18. PECULIAR TO WOMEN—AND A WORD ABOUT MEN.

"The business of being a woman is a highly specialized affair. Involved are not only the elaborate and miraculous organs themselves, but also the nervous and glandular systems associated with them. As a result of this, women have certain special situations to meet and cope with all their lives, from the day they are born."—(Maxine Davis, in Women's Medi­cal Problems.)

Listlessly, Katherine Yarney watched her husband drive away in his buggy, the summer dust from the street forming a small cloud in his wake. Behind the house, in the back yard, the children were playing Indian, shrieking in their excite­ment over the mock battle. Across the street, Mrs. Loveline came out of the house to water some flowers at the edge of the Loveline front porch. She saw Katherine and waved. After a moment she put down her sprinkling can and came across the street.

"It's going to be hot again," she said, sinking down into a wicker chair as her hostess sat in a porch swing. "Terrible hot." She tucked a wisp of gray hair neatly in place and smiled at Katherine. "How do you feel today, Katherine?"

"I'm just not well," Katherine sighed. "My back aches and I can't seem to get out of my tracks."

Mrs. Loveline looked closely at her neighbor. As a matter of fact, Katherine did look a little peaked, she thought. Too much so for a woman only in her thirties, even if she had given birth to six children.

"You're not pregnant again?" she asked bluntly.

"I don't think so. Only there was so little blood ... I mean—" Katherine blushed a little. Even with Mrs. Loveline, who was almost like her mother, it was difficult to speak frankly sometimes.

"You mean the flow has been light?" Mrs. Loveline asked, again resorting to her bluntness.

"Well, yes," Katherine admitted.

"Do you have a feeling of heaviness down there?"

Katherine nodded. "And the backache. Have you any idea what it is? Maybe I should see Dr. Loomis."

"If you ask me, the answer is easy, Katherine. I think you have a fallen womb."

Katherine looked a little startled.

"I've heard of it. Is this the way it acts?"

"It's the way it acted with my aunt Sarabelle. And you know, I think I wrote down what they did for her. I keep things like that in a little book. It comes in so handy some­times. You wait here—I'll only be a minute."

The older woman stood up, bustled across the street and into the Loveline house. In a few moments she returned, leafing through a notebook.

"I found it!" she announced. "Here it is, exactly as I wrote it down when Aunt Sarabelle was sick."

"What does it say, Mrs. Loveline? Something I can try?"

"Well, first you have to improve your health, Katherine. And you do look a little peaked. It says here to take cod liver oil."

"But what about the other?"

"You can try some hot injections—you know the kind I mean—using a teaspoon of powdered alum in a pint of water. Then you ought to take a sitz bath every day." She closed the book with a snap and sighed. "But you'll probably have to see Dr. Loomis," she added. "I remember now."

"Why? Is there something special?"

"You'll have to let the doctor decide that. But I remember now that the doctor had to put the womb back where it belonged with Aunt Sarabelle. I think she had to wear a sort of support—a contraption he called a supporter."

Katherine listened and suddenly she began to weep quietly, the tears running down her cheeks. She hurried to use a handkerchief while the older woman looked at her with sym­pathy and came over to sit beside her in the porch swing.

"Now, Katherine, honey, it just isn't that serious. I'm certain Dr. Loomis will have you all right in no time at all!"

"There's—there's something more," Katherine said miser­ably. "Only I can't talk about it."

"If it's that bad, I think you should talk about it, Katherine. You know you can talk to me. Land's sake, you're like my very own daughter."

"I'm—well, I'm afraid I've caught something dreadful."

"Caught something? What do you mean?"

"I know that Clinton never would—I mean . . . well, you know how Clinton is in the church and at the bank and everything. And I've heard that sometimes in public toilets you can—I mean, I guess it's possible. I know it couldn't be anything he did, because he'd never . . . well—" She broke off abruptly and looked helplessly at the older woman.

Mrs. Loveline shook her head sympathetically and smiled. "Oh, my dear! ... is that what's worrying you? Is it a dis­charge? And you thought it might be a disease?"

Katherine nodded.

"Well, I'm certain it isn't," Mrs. Loveline assured her. "Aunt Sarabelle complained of the same thing, and lots of women have it. My goodness, I had a touch of it myself three years ago. Let's see ... no, four years ago, in 1892."

"But what is it?" Katherine asked, almost impatiently.

"There's a real fancy name for it. Leucorrhea, I think they call it. But you must have heard of it, Katherine. Most women simply call it the 'whites.' "

"Oh!" Katherine blushed again. "I guess I am awfully innocent about some things. But I can understand now. Do you really think it's that, Mrs. Loveline?"

"Of course, silly! You don't think that pillar-of-the-commu-nity husband of yours would be fooling around any sporting women, do you? Of course not! He wouldn't bring home anything like that to you. And I'm very certain that you haven't been misbehaving!" She laughed a little and patted Katherine's hand. "But I don't blame you for being worried."

"What did you do for it?"

"Well, I can tell you that without looking it up in my book. You take one tablespoonful of Pond's extract of witch hazel to a cup of warm water. Then you douche with it three times a day. And that will take care of thatl"

Today if Katherine actually had a prolapse of the uterus— "fallen womb"—she probably would have surgery to correct the condition. But before such surgery would be used, she would receive a very thorough examination to determine the causes of her various symptoms.

The leucorrhea would not be a disease in itself, but a symptom of some disorder in the genital tract or elsewhere in the body. A physician probably would trace it down before beginning treatment.

However, another long-honored treatment of the ordinary whitish discharge still is in use in many homes, frequently handed down from generation to generation.

The treatment consists of four tablespoons of white vinegar to two quarts of warm water used as a douche. The full two quarts should be used with each douching, and the treatment usually recommended for ordinary cases is once a day for 10 days, and two or three times a week after that.

Another annoying condition for some women is an intense itching at the opening of the vagina. A physician can usually suggest the proper treatment for the condition. Dr. Eichen-laub suggests that the area should be cleansed twice a day with a mild detergent such as pH isoderm and several cotton balls. He advises that four times daily a mixture should be made of one tablespoon of Burow's solution and one cup of water with which to wet a washcloth or piece of cotton to place against the itching area for ten minutes.

The itching should be controlled within about one week, and until that time, the area should be thoroughly dried after each cleansing and a thin coat of Lassar's paste should be applied. The paste may be obtained without a prescription.

"After itching ceases," the doctor advises, "continue cleans­ing once a day. Dry thoroughly. Powder lightly with corn-starch. Continue this program for two weeks."

He warns that a doctor should be consulted if the itching does not yield to the treatment or if there is excessive dis­charge, a lump, or a sore or leathery white patch.

As a matter of fact, most home treatments should be ap­proached with extreme caution, and a physician should be consulted when simple treatments are not successful, or if conditions indicate anything of a serious nature—as suggested in previous chapters in relation to cancer and other conditions.

In the case of itching, for instance, all the home treatment available may not be of any use if a woman is allergic to a fabric or a body powder that may come in contact with the area.

The folkways concerned with woman's menstruation are replete with odd and frequently nonsensical customs and treatment.

Anglo-Saxons called menstruation "the curse" and the term still is familiar. Tribal customs of a good many people segre­gated the menstruating women from the rest of a village. Strict laws have been observed about the relationship between a man and a woman in her menses. Some peoples had great fear of the woman in this state. Latin history of Pliny's time lists a series of dangers that may come from even the touch of a menstruating woman. Her touch, said Pliny, would turn wine to vinegar, blight crops, kill seedlings, blunt fine steel, rust iron, drive bees from hives and cause mares to miscarry.

With the superstitions and fallacies concerned with this natural function of woman there also grew beliefs about what a woman might or might not do during her "periods."

She was advised against taking baths during that time, or to exercise, swim, ride horseback, or participate in any stren­uous activities.

The modern woman of today has discarded the nonsense concerning menstruation. Certainly she will not overdo her activities, especially during the first couple of days of men­struation, but she lives a very normal life during this time as compared to life under similar circumstances in her grand­mother's era.

She—and her modern husband—recognize it as part of the continuing cycle of life that is virtually the essence of womanhood.

Within the lifetime of many of us we may remember when flight to bed with a hot water bottle was the prescribed monthly routine for some girls and women. Today if she has a painful time during the menses, she logically consults a doctor. If she has an unusually heavy flow, she will do the same thing. In a day when diagnosis is so highly efficient in this area of medicine, it is indeed foolish to suffer or live in doubt when the condition probably can be remedied—espe­cially if a doctor is consulted early enough.

Undoubtedly, however, woman has always suffered such ailments. In every age of medical history there are references to them.

Ancient Aztec remedies, for instance, were sometimes unique, and frequently segments of them may be found in the folk remedies of later generations in America, possibly handed down through Indians.

For a menstrual flow that was too copious or of too long a duration, the Aztec treatment to dry up and stay the flow consisted of an ointment "which you make of salt, the ash of a stag and of frogs, the white of egg, rabbit hairs, the roots of hahuiyacxihuitl (fragrant plant) and of willow, acorns, paper burned with a stag's horn, the stone eztetl, purest gold, ground iron.

"These then are to be strained in rain water, and the juice is to be poured into the part which is bleeding profusely. Kill also a lizard, cut off its head, eviscerate it and salt it, hang it up in a cold place to dry; when it is dry burn it. Anoint the woman with that ash in Indian wine and white honey."

We have come a long ways since those days!

As we know, Ephraim McDowell is credited with perform­ing the first hysterectomy in this country. Since his operation in the last century, surgery for women has progressed far.

The hysterectomy (removal of the uterus), while still considered to be a major operation, has become singularly safe. The mortality rate for hysterectomy is less than 1 per cent.

Likewise, the removal of an ovary is not dangerous. If both are removed, the menopause is likely to be brought on in women who have not already experienced it. If only one ovary is removed, the other continues to function and the menopause is not hastened. Cysts and cystic tumors are fre­quent reasons for removal of ovaries. Ovarian cysts are very common.

Vaginal plastic operations are many and varied. Most of them result from damage following one or more births. Re­sults of this type of surgery are excellent in most cases. Usually the patient is out of bed and ready to go home in five to seven days.

While there was a time in history when women's lives were lost because there was no surgery available to them, there have been some in our contemporary times who have ques­tioned whether all such surgery today is essential.

Most American surgeons are responsible, honest, qualified doctors who live up to the American Medical Association's code of medical ethics. There are, however—admittedly, very few—surgeons who may be guilty of "ghost surgery" (an operation performed by one surgeon for another, without the patient knowing about the substitution), or who may be guilty of charging exorbitant fees, or who may perform unjustified operations.

Such actions certainly are to be deplored, and are the active target of most honored and respected groups in the practice of surgery. Dr. Isidore S. Ravdin, chairman of the 16-member Board of Regents of the American College of Surgeons and Dr. Paul R. Hawley, director of the American College of Surgeons, have led the attack.

The two most frequently abused operations are the ap­pendectomy and the hysterectomy, deplore many medical authorities.

With proper medical care, by competent, responsible doc­tors, an operation is not performed unless it is considered to be necessary.

In the case of a hysterectomy, the doctor should have a pre-operation conference with the husband and wife when a married woman is involved.

When Dr. Quincey Max told his pretty, middle-aged pa­tient, Mrs. Constance Elling, that she must have a hyster­ectomy, she paled, and her lip began to tremble.

"Now, don't worry about it," the doctor hastened to say. "It's really a very safe operation."

"It isn't that, Doctor," Mrs. Elling said. She looked away from him. "It's my husband, John."

"What about your husband?"

"About us, I guess I really mean. I understand that after a hysterectomy I'll—well, I'll stop being a woman. I mean the sex part and all of that. And I'll probably put on a lot of weight."

"Bridge club?" the doctor asked, a little wryly.

"Well ... the garden club," Mrs. Elling admitted. "They were talking about it several months ago."

"Nonsense," Dr. Max snapped. "And I hear it at least once a month. I want you to bring your husband in tomorrow so we can talk this over, but I'll tell you this much now: if you enjoy sex relations, you probably will after your oper­ation—and possibly more so. You'll be free from some of the pain you say you've experienced. And as far as putting on weight—that's entirely up to you. That will depend on what you eat and how much you eat. It would if you didn't have a hysterectomy."

"But they said that—"

"I don't care what they said," the doctor emphasized gently. "You listen to what / say."

Mrs. Elling suddenly smiled in relief.

"John is going to be happy to hear this, too," she admitted. "We've both been worried. He was afraid, mainly, that it would be a dangerous operation for me, and I—well, I guess I was more worried about what it might do to me."

Dr. Max's pre-operation conference with his patient and then with both husband and wife served to help them through a bad time into a future of health and happiness following the successful and very necessary operation.

A hysterectomy will not affect a woman's sex life, as the doctor explained to his patient. As a matter of fact, it has made it more satisfactory in some cases.

The "bridge club talk" that women will become fat and flabby after a hysterectomy is unfounded. Nor will there be a change of voice nor excessive growth of hair, as some women believe!

Menstruation will cease, of course. And if both ovaries are removed, an artificial menopause results. It usually can be controlled through female sex hormones or other medications.

When this artificially induced menopause happens to a younger woman in her late twenties or early thirties, for in­stance, it may bring about a feeling in her that she is "no longer a woman."

Emil Novak, M.D., eminent gynecologist of Johns Hopkins Medical School, has said of this: "... the woman has no reason to consider herself 'unsexed.' It is true that she will no longer menstruate, nor will she bear children. In the latter respect she is usually no worse off than before, because the disease which makes such operations necessary practically always make pregnancy impossible. Nor need she have any great fear that her sex life is inevitably over."

In any event, if a woman has had a hysterectomy and is emotionally disturbed about it for any significant period of time afterwards, she might well consult her doctor or seek psychiatric aid.

If a woman who faces surgery—whether it be a hysterec­tomy or some other operation—is unacquainted with the qualifications of a surgeon, and wishes to be certain of his ability and background, she is privileged to either ask him direct questions, or inquire at the hospital where he operates.

It may be helpful for her to find out where he went to school and at what hospitals he served as intern and resident in surgery.

She may inquire if he is a diplomat of the American Board of Surgery. If he is, it means that he has been thor­oughly investigated and had to take a series of examinations in his specialty.

She may ask if he is a member of the American College of Surgeons.

She can ask for a consultation with one or more other surgical specialists, and should if she is in doubt.

If she is unacquainted in the community, she can go to the County Medical Society or to an accredited hospital for reliable information about qualified surgeons.

The problems of pregnancy and childbirth have been greatly eased by modern techniques and drugs. With highly trained obstetricians now available in almost every commu­nity, a woman can be fairly certain of receiving competent, expert care throughout pregnancy and the birth of the child.

As pointed out in a previous chapter, the children of today receive more and better care than ever before. And it is safe to say that in most cases the care begins shortly after the mother conceives and first visits her doctor.

How efficient such care has become is reflected in the dra­matic drop in fatalities of newborn babies over the last three decades.

Infant mortality—deaths during the first year—has de­clined from 76.7 deaths per thousand live births in 1920-24 to 26.4 in 1959. Fetal deaths—stillbirth, fetuses weighing more than 14 ounces and born dead—declined from 39.2 to 22.9 by 1950. (Totals for 1959 not available at this writing.) The neonatal deaths—infants born alive weighing more than 14 ounces but dying within the first four weeks of life— declined from 39.7 in 1920-24 to 19.1 in 1959.

Maternal mortality has dropped very dramatically from 6.9 in 1920-24 to 0.4 in 1959.

The subject of pregnancy and birth is far too great and complex to explore in a relatively few words. Certainly some of the folk medicine, once a part of birth and death every­where on earth, contributed knowledge and wisdom about the bearing of children. But the old practices are almost com­pletely eclipsed by the amazing triumphs that medicine has scored over the last few decades in the field of obstetrics.

However, some of the practices and fallacies concerned with birth during our pioneer days in this country may still be remembered by many, passed down from one generation to another.

Frequently a doctor was not available for the pioneer women, and midwives ("grannies") delivered hundreds of our pioneer young. Some of the grannies developed individual techniques born of experience and, occasionally, common sense.

For instance, when the arriving baby was having a little difficulty in emerging, it was not unusual for one of the gran­nies to blow a little dried snuff through a goose quill into the mother's nose. The resulting sneezing paroxysms probably brought about the desired results.

Fallacies surrounding pregnancy and childbirth in the last century are almost astounding. A number of weird beliefs continued even into the 20th century, nurtured, perhaps, by some of the "home remedies" type of literature available at that time.

As an example, pregnant women frequently were warned that their thoughts and actions might have a definite bearing upon "markings" the child might be born with.

In a book called Search Lights on Health, "A complete sexual science and a guide to purity and physical manhood— advice to maiden, wife, and mother" that was published in 1910, there is this item under a series of "Solemn Lessons for Parents": "Pregnant women should not be exposed to causes likely to distress or otherwise strongly impress their minds. A consistent life with worthy objects constantly kept in mind should be the aim and purpose of every expectant mother."

There follows a segment entitled "Cases Cited" with the introductory words: "Thousands of cases occur every year that might be cited to illustrate these principles. A mother cannot be too careful, and she should have the hearty co­operation and assistance of her husband. We quote the fol­lowing cases from Dr. Pancoast's Medical Guide, who is no doubt one of the best authorities on the subject."

A few of the "examples" are:

"A woman bitten on the vulva by a dog, bore a child having a similar wound on the glans penis. The boy suffered from epilepsy, and when the fit came on, or during sleep, was frequently heard to cry out, 'The dog bites me!' "

"A pregnant woman who was suddenly alarmed from seeing her husband come home with one side of his face swollen and distorted by a blow, bore a girl with a purple swelling on the same side of the face."

"A woman who had borne healthy children, became fright­ened by a beggar with a wooden leg and a stumped arm, who threatened to embrace her. Her next child had one stump leg and two stump arms."

"A woman absent from home became alarmed by seeing a great fire in the direction of her own house, bore a child with a distinct mark of the flame upon its forehead."

There were many similar fallacies and superstitions, and occasionally one or another may still be heard, or even believed.

Among the factors which have made childbirth immeasur­ably safer are: the greater use of hospitals, virtual elimination of the midwife, availability of antibiotics and chemothera-peutics, blood transfusions, a wider use of anesthesiologists and improved obstetrical anesthesia, greater use of X-ray to measure the pelvis, locate the placenta, and determine the progress of labor. In addition to these factors, there are, of course, the many improvements in medical education, meth­odology, equipment, and hospital facilities. Too, the layman has become better educated, and parents now can avail them­selves of excellent help in adjusting to parenthood.

Discovery of the Rh factor in blood has been very signifi­cant and in the words of Nicholson J. Eastman, M.D., Profes­sor of Obstetrics, the Johns Hopkins University School of Medicine: ". . . has revolutionized the whole field of blood transfusion, especially in relation to obstetrics, and has served to explain the etiology of hemolytic disease of the newborn."

Alan F. Guttmacher, M.D. as Director of Gynecology and Obstetrics at Mt. Sinai Hospital, New York, and Clinical Professor of Obstetrics and Gynecology, Columbia Medical School, in the epilogue to his book Pregnancy and Birth prefaced his concept of even greater goals for the future in obstetrics by summing up the accomplishments to date: "This is a wonderful time to have a baby, wonderful for both mother and baby, for in the long history of man birth has never been so safe. The progress made in this area during the past two decades defies imagination . . ."

Talk about pregnancy and birth very frequently brings up the subject of birth control.

Within the last few years the problems posed by an "explod­ing population" have brought discussions of birth control and contraception out into the open in unprecedented frankness and completeness.

The pros and cons are being discussed nationally and internationally, on occasion, with some heat, and undoubtedly the world will hear much more about all facets of birth control in the future.

Efforts to control conception are by no means new in the world, and go back to antiquity. As yet no safe, certain, satis­factory contraceptive technique has met all the requirements that would make a method ideal.

In recent years those used most frequently probably fall into three main classifications of the dozen or so individual practices. The three are:

Rhythm. This is the only method sanctioned by the Roman Catholic Church and relies upon the fact that the woman can conceive only within some 24 hours after ovulation, which usually occurs 12 to 16 days after the beginning of each menstrual cycle.

Condom. This is the only method that is used solely by the man and consists of a sheath that prevents the meeting of sperm and ovum. It is estimated that the yearly sale of condoms in the United States approximates $150 million.

Diaphragm And Spermicide. This method, most prescribed by physicians over the last 30 years or so, consists of a rubber diaphragm used by the woman to form a barrier to the mouth of the womb. A spermicide is usually used with the dia­phragm to provide additional protection.

Suppositories. A long used method, the suppository usually is made of a spermicidal chemical in cocoa-butter or gelatin base. It is designed to melt at body temperature when inserted into the vagina, and to form a mechanical barrier to the uterus as well as furnishing a spermicide to destroy the male sperm. It frequently fails to melt quickly enough to form the barrier, and the spermicide may not be adequate.

Jellies And Creams. These agents are designed to serve the same purpose as suppositories—barrier and spermicide. Usu­ally they require a special applicator for insertion into the vagina. Experimental work as to their effectiveness still is being done, with some reports of excellent results. As already noted, they are suggested for use with the diaphragm, and with the condom as a lubricant.

Sponge or Tampon. Sponges, usually of soft rubber or sea sponge, are used with spermicidal foam powders or paste designed for that purpose. Usually the sponge is hollowed on one side to fit the cervix area. In use it is soaked in water, squeezed almost dry, and then spermicidal powder or paste is applied to it and worked into a foam. It is then inserted to form a mechanical barrier with spermicidal foam to im­mobilize male sperm. The method has been popular abroad.

Tampons are made of wads of wool cotton, or clean cotton cloth. They are intended to function as the sponges do. In folk medicine application they frequently have been used with weak solutions of vinegar, soap lather, or lemon juice—all of which give questionable protection.

Foam. Foam tablets used without a sponge or tampon are intended to provide a barrier-spermicide protection. The foam tablets frequently dissolve too slowly to be of any use, and occasionally there have been reports of irritation from their use.

Recently an entirely new approach to contraception is making news the world over. This method makes use of revo­lutionary new birth-control pills that are made of synthetic steroid chemicals called progestins.

Until now, virtually all contraceptive measures aimed at preventing the sperm and ovum from uniting. This theory has inspired the sheath, the diaphragm, foams, sponges, and other mechanical barriers; the germicides, the irrigation techniques, and even the rhythm system.

The new "pill" system works entirely differently. The pro­gestins prevent ovulation, and thus eliminate the possibility of conception. In practice, a woman takes one pill every day from the fifth to the 25th day of the menstrual cycle and remains free of pregnancy.

One of the first to explore this new approach to contracep­tion was Dr. Gregory Pincus, co-director of the Worcester Foundation for Experimental Biology, and a world-renowned leader in research on the steroid hormones.

Basically, much of this type of experimentation came from seeking methods of overcoming infertility.

The first "pill" tried was progesterone. Dr. Pincus took his findings about the effect of progesterone in animals to Dr. John Rock, Clinical Professor of Gynecology at Harvard. Dr. Rock was interested in discovering if inducing a "make-believe" pregnancy in barren women would help in establish­ing fertility.

The progesterone, in the first tests with 29 barren women, seemed to work on both scores. The drug halted ovulation in most of the women. There were no pregnancies in these women, of course. Then the treatment was stopped so that ovulation could resume. Four of the previously barren women became pregnant within the following four months.

Still not fully satisfied with progesterone, the research con­tinued for a better drug. Dr. Pincus and Dr. Chang, his co-worker, tested more than 175. The most powerful and safest one they found for the job was later named Enovid when it was placed on the market and "approved" by the U. S. Food and Drug Administration.

Mass clinical tests of the pills began in 1956 in Puerto Rico. By the end of 1959 the effectiveness of the new pills was completely verified. Additional studies were instituted else where. A sample of results may be realized by glancing at one summary of these studies.

The report reveals that in a study of 897 patients, for a total of 801.6 woman years and a total number of cycles numbering 10,427, not one of the patients became pregnant while taking Enovid as directed.

Furthermore, researchers have found that ovulation re­sumed when the pills are stopped, and conception occurred at a phenomenal rate among those women who ceased taking the pills to become pregnant.

For those who have asked about the possibility of cancer as a result of taking the pills, it was revealed that many fewer cases of cancer of the cervix than ordinarily would be ex­pected had developed in the study groups. Some women who had very early cancer of the cervix had their disease tem­porarily arrested.

"Enovid doesn't cure cancer," stated Dr. Rock, "but it holds it in abeyance, and it emphatically has not caused cancer."

Main drawback to use of the pills so far has been cost; and they must be prescribed by a doctor. With mass produc­tion, G. D. Searle & Co., manufacturers of Enovid, believe a substantial drop in cost may result, according to Dr. Lee D. Van Antwerp of the firm.

Meanwhile, other experiments to control the birth rate are going on around the world. One non-steroid compound ap­parently will halt development of the ova after mating. An­other is a drug designed to work on the male. Another would prevent adherence of the ovum to the wall of the womb.

It is especially interesting to know that scientists are inves­tigating some of the old folk-medicine herbals and other contraceptive methods of tribes in Africa and the South Seas.

Our North American Indians used various herbs, roots or berries for birth control. The Shoshone tribe used a tea made from fresh root of false hellebore. The Owyhee women used stone seed in a tea. A tea made from juniper berries also was said to be effective.

The ban on contraceptive information that was so strong over this nation for many years was not quite as strong back around the time of the Civil War when contraceptives were advertised in daily newspapers.

As an example, part of an advertisement in the Louisville Daily Journal, July 6, 1865, reads:

Also M. La Croix's French Preventive Powders. By their use married ladies may limit the number of their offspring at pleasure, without the least danger of injury to the health. They act by preventing conception taking place. One box will last you for years. Price by mail $2.00 and two postage stamps.

The advertisement also advertised Best quality French Male Safes for sale. Price 50$ each or $5.00 per dozen.

And not too subtly was proclaimed the information that the advertisers were agents for:

Mad. Caparal's Female Monthly Pills, a safe and effectual remedy for all female diseases, such as Irregularities, Obstruc­tion of the Menses, Whites, etc. Price by mail, $1.00 and one postage stamp.

Caution:

These pills should not be taken during pregnancy, as they are sure to produce miscarriage.

Probably most common of the older contraceptive tech­niques were the vinegar and water douches, which are rela­tively ineffective, the use of sponges (more of a Continental device) and the male condom.

The role of contraception in the future will probably grow in direct proportion to the problem brought about by the "exploding population." The voices of overpopulated coun­tries like India will make their mark upon world conscious­ness and in the laboratories of the scientists.

Meanwhile, the serious problem of abortion is always with us. Although not legally sanctioned, it is prevalent in this country and elsewhere in the world, as it has always been.

Even in these illegal operations, the miracles of the newer drugs find their place. Undoubtedly the more skilled abor­tionists make considerable use of them to fight the danger of infection, partly for the sake of their patients, but also for their own protection. The death of a patient from an illegal abortion usually brings about exposure, arrest and conviction. Abortionists welcome the additional safety the drugs offer them.

MENOPAUSE—A most significant change has come to us with the great improvements in medical care and the increased years of life allowed the average person. While medical prog­ress is, in the main, responsible for this, our socioeconomic advances can also claim some of the credit. As we go rapidly into the age of automation, we probably will be less burdened, and live even longer.

It was a different story back in the last century, and espe­cially during the pioneer days. Pickard and Buley say it aptly in The Midwest Pioneer:

"All too many women lost their bloom with their teens, were tired and run-down by the twenties, and old at forty. Tombstones in the churchyards bear testimony that many a wife, having delivered numerous progeny, died young, to be followed by a second who contributed her quota and labors, and perhaps by a third who stood a good chance to outlive the husband."

Today, probably millions more women than ever before will come to know the female experience in her cycle of life known as the menopause. In previous centuries a vast number of women never experienced it, simply because they didn't live long enough, since it usually begins somewhere between the ages of 38 and 55.

For those who did approach it in bygone years, what did they anticipate? What did they hear about it? What was done about it for them?

Two women in their early forties sat in the kitchen of Mrs. Amy Docker's home. Her guest, Mrs. Ruth Flintwood, sipped her tea and looked out into the backyard. It was in the au­tumn of 1872 and leaves were falling. The day was warm and the door open. The smell of burning leaves crept into the kitchen to mingle with the fragrance of bread baking in the wood stove.

"I think I'd almost rather die than face it," Amy Docker was saying. "And I know it's almost upon me. Have you had any signs?"

"I know, Amy. I'm afraid, too. I talked with Mrs. Powers. She knows about such things. She says it's terrible. Awful burning in the stomach and pain and those dreadful hot flashes. I think I had one yesterday. And I know I get so cross and everything with Harold and the children."

Ruth Flintwood put down her cup. She was a plump, pleasant-appearing woman with gray showing in her hair. Amy Docker was tall, thin and given, as her husband said, to "mooding."

Now Amy Docker got up, checked the bread in her oven and returned to the kitchen table and her tea.

"I'm afraid of more than that, Ruth. I couldn't tell anyone but you. At night I can't sleep and I stare into the darkness and I know it's going to happen."

"What's going to happen, Amy?"

"I read it in a book. A good medical book that Mother used to have. It says that insanity can come from the change. You know how I've always been. Like Peter says, 'moody.' Oh, Ruth—I'm really scared. And this awful feeling inside me as if I want to scream or tear something. I'm worried sick."

She got up, went to the window and looked out into the yard. ."It's been a good life with Peter and me, Ruth. Really good, with the children and all. Sometimes now, I feel as if I could almost do away with myself knowing that it's all going to end."

"End? Oh, Amy—lots of women go through this without—"

"Oh, I don't mean I'll die. But you know as well as I do that with the change all the rest stops. Between you and your husband. Not only the menstruation, but—well, the marital relationship."

"Yes," Ruth said thoughtfully. "I know. I've heard that. Only I just hope it isn't true. I hope it's just going to be hot flashes and being cross and jumpy and all the rest of it."

Amy shook her head. "I only know what I heard, Ruth— but I just know something is going to happen!"

Nothing dreadful happened to Amy Docker. She went through her period of menopause without too much trouble. Eventually, she was well and happy again.

However, the fears, apprehensions and uncertainties were part of it, intensified, in her case, by her belief in old wives' tales that had frightened her even before she was fully into her menopause.

When she began to experience the true symptoms of meno­pause she became almost frantic with fear and despair as she remembered the dire things she had heard.

Somehow she suffered through the hot flashes, abrupt sweating spells, sinking spells, crawling skin sensations, times of mental fogginess, and nervous irritation that marked the period for her.

The few home remedies she knew seemed to be of little help. She tried shallow baths for the nervousness. She tried several herb teas suggested by a friend. When she complained of a headache, another friend suggested her favorite remedy, consisting of fluid extract of rhubarb, brandy, essence of spearmint, bicarbonate of soda, and simple syrup.

For a time she kept to her bed. She used a cloth with cold water on her head. She took long, moody walks. But some­how, she managed to get through and when it was finished she looked back and wondered a little about her fears. She was also surprised to learn that her "marital life" with her husband was by no means ended after the period of meno­pause. As a matter of fact, it seemed a little more enjoyable because she didn't have to worry now about becoming pregnant.

Today, the physical symptoms of the menopause are the same for millions of women as they were for Amy. Unfortu­nately, probably too many contemporary women will experi­ence the same fears. The ones who have kept a sensible patient-doctor relationship with a good family doctor will actually have little to fear with the approach of the meno­pause, and modern medicine will make it much more endur­able than ever before.

Dr. James H. McClure, Associate Professor of Obstetrics and Gynecology, University of Illinois Professional Colleges, has this to say in the November 1960 issue of Today's Health: "... menopause is a normal transition in life. Just as a female at the time of puberty goes through the transition from girl to woman so she goes through a transition at an older age. But this time it's a little less marked transition. Her bodily functions take on some general change due to her increased aging. The majority of fears about menopause are unfounded. Like many things in life, if we expect it to be bad, it is bad ... If a woman comes into the menopausal years without much concern or worry, she usually has little trouble."

When the time comes for a woman's menopause she has little or nothing to fear. If she will consult her doctor, he has tranquilizing drugs, hormones, and other help for her.

Outside the Martin Frederick house a horse clip-clopped down the street in the summer night, harness jingling a little in the stillness. Across the street a dog barked at the moon. Three doors down the street the Shipsted girl and her young man rocked in the porch swing. It made a creaking noise.

In the two back bedrooms of the Frederick house the four Frederick children, the oldest nine years old, slept soundly. In the darkness of the big front bedroom Helen Frederick cried softly as her husband's voice rose a little with impatience.

At 38, Martin Frederick owned a small and thriving hard­ware store. He was tall, well-proportioned and still walked with the military erectness he had acquired during service in the Spanish-American War a few years previously.

He was six years older than his wife, Helen, who was said to be one of the best-looking women in town. As a matter of fact, Martin was well aware of a certain masculine • envy of him among many of the men in the community, and he frequently saw the contemplative look in their eyes as they glanced at his wife, looked at the prettiness of her face, the fullness of her breasts and the feminine allure of her hips.

"If they really knew," he frequently told himself, with a small bitterness born of disappointment built up over the years of his marriage.

This summer night had been another night of disappoint­ment. Perhaps he should think more about Helen, and what it was probably doing to her, but a man couldn't forever conceal his desires and frustrations.

"But I let you, Martin. I've always let you. . ." she sobbed.

"That's just it," he snapped. "You let me. As if it's your duty."

"It is my duty. A wife's duty. I don't see why—?"

"But you never do anything. You act . . .well, as if you hate it. That there's nothing about it that you like."

"I like pleasing you, Martin. That's enough—"

"It isn't enough," he interrupted savagely. "A man wants more than submission. He wants a woman who likes what's happening. Not a woman who's . . . who's just a motionless log!

Helen broke into fresh sobs. Her mother had been right. She had always been right! All a man wanted was this dirty thing. To take what he wanted. Her father had been this way with her mother. Her mother had told her so.

"You'll find out," her mother had said. "Men are all alike. But we have to put up with it. It's our duty as wives. We can't do anything about it. But we don't have to like it, Helen. Always remember that. It's the only way we can have chil­dren. And heaven knows we suffer enough to have them! First, the getting them in that ugly way, and then, the having them with all the pain. But they're worth it. I have you, and you're a million times worth all of it. But you'll find out how it is. Just learn to put up with it, Helen."

Now Martin was angry with her. He had been angry when she refused to take off her nightgown. He had been angry when she wouldn't let him touch her breasts. And then he had been angry when she wouldn't move in the horrible way he wanted her to move with her hips.

Suddenly Martin got out of bed. This had been one of the bad nights because he hadn't completed the act. He said she spoiled it so that he couldn't. And now he was impatient, unsatisfied, angry.

"Martin! Where are you going?" she asked, trying to stop the weeping.

"Downstairs. At least, I can find something to eat?" He went to the door, stopped and looked back, his mouth hard, his expression bitter.

"I know where I should go," he said. "If I had any guts, I would. I'd go out to the edge of town to May's place and I'd take one of her girls to bed and get what you've never given me! Only I won't. So go to sleep. You've done your duty as a wife—such as it was. Good night." He closed the door after him and she heard him go down the stairs.

That's what they really want, she thought. What those hor­rible girls will do for money. Whores! They're dirty, filthy— all of them. Men and whores and sex. I hate it! I hate it!

Still sobbing, she dropped off to sleep eventually while her frustrated husband sat at the kitchen table and stared moodily at a sandwich he didn't want.

// those men who look at her with a gleam in their eyes only knew, he thought. Probably all of them are better off that way than I am. . .

The above episode from life a good many years ago is, no doubt, often repeated today. While it must have occurred more frequently in those days, the problem of the "frigid" woman is still with us. However, a great many sensible, well-educated women will face up to the problem early in marriage, and not a few of them will seek competent medical help.

In the contemporary case of Edna Arley there had been no influencing mother who painted the distorted picture of sex that Helen's mother had painted.

Certainly Edna's mother had not been a fountainhead of sexual information, and, in fact, had been a little vague about some of it. She was much more skilled in teaching her daughter the finer points of contract bridge. But she had tried to prepare Edna for marriage as best she could, and she had sent Edna to see old Dr. Lippin, although she was not too sure how much the old doctor really could help someone in this new generation. But, she had certainly tried.

Once, when she had attempted a serious discussion about the "facts of life," her daughter had shushed her with a smile.

"Please don't worry about it, Mother," Edna had said. "I'm not worried. Know why? Because my John Arley is just like Daddy! He even looks like him. And you know how utterly wonderful Daddy is! I just couldn't bear to marry someone who isn't at least a little like him!"

"Well, I don't know if that's enough reason not to want to know more about. . ." her mother started to say doubtfully.

"Stop worrying! I know about the birds and bees. I'm going to stay a nice little virgin until John and I are married, and then it's going to be fine. I just know it is. So stop worrying."

Unfortunately, it had not turned out to be "just fine." By the end of three months Edna was worrying about her sexual relations with her husband. He had been gentle and kind and considerate. But she still had not experienced what they called the "climax" with John. She knew that.

Sometimes she was certain it was going to happen, and she would get breathless, and so excited she was almost floating away in the intensity of her expectations—and then there would be the strange guilt feeling. As if she shouldn't. As if it was wrong!

She explained some of this to the family doctor she and John had selected, a younger doctor than her mother's. The younger man, Dr. Kramer, listened as she spoke frankly of her relationship with her husband.

"Well, Doctor, that's it," she finished with a small, forced smile. "So what do we do?"

"First of all, we make an examination," he said. "Some­times there can be a physical cause. If it isn't that, I want you to talk with Dr. Tait."

Edna's eyebrows raised a little. "The psychiatrist?"

"Don't lift your eyebrows that way," Dr. Kramer smiled. He's helped a lot of women get over problems. For instance, almost any of you gals might grow up with a father fixation."

"Electra complex," nodded Edna. "I've thought about that. I took quite a bit of 'psych' at the university. Well . . . could be!"

"I don't know. That would be guessing without facts. Could be several things," said Dr. Kramer. "Let's find out."

A quick examination disclosed nothing physically wrong which might account for her frigidity.

"Before I refer you to Dr. Tait, let me ask a few more questions," the doctor suggested. "I assume John has no trou­ble in reaching an orgasm?"

"Well, hardly!" she said. "As a matter of fact, he usually

does just about when I get the funny feelings about guilt. Sometimes I think if he just kept on a little longer . . . only he's so sort of—quick?"

"I think," said Dr. Kramer, "that you'd better have John stop in. It looks as if we may have a small problem of premature ejaculation."

"I—I guess I hadn't thought of that. I just assumed that I should be ready in a few minutes like John. . ."

Edna and John quickly found an answer to their problem, after additional explanation of sexual techniques from their doctor. John learned greater skill in the foreplay to inter­course, bringing his wife closer to culmination before proceed­ing with the actual sexual relation. He also learned how to control his own rise toward climax by resting while still keep­ing close clitoral contact and movement.

The possibility that Edna might have had a "father fixation" was not without reason. She had selected a man who resem­bled her father. Occasionally, a woman is subconsciously in love with her father, as a result of a fixation developed in her youth. A subconscious feeling of guilt in having the most intimate of relations with someone other than her childhood love will prevent her from achieving orgasm with her husband.

Other emotional disturbances may result in nymphomania. The plea of a woman in her early thirties, who sat in a psy­chiatrist's office recently, demonstrates the emotional turmoil that may exist in this condition.

"I can't help myself, Doctor," the well-dressed, attractive woman said. "I don't want to be unfaithful to my husband. I love him. I truly do. Except—it seems that I'm forever seeking something that he doesn't give me. There is the con­stant, driving, terrible urge which keeps telling me that with this new man it will be different. I'll find something I've been seeking—something new. Something I never received from my husband. Maybe something as simple as a complete and satisfactory orgasm. . ."

The details of this case became complex and went deep into emotional problems that could only be aided by compe­tent psychiatric aid.

However, the very fact that this relatively young, well-educated, intelligent woman had recognized her own problem and had sought competent help is an indication of the new concepts of medical and mental health that gradually are becoming established in the nation.

While many of the grandmothers and great-grandmothers of contemporary generations would have been shocked to learn about the homosexual relations between women who are lesbians, or men who are homosexual—and, in many cases, would firmly "refuse to believe it!"—the young people of contemporary generations usually have some understand­ing of the meaning of homosexuality, and some of the prob­lems that arise from the condition. Certainly, they are accus­tomed to seeing it touched upon in the world news.

It is such understanding that leads toward a better physical and mental health in the nation.

However, it should be noted that homosexuality and some of the odd byways of sex are by no means new. They have existed down through history, and have even been approved and accepted in some of the ancient civilizations.

Perhaps we might paraphrase in this instance by saying that: "There is nothing new in the world—except understand­ing, attitude, and treatment."

THE MEN—Compared to women, men have fewer and less-complicated problems that are not germane to both sexes. For one thing, man's reproductive system is considerably less com­plex in any ways. He is equipped to father the child, but the woman is equipped to conceive and then nurture and develop the child in her own body until birth.

Man may experience minor psychological and physical cycles in living, but by no means as definitive as the monthly cycle of the woman, or the major experience of menopause, although it is generally conceded that men may go through a "male climacteric."

S. A. Lewin, M.D., and John Gilmore, Ph.D., in Sex With­out Fear say this about the male climacteric: "Until recently, the possibility of a male change of life was not recognized, fully, and it still is news to the average layman. The climac­teric is not universal, as with women, and occurs at a later period. It is marked by nervousness, hot flushes, dizziness, headaches, etc. There is frequently a loss of sex desire and potency. Treatment with sex hormones will relieve the symp­toms and restore the normal sex activity."

Emotionally, some men may experience illnesses fully as disturbing as those that some women may experience. In this area of life, the male may be fully as complex as the female.

Homosexuality among men is frequent. Kinsey indicated that 37 per cent of the male population between the onset of adolescence and old age has had some homosexual experience to the point of orgasm.

Whether or not psychiatry can help the male homosexual is a moot question. Some psychiatrists believe it is possible to help them. Some say it isn't; that the most that can be offered them is help in adjusting to their lot in life.

One of the most recent studies, however, holds out hope for them. Over the last 30 years Dr. Edmund Bergler, a Manhattan psychiatrist, has examined or treated about 1,000 male homosexuals. In his recently published book, 1,000 Homosexuals, Dr. Bergler expresses his belief that a homo­sexual may be cured by psychiatric treatment if he has the will to change, and the willingness to accept the fact that what he actually seeks may not be a synthetic type of sex but self-punishment.

Psychiatrists, psychologists, and others have long probed and studied to discover the causes of male homosexuality. They have come up with some suggested answers:

Homosexuality may be the expression of submission and attachment to a dominant mother. It may also be identifica­tion with a mother and a submission to aggressive men, such as a father and brothers.

Some believe that homosexual tendencies may arise from a longing for affection from a "father image."

It may be an expression of innate effeminacy. Or it may be explained by one modern theory based upon an assump­tion of bisexuality in all persons, meaning that components of both sexes exist in all males and females, psychologically as well as anatomically.

One thing should be emphasized. Appearances may very much belie the facts in relation to homosexuality. The man with feminine characteristics may by no means be homo­sexual, and some homosexuals are remarkably masculine in appearance, heavily muscled, and athletic in movements. The same is true in relation to women who are lesbians. Some may be very "femininely" beautiful and most attractive to men whom they shun.

Dr. Bergler's explanation of the reasons for homosexuality may be interpreted thus: From the first day, life is a series of shocks. Most humans make adjustments to them, but oth­ers are overwhelmed and attempt to turn the pain itself into pleasure. They become psychic masochists. In the nursery, males learn to fear the woman. She takes the nipple from his mouth. She disciplines him. Many persons may grow up to flee from the fearful mother image. At the same time they unconsciously may court self-damage. Both tendencies may culminate in homosexuality.

Historically, we have always had another type of man with us—the Don Juan.

Frank S. Caprio, M.D., the eminent psychiatrist, succinctly says of him: "... the Don Juan spends his life proving to himself that he can make women love him. This is his way of assuring himself that he is a real man."

The causes for Don Juanism may be deeply seated. A mother may smother a boy with too much attention and af­fection, protecting him, keeping him tied to her and depend­ent upon her. Later, as a man, he may retain his love of the mother image, going from woman to woman in a futile search for his "ideal" and to escape deep, unrecognized tendencies toward incest and, in some cases, homosexuality.

Fifty years ago, the problems besetting a marriage that involved a man who was a Don Juan could indeed be devastating.

Clarice Eaden had fallen in love with Claude Eaden on the first night they met. He was tall, handsome, and exceed­ingly attractive to all the girls.

The girls' opinion of Claude was not so fully shared by some of the young men in the group. "Mama's boy," one of them smirked.

Clarice had defended him fiercely. "Well, it wouldn't hurt you and some of the others to be more like him! At least, he knows how to treat a girl."

"I'll bet!"

Within a few weeks after the party at which they had met, Clarice was being swept off her feet by Claude's attentions.

"I love you," he told her. "You're beautiful . . . lovely . . . everything I've ever wanted in a woman."

It was a beautiful summer in the small town. Evenings, they went for walks. They bicycled through the countryside. They picnicked—once too often, perhaps.

In a secluded spot in the woods, Clarice opened her eyes dreamily and looked up at the interlacing pattern of tree branches above them. She smelled the fragrance of clover and heard the singing of birds, the industrious sound of crickets, but all that she really felt was the knowing skill of Claude's hands upon the flesh of her breasts and thighs; the breathless transgressions; and her inability to do anything but whisper a protest, even as she shut her eyes and welcomed his kisses and caresses and ultimately his complete possession of her.

Seduction is as old as man, and probably as natural. So may be the consequences.

Weeping in fright six weeks later Clarice managed to meet Claude after he had evaded her following the day of the picnic.

"You've got to marry me," she wailed. "I'm going to have a baby . . ."

Claude paled at her words, but he nodded. In such a small town there could be no other logical course for him if he was to stay there, keep his job in the factory office, and face the community in which he had been reared.

He and Clarice were married in an "elopement" and settled down in a small house. Claude's mother had died two years previously, and during the period when he tried to adjust to married life he found himself longing for his mother's aid,

her understanding. He felt lost and without security. As Clarice's pregnancy went on, he found that he almost hated her.

Even before the baby was born, he had been unfaithful to her in a sudden impetuous affair with one of the factory girls where he worked.

Other affairs were to follow. They continued throughout most of their married life, as Claude sought to find the elusive woman of his dreams in his driving compulsion.

Clarice knew about the other women, and she retreated into a silent, bitter shell, refusing him marital relations, al­though he seldom asked for them after the baby came.

For years they lived in a strained, unhappy alliance from which neither gained happiness. Only her love for their only child, a daughter, made any sense to Clarice.

They kept up an outward appearance of compatibility because it was "the thing to do" in that time and place. Claude continued to have affairs, frequently with girls employed in the factory. When he died of a heart attack in his early forties, Clarice was a bitter, old-appearing woman. She never had shared "her secret" with anyone, yet she knew that many people were fully aware of what had been happening.

Silently but defiantly she maintained an aloofness toward most people in the town, afraid of their knowledge about her married life, fearful for the reputation of her daughter.

She died shortly after her daughter's marriage—a lonely, unhappy woman who had found her only happiness in her daughter.

Today such a story might be very different. Every day worried wives and husbands have sought the help of psy­chiatrists and recognized marriage counselors for aid in simi­lar cases. Doctors have heard the apprehensions and the con­fessions. Ministers, priests, and rabbis have listened, advised and helped; the complexities of unhappy marriages and the problems of emotionally unstable persons have been solved, or greatly aided, by intelligent modern treatment.

PHYSICAL PROBLEMS—MEN

Prostate Gland. The membranous canal that conveys urine from the bladder to the surface is called the urethra. In the male the tube leads out through the penis and it also carries the seminal ejaculation.

The prostate is a glandular organ, found only in men, that surrounds the neck of the urinary bladder and the beginning of the urethra. Its function is to secrete the fluid which makes up a large part of the semen which carries the male sperm.

For some reason, an aura of mystery and secrecy has sur­rounded the prostate and its troubles, somewhat like the secrecy which enveloped sex in the past. Prostate disorders even now are not too openly talked about. It appears to be a taboo subject in many instances.

Prostate trouble is actually rather common. Prostatitis, in­flammation of the prostate, attacks about 20 per cent of men over 50, and about a third over 60 suffer from it.

Infection and congestion of the gland have definite symp­toms. Impairment of potency, a low backache, slow and difficult urination, and burning during urination, are usually indications of prostate trouble. With infections there may be a slight discharge.

The gland, not infrequently, is the site of malignant growths, and a large proportion of men—70 to 80 per cent over 60— experience a simple enlargement that is benign (not malig­nant) and called prostatism.

Many infections of the prostate gland now can be handled quickly and effectively with antibiotic drugs. With the wane of gonorrhea, one of the previously common causes of such infections, these have been greatly reduced because the primary disease can be controlled.

Sometimes an abscess may form from an infection and surgery may be necessary. The operation usually is simple and not dangerous.

When simple enlargement is present, the first symptoms frequently manifest themselves in an increasing difficulty in urination, or they may be found in an increased frequency of urination during the day and a need to void at night.

Other complications may result from enlargement, includ­ing bladder stone formation, and hernias of the bladder wall. Surgery is demanded if complete urinary retention takes place.

One of the great dangers involving the gland is the possi­bility of cancer. Cancer of the prostate is primarily a disease of older men, occurring most often in those over 60. When it is discovered early, and when it is confined within the capsule of the gland, in a large majority of the cases it can be cured. Unfortunately, symptoms of early prostate cancer may be very similar to those of simple prostate enlargement.

Virtually all doctors echo the warning of Milton E. Klinger, M.D., who, as Adjunct Attending Urologist at the Jewish Hospital of Brooklyn and Attending Urologist at Beth El Hospital, warned: "Symptoms (cancer of the prostate) often make their appearance when the growth has already spread beyond the gland and throughout the body. It is essential, therefore, that all men over forty-five years of age have their prostates examined every year."

Treatment of the cancer usually is through surgery, which is hearteningly successful in most cases. Occasionally, when extensive radical surgery is not advisable, surgical removal of the testicles— combined with regular administration of female sex hormones—is necessary. Prolongation of life (occasion­ally for years) may result.

Obviously, a doctor should be consulted when the above symptoms of burning urination or difficulty in urination, im­pairment of potency, low backache, discharge, or other obvious indications, point to prostate trouble.

Meanwhile, a few folk medicine treatments have long been known in relation to these problems, passed along from one male generation to the other, usually from one old man to another, as the more frequent problems of old age and the prostate become of concern to older men.

As indicated, a doctor should always be consulted. A good physician has aid for prostate sufferers. There are antibiotics for infections. There are massage techniques the doctor can use for prostatitis. There are treatments and aids for virtually all the conditions mentioned. It is only common sense to make certain that cancer is not present. Thus the doctor's diagnosis is essential.

Mild cases of prostate congestion sometimes have been relieved by the old stand-by—hot sitz baths. Usually the water should be about four or five inches deep and heated to about 112 degrees. Be certain to test the water with your hand to make certain it is not of burning temperature, and cover your shoulders with a towel or robe to keep from getting a chill. Sit for about 20 minutes in the water, adding hot water as you need it.

Some men who find it difficult to start urination may get immediate and temporary relief by applying hot towels to the area around the crotch and lower abdomen.

Men with congestion of prostate may find a measure of relief, too, by avoiding cold, dampness, pepper, alcohol, and long rides in automobiles and trains.

It is not uncommon for uncircumcised men to develop an irritation under the foreskin of the penis. This is usually simply called smegma irritation, the smegma being the thick, whitish discharge from the glands inside the foreskin.

The condition may be prevented by thorough cleansing beneath the foreskin. Th. H. Van de Velde, M.D., the famous Dutch authority on sexual matters, believes that the penis, and the glans—or top—should be cleansed twice a day. Many men apply a little talcum powder to the area to help prevent the accumulation of smegma.

Burning during urination calls for aid from a doctor if it is consistent or becomes more severe. However, a temporary and immediate relief is recommended in folklore: drink four or five quarts of water, fruit juice, or ginger ale for two or three days and the attack may come under control.

Impotence. A very real worry to a great many men is the fear of impotence. Strangely enough, the very fear that a man may experience impotence sometimes is enough to bring it about. As a matter of fact, experts generally agree that 90 per cent of it is due to psychological reasons. Only a very, very few cases are due to organic causes or disease.

This does not mean that sexual inadequacy cannot be brought on temporarily for a night or two, or sometimes longer, by fatigue, illness, worry, too much to drink, or con­tributing factors of that nature.

But a vast number of men who experience consistent im­potence with their wives suffer from a psychological im­potence that usually can be remedied.

Physicians, especially psychiatrists, may find a number of psychological causes for the condition. If "physical" reasons have been ruled out, and the man appears to be otherwise "normal," his impotence usually can be explained and promptly cured.

A young married man, a lineman for an electric utility company, was assigned to work with a slightly older man.

One day, while they were eating lunch out on the job, the talk between the two turned to sex.

Bill, the younger man, was a little reticent about discussing his own sexual relations, but Mike, the older man, treated the subject almost casually.

"I'm dragging today," he grinned as he bit into a sandwich. "The wife and I had a party last night. Better than usual. Three times. Most nights once or twice is enough, but once in a while we go all-out. Know what I mean?"

Bill nodded knowingly, attempting to maintain a casual expression. Three times! He and Corinne only experienced a sexual culmination once a night on those nights when they made love.

Bill changed the subject, but during the rest of the after-noon he remembered the conversation and wondered about himself.

That night he made love to his wife, waited a short time and then began to make his customary overtures again.

"Bill!" Corinne laughed. "Not again!"

"Why not?" He did not want to mention Mike's conversa­tion, but he did want to make certain that he was as com­petent as Mike.

Corinne relaxed beneath his hands. "Well, all right ... if you can."

"Don't worry about that, darling!"

It was a futile boast. For some reason, he suddenly dis­covered that he could not complete the second act of love. Corinne chicled him gently, kissed him good night and snuggled against him to sleep.

Bill stared into the darkness. What was wrong with him that he couldn't make love more than once? Was he losing his manhood so soon in life?

The next night he was determined to try again. To his great consternation he discovered that he could not accomplish even the first satisfactory contact. Even Corinne was a little disturbed.

"Maybe you're more tired than usual," she suggested. "You'll be all right tomorrow night."

"I don't know," Bill murmured. "Maybe—"

The next night he failed again. Now Bill felt a masculine panic that, perversely, made him angry with Corinne.

"Why don't you let go a little?" he demanded. "You act almost as if you don't care."

"That's not true, Bill! I do care. I can't help it if you can't—"

Within a week the situation had become a serious problem for them. Finally, in desperation, Bill confessed his fears to Corinne.

"They call it impotence," he said in the dark after he had failed once again. "Lost manhood, I guess."

"But you didn't used to be this way!" Corinne said in a worried voice.

"Well, I am now! I guess I'm no good to you any more. You'd be better off—"

"Stop it!" Corinne said. She leaned on one elbow and looked down at him in the dimness of their unlighted bedroom. "Don't ever say that. Maybe you're just sick. Why don't you go to Dr. Bjorth?"

"And tell him I can't—can't make love to my wife?"

"Why not? Maybe you hurt yourself or something. Will you go? At least, find out?"

Reluctantly he agreed.

Dr. Bjorth had trouble getting the full information from him, but finally the truth came out and Bill explained about his inability to perform even once during a night when, evi­dently, most men could two or three times.

"Bill," Dr. Bjorth said quietly, "you're all wrong with your facts. Very few couples experience more than one session of love-making in a night—especially after they have been married for a while, like you and Corinne. As a matter of fact, a great many couples only make love one to three times a week. Stop worrying. You're normal and potent. You've worried about something you shouldn't worry about. And I wouldn't be surprised if your friend Mike isn't doing some truth-stretching in his report!"

They talked about it a few moments longer and Bill left the office feeling much better. After he had left, the doctor called Corinne. She had called him earlier and explained her worry about Bill. The doctor had taken care of her all her life and she felt no hesitation in talking with him.

"He's all right," Dr. Bjorth told her. "I gave him a good examination. There's nothing physically wrong with him. He just had a crazy idea or two. Thought he should be a super­man. Which he shouldn't."

"Oh, I'm glad, Doctor!" Corinne exclaimed. "Is there any­thing I could do to help?"

The doctor chuckled a little. "Well, you might be a little extra seductive and uninhibited to get him started," he said. "I don't think he'll have much trouble if you give him a little feminine help!"

"Thanks, Doctor, I will," Corinne said, suppressing a small giggle.

That night Bill's "impotence" was completely cured.

Other causes of impotence may go deeper and require skilled aid from the physician or psychiatrist, but much help is available for the condition if the man will seek it. Not infrequently, the wife may seek help for her husband, and, with the advice of the doctor, aid her husband to overcome his problem.

There is no reason why any man in our world of today should suffer hopelessly the humiliations and frustrations that impotence may bring to his marriage. Help may be just as near as the closest telephone and as easy as a call to a physi­cian for an appointment.

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