EDUCATIONAL METHODS.

On the whole the present writer believes the remedy lies in public education. The great majority of the people have no knowledge of the subject, simply because of the erroneous assumption that it is not one which lends itself to general discussion.

It is indeed gratifying that such a respectable magazine as the “Ladies Home Journal" has given attention to topics of this character and insisted for several years upon a greater parental frankness with children about their physical selves. In the Editor's Personal Page, in the issue of September, 1908, we find the following courageous statement: "Because of the secrecy with which the whole question is enshrouded it is practically impossible to obtain absolute figures. But so far as the highest authorities have been able, through the most careful inquiries, to secure accurate figures, it is a conservative statement to make that at least 60 out of every 100 young men are today "sowing their wild oats.' Of these 60 young men a startling number are either already making or will make a tragedy of marriage. They produce either childless homes, dead-born or blind babies; children with life-long diseases with them, or they will send thousands of women to the operating table. * * * This frightful condition has been brought about largely by two contributing factors. First. The parental policy of mock modesty and silence with their sons and daughters about their physical selves, and second, the condoning in men what is condemned in women. Fathers and mothers, and in consequence girls, have condoned in a young man this sowing of his 'wild oats,' because it was considered a physical necessity; that it 'would do him good'; that it 'would make a man of him,' that 'it would show him the world'-all arguments absolutely baseless. The remedies proposed are along the principles already indicated, viz.: knowledge of the subject, and that 'we fathers of daughters must rid ourselves of the notion that has worked such diabolical havoc of a double moral standard. There can be but one standard-that of moral equality. Instead of being so painfully anxious about the 'financial prospects' of a young man, *** it is time that we put health first and money second. *** Let a father ask the young man, as the leading question, whether he is physically clean; insist that he shall go to his family physician, and if he gives him a clean bill of health, then his financial prospects can be gone into. But his physical self first. That much every father would do in the case of a horse or a dog that he bought with a view to mating. Yet he does less for his daughter, his own flesh and blood. Once let young men realize that such a question would be asked them by the father of the young women whom they would marry; that a physical standard

would be demanded, and that knowledge would be more effective for morality among young men than all the preaching and moralizing and exhortations of the past thousand years. Thus, and thus only, can we save our daughters and their unborn children. But in no other way."

It should be stated in justice to my friend and teacher that the late Dr. J. Harry Thompson, then in charge of the Columbia Hospital for Women in Washington, as early as 1873 advocated the plan of insisting upon a clean bill of health and related to the class an instance in which the young man, after complying with what he considered a reasonable parental request, told the father: "Now that I have furnished you with evidence of my own physical cleanness, I shall insist upon a similar evidence in your case, as I am equally anxious to perpetuate the purity of my blood." To which request the father unhesitatingly acceded.

As a teacher of hygiene I can not find words strong enough in commendation of the brave editorial and the excellent article, "The Tragedy of the Marriage Altar" (by Dr. Abraham L. Wolbarst), in the "Ladies Home Journal" for September and October, 1908. The writer has realized for years the necessity of proper education, for if we expect the parents to impart information on sexual purity, they must acquire it primarily from some competent and reliable source. Few of our magazine writers have heretofore been brave enough to present this question as the "Ladies Home Journal" has done. For all these reasons I have advocated for years that hygiene should form part of the curriculum in our public. schools and the question discussed from the standpoint of sexual hygiene pure and simple. Public lecturers on the purity of man commit a serious mistake, generally, when they picture the consequences of the social evil, without offering a suitable remedy. Many a young man thinks it essential to his health to give vent to his penned up secretions by sexual intercourse and to demonstrate his manhood. If deterred by fear of contracting venereal diseases, in the absence of other remedies he will most likely resort to unnatural methods.

We should make a strong plea in favor of continence, and tell our young men, that while the sexual passion is very strong, it can be accelerated or delayed, excited or lowered by the influence of the will. We should assure them that sexual indulgence is not a physiological necessity, and that nature will relieve herself by an occasional nocturnal emission. By the cultivation of pure thoughts, removal of temptation, normal mental conditions and especially by cold baths and vigorous physical exercise and avoidance of an excessive meat diet, continence may not only become possible, but easy. Those who witness the good effects of athletic sports cannot fail to appreciate that here is a good field in which

to expend exuberant animal spirits and in this sense "public playgrounds" are a strong factor in the promotion of sexual purity. We can hardly go astray if we follow Dr. Parkes in advising a pure young man to make his home after the age of 22 or 23, and thus secure himself both from the temptations and expenses of bachelorhood. Dr. Howard A. Kelly believes that the Christian standard is the solution of the whole problem of chastity. I quite agree with him, provided the church makes an endeavor to combine religious and social work, and until this is accomplished we should not hide the evil because it is not a pleasant subject to talk about.

Suggestions as to what the church may do have been offered in a former report, see page 100 "Industrial Hygiene," and the desirability of social settlements in connection with schools and churches has already been emphasized in connection with the drink evil.

Among the sensible recommendations submitted by the "Committee of Fifteen" in the city of New York were, first, "strenuous efforts to prevent, in the tenement houses, the overcrowding which is the prolific source of sexual immorality. *** Secondly, the furnishing, by public. or private munificence, of purer and more elevating forms of amusements to supplant the attractions of the low dance halls, theaters and other similar places of entertainment that only serve to stimulate sensuality and to debase the taste. The pleasures of the people need to be looked after far more earnestly than has been the case hitherto. * * * Thirdly, whatever can be done to improve the material conditions of the wageearning class, and especially of young wage-earning women, will be directly in line with the purpose which is here kept in view. It is a sad and humiliating admission to make, at the opening of the 20th century, in one of the greatest centers of civilization in the world, that in numerous instances it is not passion or corrupt inclination, but the force of actual physical want, that impels young women along the road to ruin." Referring to the question of intimate contact in tenement houses as a predisposing cause to prostitution, it is a matter of satisfaction to record that both General Sternberg and the writer realized this danger when they urged, in 1898, the adoption of model two-story apartment houses with separate entrance and exits for each family so that the sanctity of the home might be preserved.

STATE METHODS.

The question naturally arises, what can and should the State do to prevent the moral, social and physical ravages of these diseases? It must be confessed that the measures looking to the inspection and con

trol of prostitutes are sadly inadequate. It has been suggested by German authors that the evil might be materially lessened by holding the persons who knowingly spread venereal diseases responsible for the damages. Indeed, a German Jurist goes so far as to advocate the punishment of persons who neglect to seek treatment when afflicted with sexual diseases. Apart from this the State should certainly insist upon, first, the enforcement of laws or police regulations relating to houses of illfame and to the sale of alcohol, particularly to minors. A closer supervision of soliciting in streets and enticing females under a fixed age. There is certainly no good reason why the terrible temptations which greet our young men and women on every street and in many public places should not be removed. A well-trained police force will have no difficulty in recognizing and banishing the solicitors, both male and female, from the streets, and in cautioning young men, especially minors, of the dangers in the red light districts.

Second. Health Boards can also recommend the enactment of laws for the prevention of syphilis, acquired in an extra genital way, by regulating the profession of barbers, chiropodists and manicurists, and requiring a special examination of wet nurses, cigarmakers, and glass blowers. Apart from the real dangers from these sources, the educational effects of such ordinances will be beneficial.

Third. Health Boards should also exert their influence towards securing adequate facilities for the treatment of indigent patients.

In Northern Europe, where venereal diseases are reportable and treatment is within the reach of all classes, these diseases, according to Weiss, have greatly diminished, but here, as Bulkley puts it, "ignored through ignorance, neglected through negligence of our duty, so ostracised and cutclassed, venereal diseases, through false shame, concealment, prejudice, carry on their slaughter unhampered, unchecked and undisturbed, devastating coming generations and ruining the present one."

Fourth. Health Boards may co-operate with the Profession and Dispensaries by printing, for distribution, leaflets stating the nature of the diseases, the manner in which they are contracted and the ways in which they can be transmitted to other persons, and by the encouragement of a general educational campaign in which sexual purity, respect for women, and the possibility of physiological continence should be inculcated. The evil and far-reaching consequences of impure and unlawful gratification should be clearly pointed out.

In conclusion, a word of caution is necessary to impress upon the victims of sexual diseases the utter uselessness of securing treatment with various advertised cures. As very properly said by Mr. Samuel

Adams Hopkins in "Collier's Weekly," September 22, 1906: "All this class of practitioners are frauds and swindlers. Many of them are excriminals in other fields." "The Old Doctors," the "Physicians' Institutes," the "Medical Councils" and the "Quick Cures" are all equally to be shunned. Blackmail is the underlying principle of this business. These treatments can not cure; ten to one they only aggravate the disease and render it dangerous or even deadly. But once they have a man in their clutches they need not help him in order to get his money. If he demurs at their charges a threat to expose the nature of his ailment to his family or employers is enough. *** Every advertisement of private diseases or "men's specialists" ought to be a danger signal pointing not only to wasted money, shame and misery, but often to invalidism and a dreadful form of death, where in 90 per cent of cases reputable treatment would have brought the patient through.

In some localities it is against the law to publish advertisements of this class. Pennsylvania has such a law, but it is a dead letter. St. Louis is attempting to enforce its illegal advertising ordinance and the St. Louis newspapers are fighting to save themselves the dollars tainted with unspeakable filth."

THE TOBACCO HABIT.

In view of the fact that our sociological study of 1,217 families in this city show an average annual expenditure of $12.19 for each family, which at a conservative estimate would amount to $239,655,000 for the annual tobacco bill in the United States, it is important to consider the effects of tobacco on the system.

Tobacco owes its general effects to the presence of toxic alkaloids known as nicotine, nicotianin and the "pyridin bases" which are formed during smoking. Syrian and Havana tobacco contain little or no nicotine, while the common grades contain from 3 to 4%. Nicotine is a poison which produces a local irritation of the digestive tract, nausea and diarrhea. In some instances there may be dizziness, weakness, restlessness, depressed action of the heart and convulsions. Strange enough, man becomes accustomed to these effects and may even experience an agreeable excitation of the nervous system, characterized by increased mental and physical elasticity. There is nothing to justify the assumption, however, that the use of tobacco is free from danger. Prof. Seaver's observations on Yale students appear to show that non-smokers made the best physical gains in weight, chest measure and lung capacity, and that out of every 100 of the best students only 5 were smokers, while 95