out of every eight marriages is barren. The average time which elapses after marriage and the birth of the first child is seventeen months. Physicians agree that if a woman goes over three years after marriage without having a baby her chances of having one are small. If children are desired, and they usually are by childless parents, every effort should be made within the first three years to ascertain the cause of the sterility, and if it can be rectified. The barrenness may be dependent upon some physical defect which will quickly respond to the proper medical treatment. It is well to remember, however, that the defect is not always the woman's. In every six childless marriages about one is due to sterility in the husband. The age of the greatest fertility in women is between twenty and twenty-four years. It is rare to find a barren woman between these years. Nature evidently intended that the duties of maternity should be assumed between the twenty and twenty-fourth year. If married before the age of twenty the statistics prove that barrenness exists in one woman in every twelve. If married after the twenty-fourth year the chances of having children decreases with the age of the woman.
If a mother goes for three consecutive years without becoming pregnant the chances are that she will have no more children. Consequently if other children are desired it is unsafe to rest upon the assumption that a woman will again be a mother simply because she has been one in the past. Many conditions could, and may, have occurred since the last pregnancy (and may be as a result of that pregnancy) to change her natural fertility into a condition of temporary sterility. An examination should therefore be made before too long an interval elapses and the facts learned. It will usually be found in such cases that a displacement or laceration, or at most, some cause easily remedied is immediately responsible for the apparent barrenness.
CONDITIONS WHICH AFFECT THE FERTILITY OF WOMEN
Climate.—It is a well-known fact that more children are born in southern regions than in northern countries. It may be asserted, therefore, that climate affects the fertility of the race.
Station in Life.—Children are more numerous among the poor than among those who are wealthy and enjoy the luxury of riches. This condition cannot, however, be construed as a true expression of fertile efficiency. It is more a comparison of ethics, and when we express it thus we are giving it its most charitable name.
Season of the Year.—The spring of the year, being more favorable to fecundity, exerts an influence over the increase of population. Nursing mothers are as a rule sterile until after weaning time. This is not always so however, and the possibility of pregnancy taking place while nursing a baby, and before menstruation is reestablished must be reckoned with as it occurs quite frequently.
Age.—Age may be said to affect the fertility of women inasmuch as sterility is the natural and proper condition before menstruation is established and after menstruation ceases.
The Tendency to Miscarry.—Because a woman has never given birth to a living child is no proof that she is sterile. Many women have the ability to conceive but for some reason they have acquired the misfortune, or the "knack," of miscarrying. This is a condition of the gravest significance and will be considered at length in its proper place.
The influence of a temporary separation has had excellent results in a great many historical cases. Where the married couple seem to be lacking in some one or other of the emotional or temperamental qualifications, it is advisable to suggest a temporary separation. When this period has expired and they resume marital relationship the element of novelty, acting as a stimulus, quite frequently reestablishes a fertility that was seemingly suspended, or awakens it if conception has never previously taken place.
There are a great many cases on record where, conditions having remained the same, women have become fertile after years of seeming barrenness. It is impossible to explain, or to satisfactorily understand these cases. It is quite common to note cases in which women have never become pregnant until a number of years after marriage, even when the desire to have children existed. There is one case on record of a woman married at eighteen, but although both herself and her husband enjoyed habitual good health, conception did not take place until she was forty-eight years of age when she bore a healthy child. Women should not, therefore, become easily discouraged in the hope of having a baby, especially when they have a clean history, and a healthy body. The conditions may change and may become favorable when hope is about to die.
CAUSES OF STERILITY IN WOMEN
Inasmuch as it is necessary to consult a competent physician in all cases of sterility, it is not necessary to go into detail regarding each possible cause, other than to explain how each may produce barrenness. It will be observed that a competent physician is specified and advised in these cases. This is very important because many advertising, or "quack" doctors, particularly solicit these kind of cases. They are not competent to be trusted with such cases and will likely effect more harm than good. A woman should not hesitate to consult the best available medical authority if she is a victim of sterility. There is nothing to be ashamed of. It is a perfectly proper medical situation and should receive the best medical advice and investigation. The following are the more frequent causes of absolute sterility.
(A) Displacement of womb.
(B) Diseases of womb, ovaries or fallopian tubes.
(C) Malformations.
(D) Lacerations or tears of mouth of womb.
(E) Tumor.
(F) Leucorrhea.
(G) Physical debility.
(H) Special blood poisons.
(I) Great obesity.
(J) Anemia.
(K) Self-abuse.
(L) Habitual alcoholism.
(M) Lack of moderation in the marital relations.
(N) Certain diseases may be associated with barrenness: cancer, diabetes, consumption, Bright's disease, etc.
(O) Certain temperamental conditions may be associated with barrenness: lack of affinity, frigidity.
THE KNACK OF MISCARRYING
Displacement of Womb.—In many instances the primary cause of the displaced womb was some energetic, muscular effort, made while the victim was yet a girl,—probably before menstruation began. Whatever act first caused a slight tilting of the womb, must necessarily have been an unusual physical effort, and as girls are getting more and more strenuous we may look for more trouble in this direction in the future. Inasmuch as a slight tilting of the womb gradually gets worse it is a reasonable expectation to believe that sterility is a natural sequence to displacement. The girl may have been the victim of painful menstruation which was neglected, because not quite painful enough to compel medical relief, which is sought for only as a last resource unfortunately under the circumstances. Intercourse may also have been more or less painful,—a condition which again is mistakenly and imprudently borne in silence and left to take care of itself. But when persistent sterility faces her, the woman seeks medical assistance and her trouble is discovered. As the displacement is found to be the cause of her sterility, its correction, which is a comparatively easy medical problem, not only cures the barrenness but happily relieves her of the menstrual distress and all other pain.
The treatment for displacement consist of placing medicated pieces of wool or cotton, called tampons, in the vagina in such a position as to hold the womb, as nearly in its proper place as is possible. After a time nature will so strengthen the ligaments that they will hold the womb and a cure is, therefore, affected. The length of time necessary to cure depends upon the length of time the displacement has existed. It may take, from two to four months. When the displacement is of long standing and is accompanied with more or less inflammation, adhesions sometimes grow between the womb and the adjacent organs. It is necessary to resort to surgery in such cases, but the result is always good and the danger practically nothing.
Disease of the Womb, Ovaries or Fallopian Tubes.—Disease of the womb, ovaries, and fallopian tubes, which renders the victim sterile, is as a rule the direct result of infection. Such infection is conveyed by the husband to the wife. This is quite a common condition. The simple fact that such conditions exist leads us to hope that the time is not far distant when it will be compulsory for all participants in the marriage ceremony to submit to a thorough physical examination. By this means, and by this means only, will the innocent be protected. No one can conceive, unless he has been identified, as a physician, with one of the large metropolitan hospital clinics, of the extent of this class of disease, and of the frightful suffering caused, and innocent lives ruined, by infection conveyed in this way. It is a tragic corollary to the marriage vow "for better or for worse."
If a woman is fortunate enough to fall into the hands of an honorable physician, who will tactfully explain to her the serious significance of her condition and obtain her consent to treat her until she is cured, which in all probability will include a surgical operation, and will do so with diligence, without regard to the size of the bill, she will indeed be a lucky woman. It is from women who are suffering with such diseases,—most of them without the slightest idea of what ails them,—that the venders of advertised nostrums reap their fortunes, and it is from the same victims that most of the advertised medical "quacks" look for their blood-money. The great difficulty, however, lies in the failure of the woman to appreciate the seriousness of her condition, and as a consequence she fails to understands why it should take so long to cure her. She loses confidence in her physician, she buys certain "cures" recommended to her by Mrs. Busybody and later tries other physicians and ends by losing faith in herself. Meantime she grows worse and worse. There are thousands such. It may be here stated without fear of contradiction that if the public in general would repose more confidence in the medical profession, there would be much less suffering, much less sorrow, fewer regrets, fewer irresponsible "isms," and cults, because there would be fewer disappointed individuals to support them. If the medical profession would condescend to employ the tactics and devices of those questionable, fashionable agencies that claim the power to cure human suffering, it could quickly reap the profit and the laudation that it now escapes because it keeps the faith.
The way to be cured of any disease, if it is curable, is to engage a reputable physician and follow his instructions implicitly. Let him understand you expect him to see you through your trouble and let him know you have confidence in him. There isn't one physician in a thousand who will cheat you under these circumstances.
Malformation.—Under this heading are all those cases of sterility resulting from imperfect generative organs. These are products of a failure on the part of nature to furnish or develop the structures participating in the propagation of the species. The entire generative organs are sometimes wanting. The womb may have failed for some reason to grow with the rest of the body, it remains (as it is known) as an "infantile womb." Occasionally the womb grows together, that is, it is solid instead of being a hollow organ. The mouth of the womb may be too small, representing what is called "a pin head opening." The natural opening is large enough to admit a lead pencil, a "pin head opening" would not be larger than the lead in the pencil. The latter condition is quite a common cause of sterility and is readily amenable to treatment. Most of the malformations which produce sterility are impossible to cure.
Lacerations or Tears in Mouth of Womb.—This subject is fully discussed on another page of this volume.
Tumor.—A tumor may be so situated as to prevent conception, or it may involve the body of the womb constituting a reason in itself for sterility.
Leucorrhea.—Leucorrhea or "the whites" may be of such an acid character as to kill the spermatozoa in the vagina, or it may be of such volume as to render impregnation impossible. The treatment of this condition is discussed elsewhere.
Physical Debility.—When the general health is bad, no matter from what cause, sterility usually exists. This lack of vitality may be due to chronic disease, or it may have been caused by a very severe acute illness, such as typhoid fever. One's mode of living, if unhygienic, may be responsible for continued bad health and a consequent sterility.
Obesity.—Very fat women are usually barren. If a woman rapidly accumulates fat after marriage she as a rule does not have more than one or two children. Women often become stout immediately after the child bearing age ceases.
Special Poisons.—Certain special poisons in the blood cause sterility by producing miscarriage.
MISCARRIAGE
By the term "miscarriage" we mean that for some reason the progress of pregnancy has been interrupted and the fetus is expelled from the womb. A miscarriage or abortion (both terms meaning the same—the difference between the two terms is a technical one and need not concern us here) can occur any time after conception up to approximately the seventh month, when, if labor takes place, the child may be born alive. The condition would then be termed a premature labor. A miscarriage or abortion is an immature labor and implies an immature or dead child.
The condition is a serious one no matter whether it is attended with grave symptoms or apparently no symptoms. If it occurs shortly after conception, during the first few months of married life it is serious, if not in its physical consequences, it is in its significance, because it establishes the tendency to miscarry,—a tendency that may result in great mental distress because of the worry and fear it engenders, and of sorrow and heartache because it may blast the hope of parentage. Such a miscarriage may take place at once after conception. If so, the following menstruation may be delayed for a week or so and is then a little more profuse than is customary. This will be the only indication that a life has been sacrificed that the young wife may have, and frequently the significance of such an occurrence is never understood, yet the tendency to miscarry is nevertheless established, and a seeming sterility is apparently the fate of the woman. It is, therefore, of the greatest importance that extreme care should be taken to bring the first pregnancy to a successful consummation. A young wife should realize that she is apt to become pregnant at any time. Her conduct therefore should be such at least as not to harm the life principle with which she has been entrusted. To this end any excessive sexual activity should be strictly avoided.
Causes of Miscarriage.—Any strenuous physical effort must be guarded against. Included in such efforts may be the following: dancing, running, jumping, surf-bathing, sewing on a machine, sweeping, washing, house-cleaning, moving furniture, etc. Sometimes the primary cause of a miscarriage is to be found in some hygienic act, such as a hot bath, too prolonged or too many hot douches near the menstrual periods. A blow or a fall, even a fright or shock may cause a miscarriage. Anything that violently shakes or agitates the womb, which may at this time be irritable because of its condition, will be sufficient to excite it to contract and miscarry. Hence violent coughing or vomiting should be avoided if possible; horseback riding, jolting in a carriage, convulsions, hysterical crying, may also be the causative factors. Displacement of the womb by limiting its tendency to grow when pregnant, may cause it to miscarry. Very severe general diseases such as small-pox, pneumonia, etc., will cause the womb to empty itself. Disease of the fetus or the presence of syphilis in either of the parents will also have the same result.
The Course and Symptoms of Miscarriage.—The cause of a miscarriage or abortion is much the same as an ordinary labor at term. Whatever interrupts the pregnancy causes the death of the fetus. The dead fetus acts as a foreign body and excites the womb to contract as it does during an ordinary confinement. The contractions open up the mouth of the womb and the fetus is expelled together with its membranes and after-birth. The significant and the most important symptom of a miscarriage or abortion is hemorrhage or bleeding from the privates. The flow of blood may not amount to much or it may be excessive and alarming; it may not be constant, it may come from time to time in the form of clots.
The next significant and important symptom of miscarriage or abortion is pain. The pain, like the flow of blood, may be only slight or it may be very severe, sometimes it is absent in very early miscarriage. As a rule the pain is severe when the miscarriage occurs after pregnancy has lasted for a number of months.
A miscarriage or abortion is said to be "complete" when the fetus with its membranes and after-birth is expelled clean and whole, or in other words when the womb empties itself completely. A miscarriage or abortion is said to be "incomplete" when some part of the embryo is left in the womb.
What to Do When a Miscarriage is Threatened.—When a woman, who is pregnant, begins to flow she should at once go to bed and keep perfectly quiet and send for a physician. A miscarriage is a treacherous condition and is so regarded by all medical men. It may not amount to much or it may, on the other hand, develop into a serious situation. The immediate danger is from hemorrhage; the ultimate or remote danger is sepsis or blood poisoning. The condition is one that can only be taken in charge by a qualified physician in whose hands we can safely leave the conduct of the case.
As a general rule it is quite safe to assert that a woman will not bleed enough at the beginning of a miscarriage to do any permanent harm. Consequently there is no occasion for unnecessary alarm. She must, however, as stated above, heed the warning and go to bed, keep perfectly quiet and send for a physician. If she fails to follow this advice it is quite possible that she may have a hemorrhage during the course of the miscarriage of a sufficiently serious character to endanger her life or from the effects of which she may suffer for the remainder of her life.
There is practically no danger during the course of or after a "complete" miscarriage. The danger which may ensue from an "incomplete" miscarriage is hemorrhage and a form of poisoning caused by the absorption into the system of putrifying products of the part of the dead embryo left in the womb.
There are a large number of cases of criminal abortion in which septic poisoning occurs caused by the utensils or instruments used in inducing the abortion. All of these cases are operative cases which must be attended to promptly to save life.
Treatment of Threatened Miscarriage.—Not all of the cases of beginning miscarriage end in miscarriage. If the physician is sent for in time he can very frequently give directions that will, if carried out faithfully, avert the disaster. Success is more likely to attend those cases in which the trouble has been caused by some accidental injury, as a fall, or blow, or extra exertion. This is more especially the case if the woman has previously borne children, is healthy and in good condition and whose womb is known not to be diseased. In these cases there is a partial separation of the fetus from the wall of the womb, which causes the bleeding. The physician will direct that the woman be put to bed, in a quiet, darkened room. He will instruct the nurse to sterilize the external genital region: a sterile gauze dressing is then left in place. Some form of prescription will be given to diminish the patient's nervous fear and to allay any tendency on the part of the womb to contract. It is always essential and very important to save everything that passes from the womb during the course of a threatened miscarriage in order that the physician may know exactly just what the condition is. Each cloth, each clot of blood will have to be examined before the proper treatment can be pursued in safety.
When the miscarriage cannot be prevented it is called an "Inevitable miscarriage."
Treatment of an Inevitable Miscarriage.—In these cases every precaution is taken, just as in a normal confinement, to avert blood poisoning. The hands, instruments, dressings, etc., are carefully rendered sterile and the whole field must be surgically clean. The physician will conduct the case as conditions justify and as the situation develops.
After Treatment of a Miscarriage.—It is one of the many thankless tasks of a physician's life to insist on each patient staying in bed at least ten days after a miscarriage. The average woman and frequently the intelligent woman fails to appreciate the absolute necessity for this procedure. It is necessary and it is the physician's duty to insist on it being done in the interest of the woman. Many of the multitude of diseases of women are caused by disregarding advice on such occasions.
The Tendency to Miscarry.—If a woman, for any reason, has had a miscarriage, her womb will tend to miscarry at the same period during a subsequent pregnancy. If the miscarriage should occur during her first pregnancy the tendency to miscarry will be greater than if acquired after she has had a baby.
This is one of the reasons why young wives often fail to have children. They "get rid" of the first one or two, because they are not ready to have children, or because they want some enjoyment themselves before they are tied down with a family. Having established the habit their womb has been educated to abort, and it will keep this habit up, much to their astonishment and chagrin.
Young wives should therefore faithfully follow out all the rules of the Hygiene of Pregnancy laid down by their physician, and which are given in detail in this book.
Courtesy of New York World At Work with the Calipers
Watching carefully the physical development of the child month by month is one of those many little things which may result in disaster if neglected.