Woman, William J. Robinson [classic literature books txt] 📗

The Physician Often Consulted as to Advisability of Marriage—Venereal Disease the Most Common Question—Tuberculosis—Sexual Appetite of Tubercular Patients—Effect of Pregnancy Contraceptive Knowledge for Tubercular Wife—Heart Disease—Serious Bar to Marriage—Influence of Sexual Intercourse—Cancer—Fear of Hereditary Transmission—Exophthalmic Goiter—Most Frequent in Women—Simple Goiter—Exceptions to Rule—Obesity—Family History—Obesity and Stoutness Not Synonymous—Arteriosclerosis—Danger in Sexual Act—Gout—Real Causes of Gout—Mumps—Parotid Glands and Sex Organs—Mumps and Sterility—Oöphoritis Due to Mumps—Hemophilia—Hemophilic Sons May Marry—Hemophilic Daughters May Not Marry—Anemia—Chlorosis—Epilepsy—Hysteria—Symptoms of Hysteria—Marriage of Hysterical Women—Alcoholism—Effect on Offspring—Alcoholics and Impotence—Feeblemindedness—Evil Effects on Offspring—Sterilization of Feebleminded Only Preventive—Insanity—Functional Insanity—Organic Insanity—Hereditary Transmissibility of Insanity—Fear Resulting in Insanity—Environment versus Heredity in Insanity—Neurosis—Neurasthenia—Psychasthenia—Neuropathy—Psychopathy—Nervous Conditions and Genius—Sexual Impotence and Genius—Drug Addiction—External Causes—Consanguineous Marriages—When Consanguineous Marriages are Advisable—Offspring of Consanguineous Marriages—Homosexuality—Homosexuals Often Ignorant of Their Condition—Sexual Repression and Homosexuality—Sadism and Divorce—Masochism—Sexual Impotence and Marriage—Effect Upon the Wife—Frigidity—Marital Relations and Frigid Woman—Excessive Libido and Marriage—Excessive Demands Upon Wife—Satyriasis—The Excessively Libidinous Wife—Nymphomania—Treatment—Harelip—Myopia—Astigmatism—Premature Baldness—Criminality—Crime as Result of Environment—Legal and Moral Crime—Ancestral Criminality and Marriage—Rules of Heredity—Pauperism—Difference Between Pauperism and Poverty.

In former years, nobody thought of asking a physician for permission to get married. He was not consulted in the matter at all. The parents would investigate the young man's social standing, his ability to make a living, his habits perhaps, whether he was a drinking man or not, but to ask the physician's expert advice—why, as said, nobody thought of it. And how much sorrow and unhappiness, how many tragedies the doctor could have averted, if he had been asked in time! Fortunately, in the last few years, a great change has taken place in this respect. It is now a very common occurrence for the intelligent layman and laywoman, imbued with a sense of responsibility for the welfare of their presumptive future offspring and actuated, perhaps, also by some fear of infection, to consult a physician as to the advisability of the marriage, leaving it to him to make the decision and they abiding by that decision.

As a matter of fact, as often is the case, the pendulum now is in danger of swinging to the other extreme; for, a little knowledge is a dangerous thing, and the tendency of the layman is to exaggerate matters and to take things in an absolute instead of in a relative manner. As a result, many laymen and laywomen nowadays insist upon a thorough examination of their own person and the person of their future partner, when there is nothing the matter with either. Still, this is a minor evil, and it is better to be too careful than not careful enough.

I am frequently consulted as to the advisability or nonadvisability of a certain marriage taking place. I, therefore, thought it desirable to discuss in a separate chapter the various factors, physical and mental, personal and ancestral, likely to exert an influence upon the marital partner and on the expected offspring, and to state as briefly as possible and so far as our present state of knowledge permits which factors may be considered eugenic, or favorable to the offspring, and dysgenic, or unfavorable to the offspring.

The questions concerning the advisability of marriage which the layman as well as the physician have most often to deal with are questions concerning venereal disease. On account of the importance of the subject, these have been discussed rather in detail under the headings "Gonorrhea and Marriage" and "Syphilis and Marriage." Other factors affecting marriage, either in the eugenic or dysgenic sense, will be discussed more briefly in the present chapter, and more or less in the order of their importance.

Tuberculosis, which carries off such a large part of humanity every year, is caused by the well-known bacillus tuberculosis, discovered by Koch. The germ is generally inhaled through the respiratory tract, and most frequently settles in the lungs, giving rise to what is known as pulmonary consumption. However, many other organs and tissues may be affected by tuberculosis.

Tuberculosis used to be considered the hereditary disease par excellence. Entire families were carried off by it, and, seeing a tuberculous father or mother and then tuberculous children, it was assumed that the infection had been transmitted to the children by heredity. As a matter of fact, the disease was spread by infection. In former years, little care was exercised about destroying the sputum; the patients would spit indiscriminately on the floor, and the sputum, drying up, would be mixed with the dust and inhaled. Often the children crawling on the floor would introduce the infective material directly, by putting their little fingers in their mouths.

It is now known that tuberculosis is not a hereditary disease, that is, that the germs are not transmitted by heredity. The weak constitution, however, which favors the development of tuberculosis, is inherited. And children of tuberculous parents, therefore, must not only be guarded against infection, but must be brought up with special care, so as to strengthen their resistance and overcome the weakened constitution which they inherited.

That a person with an active tuberculous lesion should not get married goes without saying. But, it is a good rule to follow for a tuberculous person not to marry for two or three years, until all tuberculous lesions have been declared healed by a competent physician. As a rule, a tuberculous patient is a poor provider, and that also counts in the advice against marriage. Then sexual intercourse has, as a rule, a strong influence on the development of the disease. Unfortunately the sexual appetite of tuberculous patients is not diminished, but, rather, very frequently heightened; and frequent sexual relations weaken them and hasten the progress of the disease.

As to pregnancy, that has an extremely pernicious effect on the course of tuberculosis, and no tuberculous woman should ever marry. If such a one does marry or if the disease develops after her getting married, means should be given her to prevent her from having children. During the pregnancy, the disease may not seem to be making any progress—occasionally the patient may even seem to improve—but after childbirth the disease makes very rapid strides and the patient may quickly succumb. In the early days of my practice I saw a number of such cases. If precautions are taken against pregnancy, then permission to indulge in sexual relations may be given, provided it is done rarely and moderately.

If a patient who has tuberculosis conceals the fact from the future partner, a fraud is committed, and the marriage is morally annullable. It has been declared legally annullable by a recent decision of a New York judge.

Heart disease also is no longer considered hereditary. Nevertheless, heart disease, if at all serious, is a contraindication to marriage. First, because the patient's life may be cut off at any time. Second, sexual intercourse is injurious for people having heart disease; it may aggravate the disease or even cause sudden death. It is more injurious even than it is in tuberculosis. Third—and this concerns the woman only—pregnancy has a very detrimental effect upon a diseased heart. A heart that, with proper care, might be able to do its work for years, often is suddenly snapped by the extra work put upon it by pregnancy and childbirth. Sometimes a woman with a diseased heart will keep up to the last minute of the delivery of the child and then suddenly will gasp and expire. In the first year of my practice I saw such a case, and I never have wanted to see another. Women suffering from heart disease of any serious character should not, under any circumstance, be permitted to become pregnant.

No man will knowingly