disease. While in some cases, after the disease has lasted for some
time, a certain poison is generated by the germs which circulates in
the blood, and while the germs may occasionally wander into distant
organs, still in 98 per cent. of all cases gonorrhea is a local
disease, and if taken in time is cured without leaving any traces on
the general organism.

=Gonorrhea Not Hereditary.= Then, gonorrhea is not a hereditary
disease. Nobody ever _inherits_ gonorrhea. A child may be born with a
gonorrheal inflammation of the eyes (ophthalmia neonatorum), but this
inflammation is not inherited; it can only be acquired if the mother
is suffering with gonorrhea while the child is being born: some of the
pus in the mother's birth canal gets into the child's eyes while it
passes through the uterus and vagina. This is not heredity; this is
simple infection, and can be avoided by keeping the mother's birth
canal clean by antiseptic douches before childbirth. In short, I
repeat gonorrhea is essentially a local and not a constitutional
disease, and is not hereditary. In which two respects it differs from
syphilis, which is the most constitutional and most hereditary of all
diseases.

=Course of Gonorrhea in Men and Women.= Gonorrhea runs an entirely
different course in women than it does in men. When a man has
gonorrhea he knows it immediately; first, because the discharge tells
him that there is something the matter with him, for a man is not used
to having any discharge from the urethra unless there is something the
matter with him. Second, the urine becomes at once burning and
painful. In women the urethra is a separate canal from the vagina, and
the urethra is very frequently not affected in gonorrhea. The
infection generally starts in the cervix, and the disease may last for
considerable time before the woman becomes aware of it. In general,
gonorrhea is a less painful disease in woman, and this is a bad thing,
because she thus neglects treatment and loses valuable time,
permitting the disease to develop. Even when the urethra is affected
in women, it does not give as severe symptoms as inflammation of the
urethra in men. If the woman does have pains she often pays no
attention to them, because woman is used to pains; as we have seen
before, fifty per cent. of all women suffer more or less with
dysmenorrhea. Many of them have a leucorrheal discharge of greater or
lesser degree, and therefore if there is an increase in the pa