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Ni Hao 1 Simplified Character Revised Student
Workbook Edition Shumang Fredlein Digital Instant
Download
Author(s): Shumang Fredlein, Paul Fredlein
ISBN(s): 9781876739072, 187673907X
Edition: Revised Edition
File Details: PDF, 6.81 MB
Year: 2003
Language: english
 ①
Student Workbook

mmIlmmIbfln

ChinaSoft
你好 (1 )

d
第·
yl
…-‘ i采 中国

A Do research on China and complete the following sentences.

1. China, in Chincsc , is cal1 ed Zhδngguó (中罔)， which means

2. The Chinese nation a1 1anguage, known in English as Mandarin, is called PU的nghuà (普

通话)， which means . It is also called Hànyu (2又t吾)，

whích comes 企om the name of the majority race called the people.

3. Mandarin is used as 也 e official language by 由ree c 01!mtries/areas. They are China,

and

4. Tb e population of China is . which is about times that of

Aus甘a11a.

5. The area of China is km 2 , which 1S about times t.hat of

Australia.

6. Th e capital of China is

7. The most famous animal native to China is

8. The only man-made object visible from outer space is

9. The two m缸n rive.rs in China are and

10. Th e entombed terracotta warriors were fOlll1d in 也e city of , and

they were built ìn the reign of Emperor

 你好 (1)

B The names of rr呵。r cities and rivers in Cbilna are hidden in the puzz[e below. Find and
cir c1 e them.

H A U N G C C E R S E C K S
H U A N G H E B A H A D D S
S U G A R A R E N A T II U E飞
3

H A R B 工 N B I 工 N O O N E

E A S Y I G 工 J 工 G O H H T
N O S E S J H 工 I H H U U T
Y E S A X 工 A N O A H S A S
A R E N N A U G U 工 L I N U

N O 工 S A N D W 工 C H S G Z

G G U A N G Z H O U G H T H

E G G S J E M M A S D A D 。

G O N E 工 N H A N G Z 日 O U

S T 工 A N J I N S 工 D E S E

C H O N G Q 工 N G O I N G S

黄河 Huang He 长江 Chang Jiang 西安 Xi'an

广州 Guangzhou 北京 Beijing 哈尔滨 Harbin

沈阳 Shenyang 上海 Shanghai 南京 Nanjin

重庆 Chongqìng 天津 Tianjin 桂林 Guilin

敦煌 Dunhuang 苏州1 Suzhou 杭州，1 Hangzhou

你好 (1 )

C Refer to the cities numbered on thc map and list them in Pinyin with their important
features.

巾
H 咚哈

md闲
组
尔 .
-
川
'

m沈
m日
cakn VJ

。a
W
P
-

­
Du nhuang
敦煌
•

。挂'飞

。)--'，Ijj
C
Pínyin: Features:

2.

3.

4.

5.
 你好( ,)
D 矶Th at do you know about the Chinese language? Cboose the appropriate answer for each
questìon. There may be more than one correct answer for some .questions.
四

1. [ ] What ìs the offi ciallanguage of China?

(a) Cantonese (b) Taiwanese (c) Manda口n

2. [ ] The basis of the Chinese writing system is

(a) alphabetical (b) pictoσraphic (c) tona1.

3. [ ] The earliest Chinese writings díscovered

(a) were written over 3 ,000 years ago (b) were inscribed on oracle bones

(c) were inscribed on turtle shells.

4. [ ] Each Chinese character is pronunced as

(a) one syllable (b) two syllables (c) various syllables.

5. [ ] The style of Chinese writing currently used is

(a) simp 1ified (b) traditional (c) neìther.

6. [ ] The official sty1e of Chinese wríting i[] Ch;na js

(a) simplìfied (b) traditional (c) bo也

7. [ ] The traditional style of writing is currcntly used in

(a) China (b) Taiwan (c) overs巳as Chinese communlties.

8. [ ] The method ofwriting a Chinese character is

(a) le白 to right (b) top to bottom (c) a tick and a hook.

9. [ ]刀1e pronunciation system currently uscd in China is

(的 Wade-Giles system (b) Intemational system (c) Pinyin.

10. [ ] Apart from the nelltral tone , how many tones are therc ìn spoken Chinese?

(a) four tones (b) two tones (c) numerous tones

你好 (1 )

E Listen to the tape and choose the correct answer 怡， b ， C).

a. dà。 b. dià。 c. dài

i 王
2. a.pang b. pán c. pJan

3. a. bãi b. pãi c.bão

4. a. na b. nú C. nuo

5. a. huang b. fang C. I 益 ng

6. a. men b. fèn c. ren

7. a. zhãng b.chãng c. shãng

8. a. cal b. zài c. sal

9. a. rao b . sh益。 c.zh 益。

10. a. gual b. gãî C‘ gao

11. a. Jla b. xiã c. qla

12. a. wan b. yu 益n c.huan

13. a. xuan b. suãn c.quan

14. a. shì b. sì c. n

15. a. yong b. xiõng c. rong

16. a. rang b.shàng c.cáng

17. a.xue b. xis c. shuT

18. a. I 。 b.1 自 c.luè

19. a. liú b.lià。 c.luó

20. a. ZI b. sï C. CI

F Listen to 由e tape and choose the correct answer 怡， b , c, d).

a.yu b.yú c.yu d. yù

歹告知
2. 可 a.yue b. yué c.yue d.yuè

3.
左§ a. mao b. máo C. mao d. mào

4. fν
~~ a. nlao b. niáo <..:. nlao d. niào

5. ~)~吃
L a.gou b.g6u c.gou d.gòu
 你好 (1 )

G You have learnt that many Chinese cbaracters werc origínal1y drawings oftbe objects
they represent. The earlier the style of character, the closcr the character resembles the
J\
object

You wi 11 be given three sets of cards. The red set has the modcrn characters , the blue set
has the old style ofwrìting and the yellow set has pictures ofthe actual objects. Use the
blue cards as the bridge between the yeHow set and the red set to match the three sets of
cards. You will then be able to discover the meaning of the characters for yoursel f.

Character Old writíng Meaning Character Old wríting Meanìng

日 女

yue zl
月 子

shãn rén
山 人

shui men
水

hu 凸 ch 邑

火 车

kóu shü
口 鼠

shou Iú
手 兔

岳「

耳 羊

mu 厅la

木 马
你好 (1 )

H Circle the character that matches the picture in each 企ame .

! 七

J-l 日 平 马 火 月 山 人

矿、
F JJ 合
车 马 山 火 水 火 马 月

等写3 伊时飞丁 ~
川 全支乙
平 兔 女 兔 子 山 门 l

b 总 只
可 [且
口 子 山 手 火 木 口 日

号〉 哟 升2 在
鼠 耳 人 水 口 山 羊 耳

会 j司
生 F飞
 你好 (1 )

1 The numbers indicate the stroke order ofthe Cbinese characters. Colour each stroke
accordìng to 也e colour indicated.
),
l-red 2- orange 3 二 ye l1 0w

J Guess the meaning of the following combined characters.

l 山 7}之 2. 火车

3 口水 4.λ、口

5. 水车 6. 火山

K Write in each box the Chinese character which matches the picture.

号〉 F飞
你好 (1 )

er kè
第 - t采 你好

A Listen to the statement and choose the best answer.

b C

2. [ a C

b C

4. [ ] a b C

] a b C

6. [ ] a b C
 你好 (1 )

B This is your first meeting with 兰兰 Lánlan. Draw yourself in the oval on the right and
write your part ofthe conversation.
+

你好。

wò shl Lánlan
我是兰兰口

再见。

C Now that you can recognise some Chìnese words , write the meanÍllg ofthe following.

l 再见 2. 你好

3 老师好 4 平

5 同学们好 6 老师再见
1m 好 (1)

D This is a list of some famous Chinese people. Write theìr surnames and frrst names in the
spac臼 . Th en briefly research and report on each person.

Máo Zédδng

毛泽东 su口lame glven name

inforrnation

2. 孙逸仙 surname glven name

inforrnation

Dèng Xiaopíng
3. 邓小平 surname glven name

inforrnation

4. 蒋介石 su口lam 巳 gIVen name

information

Jìãng Qing
5. 江青 suma口le glVenname

inforrnation

Qû Yuán
obv n na m
6 . 屈原
户LV

口lw

surname

inforrnation
 fð:好 (1 )

E Choose the correct conversation for cach of thc situations givcn bclow and wrÍtc thc
十 answer in the box providcd.

再见。 你好 B 同学们好。

老师好 Q 平。

2.

4.
你好 (1)

F Write appropriate answers in the blanks to complete the following sentences.

1. The most common way Chinese greet each other is to say

2. The character 好 (good) is a combination of 女， meanmg , and 子，

meanmg

3. The reason for combining 女 and 子 to mean good is

4. ln English ，皇旦 is used for "1" ，旦旦 for "you" and is for "he" and "she". Tn Chinese , the

single word is used for a11 of the above.

5. Th ere is a common element in the characters 你，他 and 们， which is

meanmg

6. The plural word for a pronoun or a noun associated with people is

7. The plural form of 你 IS ， of 我 IS , of 1-也 lS and

。f 她 LS

8 ‘ In a Chinese name the order of thc given name and family name is

9. Instead ofusíng 1\仕 or Mrs, Chinese students address their teachers as

10. Assurnc your Chinese teacher 's surname is 白， you should call your teacher
 你好( 1 )

san yl 6r San
第 - i采 -凰 ‘"圈-

A What is ìn the picture? Colour in the pícture accordìng to the cotours indicated by the
numbers to discover the answer.
1 - green 2 - orange 3 - red 4 - white 5 - black

6 - yellow 7 - purple 8 - brown 9 - light blue

你好 (1 )

ß Draw a hne from the Chinese character to the correct match.

十
1. (a) 五九六一三 2. (a) .J\七 O 四 五

(b) 9 6 3 5 (b) 7 4 。 8

3. (a) 六四八二 4. (a) 十五六。

(b) bã sì èr sãn liù (b) wu Iiù shí líng yi

C Here are five telephone numbers. Rewrite the Chínese numbers in English and the
English numbers in Chinese.

L 六八五 九七 Te l:

2. 四五八九七
、­

一
/、 Te 1:

3. -=- J飞、 七 四 一
/、 Tel:

4. 1542109 Tel:

5. 7810563 Tel:

D Write two of yo盯 important tclephone numbers and recite them to the class.

English Chinese

2
 你好 (1 )

E Count the objects in each frame and write the answer in Chinese.
+六

西跑

F Now write the numbers 1-10 in ascending order.

你好 (1 )

G What is the picture? Join the numbered dots to find out , then colour 1t ín.

八十二
r
主享了八十四 ·六+八

·八十二
·八十 一
·八十
·七十一
·七十九
·六十七
·七十八
·七十七
.七十六
·七十四 七十五 ·六十六
•
·七十三 ·六十五

·五十七
•
•

十一 ·五十九
·五十八 ·五十一
•
·五十六 ·六十一 ·五十二
十· ·六十二 五十
·六十 .十五

六十四 ·十六
·四 二t\、/.\. ·十二 五十五
六十二 •
• • ·三十九
·五十三
•
五十四
·十七
九.
十三
十四
七·
五 ·二十 ·十九
·二 十一 ·十八 ·二十九 ·二十八

.二十一 二千五·二十七
.二十四
·二十八 四十一 ·四十
·三十
r
十
十

、穴
一二

•
三·

·三十- 四十=
十

.一四十五四十九
十
三·

·三十七 • .·四十八
四十穴
·四十二

.四十四

四十七
 {$好 (1)

H 孙悟空 Sün Wùkδng ， the monkey king , 1S half-way on his journey to the Jade
十 Temple. 阶
W川n阳hem
巩1Um
八
j 飞
你好 (1 )

1 The numbers are jumbled, rewrite them in ascending order.

十
九
l 八十，七十，四十 p 九十吉六十，五十

2. 十二 3 二十 3 八，八十，八十八?五十九

3. 六十三， 十九， 二十五， /\3 四十七

、

4. 二十，三十五 p 二十五，十五，二十，四十

5. 九， 七十二十八，二十四，十七

J These are boxes for you to play bíngo or noughts & crosses.
Other documents randomly have
different content
 In the third place, the occurrence of syphilis in little children—
partly owing to inheritance, partly, however, acquired in the way
already mentioned by casual contact—affords a striking refutation of
the above idea, which, unfortunately, still dominates and fascinates a
large circle of people.
We could adduce further arguments against this view, but what
we have said should suffice to show clearly the untenability of such
a superstition. The syphilis of one individual is not the consequence
of sexual intercourse, but the consequence of another case of
syphilis in another individual—that is to say, syphilis is a specific
infective disease, transmissible only by means of its peculiar
specific virus, and this transmission can be effected without any
sexual intercourse, by means of contacts of other kinds. Syphilis
arises only from syphilis.
We have, therefore, to attack this disease precisely in the same
manner as the other venereal diseases. As a Portuguese physician
has most aptly remarked, to the tyranny of syphilis we must oppose
the tyranny of human reason. The principal aim of a campaign
against venereal diseases will be the organization of the means
offered to us by reason and experience to cope with the disease.
The knowledge of these means must be diffused in ever-wider
circles of humanity, and care must be taken that every individual is
fully and clearly informed regarding the importance and the dangers
of syphilis and the other venereal diseases.
Here also history is our teacher, our lamp of truth, and promises
us complete success as the result of our campaign against venereal
diseases.
The results of my investigations regarding the origin of syphilis all
point to a single extremely important fact—namely, that in the case
of syphilis, and as regards the “old world,” we have to do with a
specific disease of modern times, which made its first
appearance at the end of the fifteenth century, and of the
previous existence of which, even in the most distant prehistoric
times, not the minutest trace remains. This view was held by very
eminent physicians, even before the publication of my own critical
work, based upon entirely new sources of study. Among these
authorities I may mention Jean Astruc and Christoph Girtanner, in
the eighteenth century; in the nineteenth century, the Spanish army
surgeon Montejo, and of German physicians, above all, Rudolf
Virchow, A. Geigel, von Liebermeister, C. Binz, and P. G. Unna. The
great philosopher Arthur Schopenhauer held the same view.[312]
Ricord, the celebrated French syphilologist, spoke once of a
romance of syphilis which still remained to be written. I should
rather compare it with a drama, the separate acts of which are
centuries. Of this drama, four acts have already been played. At
the present moment we find ourselves at the beginning of the
fifth act. Thus, we have an entire century before us, in which, with
all the powers placed at our disposal by scientific medical research,
by practical therapeutics, and by hygiene in association with social
measures, we must work to this end, that this fifth act shall also be
the last, as it is in the case of a proper drama.
The history of syphilis has remained so long obscure, because,
until the time of Philipp Ricord—that is to say, until the
beginning of the second half of the nineteenth century—the
three venereal diseases, syphilis, or lues, the so-called soft
chancre (venereal ulcer or chancroid), and gonorrhœa, were
regarded as essentially one disease; whereas we know to-day that
syphilis is a specific infective disease of a constitutional character,
which permeates the whole body, and must be absolutely
distinguished from the other venereal diseases, these latter being
purely local in character. This earlier belief in the identity of all
venereal infections, an error held even by so great an authority as
John Hunter, who was misled by falsely interpreted experiments,
renders it necessary that the historical side of the question should be
considered also from this point of view.
If gonorrhœa and chancroid were of a syphilitic nature, then
certainly syphilis must have existed from very early times. It would
not be difficult to refer to syphilis some descriptions and accounts of
diseases of the genital organs given by the ancient and medieval
writers. It was the progressive enlightenment regarding the essential
differences between the three venereal diseases which first proved
the untenability of such opinions; we were further assisted by the
knowledge of pseudo-venereal and pseudo-syphilitic diseases
which we have obtained from modern dermatology. Moreover, in the
old world syphilitic bones belonging to ancient or medieval times
have never been discovered.[313] The first syphilitic bones date from
after the time of the discovery of America. They appear, above
all, after the outbreak of the great epidemic of syphilis which
followed the Italian campaign of King Charles VIII. of
France, in the years 1494 and 1495; it was then that syphilis
first became diffused in the old world.
In my work on “The Origin of Syphilis” (Jena, 1901),[314] I have
adduced proof, basing my views upon the criticism of older opinions,
and assisted by the utilization of very abundant new sources of
material, that syphilis was first introduced into Spain in the years
1493 and 1494 by the crew of Columbus, who brought it from
Central America, and more especially from the island of Hayti; from
Spain it was carried by the army of Charles VIII. to Italy, where it
assumed an epidemic form; and after the army was disbanded the
disease was transported by the soldiers to the other countries of
Europe, and also was soon taken by the Portuguese to the Far East,
to India, China, and Japan. At the time of its first appearance in the
old world, syphilis was extraordinarily virulent. All the morbid
phenomena produced by the disease had a more rapid and violent
course than at the present day; the mortality was much higher; the
consequences, even when a cure was effected, were much more
severe. This virulence of syphilis at the time of its first introduction
can only be explained, in accordance with our modern views of the
nature and mode of appearances of the disease, by the fact that the
nations of the old world (who, nota bene, were all attacked with
equal intensity) had, until that time, been completely free from
syphilis. All classes of the people and all nations were visited by
syphilis to an equal extent and with the same violence.
Even to-day we observe everywhere, when syphilis is introduced
into regions which have hitherto been free from the disease, that it
has the same acute course, the same violence of morbid
manifestations, that characterized its first appearance in Europe. In
the four centuries that have elapsed since its introduction into
Europe there has occurred a gradual mitigation of the syphilitic
virus, or rather a certain degree of immunization of European
humanity against the disease. Speaking generally, syphilis has to-day
—in comparison with that earlier time—a relatively mild course. To
this point we shall return later.[315]
The two other venereal diseases, gonorrhœa and chancroid,
unquestionably existed in Europe in the days of antiquity. But they
also are specific infective diseases, and are only produced by the
virus peculiar to each, just as syphilis has its own peculiar virus.
Ricord (1800-1889), in the years 1830 to 1850, proved the
complete diversity of syphilis and gonorrhœa, established the
doctrine of the three stages of syphilis—primary, secondary, and
tertiary—and, finally, taught us to distinguish the soft, non-
syphilitic chancre (chancroid) from the hard, syphilitic
chancre. Virchow, in his celebrated essay on “The Nature of
Constitutional Syphilitic Affections” (Virchow’s Archiv, 1858, vol. xv.,
p. 217 et seq.), then threw a clear light on the peculiar course of
constitutional syphilis and on the causes of the occasional
disappearance and sudden reappearance of the morbid phenomena.
Hitherto, however, our knowledge of venereal diseases had rested
on an extremely insecure foundation; and the truly scientific
study of the subject may be said to have begun in the year 1879,
with Albert Neisser’s epoch-making discovery of the gonococcus as
the specific exciting cause of gonorrhœa. In the years 1889 to 1892
there followed the discovery of the bacillus of chancroid by
Ducrey and Unna, by means of which discovery the complete
distinction between the soft and the hard chancre was definitely
proved; and, finally, the three years 1903 to 1906 were
characterized by remarkable discoveries, the full importance of
which is not as yet fully realized, regarding the nature of the
syphilitic virus. In the year 1903 Eli Metchnikoff succeeded in
transmitting syphilis from human beings to apes, and thus laid the
foundation for progressive research regarding syphilis by means of
experiments on animals; this was carried further by Lassar, by the
inoculation of the syphilitic virus from one ape to another, and also
by A. Neisser in his experimental researches in Java;[316] and in
March, 1905, the Berlin protozoologist Fritz Schaudinn, since
prematurely lost to the world of science, published his first studies
on the probable exciting cause of syphilis, the so-called
“spirochæte pallida.” Numerous subsequent investigations have
established the connexion between this spirilla-form, belonging to
the order of protozoa, and syphilitic disease. In this way we have
been brought notably nearer to the discovery of the certain cure of
syphilis and to the discovery of means of immunization against the
disease. In this direction quite new views are opening before our
eyes.[317] Numerous ideas suggested by recent discoveries in the
province of syphilitic research are described in the admirable essay
by J. Jadassohn, “Contributions to Syphilology,” published in the
German “Archives for Dermatology and Syphilis,” 1907. Cf. also the
account of the recent doctrines regarding syphilis by P. G. Unna and
Iwan Bloch, “Die Praxis der Hautkrankheiten,” pp. 548-592 (Vienna
and Berlin, 1908).
When some day humanity has been freed from the “sexual
plague,” from the hydra of venereal diseases, and when a
monument is erected to the liberators, four names will there be
commemorated: Ricord, Neisser, Metchnikoff, and Schaudinn!
After these preliminary remarks on the nature of venereal
diseases, I proceed to a short description of them, and I begin with
the most dangerous of all the venereal diseases, syphilis.[318]
The first manifestations of syphilis make their appearance about
three or four weeks after infection, at the place at which infection
has occurred, and this is not in every case the genital organs. It is
true that syphilis is most commonly transmitted by means of sexual
intercourse, but frequently also by contacts of other kinds—for
example, by kissing; by gynecological or surgical examinations and
operations; by drinking from a glass which has previously been
used by some one suffering from syphilis; by the use of uncleansed
pocket-handkerchiefs, towels, and bedding, which have been used
by a syphilitic patient; by the use of tobacco-pipes, wind-
instruments, tooth-brushes, tooth-picks, a glass-blower’s
mouthpiece, etc., belonging to strangers; by an uncleansed razor;
by the nasty habit of licking the point of a pencil; by moistening
postage-stamps with the tongue; by sucking the wound in
circumcision; by the suckling of the infant at the breast of a
syphilitic wet-nurse, etc.[319] In England the custom, when taking
a judicial oath, of kissing the Bible has repeatedly sufficed to
transmit syphilitic infection.
In certain districts in which the level of civilization is a low one—
as, for example, in some parts of Russia and of Turkey—as many as
50 to 60 % of all infections occur independently of sexual
intercourse.
All the discharges from syphilitic lesions in all three stages of the
disease are infective. The infective character of the tertiary stage of
syphilis was formerly doubted, but has recently been proved beyond
dispute. Blood also, although more rarely, can prove infective. On
the other hand, the pure secretions—that is, the physiological
secretions, not contaminated by morbid products—such as the
saliva, tears, and milk, are not infective. Syphilis is, however, very
frequently transmitted by means of the semen.
Infection occurs in places in which there is a solution of continuity
of the skin or mucous membrane, such as a scratch or a superficial
wound, through which the virus can enter. In this way an apparently
healthy syphilitic patient—when, for example, he gets a small
abrasion on the penis (or, in the case of a woman, in the vagina)—
can transmit syphilis if the other individual also has a similar
abrasion through which infection can occur.
As we have said, it is not till the lapse of two to four weeks after
infection has occurred that the first manifestations of syphilis appear,
in the form of a small vesicle or nodule in the infected area; less
often merely an abraded area of a peculiar red colour. Gradually this
nodule or area enlarges, and becomes continually harder at the
base, whilst the surface often undergoes ulceration, and secretes
extremely infective pus (the so-called “hard chancre” or “primary
lesion”[320]).
This induration is in most cases a certain sign that the syphilitic
virus has already entered the body; at least, it has only been
possible in a few very rare cases, by excision or cauterization of the
hard chancre, to prevent syphilis from entering the blood. Almost
always, notwithstanding such endeavours, the manifestations of
general infection of the body soon appear.
From the place of infection—that is, from the place at which the
hard chancre forms—the syphilitic virus next passes by way of the
lymph-stream into the inguinal glands, so that these, in the third or
fourth week after the appearance of the hard chancre, begin to swell
and to become hard. This swelling of the inguinal glands is painless
(the so-called “indolent bubo”), in contrast to the painful swelling
which accompanies the soft chancre. From this region the poison
now proceeds by way of the bloodvessels and lymph paths on its
wanderings all over the body, the individual stages of which can be
detected by swellings of the lymph-glands of the axilla, the elbow,
the neck, etc. Sometimes other symptoms of general infection are
noticeable; above all, the appearance of fever (never earlier than
forty days after infection), pains in the muscles, joints, nerves, also
severe headaches, a general feeling of lassitude, pallor, and a
falling-off in the nutritive condition.
These are the forerunners of the so-called secondary stage of
syphilis, which now manifests itself by the appearance of a multiform
skin eruption, rendering the diagnosis of syphilis absolutely
certain. For this reason, in doubtful cases of ulceration of the genital
organs the patient should inspect his skin very carefully every day
for several weeks or months, and keep watch for the appearance of
red spots or nodules. This syphilitic eruption on the skin is also in
the later periods one of the most certain and most characteristic
insignia of the disease.
The eruption commonly appears first on the trunk, in the form of
rose-coloured spots (the so-called “roseola syphilitica”), spreads
thence over the whole body, and in many cases, simultaneously with
or shortly after the spotted eruption, nodules appear on the skin,
and marked thickenings form on the mucous membranes, especially
at the anus, in the mouth, and on the tongue (the so-called
“plaques muqueuses,” or “condylomata”). The patient’s
attention is spontaneously directed to these lesions by painful
sensations in the mouth or by itching of the anus. Often it is these
painful sensations, associated with a violent inflammation of the
tonsils and pharynx (the so-called “angina syphilitica”), which first
lead the patient to consult a doctor, after all the earlier symptoms
have passed by unnoticed! As characteristic forms of the secondary
syphilitic changes in the skin must, therefore, be mentioned the so-
called “corona Veneris,” by which distinguished name is denoted
an eruption on the forehead, especially along the margin of the hair,
which by members of the laity is easily confused with other
affections of the skin common in this locality; the so-called “collier
de Venus,” or leukoderma syphiliticum, a peculiar pigmentation
of the skin on the throat and the back of the neck in the form of
brown patches with white intervening areas. This symptom,
which occurs almost exclusively in women, is an absolutely
certain sign of syphilis. Equally characteristic is the so-called
“syphilitic psoriasis,” the appearance of peculiar patches and
thickenings on the palms of the hands and the soles of the feet;
characteristic also is the syphilitic loss of hair, by its sudden onset
and by the patchy way in which it occurs. Not rarely do we see
purulent eruptions on the skin in this secondary stage of syphilis.
The syphilitic eruption of the skin is only an external manifestation
of a disease affecting the entire body, for the internal organs also
suffer. The affection of the liver manifests itself by jaundice; that of
the brain and the meninges by headaches and by weakness of
memory, which is often well marked at this stage; that of the
spleen by swelling; that of the kidneys by the appearance of albumin
in the urine; that of the bones by very painful inflammatory
swellings; that of the eyes specially by the well-known syphilitic
iritis (60 % of all inflammations of the iris are syphilitic in nature!).
If the disease remains untreated, the appearances just described
become more general and continually more severe; and after some
time, quite new morbid symptoms are superadded (often as early as
the third year, on the average five to ten years after infection, but
also later), resulting from the transformation of the syphilitic morbid
process into the tertiary stage. To these new manifestations belong
the appearance of large nodules in the skin and other organs,
which sooner or later undergo ulceration, the so-called “syphilitic
gummata”; their ulcerative destruction may entail the greatest
disfigurement or danger to life—for example, perforation of the hard
palate; sinking of the bridge of the nose (the syphilitic “saddle-
nose”); ulcerative destruction of large portions of the bones of the
skull, of the intestine, of the liver, the lungs, the testicles, the
bloodvessels (especially dangerous are gummous diseases of the
bloodvessels of the brain), the brain, and the spinal cord.
Apoplectic strokes occurring in comparatively young persons and
nervous paralysis of the most various kinds, as well as sudden
deafness and blindness, are in most cases referable to syphilitic
disease. Many chronic diseases of the liver, kidneys, and nervous
system, are consequences of previous syphilis; also calcification of
the arteries, the very dangerous dilatation of the great
bloodvessels, especially of the aorta (aneurism of the aorta), are
very often of syphilitic origin.
By the researches of Alfred Fournier and Wilhelm Erb, we know to-
day that two severe diseases of the central nervous system—tabes
dorsalis or locomotor ataxy, and general paralysis of the
insane (paralytic dementia)—are almost always (in about 95 %
of the cases) referable to earlier syphilis. Among 5,749 cases of
syphilis encountered in his own private practice, Fournier observed
no less than 758 cases of brain syphilis, 631 cases of tabes, and 83
cases of softening of the brain. Tabes and general paralysis of the
insane are all the more dangerous because they are no longer,
properly speaking, “syphilitic” diseases, and therefore they cannot be
cured by antisyphilitic treatment; they are severe degenerative
changes of the central nervous system, which has been, as it were,
prepared for their occurrence by the previous syphilis. These belong
to the class of the so-called “parasyphilitic” diseases in which
antisyphilitic treatment has little or no good effect.
Even more tragic are the consequences of syphilis to the family,
the offspring, and the race. Syphilis in married life, congenital
syphilis, and the degeneration of the race by syphilis—these
are the tragic manifestations which come under consideration in this
connexion.
In his admirable work on “Syphilis and Marriage,” Alfred Fournier,
the greatest living authority on syphilis in all its manifestations and
relationships, has described the momentous influence exercised by
syphilis in conjugal life; and in his recently published work, “Syphilis
a Social Danger,” he has dealt also with congenital syphilis and racial
degeneration. He found that, on the average, among 100 women
suffering from syphilis, 20 had been infected by their husbands,
either at the very commencement of married life, or in its later
course, or finally through the offspring after conception. Divorce on
the ground of syphilitic infection by the husband is at the present
day of frequent occurrence.
The transmission of syphilis to the child by inheritance may be
effected either by the father or the mother; when both the father
and the mother are syphilitic, it occurs with absolute certainty. The
various possibilities of transmission, and the contingent immunity of
mother or child, as they are expressed in Colles’s law (Baumès’s
law), and in Profeta’s law, cannot here be further dealt with. If the
mother has herself been infected with syphilis, or if she was
previously syphilitic, either the child is not carried until term,
abortion or miscarriage ensuing, or, finally, it is born with symptoms
of congenital syphilis.[321]
The frequent occurrence of premature births and still-births in any
family suggests strong suspicions that they are due to syphilis. The
general mortality of the children in a family is regarded by
Fournier as an important sign to the physician of congenital syphilis.
Syphilitic infection of the father gives rise to a mortality in the
children of 28 %; syphilis in the mother causes a mortality in the
children of 60 %; when the disease affects both parents, the
mortality among the children amounts to 68 %. Absolutely
astounding is the mortality of the children of syphilitic prostitutes; it
amounts to from 84 to 86 %.
Children born alive, suffering from congenital syphilis, are
generally weakly,[322] of deficient body-weight; have often a flaccid,
wrinkled skin, covered with typical syphilitic eruptions, and
frequently with great purulent vesicles, especially on the palms of
the hands and the soles of the feet (“pemphigus syphiliticus”); the
internal organs also, the spleen, the liver, and the bones, exhibit
morbid changes. Characteristic is the syphilitic affection of the upper
air-passages, especially the syphilitic “cold in the head” (syphilitic
rhinitis—“snuffles”), of new-born congenitally syphilitic children.
Congenital syphilis further gives rise to severe disturbances of
development and to phenomena to which Fournier has given the
name of “late syphilis” (“syphilis hereditaria tarda”), because they
first make their appearance in the later years of life.[323] Permanent
debility, arrest of development, stigmata of degeneration, in
the form of various malformations—as, for example, notching of
the edge of the upper central incisor permanent teeth (a symptom
first described by Jonathan Hutchinson), malformations of the nose,
the ears, and the palate, dwarfing, deaf-mutism, malformations of
the external and internal reproductive organs, rickets,[324] epilepsy,
and mental weakness—are the consequences of congenital syphilis.
Tarnowsky, Fournier, and Barthélémy have traced the consequences
of congenital syphilis into the second and third generation, and so
have discovered an important cause of racial degeneration. Syphilis
in the grandfather can still exercise its disastrous influence in the
grandson, and give rise to the above-mentioned stigmata of
degeneration.[325] Indeed, congenital syphilis of the second
generation often appears with the same severity as that of the first
generation; and, like acquired syphilis, congenital syphilis in women
can cause a predisposition to miscarriages and still-births.
According to statistics obtained by Edmond Fournier, relating to
11,000 cases of syphilis (10,000 men, 1,000 women) from the
private practice of his father, Alfred Fournier, regarding the age at
which infection occurs, it appears that in men it most commonly
occurs between the ages of twenty and twenty-six years (the
maximum number of infections during the twenty-third year); in
women, between the ages of eighteen and twenty-one; 8 % of
syphilitic males and 20 % of syphilitic females were infected before
the age of twenty years. Syphilis is to a considerable extent at the
present day a disease of inexperienced youth. This fact is
important in relation to the problem of prevention and the problem
of enlightenment.[326]
Of much less importance than syphilis is the purely local soft
chancre, or chancroid, which never results in general infection.
Chancroid is produced by a specific exciting cause, a chain-forming
bacillus (streptobacillus), Bacillus ulceris cancrosi, which is found in
the pus secreted by the ulcer. One or two days after infection, a
small pustule forms at the site of inoculation, generally on the
external genital organs. This pustule soon bursts, and a deeply
hollowed ulcer makes its appearance, which usually undergoes rapid
increase, and frequently, owing to the infective character of the pus,
gives rise to new chancres in the neighbourhood of the original one,
so that the soft chancre is commonly multiple. When suitably treated
with antiseptic powders and cauterization, chancroid usually heals
quickly; there are, however, very dangerous varieties of chancroid—
for instance, the serpiginous chancre, which continues to creep
irresistibly forward; and the phagedænic or gangrenous chancre,
which puts the skill of the physician to the utmost test. A less
dangerous but extremely disagreeable complication of chancroid is
inflammation of the inguinal glands, most commonly only on one
side; this painful “bubo” (painful in contrast with the painless
syphilitic bubo) has a well-marked tendency to suppuration. If this
occurs, and the pus finds its way to the surface, fistulas and new
chancrous ulcers are liable to occur at the place where it opens. By
rest in bed, the inunction of iodide ointment, the application of cold
compresses, the injection into the bubo of a solution of nitrate of
silver, and the internal use of iodide of potassium, this unfortunate
course may be prevented.
A remarkable change of views has, in the course of the last
thirty years, taken place in respect of the nature and importance of
gonorrhœa.[327] Whereas formerly this was regarded as a
comparatively harmless disease, we know to-day that gonorrhœa in
the male, and still more in the female, gives rise to tedious dangers
and painful morbid phenomena, and is the source of unspeakable
sorrows, and of the miserable ill-health of numerous women, and
that it is the chief cause of sterility in both sexes.
Gonorrhœa is principally a disease of the mucous membrane,
and is, in this way, distinguished from syphilis, which is a general
disorder, diffusing itself by way of the bloodvessels. In rare cases,
indeed, gonorrhœa can exhibit general morbid manifestations, the
so-called gonorrhœal rheumatism, gonorrhœal affections of the
spinal cord and of the heart, and gonorrhœal nervous troubles, all of
which are so rare, that for practical purposes they can be left out of
consideration.
The typical seat of gonorrhœa is the mucous membrane of the
urinary and the genital organs of the male and the female; in
the male affecting chiefly the urinary organs, and in the female
affecting chiefly the genital organs. The cause of genuine
gonorrhœa is always infection, the transmission from one human
being to another of the purulent inflammation produced by the
gonococcus discovered by Neisser in 1879. Simple urethral
inflammations with a purulent discharge also occur in which no
gonococci are found. These arise also from infection, but their actual
exciting cause has not yet been discovered. Not less obscure is the
relationship of many of the irritants giving rise to simple urethral
catarrh—for example, that which is active during menstruation—to
the supposed exciting cause. In any case, these simple catarrhs
have a very mild course, and undergo a cure after a few days or
weeks, spontaneously or as a result of treatment with mild
injections.
Quite otherwise is it with genuine gonorrhœa. In the male it
begins from two to six days after the infective intercourse, with a
burning sensation on passing water, itching at the urethral orifice,
which very easily becomes reddened, and this is soon followed by
the discharge, either spontaneously or as a result of pressure on the
urethra, of a thick fluid, at first mucous, later purulent, and then of a
yellow or a greenish colour. Inflammation, discharge, and pain, the
latter especially in association with urination, increase during the
subsequent weeks; in addition, in a good many cases there are
slight fever, lassitude, and mental depression, and the patient is
tormented, especially during the night, by violent, painful erections.
In exceptional cases there are hæmorrhages from the urethra (the
so-called “Russian clap”). In some cases the disease terminates
favourably; this is especially observed after the first attack of
gonorrhœa. As early as the third week the above symptoms become
less severe, and in the fourth or sixth week after infection the whole
morbid process may come to an end, the discharge ceases, the urine
becomes clear once more, and, in fact, definite cure of the
gonorrhœa ensues.
But the number of those who are so fortunate is comparatively
small. In the majority of cases, there are other morbid phenomena
and complications; the gonorrhœa becomes “subacute,” and later
“chronic.” Ricord wrote many years ago: “When anyone has once
acquired gonorrhœa, God only knows when he will get well again!”
Happily, this pessimism is no longer fully justified at the present day;
but it is a fact that in the majority of cases even to-day gonorrhœa
is a very obstinate, wearisome illness, a long-continued burden, not
only for the patient, but also for the doctor. The gonococci proliferate
in the deeper layers of the mucous membrane, and pass upwards
into the posterior part of the urethra, this latter migration being
manifested especially by frequent and painful strangury; further,
the bladder, the prostate gland, and the epididymis may be
attacked. Bilateral epididymitis has often serious consequences as
regards the procreative capacity. In about 50 % of the cases
incapacity for fertilization (impotentia generandi) has resulted.
If the gonorrhœa becomes chronic, thickenings occur in isolated
portions of the urethral mucous membrane; the urine remains turbid
for a long time; the discharge, it is true, becomes scantier, but
shows itself with the most annoying persistency every morning as
soon as the patient leaves his bed, in the form of the so-called “bon
jour” drops in the meatus; there are also troubles connected with
the prostate (painful sensations, especially during defæcation), and
symptoms of stricture of the urethra may occur. Very often, also,
relative impotence and severe sexual neurasthenia are observed, as
consequences of chronic gonorrhœa. Worst of all is the long
duration of the infectivity. There is always the danger that
somewhere or other some gonococci may remain hidden, and, given
an opportunity, may start the process all over again, or may transmit
the infection to another person. Zweifel reports a case in which a
man actually infected a woman thirteen years after he had first
acquired gonorrhœa!
 The infection of a woman with gonorrhœa, as we know to-day, is
a disaster. It is the immortal service of the German-American
physician Noeggerath that, in the year 1872, he proved that the
majority of the stubborn “diseases of women” were nothing more
than the consequences of gonorrhœal infection. Gonorrhœa selects
by preference the internal reproductive organs of woman; upon the
extensive mucous membranes of these organs the gonococci find
the most favourable conditions for their persistent life; they find a
thousand out-of-the-way comers and hiding-places, where they can
elude the therapeutic activity of the physician.
“They grow luxuriantly, like a weed which it has not been possible to uproot,
over the entire surface of the genital mucous membrane, attacking with the same
vigour the mucous membrane of the uterus and that of the Fallopian tubes. In
women, as in men, they induce ulceration, they cause adhesions, and they give
rise to sterility. But in the case of women, something further must be added—that,
namely, this disease has upon them a miserably depressing effect, and that, in
contradistinction from men, they are likely to suffer for many years from intense
pains. Whenever they execute certain bodily movements, it may be during ten
years in succession, they experience pains, often horribly severe, and in most
cases they are condemned to a life of deprivation and misery—not usually for any
fault of their own, since most women are infected by their husbands” (Zweifel).

Gonorrhœa in women, attacking successively the vagina, the

uterus, the Fallopian tubes, the ovaries, and the peritoneum, is a
true martyrdom, a hell upon earth. Sick in body and in mind, these
unhappy women drag out a miserable existence; and to them so
often the last consolation, that of motherhood, is denied, for
gonorrhœa is the most frequent cause of sterility in woman.
Patients infected with gonorrhœa further run the danger of
blindness, by transference of the gonorrhœal virus to the eye. This
is one of the most distressing of the possible results of the disease.
New-born children whose mothers are infected with gonorrhœa are
during birth exposed to the same danger of eye infection, as they
pass down the genital passage. In earlier days a very large
proportion of the blind were persons who had lost their sight in this
way very shortly after birth. Since Crédé advocated the admirable
method of introducing nitrate of silver solution into the conjunctival
sacs of new-born children, gonorrhœal inflammation of the eye has
become one of the greatest rarities.

APPENDIX
VENEREAL DISEASES IN THE HOMOSEXUAL
It is an old belief, shared by the homosexual themselves, that
venereal infections are extremely rare among them. If male
homosexual persons had sexual intercourse only with one
another, this assumption would be in some degree plausible. For
the principal focus of venereal infection is feminine prostitution, by
which venereal diseases are transmitted to heterosexual men. But
since these homosexual men often undertake sexual acts with
heterosexual men—apart from occasional sexual intercourse with
women—a priori there is a possibility of infection in their case, and
such infection is, in fact, observed. Above all, many male prostitutes
also indulge in intercourse with women, and thus diffuse venereal
troubles among homosexual men.
It is obvious that syphilis can be diffused among the homosexual
as easily as among the heterosexual, for syphilis is transmitted by
many varieties of contact—by kisses, other caresses, etc. But how is
it as regards gonorrhœa?
In the case of heterosexual men and women gonorrhœa is almost
exclusively transmitted by the sexual act, by the introduction of the
male penis into the female vagina. The analogous act between men
—that is to say, pæderasty, immissio penis in anum—is
unquestionably far rarer than the ordinary sexual act between men
and women; it is commonly replaced by mutual onanism, by kisses
and other caresses, and quite frequently by coitus in os. This last is
much commoner than genuine pædication. Of gonorrhœa of the
rectum produced by pædication when the active man is suffering
from gonorrhœa, we very rarely hear. But is there, in the case of
homosexual men, any possibility of gonorrhœal infection due to
coitus in os?
There can be no doubt that typical gonorrhœa of the mouth
occurs. The observations of Kuttler, Atkinson, Rosinski, Dohrn, and
Kast, have proved it.[328] Horand and Cazenave have even observed
gonorrhœal infection of the urethra as a result of oral coitus![329] A
homosexual patient told me that some years before, after coitus in
os with a man, he had for several weeks had a discharge from the
urethra, which spontaneously ceased, and therefore cannot have
been genuine gonorrhœa, but only urethritis resulting from infection
by contagious angina. In the case in question, the urethral catarrh
was certainly due to the coitus in os, since any other sources of
infection could be excluded.
On the other hand, in a second case an apparently gonorrhœal
infection of the oral cavity was transmitted from the urethra.
A homosexual man, forty-five years of age, one day allowed a heterosexual
man to perform coitus in os on him. Some days afterwards he experienced
difficulty in swallowing, was feverish, and saw in the looking-glass that the uvula
was swollen. A specialist for throat troubles diagnosed merely a catarrhal infection.
The illness became worse, and a second throat specialist detected the presence of
a purulent angina of both tonsils, ordered painting with argentamin, also vapour
baths, and an astringent gargle, whereupon the affection gradually subsided. Six
weeks later the patient had swelling and pain in the joints of the right knee and
foot; under cold compresses these swellings subsided after a fortnight. Of the
whole trouble nothing now remains.

This description, on the part of a patient who is thoroughly

trustworthy, aroused strong suspicion of a gonorrhœal angina,
with a consecutive gonorrhœal arthritis. Unfortunately, the purulent
discharge from the tonsils was not examined for gonococci by either
of the physicians in attendance. The case remains, anyhow, very
remarkable.
In the case of homosexual women, it is obvious that syphilis, and
also gonorrhœa, can be transmitted, the latter by mutual friction of
the genital organs. I do not know what actually occurs in practice.
[312] Cf. Iwan Bloch, “Schopenhauer’s Illness in the Year 1823. A
Contribution to Pathography based upon an Unpublished
Document.” Published in Medizinische Klinik, 1906, Nos. 25 and 26.
(This gives an account of all Schopenhauer’s utterances regarding
syphilis.)
[313] At a meeting of the Société d’Anthropologie de Paris, held on April
19, 1906, I read a paper on “La Syphilis Prétendue Préhistorique,” in
which I discussed this question. The important question of ancient
bones is further considered in the second volume of my work on
“The Origin of Syphilis,” pp. 317-364 (now in the press).
[314] The results of this study I have briefly epitomized in an address
given before the Social Science Congress in Berlin, entitled “The
First Appearance of Syphilis in Europe” (Jena, 1904).
[315] Regarding the gradual acquirement (by means of natural selection)
of immunity to epidemic diseases, the works of Archdall Reid may
be most profitably consulted (“The Present Evolution of Man,”
London, 1896; “The Principles of Heredity,” London, 1905). Dr.
Reid’s views on the part played in human history by the
transference of diseases from immunized to non-immunized races
are of especial interest. Unfortunately, as regards syphilis, he
accepts Hirsch’s erroneous statements relative to the antiquity of
that disease, and its origin in the eastern hemisphere (see also p.
384, note [346]).—Translator.
[316] Cf. A. Neisser, “The Experimental Investigation of Syphilis as it
Stands at the Present Day” (Berlin, 1906).
[317] Cf. Erich Hoffmann, “The Etiology of Syphilis” (Berlin, 1906); Hans
Hübner, “Recent Researches into the Nature of Syphilis,” published
in the Journal for the Suppression of Venereal Diseases, 1906, vol.
v., pp. 468-481.
[318] I must not omit allusion to some recent admirable works on
venereal diseases: A. Blaschko, “Venereal Diseases”—a popular
exposition—(Berlin, 1904); Paul Zweifel, “Venereal Diseases and
their Importance to Health” (Leipzig, 1902); Alfred Fournier,
“Syphilis a Social Danger”; Karl Ries, “Blameless Sexual Infection”
(Stuttgart, 1904); O. Burwinkel, “Venereal Diseases” (Leipzig,
1905); Waldvogel, “The Dangers of Venereal Diseases and their
Prevention” (Stuttgart, 1905). In view of the large number of
popular works on venereal diseases, those without professional
knowledge should confine themselves to the best names, because
in this province trashy literature is extraordinarily abundant, and by
 the false and erroneous views it diffuses, it does much more harm
than good. The writings mentioned in this note I am able to
recommend as thoroughly scientific and trustworthy.
[319] Galewsky, “The Transmission of Venereal Diseases in the Suckling of
Children,” published in the Journal for the Suppression of Venereal
Diseases, 1906, vol. v., pp. 365-371.
[320] It is true that such a hardening may also occur in other non-
syphilitic affections of the genital organs—for example, when they
are peculiarly situated or as a result of cauterization. Only the
physician can determine whether in such a case syphilitic infection
has actually occurred.
[321, 322] According to English experience, the congenitally syphilitic child
rarely exhibits any sign of syphilis when born. Thus, Hutchinson
writes (“Syphilis,” p. 73): “At the time of birth, the congenitally
syphilitic infant almost invariably has a clear skin, and appears to be
in perfect health.” According to Osler also (“Medicine,” sixth edition,
p. 269): “The child may be born healthy-looking or with well-
marked evidence of the disease. In the majority of instances the
former is the case, and within the first month or two the signs of
the disease appear.”—Translator.
[323] Cf. the recently published admirable work of Edmond Fournier,
“Recherches et Diagnostic de l’Hérédo-Syphilis Tardive” (Paris,
1907).
[324] Parrot regarded rickets as a manifestation of congenital syphilis, but
this view has never found acceptance in England. Hutchinson
remarks (“Syphilis,” p. 408): “The typical forms of rickets are
constantly met with in conditions which do not lend the slightest
support to the suggestion of syphilis.” As Cheadle remarks: “Syphilis
modifies rickets; it does not create it.”—Translator.
[325] This view must be accepted with reserve. See, for instance, Osler’s
“Medicine,” sixth edition, p. 271: “Is syphilis transmitted to the third
generation? The general opinion is opposed to this view.
Occasionally, however, cases of pronounced congenital syphilis are
met with in the children of parents who are perfectly healthy, and
who have not, so far as is known, had syphilis, and yet, as
remarked by Coutts, who reported such a group of cases, they do
not bear careful scrutiny. The existing difference of opinion is well
illustrated in the account by G. Boeck (Berl. Klin. Wochenschrift,
September 12, 1904) of four instances of hereditary lues in the
second generation, while in the same journal Jonathan Hutchinson
 expresses his belief that syphilis is not transmitted to the third
generation.”—Translator.
[326] As more important scientific works on syphilis I must mention that
of Isidor Neumann (Vienna, 1899, second edition), containing the
entire bibliography of the subject; that of Joseph Lang (Wiesbaden,
1896, second edition); but, above all, the epoch-making work of
Alfred Fournier, “Traité de Syphilis” (Paris, 1898)—English
translation, Fournier, “The Treatment and Prophylaxis of Syphilis”
(Rebman Ltd., London, 1906).
[327] The most important scientific work on gonorrhœa is that of Ernest
Finger, “Blennorrhœa of the Sexual Organs,” fifth edition (Leipzig
and Vienna, 1901).
[328] Cf. M. von Zeissl, “Diagnosis and Treatment of Venereal Diseases,”
third edition, pp. 171, 172 (Berlin and Vienna, 1905).
[329] Op cit., p. 172.
 CHAPTER XV
PROPHYLAXIS, TREATMENT, AND
SUPPRESSION (BEKÄMPFUNG) OF VENEREAL
DISEASES

“The friend of humanity may with some confidence

anticipate a gradual diminution in the prevalence of venereal
diseases, and may hope for their complete extinction in a not
too distant future. All that is requisite for the attainment of
this end is that those engaged in the study and practice of
general hygiene, and those concerned in the safeguarding of
public morality, should not weary in their efforts; and that
scientific research should pursue its aims firmly and clearly,
uninfluenced by the tyranny of custom, and independent of
prejudice.”—K. F. Marx.

CONTENTS OF CHAPTER XV
The suppression of venereal diseases — Organization of the campaign against
them — International Conference in Brussels — Foundation of the German
Society for the Suppression of Venereal Diseases — Three methods of
carrying on the campaign against venereal diseases.
Personal Prophylaxis against Venereal Diseases: Rôle of cleanliness — The
preputial secretion and balanitis — Importance of circumcision — Technique
of the cleansing of the genital organs before and after sexual intercourse —
Examination for disease — Dangers of repeated coitus — Special protective
 measures — The condom — Varieties and technique of its use — The
instillation of solutions of silver salts — Their relative value — The inunction of
fat — Metchnikoff’s ointment for the prevention of syphilis — Antiseptic
washings — The public advertisement of protective measures — Legal
protection against venereal infection — Opinions of legal authorities on this
subject (von Liszt, von Bar, Schmölder).
The Suppression of Venereal Diseases by Medical Treatment: Favourable
conditions as regards syphilis — Mitigation of the syphilitic virus — Mercury
and its importance — A “triumph of medicine” — Methods of employing
mercury in the treatment of syphilis — Mode of action of the mercury cure —
Means for the after-treatment of syphilis — Curability of syphilis — Treatment
of gonorrhœa — Necessity for microscopical examination and the scientific
methods to be employed — The different modes of treatment — The
determination of the cure of gonorrhœa — Facilitation of the treatment of
venereal diseases for the great mass of the public — “Krankenkassen”[330] and
venereal diseases.
State Action and Public Action in the Campaign against Venereal Diseases:
Statistics of venereal troubles — Blaschko’s researches — Frequency of
venereal diseases in Denmark — Among various classes in Germany —
Prussian statistics of April 30, 1900 — Conclusions deducible from these
statistics — The different sources of infection — Prostitution the principal
source of infection — Danger of youthful prostitutes — Measures to be taken
by the State against the diffusion of diseases by prostitution — Regulation —
Criticism of this measure — Its illegality — Its uselessness and its dangers —
Favourable results of the withdrawal of “moral control” — Prostitution and
crime — Soutenage — Criticism of Lombroso’s theory of the relations between
prostitution and criminality — The brothel question — Diminution in the
number of brothels — Dangers of brothels — Brothel streets and the limitation
of prostitution to definite quarters — Proposals for the examination of the
male clientèle — Criticism of these proposals — The true way towards the
suppression of prostitution.

CHAPTER XV
The motto which I have placed at the head of this chapter on the
campaign against venereal diseases and on the attempt to suppress
them is taken from an interesting academic essay by the former
professor of medicine at Göttingen, K. F. H. Marx, who is well known
to have been the physician of Heinrich Heine during the latter’s
student life in Göttingen. The title of this essay is “The Diminution of
Diseases in Consequence of Advancing Civilization,” p. 35 (Göttingen,
1844).
The hopeful view which is here expressed by the university
professor regarding the ultimate eradication of venereal diseases
was shared at that time by the eminently practical physician
Parent-Duchatelet. He appeals, unfortunately, not to medical men
and students of social hygiene, but to the police:
“Pursue without cessation the diseases which are diffused by means of
prostitutes; take it as your goal to cause them to disappear from the list of
human troubles; do not doubt that your labours will ultimately be
crowned with success, although the task may be one that will occupy
several generations.”[331]

Two complete generations had, however, to pass away before the

campaign against venereal diseases and the attempt to
suppress them became a burning question of the time,
became a question of public health and social hygiene, like those
which concern the fight with tuberculosis, with infant mortality, and
with alcoholism. Once again I must repeat that the organized
systematic campaign against venereal diseases is still in its
very earliest stages. Strictly speaking, it dates only from seven
years ago, when the first international congress for the
prophylaxis of syphilis and other venereal diseases was held
in Brussels, from September 4 to 8, 1899. Almost all the civilized
countries, European and other, took part in this congress, and not
only physicians and dermatologists, but also lawyers, clergymen,
attachés of embassies, authors, and philanthropists, explained their
views, and thereby showed that the question of the suppression of
venereal diseases was one of equal interest to all classes of society,
and one which must exercise the activity of the community at large.
At the conclusion of this first international conference in 1899, there
was founded the International Society for the Sanitary and
Moral Prophylaxis of Syphilis and other Venereal Diseases,
which has its seat in Brussels, and meets at periodical intervals for
international conferences.
 Especially in Germany has this organization aroused active
interest, and it was soon decided to found a national German
Society for the Suppression of Venereal Diseases, whose first
meeting was held on October 19, 1903, in the hall of the Berlin
Rathaus. The meeting was opened by a speech from Albert Neisser,
after which Alfred Blaschko spoke on “The Diffusion of Venereal
Diseases,” Edmund Lesser on “The Dangers of Venereal Diseases,”
Martin Kirchner on “The Social Importance of Venereal Diseases,”
and Albert Neisser on “The Aims of the German Society for the
Suppression of Venereal Diseases.” The committee of the Society
consists of Messrs. A. Neisser, president; E. Lesser, vice-president
and treasurer; and A. Blaschko, general secretary. The organ of the
Society is issued six times yearly, under the title, Reports of the
German Society for the Suppression of Venereal Diseases, and has
been published for the last four years; it is supplied gratis to
members; to non-members the yearly subscription is only three
marks. In the spring of the year 1903 there was founded a larger
Journal for the Suppression of Venereal Diseases, of which five
volumes have hitherto appeared; this serves for the publication of
more comprehensive critical studies.
Still in the same year, 1902, there were formed the first branches
and local groups of the German Society for the Suppression of
Venereal Diseases in Hanover, Wiesbaden, Breslau, and Berlin.
Subsequently other branches were formed in Mannheim, Munich,
Cologne, Beuthen, Danzig, Stettin, Posen, Dortmund, Elberfeld,
Frankfurt-on-the-Main, Görlitz, Hamburg, Königsberg, Nürnberg,
Stuttgart, and Heidelberg.
During the last four years, by means of lectures, the circulation of
pamphlets and leaflets, and by public discussions, information
regarding the dangers of venereal diseases has been diffused among
the widest circles of the population. Of the other activities and
measures of the Society we shall have to speak later.
We pass on to the consideration of the principal elements of the
modern campaign against venereal diseases. In view of the limits of
this work our discussion of this question must necessarily be a brief
one. The eradication of venereal diseases must be effected in a
threefold manner:
1. By measures of personal prophylaxis against infection.
2. By the proper medical treatment of all cases of venereal
disease.
3. By measures belonging to the province of public hygiene, to
that of state action, and to that of education.
The personal prophylaxis of venereal diseases[332] has made
great progress with the increasing scientific knowledge of the causes
and modes of infection of these diseases. We know now precisely
where and how we can lay down personal rules which give us at
least a fairly secure guarantee that in an individual case venereal
infection will not occur. Various points of view must then be taken
into consideration, the combined influence of which will alone
promise a successful result. No one single measure will suffice to
gain this end.
Above all, in this department of the prophylaxis of venereal
diseases, experienced physicians, alike of earlier and more recent
times, will unanimously agree in this proposition, that the principal
preliminary means for the avoidance of venereal infection, means
which it is absolutely essential to employ in every instance, consist
of perfect cleanliness on both sides. He who insists on the most
scrupulous cleanliness of body, clothing, and underclothing, will be
sure to get rid immediately of any uncleanliness acquired in sexual
intercourse. Cleanliness and health are often (not always) identical.
In any case, the greatest mistrust should be felt as regards a
person evidently unclean, with a neglected exterior, for this is always
a sign that such a person is not particular as regards choice in
matters of sexual intercourse. “Germany, get into your bath!”
Heinrich Laube once exclaimed. This would be a good device to
adopt in the campaign against venereal diseases. Every
uncleanliness is an irritant; it impairs the intactness of the skin; and
especially is this true of any uncleanliness of the genital organs, and
above all of the male genital organs, where, under the foreskin, the
“smegma” (the sebaceous secretion of the preputial glands) often
undergoes decomposition, and gives rise to an inflammation, the so-
called balanitis, which greatly favours the probability of
infection.[333]
If the foreskin has been removed by circumcision, this secretion
entirely ceases, and the mucous membrane covering the glans penis
is transformed into a thick skin, which is much less readily affected
by the causes of infection. There is no doubt that circumcision is to a
certain extent a protective measure against syphilitic infection, whilst
it does not in any way protect against gonorrhœa. Neustätter has
recently collected some very remarkable facts relating to this
question.[334]
Breitenstein has contrasted 15,000 indigenous circumcised
soldiers with 18,000 uncircumcised European soldiers of the army
of the Dutch Indies, living under similar local and hygienic
conditions. Thus, in the year 1895 there were infected with venereal
diseases, of the circumcised 16 %, of the uncircumcised 41 %. As
regards infections with syphilis, of the circumcised 0·8 % were
infected; of the uncircumcised, on the other hand, 4·1 %—that is,
five times as many. Similar observations were made by the
celebrated English syphilologist Jonathan Hutchinson, one of the
most ardent advocates of the general introduction of circumcision as
a protective measure against venereal, and above all against
syphilitic, infection. Moreover, with regard to the observations made
in Java, the difference did not depend upon race, because similar
differences have been observed as regards comparative immunity
from infection in respect of circumcised Christians, circumcised on
account of phimosis and other troubles, whose number is by no
means insignificant.
Since, however, it is unlikely that circumcision will come into
general use in Europe as a prophylactic measure, it only remains to
recommend that, as a fundamental procedure, the greatest possible
care should be employed in the daily and delicate cleansing of the
preputial sac. By this means inflammation and laceration of these
parts will be most effectually prevented, and even without
circumcision a certain resisting power will be induced. For washing
this region, lukewarm water which has been boiled and cooled may
best be employed; then dry the part carefully, so as not to rub off
the skin. In the case of women, frequent washings of the external
genital organs, and vaginal douches, are also of great importance in
regard to the prevention of venereal infection. Before and after the
sexual act, these measures are of especial value, because often by
simple mechanical means, infective material already deposited
may be carried away. The same purpose is subserved by urination, a
procedure certainly adapted for washing out gonorrhœal pus which
has found its way into the urethra, before the gonococci have had
time to establish themselves in the mucous membrane. I know a
number of patients who use no other means of protection in
sexual intercourse beyond the observation of extreme
cleanliness, by washing and douching, in both sexes, before
and after sexual intercourse, and by passing water immediately after
intercourse, and thus have remained free from infection; but who
promptly became infected as soon as they discontinued these
simple measures.
For this reason, these measures, where possible with the
assistance of soap, which certainly exercises some antiseptic
influence, cannot be too warmly recommended, although they
naturally do not offer any absolute security. They have,
however, the advantage that, in the first place, they can always be
employed, even when the true protective measures of which we
speak below are not available, and that, in the second place, they
can always be used in addition to these. It sounds, perhaps,
somewhat absurd, and yet it is true, to say that washing and
urination are the first and most important protective measures
against sexual infection.
The second point, which must also be considered important in this
connexion, is the exercise of self-command before and during
the sexual act, as far as this is possible in view of the nature of
sexual excitement, which always lessens the personal responsibility,
and overcomes reason and understanding. Yet no one should have
sexual intercourse when in a state of alcoholic intoxication, in
which self-control is completely lost; as we have shown in an
earlier passage (pp. 292-296), there are several reasons why
intercourse is apt to be disastrous to a drunken man. Moreover, love
prefers the dark, but precaution prefers the sunlight. Before
having intercourse with a woman previously unknown to him, a man
should inspect her in clear daylight, with a view to her state of
health. Suspicious spots on the skin, especially on the forehead and
on the trunk; white areas on the lips, the tongue, the throat, and the
back of the neck; visible glandular swellings; a marked discharge
from the genital organs; ulcerated areas in this region, etc., are of
an extremely suspicious nature, and should cause abstinence from
intercourse. French physicians go so far as to recommend
examination of the inguinal and cervical glands under the harmless
form of pretended caresses; but persons without medical education
would seldom be sufficiently skilled to be able to detect glandular
swellings unless these were unusually well developed. Especially
enlargement of the cervical glands—this “pulse of syphilis,” as Alfred
Fournier terms it—is a comparatively certain indication of syphilis.
It is dangerous also in many cases to repeat the sexual act
several times in brief succession, because old experience has
taught us that infective material may first make its appearance at
the second or third act of coitus, and thus infect then only. This
affords an explanation also of a fact often observed—that in
intercourse with an infected woman on the part of two healthy men,
with but a brief interval between the acts, the one who had
intercourse first often remains healthy, whilst the second is infected.
I pass on to consider the special protective measures which
have long been recommended for the prophylaxis of venereal
infection.
1. The Condom.—This is the oldest and even to-day beyond
question the best and most trustworthy artificial protective
measure. Employed long ago in the days of antiquity, it was in the
sixteenth century once more recommended by the Italian physician
Fallopius, and therefore is not the invention of a physician “Conton,”
after whom it is said to have been named (perhaps the name is
connected with that of the French town “Condom”). Hans Ferdy (A.
Meyerhof) suggests that the word is derived from “condus”—that is,
one who preserves or protects—and that the article should properly
be called “condus” instead of “condom.”[335]
 The condom is a protective membrane, with which the penis is
covered before intercourse. We distinguish as “rubber condoms”
those made of rubber, gutta-percha, or caoutchouc; and as “cæcal
condoms” those made out of the cæcal mucous membrane of the
goat or sheep (incorrectly termed also “isinglass condoms”). The
cæcal condom is thinner and more delicate, and blunts sensation
less, than the rubber condom. The rubber condom, however, is more
trustworthy, in respect of durability and its slighter liability to
laceration, if the little precaution is not neglected to keep it in a cool
place, and to protect it from the long-continued influence of warmth.
The habit of carrying about a rubber condom in the pocket for a long
time favours its rapidly becoming untrustworthy and easily torn.
Cæcal condoms, on the other hand, very readily become fragile and
pervious, although the contrary is the common opinion, and they are
preferred to rubber condoms in the belief that the dearer article
must be the better. Advertisement is exceedingly active in this
direction, and every kind of speciality is widely recommended. In
England condoms are sometimes sold bearing the portrait of some
celebrated person!
The condom is a “general protective measure”—that is, it
protects against both gonorrhœa and syphilis, in so far as the latter
disease, as is usually the case, is transmitted from the genital
organs. All the leading physicians engaged more especially in the
treatment of venereal diseases are agreed that the condom, when of
good quality, when properly applied, and when removed with care
(for in the removal material adhering to the outer surface may very
readily give rise to infection), constitutes the very best and most
certain of all the protective measures hitherto advocated. It is true
that it can be used by men only, but when used by the man it
simultaneously protects the woman from gonorrhœal infection, and
not rarely also from syphilitic infection.
2. The Instillation of Solutions of Silver Salts.[336]—These
serve exclusively for the prophylaxis of gonorrhœa, and are not,
therefore, general protective measures. We owe their introduction to
Blokusewski, who recommended the use of a two % solution of
nitrate of silver. More recently, the albuminates of silver have
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