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  • The Sorry State Of Nigeria’s Judiciary Among Others Makes The Battle Cry For A Revolution Inevitable By Francis Adewale

    The Sorry State Of Nigeria’s Judiciary Among Others Makes The Battle Cry For A Revolution Inevitable By Francis Adewale

    Lawyers
    Lawyers

    “Those who make peaceful revolution impossible will make violent revolution inevitable.”
                                                   – President John F. Kennedy (1962)

    This week may be one of the worst weeks for Nigerian judiciary and they might have made the much vaunted Sowore’s revolution inevitable. The first salvo was the list of judges released by the National Judicial Council replete with the names of their sons and daughters as well as hangers on. Second is the farcical decision in EFCC vs Kalu where the Supreme Court “suo motu” created a new section to the constitution of Nigeria by vacating a conviction duly given under an extant law. The strange rationale by the Supreme Court is that the presiding judge, now elevated to the Court of Appeal should not have pronounced the sentence. The Court conveniently ignored the fact that the accused counsel had invited the judge to come back and continue the hearing by a formal letter!

    Gone are the days when Nigerian judiciary is famously celebrated as the last bastion of defense for the common man. The days of Kayode Esho, Chukwudifu Oputa, Muhammed Uwais is long gone. Our judiciary is no more like Caesar’s wife, above board. The problem however is not necessarily down to the hydra headed monster of corruption alone but a more sinister evil called, nepotism. It is my humble opinion that an opaque process for selection of judges led us to where we found ourselves this week. And the problem did not start with the current chief justice. The dysfunction and bastardization have been long in coming, and as we will find out in this piece, the cancer has eaten deep into the fabric of this nation. The revolution is inevitable. 

    The Sorry State Of Nigeria’s Judiciary Among Others Makes The Battle Cry For A Revolution Inevitable By Francis Adewale 1Lawyers


    What precipitate this write up is a social media post by a good friend of mine and I obtained his permission to repost his comment with my personal edits:
    “It took Orji Kalu only 4 months including Covid lockdown challenge to move from the High Court to Supreme Court to get his so called sound judgment from Supreme Court while it took ten years to get his case completed at the High Court level. Ten good years! And we are told justice in Nigeria is not cash and carry? The Supreme Court is preparing the ground for a revolution and very soon something extraordinary will take place. The same Supreme Court that will give 2021 and 2022 court date for poor defendants, sat and summarily decide a case within 4 months while cases of those facing a life sentence languish in the labyrinth of jungle justice!”

    My first response to the post, is to retort that the problem did not start with judiciary, but they seem to have led the “nunc dimitis” for the internment of democracy in Nigeria. The judiciary may have pushed us to the praecipe but they were not the only one. We all recalled the impunity days of PDP rule and how they ride roughshod on people’s right, celebrating acquisition of jets obtained from corrupt practices while hordes of masses suffer the indignity of scrapping for foods from the gutter. Towards the end of that era, we all thought, if we can just get a man of integrity into Aso Rock, someone who will brook no atom of corruption, we will change the country. The election of 2015 seems to have lulled Nigerians into thinking that all we need is someone or a duo with integrity, so we elect Buhari and Osinbajo, a puritan and a pastor and went home satiated. What we were not prepared for or more appositely choose to ignore is the fact that the vehicle that brought them into governance is none other than the decrepit system that PDP used to feather their nest. In the first 4 years, we were told that the problem is with the National Assembly where the legistlooters shifted their control of the vortex of power in Abuja, opposing every anti-corruption moves of the executives. Then come the last election where the ruling party now controls the executive and legislative arm, but corruption runs through the gamut of the judiciary and Aso Rock looks the other way while nepotism festers in its rank.

    It is as if the cancer has completely swallowed up the entire fabric of the nation. Cases involving the poor dragged on for years while those who can afford senior advocate can get quick justice. Many warned that this will sound the death knell of democracy in Nigeria. Every attempt to even build on free and fair election has been truncated by the judiciary. What with the recent confounding judgment from Imo and Bayelsa. Our two gargantuan political parties now owned our judiciary lock, stock and barrel. They sit in smoke filled rooms to determine who will be governors, legislators and judges, and those who will play ball are readily appointed as pawns in the chest board of the Nigerian ruling class, wives, nephews, cousins, sons and daughters are made judges and senior advocates overnight without recourse to any modicum of meritocracy. A friend of mine recently quipped that the problem of nepotism is not just that it defeats meritocracy and breeds mediocrity but that it infects the entire body politics and renders it comatose. Corruption can be traced, and ill-gotten wealth recovered but nepotism is more sinister. Those who obtain position of power and authority through nepotism hold fealty only to their masters who appointed them. Such appointee will readily twist the constitution, made up section that does not exist all at the behest of their “godfather”. It is insidious and evil.

    I graduated from Nigerian Law School 30 years ago, after an excellent stint at Great Ife. My class at Ife, drawn from the north, east, west middle belt and south-south has in its rank some of the best legal minds any country will be proud of. We graduated with high hopes to take on the world and change the land. Few of us found ourselves abroad on scholarship where we flourish and excel. Those in legal practice in Nigeria, either at the federal or state ministry of justice or private practice are the ones my heart bleeds for, especially those without access to members of the National Judicial Council. I have had the privilege to advance my career abroad as an attorney and public defender. I frequently sit on panels that recommend colleagues for appointment as judges in a fair, open and transparent process; something my colleagues in Nigeria could only dream of.

    When I look at the state of Nigerian legal practice my heart bleeds. The career growth of colleagues in the legal profession in Nigeria is stunted not for lack of excellence but influence in the right place. Influence peddling is an art form in Nigeria and politicians used to have the exclusive preserve of selling it to the highest bidder, but our Judicial Council seems to have mastered the art. The problem will not be this pronounced if the sons and daughters they are foisting on Nigerian judiciary are steeped in the Nigerian experience or have a modicum of merit. As many of my colleagues are apt to complain, majority of the recent appointees hardly spend few years in Nigeria. They all went to schools abroad. Totally devoid of the Nigerian experience, and constantly removed from the everyday life Nigerians suffers under. Majority of them lives in the gilded mansions of their forbears in Abuja and other state capitals, where they are rarely touched by the “better angels of our nature” to use the phrase coined by Abraham Lincoln. It is therefore no surprise that they care only for what their “godfather” demand.

    Let me however warns that the biggest mistake we could make is to think that the rot is only in the heart of our judiciary. Think again. Nepotism is next door, next street, next town and everywhere in Nigeria. It rampages through the land, be it North, East or West. Just look at our churches and mosques, who do you see minister or lead the prayers when the founder/visioner is not around? You guess right,  if you say their sons and daughters. Gone are the days when Pa Fadayomi push to have a meritorious doctor of aerodynamics succeed him. Gone are the days when the leader of the faithful in Nigeria is selected by their aptitude in the knowledge of the Quaran. Nowadays, the exit of the leader is the beginning of the reign of the progeny. It has infected our colleges and universities, scholarship and opportunities that used to be available on merit are now exclusive preserve of the vice chancelor’s children and family members. Woe betide the school senate members that dare ask questions. Advertisement for jobs that has already been reserved for the children of the privileged are means to extort money in the form of application fees a la Abba Moro immigration recruitment scheme. A recent recruitment without advertisement at our apex bank reported by Sahara Reporters shows that successful applicants names were picked out of the rolodex of the governor. Commercial Banks staff are not an exemption, they are either recruited based on sex appeal or influential ministers/senators’ “recommendation” which doesn’t come easy for the educated but less privileged applicants.

    A friend concluded an animated discussion on social media on this issue with a distinctively Nigerian resignation: “It is clear that those who do not want things to work properly in Nigeria are more powerful than those who are working towards finding solutions to our problems.” Again, my response is what do we have to lose if we embrace Omoyele Sowore’s revolution, even with its youthful disdain for experience? Especially when our current experienced leadership seems to treat the Nigerian masses with contempt. Look at it this way: They do not need our votes to win election, as they could procure midnight judgment in Abuja a la Bayelsa and Imo. They do not need to legislate to fill any lacunae in our constitutional experience as the Supreme Court proved in Kalu’s case. In fact, as long as oil flows and they have the means to fill their Cayman Island bank accounts, we may as well not exist. Greed and avarice have become the directive principle of Nigerian ruling class. To rescue ourselves from their vice grip, we need revolution now!

    Francis Adewale
    Tioluwanimi@gmail.com

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  • Motion of No Confidence against the PM

    Motion of No Confidence against the PM

    Motion of No Confidence against the PM 2

    The Speaker of the House of Representatives (Dewan Rakyat) has accepted a motion by Tun Dr Mahathir, Member of Parliament for Langkawi, that the present PM does not command the confidence of the majority of the Dewan.

    The Speaker said he made this decision to be fair and just and to uphold the integrity of the Dewan and Parliament. He is perfectly within his right to so decide.

    What next?

    The motion must be put (tabled) at the sitting of the Dewan. There will be a debate on the motion. At the end of which there will be a vote by Members of Parliament present in the Dewan.

    If the motion is carried, by a simple majority of those present and voting, then the PM must tender his resignation together with that of his Cabinet.

    The PM may also, instead of tendering his resignation, request the King to dissolve Parliament. The King is not obliged to agree to the request. Recall that the then sitting MB of Perak made this request to the then Sultan Azlan Shah of Perak in the Perak State Assembly crisis. The request was not acceded to.

    If the King agrees to the request to dissolve, and the Dewan is accordingly dissolved, a general election must be held within 60 days of the dissolution.

    The King may, as an alternative to dissolution, invite a Member of Parliament to form the next government. This person must be one who in the King’s judgment is likely to command the confidence of the majority of the Members of the Dewan Rakyat. This is in his subjective discretion. It is his judgment and based on whom he thinks is likely to have the majority confidence.

    How the King decides who has this majority confidence depends on His Majesty. He can invite members and interview them as to whom they support, as was done by the King recently when deciding on the appointment of the present PM. But he need not do so by this method. His Majesty can choose any method he thinks most appropriate to decide who in his judgment is likely to have the confidence of the majority.

    There is also the possibility that this issue of who has the confidence of the majority be decided by the Dewan on a fresh motion, if accepted to be tabled by the Speaker.

    Gurdial a former law professor, currently practises law.

    Motion of No Confidence against the PM
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    https://www.thesundaily.my/opinion/motion-of-no-confidence-against-the-pm-IL2386749

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  • Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem

    Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem

    Indonesia recently completed the last of its annual large-scale treatment for lymphatic filariasis (also known as elephantiasis or Penyakit Kaki Gajah) in Malaka District located in its southernmost province, East Nusa Tenggara. Unprecedented
    progress by the National Lymphatic Filariasis Elimination Programme has strongly placed the country on the path to achieving the elimination of lymphatic filariasis as a public health problem.

    “We reached an estimated number of 40.7 million people living in the 118 high-risk districts during this month-long treatment campaign in October 2019” said Dr Anung Sugihantono, who recently retired as Director General of Diseases
    Prevention and Control, Ministry of Health Indonesia. “
    Single doses of diethylcarbamazine citrate and albendazole facilitated by WHO were delivered to all eligible populations.”

    In 2010, an estimated 125 million Indonesians were still at risk of the disease and required treatment.

    But things changed considerably in 2015 when Indonesia mounted an annual national campaign to resolutely address transmission of the disease and to tackle the morbidity and disability associated with it. The results were apparent as early as 2017, with
    remarkable progress.

    In Indonesia, LF is considered a significant public health concern. In 2009, risk mapping identified a population of 124.5 million people needing treatment for LF. The country initiated a national level LF elimination campaign in 2015, addressing both
    disease prevention and management. 

    “In 2017 and in just two years we managed to achieve 100% geographical coverage of all people requiring treatment” said Dr Sugihantono. “It meant achieving more than 78% epidemiological coverage – much higher than the generally recommended 65% to stop transmission.”

    Transmission of lymphatic filariasis can be stopped through large-scale treatment (or mass drug administration – MDA) of entire at- risk communities with recommended medicines once a year. These medicines kill the microfilariae in an infected patient’s
    blood preventing mosquitoes to transmit1 the disease to others. Through mass treatment, the aim is to reduce the reservoir of microfilariae in the blood to a level insufficient to maintain transmission by the mosquito vector.

    This strategy to interrupt transmission is the corner-stone of the World Health Organization’s (WHO) Global Program to Eliminate Lymphatic Filariasis (GPELF). Indonesia has been using the GPELF’s strategy since 2002 using a district or city
    as its implementation unit.

    In 2005, it listed the elimination of LF as a national priority for controlling infectious diseases and the medicines it has been using in large-scale treatment programmes are diethylcarbamazine citrate (DEC) and albendazole2 which are
    largely distributed by volunteer community health workers3.

    “Community health volunteers are themselves members of the community and know how to reach people effectively to improve compliance” said Dr. Stefanus Bria Seran, the Regent of Malaka District, one of LF endemic district in Indonesia. “Besides ensuring every single person ingests the medicine given to them, these community workers help in disseminating information well before a large-scale treatment campaign and also assist in reporting activities related to each treatment campaign”. 

    Indonesia’s efforts to eliminate lymphatic filariasis began in the 1970s but faced numerous challenges including programme coordination in the many inhabited islands, conducting information, education and awareness programmes, lack of capacity and
    insufficient medicines.

    Furthermore, the situation in Indonesia is unusual than in many other countries endemic for lymphatic filariasis as the country is endemic for all three species of thread-like filarial worms – Brugia malayi, Brugia timori, and Wuchereria bancrofti –
    that cause the disease. Most of the infections in Indonesia, however, are caused by B. malayi.

    In the past, some of the factors that prevented access to the medicines (DEC and albendazole) were social stigmatization linked to the disease, the vast geography of the territory and challenges in reaching remote populations.

    With an estimated population of 242 million, Indonesia is the world’s largest island nation and consists of approximately 17,000 islands, of which 5,000–6,000 are inhabited. It is the fourth most populated nation behind China, India, and the United
    States.

    Indonesia is endemic for many other neglected tropical diseases and an estimated 110 million Indonesians are believed to suffer from at least one neglected tropical disease (NTD), including lymphatic filariasis and soil-transmitted helminth infections.
    Leptospirosis (not classified as NTD) is also widespread.

    Indonesia is the only country of WHO’s South East Asia Region with endemic schistosomiasis. Like many other countries of the Region, it also faces recurrent threats of dengue outbreaks.

    Global progress

    The world has made significant progress towards the elimination of lymphatic filariasis as a public health problem.

    Sixteen countries4 and one territory are now acknowledged by WHO to have achieved elimination of lymphatic filariasis as a public health problem.  

    Seven additional countries have successfully implemented recommended strategies, stopped large-scale treatment and are under surveillance to demonstrate that elimination has been achieved.

    The disease

    Lymphatic filariasis is caused by infection with parasitic worms living in the lymphatic system. The larval stages of the parasite (microfilaria) circulate in the blood and are transmitted from person to person by mosquitoes.

    Infection involves asymptomatic, acute, and chronic conditions. Most infections are asymptomatic, showing no external signs while contributing to transmission of the parasite. Although asymptomatic, these infections still cause damage to the lymphatic
    system and the kidneys and alter the body’s immune system.

    When lymphatic filariasis develops into chronic conditions it leads to lymphoedema (tissue swelling) or elephantiasis (skin/tissue thickening) of limbs and hydrocele (scrotal swelling). Involvement of breasts and genital organs are common.

    Manifestation of the disease after infection takes time and can result in an altered lymphatic system, causing abnormal enlargement of body parts, and leading to severe disability and social stigmatization of those affected.

     


    1Lymphatic filariasis is transmitted by different types of mosquitoes – e.g the Culex mosquito which widespread across urban and semi-urban areas; Anopheles, mainly found in rural areas; and, Aedes, mainly
    in endemic islands in the Pacific.

    2In 2017, WHO recommended an alternative three drug treatment to accelerate the global elimination of lymphatic filariasis. The treatment, known as IDA, involves a combination of ivermectin, diethylcarbamazine citrate and albendazole.
    It is recommended annually in settings where its use is expected to have the greatest impact.

    3Community health workers, also called ‘cadres’, are volunteers who form part of the communities they serve and work with local
    communities to educate families. Their contribution in promoting health has been significant in the country.

    4Cambodia, The Cook Islands, Egypt, Kiribati, Maldives, Marshall Islands, Niue, Palau, Sri Lanka, Thailand, Togo, Tonga, Vanuatu, Viet Nam, Wallis and Futuna, and Yemen

    Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem
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  • New estimates highlight need to step up the response to hepatitis D

    Lyon, France, 29 April 2020 – In a study published in the Journal of Hepatology, 1 Professor Anna Maria Geretti and Dr Alexander Stockdale from the University of Liverpool (United Kingdom), in collaboration with researchers
    from the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC), estimate that worldwide, hepatitis D virus (HDV) affects nearly 5% of people who have a chronic infection with hepatitis B virus (HBV) and that HDV
    co-infection could explain about 1 in 5 cases of liver disease and liver cancer in people with HBV infection..

    To map the epidemiology of HDV infection in the world, Professor Geretti and Dr Stockdale joined forces with the WHO Global Hepatitis Programme and IARC, alongside investigators in Germany, Malawi, and the United Kingdom. “Infection with HDV occurs
    in about 1 in 22 cases of chronic HBV infection in the world,” Dr Stockdale says. “More high-quality data are needed, but we have identified several geographical hotspots of high prevalence of HDV infection: in Mongolia, the Republic of
    Moldova, and countries in Western and Middle Africa.”

    “Although it is less common than hepatitis B, hepatitis D is a serious disease that often affects underprivileged and vulnerable populations,” says Dr Meg Doherty, Director of the WHO Global Hepatitis Programme. Those who are more likely to
    have HBV and HDV co-infection include people who inject drugs and people with hepatitis C virus or HIV infection. The risk of co-infection also appears to be higher in recipients of haemodialysis, men who have sex with men, and commercial sex workers.
    Dr Doherty points out, “This information helps in identifying the groups with HBV among whom we should be looking for HDV.”

    HDV (formerly known as the Delta agent) is a small virus – one of the smallest that is known to cause disease in humans – and can replicate only in the presence of HBV, from which HDV borrows some of its structures. Compared with people with
    HBV infection alone, those who have a chronic infection with both HBV and HDV have a much higher risk of developing disease in the form of cirrhosis and liver cancer. “HDV is a significant contributor to severe liver disease and liver cancer,”
    says IARC scientist Dr Catherine de Martel. “The findings from this study inform our work on the association between viral infections and cancer, which is focused on developing improved prevention strategies.”

    Professor Geretti concludes, “HDV has long been neglected, because for decades the prevalence of infection remained uncertain and effective treatment was lacking. Mapping the epidemiology of the infection is just the first step. More efforts are
    needed to reduce the global burden of chronic hepatitis B and develop medicines that are safe and effective against hepatitis D and are affordable enough to be deployed on a large scale to those who are most in need.”

    1 Stockdale AJ, Kreuels B, Henrion MYR, Giorgi E, Kyomuhangi I, de Martel C, Hutin Y, Geretti AM (2020). The global prevalence of hepatitis D virus infection: systematic review and meta-analysis. J Hepatol. Published online 23 April 2020;
    https://doi.org/10.1016/j.jhep.2020.04.008

    For more information, please contact

    Véronique Terrasse, Communications Group, at +33 (0)6 45 28 49 52 or terrassev@iarc.fr or IARC Communications, at com@iarc.fr

    The International Agency for Research on Cancer (IARC) is part of the World Health Organization. Its mission is to coordinate and conduct research on the causes of human cancer, the mechanisms of carcinogenesis, and to develop scientific strategies for
    cancer control. The Agency is involved in both epidemiological and laboratory research and disseminates scientific information through publications, meetings, courses, and fellowships. If you wish your name to be removed from our press release emailing
    list, please write to com@iarc.fr. 

    About University of Liverpool

    Founded in 1881 as the original ‘red brick’, the University of Liverpool is one of the UK’s leading research-intensive higher education institutions. Consistently ranked in the top 200 universities worldwide, we are a member of the prestigious
    Russell Group and have a global reach and influence that reflects our academic heritage as one of the country’s largest civic institutions. For more information please visit us at www.liverpool.ac.uk

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  • BIRTH CONTROL METHODS

    BIRTH CONTROL METHODS

    The general subject of Birth Control necessarily includes the special subject of Birth Control Methods, viz., of the methods of association between husband and wife under which offspring is conceived only at such times as desired, and consequently only in the number desired.

    These methods may be grouped into three general classes, as follows:

    I. Methods of Continence (total or temporary). In the practice of the methods under this class, there is an avoidance of sexual relations between husband and wife, either continuously or for certain periods during which the liability to conception is great.

    II. Methods of Semi-Continence. In the practice of the methods under this class, there is a partial manifestation of the sexual relation accompanied by an absence of the manifestation of the procreative functions.

    III. Methods of Contraception. In the practice of the methods under this class, the usual manifestations of the sexual relation are observed, accompanied by an avoidance of the union of the male and female elements of reproduction which result in conception.

    The student of the subject of Birth Control, of course, familiarizes himself or herself with each of the several classes of methods above noted, for the purpose of understanding the characteristic distinctions between them, and the respective advantages and disadvantages of each class. In the following pages each class will be briefly considered, that the student may acquire a general understanding thereof, and may be enabled to reason intelligently concerning them. In this presentation therewill be sought a fair statement of each class, without any desire to influence the student for or against either of them.

    Continence.

    Continence (which in this special sense means the avoidance of sexual relations between husband and wife), in the strict sense, is based upon the idea that the sexual relation should not be exercised except for the purpose and intent of procreation. In the restricted usage of the term, it refers to the abstinence from sexual intercourse during stated periods in which the liability to conception is greatest.

    Rev. Sylvanus Stall, the author of several widely-read works on the subject of Sex, says of strict continence: “One theory is that the reproductive function is not to be exercised except for the purpose of procreation. * * * There are some married people, more numerous than some suppose, who have adopted the idea of uniform continence, and who call the reproductive nature into exercise for the purpose of procreation only, and who assert that the maintenance of continence secures not only the greater strength and better health, but greater happiness also. * * * While the results of our investigations do not enable us to assert that it is the true theory, we are yet prepared to say that it is worthy of thoughtful consideration. If it is possible for married people to maintain absolute continence for a period of six months or a year, it must be conceded that it would be possible to extend that time to a longer period. The maintenance of this theory would require such a degree of self-control as is far beyond the possession of the great mass of humanity. We fear, also, that there are but few, even if they entered upon a life union with such thought and intention, who would be willing to maintain their principles for any considerable period. * * * The other theory, and that which many men and women who are eminent for their learning and religious life hold to be the correct theory, is that while no one has a right to enter upon the marriage relation with the fixed purpose of evading the duty of parenthood, yet that procreation is not the only high and holy purpose which God has had in view in establishing the marriage relation, but that the act of sexual congress may be indulged in between husband and wife for the purpose of expressing their personal endearments, and for quickening those affections and tender feelings which are calculated to render home the place of blessing and good which God intended. * * * It is held by those who advocate this theory, that while it would be possible to restrict the exercise of the reproductive functions to the single purpose of procreation, yet in the great majority of instances the effort to live by that theory would generally result in marital unhappiness. * * * Due regard is not only to be paid to the perpetuity of the race, but to the well-being and perpetuity of the individual.”

    The advocates of continence, except for the purpose of procreation, advance many arguments and evidence to justify their contention that this is the only course justified by Nature and Morality. We need not present this argument here, for it is outside the particular question now under consideration. However, in all fairness and justice, there should be presented here the general outline of their argument that there is no rational basis for the widely accepted idea that abstinence from sexual relations is in any way harmful or detrimental to the health and physical well-being of the human race.

    The advocates of continence cite the cases of many continent men who have been noted for their vigor and activity; and claim that such cases also justify their claim that continence makes for the sound mind in the sound body of mankind. The following quotations from authorities will give the general spirit of this contention.

    Dr. Kellogg says: “It has been claimed by many, even physicians, and though with but a slight show of reason, that absolute continence, after a full development of the organs of reproduction, could not be maintained without a great detriment to health. It is needless to enumerate all the different arguments employed to support this position, since they are, with a few exceptions, too frivolous to mention.” Dr. Mayer says: “This position is held by men of the world, and many physicians share it. This belief appears to us erroneous, without foundation, and easily refuted. No peculiar disease nor any abridgement of the duration of life can be ascribed to such continence. * * * Health does not absolutely require that there should ever be an emission of semen, from puberty to death, though the individual live a hundred years.” Dr. Kellogg also says: “This has been amply confirmed by experiments upon animals, as well as by the experience of some of the most distinguished men who have ever lived, among whom may be mentioned Sir Isaac Newton, Kant, Paschal, Fontenaille, and Michael Angelo. These men never married, and lived continent lives. Some of them lived to be a very great age, retaining to the last their wonderful abilities. In view of this fact, there is certainly no danger.”

    Another writer has said: “The Greek athletes training for the great Olympic Games were compelled to observe strict continence, the experience being that by this course they were able to conserve their vigor and strength much better. The prize-fighters of today are compelled by their trainers to observe strict continence during the period of training. Many of the former champions who went to pieces suddenly, owe their downfall to a violation of this rule.” Another has said: “Chastity, even continence, is the prime necessity of the successful athlete.” Dr. Kellogg forcefully says: “Breeders of stock who wish to secure sound progeny will not allow the most robust stallion to associate with mares as many times during the whole season as some of these salacious human males perform a similar act within a month.”

    Dr. Warbasse has said: “Testicular fluid in the seminal vesicles, under unexciting conditions, does not require to be discharged at intervals. I have not been able to find in the studies of the physiologists that its retention is abnormal or unhygienic. * * * I do not conceive of a man suffering from the ills of continence who has been cast away on a desert island, with no immediate prospect of relief, and whose mind and hands are occupied with raising grain, catching fish for subsistence, and constructing a boat for escape. All that has been said of men may be said of women.”

    Dr. Talmey has said: “Continence, if long continued, has been claimed to be the cause of impotence. But there is no valid reason for this belief. To prove the harmfulness of continence an analogue is brought forward between the atrophy of a muscle in enforced idleness and the injury to the sex organs in enforced abstinence. But the proof is somewhat feeble. The essential organs of generation are not muscles, but glands, and who has ever heard of a tear gland atrophying for lack of crying. * * * There is no valid proof of the harmfulness of total abstinence in a healthy individual. A perfectly healthy man is never injured by abstinence. At least there is no sufficient proof that he ever was; but there are unmistakable proofs that total abstinence does not harm the individual.”

    Dr. Stockham has said: “The testes may be considered analogous to the salivary and lachrymal glands, in which there is no fluid secreted except at the demand of their respective functions. The thought of food makes the mouth water for a short time only, while the presence of food causes abundant yield of saliva. It is customary for physicians to assume that the spermatic secretion is analogous to bile, which, when once formed, must be expelled. But substitute the word ‘tears’ for bile, and you put before the mind an idea entirely different. Tears, as falling drops, are not essential to life and health. A man may be in perfect health and yet not cry once in five or even fifty years. The lachrymal fluid is ever present, but in such small quantities that it is unnoticed. Where are tears while they remain unshed? They are ever ready, waiting to spring forth when there is an adequate cause, but they do not accumulate and distress the man because they are not shed daily, weekly, or monthly. The component elements of the tears are prepared in the system, they are on hand, passing through the circulation, ready to mix and flow whenever they are needed; but if they mix, accumulate and flow without adequate cause, there is a disease of the lachrymal glands. While there are no exact analogies in the body, yet the tears and the spermatic fluids are much more closely analogous in their normal manner of secretion and use than are the bile and the semen. Neither flow of tears nor of semen is essential to life or health. Both are largely under the control of the imagination, the emotions, and the will; and the flow of either is liable to be arrested in a moment of sudden mental action.”

    Parkhurst says: “The prostatic fluid, according to Robin, is secreted at the moment of ejaculation. The remaining element of the spermatic secretion is produced, under normal circumstances, only as required, either for impregnation or for the maintenance of the affectional function. The theory that the sperm is naturally secreted only as it is required, brings it into harmony with other secretions. The tears, the saliva, and the perspiration, are always required in small quantities, and the secretion is continuous; but if required in great quantities, the secretion becomes great almost instantly. The mother’s milk is chiefly secreted just as it is required for the infant, and when not required the secretion entirely ceases; yet it recommences the moment the birth of another child makes it necessary. * * * A man accustomed to abstinence will not suffer from any accumulation of secretions, while a man whose absorbing glands have never had occasion to take up the secretions will be in trouble; just as a dairy cow which has not been milked will be in trouble, though if running wild she would never have any necessity for milking. * * * The objection that man needs physical relief from a continuous secretion is answered by the admitted fact that men not deficient in sexual vigor live for months, and probably for years, in strict abstinence, and with no physical inconvenience such as is often complained of by men who happen to be deprived of their accustomed indulgence for a week or two at a time.”

    Dr. Nystrom, the eminent Swedish writer on the subject, however, utters the following warning to those who would make hasty generalizations on the subject: “In speaking of relative abstinence or regulation and command of the sexual instinct, I warn against absolutism in this regard, and especially against the generalizing of abstinence as possible for everybody. Although abstinence during an entire lifetime does not injure certain individuals, it cannot be endured by others for some length of time without undesirable consequences. I therefore oppose the principle of absolute continence as in the main false. It may possibly be applied to a few deeply religious or philosophical persons, but not to the majority of normal people, despite good resolutions and habits. * * * We must consider the different bodily constitutions and passions—why some people without difficulty, others with the greatest difficulty, can master their feelings regarding sexual relations. * * * May those who try to better humanity in sexual respects first give their attention to the subject when well prepared with a rich experience and deep study, for otherwise they cannot give advice which can be followed, and their work should fail as being contrary to human nature.”

    Temporary Continence. Many married couples who are desirous of preventing too-frequent conception, or conception following too soon after the birth of the youngest child, practice the method of refraining from the marital sexual relations during certain periods in which conception is most likely to occur. This custom is said to be favored by those acting under the advice of their religious instructors, and who regard all methods of birth-control other than continence as sinful. Even the most orthodox objectors to birth-control as a general principle seem to regard this particular method as free from objection, providing that the married couple do not seek to entirely escape parenthood in this manner.

    This plan is based upon the well-known, and well-established physiological principle that the time immediately before the menstrual period, and still more, immediately after the period is the most favorable to conception. Impregnation is most likely to occur just after the menstrual period; while from about two weeks after the beginning of the period, to a few days before the beginning of the next period, is the time of comparative sterility when impregnation and conception are the least likely to occur. Consequently, the authorities hold that the period of from ten to fifteen days after the end of the menstruation is one peculiarly free from the probability of impregnation and conception.

    This plan of temporary continence, continuing during the period in which conception is most probable, and terminating when that period has passed each month, until the new period approaches, is followed by many married couples with the full approval of the conscience and their religious guides. In many cases the result fulfills the expectations, though as there is a considerable variation observed among different women there is no absolute certainty to the plan considered as a birth-control method—at the best it is but taking advantage of the law of probabilities, the chances being in favor of the result sought.

    Semi-Continence.

    Semi-Continence (in the sense in which the term is employed herein) consists of the abstinence from the exercise of the procreative functions, while there is a partial manifestation of the sexual relation. Under various fanciful names, backed by as many curious theories, this birth-control method is practiced by very many married couples in this and other countries.

    Among the earlier advocates of this general class of birth-control methods was Noyes, the founder of the one-time famous Oneida Community, who taught the doctrine of what he called “Male Continence.” The gist of his teaching was as follows: That the sexual relation (in its entirety) should be exercised solely for the purpose of reproduction, all else being contrary to nature. But, he held, notwithstanding this, there was possible and proper a certain degree of such physical relation which, while not opposing Nature’s laws of reproduction, yet was sufficient to afford a complete manifestation of the “affectional desire and function.” In other words, as a writer has expressed it, “that one might manifest a marked degree of sexual gratification and still remain continent, while feeling none of the irksome restraints of continence.”

    Noyes claimed that his community followed this plan with satisfactory results, the ordinary sexual relations being manifested only when reproduction was specially desired and deliberately decided upon. Noyes claimed that in this way there was no secretion of the seminal fluid, and therefore no waste of the same, and no unnatural practices such attached to the common custom of “tricking Nature” by methods of preventing impregnation and conception. Parkhurst (who, as we shall see presently, followed Noyes) objected to the Noyes plan, claiming that “it necessarily stimulates into activity the generative functions of the sexual batteries, and this not only causes a wasteful use of sperm, but diverts the sexual batteries from their affectional function, diminishing amative attraction.”

    In the year 1896, Dr. Alice B. Stockham, of Chicago, published a book called “Karezza” which has since attained an enormous sale, the leading principle of which seems to have been almost similar to that of Noyes, as above stated. The book was built around the idea previously announced by the same author in an earlier book, which she stated as follows: “By some a theory called ‘secular absorption’ is advanced. This involves intercourse without culmination.” In her book “Karezza” this author further stated: “Karezza so consummates marriage that through the power of will, and loving thoughts, the crisis is not reached, but a complete control by both husband and wife is maintained throughout the entire relation, a conscious conservation of the creative energy. * * * It is both a union on the affectional plane, and a preparation for the best possible conditions for procreation.”

    About 1882, Henry M. Parkhurst published a booklet called “Diana,” which since that time has passed through several editions, and has had a large number of readers. The principle advocated is radically different from that of Noyes or Dr. Stockham, above mentioned, although some of the writings of Dr. Stockham seem to favor the Parkhurst idea as much as the one advanced by herself. Parkhurst, as we may see by reference to a quotation from him in connection with the Noyes’ idea, did not approve of the “male continence” as taught by the latter, although he seems to have considered it a step in the right direction.

    The gist of the Parkhurst idea is expressed in the following quotations from his booklet, “Diana”: “In order to secure proper and durable relations between the sexes, it is necessary to live in harmony with the law of Alphism, that is abstinence except for procreation. But if that principle is adopted alone, no means being taken to provide for the due exercise of the sexual faculties, it will likely be abandoned or lead to a life of asceticism. In order to make Alphism practicable for ordinary men and women, another law has to be observed, that is, the law of sexual satisfaction from sexual contact; understanding by the term ‘contact’ not merely physical external contact, but using the term in its more general sense to include sexual companionship, or even correspondence, bringing the minds into mental contact. The observance of this law will lead to complete and enduring satisfaction in abstinence.

    “It is an observed fact that contact incites to activity the affectional action, * * * extending over the whole frame, and by their activities satisfies them, without calling into action the special generative function of the generative organs. And it is also an observed fact that the repression of this affectional activity naturally creates a desire for the exercise of the other; so that a true remedy for sexual intemperance is the full satisfaction of the affectional mode of activity by frequent and free sexual contact. Sexual satisfaction may be obtained by personal presence, conversation, a clasp of the hands, kissing, caressing, embracing, personal contact with or without the intervention of dress.

    “The exercise of the affectional function tends to satiety and exhaustion in the same way as all other physical or mental exercise; but if it is not carried to excess it is a permanent benefit. * * * The principle of Alphism will tend to diminish prostitution, not only by diminishing sexual intemperance, even if the principle is not at once accepted in practice to the full extent, thus diminishing the temptation of the present generation, and the hereditary temptation of future generations; but also by correcting the physiological error which has led astray so many, i. e., that total abstinence is not conducive to health, or to the highest physical pleasure, but that the ordinary physical relation is an essential feature in male existence.

    “To avoid misapprehension, these two theories should be clearly defined and the distinction between them explained. The doctrine of Alphism is confined to one principle, i. e., the law of abstinence except for procreation. Those who believe in this doctrine may be divided into different classes. Some believe in it as a matter of duty, to be enforced by precept and self-denial; and some believe in it as a matter of right, requiring no self-denial. In the latter is included the doctrine of ‘Diana,’ which may be defined as the law of sexual satisfaction from sexual contact. In other words, Dianism is Alphism as the result of sexual equilibration.”

    The general idea of Parkhurst, and those who have followed his teachings in some modified or adapted form, may be said to be based upon the following general proposition: That there is a dual function in the sexual relations, which may be stated as follows: (1) the function exercised from purely physiological causes, and which expresses the desire for the relation resulting in procreation; and (2) the function exercised from emotional causes, and which expresses what may be called the “affectional desire,” i. e., the desire for the embrace, caress, fondling, and general companionship with the loved one of the other sex.

    The first one of these phases, i. e., the reproductive function, is manifested by the lower animals as well as by man, and is elemental and primitive in character. It is often manifested by man without the accompaniment of the affectional function, and at times seems to be almost entirely divorced from the idea of high human affection. The second one of these phases, i. e., the affectional function, usually accompanied the procreative function in the human sexual relation, at least in the highest forms of that relation. But also, it may be and often is manifested independently of the procreative function by men and women of refinement. In fact, it would seem to be the form of physical attraction accompanying the very highest phase of love, particularly in women.

    It is this affectional function which is manifested by betrothed lovers in their beautiful period of mutual understanding, sympathy, and affection. It is that characteristic of the courting days which is so precious to the woman, but which is too often sadly missed by the wife after the honeymoon. It exists often before the fires of passion are kindled, and it persists often after the flame of passion has died away. It is the expression of the purest love of youth, and of the tenderest affection of age. It is this form of sexual relation, physical though it may be, that is the outgrowth of evolution in man. May it not be that in this way man has “improved upon the sexual habits of the animals”; and that when man violates the natural restrictions held sacred by animal life, and indulges in excessive sexual relations in and out of season, that he is really manifesting a degenerative tendency instead of taking an upward step on the evolutionary scale.

    There have been many excellent authorities who have held that this affectional function, and its manifestation, is far better calculated to satisfy the sexual instincts of advanced men and women than is the ordinary physical sexual relation. They claim that in the higher form of this affectional relation is to be found the secret of the joy, bliss, and happiness of the betrothed lovers, which alas! too often disappear when the other form of the relation is manifested, particularly when manifested to excess in the manner customary to so many married men. They claim that in the recognition of this fact of human life and love is to be found the secret of married happiness between wedded advanced and cultured individuals. They assert that the experience of the race, rightly considered and understood, full proves this contention.

    Edward Carpenter has the following to say on this point: “It is a matter of common experience that the unrestrained outlet of the purely physical desire leaves the nature drained of its higher love-forces. * * * There are grounds for believing in the transmutability of the various forms of the passion, and grounds for thinking that the sacrifice of a lower phase may sometimes be the only condition on which a higher and more durable phase can be attained; and that, therefore, restraint (which is absolutely necessary at times) has its compensation. Anyone who has once realized how glorious a thing love is in its essence, and how indestructible, will hardly need to call anything that leads to it a sacrifice; and he is indeed a master of life who, accepting the grosser desires as they come to his body, and not refusing them, knows how to transform them at will into the most rare and fragrant flowers of human emotion * * * Between lovers, then, a kind of hardy temperance is to be recommended—for all reasons, but especially because it lifts their satisfaction and delight in each other out of the regions of ephemeralities (which too often turn into dull indifference and satiety) into the region of more lasting things—one step nearer at any rate to the eternal kingdom.

    “How intoxicating, indeed, how penetrating—like a most precious wine—is that love which is the sexual transformed by the magic of the will into the emotional and spiritual! And what a loss, on the merest ground of prudence and the economy of pleasure, is the unbridled waste along physical channels! So nothing is so much dreaded between lovers as just this—the vulgarization of love—and this is the rock upon which marriage so often splits. There is a kind of illusion about physical desire similar to that which a child suffers from when, seeing a beautiful flower, it instantly snatches the same and destroys in a few moments the form and fragrance which attracted it. He only gets the full glory who holds back a little, and he only truly possesses who is willing if need be not to possess. * * * It must be remembered, however, that in order for a perfect intimacy between two people their physical endearment must by the nature of the case be free to each other. The physical endearment may not be the object for which they come together; but, if it is denied, its denial will bar any real sense of repose and affiance, and make their mutual association restless, vague, tentative and unsatisfied. I think, from various considerations, that, generally, even without the actual physical sex-act, there is an interchange of vital and ethereal elements—so that it may be said that there is a kind of generation taking place within each of the persons concerned, through their mutual influence on each other, as well as that more specialized generation which consists in the propagation of the race.”

    Count Tolstoi said on this subject: “The difference in organization between man and woman is not only physiological but extends also into other and moral characteristics, such as go to make manhood in man, and womanhood (or femininity) in woman. The attraction between the sexes is based not merely upon the yearning for physical union, but likewise upon that reciprocal attraction exerted by the contrasting qualities of the sexes each upon the other, manhood upon womanhood, and womanhood upon manhood. The one sex endeavors to complement itself with the other, and therefore the attraction between the sexes demands a union of spirit precisely identical with the physical union.

    “The tendency toward physical and spiritual union forms two phases of manifestation of one and the same fountain-head of desire, and they bear such intimate relations to each other that the gratification of the one inclination inevitably weakens the other. So far as the yearning for spiritual union is satisfied, to that extent the yearning for physical union is diminished or entirely destroyed; and, vice versa, the gratification of the physical desire weakens or destroys the spiritual. And, consequently, the attraction between the sexes is not only physical affinity leading to procreation, but is also the attraction of opposites for one another, capable of assuming the form of the most spiritual union in thought only, or of the most animal union, causing the propagation of children, and all those varied degrees of relationship between the one and the other. The question of upon which footing the relation between the sexes is to be established and maintained, is settled by deciding what method of union is regarded at any given time, or for all time, as good, proper, and therefore desirable. * * *

    “The nearer the union approaches the extreme physical boundary, the more it kindles the physical passions and desires, and the less satisfaction it gets; the nearer it approaches the opposite extreme spiritual boundary, the less new passions are excited and the greater is the satisfaction. The nearer it is to the first, the more destructive it is to animal energy; the nearer it approaches the second, the spiritual, the more serene, the more enjoyable and forceful is the general condition. * * * Taking into consideration the varying conditions of temperament, and above all what the contracting parties regard as good, proper, and desirable, marriage for some will approach the spiritual union, and for others the physical; but the nearer the union approaches the spiritual the more complete will be the satisfaction. The substance of what has been said is this: that the relation between the sexes have two functions, i. e., the reproductive, and the affectional; and that the sexual energy, if only it have no conscious desire to beget children, must be always directed in the way of affection and love. The manifestation which this energy assumes depends upon custom or reason; the gradual bringing of the reason into accord with the principles herein expounded, and a gradual reorganization of customs consonant with them, results in saving men from many of their passions, and giving them satisfaction for their higher sexual instincts and desires.”

    Some capable writers on the subject have held that in the practice of the methods of semi-continence, such as have been referred to in the foregoing pages of this part of the book, there may lie the danger of excessive stimulation of the sexual centres, without the safety-valve of the physical and nervous relief which follows as a natural sequence in the ordinary sexual relations. The advocates of these methods, however, reply that such objections while valid in the case of persons who practice the same only because opportunity prevents the performance of the usual physical relation, still have no true application to those who adopt these methods in a conscientious and honest manner, and who maintain the proper mental attitude toward the whole question.

    These advocates say that the mental effect upon the secretions of the body must be taken into account in all considerations of the question. They say that just as the gastric juice will begin to flow in response to the mental image or idea of food, and the mother’s milk in response to the cry of the child for food, so do the sexual secretions, direction of the circulation, and other physiological activities result from the mental pictures or idea of sexual congress. They hold that if the mind of the husband be filled with mental images of sexual congress, then there is set into operation the process of secretion of seminal fluids, and the consequent engorgement of the blood-vessels concerned therewith, which are denied the normal physiological relief, and accordingly produce bad effects upon the nervous system. But they likewise claim that if the mind of the husband entertains ideas merely of physical endearment and caress as “an end to itself,” then there is no mental incentive toward the secretion of the seminal fluids, and the constant engorgement of the blood-vessels, and no nerve force is generated—and therefore no nerve-shock is experienced by reason of frustrated manifestation and expression.

    Parkhurst says regarding the point just mentioned: “In the relations between the sexes, the question of how the association of the husband and the wife shall stimulate the affectional or generative action or sexual batteries must depend greatly upon their habits of association. We have only to accustom ourselves to associating the relation with the affectional action, by repeated repetition when the affectional action is all that is felt or thought of, in order to cultivate such habits and associations as will make the association tend to repress passional desires, by the direction of the sexual forces into the channel of affectional attraction and functioning. * * * The form of the sexual manifestation will be largely influenced, by the mind, and largely by force with these principles, and the gradual formation of habits consistent therewith, will make more and more evident their beneficial operation.”

    There is much interest now being taken by thinking people in some phases of the general subject of semi-continence, and many thoughtful and conscientious persons find in it at least the promise of a worthy and honest solution of the problem of Continence as applied to Birth Control. Such persons claim to find in this general class of Birth Control methods a happy medium between the rigid practice of absolute Continence in the marriage relations, on the one hand, and the more popular methods of Contraception, on the other hand.

    Contraception.

    We now come to the consideration of the subject of Contraception, pure and simple, the methods of which contemplate the manifestation of the usual physical sexual relations between husband and wife, accompanied by an avoidance of the union of the male and female elements of reproduction which result in conception.

    It should once more be positively emphasized that by Contraception is NOT meant Abortion. Abortion means “the premature expulsion of the human embryo or foetus; miscarriage.” Contraception, on the other hand, means simply the prevention of the union of the male and female elements of reproduction, and consequently, the preventing of the process which evolves the foetus or embryo. Contraception is prevention; abortion is destruction. There is here a difference as wide as the poles. As Dr. William J. Robinson says, in a paragraph previously quoted in this book: “In inducing abortion, one destroys something already formed—a foetus, or an embryo, a fertilized ovum, a potential human being. In prevention, however, one merely prevents chemically or mechanically the spermatozoa from coming in contact with the ovum. There is no greater sin or crime in this than there is in simple abstinence, in refraining from sexual intercourse.”

    Unfortunately for the cause of scientific Birth Control in America, the laws of the United States (and of most of the separate States) at present prevent the public dissemination by written or printed words, or by public teaching of information concerning the contraceptive methods known to all intelligent physicians and others who have made a scientific study of the subject. The conveyal of such information, in the manner stated, is made a criminal offence, subject to heavy fines and imprisonment. Though there is a strong movement underway on the part of many intelligent and earnest citizens of this country, having for its object the repeal of such prohibitive laws, and the passage of careful legislation designed to give the dissemination of such instruction a legal and certain status, under the restrictions imposed by common sense, intellectual honesty, and the best interests of the race—to place it upon the same footing as in certain advanced European countries—the fact remains that at the present time no person may give such information without subjecting himself to indictment and probable conviction as a law-breaker and enemy of society.Under the circumstances, of course, there has been, and will be, no attempts to furnish such forbidden information in this book. So long as these laws stand unrepealed on the statute books, they must be observed by all law abiding citizens.

    Dr. Wm. J. Robinson, an authority on the subject, says: “We believe that under any conditions, and particularly under our present economic conditions, human beings should be able to control the number of their offspring. They should be able to decide how many children they want to have, and when they want to have them. And to accomplish this result we demand that the knowledge of controlling the number of offspring, in other and plainer words, the knowledge of preventing undesirable conception, should not be considered a criminal offence punishable by hard labor in Federal prisons, but that it should be considered knowledge useful and necessary to the welfare of the race and of the individual; and that its dissemination should be as permissible as is the dissemination of any hygienic, sanitary or eugenic knowledge.”

    The only possible relief from the present condition is seen by careful thinkers to be in the education of the public as to the needs of the case, and the presentation of the scientific argument in favor of rational and proper Birth Control, to the end that public opinion, once seeing the truth in the case, may be sufficiently strong as to bring about a change in the present antiquated and bigoted laws. But, so long as the laws remain on the statute books, they must be observed and obeyed. Education, not Anarchy, is the true remedy.

    The following general remarks on the subject of Contraception, by Havelock Ellis, the well-known English authority of the subject of Sex in Modern Society, may perhaps prove interesting to students of the general subject: Ellis says: “Many ways of preventing conception have been devised since the method which is still the commonest was first introduced, so far as our certainly imperfect knowledge extends, by a clever Jew, Onan (Genesis, Chap. XXXVIII) whose name has since been wrongly attached to another practice with which the Mosaic record in no way associates him. There are now many contraceptive methods, some dependent on precautions adopted by the man, others dependent upon the woman, others again which take the form of an operation permanently preventing conception, and, therefore, not to be adopted save by couples who already have as many children as they desire, or else who ought never to have children at all and thus wisely adopt a method of sterilization. It is unnecessary here, even if it were otherwise desirable, to discuss these various methods in detail. It is even useless to do so, for we must bear in mind that no method can be absolutely approved or absolutely condemned. Each may be suitable under certain conditions and for certain couples, and it is not easy to recommend any method indiscriminately. We need to know the intimate circumstances of individual cases. For the most part, experience is the final test.

    “Forel compared the use of contraceptive devices to the use of eyeglasses, and it is obvious that, without expert advice, the results in either case may sometimes be mischievous or at all events ineffective. Personal advice and instruction are always desirable. In Holland nurses are medically trained in a practical knowledge of contraceptive methods, and are thus enabled to enlighten the women of the community. This is an admirable plan. Considering that the use of contraceptive measures is now almost universal, it is astonishing that there are yet so many ‘civilized’ countries in which this method of enlightenment is not everywhere adopted. Until it is adopted, and a necessary knowledge of the most fundamental facts of sexual life brought into every home, the physician must be regarded as the proper adviser. It is true that until recently he was generally in these matters a blind leader of the blind. Nowadays it is beginning to be recognized that the physician has no more serious and responsible duty than that of giving help in the difficult path of sexual life. Very frequently, indeed, even yet, he has not risen to a sense of his responsibilities in this matter. It is well to remember, however, that a physician who is unable or unwilling to give frank and sound advice in this most important department of life, is unlikely to be reliable in any other department. If he is not up to date here, he is probably not up to date anywhere.

    “Whatever may be the method adopted, there are certain conditions which it must fulfill, even apart from its effectiveness as a contraceptive, in order to be satisfactory. Most of these conditions may be summed up in one: the most satisfactory method is that which least interferes with the normal process in the act of intercourse. Every sexual act is, or should be, a miniature courtship, however long marriage may have lasted. No outside mental tension or nervous apprehension must be allowed to intrude. Any contraceptive proceeding which hastily enters the atmosphere of love immediately before or immediately after the moment of union is unsatisfactory and may be injurious. It even risks the total loss of the contraceptive result, for at such moments the intended method may be ineffectively carried out, or neglected altogether. No method can be regarded as desirable which interferes with the sense of satisfaction and relief which should follow the supreme act of loving union. No method which produces a nervous jar in one of the parties, even though it may be satisfactory to the other, should be tolerated. Such considerations must for some couples rule out certain methods. We cannot, however, lay down absolute rules, because methods some couples may find satisfactory prove unsatisfactory in other cases. Experience, aided by expert advice, is the only final criterion.

    “When a contraceptive method is adopted under satisfactory conditions, with a due regard to the requirements of the individual couple, there is little room to fear that any injurious results will be occasioned. It is quite true that many physicians speak emphatically concerning the injurious results to husband or to wife of contraceptive devices. Although there has been exaggeration, and prejudice has often been imported into this question, and although most of the injurious results could have been avoided had trained medical help been at hand to advise better methods, there can be no doubt that much that has been said under this head is true. Considering how widespread is the use of these methods, and how ignorantly they have often been carried out, it would be surprising indeed if it were not true. But even supposing that the nervously injurious effects which have been traced to contraceptive practices were a thousandfold greater than they have been reported to be—instead of, as we are justified in believing, considerably less than they are reported—shall we therefore condemn contraceptive methods? To do so would be to ignore all the vastly greater evils which have followed in the past from unchecked reproduction. It would be a condemnation which, if we exercised it consistently, would destroy the whole of civilization and place us back in savagery. For what device of man, ever since man had any history at all, has not proved sometimes injurious?

    “Every one of even the most useful and beneficial of human inventions has either exercised subtle injuries or produced appalling catastrophes. This is not only true of man’s devices, it is true of Nature’s in general. Let us take, for instance, the elevation of man’s ancestors from the quadrupedal to the bipedal position. The experiment of making a series of four-footed animals walk on their hind-legs was very evolutionary and risky; it was far more beset by dangers than is the introduction of contraceptives; we are still suffering all sorts of serious evils in consequence of Nature’s action in placing our remote ancestors in the erect position. Yet we feel that it was worth while; even those physicians who most emphasize the evil results of the erect position do not advise that we should go on all-fours. It is just the same with a great human device, the introduction of clothes. They have led to all sorts of new susceptibilities to disease and even tendencies to direct injury of many kinds. Yet no one advocates the complete disuse of all clothing on the ground that corsets have sometimes proved harmful. It would be just as absurd to advocate the complete abandonment of contraceptives on the ground that some of them have been misused. If it were not, indeed, that we are familiar with the lengths to which ignorance and prejudice may go we should question the sanity of anyone who put forward so foolish a proposition. Every great step which Nature and man have taken in the path of progress has been beset by dangers which are gladly risked because of the advantages involved. We must never loose sight of the immense advantages which Man has gained in acquiring a conscious and deliberate control of reproduction.”

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • GESTATION OR PREGNANCY

    GESTATION OR PREGNANCY

    Gestation is “the act of carrying young in the Uterus, from the time of conception to that of parturition.” Conception occurs at the moment of the impregnation of the ovum; parturition is the act of delivery, or childbirth. Pregnancy is “the state of being with child.” The terms “period of gestation,” and “period of pregnancy,” respectively, are employed by medical authorities to designate the time during which the mother carries the young within her own body—from the moment of the impregnation of the ovum until the moment of the final delivery of the child into the outer world.

    The term of pregnancy in woman continues for over nine calendar months (or ten lunar months)—from about 275 to 280 days, though in exceptional cases it may be terminated in seven calendar months, or on the other hand may continue for ten calendar months. The usual method is to figure 280 days from the first day of the last menstruation. A simple method of calculating the probable date of delivery is as follows: Count back three months, and then add seven days, and you will have the date of probable delivery. Example: A woman’s first day of last menstruation is March 28. Counting back three months gives us December 28; and adding seven days to this gives us January 4, as the date of probable delivery. There will always be a possible margin of a few days before or after the ascertained probable date—but the delivery will very closely approximate said date. Ignore the shortage of days of February in this calculation, the same being covered by the general margin allowed.

    Development of the Impregnated Ovum. In the preceding lesson we terminated our consideration of the impregnated ovum at the point at which, after the process of segmentation, the “primitive trace” had appeared. This primitive trace appears as an opaque streak, or straight line, formed of an aggregation of cells of a distinctive quality. This delicate “trace” or “streak” is the first indication of the form of the coming child. It is the basis, pattern, or mould, in or around which the spinal column is to be formed, and around which the entire young body is to be developed by the wonderful and intricate processes of dividing and reduplication, and the folding and combination of cells. From one end of this “trace” develops the head; from the other end develops the lower end of the spine. At a later stage there appear tiny “buds” in the positions at which the arms and legs should be; these gradually develop, and their ends split into tiny fingers and toes, and finally are transformed into perfect little arms and legs, miniatures of those of the adult human being.

    The term “the embryo” is employed to designate the developing young creature in the earlier stages of its development, particularly before the end of the third month of its existence. After the end of the third month the embryo is called “the fetus.” In the short space of 280 days the young creature evolves and develops from a single simple cell into a complex organism—a perfect miniature human being. Nature works a wonderful miracle here, and yet so common is it that we take it all as a matter of course, and lose sight of the miracle. From the most simple forms are formed in the developing creature the most complex organs and parts. The heart is formed from a tiny straight line of cells, by enlargement and partition. The stomach and intestines, likewise, develop from a tiny straight line of cells arranged as a tiny tube—the stomach is formed by dilation of one part of the tube, while the large intestine experiences a similar though lesser distention and a greater growth in length; the smaller intestines being formed by growth in length and circumference. The other organs evolve from similar simple beginnings.

    The embryo is nourished during its earlier stages by means of the “yolk sack,” or “umbilical vesicle,” which is outside the body of the embryo, being joined to it by means of the umbilical duct. This yolk sack (originally formed by a “drawing together” in the ovum, which thus separates itself into two portions or areas) is an important feature of the life of the embryo, as it nourishes and sustains it in its earlier stages. Blood vessels form in this yolk sack, and after a time its fluid is absorbed, and after the third month the sack gradually disappears.

    After the passing away of the yolk sack, the embryo is nourished and sustained by the “allantois,” another peculiar sack which is formed. This sack readily becomes filled with blood-vessels, and serves to nourish the embryo by sustenance obtained from the body of the mother through the walls of the Uterus, a direct communication with the blood-vessels of the mother thus being secured. The blood in the embryo, and that in the mother, come into close contact, thus allowing the embryo to be nourished by the blood of the mother. After a time, in turn, the allantois diminishes and dwindles away, its offices being taken up and performed by the “placenta” or “afterbirth.”

    The Placenta or Afterbirth. The Placenta, or afterbirth, is a round, flat substance or organ, contained within the Uterus, by which communication and connection is established and maintained between the fetus and the mother, by means of the umbillical cord. It is a flat, circular mass, about seven inches in diameter, and weighing about sixteen ounces. It is attached to the sides of the Uterus of the mother during the period of gestation, and is expelled from the body of the mother, as “the afterbirth,” after the birth of the child.

    Let us pause a moment, and reconsider the several steps in Nature’s plan for nourishing the embryo and fetus. In the first place, as we have seen, there is the yolk sack or umbillical vesicle, filled with a fluid which nourishes the embryo. This gradually disappears in time, and is replaced by the “allantois” which by connection with the walls of the Uterus is enabled to nourish the fetus from and by the blood of the mother. For a short time, however, the embryo is nourished by both the yolk sack and the allantois. Then the allantois assumes the entire task, and the yolk sack passes away. Then, later, the placenta replaces the allantois, and the latter passes away as did its predecessor. The placenta works along the same general lines as the allantois, but is a far more complex way and with a much higher degree of efficiency, as we shall see presently.

    The placenta is connected with the body of the fetus by what is known as “the umbillical cord.” The “umbillicus” or “navel” in the human being marks the place at which the umbillical cord entered the body of the fetus, from which it was severed after the birth of the child. The purpose of the umbillical cord is to contain and support the umbillical arteries and veins through which the fetus obtains nourishment from the placental substance, and through which the return blood flows. The rich red arterial blood is carried from the placenta to the fetus, and is then distributed over the body of the fetus, nourishing and building it up; the dark venous blood, laden with the waste products of the body of the fetus, is carried back to the placenta, there to be repurified and rendered again rich and nourishing.

    The story of the circulation of the blood of the fetus is most interesting. Although the fetal blood is derived from that of the mother, as we have said, yet the maternal blood does not pass directly from the circulatory system of the mother into that of the fetus; nor does the blood of the fetus return directly into the circulatory system of the mother. In fact, the fetal blood never comes in direct contact with that of the mother, or vice versa. The fetus has an independent circulatory system of its own, and yet, at the same time, from the moment of the placental connection until the moment of childbirth, all its nourishment is derived from its mother.

    The secret of the above paradoxical statement is made apparent when we understand the meaning of the scientific term “osmosis.” Osmosis is “the passage of a fluid through a membrane”; it is a chemical process, caused by the chemical affinity between two liquids or gases separated one from the other by a porous diaphragm or substance. In the process of osmosis in the case before us, the fetal blood takes up nourishing substances and oxygen from the blood of the mother, and passes on to the latter the waste products of the fetal system, by means of passing these substances through the thin porous membranes which separate the two independent systems of blood vessels, i. e., the system of the fetus, and that of the mother. Before birth, in fact, the fetus has its blood nourished and oxygenated by means of the food partaken of by its mother, and the oxygen taken in by the mother in her breathing. After its birth, the infant eats and breathes for itself, and thus nourishes its blood supply directly, instead of receiving it indirectly from the mother.

    The Placenta begins to be formed about the third month of gestation, and continues to develop steadily from that time. At the time of the delivery of the child the Placenta covers nearly or quite one-third of the inner space of the distended Uterus of the mother. The total “afterbirth” consists of the Placenta, the umbillical cord, and the remaining membranes of the ovum, all of which are expelled after the birth of the child.

    The Amnion. An important appendage contained in the Uterus in connection with the developing fetus is that known as “The Amnion.” This is an inner sack which forms within the womb, and which serves to enclose the fetus, and also to sheath the umbillical cord. The Amnion encloses the embryo very snugly during the early stages of its development, but it gradually becomes distended with a pale watery fluid, known as “the amniotic fluid,” the purpose of which is to “float” the fetus and to give it mechanical support on all sides. This fluid is composed of water carrying in solution small quantities of albumin, urea, and salt.

    Sex in the Embryo and Fetus. It is impossible to determine the sex of the embryo during its early stages. During the fourth week the first traces of the sexual glands appear, but not until the fifth week can the sex be determined even by the microscope. If the embryo is to become a male, certain ducts are transformed into convoluted tubules, and each is attached to the testes which have been formed from the genital nucleus. If the embryo is to become a female, the ducts join to form the uterus and vagina, other portions being transformed into the fallopian tubes and connecting with the ovaries which have been formed otherwise. The outer genitals appear in the early stages of the embryo, but there is no apparent distinction between the sexes, the external organs being the same in all cases, and consisting of a small tubular organ with a small lateral fold of skin on either side. Later, in the male, a groove appears on the under side of this primitive organ, thus forming the urethra, the scrotum being formed from the folded skin at the side. In the female, the primitive organ ceases to develop as in the male, and thus becomes proportionately smaller, and evolves into the clitoris of the female; the two lateral folds, on each side, being transformed into the labia majora, or “outer lips” of the female external genitals.

    Position of the Fetus. During the period of gestation the fetus lies “curled up” in the bag of the amnion. The head is usually relaxed and inclined forward, the chin resting on the breast; the feet are bent up in front of the legs, the legs bent up on the thighs, the knees separated from each other, but the heels almost touching on the back of the thighs; the arms bent forward and the hands placed between them as though to receive the chin between them. The folded-up fetus forms an oval, the longest diameter of which is about eleven inches at its greatest stage of growth. Nature here shows a wonderful ability to pack the fetus into as little space as possible, and in such a position as to protect it from injury, and to discommode the mother as little as possible.

    The following interesting statement made by Helen Idleson, M. D., in a European medical journal several years ago, gives a very clear idea, expressed in popular terms, of the appearance and characteristics of the embryo or fetus in the various stages of its development:

    “The growth of the embryo after fecundation is very rapid. On the tenth day it has the appearance of a semi-transparent grayish flake. On the twelfth day it is nearly the size of a pea, filled with fluid, in the middle of which is an opaque spot, presenting the first appearance of an embryo, which may be clearly seen as an oblong or curved body, and is plainly visible to the naked eye on the fourteenth day. The twenty-first day the embryo resembles an ant or a lettuce seed. Many of its parts now begin to show themselves, especially the cartilaginous beginnings of the spinal column, the heart, etc. The thirtieth day the embryo is as large as a horse-fly, and resembles a worm, bent together. There are as yet no limbs, and the head is larger than the rest of the body. When stretched out it is nearly half an inch long. Toward the fifth week the heart increases greatly in proportion to the remainder of the body, and the rudimentary eyes are indicated by two black spots toward the sides, and the heart exhibits its external form, bearing a close resemblance to that in an adult. In the seventh week, bone begins to form in the lower jaw and clavicle. Narrow streaks on each side of the vertebral column show the beginning of the ribs. The heart is perfecting its form, the brain enlarging, and the eyes and ears growing more perfect, and the limbs sprouting from the body. The lungs are mere sacks, and the trachea is a delicate thread, but the liver is very large. In the seventh week are formed the renal capsules and kidneys.

    “At two months, the forearm and hand can be distinguished, but not the arm; the hand is larger than the forearm, but it is not supplied with fingers. The distinction of sex is yet difficult. The eyes are prominent. The nose forms an obtuse eminence. The nostrils are rounded and separated. The mouth is gaping, and the epidermis can be distinguished from the true skin. The embryo is from one-half to two inches long, the head forming more than one-third of the whole. At the end of three months, the eyelids are distinct but shut; the lips are drawn together; the forehead and nose are clearly traceable, and the organs of generation prominent. The heart beats with force; the larger vessels carry red blood; the fingers and toes are well defined, and the muscles begin to be developed.

    “At the fourth month, the embryo takes the name of ‘fetus.’ The body is six to eight inches in length. The skin has a rosy color, and the muscles produce a sensible motion. A fetus born at this time might live several hours. At five months the length of the body is from eight to ten inches. At six months, the length is twelve and one-half inches. The hair appears on the head, the eyes closed, the eyelids somewhat thicker, and their margins, as well as their eyebrows, are studded with very delicate hairs. At seven months, every part has been increased in volume and perfection; the bony system is nearly complete; length, twelve to fourteen inches. If born at this period, the fetus is able to breathe, cry and nurse, and may live if properly cared for.

    “At eight months, the fetus seems to grow rather in length than in thickness; it is only sixteen to eighteen inches long, and yet weighs from four to five pounds. The skin is very red, and covered with down and a considerable quantity of sebaceous matter. The lower jaw, which at first was very short, is now as long as the upper one. Finally, at term, nine months, the fetus is about nineteen to twenty-three inches long, and weighs from six to eight pounds. The red blood circulates in the capillaries, and the skin performs the functions of perspiration; the nails are fully developed.”

    Another writer says: “There is a superstition that a child born at eight months is not as liable to live as if born at seven months; indeed, many suppose that an eight months’ child never survives. Facts do not prove this idea to be correct. Personally, I have known several eight months’ babies to live and do well, and I believe that their chance of life is much greater than if born at seven months.”

    Children born in the seventh month of gestation are capable of living, though great care is required to rear them for the first few months after birth. The “incubators” now so common in large cities have greatly increased the chances of the “seven months’ child,” and, for that matter, of those born even earlier. There are a number of cases of record where children have been born after six months of gestation, and a few even before the six months, but these cases are rare and unusual, and such children usually die soon after birth.

    The following table, given by a good authority, shows the average length and weight of the human embryo and fetus:

    Age. Length in inches. Weight.
    2 weeks 0.1 Not given
    3 weeks 0.2 3 grains
    4 weeks 0.3 Not given
    5 weeks 0.5 Not given
    6 weeks 0.7 Not given
    7 weeks 0.9 Not given
    8 weeks 1.5 4 drachms
    3 months 3.0 2 ounces
    4 months 6.0 5 ounces
    5 months 9.0 10 ounces
    6 months 12.0 1 pound
    7 months 15.0 3 pounds
    8 months 17.0 5 pounds
    9 months 20.0 6 to 9 pounds

    Professor Clark holds that if at birth the infant weighs less than 5 pounds, it rarely thrives, though the records show that many infants weighing much less than this have lived and thrived. In very rare cases, infants have been known to weigh no more than one pound at birth, and to have still survived and thrived. And, on the other hand, many cases are known where infants were born, and thrived, who weighed more than twice the average weight. So, at the last, it is difficult to lay down hard and fast rules in the case.

    Delivery. At the termination of the period of gestation, the child is born into the world, and, instead of depending upon the blood of the mother for nourishment and oxygen, it begins to ingest its own food, to eliminate its own waste matter through the regular channels of the body, and to use its own lungs for the purpose of obtaining oxygen for its blood and to burn up the waste products in the lungs.

    The process of bringing a child into the world is called “parturition.” The fetus is expelled from the body of the mother by the contraction of the muscles of and around the Uterus, and also by the contraction of the abdominal walls. In the early stages of labor, the uterine muscles are brought into play; but when the fetus enters into the vaginal passage the abdominal muscles manifest their energy. The uterine and abdominal muscular movements are purely involuntary, although the mother may aid in the delivery by voluntary muscular movements. The involuntary muscular movements are due to the reflex action originating, probably, in a part of the spinal cord.

    The uterine contractions are rhythmical, and have been compared to the contraction of the muscles of the heart. Each “labor pain” begins with a minimum of contraction, the activity increasing until a maximum is reached, when it gradually decreases, only to be followed a little later by a new contraction. When the fetus is finally expelled from the Uterus (followed later by the placenta or “afterbirth”) that organ begins a gradual contraction to its normal size, shape, and condition, the restorative process usually lasting over several weeks.

    The Physical Signs of Pregnancy. The physical signs of pregnancy in the case of women of normal health are as follows:

    (1) Cessation of the menses, or menstruation. While it is true that a non-pregnant woman may occasionally pass over a menstrual period, yet as a general rule the complete cessation of a period by a married woman, particularly when the woman has previously been regular in this respect, may be considered a probable indication of pregnancy; and when the second period has been passed the probability merges almost into a certainty. An examination by a competent physician will set all doubts at rest.

    (2) Enlargement of the breasts. This indication usually manifests itself in about six or eight weeks after conception. This enlargement is usually preceded by a sensation of tingling and throbbing. The enlargement is manifested in the form of a rather hard and knotty increase, differing from the ordinary fatty increase; the lobules, arranged regularly around the nipple, are plainly distinguishable beneath the skin by means of the touch of the fingers.

    (3) Darkening of the areolar tissue surrounding the nipple. In the unimpregnated condition this tissue is of a pinkish shade; but after impregnation the shade grows darker and the circle increases in size. However, when the woman bears several children in somewhat rapid succession, this dark color may become permanent and accordingly ceases to be an indication.

    (4) Enlargement of the abdomen. This indication manifests itself about the second month, at which time the Uterus begins to elevate the intestines by rising up from the pelvis. In the fourth month the Uterus has risen so far out of the pelvis that it assumes the form and appearance of a hard round tumor. The entire abdomen then begins to enlarge. The Uterus causes an enlargement in the region of the navel at the sixth month, and the region of the diaphragm at the ninth month.

    (5) Quickening, or “signs of life.” This indication manifests first from the fourth month to the fifth—at about the exact half of the entire period of gestation. At this time, and afterward, the movements of the embryo are plainly discernable to the mother.

    The Disorders of Pregnancy. There are a number of physical disorders usually accompanying pregnancy, some of which are trifling, but some of which require the advice of a competent physician. The best plan is for the woman to consult a physician shortly after she discovers herself to be pregnant, and thereafter to visit him occasionally for advice during the period of gestation. The too common plan of postponing the call upon the physician until the eighth or ninth month is not a wise one, for in many cases the advice of a competent physician at an earlier stage of the pregnancy will obviate serious complications. The call upon the physician should usually be made not later than the third or fourth month, and positively not delayed longer than the fifth month. The physician should make an examination to ascertain whether the child is in the normal position in the Uterus, and should also examine the urine each month to ascertain whether the kidneys are functioning normally.

    What is called “morning sickness” is one of the most common of the disorders of pregnancy. It is marked by nausea or vomiting, or both, early in the morning, usually shortly after arising. Some women have at least faint symptoms of this disorder from the very beginning of conception, but usually it does not manifest until the third, fourth, or fifth week of pregnancy. It usually ceases at the end of the third or fourth month. Except in very severe cases, in which the physician should be consulted, the disorder is not serious, and requires but a little common-sense treatment, and rational habits of living. An authority says: “Eat of some fruit that best agrees with palate or stomach; drink hot water; eat nothing until a real hunger demands food. Where nausea occurs after eating, a tart apple or orange is good.” Another authority says: “Let women suffering from morning sickness try acid fruit—apples, oranges, or even lemons, if their sourness is not unpleasant. If a single orange or apple after each meal does not suffice, let them try two; let them eat ten if that number is necessary to conquer the distress. The principle is a correct one, and the relief certain. Let fruit be eaten at all hours of the day—before meals and after, on going to bed at night and at getting up in the morning. If berries are in season, let them be eaten in the natural state—that is, without sugar. If the sickness still continues, omit a meal now and then, and substitute fruit in its stead. By persistence in this course, not only will nausea be conquered, but an easy confinement guaranteed.”

    The pregnant woman often develops a capricious appetite. This disorder may manifest in one or more of several forms, as for instance: the woman may lose her appetite, and take but little food; or she may develop an abnormally large appetite, and eat much more than is necessary; or she may take a dislike to certain kinds of food—many women have an aversion toward meat during pregnancy; or she may have a “craving” for certain articles of food, sometimes for kinds of food not liked at other times, such as sour pickles, sour cabbage, etc. A little common sense, and the presence of attractive articles of fruits, etc., will do much to relieve these troubles; in extreme cases the physician’s advice will help.

    The pregnant woman should have her teeth put in good order as soon as possible, as troubles with teeth sometimes manifest themselves during pregnancy, and give much trouble and annoyance. Difficulty in urination, constipation, piles, irritation or itching of the genital organs, varicose veins, liver spots, and similar disorders, which are sometimes manifest during pregnancy, in some form or degree, should receive the attention and care of a competent physician.

    The following general advice from a competent authority is worthy of being followed: “If everything is satisfactory, if there is no severe vomiting, kidney trouble, etc., the usual mixed diet may continue. The only changes I would make are the following: Drink plenty of hot water during the entire time of pregnancy: a glass or two in the morning, two or three glasses in the afternoon, the same at night. From six to twelve glasses may be consumed. Also plenty of milk, buttermilk and fermented milk. Plenty of fruit and vegetables. Meat only once a day. For the tendency to constipation, whole wheat bread, rye bread, bread baked of bran, or bran with cream. As to exercise, either extreme must be avoided. Some women think that as soon as they become pregnant, they must not move a muscle; they are to be put in a glass case, and kept there until the date of delivery. Other women, on the other hand, of the ultra-modern type, indulge in strenuous exercise, and go out on long fatiguing walks up to the last day. Either extreme is injurious. The right way is moderate exercise, and short, non-fatiguing walks. Bathing may be kept up to the day of the delivery. But warm baths, particularly during the last two or three months, are preferable to cold baths.”

    Childbirth. The first indication of approaching delivery of the child is that of the descent of the child into the pelvis of the mother, from its former position up near the diaphragm. When this occurs, the mother usually experiences a feeling of relief, and a greater ease in breathing because of the relaxation of the former pressure on the diaphragm. Sometimes this occurs several days preceding delivery, while in other cases it occurs only a few hours before delivery. There usually occurs about the same time a slight discharge of mucus tinged with blood. The latter is called “the show,” and is caused by the unsealing of the mouth of the womb, and indicates that the Uterus is preparing to discharge its contents.

    Labor, in childbirth, consists of three stages. In the first stage, the Uterus alone contracts, and the mouth of the womb dilates; in the second stage, the abdominal muscles assist the Uterus in expelling the child; in the third stage, the Placenta (afterbirth) and membranes are expelled.

    After the delivery of the child, and after the pulsation in the umbillical cord has ceased (usually from ten to thirty minutes after delivery), the umbillical cord is severed and tied by the physician. In natural labor, the expulsion of the afterbirth occurs from within a few minutes to an hour after the delivery of the child. Nature is sometimes slow in expelling the afterbirth, but caution should be exercised in the matter of using force to assist Nature in this matter, for injury to the Uterus has often resulted from malpractice in such a case. The afterbirth is not firmly attached to the womb, but is like the peel of an orange which Nature sloughs off in due time.

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • Monster rocky exoplanet could let us glimpse the heart of Jupiter

    Monster rocky exoplanet could let us glimpse the heart of Jupiter

    An enormous rocky planet orbiting a distant star may be a gas giant that has had its atmosphere ripped off, which could help us understand how huge worlds like Jupiter form
    Monster rocky exoplanet could let us glimpse the heart of Jupiter
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    https://www.newscientist.com/article/2240224-monster-rocky-exoplanet-could-let-us-glimpse-the-heart-of-jupiter/?utm_campaign=RSS%7CNSNS&utm_source=NSNS&utm_medium=RSS&utm_content=home

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  • WHO public consultation on draft Target Product Profiles for Tuberculosis Preventive Treatment

    Tuberculosis (TB) is a major yet preventable global health problem, with an estimated 10 million new cases worldwide in 2018, resulting in more than 1.5 million deaths, making it the leading infectious disease cause of death worldwide. An estimated one fourth of the world’s population is infected with the TB bacterium, of whom 5–10% advance to active TB disease in their lifetime.

    Prevention of TB is a crucial component of the World Health Organization (WHO) End TB Strategy that calls for 90% coverage of TB preventive treatment (TPT) among persons living with HIV (PLHIV) and household contacts of infectious TB cases by 2035. The UN high-level meeting on TB, in September 2018, further emphasized the need to strengthen implementation of TPT and called for 30 million people, including 4 million children under 5 years of age to receive TPT by 2022.

    However, uptake and scale-up of TPT have been slow, mainly due to the limitations of both diagnostic assays and available regimens (long duration, cost, toxicity, adherence issues, and operational aspects), indicating the need for new short, safe, efficacious and easy-to-take regimens for the treatment of TB infection and prevention of TB disease. The WHO has developed draft Target Product Profiles (TPPs) for TPT to align developers’ performance and operational targets for new TPT regimens with the needs of end-users.

    The draft TPPs are now available online for comment.

    WHO invites comments or feedback from all stakeholders by 27 April 2020 via this link:

    Based on the comments received on this draft, WHO will prepare the final non-draft TPP (version 1.0), which will be posted on WHO’s website and uploaded into the (WHO) Product Profile Directory by October 2020.

    Read More
    https://www.who.int/news-room/detail/31-03-2020-who-public-consultation-on-draft-target-product-profiles-for-tuberculosis-preventive-treatment

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  • Strengthening accountability to end TB

    WHO today released a Checklist to enable Member States and their partners to assess the status of work at the national level to strengthen accountability to End TB, principally: national commitments made, actions taken on those commitments, monitoring & reporting approaches, and the nature of any high-level review mechanisms. The Checklist has been developed in response to requests from Member States, regions, civil society and partners as a tool to support the adaptation and implementation of the WHO Multisectoral Accountability Framework (MAF-TB) released in 2019. It responds also to the UN General Assembly request to WHO to ensure implementation of the Framework.

    There are four components of the MAF-TB that form a cycle for strengthening accountability: Commitments, Actions, Monitoring and Reporting, and Review, that were released during the World Health Assembly in May, 2019. In the political declaration of the first UN high-level meeting on TB, world leaders called for WHO to finalize the framework and ensure its implementation in 2019.

    After its publication in May, 2019, WHO began work with pathfinding country counterparts who were seeking to move ahead on key elements including, among others: formal adoption of country-specific targets for 2022 for increased TB case detection and treatment in line with the global targets in the political declaration; updating or development of new national TB strategic plans based on 2022 and 2030 targets and other new commitments; coordination platforms across sectors and stakeholders; formalizing engagement with civil society across End TB efforts;  producing robust performance reports; and, using those reports to inform high-level review bodies that will assess and drive faster progress.  Based on the MAF-TB document, relevant country experiences, and specific requests from countries and partners, WHO developed the MAF-TB Checklist. The Checklist is especially relevant for high TB burden countries, but has content relevant to all countries.  The appropriateness of different approaches may vary, according to national constitutional, legal and/or regulatory frameworks or other relevant factors.

    The MAF-TB Checklist has three annexes on:

    1. engagement across government ministries and bodies;
    2. engagement of civil society and affected communities; and,
    3. adoption  and implementation of WHO TB guidance.

    In releasing this MAF-TB Checklist today, Dr Tereza Kasaeva, Director of the WHO Global TB Programme noted,  “At this enormously difficult time, all countries and partners are focused on the COVID-19 pandemic.  Lessons learnt from ongoing TB programmes are helping the response. Likewise, TB efforts will benefit from learning underway on collaboration, innovation and accountability in confronting the virus.”

    WHO will be helping Ministries of Health and partners to use the Checklist, hold related consultations and move forward with more effective collaboration and review mechanisms.  The WHO Civil Society Task Force on TB also will support countries and civil society partners, using the Checklist. Progress in strengthening accountability will be assessed in the 2020 Report of the UN Secretary-General on progress since the 2018 TB UN high-level meeting, as well as in the WHO Global TB Report 2020.

    The WHO TB Civil Society Task Force, National TB  Programme Managers and other country officials, WHO staff at all levels, consultants working with WHO and The Global Fund, and staff of partner agencies, contributed content to, and/or provided feedback on, the MAF-TB Checklist during its development.   Access the Checklist and 3 annexes.  

    An online form of the checklist will be available shortly here, along with additional information.  

    Translations of the Checklist and annexes, as soon as available in Arabic, Chinese, French, Russian and Spanish, will be posted at the above link as well.   Kindly contact gtbprogramme@who.int if you have questions regarding the MAF-TB Checklist or to request versions in MS Word format if needed.

     

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    https://www.who.int/news-room/detail/08-04-2020-strengthening-accountability-to-end-tb

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  • Glossary of Youth: Its Education, Regimen, and Hygiene, by G. Stanley Hall

    Glossary of Youth: Its Education, Regimen, and Hygiene, by G. Stanley Hall

    GLOSSARY

    AGAMIC. Unmarried; unmarriageable, sometimes non-sexed.

    AGENIC. Lacking in reproductive power; sterile.

    AMPHIMIXIS. That form of reproduction which involves the mingling of substance from two individuals so as to effect a mixture of hereditary characteristics. It includes the phenomena of conjugation and fertilization among both unicellular and multicellular organisms.

    ANABOLISM. See METABOLISM.

    ANAMNESIC. Pertaining to or aiding recollection.

    ANEMIC. Deficient in blood; bloodless.

    ANTHROPOMORPHISM. The attributing of human characteristics to natural, supernatural, or divine beings.

    ANTHROPOMETRY. Science of measurement of the human body.

    ARTIFACT. Any artificial product.

    APHASIA. Impairment or lose of the ability to understand or use speech.

    ASSOCIATIONISM. The psychological theory which regards the laws of association as the fundamental laws of mental action and development.

    ATAVISTIC. Pertaining to reversion through the influence of heredity to remote ancestral characteristics.

    ATAXIC. Pertaining to inability to coördinate voluntary movements; irregular.

    CALAMO-PAPYRUS. Reed papyrus or pen-paper.

    CATABOLISM. See METABOLISM.

    CATHARSIS. Purgation or cleansing. Aristotle’s esthetic theory that little renders immune for much.

    CEREBRATION. Brain action, conscious or unconscious.

    CHOREA. St. Vitus’s dance; a nervous disease marked by irregular and involuntary movements of the limbs and face.

    CHRESTOMATHY. A collection of extracts and choice pieces.

    CHRISTENTHUM. The Christian belief; the spirit of Christianity.

    COMMANDO EXERCISES. Gymnastic exercises whose order is dependent upon the spoken command of the director.

    CORTEX. The gray matter of the brain, mostly on its surface.

    CORTICAL. Pertaining to the cortex.

    CRANIOMETRY. The measurement of skulls.

    CRYPTOGAMOUS. Having an obscure mode of fertilization; or, of plants that do not blossom.

    CULTUS. A system of religious belief and worship.

    DEUTSCHENTHUM. The spirit of the German people.

    DIATHESIS. A constitutional predisposition.

    EPHEBIC. Pertaining to the Greek system of instruction given to young men to fit them for citizenship; adolescent.

    EPIGONI. Successors; followers who only follow.

    EPISTEMOLOGY. The theory of knowledge; that branch of logic which undertakes to explain how knowledge is possible and to define its limitations, meaning, and worth.

    EUPEPTIC. Having good digestion.

    EUPHORIA. The sense of well-being; of fullness of life.

    EVIRATION. Emasculation; loss of manly characteristics.

    FERAL. Wild by nature; untamed; undomesticated.

    FORMICARY. An artificial ants’ nest.

    GEMÜTH. Disposition; the entire affective soul and its habitual state.

    HEBETUDE. Dullness; stupidity.

    HEDONISTIC. Relating to hedonism, that form of Greek philosophy which taught that pleasure is the chief end of existence.

    HETAERA. A Greek courtesan. This class was often highly trained in music and social art, and represented the highest grade of culture among Greek women.

    HETEROGENY. (1) The spontaneous generation of animals and vegetables, low in the scale of organization, from inorganic elements. (2) That kind of generation in which the parent, whether plant or animal, produces offspring differing in structure or habit from itself, but in which after one or more generations the original form reappears.

    HETERONOMOUS. Having a different name.

    HOROLOGY. The science of measuring time and of constructing instruments for that purpose.

    HYGEIA. The Greek goddess of health; health.

    HYPERMETHODIC. Methodic to excess; overmethodic.

    HYPERTROPHY. Excessive growth.

    INDISCERPTIBLE. Incapable of being destroyed by separation of parts.

    INHIBITION. Interference with the normal result of a nervous excitement by an opposing force.

    IRRADIATION. The diffusion of nervous stimuli out of the path of normal discharge which, as a result of the excitation of a peripheral end organ may excite other central organs than those directly connected with it.

    KINESOLOGICAL. Pertaining to the science of tests and measurements of bodily strength.

    KINESOMETER. An instrument for measuring muscular strength.

    MEDULLATION. The investment of nerve fibers with a protective covering or medullary sheath, consisting of white, fat-like matter.

    MERISTIC. Pertaining to the levels or spinal and cerebral segments of the body.

    METABOLISM. The act or process by which, on the one hand, dead food is built up into living matter—anabolism, and by which, on the other, the living matter is broken down into simpler products within a cell or organism—catabolism.

    METAMORPHOSIS. Change of form or structure; transformation.

    METEMPSYCHOSIS. The doctrine of the transmigration of the soul from one body to another.

    MONOPHRASTIC. Pertaining to or consisting of a single phrase.

    MONOTECHNIC. Pertaining to a single art or craft.

    MORPHOLOGY. The science of form and structure of plants and animals without regard to function.

    MYOLOGY. The scientific knowledge of the muscular system.

    MYTHOPOEIC. Producing or having a tendency to produce myths.

    NOETIC. Of, pertaining to, or conceived by, mind.

    NUANCE. Slight shade; difference; distinction; degree.

    ORTHOGENIC. Pertaining to right beginning and development.

    ORTHOPEDIC. Relating to the art of curing deformities.

    OSSUARY. A depository of dry bones.

    PALEOPSYCHIC. Pertaining to the antiquity of the soul.

    PANTHEISTIC. Relating to that doctrine which holds that the entire phenomenal universe, including man and nature, is the ever-changing manifestation of God, who rises to self-consciousness and personality only in man.

    PATRISTICS. That department of study occupied with the doctrines and writings of the fathers of the Christian Church.

    PHOBIA. Excessive or morbid fear of anything.

    PHYLETICALLY. In accordance with the phylum or race; racially.

    PHYLETIC. Pertaining to a race or clan.

    PHYLOGENY. The history of the evolution of a species or group; tribal history; ancestral development as opposed to ontogeny or the development of the individual.

    PHYLUM. A term introduced by Haeckel to designate the great branches of the animal and vegetable kingdoms. Each phylum may include several classes.

    PICKELHAUBE. The spiked helmet of the German army.

    PLANKTON. Sea animals and plants collectively; distinguished from coast or bottom forms and floating in a great mass.

    POLYGAMIC (LOVE). Pertaining to the habit of having more than one mate of the opposite sex.

    POLYPHRASTIC. Having many phrases; pertaining to rambling, incoherent speech.

    POST-SIMIAN. Pertaining to an age later than that in which simian or monkey-like forms prevailed.

    PRENUBILE. Pertaining to the age before sexual maturity or marriageability is reached.

    PRIE DIEU. A praying desk.

    PROPEDEUTIC. Preliminary; introductory.

    PROPHYLACTIC. Any medicine or measure efficacious in preventing disease.

    PSEUDOPHOBIAC. Pertaining to a morbid condition in which the subject is continually in fear of having said something not strictly true.

    PSYCHOGENESIS. The origin and development of soul.

    PSYCHONOMIC. Pertaining to the laws of mind.

    PSYCHOSIS. Mental constitution or condition; any change in consciousness, especially if abnormal.

    PUBERTY. The age of sexual maturity.

    PUBESCENT. Relating to the dawning of puberty.

    PYGMOID. Of pygmy size and form.

    RABULIST. A chronic wrangler; one who argues about everything.

    SCHEMA. A synopsis; a summary. In the Kantian sense, a general type.

    SCHEMATISM. An outline of any systematic arrangement; an outline.

    SUPERFOETATION. A second conception some time after a prior one, by which two foetuses of different age exist together in the same female. Often used figuratively.

    TEMIBILITY. (From Italian temibile, to be feared.) The principle of adjustment of penalty to crime in just that degree necessary to prevent a repetition of the criminal act.

    TIC. A nervous affection of the muscles; a twitching.

    TRANSCENDENTAL. In the Kantian system having an a priori character, transcending experience, presupposed in and necessary to experience.

    TRAUMATA. Wounds.

    TRAUMATISM. A wound; any morbid condition produced by wounds or other external violence.

    VERBIGERATION. The continual utterance of certain words or phrases at short intervals, without reference to their meaning, as seen in insane Gedankenflucht or rapid flight of thought.

    Extract from Youth: Its Education, Regimen, and Hygiene, by G. Stanley Hall

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