rule, a strong influence on the development of
the disease. Unfortunately the sexual appetite of tuberculous patients
is not diminished, but, rather, very frequently heightened; and
frequent sexual relations weaken them and hasten the progress of the
disease.

As to pregnancy, that has an extremely pernicious effect on the course
of tuberculosis, and no tuberculous woman should ever marry. If such a
one does marry or if the disease develops after her getting married,
means should be given her to prevent her from having children. During
the pregnancy, the disease may not seem to be making any
progress--occasionally the patient may even seem to improve--but after
childbirth the disease makes very rapid strides and the patient may
quickly succumb. In the early days of my practice I saw a number of
such cases. If precautions are taken against pregnancy, then
permission to indulge in sexual relations may be given, provided it is
done rarely and moderately.

If a patient who has tuberculosis conceals the fact from the future
partner, a fraud is committed, and the marriage is morally annullable.
It has been declared legally annullable by a recent decision of a New
York judge.

=Heart Disease=

Heart disease also is no longer considered hereditary. Nevertheless,
heart disease, if at all serious, is a contraindication to marriage.
First, because the patient's life may be cut off at any time. Second,
sexual intercourse is injurious for people having heart disease; it
may aggravate the disease or even cause sudden death. It is more
injurious even than it is in tuberculosis. Third--and this concerns
the woman only--pregnancy has a _very_ detrimental effect upon a
diseased heart. A heart that, with proper care, might be able to do
its work for years, often is suddenly snapped by the extra work put
upon it by pregnancy and childbirth. Sometimes a woman with a diseased
heart will keep up to the last minute of the delivery of the child and
then suddenly will gasp and expire. In the first year of my practice I
saw such a case, and I never have wanted to see another. Women
suffering from heart disease of any serious character should not,
under any circumstance, be permitted to become pregnant.

=Cancer=

No man will knowingly marry a woman, and no woman will marry a man,
afflicted with cancer. However, this question often comes up in cases
where the matrimonial candidates are free from cancer, but where there
has been cance