warning, which they may have received, are forgotten. Idleness is also another influential factor in indirectly causing sexual disease; hard physical and mental work are powerful correctives of the passions.

It may be of interest to readers to know that but recently an association of American physicians, alarmed by the fearful prevalence of sexual diseases in this country, has been taking measures to inform youths and adults and the general public, through special instruction in schools, and by means of pamphlets and lectures to teachers and others, of the prevalence and great danger of this evil.

When young adult life has been attained it is also desirable for the parent, or the family physician, to inform the young man or woman-especially if either is about to enter a marriage engagement—that close and frequent personal contact with the opposite sex, especially when the affections are involved, will necessarily, though involuntarily, excite local stimulation of the sexual organs and general irritability and exhaustion of the entire nervous system. Long engagements-when the participants are frequent companions are thus peculiarly unfortunate. It is only when the sexual functions are normally exercised in adult life, as in sexual intercourse, that sexual excitement is not harmful.

Young women about to marry should receive instruction from their mothers as to the sexual relations which will exist after marriage. Most girls are al

lowed to grow up ignorant of such matters and in consequence may become greatly shocked and even disgusted by the sexual relations in marriage-fancying that there must be something unnatural and wrong about them because the subject was avoided by those responsible for their welfare..

Any excess in frequency of sexual intercourse after marriage is followed by feelings of depression and debility of some sort which may be readily attributed to the cause and so corrected. Any deviation from the natural mode of intercourse is pretty certain to lead to physical disaster; thus, unnatural prolongation of the act, or withdrawal on the part of the man before the natural completion of the act in order to prevent conception, often results in deplorable nervous disorders.

In conclusion, it may be said that parents must take upon themselves the burden of instructing their children in sexual hygiene or shift it upon the shoulders of the family physician, who can undertake it with much less mental perturbation and with more intelligence. Otherwise they subject their offspring to the possibility of incalculable suffering, disease, and even death-largely through their own inexcusable neglect.

CHAPTER II

Genito-Urinary Diseases

Contagious Disorders-Common Troubles of Children—Inflammation of the Bladder-Stoppage and Suppression of UrineCauses and Treatment of Bright's Disease.

GONORRHEA.-Gonorrhea is a contagious inflammation of the urethra, accompanied by a white or yellowish discharge. It is caused by a specific germ, the gonococcus, and is acquired through sexual intercourse with a person suffering from this disease. Exceptionally the disease may be conveyed by objects soiled with the discharge, as basins, towels, and, in children, diapers, so that in institutions for infants it may be thus transferred from one to the other, causing an epidemic. The mucous membrane of the lower part of the bowel and the eyes are also subject to the disease through contamination with the discharge. The disease begins usually three to seven days after sexual intercourse, with symptoms of burning, smarting, and pain on urination, and a watery discharge from the passage, soon followed by a yellowish or white secretion. Swelling of the penis, frequent urination, and painful erections are also common symptoms. The disease, if uncomplicated and running a favorable

course, may end in recovery within six weeks or earlier, with proper treatment. On the other hand, complications are exceedingly frequent, and the disorder often terminates in a chronic inflammation which may persist for years even without the knowledge of the patient-and may result in the infection of others after all visible signs have ceased to appear.

Treatment.-Rest is the most important requisite; at first, best in bed; if not, the patient should keep as quiet as possible for several days. The diet should consist of large quantities of water or milk, or milk and vichy, with bread, cereals, potatoes, and vegetables -absolutely avoiding alcohol in any form. Sexual intercourse is harmful at any stage in the disease and will communicate the infection. Aperient salts should be taken to keep the bowels loose. The penis should be soaked in hot water three times daily to reduce the inflammation and cleanse the organ. A small wad of absorbent cotton may be held in place by drawing the foreskin over it to absorb the discharge, or may be held in place by means of a bag fitting over the penis. All cloths, cotton, etc., which have become soiled with the discharge, should be burned, and the hands should be washed after contact with the discharge; otherwise the contagion may be conveyed to the eyes, producing blindness. It is advisable for the patient to take onehalf teaspoonful of baking soda in water three times daily between meals for the first four or five days, or, better, fifteen grains of potassium citrate and fifteen

drops of sweet spirit of nitre in the same way. Painful erections may be relieved by bathing the penis in cold water, urinating every three hours, and taking twenty grains of sodium bromide at night in water. After all swelling and pain have subsided, local treatment may be begun.

Injections or irrigations with various medicated fluids constitute the best and most efficient measures of local treatment. They should be used only under the advice and management of the physician. No greater mistake can be made than to resort to the advertising quack, the druggist's clerk, or the prescription furnished by an obliging friend. Skillful treatment, resulting in a complete radical cure, may save him much suffering from avoidable complications and months or years of chronic trouble.

At the same time the first medicines advised are stopped and oleoresin of cubebs, five grains, or copaiba balsam, ten grains-or both together-are to be taken three times daily after meals, in capsules, for several weeks, unless they disturb the digestion too much. A suspensory bandage should be worn throughout the continuance of the disease. The approach of the cure of the disease is marked by a diminution in the quantity and a change in the character of the discharge, which becomes thinner and less purulent and reduced to merely a drop in the passage in the early morning, but this may continue for a great while. Chronic discharge of this kind and the complications cannot be