SEXUAL HYGIENE OF THE ADOLESCENT MALE.
SEXUAL HYGIENE OF THE ADOLESCENT MALE.
No rational or acceptable system of sexual hygiene for the human male
can be worked out without constant reference to the lower ranks of the
mammalian class and to primitive social conditions.
In our study of the anatomy and physiology of the sexual apparatus of
the human male, it must have become evident that man has many things
in common with other mammals, and that no adequate knowledge of man's
physical or psychical attributes can be obtained without a study of
similar phases of life among related animals.
All of the changes which Nature introduced into the physical and
psychical development of the adolescent male were of a character to
equip the individual for the maintenance and protection of a wife and
children. This development has been reached by the time the young man
is twenty-one to twenty-three years of age, when, in the average case,
he would be able, so far as concerns his physique and temperament, to
establish and maintain a home. The fact that his adolescent
development is complete by the age of twenty-five, and that he has, by
the time he arrives at that age, grown into the full stature of all
his physical and mental powers, may certainly be interpreted as
nature's indication that his home-building should be begun not later
than the twenty-fifth year. This means, then, that young men ought, if
possible, to marry as young as twenty-five.
But the conditions of society at the present time are such that a
large proportion of the young men, particularly those who are
preparing for any of the learned professions (theology, medicine, law,
pedagogy, etc.) are hardly through their professional courses by the
time they reach that age, and most of them feel that they must make a
start in their profession before they assume the responsibilities of
supporting a home. This means that a large proportion of them marry as
late as thirty years of age.
If we consider now those commercial, financial and industrial
vocations which involve considerable preparation in technical
institutions or a long apprenticeship (engineering, pharmacy,
manufacturing chemists, banking, journalism, etc., etc.) we find that
the young man is hardly able to establish such a home as most such
young men feel that they must maintain on any salary that they receive
before they are twenty-eight to thirty years old. This consideration
applies particularly to college and university men, as, almost without
exception, these men are preparing for some of the above mentioned
professions or vocations.
Now the conditions of college life, the field sports and athletics,
together with the social conditions, tend to develop in college
circles a body of most virile young men. The problem which now
confronts us is: How may these young men live a hygienic life under
these unnatural circumstances?
If a man becomes able to procreate his kind at seventeen but is hardly
able to marry before he is thirty he must solve the problem as to what
his attitude shall be regarding matters of sex. The earlier this
problem is solved the better it is for the young man. Unfortunately, a
large proportion of young men do not realize that they have any
problem in this field to solve until circumstances, more or less
accidental, have already established in them a mental attitude and,
perhaps, a habit of life that may not be either wholesome or wise.
From what has preceded, it must be evident that from the early months
of the period of puberty, through the adolescent and adult period,
even until some progress is made in the senile period, every normal
male will experience sexual desires. It has been shown that these
particular experiences are linked, more or less intimately, with the
condition of the sexual apparatus; but whatever the cause, we are
confronted with the question, What shall be done about it?
When a man experiences a sexual desire does it necessarily follow that
the desire must be satisfied? Some have reasoned that the muscles of
the arm, if not exercised, wither and become weak, therefore the
sexual desires, if not exercised will become weak, and the sexual
apparatus, if it does not exercise its function, must become withered
and atrophied. While this course of reasoning may seem rational and
the conclusion may seem tenable, it is well known to physiologists and
sociologists that the reasoning is fallacious; the fallacy rests in
the premises. It was assumed above that the activity of the sexual
glands was comparable with that of muscles.
We must not lose sight of the fact that the male sexual glands are
continuously active, and in this continuous activity get their
exercise. This activity develops them and keeps them physically
perfect after the onset of the period of puberty. Their activity
consists very largely in the formation of an internal secretion, the
office of which is to develop in the male the highest possible state
of virility. Nor must we lose sight of the fact that every procreative
act is performed at a sacrifice of some of this vital fluid on the
part of the male. A wanton sacrifice of vital fluid either in the act
of self abuse or in excessive venery is not justifiable under any
consideration; nor may these acts, under any circumstances, be looked
upon as sustaining to the gland a relation similar to that which
muscular exercise sustains to muscle tissue.
In the light of these facts every normal man would admit that
frequent masturbation or excessive sexual intercourse, in wedlock or
out, should certainly not be recommended as a method of developing the
sexual apparatus.
Most men, however, raise the question: "Is any indulgence or any
artificial means for satisfying the sexual inclination to be
discouraged?" This inclination comes to us in the course of nature.
Man in the primitive state would seek a mate as soon as he felt this
inclination; would fight for the possession of her as soon as he had
reached a sufficient stage of muscular development, and once in
possession of his mate, would take her to his perch in the trees or to
his cave. In his primitive home he would follow his sexual
inclination, impregnate his wife and protect her against all dangers.
Under our present social conditions the young man experiences all
these desires the same as his primitive ancestor, but he may not be
able to choose a mate and begin with her the building of a home for a
whole decade after he experiences the desire to do so. What is the
solution?
It must be evident that the solution lies in the acceptance of one or
another of three alternatives--either the young man may seek illicit
intercourse with women to satisfy his sexual desire, or he may adopt
some artificial measure, such as masturbation (self abuse) or,
finally, he may lead what is known as a continent life. By continence
we mean to adopt neither one of the first two alternatives mentioned,
but to leave the care of the sexual apparatus wholly with Nature.
We may now consider these three alternatives in turn.
1. ILLICIT INTERCOURSE WITH WOMEN.
By illicit intercourse with women we mean, sexual intercourse out of
wedlock. The term applies either to intercourse between any man and a
prostitute, between an unmarried man and a married woman, between an
unmarried man and an unmarried woman or between a married man and a
married woman not his wife. The term, illicit intercourse, applies to
all sexual intercourse that is illegal.
In our discussion of the young man's problem, we may confine our
consideration particularly to intercourse with professional
prostitutes and with clandestines, or women who are willing to accept
the sexual embrace for their own gratification or for money.
In this phase of sexual gratification, it is assumed that the woman
has these relations with various men. We purposely eliminate from this
discussion the deliberate seduction of pure girls for the purpose of
sexual gratification, as such seduction is a heinous offense against
the victim and against society, for which offense the man is legally
responsible. We are here discussing not the crimes of men, but their
vices.
The question that the young man naturally asks is--"Why should society
hold these relations as a vice when the woman, who is party to the
act, gives her free consent, perhaps even soliciting the relation, and
has given herself up to this sort of a life, either as a sole
occupation (prostitute) or as an auxiliary occupation (clandestine) to
supplement a wage on which she may not be able to live in luxury?"
The answer to this question is not far to seek. Women so occupied
have, as a rule, made themselves incapable of maternity. They are
outcasts from society, unfortunately exerting a most harmful influence
on all those who come into relation with them. Furthermore, they are
centers for the dissemination of venereal diseases which wreck the
health of all those who become infected. But for the uncontrolled
passions of men, there would be no such women. So while we,
individually, as men, may not be responsible for the ruin of any one
woman, we must confess that men as a class are responsible for this
condition of prostitution and clandestine intercourse. An overwhelming
majority of women would, if following their inclinations, seek these
relations in wedlock only and for procreation only. But many a young
woman, under promise of marriage, sometimes even under a bogus
marriage, is brought into a condition of hypnotism or into a mental
state that puts her in the power of the man whom she loves and
respects. If he deceives her and betrays her, continuing such betrayal
until the victim becomes pregnant, he will, in the average case, leave
her to bear her child in shame, while he slips away to other scenes of
activity. We cannot wonder then, that the girl--deserted, humiliated,
crushed by the one in whom she reposed absolute confidence; cast out
of society, perhaps thrust from the protection of her own father's
roof--gives up the struggle and says--"_What's the use?_"
A vast majority of such poor girls make their way to houses of ill
fame and give themselves over to a life of prostitution. Hardly one of
these women, if married by the man who brought her to this condition,
would have failed to make a true and loving wife and mother. So
society, while it casts these women out, has come to recognize that
men are the real sinners in such cases.
It may be added here, that an occasional girl goes wrong through
temperamental shortcomings within herself--perhaps she may even be a
degenerate; but the proportion of women who would willingly and
deliberately sacrifice their virtue is vanishingly small as compared
with the proportion of young men who seem to be willing to sacrifice
their virtue. This is probably in part due to their training.
Mothers, as a rule, instruct their daughters carefully regarding their
relations with boys and men. It is in part due to the instinctive and
inherent purity of mind of the normal woman.
Nature has devised a retribution for illicit intercourse in the form
of venereal disease. If the parties observe fidelity to the marriage
vows venereal disease is experienced in wedlock only on very rare
occasions, and then through some accidental infection, as from contact
with some public utensils, as a public water closet, a public towel or
drinking cup. So rare is this unfortunate accident, however, that we
may say, that intercourse in undefiled wedlock results normally in
pleasure and gratification to both parties, while intercourse out of
wedlock, or illicit intercourse, is destined, as a rule, to be visited
with retribution.
What form does this retribution that nature metes out to the vice of
illicit intercourse take? Besides the various psychic punishments, the
principal of which are remorse, and impure thoughts, there are
physical punishments in the form of venereal diseases. So prevalent
are these venereal diseases among lewd women, whether prostitutes or
clandestines, that specialists in this field say that "_all lewd women
are diseased part of the time and some lewd women are diseased all the
time_."
These sexual diseases are contagious--that is, transmitted by contact.
They are all germ diseases; one of them is practically local, one is
capable of spreading the infection to contiguous organs and one is
systemic.
a. =Chancroid or Soft Chancre.=--This is the least dangerous of the
venereal diseases. It is a contagious disease of purely local type,
usually acquired during the sexual act, the infection taking place
through a break in the continuity of the mucous membrane.
Chancroid may be single, though most often is multiple. It makes its
appearance in from one to five days after exposure, anywhere on the
penis, but most frequently on the under side of the glans beside the
frænulum as a small red spot. This rapidly takes the form of a blister
containing serum and pus, and in a few days may become the size of a
ten-cent piece. When the roof is removed the ulcer has the appearance
of having been punched out, the floor being covered with pus. It is
surrounded by a zone of inflammation and is painful.
If uncomplicated the disease runs its course in from two to five
weeks. The most common complication is swollen and suppurating glands
of the groin on one or both sides. This condition is termed _bubo_ or
"blue ball" in common language.
Sometimes serious complications arise which may prove dangerous and
require the individual to be confined to his bed for weeks.
b. =Gonorrhea.=--This is incomparably more serious than chancroid.
This disease is very prevalent among the incontinent, and it is
claimed by some specialists in this field that from sixty to
seventy-five per cent. of men have had gonorrhea before the age of
thirty.
It is a contagious disease, acquired usually during intercourse,
though the individual may become infected innocently from water
closets, bath tubs, etc.
To become infected it is not necessary that there be an abrasion of
the mucous membrane.
The disease manifests itself in from three to seven days after
exposure by swelling of the orifice of the urethra, peculiar
sensations between tickling and itching, and smarting or burning
during urination. The peculiar sensations fix the attention to the
genitals, thus causing frequent passage of urine.
These symptoms increase for about a week, when the disease reaches its
maximum degree of severity, which is maintained a variable time, the
discharge from the urethra being thick, creamy and of a greenish
yellow color.
In the majority of carefully treated cases, the discharge ceases in
from three to six weeks with apparent recovery. Unfortunately,
however, there is frequently a tendency for the disease to become
chronic. The discharge becomes thin and more watery and persists for
an indefinite period. This condition--chronic gonorrhea--is commonly
known as "gleet."
c. =Syphilis=, popularly termed the "pox," is a constitutional
affection of the type known as "blood diseases."
It is by far the most important and most greatly to be feared of the
venereal diseases. No disease has been so wide-spread in its
dissemination or more potent in its influence upon humanity.
It has been known for centuries, having been mentioned by Japanese
historians and in Chinese writings two thousand years ago.
Syphilis is contagious and is transmitted by inoculation. The
infectious material enters the broken surface of either the skin or
mucous membrane, called "contact" or "acquired" syphilis. When it is
transmitted by the mother to the embryo, it is called "hereditary" or
"inherited" syphilis.
The disease manifests itself first in a "_primary lesion_" which is a
local ulcer (hard chancre) at the point or points of inoculation at a
period ranging from ten to thirty days after exposure. It may appear
as an erosion or as a dry scaling and indurated papule, varying in
size from a pin-head to a silver dollar. The base of the ulcer is
indurated. It is oval in shape, perhaps somewhat irregular, with a raw
surface and red colored base devoid of pus.
Immediately following the appearance of the chancre, the glands in
direct connection with it become enlarged, hard and rarely painful,
but they have no tendency to suppurate like the enlarged glands of
chancroid.
The chancre disappears in a few weeks and then there is a period when
the individual has no outward manifestations of the disease. In about
six weeks after the chancre the so-called _secondary symptoms_ make
their appearance. They are heralded by headache, pains in the limbs
and back, nausea, sleeplessness and nervous irritability and fever,
followed by the appearance of a rash upon the face and body, falling
out of the hair, sore throat and mouth. These symptoms disappear to be
again followed by a period free from symptoms. After a longer or
shorter time the so-called _tertiary symptoms_ make their appearance,
which are many and varied.
The disease presents a succession of morbid constitutional
disturbances, appearing at variable intervals, and pursues a chronic
course.
This disease remains in the body for years and affects the most vital
organs, particularly the brain and spinal cord.
When one is infected with this disease he should seek the services of
a reputable physician. The treatment of this extends over a long
period, usually about three years, and must be strictly and
conscientiously carried out. Marriage upon the part of an individual
once infected should be only upon the approval of a physician.
After having detailed, as above, the terrible consequences of the
venereal diseases, it is hardly necessary to add that the young man
who deliberately seeks any of the usual chances for illicit
intercourse, is more than taking his life in his hands. If infection
with a venereal disease meant simply the death of the infected
individual, it would really be very much less deleterious to society
than is the present condition. When the young man "sows wild oats" and
catches incidently gonorrhea, that twenty years ago was considered a
sort of a "good joke," he will, in a large proportion of cases, lay
the foundation for broken health and will run a serious risk of
transmitting the disease to an innocent, pure wife.
When a woman catches this disease, particularly from her husband, she
is very likely to interpret the discharge as a leucorrhea, may say
nothing about it to her husband or her physician, but adopt simple
home treatment with antiseptic and astringent douches. Such treatment
will usually result in allaying the inflammation in the superficial
organs, but will not eradicate it from the deeper organs. It spreads
to the uterus, Fallopian tubes and ovaries and may even affect
peritoneal tissues, first of the pelvis, then of the abdomen--may even
finally affect the heart and joints. Of course, these are rather the
extreme limit, but they are not at all rare cases. Once this terrible
disease gets into a woman's organs, it is very likely to lead to a
sojourn in a hospital where she loses some portion of her body as a
sacrifice to this mogul of gonorrhea.
It is claimed by specialists in this field that at least sixty-five
per cent. of the operations that women are subjected to in the
hospitals for diseases of the pelvic organs are the results of
gonorrheal infection. Besides the cases that require operation, a
large proportion of cases of sterility is due to gonorrheal infection,
either in the man or woman, or both.
If we consider the revolting sequences of syphilis with its train of
operations, and progeny of scrofulous children, it would seem to make
the natural retribution for illicit intercourse infinitely outweigh
any brief pleasures derived from the enjoyment of the stolen fruits.
It hardly seems possible that any young man who knows the whole truth
about these venereal diseases and their terrible after-effects could
be tempted to indulge in illicit intercourse.
2. MASTURBATION.
The vice of masturbation or self-abuse is very likely to be learned in
boyhood, perhaps even by boys of six or eight years of age through
their associations with obscene playmates. It not infrequently
happens, however, that the habit is learned independent of these evil
associations. It has been explained above that secretions frequently
accumulate under the prepuce and accumulating there serve as a local
irritation, causing itching of the organ. This local irritation leads
the boy to attempt to allay the irritation through rubbing. Such
manipulation of the organ is very likely to excite it and to lead to
the discovery on the part of the boy that such local manipulation may
lead to pleasurable sensations of momentary duration. If he has not
been instructed by his parents that these organs are sacred to the
uses of manhood and that they will be injured if handled during
childhood, he is very likely to repeat this act until it becomes a
more or less fixed habit.
While it must be admitted that anything short of extreme excess in
this habit among little boys will not be permanently injurious if the
habit is stopped at puberty, it must be perfectly evident that if a
boy enters puberty with this habit, the psychical and physical
conditions of puberty are such as to make the habit very difficult to
stop. If it is not stopped a serious injury may result. So the
necessity hardly need be further urged for explaining to young boys
that these organs should not be handled.
After the boy enters puberty, the habit of masturbation either
acquired during puberty or carried into that stage from early boyhood,
begins to have a distinctly deleterious effect.
Let us now consider just what is the character of this deleterious
effect. From what we know of the physiology of the sexual apparatus,
it must be evident that a sexual orgasm could be produced during
waking hours only through strong stimulation of the activity of the
testes, accompanied by liberation of spermatozoa and of the other
elements of the vital fluid. Let us not forget in this connection, the
statement made above: that the testis produces two forms of secretion,
the internal secretion and the external secretion, the internal
secretion being absorbed, produces those male characteristics which we
group together under virility, while the external secretion is used
for procreation. Spermatozoa do not make any part of the internal
secretion. One reason for this must be evident, i.e., that being
cellular elements, they could not pass through the vessel walls and be
absorbed into the blood current, and if they could, by some special
adaptation, get into the blood current, there is no conceivable action
which they could perform in the body. We must then look upon the
internal secretion as composed of the liquid elements of the
testicular secretion.
So far as physiologists know at present, the external secretion
differs from the internal secretion only in possessing spermatozoa.
When we say that the testes form their external secretion under sexual
excitement only, we simply mean that they liberate or release
spermatozoa under sexual excitement. The spermatozoa must be looked
upon as the fertilizing element of the semen, while the liquid portion
of the semen probably contains that mysterious element which, absorbed
into the body, produces virility and which, passed out with the
spermatozoa, may have an important role to perform in the fertilizing
function.
If the adolescent young man is leading a continent life, we may assume
that from time to time he is subjected to conditions which serve as
strong sexual stimuli, arousing in him a definite desire for sexual
intercourse; but leading a continent life, he curbs his desire and
fixes his thoughts upon other subjects. In this way, though the sexual
excitement is brought quickly under abeyance, we can rest assured that
a certain number of spermatozoa have been released from the testes;
and that the other secretions have been increased in volume. The
excitement may be sufficient even to cause an erection, and produce a
few drops of the secretion of Cowper's glands. The spermatozoa,
together with a small amount of the liquid secretion, will make their
way gradually along the vasa deferentia and collect in the ampullæ.
The bulk of the liquid secretion, however, will, in the course of the
following hours or days, be reabsorbed, thus making for virility. The
small advance guard of spermatozoa that may have made their way to the
ampullæ will undergo a gradual decrease of their nascent activity, as
the days go by. On the occasion of the next nocturnal emission the
ampullæ will empty along with the seminal vesicles and these
spermatozoa pass out. If they be examined under the microscope as a
part of a normal nocturnal emission, they will be found to be almost
motionless or very greatly lacking in typical spermatozoon activity.
Now let us suppose that the young man, instead of curbing his sexual
appetite, resorts, after a season of erotic imaginations, to the act
of masturbation. We may picture the seminal ducts, vasa deferentia and
ampullæ as being gorged with the secretion of the testes, including,
of course, myriads of just released and nascent spermatozoa, together
with several cubic centimeters of the liquid portion of the testicular
secretion. The act of masturbation causes an orgasm and leads to a
complete emptying of all these ducts. Thus we note that in this case
the virile fluid is wasted, not being used in the procreative act or
reabsorbed to exert its influence on virility. Nature's ends have been
defeated. The system suffers a certain degree of depletion from which
it recovers only after hours or even days. It must be evident from
this picture of the processes that go on in the male sexual apparatus
incident to the act of masturbation that the act cannot be performed
repeatedly, as it naturally is when it becomes a habit, without
interfering with the virility of the adolescent male.
In the study of a large number of cases the author has found that the
principal _physical_ changes that occur in a young man as the result
of this habit are, flabbiness of muscle and clamminess of hands. The
really virile man possesses firm muscles and clear, direct eyes and a
strong grip; usually also a warm grip.
It has been thought by some that pimples on the face are a sign of
masturbation in the youth, but such is not the case. They are a sign
of lack of elimination through the kidneys and bowels and are not to
be interpreted as having any essential relation to masturbation. There
may possibly be an incidental relation growing out of the fact that in
some cases of masturbation that habit seems to affect the nutrition
and that in turn may cause the appearance of pimples on the face of
the adolescent. However, one must be very slow to pass judgment in
these cases.
Not the least important among the results of masturbation is the
attitude of the victim to society in general. This _psychical_ change
is noticed in immoderate cases of masturbation and takes the form of
disinclination to enter into any physical contests, or games; and
disinclination to cultivate the society of the opposite sex. Here
again one must be conservative in his judgment, because there are
individuals who possess a very retiring temperament naturally, and who
may become so engrossed in study or productive work that they take
little share in the society of either sex, so that individuals who may
be wholly innocent of any abuse of their sexual apparatus would suffer
a very grave injustice if they were classed among the masturbators. So
allow the author at this place to emphasize the importance of never
passing judgment on anybody in these matters on circumstantial
evidence.
While the damage that one may do to his system through the practice of
masturbation may not be very serious, in many cases that have come
under the author's observation in which the habit has reached extreme
limits, very serious, sometimes irretrievable damage has been done,
yet the encouraging feature of this whole matter is, that if the
adolescent youth, who is practicing this habit, is warned of its
danger and stops at once absolutely, nature comes to his rescue, and
gradually, step by step, but surely, rebuilds the whole fabric of his
virility, bringing back gradually the flush of perfect health into his
cheek, the light of perfect manhood into his eye and the tone of
perfect virility into his muscles.
This change can be wrought in from one to three years of absolute
continence. Nature, like a loving mother, heals the wounds of her
child with a kiss.
3. CONTINENCE.
Such frequent reference has been made above to continence in
antithesis to illicit intercourse and masturbation that little need be
said in addition to that which has preceded. The young man who holds
before his mental vision an ideal of the home he hopes some day to
establish--in which a pure wife reigns as queen, sovereign of his
life, and gently hovers over a brood of lusty boys and fair
girls--cannot for a moment consider as a sane solution of his sexual
problem, periodic visits to the house of ill fame or the periodic
lapse into illicit intercourse with clandestines; nor can he expect to
develop his powers, physically or intellectually to the highest
possible degree if he permits himself to contract that habit
[masturbation] which, step by step, undermines his development. There
is open to the young man only one of the three alternatives mentioned
above, i.e., TO LEAD THE "CONTINENT LIFE."
The continent life is a goal which every healthy young man should
strive to reach. To arrive at a goal that is before us and above us
requires sacrifice and brings compensation. The sacrifice takes the
form of the exertion of the whole will power of the man and the
painstaking observance of those rules of hygiene which make continent
living more easily attainable. The compensations of continence are
those that come from the assurance that the young man has of his
virility, of his worthiness to take the hand of a pure wife in
wedlock, of the consciousness of his ability to establish and maintain
a home, and to protect this home against all dangers.