and the fault lies with the man alone. It may be due either to some
inborn anatomical defect, or, what is infinitely more common, to some
venereal disease. In these cases, the male embryos-spermatozoa are
either absent or unable to travel in normal channels and to penetrate in
the female organs. This inability may be due to a different cause; _the
most common cause_ of all is Gonorrhea, or, more exactly, a _gonorrheal
epididymitis_. As mentioned above, Epididymitis, if uncured, often
leaves behind hard nodules which obliterate and obstruct the spermatic
channel, partially or completely, thus blocking and preventing
spermatozoa from passing from the testicles, where they are produced
thru the urethral canal out of the body. A man who has had Epididymitis,
with the complete obstruction of the spermatic channel only on one side,
may yet have children, but if the obstruction is on both sides, he
becomes absolutely sterile.
Another cause of male sterility, tho not as common, are strictures,
which, by obstructing and twisting the urethral canal, may divert or
weaken ejaculation of spermatozoa in such a way as to make conception
impossible. It may happen also that tho all channels for the passage of
spermatozoa are free, the spermatozoa themselves, due to a sexual or
general exhaustion, are either missing or are of such low vitality as to
give no hopes for living or healthy children.
Every man with a history of a venereal disease should have his seminal
secretion examined under microscope before his marriage, to test its
vitality. The knowledge of these facts and the application of these
principles in practical life by the average man could save thousands of
happy homes and prevent as many divorces.
SEXUAL NEURASTHENIA.
The last complication to be developed in the course of Gonorrhea, but
not by any means the last in importance, is sexual neurasthenia; i. e.,
a chronic state of nervous and mental weakness and irritability.
Possibly no other condition illustrates so well how far and
deep-reaching is the influence of Gonorrhea on the whole system, tho it
is a local disease; how thoroughly it affects the entire mental and
nervous system of a man; how much moral anguish and suffering it
inflicts on its victims. The reason for such a powerful effect of
Gonorrhea on the human mind and emotions has been explained before by
the fact that the genito-urinary tract and different sexual glands which
are usually affected by Gonorrhea are richly supplied with nerves and
are most intimately and abundantly connected thru these nerves with the
highest centers of the nervous system, controlling the mental and
emotional activities.
It has been mentioned already that the nervous weakness can be brought
about by various sexual abuses and irregularities, such as the
masturbation habit, sexual excesses, or over-stimulated and ungratified
desire, but the cases following in the wake of chronic Gonorrhea and its
complications are so numerous, so persistent, and distressing as to
deserve special prominence and consideration.
Sexual Neurasthenia develops as a rule slowly, and it comes either
during the treatment or long after Gonorrhea has been cured. The
predisposition to this condition is created by excessive worrying and
brooding over the disease, and the basis of sexual Neurasthenia
constitutes an idea slowly formed and fixed in the mind of the patient
that he is “full of disease,” and that his condition is incurable. As a
result of this self-suggestion and constant concentration of his mind on
different parts of the body, he feels, or rather he thinks he feels, an
endless variety of different painful and morbid sensations. There is not
a single spot on his body, there is not a single kind of pain or
discomfort that should not be complained of by this class of patients.
It does not matter whether his case is improving or even cured and does
not show a single positive symptom of the disease, the patient cannot be
won over to the cheerful view of his condition. No amount of argument or
persuasion on the part of the physician avails to shake off his gloom
and despair. If the physician, after a careful examination, states to a
sexual neurasthenic that he does not need any more treatment, the
patient accuses the physician of being indifferent, and not taking
sufficient interest in his case and goes elsewhere. If the physician
yields to the pleadings of the patient and keeps up an active treatment,
that makes matters only worse, and still more confirms the patient of
the deep and dangerous character of his condition. The only way to break
the eternal chain of fear and anxiety, which is the main basis of sexual
neurasthenia, is to turn the mind of the patient away from his sickness
by stopping treatment, sending him away, if possible, from old
associations and surroundings, and by building up his general and
nervous system. The treatment of this condition lasts several months,
but they all recover in due course of time.
This class of patients, in their frantic search for a cure from the
imaginary sickness, are naturally more exposed to the danger of drifting
away into the hands of medical quacks, and are more exploited than any
other class of venereal patients. A sympathetic attitude on the part of
the physician and evidence of his sincere and earnest interest in the
condition of the patient is the only thing that slowly gains the
confidence of sexual neurasthenics, brings them back courage, ease of
mind, and restores them to a healthy and happy life.
Chancroid
Now before going over the greatest of all venereal scourges, Syphilis,
we shall briefly consider the third and the least dangerous of the
venereal diseases—Chancroid.
Chancroid is also called a _soft chancre_, to differentiate it from
_hard chancre_, which is the initial sore of Syphilis.
_Chancroid usually appears from two to five days after exposure_, seldom
longer. It may develop on the skin of any part of the sexual organs. It
starts as a small red spot or pimple, which rapidly breaks down and
forms a round ulcer, painful on touch, with undermined borders and
profusely secreting pus surface. Chancroid may start at once as a
multiple ulcer or it may grow in numbers after it has started as a
single sore. The number of Chancroids may reach five, ten, or even more.
The peculiar characteristic of Chancroid is that its poison can be
transferred from one place to another by contact, and it is a common
clinical fact, particularly in uncleanly and careless people, that a
single Chancroid or ulcer may duplicate itself on the skin surface that
comes in contact with the Chancroid.
_Chancroid is usually painful_ and disables a man to a smaller or
greater extent, so for this reason it is seldom neglected. Under proper
care, Chancroid _heals up in from three to six weeks_. Only in
exceptional cases, due to low vitality and general debility of the
patient, or due to unusual virulence (intensity) of the Chancroidal
poison, the Chancroidal ulcer assumes a gangrenous character, and in
spite of the best treatment, shows a tendency to spread and to destroy a
large area of tissue. But even in these rare cases, after a few weeks or
months, the ulcerated area gradually heals up without leaving any
permanent systemic damage.
The only complication Chancroid has is a development of bubo, an abscess
of inguinal (groin) glands. _Buboes_ develop in about half the
Chancroidal cases, and are treated by incision on general surgical
principles. The average duration of a bubo is from three to four weeks,
and the total duration of the average Chancroid and bubo from six to
eight weeks.
While Chancroid brings more pain and distress and disables a patient
more than many Gonorrheal complications and average Syphilitic cases, in
reality, Chancroid is the least harmful of all venereal diseases, as it
has a self-limited duration, never penetrates into the blood, does not
lead to any deep or constitutional complication, and does not affect
whatsoever the second generation.
Syphilis
Syphilis is one of the oldest diseases in human history. Its ravages and
destruction of health and life thruout many centuries up to our days
have been such that it has been called a “black plague,” in distinction
from the great “white plague,” tuberculosis. It is hard to say which one
of the scourges of humanity is superior in its destruction and wrecking
of humanity. While tuberculosis apparently carries away more lives in
their prime and selects victims principally among the young at the very
height of individual happiness and social usefulness, Syphilis surpasses
its terrible rival in its universal character of distribution, in the
easier mode of infection, and more lasting presence of the poison in the
human body. No country or climate is free from the scourge of Syphilis.
No age, no station of life gives protection from its infection. Syphilis
claims its millions of victims in all parts of the universe. It has
populated cemeteries with untold numbers of bodies of still-born babies
and infants who died in the early months of life; it has filled the
insane asylums of the world with thousands of hopelessly insane men and
women; it has crowded the institutions for the incurable and defective
with paralytic adults and children crippled mentally and physically from
birth.
The individual suffers as much from the ravages of Syphilis as society.
Lucky is the man who can say that he is perfectly cured from Syphilis
after two or three years of the most thorough treatment. Lucky is the
man if he can be sure that later in life, after he may have forgotten
all about his primary infection, the dormant germs of Syphilis lurking
in the deep recesses of his body will not attack his most vital organs,
as arteries, heart, or brain, and will not strike him down to permanent
invalidism or slow but hopeless agony of an incurable disease.
Great as the latest medical discoveries in the recognition and treatment
are, the course of the disease is so insidious and treacherous, and the
treatment requires such persistence and patience and such expenditure of
time and money, that probably no more than half of the syphilitic
patients carry out to the end the treatment and period of medical
observation, and thousands and thousands of them are sure to be stricken
down later in life with the above mentioned terrible after-complications
of Syphilis, and are doomed to premature invalidism, paralytic diseases,
and insanity.
DIAGNOSIS (RECOGNITION) OF SYPHILIS.
In every disease an early and correct diagnosis is an essential
condition for a successful treatment. This is particularly true in
Syphilis. The early recognition of Syphilis can prevent a development of
most dangerous complications, can forestall the destruction of most
vital nervous centers and organs.
The recognition of Syphilis is beset with peculiar difficulties, due to
the fact that Syphilis has a remarkable tendency to imitate in
appearance all possible diseases. This simulation is rendered
particularly effective because Syphilis has universal and all-pervading
distribution in the human body, and not a single part, organ, or tissue
is free from the invasion of syphilitic poison. Until lately the
diagnosis of Syphilis was based on the rather uncertain basis of
clinical experience, but the latest medical discoveries have put it upon
a more definite foundation, and rendered it immeasurably more certain.
The first step in this direction was the discovery by a French
scientist, Shaudin, of a germ producing Syphilis, a germ that he has
called _Spirocheta pallida_. Spirocheta under the microscope looks very
much like a corkscrew, and can be easily demonstrated in all fresh
Syphilis sores. A finding of Spirocheta at once and absolutely
establishes a diagnosis of Syphilis. Another valuable method by which a
doubtful or latent case of Syphilis can be recognized is a _blood test_,
known by the name of its discoverer as _Wasserman Test_. This is a very
complicated test, requiring a highly-developed technic, and it can be
properly done only in specially equipped laboratories.
The Wasserman test is not as absolutely sure and positive as finding of
Spirocheta, yet it is very useful, and indeed indispensable in many
cases of latent Syphilis, i. e., Syphilis that does not show any active
symptoms like sores, breaking out, etc.
There is one more way to test the blood for Syphilis—_luetin test_,
discovered by a Japanese scientist, Noguchi. Luetin test is made by
injection in the skin of a certain substance, and also is very useful in
old and latent cases of Syphilis. Recognition of Syphilis by the
appearance and character of the sores and skin eruptions is in many
cases very difficult, and can be done in doubtful cases only by a
physician specially trained in this class of diseases.
CLINICAL COURSE OF SYPHILIS.
The clinical course of Syphilis is usually divided, for the sake of
convenience of presentation, into three periods.
PRIMARY PERIOD OF SYPHILIS.
The first manifestation of Syphilis in the human body is a primary
syphilitic sore, so-called _hard chancre_. This chancre _appears usually
two or three weeks after exposure_, and this is a very important point
to remember. Most men think that every venereal disease shows up a day
or two after intercourse, and if a week passes without any signs of
infection, they congratulate themselves upon having escaped the penalty
of the transgression. Therefore when, two or three weeks after the
exposure, they notice a small pimple or nodule on the genital organs,
they ascribe it to some accidental cause, and never think of the
possibility of it being of a venereal nature. This error of judgment is
rendered particularly easy by the fact that the initial syphilitic sore
has such a harmless, insignificant appearance, and is commonly so free
from any pain, discomfort, or acute distress, that the patient, as a
rule, ignores it, believing it will pass away by itself, or applies some
ordinary salve. Only after they see that this “pimple” does not
disappear, and gets harder and bigger in size, only then they become
alarmed and consult a physician. This is the reason that so many
patients present themselves to the physician when the syphilitic poison
has already spread all over the body and has broken out in a general
eruption.
A deceiving appearance and mild clinical course of primary syphilitic
chancre that gives to a patient a false feeling of security cannot be
too strongly emphasized and warned against. The following injunction
seems to be well indicated to all men taking chances with venereal
infection: _Beware of the little, painless, insignificant pimple on the
genital organs, that comes up two or three weeks after exposure and
shows a tendency to become firm and hard on touch._
Primary syphilitic chancre may look like a plain pimple or swelling
without any sore on it, or it may present a greasy-looking ulcer with a
very slight discharge, but all syphilitic chancres have _one
characteristic feature_ always present; this is a hard, almost wooden
feel and _firm consistence on touch_.
SYPHILITIC BUBOES.
Shortly after the appearance of primary chancre the patient notices a
swelling of the glands in the groin on one or both sides, which feel
like hard nuts, _syphilitic buboes_. These buboes never turn into an
abscess, and remain hard for many, many months, until, under treatment,
they slowly go down.
MIXED CHANCRE.
The fact that a man two or three days after an exposure begins to show a
sore of Chancroidal type does not mean that he is already safe from
developing a syphilitic chancre besides. In fact, it is a quite common
occurrence that after development of typical Chancroid, in a week or two
this sore begins to change in appearance and turns gradually into a
syphilitic chancre. In other words, this man has contracted a double
infection of both chancres, only their appearance takes place at
different times, according to the difference in the length of time of
their periods of incubation. The treatment of these mixed cases is
naturally of more complicated character.
SECONDARY PERIOD OF SYPHILIS.
The secondary period of Syphilis begins with the first evidence that the
syphilitic poison has spread all over the body, and that Syphilis from a
local sore has become constitutional-blood disease. It takes usually
about _six weeks_ from the time of appearance of the primary chancre
until the development of the constitutional symptoms. The very first
symptom of the constitutional syphilis is a general rash, which has such
a peculiar appearance that no competent physician has any difficulty in
recognizing its nature. Together with the skin eruption, so-called
“_mucous plaques_” can be seen in the throat, on the tongue, lips, etc.
Very often syphilitics of the secondary period suffer from attacks of
fever and get rapidly run down and wasted. In fact, an experienced
physician can recognize a syphilitic by a peculiar paleness and general
appearance suggesting slow waste of the body by some chronic poison.
The most common complaints in the secondary period of Syphilis are:
Severe headaches and boring pains in the bones, particularly at night;
different skin eruptions and patches of mucous plaques around the mouth
or genital organs. These mucous plaques contain millions of active
spirochetae, and for this reason the _secondary period of Syphilis is
the most dangerous period for transmission of the infection_. The
secondary period may last from a few months to one to two years,
depending on the gravity of the case and the character of treatment.
TERTIARY PERIOD OF SYPHILIS.
The tertiary period of Syphilis is the longest in duration and the most
dangerous stage of the disease. It gradually succeeds the secondary
active period of Syphilis and lasts, if not treated thoroughly, for many
years, and sometimes thru the entire life.
The main characteristic of this period is that its lesions (sores) are
fewer, but they are very deep and penetrate to the most vital and
important organs, such as blood vessels, heart, spinal cord, and brain.
This is the time when syphilitic germs, after a long period of apparent
cure of the disease, suddenly renew their destructive activity and
strike down their victim with some permanently crippling and incurable
chronic disease. It has been mentioned before that Syphilis does not
spare a single part or organ or tissue of the body. Anywhere, in the
deepest recesses of the most vital and life-bearing centers of the body,
a tumor of tertiary Syphilis can form, so-called _Gumma_, that has a
natural tendency to break down, forming an ulcer and leading to a
terrible destruction of tissues.
We shall not tire the reader by a detailed description of the possible
results of this destruction of the body; it is sufficient to say that
death is a welcome relief to the crippled, palsied, and insane victims
of advanced Tertiary Syphilis. We shall mention only two diseases that
are definitely proven to be after-results of Syphilis—diseases that are
both incurable and that count as their victims countless thousands of
men all over the world.
The first, a _progressive paralysis_, a chronic, progressively
increasing insanity, that draws out for many years and invariably ends
fatally, after a long agony of physical and mental decay and waste.
The second disease is _Locomotor Ataxia_, a chronic, slowly-spreading
decay of the spinal cord, in which are located the most important nerves
controlling the sensation and locomotion of the body. As the result of
the slow death of these nerves, a man is gradually transformed into a
helpless and hopeless paralytic, doomed to stay bedridden for life.
Any and all complications of Tertiary Syphilis can arise and strike down
a man in a most insidious and unexpected manner. The most dangerous and
deceiving feature of syphilitic lesions is that they develop painlessly
and without acute distress or discomfort to the patient, who becomes
aware of the disease only after a considerable amount of tissue is
destroyed and irreparable damage has been done. No man who has a
syphilitic chancre is safe from a possibility of development of
complications of Tertiary Syphilis unless his blood, after repeated
tests, has been pronounced pure and free from syphilitic poisons.
HEREDITARY SYPHILIS.
Nowhere else are the ravages of Syphilis more destructive and cruel; no
other disease punishes the offspring for the sins of its parents so
ruthlessly and wantonly; no other scourge inflicts its terrible
retribution on the second generation at such a tender age as hereditary
Syphilis. Hereditary Syphilis is undoubtedly the saddest and most
gruesome chapter in the long black record of Syphilis.
The offspring _may inherit Syphilis from his father_ thru sperma
(semen), _from his mother_ thru ovum and blood circulation, or it may
get infection _from both parents_ at once. Most of the cases are due to
infection from the father. Fortunately, experience has shown that the
older the case of Syphilis is, and the better it has been treated, the
more chance the offspring has to escape a syphilitic heredity, and the
milder will the infection be if it be inherited.
If a man in the active stage of Syphilis marries a healthy woman,
whether she herself be infected or not, she will not bear living
children for a certain period of time. The first two or three years she
will miscarry in the early months of pregnancy, a truly merciful
provision on the part of nature, as death is certainly preferable to the
drawn-out agony of the little creature, mutilated and crippled from
birth. A little later the wife of a syphilitic is able to carry children
to a full term, but they are born with the indelible stamp of loathsome
heredity on their dwarfed bodies. The appearance of such children is as
pitiful as it is repulsive. Wizened, old-looking faces, stunted bodies,
numerous sores and skin eruptions, bone deformities, soft joints, due to
decaying of bone ends and skulls distended with water; these and many
other defects are the legacy these innocent victims come into the world
with. Naturally, the vitality of such children is so low that many of
them die in early infancy. Yet some of them can be saved by an early and
thorough treatment. The farther it goes the more healthy-looking
children are born, the fewer evidences of syphilitic heredity they
present, and the later in life these evidences develop. Gradually, as
the father or both parents receive proper treatment, their offspring
born are more and more healthy and free from taint. _There is no
question whatsoever that syphilitic parents, one or both, can have,
after they have cured themselves, perfectly healthy children, physically
and mentally free from any blood taint or possibility of later
relapses._
TREATMENT OF SYPHILIS.
It is remarkable that while modern science has introduced hundreds of
new drugs for different diseases, Syphilis, with one exception, is still
treated with the same drug that was used centuries ago; _this drug is
mercury_; the only thing that has changed is the method of
administration. Mercury, or rather its different salts, are used now in
a number of ways. It can be used internally, in powders, pills, and
mixtures; hypodermically, intradermically, thru inunctions (rubs into
the skin), intramuscularly, and even intravenously. Which particular
method and which particular salt of mercury is to be preferred, depends
on the judgment of the physician and the character of the case. The main
condition of the success of treatment is not the selection of this or
the other method of treatment, but in the thoroughness, persistence, and
systematic use of it.
Mercury is proven to be an excellent germicide, and it cures Syphilis by
killing its germs—Spirochetae.
SALVARSAN—606.