Margaret Sanger, "What Every Girl Should Know," 2 Mar 1913.

Published article. Source: New York Call, Mar. 2, 1913, p. 15 , Margaret Sanger Microfilm C16:60 .

This is the last article in an 12-part series. For "Introduction," see Nov. 17, 1912, for "Girlhood-Part I" see Nov. 24, 1912, for "Girlhood-Part II" see Dec. 1, 1912, for "Puberty-Part I" see Dec. 8, 1912, for "Puberty-Part II" see Dec. 15, 1912, for "Sexual Impulse--Part I" see Dec. 22, 1912, for "Sexual Impulse-Part II" see Dec. 29, 1912, for "Reproduction--Part I" see Jan. 2, 1913, for "Reproduction--Part II" see Jan. 19, 1913, for "Some Consequences of Ignorance and Silence--Part I" see Jan. 26, 1913, and for "Some Consequences of Ignorance and Silence--Part II" see Feb. 2, 1913.


By Margaret H. Sanger.

(The Censored Article) Part III. Some Consequences of Ignorance and Silence.

Prominent medical authorities claim that syphilis was not known in Europe before the discovery of America. Others equally as prominent hold that it has existed for many centuries in Europe, but was confused with other diseased such as leprosy. It makes little difference to the girl or boy today just how long or where it came from; the point we do know is that it is here in our homes and workshops, and we should know what it is like and how to avoid it.

A story is told of a French nobleman whose son was about to leave his home to live in a big city. Said the father to the son: "If you are not afraid of God, fear at least syphilis." This advice might be applied today, for if boys or girls knew, or could see the appalling results of syphilis, they would surely fear it, for it is humanity's most deadly foe.

Syphilis is an infectious disease, caused by a special microbe which is acquired by contagion or heredity.

It is chronic in course, varied and intermittent in character, and the length of time it remains in the body is indefinite.

It is so widespread that no country in the world is free from it, neither is any organ of the body exempt from its ravages.

Let us take a young man accustomed to promiscuous sexual intercourse, who cohabits with a syphilitic woman. He notices nothing wrong for about five weeks, when he becomes aware of a pimple on the sexual organs to which perhaps he pays little attention. This grows and becomes hard at the base and ulcerated on the top.

About ten days after the appearance of the ulcer (or chancre) the boy notices that the glands of the groins begin to swell, but as there is little or no pain attached he still pays no attention to all this.

After three, or sometimes four, weeks the ulcerated opening heals, but leaves the hard lump under the skin. In two or even three months after the time of infection the first general symptoms appear. His bones ache, he is mentally depressed, slightly feverish at night, and a rash appears upon his body and sore spots in the mouth. These symptoms usually decide him to consult a doctor, who finds him in the second stage of syphilis. This condition lasts usually about two and a half years, the rash often lasting a short period, and leaving, but to return again.

The blood and ulcers on the body contain the poisons of the disease, and for three or four years the poison CAN BE TRANSMITTED by contagion, or by heredity.

The third stage is the most destructive, especially to the nervous system, for this disease is recognized as the greatest factor in organic disturbances of the nervous system.

It not rarely is the cause of cerebral and spinal meningitis, paralysis of the legs, paralysis of one side of the body, and that most helpless and terrible disease, locomotor [ataxia] ; [softening] of the brain and many other diseases which affect the spinal cord and which are seldom ever cured. The majority of those diseased are left with physical or mental infirmities, rendering them public charges.

There have been cases where the third stage did not develop and as this stage is not distinctly separated from the second stage by a definite line, it may not take place for months, or even years after the first sore appeared. Again, this stage has been averted by careful treatment in the early stages, and it is here the hope of all afflicted lies.

Every case of syphilis begins with the characteristic pimple or chancre, except inherited syphilis. The chancre always appears where the infection enters, and the glands swell in the same vicinity. For instance, if in using a pipe of a syphilitic, whose mouth contains the sore patches, the victim finds the chancre will appear on his lips, mouth, or throat, and the glands of the neck will swell.

It is said that almost 10 per cent of the infections are contracted innocently, especially in European countries, where kissing and other forms of endearment are much indulged in. In this country it is not so common, but more women than men contract it innocently and in this manner.

In women, too, the first symptoms are not so characteristic as in men. She may pay no attention to the chancre for a month, even if she does feel aches in the bones, she thinks she is run down, or thinks she has malaria; even the rash does not alarm her, and often only repeated miscarriages will be the only symptoms she can remember of the early stages. She may continue for years before the disease reaches the third stage. This is not always so, for in every individual the disease differs in character and duration.

Gonorrhea and syphilis differ in many ways. For instance, the former shows itself in a week or ten days after infection, where syphilis shows no signs for five or six weeks.

Gonorrhea is considered a purely sexual disease, because infection takes place only in sexual relations (except where the germ gets into the eyes), while syphilis can be contracted in many other ways, through forks, spoons, glasses or cups, towels, sponges, bathtubs, toilets, pipes, dental and barbers' instruments and kissing.

Gonorrhea is considered a social danger because of its effect upon the sexual organs, often rendering them sterile. Syphilis is also a social danger, but it has a direct effect upon the offspring, and upon future generations because its effects are visited upon the child.

Sixty to 80 per cent of the syphilitic offspring die at birth or in early infancy. Someone has well said, "The greater criminal is he who poisons the germ cells."

In hereditary syphilis there is more difficulty in gathering facts, for the laws which control it are not so well understood, as yet.

There is no sore or chancre in hereditary syphilis but other symptoms appear which every physician recognizes and of course attends to at birth.

Under proper treatment the danger of the father transmitting the disease to the child should cease in from two to five years, while the danger of the mother transmitting it to her offspring does not end at any definite time.

There have been mothers known to have given birth to syphilitic offspring years after all disappearance of their own symptoms.

The strongest features of the disease transmitted to the offspring are the deformities which it imparts to the bones of the head as well as of the body.

It is said on good authority that if a patient, at the end of five years, has been two years without symptoms of treatment, he may be guaranteed for marriage. Though he can never be wholly guaranteed from relapses in his own person. These however, are considered noninfectious.

The cure of the disease depends upon the individual's environment, constitution and his habits, chiefly as regards alcohol and tobacco.

Alcohol is considered the commonest and most active enemy of the patient's recovery. Men addicted to the use of alcohol are the most difficult to cure.

There seems to be no doubt that if the disease receives the proper treatment there is every hope of the individual to live a normal life. Fournier, a French authority, says:

"Personally I could cite several hundred observations concerning syphilitic subjects who, after undergoing thorough treatment, have married and became fathers of healthy, good-looking children." The question, then, to receive some attention is what means are valuable for the treatment of both syphilis and gonorrhea.

Dr. Prince A. Morrow says: "Prompt curative treatment is not only in the interests of the patients themselves, but especially in the interests of the others they might infect. But everywhere we are confronted with this situation: There are no special hospitals for this class of diseases; few general hospitals receive them in the early, curable stage; still fewer have special venereal wards; even the dispensary services are not organized with special adaptation to the needs of venereal cases; few have night classes, so that working people who go to the dispensary must lose half a day, which often means the sacrifice of their employment. As a consequence they resort to quacks or the use of nostrums (secret or quack medicines). They are not cured, but go on spreading the seeds of contagion."

This is the condition as far as hospitals are concerned in the matter of venereal diseases. And in the relation to private practice the average person's position is still more deplorable. Take, for example, the story of a girl who came under my care some years ago, after having suffered three years with the disease. She had been refused attendance in public hospitals in three different cities while she was working her way to New York. At different times she consulted physicians, only to learn that to be cured she must be treated regularly, and to be so treated would require money. Different estimates were quoted her from $150 to $500 for treatment. As the amount of money left over after she had paid her expenses each week was never over $2, the possibility of a cure looked hopeless. She concluded to purchase patent medicines whenever she could, but her condition became worse, until she was picked up by a charitable organization, who cared for her until she died. When I saw her all hair; eyebrows and eyelashes were gone, her nose and upper lip were eaten almost entirely away, most of her teeth were gone--in fact, to try to describe her condition would be almost impossible.

This is only one case, but there are thousands of syphilitics who are wandering about unable to pay the prices which the physician asks to treat this disease. The same can be said of gonorrhea, and the same physician who clamors against the prices of the so-called quack, forgets that the price he asks of the public is exorbitant in the extreme. So the only course for the individual to take, if he cannot pay the price, is to remain a menace to society. The physician assumes no responsibility toward society to find out if the patient is under treatment elsewhere; the patient can do as he pleases with his disease when he closes the doctor's door. This, then, is the situation as regard society's attitude toward the venereal subject.

In concluding this series of articles I cannot refrain from uttering just a work about the relation of the entire subject I have been discussing, to the economic problem. It is impossible to separate the ignorance of parents, prostitution, venereal diseases, or the silence of the medical profession from the great economic question that the world is facing today. It is here ever before us, and the more we look into the so-called evils of the day the more we realize that the whole structure of present day society is built upon a rotten and decaying foundation. Until capitalism is swept away, there is no hope for young girls to live a beautiful life during their girlhood. There is no hope for boys or girls to build up strong and sturdy bodies. There is no hope that a woman can live in the family relation and have children without sacrificing every vestige of individual development. There is no hope that prostitution will cease as long as there is hunger. There is no hope for a strong race as long as venereal diseases exist. And they will exist until women rise in one big sisterhood to fight this capitalist society which compels a woman to serve as a [sex] implement for man's use.

Education is necessary--education is the need of the people. For this will soon enable one to see that knowledge alone does not suffice, but that it is only through economic [ security] that the man and the woman will emerge in a future civilization.

(The end.)

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