Masturbation is prevalent among boys. Two hundred and thirty-two replies were received to a question asked college students regarding their severest temptations of school days. Of these, one hundred and thirty-two said that masturbation had been one of their severest temptations and one hundred and thirty-one said they had yielded to it.[42] Similar inquiries have brought similar results. The sum total of vitality lost to humanity by this practice is great. There is much needless mental suffering among boys and young men due to ignorance and false ideas advanced by quacks. Groundless fear, brooding anxiety, and despair sometimes start before adolescence and often last into the twenties. Physical peculiarities of no consequence sometimes cause boys to fear that they are abnormal. Unaware of the fact that spontaneous nocturnal emissions are to be expected, many suffer mental anguish. According to one writer, a single New York dealer had 3,000,000 "confidential" letters, "written to advertising medical companies and doctors, mostly by youth with their heart's blood."[43] Large sums of money are obtained by quacks everywhere for treating normal conditions. Many men have applied to the Advisory Department of the Oregon State Board of Health after years of worry. Although those who apply are no longer boys, most of their troubles began in boyhood. A large proportion of the suffering could have been avoided by simple instruction in sexual hygiene. Social vice often occurs in adolescent boyhood, both as a direct result of unmastered passion and as an indirect result of individual vice. In some cases, the habits a boy forms in his early 'teens make him a subject of venereal disease in later life. A doctor writes, "I am aware that it is popularly supposed that self-abuse and sexual intercourse are antagonistic--by many, the one is regarded as a necessary alternative of the other. So far from being a protective, the former is a most powerful provocative of the latter. According to my own observation, it is not the strongly sexed, the most virile young men, who are most given to licentiousness, but those whose organs have been rendered weak and irritable from this unnatural exercise--in whom the habit of sensual indulgence has been set up, and in whom self-control has not been developed by exercise."[44] This combination of silence, misinformation, and bad influence causes a damnable attitude of mind on the part of the boy toward women, love, marriage, and the home.[45] The experience of a Chicago business man with his sixteen-year-old son is told in a recent popular magazine. Whether an actual occurrence or not, it is typical of conditions in most any city.