RX 351 <*& *> • •••] o ,0° ^°^J "^tf "W 4 o ^* o J*. v^v v 4* **> \ 4 o V » ' * «-. \T* /- T> ^ — i'i,i Hit — ~V '•S* -C\. Sexual Health. A COMPANION TO "MODERN DOMESTIC MEDICINE." A PLAIN AND PRACTICAL GUIDE FOR THE PEOPLE IN ALL MATTERS CONCERNING THE ORGANS OF REPRODUCTION IN BOTH SEXES AND ALL AGES. / BY HENRY G. HANCHETT, M.D., Member of the New York County Medical Society ; late Physician to the New York Homoeopathic College Dispensary, and to the Wil- son Mission Out-patients' Department; formerly Professor of the Martha Washington College, Va.; Author of "Modern Domestic Medicine," "Teach- ing as a Science," and of numerous Essays and Lectures. issued after careful revision by ■f\ 1 fc^ qOP YIii\ A. H. LAIDLAW, AM., M.D.^ j ! NEW YORK: CHARLES T. HURLBURT, No. 3 EAST 19th STREET. 1887. ■RX3.SI Entered according to Act of Congress, in the year 18S6, by HENRY G. HANCHETT, M.D., in the Office of the Librarian of Congress, at Washington. TROWS PRINTING AND BOOKBINDING COMPA547, NEW YORK. ft PREFACE. The following pages form a very important part of the author's " Modern Domestic Medicine." They have been put by themselves between separate covers in order that the method of their use in the family might be de- termined in each case in accordance with the views of the father or mother. A wofk on domestic medicine to be of any service must be at hand when wanted, and many persons are not willing that such information as these pages contain, should be within easy reach of boys and girls. The plan of publishing the following chap- ters separately enables such persons to use the author's "Domestic" with perfect freedom, as a family guide; while it avoids the necessity- that would otherwise exist of allowing important omissions in that work. The present work is, however, an entirely independent one, complete in itself. It contains its own materia medica, with index of symptoms, and also treats of some subjects, such as menstruation, leucorrhcea, and the dis- orders of the " change of life " in women, which are in- cluded in the larger work. "With regard to these sub- jects, although the books will be found consistent with each other, the matter has not been copied, but each book has been written by itself, throughout. The list of medicines used in this book is largely made up from 4 PREFACE. that in the larger work, and those who have the medi- cines contained in that list will require only the articles marked by a * in the list below, in order to carry out the directions of this book ; and, as a matter of course, the author can only be held responsible for his prescrip- tions when the dose and strength of medicines are those designated in the list which follows this preface and in the materia medica at the end of the book. In conclusion, the author has no apology to make for the plain and outspoken manner in which he has treated the delicate subjects considered in the following pages. He is fully convinced that much of our disease, as well as of the vice in which it originates, is due to the pre- vailing ignorance on sexual matters ; that much of this ignorance, on the part of young persons at least, is due to a shameful neglect of duty on the part of parents, growing out of false ideas of delicacy, the wilful blind- ness which nurses the flattering delusion that " my child is safe ; he is above such thoughts or acts," or in some cases, perhaps, out of the ignorance of parents them- selves as to what is going on in the world and in the bodies of their children, and what they ought to teach. Advising parents to instruct their children on sexual matters is of very little use unless accompanied with in- formation as to what instruction should be given. A warning that danger to health and morals lies before the young, is to no purpose unless the nature of that danger and the path which leads to it be pointed out. Young ladies do not know that by exposing their persons in evening dress and allowing intimacies and even receiv- ing caresses from young gentlemen, they often awaken PEEFACE. 5 passions in the latter which send them to the brothels for gratification. Mothers often do not know that the long foreskin nature frequently gives their boys is a source of more or less constant irritation to their sexual organs, and consequent excitation to the animal passions, from which circumcision offers the only escape. They do not know that the well-dressed decent appearing " young lady " whom they pass in the street and who is the picture of decorum while they are within earshot, will shamelessly ask their sons to attend her to her chamber, when she chances to meet them alone. To quote Mr. Emerson : " The preservation of the species was a point of such necessity, that Nature has secured it at all hazards by immensely overloading the passion, at the risk of perpetual crime and disorder." But St. Paul assures us that " God is faithful, who will not suffer you to be tempted above that ye are able; but will with the temptation make also the way of es- cape, that ye may be able to endure it." The way of escape must be found by the light of instruction point- ing out the danger, the disease, the sin, the shame on the one hand ; the straight and narrow path of conse- cration, self-denial, righteousness, and honor on the other. In the hope of lighting some one in the search for this path, this book has been written. No. 38 West Ninth Street, New York, April, 1887. TABLE OF CONTENTS. PAGE Preface < 3 List of Medicines 8 CHAPTER I. Sexual Health of the Male 9 CHAPTER II. Sexual Health of the Female 36 CHAPTER HI. Marriage 60 CHAPTER IV. The Medicines and their Indications 73 Index 83 LIST OF MEDICINES AND AETICLES EE- QUIKED. N. B. The articles marked * are required in this volume only ; the others are in- cluded in the list required by the author's "Modern Domestic Medicine." (d) HOMOEOPATHIC PREPARATIONS. Name. Abbreviation. Strength. Form. Bryonia alba Bry. Calc. carb. Chin. Coccul. Gels. Ipec. Lach. Phos. ac. Puis. Sabin. Sang. Sil. Sulph. Vib. 1st decimal 6th centesimal Mother tincture 3d centesimal Mother tincture 3d centesimal 9th " 3d decimal 3d centesimal Mother tincture 3d centesimal 12th " 12th " Mother tincture No. 20 globules it C( (C u Calcarea carbonica China Cocculus C( it Gelsemium Liquid. No. 20 globules Ipecacuanha Lachesis *Phosphoric acid Pulsatilla ft u a tt Sabina u it Sanguinaria CI (C Silicea c< u Sulphur , a ci Viburnum opulus Liquid. (b) Ordinary Drugs and Miscellaneous Articles. Name. Remarks. Balsam of Peru. Borax. Fountain Syringe Select the largest size of reservoir. Nitrate of Silver Buy in solution — a drachm in six ounces of water. Rubber Sheet. *Sandal-wood oil Buy in capsules, each containing ten drops, of which several dozen will be needed. Spinal Ice-bag Should be fifteen or eighteen inches in length. SEXUAL HEALTH. CHAPTER I. SEXUAL HEALTH OF THE MALE. It is a mistaken idea that the sexual organs demand no attention before puberty. It is true that marked changes occur at that epoch, without which the special functions of those organs could not be performed, but it is also true that sexual life begins before birth, is usu- ally or often expressed by outward signs or inward feel- ings some years before puberty, which marks neither the dawn nor the maturity of that life, and that sexual health may be very decidedly influenced by the treat- ment the sexual organs receive in the very earliest years. The boy and the girl are different creatures from the first moment they have the power of expression, and the wise parent will not allow the reproductive organs to be neglected in infancy from the false idea that they need no attention till they are fully developed and ready to fulfil their functions. With regard to the boy, the first attention demanded by the sexual organs, as such, is circumcision. The 10 SEXUAL HEALTH OF THE MALE. foreskin is a sort of cap or bag, consisting chiefly of skin outside, and mucous membrane inside, which covers over an enlargement at the extreme end of the male organ of generation, known as the " glans penis." The fore- skin is, usually, capable of being retracted, so as to fully expose the glans, and even when this cannot be done in infancy it often becomes possible in later life. In rare instances, however, there is no orifice in this foreskin for the escape of urine, or the orifice is too small to admit of its retraction behind the glans ; in the former case making an immediate operation necessary for the con- tinuance of life itself. Far more frequently the foreskin is so long that it extends beyond the glans, and its re- traction is either an impossibility from the superabun- dance of flesh or, for the same reason, the foreskin is forced over the glans again the moment it is released. In any of the above cases the glans remains covered by the foreskin, at least until years of maturity, while health requires that it be freely exposed. The glans penis is perhaps the most sensitive point in the whole body, although its sensibility is of a peculiar kind, giving rise both to the pleasure peculiar to sexual intercourse and, by what is called "reflex action," to the emission of the fluid which follows such intercourse. The glans is not specially rich in nerves of ordinary feeling, and hence its peculiar sensitiveness is not readily appreciated, except in connection with sexual acts. The nerves are there, however, and excit- ing them to action is known to be one of the most ex- hausting of the processes of animal life. These nerves are excited naturally by contact with the warm and CIRCUMCISION. 11 moist lining of the female organs, combined with fric- tion, and a very similar excitement, milder, but vastly more enduring, is set up by the contact with an elongated foreskin. If, then, this glans be constantly covered by loose skin for several of the earlier years of life, the delicate sexual organs are maintained in a condition re- sembling, in some degree, a perpetual masturbation or self-abuse, besides which the irritation so induced is a direct and strong temptation to that habit. Another reason for exposing the glans is found in the fact that around its neck a number of small orifices exist, through which is discharged a fluid of peculiar odor and properties. Unless this discharge is frequently washed away it sets up an irritation closely resembling some of the impure diseases to which these organs are liable, and it can evidently be better cared for where the glans is freely exposed than under other circumstances. In these two conditions we find the sources of many of the nervous disorders which are known to be caused by a long or tight foreskin, and among which are troub- les of every sort in all parts of the body, including wetting the bed, stammering, twitchings, headache, epi- lepsy, and even something very like hip disease ; none of which troubles, when arising from a long foreskin, can be permanently cured without first circumcising the patient. General as well as sexual health, then, re- quires that the glans penis be freely exposed, and that the foreskin be habitually and permanently retracted, and to accomplish this exposure and retraction from earliest infancy circumcision is usually necessary. This 12 SEXUAL HEALTH OF THE MALE. rite, as is well known, was made one of fundamental religious importance among the Jews, but was by no means limited to the descendants of Abraham, and un- doubtedly was established primarily as a sanitary pre- caution. The eighth day of life being the established one amongst a race of people scattered over all parts of the globe, shows conclusively that the act can scarcely be performed at too early an age if the infant be other- wise healthy. By all means, then, let every boy baby be circumcised at the earliest convenient day — of course committing the operation to a surgeon — and let every boy or man of whatever age also undergo the operation unless he can habitually retain the foreskin retracted so as to fully expose the glans penis. But a long foreskin is by no means the only source of irritation from which the immature sexual organs must be protected. Great care must be taken to guard them from unnecessary handling, even in washing, and too much pains cannot be bestowed upon the choice of a nurse with regard to this very thing. Some nurses will endeavor to soothe a child to sleep by tickling the privates, and many a boy has thus been taught by his nurse to seek pleasures of which he should have had no knowledge whatever. For pleasure is associated with many move- ments of the sexual parts in the earliest years of life, and it is probably to this fact that we must look for an explanation of the fondness children manifest for the amusement of sliding down a stair-balustrade, a form of play which ought to be looked upon with disfavor. Play in general, however — active, romping, boisterous PLAY AND EXERCISE. 13 play, of boys and girls together, regardless of noise, dirt, and proprieties — is always to be looked upon as the most natural and healthful employment in which chil- dren can engage, and little fear need be felt of their having too much of it. The danger lies entirely the other way, for fashion and propriety, school-boards and, alas ! poverty, combine to deny to the rising generation its fair share of out-door play, with the essential acces- sories of noise, dirt, and torn clothes. As the boy grows older it becomes of the ut- most importance that he should be actively employed, and that his parents should retain his perfect confi- dence. The more physical exertion and the more play- mates, both boys and girls, a boy has, the less likely will he be to have any morbid tendencies toward habits which at his age are certainly not natural or dependent upon natural sexual instincts ; for such instincts, if al- lowed to come of themselves, would wait upon the ma- turity of the organs through which they must find ex- pression, and are hence unnatural, however strong, in earlier years. But playmates are apt to be the princi- pal teachers of the young boy, and they often teach w T hat would be better unlearned. It becomes, then, a matter of the utmost importance that parents hold on to the boy's confidence, so that nothing shall enter his mind to be concealed from them, and no teaching from whatever source shall be preferred to theirs. And while it is doubtless the best plan to keep the boy's mind as far as possible from the sexual organs and their uses, let no parent delude himself with the idea that thoughts of these things can be entirely excluded, 14 SEXUAL HEALTH OF THE MALE. Too much of what goes on in the animal world, too much that is tolerated in the daily papers, comes under his notice, too many of his daily experiences are com- pared with those of his companions, to make it possible to exclude entirely from his mind questions that sooner or later will find their answers, perhaps in a way par- ents would not prefer. Boys will even make a compet- itive game of the simple emptying of their bladders, and in this act may easily begin a habit difficult enough to uproot. A boy should be taught that the privates must not be handled except for washing and passing water. He can easily be shown that the urine is a fluid which carries impurities out of his body that would do him harm if retained, and that handling the privates may result in obstruction to the flow of urine, and thus make him sick. There is no need of teaching more till his questions demand it ; but when his curiosity is aroused the safest course is to satisfy it with the wholesome ar- ticle of truthful information, rather than run the risk of having the moral poison that circulates all too freely among the young, taken into the mind and accepted as sound teaching with regard to sexual relations. Fuller informatSon than this ought to be given a boy, regardless of his questions, not later than the ad- vent of puberty. This crisis is signalized by the growth of hair at the lower part of the abdomen, and by the change of voice. At about the same time the organs of reproduction begin to secrete a fluid upon which de- pends their power to perform their part in the preser- vation of the species, and, as we shall see later, it is the INSTRUCTION FOE BOYS. 15 accumulation of this fluid, and the consequent desire to empty the organ in which it is contained, that gives rise to the sexual instinct upon which the life of the race depends. Nature will discharge this fluid spon- taneously at long intervals ; but its presence will awaken feelings that will need but little instruction, of a kind sure to come to every boy in the land, no matter where his home or how sacredly guarded, to start him upon a course of masturbation, or self -abuse, which may lead to very unhappy consequences. The hope of keeping a boy in ignorance of this practice, and the pleasure to be derived from it, may as well be abandoned first as last, for it is simply impossible. Nature has determined that the species shall be preserved at any cost, and the only way to guard a boy from the dangers of masturba- tion is by clearly recognizing the fact that temptation is inevitable, and that the only protection is in developing strength of character to resist, and by full instruction as to the nature, office, use, and abuse of the sexual organs. Teach him that these organs have but one proper use, and were created with but one object-— the preservation of the species. Show him that there is but one way in which they can properly fulfil their mission — through marriage. Call his attention to the fact that the Creator has provided for the rearing of a human being far more carefully than for the reproduction of lower ani- mals, has designed that the child shall have the nurture and attention of both father and mother, and has made it evident, both in nature and in revelation, that no plan of preserving the species that does not provide each child with an acknowledged and responsible father, as 16 SEXUAL HEALTH OF THE MALE. well as mother, can meet with His approval, or be for the best interests of the race. Show him that while pleasure is associated w T ith this, as with all properly used natural functions, there is, and can be, no plan of securing that pleasure, without performing the associ- ated duties, that will not cost more in pain and suffer- ing, eventually, than it returns in pleasure. Teach him that his early inclination to seek such pleasure is one of his opportunities to test and strengthen his character ; that the grade of his manhood is established by the amount he can overcome, and that his value in the world depends much on the question as to whether he will rule his body, or his body him ; that by cultivating the mind and the other parts of the body he can hinder these organs and their desires from becoming too strong for him, while their natural growth will be associated with the development of gentleness, tenderness, unsel- fishness, and other mental traits which belong to nobil- ity of character, and is intended to remind him in time of the duties of manhood to which he is approaching, in order that he may prepare for parenthood himself, first by the development of his own character, and second by the wise choice of a mother for his future children. Moreover, this boy should be taught that no function of his body exhausts vitality so rapidly as the sexual function ; that it is one intended to be shared, not only by all the members of his own body, but also by all those of another and different body, and that to drain the distinctively sexual organs in solitude is to abuse them, because it is to imperfectly and in- completely perform a very delicate, complicated, and MASTURBATION. 17 important act. He should have explained to him, also, the nature, strength, and danger of habit, because it is the habit of self-abuse that is to be most of all dreaded in this connection. But do not teach him that the sim- ple act of self -abuse in itself is a thing of overwhelming danger, for this is not true, and the boy will unquestion- ably satisfy himself sooner or later that it is not true, and, detecting you in one falsehood, he will discredit all your teaching. Besides, when a boy gets his mind fixed on the idea that the act of self -abuse will of itself lead to dire consequences, he becomes the easy prey of designing quacks, who, through advertisements and cir- culars, some of which will be sure to reach his eye, will awaken fears that will torment him every time any ail- ment affects his body, and probably extort from him money for worse than useless, if not harmful, medica- tion. Self -abuse is undoubtedly an evil in itself, be- cause it is incomplete and unnatural, and sad is his state who has bound himself with the chains this vice can so deftly forge ; but its chief danger is that it so quickly and easily becomes a habit, and then it is in- dulged beyond the power of the body to recuperate. But if his state be sad who has lost his sense of man- hood in the vice of self- abuse, how much sadder is his who has sacrificed self-respect, health, strength, and money in the house of the " strange woman." Nothing but shame and remorse wait for him who enters these portals. It is unfortunately true that some physicians advise those who have bound the chains of the habit of self- abuse about their lives, to seek to break them by binding over them the stronger chains of the strange 2 18 SEXUAL HEALTH OF THE MALE. woman. Nothing could be more hopeless than to at- tempt to gain anything in this way. Illicit indulgence must from the nature of the case be irregular, under the influence of excitement if not of alcohol, degrading, and almost certain to result in diseases loathsome in the extreme, painful, and dangerous to life. That should be enough were it not also true that prostitution strikes at the very root and foundation of society — the family — and does nothing and can do nothing to help the indi- vidual out of the chains of bad habits. The best treatment for these bad habits is the preventive, and that is applied by early instruction in their evil effects and tendencies, by providing for the development of both mind and body, and by guarding against moral poison in the reading or conversation of the growing boy. Keep an eye on what he reads, and consign all books, pamphlets, or circulars devoted to any special quack medicine to speedy destruction, and try to introduce such newspapers into the family as refuse to admit advertisements of quack medicines of any kind — a very difficult kind of newspaper to find, unfortunately. Keep the boy interested in active sports during his spare time by day, and in the evenings, besides wholesome games, teach him to read wholesome books, and be sure that you know where he is and what he is doing in the evenings. Try to give each boy his separate bed and bedchamber ; at least let him have a single bed parti- tioned off by a screen if it must be in a room with others. Let him have plenty of society and send him to a mixed school, if possible ; for the family model, male and female, man and wo::ian, boy and girl, in constant association and TREATMENT OP MASTURBATION. 19 contact, is the true one for school-days as for all the other periods of life. But keep him out of the city public school, when you can make a choice. The press- ure there is too great to be resisted, in favor of cramming facts and training memory to the neglect of true educa- tion — teaching principles and cultivating character — which should be the main object of school- work. But if habits of self-abuse, with the consequent spermatorrhoea or seminal emissions (the so-called " wet- dreams "), have become seated, they must be broken up by some such plan as suggested for their prevention, with additions. Diet is an important consideration, and should be rather light but nutritious, consisting of grains, vegetables, brown-bread, rice and Indian puddings, fruit, fish, oysters, and, above all, milk. Meats should be used in great moderation and must be well cooked. The fol- lowing named articles should be entirely forbidden dur- ing the treatment : viz., coffee, cinnamon, nutmeg, pep- per, mustard, vanilla, radishes, horseradish, onions, rhu- barb, tomatoes, water-cresses, and sorrel. Late meals must be avoided. The supper should be light, and taken not later than six o'clock. Other important elements in the treatment are, systematic gymnastic training, early hours, a hard bed, a cool sleeping-room and light bedcovers, insistence upon rising and dressing at the first waking moment, and, if possible, the constant day and night society of one who wishes to help in the cure of the habit and who is old enough and mature enough to be a guard while yet a companion. A daily cold sponge- bath before breakfast or at bedtime is also to be ad- vised, and the moral nature must be aroused to fight to 20 SEXUAL HEALTH OF THE MALE. the utmost against the degrading animalism that is be- trayed by persistence in habits of sensuality. The best medicine for the weakness upon which " wet- dreams " depend is Phos. ac. which may be taken in tablespoonf ul doses, four times a day, using a solution of twelve globules in two-thirds of a glass of water. A still better remedy is the sitz-bath taken twice daily, before breakfast and before supper, or before dinner and at bedtime — at least two and a half hours after supper. It must be exactly 95° F., must be taken in a common wash-tub of wood, in which the patient must sit quietly for full thirty minutes, allowing the water to cover his hips and belly. A sheet should be spread over the patient and tub and gathered about the neck so as to exclude draughts. Further treatment, if any be needed, should be under the direction of a physician, but choose one who will not rely upon medicines only, for these cases will not yield usually unless treated by the steel sound which must be passed into the bladder not of tener than once a week, and by a physician. The sexual organs of a growing boy need no at- tention whatever except circumcision and cleanliness, unless, of course, some accident befall them. The more completely they are let alone the better, and some au- thors assert, that if they can be entirely left to them- selves no fluid whatever will escape from them. This is probably a mistake, but the instances in which these organs receive absolutely no handling are so rare as to make it difficult to state what does occur under such cir- cumstances. An occasional involuntary loss of the seminal fluid, say once a month, or even somewhat SEMINAL EMISSIONS. 21 oftener, is of no serious consequence unless it be asso- ciated with other evidences of the presence of disease. But frequent "wet-dreams" signify weakness of the sexual organs, and this is the usual result of self -abuse. The fluid itself seems to be an expensive one for the blood to elaborate, and its frequent discharge by even the most natural method, is something of a drain upon the resources of the body. "When it accumulates in too large quantity, nature will discharge it during the re- laxed state of the parts induced by sleep or disease, in the form of what are called " wet-dreams," and it may safely be said that no other form of discharge of this fluid, either by masturbation or sexual intercourse is necessary to the well-being and health of the reproduc- tive organs at any time of life. It is a very prevalent opinion that sexual de- sires indicate the necessity of sexual indulgence. It may safely be asserted that this opinion is an error. Sexual desires are among the strongest influences known to human nature ; very few men are able to go through life without paying some heed to such desires ; many have even confounded those desires with the strongest and loftiest passion known to the human heart, and have named these irrepressible longings with the sacred name of Love. But their strength simply indicates the importance put by Nature upon the preservation of the species, they assure permanent vitality to the institution of marriage and make it certain that men, as a class, will always provide themselves with wives — or worse. 22 SEXUAL HEALTH OF THE MALE. Nature never intended that animal impulses should over- ride the will and the free choice of any individual man, that they should be masters and make him slave. Prop- erly understood, sexual desires make a man better, for they call to mind his duties to society and posterity, and show him that he cannot indulge his baser nature, give rein to appetite and passion, and neglect his mind and spirit, without stamping upon some other life more or less of the evil consequences of his acts. Properly used, sexual desires lead a man into the holiest, happiest, and most useful relations in life, and give him a right to the name which God himself has chosen as best symbolizing the relationship which He would have us consider His toward us — Father. Let us then seek to understand the proper nature and use of the sexual organs. A healthy man develops from his blood a fluid which in some mysterious way is capable, under certain circumstances, of calling into life a new being who, starting from an egg less than one one-hundredth of an inch in diameter, and developing in and out of the mother's body for some years, will eventually and throughout life present unmistakable evidences of the source of the fluid which originated this new life, in the form of remarkable resemblances to certain traits of the person in whose body that fluid was secreted. This fluid (called " semen " or the " seminal fluid ") gradually collects in a small sac which it sooner or later distends, and by so doing sets in motion a train of phenomena designed to bring about its discharge, but extremely complicated and very imperfectly understood. The mind is influenced powerfully, and either a vague in- SEXUAL DESIRES. 23 stinctive attraction toward members of the opposite sex, or a very definite impulse toward the sexual act is ^aroused, according to the experience, previous habits, knowledge, or moral stamina of the particular individual. This mental impression reacts upon the sexual organs themselves, which thus more powerfully attract atten- tion to their desires, while their physical condition is automatically made more favorable for carrying the fluid to be discharged into proximity to the egg to be vitalized by it ; a change of form and position occurring in these organs, that closes the outlet from the urinary bladder and arranges nerves, muscles, and passages con- veniently for the emptying of the little sac containing the vitalizing fluid. If, now, no attention be paid to the demands of the organs in question, the fluid sets up nervous influ- ences which result in its discharge, usually during the hours of sleep, a fact which is of itself amply sufficient to overthrow any claims that the sexual act is absolutely necessary. Habitual and persistent neglect of the sex- ual desires will result in their subsidence and the length- ening of the intervals at which they are felt, owing to diminished production of the fluid which is their prime excitant ; and eventually the accumulation of this fluid will entirely cease, but not till long after maturity and persistent repression shall have fixed the character and state in life of the individual. But if, on the other hand, indulgence be accorded to sexual desires, only one right, natural, and healthful course is open to the man — that, namely, of joining in the bonds of holy wedlock the woman who 24 SEXUAL HEALTH OF THE MALE. commands the love of his heart, the respect of his mind, and who, recognizing that the sexual organs, so-called, by no means fully comprehend all the sexual functions,* meets his advances actively with eyes, lips, breasts, limbs, and body as well as with the organs upon which her capacity for motherhood depends, assured that in so doing she is responding to the heaven-appointed im- pulses and methods that can raise her to the lofty pinna- cle of motherhood, and give her children animated with the qualities which have called forth her love for her husband and given her a right to respect herself. In this way, and in this way only, can the sexual instincts fulfil the design of the Creator. Any attempt to limit the act exclusively to the organs which false shame or prudery would ignore, and to deny to them their full dignity and activity, can only result in local excitement but little better than masturbation, save that it can re- sult in offspring of a puny, bloodless, half-vital sort. Any attempt to give play to these instincts out of wed- lock involves contact with moral poison and physical, disease-breeding filth ; involves the soul-consuming ex- citements of law-breaking, of skulking from discovery, and of spasmodic, irregular, and inordinate sexual activ- ity ; costs health, strength, wealth, self-respect, and vir- tue ; sacrifices purity and the restraining and elevating power of a true valuation of womanhood; exchanges liberty for the domination of a creature too vile to be called a woman ; barters useful citizenship for the state of the criminal sapping the foundations of society by striking at marriage and the family; and degrades the impulse toward fatherhood into a disgusting animalism. PROSTITUTION. 25 Nor can these facts be too widely proclaimed or too much emphasized. The mothers and fathers of this land are too prone to nurse the flattering delusion that their sons are pure and innocent, and will escape the wiles of the strange woman, and hence the impression- able and teachable period of youth is allowed to pass without the needed warning, for fear that the warning itself may open the avenue to temptation. The idea is delusive. The danger of the warning is nothing in comparison with the danger of silence, which exposes ignorance to the inevitable, the positively unavoidable temptation, the power of which probably few women realize. The temptress lurks and bides her opportun- ity. Rarely does she speak when a woman is within hearing. The whispered word in the ear of youth is her weapon, and what man would be likely to say to the woman he esteems that such a word had been spoken by one of those who have often every outward appearance of being ladies ? This evil lurks and hides, and those who would fight it must neglect no safe- guard and spare no warning. No man can reach twenty without being tempted many times — no matter whether he live on the farm, in village, or in city. For any mother to believe that her son will not be put to the test is the height of folly and blindness. But there is hope that he may pass through the fire of temptation unscathed if he be but thoroughly armed and equipped with knowledge of the danger and the way of escape, with principle and strength of character, and a high idea of his responsibilities to God, society, and himself. The sexual act is an exhausting one. It takes 26 SEXUAL HEALTH OF THE MALE. hold of the whole body, and demands the best energies of every part of the system. It requires so much of nerve-force that it ought always to be followed by a period of rest. It is true that there are states of the system in which vitality is low while the impulse to the act is unusually strong, as is sometimes the case in con- sumption and with those who have indulged the sexual appetites to excess ; but such demands are abnormal, and should be resisted precisely as should the ravenous, insatiable hunger that is a symptom of some forms of dyspepsia. ISTo rule can be given regarding the fre- quency with which the sexual act may be performed. Men differ greatly in regard to their capacities in this as in all other respects. It may be said, however, that when anything more lasting or unfavorable than a tem- porary feeling of lassitude follows the act, it is indica- tive of excess. But the act should always be fully com- pleted when once begun. With some men this is impossible by a single effort. On account of some idio- syncrasy they experience a discharge of semen almost as soon as they attempt sexual intercourse — a prema- ture and unsatisfying result that should be followed in from two to three hours by another effort which will usually fully and properly empty the sac of its semen. in this connection is the proper place to speak of the disadvantages of long engagements. It is, prob- ably, too much to expect of human nature that two young persons should be very much in love with each other, and should have frequent opportunities of seeing each other alone, without indulging in sundry endear- ing words, looks, and embraces ; nor has the author one SEXUAL EXCITEMENT. 27 word to say in disparagement of what goes so far to turn life into a poem, and put softness and sweetness into natures too prone to harshness and selfishness. But there are proper limitations for all things. ISTo man can indulge in such caresses without experiencing more or less activity in the sexual organs. This is a matter wholly involuntary and beyond his control ; so his body has been made and so it must act, whether he will or no, if he put himself in a position to apply the stimulus. Now this is well enough within bounds, but for this excitement and partial activity of the sexual organs to go on for months with no result will surely have a bad effect. Three months is long enough for an engagement, especially if the parties can see each other frequently. A courtship conducted by corre- spondence might continue longer without the same danger, but long engagements should be avoided where possible. The diseases of the sexual organs to which men are specially liable are Gonorrhoea, which in popular language is designated Clap ; Syphilis, which is limited to the sexual organs only in its first stage, and may even enter the system through other channels, and which is popularly known as the Pox ; and Chancroids or Vene- real Sores. These diseases are none of them suitable for treatment by the patient himself, or by domestic methods. They should send the patient to his physician as soon as they are recognized. But a few remarks upon their causes, nature, and proper treatment will be ap- propriate here, and may save the sufferer from mistake^ 28 SEXUAL HEALTH OF THE MALE. and unnecessary anxiety. Many misconceptions regard- ing these diseases are prevalent, and result in much evil. Quacks thrive upon them, partly because of these mis- apprehensions, partly because patients are reluctant to have the family physician know of their existence, and partly, no doubt, because of the medical gullibility of a class still large in the community. Gonorrhoea is an inflammation of the membrane lining the canal through which the urine passes after leaving the bladder. In women the disease has a dif- ferent seat, but it is the purpose here to speak only of gonorrhoea in men. It is caused by the contact of irri- tating matters of a certain kind directly with this mem- brane, and many authors claim that the only substance that will produce it is the discharge from another case of the same disease. Be that as it may, there is a dis- ease known as Urethritis, or inflammation of the lin- ing membrane of this same urinary canal, which an un- professional person would be unable to distinguish from a true gonorrhoea, unless by positive knowledge of its cause, and no attempt will be made in this place to distinguish the two. The enormous prevalence of this disorder, and its indiscriminate invasion of all classes of society, are among the most shocking revelations that come to a medical practitioner, and if known gen- erally, would doubtless do much to break down that hugely false idea that safety for the young is to be found in ignorance on sexual subjects. Ignorance lends power to temptation, and temptation comes to all in some de- gree. For nine hundred and ninety-nine of every thou- sand cases of gonorrhoea are due to impure sexual inter- GOiSTORRHCEA. 29 course. The contact of the mucous membrane with the impure and irritating discharges which are very common among women who submit their bodies to indiscriminate intercourse, sets up an acute inflammation which occa- sions, first, a tingling and itching on passing water, and later, a discharge which at the start is slight and merely glues up the outlet, but soon becomes abundant, thick, like matter, and accompanied with intense pain in pass- ing water, and erections which are also very painful. As has been said, it is not the intention to fully de- scribe the disease or its treatment in this place, but to allude to some misapprehensions concerning it. And, first, the disease is not always due to impure sexual intercourse. The irritating substance which causes it may be a discharge of the " whites " in the wife of the patient — a disease to which she may become a victim in the most innocent manner possible — or it may be the menstrual discharge itself. Again, the disease may be caused by simple excesses of intercourse, or by irritating discharges in the urine of the patient himself, as in some cases of gout, and the inflammation may result from accidental wounding of the penis by some mechan- ical injury. There is perhaps a bare possibility that in some cases the disease has been communicated from one man to another by the patient's allowing the discharge to touch some article which was afterward touched by the private member of another person — such cases are, however, too rare to be worth considering. Secondly, the disease is by no means a trivial affair. It is the most fatal of all the venereal diseases, and often results in permanent, or at best very intractable 30 SEXUAL HEALTH OF THE MALE. injuries to the sexual organs, and to the body generally. One attack makes the patient more liable to a second, and each subsequent attack is more difficult to cure than its predecessors. Thirdly, it is not a disease to be quickly or easily cured, nor is the patient wise who takes his case into his own hands, who delays treatment, or who seeks the ad- vice of either a druggist or a quack. Moreover, it seems almost unnecessary to remark, the disease can never be cured by " giving it away " to someone else. The pa- tient who gets entirely rid of an ordinary attack of gon- orrhoea in six weeks may count himself unusually fortu- nate. Many patients continue treatment for from two to five or six months, and strictures, inflammations of the testicles, bladder, eyes, or deeper organs may easily complicate the case and make longer treatment neces- sary. With regard to treatment, as has been said, a physician should be consulted, and one should be se- lected who is neither afraid of local measures or so bound to them that he will use them indiscriminately in every case. In the four or five days that usually in- tervene between the contact, and the development of the inflammation, injections offer the most promising and helpful mode of treatment, but they are never safe in the hands of patients, are never admissible in the stage of inflammation, although they may come in again after that is passed and while a mild discharge — a Gleet — still persists. Late in the treatment, too, it may be necessary to pass steel sounds into the bladder once a week or so. The best medicine is usually the TREATMENT OF GONORRIKEA. 31 oil of sandal-wood, wliich may be had put up in cap- sules each containing one dose, or the oil itself may be taken on a lump of sugar, ten drops, four times a day. The medicines wanted in the disease are numerous, and no one of them has a record of universal success. The treatment is very greatly facilitated by absolute rest in bed and the use of a diet of very plain food, chiefly vege- table, and absolutely excluding all drinks containing the least alcohol, tobacco, coffee, tomatoes, rhubarb, onions, garlic, strawberries, sorrel, water-cresses, aspara- gus, and even meats. An abundance of water should be drank, and of course, sexual indulgences must be en- tirely abandoned. Chancroid or the venereal sore, is a disease which seems to be almost exclusively propagated by direct contagion in impure sexual intercourse, but the sore is one that can only be distinguished from the chancre or first symptom of syphilis by the careful examination of a physician, and even he is hardly warranted in pro- nouncing a positive opinion in all cases without making experiments and holding his judgment in reserve for several days. The disease is mentioned here merely for the purpose of informing those who may be afflicted with a sore on the private parts that it does not neces- sarily prove that they have that justly dreaded disease, syphilis. While a chancroid may give rise to much trouble and is the usual cause of buboes — those distress- ing abscesses in the groin popularly named " blue balls" — it is still a purely local disease, and when cured it leaves no blood-taint behind. Syphilis, however, is a constitutional disease of the 32 SEXUAL HEALTH OF THE MALE. most dreadful proportions, pronounced by many emi- nent medical authors to be incurable, eating its way, year after year, into the very bones and marrow, making a wreck of both body and mind, and destroying innocent children as well as the victim who can trace to his own act the origin of his plague. Probably the disease is curable by long-continued, patient, and persistent effort, but it so often suddenly breaks out again, after the most thorough treatment has suppressed, perhaps for months, all signs of its existence, that one is disposed to doubt the reality and permanence of many of the so-called cures. But this is not the place to discuss the disease or its treatment further than to say that as its first symptom — a chancre — is very similar to another and perfectly curable disease — venereal sore — so its later ex- pressions resemble quite closely other maladies, many of which are of inconsiderable importance. Many a man has been rendered miserable by the thought that he was afflicted with the dire plague of syphilis when his sole trouble was a tetter or some other harmless skin disease. When in doubt, then, consult some regular, well- known, honest physician ; tell him your whole story, and when you know positively what is the matter, it will be time enough to consider what has to be done about it. Syphilis first manifests itself by a local sore at the point of contact of the poison conveying the disease. This sore may be so small as to escape notice, or it may be considered of no importance, for, as we shall soon see, it is by no means limited to the sexual, organs. After a time, which is extremely variable extending SYPHILLIS. 33 from ten days to even six months, this first sore will be followed by other symptoms of a superficial character. Eruptions on the skin and on the lining membrane of the mouth will be noticed, the glands may enlarge, the hair may fall off, perhaps the throat will be sore ; and from this beginning the disease will go deeper and deeper into the body unless arrested by treatment. Any discharge from a syphilitic patient is capable of communicating his disease, if it be active at the time in the patient. There are periods of seeming quiescence during which the poison of syphilis is apparently dor- mant in the system, and at such times contact with the patient may not result in the communication of the dis- ease ; but except at such times the plague passes from one person to another with fearful facility. A pipe or drinking-cup used by a patient may communicate his malady, a kiss may easily convey the poison and the kissing of infants born of syphilitic parents has done much to spread the disease. Of course the principal mode of contagion is in sexual intercourse, and thus many an innocent wife has acquired this loathsome and deadly plague from a vicious husband. 'No matter what the stage of the disease, it can be communi- cated in these ways, and it always begins with the local sore at the point of contact. It will be seen from the above, that a person afflicted with this disease, cannot be too careful to avoid every possible form of contact with his fellows, and of course no such person, if single, has a right to think of mar- riage until he is not merely pronounced to be cured, but until he has passed a full year after his cure is pro- 34 SEXUAL HEALTH OF THE MALE. nounced without the smallest sign of relapse. One can- not be too careful on this point for, as remarked above, long periods are often passed without a sign of the dis- ease, which will then break out in full vigor and pro- ceed with its work of spreading a living death through the system. Syphilis is probably a curable disease but its consequences are so dreadful that no man who has the slightest self-respect will run any risk of contaminating the blood of an innocent wife and of causing her to en- dure the pains of child-birth only to bury her infant within a few months or years. The only way of avoid- ing such risks is by submitting the case to professional treatment, and when it is cured by still waiting long enough to leave no doubt that the cure is permanent be- fore venturing to enter the bonds of matrimony. With regard to the other impediments to marriage on the part of the man — impotency and ster- ility—they are not conditions that an unprofessional person could recognize, and therefore no man should give himself any concern about them till he has secured the opinion of a physician regarding them ; but of course no man who has any reason to suspect the existence of such impediments should contract a marriage without consulting a medical man. Impotency signifies a permanent condition of inability to effect sexual con- nection, such as might result from an entire destruction of the penis and such as does occasionally result from nervous causes brought on by long-continued misuse of the sexual organs or by disease. Sterility signifies a condition in which the fecundating germs are absent from the seminal fluid, thus preventing a man from be- IMPEDIMENTS TO MARRIAGE. 35 coming a father, although he may be able to have con- nection and to discharge a fluid which can only be known to be sterile after a careful microscopic exami- nation. There are temporary conditions which are per- fectly curable which simulate impotency, and these are magnified by quacks into an importance which does not belong to them, in order to frighten the ignorant out of money for worse than useless treatment. The impor- tant relations and the delicate character of the sexual organs make it necessary to put the treatment of their diseased conditions into the hands of the physician, but the advertising specialist and his false and overdrawn printed statements and insinuations should be shunned, and the honest, settled, regular practitioner should be frankly consulted and his advice confidently followed. CHAPTER 11. SEXUAL HEALTH OF THE FEMALE, While the sexual organs of little girls rarely require such special attention as is involved in circumcision for their brothers, the corresponding operation is necessary at times, and certainly not less care should be expended upon the selection of their nurses. The same pleasur- able sensations which it is possible to arouse in the boy- baby's private parts lie dormant also in his little sister's organs, and can be called into action by an unscrupulous nurse to quiet the child, regardless of the serious conse- quences to the physical and moral nature which may ensue. There are foreign nurses in this country, too, who make a habit of breaking up the hymen — the u maiden-head," or membrane that closes in the vagina — in new-born or very young girls ; a practice which, of course, should be condemned. But care must be taken to maintain perfect cleanliness about the private parts, and to avoid all such sources of irritation as are found in woollen diapers ; in skin diseases due to neglected discharges upon the dia- pers, to ill-fitting cloths or careless washing ; and in the crawling forward from the back passage of worms, in case such pests should afflict the little infant. All of these causes may contribute to derange the sexual or- gans of girls at a very tender age, and even in the earli- SEXUAL HEALTH IN LITTLE GIKLS 37 est years the female sexual apparatus is of prime impor- tance with regard to the physical well-being of the future woman. And conversely, the general physical well-being of the girl or woman is of prime importance in the mainte- nance of sexual health and activity. A woman differs from a man more or less in every department of her nature, and these differences, one and all, are calculated to fit her for the special work of motherhood. Every part of her body and every faculty of her mind is in subtle communication and sympathy with the organs in which sexual life centres. General health involves sex- ual health ; sexual disease inevitably involves general ill-health. It follows, then, thatthe best foundation for sexual health will be laid by the most judicious attention to general health in those years during which sexual life is comparatively quiescent owing to the undeveloped state of the organs through which it finds expression. En- courage " tom-boy-ism " and activity by every possible means in the growing girl, and never think of finding fault with dirt or rents acquired in healthful sport. Let her join her brothers and their friends in romping out of doors, and keep her in the open air and at active sport as much and as long as possible. Be sure she has plenty of sleep and let her wake up when she will in the morning, and in general let the body and its health be the chief considerations till childhood is past. Sexual feelings are probably less likely to be awakened in girls than in boys before puberty. In fact, it seems to be true through life that distinctively sexual 38 SEXUAL HEALTH OF THE FEMALE. desires are, on the average, less imperious in the female than in the male. At least, society is organized on this hypothesis, and it is one that seems reasonable enough from the fact that in women, no such main-spring of passion can be discovered as is found in man in the se- cretion of the semen and the distention of the sac in which it is stored. But on the other hand, nothing is more certain than that even very young girls do some- times manifest decided capacity for sexual pleasure, and it therefore becomes a matter of importance that parents should be on their guard, and that young girls as well as boys should be taught the functions, and the dangers of abuse of the genitals. Questions will present themselves to the girl's mind as to the boy's, and she will not be behind him in seek- ing answers. None but honest answers will stand the test of time, and keep intact that perfect confidence in parents which is the only security for the maintenance of a wholesome parental influence. But as a matter of course it is the best plan in early life to keep the mind as far from sexual subjects as possible, and to do this reliance must be placed on general instruction in delicacy and modesty, upon activity and constant employment, and upon the positive teaching that no handling or irri- tating of the privates, except for washing, is good for them, but that, on the contrary, it may do harm. The exception just made is, however, one of great importance. Young girls frequently have so impressed upon them an idea of the shamef ulness of touching the privates, in fact in some cases almost of the disgrace of having privates at all, that cleanliness of those parts is WASHING THE VULVA. 39 neglected with far worse than ordinary consequences. There are glands between the inner and outer lips of the external genitals, discharging themselves into the furrow at that point, precisely as the glands under the foreskin of the male organ discharge about the head in which it terminates, and this discharge allowed to re- main untouched dries out partially and becomes, in the one case as in the other, a source of persistent irritation such as may lead to disease and to bad habits. It not infrequently happens that persistent itching and discom- fort, nervousness, irritability, peevish restlessness, dis- content, melancholy, and even mental disturbance in girls and unmarried women who have been taught never to touch the privates, may be completely cured by sim- ply separating the larger and smaller lips that are found on either side of the vagina, and cleaning out from the furrow between them a mass of cheesy matter, the ac- cumulated discharge of the glands at that point. So greatly have very serious symptoms been benefited in so many cases by this simple procedure that it must be thought an important matter to instruct girls and women to separate these lips and wash between them at least once a month, and in warm weather — say from May to November — as often as once a week. And girls should be taught before puberty what they are to expect at that time. The flow of blood coming for the first time to an uninformed girl is more than likely to frighten her into doing something to ar- rest the bleeding, and she may easily injure herself for the rest of life by applying or sitting in cold water, or taking some other ill-advised step. The time of puberty 40 SEXUAL HEALTH OF THE FEMALE. cannot be foretold definitely ; it is usually between the twelfth and the sixteenth year in this country, and the best guide in any given case is the age at which the girl's mother began to menstruate, or " have her courses," as it is popularly expressed. When the epoch does ar- rive, however, there is precisely as much, if not more, need of full and careful sexual instruction, as in the case of the boy. Natural sexual feeling may be less in the girl and the woman than in the boy and the man, but it exists, and to it is added the regularly recurring monthly flow to which attention must be given ; and it would be strange, indeed, if these two elements together did not lead many an uninformed girl into the way of temptation and even into thoughts and acts certain to be followed by disastrous consequences. The very bad habit of exciting the sexual organs by the hand is undoubtedly one into which many girls fall, although it is not so prevalent among them as among boys. Its results, however, are somewhat similar, as it puts an exhausting drain upon nervous vitality, draws blood to the parts, by which means menstrual irregular- ities and local pain are brought about ; and it is, in all respects, mental, moral, and physical, as disastrous as is the corresponding habit among boys. It is to be met by much the same course of diet, surroundings, social influences, moral and physical treatment, and education, as that already advised for the opposite sex. And let no mother lull her conscience to sleep with the idea that her daughter is above such habits, or the temptation to them which comes from natural feel- ings misunderstood or misguided. The girl who lacks MASTURBATION IN GIRLS. 41 sexual feeling is as much to be pitied, and is as truly in an abnormal condition, as the girl who lacks sight or ap- petite ; but the girl who, having sexual feeling without knowledge of its significance or proper restraints, ac- quires harmful habits ignorantly, as so many do, is far more to be pitied than blamed, even when she falls the victim of some designing rascal who understands her nature better than does the mother who was made her guardian and instructor by the Creator Himself. The supreme sphere and office of woman is motherhood. Attain to what she may in other directions, this must ever be her crowning glory if it be accepted and used in accordance with the divine intention. So long as this is true — and it is admitted on all sides — the impor- tance and beauty of the organs and functions which make tlie office possible must be admitted. It is no shame to have organs which can house and nurture a budding human life ; it is no shame to study those or- gans, and learn how they can best serve the new being that will be dependent upon them and their healthy condition for a fair start in the race of life. It is a shame to consider those organs either nuisances, able to put unwelcome responsibilities upon us, or mere sources of animal gratification and pleasure, either in or out of wedlock ; it is a shame to neglect, trifle with, or abuse those organs, as such treatment can but interfere with their office of nesting-place for a new soul. Let the girl be taught that every menstrual pe- riod is a new evidence of her capacity to hand down to another generation, not merely her life, but her dispo- sition, her mental power or weakness, her ambition, 42 SEXUAL HEALTH OF THE FEMALE. her faults, and shortcomings ; that it is a reminder that she is responsible to posterity for her habits, and daily behavior, and that the important relations of her sexual life to every other part of her being, show that she should never fail to consider whatever she does in the light of its possible influence upon her children. "Women, as a rule, are not properly prepared for the simpler, and more easily understood duties of child-bearing and nurs- ing. Generally, a woman is thought to be a pretty good mother if she get her children up to their tenth year without making them, or allowing them to become, nui- sances to her neighbors. But rare enough are the moth- ers who can claim to have successfully coped with their duties toward children in their teens, and why should not this constantly recurring flow be considered as nature's way of reminding them of their life-work, in preparing for which they cannot by any possibility spend too much time or thought ? Any young girl who is taught so to look upon her menstruation and sexual organs will be in very little danger of sacrificing her health and strength to the momentary, unsatisfactory, and degrading pleasure of masturbation, or of falling a victim to vice in any form. Menstruation, or the monthly flow of blood from the womb, usually begins somewhere between the twelfth and the sixteenth year, and continues for about thirty years, during which time its only healthy interruptions are those occasioned by pregnancy and nursing. The periods in health are regular, except for a time near the beginning, and again near the close of the reproductive MENSTRUATION. 43 portion of a woman's life, which is that portion during which menstruation continues. But regularity with re- spect to the periods does not mean the same thing for every woman ; for with some, two weeks is the usual interval, with others, six, while still others experience a regular return of the " courses " at almost any time between those limits. In other words, every woman is a "law unto herself," and what is regularity for her must be determined by observing the usual interval at which this function is repeated by her body under ordi- nary circumstances. Health simply requires its regular performance, not its repetition at any stated time. And the same thing is true with regard to the duration of the flow. With some it is two days, with others, ten ; some lose a tablespoonful of blood, others, half a pint. As an average, however, it may be said that menstru- ation returns once in twenty-eight days, and lasts five days. The Derangements of Menstruation con- sist of irregularities in the quantity, quality, duration, or frequency of the flow, and of various symptoms asso- ciated with the function. More or less irregularity is to be expected at the establishment of the flow, and two very important things should be remembered by those who are in charge of a girl during this epoch : First, no amount of irregularity in the periods or of delay in the appearance of the flow will warrant medical inter- ference, unless there are other symptoms indicating de- ranged health ; and, second, the establishment of this flow is an important effort of the body, requiring all the nervous energy that can be spared from absolutely essen- 44 SEXUAL HEALTH OF THE FEMALE. tial vital processes, and for this reason, as little as pos- sible should be required of the girl's mind and muscles, till the new function is thoroughly well established, and proceeding regularly and painlessly. When a girl nears her " teens," or comes to about the age at which her mother began to menstruate, she should be watched with extra care, and any disturbance of health should be met by prompt measures. If nat- ure be engaged in establishing menstruation, more or less indefinite pain, languor, loss of appetite, and dis- inclination for society and regular employments are to be expected, and should be the signal for laying aside studies, work, and every taxing employment. Let the dictates and even the caprices of appetite have much weight in the selection of food, so long as no attempt to eat positively indigestible articles is made. If break- fast be not wanted, do not urge it — the patient has other work on hand in the body more important for the present than the digestion of food, and there is no danger of starvation before the appearance of the sense of hunger. But hold in check the ambition of the girl herself, or of her teachers, which would ignore the de- mands of the body for the sake of accomplishing a cer- tain amount of study or other work in a certain time. During the actual continuance of the first period the girl ought to lie down, and if there be any pain or dis- turbance of general health at subsequent periods, the same rule should be observed till the flow is well estab- lished. The relationship of this function to the whole mental, moral, and physical life of the woman is so very important that too much care can hardly be bestowed PUBERTY. 45 upon the girl during its establishment. All the little ailments and whims which at another time might better be repressed and ignored, should now be considered in their possible relation to derangements which, if al- lowed to become seated at this crisis, may result in per- manent ill-health and disability. It is far better to allow nature even a year or two of entire freedom from ordinary demands at this time, that she may perfect the body and its functions on the sound basis of health, than it is to crowd studies, piano-practice, and other tax- ing employments at the cost of a life of invalidism. Usually between the periods the girl will feel as well as usual, and it will be sufficient to keep her at rest on the back while the flow actually continues. But if her ill- feelings demand attention at other times they should not be neglected. If the first menses do not appear at the time they are expected, but other symptoms of general dis- turbance of health are present, the case demands inves- tigation. Possibly the membrane that closes in the vagina in many (not all) women is without* an opening for the escape of the blood. This is a condition that can only be discovered by local examination, and the person who should thus examine is, of course, the mother. A " maidenhead " without an opening is not difficult of recognition, and the cure for it is a surgical operation. Possibly the obstruction may be more seri- ous and deeper, or there may be, in very rare cases, no vagina at all. Such things demand a surgeon's atten- tion, and if present where menstruation is attempted by the womb, will occasion heaviness, fulness, and swell- 46 SEXUAL HEALTH OF THE FEMALE. ing in the lower part of the abdomen, backache, nausea, swelling and tenderness of the breasts, constipation, and other symptoms requiring careful professional treat- ment. When backache, " bearing-down " pains, headache, and lassitude indicate that nature is endeavoring to bring about the monthly flow, but nothing is seen of such flow, and no obstruction can be discovered, a warm foot-bath may be tried as a stimulant to the function. Let the water be at 110° F. — measured by the ther- mometer, and not guessed at — deep enough to come up well on the ankles, let it contain two teaspoonfuls of ground mustard, and let the patient sit quietly with her feet in the bath for full thirty minutes. The bath and lower part of the body should be covered by a sheet or blanket to keep in the heat and guard against draughts. Such a bath may be advised for a similar purpose at any time of life ; but cold bathing of any kind should always be entirely omitted during menstruation, no mat- ter how well and strong the patient may think herself. Baths, of whatever character, should never be taken within less than two and a half hours after a meal, and a good time for a warm foot-bath, such as just de- scribed, is immediately before retiring. !f a medicine be required for delayed or sup- pressed menstrual flow, either at its first establishment or later in life, Sil. or Ptds. will be most likely to be in- dicated. Sil. should be given in tablespoonful doses, morning and night, using a solution of twelve globules in half a glass of water, when the patient complains of a hot head, with pain and dizziness, backache, sweating DELAYED MENSES. 47 feet, has a tendency to boils, and itching or soreness about the sexual organs. Pals, should be given in similar doses, four times a day, to a patient who com- plains of chilliness, want of appetite, especial aversion to fat foods, pains that are constantly changing both locality and character, and who is better in the open air although, perhaps, not anxious to get out of doors. This medicine is often of service where the failure of the menses to appear can be traced to wetting the feet or to cold. Sometimes failure of the menses to appear in those who are fat and flabby, who sweat much about the head, have cold feet, are pale and lack vitality, may be corrected by giving Calc. carl), dissolved in water, a tablespoonf ul four times daily. The menses are intended to relieve the womb of a quantity of blood sent to that organ each time an egg is matured and cast off. This blood is put to other uses in case the egg is fecundated, as it is called, that is, put into condition to become a new human being ; otherwise it flows off, and at times it does not escape by the usual channel, but, instead, leaves the system through the nose, lungs, or some other outlet, giving rise to a dis- order known as vicarious menstruation* The patient feels as if the menses were about to appear, but they do not flow, or flow very scantily, while at the same time nose-bleed, or vomiting or spitting of blood does occur. Such losses of blood do not always indicate that the organ through which the blood flows is dis- eased, although it does indicate a tendency that way by reason of weakness of that organ, and it makes care for the health and rest during the menses imperative. Bry. 48 SEXUAL HEALTH OF THE FEMALE. is the best medicine in such a condition, and should be given dissolved in water, in doses of a teaspoonful every hour or two hours while the periods lasts, and in tablespoonful doses twice daily during the interval between the periods. If this medicine be not sufficient to effect a cure, the case may easily be of such gravity as to require professional treatment. Menstruation in health should be painless as well as regular. When it is otherwise we have the dis- order known as dysmenorrhea, meaning painful or difficult menstruation. This condition may depend upon several causes, and manifests itself by many symp- toms. Sometimes deformities, displacements, or ob- structions in the womb itself are the cause, sometimes nervous or other diseases, sometimes it is due to cold or to imprudence or exhaustion. The pain may be a colic, a backache, headache, a " bearing-down," or something else, local or general, may be accompanied by the dis- charge of a membrane from the womb, or by scanty, profuse, intermittent, or variable flow. Such a cata- logue of causes and effects makes it evident enough that a full plan of treatment for difficult menstruation can have no place in a work like the present ; still some suggestions can be made. The first thing to advise when there is pain with the menses is lying down so long as it continues. Lie on side, face, or back, as is most agreeable, but hori- zontal, and with the head rather low. The next thing to be thought of, especially if there be backache, is the hot foment — as hot as can be borne. In preparing foments it is absolutely essential FOMENTATION. 49 that a good thermometer be used, and one that will reg- ister as high as the boiling-point of water. First, place a rubber sheet or waterproof over the bed to protect it. Then have at hand a piece of flannel or old blanket, large enough to make a pretty solid roll eighteen inches long and three to four inches in diameter when rolled up. The patient must be entirely undressed. Water of exactly 115° F. should be brought to the bedside — not 115° F. by guess, but by the thermometer. The flannel is to be clipped into this water, wrung out, not too dry but so it will not drip, rolled up, and while the patient sits up in bed it is to be applied along the length of the backbone. This is to be done as quickly as pos- sible, and the patient is then to lie back upon the flan- nel the nurse holding it in position while she does so, and then covering her with a sheet and blanket. The patient should lie quietly for ten minutes, and then the pail should be again brought, but this time containing water of 120° F., again exactly measured by the ther- mometer. Into this the cloth should be dipped, wrung out, and applied for another period of ten minutes pre- cisely as before. After this interval the cloth should be wrung out for the third time ; but now from water of exactly 125° F. Then it should be reapplied for an- other period of ten minutes, making the whole treat- ment last for half an hour. When this last period is over, water of 100° F. should be brought, and with this the back should be sponged off quickly, dried, and the patient allowed to lie quietly or to get up if she be well enough. A foment should be given, as just described, twice 4 50 SEXUAL HEALTH OF THE FEMALE. a day, either before breakfast and supper or before the midday meal and bedtime, never sooner than two hours and a half after a meal. The cloths may feel pretty hot at first contact, but the skin soon becomes accustomed to them, and the patient finds the moist heat very sooth- ing — a statement that will not hold true of dry heat, as applied by hot water bottles, sand-bags, and the like. If the foments be well borne at the temperatures given, the next day each cloth may be made five degrees hotter, making the first 120° F., the second 125° F., and the third 130° F., and the next day they may be raised again to 125°, 130°, and 135° F., respectively, the" wash off " remaining at 100°. Hotter than this it is not often necessary to go for a young person, although still greater heat given in this way would not in the least scald or burn the skin, and the hotter the cloths can be borne the more serviceable they are in relieving pain. It is some- times a troublesome matter for the nurse to wring out these very hot cloths. It may be done, however, by using a clothes-wringer, or by wrapping the wet cloth in a dry towel, or even by simply dipping the hands in cold water just before grasping the hot cloth. For a medicine, the mother tincture of Vibum. ojp. is most generally useful, especially if there be cramps and colic-like pains through the bowels. It must be taken in doses of ten drops, mixed with about a table- spoonful of hot water, and this dose is to be repeated every two hours until the patient is relieved. If im- provement follow the administration of this drug in this manner, it would be advisable to continue its use for the whole interval before the next period, but in smaller DYSMENORRHEA. 51 doses. Take five drops of the tincture morning and evening, mixing the dose with a tablespoonful of hot water. Another useful medicine is Gels., if there be headache, dizziness, blurred vision, drooping eyelids, large quantities of urine, spasmodic pains, and also where a membrane is discharged from the womb. The dose will be five drops of the mother tincture in a tablespoon- ful of hot water, repeated once every two hours. This drug may also be continued till the next period if it prove helpful, but in the interval use only two drops to the tablespoonful of hot water, a dose morning and even- ing. Cocculus is often a useful remedy where the pains are like colic, worse by every touch and motion, and by cold, with a fitful flow of the menses. The patient is usually very nervous. Dissolve twelve globules of the medicine in half a glass of water, and give a tablespoon- ful every two hours. The same dose may be continued morning and evening till the next period. If difficult menstruation be associated with obstruction or pain in the bowels, a full injection of warm water containing a little castile soap is to be advised. Very profuse or long-lasting menstrua- tion, or a similar flow of blood from the womb between the menstrual periods, will demand treatment, as the loss of the vital fluid may be so great as even to threaten life itself. Abnormal growths in the womb, conges- tions of that organ induced, perhaps, by masturbation, or by imprudences of various sorts, bad conditions of the blood itself or of the blood-vessels, are among the causes of such bleeding, and several of these will demand pro- fessional treatment for their cure. 52 SEXUAL HEALTH OF THE FEMALE. Best on the back must be the main reliance in domes- tic treatment. If there be pain in the back give fo- ments as described above. If enough blood have been lost to really weaken the patient and induce paleness of the face and f aintness, China is the medicine. Dissolve twelve globules in half a glass of water, and give a table- spoonful every hour or two hours as needed. Of course, in this condition a physician will have been called. If the blood lost be bright red, and the patient complain of nausea, Ipec. should be given as directed for China. If the periods be regularly too profuse and long-lasting, especially if they begin a little too early, and the patient be pale, fat, flabby, rather dull, and subject to cold feet, use Calc. carb. between the periods for some months, dissolving twelve globules in half a glass of water, and giving a tablespoonful dose, morning and night. The serious and sudden gushes of blood from the womb known as flooding, to which women are liable during pregnancy, abortion, or miscarriage, after labor, and at the change of life, require the attendance of a physician as soon as that can be obtained, and in the meantime such prompt measures as those at hand can apply. Lay the patient down flat in the nearest convenient place — on the floor is as good a place as any — and slightly elevate the hips by a pillow, cushion, or shawl rolled up. Apply a napkin, towel, sponge or any- thing soft to stop the flow of blood, and if possible without disturbing the patient too much, get the cloth- ing off sufficiently to apply ice to the backbone. This can best be done by using small pieces of ice inclosed in a rubber ice-bag, but any other plan will answer. METKORRHAGIA. 53 Neither cold water nor snow will substitute the ice sat- isfactorily, and the application should be to the lower part of the spine. Mix twelve globules of Sdbina in half a glass of water, and give teaspoonf ul doses every ten or fifteen minutes, if necessary, till the bleeding ceases or the doctor arrives. Be very careful about disturbing the patient, even for the sake of undressing or getting her to bed. If she must be moved let it be in the hori- zontal position, unless several hours have passed without bleeding. Great care must be taken for days after such an accident, lest a strain, a jar, an exertion, or some ex- citement result in renewed flooding. At the " Change of Life," as at puberty, men- strual irregularities are to be expected, and the impor- tant change that Nature is establishing in the habits of the system should be facilitated by especial moderation in the demands made upon body and mind. Many serious diseases are apt to make their attack at about this time, and perhaps the more easily because of the pre- vailing disposition among women to charge to the " change of life," all the symptoms of ill-health or phy- sical discomfort that they may experience perhaps dur- ing a whole decade. Many symptoms may be due to that cause, but it is nevertheless a wiser plan to seek professional advice before assuming such to be the case. And good judgment must be exercised, too, in treating many of the derangements of this epoch, for they may be Nature's efforts to equalize a circulation deprived of the accustomed relief afforded by menstruation. Piles, especially bleeding piles, are frequently to be looked upon as a relief to the over-active blood-making organs, 54 SEXUAL HEALTH OF THE FEMALE. and as a complaint to be removed cautiously and gradu- ally. Quick cures of piles are always to be considered ill-advised and dangerous unless the causes upon which they depend can first be put quite out of the way. Among the more common disturbances of the circu- lation at the " change of life " are vertigo, and flushes of heat. Vertigo may arise from either too much or too lit- tle blood in the head, the latter condition being fre- quently occasioned by the losses of flooding. The best medicine for a vertigo so produced is China, twelve globules to half a glass of water, a tablespoonful of which should be taken every one, two, or four hours as needed. Plenty of easily digested nourishing food should be taken by a patient suffering from this kind of vertigo, milk in some form, or some of the prepared foods made from beef, and sold at the drug-shops, being best adapted to the needs of the system. When the vertigo depends upon too much blood in the head, and is accompanied by flushed face, hot head, dulness of sight, and weight, and fulness at the upper part of the neck, the best treatment is a hot foot-bath, and a full injection into the bowels. Let the water for the foot-bath be at 110° F., deep enough to come up well on the ankles, and let it contain two teaspoonfuls of ground mustard. The bath should last for thirty minutes, and the feet and tub should be covered. For the injection, use a quart of warm water, contain- ing a little soap. The best medicine will be the mother tincture of Gels., of which five drops should be taken at a dose, mixed with a tablespoonful of hot water, and THE CLIMAX. 55 repeated once in three hours, if necessary. Cloths wet in cold water, applied to the head, and changed as often as they become warm, will also be of service. Flushes of Heat are a very common form of an- noj^ance at this period, and are best met by either Lach., or Sang., the former where the trouble is worse after sleeping, affects the left side the more, and the patient's skin is very sensitive ; the latter where there is headache, nausea, chilliness, and cough. Of the selected medi- cine, dissolve twelve globules in half a glass of water, and take a tablespoonful four times daily. A few other disorders of the " change of life " are mentioned in the author's " Modern Domestic Medicine," but most of the troubles of this period should receive professional attention. Leucorrhcea or the "Whites" is an ex- tremely common disease among women, manifesting itself at all ages, in several varieties and many degrees, and resulting from a long list of causes. It consists of an abnormally profuse discharge of a fluid, colorless, white, yellowish or greenish, from the private parts, the fluid being variable in consistency, quantity and odor, and the disease resembling in most points a common " cold in the head." The character of the discharge in- dicates the particular glands from which it comes, and it is usually an excessive flow of the natural fluids de- signed to moisten and lubricate the parts affected. ISTer- vous weakness or exhaustion, a thin condition of the blood, an increased flow of blood to the sexual organs, cold, mechanical or other local irritation, or specific poisons may cause the trouble in some of its phases. 56 SEXUAL HEALTH OF THE FEMALE. The first may come from confinement at studies, especi- ally instrumental music, without sufficient rest, air, and exercise ; an increased flow of blood to the parts is nat- ural at the monthly periods, and during pregnancy, and a slight leueorrhcea at such times can hardly be thought a disease ; cold locally applied is frequently a cause of the trouble in little girls, who seem to have a remark- able fondness for sitting on such articles as stone door- steps ; or, it may result from wetting the feet, or in any of the ways that bring about colds of the head or chest ; mechanical and local irritations are induced by mastur- bation, sexual excesses, pessaries, and in little girls by worms, which crawl forward from the back passage, also by displacements or injuries to the womb itself ; and specific poisons are found in the diseases of the pri- vates of men, which a husband may convey to his wife. The discharge undoubtedly cleans the body, at times, of worn out material, which finds an obstacle to its escape through other channels. in treating the Whites, it will be first necessary to remove the cause of the trouble, and this will often require a physician's or surgeon's services. But a plan that will almost invariably be useful, whether as a cure or as a temporary relief, is that of washing out the vagina with injections of hot water. Such a treatment, however, or any other local measures, should never be practised during the flowing of the menses ; only in the intervals. To give a proper injection, a large fountain syringe will be necessary, and its reservoir should be hung as high as the tube will allow. About a gallon of water LEUCORRHOEA. 57 must be used, and this should be at exactly 110° F., measured by a good thermometer. A tablespoonf ul of common salt added to the water will be advantageous, and the injection should be taken at such a time as will admit of its being followed by at least an hour of rest, lying down. Take the injection about three hours after breakfast and again at bedtime, or if a morning douche cannot be followed by the hour of rest, take but one in- jection daily. Better no treatment than the treatment without the subsequent rest. The injection should be taken sitting upon a rub- ber sheet, arranged to collect the water as it runs away and conduct it into a receptacle. The water after being made exactly 110° F., should be put into the receiver of the syringe (which will have to be refilled two or three times during the treatment), the receiver is then to be hung up on a nail, bedpost, chandelier, or anything high enough to give it all the " head " or pressure of water that the length of the tube will allow. The tube or nozzle — which should have been well anointed with vaseline or sweet oil — is then to be passed into the va- gina as deeply as it will go easily, the water is to be al- lowed to flow, and the hand is to be placed over that organ so as close its lips somewhat, obstructing the out- flow of the water and obliging it to distend the folds of lining membrane and come in contact with every part of its surface. The water should flow rather slowly and about a gallon should be used at each treatment. At the end of a week of such treatment the temper- ature of the water should be reduced five degrees, to 105° F., and each subsequent week a further reduction of 58 SEXUAL HEALTH OF THE FEMALE. five degrees should be made till water of 85° F. is used. At this point the temperature should remain — harm may be done by going lower — and the injections may be continued indefinitely. In fact any woman who be- comes accustomed to these internal baths will be more than likely to keep them up at short intervals, merely for the sense of cleanliness and comfort they occasion, but, as just remarked, care must be taken not to use water too cold — 85° F. is cold enough, as a general rule. Among many medicines for the whites, the best for domestic use will be Cede. carb. or Puis., the former where the patient is pale, fat, flabby, indolent, has cold feet and a tendency to perspire about the head and neck; the latter for patients who have easily dis- ordered stomachs, and vague pains, changing character and location easily, who are apt to grow chilly on the slightest provocation and always feel better in the open air. Twelve globules of the selected medicine should be dissolved in half a glass of water, of which a table- spoonful should be taken four times a day. For the troublesome itching of the pri- vates, which is sometimes so annoying as almost to make life a burden, thorough bathing of the parts in warm water is to be advised as a preliminary measure whatever further treatment may be required. Among external applications, the best are Borax, in powder or in solution, Nitrate of Silver, in solution, ten grains to the ounce of water, and Balsam of Peru, which last must be applied with caution, as it is often very distress- ing and irritating to the delicate membranes at this PRURITUS. 59 point. Internally, a medicine is often of service, and the best selection usually is Sulph. y which should be taken twice daily, at each dose using a tablespoonf ul of a solu- tion of twelve globules of the medicine in half a glass of water. This trouble often offers a perplexing prob- lem to the physician, who should be consulted if the above measures are unsuccessful. Impediments to marriage on the part of the woman, consist in the absence of the sexual organs, an unyielding maidenhead, and certain diseases which ren- der the sexual act unendurable or hopelessly unfruitful. As a rule, they cannot be recognized by an unprofes- sional person ; the majority are curable, and when they are incurable they are a ground for annulling a marriage ceremony, if it can be proven that they existed at the time it was performed, and the dissolution of the mar- riage is sought by the injured party. A physician who is also a surgeon should always be consulted with regard to them. CHAPTER III. MARRIAGE. Why women marry, is a question that has long puzzled the philosophers, and becomes more and more difficult to answer as one by one the avenues of profes- sional and business life open to them. It is impossible to believe that any considerable portion of them do so because only through marriage can they attain to that most exalted office open to humanity — motherhood — and perhaps we cannot do better than content ourselves with the answer that it is because marriage is an insti- tution established by the Creator Himself, and rooted into the very basis and fibre of human nature, and be- cause in the case of each individual married woman, some man asked her. But both portions of that answer plead, in their very statement, for more sound and complete instruction for the young, and especially for girls, on ail subjects con- nected with this institution. Unfortunate, unhappy, unworthy marriages are matters of almost every-day oc- currence ; immature young girls are asked by boys and men, of whose real character they know, and can know almost nothing, to enter a state of which, in its real sig- nificance and relations, they are absolutely ignorant be- yond, perhaps, the facts that the majority of grown-up folk are, or have been married, and that only such, for EARLY PREPARATION FOR MARRIAGE. 61 some mysterious reason, are burdened with the nuisance of children. We shall not be rid of matrimonial blun- ders ; of marrying for money, for a home, for conveni- ence ; of ruined health ; of blighted happiness ; of worth- less, incompetent mothers, and frivolous, unprincipled children ; or of our disgraceful divorce record, until we begin to give our daughters sound ideas of the meaning and importance of marriage, and wise and practical guid- ance in forming their opinions of boys and men ; and to do this successfully, experience shows that we must be- gin early, long before school-days are over. The best school for the girl, as for the boy, is the mixed school, and until the highest grades are reached, as a rule, it is better to avoid both the board- ing, and the city public school. As the home itself is by far the best place in which to train and develop the character of the young, so the home and family model — male and female, man and woman, boy and girl, shar- ing together the tasks, the experiences, the joys, the troubles, that go to make up life — is the best one to adopt a3 far as it can be made to apply to those means of education which cannot be brought under the domes- tic roof. The monastic system is a failure, at least, it has no relation to our modern conception of social and family life. To prevent the evils of ill-assorted mar- riages, educate young people, and especially girls, on this very subject. And the only way to teach a girl what a boy or man is, or should be, is to put her in con- tact with him. Let her study the same books in the same classes, meet him at the same games, and discuss the same problems and every-day affairs with him, and 62 MARRIAGE. thus she will best learn how to judge him when he asks her to risk life's voyage with him, and at the same time how best to make true men out of her own boys in the future. And teach her plain iy and truly what marriage is and what it signifies. Root out that false idea that it is founded upon lov r e, while at the same time you teach that its relations are so intimate and binding that there is no possible safety for those entering its bonds unless they are absolutely certain that there is between them that devoted, pure, self-sacrificing love which the Master's command makes it the duty of each of His creatures and disciples to feel for all his fellows. And on the other hand save her from the conception of mar- riage that has given polygamous Mormonism its power, namely, that its sole object is the preservation of the species, while at the same time you teach that no one has a right to enter this holy estate unless willing to accept all the duties and responsibilities, including parenthood, which the all- wise Father has seen fit to associate with this institution. The object of marriage is the development of character ; it is founded not upon love but upon sexual instincts, which, though given by the Creator, honorable in all, and beautiful in their proper uses and relations, are yet unworthy the sacred name of Love. Teach your daughter that these instincts, of which she probably knows comparatively little in her own body before mar- riage, are the impelling motive in the man who seeks her hand and heart. Teach her that without these sexual desires no man would ever sacrifice his personal TRUE OBJECT OF MARRIAGE. 63 liberty, or see the many charms her lover now discovers in her person or in the thought of being ever near her, no matter how many and how different causes combine with this one to make her attractive to him ; and you have given her more profit than she could find in a hun- dred romantic novels. Let her know that her failure as a wife, whatever the cause, to meet and fall in with the instincts in her husband upon which marriage is founded, will almost certainly alienate from her his affec- tions sooner or later, no matter how faithful he may seem or how congenial otherwise she may be ; and you have given her a secret which will do more to secure for her happiness in the married state than all the fashion plates and cookery recipes in existence. Health and happiness are not prizes drawn in a lottery ; they are the result and evidence of right living. Sexual organs and instincts are heaven-implanted, and the woman who marries has not merely a privilege regarding them, it is her duty to her husband, her children and herself, to heartily enjoy with her husband sexual intercourse, and to keep herself in such condition that she may en- joy it. And this involves knowledge of the signifi- cance of marriage before its consummation. The day for this event should be selected so as to be as remote as possible from the monthly flow, for, as a general rule through life, a woman should be excused from sexual intercourse during her periods, and her first experiences of that act should interfere as little as possible with them. The only exception to the rule just given is that in case a woman seems barrren, and no other time of 64 MAEEIAGE. meeting her husband results in conception, a union dur- ing her period may be tried as an experiment that some- times succeeds if tried with sufficient caution and gen- tleness. And gentleness should always characterize the performance of this act. Usually at the beginning it is necessary that the membrane which closes in the vagina to a greater or less extent, be broken, and this is com- monly more or less painful to the woman, besides being attended with some loss of blood. Any violence on the part of the husband in effecting this initial connection is far worse than unnecessary — it is brutal, and quite likely to result in permanent injury to the wife, possi- bly making all future sexual intercourse painful instead of pleasurable to her. Once the membrane is fairly broken and the act completed the woman ought to be allowed an interval of several days before repeating in- tercourse, to allow the healing of the wounded parts in their new conditions ; then the act may be safely and pleasantly performed with due moderation in the future, and without so much likelihood of evil conse- quences. This membrane which closes the vagina is called the hymen, and its object is undoubtedly to serve as an evidence of virginity. But it should never be forgot- ten that it is far from being a positive or infallible evidence. It is even possible for it to persist after marriage, and cases have been known in which this membrane has been found impeding the progress of an infant on its way into the world. Such a state of things is, however, extremely rare, while the absence of the membrane in a young and innocent virgin is by no CONSUMMATION OF MARRIAGE. 65 means uncommon. A certain class of midwives and wet-nurses frequently make it a point to break up this membrane in new-born girls, and necessary surgical interferences and occasional accidents destroy the hy- men in others. Then, too, the hymen is a variously- shaped organ and is sometimes so small as scarcely to be noticed by an unprofessional person. Undoubtedly it is broken in some cases by attempts at masturba- tion, and occasionally girls are born without this mem- brane. All these things make it highly unjust to en- tertain the slightest suspicion of a woman's virtue solely because at her marriage the hymen is not present. After its rupture the membrane curls up at the sides of the vagina and shrivels away, but if during this pro- cess it is irritated and inflamed by repeated acts of sex- ual indulgence it is apt to become a permanent source of pain of a neuralgic character, lasting often until the birth of a child so alters the arrangement of parts as to cure the difficulty. With regard to the repetition of the sexual act, what was said on a preceding page must apply here. When anything more than a temporary feeling of lassi- tude succeeds it, indulgence is probably excessive. A woman ordinarily can endure more indulgence than can a man, but she ought to be entirely excused during her period, and even for a day or so after it, and also daring any illness, since a woman can hardly be ill without ex- periencing some untoward effects in the sexual region of her body. And again after a " confinement," a wo- man ought to excuse herself from the approaches of her husband for from three to six months, that the 5 66 MARRIAGE. greatly distended parts may have ample time and rest to resume the normal conditions. The sexual act is to be looked upon both as a pleasure and a duty. A legitimate and exquisite pleas- ure if properly performed ; whenever it becomes any- thing else, errors or disease are to be suspected. Con- sidered as a duty toward one's husband, it cannot be properly fulfilled except when it is a pleasure to both parties. Clothing of any kind is an obstacle to proper sexual intercourse, and the act is never what it should be unless it is an expression of perfect confidence and mutual affection, as well as an accompaniment of endear- ing caresses otherwise expressed. Evidence is sadly, shamefully abundant in the practice of every physician, that a wife cannot count on her husband's faithfulness unless she is both able and willing to satisfy the crav- ing which with him is vastly the most important incen- tive to marry. This is exactly one of the facts concern- ing which the ignorance of young women is so general and so lamentable. Having been so persistently and industriously taught that everything connected with the sexual act, or even the sexual organs, is a shame and a disgrace, they learn after marriage rather slowly and re- luctantly what the true estimation, importance, and relations of these organs and acts really are. Anything bordering upon animalism or sensuality, in either man or woman, is, of course, shameful and disgraceful, and too much care can hardly be expended in guarding against it. But that is a poor cure which degrades natural instincts till it can be thought that the Creator SEXUAL RELATIONS. 67 lias made a mistake or dishonored his creatures by so endowing them. Give them their proper place — the lowest among the gifts and endowments of the body, perhaps — never cultivate them, but rather cultivate body, mind, and spirit at their expense and with the object of keeping them within bounds ; but recognize them as a legitimate and necessary element in life, a source of real pleasure if exercised in accordance with the laws of their Maker, and, at least in the man, as im- periously demanding gratification, because upon their fulfilling their function the life of the race depends. Sexual health in the marriage relation requires moderation and consideration in undertaking its duties. The wretched fashion of taking a bridal journey imme- diately after the ceremony should be condemned from every point of view. The bride is usually exhausted with her preparations for the event and the excitement of anticipation, and is in no condition for either her new physical experience or her journey. To put both on her at once is a serious mistake, and one that results in much harm to health. The first approach should be accomplished at a time of as much physical and mental quiet as possible. Three or four days should elapse be- fore a repetition of the act, to allow the parts of the woman's body to recover from the changes and injuries which the first connection usually involves. Persons who have passed the prime of life should in- dulge sexual desires with less and less frequency as they find power and inclination to do so dying out ; and as it is important that these matters should be mutual in all respects, it is well worth while to consider, in con- 68 MARRIAGE. tracting a marriage, that sexual life ceases in woman at an earlier age than in man, and that, therefore, a man should select a life partner some years younger than himself. Just when sexual powers will begin to decrease in any individual is, of course, a matter that cannot be accurately foretold. It will depend on many considera- tions of general health and physical activity, and espe- cially upon the moderation of indulgence in early life. Therefore it is impossible to say just how many years should separate the ages of husband and wife. Life is not very accurately measured in years at any rate ; but probably from three to fifteen years would be the limits within which the differences in ages should range, the man, of course, being the elder. With regard to the proper age at marriage of each contracting party, it may be said that physical maturity should have been attained in order that a sound and well developed body may be handed down to offspring ; but, that secured, the younger the marriage takes place the better will the couple succeed in blending their two lives into one, by mutual concessions to the ruts and habits of each other. For the man the best years are from twenty-four to thirty-six, for a woman, from twenty to thirty. A more significant consideration than age, for those contemplating marriage, is temperament, and it is, perhaps, at once the most neglected and, in a medi- cal sense, the most important item bearing upon this in- stitution. The objections to the marriage of cousins are not due to the mere fact of blood-relationship be- tween the parties, but to the almost certain conse- CONSANGUINITY. 69 quences of that consanguinity, namely, similar temper- ament and a tendency toward similar diseases, which are almost certain to show themselves with fatal effect in the offspring of such marriages. But persons who appreciate the sin of marrying cousins, and who would on no account risk parenthood if they knew themselves to be afflicted with diseases which would probably occa- sion the early death of their children, will yet ally themselves with those of identical temperament, in ig- norance of the fact that in so doing they are forming a union more objectionable than the marriage of cousins, objectionable for precisely the reasons that should keep blood relatives apart, and more likely to result in short- lived offspring than is the existence of transmissible disease in a parent. Identical temperaments are childless. Per- sons whose temperaments are nearly alike, if married, are likely to beget children who, if born alive, will die young, or manifest physical or mental weakness through life. Consumption, meningitis, rickets, scrofula, and the like, are carrying off every year thousands and thousands of young persons, and making thousands more weakly and burdensome to themselves, their friends, and the world ; and for the cause of this state of things we must look to the ill-considered and unwise, if not criminal marriages. Yet the world goes on refusing to allow young persons to learn the true significance of marriage, and acquiescing in the foolish idea that because a young man and maiden love each other, or fancy that they do, there is reason enough for their union. As a rule, cousins and second cousins should not 70 MAEEIAGE. marry. Persons of similar temperament should never marry, and the more pronounced the lymphatic tem- perament is in any young person, the more careful he or she should be to choose as a life partner one in whom no trace of its predominance can be found. A person in whom the mental or nervous temperament is marked should be careful to choose predominantly vital charac- teristics in a conjugal companion, and, of course, every effort should be made in cases where any diseased ten- dency is suspected, to be sure that nothing at all similar exists in the person or the family of the one he or she intends to wed. The bedchamber should be a large, airy, and sunny room, well ventilated and containing about twelve hundred cubic feet of space for each individual. The custom in America is for a married couple to occupy the same bed, but on many accounts the European custom of separate beds is better, especially for young persons, who can but find difficulty in keeping the gratification of desire within due bounds of moderation if opportun- ity for indulgence be so convenient, and in those cases where either husband or wife is seriously ill or liable to be disturbed during the night. Separate rooms are not necessary, but a single bed for each individual has much to recommend it. With regard to the avoidance and limitation of offspring there is but one sure, safe, and proper plan for the healthy, and that is to remain single, or, being married, to live as if single. Any interference with the course of Nature is a fraud that she will be sure to pun- ish, and any attempt to rid the healthy body of the * OFFSPRING. 71 fruits of conception otherwise than by natural labor, is certainly a cowardly crime, if it be not actual murder. No such attempts can be made without risking the life or health of the woman, and nothing can ever excuse them except the moral certainty that without them her life will be sacrificed. Much has been written about the predetermina- tion of the sex of the offspring, but no theory is as yet generally accepted. The difficulty of getting at a suf- ficient number of undoubted facts regarding conception in the human family effectually prevents the formulation of any law by which parents may infallibly decide in advance whether they w T ill produce boys or girls. The probabilities, however, are, that intercourse soon after menstruation or just before it, if fruitful, will result in female offspring ; while the conceptions occasioned in the latter part of the interval between the menses will result in male children. The relative age, health, de- velopment, and, perhaps, desires of the parents may in- fluence the matter, however, and some women seem incapable of conception at all during a variable time in each interval between their periods, and just before the return of the flow. In conclusion, the author would quote St. Paul, (seventh chapter of his first letter to the Corinthians), as good authority for his advice to those men and women who have a purpose and an object in living, who can rule their own bodies and spirits, and who wish to at- tain to the highest development and usefulness of which human nature is capable, not to marry. The life of chaste celibacy, chaste in thought, word, and deed, de- 72 MARRIAGE. voted to some high purpose and unselfishly spent for the advantage of mankind — this is undoubtedly the highest ideal and gives best promise of health, happi- ness, and usefulness. For woman, it is true, the high- est office is motherhood, but not all are capable of filling that office worthily, and not all desire it. Any man or woman is living best when he is filling the highest office for which he or she is adapted, and many a woman as well as man will find that sphere outside of marriage. But for the majority, now as ever, the married state is the natural and proper one, honorable in all, and best adapted for the development of individual character and . the welfare of society. Health, happiness, and useful- ness await those who enter this state from pure motives, accept its responsibilities, live up to its duties, and share its joys in moderation, and with due regard to that pro- portionate exercise of all the bodily, mental, and spirit- ual powers and faculties which alone can result in per- fect health. CHAPTER 1Y. THE MEDICINES AND THEIR INDICATIONS. Pretty full instructions as to dose and the frequency of its repetition have been given wherever in the preced- ing pages a medicine has been prescribed. The ordinary preparations, as sold in the drug-stores, and medicines known as homoeopathic have been prescribed, and with regard to the latter, especially, it is important that the exact strength or potency indicated below be used in every case. Where the medicine is ordered in glob- ules those should be of ISTo. 20 size. These are best taken in water, and the proportion usually advised is twelve to the glass half full of pure soft water. Of this solution, a teaspoonful every hour or a tablespoon- f ul once every four or five hours is the usual dose. For a young child, six instead of twelve globules should be dissolved in the water. In case the medicine is a powder, a solution should be made in the same way, using for a glass half full of water as much of the powder as will lie piled upon a dime — half this quantity for a child. Liquid medicines should be mixed with water in the same way, using six drops to the half glass, or three drops for a child. Spe- cial directions, regarding dose, are given when required. In order to drop liquids accurately, it is only necessary to place the middle of the lower surface of the cork 74 THE MEDICINES AND THEIR INDICATIONS. against the lip of the vial, so that the liquid may rest against the cork when the vial is tipped — it will run down the cork and drop from its lower edge. If for any reasons the globules or powders must be taken dry, give of the powders, at one dose, as much as will lie upon an old-fashioned three-cent silver piece, and of the globules give two if the dose prescribed be a teaspobnf ul, and four if it be a tablespoonf ul. It is better always when practicable to take the dose in water, or to swallow a mouthful or more of water after a dose taken dry. The medicines should be kept by themselves in a chest or cabinet, in a cool, dry, and clean place ; every vial should have its own cork, which should be marked, and always remain in its proper vial. The water with which the doses are mixed should be as pure and soft as possible, and the mixtures should be made fresh daily, throwing away whatever is left over from the preceding day. Keep the glass containing medicine well covered, and use a perfectly clean silver spoon in giving the doses. Never allow the spoon to remain in the medi- cine, and remember that a tablespoonf ul is equal to four teaspoonfuls. Balsam of Peru is a thick, reddish-brown fluid, sticky, and of pleasant odor, which may be had of any druggist. Its external use only is advised in domestic practice, and that as a remedy for itching of the privates of women, or of the back passage. It should be applied with caution, as it may cause an unpleasant irritation of the parts. Borax is a crystalline powder, sold by all druggists, BALSAM — CHINA. 75 and useful as a local application in solution, or even in the dry powder, for itching of the privates. Bryonia alba should be used in globules of the first decimal potency. It is useful for complaints occur- ing during menstruation, especially for nose-bleed in- stead of, or with scanty, dark, bad-smelling menses. Headache in the back of the head, worse by every mo- tion, but better by lying quietly, and coming on with the menses, is also cured by it. Patients requiring this medicine are apt to have much thirst, to perspire easily, and especially to be better by keeping still, and worse from every motion. Calcarea carbon ica in globules of the sixth po- tency will be indicated more by the general condition of the patient than by any special symptoms of disease. Those who lack firmness of flesh or solidity of bone, who are flabby, fair-complexioned, inclined to be fat, and who perspire about the head and have cold, damp- feeling feet, want this medicine when the menses are suppressed, and also w^hen they flow with great profu- sion, come on too early, and last too long. The latter condition is more likely to affect persons of this type. The medicine also helps such persons when they have a leucorrhoea, especially if the discharge be milky and cause itching and burning. China must be purchased in globules, made from the mother tincture. It is chiefly required to enable the system to recover from great loss of fluids, as from flood- ing or excessive menstruation. Dizziness, ringing in the ears, sparks before the eyes, f aintness, and other symp- toms induced by such losses w r ill be relieved by its use. 76 THE MEDICINES AND THEIR INDICATIONS. CoccuEus in globules of the third potency is of use in some forms of difficult menstruation where there is colic with great nervousness, quick jerking motions, darting pains, shuddering and the like. The menses are apt to come too early, and the patient feels week. Gelsemium should be bought in mother tincture, and that sold by homoeopathic pharmacies is to be pre- ferred. It is indicated when the head seems full of blood, heavy, dizzy, with blurred vision, drooping eye- lids, and, perhaps, double vision. If, with these condi- tions, we have difficult menstruation, especially if a membrane be discharged, and the urine be very abun- dant, this medicine will do good. But the dose must be five drops taken in hot water once in three hours. Ipecacuanha in globules of the third potency will be of great service in profuse flowing of the menses, or of blood from the womb, especially where the blood is bright red in color, and there is pain about the navel, and constant sickness at the stomach which is not re- lieved by vomiting. All complaints for which this medi- cine is useful are accompanied by this constant nausea. Lachesis in globules of the ninth potency is a very useful remedy for women at the " change of life," and is given especially for the flushes of heat of that period. The patient presents certain marked characteristics when Lack, is wanted, among which are aggravation after sleep, and the location of pains by preference on the left side of the body, or their commencing on the left side if they afterward pass over to the right. Nitrate of Silver is mentioned as one means of arresting a troublesome itching of the privates. For COCCULUS — SABINA. 77 this purpose, it should be purchased of any druggist in solution, ten grains to the ounce of water. This medi- cine is for external, local use only, and care must be taken to keep the bottle in the dark. Phosphoric Acid in globules of the third decimal potency will be found a useful remedy for a weak con- dition of the male organs resulting in frequent and de- bilitating seminal emissions or " wet-dreams." The pa- tient will seem very much weakened by these emissions, and is likely to be very indifferent to all that goes on about him when this medicine is wanted. Pulsatilla in globules of the third potency isavery important remedy for sexual disorders in women. In suppressed, delayed or scanty periods, in painful men- struation or diarrhoea with menses, and in "whites" in general, especially with a thick, milky, burning dis- charge, it is one of the first medicines to consult. It is especially valuable when the trouble is caused by getting the feet wet and the complaints are worse in a close, warm room. The patient wants to get out, and is bet- ter in the open air, complains of chilliness and has symptoms which change their character or location in the body frequently. The patient is apt to be sleepless, especially in the early part of the night, although dull and drowsy both morning and evening. Sabina in globules made from the mother tincture is one of the best medicines to use for flooding, especial- ly in case of miscarriage, or of threatened miscarriage. There is pain through the lower part of the abdomen from the front to the back bone, and the blood is partly fluid and partly in clots as it escapes from the vagina. 78 THE MEDICINES AND THEIK INDICATIONS. Sandal -wood Oil is perhaps the best single medi- cine known for the clap, especially in men. The crude oil as sold at the drug-stores should be used, but care must be taken to buy a pure article. The taste and smell on the breath are both avoided by having capsules filled with the proper dose, which is ten drops, or the oil may be dropped on a lump of sugar. Repeat the dose four times daily. Sanguinariain globules of the third potency will be needed at the " change of life," for flushes of heat with rush of blood to the head, dizziness, nausea, ringing in the ears, and rheumatic pains, especially in the shoulders. Silicea in globules of the twelfth potency is one of those important, deep-acting constitutional remedies like Gale, carb., but its menstrual symptoms are usually those of suppression and delay. The patient complains of backache, pains in the bones, neuralgia, perspiring and bad-smelling feet, and has a tendency to boils and felons. There is also a sense of weakness and desire to lie down much of the time. Sulphur in globules of the twelfth potency is an- other deep-acting, constitutional remedy, and one of its most important indications is an itching sensation any- where on the skin, hence its value in itching of the privates. It may be used also for profuse but short- lasting menses, with constipation, itching of the parts, flushes of heat, and burning sensation in the soles of the feet. Viburnum opulus should be purchased in mother tincture, and that prepared by an homoeopathic phar- SANDAL OIL — REPERTOKY. 79 macist is to be preferred. Taken in doses of ten drops repeated once in two or three hours, in hot water, it is one of the best means of relieving the cramps and colics associated often with difficult menstruation. Where this trouble returns every month the medicine should be taken in doses of two drops morning and evening through- out the interval between the periods. The following indications are offered as a sort of index to the medicines just mentioned. The symp- toms given are those most characteristic of the drugs to which they refer, with regard to their action in the sex- ual sphere. If a patient present one of the following symptoms, study what is said about the drug mentioned in the preceding pages, and if it then seem appropriate to the case give it in accordance with the directions at the beginning of this chapter. "When two or more medi- cines are named in connection with a symptom, the one usually the best to use, in default of other indications, is printed in italics. Abortion, bleeding of. Sabin. Abundant nrine, with painfnl menstruation. Gels. Aggravation after sleeping. Lach. Aggravation from motion. Bry. Aggravation in warm room. Puis. Backache with delayed menses. Sil. Bad odor from sweating feet. Sil. Better by keeping quiet. Bry. Better in open air. Puis. Bleeding from womb. Sabina. Bleeding from womb, bright blood, with nausea; Ipec. Bleeding instead of menses. Bry. Boils and felons, tendency to. Sil. Bones, pains in, with delayed men- ses. Sil. Burning leucorrhoea. Puis. Burning soles of feet. Sulph. 11 Change of life," see max." ^ fP V ' "k /^St% FLA ^ w V*» 4 *4 ^g#32084 %; «l O^ LIBRARY OF CONGRESS 00055^73^36