Gonorrhoea: The hidden epidemic that was 'more baneful to the race' than syphilis

“ Such innocent people surely do not deserve punishment and ought to be protected. The traditional shameful character with which the venereal diseases have been invested by popular prejudice is surely absent in this class of cases. The only practical protection is the removal of the mist of ignorance.BR Ignorance of the results of venereal diseases is often ruinous.
Especially is ignorance, prevailing about gonorrhoea, often329 very disastrous. Gonorrhoea is commonly considered a benign local disease. Young men think it a joke to have gonorrhoeal infection several times in their lives. ”

“ They think gonorrhoea is not more serious than a bad cold. The young man who happens to have escaped gonorrhoeal infection is the target of his friends’ jests. Yet gonorrhoeal infection may make a tragedy of marriage by destroying the woman’s conceptional capacity and rendering her irrevocably sterile, in this way producing childlessness, and by sending thousands of women to the operating table to be condemned to the mutilation of their generative organs to save their lives. ”

“ There is no greater scourge devastating every nation to-day than the two venereal diseases. No other disease has such a murderous influence upon the offspring as syphilis, and no other disease is so destructive to the health and reproductive function of woman as gonorrhoea.
Thus the dangers of venereal diseases beset not only the individual but through the individual the whole race. Both venereal diseases respect no social position and recoil before no virtue. They ramify through every class and rank of society. ”

“ It is a wellestablished 81opinion among the medical scientists at the present time that the total amount of damage and suffering to individuals and to society at large produced by gonorrhea falls not far below that produced by Syphilis, which is justly known as a black scourge of humanity. Gonorrhea is considered now a very serious disease, requiring, for a complete and permanent recovery, long and painstaking treatment. The complications of gonorrhea are numerous and far-reaching. ”

“ Gonococci may remain in the genital tract during the entire period of pregnancy, without clinical manifestations, and yet become active during the puerperium, which explains many obscure cases of puerperal infection. In this way the ignorance of the prolonged infectious character of latent chronic gonorrhoea has ruined many and many a young wife. The individual considers himself cured, while in fact the gonorrhoea remains contagious for many years to the innocent wife and her child. ”

“ But it is by virtue of its byproducts, so to speak, that gonorrhoea is most injurious and is really more baneful to the race than syphilis. The organism which causes it is in a high degree destructive to the eyes. Newborn infants are very frequently infected in this way by gonorrhoeal mothers. Probably a quarter of all permanent blindness in this country is caused by gonorrhoea. The effect of the disease upon women is disastrous. Half of all abdominal operations on married women, excluding appendicitis, are the results of gonorrhoeal infection from their husbands. ”

“ Gonorrhea in women is frequently a serious and even fatal disease. It usually renders women incapable of having children, and its treatment necessitates often the most serious operations. Gonorrhea of the eyes, affecting especially newborn children, is one of the principal causes of blindness. Gonorrhea may be transmitted to little girls innocently from infected toilet seats, and is all but incurable. Gonorrhea, wherever it occurs, is an obstinate, treacherous, and resistant disease, one of the most serious of modern medical problems, and fully deserves a place as the fourth great plague. ”

“ It follows that at least every other person in the Kingdom has suffered from venereal disease. Probably not a family has escaped infection. In proportion to its prevalence syphilis is not very deadly, yet it has been reckoned as the fourth killing disease. The victims of gonorrhœa are incalculable. Venereal diseases fill our hospitals, asylums, and workhouses. They are the principal causes of heart disease, apoplexy, paralysis, insanity, blindness in children, and of that life of sterility and pain to which so many women are condemned. ”

“ We cannot expect to do away all at once with the feeling that venereal disease is "shameful." It may not even be desirable. But we can at least make clear that, in so far as there is any shame, it must be a question between the individual and his own conscience. From the point of view of science, syphilis and gonorrhoea are just diseases, like cancer and consumption, the only diseases with which they can be compared in the magnitude and extent of their results, and therefore it is best to speak of them by their scientific names, instead of trying to invent vague and awkward circumlocutions. ”

“ Medicine.—A virulent gonorrhœa can rarely be cured speedily and effectually at the same time. The patient ought, therefore, not to expect nor the physician to promise it. It will often continue for two or three weeks, and sometimes for five or six, even where the treatment has been very proper.
Sometimes, indeed, a slight infection may be carried off in a few days, by bathing the parts in warm milk and water, and injecting frequently up the urethra a little sweet oil, or linseed tea, about the warmth of new milk. ”

“ The reason why the medical student with all his supposed knowledge of sex is not different from any other young man, is that he acquired his knowledge too late to be of any value. If he had begun his studies on the pathology of syphilis and gonorrhoea and had known the dangers of the venereal scourge before he ever had a taste of sex, it is very likely that with the knowledge of the danger lurking, not only to himself but also to those dearest to a man’s heart, his future wife and children, he would abstain from the association with meretricious venery. ”

“ From the fact that about 90% of sterile women are married to men who have suffered from gonorrhoea either before or during their married life, he infers that the sterility is due to latent gonorrhoea communicated from husband to wife. If this inference were justified, sterility would be far commoner than it actually is. Nöggerath makes use of the term “latent gonorrhoea” because the woman becomes infected without the obvious outbreak of any acute phase of the disorder. The disease remains latent, and a radical cure is not to be expected until the menopause. ”

“ A curious point to know is that a man may have a hidden or latent gonorrhoea, of which he is not aware, for it gives him no trouble, and may infect a clean, healthy woman during sexual relations, and she in turn, can infect him with the same disease, acting like a fresh infection, giving rise to pain and discomfort. The great majority of infections in women are contracted from men who believe themselves cured, being under the false impression that they are cured because the discharge has ceased. ”

“ The so-called cure of gonorrhoea is not seldom only the establishment of toleration of the presence of the gonococcus on the part of the individual’s urethra. But the imperceptible discharge still remains virulently contagious to the healthy virginal genito-urinary passage of the young wife and to the delicate tender conjunctiva of the new-born baby. ”

“ The insanity caused by syphilis may mimic every known form of mental derangement, such as mania, melancholia, paretic dementia, locomotor ataxia and general paresis.
Any of these terrible diseases may be the gift the young wife receives from her infected husband in the wedding-night. Still the danger from syphilis for the woman is by far less imminent than that threatening her from gonorrhoea. No man, except he be an idiot, would think of getting married while still suffering from syphilis of the initial and secondary stages, when the disease is highly infectious. ”

“ Your general practitioner will always recommend to you a specialist if you ask him to. When the disease attacks the uterus and ovaries it very often blocks the fallopian tubes and prevents the impregnation of the ovum. It is said that over one-third of the childless marriages are due to gonorrhoea in women, innocently contracted from their husbands. Both men and women can become sterile from this disease. The seminal tubes in the man become blocked, thus disabling him from impregnating the ovum. ”

“ Gonorrhœa is characterized in its commonest form by a discharge of pus from the urethra, and causes acute pain at its onset in the male, but in the female it commonly causes little or no discomfort. Unless carefully treated, and treated early, it gives rise to many complications, such as inflammation of the bladder, gleet, stricture, inflammation of joints, abscesses, and rheumatism. It is a common cause of sterility and of miscarriages, and, in the female, of many internal inflammations and disablement, and in its later effects requires often surgical operations on women. ”

“ That gonorrhoea in the acute form may extend by propagation from a vaginitis through the uterine cavity and Fallopian tubes to the peritoneum, and produce an inflammation of that membrane, is probable. Cases have been met with where a history of specific infection was undoubted, in which an attack of perimetritis followed soon after the initial symptoms and physical signs of gonorrhoea were manifested. But it is quite another thing to believe that the specific poison may remain latent and harmless in the genital system of the male to be transferred years afterward to that of the female. ”

“ They cause frequent inflammations and lead to growths in the belly. Women thus attacked usually are apt to be sterile; they suffer agonies, and often become chronic invalids. The child born of a gonorrheal mother, while passing through the infected genital organs, comes to life with infected eyelids. This is Blennorrhea, which may result in total blindness. Gonorrhea also causes inflammation of the joints, gonorrheal rheumatism, testicular inflammations which may lead to sterility. ”

“ All these anomalies may produce either absolute or relative sterility. In regard to frequency they are of slight significance in comparison with endometritis and pelviperitonitis after gonorrhoea. The gonorrheic infection is, therefore, the cause par excellence of the impotence of procreation in women as in men.
Impotence of libido.—While in men the common form of impotence is inability of conjugation, the common form of impotence in women is failure to experience the orgasm, or the impotence of libido. ”

“ Hofmeier rightly points out that whilst gonorrhoeal infection in women may cause sterility, such sterility is by no means an inevitable consequence of the disease.
537Other gynecologists are even more reserved in admitting the importance of gonorrhoea as a cause of sterility in women. Fritsch is of opinion that in many cases a casual relation is believed to exist, when in reality there is nothing more than a coincidence. Sterility and slight perimetritis, he remarks, are common in women; gonorrhoea is common in men. ”

“ Often the inflammation extends, becomes chronic and attacks other organs. This chronic gonorrhea often causes permanent contraction of the urethra, which leads to the painful retention of urine, catarrh of the bladder, and stone. Chronic gonorrhea, too, often ends in death, especially if the kidneys are attacked. A cured case of gonorrhea does not mean immunity from further attacks. New infections are all the more easily acquired. Gonorrhea has even more dangerous consequences in women than in men. ”

“ It is women only who have allowed the double standard of morals to stand so long, giving men the purest and best of their womanhood, but not demanding the same from them. As soon as women realize the danger to themselves and their children which they are likely to incur from men who have lived promiscuously, they will revolt against such standards.
Gonorrhoea differs from syphilis, and though it is not a disease which can be transmitted from the parent to children, as syphilis can, yet it is a subtle, wrecking disease and can do almost as much harm to the individual. ”

“ Gonorrhoea is a still commoner disease than syphilis; how common it is very difficult to say. It is also an older disease, for the ancient Egyptians knew it, and the Biblical King Esarhaddon of Assyria, as the records of his court show, once caught it. It seems to some people no more serious than a common cold, yet it is able to inflict much prolonged misery on its victims, while on the race its influence in the long run is even more deadly than that of syphilis, for gonorrhoea is the chief cause of sterility in women, that is to say, in from 30 to 50 per cent. ”

“ The illicit sexual relation is the chief though not the only factor in the dissemination of the two serious venereal diseases; so prevalent are these in our large cities that at least half the adult male population of all social grades, according to conservative estimates, contract one or both of them. (In Germany gonorrhoea is the most frequent of all diseases, with the single exception of measles; in America it is about as frequent.) ”

“ It is painful to think of the vast mortality and misery that is caused by this one disease when every decent doctor knows exactly how to prevent it. With moral education in self-restraint together with application of Metchnikoff’s discoveries, which are known to every doctor, there is no reason whatever why syphilis should not be entirely abolished from the educated world. The other venereal diseases though serious are of comparatively minor importance; even gonorrhœa, which sterilises so many women and blinds so many babies, is less important because it does not affect the brain. ”