Circumcision is an operation that is seldom, if ever, necessary in very young children. Sometimes a tight prepuce has been neglected for five to ten years, and, as cleanliness is impossible, irritation causes so much itching and rubbing of the parts that the tissues become thickened, indurated and elongated. Irritation and inflammation end in ulceration, which infects the blood. This, joining Toxemia, causes general ill-health. Such cases require the removal of the extra growth--the tissues become so thick and hardened that it is necessary to remove that portion that is decidedly elongated and indurated. I have seen cases that required as much as two or more inches removed. A few cases have come under my observation in men from thirty to forty years of age. In all such cases there has been a blighting of the development of the entire reproductive system, including the co-ordinate brain-centers. There would be more forceful men and women in the world if proper care were given their genital organs in infancy and childhood.

    Parental ignorance and stupidity concerning proper care of the reproductive organs of children have caused blighting or dwarfing of the entire reproductive system; which means sending a child through life held down in development, physically and mentally. Ambition requires super-sexuality. If such endowment is not safeguarded by wisdom, it may be dissipated.

    There is a large class of children neglected in the line of cleanliness. Neglect of teaching children the art of keeping clean--that it is as important to keep the genitalia clean and free from odor as it is to keep the eyes, nose, ears, and mouth clean--leads to disease and crime.

    The origin of venereal diseases, as of all other so-called diseases, is in filth.

    Allowing the genitals of children to accumulate the natural secretions leads to the fermentation of these secretions. This change causes irritation, and in time inflammation. The irritation causes rubbing, pinching, and scratching. Herein lies the beginning of secret vices of children, which lead on to libertinism in the male and nymphomania in women. Judge Lindsey has called down upon his head the imprecations of the just in publishing to the world his remedy for the wiles of the sex-neuroto-maniacs. His books should be read by all who are not afraid of truth.

    All this social perversion starts from a lack of cleanliness of the sex-organs in babies. We results of this neglect end in self-pollution, sex-mania, promiscuity, and finally in a sexo-mental impotency that even a Solomon's harem would give no appeal.

    When babies are cared for as they should be, there is no need of such operations. Where the foreskin is exceedingly close, and cannot be drawn back over the glans, a small dilating or prepuce forceps may be used. Introduce the forceps gently far enough back under the prepuce to get to the glans. Enough pressure should be put on the forceps to make the dilation thorough, if possible, at the first stretching. Then push the foreskin back, wash with hot water, dry, and use Vaseline. The parts should be bathed in hot soap-water morning and evening, and after manipulating the foreskin a little--gently pushing back once or twice.

    This procedure need not be dignified by the name of operation; for it amounts to nothing except dilating and retracting the foreskin in all those that are too small to be drawn back over the glans without force at the time when the child is having its first bath.

    The procedure need not be undertaken if the child is unusually weak from a tedious, hard birth. Postponing for a week will be all right under the circumstances. Neglect in this matter will cause children to rub themselves. On examination it may be found that there is a slight adhesion of a portion of the prepuce, so that the foreskin cannot be completely pushed back over the glans. It may require a little force to push or peel such adhesions back, but it must be done.

    I have found a slight adhesion to exist, in boys from six to twelve years of age, at the corona or ridge of the glans, overlooked by examiners. It causes itching, and it lays the foundation for early self-abuse. Family physicians cannot be too careful in this regard. Children should be taught as early as possible that they are not to handle this part of the body any more than they would put their fingers into the ears, nose, or eyes. A little care in this by mothers, when children are young, will forestall the vicious manipulations in childhood that lead to self-abuse. Training children in this regard is often neglected until they are old enough to be self-conscious. This education should not be neglected until vicious habits are formed. Too many parents neglect their duty until unaccountable symptoms or discomfort draw their attention to possible secret habits. Then they shift their responsibility to the doctor.

    Cleanliness and care of the genitalia should receive very much the same attention as the nose, eyes, teeth, and ears. If children are taught the importance of entire cleanliness of the body, it will end one of the active causes for onanism in children. Parents should not allow false modesty to grow up between them and their children.

    I am frequently asked by mothers to give them the name of the best books on sex-life. Care, such as suggested above, has been neglected until all the teachings that a mother can give from one of these books would be on the order of locking the barn after the horse is gone. Cleanliness of body and mind should begin at the breast, or with the grandparents. Boys and girls will never learn to be cleanly, and take the proper care of their genital organs, if the teaching is left until puberty.

    The art of keeping clean is a transmissible tendency, and parents should cultivate it. Near-clean is about as close to the art of living clean as most people can boast--even those who enjoy the luxury of bath-tubs.

    The use of bath-tubs has become quite general, but few people have learned to think in the language of cleanliness. Until we learn to think in the language of health, or any division of knowledge, we are novices. No knowledge is our knowledge until we have lived it long enough to affect our personality.

    Knowledge of cleanliness must not end with keeping the surface of the body clean. It must be so clean that so-called skin diseases will not develop.

    The washing of the surface of the body must extend to all openings to the surface. The mouth, the teeth when they erupt, the nose as far as possible, the eyes and the eyelashes, and the margins of the lid must be kept scrupulously clean. If the eyes are kept clean--not pretty nearly clean--there will be no excuse for carrying out the medical superstition of medicating the eyes of every new-born infant with argyrol, to prevent the possibility of ophthalmia neonatorum--gonorrhea! inflammation of the eyes developing; a sort of left-handed compliment that all mothers have venereal disease. Gonorrhea is a disease of filth, and will end when the human family learns the art of keeping clean (not near-clean).

    Few, if any, mothers know how thoroughly to wash a child. When they learn how, there will be fewer blind, deaf and catarrhal. Skin diseases will disappear if personal liberty ceases to be abrogated by manufacturers of vaccine and serum through their henchmen, the vaccinators, and such diseases as infantile paralysis, meningitis, epilepsy, and rheumatism will be heard of no more.

    Cleanliness must be internal as well as external. Correct eating and thinking habits are as necessary as soap and water.


    Vulvitis is inflammation of the external organs of generation in girls.

    Symptoms.--Itching and rubbing of the genitals attract the mother's attention, if she has not noticed redness and sensitiveness when bathing the child. The inflammation may be very slight, and may possibly be overlooked, starting, as it does, in the folds of the tissues. This is especially true of fat children. The inflammation may be severe enough to involve all the external vulva.

    Treatment.--Cleansing the parts three or four times a day with quite warm water. The first washing of a morning should be thorough, with a mild soap and careful rinsing, so that there will not be any irritation from the effect of the soap left on. After thorough washing, a very small amount of vaseline or a bland face-cream may be gently rubbed on; then dust the parts with talcum powder. If the irritated parts are not involving too much tissue, one more dressing of the same character in the evening may be sufficient; but in severe vulvitis the washing should be every three hours, following with a gentle drying and dusting with powder. The first washing for the morning may be as recommended, bathing with a little soap and water. Where it is necessary to bathe the parts every three hours, it may be that the inflammation will be so severe that it would not be prudent to use soap in the water for more than one bathing a day. The rest of the baths should be simply of warm water. Use cotton to apply the water, or very soft gauze. Rough handling should be avoided.

    Vaginitis.--This is inflammation of the vagina in infants and children. It may be an extension of the vulvitis, especially in children large enough to injure themselves with rubbing and scratching.

    It is possible that pinworms may be a cause, coming from the rectum. A child that is troubled with pinworms, if the derangement is not overcome, may have the vagina infested with these little worms, causing vaginitis or symptoms of the same.

    Symptoms.--The symptoms of vaginitis are redness and irritation, causing the child to be irritable and endeavoring to get relief by rubbing or scratching. The mother, on examination, will find a white discharge oozing from the vagina. This means a little ulceration. A yellow or milky discharge must have a certain amount of pus to give it color. This, of course, means that the inflammation has extended to a slight ulcerative stage. The mucous membrane is denuded, and ulceration is starting up.

    Treatment.--The child may be treated the same as for vulvitis, with the addition of using a douche once or twice a day. Put quite warm water into a fountain syringe, and use the smallest rectal tube to introduce into the vagina, thoroughly cleansing the tube before using. The water need not be medicated--cleanliness is the only thing necessary. The douching must be thorough, and used until the child is well. Feeding under these circumstances should be light. The child should not be allowed to eat heavily--in fact, should be confined to milk three times a day, and a little orange juice. The milk can be taken three times a day at regular meal times, and an ounce of orange juice and an ounce of water after each feeding of milk.

    When children are nervous and irritable, they should be kept in bed until normal. This rule should apply at all times when children are irritable or peevish and hard to please. When they have a white line around their mouths, or at the sides of the nose, keep food away from them until they are feeling fine, as indicated by playfulness.

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