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Diseases Of Men - Their Home Treatment

( Originally Published Early 1900's )

PLEASE note that we do not maintain that these instructions will take the place of a competent doctor. They can be used when one is not able to secure expert advice, or they can assist one in selecting an intelligent physician who thoroughly understands the pathology and physiology of natural treatment.

The venereal diseases are without doubt the most terrible to which humanity is at present exposed. Both because of their malignant and destructive character, and their wide-spread prevalence, they work more harm and cause more misery than any other form of disease known to the modern world. Yet, curiously and unfortunately, they have been carefully kept under cover. Our children are told ,about measles, mumps, scarlet fever, consumption and other "respectable" disorders, but not a word of warning is spoken on the subject of these maladies that are infinitely more dangerous and horrible.

Tuberculosis has been called the "white plague." But the venereal diseases, which claim an even greater number of victims, are rightly coming to be called the "black plagues." Among those adequately informed there is complete agreement that no plague or war in the history of the world, even including this last overwhelming conflict in Europe, has ever caused so much havoc and misery as these infections, and during the last few decades their ravages have be-come more alarming than ever. For conditions of civilization and city life have naturally tended to favor their spread, until now they threaten to poison the entire human race. Because of the secrecy in which the whole subject is shrouded, it is impossible to ascertain the exact facts in regard to the prevalence of these disorders, but it is reasonably certain that any estimate is likely to be below rather than above the truth.

One authority declares that there are five mil-lion syphilitic persons in the United States. Others hold that from twelve to twenty per cent. of young men become infected with this disease. As to the prevalence of gonorrhea, estimates of careful observers in armies, hospitals, dispensaries and private practice, place the number at anywhere from seventy-five to ninety per cent. of men who have reached the age of thirty.

It used to be said that venereal disease was a punishment, severe but richly deserved by the transgressor. Unfortunately, the innocent suffer as well as the guilty, and often suffer far more. Wives and children only too frequently pay the price. Gonorrhea is a far more terrible disease in a woman than in a man, and in its worst manifestations, often necessitates mutilating and unsexing operations. Yet some authorities have estimated that there are over a million innocent wives suffering from this disease in the United States, perhaps even more than the number of prostitutes afflicted with it. It is such a simple matter for the husband to infect his wife; in fact, it is almost a certainty that he will do so, if he marries with the disease still present, or contracts it after marriage. One investigator estimates that forty-five per cent. of sterility in women is due to this infection, and there is no doubt that it is responsible for seventy-five per cent. of operations on women. Blindness in the offspring is an-other result of this supposedly trifling disorder, for thirty per cent. of the cases of lost vision are attributable to it.

Syphilis, on the other hand, not only destroys health but disfigures, maims, makes insane and kills many of its victims, and is transmitted to their offspring. It has been called the great child murderer, being the cause of innumerable involuntary abortions, and deformities in children. From thirty to forty thousand deaths occur in this country each year from hereditary syphilis alone. A considerable proportion of all cases of apoplexy are due to syphilis of the arteries of the brain. Locomotor ataxia and the form of in-sanity known as paresis, or "softening of the brain," are, in practically all cases, the result of syphilis.

These diseases are sometimes called private diseases. But from the way in which they are spread they might more appropriately be called public diseases, and dealt with in a public way. No disease that is communicable is a private matter, and inasmuch as the infected one is necessarily a danger to other persons, no one has a right to contract a disease of this kind. More over it is not simply a matter of health, but also a question of eugenics.

Gonorrhea. This disease is very commonly known as Clap. Scientifically, it is also known as Blennorrhagia, or Specific Urethritis. It is not only the most common venereal disease, but among adult males it is the most frequent of all diseases. It is due to a very persistent micro-organism known as the gonococcus, which attacks the mucous membrane of the urethra, the infection being almost invariably contracted during sexual intercourse. Any mucous membrane may be attacked, however, and when the infection reaches the eye, as it sometimes does, it produces a violent inflammation which leads to total blindness in a short time if radical treatment is not immediately adopted. One infection does not offer protection against future attacks.

Most men do not realize what a serious disorder gonorrhea really is. Some men think it a great joke. Others boast of it, thinking that it only shows what a delightful "devil of a fellow" a man is. What fools these mortals be! Many men declare that they "would just as leave have it as a bad cold." They do not think of the consequences. Even if cured, the affected mucous membranes are never quite the same afterward.

A man is never quite the same man again, according to the best authorities. Although the disease is usually a local disorder, yet the germs some-times penetrate through the membranes and get into the blood, causing fatal septicemia. Gonorrheal rheumatism is rheumatism at its very worst, the infection invading the joints, heart, muscles, tendons or other parts. . More than half the cases of rheumatism among men below middle age are of gonorrheal origin. Sudden death from heart disease is sometimes due to gonorrheal infection of the cardiac lining. The death certificate does not mention the real cause.

Infection of the innocent wife may not only blast her life and health, but may be responsible for a miscarriage, or for the infection of the eyes of her baby at birth. Blindness from this infection, which when it attacks the eyes is known as ophthalmia neonatorum, can be prevented only by the immediate application of a solution of nitrate of silver, which kills the germs. If this is not done the vision of the new-born child is totally destroyed in two or three days. "No worse than a bad cold!"

When gonorrhea is confined to the front end or anterior portion of the urethra, in which case it is called anterior urethritis, a reasonably quick and complete recovery may be expected if proper treatment is adopted, though even such a case may possibly be followed by stricture. But when the infection travels farther back, becoming posterior urethritis, the situation is much more serious. The disorder is then more difficult to cure and there are likely to be complications leading to permanent trouble of one kind or another.

There is a rare form of simple urethritis which is not due to the gonococcus, but is contracted as a result of the discharges of an inflamed womb, or a bad case of leucorrhea, and sometimes through intercourse during menstruation when the discharge is not of a healthy character. This of course is a mild form of infection, as compared with the gonorrheal or "specific" inflammation. Usually this simple form of urethritis is quickly cured by cleanliness, light diet or fasting, free water-drinking and general care of the health. It sometimes causes domestic trouble by giving rise to unjust suspicions and accusations.

Gonorrhea starts with inflammation, commencing in from three days to a week after exposure. The first sign is an itching or tickling at the end of the urethra. The meatus is red, there is a slight discharge of thin, grayish mucus, the organ swells somewhat and there is marked tenderness along the underside and in the reddened parts. This condition represents what may be termed the first stage, and Iasts three or four days. The passage of water may be painful even at this time.

The first symptoms gradually become more marked until the second stage of severe inflammation is reached. In this the discharge becomes copious, and is of a thick, yellowish character. The end of the organ sometimes swells and becomes very red and sore in appearance. The passage of the urine now becomes excruciatingly painful, with a burning or scalding sensation. This inflammatory stage usually lasts from two to four weeks, or longer, and then gradually subsides. The third stage is the period during which the discharges and pain decline.

Naturally, it is important to limit the disease to the anterior urethra, and to avoid the infection of the prostate gland, bladder and other of the more remote structures, in which case one may be through with it in the course of a few weeks.

When the posterior urethra is involved there is greatly increased frequency of urination and more pain, though there may seem to be less discharge. There may also be retention of the urine. A good test of the location of the disease is found in the cloudiness of the urine. In anterior urethritis, the first part of the urine voided is clouded, and the last part clear, as may be seen by passing the first part into one glass, and the last part into a second glass. In posterior urethritis both first and last specimens will be clouded.

Following posterior urethritis there is always a possibility of inflammation of the bladder, and even of the kidneys, resulting in severe illness and even death in some instances. Infection of the prostate gland, at least, is probable in all such cases, and a permanent enlargement of this organ may follow. Cowper's glands may also be involved. There may be abscesses in these glands, abscess of the prostate or abscess of the kidney, The seminal vesicles may become diseased, and the infection may travel along the spermatic ducts to the testicles themselves, most frequently attacking the epididymis, the very fine, convoluted tube adjacent to the testicle which forms the beginning of the vas deferens, or duct. It is the permanent closing up of the epididymis through this inflammation that causes most cases of sterility in men.

Chordee is a very distressing symptom or complication of the inflammatory stage of gonorrhea, involving a state of painful erection, with a marked downward curve of the organ. Gentle handling is imperative in such a case; otherwise one may cause much bleeding and subsequent stricture. Local cold applications, with a hot sitz bath each evening before going to bed, are recommended.

When the prostate gland is involved and the inflammation is marked, there is likely to be more or less fever, with a sense of heat and weight, and possibly considerable pain in the perineal region. The movement of the bowels usually causes intense pain, and there may be an almost constant desire to evacuate. Very frequent urination is the rule, though there may also be retention of urine. The prostate gland, unfortunately, is a structure well adapted to serve as a hiding place for the gonococci after the disease appears to have been cured. In the recesses of this organ collections of pus cells containing the germs may linger in a dormant condition for years after the victim believes himself cured and later becoming active, may reinfect him, or, it may be, infect his innocent wife. Violent exercise or sexual indulgence may have the effect of opening up such lingering collections of gonococci.

Gleet may be regarded as a chronic form of gonorrhea in the urethra. In a normal recovery, the discharges and signs of the acute disease gradually disappear until the-parts are restored to a fairly healthy condition, though even then there is likely to be a somewhat catarrhal condition of the mucous membranes. There will also be a catarrhal condition of the prostate gland in most cases, even after all the germs have been eradicated. But when the third stage of urethritis is followed by a persistent, chronic inflammation, it is known as gleet. Usually this is localized in one or more spots, and there is always danger of a stricture at such points.

The after effects of gonorrhea may in different cases include impotence, sterility, stricture, spermatorrhea, prostatorrhea, sexual neurasthenia, hypochondriasis, melancholia, rheumatism, heart trouble, bladder and kidney disease and other permanent ills. "No worse than a bad cold !"

The successful treatment of gonorrhea is partly at least a matter of purifying the blood. There should be no internal drug treatment, by way of the stomach. Local medicinal treatment should be very mild. Many specialists do not believe in injections under any circumstances, because of the danger of driving the infection back into the posterior urethra, bladder and prostate gland, though there is but slight danger of this possibility.

To improve the condition of the blood rapidly, an extremely light diet, chiefly of fruit, salads and green vegetables, for two or three days at least, is necessary. Buttermilk can be recommended. In a severe case, especially one in which the prostate gland is involved, a complete fast of several days is occasionally desirable. In severe prostatitis, after a fast of five to seven days, the exclusive milk diet could be recommended, though this diet can not be recommended in active gonorrhea. Be temperate in the use of meat until all active signs of the inflammation have passed. One should be sparing in the use of eggs, nuts, beans and proteid foods generally.

The free drinking of water is especially impor. tant—the more the better. Usually one can absorb more hot water than cold, and it is well to use it hot to a large extent. Lemonade is permissible, but should not be too strong, nor too sweet. Free water-drinking from the time of exposure will usually make the attack lighter. The increased passage of urine will tend to wash out the germs of the disease, and this will still hold true after the inflammation has become active. Also, the urine will be diluted and made less irritating, thus relieving, to some extent, the scalding pain experienced when passing water.

This water-drinking is perhaps the most important single feature of the treatment, and will do much to reduce the inflammation and prevent the infection from travelling to the posterior urethra.

Rest is very important, to avoid irritating the inflamed parts and to prevent the infection from spreading to other parts. In a bad case, rest in bed is desirable. If you must be about, be as quiet as possible.

Constipation must be avoided. Keep the colon as clean and free from accumulations as possible. Warm enemas will be advantageous, especially if the prostate gland is affected.

Alcohol must be rigidly eschewed. It has an irritating and weakening effect upon the tissues. Tobacco, condiments and all stimulating drinks should be avoided. There should be no sexual indulgence, or even sexual excitement, while any traces of the disease remain. Avoid excitement of any kind, and also overheating.

The strictest cleanliness is imperative. The contagious character of the disease and the infectious nature of the discharges must be kept continually in mind. A careless person may infect his own eyes, or convey the disease to another. With his unclean hands he may soil a towel which will be the means of producing blindness in an-other member of his family. Towels, handkerchiefs, shirts or other articles of clothing soiled with these discharges should be thoroughly washed and sterilized, preferably by prolonged boiling. The safest plan is to wash the organ frequently with good soap and water, and to wrap the end well in aseptic absorbent cotton, to take up the discharges and protect the clothing. It is a good plan to wear a pair of swimming tights inside of the other clothing to keep these wrappings in position. Local packs of cold wet cloths will reduce the inflammation, and it is best to use cold salt water for this purpose. If convenient, it would be well to keep the organ continually wrapped in these wet salt packs, renewed as often as possible; but at least they should be used in the evening, or at any other time of the day when it is possible. All such cloths and cotton wrappings should preferably be burned. Wash the hands very thoroughly after each handling of the parts.

Much harm can be done by the use of strong injections of permanganate of potash or nitrate of silver. If injections are used the solution must be weak. Strong injections will often destroy the mucous membranes. It is important that the tissues should not be deprived of their vitality and power of resistance. A good rule to observe is to use no injection so strong that it could not also be used in the eye.

The main purpose of any injection should be cleanliness. A mild antiseptic injection may thus be useful for cleansing the membranes, flushing out the urethral canal and thus removing many of the germs. During the first stage irrigation of the canal with a very mild solution of sulphate of zinc can often immediately arrest the disease and all signs of it soon disappear. A very weak solution of permanganate of pot-ash is often used, especially in the acute stage, just enough of the permanganate being used to color the water, but never enough to make the injection painful or even enough so that it can be felt. Painful injections are invariably detrimental. In making injections, much care should be used to introduce the liquid into the urethra gently and gradually. Injections or other medical remedial measures should be pre-pared by a medical or other qualified practitioner. It is not safe to tamper with remedies of this sort without knowledge of their use.

One of the most valuable remedial measures is the hot and cold sitz-baths, changing from hot to cold from three to four times. The cold water should be as cold as can be obtained, and the hot water should be as hot as can be borne without burning. Sit in hot water from three to five minutes, then quickly change, sitting in cold tub of water one or two minutes, or until the water becomes uncomfortably cold. Change in this way from hot to cold three to five times once daily. 'Where the inflammation is unusually severe this treatment could be advantageously taken twice daily, morning and evening.

In some severe cases mud packs if worn all night will be especially efficacious. In the third stage, when the symptoms are on the decline, the cold sitz-bath morning and evening can be recommended.

The treatment should be the same in nearly all particulars when the seminal vesicles, epididymis and other parts are involved. Improvement of the blood is always important. Gleet is uncured gonorrhea, and a little stickiness on the end of the organ is due to the same cause. The condition calls for prolonged treatment. In this chronic form of the disease plenty of exercise is desirable, which of course is the exact contrary of the requirements in the acute stages of the disease. Also, when the prostate and seminal vesicles have been diseased, a great deal of vigorous exercise is desirable after the cure, partly in order that any remaining traces of the disease may be brought to light and eradicated.

When is it safe to marry, after having suffered from gonorrhea? The question is a troublesome one, simply because of the possibility that germs may lurk in the recesses of the prostate and other parts for prolonged periods after an apparent cure has been effected. If the disease has been confined to the anterior urethra, and one is in ,a position to know this positively, then the question is very simple, and one is quite safe in marrying within a year after all signs of the trouble have disappeared. It might not be necessary to wait as long as that, if there remains no trace of the infection. But when the deeper structures have been affected one is not justified in considering marriage until one has been free from all active signs of the disease for at least two years, and then only when repeated careful examinations of the prostatie fluid, semen and the mucous secretions of the membranes generally, show complete freedom from any signs of the disease.

GONORRHEA.----Important features of the treatment. When the first symptoms appear, or even if suspicions of having been infected, an injection should be taken of a weak solution of sulphate of zinc or permanganate of potash. These injections should be repeated every three or four hours for the first two or three days at least, gradually lessening their frequency.

Drink very freely of pure water, cold or hot as desired. A glass every half hour or hour at least for the first few days. These pre-cautions without any additional treatment will often destroy the germs thus curing the disease before it develops.

If the complaint persists then the hot and cold sitz-baths, as previously described, can be taken- once or twice daily. Applications of cold wet towels to the affected parts should be taken at least during part of the night.

Great care should be used to avoid constipation, though usually the free drinking of water suggested will remedy this difficulty if present.

Following ,the very short fast advised for this disease, it is often well to satisfy the demands of the appetite for nourishing foods to build the vital vigor necessary to throw off the complaint.

Active exercise is not advised. Remain as quiet as possible at least for the first few days of the treatment.

GLEET.—Important features of treatment. The treatment of gleet depends almost entirely upon an upbuilding process for increasing the general vital strength. This naturally will include a course of exercise, together with friction baths, followed by cold baths, long walks, wholesome diet, etc.

The treatment might begin with a short fast, though this will be of little advantage further than its effects on the assimilative organs. Every function of the body must be made to perform its office in the treatment of this complaint.

In addition to this, there is one very important suggestion that is often of tremendous importance. In the chapter on exercise, page 277, you will find a movement for stimulating the prostate gland which has a decided influence on the urethral canal. This exercise, practiced two or three times a day assists very materially in remedying this troublesome complaint.

Stricture of the urethra is an abnormal constriction of the canal, interfering with the flow of urine. It is most frequently the result of gonorrhea, though it may be due to other causes. Gleet is often accompanied or followed by stricture. Inflammatory stricture may be a temporary condition, the result of swelling which naturally tends to obstruct or close up the canal.

Usually it yields entirely to treatment, but in a serious case may lead to organic stricture, which is usually a more or less permanent change in the structure of the canal. Strong chemicals or wrong doses of curative drugs used for injections may cause stricture, and tumors or deposits of foreign matter may also produce it. Masturbation, sexual excess or rough usage, causing prolonged congestion of the parts, may possibly result in such a thickening of the walls of the urethra as. to obstruct the passage. Spasmodic stricture is of nervous origin, the constriction beng caused by a muscular spasm.

In inflammatory or spasmodic stricture, a fast of a few days, combined with free water drinking, and the application of cold wet cloths to the affected parts, is especially recommended. If gonorrhea is the cause, the treatment must be directed toward the eradication of that disease, and little other will be required. Constitutional and blood-purifying treatment are essential. Whatever the cause of the condition the free drinking of water will be useful, both because it renders the urine less irritating and because of the mechanical effect of the passage of large quantities of water. When there is retention of urine, medical help must be obtained at once.

Stricture is commonly treated by physicians through the use of sounds, and to a certain extent also by means of caustics. I do not believe that caustics can ever be recommended. Certainly one should never experiment upon oneself in this way. The forcible passing of large quantities of non-irritating urine, following free water-drinking, is a better way to expand or open the constricted part. In a case of organic stricture, one may even compress the meatus of the urethra when on the point of urinating, thus holding the water back in the canal, and causing the constricted part to be expanded or opened. A little force in the expulsion of the water under such conditions will make this procedure very effective, and the tissues will not be lacerated, as they often are by the passage of sounds and probes. When there is much inflammation, however, one must be careful with this method, as there is danger of causing rupture of the urethra with serious complications. If there is marked tenderness it would be well not to use it at all, but to pursue treatment to overcome the inflammation, as out-lined for the cure of gonorrhea. Local wet packs are always helpful, hot if the condition is painful, but otherwise cold. Don't trust quack doctors, and avoid advertised remedies which claim to cure stricture by "dissolving" it.

STRICTURE.-Important features of treatment. The treatment of this complaint is to a large extent constitutional. The hot and cold sits baths advised in gonorrhea is of great value if taken once daily. The sits baths could be taken in the morning, and at least part of the night cold wet cloths should be applied to the affected part. A short fast or a rigid dietetic regime for a few days would remedying this complaint.

Mud packs can be used advantageously in serious cases of this complaint.

Chancroid is a local infection, the least serious and the least frequent of the three common venereal diseases. It takes the form of an ulcer, usually found on the head of the generative organ, which secretes and discharges a purulent pus. It is not followed by constitutional or other symptoms,` except for the infection of the lymphatic glands of the groin in many cases, causing what is known as a bubo. If great care in the way of cleanliness is not taken, one may have several ulcers of the same kind. The disease is seldom contracted except through association with the most unclean type of woman. The ulceration may be very severe, possibly destroying considerable tissue, but when cured one is through with it. In rare cases, when the infection reaches the larger blood vessels and gets into the general circulation, a general septic infection or blood-poisoning results and this may end fatally.

Chancroid is commonly called soft chancre to differentiate it from the hard chancre which is the initial sore of syphilis. It is important to distinguish between the two, but some authorities maintain that a Wassermann blood test and a microscopic examination is the only sure means of doing so, for at times the chancroid may be hard and the syphilitic sore soft. It is possible, too, to contract both diseases at the same time. The syphilitic chancre is not always, but usually, indurated or hardened, and is commonly smooth and glazed, with little or no secretion. The chancroid has rough, punched-out edges, and has a copious pus secretion. Again, the chancroid develops quickly, always within a week and often within two or three days after exposure, while the syphilitic chancre does not appear until fully three weeks, or more, from the time of exposure and infection. The "mixed sore," resulting from the complication of syphilis with the less serious affection has, at first, the appearance of the quickly developing chancroid.

The treatment of chancroid is to a large extent simply a matter of cleanliness, although the improvement, of the blood is important. The free drinking of water and the use of a light diet, at least for a few days, the same as in gonorrhea, are essential. One must be careful to keep the secretions of the ulcer from reaching other parts of the body. Washing with soap and hot water or with an antiseptic morning and evening is necessary, after which a cold sitz-bath could advantageously be taken. Thereafter absorbent cotton wet with "black wash" made by adding calomel to lime water should be applied to the ulcer, and wrapped around the organ. The cotton should be kept on the ulcer continually to take up the purulent discharge and prevent other parts being infected. More frequent washings are advisable if convenient.

CHANCROID.-Important features of treatment. As this is a local complaint produced entirely by local infection, if the "black wash," previously referred to, is applied to the affected parts, immediately upon the appearance of the first symptoms, the disease usually disappears quickly.

If the disease has already progressed sufficiently to be accompanied by the swelling in the groin previously referred to, then the hot sitz-baths and the other features of the treatment could also be used.

Cleanliness of the parts, as described previously, must be rigidly insisted upon.

A short fast or a strict dietetic regime in the beginning of the treatment could be adopted with advantage, but as the treatment progresses, the diet must be sufficiently nourishing to build the highest attainable degree of vitality.

Bubo. —A bubo is an inflammation and enlargement of a lymphatic gland in the groin, resulting from infection, and usually of venereal origin. A simple bubo may be due to any ordinary infection, and is usually not serious. A virulent bubo is one of chancroidal origin, the virus from which is capable of inoculating others.

The bubo characteristic of syphilis is usually not painful, and simply takes the form of a hard swelling of these glands. Chancroid is most frequently followed by bubo, the disorder being painful and frequently ending in suppuration. It may appear a couple of days after the chancroid or later. When following gonorrhea it appears usually one or two weeks after.

The first symptoms of a bubo are hardness and swelling of the gland, pain in the groin, tenderness, heat and discoloration, as in any inflammation. A mild case may go no further than this, but when more serious the pain may be continuous for a few days before suppuration occurs, when the pain subsides and a softening of the part can be felt. The bubo next turns dark and finally breaks, discharging the pus, very much like any other abscess. Free drainage is desirable, and great care to maintain cleanliness. In a serious case surgical help for the purpose of opening up the abscess and insuring' good drainage will be advantageous. If the pus burrows into the surrounding tissues, other abscesses will follow, or the skin may be perforated at several points, forming fistulous ulcers, and more or less destruction of tissue. When the chancroidal bubo discharges, the edges become ulcerated with the chancroid virus, often resulting in much destruction of tissue, and nearly always in very slow healing.

The first signs of trouble indicate the need for quiet. In fact, violent exertion may be instrumental in carrying the primary infection to the lymphatic glands. Constitutional treatment is then necessary free drinking of water, a light diet, with plenty of fruit and green vegetables, and the avoidance of constipation. A fast of one or two days is recommended. Of course the original disease should have first attention, with such sitz-baths and other treatment as may be required. When the swelling is very painful, hot sitz-baths are especially helpful. Hot enemas may also be used. This general treatment will in nearly every case prevent suppuration. It is especially important to avoid alcoholic drinks of all kinds.

In the very beginning, the application of cold wet cloths and cold sitz-baths will often give relief, but if the pain becomes more severe hot water will be found more soothing. After the bubo breaks, or is opened by the surgeon, great care in the way of cleanliness will be necessary. Use absorbent cotton plentifully for this purpose, to absorb all discharges, and as much of the time as possible use wet packs, dipping the cloths in cold salt water or in some mild antiseptic solution.

BUBO.—Important features of treatment. the hot sitz-bath and the hot and cold sits-bath advised in gonorrhea are valuable in this disease.

Cold, wet cloths applied to the affected part is of especial advantage, though the Constitutional treatment previously referred to will be of decided advantage.

Mud packs are of special value. Apply at night and allow pack to remain until morning.

Syphilis.—Syphilis is the one infectious venereal disease that is constitutional, poisoning the blood, secretions and tissues of the entire body. It is sometimes called "the pox." Fastidious persons often call it by the polite name of "Lues," and still more often it is hinted at by the indefinite name of "blood-poisoning." The specific micro-organism which is now believed to be the active factor in syphilis is a protozoon, the treponemapallida, which is threadlike or spiral in form, or corkscrew-shaped, and possessed of great vitality.

There are three methods of infection. First, direct transmission, from one person to another. Second, mediate transmission, in which the poison is carried by a towel, drinking-cup, tooth-brush, dental or surgical instrument, spoons, forks or other table implements, or any other object upon which the virus has been deposited by a diseased person. Infection in this way is commonly called "innocent" or accidental. The saliva of a syphilitic is literally alive with the germs, so that kissing, and the use of drinking-cups, towels and other objects that touch the mouth are sources of danger. The third method is congenital trans-mission. Syphilis is the one disease that is directly inherited, though usually the offspring is fatally infected before the time of birth.

Infection most commonly takes place through sexual intercourse, though it may enter the system through a scratch on any part of the body. Direct infection depends upon some break or abrasion of the skin, or of the epithelium of a mucous membrane, which offers a doorway, so to speak, through which the poison may reach the blood. A fissure in the skin or mucous membrane may be so small that you cannot see it, but if it is there it will provide a channel through which the disease may enter the body. This ex-plains why one may sometimes escape, even when exposed. Such escape, however, is not usual. Intercourse itself is likely to produce the slight break in the mucous membrane or skin which will admit the infection. It is claimed that it may sometimes penetrate through a thin soft membrane without any such abrasion.

The incubation period of syphilis is usually about three weeks, sometimes a little less, and often longer, even up to six weeks. This is one way to distinguish it from chancroid, in which the sore appears in from two or three days up to a week after infection. See the comparison. given on page .

The first sign of syphilis is the hard, red, glazed sore or ulcer, known as a chancre, which is found on the site of infection. This does not, as a rule, give one much trouble. It usually heals up by itself in a few weeks, though sometimes it develops into an inflammatory or gangrenous ulcer, in which case it should have the care as to cleanliness and antiseptic treatment that I have suggested for chancroid.

The second symptom characteristic of syphilis, following closely upon the appearance of the chancre, is the swelling and hardening of the nearest lymphatic glands. This of course means in most cases a syphilitic bubo in the groin, which is not painful. If the chancre is on the face, the glands of the neck swell; if on the hand or arm, those of the armpit are involved.

The second stage of the disease, called secondary syphilis, is usually reached in about two months after the development of the chancre. It may be from six weeks to ten weeks after. If these constitutional symptoms do not show up for from three to six months, you can assume that the suspected sore was an ordinary pimple and that there is no danger.

With the secondary stage there is more or less enlargement of all the lymphatic glands, notably in neck, armpits and groin, but the most conspicuous feature of this stage is the characteristic eruptions and ulcerations of the skin and mucous membranes of the body. The throat and mouth, for instance, are subject to mucous patches and ulcers, which may also be discovered in the rectum and on other mucous surfaces. The skin symptoms take various forms, which may vary from simple eruptions to severe ulcerations and ,crusts. One can never tell where or when the manifestations of this disease will crop out. Usually there is a first eruption of a copper color, by which the disease is distinguished from most red skin disorders. These blotches or pustules dry in a little time, after which they may be rubbed off like bran, leaving the skin apparently in a fairly healthy condition for a time, but the rising hope of the sufferer is soon dashed to the ground by the appearance of another eruption, probably more severe than the first, and taking the form of a serious ulcer. The various eruptions may vary in color, but the copper color is most frequent. Vesicles like those of small-pox, drying and leaving scabs, may develop, or there may be blotches covered with scales, followed by scabs and shallow ulcers with copper-colored edges. The ulcers of the mouth, throat and rectum, however, are likely to be the most trouble-some, often being thought to be cancers or fistulas. The hair is usually affected in the secondary stage, falling out extensively; and one is likely to suffer more or less from fever, pains in the head, joints and bones, loss of weight and strength, mental torpidity and other general symptoms. The headaches and pains in the bones are sometimes severe.

The third stage, or tertiary syphilis, is that which involves the more frightful developments and ravages of the disease, the "horrors" which are so much feared. With proper treatment one should not reach even the second stage, .but when the poisons have not been eradicated from the system, and the vitality is lowered, serious symptoms are likely to ensue. The third stage inVolves the deeper structures, such as the vital organs, the internal membranes and the bones. Any part of the body may be attacked. The formation of characteristic tumors or "gumma" is the rule, in the third stage, leading to the degeneration of the tissues affected. The bones may be eaten away, piece by piece, those of the nose and face being often the first to suffer in this way. The associated pains are usually most, frightful at night. The eyes and ears may suffer, ending in blindness and deafness. The nails may go. The vital organs may be involved and the blood-vessels are usually affected more or less, even when the disease does not reach the third stage. The weakened arteries may later on be responsible for a rupture in the brain, or apoplexy.

In the past, medical men have regarded syphilis as having only these three stages. But there is sometimes a fourth stage, possibly occurring twenty or twenty-five years afterward, in which the brain and nervous system are chiefly concerned. The fact is that paresis, or general paralysis, the most dreaded and always fatal form of insanity, is in nearly every instance due to syphilis which has been "cured" (?) a long time previously. The same thing is true of locomotor ataxia, which is nearly always the result of the same disease.

Hereditary syphilis naturally does not have the first stage, or chancre, but otherwise is not unlike the ordinary case, and is very commonly accompanied by deformities, often by mental defectiveness. However, when syphilis is active in the parent an abortion is almost certain to take place. As the severity of the disease is diminished somewhat, the next child may go to full term and then be born dead. As the virulence of the disease is further decreased a living child may be born, which may or may not die shortly. The mortality among such children is very high. When a syphilitic child lives it may present no appearance of the disease at birth but symptoms usually manifest themselves in a few weeks. Sometimes the marked developments of the disease do not occur until puberty or later. The eyes and bones are likely to suffer. The brain and nervous system are often affected, epilepsy sometimes resulting. In babyhood the symptoms include a peculiar snuffling, difficult breathing, an appearance of old-age, emaciation, weakness and other indications of disorder.

The treatment of syphilis requires most of all a course of blood purification and vitality building. All natural measures that help to eliminate poisons from the system and to build resistance will be helpful, and a regimen that will most thoroughly accomplish these results will offer the best and speediest means of cure. I have known of many cases in which the most surprising results have been accomplished by such constitutional treatment.

Mercury has been the favorite resort of the medical profession in the treatment of syphilis for an indefinite time, but there is good reason to believe that so far as this poison is concerned the treatment is even worse than the disease. Chronic mercurial poisoning often adds to the difficulties of the body already struggling against the syphilitic poison.

One of the most important features of the treatment is abstinence from both alcohol and tobacco. Not only do these poisons directly cause the patches and ulcers of the mucous membranes to be much more numerous and severe, but they weaken the resistance of all the tissues. I am inclined to believe that the virulent character of this disease in the past has been due in part to the fact that it has most commonly been contracted by the more or less dissipated class of men, those who both drink and smoke, and who are usually disinclined to give up their pet habits even for the sake of a cure. It is well known that women as a rule bear this disease better than men, or at least show it less, and it is quite likely that this difference is due to the fact that women as a rule do not use tobacco and alcohol, or at least consume them to a less extent than men. In any case, it is impossible to make any progress with any kind of treatment if one uses either of these poisonous narcotics.

Constitutional and blood-purifying treatment should be commenced upon the first appearance of the chancre. Cauterizing this primary sore does some good, despite the fact that infection has already entered the blood. Cleanliness and antiseptic washes may be used, but no strong antiseptic that will have a destructive effect upon the tissues.

Fresh air and exercise are of vital importance. Cleanse the blood stream through activity and plenty of oxygen. Work outdoors, live outdoors and sleep outdoors if you can. Get as much active exercise as you can stand without lowering your vitality. Walks are invaluable. Try to walk ten miles a day at least, and walk fast enough to make you breathe deeply and perspire.

Drinking water will help greatly in purifying the blood. Drink at least two or three pints of hot water within an hour after rising in the morning. Use distilled water by preference, and quarts of it. Boiled water is next best, but the softer the better. "Hot springs" have no special value over the water at your own home, if you will only use the latter , as freely. The "Hot springs" fallacy has grown up, because many have not the strength of mind to follow the same regimen at home.

The eliminative activity of the skin should be encouraged by friction baths daily, except where eruptions interfere, by air baths and sun baths in every case, and by the external use of water. The air baths and sun baths are more important than you may think, and I would insist upon them if you wish the best results. A wet sheet pack each day or three times a week, would serve as a powerful eliminative treatment, combined with a soap-and-hot-water bath twice a week.

After the cold wet sheet is thoroughly wrapped around the body, one should be bundled up with blankets outside of it, remaining in the pack a couple of hours if convenient. The sheet should be boiled afterward. If the sheet pack is not convenient, take a cold sponge, dip or shower in the morning, following your exercises, and take a short hot bath of five or ten minutes each evening, followed by a cool sponging or shower. These will have an active eliminative influence. A dry hot-air or steam bath once a week will also be effective. A cabinet bath is satisfactory.

The skin eruptions, when ulcerations are present, should be treated with a mild antiseptic wash after your baths. You may use a weak solution of permanganate of potash, bichloride or any other standard antiseptic. Any mouth wash for the mucous patches must be mild. Peroxide of hydrogen or even boric acid or salt water may be used. Thorough and prolonged boiling of all underwear, handkerchiefs, napkins, towels and the like used by the syphilitic is necessary.

The diet, should be limited in respect to rich foods. It is usually best to avoid meat entirely, but eggs may be used in moderation. Tea and coffee should be eliminated from the diet, but buttermilk is highly to be recommended, if you like it. Use fruit as extensively as your appetite will permit, also green salads and all vegetables that grow above the ground, preferably uncooked, if they are palatable that way. Fruit drinks, such as apple juice, unfermented, grape juice, orange juice and lemonade are all advisable, but be sure they are pure.

If one has much flesh to spare it is well to commence the treatment with a fast of one or two weeks. This is a rapidly-purifying treatment. If you have no flesh to spare, it would often be a good plan to fast a couple of days, drinking water plentifully, and then adopt the exclusive milk diet for a few weeks, after which adopt a diet of fruit, salads, nuts, cereals and other natural foods. Fresh milk does not harmonize so well with other foods as buttermilk or fermented milk. Overeating should be guarded against. Constipation particularly should be combated, according to the suggestions given in a previous chapter.

Everything must be done to build vitality. One should get just as much sleep as possible, and in the fresh air. It is best to avoid excitement. Live a quiet healthful life that will tend to purify your blood and give you the maximum degree of energy. If you follow the suggestions for treatment that I have given here, together with the advice as to exercise and other matters relating to virility building, you can depend upon a much more rapid recovery than would be possible from drug treatment.

The question as to when one is really cured and in a condition to marry is a very delicate and puzzling one. One may seem cured and yet carry traces of the disease. Positive signs of it are certain evidence of its presence. Lack of such signs, however, is not evidence of its absence. Even the Wassermann blood test is not entirely reliable. The positive reaction is said to be conclusive. But the negative reaction, while a favor-able sign, is not absolute evidence of a cure. The disease may reappear at any time, and in any form. It is the rule, however, that some years after recovery from syphilis a man will have normal and healthy children. It is entirely a question of being free from the disease, but this is always uncertain. Some syphilologists hold the opinion that a syphilitic man should never marry. The preponderance of opinion on the subject, however, is that it is usually safe to marry in about five years from the time when the disease was contracted, provided there have been no signs of it for at least two or three years. It is well to have a series of blood or Wassermann tests at intervals of two or three months, extending over a period of a year or more. Even this will not make the case absolutely sure, but if the results are negative the chances that the infection has been eradicated are fairly good. The former syphilitic should always continue, however, to take the best care of himself, keep his blood in good condition, and even take a fast of three or four days twice a year as a constitutional and cleansing measure. He should form life-long habits of fruit-eating, water-drinking, outdoor exercise, long walks, air baths, sun baths, friction baths, daily cold-water baths and frequent hot baths.

SYPHILIS: Important features of treatment. A fast of from seven to fourteen days is of unusual value in the treatment of this complaint.

The exclusive milk diet to follow the fast as advised, is another remedy that produces extraordinary results.

Frequent bathing and dry friction baths to insure an active skin is very important.

If the milk diet is not used then water must be drunk very freely.

Foods must be used that will insure bowel activity. Constipation aggravates this complaint.

A full nourishing diet is not advised. Use as little food as possible to maintain your weight and strength. Two meals a day are better than three,—one is sometimes better than two. Thorough mastication must be insisted upon. Outdoor exercise of all kinds, especially walking, is rigidly required.

These more important suggestions together with the previous hints ought to enable any one to remedy this terrifying complaint if it has not progressed too far.

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