The Social Evil in University Life A TALK WITH THE STUDENTS OF THE UNIVERSITY OF PENNSYLVANIA By ROBERT N. WILLSON, M.D. fqk THE VIR PUBLISHING COMPANY 1304 Land dtltle ' feu i i'dTn PTITa cl e f pKT a 7, Imperial Arcade, Ludgate Circus, London, E.C. WM. BRIGGS, 33 Richmond Street, Toronto Copyright, 1905, by VIR PUBLISHING COMPANY Entered at Stationers' Hall, London, England Protected by International copyright in Great Britain and all her colonies, and, under the provisions of the Berne Convention, in Belgium, France, Germany, Italy, Spain, Switzerland, Tunis, Hayti, Luxembourg, Monaco, Mon- tenegro, and Norway. All rights reserved. [printed in the united states] > Author and publisher desire to enlist the co-operation of every person who reads this book to further the dissemina- tion of the information it contains. The complete contents of this book in smaller type, printed in pamphlet form, is fur- nished in lots of 50, 100, and upwards, to persons desiring to purchase them for Free Distribution. Price, postpaid, 50 copies, 75 cents (3 shillings); 100 copies, $1.50 (6 shillings). The pamphlet is not sold in single copies. INTRODUCTION. The universal acquaintance of young men with the facts contained in this book would tend greatly to reduce the sum total of human suffering and misery. The social evil and venereal diseases are not confined tothe ignorant and degraded classes. It prevails alike among the educated and those who are intelligent upon other subjects, but who are wholly uninformed and ignorant upon this sub- ject. Socrates was correct when he said "Ignorance is vice." To dissemi- nate this information will work a revolu- tion in human thinking, in human con- duct and even in character itself-it will help to dispel ignorance, to abate vice and exalt virtue, now so much obscured and so little recognized. The fitness of Dr. Willson to perform what he has accomplished in this 3 4 INTRODUCTION. address is manifest. With the ex- perience afforded him as physician and confidential adviser to the hundreds of young men constituting a University community, with a thorough under- standing of his subject, and a profound personal interest in young men them- selves, but few physicians are so well qualified to speak upon the subject of the social evil and its consequences as he. His motive was not money; his inspira- tion was his love for the men he was seeking to save. May I seek to enlist in the widest possible dissemination of the informa- tion contained in the following pages, and in the circulation of the booklet itself, the large number of people every- where who love their fellow-men and who would do them good ? Sylvanus Stall. Philadelphia, Pa. THE SOCIAL EVIL IN UNIVERSITY LIFE. A TALK WITH THE STUDENTS OF THE UNIVERSITY OF PENNSYLVANIA. I congratulate those of you, to-day, who are just entering this old University! Those who have already learned to call her Alma Mater need no word from me to tell them of the joys and responsibili- ties of college life. It is because some of us older college boys have learned just what you are to encounter in the four years of city and university ex- perience, that we have called you to- gether for a frank talk on matters that will have a vital influence on your college and after-careers. You will have guarding over your in- terests, and watching with a keen and 5 6 THE SOCIAL EVIL kindly eye your successes and failures, one of the warmest-hearted men that our Provost's chair has ever held. In the midst of responsibilities that would bend the shoulders of an ordinary man, you will find that he has a smile and a grasp of the hand for each one of you, no matter how unimportant you may con- sider yourself to be in your particular sphere of activity. He wishes you simply to assure him that you are active in that sphere. I have learned to know him as a man whose aim in life to-day is the genuine benefit and happiness of young men like you and me. In close touch with your Provost, and equally a man, you will learn to know and love one of the best friends of my college days, and one who learns for the first time to-day, perhaps, that his influence was stronger than almost any other in making my college life of what- ever value to myself and others it may chance to be. If he could but know how many men have left these walls with IN UNIVERSITY LIFE. 7 the same sentiment in their breasts, he would tell you, as I now do, that he has not lived in vain. I have seen Vice- Provost Smith, in the midst of his day's work, stop as each of a number of thoughtless students pushed his way into the office, and show the same warm interest in the last one that sent the first away with the feeling that he had talked with a friend and one whom he could trust. For myself, I can simply say that I have worked among you as one of your University physicians for over three years, and that I have considered my work a rare privilege and a sacred trust. I have learned many things of student life which escaped me while a student myself; and I have learned the value, during these thirteen years of college associations, of the opportunity of look- ing on many of the problems that will soon come before you. Perhaps they mean more to me because I have seen many of them both from the standpoint 8 THE SOCIAL EVIL of the student and later as your con- fidential medical friend. One of these problems involves a temptation that meets every man sooner or later, will certainly meet you during your college days, and perhaps has already stood in the path of some. I refer to the temptation to risk your health of mind and body by illicit inter- course with women, whom you would be unwilling and even horrified to con- sider of the same order of being as your mothers or your future wives. Every large city swarms with such women, nearly all of whose lives are wrecked by marital infidelity before they begin to prey upon the happiness of other homes. Shall I tell you in another way why you are gathered here to-day ? Last spring a country boy came to Philadel- phia for the first time. He was induced by friends to visit a house of ill fame. He was infected by the woman with gonorrhea, and, though at the time none of the ordinary symptoms appeared, in IN UNIVERSITY LIFE. 9 a day or so his eyes began to smart. Another of his so-called friends advised him in all earnestness to wash his eyes in his own urine. He did this at once. Gonorrheal inflammation developed, probably had developed before the urine made the infection sure, and to- day that country boy is totally blind, and for his lifetime. Your Provost and Vice-Provost have watched with increasing interest and alarm the influence upon those who have gone before you of the temptations offered by university life in a great city. They have asked me to talk to you to- day of this matter as one of the students' physicians, and therefore one who ought, and I am glad to say does, hold intimate and strictly confidential relations with every one of you that cares to use me as an adviser and friend. In the last three years of my work among the students of the University I have seen you at times, and under con- ditions, that have led you to open your 10 THE SOCIAL EVIL hearts to me; whether always through friendship or necessity it is at present unnecessary to inquire. I have seen many of you at times when you would have given worlds had some one told you in advance of the facts which I hope to make plain to you to-day. I have listened, more regretfully on each oc- casion, to the old cry, "Why did not some one tell me in time?" until it seemed impossible that another year should be allowed to slip by without giving those who are coming on the warning of the experience of those who have gone before. I have seen some of you injured physically, and for life, by either the lack of some such frank, clear discussion of the dangers of impure liv- ing, or by wilful disregard of advice in the few instances in which it had been offered. In my capacity as University phy- sician, therefore, and one who holds himself ready to serve you at any time, day or night, I wish to talk briefly but IN UNIVERSITY LIFE. 11 earnestly of three of the almost inevitable results of impure sexual life. I have said that the opportunity of lowering yourselves in the eyes of God and of true men will certainly be presented to you within the nearest future. In a large city this is unfortunately and peculiarly true. Example, fear of ridicule, or curi- osity may be the impelling force; and if any one influence has had a dastardly effect upon the lives of young men, ridicule is that one. Whatever or who- ever you are, we are interested in you, and want you to know to-day and finally that you transgress the laws of pure sexual living at your peril, and perhaps literally, sooner or later, at the cost of your life. It may be stated with the barest possi- bility of error that no man who has once had sexual intercourse with a woman not his wife, fails to make a habit of the crime. It is equally certain that no one has ever indulged in such excesses with- out sooner or later contracting some venereal disease. This is so literally 12 THE SOCIAL EVIL true that such conditions are considered among medical men as inevitable at- tendants upon impure intercourse with the other sex. Every preventive has been tried, and all have failed. On the other hand, let me say to you as a phy- sician voicing the consensus of medical opinion, that there has never existed a man who could not live a healthy, active existence, throughout his whole life, in the absence of any sexual intercourse whatever. It is a common story among college students that after a certain age a man requires sexual satisfaction, if he is to preserve vigor of mind and body. Let me characterize this idea as a curse that has done more harm in the home-world than any other influence, and one which, together with ignorance of the inevitable results in the way of venereal infection, has made it unsafe for men and women to drink out of a neighbor's glass, or for men to accept a pipe or a cigar or a cigarette from the fingers of a friend un- less they know him through and through IN UNIVERSITY LIFE. 13 in a way that few men are known. Nature has provided for man's sexual necessities in a way with regard to which you do not need to be informed, and that provision is one that is as ample as it is providential. If, in addition, a boy has a wise father, who remembers his own temptations and takes a judicious and the only fair way of strengthening his son against them, by opening his eyes to the danger of transgressing Nature's laws, he is well equipped for growth into noble and healthy manhood. Would that every boy had such a father! Too often the whole subject is treated in open conversation as a necessary and unavoidable evil. We should look upon the man or woman who trifles with the subject of sexual impurity as a criminal, either by virtue of ignorance or by intent, and we will even then not reward them as they deserve. We have come to a time when, if the young men of this and other countries do not engage and con- quer the social evil, it must be accom- 14 THE SOCIAL EVIL plished by the enlightenment of the pure women that still exist; and when your mothers and your future wives and your daughters are warned even against their sons, husbands, and fathers, because they are dangers to humanity, you will begin to regret that you did not lay hold on the cause in time. The trend of the law is in this direction, and by the nature of things it is bound to insist upon it sooner or later. Lincoln is said to have made the remark that "every man who contemplated marriage should stand over the doctor with a club and make him tell the truth in reference to the chosen partner for life. Also that the parents who would allow a girl to marry a man without knowing as clearly as could be known his physical as well as his moral condition deserved to be scalped." Unfortunately, no one is in a position as yet to know these things certainly, and no woman will believe them of her lover. Yet men have married women IN UNIVERSITY LIFE. 15 the day after lying with a common pros- titute, and days and perhaps weeks and months after syphilis or gonorrhea has appeared in the man, who invariably has been ignorant or cowardly enough to transmit the disease to his wife rather than acknowledge his condition. Many another man has struggled for months towards a cure and has been pronounced well by his physician, only to infect his wife with his latent disease. Add to this the fact that the average physician is unqualified to treat gonorrhea and syph- ilis successfully, and should not attempt the task, and you will learn how helpless the victim of such a disease is. In all this great city there is hardly a hospital bed that will admit openly and as such a subject of venereal disease. There is a tremendous duty to-day upon the phy- sicians and parents to learn and dis- seminate the truth in regard to sexual sin, and my conscience will be clearer when I have spoken to you. Let me talk to you now of three con- 16 THE SOCIAL EVIL. ditions, gonorrhea, syphilis and illegiti- mate fatherhood, the three most frequent attendants upon harlotry, and the two former of which are far more contagious and widespread than tuberculosis, which is occupying the attention of the public to-day. At the end of our discussion I trust I may have proved assertions which may seem to you at first harsh and ex- treme. It may be a significant fact to you that the first student treated by me after my appointment as students' physician, and the last one seen at the close of the session of 1902-3, were suffering from gonorrhea contracted during illicit inter- course with a woman. Both of these were sons of refined, well-to-do fathers and mothers. Both of them were ig- norant of the imminent danger of in- fection, and both quoted the oft-heard lie, that "a case of gonorrhea is no worse than a bad cold." Both men had GONORRHEA. GONORRHEA. 17 been told this lie by other students, who had themselves previously contracted and suffered from the disease. One had repeated attacks before consulting me, and was then in a serious condition. One of these students is apparently well to-day. The former will carry traces of his gonorrhea to his grave, and can never be the father of a child. He should certainly never marry, both for this reason and for fear of infecting his wife. During the three intervening years between these two cases, a number of students have consulted me each month, and many with the same story of ig- norance of danger. All knew, no doubt, but few realized the fact until too late. Some few, through despair of being cured of a chronic condition, had thrown precaution to the winds and con- tracted new infection and new trouble. In one instance that came under my care a woman, herself a medical student at another institution, had infected five 18 THE SOCIAL EVIL. men with gonorrhea, and one of them either she or some other had also infected with syphilis. Two of these men were brothers, yet it would appear that none of the five had confided in any of the rest. It seems strange that it should not be generally known by students that there is little likelihood of a woman who ad- mits of such attentions herself escaping venereal infection, no matter what her social status or what her precautions. It is a rule borne out by medical ex- perience that a woman who encourages the advances of one man will invariably do the same with others. It is also a frequent experience for a number of men separately to consult a physician and assure him that the subject of their at- tention could not possibly have infected them, as she had never had intercourse with any other man, and yet the fact appear clear to the physician that she had infected each and every one. It is safe to say that every harlot (I use this GONORRHEA. 19 term advisedly, with reference to her of good family connections, for there are such, as well as to the common prosti- tute; they belong in the same category) has at some time been infected with gonorrhea, and if one stops to learn how difficult and rare a thing it is to thor- oughly cure a woman of gonorrhea, he will understand also how dangerous it is to trust himself at any time in her subsequent life within her infected presence. A few statistics may serve as an il- lustration, not only of the prevalence of temptation on the streets of a great city, but of the ubiquity of gonorrheal disease in its many forms. It has been well characterized as the most widespread of all contagious diseases, with the single exception of measles. It has been shown that in some of the cities of Europe more than one-half of the entire population, and more than three-quar- ters of the male population, suffer from gonorrheal infection. Dr. Allen reports 20 THE SOCIAL EVIL. from one hospital dispensary in New York City 86,000 cases of all kinds treated in 1900, of which over 3000 were cases of venereal disease. In 1903 we learn from a commission appointed to study the subject that there are in New York City to-day about 200,000 syphi- litic subjects, and probably four times as many (800,000) cases of gonorrhea. To care for these cases and to prevent the spread of infection, there is one bed for every 5000 cases. This ratio holds good for nearly all the large cities of America. While all prostitutes are considered gonorrheic subjects, it is estimated that every fourth one is qualified to transmit syphilis. In Prussia it is estimated that there are annually 773,000 cases of venereal dis- ease. Still more exact are the following figures: Out of 1155 patients (mostly venereal) treated at Hot Springs, Ar- kansas, and coming from all over the United States, it was learned that 818 (70 per cent.) had, at the time of exami- GONORRHEA. 21 nation, or had had gonorrhea; 337 had never contracted the infection. Most of these patients were from the so-called better classes. The ages at which the gonorrhea was contracted varied from 10 to 57 years, averaging 21.8 years. Three hundred and eighty-two cases were be- low 21 years of age and 58 cases were below 17 years. Of 60,000 sick soldiers in our army of occupation in the Philip- pines, 10,000 were cases of venereal disease; nearly all of these have since come home, and many remain uncured to-day. These figures will suffice to show that gonorrhea is so frequent a condition that it literally leaves few homes unscathed, if the truth be fully known. As already stated, the prostitute offers a ready in- fection to the male urethra in its virgin state, and a still more likely one to a chronically inflamed mucous membrane. Probably she can and does infect as long as she lives, and undoubtedly she does infect many men in one day. Long 22 THE SOCIAL EVIL. after she is visibly cured she may be a source of virulent infection. The result is that she may be honest in be- lieving herself free from danger to others and become the more dangerous in the belief of her cure. Under the most benign circumstances she is a danger, and under the worst she is a scourge. Infected many times, with each new occasion she becomes freshly virulent. The result is that the world is to-day overrun with venereal disease. Let me ask a few questions that naturally arise, and in their answers endeavor to em- phasize the points I wish to bring home to you. What is gonorrhea in the male sub- ject ? An extremely infectious disease, usually involving some portion or all of the urinary passage from the bladder outward. Any portion of the body may, however, be infected, including the eyes, the skin, the nose, ears, mouth, bowel, and any or all of the internal organs of the body. Its minimum average dura- GONORRHEA. 23 tion is six weeks. It often lasts for years, and unless promptly and intelli- gently treated its effects often remain evident for life. It is a disease for which eminent specialists are constantly seek- ing some new and effective remedy, which has not yet been found. The question is still under discussion whether either syphilis or gonorrhea is certainly curable. One prominent student of the subject says of the latter, "I have studied and treated gonorrhea for fifteen years, and I feel to-day that I know less about that disease than I thought I did several years ago." Another writes, "A large number of chronic gonorrheas, speaking generally, remain uncured. Some of these may be explained by the indolence and discouragement of the patient, others by want of care or under- standing on the part of the physician, others by constant reinfection, and still others from no tangible cause, all gonococci having 'apparently' been eliminated." Still another says, "The 24 THE SOCIAL EVIL. importance of gonorrhea with that of syphilis is 100 to I, not only from the standpoint of the number of persons attacked, but also from the standpoint of the gravity of the lesions and their perpetuity." Have I said enough to prove to you that gonorrhea is "worse than a bad cold"? What are its possible complications and their frequency? Among the most frequent of the complications of gon- orrhea are stricture of the urinary passages and sometimes even of the bowel, inflammation and destruction of the internal genital apparatus (the tes- ticles and the tubes leading thereto), blindness, bladder and kidney disease, abscess at any point in the body, and joint rheumatism-all frequent condi- tions. Less frequent are septic blood infection (usually fatal), brain disease, degeneration of the spinal cord, heart disease, bone disease, peritonitis, pneu- monia, and death. You may ask, GONORRHEA. 25 "Why have we not heard before of the serious features of what we believed to be a temporary inflammation ?" I an- swer, " Because every case of gonorrheal infection is concealed more jealously than a crime would be, and if serious complications follow, the specific origin is denied or withheld by both the victim and his doctor." Last winter an officer of the University showed his interest in one of the students by calling on him in the University Hospital. He was told by the student and by the nurse that the trouble was appendicitis, and was shocked and disgusted later on when he learned that the case was one of gonorrhea. A large percentage of cases of chronic gonorrhea leave behind a stricture of the urethra. Nearly all leave an ir- ritable and often a diseased prostate gland; many leave an irritable or dis- eased bladder. Between io and 20 per cent, of all cases of infantile blindness are due to 26 THE SOCIAL EVIL. gonorrheal infection. Statistics of the German Empire for 1894 showed that 80 per cent, of all children born with healthy eyes who became blind did so as the result of transmitted gonorrhea. In that country there are 30,000 cases of blindness to-day due to gonorrhea, and mostly transmitted from other persons. In spite of all the latest knowledge and the newest methods, approximately 600 cases of blindness oc- cur annually in Germany from this one avoidable cause. In this country from 25 to 50 per cent, of the blind in in- stitutions owe their loss of sight to gon- orrheal infection. In one year in New York City 136 cases of gonorrheal ophthalmia were reported. Inflammation of the epididymis (the tube from the testicle outward) is a very frequent complication, often resulting in absolute sterility, as will be shown later. Gonorrheal rheumatism is also a seri- ous affection, usually occurring in a GONORRHEA. 27 large joint like the hip or knee, and fre- quently leaving a permanent disability. The other complications mentioned occur with varying frequency, depending upon the attention paid to the condition by doctor and patient, as well as upon the promptness with which the disease yields to treatment. While far less frequent, they are even more serious. There is no question that many cases of kidney disease owe their origin to gon- orrhea, many resulting years after in fatality. During each year a number of deaths are recorded as directly due to infection by the gonococcus of one of the vital organs of the body. While writing this statement, I have before me the records of five fatal cases that have come easily to my notice, three from gonor- rheal peritonitis, one from gonorrheal valvular disease of the heart, and one of gonorrheal septicemia, which will be mentioned later. Can gonorrhea be cured, and can the patient be sure he is cured? To the first 28 THE SOCIAL EVIL. question probably "yes," and to the second certainly "no." We have already heard doubtful statements of eminent students of the disease. Neisser, one of the first authorities of the world on vene- real disease, claims that gonorrhea can be cured. Your own professors of surgery, White and Martin, also claim that it can. All admit that very many cases are not cured, owing to one reason and another. Every year brings forward new instances of old, supposedly cured infection relighted by disease, debility, or de- bauch. In children, undoubtedly, the prognosis is better than in adults, prob- ably because the disease is taken in hand earlier and more systematically; also because all the tissues in the child tend towards healthy growth. Frank, in Germany, has shown, however, that the gonococcus may remain quiescent in the prostate gland for months and years. No symptoms remain, yet the disease may be relighted and others be infected. I have already quoted Van der Poel to GONORRHEA. 29 the effect that a large number of chronic gonorrheas remain uncured. Koppen cites many cases in which all symptoms had disappeared, and yet the disease re- mained latent. In regard to one of these he says, "Not one sign was left of a pre- vious gonorrhea." Six years later there was irritation in the urethra, and he ob- tained gonococci from the urinary canal. In another case none of the germs of gon- orrhea had ever been discovered in the discharge, though the clinical picture was complete. Six years later he found gonococci in the urethra. He concludes his article with the statement, "Gon- ococci can exist for years in the or- ganism, as proved by numberless cases." A case is described in one of our own medical journals, dated September, 1903, in which a man infected his own eye with gonorrhea after six years, during which the disease appeared to be cured. At the same time all his joints became involved, as well as the tendon sheaths of one foot. The gonococcus 30 THE SOCIAL EVIL. was obtained from the discharges of the eye, proving the real nature of the in- fection. Our answer to the question, then, must be that under favorable circum- stances gonorrhea probably can be cured. No case is cured until all gon- ococci have disappeared from the ure- thra. Many doctors either do not know how or do not take the trouble to look for these micro-organisms. Many pa- tients never return for completion of the cure after the symptoms have become tolerable. Under the best treatment, it should be remembered, success may not be attained. Only time will show whether an actual and permanent cure has been secured. No victim of gon- orrhea can be absolutely sure, when the symptoms have disappeared, that he is cured of his infection, or that he will not infect his wife years after. How long after an attack can a man inject a woman with gonorrhea? We have already seen in our answer to the GONORRHEA. 31 preceding question that years may pass by and a man may still be infectious to a wife. As long as there are active symp- toms, transmission of the disease is likely. When these have subsided the danger decreases, but never disappears until the last gonococcus has been des- troyed. If gonococci can live six, ten, and fifteen years in the organs of the body, as they have been shown to do, probably they can live longer and to an almost indefinite time. The only in- ference from the cases cited is that the gonorrheic subject must never be sur- prised if he finds in after years that his disease has remained latent, and that he has infected some innocent person. The possibility is always be- fore him. What are the possible permanent in- juries from an attack of gonorrhea? We will at present consider only the male sex. It has already been shown that fatality is occasional. The most fre- quent permanent disability is a chronic 32 THE SOCIAL EVIL. gleet or catarrh of the urethra, prostate gland, the bladder, or of all three. Such a chronic inflammation of the urethra usually results in stricture of that passage. Stricture causes obstruc- tion to the flow of urine, and as a con- sequence bladder inflammation often follows, and the disease often spreads from there to the kidney by direct ex- tension. Gonorrheal rheumatism very frequently-we may say nearly always -leaves a crippled joint. By far the most serious sequela of gonorrhea is sterility, or lack of power to produce progeny. The commission ap- pointed by the American Medical As- sociation estimated that 42 per cent, of all gonorrheic subjects become sterile, and that many more cause sterile mar- riages after the first child-birth because of the infection and consequent sterility of the wife. Czerny says that "50 per cent, of all sterility is due to the husband's gonorrhea." Morrow says, "Syphilis curses the child; gonorrhea GONORRHEA. 33 prevents its existence by rendering the male sterile." President Roosevelt has recently spoken of the social evil, meaning the wilful sterility of the wedded life. Would that he might cry out from his Presidential chair against the dangers of venereal infection and the real cause of sterility of the sons of America! What are the results of gonorrhea in the woman? Fewer women, by far, are cured of gonorrhea than is the case with men. I shall not speak, however, of the clinical picture in the female sex. It will be sufficient to say that with the woman gonorrhea means almost cer- tainly an infection of her internal or- gans, and sooner or later a serious operation. Pregnancy increases the danger of upward and general infection. Sometimes there is no serious sign of trouble until the woman becomes preg- nant. Noggerath states that 50 per cent, of sterile women owe their sterility to gonorrhea. Neisser, already quoted, 34 THE SOCIAL EVIL. fixes the percentage at a higher figure. Ascher found that of 227 sterile women in his care, 121 were sterile owing to gonorrhea. Sanger says that abortion occurs as frequently owing to gonorrhea as it does as the result of syphilis. Noggerath cites the cases of 53 women, pregnant during a gonorrhea, of whom 19 aborted. Fruhingsholtz cites 101 cases, of which 23 aborted and 7 went into premature labor. Price, of this city, says that of 1000 abdominal operations in women, 95 per cent, were the result of con- ditions due to gonorrhea. The statistics of the German Empire for 1894 showed that 80 per cent, of the women who died of uterine or ovarian disease died as the result of con- ditions dependent upon gonorrhea. Have I convinced you that the disease is of more significance than a "bad cold"? If not, let me add a final ar- gument; and if you resist the plea of the children, no influence on earth can save GONORRHEA. 35 you from an experience which you nearly earn. Can gonorrhea be transmitted to others than your wife? From what I have already told you, you now know that the vast number of cases of gonorrhea in the woman in married life are in- stances of innocent infection on her part. We h ave omitted until now the pos- sibility of infecting others, and by means other than by sexual intercourse. First, and least important by all odds, you can infect your own eyes, nose, mouth, or bowel, and probably will unless you learn the virulence of the gonorrheal germ. Next, you can infect, and usu- ally do infect, the bedclothes, towels, napkins, handkerchiefs, forks, your pipe, and all articles of ordinary and constant use; and sometimes, by means of them, your wife and children, your friends- even, mayhap, your mother. It is the result of nature's protecting laws and not your care that you fail to pass to all who are around you the curse that you have 36 THE SOCIAL EVIL. brought upon yourself. Let me prove this to you in all its hideousness of truth. Cook has reported recently a case of a 4-year-old daughter of a 35-year-old father, from a refined family. The father contracted gonorrhea in the usual manner, and soon the little girl de- veloped the disease. There was abso- lutely no other traceable source of the infection. Morrow cites the case of a little girl into whose eye a playmate's finger had been poked. The injured child suffered a typical gonorrheal con- junctivitis, from the discharge of which the gonococci were obtained. Not long age there was an epidemic of gonorrhea among the children of Posen in Ger- many. In two weeks 236 children con- tracted the disease, which was finally traced to the use of the public bath. Some one had infected the pool. In spite of the constant suppression of such cases, there are many such reported in the medical journals. I have myself seen, in hospital work, many cases of GONORRHEA. 37 gonorrhea in children under 5 years, sometimes transmitted by accident, sometimes by intention. Only when the law imposes fine and imprisonment upon him who knowingly infects another person will this crime be blotted out; it may be that a sterner penalty still might be effective (as already suggested), and meted out at the hand of the sur- geon's knife. Innocent infection of children occurs usually among those who sleep in bed with their parents or use the same towels or table linen. Night-clothes, bed linen, towels, sponges, underclothing, soap, the water-closet, if once infected, may retain the germs for weeks and months, and the origin of the infection may, sad to say, never be discovered. On the Scandinavian Peninsula every case of venereal infection is reported to the authorities, as it will be some day here. There will then be fewer cases of venereal disease and fewer innocent victims. I believe, moreover, that in 38 THE SOCIAL EVIL. this procedure lies the remedy for mari- tal infidelity and for sexual sin in all its forms. There is another serious phase to the gonorrhea of children. When once in- fected they also transmit the disease, and oftentimes in the same manner as their fathers, and with equal avidity. Wolbarst, in New York City, cites 22 cases occurring in his work during two years, in children between 18 months and 12 years of age. The usual mode of infection was attempted sexual inter- course. On investigation he found that it was by no means an unusual occur- rence in this district for children not yet in puberty to indulge in sexual inter- course. He saw three cases of boys, 4, 10, and 12 years respectively, infected by girls between 10 and 12 years. Many other cases were due to the child sleeping with parents, brothers, sisters, who had gonorrhea. Cotton calls at- tention to a " string of little girls coming to my clinic suffering from gonorrhea. GONORRHEA. 39 A week later," he says, "my assistant brought a boy of io years who had been infecting these little girls." Last year I saw more than one student of this University who would not return home for his holiday when he heard that he must be careful not to infect himself or his family. I shall never forget the expression of one who said, "God! You don't mean that I might give this to my mother!" Boys, forget yourselves! If you owe anything to that mother, sister, perhaps some day a wife, your children, your friends, servants, even the laundry- woman, do not risk this disease! Just a word as to the mortality of gonorrhea. This is occasional, though by no means as high as that of syphilis. Only last year there came to my notice the case of a young man, dying from a diffuse abscess and pyemia (blood- poisoning) of unknown cause. His life was pledged to a lovely girl, who nursed him on the edge of his grave. Both 40 THE SOCIAL EVIL. were of our nation's best blood. Cul- tures from the pus of his abscess and from his blood showed colonies of the gonococcus, and a history of an almost forgotten attack of gonorrhea was ob- tained. It is almost too horrible to think of the crime of the future had he lived to marry the woman who was nursing him in an ignorance of the cause of their double sorrow as complete as his own. Such a tragedy is being enacted cer- tainly many times every year in this wide world, and bids fair to become an even more frequent occurrence. I have mentioned four other deaths to you. The aggregate of deaths from the sequelae and complications of gonorrhea would amount to no small total, and must soon attract the attention of those who have heretofore looked on it as a passing ailment. Have I made plain to you that as the result of one rash act- Your wife may be a lifelong victim; may be deprived of the power of con- GONORRHEA. 41 ception; may lose her life by an opera- tion or by infection ? Your child may lose its chance of birth; may, if born, be deprived of sight or hearing; may, if a male, suffer consequences equal to your own; if a female, suffer like the mother ? Yourself may never be cured; may infect those who are dearest to you; may lose your own life and those of others ?* Let us now for a brief moment con- sider syphilis. * The latest medical information upon the nature and results of gonorrhea upon men, both single and married, and upon wives and children, is treated fully in "The Social Peril," a book of 260 pages by Sylvanus Stall, D.D., the author of "Stall's Books," and issued by the Vir Publishing Company at $1.00 (4 s.) per copy. A condensed pamphlet of 24 pages, upon the same subject, by Dr. Stall, entitled "Not a Toothache, or a Bad Cold in the Head," is sold only for free dis- tribution, and in lots of fifty at 50 cts. (2 s.) and one hundred at $1.00 (4 s.). 42 THE SOCIAL EVIL. SYPHILIS. Probably far less need be said about this disease, as its name is known to most of you, and few speak of it lightly. When you learn that many of those who surround you in your daily life are viru- lent with this disease, and that change- ling children are born into our best families as the result of it, and that pros- titution is likely to fix the unyielding grasp of syphilis upon you, it may act as a persuasive to keep you true to your ideals. What is syphilis? It is an infectious disease of the whole system, usually making itself first known by means of what is called a chancre, or initial sore. This is followed usually by a general skin eruption, swelling of the glands, falling of the hair on all parts of the body, and later on by serious disease of the blood-vessels and internal organs. It is usually contracted during sexual intercourse, in the case of men usually SYPHILIS. 43 in prostitution, in the case of women very frequently in an innocent manner and in wedlock. It involves a course of treatment of at least three years, and sometimes resists all treatment. It is found in the highest and lowest classes of society. How prevalent is the disease? Four- nier states that one-seventh of the popu- lation of Paris is syphilitic, while in Russia whole towns have been decimated by the disease. The victims in the latter country are mainly women and children, and many cases are due to the kissing of sacred images and to the embraces of syphilitic acquaintances. In certain of the European countries 25 per cent, of the population of some of the villages is syphilitic, in most instances due to innocent infection, prostitution being almost unknown. China and Japan are overrun with syphilis. It has been estimated ("Dictionary of Statistics," Mulhall) from the cases in the military hospitals in Europe that between 7 and 44 THE SOCIAL EVIL. 43 per cent, of the entire soldiery is infected; the average national percent- age was found to be 14 per cent. The report of the American Dermatological Society finds that 11.5 per cent, of all skin diseases are syphilitic. And in our own country again, out of 1485 cases (mostly venereal) treated and questioned at Hot Springs, Arkansas, in 1901, 831 had had syphilis. Gihon estimates that there are 2,000,000 cases of the disease constantly in the United States. Sanger has shown that nearly one- half of all the prostitutes in New York City freely admit that they have had syphilis, and half of these give birth to syphilitic children. And as a gloomy shroud for all of these figures, Morrow finds that 70 per cent, of the syphilis in the women of New York City is the result of conjugal infidelity. Can syphilis be cured? This is a far more difficult question to answer than that with regard to gonorrhea. My personal belief is that it usually can, if SYPHILIS. 45 well treated and in time. A cure, under the most favorable circumstances, re- quires at least three years of constant medication. Many cases require a longer time. Some prominent syphilol- ogists declare that the disease is in- curable. Certain cases are absolutely incurable. Among these may be cited one reported recently by Schamberg, which was under treatment without success for eight years, and two malig- nant cases reported by Fournier in 1899. The general prognosis of syphilis is probably a good one. The constant danger that the treatment has not been radical or thorough enough always threatens, however, and is well expressed by Osler when he speaks of "extra- ordinary frequency of the cerebral and other complications in persons who have had the disease, and who may even have undergone thorough treatment." Howard has reported a case seemingly cured and relighted, after a year of quiescence, by influenza. Many other 46 THE SOCIAL EVIL. cases appear to be free from symptoms for a time and then die of insanity, softening of the brain, locomotor ataxia, or some other nervous disease. How long after the infection can the disease be transmitted to others? During the entire period of what are called the primary and secondary stages. The latter, if the disease has been thoroughly and conscientiously treated, is usually confined to the first few years following the infection. Only in exceedingly rare instances has infection taken place after the fifth or sixth year. Such cases do, however, occur. Sack reported last year the case of a man on whose person appeared an ulcer (gummatous) ten years after the original infection, and in- fected his young wife, who displayed typical symptoms of a new syphilitic infection. Six months later she also had a miscarriage. Herscher reports a case of contagion from a husband who unquestionably contracted the disease thirteen years previously. Kopelinski SYPHILIS. 47 has reported two cases of inherited syphilis infecting previously healthy in- dividuals, and (an almost unheard-of thing) in both instances a grandmother. What are the effects of syphilitic in- fection upon the man? Perhaps the most serious is the fact that he becomes at once a source of danger to his family, friends, and society in general. This begets the next most serious influence, which is the mental condition. Four- nier cites 18 cases of suicide in young syphilitics. We have already sketched the course of the disease itself, and need not repeat the symptoms here. Proba- bly the most serious physical damage is done the blood-vessels and kidneys. Many a case of apoplexy and aneurism is directly due to syphilitic change in the arteries of the brain or elsewhere. Many cases of insanity are also due to this disease. At present there is an at- tempt to prove, what many authorities believe to be true, that locomotor ataxia is purely and simply a syphilitic picture. 48 THE SOCIAL EVIL. Many cases of syphilis become and re- main completely bald, with no eyebrows and no facial hair. Some few severe cases lose all the bony features of the face, the nose and roof of the mouth undergoing complete necrosis (bone gan- grene). Many have a persistent skin eruption. Those who inherit syphilis are usually marked for life and die at an early age. Tuberculosis frequently ac- companies or follows syphilis, like the driver of a hearse. What are the effects of syphilis upon the woman? The physical effects are the same as those in the man. If she bears children during the course of the disease, they are likely to be syphilitic and otherwise defective. Still more likely will they be still-born or abortion takes place. There is no other cause of abortion that compares with the vicious influence of this disease. A syphilitic woman is likely to infect many more persons than is a man. If a prostitute, she probably infects most of SYPHILIS. 49 those with whom she has intercourse. Even in everyday life, a syphilitic woman is a source of great danger. Kissing is the most prolific source of transmission next to sexual congress, and especially in this country, where men confine their embraces to their in- timates only and to the female sex, unless it be in the case of children. A woman's embraces are much more promiscuous, and she proves much the more active in spreading the disease. What are the effects of syphilis upon the offspring? These are two, and both are serious in the extreme. First, a tremendous percentage of the children born of syphilitic parentage are deficient mentally and physically. Secondly, be- tween 20 and 40 per cent, of all concep- tions by a syphilitic woman result in either abortion, still-birth, or premature labor. Even if born with a competent mind, the child who has inherited syphilis is cursed as Job was not. It is likely to die before it reaches puberty, 50 THE SOCIAL EVIL. and is generally marked so as to be an object of pity throughout its life, to itself as well as to those who know the cause. How can syphilis be transmitted? By contact with a syphilitic sore during the primary and secondary stages of the disease, also with the blood, with the saliva, or any fluid that may carry with it the discharges from a mucous patch or other syphilitic lesion, etc., etc. Usu- ally the infection is transmitted during sexual intercourse, though extragenital and innocent infections are now recog- nized to be very frequent, as by means of knives, forks, spoons, drinking glasses, pipes, cigars, etc. Kissing, as has al- ready been stated, is one of the most frequent methods of contagion. There is danger in any abraded surface upon the body when in company with a syphilitic in the infectious stages of the disease. A mother may infect a baby, a baby may infect a nurse, the father may infect the whole family. Weit- SYPHILIS. 51 lander has reported within the last three weeks two instances of infection of entire families, in each case by a small child, known to be syphilitic, who was taken in to board. The infection un- doubtedly took place by means of spoons, dishes, etc. If any warning given at this time will take root in the minds of those who are unfortunate enough to have contracted the disease innocently, and to have extragenital sores upon their body, it must be this, that such cases are the most dangerous to mankind. The very irony of this fact makes it the more pitiful, and the crime of the original infection the greater. I do not think I need emphasize the burden of the cry of the infected one, who would warn each one of you from the possibility of becoming a danger to your family, your doctor, and all around you. What is the mortality of syphilis? In England, in the period 1880-90, 1742 males over five years of age died from 52 THE SOCIAL EVIL. the disease. Whole towns have been decimated in Russia. Last year in Philadelphia there were 37 deaths regis- tered as due directly to syphilis. If we add the many deaths due to apoplexy directly dependent upon syphilitic ar- teries, or to other more obscure syphilitic conditions, the total would in all likeli- hood be an appalling one. It is suf- ficient to say that there is a decided mortality as the direct result of the disease and its complications that can- not be overlooked. The secondary mor- tality has recently been brought home in a most impressive way by Fournier, a French physician, already quoted, who has collected 18 cases of suicide directly or indirectly dependent upon the knowl- edge of the patient that he had syphilis. There is only one condition, more serious than those of which we have been speaking, to which the man subjects ILLEGITIMATE FATHERHOOD. ILLEGITIMATE FATHERHOOD. 53 himself who trifles with his power of reproducing the image of his Maker. This is the risk that he runs of impreg- nating the woman with whom he has sexual intercourse. Except in the rarest instances, she knows her danger, and endeavors to provide for it. I trust it is true that few men realize until too late, how often the precautions of their mis- tresses fail. Probably no woman exists, of normal development, who, having made a practice of illicit sexual inter- course, has failed to conceive, and to be delivered of the product of conception. Usually the delivering is premature (under the direction, I believe, of a merciful Creator) and the life of the fetus dies out with its birth. Often, however, a child is born into the world whose father and mother will not, and dare not, own it, and who look upon its life as a cloud upon their future, and a menace against their reputation (fair now only in name) to be dissipated not even when the grave closes over them. 54 THE SOCIAL EVIL. The illegitimate may still claim its in- heritance from the dead parent who re- fused, when alive, to acknowledge his title of fatherhood. If the mother conceives, the father is responsible for the life, whether the child is born to live, or whether it dies in the womb. If murder can be forgotten, and if it rests lightly on the soul of any man, he who fathers an illegitimate child has this one recourse. Even the law holds the crime to be murder after the child is viable. The moral law, which upholds the only true standard of right, declares murder to begin when the living product of conception is destroyed. Here, then, is a danger compared with which gonorrhea and syphilis are trifling peccadilloes, and in the knowledge of which the human race should hide its face in shame. In Europe and in America whole institutions are popu- lated by children, without father or mother, the harvest of crime. Do you dare to swell the number of that army ILLEGITIMATE FATHERHOOD. 55 of children, who will one day claim their unworthy parents before a higher Trib- unal than public opinion or human law ? Let us now gather together the lines of our talk. I have told you many of the consequences of gonorrheal disease. I have purposely said much less of syphilis. Other venereal infections I have entirely passed by. I have told you that prostitution means possible criminal fatherhood. May I now fairly ask you for your decision in regard to certain questions which I put to you earlier in the day ? Is prostitution worth while ? Is it safe ? Do you dare to run the risk ? Have I said enough to sufficiently warn without rendering you callous through overtalking ? If so, I shall welcome the day when your Pro- vost asked me to work among you as students' physician. There are those who make light of the social crime, and you now know why I shudder when I hear them trifle about a subject of the gravity of which they 56 THE SOCIAL EVIL. know nothing. I have recently read a book by one of the prominent literary women of the day, as full of vile in- sinuation, and as wicked in its flagrant discussion of man's and woman's in- fidelity, as if she had never heard of a wrecked home or life. The story itself was of a social crime, and was read with avidity by the unthinking public. Per- haps you have all read it. This very summer there appeared a book which I found on my library table, loaned by a "friend" to my wife. Its central figures were separated by the crime of the age and, though lovers in- deed, could not marry. There were three other marriages prominently in- troduced into the story, and two of these were blighted by infidelity of one or the other party. I read this book because the author-this time a man-had written others of surpassing beauty and brilliancy of thought and theme. If such books influence others as they do me, their authors must shoulder many a ILLEGITIMATE FATHERHOOD. 57 responsibility for a mental and moral downward plunge, and only after an effort to struggle upward. God forgive anyone, I say, who dares urge a man, and, above all, a young unmarried man, to trifle with the purity of sexual re- lations as these writers have presumed to do! And now one last word to a body of men that will one day take part in the destiny of this country. I have care- fully avoided telling you that you owe the sterling purity of mind, soul, and body to your God and Maker. I trust that some one else may do this in the near future and in this same old chapel, whose benches already hold the sons of fathers who have gone before. I would not have you forget the fact that God has made for your use a body that is more wonderful and delicate in its mechanism than any invention of human genius, and that in your power of raising up children after you who may do Him honor He has given you control of a 58 THE SOCIAL EVIL. mystery that no scientist has been per- mitted to unfold. Use this gift nobly and well, and in order to do this thing, guard your purity of thought and action as jealously as you would on the day that you bind yourself, for life and death, to the wife whom God gives you in the place of your mother. You owe to her and to your children a perfect moral and physical legacy! Pure Books on Avoided Subjects Books for Men By Sylvanus Stall, D. D. "What a Young Boy Ought to Know." "What a Young Man Ought to Know." "What a Young Husband Ought to Know." "What a Man of 45 Ought to Know." Books for VKomen By Mrs. Mary Wood-Allen, M. D., And Mrs. Emma F. A. Drake, M. D. "What a Young Girl Ought to Know." "What a Young Woman Ought to Know." "What a Young Wife Ought to Know." "What a Woman of 45 Ought to Know." PRICE AND BINDING The books are issued in uniform size and but one style of binding, and sell in America at $i, in Great Britian at 4s., net, per copy, post free, whether sold singly or in sets. PUBLISHED BY IN THE UNITED STATES THE VIR PUBLISHING COMPANY 1304 Land Title Building Philadelphia IN ENGLAND THE VIR PUBLISHING COMPANY 7 Imperial Arcade, Ludgate Circus, London, L-C. IN CANADA WILLIAM BRIGGS 29-33 Richmond Street West Toronto, Ontario A REMARKABLE BOOK. ON A VITAL SUBJECT "THE SOCIAL PERIL" By SYLVANUS STALL The author of the widely known Self and Sex Series of books which are translated into many languages and circulated in every land on the globe. Condensed Table of Contents CHAPTER I. PAST AND PRESENT KNOWLEDGE OF GONORRHEA. Gonorrhea formerly thought a simple disease; now known to be one of the most serious-Formerly regarded self-limited; now regarded as difficult to cure-Subsidence of inflammation ana disappearance of discharge no proof of cure-Formerly thought that only urethral tract was infected, but entire system may be involved-Inflammation of the testicles as cause of sterility-Chordee and stricture as preludes to ascending inflammation-Troubles which follow later on in life-Germs may invade every vital part of the body-Requires most skilful treatment-Instead of weeks, months and sometimes years required for complete cure-Guessing and uncertainty replaced by positive knowl- edge-The medical profession now regard the disease with gravest consideration-Known to be highly contagious- Causes sterility in many men-Danger of children from sheets, towels, bathtubs, etc.-Epidemics caused by public baths-Question of personal guilt of husband-Profound ignorance of those who speak lightly of gonorrhea-The facts make a dark picture-What is to be accomplished by making the public intelligent concerning gonorrhea. CHAPTER II. HISTORY AND CHARACTER OF GONORRHEA. Purpose of the author-Earliest knowledge of gonorrhea- Its real nature only recently understood-References in the Old Testament-Gonorrhea and syphilis formerly thought different manifestations of the same disease-Differences established only seventy years ago-Advance in knowledge and treatment of syphilis-Discovery of germ of gonorrhea -Its virulence established after centuries of ignorance- Why so little is known concerning it-The microscope, its revelations and the revolutions-The germs now seen and recognized in whatever part of the body found-The differ- ent forms of venereal disease-Difference between chancre and chancroid-Their first appearance and differences-Pri- mary, secondary, and tertiary stages of syphilis-When and where gonorrhea makes its attack-How it manifests itself. CHAPTER HI. MEN AND GONORRHEAL INFECTION. The period of inoculation-Earliest manifestations-Early subsidence and later results-Trend of medical opinion-In- determinate period of vital activity of gonococcal germs- May persist for years-Chordee and its cause-What occa- sions stricture-The rupturing and the mending of the ure- thra-Agony occasioned in the reducing of a stricture- Blanitis or inflamed condition of glans penis-Buboes- Hemorrhage-Inflammation of the spermatic cords and tes- ticles-What may result-Inoculation of posterior inflam- mation-Consequence in later life-Eocation and office of prostate gland-The germs may permeate any or every por- tion of the body-Some effects enumerated-Why gonorrhea not previously understood-Fatal results-A monster with as many stings as fangs-Jeopardy of wives and children- Anxieties and mental agonies of guilty husbands-Confes- sions of young men to their medical advisers-Testimony of eminent physicians-Visit to hospital-Why visitors ex- cluded from venereal wards-A case of chordee-A case of stricture-A patient suffering with blanitis-Sad plight of a poor sufferer with stricture-A visit to the doctor's office- Young men making payment in pelf and pain-The penalty of wrong-doing-The young man with a dilapitated sexual member-Striking a trial balance-Duration and extent of results-Congenial soil for germ culture illustrated-Germs like an invading army-Value of virile power-Syphilis and gonorrhea as causes of depopulation-Gonorrhea as a cause of sterility. CHAPTER IV. GONORRHEAL INFECTION AND MARRIAGE. Marriage the divine intent and universal desire-Mating universal-Eater regrets of those who have missed marriage because of vice-The remorse of women who have been wronged and ruined-Magnitude of the guilt of the man who wrongs a woman-Men who deliberately communicate disease to women-The husband who affects his bride-Re- sults which speedily follow-Confession before marriage of the character of past life-Strictest confidence important- Men who expect but who will grant no forgiveness-Sinners who want saints for their wives-Relation of men affected with gonorrhea to marriage-Mistakes of men who think themselves cured-Many brides slain by disease communi- cated to them on their wedding night-The groom who sets upon his bride the seal of his own sin-The purveyors of gonorrhea ignorant of its persistent character-The need of caution-The views of Dr. Morrow-The endless martyr- ology of marriage-Picture of those who developed disease on their wedding tour-Intensity of initial symptoms-Eater results-The danger of pregnancy to a woman suffering from cervical gonorrhea-The husband the author of his wife's misery-Duty of the physician when consulted by men prior to marriage-How infection manifests itself in the wife-Her reluctance to seek medical advice-Eater prog- ress of the disease-Some cases described-The mistaken logic of some prospective husbands-What they realize later -The more simple cases-Extensive and serious complica- tions-The guilty husband with a quiet conscience-How to establish the fact of a perfect cure-Selecting a physician- Danger from quacks. CHAPTER V. THE WIFE AND GONORRHEAL INFECTION. Diversity in progress and manifestations of gonorrhea in men and women-Profound ignorance of men and women of the reproductive system-Early manifestations of gonor- rhea in men-Predicting extent of its ravages-The wife inoculated at the neck of the womb-Its further progress- Similarity of corresponding parts of the reproductive system in men and women-The slight diversity of function-In man gonorrhea begins remote from center of reproductive system •-In women it generally begins at the very center of the reproductive system-Why peritonitis frequently occurs in women-Effects of overotomy-Husbands who blame their wives for sterility-Extra-uterine impregnation-Its cause- The nature of the spermatozoon-The serious consequences of extra-uterine impregnation-Results of investigation of gonorrhea formerly overlooked in women-Insidious inva- sion of the reproductive system of women-Perils which attend childbirth in women with concealed gonorrhea-The number of wives who suffer effects of gonorrheal infection -Dr. Morrow's observations-Percentage of surgical opera- tions due to gonorrhea-Nature of gonorrhea and syphilis contrasted-An inflammation simulating gonorrhea formerly thought to be naturally inherent in women-Exonerated by the microscope-The wrongs which men inflict upon their wives. CHAPTER VI. THE CHILDREN AND GONORRHEAL INFECTION. How gonorrhea affects a man's children-Infection of the eyes-Blindness-How the infection may be brought into the home-Vulvovaginitis or infantile gonorrhea-How it affects little girls-Its significance often overlooked-Eater medical opinion-May involve a portion or the entire repro- ductive system-How children are affected by their parents and others-Why children under two years of age more likely to escape-Why girl children more generally affected -The prevalence of infantile gonorrhea-Infection of chil- dren in hospitals-Infection of 236 school girls-The bath- tub and infection-The public bath and infection-The cus- tom of permitting children to spend the night away from home-Interesting facts disclosed by hospital clinic. CHAPTER VII. SAFEGUARDING FROM GONORRHEAL INFECTION. Widespread prevalence of gonorrheal infection-The large number of wives operated upon-The thousands of women infected-More innocent wives affected than total number of public prostitutes-One-eighth of human suffering-Im- portance of a sufficient quarantine-Duty of safeguarding individuals, society, the State-Impossibility of divorcing vice from disease-The only security a correct life-Mediate or indirect contagion-Safeguarding the innocent-Danger in public toilets-Washbowls at hotels-Prevalence of gonor- rhea-The burdens it imposes-Its prevalence and effects in the army-The duty of the State-The guarding of minors -Sanitary regulation of vice-Causes of failure of regula- tion-The difficulty of regulating those who defy natural, civil, and divine laws-Why the exactions imposed by regu- lation are offensive-The prostitute treated as a mere chat- tel-Sanitation sought only for the protection of her clients -Importance of examination of vicious men-The number of clandestine prostitutes-The universal purpose of prosti- tutes to reform, marry, and become mothers-Why frequent examinations cannot be enforced-patent germs defy ordi- nary medical inspection-Infection immediately after ex- aminations- Difficulties which encompass inspection - Regulation as an incitement to debauch-Prevalence of gonorrhea among minors-Danger from minors and the clandestine-Men diseased by women presumed to be pure -Inadequate provision in hospitals for the treatment of venereal diseases-Incompetent physicians and quacks- Necessity of a competent physician-The safeguarding of brides-Health certificates for both parties-Requiring phy- sicians to report venereal cases to Board of Health-The pros and cons of law requiring professional secrecy-The rights of parents and intended brides-The French law and the protection of nurses-Physicians in Holland relieved of obligations of secrecy in face of marriage-Views held in France. CHAPTER VIII. A FINAL WORD. Physical (not moral) questions discussed-All understand the logic of suffering-Knowledge not a sufficient safeguard -Medical students-The hotel proprietor and his clerk- The man who has communicated his disease to his wife- The changes which result-His duty to his wife-Difficulties of guilty husband in efforts to conceal his condition from his wife-The estranged husband and wife-How to restore affection-The large army of disappointed prodigals-Tetter from erring young man-The frequenters of Sunday Break- fast Association-Young men who die in hospitals-Beech- er's wonderful picture of "the strange woman"-The closing scenes in a life of vice-Plea with young men just entering upon vice-Pharaoh opening Egypt to the plagues -Danger to mother and sisters-Remorse and regrets of the vicious in later life-The event from which all other events date-Why we shudder-The man who makes a prey of pure women-Absurdity of the plea of physical necessity- The plea that passions are too strong-Why the Creator in- tends this passion to be strong-The testimony of learned physicians-The virtuous miss nothing, but escape much- Many pure men and women in the world-Companionships to be avoided-The great power-house at Niagara Falls. Price | } net per copy, post free THE VIR PUBLISHING COMPANY 1304 Land Title Building, - PHILADELPHIA, PA. 7, Imperial Arcade, Ludgate Circus, - LONDON, E. C. Important Books and Pamphlets 44 The Bloom of Girlhood/* By Pauline Page. A dainty and beautiful booklet, containing essential information concerning the physical development at- tendant upon unfolding womanhood. Printed on Japanese parchment, bound in green ooze leather, boxed, price 60 cents (2s. 6d.) net, post free. 44 Parental Responsibility." By Sylvanus Stall, D.D. An important booklet to parents upon the importance and manner of safeguarding the purity of young chil- dren. Printed on Japanese parchment, bound in green ooze leather, boxed, price 60 cents (21. 6 d.) net, post free. 44 The Social Evil in University Life." By Robert N. Willson, M.D. A book founded on the experience of the author in the treatment of social diseases as physician to the stu- dents of the University of Pennsylvania. 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