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WOMAN

Her Sex And Love Life

by

WILLIAM J. ROBINSON, M.D.

Chief of the Department of Genito-Urinary Diseases and
Dermatology, Bronx Hospital Dispensary Editor of the
American Journal of Urology and Sexology; Editor of The
Critic and Guide; Author of Treatment of Sexual Impotence
and Other Sexual Disorders in Men and Women; Treatment of
Gonorrhea in Men and Women; Limitation of Offspring by the
Prevention of Conception; Sex Knowledge for Girls and Women;
Sexual Problems of Today; Never-Told Tales; Eugenics and
Marriage, etc. Fellow of the New York Academy of Medicine,
of the American Medical Editors' Association, American
Medical Association, New York State Medical Society,
Internationale Gesellschaft für Sexualforschung, American
Genetic Association, American Association for the
Advancement of Science, American Urological Association,
etc., etc.

Illustrated

Twenty-First Edition







1929
Eugenics Publishing Company
New York

Copyright, 1917,
by Eugenics Publishing Company

Press of
J.J. Little & Ives Co.
New York




THE CREATION OF WOMAN


This old Oriental legend is so exquisitely charming, so superior to
the Biblical narrative of the creation of woman, that it deserves to
be reproduced in WOMAN: HER SEX AND LOVE LIFE. There are several
variants of this legend, but I reproduce it as it appeared in the
first issue of THE CRITIC AND GUIDE, January, 1903.

    At the beginning of time, Twashtri--the Vulcan of Hindu
    mythology--created the world. But when he wished to create a
    woman, he found that he had employed all his materials in the
    creation of man. There did not remain one solid element. Then
    Twashtri, perplexed, fell into a profound meditation from which
    he aroused himself and proceeded as follows:

    He took the roundness of the moon, the undulations of the
    serpent, the entwinement of clinging plants, the trembling of
    the grass, the slenderness of the rose-vine and the velvet of
    the flower, the lightness of the leaf and the glance of the
    fawn, the gaiety of the sun's rays and tears of the mist, the
    inconstancy of the wind and the timidity of the hare, the vanity
    of the peacock and the softness of the down on the throat of the
    swallow, the hardness of the diamond, the sweet flavor of honey
    and the cruelty of the tiger, the warmth of fire, the chill of
    snow, the chatter of the jay and the cooing of the turtle dove.

    He combined all these and formed a woman. Then he made a present
    of her to man. Eight days later the man came to Twashtri, and
    said: "My Lord, the creature you gave me poisons my existence.
    She chatters without rest, she takes all my time, she laments
    for nothing at all, and is always ill; take her back;" and
    Twashtri took the woman back.

    But eight days later the man came again to the god and said: "My
    Lord, my life is very solitary since I returned this creature. I
    remember she danced before me, singing. I recall how she glanced
    at me from the corner of her eye, how she played with me, clung
    to me. Give her back to me," and Twashtri returned the woman to
    him. Three days only passed and Twashtri saw the man coming to
    him again. "My Lord," said he, "I do not understand exactly how
    it is, but I am sure that the woman causes me more annoyance
    than pleasure. I beg you to relieve me of her."

    But Twashtri cried: "Go your way and do the best you can." And
    the man cried: "I cannot live with her!" "Neither can you live
    without her!" replied Twashtri.

    And the man went away sorrowful, murmuring: "Woe is me, I can
    neither live with nor without her."




PREFACE


In the first chapter of this book I have shown, I believe
convincingly, why sex knowledge is even more important for women than
it is for men. I have examined carefully the books that have been
written for girls and women, and I know that it is not bias, nor
carping criticism, but strict honesty that forces me to say that I
have not found one satisfactory girl's or woman's sex book. There are
some excellent books for girls and women on general hygiene; but on
sex hygiene, on the general manifestations of the sex instinct, on sex
ethics--none. I have attempted to write such a book. Whether I have
succeeded--fully, partially or not at all--is not for me to say,
though I have my suspicions. But this I know: in writing this book I
have been strictly honest with myself, from first page to last.
Whether everything I have written is the truth, I do not know. But at
least I believe that it is--or I would not have written it. And I can
solemnly say that the book is free from any cant, hypocrisy,
falsehood, exaggeration or compromise, nor has any attempt been made
in any chapter to conciliate the stupid, the ignorant, the pervert, or
the sexless.

As in all my other books I have used plain, honest English. Not any
plainer than necessary, but plain enough to avoid obscurity and
misconception.

Science and art are both necessary to human happiness. This is not the
place to discuss the relative importance of the two. And, while I have
no patience with art-for-art's-sake, I recognize that the scientist
can not be put into a narrow channel and ordered to go into a certain
definite direction. Scientific investigations which seemed aimless and
useless have sometimes led to highly important results, and I would
not disparage science for its own sake. It has its uses. Nevertheless
I personally have no use for it. To me everything must have a direct
human purpose, a definite human application. When the cup of human
life is so overflowing with woe and pain and misery, it seems to me a
narrow dilettanteism or downright charlatanism to devote one's self to
petty or bizarre problems which can have no relation to human
happiness, and to prate of self-satisfaction and self-expression. One
can have all the self-expression one wants while doing useful work.

And working for humanity does not exclude a healthy hedonism; not the
narrow Cyrenaic, but an enlightened altruistic hedonism. And in
writing this book I have kept the human problem constantly before my
eyes. It was not my ambition merely to impart interesting facts: my
concern was the practical application of these facts, their relation
to human happiness.

If this book should be instrumental, as I confidently trust it will,
in destroying some medieval superstitions, in dissipating some
hampering and cramping errors, in instilling some hope in the hearts
of the hopeless, in bringing a little joy into the homes of the
joyless, in increasing in however slight a degree the sum total of
human happiness, its mission shall have been gloriously fulfilled.

For this is the mission of the book: to increase the sum total of
human happiness.

                                               W.J.R.


  12 Mount Morris Park W.,
    New York City.
      Jan. 1, 1917.




CONTENTS


CHAPTER                                                           PAGE

I. THE PARAMOUNT NEED OF SEX KNOWLEDGE FOR GIRLS AND WOMEN          23

 Why Sex Knowledge is of Paramount Importance to Girls and
    Women--Reasons Why a Misstep in a Girl Has More Serious
    Consequences than a Misstep in a Boy--The Place Love
    Occupies in Woman's Life--Woman's Physical Disabilities.

II. THE FEMALE SEX ORGANS; THEIR ANATOMY                            31

 The Internal Sex Organs--The Ovaries--The Fallopian Tubes--The
    Uterus--The Divisions of the Uterus--Anteversion,
    Anteflexion, Retroversion, Retroflexion, of the
    Uterus--Endometritis--The Vagina--The Hymen--Imperforate
    Hymen--The External Genitals--The Vulva, Labia Majora, Labia
    Minora, the Mons Veneris, the Clitoris, the Urethra--The
    Breasts--The Pelvis--The Difference Between the Male and
    Female Pelvis.

III. THE PHYSIOLOGY OF THE FEMALE SEX ORGANS                        49

 Function of the Ovaries--Internal Secretion of the Ovaries--
    Function of the Internal Secretion--Number of Ova in the
    Ovaries--The Graafian Follicles--Ovulation--Corpora
    Lutea--Function of the Fallopian Tubes--Function of the
    Vagina--Functions of the Vulva, Clitoris and Mons Veneris--
    Function of the Breasts--Besides Secreting Milk Breast Has
    Sexual Function--The Orgasm--Pollutions in Women--Secondary
    Sex Characters--Differences Between Woman and Man.

IV. THE SEX INSTINCT                                                62

 Universality of the Sex Instinct--Not Responsible for Our
    Thoughts and Feelings.

V. PUBERTY                                                          65

 Physical Changes in Puberty--Physical Changes in the Genital
    Organs and in the Rest of the Body--Psychic Changes--Puberty
    and Adolescence--Nubility.

VI. MENSTRUATION                                                    71

 Definition of Menstruation--Where Menstrual Blood Comes
    From--Age of Menstruation--Age of Cessation of
    Menstruation--Duration--Amount--Regularity and Irregularity.

VII. ABNORMALITIES OF MENSTRUATION                                  75

 Disorders of  Menstruation--Menorrhagia--Metrorrhagia--
    Amenorrhea--Vicarious Menstruation--Dysmenorrhea of Organic
    and of Nervous Origin.

VIII. THE HYGIENE OF MENSTRUATION                                   78

 Lack of Cleanliness During Menstrual Period--Superstitious
    Beliefs--Hygiene of Menstruation.

IX. FECUNDATION OR FERTILIZATION                                    82

 Fecundation or Fertilization--Process of Fecundation--When the
    Ovum Matures--Fate of Ovum When no Intercourse Has Taken
    Place--Entrance of Spermatozoa as Result of Intercourse--The
    Spermatozoa in Search of the Ovum--Rapidity of Movements of
    Spermatozoa--Absorption of Spermatozoön by Ovum--Activity of
    Impregnated Ovum in Finding Place to Develop--Pregnancy in
    the Fallopian Tube and Its Dangers--Twin Pregnancy--Passivity
    of Ovum and Activity of Spermatozoön Foretell the Contrasting
    Rôles of the Man and the Woman Throughout Life.

X. PREGNANCY                                                        88

 Period of Pregnancy in Human Female--Physiologic Process of
    Pregnancy--Growth of Embryo from Moment of Conception--
    Pregnant Woman Provides Nourishment for Two--Her Excreting
    Organs Must Work for Two.

XI. THE DISORDERS OF PREGNANCY                                      93

 Smooth Course of Pregnancy in Some Women--Pregnancy and
    Parturition May be Made Normal Processes Through Education
    in True Hygiene--Morning Sickness and Its Treatment--Necessity
    for Medical Advice in Pernicious Vomiting--Anorexia--Bulimia--
    Aversion Towards Certain Foods--Peculiar Cravings--Tendency
    to Constipation Aggravated by Pregnancy--Dietary Measures in
    Constipation--Rectal Injections in Constipation--Laxatives--
    Cause of Frequent Desire to Urinate During First Two or Three
    and Last Months of Pregnancy--Treatment of Frequent Urination--
    Cause of Piles During Pregnancy and Their Treatment--Cause of
    Itching of External Genitals During Pregnancy and Treatment--
    Cause of Varicose Veins and Treatment--Liver Spots.

XII. WHEN TO ENGAGE A PHYSICIAN                                    102

 Necessity for the Pregnant Woman Immediately Placing Herself
    Under Care of Physician and Remaining Under His Care During
    Entire Period.

XIII. THE SIZE OF THE FETUS                                        105

 Approximately Correct Measurements and Weight of Fetus at End
    of Each Month of Pregnancy.

XIV. THE AFTERBIRTH (PLACENTA) AND CORD                            108

 How the Afterbirth Develops--Bag of Waters--Umbilical Cord--The
    Navel--Fetus Nourished by Absorption--Fetus Breathes by Aid
    of Placenta--No Nervous Connection Between Mother and Child.

XV. LACTATION OR NURSING                                           110

 No Perfect Substitute for Mother's Milk--When Nursing is
    Injurious to Mother and Child--Modified Milk--Artificial
    Foods--Care Essential in Selecting Wet Nurse--Suckling Child
    Benefits Mother--Reciprocal Affection Strengthened by
    Nursing--Sexual Feelings While Nursing--Alcoholics are
    Injurious--Attention to Condition of Nipples During
    Pregnancy Essential--Treatment of Sunken Nipples--Treatment
    of Tender Nipples--Treatment of Cracked Nipples--How to Stop
    the Secretion of Milk When Necessary--Menstruation While
    Nursing--Pregnancy in the Nursing Woman.

XVI. ABORTION AND MISCARRIAGE                                      117

 Definition of Word Abortion--Definition of Word Miscarriage--
    Spontaneous Abortion--Induced Abortion--Therapeutic Abortion--
    Criminal Abortion--Missed Abortion--Habitual Abortion--
    Syphilis as Cause of Abortion and Miscarriage--Dangers of
    Abortion--Abortion an Evil.

XVII. PRENATAL CARE                                                121

 Meaning of the Term--Misleading Information by
    Quasi-Scientists--Exaggerated Ideas Regarding Prenatal
    Care--Nervous Connection Between Mother and Child--Cases
    Under Author's Observation--Effects on Offspring--Advice to
    Pregnant Women--Germ-plasm of Chronic Alcoholic--A Glass of
    Wine and the Spermatozoa--False Statements--Cases of
    Violence and Accidents During Pregnancy.

XVIII. THE MENOPAUSE, OR CHANGE OF LIFE                            128

 Time of Menopause--Cause of Suffering During Menopause--
    Reproductive Function and Sexual Function Not Synonymous--
    Increased Libido During Menopause--Change of Life in Men.

XIX. THE HABIT OF MASTURBATION                                     135

 Definition of Masturbation--Its Injurious Effects in Girls as
    Compared with Boys--Married Life of the Girl Masturbator--
    Necessity for Change in Injurious Attitude of Parents who
    Discover the Habit--Common-sense Treatment of the Habit--
    How to Prevent Formation of Habit--Parents' Advice to
    Children--Hot Baths as Factor in Masturbation--Other Physical
    Factors--Mental Masturbation and Its Effects.

XX. LEUCORRHEA--THE WHITES                                         143

 Misconception Regarding the Meaning of the Term "Leucorrhea"--A
    Common Complaint--Severe Cases--Reasons for Resistance to
    Treatment--Proper Local Treatment of the Disorder--Sterility
    Due to Leucorrhea--Causes of Leucorrhea--Tonic
    Medicines--Local Treatment--Formulæ for Douching.

XXI. THE VENEREAL DISEASES                                         149

 Derivation of Word "Venereal"--Three Venereal Diseases--
    Innocent Contraction of Syphilis Through Various Objects--
    The Hygienic Elimination of Common Sources of Venereal
    Infection--Measures for Prevention After Sexual Relations.

XXII. THE EXTENT OF VENEREAL DISEASE                               151

 Former Ban on Discussion of Venereal Disease and Its Evil
    Results--Present Reprehensible Exaggerations of Extent of
    Venereal Disease--Erroneous and Ridiculous Statements of
    "Reformers"--Senseless Fear of Marriage in Girls Due to
    Lurid Exaggerations--Study by Woman Psychologist Reveals
    Harmful Results of Exaggerated Statements--Truth in Regard
    to Percentage of Men Afflicted with Venereal Disease.

XXIII. GONORRHEA                                                   158

 Source of Gonorrhea--Mucous Membrane of Genital Organs and of
    Eye Principal Seats of Disease--Symptoms in Men and in
    Women--Vagina Seldom Attacked in Adults--Nobody Inherits
    Gonorrhea--Ophthalmia Neonatorum--Differences of Course of
    Disease in Men and Women--Gonorrhea Less Painful in
    Women--Symptoms not Suspected by Woman--Necessity for the
    Woman Consulting a Physician--Self-treatment When Woman
    Cannot Consult Physician--Formulæ for Injections.

XXIV. VULVOVAGINITIS IN LITTLE GIRLS                               164

 Former Causes of Vulvovaginitis in Little Girls--Discharge
    Chief Symptom--Evil Results of Vulvovaginitis--Psychic
    Results of Treatment--Effects in Hastening Sexual
    Maturity--Vulvovaginitis a Cause of Permanent
    Sterility--Measures to Prevent the Disease--Toilet Seats and
    Vulvovaginitis.

XXV. SYPHILIS                                                      168

 Syphilis Due to Germ--Syphilis a Constitutional Disease--
    Primary Lesion--Incubation Period--Roseola--Primary
    Stage--Secondary Stage--Mucous Patches--Tertiary
    Stage--Gumma--Hereditary Nature of Syphilis--Milder Course
    in Women Than in Men--Obscure Symptoms in Syphilis--
    Necessity for Examination by Physician--Locomotor Ataxia--
    Softening of the Brain--Chancroids.

XXVI. THE CURABILITY OF VENEREAL DISEASE                           174

 Gonorrhea May Be Practically Cured in Every Case in
    Man--Extensive Gonorrheal Infection in Woman Difficult to
    Cure--Positive Cure in Syphilis Impossible to Guarantee.

XXVII. VENEREAL PROPHYLAXIS                                        177

 Necessity for Douching Before and After Suspicious
    Intercourse--Formulæ for Douches--Precautions Against
    Non-venereal Sources of Infection--Syphilis Transmitted by
    Dentist's Instruments--Manicurists and Syphilis--Promiscuous
    Kissing a Source of Syphilitic Infection.

XXIII. ALCOHOL, SEX AND VENEREAL DISEASE                           181

 Alcoholic Indulgence and Venereal Disease--A Champagne Dinner
    and Syphilis--Percentage of Cases of Venereal Infection Due
    to Alcohol--Artificial Stimulation of Sex Instinct in Man
    and in Woman--Reckless Sexual Indulgence Due to
    Alcohol--Alcohol as an Aid to Seduction.

XXIX. MARRIAGE AND GONORRHEA                                       187

 Decision of Physician Regarding Marriage of Patients Infected
    with Gonorrhea or Syphilis--Advisability of Certificate of
    Freedom from Transmissible Disease--Premarital Examination
    as a Universal Custom--When a Man Who Had Gonorrhea May Be
    Allowed to Marry--When a Woman Who Had Gonorrhea May be
    Allowed to Marry--Antisepsis Before Coitus--Question of
    Sterility in the Man Who Has Had Gonorrhea Easily
    Answered--Impossibility of Determining Whether the Woman is
    Fertile or Not.

XXX. MARRIAGE AND SYPHILIS                                         195

 Rules for Permitting a Syphilitic Patient to Marry--Rules More
    Severe in Cases Where Children Are Desired--Where Both
    Partners Are Syphilitic--Danger of Paresis in Some
    Syphilitic Patients--A Case in the Author's Practice.

XXXI. WHO MAY AND WHO MAY NOT MARRY                                200

 The Physician Often Consulted as to Advisability of Marriage--
    _Venereal Disease_ the Most Common Question--_Tuberculosis_--
    Sexual Appetite of Tubercular Patients--Effect of Pregnancy
    Contraceptive Knowledge for Tubercular Wife--_Heart Disease_--
    Serious Bar to Marriage--Influence of Sexual Intercourse--
    _Cancer_--Fear of Hereditary Transmission--_Exophthalmic
    Goiter_--Most Frequent in Women--Simple Goiter--Exceptions
    to Rule--_Obesity_--Family History--Obesity and Stoutness Not
    Synonymous--_Arteriosclerosis_--Danger in Sexual Act--_Gout_--
    Real Causes of Gout--_Mumps_--Parotid Glands and Sex Organs--
    Mumps and Sterility--Oöphoritis Due to Mumps--_Hemophilia_--
    Hemophilic Sons May Marry--Hemophilic Daughters May Not
    Marry--_Anemia_--_Chlorosis_--_Epilepsy_--Hysteria--Symptoms
    of Hysteria--Marriage of Hysterical Women--_Alcoholism_--
    Effect on Offspring--Alcoholics and Impotence--
    _Feeblemindedness_--Evil Effects on Offspring--Sterilization
    of Feebleminded Only Preventive--_Insanity_--Functional
    Insanity--Organic Insanity--Hereditary Transmissibility of
    Insanity--Fear Resulting in Insanity--Environment versus
    Heredity in Insanity--_Neurosis_--_Neurasthenia_--
    _Psychasthenia_--_Neuropathy_--_Psychopathy_--Nervous
    Conditions and Genius--Sexual Impotence and Genius--_Drug
    Addiction_--External Causes--_Consanguineous Marriages_--When
    Consanguineous Marriages are Advisable--Offspring of
    Consanguineous Marriages--Homosexuality--Homosexuals Often
    Ignorant of Their Condition--Sexual Repression and
    Homosexuality--Sadism and Divorce--Masochism--Sexual Impotence
    and Marriage--Effect Upon the Wife--Frigidity--Marital Relations
    and Frigid Woman--Excessive Libido and Marriage--Excessive
    Demands Upon Wife--Satyriasis--The Excessively Libidinous
    Wife--Nymphomania--Treatment--Harelip--Myopia--Astigmatism--
    Premature Baldness--Criminality--Crime as Result of
    Environment--Legal and Moral Crime--Ancestral Criminality and
    Marriage--Rules of Heredity--Pauperism--Difference Between
    Pauperism and Poverty.

XXXII. BIRTH CONTROL OR THE LIMITATION OF OFFSPRING                244

 Knowledge of Prevention of Conception Essential--Misapprehensions
    Concerning Birth-control Propaganda--Modern Contraceptives Not
    Injurious to Health--Imperfection of Contraceptive Measures
    Due to Secrecy--Prevention of Conception and Abortion
    Radically Different--More Marriages Consummated if Birth-control
    Information were Legally Obtainable--Demand for Prostitution
    Would be Curtailed--Venereal Disease Due to Lack of
    Knowledge--Another Phase of the Birth-control Problem--Knowledge
    of Contraceptive Methods Where There Was a Taint of Insanity,
    and the Happy Results.

XXXIII. ADVICE TO GIRLS APPROACHING THE THRESHOLD OF WOMANHOOD     261

 The Irresistible Attraction of the Young Girl for the Male--The
    Unprotected Girl's Temptations--Some Men Who Will Pester the
    Young Girl--Risk of Venereal Infection--Danger of
    Impregnation--Use of Contraceptives by the Unmarried Woman
    May Not Always Be Relied Upon--Nature of Men who Seduce
    Girls--Exceptions--Illegitimate Motherhood--Difficulties in
    the Way of Illegitimate Mother Who Must Earn Her Living--The
    Child of the Foundling Asylum--Social Attitude Towards
    Illegitimacy Responsible for Abortion Evil--Dangers of
    Abortion--The Girl Who Has Lost Her Virginity.

XXXIV. ADVICE TO PARENTS OF UNFORTUNATE GIRLS                      273

 Attitude of Parents Towards Unfortunate Girl--The Case of Edith
    and What Her Father Did--The Pitiful Cases of Mary B. and
    Bridget C.

XXXV. SEXUAL RELATIONS DURING MENSTRUATION                         279

 Heightened Sexual Appetite of Many Women During Menstruation--
    Sexual Intercourse During Menstrual Period--When Intercourse
    May be Permitted--Injection Before Coitus During
    Menstruation--Fallacy of Ancient Idea of Injuriousness.

XXXVI. SEXUAL INTERCOURSE DURING PREGNANCY                         282

 Complete Abstinence During Pregnancy--Bad Results of Complete
    Abstinence--Intensity of Relations During First Four Months--
    Intercourse During Fifth, Sixth and Seventh Months--
    Intercourse During Eighth and Ninth Months--Abstinence
    After Birth of Child.

XXXVII. SEXUAL INTERCOURSE FOR PROPAGATION ONLY                    284

 Belief in Sexual Intercourse for Propagation Only--What Such
    Practice Would Lead to--Nature and the Sex-fanatics--Sexual
    Desire in Woman After Menopause--Sex Instinct of Sterile Men
    and Women--Sex Instinct Has Other High Purposes.

XXXVIII. VAGINISMUS                                                288

 Vaginismus--Dyspareunia--Difference Between Vaginismus and
    Dyspareunia--Adherent Clitoris a Cause of Masturbation and
    Convulsions.

XXXIX. STERILITY                                                   291

 Definition of Sterility--Husband Should First be Examined--
    One-child Sterility--The Fertile Woman--Salpingitis as a
    Cause of Sterility--Leucorrhea and Sterility--Displacement
    of Uterus and Sterility--Closure of Neck of Womb and
    Sterility--Sterility and Constitutional Disease--Treatment
    of Sterility.

XL. THE HYMEN                                                      294

 Difference Between Chastity and Virginity--Worship of Intact
    Hymen--Sacrificing Hymen Sometimes Essential for Health of
    the Girl--Certificate from Physician who has Ruptured Hymen.

XLI. IS THE ORGASM NECESSARY FOR IMPREGNATION?                     297

 Suppression of Orgasm by Woman to Prevent Impregnation--Bad
    Results of Suppression by the Woman--Orgasm: Relation of to
    Impregnation--A Hypothesis--A Fanciful Hypothesis--Why
    Passionate Women Frequently Fail to Become Mothers--Advice
    to Passionate Women who Desire to Conceive.

XLII. FRIGIDITY IN WOMEN                                           301

 Meaning of Term Frigidity--Types of Frigidity--Large Percentage
    of Frigid Women--Repression of Sexual Manifestations and
    Frigidity--Frigidity and Masturbation--Frigidity and Sexual
    Weakness of Husband--Frigidity and Dislike of Husband--Organic
    Causes of Frigidity--A Frigid Woman May Become Passionate--
   Treatment of Frigidity.

XLIII. ADVICE TO FRIGID WOMEN, PARTICULARLY WIVES                  304

 Advice to Frigid Women--Attitude of Different Men Towards
    Frigid Wives--Orgasm a Subjective Feeling--A Justifiable
    Innocent Deception--The Case of a Demi-Mondaine.

XLIV. RAPE                                                         308

 Definition of Rape--Age of Consent--Unanimous Opinion of
    Experts--Exceptional Cases--False Accusation of Rape Due to
    Perversion--Erotic Dreams Under Anesthesia Causing
    Accusations Against Doctors and Dentists.

XLV. THE SINGLE STANDARD OF SEXUAL MORALITY                        311

 Chastity--Double Standard of Morality--Attempt to Abolish
    Double Standard--Late Marriages and Chastity in Men--Harmful
    Advice Given to Young Women--Chastity in Men Not Always Due
    to Moral Principles--Chaste Men and Satisfactory Husbands--A
    Statement by Professor Freud--A Statement by Professor
    Michels--What a Girl has a Right to Demand of Her Future
    Husband--Three Cases Showing Disastrous Effects of Wrong
    Teachings.

XLVI. DIFFERENCE BETWEEN MAN'S AND WOMAN'S SEX AND LOVE LIFE       318

 Seemingly Contradictory Statements--Faulty Interpretations of
    Words Sexual Instinct and Love--Difference in Manifestations
    of Male and Female Sexual Instincts--Man's Sex Instinct
    Grosser Than Woman's--Awakening of Sexual Desire in the Boy
    and in the Girl--Woman's Desire for Caresses--Man's Main
    Desire for Sexual Relations--Normal Sex Relations as Means
    of Holding a Man--A Physiological Reason Why Man is Held--Man
    and Physical Love--Woman and Spiritual Love--Preliminaries of
    Sexual Intercourse in Men and Women--Physical Attributes--
    Mental and Spiritual Qualities--Difference Between Love and
    "Being in Love"--Love as a Stimulus to Man--When the Man
    Loves--When the Woman Loves--Man's More Engrossing
    Interests--Lovemaking Irksome to Man--Man's Polygamous
    Tendencies--Woman Single-affectioned in Her Sex and Love
    Life--Man and Woman Biologically Different.

XLVII. MATERNAL IMPRESSIONS                                        327

 Wide-spread Belief in Maternal Impressions--No Single
    Well-authenticated Case of Maternal Impression--Birth of
    Monstrosities--Ridiculous Examples Given by Physicians--
    So-called Shock Often a Product of Mother's Imagination--
    Four Cases of Alleged Maternal Impressions--Mother's
    Health During Pregnancy May Have Effect Upon Child's
    General Health.

XLVIII. ADVICE TO THE MARRIED AND THOSE ABOUT TO BE                336

 Marriage as an Ideal Institution--Monogamic Marriage--Some
    Reasons for Husbands' Deviations--Importance of First Few
    Weeks of Married Life--Necessity for Understanding at
    Beginning--Preventing and Breaking Habits--The Wife's
    Individuality--Husbands Who are Childish, Not Vicious--
    Wife's Interest in Husband's Affairs--The "Slob" Husband--
    The Well-groomed Husband--Bad Odor from the Mouth--Odors
    from Other Parts of the Body--Treatment for Bad Odor from
    Perspiration--A Beneficial Powder--Advice Regarding
    Flirting--Dainty Underwear--Fine External Clothes and Cheap
    and Soiled Underwear--Delicate Adjustments of Sex Act
    Required with Some Men--Wife Who Discusses Her Husband's
    Foibles--A Professional Secret--A Case of Temporary
    Impotence--The Wife's Indiscretion--The Disastrous Result--A
    Big Stomach--The Wife's Attitude Towards the Marital
    Relation--Behavior Preliminary to and During the Act--
    Congenital Frigidity--Prudish and Vicious Ideas About the
    Sex Act--Sexual Intercourse for Procreative Purposes
    Only--Fear of Pregnancy on the Part of the Wife--The
    Remedy--Other Causes--Wife who Makes too Frequent Demands--
    Sacrificing the Future to the Present--Esthetic Considerations.

XLXIX. A RATIONAL DIVORCE SYSTEM                                   356

 A Rational Divorce System--Storms and Squalls--Two Sides of the
    Divorce Question--Outside Help and Marital Tangles--A
    Husband who was a Paragon of Virtue--The Case of the Sweet
    Wife--The Proper Untangling of Domestic Tangles.

L. WHAT IS LOVE?                                                   361

 Is Love Definable?--Raising a Corner of the Veil--Two Opinions
    of Love--The First Opinion: Sexual Intercourse and Love--The
    Second Opinion--The Grain of Truth in Each--The Truth
    Concerning Love--Foundation of Love--Sexual Attraction and
    Love--The Frigid Woman and Her Husband--Puzzling Cases of
    Love--The Paradox--Blindness of Love and the Penetrating
    Vision of Love--Limits of Homeliness--Physical Aversion and
    Genesis of Love--Mating in the Animal Kingdom--Mating in Low
    Races--Love in People of High Culture--Difference in Love of
    Savage and Man of Culture--Distinctions Between
    Loves--Varieties of Love and Varieties of Men--"Love"
    Without Sexual Desire--Refraining and Wanting--Cause of
    Love at First Sight--"Magnetic Forces" and Love at First
    Sight--The Pathological Side--Differentiation of Phases of
    Love--Infatuation--Difference Between "Infatuation" and
    "Being in Love"--Sexual Satisfaction and Infatuation--Sexual
    Satisfaction and Love--Infatuation Mistaken for Love--Love
    the Most Mysterious of Human Emotions--Great Love and
    Supreme Happiness.

LI. JEALOUSY AND HOW TO COMBAT IT                                  375

 Jealousy the Most Painful of Human Emotions--Impairment of
    Health--Mental Havoc--Jealousy as a Primitive Emotion--
    Jealousy in the Advanced Thinker and in the Savage--Jealousy
    in the Child--Feelings and Environmental Factors--Essential
    Factors--Vanity--Anger--Pain--Envy--The Impotent Husband's
    Jealousy--Anti-social Qualities--The Jealous and the
    Unfaithful Husband--Means of Eradicating the Evil--Iwan
    Bloch on the Question--Prof. Robert Michels' Statement--
    Remark of Prof. Von Ehrenfels--Havelock Ellis on Variation
    in Sexual Relationships--Advanced Ideas--Woman as Man's
    Chattel--The Change and the Changer--Teaching the Children--
    Casting Epithets at Jealousy--Free Unions and Jealousy--
    Feelings, Actions and Public Opinion--The Adulterous Wife of
    the Present Day--Jealousy Defeating Its Own Object--Jealousy
    of Inanimate Objects.

LII. REMEDIES FOR JEALOUSY                                         395

 Prevention and Cure--Prophylaxis of Jealousy--Fitting Remedy to
    Circumstances--The Neglectful and Flirtatious Husband--No
    Question of Love--Advice to the Wife of the Flirtatious
    Man--An Efficient Though Vulgar Remedy--Jealousy Must Be
    Experienced to Be Understood--Necessity for Freedom of
    Association--Lines of Conduct for the Wife--Contempt for a
    Certain Type of Wife and Husband--The Abandoned Lover--The
    Effects of Unrequited Love--Sublimated Sexual Desire--
    Replacing Unrequited Love--The Attitude of Goethe--
    Simultaneous Loves Possible--Successive Loves Possible--
    Eternal Loves--When Sex Relationships May Be Beneficial--
    Purchasable Sex Relations and Their Value--The Broken
    Engagement--The Terrible Effects on the Young Man--The
    Young Streetwalker--Sex Relations with Fiancé--Inundating
    Sense of Shame--Collapse--Attempts at Suicide--An Active Sex
    Life--The Results--The Prevention of Jealousy.

LIII. CONCLUDING WORDS                                             409





WOMAN: HER SEX AND LOVE LIFE


CHAPTER ONE

THE PARAMOUNT NEED OF SEX KNOWLEDGE FOR GIRLS AND WOMEN

 Why Sex Knowledge is of Paramount Importance to Girls and
  Women--Reasons Why a Misstep in a Girl Has More Serious
  Consequences than a Misstep in a Boy--The Place Love Occupies in
  Woman's Life--Woman's Physical Disabilities.


All are agreed--I mean all who are capable of thinking and have given
the subject some thought--that for the welfare of the race and for his
own physical and mental welfare it is important that the boy be given
some sex instruction. All are not agreed as to the character of the
instruction, its extent, the age at which it should be begun and as to
who the teacher should be--the father, the family physician, the
school teacher or a specially prepared book--but as to the necessity
of sex knowledge for the boy there is now substantial agreement--among
the conservatives as well as among the radicals.

No such agreement exists concerning sex knowledge for the girl. Many
still are the men and women--and not among the conservatives only--who
are strongly opposed to girls receiving any instruction in sex
matters. Some say that such instruction--except a few hygienic rules
about menstruation--is unnecessary, because the sex instinct awakens
in girls comparatively late, and it is time enough for them to learn
about such matters after they are married. Others fear that sex
knowledge would destroy the mystery and romance of sex, and would rob
our maidens of their greatest charms--modesty and innocence. Still
others fear that sex instruction would tend to awaken the sex instinct
in our girls prematurely; would direct their thoughts to matters about
which they would not think otherwise; and they argue that the warnings
about venereal disease, prostitution, etc., which are an integral part
of sex instruction, tend to create a cynical, inimical attitude
towards the male sex, which may even result in hypochondriac ideas and
antagonism to marriage.

I do not deny that there is a grain of truth in all the above
objections. Sex instruction does cause _some_ girls to think of sex
matters earlier than they otherwise would, and some girls have been
made bitter and hypochondriac, and disgusted with the male sex. But it
would not be difficult to demonstrate that it was not sex instruction
_per se_ that was responsible for these deplorable results; it was the
_wrong_ kind of instruction that was to blame--it was the wrong
emphasis, the lurid exaggerations that caused the mischief, and not
the truth. In other words, it is not sex information, it is sex
misinformation, that is pernicious. And, of course, to this everybody
will agree: rather than false information, better no information at
all.

But if the information to be imparted be sane, honest and truthful,
without exaggerating the evils and without laying undue emphasis on
the dark shadows of our sex life, then the results can be only
beneficent. And the task I have put before myself in this book is to
give our girls and women sane, square and honest information about
their sex organs and sex nature, information absolutely free from
luridness, on the one hand, and maudlin sentimentality, on the other.
The female sex is in need of such information, much more so than is
the male sex. Yes, if boys, as is now universally agreed, are in need
of sex instruction, then girls are much more in need of it. Why? For
several important reasons.

The first reason why sex instruction is even more important for girls
than it is for boys is because a misstep in a girl has much more
disastrous consequences than it has in a boy. The disastrous results
of a misstep in a boy are only physical in character; the results of
the _same_ misstep in a girl may be physical, moral, social and
economic. To speak more plainly. If a boy, through ignorance, rashly
indulges in illicit sexual relations, the worst consequence to him may
be infection with a venereal disease. But he is not considered
immoral, he is not despised, he is not ostracized, he does not lose
his social standing in the slightest degree, and when he is cured of
his venereal disease he has no difficulty in getting married. He does
not even have to conceal his past sexual history from his wife. But if
a girl makes a misstep the consequences to her are terrible indeed; it
may not only cost her her health and social standing, she may have to
pay with her very life. She runs the risk of venereal infection the
same as the boy does, but in addition she runs the risk of becoming
pregnant, which in our present social system is a catastrophe indeed.
To save herself from the disgrace of an illegitimate child she may
have an abortion produced; the abortion may have no bad results, but
it may, if performed bunglingly, leave her an invalid for life, or it
may kill her outright. If she is so unfortunate as to be unable to get
anybody to produce an abortion, she gives birth to an illegitimate
child, which she is forced in most cases to put away in an institution
of some sort where she hopes and prays it may die soon--and, in
general, it does. If it does not die, she has for the rest of her life
a Damocles' sword hanging over her head, and she is in constant terror
lest her sin be found out. She does not permit herself to look for a
mate, but if she does get married, the specter of her antematrimonial
experience is constantly before her eyes. After years and years of
married life, the husband may divorce her if he finds out that she had
"sinned" before she knew him. And unless the husband is a broad-minded
man and loves her truly and unless she made a clean breast of
everything to him before marriage, her life is continuous torture. But
even if the girl escaped pregnancy, the mere finding out that she had
an illicit experience deprives her of social standing, or makes her a
social outcast and entirely destroys or greatly minimizes her chances
of ever marrying and establishing a home of her own. She must remain a
lonely wanderer to the end of her days.

The enormous difference in the results of a misstep in a boy and a
girl is clearly seen, and for this reason alone, if for no other, sex
instruction is of more importance to the girl than it is to the boy.

But there are other important reasons, and one of them is beautifully
and truthfully expressed by Byron in his two well-known lines.

    Man's love is of man's life a thing apart,
    'Tis woman's whole existence.

Yes, love is a woman's whole life.

Some modern women might object to this. They might say that this was
true of the woman of the past, who was excluded from all other avenues
of human activity. The woman of the present day has other interests
besides those of Love. But I claim that this is true of only a small
percentage of women; and in even this small minority of women, social,
scientific and artistic activities cannot take the place of love; no
matter how busy and successful these women may be, they will tell you
if you enjoy their confidence that they are unhappy, if their love
life is unsatisfactory. Nothing, nothing can fill the void made by the
lack of love. The various activities may help to cover up the void, to
protect it from strange eyes, they cannot fill it. For essentially
woman is made for love. Not exclusively, but essentially, and a woman
who has had no love in her life has been a failure. The few exceptions
that may be mentioned only emphasize the rule.

But not only psychically is a woman's love and sex life more important
than a man's, physically she is also much more cognizant of her sex
and much more hampered by the manifestation of her sex nature than
man is. To take but one function, menstruation. From the age 13 or 14
to the age of forty-five or fifty it is a monthly reminder to woman
that she is a woman, that she is a creature of sex; and, while to many
women this periodically recurring function is only a source of some
annoyance or discomfort, to a great number it is a cause of pain,
headache, suffering, or complete disability. Man has no such
phenomenon to annoy him practically his whole life.

But more important are the results of love-union, of sex relations. A
man after a sexual relation is just as free as he was before. A woman,
if the relation has resulted in a pregnancy, which is generally the
case, unless special pains are taken it should not so result, has nine
troublesome months before her, months of discomfort if not of actual
suffering; she then has an extremely trying and painful ordeal, that
of childbirth, and then there is another trying period, the period of
lactation or of nursing and of bringing up the baby. The penalty seems
almost too great.

And when the woman is on the point of ceasing to menstruate she does
not do so smoothly and comfortably. She has to go through a period
called the menopause, which may last one or two years and which may
bring discomforts and dangers of its own. Man does not have to go
through such a distinct period of demarcation separating his sexual
from his non-sexual life. Altogether it cannot be denied that woman is
much more a slave of her sex nature than man is of his. Yes, Nature
has handicapped woman much more heavily than she has man.

In short, both in view of the fact that sexual ignorance with its
possible missteps has much more disastrous consequences for the girl
than it has for the boy, and in view of the fact that the sex instinct
and its physical and psychic manifestations occupy a much more
important part in woman's life than they do in the life of man, we
consider the necessity of sex instruction much greater in the case of
woman than in the case of man. I do not wish to be misunderstood as
underestimating the need of sex instruction for the male--only I
consider the need even greater in the case of the female.




CHAPTER TWO

THE FEMALE SEX ORGANS: THEIR ANATOMY

 The Internal Sex Organs--The Ovaries--The Fallopian Tubes--The
  Uterus--The Divisions of the Uterus--Anteversion, Anteflexion,
  Retroversion, Retroflexion, of the Uterus--Endometritis--The
  Vagina--The Hymen--Imperforate Hymen--The External Genitals--The
  Vulva, Labia Majora, Labia Minora, the Mons Veneris, the
  Clitoris, the Urethra--The Breasts--The Pelvis--The Difference
  Between the Male and Female Pelvis.


The organs which primarily distinguish one sex from the other are the
sex organs. It is by the aid of the sex organs that children are
begotten and brought into the world, that the race is _reproduced_ and
perpetuated. It is for this reason that the sex organs are also called
the Reproductive Organs.

The first thing we must do is to become familiar with the _structure_
and _location_ of the sex organs; in other words, we must get a fair
idea of their _Anatomy_.

The female sex organs, also called the reproductive or generative
organs, are divided into internal and external. The internal are the
most important and consist of: the ovaries, Fallopian tubes, uterus
or womb, and vagina. The external sex organs of the female are: the
vulva, hymen, and clitoris. Among the external organs are also
generally included the mons Veneris and the breasts or mammary glands.


SUBCHAPTER A

THE INTERNAL SEX ORGANS

    [Illustration: OVARY.]

=The Ovaries.= The ovaries are the essential organs of reproduction.
For it is they that generate the eggs, or _ova_, or _ovules_, which,
after becoming _fertilized_ or _fecundated_ by the spermatozoa of the
male, develop into children. Without the ovaries of the female, the
same as without the testicles of the male (to which they correspond),
no children could be begotten, and the entire human race would quickly
disappear from our planet. The ovaries are two in number; they are
embedded in the _broad ligaments_ which support the womb in the
pelvis, one on each side of the womb. They are of a grayish or whitish
pink color, and are about an inch and a half long, three-quarters of
an inch wide, and one-third of an inch thick. They weigh from
one-eighth to one-quarter of an ounce. Their surface is either smooth
or rough and puckered. Think of a large blanched almond and you will
have a pretty fair idea of the size and shape of an ovary.

=The Fallopian Tubes.= The Fallopian tubes (so called from Fallopius,
a great anatomist, who discovered them; also called oviducts: egg
conductors, because they conduct the eggs from the ovary into the
uterus) are two very thin tubes, extending one from each upper angle
of the womb to the ovaries; but at their ovarian end they expand into
a fringed and trumpet-shaped extremity. The fringes are referred to as
_fimbria_. They are about five inches long and only about
one-sixteenth of an inch in diameter; the function of the tubes is to
catch the ova as they burst forth from the ovaries and to convey them
to the uterus. Taking into consideration the very narrow _lumen_, or
_caliber_, of the Fallopian tubes, it is easy to understand why even a
very slight inflammation is apt to clog them up, to seal their mouths
or openings, thus rendering the woman _sterile_, or incapable of
having children. For, if the Fallopian tubes are "clogged" up, the
eggs, or ova, have no way of reaching the uterus.

The Greek name for the Fallopian tube is salpinx (salpinx in Greek
means tube). An inflammation of the Fallopian tube is therefore called
salpingitis. (A salpingitis has the same effect in causing sterility
in the female as has an epididymitis in the male.) Salpingectomy is
the cutting away of the whole or of a piece of the Fallopian tube
(corresponds to vasectomy in the male).

=The Uterus.= The uterus or womb is the organ in which the fertilized
ovum, or egg, grows and develops into a child. It is a hollow muscular
organ, about the size of a pear, with thick walls, capable under the
influence of pregnancy of great expansion and growth. The broad part
of the pear is called the _body_ of the uterus; the lower narrow part
is called the _neck_ of the uterus, or _cervix_. The uterus in the
adult girl or woman is about three inches long, two inches broad in
its upper part and nearly an inch thick. It weighs from an ounce to an
ounce and a half. When the uterus is in a pregnant condition, it
increases enormously, both in size and in weight, as we will see in a
future chapter. The cavity of the uterus is somewhat triangular in
shape; at each upper angle is the small opening communicating with the
Fallopian tube; the upper portion of the uterus is called the fundus;
the external opening of the womb, situated in the center of the
cervix, is called the mouth of the womb, or the _os_, or external os.

   [Illustration: 1. OPENINGS INTO THE FALLOPIAN TUBES. 2. MOUTH OF
   THE WOMB.]

The uterus is situated in the center of the pelvis, between the
bladder and the rectum. It is supported by certain ligaments, the
chief of which are the broad ligaments; but, on account of general
weakness, too hard physical labor, or lifting heavy weights, the
ligaments may stretch, and the uterus may sink down low in the vagina,
and we then have the condition known as prolapse of the womb. Or, the
womb may turn forward, when we have a condition of _anteversion_. If
the womb is _bent_ (or _flexed_) forward on itself the condition is
called _anteflexion_. If the womb is turned backwards, the condition
is called _retroversion_; if it is bent or flexed backward upon itself
the condition is called _retroflexion_. An extreme degree of
anteversion or anteflexion, or retroversion or retroflexion, may
interfere with impregnation, as the spermatozoa may find it
difficult or impossible to reach the opening of the womb--the external
os.

    [Illustration: (Female Reproductive Organs)]

The entire cavity of the uterus is lined by a mucous membrane;[1] this
mucous membrane is called the endometrium (endo--within;
metra--uterus). An inflammation of the endometrium is called
_endometritis_. It is the endometrium that is principally concerned in
menstruation--that is, it is from it that the monthly discharge of
blood comes.

=The Vagina= [vagina in Latin--a sheath]. The vagina is the tube or
canal which serves as a passage-way between the uterus and the outside
of the body. It extends from the external genitals or vulva to the
neck of the womb, embracing the latter for some distance. It is a
strong, fibromuscular canal, lined with mucous membrane. It is not
smooth inside, but arranged in folds, or _rugæ_, so that when
necessary, as during childbirth, it can stretch enormously and permit
the passage of a child's head. The length of the vaginal canal is
between three and five inches, but it is in general much more
capacious in women that have borne one or more children than in those
who have not borne any.

Near the vaginal entrance are situated two small glands; they are
about the size of a pea, and secrete mucus. They are called
Bartholin's glands; occasionally they become inflamed and give a good
deal of trouble.

    [Illustration: ANTEVERSION OF THE UTERUS.]

    [Illustration: ANTEFLEXION OF THE UTERUS.]

    [Illustration: RETROVERSION OF THE UTERUS.]

    [Illustration: RETROFLEXION OF THE UTERUS.]

=The Hymen= [hymen in Greek--a membrane]. The external opening of the
vagina, in virgins, that is, in girls or women who have not had sexual
intercourse, is almost entirely closed by a membrane called the hymen.
The vulgar name for hymen is "maidenhead." The hymen may be of various
shapes, and of different consistency. In some girls it is a very thin
membrane, which tears very readily; in others it is quite tough. On
the upper margin or in the center of the hymen there is an opening
which permits any secretion from the vagina and the blood from the
uterus to come through. In rare cases there is no opening in the
hymen, that is, the vagina is entirely closed. Such a hymen is called
_imperforate_ (not perforated). When the girl begins to menstruate,
the blood cannot come out and it accumulates in the vagina. In such
cases the hymen must be opened or slit by a doctor. In some cases the
hymen is congenitally absent; that is, the girl is born without any
hymen. While the hymen is usually ruptured during the first
intercourse, it, in some cases, being elastic and stretchable,
persists untorn after sexual intercourse. It will therefore be seen
that just as the presence of the hymen is no absolute proof of
virginity, so is the absence of the hymen no absolute proof that the
girl has had sexual relations, She might have been born without any
hymen, or it might have been ruptured by vaginal examination, by a
vaginal douche, by scratching to relieve itching, or by some accident.

The remains of the hymen after it is ruptured shrink and form little
elevations which can be easily felt; they are known as caruncles.
[In Latin, _carunculæ myrtiformes_, which means in English
myrtleberry-shaped caruncles; caruncle is a small fleshy elevation;
derived from _caro_, which in Latin means flesh.]


SUBCHAPTER B

THE EXTERNAL GENITALS

=The Vulva.= The external genitals of the female are called the
_vulva_. The vulva consists of the labia majora (meaning the larger
lips), which are on the outside and which in the grown-up girl are
covered with hair, and the labia minora (the smaller lips), which are
on the inside and which are usually only seen when the labia majora
are taken apart.

[Vulva in Latin means folding-door. The ancients Were fond of giving
fancy names to things.]

=The Mons Veneris.= The elevation above the vulva, which during
puberty becomes covered with hair, is called by the fanciful name,
_mons Veneris_, or Venus' mountain. It is usually well padded with
fatty tissue.

=The Clitoris.= The clitoris is a small body about an inch in length,
situated beneath the mons Veneris and partly or entirely covered by
the upper borders of the labia minora.

=The Urethra.= Between the clitoris above and the opening of the
vagina below is situated the opening of the _urethra_, or the urinary
meatus, through which the urine passes. Many women are so ignorant,
or, let us say innocent, that they think the urine passes out through
the vagina. This is not so. The vagina has nothing to do with the
process of urination.

Again enumerating the female sex organs, but in the reverse order,
from before backward, or from out inward, we have: The mons Veneris
and the labia majora, or the external lips of the vulva; these are the
plainly visible parts of the female genital organs. When the labia
majora are taken apart we see the labia minora; when the labia majora
and minora are taken apart we can see or feel the clitoris and the
hymen, or the remains of the hymen. We then have the vagina, a large,
stretchable musculo-membranous canal, in the upper portion of which
the neck of the womb, or the cervix, can be seen (when a speculum is
used), or felt by the finger. Only the cervix, or neck of the womb,
can be seen, but the rest of the womb, the broader portion, can be
easily felt and examined by one hand in the vagina and the other hand
over the abdomen. Continuous with the uterus are the Fallopian tubes,
and below the trumpet-shaped ends of the Fallopian tubes are the
ovaries, embedded in the broad ligaments, one on each side.

=The Breasts.= The breasts, also called mammary glands, or mammæ
[mamma in Latin, breast], may be considered as accessory organs of
reproduction. They are of no importance in the male, in whom they are
usually rudimentary, but they are of great importance in the female.
They manufacture milk, which is necessary for the proper nutrition of
the infant, and they add a great deal to the beauty and attractiveness
of the woman. They are thus a help to the woman in getting a mate or a
husband. The projecting elevation of the breast, which the child takes
in his mouth when nursing, is called the nipple; the darker colored
area surrounding the nipple is called the areola.

    [Illustration: THE PELVIS OF THE MALE.]

    [Illustration: THE PELVIS OF THE FEMALE.]


SUBCHAPTER C

THE PELVIS

The internal sex organs are situated in the lower part of the
abdominal cavity, the part that is called the _pelvis_, or pelvic
cavity. The meaning of the word pelvis in Latin is basin. The pelvis,
also referred to as the pelvic girdle or pelvic arch, forms a bony
basin, and is composed of three powerful bones: the sacrum, consisting
of five vertebræ fused together and constituting the solid part of the
spine, or vertebral column, in the back, and the two hipbones, one on
each side. The two hipbones meet in front, forming the _pubic arch_.

The hipbones are called in Latin the ossa innominata (nameless bones)
and each hipbone is composed of three bones: the ilium, the ischium,
and the os pubis. The thighs are attached to the hipbones, and to the
hipbones are also attached the large _gluteal_ muscles, which form the
buttocks, or the "seat."

The pelvis of the female differs considerably from the pelvis of the
male. The female pelvis is shallower and wider, less massive, the
margins of the bones are more widely separated, thus giving greater
prominence to the hips; the sacrum is shorter and less curved, and the
pubic arch is wider and more rounded. All this is necessary in order
to permit the child's head to pass through. If the female pelvis were
exactly like the male pelvis, a full-term living child could never
pass through it. The two illustrations show the differences between
the male and female pelvis very clearly.

Note particularly the differences in the pubic arches: in the male
pelvis it is really more of an angle than an arch. Also note how much
longer and more solid the sacrum (with its attached bone, called the
coccyx[2]) is in the male pelvis. The differences in the pelves (the
plural of pelvis is pelves) of the male and female become fully marked
at puberty, but they are present as early as the fourth month of
intra-uterine life.

FOOTNOTES:

[1] Mucous membrane--briefly a membrane which secretes mucus or some
other fluid.

[2] The coccyx consists of three rudimentary vertebræ; it is the
vestige of an organ which we once possessed in common with many other
animals, namely--a tail.




CHAPTER THREE

THE PHYSIOLOGY OF THE FEMALE SEX ORGANS

 Function of the Ovaries--Internal Secretion of the
  Ovaries--Function of the Internal Secretion--Number of Ova in the
  Ovaries--The Graafian Follicles--Ovulation--Corpora
  Lutea--Function of the Fallopian Tubes--Function of the
  Vagina--Functions of the Vulva, Clitoris and Mons
  Veneris--Function of the Breasts--Besides Secreting Milk Breast
  Has Sexual Function--The Orgasm--Pollutions in Women--Secondary
  Sex Characters--Differences Between Woman and Man.


The importance of an organ depends upon its _function_, upon what it
does, and not so much upon what it is. It is important to know the
size, structure and location of an organ, but it is still more
important to know its function; in other words, for our purpose it is
more important to know the _physiology_ than the anatomy of the sex
organs.


SUBCHAPTER A

FUNCTION OF THE OVARIES

Like the testicles in man, so the ovaries in woman are the essential
sexual organs. They are the fundamental organs, without which the
other sexual organs are useless. Also like the testicles in man, the
ovaries have two distinct functions, manufacturing two distinct
substances. One function is to manufacture eggs; this, called the
oögenetic or egg-producing function, is its _racial_ function; without
it the race could not perpetuate itself. But the ovary has also an
_individual_ function. Besides the ova, the ovary manufactures what we
call an _internal_ secretion which is absorbed by the blood, and which
is of the greatest importance to the woman herself. While the
manufacture of ova begins only at puberty, with menstruation, and
closes at the menopause, the manufacture of the internal secretion
lasts throughout the woman's entire life. This secretion, which
consists of various chemical substances, has a tremendous influence
not only on the development of the woman's body, but also on her
feelings.

First of all it is necessary for the development of the woman's
special characteristics, or _secondary sexual characters_. Without
that internal secretion of the ovaries, a woman would look more or
less like a man; she would not develop her beautiful rounded form, her
pretty long hair, her breasts, her broad pelvis, her feminine voice,
etc. _Second_, the secretion is necessary to the proper development of
her other sexual organs; if the ovaries are cut out, then the uterus
and the vagina and even the vulva shrivel up. _Third_, it is that
internal secretion that excites in woman sexual desire and makes her
enjoy relations with the male sex. If the ovaries are cut away,
particularly if it is done early in life, the woman has no sexual
desire and no enjoyment. _Fourth_, it contributes to the general
health, wellbeing, energy, and mental alertness of the woman.

You see the importance of the internal ovarian secretion, and you will
readily understand why, when the ovaries are removed by operation, the
woman, particularly if she is young, undergoes such marked changes. It
is because we recognize now the great importance of the ovaries that
we always, when operating on diseased ovaries leave at least a small
piece of ovary, if at all possible.

=Number of Ova.= When the female infant is born, her ovaries contain
as many ova or eggs as they ever will contain. In fact, they contain
more than they will at puberty. For it is estimated that at birth each
ovary contains about 100,000 ova; the majority of these, however,
disappear so that at the age of puberty each ovary contains only about
30,000 ova. As only one ovum ripens each month from the time of
puberty to the time of the menopause (i.e., about 300 to 400 ova at
the utmost during a lifetime), and as only a dozen or two ova would
be necessary for the propagation of the race, it seems a
superabundance of ova, an unnecessary lavishness. But nature _is_
lavish where the propagation of the species is concerned. A portion of
an ovary or of both ovaries might become diseased, and thousands of
ova might become unfit for fertilization; nature therefore puts in an
extra reserve supply. We see a still more striking example of this
extreme extravagant lavishness in man; only one spermatozoön is
necessary to impregnate the ovum, and only one spermatozoön can
penetrate the ovum; nevertheless each normal ejaculation of semen
contains between a quarter and half a million spermatozoa.

=The Graafian Follicles.= Each primitive or primordial ovum[3] is
imbedded in a little vesicle or follicle, which is generally known as
_Graafian follicle_, and there are as many Graafian follicles as there
are ova. (The Graafian follicles were first described about 250 years
ago--in 1672--by a Delft physician named De Graaf, hence the name.)
Until puberty, that is the commencement of menstruation, the Graafian
follicles with the oöcytes or primitive ova are in a more or less
dormant condition. But with the onset of puberty there commences a
period of intense activity in the ovaries. This period of activity is
repeated regularly once a month, and it constitutes the process of
_ovulation_ and _menstruation_. The two processes are closely though
not causally connected. Ovulation consists in the monthly maturation
and extrusion of a ripe ovum; menstruation, which will be further
discussed in a separate chapter, consists in the monthly discharge of
blood, mixed with mucus from the inside lining of the uterus. Every
twenty-eight days, from the time of puberty to the time of the
menopause, a Graafian follicle bursts and an ovum is extruded from the
ovary. Before the follicle bursts, it swells and enlarges and reaches
the surface of the ovary; the whole follicle is congested with blood,
but at one point near the surface of the ovary it is pale and thin,
and here the rupture takes place.

    [Illustration: SECTION OF OVARY.
    1. Graafian follicle in the earliest stage. 2, 3, 4. Follicles in
    more advanced stages. 5, 7. Almost mature follicle. 6. Follicle
    from which the ovum has escaped. 8. Corpus luteum.]

=Corpora Lutea.= After the Graafian follicle has burst and the ovum
has been pushed out, the cavity that is left does not remain empty and
functionless; there is a further process going on there; there is a
growth of cells, of a yellowish color, and the follicle becomes filled
with a yellowish body, which on account of its color is called the
_corpus luteum_ (plural--corpora lutea; luteum in Latin--yellow,
corpus--body). This corpus luteum grows in size until it sometimes
occupies as much as one-third of the ovary. But there is considerable
difference between the corpora lutea of non-pregnant and pregnant
women. Up to the end of about a month the corpora lutea are the same,
but after that the corpus luteum of the non-pregnant woman begins to
get smaller, to shrink, so that at the end of two or three months it
is reduced to a small scar and later cannot be noticed at all. The
corpus luteum of the pregnant woman keeps on increasing until the end
of the second month, remains about the same size until the end of the
sixth month, and only then begins gradually to diminish. The corpus
luteum of the non-pregnant woman, that is, the one following
menstruation, is called false corpus luteum; the corpus luteum
following pregnancy is called a true corpus luteum. The corpus luteum
acts like a gland and elaborates a secretion which has an influence on
the circulation in the uterus and on menstruation. It probably
possesses other properties, with which we are not yet quite familiar.
The corpora lutea of various animals are now prepared in powder or
tablet form and used in medicine in the treatment of certain diseases
of women.


SUBCHAPTER B

FUNCTION OF THE OTHER GENITAL ORGANS

=Function of the Fallopian Tubes.= The function of the Fallopian tubes
or oviducts as they are sometimes called is to catch the ovum as it
bursts through the ovary and to conduct it from the ovary into the
uterus. It is while the ovum is in the narrow lumen of the tube that
the spermatozoön which has travelled up from the uterus usually finds
it, and it is in the tube, near its entrance to the womb, that
impregnation usually takes place. After the ovum is impregnated or
fecundated, it slowly moves down to the uterus, where it attaches
itself and remains and grows for nine months, until it is ready to
come out and start an independent life.

The uterus or womb is the house of the embryo almost from the moment
of conception to the moment of birth. Within the thick warm sheltered
walls of the uterus the child grows, develops, eats and breathes,
until all its organs and functions have reached such a stage of
perfection that it can live by itself and for itself. And this may be
said to be the sole function of the uterus, or at least its sole
useful function. For the other function of the uterus, menstruation,
cannot be said to be a necessary or a useful function. It is a normal
function because it occurs regularly in every healthy woman during her
child-bearing period, but not every normal function is a necessary or
useful function. Not everything that is is right or useful.

=Function of the Vagina.= The vagina is the canal in which sexual
intercourse takes place. It receives the male organ (penis) during the
sexual act, and serves as a temporary repository for the male semen.
After the spermatozoa have reached the uterus, the vagina has no
further function to perform.

=Functions of the Vulva, Clitoris=, and =Mons Veneris.= The vulva and
the clitoris have no special functions to perform; but in them, in the
clitoris particularly, but also in the labia minora, resides the
feeling of voluptuousness, the pleasurable sensation experienced
during the sexual act. Another seat of voluptuousness in the woman is
located in the cervix of the uterus.

The mons Veneris has no special physiological function to perform, but
it as well as the vulva serve as strong points of attraction for the
male sex. While the entire female body is attractive to the male, and
vice versa, there are certain zones which are especially attractive or
exciting. Such zones or areas are called _erogenous zones_--the word
erogenous means love-generating. The vulva and the mons Veneris are
the strongest erogenous zones; other erogenous zones are the lips, the
breasts, etc.

=Function of the Breasts.= The function of the breasts is to nurse or
suckle the young on the mother's milk until they are able to live on
other food. The other name for breasts is mammary gland (in Latin,
mamma--breast), and all animals who suckle their young are called
mammals or mammalia. Besides its milk secreting function, the breasts
constitute a strong erogenous zone; they are a point of strong
attraction for the male sex, many men being more attracted by
well-developed breasts than by a pretty face. There is a good
biological reason for this. Well developed breasts indicate that the
other sexual organs are well developed and that the woman will make a
satisfactory wife and satisfactory mother. Considering then the
importance of the breasts in attracting a husband and their function
in nursing the young, also their erogenous properties, it is perfectly
proper to class them among the reproductive organs.


SUBCHAPTER C

THE ORGASM

The culmination of the act of sexual intercourse is called the orgasm.
It is the moment at which the pleasurable sensation is at its highest
point, the body experiences a thrill, there is a spasmodic contraction
in the genital organs, and there is a secretion of fluid from the
genital glands and mucous membranes. This fluid in women is not a
vital fluid like the semen in man; it is merely mucus, and in some
women it is very slight in amount or altogether absent. Adult women
who live without sexual relations occasionally have sexual or erotic
dreams; that is, they dream that they are in the company of men,
playing or having relations with them. Such dreams are usually
accompanied by an orgasm or an orgastic feeling, and by a discharge of
mucus, the same as in sexual intercourse. Such a discharge of mucus
during sleep is called an emission or pollution.

In the male sex pollutions play an important rôle (see the author's
"Sex Knowledge for men"), because the semen is a vital fluid, and if
it is lost too frequently the system is put under a heavy drain. In
boys and men the pollutions or night losses may occur several times a
week or even every night, or several times a night. When they occur
with such frequency the man may become a wreck. Not so with women.
First, pollutions or night dreams in women are much more rare than
they are in men; and second, as just mentioned, the fluid secreted by
woman during intercourse or during an erotic dream is not of a vital
character, as the semen is in man; it is mucus, and the secretion of a
mucous fluid, even if somewhat excessive, does not constitute a drain
on the system. For this reason women can stand frequently repeated sex
relations and emissions or pollutions much better than men can.


SUBCHAPTER D

THE SECONDARY SEX CHARACTERS

The sex organs constitute the primary sex characters. It is they that
distinguish primarily one sex from another. But there are numerous
other sex characters or sex differences which while not so important
serve to differentiate the sexes, at the same time forming points of
attraction between one sex and another. For instance, the beard and
mustache are a distinct male characteristic and constitute one of the
secondary male sex characters. The secondary sex characters are very
numerous; one might say that each one of the billions of cells in the
body bears the impress of the sex to which it belongs.

First, the skeleton. The entire female skeleton differs from the male
skeleton; all the bones are smaller and more gracile; the pelvis, as
we have seen before, is shallower and wider. Then the muscles are
smaller and more rounded. The entire contour of the body is rounded
rather than angular as in man. The skin is finer, softer, more
delicate. The hair on the head is longer and of a finer texture, while
over the body the hair is also finer and less abundant. The voice is
finer, more pleasant, and of a higher pitch (soprano). The breasts are
well developed, and serve an important purpose, while in men they are
rudimentary. The breathing is also different; woman breathes
principally with the upper part of the chest, man with the lower. The
brain is smaller and its convolutions somewhat less complex in woman.

Woman differs considerably from man not only physically, as we have
seen, but also mentally and emotionally. But into this phase of the
subject we will not enter, except to remark that it is foolish to
speak of the superiority or inferiority of one sex to another. In some
respects man is greatly superior to woman, in others he is inferior;
on the whole the sexes balance one another pretty well, and while the
sexes are not and never will be exactly alike, we have no right to
speak of the inferiority of one sex to another. We recognize that the
sexes are different, but they complement one another, and the claim of
the reactionary and of the woman-hater that woman is an inferior
creature is just as senseless as is the claim made by some
ultra-militant feminists that woman is the superior and man the
inferior.

FOOTNOTES:

[3] The ovum is really the fully mature egg ready for fecundation;
before maturity it should not be called ovum but oöcyte; and in
advanced treatises it is so referred to. But here ovum will do for
both the unripe and ripe egg.




CHAPTER FOUR

THE SEX INSTINCT

 Universality of the Sex Instinct--Not Responsible for Our Thoughts
  and Feelings.


THE sex instinct, which runs all through nature from the lowest animal
to the highest, is the inborn impulse, craving or desire which one sex
has for the other: the male for the female and the female for the
male. This instinct, this desire for the opposite sex, which is born
with us and which manifests itself at a very early age, is not
anything to be ashamed of. There is nothing disgraceful, nothing
sinful in it. It is a normal, natural, healthy instinct, implanted in
us by nature for various reasons, and absolutely indispensable for the
perpetuation of the race. If there were anything to be ashamed of, it
would be the lack of this sex instinct, for without it the race would
quickly die out.

=Not Responsible for Thoughts and Feelings.= It is necessary to
impress this point, because many girls and women, whose minds have
been perverted by a vicious so-called morality, worry themselves to
illness, brood and become hypochondriac because they think they have
committed a grievous sin in experiencing a desire for sexual relations
or for the embrace of a certain man. Altogether it is necessary to
impress upon the growing girl, when the occasion presents itself, that
a thought or a feeling can never be sinful. An action may be, but a
thought or a feeling cannot. Why? Because we are not responsible for
our thoughts and feelings; they are not under our control. Though it
does not mean that when they do arise we are to give them full sway.
We should attempt to combat them and drive them away, but there is
nothing to be ashamed of, because for their origin we are not
responsible.

=Responsible for Actions.= Our actions are under our control, to a
certain extent at least, and if we do a bad or injurious act, we have
committed a sin and are morally responsible. The _desire_ for the
sexual act is no more sinful than the desire for food is when one is
hungry. But the performance of the act may, under certain
circumstances, be as sinful as the eating of food which the hungry man
obtained by robbing another fellow-being, just as poor as himself.

I am not preaching to you. But I am not an extremist nor a hypocrite.
I am advocating neither asceticism nor licentiousness. One is as bad,
or almost as bad, as the other.

What I am trying to do is to inculcate in your minds, if possible, a
sane, well-balanced view of all things sexual.

For I believe that wrong, perverted views of the physiology and
hygiene of the sex act and of sex morality, that is, the proper
relationship of the sexes, are responsible for untold misery, for
incalculable suffering. Both sexes suffer, but the female sex suffers
more. The woman always pays more. This is due to her natural
disabilities (menstruation, pregnancy, lactation), to her age-long
repression, to the fact that she must be sought but never seek, and to
her economic dependence.

For the above reasons, sex instruction is a matter of double
importance to woman--this fact has been emphasized in the first
chapter. But woman's disabilities impose upon us another duty:
_because_ she carries the heaviest burden, _because_ she always pays
more dearly than the man, it becomes incumbent upon man to treat her
with special consideration, with genuine kindness and chivalry.




CHAPTER FIVE

PUBERTY

 Physical Changes in Puberty--Physical Changes in the Genital
  Organs and in the Rest of the Body--Psychic Changes--Puberty and
  Adolescence--Nubility.


Puberty is the most wonderful, the most significant period in a girl's
life. Important as it is in a boy's life and development, it is still
more so in a girl's. At this period there are often laid the
foundations which either make or mar the girl's future life.

The meaning of the word puberty is maturity. It is the period at which
the girl and the boy reach sexual maturity; in other words, the period
at which the sex glands of the boy begin to generate spermatozoa, and
the sex glands of the girl begin to mature and expel eggs or ova; with
the girl puberty is marked by an additional phenomenon, which has no
analogue in the boy, namely, menstruation.

=Physical Changes.= The word puberty is derived from the word _puber_,
which in Latin means mature, ripe. But the word puber is itself
derived from the word _pubes_, which in Latin means fine hair or
down. For at this period of maturity all mammals (that is animals
which have breasts and nurse their young) begin to develop a growth of
hair. You know that our entire body, with the exception of the palms
of the hands and the soles of the feet, is covered with innumerable
hair follicles, and from our birth our entire body, with the exception
named, is covered with fine hair. The hair may be too delicate to be
seen, but it is there, and with a magnifying glass you can see it
without any trouble. But at puberty the hair increases in thickness
and in quantity, and becomes abundant in places where it was hardly
noticeable before--the upper lip and face in boys, and the armpits and
lower part of the abdomen in both boys and girls.

And so the first apparent physical sign of puberty in a girl is the
gradual appearance of hair in the armpits, on the mons Veneris and the
labia majora. But all the genital organs are undergoing rapid
development; the vulva, the vagina, the uterus and the ovaries become
larger, and the ovaries which up to that time were elaborating an
internal secretion only, now also begin to manufacture ova; in other
words, the monthly process of ovulation is begun. Synchronously with
the process of ovulation, there commences the monthly function of
menstruation. The breasts also increase in size, assume the
characteristic contour, develop their glandular substance, and become
capable of secreting milk for the use of any possible offspring.
During this period of development they are often very sensitive to the
touch or feel painful without being touched.

But not only the genital organs undergo growth and development--the
entire body participates in the process. The growth in height is the
most rapid at this period; the greatest growth takes place in the
limbs--legs and arms. The pelvis becomes broader, and the chest or
thorax also becomes broader and larger. The muscles become larger and
rounder and finally give the girl the beautiful womanly form.

=Psychic Changes.= But the changes are not only physical; the changes
that take place in the girl's psychic sphere during the pubertal years
are also highly important. That is the period of the development of
the emotions; she is overflowing with emotion; she becomes sensitive;
in her relations with boys and men she becomes self-conscious.
Distinct sexual desire fortunately does not make its appearance in the
girl at this period, as it does in the boy, but she becomes filled
with vague undefined and undefinable longings. It is the period of
"crushes" when the girl is apt to bestow her overflowing emotion on a
girl friend. There is nothing reprehensible in these crushes--they
act as a safety valve--and only in rare cases are they apt to lead to
abnormal development. This is also the period of day-dreaming and of
romancing; the girl likes to read love-stories and novels in which she
identifies herself with the heroine. And it makes quite some
difference as to what the girl reads during this period, for
literature has a strong influence on the young in the most plastic
period of their lives; and it is important that older persons see to
it that those in their care spend their time on books of noble ideals
and high artistic value.

Girls of a highly sensitive or so-called "nervous" temperament,
especially if there is "nervousness" in the family, must be
particularly looked after. For it is during the years of puberty and
adolescence that any neurotic traits are apt to develop and become
emphasized. It is also the period when bad sexual habits
(masturbation) are apt to develop, and the careful mother will devote
special attention to her girls in their years of puberty, and guard
them as much as possible against physical and emotional shocks.

The age of puberty in girls is by many writers considered as
synonymous or synchronous with the onset of menstruation, which in
this country in the majority of cases occurs between the ages of
thirteen and fourteen. The year of gradual development before the
onset of menstruation is by some referred to as the pre-pubertal year;
and the first year after the onset of menstruation is the
post-pubertal year. The period from puberty to full sexual maturity is
called adolescence, and this term is applied generally to the period
between thirteen and eighteen. For at eighteen the boy and the girl
have reached full maturity. Mentally we acquire things as long as we
live, and even physically the body gets larger for some years after
eighteen. But sexually both boys and girls are fully mature at
eighteen, though in order to become parents it is best, for various
reasons, to wait to the ages of twenty or twenty-five.

=Nubility.= Nubility is the age or state when a boy or a girl is "fit"
for marriage. This is a vague and unsatisfactory term. At the age of
thirteen to fifteen boys and girls are physically "fit" for marriage,
that is at that age a boy is capable of begetting and a girl of having
children. But it does not mean that it would be advisable for them to
marry at such an early age. Neither their bodies nor their minds are
fully developed, and children begotten of such young parents are apt
to be weaklings, both mentally and physically. The youngest age for
girls to marry should be eighteen, and for boys twenty; but the
youngest age for becoming parents should be twenty to twenty-two for
the mother and twenty-three to twenty-five for the father.




CHAPTER SIX

MENSTRUATION

 Definition of Menstruation--Where Menstrual Blood Comes From--Age
  of Menstruation--Age of Cessation of
  Menstruation--Duration--Amount--Regularity and Irregularity.


The first function with which the girl will be confronted, which will
impress upon her that she is a creature of sex, that she is decidedly
different from the boy, is _menstruation_. And this function we will
now proceed to study.

What is menstruation? Menstruation is a monthly discharge of blood.
The word is derived from the Latin word mensis, which means a month;
and menstruation is also frequently spoken of as _the menses_. It is
also called the catamenia or catamenia-flow (Greek, kata--by, men--a
month). Other terms are: the periods, courses, monthlies, turns,
monthly changes, monthly sickness, sickness, flowers, to be unwell, to
be regular. "Not to see anything" is a common term for having missed
the menses. This flow of blood recurs in most cases with remarkable
regularity once a month; not a calendar month, but once a lunar month,
i.e., once every twenty-eight days. And as there are thirteen lunar
months a year, a woman menstruates not twelve but thirteen times a
year.

Where does the menstrual blood come from? The menstrual blood comes
from the inside of the womb. Every month, for a few days prior to
menstruation, the inside lining of the womb (what we call the mucous
membrane or endometrium) becomes congested and its bloodvessels become
distended with blood. If the woman has sexual intercourse and
pregnancy happens to take place, then this extra blood is used to
nourish and develop the new child; but if no pregnancy takes place,
that extra blood exudes from the bloodvessels (some of the
bloodvessels rupture) and is discharged from the uterus into the
vagina, and from there to the outside, where it is caught on cotton,
sanitary napkins or some other pad.

=At what age does menstruation begin?= The usual age at which
menstruation begins in this country is thirteen or fourteen; in some
it may occur as early as twelve, in others as late as fifteen, sixteen
or even seventeen. For menstruation to begin earlier than twelve or
later than seventeen is in this country a rare exception. But in cold
northern climates the age of eighteen is not rare, and in the hot
southern climates menstruation often starts at the ages of ten or
eleven. Change of climate or of country will often have an influence
on the menses. In the early years of his medical practice, the author
had many Finnish girls as patients. It was a very common occurrence
for them to stop menstruating for the first few months or even for the
first year of their residence in this country.

=At what age does menstruation cease?= The age at which menstruation
ceases is called the _menopause_ or _climacteric_. It usually takes
place at the age of forty-eight or fifty. In some cases it does not
take place until the age of fifty-two, in others it takes place as
early as forty-five or forty-four. In general, it may be said that the
woman's menstruating period, during which she is able to have
children, lasts about thirty-five years. And if no restraint be taken,
and if no precautions be taken against conception, a woman could have
twenty or thirty children during her childbearing period.

=How many days does a woman menstruate?= The usual number of days is
from three to five; in some cases menstruation lasts only two days, in
others as long as seven. As a rule, the greatest amount of blood
passed is during the first two days.

=The amount of blood.= It is hard to estimate the exact amount of
blood passed by a woman during her menses, but it reaches about an
ounce and a half to three ounces. In some women the amount may reach
as much as four or five ounces and in exceptional cases as much as
eight ounces. Where it exceeds this amount, it is an abnormal
condition, requiring treatment. The usual statement that a normally
menstruating woman should not have to use more than three napkins
during the twenty-four hours is correct.

_The periodical regularity_ with which menstruation recurs in many
women is remarkable. I know a woman who has not missed her menses in
twenty years; during those twenty years the menses have started every
fourth Friday, almost always at the same hour. I know another one who
has her menses every fourth Wednesday, about seven in the morning. She
skipped her periods during her two pregnancies, then they were
irregular for a while, then they came back to Wednesday. Other women
have their menses on a certain day of the month, say the first or the
fifth, regardless of the number of days in the month (such cases are,
however, exceptional). And in some women the menses are irregular:
every three weeks, every five or six weeks, every six or seven weeks,
etc. Some women never know when they may expect their menses, so
irregular they are.




CHAPTER SEVEN

ABNORMALITIES OF MENSTRUATION

 Disorders of Menstruation--Menorrhagia--Metrorrhagia--Amenorrhea--
  Vicarious Menstruation--Dysmenorrhea of Organic and of Nervous
  Origin.


In many girls and women menstruation is a perfectly normal,
physiological process. They suffer no discomfort whatever from it.
They suffer no pains, no headache, no irritability, they have no
admonition of its onset, until they feel the blood oozing or trickling
out. But, unfortunately, this is true only of a small percentage. The
majority of women have some unpleasant symptoms. Some have a headache
for a day or two, some complain of a dragging down sensation, some are
irritable, feel depressed or quarrelsome; some have no appetite, no
ambition, no desire for work or company, while some girls have such
severe pains and cramps that they are obliged to go to bed for a day
or two and call in medical aid.

When the menstruation is very profuse, resembling more a hemorrhage
than normal menstruation, it is called _menorrhagia_; if the
hemorrhage from the uterus occurs out of the regular menstrual
periods, it is called _metrorrhagia_. When the menses are skipped, or
when they are so scanty that you can hardly notice any blood, we use
the term _amenorrhea_. In a few rare cases the menstruation instead of
coming normally from the uterus, comes from some other part of the
body, for instance, the nose. Some women have a hemorrhage from the
nose every month. In some a bloody discharge may come from the
breasts. To such a substitute menstruation we apply the term
_vicarious menstruation_. Such cases, however, are rare, and are mere
curiosities.

=Dysmenorrhea.= I mentioned before that in some girls and women the
menses are accompanied by pains and cramps. This affliction, which is
the lot of millions of women, and from which men are entirely free, is
called _dysmenorrhea_. Dysmenorrhea means painful and difficult
menstruation. A slight pain or at least a feeling of discomfort is
present in most cases of menstruation. But in many cases the pain is
so severe, so _excruciating_, that the sufferer, girl or woman, is
incapacitated for any work, and must go to bed for a day or two. In
some cases the pain is so severe as to necessitate the use of
morphine, and as it is a very bad thing to have to give morphine every
three or four weeks, every endeavor should be made to find out the
cause of the trouble and to remove it. It is a mistake, however, to
think that all or even most cases of dysmenorrhea are due to some
local trouble, that is, to an inflammation of the ovaries, or a
displacement of the womb. Many cases of dysmenorrhea are of _nervous_
origin; the cause resides in the central nervous system, and not in
the genital organs themselves. It is, therefore, not advisable to
undertake any local treatment, unless a competent physician has made a
thorough examination and has decided that local treatment is
advisable.

As to the percentage of dysmenorrhea, a recent statistical examination
of 4,000 women showed that dysmenorrhea of some degree was present in
over one-half, namely, 52 per cent.




CHAPTER EIGHT

THE HYGIENE OF MENSTRUATION

 Lack of Cleanliness During Menstrual Period--Superstitious
  Beliefs--Hygiene of Menstruation.


The hygiene of menstruation can be expressed in two words: cleanliness
and rest. Common sense would suggest these two measures, and as far as
rest is concerned, many women do rest or take it easy while they are
unwell. Some are forced to do it, because, if they don't, their
dysmenorrhea is worse and the amount of blood they lose is
considerably increased. The same cannot be said of cleanliness. Due
undoubtedly to the superstitious opinions about menstruation, which
came over to us from the ages-of-long-ago, menstruation is still
considered a _noli-me-tangere_, and women are afraid to bathe, to
douche or even to wash during the periods. And if there is any period
when a woman needs a douche it is during menstruation. Any leucorrhea
that a woman may be suffering from becomes aggravated around the
periods; the menstrual blood of some women has a decided odor, and if
no cleansing douche is taken during four or five days, some of the
blood decomposes and acquires a decidedly offensive odor, which can be
noticed at some distance and to which some men and women are very
susceptible. There are some women who never take a vaginal douche.
Some consider it a useless and unnecessary luxury; while some orthodox
puritanical women consider it an ungodly procedure (forgetting that
cleanliness is next to godliness) fit only for women of gay and
questionable character. If these orthodox women knew what was good for
them--and for their health--they would take a douche at least during
menstruation, if at no other time.

=Cleanliness.= When the girl reaches the age of twelve or thirteen the
mother should explain to her the phenomenon of menstruation and the
likelihood of its making its appearance in a short time. Of course she
should be told that there is nothing shameful in it, that when it
makes its appearance she should at once tell her mother, who will
instruct her what to do. She should be shown the use of sanitary
napkins. Rags, unless recently washed and kept wrapped up and
protected from dust, should not be used. Unclean rags may lead to
infection. I have no doubt that many cases of leucorrhea date back
their origin to unwashed rags. Every morning and every evening the
girl should wash the external genitals with warm water, or plain soap
and water. Married women should also take a douche once a day--the
douche may consist of two quarts of water in which has been dissolved
a teaspoonful of common table salt, or a tablespoonful of borax or
boric acid. Such things like alum, potassium permanganate, carbolic
acid, lactic acid, or tincture of iodine should only be used when
there is leucorrhea present and generally only under a physician's
directions. Bathing is permissible, but it is safe to use only a
lukewarm bath. Cold tub baths, cold shower baths, as well as ocean and
river bathing are best avoided during the period; at least during the
first two days. I do not give this as an absolute rule; I know women
who bathe and swim in the ocean during their menstrual periods without
any injury to themselves, but they are exceptionally robust women;
advice in books is for the average person, and it is always best to be
on the safe side.

=Rest.= Rest is just as important during menstruation as cleanliness,
if not more so. Some women as mentioned before feel during their
menses just as well as they do at other times, and do not need any
special hygiene. But these are in the minority. Most girls and women
do feel somewhat below par during that period, and it is very
important that they take it easy, particularly during the first two
days. It is an outrage that many delicate, weak girls and women must
stay on their feet all day or work on a machine when they should be at
home in bed or lying down on a couch.

The womb is congested during the period, is larger and heavier than
normal, and it is then that there is often laid the foundation for
some future uterine disease, the well-known "womb trouble," or "female
disease." It is not necessary that work be given up altogether, but
there certainly should be less of it and there should be as much rest
as possible. For delicate and sensitive girls it is always best to
stay away from school during the first and second days. Speaking again
of the average and not the exception, it is best that dancing, bicycle
riding, horseback riding, rowing, and other athletic exercises be
given up altogether during the menses. Automobile riding and railroad
and carriage travelling prove injurious in some instances, greatly
increasing the flow of blood. But these are the exceptions at the
other extreme.




CHAPTER NINE

FECUNDATION OR FERTILIZATION

 Fecundation or Fertilization--Process of Fecundation--When the
  Ovum Matures--Fate of Ovum When no Intercourse Has Taken
  Place--Entrance of Spermatozoa as Result of Intercourse--The
  Spermatozoa in Search of the Ovum--Rapidity of Movements of
  Spermatozoa--Absorption of Spermatozoön by Ovum--Activity of
  Impregnated Ovum in Finding Place to Develop--Pregnancy in the
  Fallopian Tube and Its Dangers--Twin Pregnancy--Passivity of Ovum
  and Activity of Spermatozoön Foretell the Contrasting Rôles of
  the Man and the Woman Throughout Life.


Fecundation and fertilization are important terms to remember. They
stand for the most important phenomenon in the living world. Without
it there would be no plants and no animals, excepting a few very low
forms of no importance, and of course no human beings.

=Fecundation= or fertilization is the process of union of the female
germ cell with the male germ cell; speaking of animals, it is the
process of union of the egg or ovum of the female with the
spermatozoön of the male. When a successful union of these two cells
takes place a new being is started. The process of fertilization or
fecundation is also known as impregnation and conception. We say, to
fertilize (chiefly, however, when speaking of plants) or to fecundate
an ovum, or to impregnate a female or woman, and to conceive a child.
We say the woman has become impregnated or has conceived.

_The Process._ The process of fecundation is briefly as follows. An
ovum becomes mature, breaks through its Graafian follicle in the ovary
and is set free. It is caught by the fimbriated or trumpet-shaped
extremity of the Fallopian tube and, moved by the wave-like motion of
the cilia[4] of the lining of the tube, it begins its travel towards
the uterus. If no sexual intercourse has taken place nothing happens.
The ovum dries up, or "dies," and either remains somewhere in the tube
or womb or is removed from the latter with the menstruation, or mucous
discharge. But if intercourse has taken place, thousands and thousands
of the male germ cells or spermatozoa enter the uterus through its
opening or external os, and begin to travel upward in search of the
ovum. The spermatozoa are capable of independent motion, and they
travel pretty fast. It is claimed that they can travel an inch in
seven minutes, which is pretty fast when you take into consideration
that a spermatozoön is only 1/300 of an inch long. Many of the
spermatozoa, weaker than the others, perish on the way, and only a few
continue the journey up through the uterus to the tube. When near the
little ovum, which remains passive, their movements become more and
more rapid, they seem to be attracted to it as if by a magnet, and
finally one spermatozoön--just one--the one that happens to be the
strongest or the nearest, makes a mad rush at it with its head,
perforates it, and is completely swallowed up by it. As soon as the
spermatozoön has been absorbed by the ovum, the opening through which
it got in becomes tightly sealed up--a coagulation takes place near
it--so that no other spermatozoa can enter the ovum. For if two or
more spermatozoa got into the same ovum a monstrosity would be apt to
be the result.

    [Illustration: SPERMATOZOÖN PENETRATING THE OVUM.]

What becomes of all the other spermatozoa? They perish. Only one is
needed. But in the ovum that has been impregnated, and which is now
called an embryo, a feverish activity commences. First of all it looks
for a fixed place of abode. If the ovum happened to be in the uterus
when the spermatozoön met and entered it, it remains there. It becomes
attached to some spot in the lining of the womb and there it grows and
develops, until at the end of nine months it has reached its full
growth, and the womb opens and it comes out into the outside world. If
the ovum is in the Fallopian tube when the spermatozoön meets it, as
is usually the case, it travels down to the uterus, and fixes itself
there.

=Extra-Uterine Pregnancy.= The tube is a bad place for the ovum to
grow and develop, because the tube cannot stretch to such an extent as
the uterus can, nor can it furnish the embryo such good nourishment as
the uterus can. Occasionally, however, it happens that the impregnated
ovum remains in the tube and develops there; we then have a case of
what we call _extra-uterine_ (outside-of-the-uterus) or _tubal_
pregnancy. Extra-uterine pregnancy is also called _ectopic_ pregnancy,
or ectopic gestation. Unless diagnosed early and operated upon, the
woman may be in great danger, for after a few weeks or months the tube
generally ruptures.

From the moment the spermatozoön has entered the ovum, a process of
_division_ or _segmentation_ commences. The ovum, which consists of
one cell, divides into two, the two into four, the four into eight,
the eight into sixteen, these into thirty-two, these into sixty-four,
128, 256, 512, 1,024, until they can no longer be counted. This
mulberry mass of cells arranges itself into two layers, with a cavity
in between. And from these layers of cells there develop gradually all
organs and tissues, until a fully formed and perfect child is the
result. If two ova are impregnated at the same time by two
spermatozoa, the result is twins.[5]

I might mention here that the moment the ovum is impregnated, i.e.,
joined by a spermatozoön, it is called technically a zygote; it is
also called embryo, and this name is applied to it until the age of
five or six weeks. Some use the term embryo up to two or three months.
After that, until it is born, it is called fetus.

A study of the development of the embryo and the formation of the
various organs from one single cell, the ovum, vitalized or fecundated
by another single cell, the spermatozoön, is the most wonderful and
most fascinating of all studies. But that belongs to the domain of
Embryology, which is a separate science.

What we see in the process of fecundation is a foreshadowing of the
future man and woman. The ovum has no motion of its own, it is moved
along by the wave-like motions of the lining cells of the Fallopian
tube, and throughout the entire act it remains passive. The
spermatozoön, on the other hand, is in a state of continuous activity
from the moment it has been ejaculated by the male until it has
reached its goal--the ovum. And as the spermatozoa carry in them the
entire impress of the man, and the ova of the woman, they foretell us
the fates of the future boy and girl. The woman's rôle throughout life
is a passive and the man's an active one. And in choosing a mate the
man will always be the active factor or pursuer. So biology seems to
tell us. Whether education--using the word in its broadest sense--will
effect a radical change in the relation of man and woman remains to be
seen. A change putting the man and the woman on a footing of
_equality_ would be desirable; but whether biological differences
having their roots in the remotest antiquity can be obliterated, is a
question the answer of which lies in the distant future. As Geddes and
Thomson so well said: The differences [between the sexes] may be
exaggerated or lessened, but to obliterate them it would be necessary
to have all the evolution over again on a new basis. What was decided
among the prehistoric Protozoa cannot be annulled by act of
Parliament.

FOOTNOTES:

[4] Hair-like appendages.

[5] Each ovum has one germinal vesicle; occasionally one ovum may
contain two germinal vesicles; and from the impregnation of such an
ovum a twin pregnancy may result.




CHAPTER TEN

PREGNANCY

 Period of Pregnancy in Human Female--Physiologic Process of
  Pregnancy--Growth of Embryo from Moment of Conception--Pregnant
  Woman Provides Nourishment for Two--Her Excreting Organs Must
  Work for Two.


From the moment the ovum has been fertilized or fecundated by the
spermatozoön, the woman is said to be pregnant (or in French
_enceinte_. This term was used very frequently and is still used by
prudes, who seem to consider the word pregnant vulgar and
disgraceful). Pregnancy, or the period of gestation, lasts from the
moment of conception to the moment that the fetus or child is expelled
from the uterus. The period of pregnancy differs very widely in
different animals,[6] but in the human female it lasts nine calendar
months or ten lunar months--from about 274 to 280 days. We usually
count 280 days from the _first_ day of the _last_ menstruation. A
pregnant woman generally wants to know the day of the expected
confinement--for this purpose a table is appended to this chapter. If
you know the first day of your last menstruation, you will see at a
glance when the confinement may be expected. There may be a difference
of a few days--either before or after the expected date--but for
practical approximate purposes the tables serve very well.

A simple way is to count back three months and add seven days. For
instance, a woman's last menstruation occurred on April 4th; counting
back three months gives you January 4th; add seven days and you get
January 11th, the probable date of delivery. The first day of the last
menstruation was December 30th; counting back three months gives you
September 30th; add seven days and you get October 6th, the probable
date of delivery. The presence of a short month like February may be
disregarded, as the calculation is not absolutely, but only
approximately correct.

The period at which the child's movements begin to be felt by the
mother is termed Quickening. It usually occurs at the middle of the
pregnancy, between the 16th and 18th week.

Pregnancy is a normal physiological process; but every active
physiological process is apt to be accompanied by disturbances, and
there is certainly no process in the animal body in which greater
activity, greater changes, go on than during the process of pregnancy.
Just see what occurs in nine months. The uterus, at first the size of
a small pear, reaches a size larger than that of the head of a big
man; it does not merely stretch, as some think, but it actually grows
enormously in size, the muscular walls of a pregnant uterus being many
times thicker than those of a non-pregnant one. They have to be or
they would not have the strength to expel the child, when the proper
time comes. It is to be borne in mind that the child does not slip out
by itself; it is the powerful muscular contractions of the uterus that
push it out. If the uterus should refuse to work, if its walls were
too thin or too weak, the child could not come out, but would have to
be taken out with forceps. Still greater changes than in the uterus
take place in the child itself. At the moment of conception it is the
size of _the head of a pin_; at the moment of birth it weighs from
seven to ten pounds; at the moment of conception it is a minute,
undifferentiated mass of protoplasm, just a single fertilized cell; at
the moment of birth it consists of millions and millions of cells,
which have become differentiated into numerous harmoniously working
organs, and different tissues, such as brain and nerve tissue,
muscular tissue, connective tissue, bone, cartilage, etc., etc. A
truly wonderful process. And in the meantime this child, which is
biologically a parasite (though it is not a nice name to call it by)
draws its sustenance from the mother's blood, and the mother has to
provide nourishment for two. And, besides providing nourishment, her
excreting organs, her kidneys, must work for two, because her system
has also to get rid of the child's excretions. No wonder that the
pregnant woman, particularly under an artificial unhealthy mode of
living, is subject to many troubles and disturbances.


DR. ELY'S TABLE FOR CALCULATING THE DATE OF CONFINEMENT

---------+-----------------------------------------------
January  | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
OCTOBER  | 8  9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 |
                   24 25 26 27 28 29 30 31  1  2  3  4  5  6  7 |NOV.
                  ----------------------------------------------+-----

---------+-----------------------------------------------
February | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
NOVEMBER | 8  9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28          |
                   24 25 26 27 28 29 30  1  2  3  4  5          |DEC.
                  ----------------------------------------------+-----

---------+-----------------------------------------------
March    | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
DECEMBER | 6  7  8  9 10 11 12 13 14 15 16 17 18 19 20 21
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 |
                   22 23 24 25 26 27 28 29 30 31  1  2  3  4  5 |JAN.
                  ----------------------------------------------+-----

---------+-----------------------------------------------
April    | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
JANUARY  | 6  7  8  9 10 11 12 13 14 15 16 17 18 19 20 21
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30    |
                   22 23 24 25 26 27 28 29 30 31  1  2  3  4    |FEB.
                  ----------------------------------------------+-----

---------+-----------------------------------------------
May      | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
FEBRUARY | 5  6  7  8  9 10 11 12 13 14 15 16 17 18 19 20
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 |
                   21 22 23 24 25 26 27 28  1  2  3  4  5  6  7 |MAR.
                  ----------------------------------------------+-----

---------+-----------------------------------------------
June     | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
MARCH    | 8  9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30    |
                   24 25 26 27 28 29 30 31  1  2  3  4  5  6    |APRIL
                  ----------------------------------------------+-----

---------+-----------------------------------------------
July     | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
APRIL    | 7  8  9 10 11 12 13 14 15 16 17 18 19 20 21 22
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 |
                   23 24 25 26 27 28 29 30  1  2  3  4  5  6  7 |MAY
                  ----------------------------------------------+-----

---------+-----------------------------------------------
August   | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
MAY      | 8  9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 |
                   24 25 26 27 28 29 30 31  1  2  3  4  5  6  7 |JUN.
                  ----------------------------------------------+-----

---------+-----------------------------------------------
September| 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
JUNE     | 8  9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30    |
                   24 25 26 27 28 29 30  1  2  3  4  5  6  7    |JULY
                  ----------------------------------------------+-----

---------+-----------------------------------------------
October  | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
JULY     | 8  9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 |
                   24 25 26 27 28 29 30 31  1  2  3  4  5  6  7 |AUG.
                  ----------------------------------------------+-----

---------+-----------------------------------------------
November | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
AUGUST   | 8  9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30    |
                   24 25 26 27 28 29 30 31  1  2  3  4  5  6    |SEPT.
                  ----------------------------------------------+-----

---------+-----------------------------------------------
December | 1  2  3  4  5  6  7  8  9 10 11 12 13 14 15 16
SEPTEMBER| 7  8  9 10 11 12 13 14 15 16 17 18 19 20 21 22
---------+-----------------------------------------------
                  ----------------------------------------------+-----
                   17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 |
                   23 24 25 26 27 28 29 30  1  2  3  4  5  6  7 |OCT.
                  ----------------------------------------------+-----

EXPLANATION.--Find in top line the date of menstruation, the figure
below will indicate the date when confinement may be expected, _i.e._,
if date of menstruation is June 1st, confinement may be expected on
March 8th, or one day earlier if leap year.

FOOTNOTES:

[6] For instance, in rabbits one month, in dogs two months, in sheep
five months, in cows nine months, in horses eleven months.




CHAPTER ELEVEN

THE DISORDERS OF PREGNANCY

 Smooth Course of Pregnancy in Some Women--Pregnancy and
  Parturition May be Made Normal Processes Through Education in
  True Hygiene--Morning Sickness and Its Treatment--Necessity for
  Medical Advice in Pernicious Vomiting--Anorexia--Bulimia--Aversion
  Towards Certain Foods--Peculiar Cravings--Tendency to Constipation
  Aggravated by Pregnancy--Dietary Measures in Constipation--Rectal
  Injections in Constipation--Laxatives--Cause of Frequent Desire to
  Urinate During First Two or Three and Last Months of Pregnancy--
  Treatment of Frequent Urination--Cause of Piles During Pregnancy
  and Their Treatment--Cause of Itching of External Genitals During
  Pregnancy and Treatment--Cause of Varicose Veins and Treatment--
  Liver Spots.


We saw that in some women menstruation runs a perfectly smooth course,
free from any disagreeable symptoms. The same is true of pregnancy. It
is remarkable how smooth and easy the entire course is with some
women. Many women know that they are pregnant only because of the
non-appearance of the monthly periods; and even in the later months
they feel no discomfort, attending to all their work and pleasures as
usual; and even childbirth is a trifling matter with them.
Unfortunately the number of such women is not very large, and,
because of our confined, unnatural, often exhausting way of living,
is becoming smaller and smaller. There is no question that the
civilized, refined woman has a harder ordeal in pregnancy and
childbirth than has her primitive sister. We confidently hope that
this will not be so in the future; we expect the time to come when
true hygiene will be an integral part of the education and the life of
every girl, and then pregnancy and parturition may become even easier
processes than they are in the primitive races. But the time is not
yet; and in the meantime our young women have a good deal to go
through.

=Morning Sickness.= One of the commonest disorders of pregnancy is the
so-called morning sickness. This consists in a feeling of nausea and
vomiting, which comes on soon after getting up. The morning sickness
makes its first appearance in the third, fourth or fifth week of
pregnancy and lasts usually until the end of the third or fourth
month. In some women, however, the morning sickness comes on in a few
days after impregnation has taken place, and those women diagnose
their condition unmistakably by the feeling of slight nausea which
they experience on getting up. Medicines are as a rule of little use
in treating morning sickness. The "disease" can be relieved but not
cured. The patient should stay in bed later than usual, should have
her breakfast in bed, and then not get up for about half an hour
afterward. If the patient is anemic, a good iron preparation may prove
useful.

=Pernicious Vomiting.= The vomiting of pregnancy sometimes becomes so
severe and uncontrollable that it has been given the name pernicious.
The patient is unable to retain any kind of food, not even liquids,
vomits almost incessantly, and may become very much run down and
exhausted. The vomited matter may contain blood. For this condition a
competent physician must be consulted, for in some cases the patient's
life may be in danger and an abortion has to be performed.

=Capricious Appetite.= A capricious appetite is very common in
pregnancy. The capriciousness may express itself in four different
directions: (1) The patient may lose her appetite, almost altogether,
partaking only of very little food, and that with effort. This
condition of loss of appetite is called anorexia. (2) The patient may
develop an enormous appetite--what we call bulimia--eating several
times as much as she does ordinarily. (3) She may develop an aversion
towards certain articles of food. Thus many women develop an aversion
towards meat, the mere sight of or talk about meat causing in them a
sensation of nausea. (4) She may show a craving for the most peculiar
articles of food and for articles which are not food at all. The
craving for sour pickles or sour cabbage is well-known; but some women
will eat chalk, sand, and even more peculiar things (for the chalk
there may be a reason: the system needs an extra amount of lime and
chalk is carbonate of lime).

=Constipation.= Constipation is very common among women in the
non-pregnant condition; but in the pregnant it is much more common and
much more aggravated. Constipation must be guarded against, but the
measures must be of a mild nature. If we can relieve the constipation
by dietary measures alone, so much the better. The dietary measures
should consist in eating plenty of fruit--prunes, apples, figs, dates,
etc., and coarse bread and bran. Constipating articles, such as cheese
or coffee, should be eliminated. Where dietary measures alone are
insufficient, the patient should take an enema--a rectal
injection--twice or three times a week. The enema should consist of
about 8 ounces (half a pint) of cold or lukewarm water containing a
pinch of salt, and should be retained about ten minutes. Instead of
water, we may advise an occasional enema of two to four drams of
glycerin. Or instead of a glycerin enema, a glycerin suppository may
be used. If internal laxatives are to be used, only the mildest and
non-griping preparations should be employed The best are: a good
mineral oil--one or two tablespoonfuls on going to bed, or fluid
extract of cascara sagrada, one-half to one teaspoonful on going to
bed. It is very important, whatever we use, _not_ to use the same
thing for a long time. If the same drug or measure is used without any
change, the bowels get used to it and cease to respond and we have to
use larger and larger doses. In fighting constipation we must
therefore constantly change our weapons: one night we use mineral oil,
the next night cascara sagrada, the third night an enema, the fourth
night a glycerin injection or suppository, the fifth night perhaps
nothing at all, the sixth night a blue mass pill, the seventh morning
a Seidlitz powder, then a rest for a day or two, then a repetition of
the same measures. But always remember: first try to get along without
any drugs at all. Many cases can get relieved of their constipation by
a proper change in diet alone. And where this is impossible, then use
mild laxatives and use them interchangeably.

=Toothache= is not uncommon in pregnancy, and a pregnant woman should
have her teeth put in first-class condition.

=Difficulty in Urination.= Pregnant women often suffer with frequency
and urgency of urination. Some have to urinate, while they are on
their feet, every few minutes. This is due to the fact that during
the first two or three months of pregnancy the uterus is not only
enlarged but is also _anteverted_, that is _turned forward_ and
_presses down_ upon the bladder. When the woman is lying down the
pressure on the bladder is relieved, and she does not have to urinate
frequently. This pressure lasts only the first two or three months,
because after that the growing womb lifts itself out of the pelvis,
rising into the abdominal cavity; it is no longer anteverted and the
pressure on the bladder is relieved. During the last months of the
pregnancy there is again frequent urination, because then the heavy
uterus sinks again into the pelvic cavity and presses upon the
bladder. The treatment for this frequent urination consists in wearing
a well fitting abdominal belt or corset, which raises the uterus and
prevents pressure on the bladder. Sometimes a pessary which prevents
the anteversion is efficient. In all cases lying down and resting is
useful. In short, keeping off one's feet is the most efficient remedy
for the treatment of frequent urination in pregnant women.

=Hemorrhoids= (Piles). On account of the pressure of the womb on the
rectum, and also on account of the constipation which is so frequent
during pregnancy, hemorrhoids or piles are quite frequent among
pregnant women. The treatment of hemorrhoids consists in removing the
cause: wearing a well-fitting abdominal belt, and relieving the
constipation. Injecting into the rectum about half a pint of cold
water three times a day is very useful. For the intolerable itching
sometimes present in hemorrhoids the following ointment will be found
very grateful: menthol, 5 grains; calomel, 10 grains; bismuth
subnitrate, 30 grains; resorcin, 10 grains; oil of cade, 15 grains;
cold cream, one ounce. The piles (the hemorrhoids) are to be well
cleansed with hot water, and this ointment is to be well smeared over;
a little is pushed into the rectum, and a piece of cotton is put over
the anus. This protects the clothes from soiling and keeps the
medicine in place for a longer time. Instead of ointment a cocoa
butter suppository may be used. A suppository of the following
composition is good: powdered nutgalls, 3 grains; oil of cade, 3
drops; resorcin, 1 grain; bismuth subnitrate, 5 grains; cocoa butter,
20 grains. One such suppository to be inserted three times a day. The
ointment and the suppository given above, if used in conjunction with
the proper regulation of the bowels, will not only relieve but will
cure most cases of hemorrhoids caused by pregnancy.

=Itching of the Vulva. Pruritus Vulvæ.= Itching of the external
genitals during pregnancy is not uncommon. This may be due to the
fact that the vulva is generally congested and swollen during
pregnancy or it may be caused by an increased leucorrheal discharge.
The itching is sometimes very severe, and if the patient scratches
with her nails and produces bleeding, she may cause an infection of
the parts. The patient should be cautioned against scratching; she
should try simple measures to relieve the itching. A small towel or
gauze compress wrung out of boiling water and applied to the vulva
several times a day, followed by a free application of stearate of
zinc powder is often efficient. If it is not, the following salve may
be tried: carbolic acid, 10 grains; menthol, 5 grains; resorcin, 15
grains; zinc oxide, 1 dram; and white vaseline, one ounce. In very
severe cases the vulva should be painted with a solution of silver
nitrate, 25 grains to 1 ounce of distilled water.

=Varicose Veins.= In most women during pregnancy the veins in the legs
become somewhat enlarged. This is due to the pressure of the womb,
which interferes with the circulation. If the veins become very
prominent, swollen and tortuous, they are called varicose. This
condition should be prevented, because it often and to some degree
always persists permanently even after the pregnancy is over. The best
precautionary measure is for the woman to wear a well-fitting
abdominal belt or maternity corset, which supports the womb and does
not permit it to sink too low into the pelvis. If varicose veins have
been permitted to develop, the woman should wear well-fitting rubber
stockings, or at least have the legs bandaged with woven elastic
bandages. The bandage must be applied by a competent person, uniformly
and not too tightly. Constipation has also a bad effect in making
varicose veins worse; the bowels should therefore also be looked
after. In some severe cases all measures are of little value unless
the patient at the same time stays in bed or on a couch for a few
days, with the legs elevated.

Swelling of the feet should be at once attended to. It may be a
trifling matter due only to pressure of the womb; then again it may be
due to some kidney trouble. The physician will determine the true
cause and prescribe the appropriate treatment.

=Liver Spots. Chloasma.= In some cases irregular brownish patches or
splotches develop on the skin around the breasts, on the sides, or on
the face. These patches are known popularly as liver spots or in
medical language as _chloasma_. Nothing can be done for them, but they
generally disappear after the pregnancy is over. A few patches here
and there may remain permanently.




CHAPTER TWELVE

WHEN TO ENGAGE A PHYSICIAN

 Necessity for the Pregnant Woman Immediately Placing Herself Under
  Care of Physician and Remaining Under His Care During Entire
  Period.


The disorders and disturbances described above are, with the exception
of pernicious vomiting, of a minor nature. They are annoying, may
cause considerable discomfort and suffering, but they do not endanger
the life of the woman or of the child. Occasionally, however,
fortunately not very often, the kidneys become affected, and for this
condition treatment by a physician is absolutely necessary. In fact,
the correct and safe thing for a woman to do is to consult a physician
as soon as she knows she is pregnant, and have him take care of her
during the entire pregnancy. Some women engage a physician during the
eighth or ninth month and this is decidedly wrong, because it may then
be too late to correct certain troubles which if taken at the outset
could have been easily cured; while many troubles in the hands of a
competent physician can be prevented altogether. I must therefore
reiterate: every woman should engage a physician from the beginning
of her pregnancy, or at least during the third or fourth and certainly
not later than the fifth month. He will examine the urine every month
and make sure that the kidneys are in order, he will make sure that
the child is in a normal position, and will prevent a host of other
ills.

    [Illustration: POSITION OF THE CHILD IN THE WOMB.]

This is not a special treatise on the management of pregnancy, and
therefore minute details are out of place. Besides, to the details the
physician will attend. But some hints regarding diet and general
hygiene will prove useful.

If everything is satisfactory, if there is no severe vomiting, kidney
trouble, etc., the usual mixed diet may continue. The only changes I
would make are the following: Drink plenty of hot water during entire
course of pregnancy: a glass or two in the morning, two or three
glasses in the afternoon, the same at night. From six to twelve
glasses may be consumed. Also plenty of milk, buttermilk and fermented
milk. Plenty of fruit and vegetables. Meat only once a day. For the
tendency to constipation, whole wheat bread, rye bread, bread baked of
bran or bran with cream.

As to exercise, either extreme must be avoided. Some women think that
as soon as they become pregnant, they must not move a muscle; they are
to be put in a glass case, and kept there to the day of delivery.
Other women, on the other hand, of the ultramodern type, indulge in
strenuous exercise and go out on long fatiguing walks up to the last
day. Either extreme is injurious. The right way is moderate exercise,
and short, non-fatiguing walks.

Bathing may be kept up to the day of delivery. But warm baths,
particularly during the last two or three months, are preferable to
cold baths.




CHAPTER THIRTEEN

THE SIZE OF THE FETUS

 Approximately Correct Measurements and Weight of Fetus at End of
  Each Month of Pregnancy.


Men and women are always interested to know how large the fetus is and
how far it is developed during the various months of pregnancy.
Absolutely exact measurements cannot be given, but the following
approximate measurements are correct:

   [Illustration: 1. EMBRYO BETWEEN ONE AND TWO WEEKS OLD.
   2. EMBRYO ABOUT FOUR WEEKS OLD.
   3. EMBRYO ABOUT SIX WEEKS OLD.
   (Illustrations are double the actual size.)]

At the end of the first month (lunar) it is about the size of a
hazelnut. Weighs about 15 grains.

At the end of the second month it is the size of a small hen's egg.
The internal organs are partially formed, it begins to assume a human
shape, but the sex cannot yet be differentiated. Up to the fifth or
sixth week it does not differ much in appearance from the embryos of
other animals.

At the end of the third month it is the size of a large goose egg; it
is about two to three and a half inches long. Weighs about one ounce.

At the end of the fourth month the fetus is between six and seven
inches long and weighs about five ounces.

At the end of the fifth month the fetus is between seven and eleven
inches long, and weighs eight to ten ounces.

At the end of the sixth month it is eleven to thirteen inches long and
weighs one and one-half to two pounds. If born, is capable of living a
few minutes, and it is reported that some six months' children have
been incubated.

At the end of the seventh month the fetus is from thirteen to fifteen
or sixteen inches long and weighs about three pounds. Is capable of
independent life, but must be brought up with great care, usually in
an incubator.

At the end of the eighth month the length is from fifteen to
seventeen inches, and weight from three to five pounds.

At the end of the ninth month the length of the fetus is from sixteen
to seventeen and one-half inches, and weight from five to seven
pounds.

At the end of the tenth lunar month (at birth) the length of the child
is from seventeen to nineteen inches and the weight from six to twelve
pounds; the average is seven and a quarter, but there are full term
children weighing less than six pounds and more than twelve; but these
are exceptions.




CHAPTER FOURTEEN

THE AFTERBIRTH (PLACENTA) AND CORD

 How the Afterbirth Develops--Bag of Waters--Umbilical Cord--The
  Navel--Fetus Nourished by Absorption--Fetus Breathes by Aid of
  Placenta--No Nervous Connection Between Mother and Child.


Whatever part of the womb the ovum attaches itself to is stimulated to
intense activity, to growth. Numerous bloodvessels begin to grow and
that part of the lining membrane with its numerous bloodvessels
constitute the placenta, or as it is commonly called _afterbirth_,
because it comes out _after_ the _birth_ of the child. From the
placenta there is also reflected a membrane over the ovum, so as to
give it additional protection. That membrane forms a complete bag over
the fetus; this bag becomes filled with liquid, so that the fetus
floats freely in a bag of waters; this bag bursts only during
childbirth. The fetus is not attached close to the placenta, but is,
so to say, suspended from it by a _cord_, which is called the
_umbilical cord_. When the child is born, the umbilical cord is cut,
and the scar or depression in the abdomen where the umbilical cord
was attached constitutes the navel or umbilicus (in slang
language--button or belly button). The umbilical cord consists of two
arteries and one vein embedded in a gelatin like substance and
enveloped by a membrane, and it is through the umbilical cord that the
blood from the placenta is brought to and carried from the fetus. The
blood of the fetus and the blood of the mother do not mix; the
bloodvessels are separated by thin walls, and it is through these thin
walls that the fetal blood receives the ingredients it needs from the
mother's blood. In other words, it receives its nourishment from the
mother by _absorption_ or _osmosis_. The blood from the placenta also
furnishes the fetal blood with oxygen, so that the fetus breathes by
the aid of the placenta, and not through its own lungs.

It is well to remember that there is absolutely no nervous connection
between mother and child. There are no nerves whatever in the
umbilical cord, so that the nervous systems of the fetus and of the
mother are entirely distinct and separate. And this will explain why
certain nervous impressions and shocks received by the mother are not
readily transmitted to the child. It is only through changes in the
mother's blood that the fetus can be influenced. As will be seen in a
later chapter we are skeptical about "maternal impressions."




CHAPTER FIFTEEN

LACTATION OR NURSING

 No Perfect Substitute for Mother's Milk--When Nursing is Injurious
  to Mother and Child--Modified Milk--Artificial Foods--Care
  Essential in Selecting Wet Nurse--Suckling Child Benefits
  Mother--Reciprocal Affection Strengthened by Nursing--Sexual
  Feelings While Nursing--Alcoholics are Injurious--Attention to
  Condition of Nipples During Pregnancy Essential--Treatment of
  Sunken Nipples--Treatment of Tender Nipples--Treatment of Cracked
  Nipples--How to Stop the Secretion of Milk When Necessary--
  Menstruation While Nursing--Pregnancy in the Nursing Woman.


Every mother should nurse her child--if she can. There is no perfect
substitute for mother's milk. There is only one excuse for a mother
not nursing--that is when she has no milk, or when the quality of the
milk is so poor that the child does not thrive on it, or when the
mother is run down, is threatened with or is suffering with
tuberculosis, etc. In such cases the nursing would prove injurious to
both mother and child.

When the mother cannot nurse the child, it should be brought up
artificially on modified cow's milk. Formulas for modified milk have
been worked out for every month of the child's life, and if the
formulas are carefully followed, and the bottle and nipples are
properly sterilized, the child should have no trouble, but should
thrive and grow like on good mother's milk. If the child is sickly or
delicate and does not thrive on modified cow's milk or on the other
artificial foods, such as Horlick's malted milk, or Nestlé's food,
then a wet nurse may become necessary. But before engaging a wet nurse
great care should be taken to make sure that she is healthy, that the
age of her child is approximately the same as the age of the child
which she is about to nurse, and particularly that she is free from
any syphilitic taint. One, two or more Wassermann tests should be made
to settle the question definitely.

Mothers should bear in mind that suckling the child is good not only
for the child, but for the mother as well. Lactation helps the
_involution_ of the uterus: the uterus of a nursing mother returns
more quickly and more perfectly to its normal ante-pregnant condition
than the uterus of the mother who cannot or will not nurse her child.

It is asserted that the reciprocal affection between mother and child
is greater in cases in which the child suckled its mother's breast.
This is quite likely. It is also asserted that the nursing mother
transmits certain traits to its child, which the non-nursing mother
cannot. This is merely a hypothesis without any scientific proof.

On the other hand, the statement that many women experience decidedly
pleasurable sexual feelings while nursing seems to be well
substantiated.

That the mother who nurses her child should partake of sufficient
nourishment goes without saying. But the advice often given to nursing
mothers to partake of beer, ale or wine is a bad one. It is a question
if a mother partaking of considerable quantities of alcoholic
beverages may not transmit the taste for alcohol to her children. No,
alcoholics should be left alone, but milk, eggs, meat, fruit and
vegetables should be partaken of in abundance.

=Preparing the Nipples.= For the infant to be able to nurse properly
the nipples of the breast must be in good condition. If the nipples
are sunken, depressed, it is torture for the child to nurse. It uses
up a lot of energy uselessly, becomes exhausted, and gets very little
milk; while if the nipples be tender or cracked the process of nursing
is a torture for the mother.

It is therefore necessary to attend to the nipples in due time--to
begin at the fifth or sixth month is not too early. If the nipples are
sufficiently prominent, little need be done for them except to wash
them with a little boric acid solution (one teaspoonful of boric acid
to a glass of water) occasionally, and now and then to rub in a little
petrolatum, plain or borated. But if the nipples are sunken so that
they are below the surface of the breast, or if they are only slightly
above the surface of the breast, they must be treated. Gentle traction
must be made on them with the fingers three or four times a day. There
are only a few cases where persistent manipulation will not develop
the nipple and make it stand out prominently.

If the nipple is tender it should be washed two or three times a day
with a mixture of alcohol and water; one part of alcohol to three
parts of water is sufficient. In washing the nipple with this diluted
alcohol it should be dried and a little petrolatum or vaseline rubbed
in. This done two or three times a day during the last month or two of
the pregnancy will generally produce a good healthy nipple.

=The Treatment of Cracked Nipples.= If the care of the nipple has been
neglected, and it develops cracks or fissures so that the nursing of
the child causes the mother severe pain, the nursing should be done
through a nipple shield, and in the meantime between the nursings the
nipple should be rubbed with the following preparation, which is
excellent and which I can fully recommend: thymol iodide, ½ dram;
olive oil, ½ ounce. This should be applied every hour to the nipple
and covered with a little cotton; before each nursing, however, it
must be well washed off with warm water or warm boric acid solution.
When the nipples are cracked, the infant's lips should also before
nursing be carefully wiped out with boric acid solution. For the
baby's mouth contains bacteria which while harmless in themselves may
if they get into the cracks of the nipple set up an inflammation of
the breast or "mastitis" and cause an abscess. If the cracks are
excruciatingly painful, as they sometimes are, it is necessary to give
the one breast a rest for twenty-four hours and have the child nurse
at the other until the cracks have partially healed.

=When It Is Necessary to Dry Up the Breasts.= In case of the death of
the child, or if the mother for some other reason finds herself unable
to nurse, such as in cases where there is absolutely no nipple,
instead of the prominence of the nipple there being a deep depression,
it becomes necessary to stop the secretion of the milk, or as it is
said in common parlance, "to dry up the breasts." In former days, not
so very long ago, and the practice is still common enough to call
attention to it and to condemn it, the breasts used to be tightly
bandaged, or they used to be pumped every few hours. The first causes
unnecessary pain and trouble, while the second procedure, the pumping,
does exactly the reverse to what it is intended to do. Instead of
drying up the breasts it keeps up the secretion. The best thing to do
in a case like that is to leave the breasts alone, not to pump them,
but just gently support them with a bandage and then in three or four
days the secretion of the milk will gradually disappear. There is some
discomfort the first twenty-four or forty-eight hours, but if left
alone the discomfort is less than if the breasts are manipulated,
bandaged or pumped.

=Menstruation or Pregnancy While Nursing.= Many women do not
menstruate and do not become pregnant while they are nursing. Some
women will not conceive, no matter how long they may nurse the
child--a year or two or longer. And some women take advantage of this
fact, and in order to avoid another child they will keep up the
nursing as long as possible. In Egypt and other Oriental countries
where our means for the prevention of conception are unknown, it is no
rare sight to see a child three or four years old interrupting his
work or his play and running up to suckle his mother's breast. But not
all women have this good luck. Some women (about fifty per cent.)
begin to menstruate in the sixth month of lactation, while some become
pregnant even before they begin to menstruate. It only too often
happens that a woman considering lactation her safeguard omits to use
any precautions and finds herself, to her great discomfiture, in a
pregnant condition.

When a nursing woman discovers that she is pregnant she should give up
nursing at once. The milk is apt to become of poor quality, but even
where this is not the case, it is too much for a woman to feed one
child in the uterus and one at the breast.




CHAPTER SIXTEEN

ABORTION AND MISCARRIAGE

 Definition of Word Abortion--Definition of Word Miscarriage--
  Spontaneous Abortion--Induced Abortion--Therapeutic Abortion--
  Criminal Abortion--Missed Abortion--Habitual Abortion--Syphilis
  as Cause of Abortion and Miscarriage--Dangers of Abortion--
  Abortion an Evil.


The word abortion, used somewhat loosely, signifies the premature
expulsion of the fetus; the expulsion of the fetus from the womb
before it is viable, i.e., before it is capable of living
independently. Used in a stricter sense, the word abortion is applied
to the expulsion of the fetus up to the end of the 16th week; to the
expulsion of the fetus between the 16th and the 28th week the term
miscarriage is applied; and when the expulsion of the fetus takes
place after the 28th week, but before full term, we use the term
premature labor. The laity does not like the term abortion, as it is
under the impression that the term always signifies criminal abortion;
it therefore prefers to use the term miscarriage ("miss"), regardless
of the time at which the expulsion of the fetus takes place.

When an abortion (or miscarriage) takes place by itself, without any
outside aid, we call it _spontaneous abortion_. When it is brought on
by artificial means, whether by the woman herself or by somebody else,
we call it _induced_ abortion. When an abortion is induced for the
purpose of saving the woman's life, we call it _therapeutic_ abortion;
this is considered perfectly legal and proper. But where an abortion
is induced merely to save an unmarried mother's reputation, or because
the married mother is too poor or too weak to have any more children,
or is reluctant to have any (or any more) for any other reason, it is
called _criminal_ or _illegal_ abortion, and, if discovered, subjects
the mother and the person who produced the abortion to severe
punishment.

When the fetus for some reason dies in its mother's womb, it is
generally expelled within a few hours or days. Sometimes this is not
the case, and the dead fetus is retained for several weeks, or months
or even years; to such a phenomenon we apply the term _missed_
abortion. Some women suffer from what might be called the abortion
habit; they can hardly ever carry a child to full term, but lose it in
the same month or even in the same week of gestation during each
pregnancy; we call this habitual abortion. And this habitual abortion
may be independent of disease, such, for instance, as syphilis. The
terms _threatened_, _imminent_ and _inevitable_ abortion require no
further explanation.

=The Causes of Abortion.= Outside of the abortion habit, which may be
due partly to heredity or be caused by a diseased condition of the
lining membrane of the uterus, the principal cause of abortion and
miscarriage is syphilis. And when a woman has had two or three or four
or more miscarriages in succession we generally assume the cause to be
syphilis, and in most cases the assumption will be correct.

When an abortion is performed by an experienced physician, with the
observance of the utmost cleanliness (asepsis and antisepsis), then
the abortion is accompanied with very little or no danger; but when
performed carelessly, by incompetent, non-conscientious physicians and
midwives, the operation is fraught with great danger to the patient's
health or to her very life. And abortion is a great cause of premature
death and chronic invalidism among women. And as long as the people
will remain ignorant of the proper means of regulating their
offspring, so long will abortion thrive.

While I recognize that there are cases in which the performance of an
abortion is perfectly justifiable from a moral standpoint, for
instance in cases of rape or where the mother is unmarried,
nevertheless abortion must be recognized as an evil, a necessary evil
now and then, but an evil, nevertheless. It is never to be undertaken
lightly, or to be considered in a frivolous spirit; and it is the duty
of all serious-minded and humanitarian men and women to do everything
in their power to remove those conditions which make abortion
necessary and unavoidable.




CHAPTER SEVENTEEN

PRENATAL CARE

 Meaning of the Term--Misleading Information by Quasi-Scientists--
  Exaggerated Ideas Regarding Prenatal Care--Nervous Connection
  Between Mother and Child--Cases Under Author's Observation--Effects
  on Offspring--Advice to Pregnant Women--Germ-plasm of Chronic
  Alcoholic--A Glass of Wine and the Spermatozoa--False Statements--
  Cases of Violence and Accidents During Pregnancy.


By prenatal care we understand the care taken during pregnancy before
the child is born. Used in a wider sense the term includes the care
which both parents should take of themselves even before the child is
conceived.

Of course the father and the mother should be in the best possible
physical and mental condition during the time of conception and even
before conception, and the mother should take the very best care of
herself--she should be in good health and as calm a spirit as possible
during the entire period of gestation. For the general health and
condition of the mother does influence the child.

And still I feel impelled to say something which may meet with violent
opposition in some quarters. The trouble is, there are too many
half-baked scientists in our midst. They spread misleading information
and the public at large is too apt to take every statement that has a
quasi-scientific seal for something absolute, for something positive,
for something that admits of no exceptions.

I have seen so much misery caused by wrong prenatal care teaching and
by the foolish, exaggerated ideas on the subject, that I consider it
my duty to say something in order to counteract those erroneous
notions. I consider it my special mission to destroy error, mysticism
and superstition. And the prenatal care teaching as imparted by some
unfortunately partakes of all three of the above.

Of course, I repeat, the mother should try to be in the best possible
condition while she is carrying the child. Nevertheless, it is foolish
to imagine if the mother is not quite well, or is worried about
something, or has a fit of anger, that it is invariably going to be
reflected on the child. The child, as we know, has no nervous
connection whatever with the mother, and it is only very violent or
prolonged shocks that are apt to have an injurious influence.

I know of children that were carried by their mothers in anger and in
anguish from the day of conception to the day of delivery. And still
they were born perfectly normal. I know of a child whose mother was
suffering the most hellish tortures of jealousy during the entire
period of pregnancy, and still the child was born perfectly healthy,
perfectly normal, and is now a splendid specimen of manhood. I know
children whose mothers went through severe attacks of pneumonia,
typhoid fever, etc., and still they were born perfectly healthy and
perfectly normal. I know children whose mothers were using every means
to abort them, took all kinds of internal medicines until they were
deathly sick, and still they were born perfectly healthy and normal. I
know children whose mothers tried to abort them by mechanical means,
who went to abortionists who made one or more attempts to induce the
abortion--I know even cases where the mothers bled as a result of such
attempts--and nevertheless, the children were born perfectly healthy,
developed normally physically and mentally.

Of course these are not things that I would advise women to do or to
undergo. I would not advise pregnant women to worry, to be sick, to
take poisonous medicines or to make attempts at abortion, but I merely
bring up these points to emphasize to my readers not to take the
necessity of prenatal care in too absolute a sense, and not to worry
themselves unnecessarily if the conditions during their pregnancy are
not all that could be desired. The child is not necessarily going to
be affected. The condition of the germ-plasms, i.e., the condition of
the ovum and the spermatozoa at the time of conception is more
important than all subsequent care during gestation.

As there are foolish people who possess a peculiar knack of
misinterpreting and misunderstanding everything, I wish to emphasize
that hygiene during pregnancy should not be neglected. Everything
possible should be done to put the mother in the best possible
physical and mental condition. All I want to say is that it is bad to
be insane on the subject, that it is bad to take things in an absolute
sense, and that it is bad to exaggerate.

You will often hear it said that a child that was conceived when the
father was in an exhilarated condition is apt to be epileptic, or
nervous, or insane, and what not. This is also to be taken with a
grain of salt. A chronic alcoholic has a defective germ-plasm, and his
children are apt to be defective. But a glass of wine at a wedding
banquet cannot affect the previously formed spermatozoa. And the
statements about children being born defective or developing
defectively because their fathers took an occasional glass of wine are
unworthy of serious consideration; are unworthy of any consideration.

In connection with the above the reports of some cases of _violence_
and _accidents_ during pregnancy which, in spite of their severity,
did not affect the children, will prove of interest.

A delicate little woman missed her periods. She was sure she couldn't
be more than two weeks over-due. And this is what she did. For five
nights in succession she took hot mustard baths and she took them so
hot that each time she nearly fainted and came out from them like a
broiled lobster. No effect. She then took a box of pills which cost
her two dollars. No effect except causing diarrhea. She then took two
boxes of capsules which upset her stomach and made her fearfully
nauseous. No other effect. She then ate one-half a colocynth, which
made her terribly sick, causing a bloody diarrhea. She had to stay in
bed for three or four days. She then took burning vaginal injections
with some ipecac in them. No effect except making her feel raw so that
she needed large amounts of cold cream. She then took secale cornutum
and radix gossypii. No effect except giving her a headache, making her
sick to her stomach and completely destroying her appetite, so that
within a very short time she lost nearly ten pounds. She was then told
that long walks might be efficient. She took walks of six and seven
miles at a time, coming home more dead than alive. No effect. She then
heard that jumping off a table is a very efficient means. She did it
a dozen times in succession so that she was completely fagged out and
out of breath. Eight and a half months later she gave birth to a
perfectly healthy, well-formed boy weighing eight pounds.

The following case was reported by Brillaud-Laujardiere. A farmer who
was responsible for the condition of a servant of his household
conceived the idea of riding horseback with her in order to bring
about an abortion, and pushing her off when the horse was running at
great speed. This he repeated several times. The woman gave birth to a
perfectly normal infant at full term.

Hofmann reports that another farmer, under similar circumstances,
brutally kicked the woman in the abdomen repeatedly until she lost
consciousness. The pregnancy continued to full term notwithstanding.
In another case of Hofmann's, a woman allowed a heavy door to fall
upon her, but the pregnancy was not affected.

Dr. Guibout relates that a German woman, living with her husband in
California, being pregnant, wished to return to Munich, her home-town,
to be delivered. The train in which she travelled through Panama
collided with another train. Threatened abortion required her to take
a rest. She took a steamer and after a very rough passage reached
Portsmouth. From there she went to Paris. Here she fell down a flight
of stairs in the hotel where she was stopping. Again she was
threatened with abortion, but after a rest was in good condition and
continued her journey. She finally reached home, and was delivered at
full term of a normal infant.

Vibert reports the case of a woman who was in a train accident which
injured her severely, killed two of her children, but did not affect
her pregnancy. She was delivered at the proper time of a normal baby.




CHAPTER EIGHTEEN

THE MENOPAUSE OR CHANGE OF LIFE

 Time of Menopause--Cause of Suffering During Menopause--
  Reproductive Function and Sexual Function Not Synonymous--
  Increased Libido During Menopause--Change of Life in Men.


In the chapter on menstruation I referred briefly to the menopause. I
will consider it here somewhat more in detail.

The menopause, also called the climacteric, and in common language
"change of life," is the period at which woman ceases to menstruate.
The average age at which this occurs is about forty-eight. But while
some women continue to menstruate up to the age of fifty, fifty-two,
and even fifty-five, others cease to menstruate at the age of
forty-five or even forty-two. Between forty-four and fifty-two are the
normal limits. Anything before or beyond that is exceptional.

Just as the beginning of menstruation may set in without any trouble
of any kind, and just as some women have not the slightest unpleasant
symptoms during the entire period of their menstrual life, so the
menopause occurs in some women without any trouble, physical or
psychic. The periods between the menses become perhaps a little
longer, or a little irregular, the menstrual flow becomes more and
more scanty, then one or several periods may be skipped altogether,
and the menopause is permanently established. Many women, however, the
majority probably, suffer considerably during the transitional year or
years of the menopause. Symptoms are both of a physical and of a
psychic character, but the psychic symptoms predominate. There may be
headache, capricious appetite, or complete loss of appetite,
considerable loss of flesh, or on the contrary very sudden and rapid
putting on of fat, great irritability, insomnia, profuse perspiration;
hot flashes throughout the body, and particularly in the face, which
make the face "blushing" and congested, are particularly frequent.
Then the woman's character may be completely changed. From gentle and
submissive she may become pugnacious and quarrelsome. Jealousy without
any grounds for it may be one of the disagreeable symptoms, making
both the wife and the husband very unhappy. In some exceptional cases
a genuine neurosis or psychosis may develop.

=Cause of Suffering During Menopause.= It is my conviction, and I have
had this conviction for many years, that many, if not most, of the
distressing symptoms of the menopause are due, not to the menopause
itself, but to the wrong ideas about this period that have prevailed
for so many centuries. We know the influence of the mind over the
body, and the pernicious effect which wrong ideas may exercise over
our feelings. The generally prevalent opinion among women, and men for
that matter, and not only of the laity but unfortunately of the
medical profession as well, is that the menopause is the end of
woman's sexual life. Every woman is laboring under the erroneous
impression that with the establishment of the menopause, with the
cessation of the menses, she ceases to be a woman, and as she does not
become a man, she becomes something of a neuter being, neither woman
nor man. And she has the idea that after the menopause she can have no
further attraction for her husband or for other men. Naturally such an
idea has a very depressing effect on any human being. Any human being
fights to the last to retain all its human functions, especially the
function which is considered as important as is the sexual function.

=Reproductive Function and Sexual Function Not Synonymous.= Of course
with the permanent cessation of the menses the woman's _reproductive_
function is at an end. But the reproductive function is _not_
synonymous with the sexual function, I must insist again and again,
and naturally until this erroneous idea is dispelled much unnecessary
misery will be the lot of our women. If women in general will learn
that with the establishment of the menopause they do _not_ cease to be
women, if they will learn that the sexual desire in women lasts long
beyond the cessation of the menopause, many women being as passionate
at sixty as at thirty, if they will learn that their attractiveness or
non-attractiveness to the male sex does not depend upon the menopause,
but upon their general condition, if they will learn that many women
at fifty and sixty are much more attractive than some women at half
that age, they will not take the onset of the menopause so tragically
and they will thereby avoid the greater part of their mental and
emotional suffering.

The actual atrophy of the ovaries, uterus, external genitals and the
breasts can, of course, not be prevented, but that atrophy is a slow
and gradual process, and is not in itself the cause of the various
distressing symptoms that we have enumerated.

The treatment of the menopause, if the symptoms are at all
disagreeable, or distressing, should be in the hands of a competent
physician. A little wholesome advice may be more efficient than
gallons of medicine and bushels of pills. In general the woman should
try to lead as calm and peaceful a life as possible. Warm baths daily
are beneficial, constipation should be guarded against, hot vaginal
douches are often efficient against the disagreeable flushes, and
last, but not least, the husband should during this critical period be
doubly kind and doubly considerate of his wife. It is during the years
between forty-five and fifty-five that the wife is most in need of her
husband's sympathy and support.

=Increased Libido During Menopause.= There is one rather delicate
symptom which I must not pass unmentioned. Some women during the years
while the menopause is being established, and for some years after the
menopause, experience a greatly heightened sexual desire. In some
cases this increased libido is normal, that is, no other pathologic
symptoms or local conditions can be discovered. In some cases the
increased libido is distinctly due to local congestion, congestion of
the ovaries, the uterus, etc. In some cases, I can distinctly testify,
it is psychic or autosuggestive. Because the woman thinks, and
believes that other people think, that she is soon going to lose all
her sexuality, she unconsciously works herself up into a sexual
passion which sometimes may be of long duration and may even lead to
disastrous results.

What to do in such cases? Where the woman's libido is normal or near
normal, then naturally it should be normally gratified. But if the
libido seems to be abnormally strong and the demands for sexual
gratification are too frequent, then the woman should be treated and
sexual gratification should not be indulged in, because in such cases,
as a rule, sexual gratification only adds fuel to the fire, and the
woman's demands may become more and more frequent, more and more
insistent. In exceptional cases it may even reach the intensity of
nymphomania. In such cases the aid of a tactful physician is
indispensable.


Change of Life in Men

To people not familiar with the subject it sounds rather strange to
speak of "change of life" in men.

Man, possessing no menstrual function, cannot have any menopause, but
still sexologists and psychologists who have studied the subject
carefully are convinced that between the ages of forty-five and
fifty-five men also undergo a certain change which may be spoken of as
the change of life or the male climacteric.

They become irritable, capricious, very susceptible to feminine
charms, are apt to fall in love, and in many the sexual instinct is
greatly increased. As in women, this increase of the sexual desire is
sometimes due to pathologic causes, such as an inflamed prostate
gland--in other cases it is of psychic origin.

Just as a man should be particularly kind and considerate to his wife
during her menopause, so the wife, understanding that her husband is
going through a critical period, will also increase her tact, patience
and consideration.




CHAPTER NINETEEN

THE HABIT OF MASTURBATION

 Definition of Masturbation--Its Injurious Effects in Girls as
  Compared with Boys--Married Life of the Girl Masturbator--
  Necessity for Change in Injurious Attitude of Parents who Discover
  the Habit--Common-sense Treatment of the Habit--How to Prevent
  Formation of Habit--Parents' Advice to Children--Hot Baths as
  Factor in Masturbation--Other Physical Factors--Mental
  Masturbation and Its Effects.


Masturbation or self-abuse is a term applied to a bad habit which
consists in handling and rubbing the genitals. It is a bad habit
because it is apt to injure the health and future development of the
girl. The more frequently it is practiced, the more injurious it is.
It is more injurious than when practiced by boys, because the effects
are usually more permanent. Girls who indulge in the habit of
masturbation to excess not only weaken themselves, become anemic and
get a dingy, pimply complexion, but they lose their desire for normal
sexual relations when they grow up, and are unable to derive any
pleasure from the sexual act when they get married. In fact, many
girls who masturbated excessively get a strong aversion to the normal
sexual act, and their married life is an unhappy one. Their husbands
often have to ask for a divorce. Fortunately, the habit is much less
widespread among girls than it is among boys. While about ninety per
cent. of all boys--nine out of every ten--masturbate more or less,
only about ten or at most twenty per cent. of girls are addicted to
this habit. But whatever the percentage may be, the habit is an
injurious one, and if you value your health, your beauty and proper
growth and mental development, you should not indulge in it. If you
are already indulging, if you are used to handling your genitals, if a
bad companion has initiated you into the habit, you should give it up.
And mothers should watch their children, guard them against developing
the habit, and do everything possible to cure them of it, if
prevention comes too late.

But while as you see I do not deny the evil effects of masturbation,
it is necessary to state that a great change has taken place in our
opinions on the subject, and it is but right that parents should know
of this change of opinion among the medical profession, particularly
among those who specialize in sexology.

=Wrong Behavior of Parents.= When parents make the "awful" discovery
that their child is fondling its genitals or is indulging in
masturbation, they feel as if a great calamity had befallen them.
They could not feel worse if they learned that the child was a thief
or a pyromaniac. Imbued with the medieval idea of the "sinfulness" of
the habit, as well as its injuriousness, they begin to scold the
child, to frighten it, to make it believe that it is doing something
terrible, that it has disgraced them and itself; and they try to
persuade it that, unless it stops immediately, the most direful
consequences are awaiting it. The results of this mode of procedure
are disastrous--much more so than is the masturbation itself.

Often the scolding and the exposure of the child are done in the
presence of others. This implants in the poor girl a sullen resentment
that only makes it more difficult for it to break the habit. When the
child is brought to the physician, you can see by its behavior, by its
downcast looks, by its sulkiness, by its attempt to refrain from
tears, and other signs, that it regards the physician in exactly the
same light as a youthful criminal regards the judge before whom he has
been brought for trial.

It is time, high time, that this silly and injurious attitude toward a
practice, which is very common, be radically changed. It is time that
parents and physicians learn that the injuriousness of the habit has
been greatly, grossly exaggerated. It is time that they know that the
vast majority of boys and girls get over the habit without being much,
or any, the worse for it. The knowledge of this fact will not only
save them and the children much needless anguish and suffering, but
will make it much easier to deal with the latter, make it much easier
to get them divorced from the habit.

If we look at the matter in a sensible, common-sense way, and do not
tell the child caught in the practice that it has done something
disgracefully vicious and criminal, but speak to it kindly and tell it
that it is doing something that may injure it greatly, that may
interfere with its future mental and physical health and development,
then we shall have far greater success in our endeavors to break the
boy or the girl of the habit of masturbation. As I have said in
another place:

"In my opinion, stigmatizing even the most moderate indulgence in
masturbation as a vice has a deleterious effect upon the people who so
indulge and makes it harder for them to break off the habit. Every
thinking physician and sexologist can tell you that picturing the
masturbatory habit in too lurid colors and stigmatizing it with too
strong epithets has, as a rule, the contrary effect to the one
expected. The victims of the habit consider themselves degraded,
irretrievably lost. They lose their self-respect, and it is, on
account of that, harder for them to break themselves of the habit."

We shall accomplish a good deal more with our youthful and older
patients if we leave alone, altogether, the moral side of the
question--if there be any moral side to it--and emphasize the physical
injuriousness of the habit. We do not want to diminish the
self-respect of our boys and girls, we want to increase it; and we can
not do this if we make them believe that a masturbator is a vicious
criminal. Inspire your patients with confidence, tell them that
indulgence in the habit jeopardizes their future growth, both physical
and mental, their health and happiness, and you will find them easier
to control.

I am not trying to minimize the danger of masturbation, for, if
indulged in from an early age and to great excess, the results _may_
be disastrous. But, even if I were to minimize the evil consequences,
that would be less of a sin than to exaggerate them the way it has
been done for so many years, by so many people in the profession and
out of it. The evil results of exaggerating the influence of
masturbation have been so great in the past that, if now the pendulum
were to swing to the other extreme, I am sure it would not be a bad
thing at all.

To deal with the subject of the _treatment_ of masturbation belongs to
a medical treatise. But, a few remarks on how to prevent children from
acquiring the habit of masturbation will not be out of place.

=Prevention of the Habit of Masturbation.= The keynote of preventing
the habit is, carefully to watch the child from its earliest infancy.
We know that not infrequently stupid or vicious nursemaids,
wet-nurses, and even governesses ignorantly or deliberately induce the
habit in children under their charge. This, of course, must be
prevented. Even children of the age of nine, ten, eleven years should
not be left alone, but always be under supervision. Too close
friendship between boys or girls, particularly of different ages,
should be looked upon with suspicion.

A number of girls never should sleep in the same room without
supervision by an older person.

The sleeping together of two in the same bed, whether it be two
children or a grown person and a child, should not be permitted under
any circumstances. I admit of no exceptions to this demand. It makes
no difference whether the other person is a mother, a father, a
brother or a sister. Leaving out of the question any _deliberate_
element, the thing is dangerous; for, very often, unintentionally,
unwittingly, masturbation is initiated by this intimate contact.

The child--boy or girl--should sleep alone, on a rather hard mattress.
The covering should be light. A coverlet may be put over the feet. The
child always should sleep with the arms out upon the cover or blanket,
never _under_ the same. If this is done from childhood on, it is very
easy to get used to this way of sleeping, and many a case of
masturbation will thus be obviated. The child should not be permitted
to loll in bed: it must be taught to get up as soon as it awakes in
the morning. The general bringing-up must be of a strengthening,
hardening character; and this applies both to the body and the will.
When the children reach the age of nine, ten, eleven, twelve or
thirteen years (we must use discrimination and judgment, for, some
children of nine are as developed as are others of thirteen), we must
tell them that it is bad and injurious to handle one's genitals, and
we must warn them to shun any companions who wish to initiate them
into any manipulations of these parts or who show an inclination to
talk about the sexual organs and sex matters.

Hot baths are very injurious for young children in their influence in
this direction. There is no question that a hot bath has a very
decided stimulating effect upon the sexual desire of adults as well as
of children, both male and female; in fact, I have had several
patients of either sex tell me that their first masturbatory act was
committed while they were in a hot bath. Of course, the sensation
having been pleasurable, they kept on repeating the experience.

Every factor liable to give rise to the habit should be removed. Thus,
for instance, eczema about the genitals, strongly acid urine,
seatworms, and the like, should be treated until cured. That anything
having a tendency prematurely to awaken the sexual instinct should be
rigorously avoided, goes without saying.

=Mental or Psychic Masturbation.= Some girls and women will abstain
from handling themselves with their hands (manual masturbation), but
will practice what we call mental masturbation. That is, they will
concentrate their minds on the opposite sex, will picture to
themselves various lascivious scenes, until they feel "satisfied."
This method is extremely injurious and exhausting and is very likely
to lead to neurasthenia and a nervous breakdown. You should break
yourself of it, by all means, if you can. For it is even more
injurious than the regular habit.




CHAPTER TWENTY

LEUCORRHEA--THE WHITES

 Misconception Regarding the Meaning of the Term "Leucorrhea"--A
  Common Complaint--Severe Cases--Reasons for Resistance to
  Treatment--Proper Local Treatment of the Disorder--Sterility Due
  to Leucorrhea--Causes of Leucorrhea--Tonic Medicines--Local
  Treatment--Formulæ for Douching.


Leucorrhea means literally a "white running," and is applied by the
laity to any whitish discharge coming from the vagina. This is wrong,
because some white discharges may be of little importance; others may
be of a serious character, and not be leucorrhea at all.

Leucorrhea is one of the banes of the modern girl and woman. It is
very frequent. Probably at least twenty-five per cent, (some say fifty
or seventy-five per cent.) of all women suffer with it in a greater or
lesser degree. In some cases it is only an annoyance, necessitating
the frequent changing of napkins, but in others it causes a great deal
of weakness, backache, erosions, itching and burning. It is very
resistant to treatment, particularly in girls. The reason it is so
resistant to treatment is because the discharge, while coming from
the vagina, _does not usually originate_ in the vagina; it originates
in the neck of the womb, and the hundreds and hundreds of injections
that women take for their leucorrhea only reach the vagina; they
cannot penetrate into the womb. And it is only by treating the cavity
of the cervix, which can only be done by a physician, through a
speculum, that the root of the trouble can be reached. And, if any
erosion or ulcer is noticed, it can be directly touched up with the
necessary application. And it is for this reason that in girls
leucorrhea is so much more difficult to treat. For fear of having the
hymen ruptured the girl objects to a thorough examination and to local
treatment, and the leucorrhea is permitted to proceed until perhaps a
chronic inflammation of the womb and the Fallopian tubes is
established. There is no doubt that many cases of sterility or
childlessness in women are due to long-neglected leucorrhea in
girlhood.

=What Is the Cause of Leucorrhea?= We can answer simply: the cause of
leucorrhea is catarrh in any part of the female genital tract. But
this is no real answer. What are the causes of the catarrh? The causes
of catarrh are many: the most common cause is a cold. Wetting the feet
and getting chilled, particularly during the menses, may set up a
catarrh in the cervix. Long standing on one's feet, lifting and
carrying heavy bundles, dancing in overheated rooms and then going out
scantily clad in the chill night air, prolonged ungratified sexual
excitement, lack of cleanliness in the external genitals--all these
are factors in setting up a catarrh of the cervix with a resultant
leucorrhea. A general rundown condition, worry, overwork, too hard
study, lack of fresh air, and a general scrofulous condition also
favor the development of catarrh of the womb and leucorrhea. It will
therefore be seen that the treatment of leucorrhea to be successful
must be general and local.

=General Treatment.= The general treatment consists in general
hygienic measures and in common sense. The patient should not be on
her feet more than she can help, and she should not walk until
exhausted or fatigued. It is better to take several short walks than
one long one. The corset she wears, if she wears any at all, should be
of the modern kind: not one that presses the womb and the other
abdominal organs down, but one that supports the abdominal walls, and
rather raises the abdominal organs up. The lacing or buttoning must be
from below up, and not from above down. That it should not in any way
interfere with the freedom of respiration goes without saying.
Constipation if any, to be treated, must be treated intelligently, by
mild measures (see Constipation, in the chapter on pregnancy), and
care must be taken that the bowels move at regular hours. Where the
leucorrhea is due to or is aggravated by anemia and general weakness,
a good iron preparation, such as one Blaud's five-grain pill three
times a day, or a tonic of iron, quinine and strychnine, will do good.
A daily cold bath or cold sponge, followed by a brisk dry rubbing with
a rough towel, is also useful.

=Local Treatment.= Local measures consist of painting or swabbing the
vagina and cervix with various solutions, of tampons, suppositories
and douches. Local application to the vagina and uterus can be done
satisfactorily by the physician or nurse only. The insertion of a
suppository or douching can be easily done by the patient herself.

While it is always best and safest to consult a physician, and, while
self-medication is generally inadvisable, there are occasions when a
physician is not available; in some small places a woman may, _for
various reasons_, have a strong objection to gynecological examination
and treatment; and some women may be too poor to pay the doctor. In
such circumstances self-treatment is justified and there can be no
objection to it if the remedies are harmless and are sure to do some
good; that is, to improve the condition where they do not effect a
complete cure.

One of the simplest things is an alum tampon. You take a piece of
absorbent cotton, about the size of a fist, spread it out, put about a
tablespoonful of powdered alum on it, fold it up, tie a string around
the center, insert it in the vagina as far as it will go, and leave it
in for twenty-four hours. Then pull it gently by the string and
syringe yourself with a quart or two quarts of warm water. Such a
tampon may be inserted every other day or every third day, and I have
known many cases where this simple treatment alone produced a cure. In
some cases, however, douches work better and the two best things for
douching are: tincture of iodine and lactic acid. Buy, say, four
ounces of tincture of iodine, and use two teaspoonfuls in two quarts
of hot water in a douche bag. This injection should be used twice a
day, morning and night. Of the lactic acid you buy, say, a pint, and
use two tablespoonfuls to two quarts of water. The lactic acid has the
advantage over the tincture of iodine that it is colorless, while the
iodine is dark and stains whatever it comes in contact with. Sometimes
I order the use of the tincture of iodine and the lactic acid
alternately: for one douche the tincture of iodine, for the next the
lactic acid, and so on. When the condition improves, it is sufficient
to use one teaspoonful of the tincture of iodine and one tablespoonful
of the lactic acid to two quarts of water. These injections are quite
efficient and have the advantage of being perfectly harmless. One
point about the injections: they should be taken not in the standing
or squatting position (in which position the fluid comes right out),
but while lying down, over a douche pan. The douche bag should be only
about a foot above the bed, so that the irrigating fluid may come out
slowly; the patient, after each injection taken in the daytime, should
remain at least half an hour in bed (in the night time she stays all
night in bed). This gives the injection a better chance to come in
contact with all the parts of the vagina, and a portion of it comes in
contact with the cervix, where it exerts a healing effect. Avoid the
use of patent medicines.




CHAPTER TWENTY-ONE

THE VENEREAL DISEASES

 Derivation of Word "Venereal"--Three Venereal Diseases--Innocent
  Contraction of Syphilis Through Various Objects--The Hygienic
  Elimination of Common Sources of Venereal Infection--Measures for
  Prevention After Sexual Relations.


The word "venereal" means pertaining to sexual intercourse: venereal
excess--excess in sexual intercourse; venereal disease--a disease
acquired from sexual intercourse with an infected person. The word is
derived from Venus (genitive--veneris), the Roman goddess of spring,
flowers and Love.

There are three venereal diseases: gonorrhea, syphilis and chancroid.
Of these, gonorrhea is the most widespread, syphilis the most serious.
Chancroid is of comparatively little importance.

While by far the greatest amount of venereal diseases--probably ninety
per cent, of the total--is contracted from illicit[7] intercourse, it
is well to bear in mind that some of it is contracted innocently,
either from a kiss, or from using a sponge or a towel which has been
used by an infected person, etc. While the gonorrheal germ is
generally transmitted directly, the syphilitic poison may be
transmitted through various objects. Syphilis contracted not during
intercourse, but in an innocent manner, from a kiss, a towel, a
toothbrush, a razor, etc., is called syphilis of the innocent, or
syphilis insontium. In former years doctors would not very rarely
contract syphilis from examining syphilitic women with their bare
fingers. Now since gloves have come into use for examining purposes,
the number of infections has considerably diminished. And no doubt
that as the people become more familiar with the danger of venereal
infection from non-venereal sources, the number of innocent infections
will greatly diminish. The dangerous roller towel and the no less
dangerous common drinking cup are being gradually eliminated as
factors of _non-venereal_ infection; and we may confidently expect
that in a decade or two the amount of venereal disease from _venereal_
infection will be greatly lessened in all civilized countries. The
general increase in cleanliness in all strata of society and the
universal use of antiseptics after suspicious sexual relations will
constitute the chief factors in this diminution of venereal disease.

FOOTNOTES:

[7] Illicit--illegal, non-permissible, outside of marriage.




CHAPTER TWENTY-TWO

THE EXTENT OF VENEREAL DISEASE

 Former Ban on Discussion of Venereal Disease and Its Evil
  Results--Present Reprehensible Exaggerations of Extent of
  Venereal Disease--Erroneous and Ridiculous Statements of
  "Reformers"--Senseless Fear of Marriage in Girls Due to Lurid
  Exaggerations--Study by Woman Psychologist Reveals Harmful
  Results of Exaggerated Statements--Truth in Regard to Percentage
  of Men Afflicted with Venereal Disease.


=Former Silence.= Only a very few years ago respectable women, by
which I mean all women outside of the women called "fallen," did not
know of the existence of venereal disease. It was considered a
prohibited, disgraceful subject, not to be mentioned or even hinted at
in conversation, in books or magazines, in lectures, or on the stage.
When I say that they did not know of the _existence_ of such a thing
as venereal disease, that the very words gonorrhea and syphilis were
unknown to them, I use these expressions not as figures of speech, but
in their literal meaning. All avenues of acquiring such knowledge
being closed to them--lay people don't usually now and they surely
didn't then purchase and read strictly medical works--where could they
obtain the information? The result was that when a woman was so
unfortunate as to contract a venereal disease from her husband, she
did not understand its character and did not suspect its source. Which
was a rather good thing--for the husband. Family peace was more
secure.

=Present Exaggerations.= Now a change has taken place in this respect,
and, as is often the case with recent changes, the pendulum has swung
to the other extreme. The silence of former days has given place to
shouting from the housetops. The last phrase is also used almost in
its literal sense. Many men and women, deeply stirred by the venereal
peril, and sincerely anxious to guard boys and girls from venereal
infection, have been indulging in very reprehensible exaggerations.
Particularly lurid have been the exaggerations as to the prevalence of
the disease in the male sex, with its consequent disastrous effects on
married women. A statement made by a Dr. Noeggerath (a German
physician who practiced at the time in New York), nearly half a
century ago, to the effect that 80 per cent, of all men have gonorrhea
and that 90 per cent. of these remain uncured and infect or are apt to
infect their wives, has been shown to be a ridiculously absurd
exaggeration. If it had been true, the race would now be at the point
of dying out. Nevertheless, this statement is copied from book to
book, as if it were gospel truth, as if it were a scientifically and
statistically established fact instead of a wild, sensational guess.
An esteemed New York physician, Dr. Prince A. Morrow, did excellent
pioneer work in calling attention to the dangers of venereal disease.
But, as is the case with so many "reformers," he permitted his zeal to
run away with him occasionally, and he made statements which caused
and are still causing the judicious to grieve. The statement, for
instance, that there is more venereal disease among innocent, virtuous
wives than among prostitutes is one to cause the real honest
investigator to weep (over the human tendency to exaggeration), or to
burst out in uproarious laughter. The ridiculousness of this statement
becomes especially evident when we recollect that the same gentleman
made the statement that every prostitute, without exception, was
diseased at one time or another. If venereal disease exists among
prostitutes to the extent of 100 per cent., then how can it exist to a
greater extent among innocent, virtuous wives? And to still further
emphasize the absurdity of the above statement, I will tell you that
the extent of venereal disease among married women is believed by
careful non-sensational venereologists not to exceed five per cent.!

Yes, the silence of former years has given place to the lurid
exaggeration of the present day. While on the whole the former was
worse than the latter, the latter is bad enough, because it makes many
girls unhappy, sowing in them the seeds of suspicion and cynicism,
tends to make them antagonistic to the entire male sex, and inoculates
them with a senseless fear of marriage. A study made by Miriam C.
Gould, of the department of psychology and philosophy in the
University of Pittsburg (_Social Hygiene_, April, 1916), corroborates
our remarks in a striking manner.

She has had confidential chats with 50 young girls, with whom she has
had some acquaintance; of these 50, 25 were college students and 25
were not. She asked them a number of questions, the purpose of which
was to find out what psychologic effect, if any, their knowledge of
prostitution and of venereal disease has had on them. She states in
her conclusions that "the histories reveal a large percentage of
harmful results, such as conditions bordering upon neurasthenia,
melancholia, pessimism and _sex antagonism_ (italics mine), directly
traceable to this knowledge. Eleven of the girls interviewed developed
a pronounced repulsion for men, although prior to their 'knowledge'
they had enjoyed men's company. They now avoid association with them,
and six have declared that they have totally lost faith in the moral
cleanness of men. Eight have already refused to marry, or intend to do
so, because of their belief that the risk of infection was too great.
If it were not for the existence of these diseases, they say they
would be glad to marry. All of these say their decision has rendered
them more or less unhappy."

In the laudable desire to keep our young women pure and to protect
them from infection, in the endeavor to make them demand one moral
standard for both sexes, our exaggerating reformers are condemning
them to lifelong celibacy, which in the case of women often means
lifelong neurasthenia and hypochondria.

=The Truth of the Matter.= Here is the Truth about venereal
disease--the truth as I know it, without concealment on the one hand
and without exaggeration on the other. Exact figures are, of course,
unobtainable anywhere; but results obtained from unbiased
investigations of _different_ classes of society, from hospital
reports, from questionnaires among students, etc., tell us that
probably about twenty per cent. of the adult male population are the
victims of gonorrhea at one time or another; that probably eight or
ten per cent. are not entirely cured when they enter matrimony; and
four or five per cent. (some would say two per cent.) of wives become
infected with gonorrhea. This, I say, is terrible enough, and makes
the greatest care and caution imperative; for, if you should be one of
the victims of the two or five per cent., it would be little
consolation to you that the other ninety-eight or ninety-five per
cent. of wives have escaped.

Of course the percentage of venereal disease among young men, and
afterwards among their wives, will vary greatly with the stratum of
society. Among the "lower" strata you may find fifty per cent. of
infection, with a very large percentage of those uncured. Not because
they are of a lower morality than the higher classes, but because the
cheap class of prostitutes that they are obliged to patronize are
frequently diseased and because they cannot afford expert treatment,
or any treatment at all. Among these classes you will naturally find a
much larger percentage of diseased wives. But then to counteract this
we must bear in mind that there are large classes of men in whom
gonorrhea exists only to the extent of five or ten per cent., and we
have large classes of wives among whom the victims of gonorrhea will
come up only to a fraction of one per cent.

The above figures, you see, differ materially from the statements
found in so many sex books that "80 per cent. of all married men in
New York have gonorrhea," and that "at least three out of every five
[60 per cent.!] married women in New York have gonorrhea." Whenever
you read or hear such a statement treat it with a smile--or with
contempt, as all false statements should be treated.

As to syphilis, the extent of the prevalence may be given as between
two and five per cent. Which percentage differs considerable from the
75, 50 or 25 per cent. given us by some sex lecturers, but which is
terrible enough as it is, without any exaggerations.




CHAPTER TWENTY-THREE

GONORRHEA

 Source of Gonorrhea--Mucous Membrane of Genital Organs and of Eye
  Principal Seats of Disease--Symptoms in Men and in Women--Vagina
  Seldom Attacked in Adults--Nobody Inherits Gonorrhea--Ophthalmia
  Neonatorum--Differences of Course of Disease in Men and Women--
  Gonorrhea Less Painful in Women--Symptoms not Suspected by Woman--
  Necessity for the Woman Consulting a Physician--Self-treatment
  When Woman Cannot Consult Physician--Formulæ for Injections.


The subject of gonorrhea and syphilis is treated pretty fully, from a
layman's point of view, in the author's _Sex Knowledge for Men_. I do
not intend to devote much space to a discussion of the details of
these two diseases here, because the subject is not of such direct
interest to women. Respectable girls and women do not indulge in
illicit relations the same as respectable men and boys do, and their
danger of contracting a venereal disease is insignificant as compared
with men's liability. I will, therefore, touch upon only a few points,
particularly insofar as the diseases differ in their course from the
course pursued in men. Those, however, who are interested may read the
chapters on the subject in the author's _Sex Knowledge for Men_, and
if they want still fuller details, they may study the author's
_Treatment of Gonorrhea and Its Complications in Men and Women_.

    [Illustration: GONORRHEAL GERMS.]

=Gonorrhea= is an inflammation caused by a germ called the gonococcus,
discovered by Dr. A. Neisser, of Breslau, Germany, in 1879. Any mucous
membrane may be the seat of gonorrhea, but it attacks by preference
the mucous membrane of the genital organs, and of one other organ--the
eye. Its principal symptoms are: inflammation, pain, burning and
discharge. In men, it attacks the urethra; in women it attacks the
cervix--the neck of the womb--the urethra, and the vulva. The vagina
is seldom attacked in adult women, because the mucous membrane of the
adult vagina is rather tough and does not offer a good soil for the
development of the gonococcus germ. The discharge that a woman has
when she has gonorrhea comes principally or exclusively from the neck
of the womb. In little girls, however, in whom the lining of the
vagina is tender, gonorrhea of the vagina and the vulva is common.
(See chapter Vulvovaginitis in Little Girls.) Gonorrhea is a local
disease. While in some cases, after the disease has lasted for some
time, a certain poison is generated by the germs which circulates in
the blood, and while the germs may occasionally wander into distant
organs, still in 98 per cent. of all cases gonorrhea is a local
disease, and if taken in time is cured without leaving any traces on
the general organism.

=Gonorrhea Not Hereditary.= Then, gonorrhea is not a hereditary
disease. Nobody ever _inherits_ gonorrhea. A child may be born with a
gonorrheal inflammation of the eyes (ophthalmia neonatorum), but this
inflammation is not inherited; it can only be acquired if the mother
is suffering with gonorrhea while the child is being born: some of the
pus in the mother's birth canal gets into the child's eyes while it
passes through the uterus and vagina. This is not heredity; this is
simple infection, and can be avoided by keeping the mother's birth
canal clean by antiseptic douches before childbirth. In short, I
repeat gonorrhea is essentially a local and not a constitutional
disease, and is not hereditary. In which two respects it differs from
syphilis, which is the most constitutional and most hereditary of all
diseases.

=Course of Gonorrhea in Men and Women.= Gonorrhea runs an entirely
different course in women than it does in men. When a man has
gonorrhea he knows it immediately; first, because the discharge tells
him that there is something the matter with him, for a man is not used
to having any discharge from the urethra unless there is something the
matter with him. Second, the urine becomes at once burning and
painful. In women the urethra is a separate canal from the vagina, and
the urethra is very frequently not affected in gonorrhea. The
infection generally starts in the cervix, and the disease may last for
considerable time before the woman becomes aware of it. In general,
gonorrhea is a less painful disease in woman, and this is a bad thing,
because she thus neglects treatment and loses valuable time,
permitting the disease to develop. Even when the urethra is affected
in women, it does not give as severe symptoms as inflammation of the
urethra in men. If the woman does have pains she often pays no
attention to them, because woman is used to pains; as we have seen
before, fifty per cent. of all women suffer more or less with
dysmenorrhea. Many of them have a leucorrheal discharge of greater or
lesser degree, and therefore if there is an increase in the pains, or
an increase in the discharge, little attention is paid to the matter.
In fact, a woman may have a chronic gonorrhea for months or years
without being aware that there is anything the matter with her. It is
important to teach women to seek medical aid as soon as they notice
any increase in the amount of the discharge, or change in color,
particularly if it becomes greenish, or if the odor becomes offensive,
or if there is chafing, burning, or irritation around the genitals,
and particularly if there is an increase in the frequency or urgency
of urination, or if there is a burning, scalding, or cutting sensation
during the act of urination. Also whenever the sexual act becomes
painful. If women consulted a physician as soon as they noticed any of
the symptoms referred to above, they would save months and years of
suffering and expense, because the disease would often be taken in
hand while still limited to the cervix, and not, as is now often the
case, after the inflammation has extended into the uterus and
Fallopian tubes.

=Self-treatment.= I do not believe in self-treatment because it is
generally unsatisfactory and may often even become dangerous, and I
decidedly advise every woman who suspects that she has contracted
gonorrhea to apply at once to a competent physician. But it happens
not infrequently that a woman is so situated that she cannot consult a
physician. And in the meantime there is danger of the gonorrhea
spreading further and further. In such cases it is advisable for the
woman to use an injection until such time when she can consult a
physician. The injection I am going to advise may in itself produce a
cure; and, if it does not produce a complete cure, it at any rate
improves the condition, prevents the extension of the disease, makes
subsequent treatment easier, and besides is perfectly harmless. The
best injection for self use in gonorrhea is tincture of iodine; the
proportion is two teaspoonfuls to a quart or two quarts of water. If
the case is very bad, such an injection may be taken twice a day. If
the case is not very bad, once a day is sufficient. After using the
tincture of iodine for five days to a week, it is good to change off
to lactic acid. Buy a pint or so of lactic acid in a drug store, and
use one tablespoonful to a quart of water. It is preferable to have
the water hot, about 100 deg., but where this is inconvenient it may
be used lukewarm. The lactic acid injection is used for three days,
then the iodine injection is resumed, then again the lactic acid, and
so on. I know of many cases that were cured by this treatment alone.
And I might mention that these injections are generally also very
efficient in leucorrhea, as stated in the chapter on Leucorrhea.




CHAPTER TWENTY-FOUR

VULVOVAGINITIS IN LITTLE GIRLS

 Former Causes of Vulvovaginitis in Little Girls--Discharge Chief
  Symptom--Evil Results of Vulvovaginitis--Psychic Results of
  Treatment--Effects in Hastening Sexual Maturity--Vulvovaginitis a
  Cause of Permanent Sterility--Measures to Prevent the
  Disease--Toilet Seats and Vulvovaginitis.


The mucous membrane, or the lining of the vulva and vagina, in little
girls is very tender, and therefore very readily subject to infection.
An infection of the vulva and vagina due to the gonococcus or to some
other germ is very common in little girls. At least it used to be,
particularly among children of the poor, in institutions and
hospitals. The very dangerous infective character of vulvovaginitis
was not known, and the infection was therefore easily transferred by
towels, linen, toilet seats, bedpans, syringe nozzles, thermometers,
the nurses' hands, and in various other ways. Now great care is being
taken and in most hospitals no children are admitted in the general
wards unless it is determined that they are free from vulvovaginitis.

Generally speaking, vulvovaginitis in children is a mild infection. A
child may have it for several weeks or months without being aware of
it, without saying anything about it, the diagnosis often being made
by the mother, who begins to notice the creamy discharge on the girl's
linen or underwear. And this is the principal symptom in little girls
thus afflicted--the discharge. This discharge may be very profuse,
covering the vulva, vagina, and cervix.

In severe cases, there is also an infection of the urethra, and the
child may complain of burning at urination, itching and pain around
the vulva and anus, and slight pain in the abdomen. There may be a
moderate rise in temperature, up to 101 deg. F., and in some instances
the attack is sufficiently acute to give rise to a chill and fever. A
mild inflammation of the joints may set in within the first weeks of
the infection, although as a usual thing it comes later on.

=Evil Sequelæ of Vulvovaginitis.= While, as stated, vulvovaginitis is
a comparatively mild infection as far as its symptoms are concerned,
it nevertheless has a very bad effect on the child who is unfortunate
enough to become a victim of the disease. First of all, it is an
extremely long drawn, persistent disease. It usually takes months, and
these months may run into years, before a complete cure, is effected.
Second, relapses are quite common. Third, the treatment is a
disagreeable one for the child, and is occasionally painful. Fourth,
it has a disastrous effect on the child's _morale_; most parents,
though they may love the child most affectionately, look somewhat
askance at it; and continuous vaginal treatment somehow or other has a
humiliating effect on the child, which begins to consider itself as an
outcast, as something apart from other children. Fifth, the child's
education is very frequently seriously and permanently interfered
with, because it must often be taken out of school, whether public or
private, and private tutoring is of course feasible only for the few.
Sixth, and this is a point not sufficiently appreciated by the
profession and the laity, but it is an important point, nevertheless:
vulvovaginitis in children has unfortunately a disastrous effect in
_hastening the sexual maturity of the child_. Whether this is due to
the congestion of the organs produced by the inflammation, or to the
speculum examinations, paintings, douches, applications, tampons,
suppositories, etc., the fact remains that girls who suffer from
vulvovaginitis in childhood become sexually mature considerably
earlier than normal girls of the same class, stratum and climate, and
their demand for sexual satisfaction is much more insistent. Seventh,
a mild vulvovaginitis may be the cause of permanent _sterility_.

It will therefore be seen that vulvovaginitis is a calamity, and
everything possible should be done to guard female children from
contracting it. _All_ children should _always_ sleep alone. Under no
circumstances should a child sleep with anybody else, be it a sister,
a mother, a friend, a governess, or a servant girl. People should be
very careful in sending their children to spend a night or two with
some friends. The friends may be all right, but still a friend of the
friends or a relative of the friends may not be. I have known several
cases where the origin of the vulvovaginitis could be traced to little
girls spending a week at the house of some friends where a boarder or
relative was infected with gonorrhea. That children should be kept
away from associating or playing with adults or other children who are
known to have gonorrheal infection goes without saying. The child's
genitals should be frequently inspected by the mother, and scrupulous
cleanliness by frequent bathing, sponging with warm solutions and
powdering, should be maintained. The toilet seats in school should
receive special attention. The wooden seat is a menace because it
often harbors gonorrheal pus from either the female or male genitals,
while the only proper seat is one of the so-called U-shaped style,
that is, one in which the front is entirely open, like the letter U.




CHAPTER TWENTY-FIVE

SYPHILIS

 Syphilis Due to Germ--Syphilis a Constitutional Disease--Primary
  Lesion--Incubation Period--Roseola--Primary Stage--Secondary
  Stage--Mucous Patches--Tertiary Stage--Gumma--Hereditary Nature
  of Syphilis--Milder Course in Women Than in Men--Obscure Symptoms
  in Syphilis--Necessity for Examination by Physician--Locomotor
  Ataxia--Softening of the Brain--Chancroids.


Syphilis is a disease caused by a germ called spirocheta; the full
name is spirocheta pallida--a pale, spiral-shaped germ. Though the
disease has been ravaging Europe and America for centuries, the germ
of it has been discovered only a few years ago, namely, in 1905, and,
like the gonococcus, also by a German scientist, Fritz Schaudinn.
Syphilis is a constitutional disease. In ten days to three weeks after
a person has contracted syphilis, he (or she) develops a sore (at the
spot where the germs got in). This sore is called _chancre_ or
_primary lesion_. But when this sore makes its appearance the
spirochetæ and the poison which they elaborate are already circulating
in the blood, all over the system. The disease is already systemic, or
constitutional, and the chancre is the local expression of a
constitutional disease. Cutting out the chancre will not cure the
disease, because, as stated, the germs are already in the system. The
time between the contraction of the disease (the infectious
intercourse) and the appearance of the chancre is called the
_Incubation Period_. The time between the appearance of the chancre
and the appearance of the rash on the body (the rash looks like a
measles rash and is called roseola, which means a rose-colored rash)
is called the _Primary Stage_. It lasts about six weeks. With the
appearance of the rash commences the _Secondary Stage_. This stage is
characterized by all sorts of _eruptions_, mild and severe, by white
little patches (called mucous patches) in the throat, mouth, tonsils,
vagina, by falling out of the hair, etc. The length of this secondary
stage depends a good deal upon the sort of treatment the patient gets.
Improperly treated, or not treated at all, it may last two or three
years or more. Properly treated, it may be cut short at once, in a few
days, so that the patient may never again in his or her life get an
eruption. The third or _Tertiary Stage_ is characterized by
_ulcerations_ in various parts of the body and by _swellings_ or
tumors. The name of a syphilitic swelling or tumor is gumma (plural,
gummata). The tertiary stage is the most terrible stage and it used to
be the terror of syphilitic patients. But at the present time, under
our modern methods of treatment, patients, if properly treated, _never
have a tertiary stage_. We have seen many patients who considered
syphilis a trifling disease, because all they knew of their disease
was the chancre and the first eruption, i.e., the roseola, and perhaps
a slight falling out of the hair. They then put themselves under
energetic treatment, the _activity_ of the disease was checked, and
they never had another symptom afterwards, though a Wassermann test
showed that the disease was not entirely eradicated. It was merely
held in check--which is the second best thing.

   [Illustration: SPIROCHETA PALLIDA, OR TREPONEMA PALLIDUM, THE
   GERM OF SYPHILIS AS SEEN UNDER THE MICROSCOPE.]

As stated before, syphilis is the most hereditary of all diseases.
Fortunately, if the disease is still very active in the parents,
particularly in the mother, the child is generally aborted. Some
syphilitic mothers will have half a dozen or more miscarriages in
succession. When the disease has become "attenuated," either by
treatment or by itself--many diseases lose their virulence in
time--the child may be carried to term. It then may be born dead, or
it may be born strongly syphilitic, and die in a few days or weeks, or
it may be born without any signs of syphilis and be apparently healthy
and then develop the disease at the age of ten, twelve, fourteen, or
later, or it may be born healthy and remain healthy. But no woman who
had syphilis, or whose husband had syphilis, should _dare_ to conceive
or to give birth to a child unless she has been given permission by a
competent physician. I mean just what I say. It is not a personal
matter. A woman has a right to marry a syphilitic husband if she wants
to and run the risk of contracting syphilis. Her body is her own, and
if she does it with her eyes open it is her affair. But a woman has no
right to bring into the world syphilitic or syphilitically tainted
children. Here society has a right to interfere.

Syphilis runs a milder course in women than it does in men. But this
milder course is not an unmixed blessing; it may be considered a
misfortune, because, the same as gonorrhea in women, syphilis is often
present for months and years until it has made such inroads that it
is but little amenable to treatment. In many women the disease runs
such a mild course, as far as definite symptoms are concerned, that
they are sure they never had anything the matter with them, and they
are perfectly sincere in their denial of ever having had any
infection. Often it is only when they complain of obscure symptoms,
for which we can find no explanation, and then take a Wassermann test,
that we discover what the real trouble is. And then the internal
organs are sometimes found so deeply affected that it is hard to do
anything. So it is seen that the mildness of the course of the
disease, while a good thing in itself, is bad in that respect that it
prevents timely treatment. It is therefore important that whenever a
woman is in any way suspicious that she may have the disease that she
have herself examined; and if she has reasons to suspect that her
husband or partner has the disease, she should persuade him to have
himself examined.

Locomotor ataxia, one of the most terrible sequelæ of syphilis, is
much more rare in women than it is in men. So is general paresis, also
called general paralysis of the insane, or softening of the brain.


=Chancroids=

There is one other minor disease belonging to the venereal diseases;
that is chancroids. Chancroids are little ulcers on the genitals; they
are purely local and do not affect the system. They are due largely to
uncleanliness, and are found only among the poorer classes of
prostitutes and therefore among the poorer classes of men. One sees
them now and then in public dispensaries, but in private practice they
are now quite rare. They used to be quite common, which shows that the
general level of cleanliness has been raised considerably among all
classes of people. At any rate, chancroids are of little significance,
as compared with syphilis and gonorrhea, and when speaking of the
venereal peril, these are the two diseases we have in mind.




CHAPTER TWENTY-SIX

THE CURABILITY OF VENEREAL DISEASE

 Gonorrhea May Be Practically Cured in Every Case in Man--Extensive
  Gonorrheal Infection in Woman Difficult to Cure--Positive Cure in
  Syphilis Impossible to Guarantee.


Just as the usual statements in regard to the extent of venereal
disease have been found untrue or greatly exaggerated, so do the
statements regarding the curability or rather incurability of venereal
disease need careful revision. The picture usually painted of the
hopelessness of gonorrhea and syphilis is too sombre, too black, and,
contrary to the assertions made by laymen and laywomen and physicians
who do not specialize in the treatment of venereal disease, I wish to
make the statement that every case of gonorrhea in man, without any
exception, if properly treated, can be perfectly cured, _as far as
practical purposes are concerned_. I add the last phrase because the
cure may not be perfect in the scientific sense of the word; that is,
the man may not be brought back into the condition in which he was
before he got the disease. But, for all practical purposes, as far as
he himself is concerned, as far as his wife is concerned, and as far
as the future children are concerned, every case may be cured, without
any doubt. And I say this, basing myself upon a varied professional
experience extending over nearly a quarter of a century.

As to gonorrhea in women, that depends to a great extent upon the
virulence of the disease and the promptness with which treatment is
instituted. If the gonorrhea is limited only to the cervix, the vulva
and the urethra, then prompt treatment will usually bring about a cure
in a comparatively short time. But if the gonorrheal inflammation has
extended to the body of the uterus, or still worse, to the tubes, then
the treatment may become a very tedious one, and some cases may not be
curable without an operation.

With syphilis the matter is different. Since the introduction by
Ehrlich of the various arsenic preparations, we have much better
success in the treatment of syphilis, and we can positively render
every case non-infectious to the partner. But, as to guaranteeing a
positive cure, that is, guaranteeing that the patient will never have
an outbreak or relapse of his disease in the future, and that the
children will be perfectly free from any taint, this we can do no more
now than we could before the modern treatment of syphilis was
introduced. The decision, therefore, as to whether we may or may not
permit a once syphilitic patient to marry will depend a great deal
upon whether or no the husband or the wife or both desire to have
children. If this is the case, we must often withhold our permission;
but if the man and woman agree to get married and to get along without
children, we will grant permission to the marriage in the vast
majority of cases. The subject of venereal disease and marriage will
be further discussed in separate chapters.

Venereal disease, I have to repeat, is terrible enough in itself,
without any exaggeration, without picturing it in too black colors.
And it is necessary that people should not have too black an idea of
it. It is necessary that they know that there are thousands and tens
of thousands of patients who suffered with gonorrhea or syphilis and
who were perfectly cured, who married, and whose wives remained
perfectly well, and who gave birth to perfectly healthy untainted
children.




CHAPTER TWENTY-SEVEN

VENEREAL PROPHYLAXIS

 Necessity for Douching Before and After Suspicious Intercourse--
  Formulæ for Douches--Precautions Against Non-venereal Sources of
  Infection--Syphilis Transmitted by Dentist's Instruments--
  Manicurists and Syphilis--Promiscuous Kissing a Source of
  Syphilitic Infection.


In his book, _Sex Knowledge for Men_, the author treated the subject
of prevention of venereal disease very thoroughly. Men need this
knowledge. As men _will_ indulge in illicit relations, we must teach
them to guard themselves against venereal infection. We must do it not
only for their own sake, but for the sake of their wives and children.
For, infection in the man may mean infection in his wife and children.
But as women readers of this book are not likely to indulge in
promiscuous relations with strangers, a detailed discussion of the
subject would be out of place.

I will merely say, that where the woman has a suspicion that her
husband is in an infectious state, she should abstain from relations
with him until she is sure that he is safe. But where for some reason
a suspicions intercourse is indulged in, the woman should use an
antiseptic douche _before_ and _after_ intercourse. Where it is
inconvenient to use a douche both before and after, a douche after
will have to suffice, but it is much safer and surer to use the douche
both before and after. When you use a douche there is always some of
the solution left in the vagina and that destroys wholly or in part
the infective germs. The following makes an effective douche: Dissolve
a tablet of bichloride (they come on the market of the weight of about
7½ grains) in two quarts of water--hot, lukewarm or cold. Use before
intercourse a small amount--about a pint or half a pint, and use the
balance after intercourse. Instead of the bichloride you may use a
tablespoonful of carbolic acid, or two tablets of chinosol, or a
tablespoonful of lysol, or two tablespoonfuls of boric acid.

Instead of the douche an antiseptic jelly in a collapsible tin tube
with a long nozzle may be used.

But besides the venereal sources of infection the woman must guard
against the non-venereal sources. Do not ever, if you can avoid it,
use a public toilet. If you are forced to use it, protect yourself by
putting some paper over the seat.

Do not use a public drinking cup. If you have to use one, keep your
lips away from the rim. One can learn to drink without touching the
rim of the glass or cup with the lips.

Do not under any circumstances use a public towel. The roller towel is
a menace to health and should be forbidden in every part of the
country.

If you have to sleep in a hotel or in a strange bed, make sure that
the linen is clean and fresh. Never sleep on bed linen which has been
used by a stranger.

Never use a public brush or comb.

Be sure that your dentist is a careful, up-to-date man, and sterilizes
his instruments carefully. Many a case of syphilis has been
transmitted by a dentist's instrument. A syphilitic who goes to a
dentist to be treated generally conceals his disease, and if the
dentist is not in the habit of sterilizing his instruments after each
patient, disaster may result.

Be sure that your manicurist is not syphilitic, or at least that her
hands are healthy, clean and free from any eruption.

And, last but not least, do not indulge in promiscuous kissing. This
is a particularly important injunction for young girls. This is a real
peril and there are thousands of cases of syphilis that are known to
have been contracted directly from kissing. People suffering with
syphilis often have little white sores (mucous patches) on their lips,
tongue and inside of cheeks. These sores are very infectious, and by
kissing the disease is readily transmitted. Kissing games have been
responsible in more than one case for the spread of syphilis to many
persons. I have now under treatment a girl of nineteen who contracted
syphilis on her summer vacation from having kissed a man once. Avoid
promiscuous kissing! It is a bad practice for more than one reason.




CHAPTER TWENTY-EIGHT

ALCOHOL, SEX AND VENEREAL DISEASE

 Alcoholic Indulgence and Venereal Disease--A Champagne Dinner and
  Syphilis--Percentage of Cases of Venereal Infection Due to
  Alcohol--Artificial Stimulation of Sex Instinct in Man and in
  Woman--Reckless Sexual Indulgence Due to Alcohol--Alcohol as an
  Aid to Seduction.


That Bacchus, the god of wine, is the strongest ally of Venus, the
goddess of love, using love in its physical sense, as the French use
the word _amour_, has been well known to the ancient Greeks and
Romans, as it is well known to-day to every saloon-keeper and every
keeper of a disreputable house. And all measures to combat venereal
disease and to prevent girls from making a false step will be only
partially successful if we do not at the same time carry on a strong
educational campaign against alcoholic indulgence. Of what use to
young men is the knowledge of the venereal peril and familiarity with
the use of venereal prophylactics, when under the influence of alcohol
the mind is befuddled, they forget everything and do things that they
never would do in the sober state? Of what use are warnings to a
girl, when under the influence of a heavy dinner and a bottle of
champagne, to which she is unaccustomed, her passion is aroused to a
degree she has never experienced before, her will is paralyzed and she
yields, though deep down in her consciousness something tells her she
shouldn't? Yields, becomes pregnant, and is in the deepest agony for
several months, and has a wound which will probably never heal for the
rest of her life? Of what use have all the lectures, books and
maternal injunctions been to her?

Or this case. Here is a young lawyer, twenty-eight years of age,
engaged to a fine girl, and with everything to look forward to. He
always was very moderate and circumspect in his sexual indulgence,
and, though careful in choosing his partners, he never failed to use a
venereal prophylactic after intercourse. There was too much at stake
for him, and he did not care to take any chances, even if the chances
were one in a thousand. For a period of one year during which he had
been engaged he abstained from sexual intercourse altogether, though
it cost him a great deal of effort to do so. He was to be married very
shortly. But ill-luck made him accept an invitation to a bachelor
dinner, where champagne and smutty stories were flowing freely, too
freely. He left about midnight, and as the night was beautiful he
decided to walk home. He met a siren, who invited him to accompany
her. Under other circumstances he would have sent her on her way, or
at least he would have stepped into a drugstore for a prophylactic.
But, excited by the wine, the smutty stories and the year's
abstinence, he went along like a sheep, as a matter of course, without
trying to reason or interposing any objections. He remembers
distinctly his feelings and the state of his mind. He was not drunk,
only exhilarated, but nevertheless the whole thing seemed to him so
normal, so natural, so expected, so matter-of-course, that he couldn't
think of acting otherwise than accept her invitation. And he stayed
two or three hours; and he used no prophylactic. And as a
result--three weeks later he had a typical primary syphilitic lesion.
How he felt and what it all meant to him the reader can imagine. This
is far from being an isolated, an exceptional case.

From my own practice I could cite a number of cases of venereal
infection in which alcohol was the direct, primary factor. How many
such cases there are altogether in the period of a year nobody can
say, but that they constitute a considerable percentage of the total
venereal morbidity every investigating sexologist will testify. Forel
claims that 76 per cent. of all venereal infection takes place under
the influence of alcohol; Notthaft is more moderate, more
discriminating in his statistics and his claims are--30 per cent. An
analysis of 1,000 cases of venereal infection, just published by Dr.
Hugo Hecht (_Venerische Infektion und Alkohol, Z.B.G._, Vol. XVI, No.
11) gives over 40 per cent. And the saddest part of it is that among
the infected were 75 married men (the author thinks there were more,
but only 75 confessed to being married), and of these, 45, equivalent
to 60 per cent., were under the influence of alcohol when they
contracted their venereal disease (extra-matrimonially, of course).

Alcoholic indulgence contributes to the spread of venereal disease
directly and indirectly. First and foremost it increases enormously
the amount of intercourse indulged in. I certainly do not belong to
those who believe that the sex instinct is merely a vicious appetite,
like the appetite for alcohol or drugs, which can easily and
completely be suppressed by the exertion of will-power. I believe that
the sex instinct can be suppressed only within reasonable limits; if
an attempt is made to exceed these limits dire results are apt to
follow. But I also believe that the sex instinct can be stimulated
artificially beyond the natural needs, and among the artificial
stimulants of the sex instinct alcohol occupies first place. And bear
in mind that alcohol produces even a stronger effect on women, in
exciting the sexual passion, than it does on men. Women are more
easily upset by stimulants and narcotics, and that is the reason why
it is more dangerous for women to drink than it is for men.

So this, then, is count number one: The man and the woman who in a
sober condition would easily abstain, with their libido stimulated and
their will-power paralyzed by alcohol, indulge unnecessarily, with the
risk of venereal infection to the man and the double risk of venereal
infection and pregnancy to the woman. Count two: The man who in the
sober condition would use care and discrimination, under the influence
of alcohol soon loses all his judgment and sees an angel and a Helen
of Troy in the worst and most impudent harlot; with the result that
the chances of venereal infection are greatly increased. Count three:
Where under ordinary circumstances the man would stay a few minutes to
half an hour, under the influence of alcohol he stays several hours,
or all night, thus increasing his chances of infection a hundredfold.
Count four: Alcohol increases the congestion in the genital organs of
both man and woman and renders them much more _susceptible_ to
infection. All other factors being equal, a connection which will
under strict sobriety remain without bad results, may when one or
both partners are under the influence of alcohol be followed by
infection. Count five: The man who is in the habit of using venereal
prophylactics under the influence of alcohol becomes both careless and
reckless; he looks with contempt at preventive measures and the result
is--venereal disease.

It is impossible to give statistics and exact or even approximate
figures. But there is no question in my mind, in the mind of any
careful investigator, that if alcoholic beverages could be eliminated,
the number of cases of venereal infection would be diminished by about
one-half. And what is true of venereal disease is also true of
seduction of young girls. Alcohol is the most efficient weapon that
either the refined Don Juan or the vulgar pimp has in his possession.

You cannot hope for complete success in eliminating venereal disease
and seduction unless you also eliminate alcoholism. For Bacchus is the
ally not only of Venus Aphrodite but also of Venus vulgivaga.




CHAPTER TWENTY-NINE

MARRIAGE AND GONORRHEA

 Decision of Physician Regarding Marriage of Patients Infected with
  Gonorrhea or Syphilis--Advisability of Certificate of Freedom
  from Transmissible Disease--Premarital Examination as a Universal
  Custom--When a Man Who Had Gonorrhea May Be Allowed to Marry--
  When a Woman Who Had Gonorrhea May be Allowed to Marry--Antisepsis
  Before Coitus--Question of Sterility in the Man Who Has Had
  Gonorrhea Easily Answered--Impossibility of Determining Whether
  the Woman is Fertile or Not.


For a man or a woman who has once suffered from gonorrhea or syphilis
to enter matrimony without having secured a competent physician's
opinion is a great responsibility. And a great responsibility rests
upon the shoulders of the physician who is called upon to give such an
opinion. For, a wrong decision--a wrong decision either way--that is,
permission to marry when permission should not have been granted or
refusal to give permission when permission should have been
granted--may be responsible for much future unhappiness and much
disease: disease of the mother and of the offspring. It may even be
responsible for death.

There is no easy, short road to a positive opinion. It requires a
thorough, painstaking examination at the hands of an experienced
physician, one thoroughly familiar with all the modern tests, to tell
whether it is safe for a man who once suffered from venereal disease
to enter the bonds of matrimony. Sometimes one examination is not
sufficient, and several examinations may be necessary; but, the
opinion of a conscientious, experienced physician may be relied upon,
and, if all men and women who once suffered from venereal disease
would seek for, and be guided by, such an opinion, there would be no
cases of marital infection, there would be no children afflicted with
gonorrheal ophthalmia, there would be no cases of hereditary syphilis.

I firmly believe that a time will come when all venereal disease will
have disappeared from the face of the earth. But, until that time
comes, it would be for the benefit of the race and of posterity if
people had to present a certificate of freedom from transmissible
venereal disease as a prerequisite to a marriage license. Custom is
often more efficient than law, and, if a premarital examination should
become a universal custom (and there are indications in this
direction), no law would be needed.

=When May a Man Who Had Gonorrhea Get Married?= For a man who once
suffered from gonorrhea to be pronounced cured and a safe candidate
for marriage, the following conditions must be present:

1. There must be no discharge.

2. The urine must be perfectly clear and free from shreds.

3. The secretion from the prostate gland, as obtained by prostatic
massage, and from the seminal vesicles, as obtained by "milking," or
"stripping," the vesicles, must be free from pus and gonococci. To
make sure, it is best to repeat such examination at three different
times.

4. There must be neither stricture nor patches in the urethra.

5. What we call the complement-fixation test, which is a blood test
for gonorrhea similar to the Wassermann blood-test for syphilis, must
be negative.

Referring to conditions 1 and 2, it sometimes happens that the patient
has a minute amount of discharge or a few shreds in the urine, and I
still permit him to marry; but this is done only after the discharge
and shreds have been repeatedly examined and have been found to be
catarrhal in character and absolutely free from any gonococci or other
germs.

It sometimes happens that a patient comes to me for an examination a
few days before the date set for the wedding. I examine him and find
that he is not in a safe condition to marry, and so advise him to
delay the wedding. Sometimes he follows the advice, but in some cases
he is unable to do so. He claims the wedding has been arranged, the
invitation-cards have been sent out, and to delay the wedding would
lead to endless trouble and perhaps scandal. In such cases I, of
course, assume no responsibility; however, I do advise the man to use
an antiseptic suppository or some other method that will protect the
bride from infection for the time being, while he, the husband, has an
opportunity to take treatment until cured. Of the many cases in which
I advised this method, I do not know of one in which infection has
taken place.

=When May a Woman Who Once Had Gonorrhea Be Permitted to Marry?= In
the case of a woman, the decision may be harder to reach than in that
of a man. Of course, the urine must be clear and the urethra must be
normal; however, we cannot insist that there must be no discharge.
This, because practically every woman has some slight discharge; even,
if not all the time, then at least immediately prior and subsequent to
menstruation. Of course, the discharge must be free from gonococci and
pus. Also the complement-fixation tests must be negative. But, even
so, we cannot be absolutely sure, because gonococci may be hidden in
the uterus or in the Fallopian tubes.

Here, we have to go a good deal by the history given us. If the woman,
during the course of the gonorrhea, had salpingitis, that is, an
inflammation of the Fallopian tubes, then we can never say positively
that she is cured; all we can say, at best, is: presumably cured. And,
further, if she has no pains in the uterine appendages, either
spontaneous or on examination, and, if several examinations made
within a day or two following menstruation are negative, then we may
assume that she is cured. It is important, though, that this
examination be made on the last day of menstruation or on the first or
second day following; for there are many cases in which no pus and no
gonococci will show in the inter-menstrual period, but will appear on
those particular days, because, if the gonococci are hidden high up,
they are likely to come down with the menstrual blood and portions of
mucous membrane that are shed during menstruation.

At best, it is a delicate problem, so that whenever there has been the
least suspicion that the woman may harbor gonococci I have always
advised (as is my custom, to be on the safe side) and directed the
woman to use either an antiseptic suppository or an antiseptic douche
before coitus. With these precautions adopted, I have never had an
accident happen.

=The Question of Probable Sterility.= Thus far I have considered the
problem of marriage from the standpoint of infectivity. But, we know
that, besides the effect on the individual, gonorrhea has also a
far-reaching influence on the race; in other words, that it is prone
to make the subjects--both men and women--sterile. And a candidate for
marriage may, and often does, want to know whether, besides being
noninfective, he or she is capable of begetting or having children.

In the case of man, the problem is, fortunately, a very simple one. We
can easily obtain a specimen of the man's semen and determine, by
means of the microscope, whether it contains spermatozoa or not. If it
does contain a normal number of lively, rapidly moving spermatozoa,
the man is fertile, regardless of whether he ever had epididymitis or
not. If the semen contains no spermatozoa, or only a few deformed or
lazily moving ones, then he is sterile.

In the case of woman, it is _absolutely_ impossible to determine
whether the gonorrhea has made her sterile or not; because there is no
way of expressing an ovum from the ovary. The woman may not have had
any pain or inflammation in the Fallopian tubes, and yet there may
have been sufficient inflammation to close up the orifices of the
tubes. On the other hand, she may have had a severe salpingitis on
_both sides and still be fertile_. Nor is there any way of telling
whether the ovaries were so involved in the process as to become
incapable of generating healthy ova, or any ova at all. In short,
there is absolutely no way of telling whether a woman is sterile or
fertile--we can only surmise. And our surmise in this respect is
liable to be wrong just as often as right. The only way the question
can be decided is by experience. If the prospective husband is willing
to take a chance, well and good.

While just as many girls marry as do young men, still, in practice, we
always shall have to examine an incomparably larger number of male
than of female candidates. This is due, not only to the fact that an
incomparably larger number of men suffer from venereal disease, but
also because very few women will confess to their fiancés that they
ever entertained antematrimonial relations and--what is still
worse--were infected with venereal disease. This, of course, is owing
to our double standard of morality, which looks upon as a trivial or
no offense in the man what it condemns as a heinous crime in the
woman. I have known hundreds of men who confessed freely to their
fiancées that they had had gonorrhea, but I have known only two girls
who made a confession of the fact to their future husbands. They got
married, however, and lived happily with their husbands ever after.




CHAPTER THIRTY

MARRIAGE AND SYPHILIS

 Rules for Permitting a Syphilitic Patient to Marry--Rules More
  Severe in Cases Where Children Are Desired--Where Both Partners
  Are Syphilitic--Danger of Paresis in Some Syphilitic Patients--A
  Case in the Author's Practice.


The problem of the syphilitic differs from the problem of the
exgonorrheal patient. When a gonorrheal patient is cured, so far as
infectivity is concerned, and is not sterile, there is no apprehension
as to the offspring. Gonorrhea is not hereditary, and the child of a
gonorrheal patient does not differ from the child of a nongonorrheal
person. In the case of syphilis, it is different. The patient may be
safe so far as infecting the partner is concerned, but yet there may
be danger for the offspring.

The rules for permitting a man or a woman who once had syphilis to
marry, therefore, are different from those applied to the gonorrheal
patient. Here are the rules:

1. I would make it an invariable rule that no syphilitic patient
should marry or should be permitted to marry before _five_ years have
elapsed from the day of infection. But the period of time alone is
not sufficient; other conditions must be met before we may give a
syphilitic patient permission to marry.

2. The man or the woman must have received thorough systematic
treatment for at least three years, either constantly or off and on,
according to the physician's judgment.

3. For at least one year before the intended marriage, the person must
have been absolutely free from any manifestations of syphilis; that
is, from any eruptions on the skin, from any mucous patches, swelling
in the bones, ulcerations, and so on.

4. Four Wassermann tests, taken at intervals of three months and at a
time _when the patient was receiving no specific treatment_, must be
absolutely negative.

If these four conditions are fully met, then the patient may be
permitted to marry.

It is important, however, to state that, in permitting or refusing
syphilitic persons to marry, we are guided to a great extent by the
fact as to whether they _expect to have children soon or not_.

In the case of a couple who are anxious to have children soon after
their marriage, the conditions for our permission must be more severe
than when the couple are willing or anxious to use contraceptive
measures for the first years of their married life. For, if a man is
free from any skin lesions and from any mucous patches, his wife is
safe from infection _as long as she does not become pregnant_. But, if
she does get pregnant, she may become infected through the fetus; and,
of course, the child also is liable to be syphilitic. Hence, much
stricter requirements for syphilitics who expect to become parents are
necessary than for those who do not.

In case both the man and the woman are or have been syphilitic,
permission to marry may be granted without hesitation, as the danger
of infection is absent, but permission to have children must be
refused _absolutely_ and _unequivocally_. Regardless of the time that
may have elapsed from the period of infection, regardless of
treatment, regardless of Wassermann tests, the danger to the child is
too great if both parents have the syphilitic taint in them. A healthy
child _may_ be born from two syphilitic parents who have undergone
energetic treatment, but we have no right to take the chance. I, at
least, never wanted to, nor ever will want to, take such a
responsibility.

=The Danger of Locomotor Ataxia or Paresis.= There is still one more
point to consider in dealing with a syphilitic patient. In patients
who did not receive energetic treatment from the very beginning of the
disease as also in patients whose treatment was only desultory and
irregular, we never can guarantee, in spite of lack of external
symptoms, in spite of a negative Wassermann reaction, that some
trouble may not develop later in life.

What shall we do in such cases and what particularly shall we do if,
from a general examination of the patient, we carry away the
impression that, while free from the danger of infection, the man is
not a good risk? Under these circumstances, we must refuse all
personal responsibility, leaving the assumption of the responsibility
to the prospective wife.

Here is a case in point. About five years ago a man came to me for
examination; he came with his fiancée. He had contracted syphilis ten
years previously, received irregular treatment by mouth, off and on.
For five years, he had had no symptoms of any kind. He _considered_
himself cured, but wanted to know, and his fiancée wanted to know,
whether he really was cured. There were no symptoms of any kind and
the Wassermann test was negative. Nevertheless, I could not give him a
clean bill of health. I noticed what seemed to me a slowness in
thinking and just the least bit of hesitation in his speech.

I told the girl (the man was thirty-five, she was thirty-two) that I
could not render a definite decision in the matter, that everything
might be all right, and then again it might not; but, that the
question about children she would have to decide definitely, once for
all, namely, that she was not to have any children. She was fully
satisfied so far as that part was concerned; she said she herself
objected to children and did not intend to have any and knew how to
take care of herself. All she wanted to know was, whether she was in
danger of being infected. I told her no, but that in my opinion there
was some danger of her husband developing general paresis or locomotor
ataxia.

The girl had been a teacher for about twelve years, and she was so
sick at heart of the work, was so anxious for a home of her own, that
she decided to take the risk. And they got married. The marriage
remained childless. The man developed general paresis (softening of
the brain) three years later and died about a year afterward. The
woman, now a widow, I understand, is not sorry for the step she had
taken. This shows what things our social-economic conditions and our
moral code are responsible for.




CHAPTER THIRTY-ONE

WHO MAY AND WHO MAY NOT MARRY

 The Physician Often Consulted as to Advisability of
  Marriage--_Venereal Disease_ the Most Common Question--
  _Tuberculosis_--Sexual Appetite of Tubercular Patients--Effect
  of Pregnancy Contraceptive Knowledge for Tubercular Wife--
  _Heart Disease_--Serious Bar to Marriage--Influence of Sexual
  Intercourse--_Cancer_--Fear of Hereditary Transmission--
  _Exophthalmic Goiter_--Most Frequent in Women--Simple Goiter--
  Exceptions to Rule--_Obesity_--Family History--Obesity and
  Stoutness Not Synonymous--_Arteriosclerosis_--Danger in Sexual
  Act--_Gout_--Real Causes of Gout--_Mumps_--Parotid Glands and Sex
  Organs--Mumps and Sterility--Oöphoritis Due to Mumps--
  _Hemophilia_--Hemophilic Sons May Marry--Hemophilic Daughters May
  Not Marry--_Anemia_--_Chlorosis_--_Epilepsy_--Hysteria--Symptoms of
  Hysteria--Marriage of Hysterical Women--_Alcoholism_--Effect on
  Offspring--Alcoholics and Impotence--_Feeblemindedness_--Evil
  Effects on Offspring--Sterilization of Feebleminded Only
  Preventive--_Insanity_--Functional Insanity--Organic Insanity--
  Hereditary Transmissibility of Insanity--Fear Resulting in
  Insanity--Environment versus Heredity in Insanity--_Neurosis_--
  _Neurasthenia_--_Psychasthenia_--_Neuropathy_--_Psychopathy_--Nervous
  Conditions and Genius--Sexual Impotence and Genius--_Drug
  Addiction_--External Causes--_Consanguineous Marriages_--When
  Consanguineous Marriages are Advisable--Offspring of Consanguineous
  Marriages--Homosexuality--Homosexuals Often Ignorant of Their
  Condition--Sexual Repression and Homosexuality--Sadism and
  Divorce--Masochism--Sexual Impotence and Marriage--Effect Upon
  the Wife--Frigidity--Marital Relations and Frigid Woman--Excessive
  Libido and Marriage--Excessive Demands Upon Wife--Satyriasis--
  The Excessively Libidinous Wife--Nymphomania--Treatment--Harelip--
  Myopia--Astigmatism--Premature Baldness--Criminality--Crime as
  Result of Environment--Legal and Moral Crime--Ancestral Criminality
  and Marriage--Rules of Heredity--Pauperism--Difference Between
  Pauperism and Poverty.


In former years, nobody thought of asking a physician for permission
to get married. He was not consulted in the matter at all. The parents
would investigate the young man's social standing, his ability to make
a living, his habits perhaps, whether he was a drinking man or not,
but to ask the physician's expert advice--why, as said, nobody thought
of it. And how much sorrow and unhappiness, how many tragedies the
doctor could have averted, if he had been asked in time! Fortunately,
in the last few years, a great change has taken place in this respect.
It is now a very common occurrence for the intelligent layman and
laywoman, imbued with a sense of responsibility for the welfare of
their presumptive future offspring and actuated, perhaps, also by some
fear of infection, to consult a physician as to the advisability of
the marriage, leaving it to him to make the decision and they abiding
by that decision.

As a matter of fact, as often is the case, the pendulum now is in
danger of swinging to the other extreme; for, a little knowledge is a
dangerous thing, and the tendency of the layman is to exaggerate
matters and to take things in an absolute instead of in a relative
manner. As a result, many laymen and laywomen nowadays insist upon a
thorough examination of their own person and the person of their
future partner, when there is nothing the matter with either. Still,
this is a minor evil, and it is better to be too careful than not
careful enough.

I am frequently consulted as to the advisability or nonadvisability of
a certain marriage taking place. I, therefore, thought it desirable to
discuss in a separate chapter the various factors, physical and
mental, personal and ancestral, likely to exert an influence upon the
marital partner and on the expected offspring, and to state as briefly
as possible and so far as our present state of knowledge permits which
factors may be considered eugenic, or favorable to the offspring, and
dysgenic, or unfavorable to the offspring.

The questions concerning the advisability of marriage which the layman
as well as the physician have most often to deal with are questions
concerning venereal disease. On account of the importance of the
subject, these have been discussed rather in detail under the headings
"Gonorrhea and Marriage" and "Syphilis and Marriage." Other factors
affecting marriage, either in the eugenic or dysgenic sense, will be
discussed more briefly in the present chapter, and more or less in
the order of their importance.


=Tuberculosis=

Tuberculosis, which carries off such a large part of humanity every
year, is caused by the well-known bacillus tuberculosis, discovered by
Koch. The germ is generally inhaled through the respiratory tract, and
most frequently settles in the lungs, giving rise to what is known as
pulmonary consumption. However, many other organs and tissues may be
affected by tuberculosis.

Tuberculosis used to be considered the hereditary disease _par
excellence_. Entire families were carried off by it, and, seeing a
tuberculous father or mother and then tuberculous children, it was
assumed that the infection had been transmitted to the children by
heredity. As a matter of fact, the disease was spread by infection. In
former years, little care was exercised about destroying the sputum;
the patients would spit indiscriminately on the floor, and the sputum,
drying up, would be mixed with the dust and inhaled. Often the
children crawling on the floor would introduce the infective material
directly, by putting their little fingers in their mouths.

It is now known that tuberculosis is not a hereditary disease, that
is, that the germs are not transmitted by heredity. _The weak
constitution_, however, which favors the development of tuberculosis,
is inherited. And children of tuberculous parents, therefore, must not
only be guarded against infection, but must be brought up with special
care, so as to strengthen their resistance and overcome the weakened
constitution which they inherited.

That a person with an active tuberculous lesion should not get married
goes without saying. But, it is a good rule to follow for a
tuberculous person not to marry for two or three years, until all
tuberculous lesions have been declared healed by a competent
physician. As a rule, a tuberculous patient is a poor provider, and
that also counts in the advice against marriage. Then sexual
intercourse has, as a rule, a strong influence on the development of
the disease. Unfortunately the sexual appetite of tuberculous patients
is not diminished, but, rather, very frequently heightened; and
frequent sexual relations weaken them and hasten the progress of the
disease.

As to pregnancy, that has an extremely pernicious effect on the course
of tuberculosis, and no tuberculous woman should ever marry. If such a
one does marry or if the disease develops after her getting married,
means should be given her to prevent her from having children. During
the pregnancy, the disease may not seem to be making any
progress--occasionally the patient may even seem to improve--but after
childbirth the disease makes very rapid strides and the patient may
quickly succumb. In the early days of my practice I saw a number of
such cases. If precautions are taken against pregnancy, then
permission to indulge in sexual relations may be given, provided it is
done rarely and moderately.

If a patient who has tuberculosis conceals the fact from the future
partner, a fraud is committed, and the marriage is morally annullable.
It has been declared legally annullable by a recent decision of a New
York judge.


=Heart Disease=

Heart disease also is no longer considered hereditary. Nevertheless,
heart disease, if at all serious, is a contraindication to marriage.
First, because the patient's life may be cut off at any time. Second,
sexual intercourse is injurious for people having heart disease; it
may aggravate the disease or even cause sudden death. It is more
injurious even than it is in tuberculosis. Third--and this concerns
the woman only--pregnancy has a _very_ detrimental effect upon a
diseased heart. A heart that, with proper care, might be able to do
its work for years, often is suddenly snapped by the extra work put
upon it by pregnancy and childbirth. Sometimes a woman with a diseased
heart will keep up to the last minute of the delivery of the child and
then suddenly will gasp and expire. In the first year of my practice I
saw such a case, and I never have wanted to see another. Women
suffering from heart disease of any serious character should not,
under any circumstance, be permitted to become pregnant.


=Cancer=

No man will knowingly marry a woman, and no woman will marry a man,
afflicted with cancer. However, this question often comes up in cases
where the matrimonial candidates are free from cancer, but where there
has been cancer in the family.

Cancer is not a hereditary disease, contrary to the opinions that have
prevailed, and, if the matrimonial candidate otherwise is healthy, no
hesitation need be felt on the score of heredity. The fear of
hereditary transmission of the disease has caused a great deal of
mischief and unnecessary anxiety to people. Scientifically conducted
investigations and carefully prepared statistics have shown that many
diseases formerly considered hereditary are not hereditary in the
least degree.

Should it, however, be shown that in one family there were _many_
members who died of cancer, it would indicate that there is some
disease or dyscrasia in that family, and the contracting of a marriage
with any member of that family would be inadvisable.


=Exophthalmic Goiter= (=Basedow's Disease=)

Exophthalmic goiter is a disease characterised by enlargement of the
thyroid gland, protrusion of the eyeballs, and rapid beating of the
heart. The disease is confined almost entirely, though not
exclusively, to women, and I should not advise any exophthalmic woman
to marry; neither should I advise a man to marry an exophthalmic
goiter woman. It is a very annoying disease, while sexual intercourse
aggravates all the symptoms, particularly the palpitation of the
heart. The children, if not affected by exophthalmic goiter, are
liable to be very neurotic.

_Simple goiter_, that is, enlargement of the thyroid gland (chiefly
occurring in certain high mountainous localities, such as
Switzerland), is not so strongly dysgenic as is exophthalmic goiter.
Still, goiter patients are not good matrimonial risks.

Of course, there are always exceptions. I know an exophthalmic goiter
woman who brought up four children, and very good, healthy children
they are. But in writing we can only speak of the average and not of
exceptions.


=Obesity=

Obesity, or excessive stoutness, is an undue development of fat
throughout the body. That it is hereditary, that it runs in families,
there is no question whatsoever. And, while with great care as to the
diet and by proper exercise, obesity may, as a rule, be avoided in
those predisposed, it none the less often will develop in spite of all
measures taken against it. Some very obese people eat only one-half or
less of what many thin people do; but in the former, everything seems
to run to fat.

Obesity must be considered a dysgenic factor. The obese are subject to
heart disease, asthma, apoplexy, gallstones, gout, diabetes,
constipation; they withstand pneumonia and acute infectious diseases
poorly, and they are bad risks when they have to undergo major
surgical operations. They also, as a rule, are readily fatigued by
physical and mental work. (As to the latter, there are remarkable
exceptions. Some very obese people can turn out a great amount of
work, and are almost indefatigable in their constant activity.) Each
case should be considered individually, and with reference to the
respective family history. If the obese person comes from a healthy,
long lived family and shows no circulatory disturbances, no strong
objections can be raised to him or to her. But, as a general
proposition, it must be laid down that obesity is a dysgenic factor.

But bear in mind that obesity and stoutness are not synonymous terms.


=Arteriosclerosis=

Arteriosclerosis means hardening of the arteries. All men over fifty
are beginning to develop some degree of arteriosclerosis; but, if the
process is very gradual, it may be considered normal and is not a
danger to life; when, however, it develops rapidly and the blood
pressure is of a high degree, there is danger of apoplexy.
Consequently, arteriosclerosis and high blood pressure must be
considered decided bars to marriage.

It must be borne in mind that the sexual act is, in itself, a danger
to arteriosclerotics and people with high blood pressure, because it
may bring about rupture of a blood-vessel. There are many cases of
sudden death from this cause of which the public naturally never
learns. Married persons who find that they have arteriosclerosis or
high blood pressure should abstain from sexual relations altogether or
indulge only at rare intervals and moderately.


=Gout=

A consideration of gout in connection with the question of heredity
will show how near-sighted people can be, how they can go on believing
a certain thing for centuries without analyzing, until somebody
suddenly shows them the absurdity of the thing. Gout was always
considered a typical hereditary disease; for it was seen in the
grandfathers, fathers, children, grandchildren, and so on. So,
certainly, it must be hereditary! It did not come to our doctors'
minds to think that perhaps, after all, it was not heredity that was
to blame, but simply that _the same conditions_ that produced gout in
the ancestors likewise produced it in their descendants.

We know now that gout is caused by excessive eating, excessive
drinking, lack of exercise, and faulty elimination. And, since, as a
general thing, children lead the same lives that their fathers did,
they are likely to develop the same diseases as their fathers did. A
poor man who leads an abstemious life doesn't develop gout, and if his
children lead the same abstemious lives they do not develop gout.
(There are some cases of gout among the poor, but they are very rare.)
But if they should begin to gorge and live an improper life they would
be prone to develop the disease.

The disease, therefore, cannot in any way be considered hereditary. In
matrimony, gout in either of the couple is not a desirable quality,
but it is not a bar to marriage; and, if the candidate individually is
healthy and free from gout, the fact that there was gout in the
ancestry should play no rôle.


=Mumps=

Mumps is the common name for what is technically called parotitis (or
parotiditis). Parotitis is an inflammation of the parotid glands. The
parotid glands are situated, one on each side, immediately in front
and below the external ear, and they are between one-half and one
ounce in weight. They belong to the salivary glands; that is, they
manufacture saliva, and each parotid gland has a duct through which it
pours the saliva into the mouth. These ducts open opposite the second
upper molar teeth.

We might be surprised to be told that these parotid glands can have
anything to do with the sex organs, but there is no other remote organ
that has such a close and rather mysterious relationship with the
sex-glands as have the parotids. When the parotid glands, either one
or both, are inflamed, the testicles or ovaries are also liable to be
attacked by inflammation. The inflammation of the testicles may be so
severe as to cause them to shrivel and dry up; or, even when no
shrivelling, no atrophy of the testicles occurs, they may be so
affected as to become incapable of producing spermatozoa. Moreover, in
cases where the testicles of a mumps patient seemingly were not
attacked--that is, where the patient was not aware of any
inflammation, having no pain and no other symptoms--the testicles may
have become incapable of generating spermatozoa.

Besides the testicles, the prostate gland, the secretion of which is
necessary to the fertility of the spermatozoa, may also become
affected and _atrophied_.

It is, therefore, a very common thing for men who had the mumps in
their childhood to be found sterile.

As to the sexual power of mumps patients, that differs. Some patients
lose their virility entirely; others remain potent, but become
sterile.

The same thing happens to girls attacked by mumps. They may have a
severe inflammation of the ovaries (ovaritis or oöphoritis) or the
inflammation may be so mild as to escape notice. In either case, the
girl when grown to womanhood may find herself sterile.

A man who never had any venereal disease, but who has had mumps,
should have himself examined for sterility before he gets married. As
explained in the chapter "Marriage and Gonorrhea," we can, in the
case of a man, easily find out whether he is fertile or sterile. But,
in the case of a woman, we can not. Time, necessarily, has to answer
that question. In all cases, mumps reduces the chances of fertility,
and no man or woman who once had mumps should get married without
informing the respective partner of the fact. There should be no
concealment before marriage. When the partners to the marriage
contract know of the facts, they can then decide as to whether or not
the marriage is desirable to them.


=Hemophilia, or Bleeders' Disease=

Hemophilia is a peculiar disease, consisting in frequent and often
uncontrollable hemorrhages. The least cut or the pulling of a tooth
may cause a severe or even dangerous hemorrhage. The slightest blow,
squeeze or hurt will cause _ecchymoses_, or discolorations of the
skin. The peculiarity of this hereditary disease is, that it attacks
almost exclusively the males, but is transmitted almost exclusively
through the female members. For instance, Miss A., herself _not_ a
bleeder, comes from a bleeder-family. She marries and has three boys
and three girls; the three boys will be bleeders, the three girls will
not; the three boys marry and have children; their children will
_not_ be bleeders; the three girls marry, and _their male_ children
will be bleeders.

What is the lesson? The lesson is, that boys who are bleeders may
marry, because they will most likely _not_ transmit the disease; but
girls who come from a hemophilic family, irrespective of whether they
themselves are hemophilics or not, must not marry, because most likely
they _will_ transmit the disease.


=Anemia=

Anemia is a poor condition of the blood. The blood may contain an
insufficient number of red blood cells or an insufficient percentage
of the coloring matter of the blood, that is, hemoglobin. A special
kind of anemia affecting young girls is called chlorosis.

Anemia and chlorosis cannot be considered contra-indications to
marriage, because they are usually amenable to treatment. In fact,
some cases of anemia and chlorosis are due to the lack of normal
sexual relations, and the subjects get well very soon after marriage.
But it is best and safest to subject anemic patients to a course of
treatment and to improve their condition before they marry.


=Epilepsy=

While epilepsy--known commonly as fits or falling sickness--is not as
hereditary as it was one time thought to be, its hereditary character
being ascertainable in only about 5 per cent. of cases, nevertheless,
it is a decidedly dysgenic agent, and marriage with an epileptic is
distinctly advised against. Where both parents are epileptics, the
children are almost sure to be epileptic, and such a marriage should
be prohibited by law. Under no circumstances should parents who are
both epileptic bring children into the world. It should be the duty of
the State to instruct them in methods of preventing conception.


=Hysteria=

Hysteria is a disease the chief characteristics of which are a _lack
of control_ over one's emotions and acts, the _imitation_ of the
symptoms of various diseases, and an _exaggerated_ self-consciousness.
The patient may have extreme pain in the region of the head, ovaries,
spine; in some parts of the skin there is extreme hypersensitiveness
(hyperesthesia), so that the least touch causes great pain; in others,
there is complete anesthesia--that is, absence of sensation--so that
when you stick the patient with a needle she will not feel it. A very
frequent symptom is a choking sensation, as if a ball came up the
throat and stuck there (globus hystericus). Then there may be spasms,
convulsions, retention of urine, paralysis, aphonia (loss of voice),
blindness, and a lot more. There is hardly a functional or organic
nervous disorder that hysteria may not simulate.

Of late years our ideas about hysteria have undergone a radical
change, and we now know that most, if not all, cases of hysteria are
due to a repression or non-satisfaction of the sexual instinct or to
some shock of a sexual character in childhood. Only too often a girl
who was very hysterical before marriage loses her hysteria as if by
magic upon contracting a _satisfactory_ marriage. On the other hand, a
healthy girl can become quickly hysterical if she marries a man who is
sexually impotent or who is disagreeable to her and incapable of
satisfying her sexually.

While hysteria, in itself, is not hereditary, it, nevertheless, is a
question whether a strongly hysterical woman would make a satisfactory
mother. The entire family history should be investigated. If the
hysteria is found to be an isolated instance in the given girl, it may
be disregarded, if not extreme; but if the entire family or several
members of it are neuropathic, the condition is a dysgenic one.
Marriage may be contracted, provided no children are brought into the
world until several years have elapsed and the mother's organization
seems to have become more stable. In some cases, a child acts as a
good medicine against hysteria. In short, every case must be examined
individually on its merits, and the counsel of a good psychologist or
psychoanalyst may prove very valuable.


=Alcoholism=

A good deal depends upon what we understand by alcoholism. The
fanatics consider a person an alcoholic who drinks a glass of beer or
wine with his meals. This is nonsense. This is not alcoholism, and
cannot be considered a dysgenic factor. But, where there is a distinct
habit, so that the individual _must_ have his alcohol daily, or if he
goes on an occasional drunken "spree," marriage must be advised
against. And where the man (or woman) is what we call a real drunkard,
marriage not only should be advised against, but most decidedly should
be prohibited by law.

Alcoholism, as a habit, is one of the worst dysgenic factors to reckon
with. First, the offspring is liable to be affected, which is
sufficient in itself to condemn marriage with an alcoholic. Second,
the earning powers of an alcoholic are generally diminished, and are
likely gradually to diminish more and more. Third, an alcoholic is
irritable, quarrelsome, and is liable to do bodily injury to his wife.
Fourth an alcoholic often develops sexual weakness or complete sexual
impotence. Fifth, alcoholics are likely to develop extreme jealousy,
which may become pathological, even to the extent of a psychosis.

If both the husband and wife are alcoholics, then marriage between
them which results in children is not merely a sin, but a crime.

We do not now come across cases so often as we used to of women
marrying drunkards in the hope or with the hope of reforming them. But
such cases still happen. This is a very foolish procedure. Let the man
reform first, let him stay reformed for two or three years, and then
the woman may take the chance, if she wants to.


=Feeblemindedness=

Feeblemindedness, in all its gradations--including idiocy, imbecility,
moronism, and so on--is strongly hereditary and is one of the most
dysgenic factors we have to deal with. It is the most dysgenic of all
factors. It is more dysgenic than insanity. Marriage with a
feebleminded person not only should be advised against, but should be
prohibited by law. A feebleminded man has much fewer chances for
marriage than has a feebleminded woman. Feebleminded girls, even to
the extent of being morons, if pretty (as they often are) have very
good chances of getting married, not infrequently getting for husbands
young men of good families who themselves of course are not very
strong mentally, but still are far from being considered feebleminded.

There are many cases of brilliant men--more than the public has any
idea of--who married pretty, shy, demure, but withal feebleminded,
girls, and the result has been in the largest percentage of cases very
disastrous. In many cases all the children are feebleminded, or if not
feebleminded, so weak mentally that it is impossible to make them go
through any college or school. All the private tutoring is often in
vain. And the brilliant father's heart breaks. It must be borne in
mind that feeblemindedness or weak mentality is much more difficult to
detect in a woman than it is in a man. Weakmindedness in a woman often
passes for "cuteness," and as among the conservatives a woman is not
expected to be able to discuss current topics, her intellectual
caliber is often not discovered by the blinded husband until some
weeks after the marriage ceremony.

As any instruction in the use of contraceptives would be wasted on the
feebleminded, the only way to guard the race against pollution with
feebleminded stock is either to segregate or to sterilize them.
Society could have no objection against the feebleminded marrying or
indulging in sexual relations, provided it could be assured that they
will not bring any feebleminded stock into the world. After the man
and the woman have been sterilized there is no objection to their
getting married.

Where a normal, able or brilliant husband finds out too late that his
wife's mentality is of rather a low order he is certainly justified in
using contraceptives; and if he is determined to have children he will
be obliged to divorce his wife. Of course this applies also to the
wife of a weak minded husband.


=Insanity=

Insanity may be briefly defined as a disease of the mind. We will not
here go into a discussion as to what constitutes real insanity, as to
what is understood by insanity in the legal sense of the term, and so
on, except to note that we have two divisions.

One is functional insanity. This may be temporary, or periodical, and
is due to some external cause, is curable, and is not hereditary. For
instance, a person may get insane from a severe shock, from trouble,
from anxiety, from a severe accident (such as a shipwreck), from a
sudden and total loss of his fortune, of his wife and children (by
fire, earthquake, shipwreck or railroad accident). Such insanities are
curable and are not transmissible. Another example is what is known as
puerperal insanity. Some women during childbirth, due probably to some
toxic infection, become insane. This insanity may be extreme and
maniacal in character. Still, it often passes away in a few days
_without leaving any trace_ and may never return again, or, if it does
return, it may return only during another childbirth. This kind of
insanity is not transmissible.

The second division is what we call organic insanity. This expresses
itself in mania and melancholy, so-called manic-depressive insanity.
This is due to a degeneration of the brain-and nerve-tissue and is
hereditary.

But, our entire conception as to the hereditary transmissibility of
insanity has undergone a radical change. There is hardly another
disease the fear of whose hereditary character is responsible for so
much anguish and torture. In former years, when there was an insane
uncle or aunt or grandparent that fact weighed like a veritable
incubus on the entire family. Every member of the family was tortured
by the secret anguish that maybe he or she would be next to be
affected by this most horrible of all diseases--disease of the mind.
If an ancestral member of the family became insane at a certain age,
every member of that family was living in fear and trembling until
several years had passed _after_ that critical age, and only then
would they begin to breathe freely. Indeed, many people became insane
from the very fear of becoming insane. It cannot be subject to any
doubt that many people do become mentally unbalanced from the fear
that they will become unbalanced. Fear has a tremendous influence on
the purely bodily functions, but its influence on the mental functions
is incomparably greater, and a person will often get that which he
fears he is going to get.

Now the hereditary character of insanity is not taken in the same
absolute sense in which it was formerly. While we still consider it a
dysgenic factor, yet we recognize the paramount importance of
environment; and we know that by proper bringing-up, using the
expression bringing-up in its broadest sense--including a proper
mental and physical discipline--any hereditary taint can be
counteracted. In connection with this subject, the following very
recent statistics will prove of interest.

The families of 558 insane persons cared for in the London county
asylums were investigated, and, according to reports received from
the educational authorities, only 15 of these (less than 3 per cent)
had mentally defective children. As to the time of the birth of the
children, whether before or after the attack of the insanity, we find
the following figures: 56 out of 573 parents had children after their
first attack of insanity, and 106 children were born after the onset
of insanity in the parent; while the remaining 1259 children were born
before the parent became insane.

Altogether, as will be seen from a discussion of the various factors
rendering marriage permissible or nonpermissible, I am inclined to
consider environment a more important factor than heredity. The purely
physical characteristics bear the indelible impress of heredity. But
the moral and cultural characteristics, which in the modern civilized
man are much more important than the physical, are almost exclusively
the results of environment.


=Neuroses--Neurasthenia--Psychasthenia--Neuropathy--Psychopathy=

I will not attempt either exhaustive or concise definitions of the
terms named in the caption, for the simple reason that it is
impossible to give satisfactory definitions of them. The conditions
which these terms designate do not constitute definite disease-entities,
and many different things are understood by different people when these
terms are mentioned. Only brief indications of the meaning will be
given.

Neurosis is a functional disease of the nervous system.

Neurasthenia is a condition of nervous exhaustion, brought about by
various causes, such as overwork, worry, fright, sexual excesses,
sexual abstinence, and so on. The basis of neurasthenia, however, is
often or even generally a hereditary taint, a nervous weakness
inherited from the parents.

Psychasthenia is a neurosis or psychoneurosis similar to neurasthenia,
characterized by an exhaustion of the nervous system, also by weakness
of the will, overscrupulousness, fear, and a feeling of the
_unreality_ of things.

Neuropathy is a disease or disorder of the nervous system. Psychopathy
is a disease or disorder of the mind.

Of late years we often hear people referred to as neurotics,
neurasthenics, psychasthenics, neuropaths or psychopaths. These are
undoubtedly abnormal conditions, and, taken as a general thing, they
are dysgenic factors.

But a dysgenic factor in an animal _is_ a dysgenic factor, and that
is all there is to it. There are no two sides to the question. But if
anything goes to show the difference between animals and human beings,
and to demonstrate why principles of eugenics, as derived from a study
of animals, can never be _fully_ applicable to human beings, it is
these considerations which we now have under discussion. To repeat,
neuroses, neurasthenia, psychasthenia, and the various forms of
neuropathy and psychopathy are dysgenic factors. But people suffering
from these conditions often are among _the world's greatest geniuses_,
have done some of the world's greatest work, and, if we prevented or
discouraged marriage among people who are somewhat "abnormal" or
"queer," we should deprive the world of some of its greatest men and
women. For insanity is allied to genius, and if we were to exterminate
all mentally or nervously abnormal people we should at the same time
exterminate some of the men and women that have made life worth
living.

And what is true of mentally abnormal is also true of physically
inferior people. An inferior horse or dog _is_ inferior. There is no
compensation for the inferiority. But a man may be physically
inferior, he may be, for instance, a consumptive, but still he may
have given to the world some of the sweetest and most wonderful poems.
A man may be lame, or deaf, or strabismic, he may be a hunchback or a
cripple and altogether physically repulsive, and yet he may be one of
the world's greatest philosophers or mathematicians. A man may be
sexually impotent and absolutely useless for race purposes, yet may be
one of the world's greatest singers or greatest discoverers.

In short, the eugenic problem in the human is not, and never will be,
as simple as it is in the animal and vegetable kingdoms. If we want to
strive after healthy, normal mediocrity, then the principles of animal
eugenics become applicable to the human race. If, on the other hand,
we want talent, if we want genius, if we want benefactors of the human
race, then we must go very slow with our eugenic applications.


=Drug Addiction or Narcotism=

Addiction to drugs, whether it be opium, morphine, heroin or cocaine,
is a strongly dysgenic factor. The addiction to the drug is of itself
not transmissible, but the weakened constitution or degeneracy which
is generally responsible for the development of the drug addiction is
inheritable.

A few cases of drug addiction are external; that is, the patient may
have a good healthy constitution, no hereditary taint, and still
because during some sickness he was given morphine a number of times
he may have developed an addiction to the drug. But those cases are
rare. And such cases, if they are cured and if the addiction is
completely overcome, may marry.

But in most cases it isn't the drug addiction that causes the
degeneracy; it is the degeneracy or the neuropathic or psychopathic
constitution that causes the drug addiction. And such cases are bad
matrimonial risks.

And it is a very risky thing for a woman to marry an addict with the
idea of reforming him. As I said about the alcoholic: Let him reform
first, let him stay reformed for a few years, and then the rest is not
so great.


=Consanguineous Marriages=

Consanguinity means blood relationship, and consanguineous marriages
are marriages between near blood relatives. The physician is
frequently consulted as to the permissibility or danger of marriages
between near relations. The question generally concerns first cousins,
second cousins, uncle and niece, and nephew and aunt.

The popular idea is that consanguineous marriages are bad _per se_.
The children of near relatives, such as first cousins, are apt to be
defective, deaf and dumb, blind, or feebleminded, and what not. This
popular idea, as so many popular ideas are, is wrong. And still there
is of course, as there always is, some foundation for it. The matter,
however, is quite simple.

We know that many traits, good and bad, are transmitted by heredity.
And naturally when traits are possessed by both father and mother they
stand a much greater chance of being transmitted to the offspring than
if possessed by one of the parents alone. Now then, if a certain bad
trait, such as epilepsy or insanity, is present in a family that trait
is present in both cousins, and the likelihood of children from such a
marriage inheriting that trait is much greater than when the parents
are strangers, the taint being present in the family of only one of
the parents. But if there be no hereditary taint in the cousins'
family, and, still more, if the family is an intelligent one, if there
are geniuses in the family, then there cannot be the slightest
objection to marriage between cousins, and the children of such
marriages are apt to inherit in a strong degree the talents or genius
of their ancestors. In short, if the family is a bad one, one below
par, then marriage between cousins or between uncle and niece should
be forbidden. If the family is a good one, above par, then marriage
between relatives of that family should be encouraged.

The idea that the children from consanguineous marriages are apt to be
deaf and dumb has no foundation in fact. Recent statistics from
various asylums in Germany, for instance, have shown that only about
five per cent. of the deaf and dumb children were the offspring of
consanguineous marriages. If 95 per cent, of the deaf and dumb had
_non_-consanguineous parents, how could one say that even in the other
five per cent, the consanguinity was the cause? If it were the other
way around, then of course we could blame consanguinity. As it is, we
can assume even in this five per cent, a mere coincidence, and we have
no right to say that consanguinity and deaf and dumbness stand in the
relation to each other of cause and effect.

It is interesting to know that among the Egyptians, Persians, and
Incas of Peru close consanguineous marriages were very common. The
Egyptian kings generally married their sisters. This was common custom
and if the children born of such unions were defectives or
monstrosities the fact would have become quickly apparent and the
custom would have been abolished. Evidently the offspring of very
close consanguinity was normal, or even above normal, or the practice
would not have been continued such a long time.

It is perhaps worth while noting that one of the world's greatest
scientists, Charles Darwin, was the child of parents who were first
cousins.


=Homosexuality=

Homosexuality (homos--the same) is a perversion in which a person is
attracted not to persons of the opposite but to persons of the same
sex. Thus a homosexual man does not care for women, but is attracted
to men. A homosexual woman is not attracted to men; she only cares for
women and may even loathe men. A homosexual, man or woman, has no
right to marry. The wrong committed by a homosexual marrying is a
double one: it is wrong to the partner, wrong to the children. The
normal partner is bound to discover the abnormality, and if he (or
she) does, then the married life is a very unhappy one. Even if the
abnormal partner uses the utmost efforts to conceal the abnormality,
he cannot afford any pleasure to the normal partner, because the
sexual act committed under loathing cannot be satisfactory. The other
wrong is committed on the offspring. Homosexuality is hereditary, and
nobody has a right to bring homosexuals into the world, for there is
no unhappier being than a homosexual. I know a homosexual woman, who,
knowing her abnormality, married for the sake of a comfortable home.
She has been successful in hiding from her husband her abnormality, he
simply considering her frigid. But each sexual act costs her tortures.
So far she has succeeded in avoiding pregnancy. I also know a highly
refined and educated homosexual gentleman, who married before
understanding his condition. Many homosexuals, not knowing that such a
thing as homosexuality even exists, do not understand their own
condition; they feel a little strange, a little puzzled, but they
don't know that they ought not to marry. Soon after marrying his
condition became clear to him, but in the meantime his wife conceived,
and he is now the father of a healthy, good-looking boy. It is
possible that with proper bringing up the development of any
homosexual traits will be prevented. It should be borne in mind that
long sexual repression is favorable to the development of
homosexuality.

But to emphasize: homosexuality is a dysgenic factor, and no
homosexual should marry.


=Sadism=

Sadism is a sexual perversion in which the person derives pleasure
only when beating, biting, striking, or otherwise inflicting pain on
the person of the opposite sex. The degree of cruelty varies, but all
sadists should be shunned. Unfortunately the fact that a man is a
sadist is often not found out until after marriage, but as soon as the
wife has found it out she should leave the man and demand a divorce.
Sadism is a sufficient ground for a separation or divorce. No person
with any moral feeling in him or her should be responsible for
bringing children into the world with a possible sadistic heredity.

Sadistic cruelty is often of the gross, brutal, repulsive kind, but
sometimes the sadist inflicts on his "beloved" object refined tortures
of which only a cunning "demon" is capable. The sufferings which the
wives of some sadists have to undergo are known only to themselves and
to a few--very few--physicians.


=Masochism=

Masochism is a sexual perversion in which the person, man or woman,
_likes_ to suffer pain, beatings, insults and other cruelties at the
hands of the beloved object. It is a dysgenic factor but much less
important than sadism.


=Sexual Impotence=

Sexual impotence is not hereditary, but impotence in the male either
so complete that he cannot perform the act or consisting only in
premature ejaculations (relative impotence or sexual insufficiency)
should constitute a bar to marriage. This impotence may not interfere
with impregnation; the wife may have children and the children will
not be in any way defective, but the wife herself, unless she is
completely frigid, will suffer the tortures of hell, and may quickly
become a sexual neurasthenic, a nervous wreck, or she may even develop
a psychosis. Any man suffering with impotence should have himself
treated before marriage until he is cured; if his impotence is
incurable, then for his own sake and for the sake of the girl or woman
he is supposed to love he should give up the idea of marriage. The
only permissible exception is in cases in which the prospective wife
knows the nature of her prospective husband's trouble, and claims that
she does not care for gross sexual relations and therefore does not
mind the impotence. In case the wife is absolutely _frigid_, the
marriage may turn out satisfactory. But I would always have my
misgivings, and should the wife's apparently absent but in reality
only dormant libido suddenly awaken there would be trouble for both
husband and wife. It is therefore necessary to emphasize: in all cases
of impotence--caution!


=Frigidity=

Frigidity, as we have explained in a previous chapter, is a term
applied to lack of sexual desire or sexual enjoyment in women. Of
course many women before marriage are themselves ignorant of their
sexual condition. Having learned to restrain their impulses, to
repress any sexual stir, they themselves are often unable to say
whether they have a strong or weak libido, or any at all. And whether
or no a given woman would derive any pleasure from the sexual act can
only be found out after marriage. Many girls, however, know very well
whether they are "passionate" or not, but they wouldn't tell. They are
afraid to confess to a complete lack of passion--they fear they might
lose a husband.

Frigidity as an agent in marriage may be considered from two points of
view: the offspring and the husband. The offspring is not affected by
the mother's frigidity. A very frigid woman, if the frigidity is not
due to serious organic causes, may have very healthy children and make
an excellent mother. As far as the husband is concerned, it will
depend a good deal on the degree of frigidity. If the woman is merely
cold, and, while herself not enjoying the act, raises no objection to
it, then it cannot be considered a bar to marriage. In fact many men,
themselves not overstrong sexually, are praying for somewhat frigid
wives. (It must be stated, however, that to some husbands relations
with frigid and non-participating wives are extremely distasteful.)
But when the frigidity is of such a degree that it amounts to a strong
physical aversion to the act, it should be considered a bar to
marriage. Such frigidity is often the cause of a disrupted home, often
leads to divorce and is legally considered a sufficient cause for
divorce or for the annulment of marriage, the same as impotence in the
man is.


=Excessive Libido in Men=

We have seen that sexual impotence is a dysgenic factor and if
complete and incurable should constitute a barrier to marriage. The
opposite condition is that of excessive libido. Libido is the desire
for the opposite sex. A proper amount of libido is normal and
desirable. A lack of libido is abnormal. And an excess of libido is
also abnormal. But a good many men are possessed of an excess of
libido; it is either congenital or _acquired_. Some men torture their
wives "to death," not literally but figuratively. Harboring the
prevailing idea that a wife has no rights in this respect, that her
body is not her own, that she must always hold herself ready to
satisfy his abnormal desires, such a husband exercises his marital
rights without consideration for the physical condition or the mental
feelings of his partner. Some husbands demand that their wives satisfy
them _daily_ from one to five or more times a day. Some wives who
happen to be possessed of an equally strong libido do not mind these
excessive demands (though in time they are almost sure to feel the
evil effects), but if the wife possesses only a moderate amount of
sexuality and if she is too weak in body and in will-power to resist
her lord and master's demands, her health is often ruined and she
becomes a wreck. (Complete abstinence and excessive indulgence often
have the same evil end-results.) Some men "kill" four or five women
before the fury of their libido is at last moderated. Of course, it is
hard to find out a man's libido beforehand. But if a delicate girl or
a woman of moderate sexuality has reasons to suspect that a man is
possessed of an abnormally excessive libido, she would do well to
think twice before taking the often irretrievable step.

I have spoken so far of excessive libido in normal men, that is, in
men who are otherwise normal, sane and can _whenever necessary_
control their desires. There is a form of excessive libido in men
called satyriasis, which reaches such a degree that the men are often
not able to control their desires, and they will satisfy their
passion even if they know that the result is sure to be a venereal
infection or several years in prison. Of course, satyriasis is a
dysgenic factor; those suffering with that disorder are not normal;
they are on the borderland of insanity, and not only should they not
be permitted to marry, but they should be confined to institutions
where they can be subjected to the proper treatment.


=Excessive Libido in Women=

Just as we have impotent and excessively libidinous men, so we have
frigid and excessively libidinous women. A wife possessed of excessive
libido is a terrible calamity for a husband of a normal or moderate
sexuality. Many a libidinous wife has driven her husband, especially
if she is young and he is old, to a premature grave. And "grave" is
used in the literal, not figurative, sense of the word. It would be a
good thing if a man could find out the character of his future wife's
libido before marriage. Unfortunately, it is impossible. At best, it
can only be guessed at. But a really excessive libido on the part of
either husband or wife should constitute a valid ground for divorce.
When the libido in woman is so excessive that she _cannot_ control her
passion, and forgetting religion, morality, modesty, custom and
possible social consequences, she offers herself to every man she
meets, we use the term nymphomania. It is a disease which corresponds
to satyriasis in men, and what I said of satyriasis applies with equal
force to nymphomania. Nymphomaniac women should not be permitted to
marry or to run around loose, but should be confined to institutions
in which they can be subjected to proper treatment.


=Harelip=

This is a congenital defect consisting in a notch or split in the
upper lip. It is due to defective development of the embryo and is as
a rule found in association with cleft palate. Probably hereditary,
but is not common and is not of much importance.


=Myopia=

Myopia means nearsightedness. This defect is undoubtedly hereditary to
a certain degree, but it is doubtful if, other conditions being
favorable, any man would give up a girl because she is myopic or vice
versa. Still, if the condition is extreme, as it sometimes is, it
should be taken into consideration. And where both the man and the
woman are strongly myopic some hesitation should be felt in
contracting a marriage. If the husband alone is myopic, then the
defect may be transmitted to the sons but not to the daughters, and
these daughters may in their turn transmit the defect to their sons
but not to their daughters. In other words, the defect is more or less
_sex-limited_.


=Astigmatism=

This is a defect of the eye, depending upon some irregularity of the
cornea or the lens, in which light rays in different meridians are not
brought to the same focus. It is to a certain extent hereditary, but
plays an insignificant rôle. It is an undesirable trait, but cannot be
considered a dysgenic factor.


=Baldness=

Premature baldness is a decidedly inheritable trait. And so is
premature grayness of the hair. But it is doubtful if any woman would
permit these factors to play any rôle in her choice of a husband.


=Criminality=

Almost a complete change has taken place in our ideas of criminality,
and there are but very few criminologists now who believe in the
Lombrosian nonsense of most criminality being inherited and being
accompanied by physical stigmata of degeneration. The idea that the
criminal is born and not made is now held only by an insignificant
number of thinkers. We know now that by far the greatest percentage
of crime is the result of environment, of poverty, with all that that
word implies, of bad bringing up, of bad companions. We know that the
child of the criminal, properly brought up, will develop into a model
citizen, and vice versa, the child of the saint, brought into the
slums, might develop into a criminal.

Then we must remember that there are many crimes which are not crimes,
per se, but which are merely infractions of man-made laws, or
representing rebellious acts against an unjust and cruel social order.
Thus, for instance, a man or a woman who defying the law, would give
information about birth control, and be convicted for the offence,
would be legally a criminal. Morally he or she would be a high-minded
humanitarian. A man who would throw a bomb at the Russian Czar or at a
murderous pogrom-inciting Russian Governor would be considered an
assassin, and if caught would be hanged; and in making up the pedigree
of such a family, a narrow-minded eugenist would be apt to say that
there was criminality in that family. But as a matter of fact, that
"assassin" may have belonged to the noblest-minded heroes in history.

The eugenists will therefore pay little attention to criminality in
the ancestry as a dysgenic factor. As long as the matrimonial
candidate himself is not a criminal, the ancestral criminality should
constitute no bar to the marriage. It is not likely to show itself
atavistically in the children. Altogether a good deal of nonsense has
been written about atavism. And people forget that the same rules of
heredity that are applied to physical conditions cannot be applied to
spiritual and moral qualities, the latter being much more dependent
upon environment than the former. Of course the various circumstances
must be taken into consideration, and each case must be decided upon
its merits. No generalizations can be permitted. The _kind_ of crime
must always be considered.

And, furthermore, it should be borne in mind that not only is a
criminal ancestry _per se_ no bar to marriage, the marriage candidate
himself may be an ex-criminal, may have served time in prison, and
still be a very desirable father or mother from the eugenic viewpoint.
A man who in a fit of passion or during a quarrel, perhaps under the
slight influence of liquor, struck or killed a man is not, therefore,
a real criminal. After serving his time in prison he may never again
commit the slightest antisocial act, may make a moral citizen and an
ideal husband and father.

This is not a plea for the under dog. For in this case, where the
future of the race is at stake, all other considerations must be put
into the background. I simply plead for an intelligent consideration
of the subject. Many honored citizens are worse criminals and worse
fathers than many people who have served prison sentences.


=Pauperism=

It may seem strange to discuss pauperism in relation to marriage and
to speak of it as a hereditary factor, but it is necessary to discuss
it, because considerable ignorance prevails on the subject, it being
generally confused with poverty. There is a radical difference between
pauperism and poverty. People may be poor for generations and
generations, even very poor, and still not be considered or classed
with paupers. Pauperism generally implies a lack of physical and
mental stamina, loss of _self-respect_ and unconquerable laziness. Of
course we know now that laziness often rests upon a physical basis,
being due to imperfect working of the internal glands. But whatever
the cause of the laziness may be, the fact is that it is one of the
characteristics of the pauper. And while we cannot speak of pauperism
being hereditary, the qualities that go to make up the pauper are
transmissible. No normal woman would marry a pauper, and the woman who
would marry a pauper is not amenable to any advice or to any book
knowledge. But men are sometimes tempted to marry daughters of paupers
if they happen to be pretty. They should consider the matter very
carefully, for some of the ancestral traits may become manifest in the
children.




CHAPTER THIRTY-TWO

BIRTH CONTROL OR THE LIMITATION OF OFFSPRING

 Knowledge of Prevention of Conception Essential--Misapprehensions
  Concerning Birth-control Propaganda--Modern Contraceptives Not
  Injurious to Health--Imperfection of Contraceptive Measures Due
  to Secrecy--Prevention of Conception and Abortion Radically
  Different--More Marriages Consummated if Birth-control
  Information were Legally Obtainable--Demand for Prostitution
  Would be Curtailed--Venereal Disease Due to Lack of
  Knowledge--Another Phase of the Birth-control Problem--Knowledge
  of Contraceptive Methods Where There Was a Taint of Insanity, and
  the Happy Results.


No girl, and no man for that matter, should enter the bonds of
matrimony without learning the latest means of preventing conception,
of regulating the number of offspring. With people who consider any
attempt at regulating the number of children a sin, we have nothing to
argue, though we believe that there are very few people except among
the lowest dregs of society who do not use some measures of
regulation. Otherwise we would see most families with ten to twenty
children instead of two or three. Nor do I intend to devote this
chapter to a detailed presentation of the arguments in favor of the
rational regulation of offspring. It would have to be merely a
repetition of the arguments that I have presented elsewhere.[8] But a
few points may well be touched upon here.

In spite of the fact that the subject of birth control is much better
known now than it was when we first started to propagate it, still it
cannot be mentioned too often, for the misapprehensions concerning it
almost keep pace with the propaganda. First, there is a foolish notion
that we would try to regulate the number of children forcibly, that we
would compel people to have a small number of children. Nothing could
apparently be more absurd, and still many people sincerely believe it.
Nothing is further from the truth. On the contrary, much as we are in
favor of birth control, we advise limitation of offspring only to
those who for various reasons, financial, hereditary or hygienic, are
unable to have many children. We emphatically believe that couples who
are in excellent health, who are of untainted heredity, who are fit to
bring up children, and have the means to do so, should have at least
half a dozen children. If they should have one dozen, they would
deserve the thanks of the community. All we claim is that in such an
important matter as bringing children into the world, the parents who
have to carry the full burden of bringing up these children should
have the right to decide. They should have the means of control. They
should be able to say whether they will have two or six or one dozen
children.


=Contraceptive Measures=

And the argument that contraceptives are injurious to the health of
the woman, of the man, or of both, may be curtly dismissed. It is not
true of any of the modern contraceptives. But even if it were true,
the amount of injury that can be done by contraceptives would be like
a drop of water in comparison with the injuries resulting from
excessive pregnancies and childbirths. Some of the contraceptive
measures require some trouble to use, some are unesthetic, but these
are trifles and constitute a small price to pay for the privilege of
being able to regulate the number of one's offspring according to
one's intelligent desires.

The commonest argument now made against contraceptives is that they
are not absolutely safe, that is, absolutely to be relied upon, that
they will not prevent in absolutely every case. This is true; but
there are three answers which render this objection invalid. First,
many of the cases of failure are to be ascribed not to the
contraceptives themselves, but to their improper, careless and
unintelligent use. The best methods in the world will fail if used
improperly. Second, if the measures are efficient in 98 or 99 per
cent, and fail in one or two per cent., then they are a blessing. Some
women would be the happiest women in the world if they could render 98
per cent. of their conjugal relations unfruitful. Third, the
imperfections of our contraceptive measures are due to the secrecy
with which the entire subject must necessarily be surrounded. If the
subject of birth control could be fully discussed in medical books
there is no doubt that in a short time we would have measures that
would be absolutely certain and would leave nothing to be desired. But
even such as they are, the measures are better than none, and as said
in the beginning of this chapter, it is the duty of every young woman
to acquire as one of the items of her sex education the knowledge of
how to avoid too frequent pregnancies. In fact, I consider this the
most important item in a woman's sex education, and if she has learned
nothing else she should learn this. For this information is
_absolutely_ necessary to her future health and happiness.


=A Few Everyday Cases=

In my twenty years' work for the cause of rational birth control I
have come in contact with thousands and thousands of cases which
demonstrate in the most convincing manner possible the tragic results
of forced or undesired motherhood, and of the fear of forced or
undesired motherhood.

Some of the cases were in my own practice, some were related to me by
brother physicians, some were described to me by the victims living in
all parts of this vast country. Were I to collect and report all the
cases that came to my notice during those twenty years, they would
without exaggeration make a volume the size of the latest edition of
the Standard Dictionary, printed in the same small type. Some of them
are positively heartbreaking. They make you sick at the stupidity of
the human race, at the stupidity and brutality of the lawgivers. But I
do not wish to appeal to your emotions. I do not wish to take extreme
and unique cases. I will therefore briefly relate a few everyday
cases, which will demonstrate to you the beneficence of contraceptive
knowledge and the tragedy and misery caused by the lack of such
knowledge.

_Case 1._ This class of case is so common that I almost feel like
apologizing for referring to it. She, whom I will call by the
forbearing name of Mrs. Smith, had been married a little over nine
years, and had given birth to five children. She was an excellent
mother, nursed them herself, took good care of them, and all the five
were living and healthy. But in caring for them and for the household
all alone, for they could not afford a servant or a nurse-girl, all
her vitality had been sapped, all her originally superb energy had
dwindled down to nothing; her nerves were worn to a frazzle and she
became but a shadow of her former self. And the fear of another
pregnancy became an obsession with her. She dreamed of it at night,
and it poisoned her waking hours in the day. She felt that she simply
could not go through another pregnancy, another childbirth, with its
sleepless nights and its weary toilsome days. She asked her doctor who
brought her children into the world to give her some preventive, but
he laughed the matter off. "Just be careful," was all the advice she
got from him. And when in spite of being careful, she, horror of
horrors, became pregnant again, she gathered up courage, went to the
same doctor, and asked him to perform an abortion on her. But he was a
highly respectable physician, a Christian gentleman, and he became
highly indignant at her impudence in coming to him and asking him to
commit "murder." Her tears and pleadings were in vain. He remained
adamant.

Whether he would have remained as adamant if instead of Mrs. Smith,
who could only pay twenty-five dollars for the abortion, the patient
had been one of his society clientele, who could pay two hundred and
fifty dollars, is a question which I will not answer in the
affirmative or negative. I will leave it open. I will merely remark
that in the question of abortion in certain specific cases the moral
indignation of some physicians is in inverse proportion to the size of
the fee expected. A doctor who will become terribly insulted when a
poor woman who can only pay ten or fifteen dollars asks to be relieved
of the fruit of her womb, will usually discover that the woman who can
afford to pay one hundred dollars is badly in need of a curettement.
Oh, no. He does not perform an abortion. He merely curets the uterus.

But to come back to Mrs. Smith. She went away from the indignant
adamant doctor. But she was determined not to give birth to another
child. She confided her trouble to a neighbor, who sent her to a
midwife. The midwife was neither very expert, nor very clean. Mrs.
Smith had to go to her two or three times. After bleeding for about
ten days she developed blood poisoning, from which she died a few days
later, at the early age of twenty-nine, leaving a disconsolate father,
who in time to come will probably find consolation with another woman,
and five motherless children, who will never find consolation. One
may find a substitute for a wife, there is no substitute for a mother.

And such tragedies are of daily occurrence. May the Lord have mercy on
the souls of those who are responsible for them.

Before I proceed further I wish to say that it is the terrible
prevalence of the abortion evil, with its concomitant evils of
infection, ill health, chronic invalidism and death, that more than
any other single factor urges us in our birth control propaganda. And
those who want to forbid the dissemination of any information about
the prevention of conception are playing directly into the hands of
the professional abortionists. They could not act any more zealously
if they were in league with the latter and were paid by them. And
having mentioned the subject of abortion, I wish to utter a note of
warning. In our birth control propaganda, we must be very careful to
keep the question of the prevention of conception and of abortion
separate and apart. The stupid law puts the two in the same paragraph,
some ignorant laymen and equally ignorant physicians treat the two as
if they were the same thing, but we, in our speeches and our writings,
must keep the two separate, we must show the people the essential
difference between prevention and abortion, between refraining from
creating life and destroying life already created; we must show the
viciousness of meting out the same punishment for two things which are
fundamentally different, different not only in degree but in kind--and
it is only by thus keeping the two things apart, by showing that we
stand for one thing--prevention--and not for the other--abortion, that
we can ever gain the general sympathy of the public and the
co-operation of the legislators. I do not say that there are not many
cases in which the induction of abortion is not only justifiable, but
imperative; but that is a different question, and the two issues must
not be confused. And we would and should resent any attempt on the
part of either enemy or friend to so confuse them.

_Case 2._ Mr. A. and Miss B. are in love with each other. But they
cannot get married, for his salary is too small. They might risk
getting married, if the specter of an indefinite number of children
did not stretch out its restraining hand. She comes from a good
family, she was brought up, if not in the lap of luxury, in the lap of
comfort and coziness, and it is the ambition of every good American to
furnish his wife at least as good a home as her father gave her. Her
father, by the way, died prematurely from overwork in trying to give
all possible comforts and advantages to a bevy of six unmarried and
marriageable daughters.

As I said, the fear of children kept them back. Each year the hope
revived that in another year their union in matrimony would be
consummated. But the years passed. Mr. A.'s hair became thin and
grayish, Miss B began to look haggard and pinched--and still the
marriage could not take place. Miss B was very religious and very
proper, and would not do anything that was improper. A was not quite
so proper; he paid occasional visits elsewhere, and as instruction in
venereal prophylaxis was not included in his college course, he
acquired a gonorrhea, which it took him about six months to get rid
of. To shorten the story, A was thirty-nine and Miss B was thirty-five
when the many times postponed marriage was consummated, but Cupid
seemed to be busy elsewhere when the ceremony took place, and there is
very little romance in their married life. The marriage has remained
childless, as I told Mr. A it would be.

I consider this a ruined life--and all for the lack of a little
knowledge.

If the anti-preventionists, those who are opposed to any information
about the prevention of conception, were not so hopelessly stupid,
they would see that from their own point of view it would be better if
such information were legally obtainable. For it would be instrumental
in causing more marriages which otherwise remain unconsummated, and
by favoring early marriages, it would be instrumental in curtailing
the demand for prostitution, in diminishing venereal disease. And as
is well known, venereal disease is one of the great factors in race
suicide.

_Case 3._ A young woman was married to a man who besides being a
brutal drunkard was subject to periodic fits of insanity. Every year
or two he would be taken to the lunatic asylum for a few weeks or
months, and then discharged. And every time on his discharge he would
celebrate his liberty by impregnating his wife. She hated and loathed
him, but could not protect herself against his "embraces." And she had
to see herself giving birth to one abnormal child after another. She
begged her doctor to give her some means of prevention, but that boob
claimed ignorance, and the illegality of the thing. The woman finally
committed suicide, but not before she had given birth to six abnormal
children, who will probably grow up drunkards, criminals or insane.

And because we object to such kind of breeding, we are accused of
being enemies of the human race, of advocating race suicide, of
violating the laws of God and man. Oh, for a mighty Sampson to strike
the imbeciles with the jaw of an ass, for a mental Hercules to loosen
the fontanelles of their petrified skulls and put some sense into
them!

_Case 4._ This observation concerns a couple both of whom had a very
bad heredity. The blood of each was badly tainted. The doctor who had
treated the husband cautioned them and told them that they had no
right to have children. But here the tables were turned. The doctor
wanted to give them the means for prevention, but the husband and
wife, pious Roman Catholics, would not go against their religion and
God (as if God wanted a world full of imbeciles), and refused to
employ any precautions. They have had four children so far. One of
them seems fairly normal, except that he is silly, in which respect he
is merely like his parents; two are deaf and blind in one eye; the
fourth is a cretin, practically an idiot.

This case brings us face to face with another phase of the problem.
What should we do when the parents, stupid and ignorant, refuse to
stop breeding worthless material? Eugenic agitation, education, will
bring about such a strong public opinion that none but idiots, who
will be vasectomized or segregated, will dare to bring into the world
children that are physically and mentally handicapped.

_Case 5._ This couple had been married eight years, and had five
children And the wife said she could not stand it any more. Another
child--no, she preferred death. They practiced coitus interruptus for
a while, with mutual disgust, but when the wife was caught again, she
said: "No more!" And she would not let her husband come near her. He
could do what he pleased--she did not care. After a few months he
began to go elsewhere--contracted syphilis, had to give up his
position, the home was broken up, the wife went out to work, the
children are scattered--in short, a home, which we are told is the
foundation of our society, is broken up, and there is misery and
wretchedness all around--and all for the lack of a little timely
information.

_Case 6._ Mr. A and Miss B, twenty-eight and twenty-five years old
respectively, have known one another for several years, and in spite
of their occupation, which is supposed to make people blasé and
cynical--he being a reporter and she a special story writer--are quite
in love with each other. But their occupation and income are such that
they cannot possibly afford to have and to bring up any children. They
would love to get married, but the specter of a child--or rather of
children--frightens them; and they remain single, to the great
physical and mental injury of both. Accidentally they learn of
appropriate means of regulating conception, get married and live
happily--ever after, that is, until they find themselves in a
position to have children and to bring them up properly.

In what way was society injured by this young couple acquiring
contraceptive information?

_Case 7._ Mr. C and Miss D are in love with each other. Unfortunately
there is a strong hereditary taint of insanity on both sides. They are
too high-minded to think of giving birth to children. They might be
all right, but with insanity one does not take any chances. The thing
is too terrible. They are condemned to a life of celibacy, which to
them means a life of loneliness and misery. But like an angel from
heaven comes to them the knowledge that one can live a love-life
without any penalties attached to it. They get married and there is
not a happier couple living.

In what way has society been injured by this couple obtaining the
contraceptive knowledge?

_Case 8._ Mr. and Mrs. E have been married five years. They have a
child four years old which shows unmistakable symptoms of epilepsy.
They are horrified and an investigation discloses the fact that on her
side in the preceding generation there was a good deal of epilepsy. Of
course, the next child may not be epileptic. But then again it may. No
parents with any sense of responsibility would take such chances. They
decide to give up conjugal relations. They keep it up for about
thirteen or fourteen months; then one night an accident happens and
very soon she finds herself pregnant. She declares she would rather
die than to give birth to and have to take care of another epileptic
child. She goes to a friendly physician who performs an abortion on
her, and now the couple, not secure against future accidents, if they
live together, decide to separate, and a tragedy is in sight.
Fortunately they learn that conception can be prevented, and they
continue to live together with benefit to themselves and harm to none.

In what way has society been injured by those people acquiring
contraceptive information?

_Case 9._ Mr. and Mrs. F have been married six years, and in these six
years they have been blessed with four children. When he married he
was getting twenty-two dollars a week, and that is exactly what he is
getting now. In the meantime the cost of living has gone up
twenty-five per cent., and there are four extra mouths to feed and
four extra bodies to clothe. What difference this has made in that
little household can better be imagined than stated. The little mother
has aged sixteen years in those six years, and there is not a trace
left of her girlishness and youthfulness. She loves her children, and
does not want to get rid of them. She would not take a million
dollars for one of them, but she would not give five cents for
another. But this is just what terrifies them; the possibility of
another. And that possibility makes her irritable, makes her repel her
husband's slightest advances, makes her move his bed to another room.
She even tells him to satisfy his sexual desires elsewhere--and at the
same time she is in fear and trembling that he might follow her
advice. In short, a nice young home is about to be disrupted.
Fortunately he reads somewhere an article on the subject of voluntary
limitation of offspring, he begins to investigate; his physician
pleads ignorance, but he is persistent, the physician investigates and
obtains the desired information, which he shares with the patient.
Harmony is restored and a happy home is re-established.

Who was injured by the couple obtaining this information? And if
nobody was injured, and everybody concerned was benefited, then why
should the imparting of such information be considered a felony,
punishable like the most atrocious of crimes?

_Case 10._ Mr. and Mrs. G have been married fifteen years. They were
the parents of seven children, a large enough number for any family.
Those seven children were born during the first eleven years of their
married life. During the past five years, afraid of having any more,
they first abstained and then adopted a method which every modern
sexologist knows is injurious to the nervous system of both the man
and the woman. The man became a wreck; first neurasthenic, then
impotent, cranky and grouchy, unable to get along in the office,
constantly squabbling with his wife, who became just as bad a wreck.
Their economic condition plus too many small children prevented the
parents' separation. They remained living together, but they lived
like a cat and a dog tied in a bag. Each silently prayed to be rid of
the other. But a conversation overheard at a Turkish baths
establishment put him on the right trail, and one year later we find
the couple reconciled, both in good health and living a peaceful and
fairly harmonious life. And those who have benefited most by the
change are the children. In what way was society injured? And still if
the doctor who gave Mr. G the information should have been caught and
convicted, he would have been sent to prison for a year or two or
five. Would he have deserved it? Here we have several plain, simple,
unvarnished and unembellished cases which are typical of millions of
similar cases and which prove conclusively that the law against
imparting information about preventing conception is brutal, vicious,
antisocial. Should not such a law be repealed, wiped off the statute
books?

FOOTNOTES:

[8] The Limitation of Offspring by the Prevention of Conception.




CHAPTER THIRTY-THREE

ADVICE TO GIRLS APPROACHING THE THRESHOLD OF WOMANHOOD

 The Irresistible Attraction of the Young Girl for the Male--The
  Unprotected Girl's Temptations--Some Men Who Will Pester the
  Young Girl--Risk of Venereal Infection--Danger of
  Impregnation--Use of Contraceptives by the Unmarried Woman May
  Not Always Be Relied Upon--Nature of Men who Seduce
  Girls--Exceptions--Illegitimate Motherhood--Difficulties in the
  Way of Illegitimate Mother Who Must Earn Her Living--The Child of
  the Foundling Asylum--Social Attitude Towards Illegitimacy
  Responsible for Abortion Evil--Dangers of Abortion--The Girl Who
  Has Lost Her Virginity.


When a girl has passed the transition period of puberty and is
entering upon young womanhood she exerts an irresistible attraction on
the male sex. Whether she give the impression of a luscious red rose
or of a delicate white lily, the charms of a beautiful, healthy,
bright girl of seventeen or eighteen are undeniable and their appeal
to the esthetic and sexual sense of every normal male is a normal,
_natural_ phenomenon. Whether it is a good thing or a bad thing that
it is so, we will not stop to discuss here. But it is a natural
phenomenon, a natural law, if you will, and one does not quarrel with
natural phenomena. It is useless. But the attraction which the girl
exercises on the male is fraught with danger to her, and therefore a
few words of advice and of warning are not out of place.

       *       *       *       *       *

=Temptations.= Fortunate are you, my young girl friend, if you come
from a well-sheltered home, if you have been properly brought up, if
you have a good and wise mother who knows how to take care of you. A
mother's wise counsel given at the proper time, and her comradeship
all the time, are more invulnerable than an armor of bronze and more
secure than locked doors and barred windows. But if you have lost your
mother at an early age, or if your mother is not of the right sort--it
is no use hiding the fact that some mothers are not what they should
be--if you have to shift for yourself, if you have to work in a shop,
in an office, and particularly if you live alone and not with your
parents, then temptations in the shape of men, young and old, will
encounter you at every step; they will swarm about you like flies
about a lump of sugar; they will stick to you like bees to a bunch of
honeysuckle.

I do not want you to get the false idea that all men or most men are
bad and mean, and are constantly on the lookout to ruin young girls.
No. Most men are good and honorable and too conscientious to ruin a
young life. But there are some men, young and old, who are devoid of
any conscience, who are so egotistic that their personal pleasure is
their only guide of conduct. They will pester you. Some will lyingly
claim that they are in love with you; some perhaps will sincerely
believe that they are in love with you, mistaking a temporary passion
for the sacred feeling of love. Some will even promise to marry
you--some making the promise in sincerity, others with the deliberate
intent to deceive. Still others will try to convince you that chastity
is an old superstition, and that there is nothing wrong in sexual
relations. In short, all ways and means will be employed by those men
to induce you to enter into sexual relations with them.

_Don't you do it!_

I am not preaching or sermonizing to you. I am not appealing to your
religion or your morals. For if you have strong religious or moral
ideas against illicit sexual relations, you are not in need of mine or
anybody else's advice. But I assume that you are a more or less modern
girl, with little or no religious bringing-up, or perhaps a radical
girl, who has shaken off the shackles of religion and tradition. And
to you I say: _Don't you do it_. Why? Because your welfare, your
future happiness, is at stake. I am speaking from the point of view of
your own good, and from that point of view I say: Resist all attempts
which men make exclusively for the purpose of satisfying their sexual
desire, their lust.

You will ask again, why? For several reasons. First, you run the risk
of venereal infection. The danger is not so great now as in former
times, but is great enough. There are still plenty of men dishonest
enough to indulge in sexual relations with a woman when they know they
are not radically cured. The same man who will not get married unless
he is sure that he is perfectly cured will not hesitate to subject a
transient girl or woman to the risk of venereal infection. I know
personally, because I have treated them; yes, I treated several
intelligent and radical young men who infected young girls. And some
of these girls in their turn, through ignorance and innocence,
infected other men. So then, the first danger is the danger of
venereal infection.

The second danger, still greater and more certain than the first, is
the danger of impregnation. And pregnancy for a girl under our present
moral and social-economic conditions is a terrible calamity. She is
ostracized everywhere, and it means, if discovered, her social death.
But you will say: "Aren't there any remedies that can be used to
prevent conception? Aren't you yourself among the world's chief
birth-controllers; one of the world's chief advocates of the use of
contraceptives?" Yes, my dear young lady, but I never made the claim
that the contraceptives were _absolutely_ infallible, I never claimed
that they were _100 per cent._ effective in _100 per cent._ of _all_
cases. But if they are effective 999 times or even 990 times in every
1000 they are a blessing. And thousands of families so consider them.
And if a married woman gets caught once in a while, the misfortune is
not so great. But if the accident happens to a non-married woman, the
misfortune _is_ great. Then again, you want to bear in mind that
accidents are less likely to happen to married than to non-married
women. The married woman has no fear, needs no secrecy, and she can go
about the method of preparation carefully, with deliberation. The
unmarried girl, _as a rule_, has not the proper conveniences, more or
less secrecy must be maintained, hurry is not infrequently necessary,
and that is why accidents are more apt to occur in spite of the use of
contraceptives. So then, the second danger, even more sinister than
the first, is the danger of pregnancy. "But if a misfortune happens,
can I not have an abortion produced?" No, not always. Physicians
willing to induce an abortion are not found on every corner. But this
is not the principal point. What I have to say on the subject, I will
say later on in this chapter.

Then it is well for you to bear in mind that those very men who use
their utmost efforts, who strain every fibre and every nerve to get
you, will despise you and detest you as soon as they have succeeded in
making you yield to their wishes. This is one of the worst blots on
the male man's character, a blot from which the female character is
entirely free. And some men--fortunately their number is not very
large--are such moral skunks that they take morbid pleasure in
boasting publicly of their sexual conquests, and unscrupulously peddle
about the name of the girl whom, by cunning false promises or other
means, they succeeded in seducing. And of course such a girl finds it
difficult or impossible to get married, and must end her days in
solitude, without the hope of a home of her own.

For the above reasons I advise you earnestly and sincerely not to
yield to the solicitations of thoughtless or unscrupulous men, who
think of nothing but their coarse sensual pleasures. It is advice
dictated by common sense, by your own deeper interest, aside from any
religious or moral considerations.

The above advice, or call it sermon if you will, is meant principally
for young girls, girls between the ages of eighteen and twenty-five.
If a girl has reached the age of twenty-eight or thirty and is
willing to enter upon illicit sexual relations with her eyes open,
with a full knowledge of the possible consequences, then it is her
affair, and nobody shall say her nay. Nobody has a right to interfere.

Nor should my advice be understood as directed to cases where there is
sincere reciprocal affection and a mutual understanding. This is an
entirely different matter, and has nothing to do with cases where the
man is the pursuer or seducer and the woman an unwilling or reluctant
victim.

But whatever the relations between the man and the girl may be,
whether she yielded in a fit of passion, or was seduced by false
promises, by "moral" suasion, by hypnotic influence or by the vulgar
method of being made drunk, what is she to do if she finds herself, to
her horror, in a pregnant condition? There are two ways open to her:
either let the pregnancy go to term or to have an abortion brought on.

If she lets the pregnancy go to term she has the alternative of
bringing up the child herself openly or of placing it secretly in a
foundling asylum. In the first case, the necessity of publicly
acknowledging illegitimate motherhood requires so much moral courage
that not one woman in a thousand is equal to it. It is not moral
courage alone that is required; the social ostracism could be borne
with stoicism and even with equanimity, if with it were not frequently
associated the fear or the real danger of starvation. For under our
present system the illegitimate mother finds many avenues of activity
closed to her. A school teacher would lose her position instantly, and
so would a woman in any public position. It is feared that her example
might have a contaminating influence on the children or on her fellow
workers. Nor could she be a social worker--I know of more than one
woman who lost her position with social or philanthropic institutions
as soon as it was discovered that she did not live up strictly to the
conventional code of sex morality. Nor could she be a private
governess.

It is thus seen that to acknowledge one's self an illegitimate mother
requires so much courage, so much sacrifice, that very, very few
mothers are now found that are equal to the task. Especially so when
it is taken into consideration that the humiliations and indignities
to which the child is subjected and the later reproaches of the child
itself make the mother's life a veritable hell. So this alternative is
generally out of the question.

To give the child to a foundling asylum or to a "baby farm" means
generally to condemn it to a slow death--and not such a slow one,
either. For as statistics show about ninety to ninety-five per cent.
of all babies in those institutions die within a few months. And the
very few who survive and grow up have not a happy life. Life is hard
enough for anybody; for children who come into the world handicapped
by the disgrace of illegitimacy, life is torture indeed. It is with a
breaking heart generally and because there is no other way out of the
dilemma that a mother puts her baby away in a foundling asylum. She
hopes and prays for its speedy death.

Taking into consideration the pitifully unhappy lot of the
illegitimate mother and illegitimate child, it is no wonder that every
unmarried woman, as soon as she finds herself pregnant, is frantically
determined to get rid of the child in the womb as soon as possible.
And abortion thrives in every civilized country. Thousands and
thousands of doctors and semi-doctors and midwives are making a rich
living in this country from practicing abortion. The greater the
disgrace with which illegitimacy is considered in a country, the
stricter the prohibition against the use of measures for the
prevention of conception, the greater the number of abortions in that
country. But abortion is not a trifle, to be undertaken with a light
heart. It is true that if performed by a thoroughly competent
physician, with all aseptic precautions, it is practically free from
danger. But when performed by a careless physician or an ignorant
midwife, trouble is apt to happen. Blood poisoning may set in, and the
patient may be very sick for a time, and may on recovery from the
acute illness remain a chronic invalid for life. And occasionally the
patient dies. Whether or not abortion is justifiable under special
circumstances is a separate question, which I have discussed in
another place. But leaving aside the ethics of the question, if you
have determined to have an abortion produced, be sure to go to a
conscientious physician, and avoid the quacks and midwives. An
unexpected and undesired pregnancy is punishment enough and there is
no reason why you should be further punished by becoming a chronic
invalid or by paying with your life. There is no sense in it. Nobody
will profit by your invalidism or your death.

I do not wish to leave this topic without re-emphasizing the fact that
abortion is not a trifle, to be undertaken or even to be spoken of
lightly. Too many women, not only in the radical ranks, but in the
conservative ranks as well, are in the habit of considering abortion
as a joke, a trifling annoyance, something like a cold in the head,
which, while disagreeable, is sure to pass away in a day or two. They
know Mrs. A and Mrs. B and perhaps Miss C who had abortions produced
on them and in two or three days they were as good as ever. Yes. But
they do not know Miss D who is resting in her grave, nor do they know
why Miss E and Mrs. F are invalids for life. The women who get over
their abortion experiences easily are apt to talk of their good luck;
the women who have become chronic invalids or who are resting in their
graves as a result of an abortion are not apt to talk of the matter.

And therefore, once more, remember, an abortion is no trifling matter.

One other piece of advice and I am through. Some men of a low moral and
mental caliber are under the influence of the pernicious idea that if a
girl has lost her virginity--no matter under what circumstances--she no
longer amounts to much and is free prey for everybody who may want her.
And, like beasts of prey, these wretched specimens of humanity pester
such a girl with much more impudence, more brazenness than they dare to
employ in the case of a girl who is still considered a virgin. And,
what is more, the girls themselves become poisoned with this pernicious
idea and dare not offer the same resistance that the virgin does. And
they often yield with resignation, though against their will, and
though they may experience a feeling of disgust against the man.

Now again, _don't you do it_. Do not nurse the medieval idea that
because you are not a virgin in the physical sense, you are "ruined,"
"no good," and an outcast. You are nothing of the kind. If through
some cause or other you are no longer in possession of an intact
hymen, it is your affair or misfortune, and nobody else's. Do not on
that account cast your eyes down and avoid meeting people. Carry your
head high, do not fear to meet people, and treat with contempt the
jeers of the stupid and ignorant. A person's entire character does not
depend upon the presence or absence of the hymen, and one misstep
should not ruin a person's whole life. A boy is not "ruined," is not
an outcast, because he has had sexual relations before marriage, and
while the boy's and girl's cases are not exactly identical, still the
poor girl should not be made to expiate one error all her life long.

It isn't fair.




CHAPTER THIRTY-FOUR

ADVICE TO PARENTS OF UNFORTUNATE GIRLS

 Attitude of Parents Towards Unfortunate Girl--The Case of Edith
  and What Her Father Did--The Pitiful Cases of Mary B. and Bridget
  C.


Suppose you are the parents of a girl to whom a misfortune has
happened. I admit it is a misfortune, a catastrophe. Probably the
greatest catastrophe that, under our present social system, can happen
to an unmarried young woman. What are you going to do? Are you going to
disgrace her--incidentally disgracing yourselves--are you going to kick
her out of the house, condemning her to a suicide's grave, or to a life
that is often worse than death? Or are you going to stand by her in her
dark hours, to shield her, to surround her with a wall of protection
against a cruel and wantonly inquisitive world, and thus earn her
eternal gratitude, and put her on the path of self-improvement and
useful social work? Which shall it be? But before you decide, kindly
bear in mind that your girl is not entirely to blame; that some of the
blame lies with you. If she had been _properly_ brought up, this would
not have happened. I know such a thing could never have happened in my
household. But I know how I would have acted if such a thing had
happened. And I will tell you how one father and mother did act under
the circumstances.

They were far from rich; just fairly comfortable; they had a
well-paying store. Edith was their treasure, because she was so pretty
and so full of life. Unfortunately, she was too pretty and too full of
life. She was only seventeen, but was fully developed, and had many
empty-headed young admirers, who showered upon her silly compliments
and cloying sweets. She became frivolous and flirtatious and was
beginning to do poorly in high school. She failed in her last year,
and refused to take the year over again. Now, all the time being her
own, and having nobody to give any account to, she began to go out a
good deal, and more than ever indulged in flirtations. One night she
stayed out later than usual, her parents were worried, and when she
came home about two in the morning there was a quarrel, and the
father, who was a strict, impulsive man, gave her a pretty good
beating. After that she went out very little, kept to herself, became
rather melancholy, lost her appetite, and did not sleep well. To all
inquiries she answered that there was nothing the matter with her,
that she just felt a little indisposed. Four or five months thus
passed.

But finally the condition could no longer be concealed. The mother was
the first one to discover it. When the fact dawned upon her
consciousness that her beautiful, not quite eighteen-year-old Edith
was pregnant she promptly fell in a faint and it took Edith and the
maid quite some time to restore her to consciousness. She became
distracted. She floundered about pitifully, not knowing what to do,
what decision to reach. She tried to conceal the matter from the
father, but he saw that there was something wrong and it didn't take
him long to worm the truth out of her. As the mother on learning the
tragic truth had taken refuge in a dead faint, so he took refuge in a
Berserker rage. He fumed and stormed and was in danger of an
apoplectic stroke. He wanted to strike the daughter, but the mother
interfered. He then ordered Edith to get out of the house and never to
cross his threshold again. Edith looked at him to see if he meant it;
the mother tried to intercede; but he was inflexible, and demanded
that she leave at once. Edith began to gather a few of her belongings,
the tears silently rolling down her face.

And here a sudden change came over the father. Some men (and women)
are crushed by small misfortunes; real catastrophes awaken their
finer qualities, which lay dormant within them and which might have
remained dormant within them forever. In these few minutes he seems to
have undergone a complete metamorphosis. He went up to Edith, took her
in his arms, kissed her, told her to stay, to calm down and they would
see what could be done. In a few days she was taken over to a
physician who performed an abortion. She was a pretty sick girl for
about six weeks, and at one time there was danger of blood poisoning
setting in. But she recovered. And she was a different girl. She had
shed her frivolity and lightheartedness like an old garment. She took
her last year in high school over again, entered Barnard, from which
she was graduated among the very first, and soon began to teach in
that very high school in which she had been a pupil. One of the
teachers fell in love with her and she fell in love with him. He asked
her to marry him. She wanted no skeleton from the past coming down
rattling its bones and marring their married life, and she told him of
the unfortunate incident. A good test, by the way, to find out a man's
real love and breadth of character. Fortunately the man's love was a
true love, not merely passion, and he was truly broadminded, which is
not a very common thing among school-teachers. Their married life is
an uncloudedly happy one. And the relation between the daughter and
the parents is one of sincere love and deep mutual respect.

Isn't it better so?

Didn't Edith's parents act more decently, more kindly, more humanely,
more wisely than the parents, say, of Mary B, who, when they found out
her condition, put her out of the house, into which she was brought
back two days later a corpse, fished out from the East River? Didn't
Edith's father act more nobly, more wisely even from a purely selfish
point of view than the father of Bridget C, who kicked his daughter
out penniless into the street, where he had to see her afterwards
powdered and painted soliciting men and boys? The mother died of a
broken heart, and the father, unable to bear the constant, daily
repeated disgrace, became an incorrigible drunkard.

Fathers and mothers! So bring up your daughters, so guard them and
protect them, that the misfortune of an illegitimate pregnancy may not
befall them. But if the misfortune has befallen them, then stand by
them! Do not desert them then in these dark hours, the darkest hours
in a girl's life. Do not kick them--they are down enough. Stand by
them, and they will become good women and you will have their eternal
gratitude. If you do not stand by them, you are worse than the beasts
of the jungle and deserve their eternal curse. You are unworthy to be,
or to be called, parents, for you are devoid of the least spark of
that sacred feeling called Parental Love, a feeling which
unfortunately in only too many parents is replaced by nothing but the
most sordid, most brutal egotism.




CHAPTER THIRTY-FIVE

SEXUAL RELATIONS DURING MENSTRUATION

 Heightened Sexual Appetite of Many Women During
  Menstruation--Sexual Intercourse During Menstrual Period--When
  Intercourse May be Permitted--Injection Before Coitus During
  Menstruation--Fallacy of Ancient Idea of Injuriousness.


This may seem to some a strange and superfluous question, a question
which would never present itself. Still the laity would be surprised
if it learned how frequently nowadays that question is presented to
the physician who specializes in sex matters. Some husbands come to
the physician complaining that the menses are the only period during
which their wives demand sex relations, and ask if something cannot be
done to cure them of what they consider an abnormal desire.

Biologically considered, the desire on the woman's part for sex
relations during the menses should not seem strange or abnormal, for
we must bear in mind that menstruation bears a certain analogy to the
rut in animals. And animals permit intercourse at no time except
during the rut.

Recent investigations have disclosed to fact that the number of women
whose sexual appetite is _heightened_ during the time immediately
preceding, during, and following the menses, is quite considerable.
And there is also a smaller percentage of women who experience the
desire _at no other time except_ during the menses.

Speaking generally, relations during the menses should be discouraged.
There are several reasons for it. The first reason, which need not be
gone into in detail, is an esthetic one. The second reason is that
intercourse during menstruation may in some cases lead to congestion
of the uterus and ovaries. Third, the menstrual discharge, which as we
know does not consist of pure blood but is a mixture of blood, mucus,
and degenerated lining membrane of the uterus, may give rise to a
catarrh of the urethra in the man. Fourth, and this is a point to be
borne in mind, any discharge that a woman may be suffering from is
always aggravated during menstruation. For these reasons relations
during the menses are undesirable.

But where the woman has strong libido during that time and has no
libido at any other time, relations may be indulged in during the last
day or two of the menses. Any unpleasantness may be obviated and any
discharge may be removed by the woman taking a mild, warm, antiseptic
injection before coitus. The ancient idea of the injuriousness of the
relations during menstruation and the disastrous results likely to
follow them have only a very slender foundation. They rest on no
scientific basis and though it may be sad to state facts, there are
many couples who do indulge in such relations as a regular thing and
without any injury to either husband or wife.




CHAPTER THIRTY-SIX

SEXUAL INTERCOURSE DURING PREGNANCY

 Complete Abstinence During-Pregnancy--Bad Results of Complete
  Abstinence--Intensity of Relations During First Four
  Months--Intercourse During Fifth, Sixth and Seventh
  Months--Intercourse During Eighth and Ninth Months--Abstinence
  After Birth of Child.


The question whether sexual intercourse is permissible during
pregnancy is often put to the physician. Some extremists and theorists
demand complete abstinence during the entire duration of pregnancy.
Such abstinence is not only not feasible, but is unnecessary and may
prove a disrupting factor; it may create not only dissension, it may
wreck the love-life of husband and wife. I know of cases where the
wife, influenced by the wrong teachings about the necessity of
complete abstinence during pregnancy, about the possible injury to the
child from intercourse, persisted in keeping the husband away; and the
result was that the husband began to go to other women, and he got in
the habit to such an extent that he refused to give up entirely, even
after the child was born. It cannot be expected from a married man,
who is used to more or less regular sexual relations, to abstain
entirely for nine or ten months. Such a demand is unreasonable and
uncalled for. All claims about the injurious effects of intercourse on
the mother and child lack proof and foundation. During the first four
months of pregnancy no change need be made in the usual sex relations.
Their "intensity" should be moderated, their frequency need not.
During the fifth, sixth and seventh months intercourse should be
indulged in at rarer intervals--once in two or three weeks--the act
should be performed without any violence or intensity, and the usual
position should be reversed or changed to a lateral one. During the
eighth and ninth months relations had best be given up altogether.

And this abstinence should last until about six weeks after the birth
of the child. During this period the uterus undergoes what we call
involution; that is, it goes back to the size and shape it had before
pregnancy, and it is best not to disturb this process by sexual
excitement, which causes engorgement and congestion.




CHAPTER THIRTY-SEVEN

SEXUAL INTERCOURSE FOR PROPAGATION ONLY

 Belief in Sexual Intercourse for Propagation Only--What Such
  Practice Would Lead to--Nature and the Sex-fanatics--Sexual
  Desire in Woman After Menopause--Sex Instinct of Sterile Men and
  Women--Sex Instinct Has Other High Purposes.


Some people sincerely believe that the sexual instinct is for
reproductive purposes only; they claim we should never indulge in
sexual intercourse unless it be for the purpose of bringing a child
into the world. The act performed without such aim in view is
stigmatized by them as carnal lust, as a sin. Some even say that such
an act is equivalent to an act of prostitution. To _argue_ the
question with such people would be a waste of time. It is not fair to
impugn the good faith, the sincerity of your opponents, because I have
convinced myself that the most insane, most bizarre notions may be
held by otherwise sane people in perfect sincerity. But we cannot help
questioning the reasoning faculties of people holding such beliefs.

Let us see where the belief of "sex relations for procreation only"
would lead us to. In a normal healthy couple impregnation follows one
connection. So if a couple wanted to limit themselves to three or four
or six children, they would be entitled to have relations only three,
four or six times in their lives. For it must be remembered that
during pregnancy sexual relations would be prohibited, as during
pregnancy no further impregnation can take place, and no intercourse
must take place which has not for its purpose the conception of a new
human being. If the people were believers in big families, and agreed
to have twelve children--no anti-Malthusian would expect more than
that--they would be entitled to twelve relations during their marital
life. Assuming that not every act is followed by pregnancy, but that
it takes on the average three or four times to bring about the desired
result, we will have it that during the wife's childbearing period the
couple may indulge in sex relations from once in three or four years
to once or twice a year.

Can a sane person knowing anything about the sexual instinct make any
such demands from married people living in the same house and perhaps
occupying the same bed? It must be borne in mind that as soon as the
wife has reached the menopause all relations must cease, because she
can no longer become pregnant, and intercourse without a probable or
possible pregnancy is a sin. Also remember that no matter how
beautiful, young and passionate the wife may be, if she has some
little trouble which makes pregnancy impossible, sex relations must be
absolutely abstained from. And of course if the husband or wife is
sterile, all relations must be renounced forever, no matter how strong
the libido may be in one or both.

It is strange that Nature did not act according to the formula of our
sex fanatics; no pregnancy, no intercourse. If she had meant it to be
that way, she would have abolished sexual desire in woman immediately
after the menopause. Unfortunately this is not the case. For we know
that the sexual libido in women after the menopause is often and for
several years stronger than before. Why? Nor has Nature abolished the
sexual instinct and the passionate desire for sex relations in all
those men and women who are for some reason or other sterile, or
otherwise so defective that no child can result from the union.

As I stated at the beginning, it is a waste of time to _argue_ the
matter. Those who believe that sex relations are for racial purposes
only, are welcome to their belief, and are welcome to live up to it.
(How few of them do, though, honestly and consistently?) We must
reiterate our opinion that the sex instinct has other high purposes
besides that of perpetuating the race, and sex relations may and
should be indulged in as often as they are conducive to man's and
woman's physical, mental and spiritual health. No iron-clad rules can
be laid down as to the frequency. For some people three times a year
may be sufficient, others may require relations three times a month
(the best for the average) and still others may not be satisfied with
less than three times a week. The human _libido sexualis_ cannot be
put into an iron mould, and you should pay no attention to religious
fanatics who are ignorant of physiology and psychology and who can
only blunder and bungle up things.




CHAPTER THIRTY-EIGHT

VAGINISMUS

 Vaginismus--Dyspareunia--Difference Between Vaginismus and
  Dyspareunia--Adherent Clitoris a Cause of Masturbation and
  Convulsions.


By the term vaginismus we understand a painful spasm or contraction of
the vaginal orifice which makes intercourse very difficult, or
impossible.

Certain cases of vaginismus, or rather false vaginismus, may be due to
laceration or inflammation of the vaginal orifice, but in genuine
cases of vaginismus no local disease can be found, because genuine
vaginismus is of nervous origin.

_Dyspareunia_ means painful or difficult intercourse, from whatever
cause. It differs from vaginismus in that the cause is generally a
local one, that is, it may be inflammation, laceration as after a
confinement, small size or atresia of the vagina, etc. When vaginismus
is present, it is present in reference to all men, in fact the mere
touch of the finger or an instrument may call forth a painful spasm;
while dyspareunia may show itself with one man and be absent with
another. The origin of the word dyspareunia shows that this may be
the case, for _dyspareunos_ in Greek means badly mated.

Dyspareunia must not be confused with true vaginismus. In dyspareunia
the sexual act can be freely indulged in, only the act is painful or
disagreeable. In vaginismus intercourse is _impossible_. In
exceptional cases where the husband attempts to use brute force, the
wife may faint away, she may get a convulsion or become wildly
hysterical. If the husband insists in attempting relations, the wife
may run away, or in exceptional cases even attempt suicide.


ADHERENT CLITORIS OR PHIMOSIS

The word phimosis means "muzzling," and it is a term applied to a
constriction or narrowing of the foreskin, so that the glands of the
clitoris cannot be freely uncovered. This condition may give rise to
an accumulation of smegma or secretion which may cause inflammation,
itching, and nervous irritation. This in its turn may be the cause of
masturbation. It is claimed by some that an adherent clitoris may even
be the cause of convulsions resembling epilepsy. In some cases it
leads to an irritable bladder, inability to retain the urine, and
nocturnal bed-wetting.

In all girls, big or little, that show a tendency to masturbate or
simply to handle the genitals, or that complain of itching, the
clitoris should be examined and if adhesions are found they should be
separated. This can easily be done under a local anesthetic.




CHAPTER THIRTY-NINE

STERILITY

 Definition of Sterility--Husband Should First be Examined--
  One-child Sterility--The Fertile Woman--Salpingitis as a
  Cause of Sterility--Leucorrhea and Sterility--Displacement of
  Uterus and Sterility--Closure of Neck of Womb and Sterility--
  Sterility and Constitutional Disease--Treatment of Sterility.


Sterility or barrenness is a condition of inability to have children.
In former years the opinion prevailed generally, whenever a couple was
childless, that the fault was exclusively the woman's. It wasn't even
thought that the man could be to blame. We now know that in at least
_fifty per cent._ of cases of sterility, or childless marriages, the
fault is not the woman's but the man's. It is therefore very unwise in
conditions of sterility to subject the wife to treatment without first
examining the husband. Nevertheless, this is still often the case,
particularly among the lower classes or among the ignorant. There are
cases where the woman goes from one doctor to another for years and is
subjected to all kinds of treatment, when a simple examination of the
husband would show that the fault lies with him.

Some women have one child and are unable afterwards to give birth to
any more. Such a condition is called one-child-sterility. It is
generally due to an inflammation of the Fallopian tubes which closes
up the openings of the tubes into the womb, so that no more ova can
pass _from_ the ovaries _through_ the tubes _into_ the womb. This
inflammation may be the result of childbirth, for childbirth alone may
set up an inflammation, or it may be due to an infection contracted
from the husband.

In order to be fertile, that is, to be able to conceive and give birth
to a living child, the woman's external and internal genital organs
must be normal, her ovaries must produce healthy ova, and there must
be no obstruction on the way, so that the ova and the spermatozoa can
meet. The mucous membrane of the womb must also be healthy, so that
when the impregnated ovum gets attached to the womb it may develop
there without any trouble, and not become diseased or poorly nourished
and cast off.

We must always remember that the woman's share in bringing forth
children and perpetuating the race is much more important than the
man's. When a man has discharged his spermatozoa his work is done--the
woman's only commences.

The conditions which cause sterility in women are many, but the most
common cause is a salpingitis or an inflammation of the Fallopian
tubes, which may be caused by gonorrhea or any other inflammation. A
severe leucorrhea may also be the cause of sterility, because the
leucorrheal discharge may be fatal to the spermatozoa. Another cause
is a severe bending or turning of the uterus either forwards or
backwards. The opening of the neck of the womb, the os, may also be
closed, or practically so, from ulceration, from strong applications,
etc. In some cases sterility may be due to severe constitutional
disease, when the person is very much run down and so anemic that
menstruation stops. Unfortunately this is not always the case, for
women even in the last stages of consumption may, and often do, become
pregnant. Syphilis unfortunately does not cause sterility; it only
causes miscarriages until controlled by treatment.

The treatment of sterility can be successfully carried out only by a
competent physician, particularly by one who is devoting himself
specially to this kind of work. But I want once more to impress upon
every woman who is sterile, and who wants to have a child, not to have
herself treated or even examined until her husband has been subjected
to an examination.




CHAPTER FORTY

THE HYMEN

 Difference Between Chastity and Virginity--Worship of Intact
  Hymen--Sacrificing Hymen Sometimes Essential for Health of the
  Girl--Certificate from Physician who has Ruptured Hymen.


I have mentioned in a previous chapter that the absence of the hymen
was no proof of unchastity, just as the presence of the hymen was no
proof of perfect chastity. Chastity and virginity are not synonymous,
and a girl may possess physical virginity, that is, an intact hymen,
and still be morally unchaste. She may be in the habit of indulging in
unnatural sexual practices. But the laity does not know these facts or
does not want to know them, and the intact hymen is still worshipped
like a fetish. This would be of little consequence, if it did not
often result in unnecessary suffering to the female child or girl.
Much disease and a good deal of sterility result from the fear of
tampering with the hymen.

When a boy gets some trouble with his genital organs, such as
phimosis, or balanitis or whatever it may be, he is at once taken to a
physician, who institutes the necessary treatment. When a little girl
complains of itching around the genitals or of some discharge, the
mother will hesitate long before taking her to a doctor. She will be
afraid he will do something to the hymen. And so she will temporize,
using salves and washes, and the disease will in the meantime be
making progress, that is, getting worse. When she does take her to a
physician, and he says that in order to treat the case thoroughly the
hymen has to be stretched or opened, the mother will withhold her
consent, and the disease will be allowed to progress. I know of many
such cases. This is wrong. When the health of the girl demands and her
future child-bearing power is at stake, no hesitation should be felt
in sacrificing the hymen.

Though in the future the fuss which is now made about the hymen, the
excessive veneration in which it is held, will appear ridiculous, and
though I consider it foolish and rather humiliating to the girl,
nevertheless, now, when the average husband does lay so much stress on
the presence of an unruptured hymen, a physician who in the course of
an operation or treatment has occasion to cut or rupture the hymen,
will do well to give the patient a certificate to that effect. In case
any question regarding the girl's chastity comes up in the future, she
can prove by the doctor's certificate that her loss of virginity was
not due to sexual relations. Of course the relations between husband
and wife, or between prospective husband and wife, should be such that
no "certificate" should be necessary; but reality differs from the
ideal, and in some cases that we know the husband's suspicions were
allayed by the doctor's oral or written statement.

This is as good a place as any to emphasize, that if the bride has a
very strong, tough and resistant hymen, the new husband should not use
brute force in rupturing it. First, because the pain may be too
excruciating and this may create in the wife an aversion to
intercourse which may last for many months or years--in some cases
forever. Second, a severe hemorrhage may result, which may require the
aid of a physician to stop. Wherever a case of very resistant hymen is
encountered, the husband should make several attempts; gradual and
gentle dilatation, with the aid of a little vaseline and not forcible
rupture should be the aim; the result will usually be satisfactory. In
exceptional cases, a physician may have to be called in. The operation
of cutting the hymen is a trifling one.

It is also interesting to know that some wives have sex relations for
months and years, and the hymen remains unruptured. Pregnancy may also
result with an intact hymen.




CHAPTER FORTY-ONE

IS THE ORGASM NECESSARY FOR IMPREGNATION?

 Suppression of Orgasm by Woman to Prevent Impregnation--Bad
  Results of Suppression by the Woman--Orgasm: Relation of to
  Impregnation--A Hypothesis--A Fanciful Hypothesis--Why Passionate
  Women Frequently Fail to Become Mothers--Advice to Passionate
  Women who Desire to Conceive.


Among the laity the opinion is quite prevalent that in order for a
woman to conceive she must experience an orgasm, she must have had a
pleasurable voluptuous sensation during the act. If she has no orgasm,
impregnation cannot take place. So sure are some women that this is so
that when they want to avoid conception they repress any orgastic
feeling; as they say, they don't let themselves go. Which, I will say,
by the way, is one of the causes of female frigidity. If you don't
habitually permit a certain feeling to develop, if you repeatedly
repress it at the very beginning, at its first manifestation, it is
apt to atrophy altogether, to become permanently suppressed, or the
suppression develops into a nervous disorder.

Among the medical profession no perfect unanimity has been reached as
to the rôle of the orgasm in impregnation. Some sexologists like Kisch
and Vaerting believe it does play an important rôle; others, like
Forel, believe it plays none. That the orgasm is not _necessary_ for
impregnation admits of no discussion. Women who suffer from frigidity
in an extreme degree, women who never experienced an orgasm, women who
repress their orgasm, women in sleep or under narcosis, women who have
been raped, women who loathe their husbands, become pregnant
frequently and readily. But does it play any rôle at all? Does it
facilitate impregnation? Other things being equal, will intercourse
accompanied by an orgasm be more likely to prove fruitful than one in
which the orgasm was entirely absent? This question I am forced to
answer in the affirmative. Because from the various investigations I
have made it can hardly be subject to doubt that the uterus during an
orgasm exerts a certain amount of suction; and that impregnation is
_more likely_ to follow when the spermatozoa are sucked up into the
uterus than when left to make their own way by their own power of
motion, stands to reason and goes without saying. In the former
instance it takes less time for the spermatozoa to reach the ovum, and
there is less chance for them to perish on the way--from malnutrition
or from coming in contact with secretions of an acid reaction. There
is another point. I do not bring it forth as a proved fact or as a
fact susceptible to proof. It is a mere hypothesis, but in my opinion
it is a correct and plausible hypothesis. I believe that the strong
spasmodic contractions that take place during the orgasm have an
influence not only in accelerating the bursting of a Graafian follicle
and the extrusion of an ovum, but they are instrumental in aiding the
Fallopian tube to grasp the ovum and helping it along on the road
towards the uterus. It is therefore not at all inconceivable that
conception may take place during or within a very short time after an
act which is accompanied by a proper orgasm. Many women claim to
experience peculiar unmistakable sensations as soon as conception has
taken place, and by calculating the day of probable delivery we know
that they are right. Taking therefore all the various data into
consideration we are fully justified in saying that while an orgasm or
a voluptuous sensation during the act is not at all _necessary_ to
impregnation, it is in many cases a helpful factor.

It is claimed by some that the offspring resulting from an orgastic
act is apt to be healthier and better developed than offspring
resulting from sexual intercourse in which the parties experience no
orgasm. The reason given being that conception in the first instance
taking place quickly, the spermatozoa are better nourished and more
vigorous. In my opinion this is merely a fanciful hypothesis which
needn't be taken seriously.

It will be found rather frequently that women of strong passionate
natures, with strong orgastic feelings, and normal in every way, fail
to become mothers. A careful investigation of their menstrual
discharge will show that _it is not because they failed to conceive_,
but because the impregnated ovum is expelled each time; in other
words, they have each month a miniature miscarriage. And these
miscarriages, or rather abortions, are due to the spasmodic
contractions of the uterus and its adnexae which accompany the orgasm.
In such cases I have advised the woman to try to remain passive during
the act, to repress the orgasm, and the results have in some instances
shown the wisdom of my advice. After conception has taken place, after
one period has been missed, the woman should abstain from intercourse
altogether or at least for two or three months until the fetus is
securely attached to, or ensconced in, the uterus.




CHAPTER FORTY-TWO

FRIGIDITY IN WOMEN

 Meaning of Term Frigidity--Types of Frigidity--Large Percentage of
  Frigid Women--Repression of Sexual Manifestations and Frigidity--
  Frigidity and Masturbation--Frigidity and Sexual Weakness of
  Husband--Frigidity and Dislike of Husband--Organic Causes of
  Frigidity--A Frigid Woman May Become Passionate--Treatment of
  Frigidity.


The word frigidity means coldness, and when a woman has no desire for
sexual relations or experiences no pleasure when she has sexual
relations, she is said to be frigid.

Some cases suffer only from lack of desire, others only from lack of
pleasure, and still others from both. In some cases the frigidity is
congenital, that is, the lack of desire with inability to experience
pleasure during the act is inborn. In most cases, however, it is
acquired, or is only temporary, and is due to various causes.
Frigidity is much more widespread among women than it is among men.
Some physicians claim it is present in fifty per cent. of all women.
This may be an exaggeration, but if we put the number at twenty-five
per cent. we will be quite near the truth.

The causes of frigidity in women are many, but here are the most
important ones: First and foremost is the repression of all sexual
manifestations which the unmarried woman has to practice, and has had
to practice for many centuries. So that a part of the frigidity is
hereditary. You cannot entirely eradicate a natural instinct, but that
by continually repressing it, by giving it no chance to assert itself,
you may weaken it--about this there can be no question.

The second cause is masturbation. Cases that have been addicted to
excessive masturbation are very apt to develop not only frigidity, but
complete aversion to the sexual act, and inability to experience any
pleasure or orgasm. Such cases we come across every day.

A third very important cause is sexual weakness in the husband. When
the husband is sexually weak (suffering with premature ejaculations)
he either fails to awaken the sexual instinct in the woman, or if it
has been awakened it is apt to turn not only into frigidity but into
aversion to the act.

The fourth cause is often merely dislike towards the husband. The last
two causes, weakness of the husband and dislike towards him, are
unfortunately very frequent, and a wife who was frigid with one
husband may show herself very passionate on marrying another man.

The fifth cause is fear of pregnancy.

The above are the five principal causes. Other causes may be disease
of the uterus, laceration of the cervix, inflammation of the ovaries,
vaginismus, disease of the thyroid gland, etc.

It is an unfortunate fact that women who were frigid up to the age of
forty or so may become very passionate after that age.

As to the treatment of frigidity, little or nothing can be done for
frigidity that is congenital. Most of the other kinds of frigidity,
however, can be cured.




CHAPTER FORTY-THREE

ADVICE TO FRIGID WOMEN, PARTICULARLY WIVES

 Advice to Frigid Women--Attitude of Different Men Towards Frigid
  Wives--Orgasm a Subjective Feeling--A Justifiable Innocent
  Deception--The Case of a Demi-Mondaine.


I wish to give you a piece of advice which is of extremely great
importance to you. I hesitated somewhat before writing this chapter,
but the welfare of so many women depends upon following this advice,
and I have seen the lives of so many wives spoiled on account of not
having followed it, that I decided to devote a few words to the
subject.

As you know, about one-third or one-quarter of all women (in other
words, one out of every three or four) are sexually frigid. They
either have little or no sexual desire, or if they do have, they
experience no voluptuous sensation during the act, and never have an
orgasm. If you are unmarried, well and good. But if you are married
and happen to belong to the frigid type, then _don't inform your
husband of the fact_. It may lead to great and permanent trouble. Some
husbands don't care. Some are even glad if their wives are frigid.
They can then consult their own wishes in the matter, they can have
intercourse whenever they want and _the way they want_. They do not
have to accommodate themselves to their wives' ways, they do not have
to prolong the act until she gets the orgasm, etc. In short, some
husbands consider a frigid wife a blessing, a God-sent treasure. But,
as I mentioned several times before, in sexual matters every man is a
law unto himself, and some men feel extremely bad and displeased when
they find out that their wives have "no feeling." Some become furious,
some become disgusted. Some lose all pleasure in intercourse, and some
claim to be unable to have intercourse with any woman who is not
properly responsive. Some begin to go to other women, while some
threaten or demand a divorce (of course, such men cannot really love
their wives; they may use their wives' frigidity as an _excuse_ to get
rid of them).

Now, a man has no way of knowing whether a woman has a feeling during
the act or not, whether or no she enjoys it, whether or no she has an
orgasm. These are subjective feelings, and the man cannot know them
unless you tell him. If you belong to the independent kind, if you
scorn simulation and deceit, if, as the price of being perfectly
truthful, you are willing if necessary to part with your husband or
give him a divorce, well and good. You are a free human being, and
nobody has a right to tell you what to do with your body. But if you
care for your husband, if you care for your home and perhaps children,
and do not want any disruption, then the only thing for you to do is
not to apprise your husband of your frigid condition. And it won't
hurt you to simulate a feeling which you do not experience, and even
to imitate the orgasm. He won't be any the wiser, he will enjoy you
more, and nobody will be injured by your little deception, which is
after all a species of white lie, and is nobody's business but your
own. An innocent deception which hurts nobody, but, on the contrary,
benefits all concerned, is perfectly permissible.

It may seem rather strange publicly to give advice to deceive and to
simulate. And it is undoubtedly the first time that this advice has
been given in print. But as I have only one religion--the greatest
happiness of the greatest number--I repeat that I can see nothing
wrong in advising something which benefits everybody (concerned) and
hurts nobody. More than one household which was threatened with
disruption was preserved safe and sound by a little simple advice
which I gave to the wife, without the husband's knowledge. He was
satisfied, and things after that ran smoothly.

Some women are afraid to simulate a voluptuous or orgastic feeling,
because they think the husband can discover whether their feeling is
genuine or they are only simulating. (Women, and men too, have funny
ideas on sexual subjects). This is not so. A notorious demi-mondaine,
who was greatly sought because she was known to be so "passionate,"
confessed that not once in her life did she enjoy intercourse or
experience an orgasm. But her mother, who also suffered with absolute
frigidity, taught her to simulate passion, telling her that in that
way she could make barrels of money; which she did.

It is deplorable that wives--or husbands--should ever be obliged to
have recourse to deception or simulation; perfect frankness should be
the ideal to be striven after. But under our present social conditions
and with the present moral code, an occasional white lie is the lesser
of two evils; it may be the least of a dozen evils.




CHAPTER FORTY-FOUR

RAPE

 Definition of Rape--Age of Consent--Unanimous Opinion of
  Experts--Exceptional Cases--False Accusation of Rape Due to
  Perversion--Erotic Dreams Under Anesthesia Causing Accusations
  Against Doctors and Dentists.


Having intercourse with a woman by force, without her consent, is
called rape. When the woman is not in a condition to give consent, as
when she is insane, feebleminded, unconscious or drunk, or when she is
not of the age at which she can legally give consent, it also
constitutes rape, and the punishment is the same. The age of consent
differs in different countries and in different States, but as a rule
is between sixteen and eighteen years. That is, if a girl under the
legal age of consent should give her consent or even if she should
urge the man to have intercourse with her the man would be punished
just as if he had committed rape.

The punishment for rape is very severe in all civilized countries and
ranges from ten years' imprisonment to life imprisonment, while in
some States in this Union the punishment is death.

It is not my intention to go into an exhaustive discussion of this
painful subject. In this brief chapter I merely wish to bring out two
facts.

First, that it is the almost unanimous opinion of all experts that it
is practically impossible for a man to commit rape on a normal adult
girl or woman if she really offers all the resistance of which she is
capable. Of course, if the man knocks the woman down with a blow,
rendering her unconscious, that is a different matter. But where no
brutality is used by the man, and the woman offers all the resistance
she is capable of, rape is practically impossible. It is, however,
possible that in some cases the girl may be so paralyzed by fear as to
be incapable of offering any resistance. When the man threatens her
with death or severe bodily injury, then it is rape even if she offers
no resistance.

The second point is that it has been established that of the many
accusations of rape brought before the courts _most_ are false. Out of
a hundred cases only about ten are true. The rest are false. This
false accusation of rape is due to a peculiar perversion with which
some women suffer. Some of the cases are due to hysteria, to
imagination, the women really believing that rape or an attempt at
rape was committed on them, while investigation shows the accusation
to be entirely false. Many accusations of rape are due to a desire
for revenge or merely to motives of blackmail.

Careful doctors and dentists will refuse to give laughing gas or
another anesthetic to women except in the presence of others, because,
as is well known, an anesthetic often causes in women erotic dreams
and sensations and makes them believe that the doctor was committing
or about to commit an indecent assault on them, and when they come out
of the anesthetic they may be so sure of the reality of their dream
that they will bring a complaint against the doctor. Many men have
suffered disgrace and imprisonment and have had their lives ruined or
even paid the death penalty on account of false accusations against
them by either pervert, hysterical, revengeful or blackmailing women.




CHAPTER FORTY-FIVE

THE SINGLE STANDARD OF SEXUAL MORALITY

 Chastity--Double Standard of Morality--Attempt to Abolish Double
  Standard--Late Marriages and Chastity in Men--Harmful Advice
  Given to Young Women--Chastity in Men Not Always Due to Moral
  Principles--Chaste Men and Satisfactory Husbands--A Statement by
  Professor Freud--A Statement by Professor Michels--What a Girl
  has a Right to Demand of Her Future Husband--Three Cases Showing
  Disastrous Effects of Wrong Teachings.


When a man marries a girl he expects her to be chaste, that is, a
virgin, without any sexual experiences. Of men, the same chastity is
not expected as a general thing. As long as a man is healthy, free
from venereal disease, his previous sexual experiences do not
constitute a barrier to his marriage. This is what is known as the
double or duplex standard of sex morality.

During the past few years a number of high-minded and well-meaning men
and women have been trying to abolish this double standard and to
introduce a single standard of morality. That is, they are demanding
that the man going to the marriage bed should be just as chaste, just
as virginal as his wife is. Whether or no the efforts of these good
men and women will ever be crowned with success we will leave open.
Whether or no it is even desirable that their efforts _should_ be
crowned with success we will also leave open. A complete discussion of
these questions belongs to a more advanced book on sexual ethics. Here
I will merely say that, taking into consideration the fact that the
sexual instinct in boys awakens fully at the age of fifteen or
sixteen, and that marriage at the present time, particularly among the
professional classes, is an impossibility before the age of
twenty-eight, thirty, or thirty-five, it seems to be impossible and
undesirable to expect that men should live a perfectly chaste life
until they enter matrimony, no matter how late that event may take
place.

Those who have made a study of the sex instinct in the male seem to
think that chastity in normal, healthy men up to the age of thirty or
thereabouts is an impossibility, and where it is accomplished it is
accomplished at the expense of the physical, mental, and sexual health
of the individual. But be it as it may, and leaving disputed questions
out of discussion, the fact remains that the vast majority of men of
the present day do indulge in sex relations before marriage. And
people that are urging upon our young women to refuse to marry men who
have not been perfectly chaste are doing our womanhood a very poor
service. As it is now, with all mandom to choose from, there are many,
too many, old maids. With only ten per cent. to choose from (because
it is admitted that at least 90 per cent. of all men have
ante-matrimonial relations), what would our women do? They would
practically all have to give up any hopes of being married and
becoming mothers. And if these ten per cent., who have remained chaste
to their married day, were at least a superior class of men in every
instance, there would be some compensation in that. Unfortunately,
this is far from being the case, because, as all advanced sexologists
will tell you, there is generally something wrong with a man who
remains absolutely chaste until the age of thirty, thirty-five or
forty. It isn't moral principles in all cases; it is mostly cowardice,
or sexual weakness. And sad as it may be to state, these perfectly
good, chaste men do not generally make satisfactory husbands, and
their wives are not apt to be the happiest ones. I fully agree with
Professor Freud in his statement "that sexual abstinence does not help
to build up energetic, independent men of action, original thinkers,
bold advocates of freedom and reform, but rather goody-goody
weaklings." And still more to the purpose is the statement of
Professor Michels, who says:

"The desire that one's daughter may marry a man who, like herself, and
on an equal footing, will gain in marriage his first experience of the
most sacred mysteries of the sexual life, is one which _may lead to
profound disillusionments_. Even if to-day the demand for chaste young
men is extremely restricted, the supply is yet more so, and the
article _is of such an inferior quality_ that in actual practice the
attempt to satisfy this desire is likely to lead to results which will
fail altogether to correspond to the hopes inspired by a contemplation
of the abstract idea of purity. Many physically intact individuals of
both sexes _are far more contaminated_ than those who have had actual
sexual experience. Others again, superior in the abstract, and from
the physically sexual aspect, are _ethically inferior to the
unchaste_, so that the union with these latter would be more likely to
prove happy than a union with those who are nominally pure." And
further, "Careful fathers of marriageable daughters, who seek this
virginity in their sons-in-law, will, if they find it, seldom find it
a guarantee for the simultaneous possession of solid moral qualities."

All a girl has a right to demand is that her future husband be in good
health, physically and sexually, and that he be free from venereal
disease. His previous sexual life, provided he is a man of fine moral
character in general, is no concern of hers. Even if the man was
unfortunate enough to have contracted gonorrhea, that fact should
constitute no bar to marriage, provided he is completely cured of it.
The only exception is that of syphilis. The girl has a right to refuse
absolutely to enter into union with any man who has been infected with
syphilis unless she is willing, and does it with her eyes open, to
live her life without any children. In syphilis we can never give an
_absolute guarantee_ of cure and we have no right to subject a woman
to any danger of infection with syphilis, be the danger ever so
slight, without her knowledge and consent.


=Disastrous Effects of Wrong Teachings=

What disastrous effects wrong teaching which inoculates the minds of
our women with wrong ideas may have, the following three cases
reported briefly in _The Critic and Guide_, will show:

=Case One= was a girl of twenty-four, of well-to-do parents, a college
graduate. She was engaged to a really very nice, sympathetic young
man, who undoubtedly would have made her an excellent husband. But
during her last two years in college she became imbued with the single
standard stupidity, and "chastity for men, votes for women" became her
slogan. She asked her fiancé if he had been absolutely chaste before
he met her. He did not want to play the hypocrite, and he told her the
truth that he had not. But he assured her that he had never been
infected and that his general and sexual health was in excellent
condition. Being then in an exalted mood, she impulsively broke the
engagement, declaring that her husband will have to be as "pure" as
she was. She soon regretted her step, because she loved the man; but
pride did not let her take the initiative towards a reconciliation,
and in the meantime her former fiancé fell in love with and married
another girl. After four years had passed, and she was in danger of
becoming an old maid, she married a man considerably beneath her
socially and intellectually, and in every way inferior to her former
fiancé. Her marriage is not a happy one.

=Case two= is similar to case one, except that the young lady in
question--now not so very young--is still living in single
blessedness, and the chances of her ever being a wife or even
somebody's sweetheart are rapidly vanishing. I might add that her
fiancé whom she discarded because of his lack of virginity was a very
bright young physician, who is now very successful and very happily
married. She I hear is a very unhappy person, in danger of sinking
into a permanent state of melancholia. And she had been of a very
jolly disposition.

=Case three= is peculiar in that the fiancé _was_ absolutely chaste.
She asked him, and he told her that he had never had any relations
with anybody and he never had a trace or suspicion of any venereal
disease. The young lady was not satisfied. She wanted her fiancé to
bring her a certificate from a specialist testifying to that effect.
The young man told her that it was foolish, that he would not subject
himself to the expense and annoyance of a number of tests when he
_knew_ that not only did he not have any venereal disease, but that
there was no possibility of his getting any. No, that did not satisfy
her. She became suspicious. "If you have nothing to fear, why do you
object to bringing a certificate?" "I have nothing to fear, but I
demand that you respect me and trust me sufficiently to believe that I
am telling the truth when I declare a thing with such positiveness. If
you do not have that much confidence in me now, our future life does
not hold much promise of success." One word led to another, and then
he broke the engagement, as any self-respecting man under the
circumstances would. He is married, and she is not and probably never
will be. Three young lives ruined by perverse teachings.




CHAPTER FORTY-SIX

DIFFERENCE BETWEEN MAN'S AND WOMAN'S SEX AND LOVE LIFE

 Seemingly Contradictory Statements--Faulty Interpretations of
  Words Sexual Instinct and Love--Difference in Manifestations of
  Male and Female Sexual Instincts--Man's Sex Instinct Grosser Than
  Woman's--Awakening of Sexual Desire in the Boy and in the
  Girl--Woman's Desire for Caresses--Man's Main Desire for Sexual
  Relations--Normal Sex Relations as Means of Holding a Man--A
  Physiological Reason Why Man is Held--Man and Physical
  Love--Woman and Spiritual Love--Preliminaries of Sexual
  Intercourse in Men and Women--Physical Attributes--Mental and
  Spiritual Qualities--Difference Between Love and "Being in
  Love"--Love as a Stimulus to Man--When the Man Loves--When the
  Woman Loves--Man's More Engrossing Interests--Lovemaking Irksome
  to Man--Man's Polygamous Tendencies--Woman Single-affectioned in
  Her Sex and Love Life--Man and Woman Biologically Different.


In reading books or listening to lectures on sex, you will meet with
statements which will seem to you contradictory. One time you will
read or hear that the sex instinct is much more powerfully developed
in man than it is in woman; next time you will come across the
statement that sex plays a much more important rôle in women than it
does in men. One time you will hear that men are oversexed, that they
are by nature polygamous and promiscuous, while woman is monogamous
and as a rule sexually frigid; the next time you will be assured that
without love a woman's life is nothing, and you will be confronted
with Byron's well-known and oft quoted two lines: Man's love is of
man's life a thing apart, 'Tis woman's whole existence.

These contradictions are only apparent and result from two facts:
first, that the words sex or sexual instinct and love are used
indiscriminately and interchangeably as if they were synonymous terms,
which they are not; second, there is failure to bear in mind the
essential differences in the natures and manifestations of the sexual
instincts in the male and the female. If these differences are made
clear, the apparent contradictions will disappear. The outstanding
fact to bear in mind is that in man the sex instinct bears a more
sensual, a more physical, a coarser and grosser character, if you have
no objection to these adjectives, than it does in woman. In women it
is finer, more spiritual, more platonic, to use this stereotyped and
incorrect term. In men the sex manifestations are more centralized,
more local, more concentrated in the sex organs; in women they are
more diffused throughout the body. In a boy of fifteen the libido
sexualis may be fully developed, he may have powerful erections and a
strong desire for normal sexual relations; in a girl of fifteen there
may not be a trace of any purely sexual desire; and this _lack_ of
desire for _physical_ sex relations may manifest itself in women up to
the age of twenty or twenty-five (something that we never see in
normal men); in fact, women of twenty-five and even older, who have
not been stimulated and whose curiosity has not been aroused by
novels, pictures, and tales of their married companions, may not
experience any sexual desire until several months after marriage. But
while their desire for actual sexual relations awakens much later than
it does in men, their desire for love, for caresses, for hugging, for
close friendship, for love letters, awakens much earlier than in men,
and occupies a greater part in their life; they think of love more
during their waking hours, and they dream of it more than men do.

A man--always bear in mind that when speaking of men and women I
always speak of the average; exceptions in either direction will be
found in both sexes--a man, I say, will generally tire of paying
attentions to a woman if he feels that they will not eventually lead
to the biologic goal--sexual relations. A woman can keep up with a man
for years without any sexual intercourse, being fully satisfied or
more or less satisfied with the sexual substitutes--embraces and
kisses.

And here is as good a place as any to refer to the notion so
assiduously inculcated in the minds of young women, that a persistent
refusal of man's demands is a sure way of keeping a man's affections;
that as soon as man has satisfied his desires, he has no further use
for the girl. This may be the case with the lowest dregs--morally--of
the male sex; it is the opposite of true of the male sex as a whole.
And I believe that Marcel Prevost was the first one to point it out
(in his _Le Jardin Secret_). Nothing will hold a man's affections so
surely as normal sex relations. And the cause of this is not, as might
be surmised, merely a moral one, the man considering himself in honor
and duty bound to stick to the woman whose body he possessed. No,
there is a much stronger and surer reason: the reason is of a
physiological character. There is born a strong physical attraction
which in the man's subconsciousness plays a stronger rôle than honor
and duty. Excesses of course must be avoided, for excesses lead to
satiety, and satiety is just as inimical to love as is excitement
without any satisfaction.


=Choice Between Physical and Spiritual Love=

But to return to our thesis: the difference between man's and woman's
sex and love life. If a man had to make his _choice_ between physical
love, i.e., actual sex relations and spiritual love, i.e., love
making, kisses, love letters, etc., he would generally choose the
former. If a woman had to _choose_, she would generally choose the
latter. The man and the woman would prefer both at the same time:
physical and spiritual love. But that is not the question. The
question is: if it came to a _choice_; and then the results would be
as I have just indicated. The correctness of my statements will be
corroborated by anybody having some knowledge of human sexuality. A
man can fully enjoy sexual intercourse without any preliminaries; with
a woman the preliminaries are of the utmost importance, and when these
are lacking she is often incapable of experiencing any pleasure. Nay,
the feeling of pleasure is not infrequently replaced by a feeling of
dissatisfaction and even disgust. A man cares more for the physical
and less for the mental and spiritual attributes of his sexual
partner; with the woman just the opposite is the case. I am leaving
out of consideration sexual impotence, because this is a real
disability, and a man suffering with it only irritates the woman
without satisfying her. For this she will not stand. But where the man
is sexually potent--he may be aged and homely--his other physical
attributes play but a small rôle with woman; his mental and spiritual
qualities count with her for a good deal more. While a woman may be
able to give a man perfect sexual satisfaction, and she may have an
angelic character, if her body is not all that could be desired, the
man will be dissatisfied and unhappy.


=Love in Man Occupies Subordinate Place=

Try as we may, we cannot get away from the fact that in man's life
love occupies a subordinate place. I am speaking now of love, and not
of "being in love." Being in love, as pointed out in another place, is
a distinctly pathological phenomenon, akin to insanity, and when a man
is in love it may engross every fiber of him, it may preoccupy every
minute of his waking hours, he may neglect all his work and shirk all
his duties, in fact he is apt to make a much bigger fool of himself
than a woman is under similar circumstances. He is less patient, he
has less control over himself, he is less able to suffer, he is less
capable of self-sacrifice. But this, as I said, all refers to "being
in love," which is an entirely different thing from loving. A man may
love ever so deeply, and if his love is reciprocated he will go on
with his work in a smooth, unruffled manner. He will do better work
for it--love is a wonderful stimulus--but he will be perfectly
satisfied if he sees his love for an hour or two every day, or even
once or twice a week. And if he has important and interesting work to
do, he can part with his love for three months or six months without
his heart breaking. Not so with woman. A woman who loves considers
every day on which she does not see her lover a day lost. And she is
apt to be unhappy and inefficient in her work on such days, and she
bears separation with much greater difficulty than does man. I do not
think that this is due to the fact that a woman's love is always more
intense than a man's; no. But he usually has other interests which
occupy his thoughts and his emotions, while most women's thoughts and
emotions are centered on the man they love. When a woman loves, she
could and would spend all her time with the man she loves. She would
never tire of love making (I am not referring here to sex relations),
or merely of being in the man's proximity. To woman love is a cloyless
thing. Man distinctly does tire. No matter how much he may love a
woman, too much lovemaking becomes cloying to him, and he wants to get
away. Even mere proximity, if too prolonged, becomes irksome to him,
and he begins to fret and fidget, and pull at his chains, even if the
chains are but of gossamer. Woman should know these facts and act
accordingly.


=Polygamous Tendencies in Man=

We now come to the last point in our discussion: the polygamous or
varietist tendencies in the male versus the monogamous tendencies in
the female. No matter what our moralists, who try to fit the facts to
their theories instead of fitting their theories to the facts, may
say, the fact remains that man is a strongly polygamous or varietist
animal. That many men live through their lives without having had
relations with any women except their wives is cheerfully admitted. I
assert this in spite of the incredulous smiles of all the cynics and
roués in the world. I have known personally a great number of such
men. But that they do it without any struggle, and in some cases a
very severe struggle, is emphatically denied. And that hundreds of
thousands of men are unequal to the struggle--or do not care to engage
in any struggle--and live a sexually promiscuous life--anybody who
knows anything about life as it is will testify. And his testimony
will be corroborated by the reports of the vice commissions and the
statements of disreputable-house keepers. To a great percentage of men
a strictly monogamous life is either irksome, painful, disagreeable or
an utter impossibility. While the number of women who are not
satisfied with one mate is exceedingly small.

A man may love a woman deeply and sincerely and at the same time make
love to another woman, or have sexual relations with her or even with
prostitutes. It is quite a _common_ thing with men. It is quite a rare
thing with women, though it may happen. As iterated and reiterated
time and again, there are always exceptional cases, but we are
speaking of the average and not of the exception. The _rule_ is that
in her sex and love life woman is much more loyal, much more faithful,
much more single-affectioned than is her lord and master--man.

Is she on account of it better than, superior to, man? It is futile to
speak of better or worse, of superior or inferior. This is the way
they are. This is the way man and woman have been made by nature, by a
thousand centuries of heredity, by a thousand centuries of
environment. The differences lie in biological roots, and it is futile
to fight and rail against nature and biology. The proper thing to do
is to recognize the facts and make the best of them. To act the part
of the ostrich, deliberately to ignore facts which are not pleasant,
may be easy, but is it wise?




CHAPTER FORTY-SEVEN

MATERNAL IMPRESSIONS

 Wide-spread Belief in Maternal Impressions--No Single
  Well-authenticated Case of Maternal Impression--Birth of
  Monstrosities--Ridiculous Examples Given by Physicians--So-called
  Shock Often a Product of Mother's Imagination--Four Cases of
  Alleged Maternal Impressions--Mother's Health During Pregnancy
  May Have Effect Upon Child's General Health.


It is believed by many people that strong impressions made upon the
mother during pregnancy may produce marks or defects in the child.
This belief dates from earliest antiquity, and is widespread among all
races. The belief particularly refers to the emotions of fright or
sudden surprise; thus it is believed that if a woman during pregnancy
should be frightened by some animal, the child might carry the mark of
the animal upon its body, or it might even be born in the shape of the
animal. Thousands of such _alleged_ cases are given in proof. There is
hardly a layman, or, particularly, a laywoman, who does not claim to
know of authentic cases of maternal impressions.

It is a thankless task to try to shatter well-established beliefs,
and I do not hope to succeed in persuading all my readers that all the
stories and examples of maternal impressions are untrue and lack
scientific foundation. But I consider it my duty to state my belief,
whether you accept it or not. In my opinion there is not a single
_well-authenticated_ case of maternal impression. There is hardly a
case of defect or monstrosity where the cause is supposed to be due to
maternal impression, which cannot be explained in some natural way, or
simply by accident. Thousands of women are frightened or shocked by
disagreeable sights, by crippled men, by animals, and still their
children are born perfectly normal. On the other hand, many marked, or
defective, or monstrous children are born in which no maternal
impressions can be given as the cause. So why can it not happen when
the mother was frightened by something during her pregnancy, and the
child was born with some mark or defect, that the latter was simply an
accident and not the _result_ of the impression? Because a thing
_follows_ another thing it does not mean that it was _caused_ by that
other thing.

Many of the cases given as examples, and by physicians too, are so
ridiculous that no scientific man can give them the slightest credence
for one moment. When a physician (Dr. Thomas J. Savage) tells us that
he attended a lady who had been frightened by a large green frog at or
about the middle of pregnancy, and that she gave birth to a
monstrosity, the head of which was that of a large frog in shape, with
the eyes and mouth and even the coloring of a frog, then he is either
telling an untruth, or he shows himself as ignorant and credulous as
any illiterate old woman can be. The doctor should know that at the
middle of pregnancy the child is _fully formed_ and that there is no
possibility of an already formed human being changing its shape into
that of an animal. Another example given by the same doctor, and
showing the calibre of his mentality, is that of a child which, when
an infant, not old enough to walk, "would crawl over the floor and
pick up little objects such as pins, tacks, small beads, without the
slightest difficulty or fumbling." The reason for this "remarkable"
skill the good doctor ascribes to the fact that four months before the
birth of this child the mother had an outing in the woods and had
derived great enjoyment from gathering hickory nuts which she found
scattered among the leaves with which the ground was thickly covered!

Very often the so-called shock or fright which the mother experiences
during gestation is simply a product of her imagination. We know of
many cases where the mothers never mentioned that anything happened
to them, and only after the child was born with some kind of mark or
defect they began to hunt for causes and claimed that such and such a
thing happened to them while they were pregnant, but on close
investigation the alleged event was found to have originated in the
mother's brain.

In short, while the subject of maternal impressions is an interesting
one and demands further investigation, there is at the present time no
scientific justification for the belief in maternal impressions.
Particularly must we scout any stories of maternal impressions during
the latter part of pregnancy, during the fifth, sixth, seventh,
eighth, or ninth month. Because after the child is fully formed no
mental or psychic impressions can make birthmarks on it, amputate its
limbs, or convert it into any sort of monstrosity.

After the above was written and ready for the printer I came across
four cases of alleged maternal impressions in a book by Laura A.
Calhoun ("Sex Determination and Its Practical Application"). The first
three cases the author relates without any comment, taking them
evidently for pure coin. The fourth case the lady investigated, and
she is frank to say that what seemed at first as a clear case of
maternal impression was nothing of the kind but merely a case of
heredity. In order to break the monotony for a little while I will
reproduce here the four cases in the lady's own words.

    The first was that of "a mother who, during pregnancy, was
    obliged for a certain continuous time to eat sheep's flesh. She
    took such a sudden abhorrence and distaste of the meat that she
    only ate it rather than go meat hungry. After the birth of her
    baby she recovered from this spasmodic distaste of this
    particular meat. But the child from its first meat-eating days
    could not endure the smell or the taste of the sheep's flesh.
    Whenever the child attempted to eat that meat, the result was
    always the same--indigestion and want of assimilation, and
    usually attended with acute indigestion cramps."

    In the second case "another pregnant mother's particular
    'longing' was for mackerel. Her baby was born with what seemed
    to be the outlines, in a brownish color, of a mackerel on its
    side, and which design never faded in after years, and the
    child's ability to eat and digest mackerel was more than
    normal."

    The third case: "The 'longing' of another pregnant mother was
    for brains to eat. This was provided for her. But as she was
    slowly approaching the dish of deliciously prepared food,
    quivering with delight and with the eagerness of a child to be
    eating it, a cat sprang to the plate and before she could
    prevent it ate the brains and licked the plate clean. She wept
    as a child might have done, and was as unhappy and brokenhearted
    over this fate of the brains food for which she had waited with
    such keen anticipation of satisfaction as a little child might
    have been. Shortly after that the little baby was born, and upon
    one of its shoulder-blades was a representation of the mess of
    brains, designed in brownish outlines, and which did not fade as
    the child grew up."

    The fourth case: "There lived in a little house in the midst of
    a flower garden, that in its turn gave into a wide-spreading
    orchard, a loving and loyal husband and wife with their
    firstborn child. The wife was now in the first months of
    pregnancy with her second child. Their nearest neighbor was a
    Mexican family, among the members of which was a dashing young
    man of about twenty-two. He and his sister and mother were
    frequent visitors to this little household of three. But the
    young Mexican was the most frequent, and the husband's being
    home or not did not disconcert him. Men of affairs must need
    spend morning hours, and sometimes afternoon hours, too, inside
    of offices, but wealthy and aristocratic young Mexicans ride
    horses all day, decked out with silver, leather, and velvet
    trappings, both horse and rider. It was this lady's custom to
    walk among her flowers and fruit trees. And it became the custom
    of this young caballero to suddenly appear before her during
    these promenades. Her startled eyes would no sooner perceive the
    vision of his blazing, dark eyes fastened upon her, than by one
    pretext and another she made him understand that he was
    dismissed, and would herself retire into the house. When she
    would be about to open a gate, suddenly and unexpectedly the
    young Mexican would appear on the other side and with gracious
    suavity open the gate, always his passionate, dark eyes upon
    her, though his words were reserved and polite. If the husband
    were present, it was still the same. By every means possible he
    would prolong his stay.

    One summer day this lady was lying on her couch on the veranda,
    sleeping, her eyes covered over. At that time she was having an
    eye malady that was epidemic in that part of the country. She
    heard footsteps approaching, but did not disturb herself, as she
    supposed it was her husband. After some time she suddenly threw
    off the covering from her face, and there to her astonished eyes
    stood the young Mexican, intensely looking down upon her with
    deep concern. At that moment the husband arrived, and the young
    man told him of a weed growing in that locality that he said
    would cure the eye malady. When the leaves of this plant were
    crushed there oozed a yellowish milk; with about a half-dozen
    applications of this milk to the sore eyes they were healed.

    After that the young caballero would ride up and down, Mexican
    fashion, in front of the house, drawing rein whenever he could
    get a glimpse of the lady or a word with her. This never failed
    to annoy her, and also to strike a sudden, sharp terror into
    her heart. Always his appearance was most unexpected, and
    always accompanied by the rapt, passionate, dark gaze. Though he
    was a most clean-souled young man.

    Afterward, when the baby was born, one of the child's eyes was
    marked by the color and fire of the dashing Spaniard's eyes,
    while its other eye was a calmish blue-gray eye. This was all
    the more remarkable as neither of the parents of the child had
    such eyes. Was it a case of maternal impression?

    Upon investigation I found that the grandparents of the baby's
    mother had just such eyes as the baby. The grandfather's were
    big, dark, flashing eyes, and the grandmother's the mild,
    blue-gray eyes. So 'bang!' went the theory of mental impression,
    and in its place came the physical law of reversion."

I do not wish to be misunderstood as claiming that a mother's
condition during pregnancy has no effect on the child, and that she
need therefore take no precautions and pay no particular attention to
her health and her feelings. This is not so. But what I do want to
convey is this: That if a mother's health during pregnancy is bad, if
she is a prey to worry and anxiety, if she was subjected to great
fright or to a shock, then the child's general health may suffer. It
may be stillborn, or the mother may have a miscarriage. But it will
not produce those specific marks, deformities and monstrosities which
are commonly supposed to be the results of maternal impressions.

If I lay somewhat special stress upon the subject of maternal
impressions, it is because I pity the poor mothers and want to spare
them as much as possible unnecessary worry and anxiety. Besides I want
them to believe in the truth and not in error.




CHAPTER FORTY-EIGHT

ADVICE TO THE MARRIED AND THOSE ABOUT TO BE

 Marriage as an Ideal Institution--Monogamic Marriage--Some Reasons
  for Husbands' Deviations--Importance of First Few Weeks of
  Married Life--Necessity for Understanding at Beginning--
  Preventing and Breaking Habits--The Wife's Individuality--
  Husbands Who are Childish, Not Vicious--Wife's Interest in
  Husband's Affairs--The "Slob" Husband--The Well-groomed Husband--
  Bad Odor from the Mouth--Odors from Other Parts of the Body--
  Treatment for Bad Odor from Perspiration--A Beneficial Powder--
  Advice Regarding Flirting--Dainty Underwear--Fine External Clothes
  and Cheap and Soiled Underwear--Delicate Adjustments of Sex Act
  Required with Some Men--Wife Who Discusses Her Husband's Foibles--
  A Professional Secret--A Case of Temporary Impotence--The Wife's
  Indiscretion--The Disastrous Result--A Big Stomach--The Wife's
  Attitude Towards the Marital Relation--Behavior Preliminary to
  and During the Act--Congenital Frigidity--Prudish and Vicious
  Ideas About the Sex Act--Sexual Intercourse for Procreative
  Purposes Only--Fear of Pregnancy on the Part of the Wife--The
  Remedy--Other Causes--Wife who Makes too Frequent Demands--
  Sacrificing the Future to the Present--Esthetic Considerations.


Whether marriage in its present form is an ideal institution destined
to endure forever, whether it is in need of radical reforms before it
can be considered ideal, or whether it has fundamental irremediable
defects, are questions which we are not going to discuss here. The
fact is that at the present time the greatest part of the adult
population of the world is married; and the part that isn't would like
to be. And the greater part of civilized humanity living in a state of
monogamic marriage, it behooves us to make the best of it, to get out
of it the greatest amount of happiness that we can, obviate as much
unhappiness as possible, and to do everything in our power to make it
permanent. Separation or divorce are remedies of last resort, and
people have recourse to them when they are at the end of their tether.
But the proper thing to do is to avoid the necessity of having to have
recourse to them. And I believe that a careful, thoughtful perusal of
this chapter will help husband and wife to get along better, to avoid
unnecessary friction and to retain the mutual physical and spiritual
attraction which we call Love for a longer period than might otherwise
be the case.

I have the confidence and listen to the intimate confessions of more
men and woman probably than any other physician in America, or perhaps
in the world. For reasons easily understood they tell me things which
they would not think of telling to their regular physician. I have
learned of many of the reasons, which in many families led first to a
coolness, then to an estrangement, or to quarrels, to separation and
divorce. I know the first steps which in many instances draw the
husband to another woman. And I wish to tell you, that while I firmly
believe in the polygamous or rather varietist tendencies of the
average man, nevertheless I am convinced that one of the great reasons
why so many married men patronize prostitutes, or have mistresses or
lady friends, is to be found in the wives themselves. Many wives
_drive_ their husbands to other women, and are alone responsible for
their suffering, for the cooling of their husbands' affections, and
perhaps even desertion. And in the following pages I will endeavor, as
stated before, to point out some of the rocks and shoals on which the
matrimonial bark is so often shattered, and to offer the wives some
suggestions which will help them to retain their husbands' affections
and perhaps even also their fidelity.

While the advice is intended primarily for wives, there will be found
here and there a salutary piece of advice for husbands. Some of the
advice is applicable to both partners, and as to those suggestions
which concern the husband only--it will be a good thing for the wives
to call their husbands' attention to them.

The first few weeks or the first few months are the most important in
the life of a married couple. The stability of the marriage, the
future happiness, often depend upon the things which are done or left
undone during the initial weeks of married life. A certain
understanding must be reached from the very beginning. If your husband
does certain things which displease you and which you know should not
be done, it is best to say so at the very start. It is easier to
prevent the establishment of a habit than to break a habit after it
has been established.

=Retain Your Individuality.= The first piece of advice I have to give
you is: _Retain your individuality_. It is a trite but perfectly true
observation that altogether too many men who during courtship were
chivalry personified assume a dictatorial tone as soon as the knot has
been tied. They think that the wife has actually ceased to exist as a
separate human being, that she has been absorbed, and with the loss of
her name she has lost all right to have her own opinions, her own
tastes, and, of course, her own friends. Friends who are obnoxious to
one of the marital partners one must give up sometimes; but do not
permit your entire personality to be obscured. Explain to your husband
that you are still an independent living human being. I do not say,
you should at once start a fight. Nothing is more offensive to me than
the militant, pugnacious woman, who wears a chip on the shoulder and
is continually ready to insist on her "rights." But with gentleness
and firmness much can be accomplished. And you want to remember that
many husbands act the way they do, not because they are vicious, but
because they are stupid or childish. Sometimes it is mere
thoughtlessness. They have been brought up wrongly, and some of them
sincerely imagine that by repressing the wife's personality, by
blotting it out, they are acting in her interest. "It is for her own
good." A serious talk with a husband will sometimes have a wonderful
effect. It may sometimes change entirely the current of his thoughts.
Of course if the husband is a cad, a conceited fool, or a brute, you
can do nothing with him; but fortunately not all husbands belong to
those categories.

=Interest in Husband's Affairs.= Be interested in your husband's
affairs. No matter what your husband's occupation may be, you should
possess enough intelligence to be able to understand what he is doing.
It is almost unbelievable how little some wives know about their
husband's profession or work. It is a bad thing when strange women
understand your husband's work better than you do, and when he finds
in them more intelligent and more sympathetic listeners. He may go to
them for sympathy. If your husband is a scientist or a research
worker or a professional man it is not necessary that you be familiar
with all the details of his work, but with the general character you
should be. And if you can be of assistance to him in his work, if it
be only looking up references, compiling tables and statistics or
merely typewriting, it will be appreciated by him, and will sometimes
help to knit the bonds a bit closer.

There is another important reason for being interested in and
understanding your husband's business. When the husband dies--and a
man is not infrequently snatched away in the prime of youth and
vigor--the wife is often left to the mercies of the cold world,
without money and without a profession. If she understands the
husband's business she can continue it and remain economically
independent. This has reference not only to ordinary business, like
stores or agencies, but to more or less specialized occupations, such
for instance as publishing. We know the cases of two widows of
publishers of medical journals. When their husbands died everybody was
commiserating with them: what will they make a living from? But they
understood the details of their husbands' business, and they kept
right on. And now those journals are financially more successful than
they were when the husbands were at the helm.

=Wife's Behavior Toward Sexual Relations.= I am now coming to a
delicate subject. But, delicate though it is, it must be dealt with
unflinchingly, because it is probably responsible for more male
infidelity than all other causes combined. I speak of the relation of
the wife to her marital duties, in other words, to sexual relations.
Too many women regard the sexual act as a nuisance, as an ordeal, as
something disagreeable to get through with as quickly as possible;
they regard the husband's demands in this line as an imposition, as
unfair or even as brutal; and their behavior preliminary to and during
the act is such as to cool the ardor of any refined and sensitive man.
The reasons for this behavior on the part of many wives are manifold;
this is not the place to consider them in detail. I will allude to
them briefly. One great cause is congenital frigidity. The woman is
cold, frigid, has no desire for sex relations and experiences no
pleasure, no sensation from them. Such women are not to blame; they
are to be pitied. But even they can behave so as not to repel their
husbands. (See Chapter XLIII).

Another great cause is the vicious, prudish bringing up, by which the
sex act is regarded as something unclean, indecent, animal-like,
brutal. Such Women need a good "talking-to," and if they are only not
natural born fools, one good explanation often fixes matters. On a par
with this general prudishness is the infamous idea promulgated by a
few semi-insane, mentally decrepit men and women, that sexual
intercourse is for the purpose of propagation only. That only when a
child is wanted is the relation permissible; at all other times it is
a sin, an "act of prostitution," an offense in the eyes of God, etc.,
etc. Of course if the wife has such ideas the husband deserves little
sympathy. A man should know what ideas the woman entertains whom he is
going to make his wife and the mother of his children. But,
unfortunately, this, the most important subject of sex and sexuality,
is never touched upon by the engaged couple (it would be so
indelicate!), and after they are married they often find themselves at
opposite poles. Here also a good heart-to-heart talk will do a world
of good. I have had several such cases where a little conversation or
even a letter saved the couple from disruption.

In many cases the cause of refusal is fear of pregnancy. In this case
the wife is right. But the remedy is simple: give her full instruction
in the use of contraceptive measures. Other causes are: excessive
masturbation, vaginismus, local malformation, inflammation, etc. But
whatever the causes of the wife's "bad behavior" may be, they are all
amenable to treatment. Some need medical treatment, some psychic
treatment, and some nothing but just a common-sense, heart-to-heart
talk.

And I would emphasize: Do not repel your husbands when they ask for
sexual favors--at least do not repel them too often. Households in
which relations are had rather frequently and in which the wives lend
their full and eager participation are happier households than those
in which the sexual act is indulged in rarely, and with grumbling and
side-remarks on the part of the wife.

But of course you should not go to the other extreme either. You
should not make too frequent demands upon your husband. With a man the
act means a good deal more than it does with a woman; it entails a
great deal more of physical and mental exhaustion, and a wife who is
unreasonable in this respect is sowing the seeds of discord and
unhappiness. She is sacrificing the future to the present. The husband
is apt to become afflicted with satiety or impotence--and the wife may
have to lead a life of continence for much longer than she would have
had to if she had been moderate. In no department of life is
moderation so important as in sex life. Non-use, insufficient use and
excessive use are all bad. A mutually joyful, eager and moderately
frequent participation in the sexual act will contribute most to a
happy and long life.

=Dainty Underwear.= This may be considered too delicate or too
trifling a subject to discuss in an important sex book. But nothing is
too delicate or too trifling that concerns human happiness, and you
will believe me if I tell you that nice underwear or dainty lingerie
plays a very important rôle in marital life. And every married woman
should have as fine and as dainty underwear as she can possibly
afford. A fine or elaborate nightgown may be more important than an
expensive skirt or hat. Unfortunately too many women ignore this fact.
Externally they will be well dressed, while their petticoats, drawers
and undershirts will be of the commonest quality and of questionable
freshness and immaculateness. And if anything in a woman's toilet
should be immaculately fresh and clean it is, I emphasize, her
underwear. Silk and lace and delicate batiste should be preferred, if
they can be afforded, and attention should be paid to the color. As a
rule, a delicate pink is the color that most men prefer. The sex act
with some men requires the most delicate adjustments, and the
condition of the underwear may determine the man's desire and ability
or inability to accomplish the act. I therefore repeat: whether you
are newly married or have been married a quarter of a century, be
sure that your underwear is the very best that your means will allow
you, and that it is always sweet, fresh and dainty. It will help you
to retain the affection of your husband. I know that some allegedly
wise ones will scoff at this statement. They may say that an affection
that may be influenced by the kind and condition of underwear is not
worth having or retaining. But what do these wise ones know! What do
they know of the numerous subtle influences which gradually either
strengthen or undermine our affections? Follow this advice and you
will be grateful.

=Do Not Offend Against Esthetics.= Some women think that because they
are married to their husbands they owe the latter no esthetic
consideration. Things that they would be horrified to let a stranger
see they do before their husband's eyes without hesitation. For
instance, not to beat about the bush, though the subject is not a
pleasant one, they will urinate in their husbands' presence, or they
will let him see their soiled menstrual napkins, etc. Some husbands
may not mind it; but some men are very sensitive--men on the whole are
more esthetic than women--and an indifference towards the wife may
have its origin in some vulgar or unesthetic procedure on the wife's
part. The sexual act, as mentioned before, is a very delicate
mechanism, and it is very easy to disarrange it. The act of
micturition before the man is known in many instances to have
instantly abolished the man's sexual desire which was present before.
And a man told me that because he noticed in a closet a lot of rags
soiled with menstrual blood he was unable to enjoy relations with his
wife for several months. You may think that these are all small
things, but life is made up of little things, and many a married life
went smash on account of disregarding the little things.

=A High Stomach.= Avoid if you possibly can a high stomach, or a big
stomach, or what we call in technical language a pendulous abdomen.
Nothing is more fatal to woman's beauty--and to man's love--than a big
stomach, and particularly a hang-down stomach. It at once takes away
her youthfulness and makes her matronly--and matronliness is fatal to
romance. It is not so much general stoutness that is objected to--some
men, as is well known, prefer plump, stout women. And there are some
savage tribes in which the preference is given to obese women with
enormous abdomens, but this is not the case with the Caucasian
race--not in civilized countries, at any rate, and surely not in the
United States. First, reduce your carbohydrates, use massage and
hydrotherapy, walk for hours at a time, but reduce your big
abdomen--or, still better, don't let it get big. Prevention here, as
elsewhere, is much better than cure.

=Bad Odor from the Mouth.= I know of no other physical ailment which
is so dangerous, so fatal to the permanency of the love relation as is
a strong, offensive odor from the mouth. As a noxious gas blights a
delicate plant, so will a strong bad odor blight the delicate plant of
love. Yes, a strong malodorous whiff will cool the most ardent
passion. The public would be astounded if it knew how many cases of
separation and divorce are due to nothing else but a bad odor from the
mouth. Therefore, if you happen to suffer from this unfortunate
ailment, lose no time in applying to a competent physician, and do not
tire of treating yourself, no matter how irksome and time-consuming
the treatment may be, until you are completely cured. It is important
to your happiness.

=Odors from Other Parts of Body.= Odors from other parts of the body
should be conspicuous by their absence. Normally no artificial aids
are needed. Frequent bathing and general cleanliness are alone
sufficient. The natural feminine odor--_odor feminae_--is pleasant,
attractive and needs no disguise. But where an unpleasant odor from
the genitals, feet or armpits is present the proper treatment should
be applied, and in such cases the use of a delicate perfume, sachet
or scented talcum powder, is quite permissible. Not only permissible
but advisable.

A very good treatment for perspiration and bad odor from the feet is
the following: bathe the feet night and morning in a basin of water to
which has been added an ounce (two tablespoonfuls) of formaldehyde
solution. Dry carefully, and then rub in well the following powder. It
is simple, cheap and efficient:

    Salicylic acid        one dram
    Boric acid            one ounce
    Dried alum            two ounces
    Talcum                four ounces

A little of the powder should be shaken into the stockings every
morning, and the stockings should be changed very frequently, once or
twice a day. This powder is also efficient against perspiration and
bad odor from the armpits.

I am not giving any treatment for bad odor from the mouth, for this
condition may be due to a great variety of causes. The cause may
reside in the nose; it may reside in the mouth, decaying teeth,
throat, tonsils. It may be due to a bad stomach, to some disease of
the lungs, etc. Sometimes it is due to overeating. What would be of
value in one condition might be useless in another. The right thing,
therefore, is to go to a competent physician, have him find the cause
of your trouble and outline the proper treatment.

Leucorrhea. Some men find themselves _entirely unable_ to have sexual
relations with a woman whom they know is suffering with leucorrhea.
The mere knowledge of the fact takes away their _ability_ to perform
the act. It renders them impotent. It disgusts them, and disgust is
fatal to sexual power. Only to-day I saw in my office a woman who
anxiously begged for advice and treatment. She had been married five
years. She has always had leucorrhea, from her fifteenth year as far
as she remembers. Otherwise she did not suffer. For the first three
years or so her married life has been a happy one. Then in an
unfortunate moment she told her husband about her profuse leucorrhea,
and instantly she noticed a change in him. He could not fully hide the
expression on his face. And since then he ceased to have intercourse
with her. He made a few attempts, but they turned out unsatisfactory
to both, and she noticed that he was forcing himself, doing it against
his will. She took some patent medicines and went to one doctor, but
without any results. Now, unless she could be cured, she feared her
husband would demand a separation or a divorce. If you have leucorrhea
treat it. And remember you need not initiate your husband in all your
unesthetic ailments.

Loyalty. Loyalty on the part of the wife is almost as important as
fidelity. And it is in the highest degree disloyal for a wife to talk
to her female or male friends about her husband's peculiarities,
foibles or weaknesses. The husband's--as well, of course, as the
wife's--peculiarities should be what we call a professional secret.
Just as a physician is forbidden to talk to outsiders about his
patient's troubles, so should a wife not talk about her husband, nor a
husband about his wife. I know of a case in which a newly married
husband was temporarily impotent (and it was the wife's fault, too).
She spoke about it in the deepest confidence to a close girl friend of
hers. The friend told it in deep confidence to another friend. And so
it went around until it reached the husband's ears. From that moment
he made no further attempt to have relations with his wife; a coolness
resulted, which led to a separation, which still persists. The wife
begged forgiveness, but he was unable to grant it--he felt so deeply
hurt.

Flirting. Do not flirt. Men are apt to misunderstand you, and you are
apt to get the reputation of a loose woman without in any way having
deserved it. I do not say that you should always wear a forbidding
expression, and should scowl at people who dare to smile at you or
otherwise pay homage to your feminine charms. But there is a
difference between a friendly expression and flirting. However, when
your husband begins to neglect you, then a mild flirtation may be
justifiable. It will _always_ do your husband good to know that there
are other males in the world beside him, and that some of these males
find interest in the female whom he considers his permanent and
exclusive property.

=Slovenly Husbands.= Don't let your husband become a slob. That is
just what I mean. It is no use mincing words. Some husbands have never
acquired the habit--or if they have acquired it they quickly lost
it--of regarding their wives as ladies. "She is not a lady, she is
only my wife," is a well-known joke, but some men take it not as a
jest. Some men think that before their wives they can be as slovenly
and unclean as they please. Give your husband to understand that
cleanliness and freshness is not a "sex-limited" attribute, and just
as a husband wants his wife to be clean and dainty and well-groomed,
so a wife may enjoy the same qualities in her husband. Some women are
very fastidious, and while they may say nothing to their husbands for
fear of irritating them, they may think a good deal.

=Carrying Life Insurance.= Every husband should carry some life
insurance--as much as he conveniently can. This should be the
husband's most pleasant duty, particularly so when the wife has no
profession of her own and there are small children to bring up. The
lack of consideration, the thoughtlessness--I would call it
dishonesty--on the part of many husbands who claim to love their wives
is simply heart-breaking. Who of us does not know of cases of refined
wives with children left absolutely penniless and forced into wage
slavery or even into menial service by the negligence of their
husbands? Such things happened even to wives whose husbands were
making from three to ten thousand a year. Thoughtlessness,
carelessness, procrastination--and then it was too late. There is not
a man who makes as little as twenty dollars a week who cannot carry
some insurance. I was once poor, very poor. And the terrifying
thought, What would happen to my wife and two children if I should be
taken off suddenly? gave me many a troubled and sleepless night. And
when I took out a thousand dollars insurance I felt some relief. But I
felt it was inadequate. I therefore made a supreme effort and soon
took an additional ten thousand dollars. And I assure you that the
annual premium of two hundred and eighty-six dollars was a terrible
burden on me. There were times when I felt as if I had to give it up.
But I deprived myself of many necessities (there was no question of
luxuries) and I paid my premiums regularly. But in compensation I had
restful nights. It was soothing to know that if I should be taken away
in my earliest youth my equally young wife and two little babies would
not be left penniless. I verily believe that an adequate life
insurance prolongs a person's life, because it removes the worry about
the future of the wife and children.

I repeat, every husband should carry some life insurance. And the
habit of the bridegroom presenting the bride with a substantial life
insurance policy is a very good one. It is not only a financial
protection to the wife; it is also more or less a guarantee of the
husband's fair health.

=Making a Will.= Another point. Every husband should make a will. This
is a delicate point about which most wives would hesitate to speak to
their husbands, but the husband should attend to the matter himself. A
will doesn't shorten anybody's life, but is very convenient in case of
a sudden taking off. This is, of course, particularly important if
there is some property. If the husband dies without a will, there is
endless trouble and red tape for the wife. An executor has to be
appointed, she has to give bonds, etc., etc. If the husband leaves a
will making his wife sole executrix, without a bond, all trouble is
avoided. I assume, of course, that the husband has perfect confidence
in his wife's wisdom and integrity. If he has not and there are
children, it is just as well to designate some outside executor or
executors. But whichever may be the case, it is a good and sensible
thing always to have a will properly made out and witnessed.




CHAPTER FORTY-NINE

A RATIONAL DIVORCE SYSTEM

 A Rational Divorce System--Storms and Squalls--Two Sides of the
  Divorce Question--Outside Help and Marital Tangles--A Husband who
  was a Paragon of Virtue--The Case of the Sweet Wife--The Proper
  Untangling of Domestic Tangles.


Of course, I am in favor of a rational divorce system. The
difficulties, the obstacles, the expense, with which divorce is now
surrounded in most civilized countries is simply disgraceful. Make
marriage harder and divorce easier, has always been my motto. When
life together becomes unbearable then it is better for both husband
and wife to cut the tie and to get divorced. Divorce is preferable to
separation, because both spouses may be able to lead a new and happier
life. Where there are no children to be taken care of a simple
declaration of husband and wife repeated perhaps after a lapse of
three or six months should be quite sufficient for the granting of a
divorce. Where there are children the state should make sure that they
will be properly taken care of before a divorce is granted. Where only
one party demands a divorce the case should be carefully studied by a
commission which should include in its personnel physicians and
psychologists; and adultery should most certainly not be the only
cause for divorce.

Yes, I am for a sensible, rational and easy system of divorce. But I
would always recommend care and caution. "Go slow" should be the
guiding motto of husband and wife in such cases. There are periods in
a married couple's life when further living together seems
unthinkable; and still a month or two or a year passes and the husband
and wife live happily together and cannot believe that there was ever
any friction between them. The couples are very few, indeed, who never
went through any squalls or storms, whose lives were not darkened by
disagreements, quarrels and apparently irreconcilable antagonisms. But
after the storm the sun shone brightly again, and the quarrels were
followed by harmony and peace. After that love was intensified. Were
divorce a simple matter, a mere matter of declaration, many couples
who live now in harmony would have been divorced--to their great
regret perhaps.

Yes, there are two sides to the divorce question. But I would
summarize it as follows: Where there is a real incompatibility of
characters, where there is no love and no respect, then the sooner the
couple is divorced the better, and not only for them but for the
children also, if there are any. An atmosphere of hatred and mutual
contempt is not a healthy atmosphere for the growing children. But
where there is merely irritability, outbreaks of temper, or
disagreements which if analyzed can be seen to be due to temporary and
remediable causes, then "Go slow," "Don't hurry," should be your
motto. There will always be time to get a divorce. While if a divorce
has been obtained, even if you regret it, you will most likely stay
divorced. Many divorced couples, I imagine, would remarry, if they
were not ashamed. They fear it would make them ridiculous--and it
would--in their friends' eyes.


=Outsiders in Domestic Tangles=

If you have a disagreement with your husband, try to straighten out
the tangle yourself. Don't call in outside help. You will regret it. A
stranger's paws are too coarse and too unsympathetic to meddle with
the delicate adjustments which constitute marital life, and after you
have gotten over your disagreement and are again living harmoniously
you will be ashamed to look that third party in the face, and you will
probably bear a grudge against him--or her.

Altogether outsiders are not fit to mix in the internal differences
between husband and wife. It is absolutely impossible for a stranger
to know just where the trouble is and who the guilty party is.
Sometimes there is no guilty party. Both husband and wife may be
right; they may both be lovely people and still together they may form
an incompatible, explosive mixture. And then again the party that to
outsiders may seem the angelic one may in reality be the devilish one.
It is a well-known fact that people who to the outside world may seem
the personification of honor and good nature may be very devils at
home. I have long ago given up not only meddling in, but even judging,
domestic disharmonies. For it is almost impossible for an outsider to
judge justly. I knew a husband who was considered a paragon of virtue.
And when a clash came between him and his wife everybody was inclined
to blame the wife. But it came out later that the husband had certain
ways about him which made the wife's life a very torture. And vice
versa. I know of another case where the wife was considered the
sweetest thing in the world. She had nice ways about her, but she
disliked her husband and made his life a hell. With genuine chivalry
he bore everything, believing that it was a man's duty to bear his
cross. She was unfaithful to him, but she was so clever and cunning
that neither he nor anybody else suspected it. The fact became
painfully patent to him, when on one of the rare occasions that they
came together she infected him with a venereal disease, which
incapacitated him for a long time. Nobody knew why he insisted upon a
separation, and everybody, with the exception of his physician and
perhaps one or two others, was blaming him for an unfeeling brute.

I will therefore repeat that as a general thing domestic tangles
should be untangled by the tanglers themselves. It is not safe to call
in outsiders--relatives or friends; they are apt to make the tangle
more tangled, and, what is more, they are quite likely to put the
blame on the innocent party, and bestow upon the guilty party the
Montyon prize for virtue and gentleness.




CHAPTER FIFTY

WHAT IS LOVE?

 Is Love Definable?--Raising a Corner of the Veil--Two Opinions of
  Love--The First Opinion: Sexual Intercourse and Love--The Second
  Opinion--The Grain of Truth in Each--The Truth Concerning
  Love--Foundation of Love--Sexual Attraction and Love--The Frigid
  Woman and Her Husband--Puzzling Cases of Love--The
  Paradox--Blindness of Love and the Penetrating Vision of
  Love--Limits of Homeliness--Physical Aversion and Genesis of
  Love--Mating in the Animal Kingdom--Mating in Low Races--Love in
  People of High Culture--Difference in Love of Savage and Man of
  Culture--Distinctions Between Loves--Varieties of Love and
  Varieties of Men--"Love" Without Sexual Desire--Refraining and
  Wanting--Cause of Love at First Sight--"Magnetic Forces" and Love
  at First Sight--The Pathological Side--Differentiation of Phases
  of Love--Infatuation--Difference Between "Infatuation" and "Being
  in Love"--Sexual Satisfaction and Infatuation--Sexual
  Satisfaction and Love--Infatuation Mistaken for Love--Love the
  Most Mysterious of Human Emotions--Great Love and Supreme
  Happiness.


I shall not attempt to give a definition, either brief or extensive,
of Love. Many have tried and failed, and I shall not attempt the
impossible. Nor shall I attempt to discuss Love in all its innumerable
details.[9] To do so would alone require a book many times more
voluminous than the one you have before you. I shall, however,
endeavor to raise a corner of the veil which surrounds this most
mysterious, most baffling and most complex of all human emotions, so
that you may get a glimpse into its intricate mechanism and perhaps
understand what Love is in its essence at least.

=Sexual and Platonic Love.= There are two widely different, in fact
diametrically opposite, opinions as to what constitutes Love. One
opinion is that Love is sexual love, sexual attraction, sexual desire.
To people holding this opinion love and sexual desire or "lust" are
synonymous. And they laugh and sneer at any attempt to idealize love,
to present it as something finer and subtler, let alone nobler, than
mere sex attraction. The writer has heard one cynical woman--and more
than one man--say: Love? There is no such a thing. Sexual intercourse
is love, and that's all there is to it.

The other opinion is that Love, true love, ideal love, or, as it is
sometimes called, sentimental love, or platonic love, has nothing to
do with sexual desire, with sexual attraction. Indeed, people holding
this opinion consider love and sexual attraction--or lust as they like
to call the latter--as antithetical conceptions, as mutually
antagonistic and exclusive.

Both opinions, as is often the case with extreme and one-sided
opinions, are wrong. Both opinions have a reason for their existence,
because there is a grain of truth in both of them. But a grain of
truth is not the whole truth, and if an opinion contains ninety-nine
parts of untruth to one part of truth, then the effect of the opinion
is practically the same as if it were all false.

Here is the truth, or at least what I think is the truth, as it
appears to me after many years of thinking and many years of
observing.

=Foundation of Love.= The _foundation_, the _basis_ of all love is
sexual attraction. Without sexual attraction, in greater or lesser
degree, there can be no love. Where the former is entirely lacking the
latter can have no existence. This you may take as an axiom. Some may
call it love, but on analyzing it you will find that it is no such
thing. It may be friendship, it may be gratitude, it may be respect,
it may be pity, it may be habit, it may even be a _desire_ or a
_readiness_ to love or to be loved, but it is not love. Experience has
proved it in thousands and thousands of sad cases. And the girl who
marries a man who is physically repulsive to her, who possesses _no_
physical sexual attraction for her, though she may experience for him
all of the feelings mentioned above, namely, friendship, gratitude,
respect and pity, is preparing for herself a joyless couch to sleep
on. Unless, indeed, she happens to belong to the class of women whom
we call frigid, that is, if she is herself devoid of any sexual desire
and feels no need of any sexual relations. Such a woman may be fairly
or even quite happy with a husband who repels her physically, but whom
she likes or respects. And what I said about the wife applies with
still greater force to the husband. A man who marries a woman who is
physically antipathetic to him is a criminal fool.

I repeat, sexual, physical attraction is the _basis_, the foundation
of love. It is true we see certain cases of love which puzzle us. We
cannot understand what "he" has seen in "her" or what "she" has seen
in "him." But let us remember this paradox, which paradoxical though
it be, is true nevertheless: Love is blind, but Love also sees acutely
and penetratingly; it sees things which we who are indifferent cannot
see. The blindness of Love helps her not to see certain defects which
are clearly seen to everybody else; but, on the other hand, her
penetrating vision helps her to see good qualities which are invisible
to others. And a homely person may possess certain compensating
_physical_ qualities--such as passionate ardor or strong sexual
power--which, render him or her irresistible to a member of the
opposite sex.

But homeliness, ugliness or deformity have their limits, and I
challenge anybody to bring forth an authenticated case in which a man
fell in love with a woman--or vice versa--who had an enormous tumor on
one side of the face, which made her look like a monstrosity, or whose
nose was sunk in as a result of lupus or syphilis, or whose cheek was
eaten away by cancer. Love under such circumstances is an absolute
impossibility, because there is physical aversion here, and physical
aversion is fatal to the _genesis_ of love. A man who loved a woman
may continue to love her after she has become disfigured by disease,
but he cannot fall in love with such a woman.

I will repeat, then, and I trust you will agree with me on this point:
sexual attraction is the foundation of all love between the opposite
sexes. Where sexual attraction is lacking you can give the feeling any
other name you choose: it will not be love.

=Other Requisites.= But a foundation is not a whole structure. To
insure the stability of a high intricate building we must give it a
good solid foundation; but the foundation does not make the building.
That still remains to be built. So sexual attraction is the foundation
of all love, but it does _not_ constitute love. Many more factors,
many more wonderful stones are needed before the wonderful structure
called love is brought into existence. This wonderful structure
sometimes goes up in the twinkling of an eye, as if by the touch of a
magic wand--who has not seen or heard of instances of "love at first
sight!"--but the rapidity of the growth of the structure called Love
does not militate against our assertion that many stones, much
variegated material, and a strong cement are needed for its
completion. Fairies sometimes work very quickly.

A little thought will show clearly that Love is not merely sexual
love, not merely a desire to gratify the sexual instinct. If love were
merely sexual desire, then one member of the opposite sex, or at least
one attractive member, would be as good as any other. And indeed in
animals and in the lower races, where love as we understand it does
not exist, this is the case. To a male dog any female dog is as good
as another, and vice versa. Cats are not particular in the choice of
their mates, nor are cows, horses, etc. And the same is true of the
primitive savage races, and even among the lower uneducated classes of
so-called civilized races. To the Hottentot, to the Australian bushman
or to the Russian peasant one woman is as good as another. If the male
of a low race has some preference, it will be in favor of the woman
who happens to have a little property.

In fact I make the assertion that real love, true love, is a new
feeling, a comparatively modern feeling, absent in the lower races and
reaching its highest development only in people of high civilization,
culture and education.

The platitudinous objection might be raised that "human nature is
human nature," that all our feelings are born with us, and as such are
inherited, that they have been with us for millions of years and that
we cannot possibly _originate_ any entirely new feeling. True from a
certain viewpoint. We cannot originate intellect either. The germ of
intellect with all its potential possibilities was present in our most
primitive tree-climbing ancestors. But as much difference as there is
between the intellect of an Australian bushman and the intellect of a
Spinoza, a Shakespeare, a Darwin, a Victor Hugo, a Goethe or a Gauss,
so much difference is there between the love of a primitive savage and
the love of the highly cultured modern man. The love or so-called love
of the primitive or ignorant man (and woman) is a simple matter and is
practically equivalent to a desire for sexual gratification. The love
of the truly cultured and highly civilized man and woman, while still
_based_ on sexual attraction, is so complex and so dominating a
feeling that it completely defies all analysis, all attempts at
dissection, as it defies all attempts at synthesis, at artificial
building up.

As previously stated, some writers attempt to make a clear distinction
between sensual and sentimental love; many reams of paper have been
used up in an endeavor to differentiate between one and the other; the
first is called animal love or lust; the second pure love or ideal
love; the first variety of love is said to be selfish, egotistic, the
other--self-sacrificing, altruistic. These distinctions read very
nicely, but they mean very little. There is no distinct line of
demarkation between the two varieties of love, and one merges
imperceptibly into the other. Most, if not all, of our apparently
altruistic actions and feelings have an egotistic substratum; and the
quality of the love depends upon the lover. In other words, there are
not two separate, distinct varieties of love, but there are separate,
distinct varieties of men. A fine and noble man will love finely and
nobly; a coarse and brutal man will love coarsely and brutally. A man
who is fine and noble may not love at all, but he cannot love coarsely
and selfishly; and a coarse and brutal man can never love nobly and
unselfishly. Which once more means: the difference is not inherent in
the love, but in the lover.

But to say that a man may deeply love a woman and not have any sexual
desire for her is nonsense. A man who loves a woman and does not want
to possess her (to use the ugly ancient verb) does not love her--or
he is completely impotent. Whatever the feeling may be for her--it is
not love. He may abstain from having sex relations with her if the
circumstances are such that sex relations may lead to her unhappiness
and suffering, but to refrain from doing a thing, when reason and
judgment lead us to refrain, does not mean not to want the thing.

=Love at First Sight.= Nothing is more firmly established than the
fact that a person may fall passionately and incurably in love with a
person of the opposite sex at the very first sight, in the twinkling
of an eye, in the literal sense of the word. One glance may be
sufficient. And such a love may exist to the end of life, and may, if
reciprocated, lead to supreme happiness, or if unreciprocated to the
deepest unhappiness.

What it is that causes love at first sight is unknown. Some have
suggested that the beloved object sets in motion or fermentation
certain internal secretions (hormones) in the lover which cannot
become "satisfied" or "neutralized" except by that person; and the
possession of the beloved object becomes a physical necessity. This
explanation really means nothing. It is a hypothesis unsusceptible of
proof. But whatever the cause of love at first sight, it is so
mysterious a phenomenon that it gives the mystics and metaphysicians
some justification for their talk about "electric currents" and
"magnetic forces." These phrases also mean nothing, but are an attempt
at explaining the suddenness and irresistibleness of the attack. So
powerful is the attraction of love at first sight that people have
been known to cross continents and oceans merely to get a glimpse of
the beloved object; and people have been known to sacrifice
_everything_--their career, their material possessions, their social
standing, their honor, and even their wife and children, in order to
gain their object. And a mother may give up her children whom she
loves dearer than life, may risk ostracism and disgrace, only in order
to be with the object of her love. This shows that love, then, becomes
pathological, because any feeling which so completely masters an
individual that he is willing to sacrifice everything he has in the
world is pathological.

=Infatuation and Being in Love.= While, as said, the feeling of love
does not readily lend itself to dissection, to analysis, still we can
differentiate some phases of it. We can differentiate between "being
in love," "infatuation," and "love." Being in love is, as just
indicated, a pathological, morbid phenomenon. The person who is in
love is not in a normal condition. He can see nothing, he cannot be
argued with, as far as his love is concerned. She is the acme of
perfection, physical, mental, and spiritual; nobody can be compared
with her. And, of course, the man is anxiously eager to marry the
object of his love--unless insuperable obstacles are in the way; for
instance, if the man happens to be married.

Infatuation may be as strong as any "being in love" feeling. But with
this difference. In infatuation the man may know that the object of
infatuation is an unworthy one, he may despise her, he may hate her,
he may pray for her death, he may do his utmost to overcome the
infatuation. In short, infatuation is a feeling, chiefly physical,
which the man can analyze, the unworthiness and absurdity of which he
may acknowledge, but which he is unable to resist or overcome. He
feels himself bewitched; he feels himself caught in a net, he is
anxious to tear asunder the meshes of the net, but is not strong
enough to do it.

And this is a pretty good way to differentiate between being in love
and being infatuated. If in love the man does not want to be free from
his chains; he does not want to cease to love or to be in love. When
infatuated the man often uses his utmost will-power to break his
shackles. Sexual satisfaction is often sufficient to shatter an
infatuation; it is not sufficient to destroy love--it often
strengthens and eternalizes it.

Neither being in love nor infatuation can last "forever"; they are
acute maladies of high tension and relatively short duration.
Infatuation may change into indifference or disgust; "being in love"
may change into indifference, hatred, or into real love--a steady,
durable love.

This will answer the often asked question: How do marriages turn out
which are the result of a sudden, violent passion, or of love at first
sight? No ironclad rules suitable for all cases can be given. Some
turn out very unhappily, the couple gradually finding out that they
are altogether unsuited to each other, that their temperaments are
incompatible, that their views, ideas, likes and dislikes are
different. In some cases what was supposed to be a great love is soon
seen to have been merely an infatuation. And satiety and disgust
follow. But in other cases, as mentioned, the sudden consuming passion
turns into a warm, life-long love and the people live happily ever
after.

Dr. Nyström relates the case of a prominent physician of France, of
high social and scientific standing, who beheld a young girl
accidentally in the street. He did not have the slightest idea who she
was. He was irresistibly attracted to her. He followed her, boarded
the same omnibus and went to the house which she entered, rang the
bell, introduced himself, begging pardon for his intrusion, but was
dismissed. He returned and explained to her his ardent passion and
asked permission to visit her parents, well-to-do people in the
country, and the climax was a mutual love and a happy marriage.

Many of us know of similar cases. But as a rule the slow developing
love is more reliable than the suddenly bursting out flame.

       *       *       *       *       *

Love is the most complex, the most mysterious, the most unanalyzable
of human emotions. It is based upon the difference in sex--upon the
attraction of one sex for another. It is fostered by physical beauty,
by daintiness, by a normal sexuality, by a fine character, by high
aspirations, by culture and education, by common interests, by
kindness and consideration, by pity, by habit and by a thousand other
subtle feelings, qualities and actions, which are difficult of
classification or enumeration.

A great love, greatly reciprocated, is in itself capable of rendering
a human being supremely happy. _Nothing else is._ Other things, such
as wealth, power, fame, success, great discoveries, may give supreme
satisfaction, great contentment, but supreme, buoyant happiness is the
gift of a great love only. Such loves are rare, and the mortals that
achieve it are the envy of the gods. But a great love, unreciprocated,
especially when admixed to it is the feeling of jealousy, is the most
frightful of tortures; it will crush a man like nothing else will, and
the victims of this emotional catastrophe are pitied by the inmates of
the lowest inferno.

FOOTNOTES:

[9] To avoid confusion, I will state here that I am discussing love
between the opposite sexes, and not maternal love, homosexual love,
love for one's country, etc.




CHAPTER FIFTY-ONE

JEALOUSY AND HOW TO COMBAT IT

 Jealousy the Most Painful of Human Emotions--Impairment of
  Health--Mental Havoc--Jealousy as a Primitive Emotion--Jealousy
  in the Advanced Thinker and in the Savage--Jealousy in the
  Child--Feelings and Environmental Factors--Essential Factors--
  Vanity--Anger--Pain--Envy--The Impotent Husband's Jealousy--
  Anti-social Qualities--The Jealous and the Unfaithful Husband--
  Means of Eradicating the Evil--Iwan Bloch on the Question--Prof.
  Robert Michels' Statement--Remark of Prof. Von Ehrenfels--Havelock
  Ellis on Variation in Sexual Relationships--Advanced Ideas--Woman
  as Man's Chattel--The Change and the Changer--Teaching the
  Children--Casting Epithets at Jealousy--Free Unions and Jealousy--
  Feelings, Actions and Public Opinion--The Adulterous Wife of the
  Present Day--Jealousy Defeating Its Own Object--Jealousy of
  Inanimate Objects.


He or she who has been so unfortunate as to experience the pangs--or
fangs--of jealousy will readily admit that it is one of the most
painful, if indeed _not_ the most painful, of all human emotions. The
suffering that it metes out to its victims is indescribable. No other
single human emotion so affects the body, so upsets the mind, so
deranges every function, as does jealousy. The torture that it causes
makes the sufferer a truly pitiable object: the complete loss of sleep
and complete loss of appetite may result in a serious impairment of
the sufferer's health, while the rage it often gives rise to may lead
to actual insanity, or at least to great mental disturbance. With good
reason has popular fancy pictured this cursed emotion as a green-eyed
monster.

Jealousy is a primitive emotion. It is present not only in the
primitive races, but even in animals. And being a primitive emotion,
we can hardly hope to succeed in eradicating it entirely. Not in the
immediate future, at any rate. But we can modify it.

The statement frequently heard that "human nature is human nature" is
only a platitudinous half-truth. The fundamental part of human
nature--the desire for happiness and the avoidance of suffering--cannot
be changed, nor would we want to change it if we could. It would mean
the disappearance of the human race. But that many of our primitive
emotions can be greatly modified by culture, by new standards, by new
ideals of morality, about this there can be no question.

Just as love in modern man is an entirely different feeling from what
it was in primitive man, so jealousy in the advanced thinker is a
different feeling from what it was in the savage; and by education and
true culture it can be modified still further. We hope that in time to
come--I will not venture to say how soon that time will be here--this
injurious, degrading, anti-social feeling may be entirely or almost
entirely eradicated from the human breast.

The primitive desire--and this primitive desire of the race is still
fully exhibited by children--is to take possession of everything nice
or useful that somebody else has and which we have not. But our
education and our cultural standards, including fear of punishment,
have so repressed this desire, have put it so deeply in the
background, that normal human beings hardly feel it at all.

It is only improperly brought up people, mental defectives and those
unable to adjust themselves to their environment who still have this
primitive feeling of taking or stealing. And so with many other
feelings and emotions; and so with jealousy.

If we, at the very first notice of a manifestation of jealousy by a
child, should frown upon it, if we should explain to the child or
adolescent that jealousy is a mean, degrading feeling, that it is a
feeling to be ashamed of, a feeling to hide and not to show off or
even be proud of--as some are now--then jealousy would manifest itself
in a much smaller number of individuals, and those unfortunate enough
to be attacked by it would try to repress it, to hide it, to overcome
it, so that it would eventually become paler and less acute and its
consequences would be less significant, less disastrous for both the
victim and for the persons concerned. Feelings, let us bear in mind,
are not spontaneous things uninfluenced by any environmental factors.
Feelings are like plants; under one environment you may foster their
growth and make them develop luxuriantly; under another environment
you may dwarf their growth and strangle them.

In order to enable us to inhibit the growth of the demon of jealousy,
we must learn what its essence is and what factors are favorable to
its development.


=Causes of Jealousy=

The essential factor in jealousy is _fear_. Fear of losing the beloved
object, fear of losing the person who provides you with sexual
satisfaction, or the mere economic fear of losing a material provider.
The latter kind of fear is, of course, more often manifested--even
though unconsciously--in women. Women who have no love for their
husbands are nevertheless often fiercely jealous, because consciously
or unconsciously they are afraid that their husbands may desert them
for other women, and that they may thus find themselves in a
precarious economic condition.

Another factor in jealousy is wounded _vanity_. We do not like to feel
that somebody is considered superior to us. This feeling of wounded
vanity is present in other varieties of envy or rivalry. A person who
loses in a race or gets a lower mark in his examination than his rival
may be filled with a feeling of envy and hatred almost equal in
intensity to, though never as painful as, sexual jealousy.

Another factor in jealousy is _anger_ over loss of what we consider
our property. In our present social order the man considers his wife
his absolute property, and so does the wife consider her husband. And
there is anger that a stranger should dare to rob us or make use of
our property, just as there would be anger if a thief came and robbed
us of a valuable material possession. This anger or rage part of
jealousy is not a sign of love. It is very far from being so. Because
it manifests itself also in men and women who have not a particle of
love for their spouses; it manifests itself in spouses who have
nothing but hatred and loathing for their partners.

Another important factor is _pain_, pain that the person we love has
ceased to love us. When we love a person and our love is not
reciprocated, we feel pain which may rise to the degree of agony, even
when there is no rival in the field. But when a person who loved us
has ceased to love us--or we imagine so--and has transferred the love
to another person that pain is so much the greater.

I will digress here for a moment to state that the fear that a person
has ceased to love us because he loves somebody else is often
groundless. It is based upon the erroneous and vicious idea that a man
cannot possibly love two women at the same time, or that a woman
cannot love two men at the same time. Psychologists, particularly
those who have made a special study of sexual psychology, know that
this idea is false. They know that love may be directed at the same
time towards two or three individuals. They know that a second love
not only does not necessarily destroy or diminish a first love, but
may deepen and strengthen the latter.

Another element is pure _envy_. Just mean envy that somebody should
have what we haven't, or what we have but are in danger of losing.
Just as we envy others an automobile, a fine house, a high social
position, etc., when we have not got them or have been deprived of
them.

A point that I would like to mention is, that if husbands who have
become impotent--having lost either the desire or the power, but
particularly the latter--become jealous, their jealousy knows no
bounds. No strongly potent man ever reaches the same intensity in
jealousy as is reached by a sexually weak or impotent man. The
knowledge that another man has displaced him and that he himself could
not replace that other man _even if he were permitted to_ fills him
with impotent rage; and, as is well known, impotent rage is always
more intense than rage that is potent. Women are free from this kind
of rage, because women are never impotent in this sense. (They may be
frigid, but they are never devoid of the _potentia coeundi_, except in
extremely rare cases of _atresia vaginae_ or the absence of the
external genitals.)

There are a number of other components which go to make up this "queen
of torments" or "king of torturers" jealousy, but those I have
enumerated are the essential ones.

What are they? Fear, vanity, anger, envy and pain. None of them
admirable qualities, none of them, with the exception of the first and
the last, even deserving our compassion. All of them anti-social and
anti-individual qualities. Should not everything be done to eradicate
such a rank weed, which draws its sustenance from roots each one of
which is dipped in poison?

We are told that in our primitive state jealousy was a social
instinct; that by killing and keeping away rivals it helped to found
and cement the family and to keep it pure. I do not care to enter
here into a discussion of this point. But whatever useful rôle
jealousy may have played in the remote ages (I doubt that it has), it
is now an utterly useless, utterly vicious, utterly anti-social and
anti-individual emotion. It is opposed to social life and it destroys
individual happiness. And everything possible should be done to
smother it, to strangle it, to eliminate it entirely from human life.

Yes, I find no compensation whatever for jealousy; I find no place for
it in our modern life and I am in complete agreement with Forel, who
calls jealousy "a heritage of animals and barbarians." "That is what I
would say," he says, "to all those who, in the name of offended honor,
would grant it rights and even place it on a pedestal. It is ten times
better for a woman to marry an unfaithful than a jealous husband....
Jealousy transforms marriage into a hell.... Even in its more moderate
and normal form, jealousy is a torment, for distrust and suspicion
poison love. We often hear of justified jealousy. I maintain that
_jealousy is never justifiable_; it is always a stupid, atavistic
inheritance, or else a pathological symptom."

But can anything be done to eradicate this agonizing, tormenting
emotion? I believe it can, and the ways and means to the eradication
of this evil will be found on analyzing its components. We may not be
able to destroy all the components; if we destroy the greater part of
them much will have been accomplished.

The underlying factors of jealousy are: the primitive instinct, also
present in many animals, our ethical and religious ideas and our
economic system. The primitive instinct we can repress and modify; we
can hardly hope to eradicate it entirely. But our ideas and economic
system we can change. It is easier to change ideas than it is a
system, and it is with our ideas we should commence.

The first idea we must endeavor to destroy is that it is impossible
for a human being to love more than one other human being at the same
time. We must show that the love of the modern educated and esthetic
man and woman is an exceedingly complex feeling, and that a man may
deeply and sincerely love one woman for certain qualities and just as
deeply and sincerely love another woman for certain other qualities.
Of course, love cannot be measured by the yard or bushel, nor can it
be weighed on the most delicate chemical balance. And it may be
impossible to determine whether he loves both women exactly alike or
he loves one woman more than the other. But that one love does not
exclude another, that it may even intensify the other love, that is
certain, and is the opinion of every advanced sexologist.

Max Nordau, a man of high and austere ideals, a man whom nobody will
accuse of a tendency to licentiousness, says in his Conventional Lies:
"It may sound very shocking, yet I must say it: we can even love
_several_ individuals at the same time, with nearly equal tenderness,
and we do not necessarily lie when we assure each one of our passion.
No matter how deeply we may be in love with a certain individual, we
_do not cease_ to be susceptible to the influence of the entire sex."

And Iwan Bloch, than whom no greater investigator in the field of
sexology ever lived, asks the question: "Is it possible for any one to
be _simultaneously_ in love with several individuals?" And he
immediately says: "I answer this question with an unconditional
'yes.'" And he says further: "It is precisely the extraordinary
manifold spiritual differentiation of modern civilized humanity that
gives rise to the possibility of such a simultaneous love for two
individuals. Our spiritual nature exhibits the most varied coloring.
It is difficult always to find the corresponding complements in one
single individual."

Prof. Robert Michels says: "It is Nature's will that the normal male
should feel a continuous and powerful sexual attraction towards a
considerable number of women.... In the male the stimuli capable of
arousing sexual excitement (this term is not to be understood here in
the grossly physical sense) are so extraordinarily manifold, so widely
differentiated that it is quite impossible for one single woman to
possess them all."

Prof. von Ehrenfels wittily remarks that if it were a moral precept
that a man should never have intercourse _more them once in his life_
with any particular woman, this would correspond far better with the
nature of the normal male and would cost him far less will-power than
is needed by him in order to live up to the conventional demands of
monogamy.

And Havelock Ellis cautiously says: "A certain degree of variation is
involved in the sexual relationships, as in all other relationships,
and unless we are to continue to perpetuate _many evils and
injustices_, that fact has to be faced and recognized."

I have devoted considerable space to this topic, and I have, contrary
to my custom, quoted "authorities," because I consider this point of
the utmost importance; it is the first step in combating the demon of
jealousy. If our wives, fiancées and sweethearts could be convinced of
the truth that a man's interest in or even affection towards another
member of the female sex does not mean the death of love, or even
diminished love, half of the battle would be won. Half of the misery,
half of the quarrels, half of the self-torture, half of the disrupted
homes, in short, half of the tyrannical reign of the demon of
jealousy, would be gone.

We must teach our women and men this truth, teach it from puberty on.
We must show them that not every woman can necessarily fill out a
man's entire life, that not every woman can necessarily occupy every
nook and corner of a man's mind and heart, and that there is nothing
humiliating to the woman in such an idea (and _vice versa_). She
should be taught to find nothing shameful, painful or degrading in
such a thought. I know that these ideas are somewhat in advance of the
times, but if nobody ever brought forward any advanced ideas because
they were advanced there would never be any advance.

Then we must teach our men that when they marry a woman she does not
become their chattel, their piece of property, which nobody may touch,
nobody may look at or smile at. A woman may be a very good, faithful
wife and still enjoy the companionship of other men, the pressure of
another man's hand or--_horribile dictu_--even an occasional kiss.

Then we must teach our men _and_ women that there is essentially
nothing shameful or humiliating in being displaced by a rival. The
change may be a disgrace for the changer and not for the changed one.
It does not at all mean that the change has been made because the
rival is superior; it is a well-known fact that the rival often _is_
inferior. The change is often made, not because the changer has gone
upward, but because he has gone downward, has deteriorated. And the
changer often knows it himself.

Inculcating those ideas would do away with the feeling of wounded
vanity which is such an important component in the feeling of
jealousy.

Further, we must teach our children from the earliest age that
jealousy is "not nice," that it is a mean feeling, that it is a sign
of weakness, that it is degrading to the person who entertains it,
particularly to the person who exhibits it. Ideas inculcated from
childhood have a powerful influence, and the various ideas exposed
above _would_ have an undoubted influence in minimizing the mephitic,
destructive effects of the feeling of jealousy. People properly
brought up will always succeed in controlling or suppressing certain
non-vital instincts or emotions on which society puts its stamp of
disapproval, which it considers "not nice" or disgraceful.

I am, therefore, an optimist in relation to the eventual uprooting of
the greater number of components of the anti-social feeling of
jealousy. And when woman reaches economic independence, then another
component of the instinct of jealousy--the terror at losing a provider
and being left in poverty--will disappear.

=Jealousy Not Toward Rivals.= Jealousy need not express itself toward
a sexual rival only. A person may be jealous of people who can never
be sexual rivals; the jealousy need not even be of people; it may be
of inanimate objects, of a person's work, profession or hobby. Thus a
wife may be intensely jealous of her husband's mother, towards whom he
is very affectionate or simply kind and considerate. She may be
jealous of her own children if she notices or imagines that the father
loves them intensely, or if he spends a good deal of time with them.
She may be jealous of his male friends, and many a husband had to give
up, not only his female acquaintances, but his life-long male
friends--in order to preserve peace in the family. A wife may be
fiercely jealous of her husband's success and reputation, and cases
are not unknown where the wife put every possible obstacle in her
husband's way, in order to make him fail in his work, to make him turn
out mediocre work, all from fear that his success would gain him
admirers, which might perhaps take him away from her. Wives have been
known to do everything in their power to _exhaust_ and weaken their
husbands, to make them physically unattractive, only to keep them. And
so powerful is this primitive, childish, savage feeling, this desire
for exclusive monopoly, that there is _nothing_ a jealous wife,
sweetheart or mistress may not do in order to retain the man, in order
to regain him, or, having lost him irretrievably, in order to revenge
herself. And what is said about the woman is applicable with equal
force to man. It is a huge mistake to assume that jealousy is woman's
prerogative, her particular characteristic, or even that it is
stronger in her than in man. A man can be as savagely jealous as any
woman and suffer the same tortures of hell.

=Jealousy Defeats Its Object.= One of the worst features about
jealousy is that it defeats its own object. We have been told, as
stated before, that jealousy was once upon a time a racial instinct,
that by frightening away rivals it helped to found the family and to
keep it chaste and pure. Quite the contrary is true now. More than one
man has, by accusing his innocent wife of infidelity and by torturing
her with baseless suspicions, driven her into the arms of a lover. We
are all more or less susceptible to suggestion, and by continually
suspecting a wife of a love affair or illicit relation a man may
implant the seed of suggestion so strongly that it may grow
luxuriantly and the wife may be unable to resist the suggested
temptation. And very often the very lover is suggested by the husband.
"Yes, don't attempt to deny it. It is useless. I know you have
relations with X. I know you are his mistress." He kept on repeating
it so often to his absolutely blameless, innocent young wife and he
made her so wretched by his rudeness and brutality that one day she
did go over to X's rooms and did become his mistress. And after that
she could stand her husband's outbursts with equanimity. "If I have
the name I might as well have the game," is a good bit of psychologic
wisdom. And a husband should be very careful about even suspecting a
wife unjustly, and thus make the first step towards rendering his
baseless suspicions a reality, his unjust accusations justified. And,
of course, what is true of the husband is also true of the wife. Many
a wife has driven her indolent husband into the hands of prostitutes
or mistresses by her incessant nagging, false accusations and vicious
epithets applied to all his female friends and acquaintances.

Yes, from whatever angle you consider it, jealousy is a mean, nasty,
miserable feeling. Because it is a more or less universal feeling,
because "we cannot help it," does not render it less mean, less nasty,
less miserable.

I do not for a moment imagine that characterizing jealousy the way it
deserves to be characterized, calling it a shameful, savage, primitive
feeling, etc., is at once going to banish it from the breasts of men
and women in which it has found an abiding place; throwing epithets at
it will not cause it to unfasten its talons. Unfortunately, I know
only too well that our emotions are stronger than our reason; the man
or woman at whose poor heart jealousy is gnawing day and night is not
amenable to reason, is not curable by arguments; all we can do is to
sympathize with such a person and ask the Lord to pity him or her.

I have known a man who lived with his wife in free union, i.e., he was
not married to her. He did not believe in marriage. Love was the only
bond that should bind people together; as soon as love was no more the
people should separate in a friendly, comradely manner. If the wife or
the mistress wants another lover, she should be free to take one; she
is a free human being and not her husband's chattel slave, etc., etc.,
etc., to the same effect. Thus the man talked. And he was sincere in
his talk--or he thought he was. But one night on unexpectedly
returning home he found another man; he promptly fired several shots
at the man, which fortunately for both did not prove fatal, and then
he beat and choked his wife--who wasn't even his wife legally--within
an inch of her life. _And then he married her_ and gave up his free
love talk. And I know of any number of men who could philosophize for
hours about the disgrace and humiliation of being jealous, but who, as
soon as there was a justifiable cause for jealousy, became as
unreasonable as a child and as jealous as any unlettered Sicilian
woman ever was.

So you see, I am not deluding myself with extravagant hopes. But,
nevertheless, this argumentation, this talk, is not entirely useless.
A beginning must be made. This essay may not perhaps help--except for
the suggestions that will be made towards the end--those who are
already victims of the demon of jealousy, but it may help some people
to keep out of his clutches (or should I say: her clutches? I really
don't know whether the demon of jealousy is a male or a female.)

Feelings are stronger than reason; but that does not mean that
feelings cannot be influenced by reason; they decidedly can be and are
so influenced, and their _manifestations_ are modified by this
influence; and the more cultured, the more educated a person is (I
trust you will know that I use these terms in their true and not their
vulgar, misused meaning), the more will his feelings, or at least
actions, be influenced by his reason. I am particularly a believer in
the effect on our feelings and actions of public opinion, of ideas
universally or generally entertained.

Let me give one example which is pertinent to the subject. In former
days it was universally held, and in many places it is still held,
that when a wife sinned she committed the most unpardonable crime that
a human being could be guilty of and that she thereby _dishonored_ her
husband. And the only right thing for him to do was to shoot the rival
and cast out the wife; or at least to cast her out. This was a
_conditio sine qua non_. To take her back to his home was a disgrace,
a sign of unpardonable weakness, of degeneracy. Our ideas on the
subject have changed a bit. A husband is no longer considered any more
dishonored--in some strata of society at least--because his wife
sinned than a wife is considered dishonored because her husband
sinned; and adultery in the wife is now, by most rational people,
considered only different in degree, but not in kind, from adultery in
the husband. These humane ideas have gained vogue only within a
comparatively very recent period; but their effect has already
manifested itself in a great number of instances. Forgiving the erring
wife is becoming quite common. A number of cases have reached the
newspapers. Recently a wife was implicated in a nasty scrape; her sin
was not only unquestionable, but notorious; it was public property.
And nevertheless the husband stood by her and took her back into his
home and arms. And the number of such cases which do not reach the
newspapers is very, very much larger than the public has any
conception of, larger than it would be safe to estimate. And in a
large percentage of these cases the husband begins to treat his wife
with more love, more consideration, and the tie between them becomes
more firm, more permanent.




CHAPTER FIFTY-TWO

REMEDIES FOR JEALOUSY

 Prevention and Cure--Prophylaxis of Jealousy--Fitting Remedy to
  Circumstances--The Neglectful and Flirtatious Husband--No
  Question of Love--Advice to the wife of the Flirtatious Man--An
  Efficient Though Vulgar Remedy--Jealousy Must Be Experienced to
  Be Understood--Necessity for Freedom of Association--Lines of
  Conduct for the Wife--Contempt for a Certain Type of Wife and
  Husband--The Abandoned Lover--The Effects of Unrequited
  Love--Sublimated Sexual Desire--Replacing Unrequited Love--The
  Attitude of Goethe--Simultaneous Loves Possible--Successive Loves
  Possible--Eternal Loves--When Sex Relationships May Be
  Beneficial--Purchasable Sex Relations and Their Value--The Broken
  Engagement--The Terrible Effects on the Young Man--The Young
  Streetwalker--Sex Relations with Fiancé--Inundating Sense of
  Shame--Collapse--Attempts at Suicide--An Active Sex Life--The
  Results--The Prevention of Jealousy.


We are all agreed that prevention is more important than cure. But
when a patient comes with a fully developed disease it is futile to
speak to him of prevention. It is too late to sermonize. What he wants
and what he needs is a cure, if such can be had. What has preceded has
reference chiefly to the prophylaxis of jealousy, to the prevention of
the development of this disease in the future.

The question is: Is there a _remedy_ for this malady? Is there a
_cure_ for this horrible disease of jealousy?

The conditions are extremely complex, and the remedy must be fitted to
the circumstances. Let us assume that the husband neglects his wife
and causes her to be jealous, not because he is in love with another
woman, but because he is flirtatious, light-headed, feather-brained
and inconsiderate. Such cases are in the great majority. Many husbands
who like or love their wives and who believe themselves secure in
their love think it is quite proper for them to hunt for new conquests
and to carry on petty love affairs with as many girls or women as they
comfortably can. There is no question here about love--it is just
flirtation or sexual relations. When this is the case the wife should
have a frank and firm talk with her husband; she should tell him that
she does not like his behavior and that it makes her unhappy. In many
instances this alone will suffice to effect a change in the husband's
conduct. Where this does not suffice, where the husband is too
egotistic and does not want to give up his little pleasures, then it
is left for the wife to adopt the old and rather vulgar remedy. It is
old and, as said, rather vulgar, but it has the merit of efficiency:
it very often works. Let the wife adopt similar tactics, let her also
flirt, let her go out and come back at uncertain hours, let her keep
the husband guessing as to where and with whom she is. And nine times
out of ten this, under the circumstances, fully justifiable conduct on
the part of the wife will effect a quick and radical change in the
conduct of the husband. He will be only too glad to cry quits. Some
people are utterly devoid of imagination. They lack the ability of
putting themselves in another person's place. Jealousy particularly is
not a feeling which any one can understand without having experienced
it, unless he is endowed with the imagination of a great poet. And as
few husbands have a great poetic imagination, it is only after they
have felt the claws of the monster tearing at their own hearts that
they can understand their wives' feelings, and are willing to act so
as to save them--and themselves, of course--the cruel tortures. Many
wives and many husbands have talked to me and written to me on the
subject, and, as stated before, in nine times out of ten the remedy
worked.

But how about the tenth case? How about the cases where the husband is
unable or unwilling to give up his outside flirtations and relations?
We, advanced sexologists, know that not all men, no more than all
women, are made in the same mould, and what is possible or even easy
for nine men may be very difficult or absolutely impossible for the
tenth. We know that there are some men to whom an ironclad monogamic
relation is an absolute impossibility. The stimulation of other
women--either the purely mental, spiritual stimulation or the
stimulation of physical relations--is to them like breath in the
nostrils. In fact, there are some men whose very possibility of loving
their wives depends upon this freedom of association with other women.
They can be extremely kind to and love their wives tenderly, if they
can at the same time associate--spiritually or physically--with other
women. If they are entirely cut off from any association with any
other woman they begin to feel irritable, bored, may become ill, and
their feeling towards their wives may become one of resentment,
ill-will, or even one of hatred. This is not the place to talk of the
wickedness of such men--thus they are made and with this fact we have
to deal.

What is the wife of such a man to do? Two lines of conduct are open to
her--two avenues of exit. The line of conduct will depend upon her
temper and upon her ideas of sex morality. But she ought to select the
line of conduct which will cause the least pain, the least
unhappiness. If she is a woman of a proud, independent temper,
particularly if she belongs to the militant type, she will leave her
husband in a huff, regardless of consequences. But if she is a woman
of the gentler, more pliable, more supple (and I may also say more
subtle) type, and if she really loves her husband, she will overlook
his little foibles, peccadilloes and transgressions--and she may live
quite happily. And the time will come when the husband himself will
give up his peccadilloes and transgressions and will cleave powerfully
to his wife, will be bound to her by bonds never to be torn asunder.
_I know of several such cases._

And I will take this opportunity to say that I have the deepest
contempt for the wife who, on finding out that her husband had
committed a transgression or that he has a love affair, leaves him in
a huff, or makes a public scandal, or sues for divorce. Such a wife
_never_ loved her husband, and he is well rid of her. And what I said
about the wife applies with _almost_ equal force to the husband.

=The Abandoned Lover.= But what shall the abandoned lover do? Let us
take the case of A and B, and let A stand for any man and B for any
woman; or, _vice versa_, let A be the woman and B the man, for in
jealousy and love what applies to one sex is applicable with
practically the same force to the opposite sex. Suppose A is intensely
jealous of and deeply, passionately in love with B; but B is utterly
indifferent and does not care what A may feel or do. A and B may be
married or not; this does not alter the case materially. Suppose B, if
unmarried to A, goes off and marries another man, or, if married to
A, goes off and leaves him; or suppose B does not love anybody else,
but just remains indifferent to A's advances or repels him because she
cannot reciprocate his love. Unrequited love alone can cause almost as
fierce tortures as the most intense jealousy. And A suffers tortures.
What shall he do? What shall he do to save himself--to save his
health, his mind, his life? For he is unable to eat, unable to sleep,
unable to work, and he feels that he is going to pieces. He has lost
his position and is in danger of losing his reason. What shall he do
to escape insanity or a suicide's grave? There is but one remedy. Let
him use all his energies to find a _substitute_. I mean a living
substitute. Mere sexual desire may be sublimated, to a certain extent,
into other channels, may be replaced by work, study, a hobby or some
engrossing interest. A great unrequited love, with the element of
jealousy present or absent, cannot be replaced by anything else except
by another love. And where as great a love is impossible let it be a
minor love or a series of minor loves. When Goethe, one of the world's
great lovers, was unable to walk in the broad avenue of a great love
he would walk in the by-paths of a number of little loves. The common
talk about a person being unable to love more than once in his or her
life is silly nonsense. A man or a woman is able to love, and love
very deeply, a number of times; and love simultaneously or
successively. It is often a mere matter of opportunity. I know that
there _are_ loves that are eternal; that there are loves for which no
substitute can be found. But these supreme, divine loves are so rare
that among ordinary mortals they may be left out of account. They are
the portion of supermen and superwomen. Ordinarily a substitute may be
found. The substitute love may never reach the intensity of the
original love, it may never give full or even half-full satisfaction;
but it will help to dull the sharp cutting edge, it will act as a
partial hemostatic to the bleeding heart, it will soothe and
anesthetize the wound even if it cannot completely heal it. And this
is a valuable aid while the sufferer is coming to himself or herself,
while the gathered fragments of a broken life are being cemented and
while the cement is hardening. Yes, the man or woman who is in inferno
on account of an unreciprocated or a betrayed love should lose no time
in searching for a substitute love. I do not believe in people losing
their health and their minds on account of suffering which does nobody
any good.

But I will go still further. Where a substitute love--great or
minor--cannot be found, then mere sex relations may help to diminish
the suffering, to quiet the turbulent heart, to relieve the aching
brain. As everything connected with sex, so our ideas about illicit
sex relations that are not connected with love, are honeycombed with
hypocrisy and false to the core. While purchasable, loveless sex
relations can, of course, not be compared to love relations, still
under our present social, economic and moral code they are the only
relations that thousands of men and women can enjoy, and they are
better than none; and in quite a considerable percentage of cases an
element of romance and greater or lesser permanency do become attached
to them, and they act as a more or less satisfactory substitute for
genuine love relations.

I am not spinning theoretical gossamer webs. I am speaking from
experience--the experience of patients and confiding friends. I could
relate many interesting cases. And I may, in a more appropriate
volume. Here one or two will have to suffice.

He was twenty-six years old and a senior student in the College of
Physicians and Surgeons, Columbia University, New York. He had been in
love with and had considered himself engaged for four or five years to
a young lady two years his junior. She was, of course, the most
wonderful young lady in the world, the whole world; in fact, there was
not another one to compare her to. She was unique; she stood all
alone. But for a year or so she was getting rather cool towards him;
which fanned his flame all the more. And suddenly he received a note
asking him not to call any more, nor to try to communicate in any
other way. He did write, but his letters were returned unopened. And
soon after he read of her engagement to a prominent young banker. He
nearly went insane, and this is used not in any figurative sense. His
insomnia was _complete_, and resisted all treatment. When his pulse
became very rapid and his eyes acquired the wild look that they do
after many sleepless nights an attempt was made to administer
hypnotics, but they had practically no effect. Chloral, veronal, etc.,
only made him "dopy," irritable and depressed, but did not give him
one hour of sound sleep. His appetite was gone, now and then his limbs
would twitch, and he would sit and stare into space for hours at a
time. To study or attend the clinics was out of the question, and he
did not even attempt to take the final examinations. The parents felt
distressed, but were unable to do anything for him. The least attempt
at interference on their part, any attempt to console him, to induce
him to pull himself together, made him more irritable, more morose; so
that they finally left him alone. He was practically a total
abstainer, but one evening he went out and came home drunk; and after
that he drank frequently and heavily. His parents could do nothing
with him. One evening on Broadway he was accosted by a young
street-walker. She had a pleasant, sympathetic face, and he went with
her. _That was his first sex experience._ Up to that time he was
chaste. He met her again the following evening. Gradually a sort of
friendship grew up between them. She found out the cause of his grief,
and with maternal solicitude she tried everything in her power to
console him, and he began to look forward to the nightly meeting with
her. His grief became gradually less acute, he gave up drinking, which
he disliked, and which he had taken up only to deaden his pain; he
began to pull himself together, and in six or eight months he took
over his last year in Columbia and was properly graduated. He kept up
the friendship with the girl for over two years, when she died of
pneumonia. He did not love her, but he liked to be with her, as her
presence gave him physical and mental comfort. It is possible that she
loved him genuinely, but there was never any sentimental talk between
them, and there was never any question between them of the permanency
of the relationship. They both knew that it was temporary. But he is
absolutely certain that but for one of the representatives of the
class that is despised, driven about and persecuted by brutal
policemen and ignorant judges, he would have become a bum, or, most
likely, he would have committed suicide--at the point of which he was
several times; only pity for his mother and sisters restrained him.

And here is another case. A girl about twenty-eight years of age fell
in love with a man four or five years her senior. The love seemed to
be reciprocated, and they soon became engaged to be married. He asked
that the engagement, on account of certain business reasons, be kept
secret. She did not know the man well; she had met him at several
entertainments and church affairs and he seemed very nice. He always
found some excuses for delaying the marriage, and after they had been
engaged about a year he began to insist on sex relations. Though of a
refined and noble character, she was of a passionate nature and she
did not offer much resistance. Many girls who would under no
circumstance indulge in illicit relations, considering it a great sin,
have no compunctions about having relations with their fiancés. They
lived together for about a year. They were together almost daily,
except now and then, when he would go away for a week or two on
business. Once he went away--and never came back. He wrote to her that
their relations were at an end; that he was a married man and a
father of children; he had hoped he might get a divorce, but that now
he had changed his mind and that she must forget him, etc. Everything
was black before her. It cost her a supreme effort not to faint, and
she was supported in this effort by the fact that when the letter came
she was in the presence of friends; a terrible, overpowering,
all-inundating sense of shame gave her the strength not to betray her
condition and her story before the world at large. But as soon as she
was alone she collapsed completely. There was the most absolute
insomnia imaginable, complete anorexia, but the most distressing
features were frequent fainting spells, severe palpitation of the
heart and tremors. She had no love for the man--so she said. Her love
had turned to hatred and contempt--but the jealousy was all-consuming.
Like a fire it was burning in her, searing her brain and her soul day
and night.

She felt that she was not strong enough to stand this physical and
mental torture, and so she decided to commit suicide. As the means she
selected gas. Fortunately, the smell became perceptible before the
injury was irreparable. She was saved. But she felt that she could not
stand the torture very long--and more than anything was she afraid
that her mind would give way. She had a special horror of insanity.
And so she decided to make another attempt This time with bichloride.
Again she was saved. A friend of hers then got an inkling of the
events that were transpiring, and she introduced her to some gentlemen
friends. They were nice people and more or less radical on the sex
question. In order to drown her pain she began to go out very
frequently with that crowd, and to her surprise and delight she found
that she soon began to think less and less about her contemptible
seducer, and, what was more important to her, she was soon able to
sleep. For about six months she led an extremely active, almost
promiscuous sex life. But then she gave it up, as she felt herself
normal and no longer in need of it. She is now happily married.

I am through with this rather lengthy essay on one of the most painful
manifestations of human emotional life. I repeat that I am aware that
feelings are often stronger than reason; but saying this does not mean
asserting that feelings cannot be modified and held in check by
reason. And I feel confident that a careful, open-minded reading of
these pages and an acceptance of the ideas therein promulgated would
aid in _preventing_ a good deal of the misery of jealousy and in
curing a certain proportion of it after it has found lodgment in the
hearts of unhappy men and women.

There are one or two more points that might be touched upon, but with
the freedom of press in reference to sex matters as it exists in this
country to-day, I have said all that I could say.




CHAPTER FIFTY-THREE

CONCLUDING WORDS


It is my sincere belief--and I cherish the belief in spite of this
horrible, wretched war which seems to be shattering the very
foundations of everything that we hold dear, destroying all the humane
and moral achievements that have been laboriously built up in the
course of many centuries--that the time will come when the world will
be practically free from pain and suffering. Almost all disease will
be conquered, accidents will be rare, the fear of starvation or
poverty or unemployment will no longer haunt men and women, every
infant born will be well-born and welcome, and the numerous anxieties
and ambitions that now disturb the lives of so many of the earth's
inhabitants will no longer plague us. They will be the dead memories
of a dead and forgotten past.

Yes, I believe that the time will come when the world will be
practically free from pain and suffering. But there is one exception.
I do not believe that we will ever be able entirely to eliminate the
_tragedies of the heart_. For our physical ills, which will be few in
number, there will be a socialized medical profession; everywhere
there will be free hospitals and convalescent homes. The unemployment
problem will be dealt with by the State, and dealt with so that there
will be no unemployment problem. There will be work for everybody and
everybody will do the work which he finds most congenial. But the
State, I fear, will be able to do nothing in affairs of the heart.
When John loves Mary with every fiber of his soul, and Mary remains
completely indifferent, then no State physician and no Government
official will be able to offer any balm or consolation to poor John.
And if Mary loves Robert, and Robert behaves so that he breaks Mary's
heart, then no official glue will put it together and no convalescent
home will make it whole.

Yes, I believe that love pangs and tragedies of the heart will cause
mortal men and women suffering even under the most perfect social
regime. But I also believe that these pangs will be less acute, that
the suffering will be less cruel than it is now.

Proper ideas about love, freer intercourse between the sexes, a normal
and regular sex life, a saner attitude towards many things which are
now unjustly considered shameful or criminal will, to a large degree,
prevent the heart tragedies and facilitate their cure where they
cannot be prevented.

And it is the duty of everybody who loves mankind to study the various
phases of human sexuality and help to spread sane and humane ideas on
the subject of Sex and Love.

The author trusts that WOMAN: HER SEX AND LOVE LIFE will help, in some
slight degree, in spreading healthy, sane and honest ideas about sex
among the men and women of America.

THE END




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