APPENDIX I. (Page 91)
The following testimony is byDr.T. Gaillard Thomas, a recognised gynæcological authority of New York.
The following testimony is byDr.T. Gaillard Thomas, a recognised gynæcological authority of New York.
‘Until the last twenty years specific urethritis was regarded, in the male, as an affection of the most trivial import, as rapidly passing off, leaving few serious sequelæ, and offering itself as an excellent subject for jest and good-natured badinage. About two decades ago,Dr.Emil Noeggerath published a dissertation upon this affection, which will for ever preserve his name in the list of those who have accomplished good for mankind, and give him claim to the title of benefactor of his race. This observer declared, first, that out of growing young men a very large proportion prior to marriage have specific urethritis; second, that this affection very generally causes urethral stricture, behind which a “latent” or low-grade urethritis is for many years prolonged; third, that even as late as a decade after the original disease had apparently passed away the man may transmit it to a wife whom he takes to himself at that time;and fourth, that the disorder affects, under these circumstances, the ostium vaginæ and urethra, and thence passes up the vagina into the uterus, through the Fallopian tubes, where it creates specific catarrh, and by this disease produces oöphoritis and peritonitis, which becomes chronic, and often ends in invalidism, and sometimes even in death. For this essayDr.Noeggerath was assailed by ridicule and by contradiction. The matter has now been weighed in the balance, and admitted to its place among the valuable facts of medicine.
‘My estimate of specific urethritis as a factor in the diseases of women—and I take no peculiar or exaggerated views concerning the matter—will be vouched for by all progressive practitioners of gynæcology to-day. Specific vaginitis, transmitted to virtuous women by men who are utterly ignorant of the fact that the sins of their youthful days are at this late period bringing them to judgment, is one of the most frequent, most active, and most direful of all the causes of serious pelvic trouble in women—one which meets the gynæcologist at every turn, and one which commonly proves incurable except by the dangerous procedure of cœliotomy.
‘Think for a moment of the terrible position in which a high-minded, upright, and pure man finds himself placed without any very grave or unpardonable fault on his part. At the age of nineteen or twenty, while at college, excited by stimulants, urged on by the example of gay companions, and brought under the influence of that fatal trio lauded by theGerman poet—“Wein, Weib, und Gesang”—the poor lad unthinkingly crosses the Rubicon of virtue! That is all! On the morrow he may put up the prayer, “Oh, give me back yesterday!” But yesterday, with its deeds and its history, is as far beyond our reach as a century ago, and returns at no man’s prayer.
‘Four or five years afterward this youth goes to the marriage bed suffering, unknowingly, from a low grade of very slight latent urethritis, the sorrowful memento of that fatal night, which has existed behind an old stricture, and a result is effected for the avoidance of which he would most gladly have given all his earthly possessions.
‘All this sounds like poetry, not prose; like romance, not cold reality. But there is not a physician in this room who does not know, and who will not at once admit, that every word that I have uttered is beyond all question true, and even free from exaggeration.
‘I mentioned, in speaking of the grave duties demanded by puberty, that one of the important functions of the physician in regard to the development of the girl during the thirteen years which precede it, is to instruct her and her guardians how to prepare her for the approaching issue. In language no less strong I would here insist upon the physician’s duty to instruct men in all stations of life as to the importance of a “clean bill of health” in reference to gonorrhœa, both acute and chronic, before the marriage contract be entered upon.
‘Until a very late period the plan universallyfollowed has been this: The man about to be married went to his physician, told him the history of a gonorrhœa, and asked if, now that all discharge appeared to have ceased, any danger would attend his consummating the tie. The physician would ask a few questions, examine the virile organ carefully as to discharge, and, if the “outside of the platter” appeared clean, give his consent to the union. The evil which has resulted from this superficial and perfunctory course has been as great as it has been widespread. To-day the question of stricture, a slight, scarcely perceptible “latent gonorrhœa,” with its characteristic “gonococcus,” is looked into, and not until all trace of disease is eradicated is permission given for the union. A marital quarantine is as necessary to-day in social life as a national quarantine is for contagious diseases in general.
‘Few men, however eager for matrimony they may be, would run the great risks attendant upon precipitancy if they only knew of them clearly and positively. In no field of medicine is the old adage, “Prevention is better than cure,” more important than in this one. If physicians would do their duty fully in the matter, how many unfortunate women now languishing from “pyosalpinx” would in the next generation be saved!’