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marry a woman, and no woman will marry a man, afflicted with cancer. However, this question often comes up in cases where the matrimonial candidates are free from cancer, but where there has been cancer in the family.

Cancer is not a hereditary disease, contrary to the opinions that have prevailed, and, if the matrimonial candidate otherwise is healthy, no hesitation need be felt on the score of heredity. The fear of hereditary transmission of the disease has caused a great deal of mischief and unnecessary anxiety to people. Scientifically conducted investigations and carefully prepared statistics have shown that many diseases formerly considered hereditary are not hereditary in the least degree.

Should it, however, be shown that in one family there were many members who died of cancer, it would indicate that there is some disease or dyscrasia in that family, and the contracting of a marriage with any member of that family would be inadvisable.


Exophthalmic Goiter (Basedow's Disease)

Exophthalmic goiter is a disease characterised by enlargement of the thyroid gland, protrusion of the eyeballs, and rapid beating of the heart. The disease is confined almost entirely, though not exclusively, to women, and I should not advise any exophthalmic woman to marry; neither should I advise a man to marry an exophthalmic goiter woman. It is a very annoying disease, while sexual intercourse aggravates all the symptoms, particularly the palpitation of the heart. The children, if not affected by exophthalmic goiter, are liable to be very neurotic.

Simple goiter, that is, enlargement of the thyroid gland (chiefly occurring in certain high mountainous localities, such as Switzerland), is not so strongly dysgenic as is exophthalmic goiter. Still, goiter patients are not good matrimonial risks.

Of course, there are always exceptions. I know an exophthalmic goiter woman who brought up four children, and very good, healthy children they are. But in writing we can only speak of the average and not of exceptions.


Obesity

Obesity, or excessive stoutness, is an undue development of fat throughout the body. That it is hereditary, that it runs in families, there is no question whatsoever. And, while with great care as to the diet and by proper exercise, obesity may, as a rule, be avoided in those predisposed, it none the less often will develop in spite of all measures taken against it. Some very obese people eat only one-half or less of what many thin people do; but in the former, everything seems to run to fat.

Obesity must be considered a dysgenic factor. The obese are subject to heart disease, asthma, apoplexy, gallstones, gout, diabetes, constipation; they withstand pneumonia and acute infectious diseases poorly, and they are bad risks when they have to undergo major surgical operations. They also, as a rule, are readily fatigued by physical and mental work. (As to the latter, there are remarkable exceptions. Some very obese people can turn out a great amount of work, and are almost indefatigable in their constant activity.) Each case should be considered individually, and with reference to the respective family history. If the obese person comes from a healthy, long lived family and shows no circulatory disturbances, no strong objections can be raised to him or to her. But, as a general proposition, it must be laid down that obesity is a dysgenic factor.

But bear in mind that obesity and stoutness are not synonymous terms.


Arteriosclerosis

Arteriosclerosis means hardening of the arteries. All men over fifty are beginning to develop some degree of arteriosclerosis; but, if the process is very gradual, it may be considered normal and is not a danger to life; when, however, it develops rapidly and the blood pressure is of a high degree, there is danger of apoplexy. Consequently, arteriosclerosis and high blood pressure must be considered decided bars to marriage.

It must be borne in mind that the sexual act is, in itself, a danger to arteriosclerotics and people with high blood pressure, because it may bring about rupture of a blood-vessel. There are many cases of sudden death from this cause of which the public naturally never learns. Married persons who find that they have arteriosclerosis or high blood pressure should abstain from sexual relations altogether or indulge only at rare intervals and moderately.


Gout

A consideration of gout in connection with the question of heredity will show how near-sighted people can be, how they can go on believing a certain thing for centuries without analyzing, until somebody suddenly shows them the absurdity of the thing. Gout was always considered a typical hereditary disease; for it was seen in the grandfathers, fathers, children, grandchildren, and so on. So, certainly, it must be hereditary! It did not come to our doctors' minds to think that perhaps, after all, it was not heredity that was to blame, but simply that the same conditions that produced gout in the ancestors likewise produced it in their descendants.

We know now that gout is caused by excessive eating, excessive drinking, lack of exercise, and faulty elimination. And, since, as a general thing, children lead the same lives that their fathers did, they are likely to develop the same diseases as their fathers did. A poor man who leads an abstemious life doesn't develop gout, and if his children lead the same abstemious lives they do not develop gout. (There are some cases of gout among the poor, but they are very rare.) But if they should begin to gorge and live an improper life they would be prone to develop the disease.

The disease, therefore, cannot in any way be considered hereditary. In matrimony, gout in either of the couple is not a desirable quality, but it is not a bar to marriage; and, if the candidate individually is healthy and free from gout, the fact that there was gout in the ancestry should play no rôle.


Mumps

Mumps is the common name for what is technically called parotitis (or parotiditis). Parotitis is an inflammation of the parotid glands. The parotid glands are situated, one on each side, immediately in front and below the external ear, and they are between one-half and one ounce in weight. They belong to the salivary glands; that is, they manufacture saliva, and each parotid gland has a duct through which it pours the saliva into the mouth. These ducts open opposite the second upper molar teeth.

We might be surprised to be told that these parotid glands can have anything to do with the sex organs, but there is no other remote organ that has such a close and rather mysterious relationship with the sex-glands as have the parotids. When the parotid glands, either one or both, are inflamed, the testicles or ovaries are also liable to be attacked by inflammation. The inflammation of the testicles may be so severe as to cause them to shrivel and dry up; or, even when no shrivelling, no atrophy of the testicles occurs, they may be so affected as to become incapable of producing spermatozoa. Moreover, in cases where the testicles of a mumps patient seemingly were not attacked—that is, where the patient was not aware of any inflammation, having no pain and no other symptoms—the testicles may have become incapable of generating spermatozoa.

Besides the testicles, the prostate gland, the secretion of which is necessary to the fertility of the spermatozoa, may also become affected and atrophied.

It is, therefore, a very common thing for men who had the mumps in their childhood to be found sterile.

As to the sexual power of mumps patients, that differs. Some patients lose their virility entirely; others remain potent, but become sterile.

The same thing happens to girls attacked by mumps. They may have a severe inflammation of the ovaries (ovaritis or oöphoritis) or the inflammation may be so mild as to escape notice. In either case, the girl when grown to womanhood may find herself sterile.

A man who never had any venereal disease, but who has had mumps, should have himself examined for sterility before he gets married. As explained in the chapter "Marriage and Gonorrhea," we can, in the case of a man, easily find out whether he is fertile or sterile. But, in the case of a woman, we can not. Time, necessarily, has to answer that question. In all cases, mumps reduces the chances of fertility, and no man or woman who once had mumps should get married without informing the respective partner of the fact. There should be no concealment before marriage. When the partners to the marriage contract know of the facts, they can then decide as to whether or not the marriage is desirable to them.


Hemophilia, or Bleeders' Disease

Hemophilia is a peculiar disease, consisting in frequent and often uncontrollable hemorrhages. The least cut or the pulling of a tooth may cause a severe or even dangerous hemorrhage. The slightest blow, squeeze or hurt will cause ecchymoses, or discolorations of the skin. The peculiarity of this hereditary disease is, that it attacks almost exclusively the males, but is transmitted almost exclusively through the female members. For instance, Miss A., herself not a bleeder, comes from a bleeder-family. She marries and has three boys and three girls; the three boys will be bleeders, the three girls will not; the three boys marry and have children; their children will not be bleeders; the three girls marry, and their male children will be bleeders.

What is the lesson? The lesson is, that boys who are bleeders may marry, because they will most likely not transmit the disease; but girls who come from a hemophilic family, irrespective of whether they themselves are hemophilics or not, must not marry, because most likely they will transmit the disease.


Anemia

Anemia is a poor condition of the blood. The blood may contain an insufficient number of red blood cells or an insufficient percentage of the coloring matter of the blood, that is, hemoglobin. A special kind of anemia affecting young girls is called chlorosis.

Anemia and chlorosis cannot be considered contra-indications to marriage, because they are usually amenable to treatment. In fact, some cases of anemia and chlorosis are due to the lack of normal sexual relations, and the subjects get well very soon after marriage. But it is best and safest to subject anemic patients to a course of treatment and to improve their condition before they marry.


Epilepsy

While epilepsy—known commonly as fits or falling sickness—is not as hereditary as it was one time thought to be, its hereditary character being ascertainable in only about 5 per cent. of cases, nevertheless, it is a decidedly dysgenic agent, and marriage with an epileptic is distinctly advised against. Where both parents are epileptics, the children are almost sure to be epileptic, and such a marriage should be prohibited by law. Under no circumstances should parents who are both epileptic bring children into the world. It should be the duty of the State to instruct them in methods of preventing conception.


Hysteria

Hysteria is a disease the chief characteristics of which are a lack of control over one's emotions and acts, the imitation of the symptoms of various diseases, and an exaggerated self-consciousness. The patient may have extreme pain in the region of the head, ovaries, spine; in some parts of the skin there is extreme hypersensitiveness (hyperesthesia), so that the least touch causes great pain; in others, there is complete anesthesia—that is, absence of sensation—so that when you stick the patient with a needle she will not feel it. A very frequent symptom is a choking sensation, as if a ball came up the throat and stuck there (globus hystericus). Then there may be spasms, convulsions, retention of urine, paralysis, aphonia (loss of voice), blindness, and a lot more. There is hardly a functional or organic nervous disorder that hysteria may not simulate.

Of late years our ideas about hysteria have undergone a radical change, and we now know that most, if not all,

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