BY THE SAME AUTHOR
HIMSELF Talks with Men Concerning Themselves $1.00
CONFIDENCES Talks with a Young Girl Concerning Herself 50 cts.
TRUTHS Talks with a Boy Concerning Himself 50 cts.
FALSE MODESTY 50 cts.
TEACHING SEX HYGIENE 50 cts.
THE HOME NURSE $1.00
YOUR BABY A Guide for Mothers $1.00
TALKS WITH WOMEN CONCERNING THEMSELVES
BY E. B. LOWRY, M.D.
Author of "Confidences," "Truths," etc.
CHICAGO FORBES & COMPANY 1917
COPYRIGHT, 1911, BY FORBES AND COMPANY
A recent number of the Journal of the American Medical Association contained this paragraph:
"A correspondent asks for a good book describing the female generative organs anatomically, physiologically and pathologically, treating also of childbirth, written in language easily understood by a layman. He desires to give copies to some of his young women patients. The editor regrets there is no satisfactory book on the subject although there is great need for one."
It is a lamentable fact that the majority of women and girls are ignorant of the structure of their most important organs. In the majority of schools and colleges where physiology is taught, absolutely nothing is mentioned about the reproductive organs. As far as books or instruction are concerned, the girl is ignorant of their very existence. If she knew something of the structure of such important organs and the harmful results of many practices or acts of carelessness affecting them, would she not be better prepared to take the proper care of herself and more liable to develop into a strong, healthy woman?
If a girl in the business world is intrusted with a delicate piece of machinery she is taught the structure, use and care of it. Why is it not just as necessary that the girl, who is intrusted with the care of delicate organisms upon whose condition depends the health of the future generation, be instructed regarding the care of these organs? Instead, she is left in absolute ignorance and then blamed if she mars them.
Every woman should have some knowledge of the structure and care of her body, especially of those parts which are concerned so intimately in the welfare of the future generation. Every woman, too, should receive some instruction regarding the care of young children and the proper management of the home. A woman who attempts to care for herself and her children without proper knowledge of these subjects is like a man who tries to run his business blindfolded.
That thinking women are awakening to the fact that they have been suffering unnecessarily and are realizing the necessity for more knowledge concerning the hygiene and physiology of their own bodies is shown by the fact that nearly every chapter in this book has been written in answer to questions asked by women readers of the author's magazine articles. With the hope that the plain facts herein set forth will aid some women to have healthier and happier lives and healthier and happier babies this series of talks has been written.
I ANATOMY AND PHYSIOLOGY OF THE FEMALE ORGANS 11
II MENSTRUATION—PUBERTY—MENOPAUSE 23
III DISEASES OF THE FEMALE ORGANS 33
IV CONSTIPATION—HEMORRHOIDS 47
V THE BLACK PLAGUES 55
VI FAKE MEDICAL ADVICE FOR WOMEN 65
VII THE MARRIAGE RELATION 71
VIII EMBRYOLOGY 81
IX ABORTIONS 89
X MATERNAL IMPRESSIONS—HEREDITY 97
XI CHILDLESS HOMES AND REAL HOMES 103
XII PREVENTION OF PREGNANCY 109
XIII SOME OF THE CAUSES OF DIVORCE 115
XIV THE NEED OF EARLY INSTRUCTION OF GIRLS 121
XV WHY GIRLS GO ASTRAY 131
XVI SELF-ABUSE 137
XVII EFFECTS OF IMMORAL LIFE 149
XVIII FLIRTATIONS AND THEIR RESULTS 157
XIX WHITE SLAVERY 163
XX THE NEED OF EARLY INSTRUCTION OF BOYS 171
XXI WHY BOYS GO ASTRAY 177
XXII HOW SHALL THE CHILD BE TOLD 183
XXIII WOMEN IN BUSINESS 189
XXIV NERVOUSNESS—A LACK OF CONTROL 195
XXV A WOMAN IS AS YOUNG AS SHE WANTS TO BE 203
ANATOMY AND PHYSIOLOGY OF THE FEMALE ORGANS
Before we can understand the care of anything we must have some knowledge of its structure; so I think it well, in this our first talk, that we should learn something of the structure of the female generative organs. As I have told some of you in former talks, the womb is designed as a nest for the babe during its process of development from the egg or ovule. It lies in the center of the pelvis, or lower part of the body cavity, in front of the rectum and behind and above the bladder. It is pear-shaped, with the small end downward, and is about three inches long, two inches wide and one inch thick. It consists of layers of muscles enclosing a cavity which, owing to the thickness of the walls, is comparatively small. This cavity is triangular in shape and has three openings,—one at the lower end or mouth of the womb into the vagina and one at each side, near the top, into the fallopian tubes. The womb, or uterus as it sometimes is called, is not firmly attached nor adherent to any of the bony parts. It is suspended in the pelvic cavity and kept in place by muscles and ligaments. As the muscles and ligaments are elastic, the womb slightly changes its position with different movements of the body. Normally, it is inclined forward, resting on the bladder; so you see, a full bladder will push it backward, while a full rectum and intestines tend to push it forward and downward.
The lower end or mouth of the womb opens into the vagina, a distensible and curved muscular tube, which helps to support the womb and also connects it with the external parts. The vagina is about three and a half inches long. It often is called the birth canal because the baby must pass through it on its way from the womb to the external world.
The two upper openings of the womb lead into the fallopian tubes or oviducts, which are two small muscular tubes leading from the ovaries to the womb. Each one is about four inches long, but the opening through the center in its largest portion is only about as large as a broom straw, while near the womb it narrows down until it will admit only a fine bristle. When the ovum or seed leaves the ovary it must pass through one of these tubes to reach the womb, so you see how necessary it is that they be kept in good condition.
From the end of each tube, but not directly connected with it, is suspended a small almond-shaped body called the ovary. Each ovary is similar in shape and size to an almond, measuring about one and a half inches in length, three-fourths of an inch in width and one-half an inch in thickness. The function or work of the ovaries is to produce, develop and mature the ova (eggs) and to discharge them when fully formed so they may enter the tubes and so find their way to the womb. In every ovary there are several hundred little ovules or eggs in various stages of development. At irregular intervals one of these ovules ripens and leaves the ovary. It passes along the fallopian tube to the womb. Here it remains if it is impregnated or fertilized, and develops into the babe. If not impregnated, it passes off with the menstrual flow. Every twenty-eight days large quantities of blood are sent to the womb, producing a natural congestion. The pressure of this extra blood in the tiny capillaries of the womb stretches and weakens their walls. This allows the blood, which is being sent to the womb to provide nourishment for the ovum if it be impregnated, to pass into the cavity of the womb, then out through the mouth into the vagina, thence to the external parts. This flow is called the menstrual flow. When the flow ceases the mucosa or lining assumes its former state. This process is repeated every month.
Lining the cavity of the abdomen and also folded over the womb, ovaries, tubes and other organs is a thin membrane called the peritoneum. An inflammation of this lining is called peritonitis.
All these organs I have mentioned are situated inside the body out of sight, but there are other organs that are external. You have noticed two longitudinal folds of skin extending from the anus, or external opening of the rectum, to the rounded eminence in front. Their outer surface is covered with hair and their inner surface with glands that secrete a lubricating material. These folds are called the labia majora. Within the labia majora are two smaller folds called the labia minora. These folds meet at their anterior (front) end. At the meeting point you will notice a very small structure which is called the clitoris. This clitoris is very similar in structure to the penis of the male, having a tiny prepuce or foreskin which folds over to protect the sensitive end. Sometimes the foreskin is bound down too tightly, so that instead of being a protection to the parts, it becomes a source of irritation. Then we say the clitoris is hooded and it is necessary to loosen or cut this fold of skin. The operation is similar to that of circumcision in the male.
Just back of the clitoris, within the folds of the labia, is situated the meatus urinarius, or opening leading to the bladder. This aperture does not open directly into the bladder but is connected to it by a tube, about an inch and a half long, called the urethra.
The orifice or external opening of the vagina is situated just back of the meatus urinarius, also within the folds of the labia. In the virgin it is partly closed by a membranous fold called the hymen or maidenhead. The shape and size of the hymen varies greatly in different individuals, sometimes being entirely absent. After marriage it usually persists as notched folds. The presence of an intact hymen is not necessarily a sign of virginity, nor does its absence necessarily indicate defloration. Its congenital absence or absence at the time of birth is known. It sometimes is injured, or may be destroyed by an accident, as by falling astride of an object; again violent exercise may rupture it (horseback riding). Surgical operations or vaginal examinations, roughly conducted, not infrequently cause rupture. Then, too, authentic cases are on record in which prostitutes have had perfectly preserved hymens. It is well known that the use of vaginal astringents may tone up and narrow the vagina and even restore the hymen to a great degree.
The surface between the vaginal orifice and the anus is called the perineum (Do not confuse this with the peritoneum, for they are entirely different). It is this perineum that sometimes becomes torn during childbirth. The vaginal opening does not always stretch sufficiently to allow the passage of the child's head and the great pressure being exerted on the child by the uterine and abdominal muscles pushes it through, causing the tear. (You will understand this better when I explain about the development and birth of the child.) If this tear is repaired immediately no inconvenience usually results but if it is neglected it may produce a series of complications, some of which are falling of the womb, inflammation and even sterility.
Not directly connected with any of the other organs but still associated with them are the breasts. They vary in size at different periods of life, being usually of small size when the girl is young but increasing in size as the generative organs develop. The breasts consist of fatty tissue surrounding milk glands and ducts. During pregnancy they increase in size and become filled with milk. After the menopause (change of life) they ordinarily shrink in size. The ancient Greek statues, such as the Venus de Medici, long regarded as a type of perfect beauty, the Venus of Capua, regarded as the bust of a perfect form, show that the Grecian ideal of the feminine form had small busts. The modern idea seems to have wandered far from the Grecian ideal and many women devote much time and money trying to develop their busts. Perhaps sometime we will give up trying to be so artificial and conform to Nature's ideal.
Nature has constructed the internal female organs so wisely that we seldom need give them much thought. But the external organs do need our attention every day. I told you that the labia secreted a lubricating material which kept the parts moist, but this secretion must not be allowed to accumulate. The scalp secretes an oil that is necessary to the health of the hair but if this and the perspiration are allowed to accumulate the hair has an offensive odor. So it is with the female organs, the parts must be bathed carefully every day. I have been surprised in the past to find how many intelligent women neglect these parts. Women come for an examination, their clothing is scrupulously clean, their bodies show recent care but in the folds of the labia, especially near the clitoris, I find an accumulation of a cheesy-like material which has an odor very offensive to any truly refined woman. Sometimes in public gatherings, I have been seated near a woman with this same offensive odor very noticeable, and I have longed to tell her how to avoid it, for I am sure others must notice the same odor. But even from a physician, in the privacy of the office, women resent any suggestion that they are not thorough in matters of cleanliness. Daily cleansing of these parts is a necessity. At least once a day these parts should be sponged carefully. The labia should be separated and every fold thoroughly cleansed. Occasional vaginal douches also are necessary, for the various secretions often are retained in the folds of the vagina and cause irritation. But in taking a douche one always should remember to have the water warm. Cold water may produce congestion. The virtue of douches (except when taken for medicinal purposes) lies in their cleansing properties and warm water cleanses even better than cold. Many women produce grave disorders by the use of cold douches under the mistaken notion that they are of greater value than hot ones. A douche should be taken at the close of the menstrual period especially.
These female organs should not be the source of worry but they do require as much or even more attention to cleanliness than we give to our mouths or other parts of the body.
The subject of menstruation seems to be troubling several of you. I am sorry that you did not all have the advantage of having this explained at an early age. You might have been saved a great deal of suffering and causeless worry.
By menstruation, or "the monthlies" as it sometimes is called, is meant the monthly hemorrhage that takes place in the uterus or womb during the child-bearing period of the normal woman except during pregnancy and lactation, when it nearly always is suspended. The child-bearing period commences at the age of puberty and ends with the menopause (change of life).
Puberty is the period of maturing of the sexual organs. It occurs about the age of twelve, although there may be considerable variation as to this. It extends over a period of several years. As a rule, girls mature earlier in warm climates than in cold and in cities than in country districts. The signs of the approach of this period are the growth of hair on the pubes and other parts of the body, the enlargement of the breasts, a general rounding and increased grace of the body, the development of the pelvis so that the hips become more prominent, and a change in the mental qualities of the child, the girl naturally becoming more retiring. The menstrual function usually is not established at once, there being premonitory symptoms of a vague nature. There may be, at first, only a slight discharge of mucus tinged with blood, later the normal menstrual flow will be established.
During this period of puberty there are great changes taking place in the girl's internal organs. This change and development requires considerable of the girl's strength and naturally influences her nervous system. It is for this reason that a girl at this period of her life should not be subjected to any great exertion, either physical or mental. She should have plenty of light, healthful exercise in the open air, but should not indulge in any very violent exercise. A little care at this time often will save her years of suffering. As the nervous system is greatly affected at this period there should be no great mental strain. In fact, if the girl shows many nervous symptoms, it may be wise to take her out of school for a year so that her strength may be used as Nature requires it. As a rule, too much work is required in school at this age. The school duties should be lessened and the girl allowed to rest a day or two during her menstrual period. The girl at this age should not attempt to accomplish as much work or study as the boy does. Her time at this period might better be occupied in learning the rudiments of housekeeping and home-making. Then, when her body has become developed, her strength can be spared and can be well used in the development of her mind. If the nervous strain too common at this age could be relieved we would have fewer nervous women and a healthier and happier posterity.
As puberty approaches, a mother should give her daughter adequate information so that she should not be frightened at the first appearance of the menstrual flow, nor take any risks at this period. Menstruation is the sign of the possibility of motherhood. If properly taught this fact, every girl will be glad she menstruates and will want to be careful during the period. On account of lack of early instruction, many a girl obtains wrong ideas regarding this function and it produces in her a feeling of repugnance. She should be taught the reasons for observing prudence during the menstrual period. The possible lifelong invalidism that may result should be pointed out. A woman owes it to herself to take good care of herself during her menstrual periods. For two or three days at least she should avoid any unnecessary strain, lie down and rest as much as possible and not worry over school or other duties. Especial attention should be paid to cleanliness during this period. A sponge bath taken in a warm room is not injurious and unpleasant odors can be avoided by sponging the parts with a warm antiseptic solution upon changing the cloth. Every woman should be provided with a circular girdle cut upon the bias so it may be elastic, and provided with tabs to which to pin the folded cloth. She also should have a supply of sanitary cloths made of absorbent cotton-fabric, or pads made of absorbent cotton enclosed in gauze. The latter especially are convenient for the girl who is obliged to room away from home, for they may be burned and the cost of new ones is no greater than the laundry of cloths. These pads or cloths should be changed at least twice a day. It also is necessary that one should bathe the parts in warm water with each change, as unpleasant odors can thereby be avoided. At the close of each period she should take a bath and change all clothing. One cannot be too careful about these matters so essential to cleanliness. It is surprising how many women neglect these important matters. The erroneous idea that bathing of any sort at this time may have disastrous results accounts for much of this neglect. If proper care is taken warm sponge baths cannot be injurious.
A woman in normal health should not suffer at the menstrual period. She normally will have a feeling of lassitude and disinclination for any great mental or physical work, perhaps accompanied by a slight feeling of uneasiness in the pelvic region. Because so many women do suffer at these periods it often is considered as "natural" and allowed to continue.
The phenomena often noted at the menstrual period are,—pains in various parts of the body, hot flashes, chilliness and various hysterical symptoms. A few days before menstruation commences there may be various nervous symptoms, as irritability and a disinclination for any exertion. Dark circles often appear under the eyes and the breasts become enlarged and painful. A sense of fullness and oppression may be felt in the head.
Any severe pain or profuse flow during the period or a discharge between periods indicates a weakened or diseased condition and should not be neglected, for it sooner or later will affect the whole system. A woman suffering from female diseases not only is unable to perform her work in a normal manner but the pale skin, dark circles under the eyes and drawn haggard look which accompany these conditions rob her of her charm of physical excellence.
The menstrual flow appears, as a rule, every twenty-eight days, although the length of time varies with the individual. The average duration is five days, but varies from three to seven. The flow consists of blood from the uterine mucosa (lining of the womb) together with small quantities of mucus. The color generally is dark at first while later it becomes more pale. Women in poor health often have a pale discharge. There always is a faint odor to the menstrual flow, which has been likened to the odor of marigolds. The quantity varies with the individual. Usually fleshy girls flow more than thin ones and dark complexioned ones than light ones. The average quantity is four to six fluid ounces. The time between the periods is required by the uterus or womb to first restore the lining and then prepare it for the reception of the ovum. Every month one or more ova (eggs) leave the ovary, pass to the uterus and, if not impregnated, pass off with the menstrual flow. The material prepared for the reception of the ovum is used to nourish the new life if pregnancy occurs, but when it does not, this surplus passes off in the form of the menstrual flow.
The menopause or change of life is the end of the child-bearing period of a woman's life. The average age at which it occurs is forty-six, although there is a great difference as to this. In some women it has been known to occur as early as the thirtieth year, while in others it does not come until the fifty-fifth year. As a rule, a woman who commences to menstruate at an early age continues to do so until a late age, while with a woman who commences to menstruate late, the change comes early. At this period of a woman's life, there are numerous changes taking place in the body. The ovaries and uterus atrophy or shrink in size, and cease to functionate. The nervous system is being readjusted to meet the changed conditions. One symptom of the approach of this period is irregularity in menstruation; sometimes several periods are missed, then the menstrual flow appears normally for several months and then disappears again. Often the woman complains of hot flashes, cramps in the limbs and other parts of the body. These are caused by the attempts to readjust the nervous system to the altered conditions. A great many women worry unnecessarily, for there is no especial danger at this time unless the body has been neglected previously and a diseased condition is present. But the body needs a little extra care, just as it did at puberty. So many women break down their health by worrying at this period over what might happen. The best plan for every woman, as soon as she perceives the approach of this period, is to go to a reliable physician and have a thorough examination. Then if there are any neglected tears or chronic inflammations they can be corrected and danger removed. If a person were to cross a deep lake and had any doubts regarding the worthiness of the vessel provided for his use, he would be very foolish if he did not have a trained boat-builder examine his vessel and repair any weak places. It is just as important for a woman about to cross this period of her life to go to a trained repairer of bodies and have him correct any weak places.
The various changes taking place consume so much of the woman's strength that she requires an extra amount of rest and cannot use up as much energy in working as at other periods of her life. The ordinary woman does not realize the need of extra rest during this period and so continues her usual work. Then the extra drain on her nervous system shows itself in various forms. The disturbances sometimes are productive of so much discomfort and so often are exaggerated beyond physiological limits that the patient is impelled to seek relief and often requires a physician's attention. Puberty or the period of development extends over several years, so the menopause or period of atrophy extends over a period of from three to five years. If a woman relaxes and allows the changes to proceed naturally she need have no cause to worry, but she must remember that rest from continual strain is necessary during this period. Freedom from care, relaxation of physical and mental effort, regular periods of complete rest once or twice a day, a reduction of the diet and regulation of the bowels should be the first principles of treatment. Then—do not worry but occupy the mind with happy thoughts.
DISEASES OF THE FEMALE ORGANS
So much of the suffering among women is unnecessary, being due to the neglect of the little things, so much ill health can be relieved by attention to a few simple hygienic measures, that I think it wise to describe some of the most common disorders of the female organs, and to explain their symptoms so that you would not ignorantly neglect them, if you should be so unfortunate as to contract any.
The most common diseases of the female organs may be classed as displacements, inflammations and tumors.
On account of its lack of strong attachment, the womb is very easily displaced. When from any cause the womb is congested and heavy the extra weight stretches the supporting muscles and ligaments, which then allow it to fall out of place. It also may be displaced by a sudden fall, by jumping or other strenuous exercise. As the womb normally is heavier at the menstrual period than at any other time and as there is a natural congestion then, it is more easily displaced at that time than during any other part of the month. This is one reason why one should be careful not to take strenuous exercise at the menstrual period.
The most common displacement, or the most common way for the womb to tip, is backwards and at the same time it usually falls downward. You remember, the rectum is directly back of the womb, so, if the womb is tipped backwards, it presses against the rectum. This tends to prevent the feces, or bowel movement, from passing out naturally and helps to produce constipation. The womb, pressing against the rectum, also presses on the blood vessels which are very numerous there. This pressure on the blood vessels prevents the blood from leaving them. If it is held there, it causes the blood vessels to dilate in order to be large enough to contain it. We call this enlarged portion of the vein a blood tumor. These tumors or dilated blood vessels of the rectum are called hemorrhoids or piles. I will explain these more thoroughly when I talk to you about constipation.
The womb may tip forward, pressing on the bladder and causing a frequent desire to urinate. More rarely it is tipped to one side. It then tends to pull on the ovaries and produce pain and various nervous symptoms.
The womb may fall downward, pressing against both the bladder and rectum and dragging the ovaries and tubes out of their natural positions. Sometimes it even protrudes from the vagina. Any falling or displacement of the womb pulls on the tubes and ovaries, often producing an inflammation. This inflammation should not be allowed to continue, as it may become serious, even extending to the peritoneum and producing peritonitis. The nerves of the uterus are very closely connected with the spinal nerves, therefore, any displacement reacts through them and may produce headache and backache, which are the common accompaniments of any uterine disorder.
One of the most simple and yet efficacious treatments to correct a displacement downward and backward is to assume the knee-chest position for a few moments morning and evening after the clothing has been removed. In the knee-chest position, the patient kneels on the bed, then bends forward until her chest touches the bed; the back slopes down and the thighs should be at right angles with the bed. This position allows the various organs to fall forward and toward the upper part of the body, the pressure on the uterus is relieved and it assumes its natural position. This treatment, persisted in, will relieve nearly every case which has not some other disorder connected with it. If every woman would assume this position for a few minutes once or twice a week, just before retiring, she would be greatly benefited; for the majority of women have a slight falling of the womb, which then presses on the rectal and other nerves causing various nervous symptoms.
The womb and ovaries are surrounded by a dense network of nerves and blood vessels, making them very liable to congestion. Tight clothing or improperly fitted clothing causes pressure and interferes with the circulation. I believe that a large percentage of the objections to the corset originated from women wearing improperly fitted corsets which pushed the organs out of place. A corset fitted to the wearer is not injurious and serves as a support. Overwork, catching cold and excesses may produce a congestion which is one stage of inflammation. The most common symptoms of inflammation of the womb are pain in the pelvic region, a dull backache, especially across the hips, and a vaginal discharge called leucorrhoea (whites). Any leucorrhoea shows a disordered condition which should be corrected. It may be simply of a catarrhal nature, due to pressure or cold, or it may indicate a more serious condition, as the presence of one of the black plagues. Whenever a woman notices a vaginal discharge, it is a wise plan to go at once to a reliable physician, find out what is the cause and nature and then take measures to correct it. In the beginning a very little treatment, such as hot douches, may be all that is required, while if untreated the condition may become serious, as you will understand when I explain about the black plagues.
Any disorder of the uterus or ovaries reacts through the nerves upon other parts of the body and may produce various symptoms such as general weakness, headaches and backaches. This drain on the system often is shown by dark circles under the eyes, pale skin and a drawn, haggard expression. All these tend to rob a woman of her charm of physical excellence, and none of us wish to lose that; for it is natural for all women to wish to appear attractive.
One of the most common of the so-called female disorders, which seems to be the lot of the majority of women, is dysmenorrhoea or painful menstruation. This is not a disease in itself, but the symptom of various disorders. A woman in normal health should not suffer at her menstrual period; so if she does suffer it shows there is something wrong. The natural thing for anyone to do who had dysmenorrhoea would be first to find the cause of this pain and then take measures to correct it. It may be due to displacements, inflammations or tumors; it may be due to a contraction of the mouth of the womb which does not dilate sufficiently to allow the menstrual discharge to flow freely. It may be due to neuralgia or rheumatism of the uterus or ovaries. Pain always indicates an unnatural condition. It is the cry of tortured nerves. The cause should be determined by a competent physician and then measures taken immediately to restore the normal condition.
One who suffers from dysmenorrhoea should try to plan her work so that she may rest the first day of her menstrual period, and, if possible, the preceding day. Absolute rest in bed at this time is beneficial. A hot sitz bath, hot foot bath or hot vaginal douche taken just previous to the commencement of the period will aid in relieving the congestion and thus lessen the pain. After the flow has started hot foot baths and hot applications to the abdomen may be used. Hot drinks also may be taken, but one should not get in the habit of using any drug at this time. Hot ginger tea will do as much good as one prepared with some habit-forming drug. Many of the remedies advertised as a cure for this condition are composed chiefly of alcohol, and, although they may give a temporary relief, the benefit is not permanent. Careful attention to diet and exercise, with regular hours of sleep, are essential points to be considered if one would be free from this disagreeable trouble.
Another symptom which often causes much alarm to the patient is amenorrhoea or deficient or scanty menstruation. This may result from fear, worry, catching cold or to an enlargement of the womb. It also is one of the first symptoms of pregnancy. Sometimes it indicates an impoverished condition of the blood and shows the need of a general building up of the system. This is true especially in young girls who have what is called chlorosis or green sickness. These girls are pale, weak, sometimes having a greenish cast to their complexions. They need good care and nourishing food and plenty of light, outdoor exercise.
In young girls I sometimes find an irritation of the vagina which causes pain. This may be due to the retention of secretions in the vagina. The general idea that only married women have leucorrhoea, or whites, is fallacious. Virgins may have it. The usual cause is catching cold at the menstrual period. Another delusion is that these girls should not take douches for fear they might injure the hymen. This is erroneous, for douches are necessary in the treatment of this condition and, except in very rare cases, a douche can be taken with an especially small douche point without injury to the parts. There normally must be a small opening in the hymen to permit the passage of the menstrual flow. If a small douche point is used no harm will result.
When I talked to you about the structure of the external generative organs, I mentioned the clitoris and explained that sometimes the prepuce or foreskin is bound down, or is too tight, so that the natural secretions are retained under it and produce an irritation; that the operation for the unhooding of the clitoris is very similiar to that of circumcision in the male and is performed for similar causes. Many a woman who has been nervous all her life, owes her condition to a hooded clitoris, which a very simple operation would correct. A hooded clitoris also may have something to do with the immoral life of some girls. The other day I received a letter from an aged physician who, in discussing the tendency to immoral practices, says: "You say in one of your articles, 'What is the remedy? Educate!' Well, perhaps, but if you would let me circumcise the girl early in life, I believe it would be more certain." There is considerable truth in his statement. A hooded clitoris produces a constant irritation which tends to lead to habits of self-abuse and perhaps immorality.
The other common disorder which I named at first is a tumor. Tumors are any unnatural growth. They may form in any part of the body, but just now we will speak only of those affecting the internal female organs. Tumors may form in the cavity of the womb, in its walls or on the outside of it. The common symptoms are an enlargement of the abdomen accompanied usually by pain due to pressure on the nerves. There also may be some hemorrhage at other than the regular menstrual periods.
Sometimes the ovaries are diseased and become enlarged, tender and filled with fluid. Then they are spoken of as cystic tumors or as cysts. The tubes may become inflamed and filled with pus. The most common cause of these pus tubes is one of the black plagues. With all these tumors the treatment usually is to remove the tumor and sometimes the entire organ. In a few cases it is possible that the fluid or other contents of the tumor may be absorbed, if the general health and circulation are improved. In some cases we find what is called a phantom tumor. There really is no tumor, although the symptoms may be such that even reliable physicians are misled. The symptoms are due to a nervous condition. These phantom tumors have given many a quack a reputation for removing tumors without the use of the knife.
A carcinoma or cancer is a malignant tumor, that is, one that tends to grow worse and to reappear if it apparently is removed. The reappearance may be in the same place or in an entirely different portion of the body. Cancer of the uterus is not uncommon in women. It frequently follows neglect of some injury. For example, it will appear on the site of an unrepaired tear. It most commonly comes after the menopause. The change that is undergone at that time seems to stir things up and bring to light any neglected injury. This is another reason why every woman at the menopause should undergo a thorough examination and have any defect repaired, thus avoiding much of the possibility of trouble. A frequent symptom of carcinoma of the uterus is hemorrhage at irregular times after the menopause. Any woman who has such a condition would be wise if she immediately repaired to a physician and determined the cause of the hemorrhage. In the beginning it is possible to remove a cancer, but later it becomes so involved in the surrounding structures that its removal is impossible.
You may think I am trying to increase business for the physicians but in reality my advice, if taken, would lessen their practice. It is another application of "a stitch in time saves nine." In the beginning almost all these diseases can be corrected with very little trouble, while if neglected the process is much slower. The probabilities are that the doctor will have the case later, if not consulted early, but instead of a few office treatments he will have an expensive operation. So, you see, I really am trying to save you doctors' bills when I urge early and thorough examinations. There is a peculiar thing about the human race. A machine will get out of order and the owner will send for an expert machinist to repair it—not attempting to patch it up himself. But when these bodies of ours, the most wonderful and complicated of machines, get out of repair we try to patch them up ourselves or try various remedies recommended by those who know worse than nothing about the physical machinery. Then we think we are saving doctors' bills, when at the same time we are spending twice as much on questionable repairs—patent medicines, which often do more harm than good. Frequently they contain stimulants which produce a mythical improvement but leave the system worse off than before.
A regular daily movement of the bowels is necessary to health. Much of the illness in the world might have been avoided if the victims had taken better care of the excretory organs. One of the first questions a physician asks a patient is, "How are your bowels, do they move regularly every day?" In some cases that is the first time the patient has thought of them, and he has to think some time before he can remember just when and how often his bowels did move. Then perhaps he is not sure. In a great many cases it is a routine practice with physicians to give a "good cleaning out," that is, to give a thorough laxative. Many times this is all the treatment required and in other cases it only is combined with a little intestinal antiseptic to further carry out the cleaning process.
The most common cause of constipation is irregularity in going to the toilet. When the desire for defecation comes, we are too busy and postpone it until some more convenient time, which time may be too late. Nature is the best judge as to when the bowels are ready to be emptied. If we do not obey her call, we must take the consequences. When the waste material is ready to be voided, it is in a semi-fluid state, but, if it remains in the intestines too long the water is absorbed and the waste material is left in a hard mass which is expelled with difficulty. Not only that, but the desire to expel it soon passes. Nature, finding we do not respond to her call, ceases to notify us.
If the waste material is allowed to remain in the bowels, not only the water is absorbed but with it some of the poisons from the waste material, which are taken up by the blood and carried to all parts of the system, causing a great deal of trouble and pain. This absorption of toxins (poisons) causes headache, loss of appetite, a sense of depression and a lack of energy.
The pressure of the hard material on the tender tissues of the rectum causes hemorrhoids or piles, by irritating the tissues and causing a congestion. Hemorrhoids are enlarged veins which have been so irritated and filled with extra blood that they have lost their power to contract. These enlarged veins may remain inside the rectum and then are known as internal piles. Sometimes they protrude externally and then are known as external piles. Frequently they become tender and cause a great deal of pain. In some cases one of the little veins becomes so engorged with blood that it bursts and allows the contained blood to escape. This is known as bleeding piles. For mild cases of hemorrhoids (piles) the treatment is to correct the accompanying constipation, then take an enema or injection of warm water morning and evening, using the water as hot as can be borne and allowing it to run in and out the rectum for some time. Following this, an astringent and soothing lotion should be applied.
Constipation may be caused by retroversion of the uterus. If the uterus is tipped backwards it presses on the rectum, preventing the passage of the feces (bowel movement). This pressure also causes hemorrhoids. In this case the treatment is to correct the displacement. In many cases all that is necessary is to take the knee-chest position for a few minutes night and morning.
Always in the treatment of constipation, the first item is to discover the cause. We have noted that the chief cause is irregularity in going to the toilet, therefore, the first measure to be taken in the treatment is regularity in going to the toilet. Choose a convenient hour, usually right after breakfast, and always go to the toilet at that time no matter if there is a desire or not. At first there may be no natural movement but if you persist, your efforts will be rewarded. For the first few days it is well to take an enema of warm, soapy water at this time. Every day take exercise that will strengthen the muscles of the abdomen. Bending forward and touching the toes with the fingers without bending the knees is one valuable exercise. This should be done ten or twelve times morning and evening. A daily brisk walk in the fresh air is another good exercise. Fruit or figs eaten with the meals or a glass of water taken before breakfast and upon retiring often proves very beneficial in relieving a tendency to constipation. There is an old saying, "An apple or two before going to bed, and the doctor will go begging for his bread." This really is a practical idea and more nearly true than many old sayings.
Cathartics or laxatives should not be taken except for an occasional dose or during illness upon the advice of a physician. So common is the practice of taking daily laxatives that it has become a "national curse"! People do not realize that they are slaves to this habit, so they continue to take their daily doses of "teas" or "waters." In many cases a patient will tell his physician that his bowels are "all right," that they move every day. Further questionings reveal the fact that he is in the habit of taking some laxative frequently. The bowels are not "all right" if any laxative is required.
Massage of the abdomen usually is very beneficial in treating constipation. It acts by stimulating the muscles and should be given at set times in the day but never until two hours after any meal. The various vibrators act in the same manner as massage. In any massage of the abdomen the thighs should be flexed, as this relaxes the abdominal muscles.
Enemas or injections of warm water may be taken occasionally and then are beneficial, but if long continued are injurious by reason of their irritating effect. At times, when the stomach and intestines have been over-loaded with irritating material, an enema is one of the quickest measures for relief. In obstinate constipation two or three ounces of warm olive oil injected slowly into the rectum at night and allowed to remain until morning will soften the waste material so it can be evacuated easily in the morning.
Constipation never should be neglected as it carries in its train a long line of disorders, as hemorrhoids (piles), abscesses, and intestinal obstruction.
Indigestion and constipation frequently are bosom friends. How often indigestion is a result of nervous strain is perhaps seldom realized. A business man eats his lunch and other meals in a hurry, with his mind on his business. His energies are being consumed by his brain and very little is left to be used in the digestion of his food. One never should eat when tired and nervous. Take a few moments' absolute rest before meals. If possible lie down and relax all muscles for a few moments. Then eat your meal slowly and if possible have some pleasant companion who will talk with you on subjects not connected with your business cares. You will be surprised to note the improvement in your digestion and incidentally in your tendency to constipation.
For the noon meal, office workers should eat only light and easily digested food. Eat your heaviest meal after the work for the day is finished and the blood which has been required by the brain can be spared to the stomach. People doing manual labor that requires physical strength need, and can digest, a heavy noonday meal but the requirements of the brain workers are quite different.
Many girls break down on account of lack of sufficient nourishment. Coffee and rolls for breakfast, ice cream and rolls for lunch and a sandwich and coffee for dinner is not sufficient food for any working girl. And yet that is about the diet of hundreds of girls. Often it is impossible for her to provide more, for when a girl must pay for her board, room, clothes and laundry from her salary of five or six dollars a week, sufficient food becomes an impossibility. Many girls actually are slowly starving on this account. When the wheels of progress make it possible for every working girl to have a comfortable home and sufficient nourishing food many of the social problems will right themselves.
THE BLACK PLAGUES
I promised to explain to you what I meant by the black plagues. It is strange when anything is as widely spread as are these diseases that so few people know anything about them, or realize their importance. At one time epidemics of typhoid fever were regarded as a revelation of the wrath of God. Now we know they are due to carelessness and lack of sanitation. It is the same with the sufferings of women. We used to think it was a dispensation of Providence if a woman were compelled to undergo an operation. Now we know it usually is due to someone's lack of care, to a desecration of Nature's teachings.
I remember when I was quite young hearing mention made of a "bad disease." Concerning the nature of this disease I was ignorant but I gathered the idea that it was some terrible disease which was contracted only by the most depraved of mortals. How little I suspected its widely-spread distribution, and how little I dreamed that among my acquaintances might be any afflicted with these diseases! nor did I dream of the danger of innocent contagion. Since then I have learned what these diseases were. Now we call them the black plagues, because, owing to the prejudice of the majority, we dare not use their correct names generally. I have no doubt you will be as surprised and shocked as I was at the things I am going to impart to you.
By black plagues we mean the two diseases spoken of by physicians as the venereal diseases, because they usually are contracted during sexual intercourse.
The most common of these diseases is gonorrhoea, or clap, as it often is called by men. How common it is may be judged by a statement made by a professor to his class in the medical college that at least eighty per cent. of the men in the world have contracted it sometime during their lives. Even the most conservative give the estimate as sixty per cent.
The prevalent idea common among men that it is no worse than a cold—a mere annoyance that all men must expect and endure sometime—is lamentable. The persistence of the disease in the deeper structures long after it outwardly is cured leads to unexpected communication of it to women, among whom may be the young wife. As a result she enters upon a period of ill-health that ultimately may compel the mutilation of her body by a surgical operation to save her life. Much of the surgery performed upon the female organs has been rendered necessary by disease contracted from the husband.
A few little germs of this disease left on even the external organs may find their way up through the vagina to the uterus or womb. Here they may produce an inflammation of the lining of the womb, causing severe pain and other symptoms, such as profuse discharge. The germs may go farther, or the inflammation may extend from the uterus to the tubes. When we consider that the passage through the tubes is only about as large as a broom straw, we see what serious trouble may result. The tubes become enlarged and filled with pus. The opening from the tubes to the uterus becomes closed, so there is no way for the pus to escape. The accumulation of pus or the products of septic inflammation stretch the walls of the tubes until the little nerves in the walls cry out in rebellion. The pain becomes so great and the reflex symptoms are so aggravated that finally the woman resorts to the only relief,—an operation for the removal of the tubes.
When we consider that the ovule, the human egg, must travel through these tubes to reach the uterus and, if they are destroyed, has no other way of reaching the womb and, if it cannot reach the womb and be impregnated, cannot develop into the babe, then we realize how this disease is dooming women to childless lives,—women whose natural instincts and desires cry out for motherhood. When we consider the factors that promote race suicide we must not forget this important one. Even though the woman refuses an operation, or in a case in which the inflammation is not so severe and is reduced until she is nearly free from pain, the result may be the same, for the tubes may remain closed permanently.
The closure of the tubes is not the only result that may follow the course of this disease. The infection may extend into the peritoneal cavity causing peritonitis, which so often results in the untimely death of the woman. Here let me say that not all cases of peritonitis or of inflammation of the womb, tubes or ovaries are due to this infection. There are other infections, other germs, that may produce similar results. These germs may reach the organs in various ways. Sometimes the woman herself is to blame and sometimes we can blame no one. Inflammation of these organs may result from pressure of clothing, colds, excitement, overwork, pregnancies, excesses or neglect. The inflammation may spread to these organs from an inflamed appendix or other neighboring organs.
Supposing, though, following this disease the tubes are not entirely closed and the woman becomes pregnant. There is still the danger that during labor the baby's eyes will become infected and may become permanently blind. It is estimated that seventy per cent. of the blindness in the world has this cause. How does this produce blindness? Some few germs of this disease have remained in the vagina or birth canal and as the baby passes along the canal they enter its eyes. They are so very strong and work so rapidly that they can cause total blindness within three days. This fact is so well known by physicians that at the present time all reliable physicians pay especial attention to the newborn baby's eyes, cleansing them with an antiseptic solution immediately after birth. This precaution doubtless has saved the eyes of thousands of babies. This is one of the reasons why it is dangerous to employ an uneducated person at the time of labor. Even though she may have assisted at hundreds of births yet often she is ignorant of the many dangers and of the precautions that should be taken in every case.
Even adults may become blind from this infection. The disease is carried to the eyes by polluted fingers or towels. In a few hours the eyes become inflamed, pus forms, and unless heroic measures are taken, the eyesight is soon destroyed.
In female children the vagina may become infected through the use of tainted sponges, wash cloths, etc. An innocent girl may thus carelessly acquire the disease. For this reason, we see how necessary it is to caution girls never to use public towels or wash cloths that have been used by another person. Even in the home, every member of the family should have his exclusive towel and wash cloth.
The symptoms of gonorrhoea that often are noted first are a profuse discharge from the vagina, usually creamy or yellowish in color. This discharge is of such a nature that frequently it excoriates the external parts so that they become very tender and inflamed. Backache, especially across the hips, is a common accompaniment of this disease. There may be general soreness in the pelvic region. If a woman suspects she has contracted this disease, she should go immediately to some reliable physician; for at first the disease may affect only the vagina but, if neglected, may extend to the uterus and tubes. In its early stages it may be cured by prompt treatment, but the majority of women postpone treatment until it is too late.
The other loathsome disease, syphilis, infects the blood and therefore all parts of the body. While under proper treatment it is not dangerous to life in the earlier years, yet the possibilities of conveying the contagion are numerous. In the second stage, which lasts for a number of weeks, the mucous patches in the mouth are a source of danger. In this stage the disease may be conveyed by a kiss or through the medium of the public drinking cup, towel, or anything that comes in contact with the virus. It may be contracted by a babe from a wet-nurse or the nurse may contract it from the babe.
The most serious results of this disease appear years after its initial appearance, when the individual has been lulled into a false sense of security by long freedom from its outward symptoms. Many of the obscure cases of stomach or nerve trouble may be traced to this disease. The results not only affect the man, but, should he marry and have children, his innocent babes may come into the world with an inherited taint. These children seldom live to reach adult life and their lives usually are burdensome and full of misery. They may be deformed or be continually afflicted with ulcers or other horrible manifestations of the disease. I will explain this more thoroughly when I speak of heredity.
Many of the disastrous effects of these diseases might have been prevented if they had been properly treated in their early stages. Ignorance as to the nature and probable disastrous effects, if neglected, prevents many a person from procuring proper treatment. It is a common practice among men afflicted with these diseases to try various remedies recommended by their friends or by the druggist. It is strange that a person who would not think of trying to treat himself for smallpox or other contagious disease will do so with these diseases. With women, the cause of their neglect is a failure to realize the importance of the symptoms. Unfortunately women have grown to think that various female ills are their lot in life which must be endured and regarded as a dispensation of Providence instead of being considered an error in living that must be corrected the same as any other disease. Some commence treatment but neglect it as soon as the noticeable symptoms have disappeared. It generally is considered among physicians that the treatment of syphilis should be continued for at least three years after contracting the disease in order to remove all traces from the blood.
It is a deplorable fact that the prevalence of these diseases might have been prevented by proper instruction of young boys. No man ever willfully contracted one of these diseases. Statistics tell us that the majority of victims contract them before their twentieth year, before the boy has learned anything of their dangers or perhaps of their existence. If these patients received the right treatment immediately and continued it until the disease had been eradicated the results would have been less serious. Here, too, lack of early and proper instruction is shown; for these immature boys do not realize the necessity for prompt and wise treatment, or are misled by unscrupulous persons. I shall talk to you again on this subject, for many of you will have sons and you must know the dangers that beset them, so they can be prepared.
FAKE MEDICAL ADVICE FOR WOMEN
One young lady wrote me, "Recently I read that imperfectly developed ovaries might be a reason why some women do not have children. I have the symptoms which the article said indicated imperfect development. Does this necessarily mean that I never can have a baby? I seem to be healthy. I am twenty-one years old. I was to have been married in three months but now I do not know what to do. 'My boy' loves children as I do. It seems as though I cannot give him up, yet it surely is not honorable to marry him if I find that I never will have a little one, without telling him. Please tell me what to do."
The probabilities are that this girl's ovaries are perfectly normal and that the article mentioned was an advertisement of some medical house which, by misleading statements, endeavors to induce women to take their treatment. There are many women who suffer a great deal mentally, and this in turn reflects on their physical health because of just such articles.
It has been said that we are a nation of dupes and the advertisements carried in some of the papers would indicate the truth of this statement. No manufacturer is going to advertise anything that does not sell well and bring a considerable profit. Men are not so altruistic as to be in business just for the good of humanity. The majority are in business for the money to be obtained from it. Somehow, women are very susceptible to the arts of these greedy manufacturers. A company commences to make a patent medicine and then, in order to derive any profits from the investment, large quantities of the preparation must be sold. In order to accomplish this they must convince possible buyers of their need of this particular treatment. The company employs an agent to write an advertisement, perhaps in the shape of an article purporting to be written by someone much interested in the human race. This advertisement or article describes some disease which may be cured by this one remedy. As there might not be enough people who know they have this given disease to make a profit for the manufacturer, it becomes his business to convince others that they have this disease. Therefore, he proceeds to enumerate a great many symptoms which he says indicate this disease. Perhaps they might! But they are just as likely to indicate any one of half a dozen other things. He details enough symptoms so that some are recognized by nearly every woman as relating to her condition, so she jumps to the conclusion that she has that certain disease and buys a bottle of the medicine.
If you will study the large medical advertisements that appeal especially to women you will notice that they all have certain symptoms enumerated. No matter if the remedy advertised is for the kidneys, the bowels, or exclusively for women, the same symptoms are claimed to indicate the need of that certain remedy. One of the symptoms most commonly given is backache. Of course! For nearly every person has a backache at some time. It may be due to a strain, to rheumatism of the lumbar muscles (lumbago), to constipation, to a displacement, or to numerous other conditions. No one can tell the cause who is not properly prepared to do so and who is not fully acquainted with the physical condition. The sewing machine runs hard and perhaps makes a noise. It requires a mechanic who is familiar with the mechanism of the machine to find the cause of the trouble. So it is with the human body. It requires a mechanic who is familiar with the structure of the body to discover the cause of the trouble. And yet people will continue to pour into their bodies drugs, harmless and otherwise, that are manufactured by some enterprising firm and then advertised by an expert who knows nothing of disease except a few symptoms common to almost all diseases.
The patent medicine consumers seldom realize the nature of the medicine they take. Because some man, desirous of selling his remedy, claims it will be beneficial, they rush in and buy. To one who knows the true nature of some of these remedies, many laughable instances are visible. One man recently discovered that a temperance agitator was daily dosing herself with a certain tonic which was known to contain a larger percentage of alcohol than did the beverages she was denouncing so ardently.
Patent medicines may benefit some, but in the majority of cases, the consumer is like a man who boards the nearest street-car hoping it will take him to his destination. It may! But it is just as likely to take him in the opposite direction.
Some people become veritable drug fiends, slaves to certain drugs without in the least realizing their condition. How many are slaves to certain laxatives or headache powders! With them the daily dose of "harmless" teas or waters or even of pills cannot be neglected. And yet such a person would be indignant at the suggestion that she was the victim of a drug habit. What are drugs, anyhow? The majority are simply extracts of herbs and vegetables. And yet people imagine that they are avoiding the use of drugs and medicines when they take "simple herb remedies, prepared at home."
Another lure of the advertiser is to state that all letters are "strictly confidential and answered by women only." Perhaps they are! But he neglects to add that the women who answer these letters are simply stenographers with no medical knowledge, employed to write according to dictation, that the letters are all written according to certain forms which have been dictated by the manager. A short time ago a young woman wrote me regarding her condition. Among other things, she said she had written to a certain woman whose name is much advertised by a patent medicine concern and that this woman had written her advice that had caused her to worry over her condition. Poor, deluded girl! How was she to know that the woman in question had been dead many years and that the business was carried on by her son and other men.
If you are ill do not be misled by these unscrupulous advertisers. Do not waste your time and money on remedies that may be entirely unsuited to your condition.
THE MARRIAGE RELATION
As several of you expect to be married soon I think it would be well to talk briefly about the cause of so much unhappiness in marriage.
It has been estimated that only about five per cent. of all marriages are successful. Is this true, and if true, why? If five per cent. made a success of marriage, why could not the other ninety-five? Marriage is a science to be studied by the prospective bride and groom in order that they may be ranked with the five per cent. and not make a failure of their married life. Few would enter the marriage relation if convinced that it would be a failure. The prospective bride looks around among her acquaintances and sees the lack of true happiness, thinks that her case will be an exception, that her marriage will turn out all right and then goes blindly ahead into the new life without any preparation.
A large percentage of the unhappiness among married couples comes through a misunderstanding of the marital relations. A great deal of this is due to ignorance on the part of the bride and thoughtlessness on the part of the husband. This is partly due to defective education during childhood in regard to the sexes. The training of boys and girls in this matter is very different. Knowledge pertaining to the sexual life is talked over very freely among boys, so that by the time the boy is of a marriageable age he is pretty well posted. With girls it is quite different. It would be considered very immodest for a girl to discuss such matters. She does not feel free even to talk with her mother or other adviser, and so she goes to the altar ignorant of many things she should know. Then during the first few days of married life this knowledge so overwhelms her and often gives her such a severe shock that it leaves a lasting impression. She has no way of knowing that her husband is just like other men. She is liable to regard him as a brute and resent his attentions.
Such a condition of affairs is altogether wrong, but the girl is not to be blamed. Had she been taught what to expect, much of the unhappiness of married life might have been avoided. If taught correctly, the girl should regard the sexual act as the culmination of true love. It should be regarded as something sacred, something that makes her and her husband as one. Fortunate indeed is the girl whose husband realizes this lack of knowledge and gently leads her to desire the fulfillment of love. Unfortunate is the girl whose husband regards this act only as the gratification of animal passions—something it is a wife's duty to endure as such.
Passion or sex sense is a sign of maturity. It is the calling for a mate. All animals have this sense and nearly all animals have a mating season. The billing and cooing of the birds in the springtime is an expression of this sense—the love sense. It is possessed by every little insect. Only by knowing their habits do we see the expression of it. This sense is nothing of which one should be ashamed. It was God-given for a divine purpose.
In the study of plants we learn that the pollen or male element must unite with the ovum or female element in order to produce the seed that will develop into the new plant. The same fact is true of the human race. Before pregnancy can take place there must be a meeting and fusion of the vital elements of the two sexes. This fertilization of the ovum or joining of the male and female elements is called conception. It is brought about by coitus, by means of which the semen of the male is deposited in the vagina of the female. This act is called insemination, although conception does not follow unless the ovum and spermatozoon (life-giving element of the semen) come together and unite. When this occurs the woman conceives and enters upon a period of pregnancy. The time at which conception is least likely to occur is from the seventeenth to the twenty-third day after menstruation ceases.
During the first year of married life couples are liable to abuse the love sense by over-indulgence and thereby use up too much of their energy. This affects their health, especially that of the young wife, who finds herself always being tired and is unable to account for it. Her daily tasks become a drudgery, for she is too exhausted to have the strength to perform them. After the tasks finally are finished, she is too tired to don the afternoon dress, and so easily falls into untidy habits. This brings its train of results. The young husband, on his return from work, fails to find his wife the bright, attractive girl he married and gradually grows indifferent.
The relation of intercourse to conception is a problem that each husband and wife must settle for themselves. Some educators claim that only for the one is the other allowable, that the bearing and raising of children is the sole aim of married life. Naturally this is the fundamental end of the sex instinct. But in the present-day, practical married life it would be impossible to convince the majority that the impulse of sex gratification was given to them for this one purpose only.
The sense of well being and the increased capacity for work, that follows a moderate exercise of this function, tends to convince us that it has a beneficial effect upon the entire system if exercised moderately. As to what constitutes moderation or temperance depends upon the individual. What would be moderation to some would be excess to others. It may be taken as a general rule that the after-effects will indicate the amount. If the after-effects are irritability, extreme lassitude or a diminution of the love or respect for the other then there has been excess. If the after-effect is a sense of well-being so that the next day one feels more inclined to take up the duties of life, then it may be considered that moderation has been practiced. A certain amount of energy is consumed in any act and, as in our present age we need a great deal of energy to carry on our everyday business, in the majority of cases fresh vitality cannot be spared for an expenditure under several days or a week. Excess in anything tends to bring on premature old age, for the nervous force is expended faster than it is manufactured.
Frequently women seem to be endowed with an excess of energy which manifests itself in various forms. Besides this, the woman does not seem to have control of her nervous energy but wastes it in numerous ways. With many a woman the regularity and moderation attendant on a happy married life seems to have a regulating effect upon her whole nervous system, so that she becomes more calm and has greater control over her energies.
Wrong training or lack of training in matters pertaining to the relationship of the sexes and to the management of a home may be given as the cause of the majority of unhappy marriages.
There must be something wrong with our system of education when the aim of this education seems to be to prepare the girl for a temporary position in an office or store or for a gay social life; and when there is no preparation for the important work of home-making and the rearing of children. A girl would not be expected to run a complicated and delicate piece of machinery without having adequate instruction concerning the necessary care of it. But the girl is allowed to go blindly into marriage and is expected to manage her home and care for her children with practically no preparation. Nowadays we require experts for every position except that of motherhood, but we apparently do not consider that of enough importance to waste any time preparing for it. A man requires his gardener or office assistant to be trained, but the mother of his children need know nothing regarding the preparation for their coming. Too often her only preparation is that of making numerous clothes. She takes no measures to insure a healthy child.
If girls would make a study of home-making and motherhood and enter into marriage with a more definite realization of its obligations we would have fewer unhappy marriages and fewer divorce cases. Some women, owing to false education, wish to have all the advantages of marriage without assuming its cares. Such a woman expects a man to be willing to provide her with all the gifts of the gods, with all the luxuries of life, but in return is not willing to become the mother of his children nor to exert herself to make their mutual habitation a home and not merely a house—a place in which to eat and sleep.
A large part of the average woman's life is devoted to home-making and the rearing of children. Usually she is poorly prepared for this work. The early years of a girl's life are spent in the acquisition of a store of general knowledge, especially that derived from books and related to subjects generally considered necessary to "culture." During this period, her time is so occupied with her studies that her mother thinks it would be an imposition to ask her to do any housework, so the girl grows up without much knowledge of the care of a home. True, she often is enabled to do a few things. She learns to make cake and several varieties of candy and perhaps can fashion a collar that is the envy of her schoolmates. Sometimes she even helps her mother with the dishes or the dusting, but it is easier for the mother to take the responsibility of the housekeeping than it is to teach her daughter to do so, and besides her daughter always is so busy with school affairs. She has no time in which to learn the science of housekeeping.
After the completion of her course in the common or high school, a few months, sometimes, are devoted to the preparation for a certain line of work which is to occupy her time for a few years. Very few girls, except those who enter the professions, expect to continue their work after marriage and nearly all look forward to marriage. If we place a girl at a new occupation, for instance lace-making, and let her work out her own salvation, we would not be surprised if she disliked her work and was unable to accomplish any good results. But that is what we do in regard to home-making. A girl upon marriage is expected to know by instinct how to keep house, cook, and do the numerous other household duties; she is expected to know how to care for herself before the birth of her baby and how to care for the baby when it comes. Fortunately for the future generation this fact has come to the realization of many of our educators. During the last few years many schools have introduced into their curriculum, courses in domestic science, including the purchasing, preparation and serving of food. Very recently some of the more progressive schools have introduced courses in nursing and the care of young babies. Perhaps in a few years motherhood will take its proper place as the most important of all sciences.
EMBRYOLOGY—THE DEVELOPMENT OF LIFE
You remember I mentioned that at various times during the month an ovum or egg leaves the ovary and passes along the tube to the uterus. Here it remains if it is impregnated or fertilized by a union with the spermatozoon or male element. The whole body of the babe is developed from the ovum or female element after it has been fertilized by the spermatozoon or male element. The union usually takes place in the tube. The spermatozoon, after being deposited in the vagina, travels to the mouth of the womb, then up through the womb into one of the tubes. Here it meets the ovum and unites with it, then the impregnated ovum continues on its way to the uterus. It attaches itself to the lining of the womb by little thread-like filaments which it projects. The ovum then begins to grow, dividing itself into portions that go to make the different parts of the body. Before I continue, let me remind you that the ovum in the beginning is only about as large as the point of a pin, being about 1-125 of an inch in diameter, while the spermatozoon is so tiny it cannot be seen without the aid of a miscroscope. Therefore, it can be realized how much the ovum has to grow before it becomes a fully formed babe.
During the time the ovum is developing into the babe we speak of it first as the embryo, then the foetus. It takes about nine calendar months or ten lunar months before the foetus is fully developed and ready to be expelled from the womb. During the process of development the foetus resembles various animals. It seems it must pass through about the same stages of evolution that our primitive ancestors did.
By the end of the third week, the dividing has progressed so far that the body is quite well indicated. By the end of the seventh week the body and limbs are quite well defined. One peculiar thing is that, at this time, the foetus has a tail which disappears during the next two weeks. During the third month the foetus increases in size and weight so that by the end of the month the weight is four ounces and the length two and three-fourths inches. It now is not directly attached to the lining of the womb but is attached by means of the cord to the placenta or afterbirth which has been forming slowly. This placenta consists of fatty tissue surrounding a great many little blood vessels. The tiny blood vessels lie so close to the blood vessels of the lining of the womb that the blood passes from one to the other. To do this, it must pass through the walls of the blood vessels, as the vessels of the mother and those of the placenta are not directly united. The blood vessels of the placenta unite to form two veins and one artery which lie very close to each other and are surrounded by a membrane. These three blood vessels united together form what we call the cord. The other end of the cord is attached to the foetus so that the blood can flow back and forth between the foetus and placenta.
By the end of the third month the limbs have definite shape, the nails being almost perfectly formed. During the next month the sexual distinctions of the external organs become well marked.
By the last of the fifth month the weight has increased to one pound and the length to eight inches. Active foetal movements begin, that is, the foetus begins to move around and not lie quietly as before. This is what is usually spoken of as "feeling life," or as "quickening." There is life from the very beginning but during the first four or five months the foetus does not move about and so the mother does not "feel life." This has caused the erroneous idea that there is no life before the fifth month.
By the end of the sixth month the weight is two pounds and the length twelve inches. The eyebrows and eyelashes have begun to grow and the lobule of the ear is more characteristic.
By the end of the seventh month the weight is three pounds and the length fourteen inches. The surface of the body, which has appeared wrinkled, now appears more smooth owing to the increase of fat underneath.
By the end of the eighth month the weight is four to five pounds and the length twenty inches. The nails have grown to project beyond the finger tips. Up to this time the body has been covered with a fine hair called lanugo. This now has begun to disappear and the skin becomes brighter and is covered with a white, cheesy material called the vernix caseosa. This almost entirely disappears during the next month, but frequently there are portions of it remaining on the body at the time of birth. The foetus is fully developed by the end of the ninth month. Then its average weight is six or seven pounds and the length twenty inches.
If we could look into the womb just before the time of labor we would find the foetus attached by the cord to the placenta and floating in a sac of water. This sac is formed partly of the placenta and partly of the membrane; the side of the placenta opposite to the child being attached to the womb. Just before labor the child takes a position with its head downward, its lower limbs flexed and its arms folded upon its breast. This allows it to come in the usual way, head first. But sometimes, for various reasons, it does not take this position and some part other than the head, for instance, the feet, may be born first.
Labor pains are caused by the contraction of the muscles of the womb in an effort to expel the foetus. The muscles, contracting, push the foetus downward to the mouth of the womb but push ahead of it a portion of the membrane enclosing some of the water. This is called the "bag of waters." As it presses against the mouth of the womb it causes it to dilate so as to allow the foetus to pass through into the vagina. The foetus, preceded by the bag of waters, then descends through the vagina or birth canal until it comes to the external opening of the vagina. This it must dilate before it can pass through it. The bag of waters should rupture normally while it is being pushed through the external opening. Sometimes the bag does not rupture directly in front of the descending head but further up along the side. Then a portion of the membrane may be over the face of the child when it is born. This is what is called being "born with a veil" or "born with a caul."
The bag of waters helps dilate the parts much easier than the foetus could do it alone. When the bag breaks the water lubricates the parts so as to make the passage of the child easier. When it breaks, as it sometimes does, at the beginning of labor we have what is termed a "dry labor." This usually is much slower than it would be otherwise. The majority of the cases of labor extend over a period of from twelve to twenty-four hours.
Sometimes the external opening of the vagina does not dilate enough to allow the passage of the child. As the head presses hard against the perineum it tears it. This tear should be repaired immediately after completion of labor.
When the baby is born it is fully formed but its lungs have never contained air. At the first cry the air rushes into the lungs and expands them. At birth there is a change in the circulation of the blood of the baby. Before this time, the blood has passed to and from the placenta through the cord but now this is stopped. Before birth there was an opening between the right and left sides of the heart but this closes during the first few days of the child's life. To assist in this closure, it is wise to keep the child on its right side for a few days. Rarely, this opening never closes and we have what is called a "blue baby," which seldom lives very long.
In a great many cases, painless childbirth could be a possibility by a little attention to diet, exercise and other hygienic measures during the last few months of pregnancy. Knowing this, it seems inconceivable that any woman would neglect to so fully inform herself on these matters that both she and her child could have all benefit of the investigations of science.
Sometimes through an accident or on account of disease, the womb expels the foetus before it is fully developed. If this occurs before the end of the third month we call it an abortion; if it occurs between the third and seventh months we call it a miscarriage; while if it occurs after the seventh month but before the normal time of labor we call it a premature labor.
Formerly it was considered that there was no possibility of the child living if it were born before the seventh month. Now, by the aid of incubators, even those born at five months have a chance to live. By that time the body is fully formed, so the chief requirements are a steady temperature and proper care and food. Great care must be exercised, as a slight cooling of the air may result in the death of the babe.
Abortions are either accidental, criminal, or justifiable, that is, brought on to preserve the life of the mother. Accidental abortions may follow a sudden fall or a sudden shock, either mental or physical, to the mother. They may be due to some disease either of the mother or of the foetus. Of the diseases responsible for abortions the one with the largest percentage is syphilis. It is estimated that this disease is responsible for forty per cent. of accidental abortions and miscarriages. Whenever a physician has for a patient a woman who gives a history of having had several abortions without any apparent cause and all at about the same age of the foetus, he immediately becomes suspicious of syphilis either of the father or the mother. It is a peculiar fact with this disease that it may be transmitted to the offspring without the mother ever actually having the disease. This is an instance of "visiting the sins of the fathers upon the children unto the third and fourth generation." Many a weak frame owes its condition to a dissipated father, grandfather or even great-grandfather. It is possible, though, for a man or woman who has had this disease to have a healthy child if the disease has been properly treated.
Under some circumstances, especially with a deformed pelvis, if pregnancy were allowed to proceed normally it probably would result in the death of the mother. Then, it is considered justifiable for the physician in charge of the case to produce an abortion in order to save the life of the mother. Those cases are rare and such a procedure never is undertaken except in extreme cases.
Criminal abortions are those brought on simply because the woman does not desire to have a child. These often are produced by the woman herself by means of drugs that set up uterine contractions (labor pains) or by means of something introduced into the uterus. In either case it is a dangerous procedure. Infections may be carried into the uterus by means of whatever is introduced into it. This may set up an inflammation that may result in the death of the woman. It is a dangerous procedure to introduce anything into the womb. Some women are extremely foolish or reckless and use anything that may be handy. Sometimes grave harm results. Instances are on record of women who have punctured the walls of the womb by the use of hatpins or other sharp instruments. If an abortion is produced by either drugs or instruments there is danger that all the products of conception may not come away. If even a small portion remains in the uterus it may cause a hemorrhage or, becoming decomposed, produce a poison that may result in the death of the woman.
It would be impossible to estimate the number of abortions performed on unmarried girls, as well as married women, during one year by midwives, unscrupulous physicians and by many respected family physicians. We never hear of one of these except through the occasional one who is so unfortunate as to meet death. We cannot entirely blame the one who performs the abortion. Sometimes it is performed because of the sympathy of the physician. It is very hard to refuse some cases. Let me read you a letter to illustrate my meaning.
"I have just finished reading your article on 'Woman's Inhumanity to Woman' and wish to say that every word impresses the truth as read. My reason for writing you is because I am one of those who have sinned through love, with one I have known all my life only to find too late that he did not love me; and the sin is killing me. I do not want to bring into this world a little child to have no father. I am not bad at heart. My only hope is to get something that will bring me all right. If you are a doctor you can give me medicine that will help me miscarry this, as I have only missed two months. Nothing would please me more than to be the mother of a little one, but, oh, not one born without a name. Dear madam, if you can help me, or show me some way that my people cannot suspect me of this sin, for the love you bear all girls, help me. I am the only one at home to care for an aged father and one of the dearest brothers that ever lived. If he knew I had sinned as I have, it would break his heart. My God in heaven, help me! is my prayer, and through his love you can help me. I am almost desperate and before I will live and bear this sin I will take my own life, which will bar me from heaven and my angel mother's face. Be gracious, kind doctor, and help me. I will repay you if it takes the remainder of my life and give my solemn promise that I will sin no more. Erring through the love of a man is my only excuse and, oh, I am the one to bear the blame. He would be forgiven. I am so nervous and ruined in mind that I hardly can go about my duties and I cannot stand the strain much longer. Let me hear from you at once and please help me, for I know it can be done, but I am ignorant; I do not know what to get or what to do. It will be no sin to try to get all right and not bear a child, but in my thoughts it is something awful to have to have it. For the love of heaven help a heartbroken girl at once and before it is too late for me to regain my chance of heaven."
Now suppose you were a physician and that girl, instead of being a stranger, was a very dear friend who had come to you in your office, would you not be tempted to grant her wishes? That is the position in which every physician is placed a great many times. Some allow their sympathies to rule and so break the laws of the land. They allow their sympathies to overcome the moral truths that previously had been their guide. They commit a crime by taking a life, even though that life were not fully developed.
Many women have the false idea that there is no life before the fifth month and so think they are not destroying life if they have an abortion at the end of the first, the second or even the third month. This idea is entirely erroneous, for there is life from the very beginning and it is just as wrong to destroy life the first few months as it would be to do so later.
Aside from this moral reason there is a very important reason for not having abortions. You may regret it afterwards! Let me give you an instance. One of my friends, a charming young woman, was married several years ago. After her marriage she moved to a distant city and I did not see her for about four years. Then she returned and called to see me. During the course of our conversation I asked her if she had any children. Her reply in a very sad tone was, "No, I guess I did too much interfering at first, so now I cannot have any." Then she told me she had the idea she did not wish to have children for several years after she was married. So during the first year she had an abortion performed. Now for two years she had been wanting a baby but none came. That is the history of so many women. The regrets!
All women naturally desire to have children. If they do not, they are the victims of false ideas or of fear. Anything which is natural is the best, so usually a woman who bears children is much healthier than one who does not. Think of the women of your acquaintance and see if the mothers are not happier and healthier than the women who are childless.
Every child has a right to be born well. An undesired child never should be brought into the world. An undesired child or a child of parents who are not in good bodily or mental condition comes into the world with an inheritance that perhaps never is overcome. How can we expect children of parents with criminal tendencies to become good citizens?
Children born in circumstances under which the expectant mother has been subjected to fright or to cruel treatment are handicapped in the very beginning of life's race. Maternal impressions from fright or physical violence undoubtedly are followed by the birth of individuals malformed and in many respects with altered minds. Although some biologists try to deny this, the coincidence is too widely observed to admit of doubt, although the precise manner in which the effect is produced has not been clearly demonstrated. Sufficient is known to make it of the utmost importance that, in the interest of her offspring, the expectant mother be not subjected to sudden or violent mechanical force or to any great nervous shock. Equally important is it that she should be surrounded by a harmonious environment in order to give the unborn child all possible benefit of such surroundings.
By many it is claimed that the mother's mental condition during this period will be reflected in the child both mentally and physically. For instance if the mother be calm, free from worry and happy in anticipation of the coming event, her offspring will have a sound nervous system, shown by a perfect digestion and an excellent disposition: while if the mother be irritable and unhappy her child is inclined to have various digestive ills, as well as to be cross and restless.