Tag: use

  • INFOSAN Quarterly Summary, 2020 #1

    Food safety incidents

    During the first quarter of 2020, the INFOSAN Secretariat was involved in 38 food safety incidents involving 109 WHO Member States and 9 territories of WHO Member States. There were 25 incidents involving a biological hazard (Salmonella spp. [8], Listeria monocytogenes [5], Norovirus [3] Shiga-toxin producing Escherichia coli [2], Clostridium botulinum [2] Bacillus cereus [2], Cronobacter spp. [1], Shigella sonnei [1], unspecified biological hazard [1]), 6 involving an undeclared allergen (milk [3], peanut (1), egg [1], gluten [1]), 5 involving a physical hazard (undetermined foreign matter [2], glass [1], metal [1], plastic [1]), one involving a chemical/toxin hazard (histamine), and one linked to an unspecified hazard.

    The food categories that were most commonly involved in the 38 incidents during the first quarter of 2020 involved fish and other seafood (8), herbs and spices (4), legumes and pulses (4), milk and dairy products (3), nuts and oilseeds (3), snacks, desserts and other foods (3), cereals and cereal-based products (2), composite food (2), fruit and fruit products (2), meat and meat products (2), vegetables and vegetable products (2), products of special nutritional use (1), and food for infants and small children (1). One incident involved an unknown food source.

    During such international food safety incidents, the INFOSAN Secretariat relies on the swift action of national INFOSAN Emergency Contact Points to respond to requests for information. Rapid sharing of information through INFOSAN enables members to implement appropriate risk management measures to prevent illness in their respective countries.

    Geographic scope

    The outlined incidents involved Member States from all WHO regions: Europe (39), followed by the Americas (24), Africa (24), the Western Pacific (18), the Eastern Mediterranean (8) and South-East Asia (6).

    Recall in several countries of frozen spring roll sheets from Singapore due to the presence of an undeclared allergen

    In February 2020, the INFOSAN Secretariat was notified by the European Rapid Alert System for Food and Feed (RASFF) and INFOSAN colleagues in Australia of a recall in Australia and several European countries of frozen spring roll sheets due to the detection of an undeclared allergen (milk), imported from Singapore. In collaboration with RASFF, the INFOSAN Secretariat was informed that the implicated frozen spring roll sheets were distributed internationally to 46 Member States from four WHO regions and 4 territories in Europe and the Western Pacific. Moreover, through engagement with the INFOSAN Emergency Contact Point (ECP) in Singapore, the INFOSAN Secretariat also received details of further distribution of implicated products to additional WHO Member States from all WHO regions, taking the total number of Member States involved to 65. It was also reported that the products involved had been redistributed by some countries to Europe, the Americas and Africa. Consequently, several countries recalled the implicated products to relabel them and investigated the issue to identify illnesses related to the consumption of the implicated frozen spring roll sheets. No illnesses were reported to the INFOSAN Secretariat.

    This incident has highlighted undeclared allergens as an important category of hazards that can result in a largescale international response to implement risk management measures and prevent illness. In addition, it exemplified efficient communication among INFOSAN members and the Secretariat.

    Outbreak of Listeriosis in the United States of America linked to enoki mushrooms imported from the Republic of Korea

    In March 2020, the INFOSAN Secretariat was made aware by the United States (US) Centers for Disease Control and Prevention (CDC) of an outbreak of Listeriosis in the US linked to the consumption of enoki mushrooms, imported from the Republic of Korea. In total, 36 cases including 4 deaths have been reported in the US. Following investigations in Canada, carried out in collaboration with the US, the INFOSAN Secretariat was informed of 6 cases of Listeriosis between 2017 and 2019 in Canada potentially related by whole genome sequencing (WGS) to the ongoing outbreak in the USA. In addition, food isolates (from enoki mushrooms from the Republic of Korea) genetically associated with the cluster of cases have been collected in 2019 by authorities in Canada. The WGS information pertaining to the cases and food isolates were shared on the INFOSAN Community Website to assist the identification of cases in other countries.

    The INFOSAN Secretariat engaged the INFOSAN Emergency Contact Point (ECP) in the Republic of Korea to seek details on any further international distribution of the implicated enoki mushrooms. Investigations are ongoing. 

    News & activities

    Food Sector and the COVID-19 outbreak

    On 31 December 2019, WHO was alerted to several cases of pneumonia of unknown origin in the city of Wuhan, Hubei Province, China. The virus, a previously unknown coronavirus has been named SARS-CoV-2 and is the cause of the COVID-19 disease.

    The WHO Epidemic Information Network (EPI-WIN) aims to share information tailored to specific sectors, including food and agriculture. The INFOSAN Secretariat has recently developed a guidance document for food businesses with regards to COVID-19 and food safety which is now available online. The guidance has also been disseminated through EPI-WIN and presented during two webinars.

    Call for applicants: INFOSAN Train-the-Trainer Workshop

    In February, the INFOSAN Secretariat issued a call for applications for the INFOSAN Train-the-Trainer workshop. With the constant growth of the network, and the increased need for training that this entails, the INFOSAN Secretariat, in collaboration with the Canadian Food Inspection Agency (CFIA), has announced this workshop which aims to increase the human resources available to train INFOSAN members on a range of INFOSAN-related topics, online or in-person. As a result, it is expected that the understanding of the roles and responsibilities of INFOSAN members will be improved, resulting in greater participation that will enhance speed and efficiency during the response to food safety emergencies at the global level. The INFOSAN Secretariat, together with CFIA, look forward to hosting this important workshop later this year.

    Developing the new INFOSAN Community Website

    The INFOSAN Community Website (ICW) continues to be an effective tool for the network to disseminate information during food safety emergencies. Over the past year, through the INFOSAN member survey, the Secretariat has gained a better understanding of how members use the ICW and how it can be improved to enhance information sharing. The information collected, together with the experience of members of the Secretariat, has provided numerous innovative ideas to guide the development of the new ICW. The Secretariat is pleased to announce that the competitive process to select the vendor that will develop the new INFOSAN Community Website has concluded and the work on the creation of the new ICW has begun. 

    Voice of an active network member

    voice-5-2020

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  • What matters to women in the postnatal period?

    What matters to women in the postnatal period?

    The right to a positive maternity healthcare experience at every stage 

    Each pregnancy is unique and clinical needs can change across the pregnancy, childbirth and postnatal periods. One thing that never changes is the right to a positive experience at every stage. 

    Achieving the best possible physical, emotional, and psychological outcomes for every individual and newborn requires health systems to take a human rights-based approach: not only preventing maternal death and morbidity, but prioritising person-centred
    care and well-being.

    WHO is developing new guidelines for a positive experience of postnatal care, due to be published next year. To inform these guidelines and ensure that postnatal services can better meet the needs of women and their babies, WHO undertook a qualitative
    systematic review on what matters to women in the postnatal period.

    Joys and challenges in the postnatal period

    There is limited research about values and preferences in the postnatal period, defined by WHO as the first six weeks after childbirth. Studies have often focused on the results of specific postnatal interventions, rather than on the individuals who use
    them. 

    ‘What matters to women in the postnatal period: A meta-synthesis of qualitative studies,’ published in PLOS ONE, gives long-overdue respect to the authority of women’s own experiences. The authors review first-hand data from 15 countries
    and 36 studies published after the year 2000 relating to women’s beliefs, expectations and values at this significant time of life.  

    These studies affirm that a positive postnatal experience can result in joy, self-confidence and enhanced capacity to thrive as both a person and a parent.

    They are also vocal about the potential challenges of adjusting to a ‘new normal’ following childbirth, including changes in self-identity, relationships, and sexual behaviour.

    What is a positive postnatal experience? 

    A positive postnatal experience for a woman will be one that responds to her specific context and preferences. 

    It will provide the confidence, knowledge and skills women need in the weeks following childbirth, supporting them to adjust to any changes in their intimate relationships and build new family ones. Women will be better equipped to navigate physical and
    emotional challenges and to experience the dynamic achievement of personal growth. 

    This should be a shared responsibility, not a solitary one. Community has a critical role in enabling a positive postnatal experience, including partners, family and elders.

    It is crucial that healthcare providers meet each woman’s needs, as well as those of their babies. 

    Supporting choices and rights to improve postnatal health outcomes

    There are an estimated 303 000 maternal deaths annually, according to recent WHO figures. Most of these deaths occur postnatally. 

    The postnatal period is therefore a vital opportunity to improve both maternal and neonatal health and wellbeing: supporting healthy behaviors, providing life-skills education, facilitating breastfeeding, counselling women about family planning options,
    supporting good mental health, preventing and treating childbirth-related complications. 

    Health care systems that empower individuals by supporting their values, preferences and rights are fundamental to improving maternal and newborn health outcomes. 

    WHO’s guidance for positive maternity care

    WHO has recently released recommendations on antenatal care for a positive pregnancy experience, and on intrapartum care for a positive childbirth experience.

    These publications made important clinical updates, including an increase from four to eight recommended antenatal contacts, and a revision to the decision-making process for interventions to accelerate labour. 

    They also uphold every woman’s right to a positive maternity care experience: one where her pregnancy does not erase her competency, autonomy and right to participate in decision-making for her own care and the care of her newborn. 

    Women’s choices and rights to sexual and reproductive health care, including maternity care, should be respected at every stage of the continuum of maternal and newborn care. This is true across all income settings, as well as in humanitarian settings
    and during public health emergencies.

    When WHO’s postnatal guidelines are released next year, they will complete the maternity care series built around what matters to women.

    Rather than dividing care into three periods of antenatal, intrapartum and postnatal, these publications can be used to establish a model in which health systems support women, their baby and wider network physically, psychologically, socially and emotionally
    through this significant life event. 

    Other resources

     

    What matters to women in the postnatal period?
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  • TRAINING AND GOVERNMENT IN THE HOME

    Home a unit of government.—As already observed, the home is a partnership. It is a unit of government. In an ideal unit of home government, every member is governed by and through an intelligent understanding of the customs, rules and laws, a conscientious recognition of what is right and wrong and the golden rule of love. Each have equal rights. What is wrong for one is equally wrong for each and all. What is right for one is equally right for each and all. Such a home is a unit of government where parents and children are organized under a constitution of intellect, conscience and love; for the purpose of building character, fitting themselves for larger citizenship in this life and the life that is to be the sequence to this one.

    The home is the biggest institution in the world. Home building is the noblest and highest vocation in life. Its responsibilities are stupendous, its possibilities are limitless and its rewards are infinite. Home builders should be the best qualified and the most skillful of architects.

    The training of a child.—Solomon said, “train up a child in the way he should go and when he is old he will not depart from it.” The thoughts, actions and habits of childhood have much to do with a child’s future character and possibilities. When a child’s training is commenced in early childhood, was it begun soon enough? After a noted surgeon had examined a patient, turning to a friend he said, “If I could have had this patient two generations ago, I could have saved his life.” When Oliver Wendell Holmes was asked when a child’s training should begin, he replied, “At least one hundred years before he is born.” Sometimes it happens that good children are made bad and bad children are made worse by the company they keep before they are born. The little boy was not far wrong, who, when he found his mother lamenting the choice she had made of a life companion, said, “Mamma, we made a bad choice when we chose papa, didn’t we?” Some children have made an equally bad choice of their mammas and some appear to have made a doubly bad choice of both parents.

    Each child must be studied.—A child is not easily understood. No two children are alike. Each child has a very complex nature. He is the product of the ages. The complex nature of his parents are blended into his being, producing a more complex being. He is not a duplicate of either. He has received from his parents a blending of their natures; in a limited way, what they inherited from his grandparents and their grandparents back to Adam. Parents and teachers should try to discover his latent forces, his slumbering passions, his genius, his inherent propensities and native goodness. They should wisely use nature’s laws and God’s gifts, in constraining, controlling and eradicating the inherited and acquainted tendencies that are pernicious; also in drawing out, giving direction to and developing the inherited and acquired good in his life.

    Importance of early training.—Children in the home are to be trained. Their prenatal culture, the most important part of a child’s education, may have been respected or neglected. This cannot be altered now. The next agency to be utilized in the child’s training is environment. This can be applied from its birth. The child is more susceptible to external influences in babyhood than in childhood, in childhood than in youth, in youth than in maturity. The child becomes more fixed in disposition and character and more difficult to change as he grows older.

    The training of parents.—If I were a perfect sage, philosopher or Christian, or all three combined into a perfect teacher, I would much prefer the task of training one hundred little children than the task of training ten parents (including the author) how to train their children. Most parents need to devote three hours, to a careful analysis and study of their inherited and acquired weaknesses, to one devoted to a similar study of a child.

    A study of disposition.—Such peculiarities of mind and disposition as cruelty, ambition, firmness, conscientiousness and affection may be so pronounced in one’s life as to bias his judgment and unfit him for the training of children. When one of these characteristics is very dominant in a father or mother, it will most likely appear in an exaggerated form in one or more of the children. Like excites like, is a law that should be thoroughly understood by parents. Where firmness is very pronounced in both parents and child, there will be a constant clash unless one or both exercise full self-control. Such a child should be controlled largely by love. A severe or cruel parent will make a coward of a timid child and a criminal of a self-willed child. The over-conscientious parent will disgust one child and make a fanatic of another. The over-affectionate parent will appeal alone to the affections and leave the will of a child undeveloped. Appealing alone to the ambition of a very proud, ambitious child is likely to make him conceited and egotistical. For a parent to quarrel, have a fit of anger or to use violence is degrading and demonstrates his weakness and incapacity to be at the head of a family. At the same time, these mental states tend to awaken similar feelings in the child, which usually result in a clash. If the child had first displayed anger, this could have been overcome by self-control, kindness and love on the part of the parent.

    The law of influence.—If you want to arouse a desirable feeling, sentiment, emotion or conviction in another, you must be controlled by that mental and moral state and allow it to emanate from you. If you are controlled, by an undesirable thought or feeling, others must have self-control enough to resist your influence, or soon they will be controlled by a similar mental state. Thus, we see that unless parents exercise judgment and self-control, they will often use methods that are unwise and harmful.

    Defects in our homes and schools.—One of the saddest defects in our home training and our system of education is, that when a child reaches maturity in the home or graduates from the high school or college, he knows more about other things than he does about himself and the essentials of building a home. How to analyze, study, know and control one’s self; how to understand, train and govern children would be of far greater value in the education of young men and women than many departments of study we now emphasize.

    The function of the home.—The children are in the home for the primary purpose of being developed into ideal men and women. To accomplish this end is the mission of parents. To do this effectively parents must possess high ideals. These ideals include such training and education as will lead to a strong and healthy body, a keen and well-trained intellect, a moral and religious character and an abiding faith in God.

    Physical training.—The physical, mental and moral natures are intimately and vitally related. One influences each of the other two. The physical health and strength of a child hinders or helps the mental and moral life. The proper time to overcome the weakness of any physical function, or inherited physical weakness, is in childhood. This is done by proper dieting, hygienic living, bathing, exercise and sexual chastity. Improperly prepared and unwholesome food are the chief causes of death among infants and a leading cause of impaired indigestion in childhood. The kind of food used, effects the mind and character of the child. Too much candy, rich pastries and meat are not good for a child, or grown people either.

    Use of medicine.—One hundred million dollars ($100,000,000) are spent annually on patent medicine and fully that much or more on mineral drugs. We are not animals. We do not know how to live. Few men would be willing to give a lawyer ten dollars to tell him how to keep out of trouble, but he will give him all he has to get him out of trouble. Few would give ten dollars to a doctor for preventive advice, but they will pay a doctor all they possess, for a cure. Oliver Wendell Holmes had a custom of saying, “If all the drugs of the world were thrown into the sea, it would be a blessing to humanity, but a curse to the fish.” Children should be kept healthy by hygienic living.

    Use of condiments, coffee, tobacco, etc.—Condiments, tea, coffee and tobacco are not foods—they stimulate—they do not strengthen; they create unnatural appetites and inflame the passions. No one would drink tea or coffee were it not for the tannin and caffeine contained in them. If these drugs were removed, these drinks would be no more tempting than a cup of warm water. Most people, who use these drinks would consider it a sin to go to a drug store, buy some pure tannin or caffeine, dilute it with water, sweeten it with sugar and drink it.

    The tobacco habit is an enormous evil.—It creates a demand for something stronger. It paves the way for the whisky habit. Drunkenness is largely due to a pathological physical condition. Remove the causes, coffee, tobacco and sensuality and it will do more to check drunkenness than all the legislation that can be secured in the next century.

    Mental training.—The mental training of children is very largely committed to school and college teachers. Parents should take a very intense interest in the child’s education. They should study the talents and discover and strengthen the weaker faculties of the child. Most children get their minds “stuffed” with unassimilated facts. Nothing is clear to them. They do not remember what they have learned. They cannot reason logically. They have had their minds “stuffed.” Parents as well as teachers, can largely prevent this. From the earliest mental training of the child, he should be trained to take a personal interest in knowing things. He should be taught to think. Encourage a child to ask questions. If he asks questions which he should understand, have him answer them and give his reasons for the answer. In some cases ask him questions that will suggest an answer. Getting a child started right is the more important half of his education. He will look after the other half.

    Moral training.—The object of all moral training of a child is self-government or self-control. Before a child is capable of self-government, he must be taught to distinguish between right and wrong. This is largely the work of the intellect. His conscience must be awakened and quickened. Conscience is a natural instinct through which God’s spirit and man’s conception, of right and wrong, prompts him to moral action, and which condemns the action he conceives to be wrong and approves the action he conceives to be right. The will must be so trained and developed that a childis able to will to do what he knows to be right and his conscience approves. He is now a perfectly free agent, a law to himself. He is governed from within and need not to be governed from without. This moral training requires years and should begin in infancy.

    Let the baby alone.—Good babies are made bad by receiving too much attention. The baby should not be lifted from the cradle, fondled and coddled, kissed and talked to, simply because it gurgles or makes an innocent attempt to be noticed. This is needless attention. At first it is disagreeable to the child. Later a demand is created and the child is spoiled. If left alone babies would entertain themselves much of the time.

    When a baby is learning to crawl and walk, observe the “let alone” policy as much as possible. Keep an eye on the child to see that it does not get hurt. What you do not want it to have, put out of its reach. It should be safeguarded from places of danger. If these precautions are taken, you will be saved the excuse for that endless round of “don’t get hurt,” “don’t touch that,” “don’t do that,” etc. By these endless “don’ts” children are taught disobedience. If the child falls, unless it is hurt, do not run and pick it up. Let it alone, it will get up. In this way you teach it to be independent and self-reliant. If you run and pick it up, the child gets the idea that you were to blame. Later, when it falls, it screams, cries and gets angry. Perhaps you hit the object and teach the child that the object over which it fell was at fault. This is deception and has a bad effect.

    Give the child something to do.—Teach it to dress itself, to take off and put on its shoes and stockings. It should have a special place to put these, on retiring. It should have a drawer or a room where it can put its individual belongings. This teaches the child the idea of responsibility.

    The first idea of wrongdoing.—When a child eats some forbidden thing, or does some forbidden act, from which it suffers, it can be led to see that it has violated the laws of nature. If possible, alleviate the pain, but the lesson which nature would teach, through pain, should be emphasized. The child should see that the pain came as a result of violating the laws of nature. A little later in life, the child can be taught that all desires, thoughts, words and acts that are helpful to self and others are right and those that injure self and others are wrong. These principles can be applied gradually to the laws of the home, of society and God.

    Parents should agree.—There should be a perfect agreement between parents, with respect to the government in the home. Where parents disagree, children lose all respect for parental authority. Differences should be discussed by parents, only when the children are not present.

    Punishment in the home.—Whipping, slapping and cuffing are relics of savagery. Whipping should never be resorted to except in extreme cases. It is not the natural consequence of disobedience. It never appeals to a child’s sense of justice. Punishment should always be natural and consistent with justice. Some examples will illustrate these principles, as follows: A child is called to breakfast—it does not come. Stubbornness or disobedience is the cause. What should be a natural punishment? Scolding, slapping, jerking the child up and forcing it to the table? No—there is no logical connection. The punishment should consist in the child’s doing without its breakfast. This should be explained to the child: A boy loses his toy. Should he be pitied and another bought for him? Certainly not. Should he be whipped? This would not be natural. He simply goes without his toy until he finds it: A boy steals some object. Should he be whipped? No. His attention should be called to the nature of his sin. He should be compelled, if necessary, to return the stolen object and confess his wrong. The deep sense of humiliation is the natural punishment. Let him feel the full force of it: A boy uses tobacco. Should he be whipped? Certainly not, as long as his teacher, the family doctor, the minister and the father use it. No child on earth could see any connection between the wrong and the punishment. What should be done? Nine times out of ten, under present conditions, the boy will use tobacco, in spite of all that a mother can do. So long as doctors, teachers, ministers and fathers use tobacco, legislation against the cigarette will increase our youthful criminals. If a father has a moral right to use tobacco, so has his boy. If the boy can be led to see clearly that the use of tobacco is wrong, if his conscience can be awakened and if his personal will can be brought to constantly oppose the use of it, then he can be saved. THIS IS THE ONLY REMEDY.

    Study the offense.—Find the natural consequence. Become an example of obedience to every law, for your child. Show the child the results of wrong living and the benefits of right living. This will usually obviate all punishment, aside from what nature inflicts.

    Corporal punishment.—If corporal punishment be unavoidable, it should not be administered when either parent or child is angry. This would only increase the cause that made the punishment necessary. In most cases it would be best to postpone the punishment until the next day. Only a very rebellious child can be helped by this method.

    Scolding and threatening.—From a hotel window I heard a mother say to her twelve-year-old girl, “I will gouge your eyes out.” “I will slap your head off, you little hussy.” A child treated in this way becomes willful or spiteful, loses self-respect or respect for the parent. Scolding and threatening children are sins against their finer natures.

    Three good rules.—The author’s father would not employ men on his farm without the understanding that they were not to swear, speak vulgarly about a woman, or tell a “ghost” or “bugaboo” story in the presence of his children. A servant, man or woman, about your business or home, can undo or counteract in a few hours or days, in a single statement or story, picture or book, act or habit, the life efforts of a noble father and a pure mother. One of the purest men recently said to me, “When I was only fifteen years of age I heard a servant utter one sentence that required a score of years to get its effects eradicated.” Men have told me of the pernicious effects of servants, dating back to when they were two and three years old. Frightful stories and startling statements, of impending dangers, destroy the natural freedom, independence and courage of many children for life. Once I sat by the side of a nervous mother holding a nervous four-year-old girl in her lap, as our train sped forward at the rate of fifty miles an hour, over one of those magnificent stretches on a western prairie. We had discussed heredity, child training and other interesting and vital subjects, when she referred to her nervous little girl and told me how at night she would notice her little body twitching, jerking, floundering and all at once she would awake with a scream having dreamed that she was falling from some dizzy height toward jagged rocks and certain death beneath; or that some huge angry beast, poised on tiptoes and in the act of pouncing upon her and tearing her body into shreds—a horrible nightmare. About the time she had finished describing one of those fearful experiences and was in the act of asking me for advice, we were passing an object on the outside that interested the little girl; quickly she turned and began peering through the window. She was in no danger. Her head was not projected beyond the window. The nervous mother grabbed the little girl by the body and cried, “You are falling! You are falling!” My reply to her request for advice was, “My! if you should handle me that way, I would have a half dozen nightmares here in open daylight.” I told that mother that her daughter’s nervousness was due to bad heredity and bad environment and that she was responsible for both.

    Personal purity.—As soon as a child begins to enquire about its origin, it is old enough to be told the truth in the right way. Some children become interested when they are three and four, all normal children by the time they are seven. Since the inquiring mind will not rest satisfied until a plausible answer has been received, and since the ignorant and vicious youth is ever alert and anxious to give this information in a pernicious way, it behooves the thoughtful parents to safeguard their children with the truth told in the right way. No normal boy should reach the age of eight, or girl the age of ten, before they have been told the story of life.

    Children often discover, or are taught, the secret vice at a very early age. Sex consciousness and pleasure may be early developed because of some unnatural conditions of the sex organs. For this reason, parents should know that these parts are normal in their children. When children are observed to frequently handle, or scratch these organs, unnatural conditions should be suspected. The child should not be slapped or scolded, rather call in the family physician. Trying to keep a child ignorant concerning this vice is impossible, therefore unwise. There is not one boy in fifty who does not know of the vice, and understands the language used to describe it. Trying to keep a child from vicious companions is good as far as it goes, but the facts are that the child is most likely to discover the vice himself, while it is hardly possible to keep a child entirely away from the vicious. The only sane method is to teach the child the laws of personal purity. If the secret vice is to be prevented, some children should receive council when they are six, others at eight, all by the time they are ten or twelve. Children have inherited lustful tendencies. Their troubles are more largely from within than from without. Hence the children that have been most carefully guarded from bad company and kept in ignorance are usually the ones who are most injured by the secret sin. A single talk to a child is not sufficient. We frequently instruct and appeal to the child to be obedient, truthful and honest; in like manner we should at reasonable periods instruct and encourage him to keep his thoughts and desires pure.

    Extract from EBook of Self Knowledge and Guide to Sex Instruction, by T. W. Shannon

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  • THE FATHER’S RELATION TO THE HOME

    The father is the head of the home.—The character of the home determines the character of the church, society and the nation. The home is the most important of all earthly institutions. The problems of society, the church and the nation, if ever solved, must be largely solved in the home. The home is both a civil and divine institution. Civil and divine law place the husband and father at the head of the home. No teacher sustains a more vital relation toeacher sustains a more vital relation to society, no minister to his congregation, no king to his empire, or president to his republic, than does the conscientious father, who does his best to build an ideal home. He is truly serving God and his country, in the highest sense. In the work of building a home, he is serving society and the church in a higher sense than he would be, were he neglecting his family, by writing books, teaching school, delivering lectures or preaching sermons.

    His relation to his wife.—The relation of husband and wife is a partnership affair. In every sense they are equal partners. Their rights and privileges are equal. Their part in building a home is not, in all respects, the same. The service of one is as important as the other. Neither can build a home without the other. Their service is incomparable.

    He is to furnish financial support.—Nature has fitted man mentally and physically for devising means of earning a support for his family. Whatever occupation, calling or profession he may engage in, he should put forth the best effort of which he is capable to produce an income that will support his family decently.

    The amount of money he can furnish his wife, will depend upon his earnings. They should talk over this matter as partners. One has as much right to the income as the other. They should not spend more than is produced. If the income is small, both should economize. They should endeavor to save something each year, even if the income is small. Money is stored-up human energy. If the income is large, they should be more liberal in the use of it, but it is always a sin to waste money. The husband has no right to cause his wife to beg him for money, to meet her personal expenses or the expenses of the children. The money is not exclusively his own. Home building is a partnership in which every member of the home is interested in every dollar produced. Legally the father may spend his money on his selfish indulgences. Morally{ he has no right to spend the home company money in a way that will not benefit each member of the home. For a father to annually spend fifty or more dollars on tobacco or drink and refuse corresponding amounts to his wife and children to be spent needlessly by them, is as dishonest, as for a member of a firm, or the president of a bank to misappropriate the funds of a partner or a depositor.

    He is to furnish moral support.—For a man to build a reputation for honesty, truthfulness, sobriety and virtue and to possess a good character are of more value to his wife and children, as a home builder, than to be able to produce large earnings and to be free with the same. When a man assumes the responsibility of building a home, his family have a right to demand of him honesty, integrity, sobriety and virtue. He has no more right to rob them of one than the other.

    He is to love his wife.—While the romance of courtship and the honeymoon cannot be continued for life, yet he should always show her a deep respect, a manly courtesy, a true love and absolute loyalty to his marriage vow.

    The relation of the father to his children.—Each child born into the home is a new member added to the partnership. The children have financial, social and moral rights that should be respected by the parents. While civil law and God place the father at the head of the home, this does not give him special rights and privileges, or constitute him a boss or ruler, but he should so conduct himself that the family will regard him as their protector, supporter and adviser. He should not swear, tell vulgar stories, use tobacco or indulge in strong drink unless he is willing for each member of his family to follow his example. As partners in the home, they have the same moral rights as himself. He should be to his children a chum, a friend, a companion. He should constantly endeavor to make the children happy. There are times, in the home, when the father’s decision must be law. He must support his family. The law holds him responsible for their support and for their deportment as citizens. As long as they are under age, if they contract a debt or damage property, the law holds the father responsible. This responsibility makes it necessary for him to decide some things, in a way that a child may not wish to coincide. This should be done in a dignified and pleasant way.

    The father should never allow himself to become angry or to use hasty and abusive language in correcting a child. If he does, he demonstrates his own weakness and inability to be a real father. Punishment of some natural kind is sometimes necessary, but corporal punishment, as a rule, is brutal.

    The father should so conduct himself as to command the respect, reverence and love of his children. He should be sociable and gentle, as well as dignified and strong. He should have their complete confidence, so they will come to him with their problems and troubles. The sacred service of a true father in the home, can only be equaled by the service of the mother. The fathers who toil long and late, study and strive to support, educate and train a family of children to become good citizens and devoted Christians, will receive a rich reward here and a royal welcome yonder.

    Extract from EBook of Self Knowledge and Guide to Sex Instruction, by T. W. Shannon

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  • THE ARGUMENT AGAINST BIRTH CONTROL

    THE ARGUMENT AGAINST BIRTH CONTROL

    The argument against Birth Control, urged by those who are opposed to the dissemination of scientific information on the subject, may be reduced to a few general points. These points of objection I shall now state, together with the rejoinder to each as given by the advocates of the proposition. I think that these points cover the main argument advanced against Birth Control, and I shall endeavor to state them as fully and as fairly as possible.

    Opposed to Religious Teachings. One of the most common arguments advanced against Birth Control is the one which holds that the idea is opposed to religious teachings. The statement, however, is usually made in a vague general way, the charge of “irreligious” being hurled without explanation, and usually without any attempt to show any proof of the accusation.

    As a matter of fact, as the advocates of Birth Control have pointed out, there is nothing whatsoever in the New Testament which in fairness may be construed as indicating Birth Control as sinful; in fact, it has been frequently asserted by authorities on the subject that there is nothing to be found in either the Old Testament or the New Testament which directly or indirectly prohibits the limitation of offspring, or which encourages the production of an unlimited number of children regardless of all other conditions.

    Nor do the majority of the various religious denominations seem to have in their statements of doctrine and living anything in the nature of prohibition along the lines indicated above. It is true, however, that the Roman Catholic Church does quite positively, and vigorously, condemn and prohibit the use of contraceptive methods among its members; and I have been informed that its priests place such methods in the category of methods producing abortion, both being regarded as practically identical with infanticide. I have been informed, however, that in this Church the restriction of marital relations to certain periods of the month in which conception is held to be not so likely to be effected, with abstinence at other periods, is a method of limiting offspring that does not come under the ban, particularly if there be a reasonable excuse offered for the desire to limit the size of the family; though, as a rule, even such method is frowned upon unless the reasonable excuse be forthcoming.

    In the case of members of the Catholic Church—and these only—there may seem to be warrant for the objection to Birth Control as “contrary to religion,” it being assumed that the teachings and rules of the Church constitute the true measure of “religion.” To such there is, of course, only one answer, and that is that if the teaching or practice of Birth Control methods be held by them to be “contrary to religion” (according to their definition of “religion”) then they have merely to adhere to the said religious teachings, and to refuse to learn anything about Birth Control. The matter undoubtedly is one entirely for the exercise of their own judgment and conscience. There is no desire on the part of the advocates of Birth Control to insist that such people must limit the size of their families—or for that matter that there is any “must” about it for anyone whatsoever.

    But we must not lose sight of the fact that the laws and customs of society in general are not based upon, or bound up with, the teachings and rules of this particular Church. On the contrary, particularly in the instance of Marriage and Divorce, many of our customs sanctioned by our laws permit and sanction things which are not countenanced or approved of by the Church in question. But just as persons outside of that Church are in no way bound by the teachings or rules thereof in the matter of Marriage and Divorce, so are they in no way bound by the teachings and rules of the said Church concerning the limitation of the size of families. The Church in question does not regard “civil marriages” as true marriages at all—yet our laws, and general public opinion, countenance such marriages; and it is extremely probable that within a comparatively short time the status of Birth Control will likewise manifest the same conflict between State and Church. But just as no Catholic is compelled to accept or practice civil marriage, so no Catholic will be compelled to accept or practice Birth Control.

    Religion is entirely a matter of individual belief and faith, and binds no one not agreeing with its precepts. There is no union of Church and State in this country, or in most other modern civilized countries; and we are not under the jurisdiction of the Church in matters of conscience or conduct, unless we voluntarily so place ourselves under such jurisdiction and control. The argument that Birth Control which is based upon the assertion that it is opposed to the edicts or dogmas of some particular Church organization, is found to be no true argument for the reasons given above; and such argument must be dismissed as fallacious by those who base their judgments and conduct upon the dictates of science, reason, and common-sense, rather than upon the dogmas or decrees of any Church organization. The answer to those who urge that “Birth Control is contrary to the teachings of the Catholic Church” is: “Well, what of it? if you are not a Catholic!”

    The force of the above objection to Birth Control becomes important when we find that those who are opposed to Birth Control merely because their Church condemns it do not content themselves with letting alone the subject, but would also endeavor to fasten the rule of their Church upon the rest of society. While such persons are undoubtedly acting in good faith, and inspired by motives which seem good to them, they should stop to remember that general society refuses to accept the rules of their Church in the matter of Marriage and Divorce, and is likely to refuse a like attempt to fasten upon it the rules of the Church in the case of Birth Control. The general public, here and in the first mentioned cases, will insist upon entering a plea of “lack of jurisdiction.”

    In the cases of persons outside of the Church in question who may consider Birth Control to be contrary to their religious convictions and teachings, there is to be made the same answer given above, namely, that the advocates of Birth Control are not trying to force anything upon those who entertain such religious or conscientious scruples—they would leave such persons free to follow the dictates of their own conscience or the religious teachings favored by them. But at the same time they would demand the legal and moral right to follow the dictates of their own conscience and reason, and would insist upon their right to receive legal protection for the dissemination of their scientific teachings. All that the advocates of Birth Control are claiming is the right of free speech and free knowledge concerning this subject which they deem concerned with the future progress and well-being of the race.

    The argument against Birth Control which is based upon the claim that it is “irreligious,” arises from the general tradition based upon the Hebrew conception of a Deity who bade the legendary first families of the race to “increase and multiply.” According to the scriptural narrative this authoritative command was addressed to a world inhabited by eight people. From such a point of view a world’s population of a few thousand persons would have seemed inconceivably great. But the old legendary command has become a tradition which has survived amid conditions totally unlike those under which it arose.

    Under this old traditionary conception reproduction was regarded as a process in which men’s minds and wills had no part. To those holding it, knowledge of Nature was still too imperfect for the recognition of the fact that the whole course of the world’s natural history has been an erection of barrier against wholesale and indiscriminate reproduction. Thus it came about that under the old dispensation, which is now forever passing away, to have as many children as possible and to have them as often as possible—providing that certain ritual prescriptions were fulfilled—seemed to be a religious duty.

    Today the conditions have altogether altered, and even our own feelings have altered. We no longer feel with the ancient Hebrew who bequeathed his ideals, though not his practices, to Christendom, that to have as many wives and concubines and as large a family as possible is both natural and virtuous and in the best interests of religion. We realize, moreover, that such claimed Divine Commands were the expression of the prophets and rulers of the people to whom they were addressed, and in accordance with the ideals concerning race-betterment which were held by these self-constituted authorities.

    To the educated men and women of today, it is seen that these ideals of human-betterment (no longer imposed upon the people under the guise of Divine Commands, but rather by an appeal to their reason and judgment) are no longer based upon the sanctification of the impulse of the moment, but rather involve restraint of the impulse of the moment as taught by the lessons of foresight and regard for the future which the race has received. We no longer believe that we are divinely ordered to be reckless, or that God commands us to have children who, as we ourselves know, are fatally condemned to disease or premature death. Matters which we formerly believed to be regulated only by Providence, are now seen to be properly regulated by the providence, prudence, foresight, and self-restraint of men themselves. These characteristics are those of moral men, and those persons who lack these characteristics are condemned by our social order to be reckoned among the dregs of mankind. Our social order is one in which the sphere of procreation could not be reached or maintained by the systematic control of offspring.

    More and more is Religion perceived to be more than a mere matter of the observance of certain ritual and ceremonies, or the belief in certain dogmas. More and more is true religion seen to be vitally concerned and bound up with the relations of man to man, and the welfare of society in general. More and more is it being perceived that anything which is decidedly anti-social, or opposed to the best interests of human-betterment, is not truly “religious,” no matter how sanctified by tradition, or bound up with ritual and ceremonies it may be.

    The spirit of modern Christianity is seen to consist of two fundamental principles, viz.: (1) the love of God; and (2) the Golden Rule. The conscientious Christian who uses head and heart in harmony and unison, cannot avoid the conclusion that the avoidance of the bringing into the world of offspring destined by social and economic conditions to misery, poverty, and sin, is more in accordance with the true spirit of Christianity than opposed to it—the ancient dogmas and traditions of the Church to the contrary notwithstanding. Modern religion is based upon Reason as well as upon Faith, and it is safe to predict the time when Birth Control will not only be sanctioned by “religion,” but also encouraged by it.

    Is It Immoral? Akin to the objection urged against Birth Control on the score of conflict with religious teachings, we find the one which states that “it is immoral.” Morality means “quality of an action which renders it right or good; right conduct.” Right conduct or “good” action depends upon the effect of the conduct or action upon the individual, other individuals, or society in general. The standards of morality, right conduct, and good actions have changed from time to time in the history of the race, and are not fixed. Reason teaches that that which is for the benefit of the individual and the race is and must be “moral,” and that which is harmful to the individual and the race is and must be “immoral.”

    As to whether Birth Control is helpful or harmful to the individual and the race—moral or immoral—the individual student of the question must decide for himself after having given the subject careful and unprejudiced consideration. The advocates of Birth Control hold that every fair argument and consideration of the question must bring the unprejudiced person to the conviction that the ideals advanced by them are in the direction of the betterment of the race, and the increased happiness of the individuals composing the race. If such be the case, then Birth Control must be regarded as positively “moral” in character and principles, and its teachings directly in the interests of “morality.”

    So true is the above statement that every argument of the advocates of Birth Control is based upon the assumption of its “morality,” in the sense of making for human betterment. If it be shown that the teachings are in anywise “immoral,” in the sense indicated, then no one would be quicker to condemn them than the intelligent and conscientious advocate of Birth Control, for the reason that his whole case is based upon the inherent “morality” of his ideals.

    Any one who has made a careful and unprejudiced study of the subject of Birth Control will discard the idea that a tendency so deeply rooted in Nature as is Birth Control can ever be in opposition to morality. It can only be so held as contrary to morality when men confuse the eternal principles of morality, whatever they may be, with their temporary applications, which are always becoming modified in adaptation to changing circumstances.

    The old ideals of morality placed the whole question of procreation under the authority (after God) of men. Women were in subjection to men, and had no right of freedom, no right to responsibility, no right to knowledge, for, it was believed, if they were entrusted with any of these they would abuse them at once. This view prevails even today in some civilized countries, and middle-aged Italian parents, for instance, will not allow their daughters to be conducted by a man even to Mass, for they believe that as soon as they are out of their sight they will be unchaste. That is their morality.

    Our morality today is different. It is inspired by different ideas, and aims at a different practice. We are by no means disposed to rate highly the morality of a girl who is only chaste so long as she is under her parents’ eyes; for us, indeed, that is much more like immorality than morality. We, today, wish women to be reasonably free; we wish them to be trained in a sense of responsibility for their own actions; we wish them to possess knowledge, more especially in the sphere of sex, once theoretically opposed to them, which we now recognize as peculiarly their own domain.

    Our ideal woman today is not she who is deprived of freedom and knowledge in the cloister, even though only the cloister of her own home; but rather the woman who being instructed from early life in the facts of sexual physiology and sexual hygiene, is also trained to exercise judgment, will, self-restraint, and self-responsibility, and able and worthy to be trusted to follow the path which is right according to the highest ideals of the society of which she is a part. That is the only kind of morality which now seems to us to be worth while.

    And, as any unprejudiced intelligent person is forced to admit, there is nothing in the policy of scientific Birth Control to run contrary to such an ideal of moral womanhood.

    But the relation of Birth Control to morality is, however, by no means a question which concerns women alone. It equally concerns men. Here we have to recognize, not only that the exercise of control over procreation enables a man to form a marriage of faithful devotion with the woman of his choice at an earlier age than would otherwise be possible, but it further enables him, throughout the whole of his married life, to continue such relationship under circumstances which might otherwise render them injurious or else undesirable to his wife.

    That the influence exerted by a general knowledge of scientific methods of Birth Control would suffice to entirely abolish prostitution it is foolish to maintain, although it would undoubtedly tend to decrease the social evil. And even the partial elimination of prostitution would be in the interests of general morality, not only in thedirection of lessening the brutal demand of women to serve in the ranks of prostitution, but also in many other ways of importance to society as a whole. The decrease of venereal disease would follow a decrease in prostitution caused by a general knowledge and practice of scientific methods of Birth Control on the part of married people; and it must be remembered that venereal disease spreads far beyond the patrons of prostitution and is a perpetual menace to others who may become innocent victims. And any influence that serves to decrease prostitution and the spread of venereal disease, must be placed in the category of “moral,” and certainly not in the opposite one.

    The objection is frequently heard that the general knowledge of scientific methods of contraception would lead to increased illicit relations among unmarried persons, particularly among the young people. This argument is apparently based upon the belief, or fear, that the fear of conception is the only thing which prevents many persons from indulging in illicit relations. It assumes that a large portion of our womankind are chaste simply because of fear of pregnancy; and that this fear once removed these women would at once plunge into such relations. In other words, it assumes that mentally and in spirit these women are already unchaste, but are restrained from physical unchastity by reason of the fear of conception.

    The answer of the advocates of Birth Control takes direct issue with the above contention. On the contrary, it asserts that the chastity of our women is the result of their general training, education, heredity, observance of the accepted customs and standards of their community, religious and moral training, etc. The woman who is chaste simply through fear, usually manages to allay that fear in one way or another, often by mistaken methods which work great harm to the woman and the community in general. The general knowledge of scientific contraceptive methods might result in such women manifesting their inclinations and desires in a “safer” manner, but this “safety” would not consist of protection against conception (for that they already think they have) but rather of a protection against the dangers of abortion and similar evil practices.

    Some of the writers go further in this matter, as for instance Dr. Robinson, who says: “If some women are bound to have illicit relations, is it not better that they should know the use of scientific preventives than that they should become pregnant, disgracing and ostracising themselves, and their families; or that they should subject themselves to the degradation and risks of an abortion; or failing this, take carbolic acid or bichloride, jump into the river, or throw themselves under the wheels of a running train?”

    The objection to Birth Control on the ground that it would increase illicit relations among men and women by means of removing the fear of physical consequences, seems to many careful thinkers to be akin to the old objection (now happily passing away) to the dissemination of the knowledge of the treatment of venereal diseases, and to the public cure of such diseases, on the ground that by so doing a part of the fear concerning illicit relations was removed, and thereby illicit relations actually encouraged. The result of this fallacious argument was the enormous spread of venereal diseases, to the great hurt of the race; and the encouragement of quacks and charlatans who fattened on the gains received from the sufferers from this class of complaints. The argument against Birth Control on similar grounds will be seen to be equally fallacious, and capable of equally evil consequences, if the matter be fairly and carefully considered.

    Illicit relations, if prevented or regulated at all by society, must be so regulated or prevented by other means than fear of conception. Such fear, though it may deter for a short time, will usually be overcome in time if the desire and temptation remain sufficiently strong. It is doubtful whether any considerable number of women remain chaste for any length of time simply by reason of fear of conception. If such fear be the only remaining deterring factor, it will usually be swept away in time under continued temptation, opportunity, and desire. Chastity and virtue must have a far more solid foundation than such fear; and experience repeatedly shows that such fear is but as shifting sand sought to be employed as a foundation for the structure of chastity.

    There is no reason whatsoever for believing that the scientific knowledge of contraceptive methods, if generally possessed by married people under the sanction of the law and society, would result in any more cases of illicit relations than exist at the present time. It might, it is true, result in less evil consequences of such relations in some cases, as Dr. Robinson has so clearly pointed out in the above quotation; but the relations in such cases would exist in either event. Fear of conception, like fear of infection, has never, and will never entirely prevent illicit relations between men and women; and to oppose scientific information in the one case on these grounds, is as futile as to oppose scientific treatment in the other case on the same grounds. And when it is considered how society in general is injured by the withholding of such information or treatment, respectively, the argument in favor of such suppression of scientific truth and method is seen to be actually dangerous to society and sub-service of the public good.

    I would like to add a few words concerning the question of morality in the matter of practicing scientific Birth Control. To me what I shall say in the succeeding paragraphs of this chapter have a vital bearing on the whole subject, and should be taken into serious consideration by the fair-minded and conscientious student of the subject. Here follows my thought in the matter:

    In my consideration of the arguments against scientific Birth Control I am impressed with one particular thought which refuses to be silenced, but which insists upon persistently presenting itself to my consciousness. This particular thought may be expressed as follows: It is admitted by unprejudiced students of the subject that the educated and cultured portions of the civilized countries of modern times do actually practice, to some extent, in some form, manner, or degree, the limitation of offspring—no honest observer will dispute this statement. This being so, does it not seem that the race should fairly and squarely, honestly and frankly, face this question and decide whether or not such rules of conduct are “right” or “wrong”—”moral” or “immoral”—and to what extent, if any, they should be permitted or encouraged to be practiced toward the ends of individual and race happiness and betterment.

    If the decision is totally against this rule of conduct, then it should be vigorously denounced, and all honest people should refrain from it. If, on the contrary, the decision should be that this mode of conduct, or some phases of it, are justified, then, in the name of Honesty and Truth, let us turn on the full light of general information, knowledge, and instruction on the subject, under the full protection of the laws and public opinion. Why should we not throw aside the mask of cowardly hypocrisy, and stand before the world showing ourselves as just what we really are?

    My thought, in essence, is that the chief “wrong,” and “immorality” about the whole matter consists in our present practice of doing one thing in private, and condemning the same thing in public. There can be no excuse, to the intellectually honest person at least, for the course of tacitly holding that a certain thing is “all right for us,” while “all wrong for the other folks.”

    Is It Injurious to Health? It is sometimes urged against Birth Control that the use of contraceptive methods is injurious to the health of women, in some cases a long list of physical and mental ills being given as possible of being caused by such methods. Opposed to this is the contention of the members of the medical profession who have arrayed themselves on the side of scientific Birth Control. The latter authorities positively contradict the assertion that women’s health is injured by the practice of rational and scientific methods of Birth Control; although these authorities freely admit, in fact they claim, that certain unscientific methods and practices popular among certain persons—such as the use of certain chemicals and mechanical appliances—undoubtedly have resulted in physical harm, and they strongly advise against the use of such bunglesome methods.

    One of the leading medical advocates of scientific Birth Control in the United States throws down the gauntlet squarely before those of his profession, and others, who urge this objection to scientific Birth Control, in the following challenging words: “I challenge any physician, any gynecologist, to bring forth a single authenticated case in which disease or injury resulted from the use of modern methods of prevention. I know they cannot do it.” And others in the ranks of the medical profession have made similar assertions and claims. The unprejudiced person who will consult the best medical authorities on the subject will unquestionably agree that the best medical opinion of the day holds that scientific Birth Control is not in fairness to be open to this objection.

    Is Birth Control Unnatural? Another favorite argument of the opponents of scientific Birth Control is the broad statement and claim that “all voluntary attempts to limit procreation are unnatural,” and therefore wrong. This objection, while usually offered without any particular argument, explanation, or proof, must be carefully and honestly met and answered by the fair-minded advocate of Birth Control.

    In the first place, it may as well be admitted that regulation, restriction, or control of the procreative functions by application of the intellect or reasoning processes isunnatural, in the sense of not being indicated by Nature and enforced through the instinctive actions of the race. The only instinct which primitive man seems to have had in this case (and these he held in common with the lower animals) was that of free and unlimited sexual intercourse, in response to his instinctive desires, with this exception (and this exception should be carefully noted), i. e.: that the male respected the instinctive disinclination to cohabit during the period in which the woman was pregnant, and often also during the period in which she nursed her infant. This instinct, unhappily for the race, the “civilized” man has overridden until it has practically ceased to manifest its voice.

    The lower animals, obeying this primitive instinct, do not manifest violation of this law of Nature. On the contrary, the female will not allow the male to approach her at such times, and will fight savagely at any attempt to violate this instinctive law of her nature. The male usually recognizes the existence of this law, and makes no attempt to violate it, but should he attempt the same he is defeated by the female as above stated. It has remained for Man alone to override and violate, and to eventually render nul and void this wise instinctive provision of Nature.

    But beyond this there is no “natural,” instinctive regulation of the sexual activities of animal or man, other than the desires of the male and female. If civilized man adhered wholly to the “natural” in this respect, he would obey the voice of instinct alone, and would show reason and intellect the door in such matters, and would also bid defiance to all legal or ecclesiastical authority when it sought to “control” his activities along these lines. But, it is needless to say, such is not the case. Not only has the Law of the Church insisted upon certain “control” of these matters—as witness the laws against adultery, illicit relations, incest, bastardy, etc.—but man, himself, has asserted a greater and still greater voluntary control over the reproductive functions as he has risen in the scale of civilization and culture.

    Today it is only the lowest and least cultured classes of society who (to use the expressive but somewhat inelegant term) persist in “breeding like pigs.” All other classes exercise a greater or less degree of “control” of some kind in the matter of limitation of offspring. In making this broad assertion I, of course, have in mind not only the modern methods urged by the advocates of scientific contraception, but also the “control” and regulation observed by married persons in either total abstinence from the marital relations for a stated time, or else the abstinence from such relations during certain portions of the lunar month, the latter method (somewhat uncertain, however, in its efficacy in some cases) being apparently favored by certain ecclesiastical authorities as the “only moral” method.

    In view of the above facts, which might be enlarged and extended if necessary, it is seen that as soon as man rises above the level of the beast or savage—as soon as he begins to manifest culture and civilization—he begins to exercise a certain “control” over the procreative function, and in the direction of the limitation of the size of his family of offspring. The contention of the modern advocates of scientific Birth Control is that the “new ideas” on the subject are simply a natural and inevitable evolution from the degrees of “control” which man has exercised since the time he emerged from savagery. The later developments are no more “unnatural” than the earlier—nor the accepted methods and forms any more “natural” than those which are now opposed by the more conservative elements of society.

    When anyone begins to talk about things being “natural” or “unnatural,” respectively, he should tread softly and watch his steps carefully. For at every step he treads upon instances of “unnatural” modes and methods of living. Strictly speaking, it is “unnatural” to wear clothes, or to cook food, or to live in houses, or to ride in conveyances or on horseback. All of these things have been evolved by the use of intellect and reason, and are not instinctive or “natural” to man. Birds build nests, wasps build shelter, hornets build homes, bees build honey-combs, worms build cocoons, snails build shells—all by instinct and “naturally”—and the young of such species do not have to be taught how to do these things. But the young of the human race requires to be taught such things as above mentioned as having been evolved by man in the course of his rise from savagery—instinct will not do it for them. And all of these things outside the plane of instinct, and within the plane of intellect, cannot be called “natural” in the strict sense of the term.

    You think that I am exaggerating the matter, perhaps. Well, then, I ask you to consider the meaning of the two terms which I have employed so freely in the foregoing paragraphs: First, let us consider the term, “Natural“; we find it defined as “fixed or determined by nature, and, therefore, according to nature, and not artificial, assumed, or acquired.” Next, let us consider the term, “Instinct“; we find it defined as “natural impulse, or unconscious, involuntary, or unreasoning prompting to any action.” It will be seen, accordingly, that merely the most elemental and primitive activities of man are “natural” in this sense; and that all his acquired activities and methods are “not natural.”

    The activities of man which are in the “not natural” class may be either desirable for the individual and the race, or else undesirable for both. Therefore, it will be seen, all such activities must be subjected to the test of reason and experience in order to determine whether they are in the best interests of the individual and the race, or else opposed to these. This is the only sane method of testing the validity and desirability of such things—Birth Control among the others. The claim of “not natural,” if applied at all, must be extended to all things which are not strictly “natural” or instinctive—it is casuistical to apply the term in reproach to certain things and to withhold it from others in the same general class.

    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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  • GENERAL ADVICE TO WOMEN ON SEX SUBJECTS

    GENERAL ADVICE TO WOMEN ON SEX SUBJECTS

    In this lesson the writer seeks to direct the attention of his women readers to certain subjects upon which the average woman is not well informed, and upon which she usually requires sound, sane, clean, frank information. In many cases women hesitate to ask even their family physicians for such information, and, although there is no rational reason for it, they even shrink from consulting better informed and capable women concerning these subjects.

    Sexual Feeling. Owing to erroneous teachings, and irrational prejudices arising from ancient distorted and perverted ideals of sex, many women have grown to maturity under the erroneous belief that it is a sign of immorality, or at least low ideals and depraved nature, for a woman to experience sexual emotions or feelings, wishes or desires. So true is this that even many married women seek to withhold from their husbands the knowledge that any sexual feeling is experienced by the wife.

    Such a belief is of course absurd. It is as natural for a woman to experience normal sexual feeling as it is for her to experience any other feeling aroused by natural instincts and organism. Without such instinct and the feelings arising therefrom, there would be no mating or marriage, and no perpetuation of the race. The woman experiencing such feelings should not allow herself to imagine that she is depraved or perverted, or immoral in thought and feeling. Incredible as it may appear to a normal, healthy-minded man, it is true that thousands of young women have lost self-respect, and have lapsed into a morbid state of mind, because of the occasional manifestation of their normal sexual feeling.

    This does not, of course, mean that the woman must necessarily manifest into action the feeling experienced by her. On the contrary, she must acquire self-mastery and self-control, just as she must in other phases of her life. It may help some women of this kind to realize that the sex feeling and impulses, arising unbidden (and often unwelcomed) from the depths of their subconscious mentality, are essentially creative impulses. If the woman be unmarried, or if married and placed under conditions in which the marital relation with the husband is impossible or undesirable, then she can transmute this creative energy in some form of creative work—in work which leads to the creation, manufacture, building-up, or composing something. There is a hint here which will prove a great blessing to the woman who will understand and apply the principle suggested—for many other women have found it so.

    As for the married woman, there is no reason whatsoever why she should seek to withhold from her husband the knowledge that she is possessed of normal, natural, healthy sexual feeling. In fact, the withholding of such information, and the concealment and deception arising therefrom, has often done much to bring marital inharmony between husband and wife. If there is any deception to be practiced in the marital association of husband and wife, it should rather be in the opposite direction, i. e., in the direction of pretending the emotional feeling when it exists only partially or is absent. The last matter, however, is one for the exercise of the judgment and conviction of each individual woman; but the first mentioned admonition is one which should be observed, as it is based on honesty, truth, and good judgment as well.

    Alcohol and Sexuality. It needs no extended argument to convince the average person that an individual will do things when under the influence of drink that he or she would not do when perfectly sober. It is an old saying that “When the wine is in, the wits are out.” But there is a deeper connection and relation between alcoholic drink and sexual indiscretions than is usually realized by the average person. Besides the commonly known weakening of will-power and self-control arising from the influence of strong drink, there are certain influences concerning the sexual nature and arising from the presence of alcohol in the system, which are not known to most persons. So true is this that the writer has thought it well to utter a few words of warning to his women readers concerning these things.

    In the first place, there is an exhilarating effect arising from certain kinds of liquor, wines, and other forms of alcoholic drinks, which manifests directly in an excitement of the sexual centers and organism. In many cases a strong sexual excitement, absent at other times, is aroused, and the person is carried away with the force of passion unknown under other circumstances. Added to this the weakened will-power arising from too much drink, and we have an explanation of many cases of “mistakes” of women. It would appear that women are even more susceptible than are men to unusual sexual excitement arising from alcoholic drinks; and that, therefore, they should be especially cautious in the indulgence in such drinks, particularly when in the company of strange men, or men careless in regard to sexual morality and respect for women in their company.

    But there is still a deeper reason, based upon the latest discoveries in psychology, why caution in this respect should be observed by women. We allude to the discovery that alcohol first affects the mental and emotional tendencies of more recent racial acquirement, acting so as to paralyze and inhibit the activities thereof, and to thus release the activity of the more primitive emotions and motive activities. Thus, the woman under the influence of alcohol finds that the more recent racial traits, such as sexual control, restraint, sexual morality, conventional observations, etc., are practically temporarily paralyzed in inhibitual—or to use the current slang phrase, are “put out of commission” for the time being; and, at the same time, the old elemental, savage, barbaric, “cave man” instincts, habits, and methods of action, are brought to the surface, and proceed to manifest their activity if opportunity be granted for the same—and the opportunity is usually granted. This being seen to be true, it is seen that the woman so under the influence of liquor is, for the time being, little more than a “cave woman,” or barbarian, with all the lax sex morality of the latter, and with all the tendencies to manifest into activity the primitive impulses arising in her nature and demanding expression. Added to this the weakening of will-power always accompanying the alcoholic influence, it is seen that the woman under the influence of strong drink is an easy prey to designing men, and a willing victim to her own lower passions.

    An authority of sex subjects says: “That Bacchus, the god of wine, is the strongest ally of Venus, the goddess of love, using the term Love in its physical sense, as the French use the word ‘amour,’ has been well known to the ancient Greeks and Romans, as it is well known today to every saloon-keeper and every keeper of a disreputable house. And all measures to combat venereal diseases and to prevent girls from making a false step will only be partially successful if we do not at the same time carry on a strong educational campaign against alcoholic indulgence. * * * Of what use are warnings to a girl, when under the influence of a heavy dinner and a bottle of champagne, to which she is unaccustomed, her passion is aroused to a degree she has never experienced before, her will is paralyzed and she yields, though deep down in her consciousness something tells her she shouldn’t? She yields, becomes pregnant, and is in the deepest agony for several months, and has a wound which will probably never heal for the rest of her life. Of what use have all the lectures, books, and maternal injunctions been to her? * * * I believe that the sex instinct can be stimulated artificially beyond the natural needs, and among the artificial stimulants of the sex instinct alcohol occupies the first place. And bear in mind that alcohol produces even a stronger effect upon women, in exciting the sexual passion, than it does on men. Women are more easily upset by stimulants and narcotics, and that is the reason why it is more dangerous for women to drink than it is for men. It is impossible to give statistics and exact or even approximate figures. But there is no question in my mind, in the mind of any careful investigator, that if alcoholic beverages could be eliminated, the number of cases of venereal infection would be diminished by about one-half. And what is true of venereal disease is also true of the seduction of young girls. Alcohol is the most efficient weapon that either the refined Don Juan or the vulgar pimp has in his possession.”

    Our advice to the woman who is asked to drink liquor when in the company of a man outside of her immediate family circle is emphatically this: DON’T DO IT!

    The Menstrual Period. As strange as it may appear to those women who have had the advantage of intelligent maternal advice, it is a fact known to all physicians that many mothers permit their young daughters to enter into the stage of puberty, with the accompanying menstrual flow, without having first instructed the daughter as to the meaning and character of this phenomenon of her nature, and without having given her advice concerning the proper care of herself during this period.

    Physicians constantly experience cases in which the young girl to whom the first menstrual flow having come, without previous knowledge on her part, has supposed it to be the result of a wound, or of a diseased condition, and has attempted to stop the flow by the application of cold water. Even where a partial knowledge has been attained by the girl, she is found to lack the knowledge of the proper hygienic care of herself during the period. The mothers in such cases are criminally negligent, and have alluded a false modesty or prudery to interfere with a natural and necessary maternal duty.

    The approach of the first menstruation is often accompanied by unusual physical, mental and emotional changes in the young girl. Her nervous system is affected, and she is apt to become irritable or morbid, or even somewhat “flighty.” Her appetite may become irregular, and there is often present a craving for indigestible food. A physical languor is often experienced, and there may be pains in the back and legs, chilliness and headaches, and a general upsetting of the usual physical condition, accompanied by a manifestation of peevishness and irritability. These unpleasant symptoms usually disappear when the periodical menstrual flow is permanently established. In fact, they are frequently superseded by the awakened energy and heightened spirits of healthy, normal adolescence.

    The time of the beginning of the menstrual period varies according to climate, race, condition of health, and temperament. In the tropical countries, menstruation begins from the tenth to the fourteenth year; in temperate countries, from the thirteenth to the sixteenth; in cold countries, from the fifteenth to the twentieth year. The Italian, Hebrew, Spanish, or French girl is apt to menstruate earlier than the English, German, or Swedish girl. The Negro girl menstruates early, as a rule. The full-blooded girl usually menstruates earlier than the anemic one.

    Normally, menstruation should proceed naturally and without pain or suffering. When pain or suffering is experienced in connection with menstruation, it is simply because of some lack of health in the general system; and when such general health is restored, the trouble ceases. Painful menstruation is called “dysmenorrhea,” and arises from several causes, principal among which are the following: Errors in diet, errors in dress, undue exposure, constipation, lack of proper exercise, or to a contracted or congested condition of the Uterus or the Fallopian Tubes. The pain, however, cannot be considered as a feature of normal menstruation, for the latter is no more painful than a normal movement of the bowels—the painful condition results from abnormal conditions, the removal of these conditions resulting in the cure of the complaint.

    Dysmenorrhea should be treated by the discarding of all unhygienic clothing, tight shoes, etc., and their replacement by rational clothing; the dietary should be carefully scanned, and improper articles replaced by nourishing elements of food—discard the pastries, pickles, confections, and stimulants, and substitute sensible articles of diet; if constipation is present, remove it by eating articles of food which promote free movements of the bowels, and drink more water each day; take a proper amount of exercise—housework is as good a form of exercise as any; many authorities advocate the free drinking of water prior to and during the menstrual period—some going so far as to say that where there is painful menstruation there is always a lack of a proper amount of water taken into the system. In some cases Dysmenorrhea is due to disorders of the general nervous system, and treatment therefore should be sought at the hands of a capable physician.

    Amenorrhea, another disorder arising in connection with the menstrual process, consists of the retention or suppression of the menses, or of “scanty” menses, or occasional “skipping” of the periods. This condition is apt to be manifest in cases of extreme obesity or “fatness;” the nervous system being burdened with superfluous flesh, its menstrual rhythm is often affected. Suppression of the menses also sometimes results from exposure and disturbing mental emotions. The most approved treatment is that of remedying the abnormal general physical condition, proper diet, and the use of hot drinks, hot sitz baths, and hot enemas about the time of the beginning of the normal period.

    Menorrhagia, another menstrual-period disorder, consists of very profuse flowing—it is, in fact, a mild form of hemorrhage. It usually arises from general debility, shocks, too violent exercise or labor, and also in many cases from undue and too frequent sexual intercourse. Sometimes the excessive flow occurs during the regular menstrual period, while in other cases it may manifest itself out of season—sometimes as often as two or three times a month. The duration of the normal period of menstrual flow, however, varies greatly among different women; the normal period may be said to last from two to six days, so what might be an excessive flow for one woman would be only normal for another—temperament plays a large part in determining the quantity of the menses.

    Some of the accompanying symptoms of Menorrhagia, or profuse flow, are lassitude, shortness of breath, faintness, dizziness, headache, irritability and nervousness, and often also leucorrhea between periods. The general treatment consists in measures calculated to bring the general health of the woman back to the normal. The building up of the general system, by means of nourishing food, proper exercise, etc., will almost always result in curing this disorder.

    A well-known authority has well said: “The hygiene of menstruation can be expressed in two words: Cleanliness and Rest.”

    So far as Rest is concerned, the woman need not be urged to take it at this period—that is, if she is able to do so. Care should be taken not to exercise unduly at this time, and under the head of exercise may be included dancing, horseback riding, and automobiling, as well as the more common forms of athletic work.

    It would seem that common sense and the general desire for cleanliness and daintiness would cause all women to observe the plain hygienic laws of Cleanliness at the time of the menstrual period. And, indeed, it is probable that such would be the case were it not for the fact that some ancient superstitions still exert their power over the mind of many women, in regard to the use of water during the menstrual period. While it is true that cold baths, or cold-water bathing, are not advisable for the average woman during the menstrual period (although some especially robust women bathe and swim as usual during this period), this prohibition does not apply to the use of warm water during the period. Lukewarm baths are permissible at this time; and the woman should wash the external genital parts with warm water, with soap if desired, every morning and evening of the period. A vaginal douche of lukewarm water is an excellent adjunct to the bathing of the parts.

    It is astonishing to meet with the superstitious prejudice existing in the minds of some women concerning the use of the vaginal douche; these good creatures seem tothink that it is either unnatural and unhealthy, or else is something “not respectable,” and fit only for the use of immoral women. These women should get in touch with modern hygienic methods, and learn to use the douche at least during their menstrual periods. At this time, if the plain rules of cleanliness are not observed, there often occurs a decomposition of the blood which has gathered in or about the genitals, and an offensive odor is manifested. Some women, while feeling distressed about this odor, are afraid to use lukewarm water in washing themselves, owing to some old unexplored superstition handed down from the great-grandmother’s time.

    The napkins should be changed at least every morning and evening. Unclean napkins may lead to infection, and it is probable that many cases of leucorrhea have their origin in lack of cleanliness concerning the napkins, cloths, or rags, used during menstruation. It may seem almost incredible to the average woman reader, but physicians know of cases (usually among the poorer and more ignorant foreign classes) in which the girl is instructed by her mother, grandmother, or aunts, that she must wear the original cloth or rag during the entire period, as she will “catch cold” by a change to a clean, fresh cloth while the flow continued. Imagine the result of such a practice! This last is an extreme instance, of course, but it will serve to show the absurd and harmful notions prevalent concerning this important natural function, and its incidents.

    Leucorrhea. A very common disorder among women is that known as Leucorrhea, or “the whites.” It consists of a discharge from the Vagina, or the Uterus through the Vagina. It is, in fact, of a catarrhal nature, and results from an over-secretion of the mucus fluids which, in proper quantity, keep the mucus membrane of the said organs in good condition. The discharge manifests in various shades and degrees of consistency. From the character of the discharge, physicians are able to determine whether it comes from the Vagina or the Uterus. The discharge from the Vagina usually is a light creamy fluid; that from the neck of the Uterus is a sticky, thick fluid flowing rather freely; that from the lining of the Uterus is alkaline, and generally precedes and follows menstruation; and that accompanying ulceration of the womb is semi-purulent and offensive in odor.

    Leucorrhea has many causes, among which may be mentioned the following: getting chilled feet or body, particularly during the menstrual period; over exertion and overwork standing on one’s feet; chills following dancing in overheated rooms; excessive worry or emotional strain, etc. It is a quite common complaint, and some assert that fully twenty-five per cent (perhaps more) of all women suffer from it to at least some extent.

    The general treatment of Leucorrhea consists of the building up of the entire system by the proper hygienic methods. Constipation should be removed, and the system is built up by the proper articles of food, exercise, etc. The use of the proper douches are also advised by the best practitioners. Physicians also treat inflamed areas by local treatments consisting of painting the Vagina or neck of the Uterus with certain medicinal solutions. Certain suppositories and douches are also employed in some cases. It is always better to consult a good physician in these cases, particularly where the trouble is aggravated or of long standing.

    A popular writer on the subject gives the following prescription for a vaginal injection: White Fluid Hydrastics, 2 ounces; Borax, 1/2 ounce; Distilled Witch Hazel Extract, 1 pint. Use of this preparation one ounce, diluted in a pint of lukewarm water, as a vaginal injection, taken twice each day.

    A well-known authority gives the following advice concerning treatment of Leucorrhea: “One of the simplest things is an alum tampon. You take a piece of absorbent cotton, about the size of a fist, spread it out, put about a tablespoonful of powdered alum on it, fold it up, tie a string around the center, insert it in the vagina as far as it will go, and leave it in twenty-four hours. Then pull it gently by the string and syringe yourself with a quart or two of warm water. Such a tampon may be inserted every other day or every third day, and I have known where this simple treatment alone produced a cure. In some cases, however, douches work better, and the two best things for douching are: tincture of iodine and lactic acid. Buy, say, four ounces of tincture of iodine, and use two teaspoonsful in two quarts of hot water in a douche bag. This injection should be used twice a day, morning and night. Of the lactic acid you buy, say, a pint, and use two tablespoonsful to two quarts of water. The lactic acid has the advantage over the tincture of iodine that it is colorless, while the iodine is dark and stains whatever it comes in contact with. Sometimes I order the use of the tincture of iodine and the lactic acid alternately: for one douche the tincture of iodine, for the next the lactic acid, and so on. When the condition improves, it is sufficient to use one teaspoonful of the tincture of iodine and one tablespoonful of the lactic acid to two quarts of water. These injections are quite efficient and have the advantage of being perfectly harmless. One point about the injections: they should be taken not in the standing or squatting position (in which position the fluid comes right out), but while laying down, over a douche pan. The douche bag should be only about a foot above the bed, so that the irrigating fluid may come out slowly; the patient, after each injection taken in the daytime, should remain at least half an hour in bed (in the nighttime she stays all night in bed.) This gives the injection a better chance to come in contact with all the parts of the vagina, and a portion of it comes in contact with the cervix, where it exerts a healing effect. Avoid the use of patent medicines.”

    Uterine Displacement. The woman suffering from Uterine Displacement should, of course, consult a competent physician and be governed by his advice. The following suggestions, however, will be found to be of service in many cases:

    In the case of Prolapsus, or falling of the womb, many women have found great relief, and in many cases permanent improvement, by taking occasional rests in bed for an hour or so, with the feet and lower part of the legs raised at least eight inches above the level of the head. In this plan, the Uterus is replaced by gravitation. Some authorities advise practicing waist-breathing while lying in this position, thus exercising the abdominal muscles. Dr. Taylor says: “Increase the pump-like action of the chest, and it will be found that the displaced viscera will return to their normal position.” Some have also found relief from the use of alum-water vaginal injections once or twice each day. The alum-water is prepared by dissolving one heaping teaspoonful of powdered alum in a pint of lukewarm water. This last treatment often strengthens the vaginal muscles whose yielding has at least partially been the cause of the falling womb.

    In cases of Retroversion, in which the Uterus is turned or bent backward, the “knee and chest” position will often aid in causing the organ to regain its normal position. In this position the woman kneels, and rests her chest upon the bed, thus causing the hips to be elevated.

    In cases of Antroversion, in which the Uterus is turned or bent forward, relief is often obtained by the woman resting upon the back, using a pillow to elevate her hips.

    Intercourse During Menstruation. It would seem that the natural esthetic repulsion to the exercise of the marital relations during the menstrual period should be sufficient to deter men and women from indulgence at this time; but many seem to have overcome this instinctive repulsion, and to these a stronger reason must be given—and the reason is at hand. The reasons in question are as follows: first, that congestion of the Uterus and Ovaries sometimes results from this unnatural practice; second, that the man may possibly contract an inflammation of the urethra by infection from the degenerated membrane, tissue, blood, etc., of the menstrual flow; and third, that such practices may result in the aggravation of discharges from the woman, such as leucorrhea, etc.

    Intercourse During Pregnancy. The best authorities advise total abstinence from sexual intercourse during the period of pregnancy; but in view of the fact that such abstinence is very difficult for most men, and that few will persist in it, it is thought well to point out the fact that at least an extreme moderation is desirable in such cases. A leading authority says on this point: “During the first four months of pregnancy, no change need be made in the usual sex relations; their intensity should be moderated, their frequency need not. During the fifth, sixth, and seventh months, intercourse should be indulged in at rarer intervals—once in two or three weeks—the act should be performed without any violence or intensity. During the eighth and ninth months relations had best be given up altogether. And this abstinence should last until about six weeks after the birth of the child. During this period the uterus undergoes what we call involution; that is, it goes back to the size and shape it had before pregnancy, and it is best not to disturb this process by sexual excitement, which causes engorgement and congestion.”

    Sterility in Women. Sterility, or barrenness, i. e., the inability to bear children, is frequently met with among married people. It is usually blamed upon the woman, whereas in at least one-half of the cases the fault is with the man.

    The causes of sterility in women are usually one or more of the following: Inflammation of the Fallopian Tubes, which may have been caused by gonorrhea or ordinary inflammation—in some rare cases childbirth has been known to set up an inflammation in this region, which has prevented the woman from future childbearing—the inflammation causes the tubes to clog up or become closed, so that no more ova can pass through them from the ovaries to the womb; in some cases, also, severe cases of leucorrhea have caused sterility, as the discharge is sometimes fatal to the life of the spermatozoa and destroys them; in other cases misplacement of the womb causes sterility; also severe inflammation of the neck or mouth of the womb operates in the same way, in some cases. In cases of sterility, the woman should have an examination made by a competent physician, and it often will be found that the cure of the disorders above noted will work a cure of the sterility.

    But, in all cases of sterility, it will be found that the husband should be examined as well as the wife—in fact, many authorities insist that the husband should be examined first. Venereal diseases frequently produce sterility in the man, although he is loath to admit this and is apt to place the blame entirely upon the woman.

    Miscarriage and Abortions. The terms “miscarriage,” and “abortion,” respectively, mean the expulsion of the fetus from the womb before its natural time of delivery. In common usage, the term “miscarriage” is usually employed to indicate instances in which the premature delivery has occurred without any voluntary act on the partof the woman, or other persons acting with her permission; the term “abortion” being reserved for instances in which the miscarriage has been voluntarily produced.

    When the fetus dies within the womb of the mother, it is usually expelled spontaneously within a few days or even a few hours. Some women suffer from certain weakness which result in habitual miscarriage; such women seem unable to carry the child for the full natural term, and lose it at some time during the period of gestation. Like results often arise from certain diseases, principal among which is syphilis. In some cases the physician produces what is known as “therapeutic abortion,” for the purpose of saving the life of the woman—this is sanctioned by medical custom and by law. Other forms of abortion, performed for the purpose of preventing the progress of the gestation, and designed for the destruction of the embryo or fetus, are known as “criminal abortion,” and are punishable by several legal penalties.

    Abortions are frequently followed by severe illness, invalidism, or even death for the woman. Many women have had their entire lives ruined by this evil practice. It is one of the curses of modern civilization, and one which must be removed by means of rational instruction and education along the lines of sexual science if the race is to be prevented from deterioration. The subject will be further considered in the subsequent lessons in this book.

    The best advice to those who have contemplated the performance of abortion is simply this: Don’t; Don’t; DON’T!

    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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  • Medical Product Alert N°4/2020

    Medical Product Alert N°4/2020

    This Medical Product Alert relates to a number of confirmed falsified chloroquine products circulating in the WHO region of Africa. Please note that this Medical Product Alert n°4/2020 will be updated as new reports of falsified chloroquine are received and validated by WHO.

    Between 31 March and 2 April 2020, the WHO global surveillance and monitoring system on substandard and falsified (SF) medical products received nine reports of confirmed falsified chloroquine products from three countries. All reported products were identified at patient level and all have been confirmed as falsified.

    This WHO medical product alert N°4/2020 refers to nine different falsified chloroquine products, with different presentations (see Table 1). It is important to note that widespread vigilance is required from all countries, regardless of where the product was originally identified.

    Table 1: List of identified falsified chloroquine products, subject of WHO Alert N°4/2020
    table1

    All the products listed in Table 1 are confirmed as falsified, on the basis that they deliberately/fraudulently misrepresent their identity, composition or source. Indeed, it can be noted that:

    • either: the products do not contain the correct amount of the active pharmaceutical ingredient, based on the results of preliminary or full compendial analysis;
    • and/or: the products were not produced by the manufacturer whose name is stated on the product labels, and the variable data (batch number and dates) of the above products do not correspond to genuine manufacturing records;
    • and/or: the manufacturer whose name is stated on the product labels does not exist.

    Chloroquine phosphate or sulfate is referenced on the WHO Model List of Essential Medicines for the treatment of Plasmodium vivax infection (malaria). Large clinical trials are under way to generate the robust data needed to establish the efficacy and safety of chloroquine and hydroxychloroquine in the treatment of COVID-19. These medicines are currently authorized for malaria and certain autoimmune diseases and it is important that patients do not face shortages caused by stockpiling or use outside the authorized indications. 
    Both chloroquine and  hydroxychloroquine can have serious side effects, especially at high doses or when combined with other medicines.

    The SOLIDARITY trial, led by WHO, is reviewing potential treatments for COVID-19. Please refer to  WHO medical product alert n°3/2020 for general information on falsified medical products in relation to the management 
    of COVID-19.

    For photographs of products listed in Table 1, please refer to the WHO Medical Product Alert website, and 
    to the annex of this medical product alert n°4/2020 (see pages 3-7).

    WHO requests increased vigilance within the supply chains of countries likely to be affected by these falsified products. Increased vigilance should include hospitals, clinics, health centres, wholesalers, distributors, pharmacies and any other suppliers of medical products.

    If you are in possession of the above products, please do not use. If you have used these falsified products, or if you suffer an adverse reaction/event having used these products, you are advised to seek immediate medical advice from a qualified healthcare professional, and to report the incident to the National Regulatory Authorities/National Pharmacovigilance Centre.

    All medical products must be obtained from licensed, authentic and reliable sources. Their authenticity and condition should be carefully checked. Seek advice from a healthcare professional in case of doubt.

    National regulatory/health authorities are advised to immediately notify WHO if these falsified products are discovered in their country. If you have any information concerning the manufacture, distribution, or supply of these products, please contact: rapidalert@who.int. 

    WHO Global Surveillance and Monitoring System for Substandard and Falsified Medical Products
    For more information, please visit: www.who.int/medicines/regulation/ssffc/en/ 

    Annex: Photographs of falsified chloroquine products circulating in the WHO region of Africa, Medical Product Alert N°4/2020

    CAMEROON

    Photographs of confirmed falsified Chloroquine Phosphate (100mg)
    ChloroquinePhosphate250mgCameroon-1

    Photographs of confirmed falsified Chloroquine Phosphate (250mg)
    ChloroquinePhosphate250mgCameroon-2

    Photographs of confirmed falsified Chloroquine Phosphate 250mg
    ChloroquinePhosphate250mg-Cameroon 3

    DEMOCRATIC REPUBLIC OF CONGO

    Photographs of confirmed falsified CLOROQUINE 250MG
    ChloroquinePhosphate250mgDRC1

    Photographs of confirmed falsified Chloroquine Phosphate 250mg
    ChloroquinePhosphate250mgDRC2

    NIGER

    Photographs of confirmed falsified Samquine 100 (100mg)

    Samquine100-100mgNiger 1

    Photographs of confirmed falsified Chloroquine phosphate tablets B.P 100mg

    Chloroquine-phosphate-tabletsB.P100mgNiger2

    Photographs of confirmed falsified Niruquine (100mg)
    Niruquine00mgNiger3

     

    Medical Product Alert N°4/2020
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  • A meeting on digital innovations, TB and implementation research organised by WHO and the European Respiratory Society

    A meeting on digital innovations, TB and implementation research organised by WHO and the European Respiratory Society

    Group of people posing after a meeting on TB, in Geneva

    WHO’s Global Tuberculosis Programme (WHO/GTB) and the European Respiratory Society convened a technical meeting on digital innovations, TB and implementation research, in Geneva on 7 February 2020. This meeting brought together funders,
    partners, representatives of national TB programmes, civil society and scientists to discuss the challenges and opportunities when evaluating, integrating and scaling up digital technologies under programmatic settings.  Specifically, this meeting
    sought to receive input on the elements of a toolkit on implementation research that is currently being developed by WHO/GTB and the Special Programme for Research and Training in Tropical Diseases (TDR) to support evidence-informed use of
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    This present meeting, is the latest in a series of efforts by WHO/GTB to facilitate the meaningful use of digital technologies for TB prevention and care. It
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    A meeting on digital innovations, TB and implementation research organised by WHO and the European Respiratory Society
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