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(of IV.), by +W. Grant Hague, M.D. + +This eBook is for the use of anyone anywhere at no cost and with +almost no restrictions whatsoever. You may copy it, give it away or +re-use it under the terms of the Project Gutenberg License included +with this eBook or online at www.gutenberg.org + + +Title: The Eugenic Marriage, Volume I. (of IV.) + A Personal Guide to the New Science of Better Living and Better Babies + +Author: W. Grant Hague, M.D. + +Release Date: October 21, 2006 [EBook #19594] + +Language: English + +Character set encoding: ISO-8859-1 + +*** START OF THIS PROJECT GUTENBERG EBOOK EUGENIC MARRIAGE *** + + + + +Produced by K.D. Thornton, Jason Isbell, Keith Edkins and +the Online Distributed Proofreading Team at +http://www.pgdp.net + + + + + + +</pre> + +<table border="0" cellpadding="10" style="background-color: #ccccff;"> + <tr> + <td width="25%" valign="top"> + Transcriber's note: + </td> + <td> + A few typographical errors have been corrected. They + appear in the text <ins class="correction" + title="explanation will pop up">like this</ins>, and the + explanation will appear when the mouse pointer is moved over the marked + passage. + </td> + </tr> +</table> + <div class="figcenter" style="width:50%;"> + <a href="images/v1frontis.jpg"><img width="100%" src="images/v1frontis.jpg" + alt="Eugenics Hath Its Own Reward" /></a> + <h4>Eugenics Hath Its Own Reward</h4> + </div> +<h1>The Eugenic Marriage</h1> + +<h2>A Personal Guide to the<br /> +New Science of Better<br /> +Living and Better Babies</h2> + +<h3>By W. GRANT HAGUE, M.D.</h3> + +<h4>College of Physicians and Surgeons (Columbia +University), New York; Member of County Medical +Society, and of the American Medical Association</h4> + +<h2>In Four Volumes</h2> + +<h2>VOLUME I</h2> + +<h4>New York</h4> + +<h3>THE REVIEW OF REVIEWS COMPANY</h3> + +<h4>1916</h4> + +<p class="center" style="margin-top: 2em;">Copyright, 1913, by <font class="sc">W. Grant Hague</font></p> + +<p class="center" style="margin-top: 2em;">Copyright, 1914, by <font class="sc">W. Grant Hague</font></p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page i --><span class="pagenum"><a name="pagei"></a>[i]</span></p> + +<h3>INDEX OF THE FOUR VOLUMES</h3> + +<font class="sc">Note</font>—The Roman numerals I, II, III and IV indicate the +volume; the Arabic figures 1, 2, 3, etc., indicate the page number. + + <p>Accidents and emergencies, IV, 629.</p> + + <p>Accouchement Beds, how to prepare, I, <a href="#page65">65</a>.</p> + + <p>Acne, IV, 576.</p> + + <p>Adenoids, IV, 519; how to tell when child has, IV, 520; treatment of, + IV, 521.</p> + + <p>Adentitis, acute, IV, 558; causes of, IV, 558; symptoms of, IV, 558; + treatment of, IV, 558.</p> + + <p>Advice to young wives, III, 357.</p> + + <p>After-birth, expulsion of, I, <a href="#page101">101</a>.</p> + + <p>After-pains, I, <a href="#page103">103</a>.</p> + + <p>Age at which to marry, III, 331.</p> + + <p>Albumen water, II, 245.</p> + + <p>Alcohol, in patent medicines, III, 455.</p> + + <p>Alcoholic drunkenness, I, <a href="#page44">44</a>; Dr. Branthwaite + on, I, <a href="#page45">45</a>; Dr. Sullivan on, I, <a + href="#page44">44</a>.</p> + + <p>Amenorrhea, causes, II, 192; absence of menstruation, II, 191; + treatment of, II, 192.</p> + + <p>Anemia, severe, IV, 567; simple, IV, 565; treatment of various forms, + IV, 567.</p> + + <p>Anesthetics, new, IV, 654; use of in confinements, I, <a + href="#page112">112</a>.</p> + + <p>Angina, IV, 508.</p> + + <p>Anti-meningitis, serum, IV, 656.</p> + + <p>Aperient waters, abuse of in constipation, III, 326.</p> + + <p>Appendicitis, IV, 546; treatment of, IV, 546.</p> + + <p>Appetite, loss of, II, 287; poor, II, 286; treatment for loss of, II, + 288.</p> + + <p>Arrest of hemorrhage, IV, 635.</p> + + <p>Artificial Food, II, 249; formulæ for, II, 253; mistakes in preparing, + II, 267.</p> + + <p>Aseptic surgery, IV, 653.</p> + + <p>Baby, amusing the, II, 217; bathing the, II, 213; care of eyes, II, + 215; care of genital organs, II, 216; care of mouth and teeth, II, 215; + care of newly-born, II, 210; care of skin, II, 216; clothing of, II, 214; + constipation in bottle-fed, II, 309; food for first year, II, 261; fresh + air for, II, 232; how it gets nourishment in womb, II, 183; how long it + should sleep, II, 236; how to weigh, II, 220; hygiene and development of, + II, 209; intervals of feeding, II, 225; night-clothes of, II, 215; + overfeeding the, II, 224; proper way to lay in bed, II, 235; what to + prepare for the coming, II, 209; why it cries, II, 237.</p> + + <p>Baby's comforter, II, 241.</p> + + <p>Bacteria, what happens if we inhale, III, 410.</p> + + <p>Barley gruel, II, 244.</p> + + <p>Barley water, II, 244, 256.</p> + +<p><!-- Page ii --><span class="pagenum"><a name="pageii"></a>[ii]</span></p> + + <p>Bath, bran, IV, 591; cold, for reducing fever, IV, 590; cold sponge or + shower, IV, 592; during pregnancy, I, <a href="#page76">76</a>; hot air + or vapor, IV, 591; hot, IV, 591; mustard, IV, 590; tepid, IV, 592; + various kinds of, IV, 590.</p> + + <p>Bathing, the baby, II, 213.</p> + + <p>Bed, proper way to lay baby in, II, 235.</p> + + <p>Bed-wetting, IV, 580.</p> + + <p>Beef juice, II, 262.</p> + + <p>Beef or meat pulp, II, 244.</p> + + <p>Bichloride of mercury solution, IV, 627.</p> + + <p>Binder, how to apply, I, <a href="#page66">66</a>.</p> + + <p>Birth, management of, I, <a href="#page99">99</a>.</p> + + <p>Birth-chamber, the, I, <a href="#page61">61</a>.</p> + + <p>Birth marks, I, <a href="#page128">128</a>.</p> + + <p>Bites, dog, IV, 638.</p> + + <p>Blackheads, IV, 576.</p> + + <p>Blood, children suffering from poor, IV, 566; poor, IV, 565.</p> + + <p>Boils, IV, 559.</p> + + <p>Boracic Acid, solution of, IV, 626.</p> + + <p>Bottle-feeding, method of, II, 256; what a mother should know about, + II, 264.</p> + + <p>Bowels, daily movement necessary, II, 307; how to wash out, IV, 586; + importance of clean, II, 306.</p> + + <p>Boy, building of, II, 139; chancre, the, II, 145; gonorrhea or "clap," + II, 142; sex-hygiene for, II, 139; social evil, II, 141; sources of + immorality, II, 141; syphilis or "pox," II, 144.</p> + + <p>Brain, complications of in syphilis, II, 146.</p> + + <p>Bran, as a food, II, 292; bath, IV, 591; muffins, recipe for, II, + 311.</p> + + <p>Branthwaite, Dr., on alcoholic drunkenness, I, <a + href="#page45">45</a>.</p> + + <p>Bread, II, 273.</p> + + <p>Breasts, care of when weaning, I, <a href="#page125">125</a>; + colostrum in, I, <a href="#page108">108</a>; how long should baby stay + at, II, 225; putting baby to after labor, I, <a + href="#page108">108</a>.</p> + + <p>Bronchitis, IV, 511; chronic, IV, 515; diet for, IV, 513; drugs in, + IV, 514; external applications for, IV, 514; inhalations for, IV, 513; in + older children, IV, 512; symptoms of in infants, IV, 512; treatment of + IV, 512.</p> + + <p>Broncho-Pneumonia, acute, IV, 516; symptoms of, IV, 516; how to tell + when child has, IV, 517; treatment of child with, IV, 517.</p> + + <p>Bruise, or contusion, IV, 633.</p> + + <p>Burbank, Luther, on education, I, <a href="#page24">24</a>.</p> + + <p>Burning Clothing, how to extinguish, IV, 641.</p> + + <p>Burns, and scalds, IV, 641.</p> + + <p>Calomel, II, 297; how to take, II, 297.</p> + + <p>Cancer, in women, III, 442; what every woman should know about, III, + 442.</p> + + <p>Carron oil, solution of, IV, 627.</p> + + <p>Castor oil, II, 295; how to give dose of, II, 296.</p> + + <p>Catarrh, acute nasal, IV, 500; symptoms of, IV, 500.</p> + + <p>Catarrh powders, III, 458.</p> + + <p>Cathartics, calomel, II, 295; castor oil, II, 295; citrate of + magnesia, II, 298; how to give children, II, 295.</p> + + <p>Cereals, II, 273.</p> + + <p>Chancre, the, II, 145.</p> + + <p>Change of life, conduct during, III, 446; the menopause, III, 443; + symptoms of, III, 444.</p> + + <p>Cheerful wife and mother, III, 400.</p> + + <p>Chicken broth, II, 244.</p> + +<p><!-- Page iii --><span class="pagenum"><a name="pageiii"></a>[iii]</span></p> + + <p>Chicken-pox, IV, 606; symptoms of, IV, 607.</p> + + <p>Child, the delicate, II, 281; diet of sick, II, 279; most helpless + living thing, II, 279; rate of growth of, II, 221; sick, should be in + bed, II, 277; washing mouth and eyes after birth, I, <a + href="#page102">102</a>.</p> + + <p>Child-Birth, I, <a href="#page61">61</a>; fear of, I, <a + href="#page111">111</a>.</p> + + <p>Children, acute intestinal diseases of, IV, 529; constipation in, II, + 303; hysterical, II, 293; rheumatism in, IV, 569; temperature in, II, + 217; with whom milk does not agree, IV, 535.</p> + + <p>Cholera infantum, IV, 540.</p> + + <p>Chlorosis, IV, 566; symptoms of, IV, 566.</p> + + <p>Chronic Nasal catarrh, IV, 503; treatment of, IV, 504.</p> + + <p>Circumcision, should it be advised, II, 169.</p> + + <p>Citrate of magnesia, II, 295; how to take, II, 298.</p> + + <p>Clap, or gonorrhea, II, 142.</p> + + <p>Clothing, baby's, II, 214.</p> + + <p>Coddled egg, II, 245.</p> + + <p>Cold-pack, IV, 589.</p> + + <p>Colds, catching, IV, 497.</p> + + <p>Colic, IV, 544; symptoms of, IV, 545; treatment of, IV, 545.</p> + + <p>Colitis, chronic, IV, 538.</p> + + <p>Colon, irrigation of, IV, 587.</p> + + <p>Colostrum, uses of, I, <a href="#page108">108</a>.</p> + + <p>Condensed milk feeding, II, 227; objections to, II, 257.</p> + + <p>Confinement, choice of physician, I, <a href="#page69">69</a>; + convalescing after, I, <a href="#page131">131</a>; domestic problem + following first, I, <a href="#page131">131</a>; how to calculate date of, + I, <a href="#page66">66</a>; how to prepare bed for, I, <a + href="#page65">65</a>; lacerations during, I, <a href="#page116">116</a>; + how long woman should stay in bed after, I, <a href="#page114">114</a>; + position and arrangement of bed for, I, <a href="#page64">64</a>; + preparations for, I, <a href="#page61">61</a>; selection of a nurse, I, + <a href="#page70">70</a>; use of anesthetics in, I, <a + href="#page112">112</a>; what to provide for, I, <a + href="#page62">62</a>.</p> + + <p>Confinement chamber, presence of friends in, I, <a + href="#page113">113</a>; presence of relatives in, I, <a + href="#page113">113</a>.</p> + + <p>Constipation, II, 315; abuse of cathartics and aperient waters, II, + 326; always harmful, II, 321; chief cause of, II, 315; cost of, II, 317; + diseases of women and, II, 320; during pregnancy, I, <a + href="#page84">84</a>; in bottle-fed infants, II, 309; in breast-fed <ins + class="correction" title="'in-infants' (line-break) in original" + >infants</ins>, II, 308; in girls between 16 and 20, II, 321; in children + over two years old, II, 309; in infants and children, II, 303; lack of + bulk in food, II, 326; lack of exercise and, II, 325; lack of water, II, + 325; negligence of, II, 324; pregnancy and, II, 321; significance of, II, + 305; social exigencies and, II, 319; treatment of, II, 323; treatment of + obstinate, II, 311.</p> + + <p>Consumption cure, III, 461.</p> + + <p>Consumptives, information for and those living with, III, 421.</p> + + <p>Contagious diseases, IV, 599; conduct and dress of nurse for, IV, 600; + convalescence after, IV, 603; rules to be observed in treatment, IV, 599; + what isolation means, IV, 600.</p> + + <p>Contusion, or bruise, IV, 633.</p> + + <p>Convulsions, IV, 577; treatment of child with, IV, 579.</p> + + <p>Cord, cutting, the, I, <a href="#page102">102</a>; dressing the, II, + 210.</p> + + <p>Cough, treatment of, IV, 505; nervous or persistent, IV, 504.</p> + +<p><!-- Page iv --><span class="pagenum"><a name="pageiv"></a>[iv]</span></p> + + <p>Cream, for constipation in infants, II, 309.</p> + + <p>Croup, false, IV, 506; treatment of false, IV, 507; spasmodic, IV, + 507; treatment of spasmodic, IV, 507.</p> + + <p>Deaf and dumb, I, <a href="#page37">37</a>.</p> + + <p>Detention, symptoms of, II, 219; treatment of, II, 219.</p> + + <p>Desserts, II, 273.</p> + + <p>Diarrhœa, inflammatory, IV, 535; summer, IV, 539; symptoms of + summer, IV, 540; treatment of inflammatory, IV, 537; treatment of summer, + IV, 541.</p> + + <p>Diet, of nursing mother, I, <a href="#page121">121</a>; of the + pregnant woman, I, <a href="#page77">77</a>; of sick child, II, 279; for + constipated child, II, 310; older children, II, 271.</p> + + <p>Dinner, the first after labor, I, <a href="#page109">109</a>.</p> + + <p>Diphtheria, IV, 610; symptoms of, IV, 611; treatment of, IV, 613.</p> + + <p>Disease, how we catch, III, 409; tendency to, III, 416; vice and, I, + <a href="#page4">4</a>; of womb, ovaries or fallopian tubes, II, 199.</p> + + <p>Disinfecting, Clothing and linen, IV, 601; mouth and nose, IV, 602; + sick chamber, IV, 604.</p> + + <p>Dislocations, IV, 640.</p> + + <p>Dog-bites, IV, 638.</p> + + <p>Douche, how to give after labor, I, <a href="#page108">108</a>; the + use of when pregnant, I, <a href="#page76">76</a>.</p> + + <p>Draw-sheet, the, I, <a href="#page65">65</a>.</p> + + <p>Dried bread, II, 245.</p> + + <p>Dusting and cleaning, II, 391.</p> + + <p>Dysentery, cause of, IV, 535; symptoms of, IV, 536.</p> + + <p>Dysmenorrhea, II, 193.</p> + + <p>Ear, foreign bodies in, IV, 631; inflammation of, IV, 556; method of + removing foreign bodies, IV, 632; treatment of inflammation, IV, 556.</p> + + <p>Earache, IV, 555.</p> + + <p>Ears, do not box, IV, 554; do not pick, IV, 554; let them alone, IV, + 554.</p> + + <p>Eczema, IV, 562; of the face, IV, 563; rubrum, IV, 563.</p> + + <p>Education, and the educator, I, <a href="#page29">29</a>; eugenics + and, I, <a href="#page4">4</a>; Dr. C. W. Saleeby on, I, <a + href="#page22">22</a>; Dr. Helen C. Putnam on, I, <a + href="#page27">27</a>; Havelock Ellis on, I, <a href="#page33">33</a>; + Herbert Spencer on, I, <a href="#page35">35</a>; Luther Burbank on, I, <a + href="#page24">24</a>; Wm. D. Lewis on, I, <a href="#page25">25</a>; true + province of, I, <a href="#page35">35</a>; what place sex hygiene will + find in, II, 162; Ella Wheeler Wilcox on, I, <a + href="#page22">22</a>.</p> + + <p>Educational systems, difficulty in devising, I, <a + href="#page27">27</a>; inadequate, I, <a href="#page22">22</a>.</p> + + <p>Efficiency, requisites of, III, 346.</p> + + <p>Egg, coddled, II, 245; white of, II, 262.</p> + + <p>Ellis, Havelock, on Education, I, <a href="#page33">33</a>.</p> + + <p>Emergencies and accidents, IV, 629.</p> + + <p>Enema, High, IV, 588; hot, 586.</p> + + <p>Enteritis, cause of, IV, 535; symptoms of, IV, 536.</p> + + <p>Entero-colitis, IV, 535.</p> + + <p>Enuresis, IV, 580.</p> + + <p>Environment, I, <a href="#page3">3</a>.</p> + + <p>Eruptions of the skin, II, 145.</p> + + <p>Establishing toilet habits, II, 240.</p> + + <p>Eugenic clubs, mother's, I, <a href="#page54">54</a>.</p> + + <p>Eugenic idea, the, I, <a href="#page9">9</a>.</p> + + <p>Eugenic principle, I, <a href="#page10">10</a>.</p> + + <p>Eugenics, I, <a href="#page12">12</a>; definition of, I, <a + href="#page12">12</a>; education and, I, <a href="#page21">21</a>; and + history, I, <a href="#page5">5</a>; husband and, I, <a + href="#page19">19</a>; <!-- Page v --><span class="pagenum"><a + name="pagev"></a>[v]</span> marriage and, I, <a href="#page11">11</a>; + motherhood and, I, <a href="#page16">16</a>; parenthood and, I, <a + href="#page15">15</a>; the unfit and, I, <a href="#page37">37</a>; what + every mother should know about, I, <a href="#page47">47</a>.</p> + + <p>Exercise enough for husband, III, 347; lack of and constipation, III, + 347.</p> + + <p>Eye, foreign bodies in, IV, 630; method of removing foreign bodies + from, IV, 631.</p> + + <p>Fake medical treatment, for venereal diseases, II, 167.</p> + + <p>Father and the boy, II, 163.</p> + + <p>Fault-finding, III, 350.</p> + + <p>Feeble-minded, the, I, <a href="#page37">37</a>; Dr. John Punton on, + I, <a href="#page42">42</a>; Dr. Max Schlapp on, I, <a + href="#page39">39</a>; segregation and treatment of, I, <a + href="#page42">42</a>.</p> + + <p>Feeding, artificial, II, 249; artificial from birth to twelfth month, + II, 254; the delicate child condition which will justify artificial, II, + 266; during second year formulæ for artificial, II, 253; how to prepare + milk mixtures, II, 259; intervals of, II, 225; overfeeding, II, 223; + regularity of, II, 227; what a mother should know about, II, 264; why + regularity is important, II, 228.</p> + + <p>Felon, run-around, or whitlow, IV, 640; treatment of, IV, 641.</p> + + <p>Female, beginning of, disease, III, 434; chief cause of diseases, III, + 436; diseases are avoidable, III, 439; generative organs, II, 178; + weakness cures, III, 470; what woman with disease should do, III, + 441.</p> + + <p>Fermentation, of the stomach, II, 304.</p> + + <p>Fertility, conditions which affect women, II, 196.</p> + + <p>Fever, cold packs for, IV, 589; cold sponging for reducing, IV, 589; + ice cap for reducing, IV, 589; methods of reducing, IV, 589.</p> + + <p>Finger, biting the nails, IV, 585.</p> + + <p>Fit, the, only shall be born, I, <a href="#page10">10</a>.</p> + + <p>Fits, IV, 577.</p> + + <p>Fly, dangerous house, IV, 645; to kill, IV, 648.</p> + + <p>Fomentations, hot, IV, 593.</p> + + <p>Food, allowable during first year, II, 261; bran as a, II, 292; + formulæ for baby, II, 243.</p> + + <p>Foodstuffs, IV, 647.</p> + + <p>Foreign bodies, in nose, IV, 632; in throat, IV, 633.</p> + + <p>Formative period, the, III, 339.</p> + + <p>Fraudulent testimonials, III, 467.</p> + + <p>Friends, choosing your, III, 367; your husband's, III, 363.</p> + + <p>Fruits, II, 273.</p> + + <p>Garbage, IV, 647.</p> + + <p>Gastric indigestion, acute, IV, 527; treatment of, IV, 527.</p> + + <p>Gastro duodenitis, IV, 547.</p> + + <p>Generative organs, female, II, 178.</p> + + <p>Genital organs, care of, II, 26.</p> + + <p>Girl, what a mother should tell her little, II, 173.</p> + + <p>Glands, swollen, IV, 558; treatment of swollen, IV, 558.</p> + + <p>Gleet, <ins class="correction" title="'I, 143' in original">II, + 143</ins></p> + + <p>Gonorrhea, symptoms of in a man, II, 142; wife infected with, II, + 147.</p> + + <p>Good health, requirements of, II, 316.</p> + + <p>Government investigation of patent medicines, IV, 486.</p> + +<p><!-- Page vi --><span class="pagenum"><a name="pagevi"></a>[vi]</span></p> + + <p>Habits, of delicate child, II, 285.</p> + + <p>Hair, falls out in syphilis, II, 146.</p> + + <p>Headache, IV, 585; during pregnancy, I, <a href="#page83">83</a>; + remedies, III, 457; treatment of, IV, 585.</p> + + <p>Heartburn, during pregnancy, I, <a href="#page84">84</a>.</p> + + <p>Hemorrhage, arrest of, IV, 635; nasal, IV, 522.</p> + + <p>Heredity, I, <a href="#page3">3</a>; and eugenics, I, <a + href="#page16">16</a>; function of education, I, <a + href="#page32">32</a>.</p> + + <p>Hiccough, IV, 523.</p> + + <p>High School, system fallacious, I, <a href="#page29">29</a>.</p> + + <p>Hives, IV, 559; cause of, IV, 559; treatment of, IV, 559.</p> + + <p>Home, good housekeeper, III, 389; owning a, III, 400; the ideal, III, + 393; what makes the, III, 394.</p> + + <p>Honeymoon, the, III, 335; marital relations during, III, 336.</p> + + <p>Hot pack, IV, 589.</p> + + <p>Housefly, dangerous, IV, 645.</p> + + <p>Housekeeper, what constitutes an efficient, III, 390.</p> + + <p>Husband, and home, III, 404; is he to blame, II, 151; the, and + eugenics, I, <a href="#page19">19</a>.</p> + + <p>Hysterics, and children, II, 293; treatment of, II, 294.</p> + + <p>Ice-cap, for reducing fever, IV, 589.</p> + + <p>Ileo-colitis, chronic, IV, 538; treatment of, IV, 539.</p> + + <p>Imperial Granum, II, 245.</p> + + <p>Incontinence, IV, 580.</p> + + <p>Indigestion, acute gastric, IV, 527; acute intestinal, IV, 532; + symptoms of acute intestinal, IV, 532; treatment of acute gastric, IV, + 527; treatment of acute intestinal, IV, 533.</p> + + <p>Infants, constipation in bottle-fed, II, 309; jaundice in, IV, 547; + mortality of, I, <a href="#page2">2</a>; records of, II, 222.</p> + + <p>Infection, direct, IV, 499.</p> + + <p>Infectious diseases, IV, 599.</p> + + <p>Inflammatory diarrhea, IV, 535.</p> + + <p>Influenza, IV, 608; symptoms of, IV, 608; treatment of, IV, 609.</p> + + <p>Injections, oil, II, 312.</p> + + <p>Insane, care of, I, <a href="#page43">43</a>.</p> + + <p>Insomnia, during pregnancy, I, <a href="#page86">86</a>.</p> + + <p>Interior organs, complications of in syphilis, II, 146.</p> + + <p>Intermittent fever, IV, 571.</p> + + <p>Intestinal diseases of children, IV, 529.</p> + + <p>Intestinal Indigestion, acute, IV, 532; symptoms of acute, IV, 532; + treatment of, IV, 533.</p> + + <p>Intestinal worms, IV, 548.</p> + + <p>Jaundice, catarrhal, IV, 547; in infants, IV, 546; in older children, + IV, 547.</p> + + <p>Junket, II, 244.</p> + + <p>Kelly pad, the, I, <a href="#page65">65</a>.</p> + + <p>Knowledge, two ways of gaining, III, 377.</p> + + <p>Labor, after-pains, I, <a href="#page103">103</a>; beginning of, I, <a + href="#page95">95</a>; clothing during, I, <a href="#page95">95</a>; + conduct during second stage of, I, <a href="#page96">96</a>; conduct + immediately following, I, <a href="#page103">103</a>; douching after, I, + <a href="#page107">107</a>; first breakfast after, I, <a + href="#page105">105</a>; first dinner after, I, <a + href="#page109">109</a>; first lunch after, I, <a + href="#page109">109</a>; first stage of, I, <a href="#page96">96</a>; + importance of emptying bladder after, I, <a href="#page106">106</a>; the + Lochia, or discharge after, I, <a href="#page104">104</a>; management of, + I, <a href="#page93">93</a>; putting baby to breast after, I, <a + href="#page108">108</a>; second stage of, I, <a + href="#page96">96</a>.</p> + + <p>Lacerations during confinement, I, <a href="#page116">116</a>.</p> + +<p><!-- Page vii --><span class="pagenum"><a name="pagevii"></a>[vii]</span></p> + + <p>La Grippe, IV, 608; treatment of, IV, 609.</p> + + <p>Laryngitis, acute catarrhal, IV, 506; treatment of, IV, 507.</p> + + <p>Leucorrhea, cause of sterility, II, 201; in girls, II, 190.</p> + + <p>Lewis, Wm. D., on education, I, <a href="#page25">25</a>.</p> + + <p>Life and insurance, III, 400.</p> + + <p>Lithia water, III, 458.</p> + + <p>Lochia, or discharge after labor, I, <a href="#page104">104</a>.</p> + + <p>Lunch, the first after labor, I, <a href="#page109">109</a>.</p> + + <p>Malaria, intermittent fever, IV, 571; serum for, IV, 656; treatment + of, IV, 571.</p> + + <p>Malformation, II, 201.</p> + + <p>Man, building a, II, 151.</p> + + <p>Marital relations, when they are painful, III, 337; when they should + be suspended, III, 337.</p> + + <p>Marriage, and motherhood, I, <a href="#page2">2</a>; best age for, + III, 331; certificate and vice, I, <a href="#page15">15</a>; certificate, + utility of, I, <a href="#page13">13</a>; evils of early, III, 333; + failures in, I, <a href="#page2">2</a>.</p> + + <p>Mastitis, in infancy, IV, 553; in young girls, IV, 554.</p> + + <p>Masturbation, or self-abuse, II, 157.</p> + + <p>Meats, medical essentials of good, III, 393; preparation and selection + of, III, 390.</p> + + <p>Measles, IV, 616; complications in, IV, 618; Koplik's spots in, IV, + 617; rules of department of health, IV, 619; symptoms of, IV, 616; + treatment of, IV, 618.</p> + + <p>Medical, letter brokers, III, 482; reliable advice, III, 486.</p> + + <p>Medicine chest, contents of family, IV, 629.</p> + + <p>Medicine concern run by women, III, 475.</p> + + <p>Menstruation, II, 187; irregular, II, 187; painful, II, 193; should + not be accompanied with pain, II, 189; symptoms of, II, 189; treatment + for painful, II, 194; why it occurs every 28 days, II, 180.</p> + + <p>Milk, children with whom it does not agree, IV, 535; difference + between human and cows, II, 252; mixture, how to prepare, II, 259; + peptonized, II, 262.</p> + + <p>Mind, training the, III, 360.</p> + + <p>Miscarriage, II, 202; after treatment of, II, 205; causes of, II, 203; + course and symptoms of, II, 204; what to do when threatened with, II, + 204; tendency to, II, 206; womb displacement in, II, 198.</p> + + <p>Mosquitoes, regarding, IV, 572; rules of Department of Health, IV, + 574.</p> + + <p>Mother, the cheerful, III, 400; education of the, II, 277; existence + of the average, III, 437; what she should know about eugenics, I, <a + href="#page47">47</a>; what she should tell her little girl, II, 173; + what she should tell her daughter, II, 173.</p> + + <p>Motherhood, eugenics and, I, <a href="#page16">16</a>; function of, I, + <a href="#page17">17</a>; preparing for, II, 187.</p> + + <p>Mothers, eugenic clubs, I, <a href="#page54">54</a>; girls must not + become, II, 184.</p> + + <p>Moths, IV, 648.</p> + + <p>Mouth, how to disinfect, IV, 601; sore, IV, 523; treatment for ulcers + in, IV, 525; treatment of sore, IV, 524.</p> + + <p>Mucous patches, and ulcers, <ins class="correction" title="'I, 145' in original" + >II, 145</ins>.</p> + + <p>Mumps, IV, 605; symptoms of, IV, 605.</p> + + <p>Mustard bath, IV, 590.</p> + + <p>Mustard paste, how to make, IV, 593.</p> + +<p><!-- Page viii --><span class="pagenum"><a name="pageviii"></a>[viii]</span></p> + + <p>Mustard pack, how to prepare and use, IV, 594.</p> + + <p>Mutton Broth, II, 244.</p> + + <p>Napkins, sanitary, <ins class="correction" title="'I, 63' in original" + >I, <a href="#page66">66</a></ins>.</p> + + <p>Nasal discharge, chronic, IV, 502.</p> + + <p>Nausea, during pregnancy, I, <a href="#page80">80</a>.</p> + + <p>Nettle-rash, IV, 559; cause of, IV, 559; treatment of, IV, 559.</p> + + <p>Night losses, or "wet dreams," II, 158.</p> + + <p>Nightmare or night terrors, IV, 583; treatment of, IV, 581.</p> + + <p>Nipples, care of, I, <a href="#page121">121</a>; cracked, I, <a + href="#page122">122</a>; tender, I, <a href="#page122">122</a>; treatment + of cracked, I, <a href="#page122">122</a>; what mother should know about + bottle and, II, 264.</p> + + <p>Normal salt, solution of, IV, 627.</p> + + <p>Nose, chronic discharge of, IV, 503; complications of in syphilis, II, + 146; foreign bodies in, IV, 632.</p> + + <p>Nose-bleeds, IV, 522.</p> + + <p>Nosophobia, or the dread of disease, III, 380.</p> + + <p>Nursery maid, qualifications of, I, <a href="#page129">129</a>.</p> + + <p>Nursing mothers, I, <a href="#page121">121</a>; diet of, I, <a + href="#page121">121</a>; mastitis in, I, <a href="#page122">122</a>; + nervous, I, <a href="#page126">126</a>.</p> + + <p>Oatmeal water, for constipation in infants, II, 309.</p> + + <p>Oat-water, II, 244.</p> + + <p>Obstetrical outfits, ready to purchase, I, <a + href="#page63">63</a>.</p> + + <p>Oil injections, II, 312.</p> + + <p>Oiled silk, IV, 594; what it is and why it is used, IV, 594.</p> + + <p>Orange juice, II, 262; for constipation in infants, II, 309.</p> + + <p>Organs, transplanting from dead to living, IV, 655.</p> + + <p>Otitis, acute, IV, 556.</p> + + <p>Ovaries, disease of, II, 199; function of, II, 179.</p> + + <p>Overeating, II, 289; III, 327; symptoms of, II, 290.</p> + + <p>Overfeeding the baby, II, 223.</p> + + <p>Parents, and the Boy, II, 153; a word to, II, 161; eugenics and, I, <a + href="#page15">15</a>.</p> + + <p>Parotitis, epidemic, IV, 605.</p> + + <p>Patent Medicines, and education, III, 493; and eugenics, III, 494; and + the newspaper, III, 484; conspiracy against freedom of press, III, 483; + dangers of, III, 489; fraudulent testimonials, III, 467; intoxicating + effects of, III, 453; government investigation of, III, 486; pure food + and drug act, III, 452, 490.</p> + + <p>Patent Medicine Evil, III, 451, 489; and the duty of mothers III, 489; + what mothers should know about the, III, 451.</p> + + <p>People, two kinds of, III, 363.</p> + + <p>Peptonized milk, II, 262.</p> + + <p>Physicians, what they are doing, IV, 649.</p> + + <p>Pimples, IV, 576.</p> + + <p>Pneumonia, IV, 516.</p> + + <p>Poultices, IV, 593.</p> + + <p>Pox, or syphilis, <ins class="correction" title="'I, 144' in original" + >II, 144</ins>.</p> + + <p>Precautions to be observed, IV, 647.</p> + + <p>Pregnancy, avoidance of drugs during, I, <a href="#page90">90</a>; + clothing during, I, <a href="#page77">77</a>; constipation during, I, <a + href="#page84">84</a>; headache during, I, <a href="#page83">83</a>; + heartburn during, I, <a href="#page84">84</a>; hygiene of, I, <a + href="#page75">75</a>; insomnia during, I, <a href="#page86">86</a>; + minor ailments of, I, <a href="#page76">76</a>; morning nausea, I, <a + href="#page80">80</a>; sexual intercourse during, <ins class="correction" + title="'I, 78' in original">I, <a href="#page76">76</a></ins>; social + side of, I, <a href="#page79">79</a>; undue nervousness during, I, <a + href="#page82">82</a>; vagaries of, I, <a href="#page90">90</a>; vaginal + discharge, I, <a href="#page88">88</a>; varicose veins, cramps and + neuralgia during, I, <a href="#page85">85</a>.</p> + +<p><!-- Page ix --><span class="pagenum"><a name="pageix"></a>[ix]</span></p> + + <p>Pregnant, few ailing women become, III, 435; conduct of woman, I, <a + href="#page75">75</a>; diet of woman, I, <a href="#page77">77</a>; mental + state of woman, I, <a href="#page78">78</a>; when woman should first call + upon physician, I, <a href="#page68">68</a>.</p> + + <p>Prickly Heat, IV, 560; treatment of, IV, 560.</p> + + <p>Principle, differences of, III, 344.</p> + + <p>Privy Vaults, IV, 647.</p> + + <p>Procreative Function, abuse of, II, 153; III, 440.</p> + + <p>Procreative Power, period of, II, 155.</p> + + <p>Puberty, age of, II, 179; period of in the female, II, 178.</p> + + <p>Pulse, rate in children and adults, II, 221.</p> + + <p>Punton, Dr. John, on feeble-minded, I, <a href="#page42">42</a>.</p> + + <p>Pure Food and Drug Act, III, 452, 490.</p> + + <p>Putnam, Dr. Helen C., on education, I, <a href="#page27">27</a>.</p> + + <p>Quacks, how they dispose of confidential letters, III, 481.</p> + + <p>Quarrel, the first, III, 349.</p> + + <p>Quinsy, IV, 523.</p> + + <p>Race Culture, I, II.</p> + + <p>Radium, IV, 652.</p> + + <p>Rashes, of childhood, IV, 574; other, IV, 575; treatment of, IV, + 576.</p> + + <p>Records, Infant, II, 222.</p> + + <p>Rectal Irrigations, to reduce fever, IV, 590.</p> + + <p>Reproductive Organs, changes in, II, 178; function of the, II, + 179.</p> + + <p>Resolves, making, III, 371.</p> + + <p>Rest and recreation, III, 398.</p> + + <p>Rest and sleep, III, 347.</p> + + <p>Rheumatism, in children, IV, 569; treatment of acute attack, IV, 570; + treatment of tendency to, IV, 570.</p> + + <p>Rhinitis, chronic, IV, 503.</p> + + <p>Rice water, II, 244.</p> + + <p>Ringworm, of the scalp, IV, 561.</p> + + <p>Rubbers, practice of wearing needs consideration, IV, 498.</p> + + <p>Run-around, or felon, IV, 640; treatment of, IV, 641.</p> + + <p>Rupture, IV, 551.</p> + + <p>Saleeby, Dr. C.W., on education, I, <a href="#page22">22</a>.</p> + + <p>Sanitary napkins, how to prepare, <ins class="correction" title="'I, 63' in original" + >I, <a href="#page66">66</a></ins>.</p> + + <p>Santonin, for worms, IV, 549.</p> + + <p>Scalds and burns, IV, 641.</p> + + <p>Scalp, ringworm of, IV, 561; wounds of, IV, 640.</p> + + <p>Scarlet Fever, IV, 620; complications in, IV, 621; eruptions, IV, 621; + measures to prevent spread of, IV, 621; treatment of, IV, 622.</p> + + <p>Scarlatina, IV, 620.</p> + + <p>Scientific Dressing, III, 427.</p> + + <p>Schlapp, Dr. Max, on the feeble-minded, I, <a + href="#page39">39</a>.</p> + + <p>Self-abuse or Masturbation, II, 155.</p> + + <p>Self-culture, young wife's incentive to, III, 379.</p> + + <p>Serum, Anti-meningitis, IV, 656; for malaria, IV, 656.</p> + + <p>Sexual excesses, II, 159; treatment of, II, 160.</p> + + <p>Sexual intercourse, during pregnancy, <ins class="correction" + title="'I, 78' in original">I, <a href="#page76">76</a></ins>.</p> + + <p>Shock, the condition of, IV, 637.</p> + + <p>Sitz bath, during pregnancy, I, <a href="#page87">87</a>.</p> + + <p>"606," IV, 655.</p> + + <p>Skin, care of, II, 216; care of in contagious diseases, IV, 602; + eruptions of, II, 145.</p> + + <p>Sleeplessness, causes of, IV, 583; treatment of, IV, 583.</p> + + <p>Social Evil, what parents should know about, II, 161.</p> + + <p>Solutions, normal salt, IV, 627; various, IV, 626.</p> + + <p>Soothing syrup, III, 458.</p> + + <p>Sore Mouth, IV, 523; treatment of, IV, 524.</p> + +<p><!-- Page x --><span class="pagenum"><a name="pagex"></a>[x]</span></p> + + <p>Sore throat, IV, 508.</p> + + <p>Sowing wild oats, II, 167.</p> + + <p>Spasms, IV, 577.</p> + + <p>Spencer, Herbert, on education, I, <a href="#page35">35</a>.</p> + + <p>Spermatozoa, functions of the, II, 181; the male, or papa egg, II, + 181.</p> + + <p>Sprains, IV, 639.</p> + + <p>Sprue, IV, 525; treatment of, IV, 525.</p> + + <p>Stables, IV, 646.</p> + + <p>Sterility, II, 195; causes of, in women, II, 198.</p> + + <p>Sterilizing, food for day's feeding, II, 260.</p> + + <p>Stomach, diseases of, IV, 527; fermentation of, II, 304; function of + the, II, 304.</p> + + <p>Stomach bitters, alcohol in, III, 455.</p> + + <p>Stomatitis, IV, 523.</p> + + <p>Story, Dr. Thomas A., on education, I, <a href="#page26">26</a>.</p> + + <p>Study habit, the, III, 374.</p> + + <p>Sullivan, Dr., on alcoholic drunkenness, I, <a + href="#page44">44</a>.</p> + + <p>Success, attainment of, III, 345; formula of, III, 373.</p> + + <p>Summer Diarrhea, IV, 539; symptoms of, IV, 540; treatment of, IV, + 541.</p> + + <p>Summer diseases of intestines, IV, 529.</p> + + <p>Surgery, aseptic, IV, 653.</p> + + <p>Syphilis, or the "pox," II, 144.</p> + + <p>Tape worms, IV, 551.</p> + + <p>Teeth, care of the, II, 219; how they come, II, 218.</p> + + <p>Temperature, in children, II, 217.</p> + + <p>Thiersch's solution, IV, 627.</p> + + <p>Thought, bad habits of, III, 360; what is a, III, 359.</p> + + <p>Thread worm, IV, 549.</p> + + <p>Throat, foreign bodies in, IV, 633; sore, IV, 508.</p> + + <p>Thrush, IV, 525; treatment of, IV, 525.</p> + + <p>Thumb-sucking, IV, 585.</p> + + <p>Tonsilitis: Angina, "sore throat," IV, 508; treatment of acute, IV, + 510.</p> + + <p>Transplanting organs of dead to living, IV, 655.</p> + + <p>Tuberculosis, best treatment for, III, 418; facts about, III, 414.</p> + + <p>Turpentine stupe, the, IV, 594.</p> + + <p>Typhoid, how to keep from spreading, IV, 625; how to prevent getting, + IV, 624; symptoms of, IV, 623; vaccine in, IV, 654.</p> + + <p>Ulcers, in mouth, IV, 525; mucous patches and, II, 144.</p> + + <p>Vacant lots, IV, 647.</p> + + <p>Vaccination, method of, II, 299; symptoms of successful, II, 299; time + for, II, 299; treatment, II, 300.</p> + + <p>Vaccine in typhoid fever, IV, 654.</p> + + <p>Vapor bath, IV, 591.</p> + + <p>Varicella, IV, 606.</p> + + <p>Varicose veins, during pregnancy, I, <a href="#page85">85</a>.</p> + + <p>Vegetables, II, 272.</p> + + <p>Venereal Diseases, fake medical treatment for, II, 167; ten million + victims of, I, <a href="#page11">11</a>.</p> + + <p>Vomiting, of children between feedings, II, 226; significance of after + feeding, II, 230.</p> + + <p>Washing dishes, III, 391.</p> + + <p>Water, drink plenty of, III, 429.</p> + + <p>Weaning, I, <a href="#page123">123</a>; care of breasts when, I, <a + href="#page125">125</a>; menstruation and, I, <a href="#page124">124</a>; + methods of, I, <a href="#page123">123</a>; rapid, when it is necessary, + I, <a href="#page124">124</a>; when to start, I, <a + href="#page124">124</a>.</p> + + <p>Wedding night, its medical aspect, III, 334.</p> + + <p>What to eat and wear in hot weather, III, 426.</p> + + <p>When delays are dangerous, III, 423.</p> + + <p>Whey, II, 244.</p> + + <p>Whitlow, or felon, IV, 640.</p> + +<p><!-- Page xi --><span class="pagenum"><a name="pagexi"></a>[xi]</span></p> + + <p>Whooping Cough, IV, 613; symptoms of, IV, 614; treatment of, IV, + 615.</p> + + <p>Wife, her part, III, 353; the cheerful, III, 400; the indifferent, + III, 401; what she owes to herself, III, 357.</p> + + <p>Wifehood, first weeks and months of, III, 336.</p> + + <p>Wilcox, Ella Wheeler, on education, I, <a href="#page23">23</a>.</p> + + <p>Womb, function of, II, 180; how baby gets nourishment in, II, 183; how + held in place, II, 189.</p> + + <p>Women, ailing, are inefficient, III, 434; diseases of, III, 433; who + don't want children, III, 439; medicine concern run by, III, 475; most + popular, III, 365; use of patent medicines in diseases, III, 473.</p> + + <p>Work, must be interesting, III, 351.</p> + + <p>Working for something, III, 395.</p> + + <p>Worms, intestinal, IV, 548; round, IV, 548; symptoms of tape, IV, 551; + symptoms of thread, IV, 549; tape, IV, 551; thread, IV, 549; treatment of + round, IV, 549.</p> + + <p>Worry, freedom from, III, 348.</p> + + <p>Wound, cleaning a, IV, 637; closing and dressing a, IV, 637; removal + of foreign bodies from, IV, 636.</p> + + <p>Wounds, IV, 634; of the scalp, IV, 640.</p> + + <p>X-Ray, treatment and diagnosis, IV, 652.</p> + + <br clear="all" /> +<hr class="full" /> + +<h4>VOLUME I</h4> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page xv --><span class="pagenum"><a name="pagexv"></a>[xv]</span></p> + +<h3>TABLE OF CONTENTS</h3> + +<h4><font class="sc">Eugenics. Race Culture</font></h4> + +<h4>CHAPTER I</h4> + +<h4><font class="sc">conditions which have evolved the science of eugenics</font></h4> + + <p>Infant mortality—Marriage and + motherhood—Heredity—Environment—Education—Disease + and vice—History—Summary ... <font class="sc">page</font> <a + href="#page1">1</a></p> + +<h4>CHAPTER II</h4> + +<h4><font class="sc">the eugenic idea</font></h4> + + <p>The value of human life—The eugenic principle—"The fit + only shall live"—Eugenics and marriage—The venereal + diseases—The utility of marriage certificates—The marriage + certificates and vice—Eugenics and parenthood—The principle + of heredity—Eugenics and motherhood—Eugenics and the husband + ... <font class="sc">page</font> <a href="#page9">9</a></p> + +<h4>CHAPTER III</h4> + +<h4><font class="sc">eugenics and education</font></h4> + + <p>The present educational system is inadequate—Opinions of Dr. + C.W. Saleeby, Ella Wheeler Wilcox, Luther Burbank, William D. Lewis, + Elizabeth Atwood, Dr. Thomas A. Story, William C. White, Dr. Helen C. + Putnam—Difficulty in devising a satisfactory educational + system—Education an important function—The function of the + high school—The high school system fallacious—The true + function of education ... <font class="sc">page</font> <a + href="#page21">21</a></p> + +<h4>CHAPTER IV</h4> + +<h4><font class="sc">eugenics and the unfit</font></h4> + + <p>The deaf and dumb—The feeble-minded—A New York + magistrate's report—Report of the Children's Society—The + segregation and treatment of the feeble-minded—What the care of the + insane costs—The alcoholic—Drunkenness ... <font + class="sc">page</font> <a href="#page37">37</a></p> + +<h4>CHAPTER V</h4> + +<h4><font class="sc">what every mother should know about eugenics</font></h4> + +<font class="sc">page</font> <a href="#page47">47</a> + +<p><!-- Page xvi --><span class="pagenum"><a name="pagexvi"></a>[xvi]</span></p> + +<h4><font class="sc">Child-Birth</font></h4> + +<h4>CHAPTER VI</h4> + +<h4><font class="sc">preparations for the confinement</font></h4> + + <p>The birth chamber—What to provide for a confinement—Ready + to purchase obstetrical outfits—Position and arrangement of the + bed—How to properly prepare the accouchement bed—The Kelly + pad—The advantages of the Kelly pad—Should a binder be + used—Sanitary napkins—How to calculate the probable date of + the confinement—Obstetrical table—When should a pregnant + woman first call upon her physician—Regarding the choice of a + physician—How to know the right kind of a physician for a + confinement—The selection of a nurse—The difference between a + trained and a maternity nurse—Duties of a confinement + nurse—The requisites of a good confinement nurse—The personal + rights of a confinement nurse—Criticizing and gossiping about + physicians ... <font class="sc">page</font> <a href="#page61">61</a></p> + +<h4>CHAPTER VII</h4> + +<h4><font class="sc">the hygiene of pregnancy</font></h4> + + <p>Daily conduct of the pregnant woman—Instructions regarding + household work—Instructions regarding washing and + sweeping—Instructions regarding exercise—Instructions + regarding passive exercise—Instructions regarding toilet + privileges—Instructions regarding bathing—Instructions + regarding sexual intercourse—Clothing during pregnancy—Diet + of pregnant women—Alcoholic drinks during pregnancy—The + mental state of the pregnant woman—The social side of + pregnancy—Minor ailments of pregnancy—Morning nausea, or + sickness—Treatment of morning nausea, or sickness—Nausea + occurring at the end of pregnancy—Undue nervousness during + pregnancy—The 100% baby—Headache—Acidity of the + stomach, or heartburn—Constipation—Varicose veins, cramps, + neuralgias—Insomnia—Treatment of insomnia—Ptyalism, or + excessive flow of saliva—Vaginal discharge, or + leucorrhea—Importance of testing urine during + pregnancy—Attention to nipples and breasts—The vagaries of + pregnancy—Contact with infectious diseases—Avoidance of + drugs—The danger signals of pregnancy ... <font + class="sc">page</font> <a href="#page75">75</a></p> + +<h4>CHAPTER VIII</h4> + +<h4><font class="sc">the management of labor</font></h4> + + <p>When to send for the physician in confinement cases—The + preparation of the patient—The beginning of labor—The first + pains—The meaning of the term "labor"—Length of the first + stage of labor—What the first stage of labor <!-- Page xvii + --><span class="pagenum"><a name="pagexvii"></a>[xvii]</span> + means—What the second stage of labor means—Length of the + second stage—Duration of the first confinement—Duration of + subsequent confinements—Conduct of patient during second stage of + labor—What a labor pain means—How a willful woman can prolong + labor—Management of actual birth of child—Position of woman + during birth of child—Duty of nurse immediately following birth of + child—Expulsion of after-birth—How to expel + after-birth—Cutting the cord—Washing the baby's eyes + immediately after birth—What to do with baby immediately after + birth—Conduct immediately after labor—After pains—Rest + and quiet after labor—Position of patient after labor—The + Lochia—The events of the following day—The first breakfast + after confinement—The importance of emptying the bladder after + labor—How to effect a movement of the bowels after + labor—Instructing the nurse in details—Douching after + labor—How to give a douche—"Colostrum," its + uses—Advantages of putting baby to breast early after + labor—The first lunch—The first dinner—Diet after third + day ... <font class="sc">page</font> <a href="#page93">93</a></p> + +<h4>CHAPTER IX</h4> + +<h4><font class="sc">confinement incidents</font></h4> + + <p>Regarding the dread and fear of childbirth—The woman who dreads + childbirth—Regarding the use of anesthetics in + confinements—The presence of friends and relatives in the + confinement chamber—How long should a woman stay in bed after + confinement—Why do physicians permit women to get out of bed before + the womb is back in its proper place?—Lacerations, their meaning, + and their significance—The advantage of an examination six weeks + after the confinement—The physician who does not tell all of the + truth ... <font class="sc">page</font> <a href="#page111">111</a></p> + +<h4>CHAPTER X</h4> + +<h4><font class="sc">nursing mothers</font></h4> + + <p>The diet of nursing mothers—Care of the nipples—Cracked + nipples—Tender nipples—Mastitis in nursing + mothers—Inflammation of the breasts—When should a child be + weaned?—Method of weaning—Nursing while + menstruating—Care of breasts while weaning child—Nervous + nursing mothers—Birthmarks—Qualifications of a nursery maid + ... <font class="sc">page</font> <a href="#page121">121</a></p> + +<h4>CHAPTER XI</h4> + +<h4><font class="sc">convalescing after confinement</font></h4> + + <p>The second critical period in the young wife's life—The domestic + problem following the first confinement ... <font class="sc">page</font> + <a href="#page131">131</a></p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page xix --><span class="pagenum"><a name="pagexix"></a>[xix]</span></p> + +<h3>INTRODUCTION</h3> + + <p>Despite the fact that much has been written during the past two or + three years with reference to Eugenics, it is quite evident to any one + interested in the subject that the average intelligent individual knows + very little about it so far as its scope and intent are concerned. This + is not to be wondered at, for the subject has not been presented to the + ordinary reader in a form that would tend to encourage inquiry or honest + investigation. The critic and the wit have deliberately misinterpreted + its principles, and have almost succeeded in masking its supreme function + in the garb of folly.</p> + + <p>The writer has yet to meet a conscientious mother who fails to evince + a reasonable degree of enthusiastic interest in eugenics when properly + informed of its fundamental principles.</p> + + <p>The eugenic ideal is a worthy race—a race of men and women + physically and mentally capable of self-support. The eugenist, therefore, + demands that every child born shall be a worthy child—a child born + of healthy, selected parents.</p> + + <p>No one can successfully assail the ethics of this appeal. It is + morally a just contention to strive for a healthy race. It is also an + economic necessity as we shall see.</p> + + <p>The history of the world informs us that there have been many + civilizations which, in some respects, equalled our own. These races of + people have all achieved a certain success, and have then passed entirely + out of existence. Why? <i>And are we destined to extinction in the same + way?</i> We know that the cause of the decline and ultimate extinction of + all past civilizations was due primarily to the moral decadence of their + people. Disease and vice gradually sapped their vitality, and their <!-- + Page xx --><span class="pagenum"><a name="pagexx"></a>[xx]</span> + continuance was impossible. It would seem to be the destiny of a race to + achieve material prosperity at the expense of its morality. When + conditions render possible the fulfilment of every human desire, the race + exhausts its vitality in a surfeitment of caprice. The animal instincts + predominate, and the potential vigor of the people is exhausted in + contributing to its own amusement. Each succeeding civilization has + reached this epochal period, and has fallen, victim of the rapacity of + stronger and younger invading antagonists, <i>themselves to succumb to + the same insidious process</i>.</p> + + <p>The present civilization has reached this epochal—this + transition—period. In one hundred years from now we shall either + have accomplished what no previous civilization accomplished, or we shall + have ceased to exist as a race. Our success depends on the response of + the people to the eugenic appeal. Few appreciate the responsibility + involved.</p> + + <p>It is not necessary, however, to combat or deplore the evils of the + past. Civilization has failed in the task of race-maintenance; it failed, + however, in ignorance. We cannot plead the same excuse. We are face to + face with conditions that we must solve quickly or our destiny will be + decreed before we apply the remedy.</p> + + <p>A function of the eugenist is to gather and attest statistics, and to + establish conclusions based on these statistics. It has been conclusively + demonstrated that, if the race continues to progress as it exists + now—that is, if conditions remain the same, and our standard of + enlightenment, so far as racial evolution is concerned, does not prompt + us to adopt new constructive measures—<i>every second child born in + this country, in fifty years, will be unfit; and, in one hundred years, + the American race will have ceased to exist</i>. We mean by this that + every second child born will be born to die in infancy, or, if it lives, + will be incapable of self-support during its life, because either of + mental degeneracy or physical inefficiency. This appalling situation + immediately becomes a problem of civilization. No state can exist under + these conditions. If these statistics are reliable—and we know they + are true and capable of verification by any individual who will go <!-- + Page xxi --><span class="pagenum"><a name="pagexxi"></a>[xxi]</span> to + the trouble of investigating them—it is self-evident that a radical + change must immediately be instituted to obviate the logical consequences + that must follow as a sequence. The eugenic demand, that "every child + born shall be a worthy child," is, therefore, the solution of the + problem.</p> + + <p>This does not imply, however, that the eugenist must solve the + elementary problem of how the state will ensure its own salvation by + guaranteeing worthy children. Worthy children can come only from fit and + worthy (clean and healthy) parents. It becomes the imperative function of + the state—the function on which the very life of the state + depends—to see that every applicant for marriage is possessed of + the qualities that will ensure healthy, worthy children. We must, + therefore, sooner or later devise a system of scientific regulation of + marriage, and it is at this point we stumble against the problem that has + prompted the ebullitions of the wit and the sarcasm of the critic. A + casual reference to the science immediately suggests to the layman an + impossible or quixotic system of marriage by force. Even the word + "eugenics" is associated in the minds of many otherwise estimable old + ladies, and others who should know better, with a species of malodorous + free love, and their hands go up in holy horror at the intimation of a + scientific regulation of this ancient function.</p> + + <p>Unfortunately, the popular mind has received the impression that this + incident constitutes the sum total of the eugenic idea, while the truth + is that the eugenist is only slightly concerned with its modus operandi. + This feature has been so magnified by widely published disingenuous + discussion that it has assumed the aspect of a test problem, a judgment + on which shall decide the utility of the science itself. Should this + decision be unfavorable, it would seem, according to its exponents, that + it would not be worth while promulgating the doctrines of the science + beyond this point. It is as though we were asked to deny ourselves the + inspiration and pleasure of a trip abroad because the morning of the day + on which the ship sailed happened to be cloudy.</p> + + <p>It is certainly no part of the function of the eugenist to <!-- Page + xxii --><span class="pagenum"><a name="pagexxii"></a>[xxii]</span> uproot + instinct, or to trample into the dust age-long rights, though the + instinct is simply the product of an established habit, based on an + erroneous hypothesis, and the so-called rights simply acquired + privileges, because the intelligence that would have builded differently + was not awakened. Eugenic necessity will render imperative the state's + solution of this fundamental problem, for the reason that civilization + will be driven to demand its just inheritance—the right to exist. + The eugenist will not be compelled to open the door; it will be opened + for him. We can afford, therefore, to wait with supreme confidence, + because the good sense of the people will not always submit to the + tactics of the jester when it needs a saviour.</p> + + <p>The eugenist does not seek to interfere with the liberties of the + rising generation: a boy may choose whom he will; the girl may select the + one who appeals to her most, and they may enjoy all the vested rights and + romance that custom has decreed the lover; but, when they resolve to + marry, <i>the state must decide their qualifications for parenthood</i>. + This must be the crucial test of the future. The life of the state + depends on it. The continuance of the race must be the supreme object of + all future constructive legislation. We must recognize that "life is the + only wealth," and that every other criterion of an advanced civilization + must measure its success according to its wealth in worthy + parenthood.</p> + + <p>The eugenist does not even dictate what the test for parenthood shall + be. Common sense, however, suggests that it will assume some form that + will eliminate those physically or mentally diseased. He believes that, + when the people are sufficiently educated to appreciate the object in + view, they will devise a system that will meet with universal + approval.</p> + + <p>Eugenics concerns itself with problems on which the destiny of the + race depends. It must not, therefore, be limited to questions relative to + mating and breeding. Every factor that contributes to the well-being and + uplifting of the race, every subject that bespeaks physical or mental + regeneration, that aids moral and social righteousness and salvation, and + promises a greater social happiness and contentment, has a eugenic <!-- + Page xxiii --><span class="pagenum"><a + name="pagexxiii"></a>[xxiii]</span> significance. So long as there exists + an unsupported mother or a suffering child; so long as we rely on + hospitals and prisons, penitentiaries and the police, to minister to the + correction and regeneration of the unfit and degenerate; so long as we + tolerate grafting politicians and deprive the poor of breathing spaces, + sanitary appliances, and a hygienic environment; so long as war and + pestilence deprive posterity of the best of the race for parenthood; so + long as we emphasize rescue rather than prevention, so long must the + eugenist strive unceasingly to preach his propaganda of race + regeneration.</p> + + <p>The scope of eugenics is too far-reaching in its beneficent purpose to + be fettered by the querulous triflings of the ancient or intellectual + prude; nor should it be belittled by the superficial insight of the + habitual scoffer. It is not a fantasy nor an idle dream. It is not even + an inspiration. The destiny of the race has brought us face to face with + conditions unparalleled in the history of this civilization, and the very + existence of the race itself may be wholly dependent on the foresight of + the minds that have made the science of eugenics possible.</p> + + <p>A brief consideration of the conditions that actually exist, with + which we are face to face, and which certainly justify the existence of a + science whose function it should be to demand serious investigation of + methods of race regeneration, may help the reader to an intelligent and + practical understanding of the tremendous importance of the subject.</p> + + <p>It has been already remarked that, at the present rate of decrease, + the birth-rate will be reduced to zero within a century. If the + birth-rates in England, Germany, and France should continue to decrease + as they have since 1880, there would be no children born, one hundred + years hence, in these countries. While we do not assert, and probably + none of us believes that either or all of these nations will actually be + out of existence in a hundred years—unquestionably because we feel, + at least we hope, that our methods will be so changed in that time that + the necessary modification will ensure a continuance of the race, + nevertheless, the fact remains that <i>the inevitable <!-- Page xxiv + --><span class="pagenum"><a name="pagexxiv"></a>[xxiv]</span> result of + continuing along present lines will be that, within the period of one + hundred years, these peoples will cease to perpetuate themselves</i>.</p> + + <p>It is not necessary to enquire closely into the various causes for + this unparalleled situation. The falling birth-rate in itself is not the + prime cause. Even admitting that there are enough babies born, too many + of them are born only to die in infancy. We need no further proof of the + urgent need for conscientious inquiry, call it by what name you please. + The science of common sense is all-sufficient. The seemingly intelligent + individual who can only find material for ribaldry in this connection is + a more serious buffoon than he imagines. It is apparent that our methods + are wrong. Any constructive effort to correct them is commendable. When + it is stated that 20 per cent. of the American women are unable to bear + children, and that 25 per cent. of all the others are unwilling to assume + the burden and responsibility of motherhood, we partly realize the + gravity of the case.</p> + + <p>On the other hand, statistics show that the majority of men have + acquired disease before they marry, and that a very large percentage of + these men convey contagion to their wives. This condition, to a very + large extent, accounts for the inefficiency of women as mothers. It is + responsible for at least 75 per cent. of the sterility that exists. The + effect of this deplorable condition is directly responsible, also, for + the ill health that afflicts women and that renders necessary the daily + operations of a serious nature that are conducted in every hospital in + every city in the civilized world. As a result of the dissemination of + this poison, children are born blind, or are born to die, or, if they + live, they are compelled to carry all through their helpless lives the + stigma of disease and degeneration. It would surely seem that the + individual to whom God has given intelligence and a conscience cannot + think of these, the saddest facts in human experience, without resentment + and humility. <i>Surely the time has arrived when every boy should know, + from his earliest youth, that there is here on earth an actual punishment + for vicious living as frightful as any that the mind of man can + conceive.</i> <!-- Page xxv --><span class="pagenum"><a + name="pagexxv"></a>[xxv]</span></p> + + <p>When we inquire into the cause of this trend toward race degeneracy, + we find that poverty and the inability of the workingman to support large + families, luxurious living, and the life of ease and amusement on the + part of the women of wealth; the fact that an increasingly large number + of women have entered professions that prevent motherhood, and that the + number of apartment-houses where children are not wanted are on the + increase, all play their part. In this age of intense living, it is not + to be wondered at that many shrink from the responsibility of rearing + children, and the same conditions that contribute to this decadent ideal + intensifies sex-hunger, and it is this dominating passion that tolerates + and makes possible the most frightful crime of the age—infanticide. + Greece and Rome paved the way for their ultimate annihilation when their + beautiful women ceased to bear children and their men sought the + companionship of courtesans.</p> + + <p>Baby contests have demonstrated that only one child in ten was found + to be good enough to justify a second examination. In a test examination + in the public schools, only eight in five thousand were competent to + qualify in all the tests. One of these eight was a Chinese boy and + another an American-born son of a native Greek. Of the twenty million + school-children in the United States, not less than 75 per cent. need + immediate attention for physical defects.</p> + + <p>While man has been assiduously improving everything else, he has + neglected to better his own condition. Every animal that man has taken + from its native haunts and domesticated, he has efficiently improved. He + has even produced more marvelous results by the application of the same + principles to the vegetable kingdom. In his haste to civilize himself, + however, he has failed to apply the principles that are essential to + self-preservation. It is regrettable, also, to know that, while the + government has spent many thousands of dollars in sending out literature + to the farmers, instructing them how to raise profitable crops and to + breed prize horses and pigs, absolutely none of the public money has been + used in instructing American mothers how to raise healthy children. <!-- + Page xxvi --><span class="pagenum"><a + name="pagexxvi"></a>[xxvi]</span></p> + + <p>A distinguished insurance expert has proved that there was an increase + of nearly 100 per cent. in the mortality from degenerative diseases in + the United States between 1880 and 1909. The growing prevalence of these + diseases indicates a falling-off in the vitality of the race. It means + that the diseases of old age are invading the younger ranks.</p> + + <p>The Life Extension Institute, of New York City, in its recent report, + states that "forty of every hundred men and women employed in the Wall + Street district require medical attention; twenty of the forty need it + immediately, and ten of the forty must have it to avert serious + results."</p> + + <p>There are from one-quarter to three-quarters of a million of + preventable deaths every years in this country. That number of + individuals could have been saved with proper care and attention to + health in the early stages of disease, or before it gained a start. + Practically all the diseases that carry business men off prematurely are + curable in the early stages.</p> + + <p>Of the percentage of Wall Street men who need medical attention + immediately, most have kidney or heart disease. The others are victims of + typical unhygienic habits, such as fast, gluttonous eating, neglect of + exercise, too much tobacco and liquor, and bad posturing in the office. + The business man considers these trifles, but they count heavily.</p> + + <p>Business efficiency is greatly increased, first, by selecting men + physically fit for work, and, second, by keeping them in that condition. + There is a tremendous waste from inefficiency constantly going on, due to + impaired health. Wall Street has an astonishing corps of + neurasthenics.</p> + + <p>We need a broader interpretation of the term Eugenics, so that we may + gain a more sympathetic and tolerant audience. The remedy does not lie in + an academic discussion of these problems; to continue the debate behind + closed doors will not lead anywhere: the public must be educated to a + just appreciation of existing conditions and the remedy must be the + product of effort on its part.</p> + + <p>Any condition that fundamentally means race <!-- Page xxvii --><span + class="pagenum"><a name="pagexxvii"></a>[xxvii]</span> deterioration must + be rendered intolerable. The prevalant dancing craze is an anti-eugenic + institution, as is the popularity of the delicatessen store. No sane + person can regard with complacency the vicious environment in which the + future mothers of the race "tango" their time, their morals, and their + vitality away. We do not assume to pass judgment on the merits of the + dance; we do, however, emphatically condemn the surroundings.</p> + + <p>The moving-picture shows, vaudeville entertainments, dancing + carnivals, the ease of travel, the laxity of laws, the opportunities for + promiscuous interviews, all tend to give youth a false impression of the + reality of life and to make the path of the degenerate easy and + attractive.</p> + + <p>The history of civilization is, curiously enough, the story of + masculine brutality, self-indulgence, and vice. The history of the world + also proves that woman's sphere has been to submit patiently and silently + to injustice and imposition. <i>Practical eugenics is the first worthy + effort in the history of all time to hold men and women responsible for + their mode of living.</i> It is a mighty problem. There is no greater nor + more difficult one to be solved. It has taken eons to bring men to the + point of questioning their right to do as they please; it will take time + to compel them to realize their disgrace and acknowledge their duty. When + we consider that there are eighty thousand women condemned to + professional moral degradation in the City of London, and that every + so-called civilized city on the globe contributes its pro rata share to + this army of potential mothers, we begin to appreciate the vastness of + the task.</p> + + <p>Eugenics has already accomplished what no other movement has ever + accomplished: it has created the spirit that gave birth to the thought of + men's responsibility, and it has taught us that the female of the race + has rights. We can now speak without fear; the light is no longer + hidden.</p> + + <p>Women must realize, however, that they have contributed, and continue + to contribute, to race degeneracy. We hear and read much about the double + standard of morals. As long as woman are willing to marry their daughters + to reformed rakes, providing they have money <!-- Page xxviii --><span + class="pagenum"><a name="pagexxviii"></a>[xxviii]</span> and social + position, so long shall we have a double standard. So long as young + society women go into hysterics over pedigreed dogs and horses and then + marry men reeking in filthy unfitness for parenthood, mothers cannot + expect any other standard of morals. So long as one marriage in twelve + ends in divorce, the ethics of the female need enlightenment. We shall + not get another standard of morals until women themselves demand it and + insist on it. If they lend themselves to breaking down the conspiracy of + silence, the women may solve the marriage problem by refusing to marry + rakes.</p> + + <p>We need a more liberal construction of the intent of eugenics in order + to clarify the obtuse minds so that its propaganda of education may be + easily and justly comprehended.</p> + + <p>There is no field for speculation in the analysis of right living. It + conforms to the law of cause and effect. It is positively concrete in + substance. A recital of the life history of Jonathan Edwards, in + comparison with that of the celebrated "Jukes" family, emphasises this + assumption with a degree of positiveness that is tragic in its + significance.</p> + + <p>Jonathan Edwards was born in England in Queen Elizabeth's time. He was + a clergyman and he lived an upright life. So did his wife. His son came + to the United States, to Hartford, Connecticut, and became an honorable + merchant. His son, in turn, also became a merchant, upright and honored. + His son, again, became a minister, and so honored was he that Harvard + University conferred two degrees on him on the same day; one in the + morning and one in the afternoon. This learned man again had a son, and + he became a minister. Jonathan Edwards was his name.</p> + + <p>Now let us see, in 1900, what this one family, started by a man in + England who lived an upright life and gave that heritage to his children, + produced: 1,394 descendants of this man have been traced and identified; + 295 were college graduates; 13 were college presidents; 65 were + professors; 60 were physicians; 108 were clergymen; 101 were lawyers; 30 + were judges; 1 was Vice-President of the United States; 75 were Army and + Navy <!-- Page xxix --><span class="pagenum"><a + name="pagexxix"></a>[xxix]</span> officers; 60 were prominent authors; 16 + were railroad and steamship presidents; and in the entire record not one + has been convicted of a crime.</p> + + <p>Twelve hundred descendants have been traced from the one man who + founded the "Jukes" family. This record covers a period of seventy-five + years; out of these, 310 were professional paupers, who spent an + aggregate of two thousand three hundred years in poorhouses; 50 were evil + women; 7 were murderers; 60 were habitual thieves; and 130 were common + criminals.</p> + + <p>It has been estimated that this one family was an economic loss to the + state, measured in terms of potential usefulness wasted; costs of + prosecution; expenses of maintenance in jails, hospitals and asylums; and + of private loss through thefts, and robberies, of $1,300,000 in + seventy-five years, or more than $1,000 for each member of the + family.</p> + + <p><i>It would seem to be worth while to be well born, after all.</i></p> + + <p>In order to succeed in the regeneration of the race, we must believe + that race regeneration is possible, and, that it is worth while. We must + preach its principles as we would a religion. The power of knowledge is a + mighty lever. We are living in a period of transition, but we are nearer + the future than the past.</p> + + <p>We are told by the average individual that it will be impossible to + arouse the public to an intelligent appreciation of the scope of race + regeneration. When the writer conceived the happy phrase, "Better + Babies," a few years ago, he builded better than he knew. It has become + the slogan of splendid achievement already, and there are a multitude of + signs and tokens that the propaganda is established on a sure + foundation.</p> + + <p>If the annihilation of all past civilizations was due to the refusal + of its members to breed for posterity, may we not reasonably assume that + we have, according to our statistics, reached the same crisis? If this is + logical reasoning, and every factor warrants this conclusion, have we not + reached the time when the perpetuation of the race is the most serious + question of our times? Is it not a problem for the enthusiastic and + immediate <!-- Page xxx --><span class="pagenum"><a + name="pagexxx"></a>[xxx]</span> support of every statesman, politician, + teacher, and preacher alike? Can any question be of more importance? What + will our marvelous material splendor avail if the race is destined to + immediate extinction?</p> + + <p>We need the assistance of every intelligent citizen, we need most, the + awakening impulse of the mothers of the race. We who are alive are + responsible for environment and nurture, and we must believe that the + purpose to be achieved is of supreme importance. Every mother, through + the power of knowledge, may become a practical eugenist. It is to aid her + in an intelligent appreciation of the practical intent of the science + that this work is presented.</p> + + <div class="poem"> + <div class="stanza"> + <p><font class="sc">W. Grant Hague, M.D.</font></p> + </div> + + <div class="stanza"> + <p>New York City.</p> + </div> + </div> + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 1 --><span class="pagenum"><a name="page1"></a>[1]</span></p> + +<h2>THE EUGENIC MARRIAGE</h2> + +<h3>CHAPTER I</h3> + +<blockquote class="b1"> + + <p>"Nations are gathered out of nurseries."</p> + + <p class="author"><font class="sc">Charles Kingsley</font>.</p> + + <p>"To be a good animal is the first requisite to success in life, and to + be a nation of good animals is the first condition of national + prosperity."</p> + + <p class="author"><font class="sc">Herbert Spencer</font>.</p> + +</blockquote> + +<h3>CONDITIONS WHICH HAVE EVOLVED THE +SCIENCE OF EUGENICS</h3> + +<blockquote class="b1"> + + <p><b>Infant Mortality—Marriage and + Motherhood—Heredity—Environment—Education—Disease + and Vice—History—Summary.</b></p> + +</blockquote> + + <p>There has been evinced during recent years a desire to know something + more definite about the science of eugenics.</p> + + <p>Eugenics, simply defined, means "better babies." It is the art of + being well born. It implies consideration of everything that has to do + with the well-being of the race: motherhood, marriage, heredity, + environment, disease, hygiene, sanitation, vice, education, + culture,—in short, everything upon which the health of the people + depends. If we contribute the maximum of health to those living, it is + reasonable to assume that the future generation will profit thereby, and + "better babies" will be a direct consequence.</p> + + <p>We are frequently told that we must take the world as we find it. This + has been aptly termed, "the motto of the impotent and cowardly." "Life is + what we make it," is the more satisfying assertion of the optimist, and + <!-- Page 2 --><span class="pagenum"><a name="page2"></a>[2]</span> most + of us seem to be trying to make existence more tolerable and more happy. + It is encouraging to know that intelligent men and women to-day seek an + opportunity to devote serious consideration to the betterment of the + race, while yet the pursuit of wealth and pleasure are enticing and + strenuous occupations.</p> + + <p>It would be superfluous in a book of this character to enter into any + lengthy explanation as to how the science of eugenics proposes to work + out its problems. We hope only to excite the interest of mothers in the + subject, and to instruct them in its rudiments and principles.</p> + + <p>It will be of distinct advantage, however, first to briefly consider + the conditions,—which are known to all of us,—which have led + up to the present status of the subject.</p> + + <p><b>Infant Mortality.</b>—No elaborate argument is necessary to + prove that the present infant mortality, in every civilized country, is + too high. It is conceded by every authority interested in the subject, no + matter what explanation he offers, or what system he advances as a + solution of the problem.</p> + + <p><b>Marriage and Motherhood.</b>—Every intelligent person knows + that most young girls enter into the marriage relationship without a real + understanding of its true meaning, or even a serious thought regarding + its duties or its responsibilities. We know that their home training in + domestic science is generally not adequate, and that their educational + equipment is inefficient. We also know that economic necessity has + deprived them of the tutelage essential to social progress and physical + health, and has endowed them with temperamental characteristics + undesirable in the mothers of the race. Maternity is thrust upon these + physically and mentally immature young wives, and they assume the + principal rôle in a relationship that is onerous and exacting. We know + that the duties of wife and mother require an intelligence which is + rendered efficient only by maturity and experience. We know that many, if + not most, young wives acquire habits which undermine their health and + their morals unwittingly, and we also know that the product <!-- Page 3 + --><span class="pagenum"><a name="page3"></a>[3]</span> of this + inefficiency results in the decadence and the degeneration of the + race.</p> + + <p><b>Heredity.</b>—Much remains inexplicable at the present time + regarding this intensely interesting department of science. We do know, + however, that its truths are being investigated and tabulated. Our + present knowledge of its principles has demonstrated the existence of + laws from which we can ethically deduce explanations of conditions which + were, in the past, not amenable to any classification. These relate to + individual and racial characteristics. We are beginning to learn that we + can modify these characteristics by proper selection, by environment, and + by education. This process will, to an eminent degree, redound to the + permanent advantage of mankind. We may reasonably aspire to a system of + race-culture which will eliminate the undesirable or unfit, and conserve + all effort in the propagation of the desirable or fit. This is a + consummation to be desired, and if by any system of eugenics the promise + of the future is realized it is deserving of the intelligent interest and + the active coöperation of every aspiring mother.</p> + + <p><b>Environment.</b>—By environment we mean the provision of + suitable surroundings in its largest sense. A child to be fit and + efficient must be born of selected parentage, the home surroundings must + be desirable, the educational possibilities must be advantageous, the + sanitary and hygienic conditions must be suitable, opportunities for + physical and spiritual culture must be provided, and the State must + ensure justice and the right to achieve success. We know + that—generally speaking—these conditions do not exist. We + know that the dregs of the human species—the blind, the deaf-mute, + the degenerate, the imbecile, the epileptic, the criminal even,—are + better protected by organized charity and by the State than are the + deserving fit and healthy. We know that in the slums thousands of + desirable children waste their vitality in the battle for existence, and + we know that, though philanthropy and governmental supervision and + protection are afforded the deaf, the dumb, the blind and degenerate + child, no helping hand is held out to save the healthy and efficient + child, who must pay in disease and <!-- Page 4 --><span + class="pagenum"><a name="page4"></a>[4]</span> inefficiency the price of + his normality in degrading toil, in factory and pit, where child labor is + tolerated. We need the awakening which is the promise of the eugenist, + that these wrongs will be righted, not by the statesmanship which + believes that empires are founded and maintained by the power of material + might, but by a process which will ennoble selected motherhood and give + to every child born its due and its right.</p> + + <p><b>Education.</b>—The present system of education is one of the + great reflections on the intelligence of the human race. One of the + greatest of contemporary writers has characterized it as "a curse to + modern childhood and a menace to the future." Even the humblest of + us—who would willingly believe the system efficient, who have no + desire to invite criticism as to our opinion—are forced to + acknowledge that there is something wrong with the educational system now + in vogue. The writer is disposed to believe, however, that the fault is + not wholly one of art. The conditions with which education has to contend + are essentially hypothetical. It may be that the laws of heredity and + psychology, when fixed, will evolve, at least, a more rational and a more + ethical hypothesis. So far as eugenics is concerned with education, its + limitation is defined and fixed. If the innate ability is not possessed + by the child, no system of instruction, and no art of pedagogy, will ever + draw it out. When the proper material is supplied by an adequate system + of race culture, science may probably supply the requisite complementary + data which will ensure an educational system that will really + educate.</p> + + <p><b>Disease and Vice.</b>—The eugenic idea is more directly + concerned with disease which tends to deteriorate the racial type. The + average parent has no means of adequately estimating the significance of + this type of disease. It has been estimated that one-half of the total + effort of one-third of the race is expended in combating conditions + against which no successful effort is possible. Think what this means. + The struggle of life is a real struggle, even with success as an + incentive and as a possible reward. It becomes a tragedy when we think of + the wasted years, the hopeless prayers and the anguish of those who fight + <!-- Page 5 --><span class="pagenum"><a name="page5"></a>[5]</span> the + battle which is predestined to end in apparent failure. We are disposed + to doubt the justice of the Omnipotent Mind who created us and left us + seemingly alone—derelicts in the eddies of eternity.</p> + + <p>This is but a finite fault, however. The truth is that the scheme of + the universe is unalterable, we are but part of the whole and must share + in the evolution of the process. An apparent failure is not necessarily a + discreditable one. Most lives are failures, if appraised by human + estimate. Take for example the life of a young wife who marries a man + with disease in his blood. She begins her wedded life with certain + commendable ideals. She is young, enthusiastic, ambitious, strong, and + she inherently possesses the right to aspire to become an efficient + home-maker and a good mother. She gives birth to a child, conceived in + love, and during her travail she beseeches her Creator to help her and to + help her baby, as all women do at such a time. Her baby is born blind and + it is a weak and puny mite. The mother recovers slowly, but she is never + the same vigorous and ambitious woman. Later her strength fades away, her + enthusiasm falters, the home is blighted and seems a desecrated spot. The + baby is a constant worry, it is always sick, it needs expensive care and + it exhausts the physical remnant of its mother's health. It finally dies + and is laid away, not forgotten, but a sad, sad memory. The ailing and + dispirited mother is informed that she must submit to an operation if she + desires to regain her health, if not to save her life. She returns from + the hospital—not a woman—a blighted thing, an unsexed + substitute for what once was a happy, sunny, healthy, innocent girl.</p> + + <p>This is not an overdrawn tale,—it is a true story, a common, + every-day story. Who was to blame? Why were her prayers not heard? Why, + indeed? One might as well ask why seemingly splendid civilizations + decayed into forgotten dust, or why empires rotted away. The answer is + the same.</p> + + <p><b>History.</b>—From the eugenists' standpoint history is + prolific only in negation. A correct interpretation of its pages teaches + us that it has not taught the lesson of the "survival of the fittest," + but rather the survival of the <!-- Page 6 --><span class="pagenum"><a + name="page6"></a>[6]</span> strongest. That the strongest is not always + the "fittest" needs no commentary. That the fit should survive is the + genetic law of nature, and it has been strictly obeyed by biology and + humanity when these sciences have adhered to, and have been under the + jurisdiction of the natural law.</p> + + <p>When religious schisms swayed the world, the stronger party, in + material strength or in actual numbers, massacred the weaker, which was + frequently the fitter from the standpoint of desirability as progenitors + of the race. Thus posterity was deprived of what probably was the + representative, potential strength of generations.</p> + + <p>At a later date religious schism changed her <i>modus operandi</i> but + accomplished the same pernicious purpose, as the following shows:</p> + + <p>"Whenever a man or woman was possessed of a gentle nature that fitted + him or her to deeds of charity, to meditation, to literature or to art, + the social condition of the time was such that they had no refuge + elsewhere than in the bosom of the Church. But the Church chose to preach + and exact celibacy, and the consequence was that these gentle natures had + no continuance, and thus, by a policy, was brutalized the breed of our + forefathers."</p> + + <p>When religion was not the dominating power, mankind was ruled by + militant tyrants. The non-elect were slaves,—uneducated, + uncivilized, debased and diseased. The elect were licentious and + indolent. Neither class practised any domestic virtues, or respected the + institution of motherhood. The process of the selection of the fittest + for survival for the purpose of parentage, and for the consummation of + the evolutionary gradation, through which the human race is apparently + destined to pass, was again in abeyance for a series of generations.</p> + + <p>In our own times, the fate of nations and the destiny of their people + would seem to depend upon the size of the fighting force and the + efficiency of the ships we build; our ability to dicker and barter, to + gain a questionable commercial supremacy, and the loquaciousness of our + politicians. This, at least, is the criterion upon which the modern + statesman estimates the quality of <!-- Page 7 --><span + class="pagenum"><a name="page7"></a>[7]</span> present-day civilization. + He is not apparently interested in the story of the ages. The progress of + God's supernal scheme through æons of bigotry and darkness neither + suggests nor inspires in him a loftier constructive analysis. He is + content to leave the destiny of nations to tons of material, tons of men + and tons of talk.</p> + + <p>Nowhere do we find any reference to the quality of the blood-stream of + the people. Nor does it seem to have been discovered by those who wield + authority, that the glory of a nation depends upon its brains, not its + bulk; nor do they apprehend that the greatness of a people is not in its + past history, but in its ever-existing motherhood; and that its battles, + in the future, must be fought, not on battlefields, but in its nurseries. + When we judge our national worth and wealth by the quality of our + maternal material, and estimate our greatness and our glory by the record + of our infant mortality, we will have carved an enduring niche in the + celestial scheme that will be unchangeable and for all time.</p> + + <p>There are in Britain to-day over a million and a quarter females of + marriageable age in excess of the number of marriageable males. A war + between Britain and Germany would unquestionably be the bloodiest war in + all history, and it probably would be the last one, because it would only + end in the dominance of one power over all the others. If we concern + ourselves only with Britain—from the eugenic standpoint—who + would dare compute the ratio of marriageable females over the males after + the war was over? The consequence of such a war on posterity would be + tragic. It would mean the annihilation of the fittest for fatherhood for + generations. Only the unfit would be left from which to begin a new + breed.</p> + + <p>The multitude of females who would necessarily be left unable to + participate in the highest function of womanhood would have to be + self-supporting. The economic problem would, therefore, have a + far-reaching influence and even if solved adequately as an economic + problem, it could never be solved satisfactorily as a sociological, or as + a problem in eugenics.</p> + + <p>Infant mortality is too high. Apart from the <!-- Page 8 --><span + class="pagenum"><a name="page8"></a>[8]</span> statistical proof which + shows it, we may rightly construe as further proof of it, the widespread + effort being made in every civilized country in the world to ameliorate + the condition.</p> + + <p>The laws and ethics of marriage are inadequate. Its true purpose is + frustrated and racial and individual injustice and imperfection are the + products of existing conditions.</p> + + <p>Motherhood, in its every aspect is not, and has not in the past, been + elevated to the plane which a true estimate of its supreme importance to + the race justifies.</p> + + <p>Heredity as a scientific principle is undeveloped, and because of + maladministration in past generations, the present generation is + endeavoring to do the work, the fruits of which it should be + enjoying.</p> + + <p>Environment in its highest sense is impossible because of inadequate + laws, imperfect hygienic and sanitary knowledge, incomplete education, + vice and disease.</p> + + <p>If there was not some supremely important, cardinal error somewhere, + it is reasonable to suppose that in one or other of the departments of + human effort we would have reached the summit of idealism. The State, as + an institution, would have evolved a perfection which would enable it to + exist as an independent mechanism, complete and ideal in all its + ramifications. We have had no such state, however. The highest type of + empire has been ludicrously dependent upon the minor exigencies of + individual human existence.</p> + + <p>Science would have evolved the superman, but history, as we have seen, + has persistently deprived science of the material wherewith to contribute + him.</p> + + <p>The institution of marriage would have been a fixed and an inviolable + guarantee of the happiness of the home, but human wisdom has erred and + the solution is as yet apparently undiscovered.</p> + + <p>Investigation into every field of human effort shows that the ultimate + aim in view, if any, was something other than the welfare of the race, as + a race or as individuals.</p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 9 --><span class="pagenum"><a name="page9"></a>[9]</span></p> + +<h3>CHAPTER II</h3> + +<blockquote class="b1"> + + <p>"The public health is the foundation on which reposes the happiness of + the people and the power of a country. The care of the public health is + the first duty of a statesman."</p> + + <p class="author"><font class="sc">Lord Beaconsfield</font>.</p> + +</blockquote> + +<h3>THE EUGENIC IDEA</h3> + +<blockquote class="b1"> + + <p><b>The Value of Human Life—The Eugenic Principle—"The Fit + Only Shall Live"—Eugenics and Marriage—The Venereal + Diseases—The Utility of Marriage Certificates—The Marriage + Certificates and Vice—Eugenics and Parenthood—The Principle + of Heredity—Eugenics and Motherhood—Eugenics and the + Husband.</b></p> + +</blockquote> + + <p>The eugenist believes the cardinal error of the past has been a + failure to recognize the worth or value of human life. In the past human + lives have counted for absolutely nothing. As we have seen, each + generation has practically deprived posterity of the best of its breed, + and we shall see, when we consider the facts which affect the present + vitality of the race, that the same preposterous conditions still + exist.</p> + + <p>It is not necessary to waste the reader's time in an effort to prove, + simply from an argumentative standpoint, the logic of the eugenic idea. + There is no existing economic problem that has established itself so + firmly in the hearts of the people who understand it, as has the study of + race culture. It is not the subject, but its scope of application, that + is new. Biologically, we see the manifestations of eugenics on every + side. In the flower garden we breed for beauty, in the orchard for + quality. In the poultry yard and on the stock farm the same process weeds + out the unfit and cultivates the desirable. The value of the eugenic idea + is most strikingly illustrated in the cultivation, or breeding, of the + horse from a primitive creature into the splendid animals which represent + the various types of equine present-day <!-- Page 10 --><span + class="pagenum"><a name="page10"></a>[10]</span> perfection. It has taken + generations of the most painstaking intelligence to understand the traits + which had to be evolved in scientific mating to reach the present + standard. If the same rules, or lack of rules, applied to the mating of + horses as applied to ourselves, there would be few, if any, + "thoroughbreds" among them. The principle which we must recognize is that + "Life is the only wealth."</p> + + <p>Progress and efficiency will be ensured and of an enduring character, + when all human effort is consecrated to this fundamental principle as a + basic law, and not till then.</p> + + <p>To cultivate the human race on prescribed scientific principles will + be the supreme science of all the future, the object and the final goal + of all honest governmental jurisprudence, and the ultimate judge of all + true constructive legislation.</p> + +<h4>THE EUGENIC PRINCIPLE</h4> + + <p>The eugenic principle is, that "the fit only shall live." This does + not mean that the unfit must die, but that only the fit shall be born. + Occasionally, as a product of bad environment, or faulty training, or + eccentricity, a horse gives evidence of vicious traits, but the + scientific breeder never mates him. He is allowed to die out. If he were + permitted to father a race, his progeny would develop murderous + characteristics that would retard the type for generations.</p> + + <p><b>The Fit Only Shall Be Born.</b>—This implies the exclusion of + those, as parents, who are incapable of creating fit children. Fit + children are children who are physically and mentally healthy. Parents + who are unfit to create physically and mentally healthy children are + those diseased in body or mind, especially if the disease is of the type + which science has proved to be transmissible, or which directly affects + the vitality of the child. In such a category we place those who are + deaf, dumb, blind, epileptic, feeble-minded, insane, criminal, + consumptive, cancerous, haemophilic, syphilitic, or drunkards, and <!-- + Page 11 --><span class="pagenum"><a name="page11"></a>[11]</span> those + known to be victims of disease of any other special type.</p> + + <p>It must not be inferred that the above classification is made + arbitrarily. There are many arguments which may be advanced limiting the + eugenic applicability of certain of these diseased conditions. These, + however, do not directly come within the province of the mother. They may + be safely left to special state regulation. We simply make the assertion + that no mother would willingly, or designedly, ally her offspring with + any member of society afflicted with any of the diseases enumerated.</p> + + <p><b>Eugenics and Marriage.</b>—The eugenic idea, practically + applied to the institution of marriage, means that no unfit person will + be allowed to marry. It will be necessary for each applicant to pass a + medical examination as to his, or her, physical and mental fitness. This + is eminently a just decree. It will not only be a competent safeguard + against marriage with those obviously diseased and incompetent, but it + will render impossible marriage with those afflicted with undetected or + secret disease. Inasmuch as the latter type of disease is the foundation + for most of the failures in marriage, and for most of the ills and + tragedies in the lives of women, it is essential to devote special + consideration to it in the interest of the mothers of the race.</p> + + <p>It is estimated that there are more than ten million victims of + venereal disease in the United States to-day. In New York City alone + there are two million men and women—not including boys and girls + from six to twelve years of age—actively suffering from gonorrhea + and syphilis. Eight out of every ten young men, between seventeen and + thirty years of age, are suffering directly or indirectly from the + effects of these diseases, and a very large percentage of these cases + will be conveyed to wife and children and will wreck their lives. No one + but a physician can have the faintest conception of the far-reaching + consequences of infection of this character. The great White Plague is + merely an incident compared to it. These diseases are largely responsible + for our blind children, for the feeble-minded, for the degenerate and + criminal, the incompetent and the insane. No other <!-- Page 12 --><span + class="pagenum"><a name="page12"></a>[12]</span> disease can approximate + syphilis in its hideous influence upon parenthood and the future. The + women of the race, and particularly the mothers, should fully appreciate + the real significance of the situation as it applies to them + individually. That they do not appreciate it is well known to every + physician and surgeon.</p> + + <p>It is first necessary to state certain medical facts regarding these + diseases. They exist for years after all symptoms have disappeared; no + evidences exist even to suggest to the patient that he, or she, is not + entirely cured. After the germs have been in the patient for some time + they lose a certain degree of their virility, and a condition of immunity + is established. In other words the tissue ceases to be a favorable medium + for the development, or activity, of the germs. If these germs, however, + are conveyed to another person, who has never had the disease, or whose + tissue is not immune, they will immediately resume their full activity + and virulence, and will establish the disease, frequently in its most + violent form, in the person so infected. The startling deduction which we + must draw from these facts is, that a man may infect his wife, and may + thereby be the direct cause of wrecking her entire life, and may, in + addition, as a consequence of the infection, cause a child to be born + blind, without even remotely suspecting that he is in any way responsible + for it. In the light of this knowledge, what is the percentage risk a + young girl takes when she selects a husband, remembering that eight out + of every ten husbands bring these germs to the marriage bed? Reread the + true story of the young woman on page <a href="#page5">five</a>, accept + my assurance that there are thousands and thousands of such cases, and + ask yourself, who is to blame? We may certainly assure ourselves that no + man living would wilfully desecrate his bride. He did not know,—did + not even suspect that the disease he had years ago was still in his + system. Society is to blame—you and I—the laxity of the law + is the culprit. Had he been compelled to pass a physical examination + before marriage he would have been told the truth.</p> + + <p>It is a notorious fact, that in every civilized city in the world, the + number of operations that are daily performed <!-- Page 13 --><span + class="pagenum"><a name="page13"></a>[13]</span> on women, is increasing + appallingly. Every surgeon knows that nine-tenths of these operations are + caused, directly or indirectly, by these diseases, and in almost every + case in married women, they are obtained innocently from their own + husbands. It is rare to find a married woman who is not suffering from + some ovarian or uterine trouble, or some obscure nervous condition, which + is not amenable to the ordinary remedies, and a very large percentage of + these cases are primarily caused by infection obtained in the same + way.</p> + + <p>When a girl marries she does not know what fate has in store for her, + nor is there any possible way of knowing under the present marriage + system. If she begets a sickly, puny child,—assuming she herself + has providentially escaped immediate disease,—she devotes all her + mother love and devotion to it, but she is fighting a hopeless fight, as + I previously explained when I stated that one-half of the total effort of + one-third of the race is expended in combating conditions against which + no successful effort is possible. Even her prayers are futile, because + the wrong is implanted in the constitution of the child, and the remedy + is elsewhere. These are the tragedies of life, which no words can + adequately describe, and compared to which the incidental troubles of the + world are as nothing.</p> + + <p>So long as these conditions exist need we not tremble for the future + of the race? Is not this future welfare a personal issue, or can we trust + the future of our daughters to the same indiscriminate fate that has + written the pages of history in the past?</p> + + <p>This problem has been debated from every possible angle without our + reaching any seemingly practical solution. The promise of emancipation, + however, came with the dawn of eugenics. It is the only solution that + gives promise of immediate and reasonable success. For that reason alone + it should receive the active support of every good mother in all + lands.</p> + + <p><b>The Utility of Marriage Certificates.</b>—There would seem to + be no question as to the utility of marriage certificates. We must + remember, however, that there is a distinction between marriage and + parenthood, and that <!-- Page 14 --><span class="pagenum"><a + name="page14"></a>[14]</span> eugenics is concerned only with parenthood. + It is interested in the institution of marriage to the extent only that + it may, by some system of regulation, be a positive and fixed factor in + the production of exclusively healthy children. The eugenist demands fit + children. If society can ensure fit children, as a consequence of any + marriage system which may or may not include medical certification, the + eugenic aim is fully met. At the present time the giving of a marriage + certificate, which is really a permit to marry, would seem to be the most + practical way promptly to accomplish the eugenic purpose. We should + promptly question the honor of any prospective husband disposed to evade + the examination simply because he was not compelled to obey by a + legislative enactment.</p> + + <p>We believe that when the public is educated to the truth and intent of + eugenics, there need be no compulsory examination. Men and women will, of + their own accord, desire to know if their marriage will jeopardize the + race. There will be questions of heredity to elucidate, questions of + inherited insanity, poison taints, of blindness and deafness, or it may + be of drunkenness.</p> + + <p>Further, marriage certificates, or permits, must be considered in + regard to the future conduct of those to whom we refuse permits to marry. + A refusal of the permission to marry will not change the desire to marry. + Many, of course, to whom a permit is refused, will accept the situation, + will be thankful to be possessed of the knowledge of their incompetency + in order that they may seek medical aid. These individuals will remain + under medical supervision until their ailments are cured and their + competency established. In this way the eugenic aim is materially + furthered. Others may not abide by the decree which forbids marriage. It + would wholly defeat the eugenic idea if the unfit children were to + continue to be born illegitimately. These individuals will comprise the + few—probably the present unfit members of society—and the + final solution of the matter must remain a question of education and + evolution. When public opinion is educated to the degree necessary to + establish a system of eugenic self-protection, we shall be <!-- Page 15 + --><span class="pagenum"><a name="page15"></a>[15]</span> provided with a + race of children whose culture will achieve the ideal of parenthood by a + process of education rather than legislation.</p> + + <p><b>The Marriage Certificate and Vice.</b>—If a prenuptial + examination were made compulsory there is no doubt of the very prompt and + salutory effect it would have on present-day vice. It has often been said + that "You cannot legislate virtue or sobriety into a people." We are + familiar too with the maxim that "You can lead a horse to the well, but + you cannot make him drink." You can lead a horse to the well, however, + and lo! he drinks. If you lead him at the right time he will always + drink. If we legislate at the psychological moment we can legislate + virtue and sobriety into a people.</p> + + <p>A very large percentage of existing vice is the immediate product of + ignorance, and the larger percentage of the remainder is the result of + propinquity and the idea that it will never be found out. Very little of + it is the outcome of innate degeneracy. It is an acquired degeneracy we + must guard against, and that is the special educational motive of + eugenics. Young men will be taught the truth about vice, and if they have + been victims in the past, they will willingly submit themselves to a + <i>competent</i> investigation of their fitness for marriage. If they are + still pure, the desire to remain so, in order to be eligible for + parenthood, will guard them against the risk of contamination. This will + not only result in a distinct improvement of the moral tone, but the + potential possibilities to posterity will be incalculable. Legislation + might therefore be the vehicle through which eugenic education could + enlighten and evolve a fit race.</p> + +<h4>EUGENICS AND PARENTHOOD</h4> + + <p>If the supreme end is a better race we must recognize that the great + need for society to-day is to educate for parenthood. History teaches + that a civilization that dissipates its virility in profligacy or spends + its energy in political and commercial trickery, and gives no thought to + the character of the men and women it produces, is destined to total + failure. Parenthood and birth—in these <!-- Page 16 --><span + class="pagenum"><a name="page16"></a>[16]</span> we have the eugenic + instruments of the future. The only permanent way to cure the ills of the + world is to prevent the multiplication of people below a certain + standard. The elevation and the actual preservation of the race depends + upon rendering it impossible for the unfit coming into existence at all. + In other words the unfit or unworthy must be rejected, not necessarily as + individuals, but as parents.</p> + + <p>Eugenics is allied to the principle of heredity,—the principle + that enables us to modify conditions so as to ensure the right children + being born. The propaganda against infant mortality is directed only + toward the provision of a good environment,—so that children, when + born, may survive and attain the maximum of their hereditary promise. The + two campaigns are essentially complementary. The one applies only before + birth, the other after birth. The statistics of infant mortality + unfortunately show that it is not a process that extinguishes the unfit + only. The healthy succumb to unfavorable environment and it was to amend + this condition that the campaign against infant mortality was undertaken. + The two campaigns appeal to the same creed: that parenthood is the + supreme function of the race, that it must not be indifferently + undertaken; that it demands the most careful preparation; that it is a + duty which can only be carried out eugenically by the highest attainable + health of body and mind and emotions.</p> + + <p><b>Eugenics and Motherhood.</b>—Any plan or scheme which has for + its object race regeneration must concern itself with the health, the + education, and the psychology of woman; the environment which shall + surround her period of motherhood, and her selection of the fathers of + the future. Society must safeguard her in all her relations. The race + to-morrow are the babies of to-day. The wealth of a nation therefore is + the type of baby that will constitute its civilization from generation to + generation, and absolutely nothing else counts. We hear much about race + suicide, but is it not monstrous to cry for more babies when we do not + know how to keep alive those we have? It is a fact that everywhere the + birth rate of the Caucasian people is on the decline. Our birth <!-- Page + 17 --><span class="pagenum"><a name="page17"></a>[17]</span> rate as a + whole, however, is ample; it is the death rate that is significant and + appalling. When we remember that one-third of all the babies born die + before they reach the age of five years; and that the deaths of babies + under one year of age comprise about one-fourth of the total death-roll; + and that fully one-half of all these deaths are needless and unnecessary, + wherein is the wisdom of working for a higher birth rate if it is merely + that more may die?</p> + + <p>The majority of babies are born physically healthy, but because of our + destructive process, we proceed to annihilate hundreds of thousands of + them yearly, and because of defective environment and education we render + thousands of others, including the fit and unfit, inefficient and + incompetent as propagating factors. It is to remove this disastrous + stigma on our intelligence that we have been forced to study the + conditions which the eugenic idea represents. When these principles are + understood and believed, and when they are acted upon, infant mortality + will cease to exist.</p> + + <p>It was the design of the Creator that human motherhood should be an + exalted occupation. He placed in her care to nurture and to love, the + most helpless living thing. Few have regarded a baby from this viewpoint + and fewer still understand its supreme significance. That it is the most + utterly helpless thing possessing life is a self-evident fact, and that + it should be destined to be King of all mammalian tribes as well as Lord + of all the earth is a superlative paradox. Because of its utter inability + to care for itself it is more in need of care than any other + representative of the animal world. It is not only in need of immediate + care, but it demands care longer than the young of any other species.</p> + + <p>It stands to reason, therefore, that the function of motherhood must + be reckoned with in any scheme of race regeneration; that it must be + provided with the most favorable environment; and that it must be + relieved of any condition which would materially retard the meeting of + the obligation to its fullest possible extent. In an ideal eugenic sense + the state must ensure sustenance to those deprived of ample food and + raiment, and science <!-- Page 18 --><span class="pagenum"><a + name="page18"></a>[18]</span> must continue to solve the problem of a + fitter sanitary and hygienic environment for the congested and densely + populated zones of habitation. Philanthropy must not continue to be + wholly misdirected, it must extend its aid to the deserving healthy and + fit, as well as to be exclusively the protecting agency of the diseased + and unfit. If life is the only wealth, and the preservation of childhood + the highest duty of society and the state,—which it would seem to + be, since the continuance and preservation of the race is obviously + essential to the continuance of the state itself,—the life of every + child must be considered an economic as well as a moral trust. If, + therefore, every child is sacred, every mother is equally sacred. If + every child is to be cared for, every mother must be cared for. If the + state cannot afford to provide for what is imperatively essential to its + own continuance, it might as well go out of existence, as it inevitably + will in the end on any other basis, and as all preceding states have + done.</p> + + <p>Mothers must not be dependent upon their children's labor for their + maintenance, because if children are compelled to work, they will not be + able to work in the future,—and adult efficiency is necessary to + the well-being of the individual, the race, and the state.</p> + + <p>No mother should work, because in the care of her children she is + already doing the supreme work. The proper care of children is so + continuous and exacting a task, and of such importance to posterity, that + it must be regarded as the highest and foremost work—and adequate + in itself—and its efficiency must not be hampered by mothers having + to do anything else.</p> + + <p>Motherhood must not be financially insecure, because this would defeat + its eugenic purpose. Society, therefore, as a matter of + self-preservation, must ensure to woman her mental and economic security. + Civilization's margin is large enough to provide this. We spend large + amounts on luxuries and evils which are contrary to the genesis of + self-preservation, while motherhood is its basic necessity. When public + opinion is educated in the essentials of eugenics much of this can be, + and will be diverted to a nobler purpose. The total cost <!-- Page 19 + --><span class="pagenum"><a name="page19"></a>[19]</span> necessary to + ensure the adequate care of dependent motherhood would be a mere fraction + of the national expenditure, and not a tithe of what we spend in pension + allowances yearly. The latter is regarded as an honorable debt and is at + best the direct product of a decadent ideal, while motherhood constitutes + the very germ of the only altruistic idealism for all the future.</p> + + <p>We concede, therefore, that the children and the mothers must be + provided for, not only as a product of the true construction of the + ethics of sociology, but in obedience to the fundamental law of a moral + system of eugenics. We must go further and assert that children must be + cared for through the mother. It has been the practice to divorce the + improvident mother from her dependent children. This has been + demonstrated to be not only an altruistic fallacy. It has proved to be an + economic blunder.</p> + + <p>There is another type of evil which largely menaces the eugenic ideal + of motherhood. It is those cases where married women who have children + are compelled to be the bread winners of the family as well as its + mothers. No woman can earn support for herself and children outside of + her home and competently assume the responsibilities of motherhood at the + same time. Whatever aid a mother renders to the state, as a result of + effort in factory or shop, is of infinitely less value, from an economic + standpoint, than her contribution as mother in caring for her own + children in her own home. A careful study of infant mortality, and the + conditions of child life, so far as survival value is concerned, condemns + in the strongest and most vital sense this whole practice. The + preservation of the race is the essential requisite, and it is the vital + industry of any people. Any seeming economic necessity which destroys + that industry is one that will contribute largely to the downfall of the + people as a race.</p> + + <p><b>Eugenics and the Husband.</b>—The question of the husband's + moral and parental obligation, as dictated by the marriage institution + and constitution, may be left out of this discussion. We may assert, + however, that we do not believe the eugenic principle intends, in + devising ways <!-- Page 20 --><span class="pagenum"><a + name="page20"></a>[20]</span> and means for the adequate protection, in + its completest sense, of motherhood, to relieve the father of any of his + moral or parental obligations. These obligations will be justly defined, + and as previously stated, will be the subject of special state + legislation. No legislation of an economic character can detract from the + performance of a moral obligation, and by no process of sophistication + can modern statesmanship accomplish the dethronement of motherhood. The + duty of the father is to support his children and the mother of his + children, and the duty of the state is to see that this is done. The + fundamental law of the eugenist must be to recognize that fatherhood is a + deliberate and responsible act, for which a fixed accountability must be + maintained. Whatever legislation is undertaken in this connection must be + with the object in view of strengthening the efforts of the right kind of + father and husband, and of rendering more difficult the path of the + irresponsible father and husband. If the supreme duty of a state is the + maintenance of justice, its whole effort in the future will be to + legislate in harmony with the eugenic principle.</p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 21 --><span class="pagenum"><a name="page21"></a>[21]</span></p> + +<h3>CHAPTER III</h3> + +<blockquote class="b1"> + + <p>"I hope to live to see the time when the increased efficiency in the + public health service—Federal, State and municipal—will show + itself in a greatly reduced death rate. The Federal Government can give a + powerful impulse to this end by creating a model public health + service."</p> + + <p class="author"><font class="sc">Ex-President Taft</font>.</p> + +</blockquote> + +<h3>EUGENICS AND EDUCATION</h3> + +<blockquote class="b1"> + + <p><b>The Present Educational System is Inadequate—Opinions of Dr. + C. W. Saleeby, Ella Wheeler Wilcox, Luther Burbank, William D. Lewis, + Elizabeth Atwood, Dr. Thomas A. Story, William C. White, Dr. Helen C. + Putnam—Difficulty in Devising a Satisfactory Educational + System—Education an Important Function—The Function of the + High School—The High School System Fallacious—The True + Function of Education.</b></p> + +</blockquote> + + <p>The fundamental law of eugenics demands that all education be exerted + for parenthood. We have proved that the child is not only essential to + the life of the state, but is the state. Consequently any function other + than parenthood is a non-essential so far as organic existence is + dependent upon it. Education can, therefore, have no higher or more + righteous motive than as a contributory agency in the perpetuation of the + function upon which all existence depends. If the only function of + education is to make one a worthy citizen, or to make him, or her, + self-supporting, or able to bear arms in defense of his country, rather + than a perfect link in the complete chain of enduring life, its purpose + is being perverted. It is not sufficient to provide a girl, for instance, + with an exclusive environment which regards her simply as a muscular + entity, as is the tendency in some of the "best" girls' schools to-day; + nor to fit her as a domestic or society ornament; nor must she be + regarded simply as an intellectual machine, as is done under the system + styled "the higher education of women." Any one of these is <!-- Page 22 + --><span class="pagenum"><a name="page22"></a>[22]</span> an example of + misdirected excess and is only part of the whole. None of these systems + strives to develop the emotional side of the complex female character, + and any educational system which ignores the emotions is not only + inadequate but reprehensible in the highest degree. The ideal which will + strive for education for ultimate parenthood will more completely solve + the question of complete (eugenic) living.</p> + + <p><b>The Present Educational System is Inadequate.</b>—There is no + question that education, as conducted at the present time, is one of the + most disastrous institutional fallacies of modern civilization. In + support of this contention, we are prompted to quote at length from + various authorities bearing on this subject.</p> + + <p>Dr. C. W. Saleeby, an international authority on education, writes as + follows:</p> + + <p>"A simple analogy will show the disastrous character of the present + process, which may be briefly described as 'education' by cram and + emetic. It is as if you filled a child's stomach to repletion with + marbles, pieces of coal and similar material incapable of + digestion—the more worthless the material the more accurate the + analogy—then applied an emetic and estimated your success by the + completeness with which everything was returned, more especially if it + was returned 'unchanged,' as the doctors say. Just so do we cram the + child's mental stomach, its memory, with a selection of dead facts of + history and the like (at least when they are not fictions) and then apply + a violent emetic called an examination (which like most other emetics + causes much depression) and estimate our success by the number of + statements which the child vomits onto the examination paper—if the + reader will excuse me. Further, if we are what we usually are, we prefer + that the statements shall come back 'unchanged'—showing no sign of + mental digestion. We call this 'training the memory.' The present type of + education is a curse to modern childhood and a menace to the future. The + teacher who cannot tell whether a child is doing well without formally + examining it, should be heaving bricks, but such a teacher does not + exist. In Berlin they are now learning that the depression caused <!-- + Page 23 --><span class="pagenum"><a name="page23"></a>[23]</span> by + these emetics (examinations) often lead to child suicide—a steadily + increasing phenomenon mainly due to educational overpressure and worry + about examinations.</p> + + <p>"Short of such appalling disasters, however, we have to reckon with + the existence of this enormous amount of stupidity, which those who + fortunately escaped such education in childhood have to drag along with + them in the long struggle towards the stars. This dead weight of inertia + lamentably retards progress.</p> + + <p>"If you have been treated with marbles and emetics long enough, you + may begin to question whether there is such a <ins class="correction" + title="'think' (hand-corrected) in original">thing</ins> as nourishing + food; if you have been crammed with dead facts, and then compelled to + disgorge them, you may well question whether there are such things as + nourishing facts or ideas."</p> + + <p>The gifted writer, Ella Wheeler Wilcox, in an editorial in the <i>New + York American</i>, expressed herself recently in the following terms:</p> + + <p>"A wave of dissatisfaction is sweeping over the country regarding our + school system. And eventually this will cause a change to be made. The + larger understanding of mothers regarding education will result in the + personal element entering into the training of children.</p> + + <p>"When women have a voice in the affairs of the nation there will be + more teachers, larger salaries, fewer pupils in each department, and more + attention will be given to the temperaments and varying dispositions of + children by their instructors.</p> + + <p>"Instead of regarding the little ones who enter public schools as + machines which must be taught to go according to one rule, each child + will be studied as a threefold being, and his mind, body and spirit will + be cared for and developed according to his own peculiar needs. All this + will come slowly, but it will come.</p> + + <p>"Before children enter the public schools there should be a great + sifting process under the direction of a national board of scientific + men. The brain equipment of each child, the tendencies given it at birth, + should be tested; then the nervous, hysterical and erratic minds <!-- + Page 24 --><span class="pagenum"><a name="page24"></a>[24]</span> ought + to be placed in a school by themselves, under the care of men and women + who know the law of mental suggestion.</p> + + <p>"Quiet, loving, wholesome rules, followed day after day and month + after month, would bring these children out into the light of + self-control and concentration. The hurried, crowding, exciting methods + of the public schools are disastrous to fully half of the unformed minds + sent into the intellectual maelstrom which America provides under the + name of Public Schools.</p> + + <p>"For the well-born, normal-minded, healthy-bodied child, who has wise + and careful guardians or parents to assist in his mental guidance, the + public school forms a good basis on which to build an education. For the + average American child of excitable nerves and precocious tendencies, it + is like deep surf swimming for the inexperienced and adventurous + bather.</p> + + <p>"The great foundation of education—character—is not taught + in the public schools. There is no systematized process of developing a + child's power of concentration; there is not time for this in the + cramming process now in vogue and with the enormous pressure placed on + teachers. No teacher can do justice to more than fifteen children through + the school hours. In many of our public schools there are fifty and sixty + children under one instructor. This is fatal to the nervous system of the + teacher and deprives the pupils of that personal sympathy which is of + such vital importance."</p> + + <p>Luther Burbank, the famous California horticulturist, declares that + the great object and aim of his life is to apply to the training of + children those scientific ideas which he has so successfully employed in + working transformation in plant life.</p> + + <p>In an editorial, entitled, "Teaching Health," the <i>New York + Globe</i> states, "Anatomy and physiology are reasonably exact sciences, + and nine-tenths of the hygienic abuses against which the doctors are + preaching would be prevented if the laity had an elementary knowledge of + physiology. Such an educational reform could be carried out without + causing any clash whatever between the warring medical sects." <!-- Page + 25 --><span class="pagenum"><a name="page25"></a>[25]</span></p> + + <p>William D. Lewis, Principal of the William Penn School, Philadelphia, + in an article entitled: "The High School and the Girl," in a recent issue + of the <i>Saturday Evening Post</i>, wrote in part as follows:</p> + + <p>... "The first thing that society wants of our girl is good health. + This is the first essential for her efficient service and personal + happiness in shop, office, store, school or home. The future of the race + so far as she represents it, depends upon her health. What is the high + school doing to improve the girl's health? In the overwhelming majority + of cases absolutely nothing. On the other hand, it is subjecting her to a + regimen planned for boys, without the slightest consideration of the + physical and functional differences between the sexes.</p> + + <p>"It pays no attention to the curvature of the spine developed by the + exclusively sit-at-a-desk-and-study-a-book type of education bequeathed + to the girlhood of the nation by the medieval monastery: It ignores the + chorea, otherwise known as St. Vitus' dance developed by overstudy and + underexercise; it disregards the malnutrition of hasty breakfasts, and + lunches of pickles, fudge, cream-puffs and other kickshaws, not to + mention the catch penny trash too often provided by the janitor or + concessionaire of the school luncheon, who isn't doing business for his + health or for anybody else's; it neglects eye-strain, unhygienic dress, + uncleanly habits, anemia, periodic headaches, nervousness, adenoids, and + wrong habits of posture and movements.... If you believe that the high + school is a social institution with a mission of public service, + regardless of the relation of that service to Latin or Algebra, then you + must agree that it should look after what everyone recognizes as the + foremost need of the adolescent girl.</p> + + <p>"One fact that every educator in both camps knows is that the home is + not attending to the health of the adolescent girl. This problem is + pressing upon us now largely because of the revolutions in living + conditions that has come within the last quarter of a century."</p> + + <p>In a report of a recent Conference on the <!-- Page 26 --><span + class="pagenum"><a name="page26"></a>[26]</span> Conservation of School + Children held at Lehigh University by the American Academy of Medicine, + the following items appear.</p> + + <p>Four great reasons why medical inspection in schools is needed were + brought out by Dr. Thomas A. Story of New York, who spoke from the + educator's standpoint:</p> + + <p>"The first reason is concerned with communicable diseases, and the + second with remediable incapacitating physical defects. It was reported + in 1906 that over twenty per cent. of the children in the schools of New + York City had defective vision, and over fifty per cent. had defective + teeth. These defective conditions are amenable to treatment whereby the + functional efficiency of the pupil is improved. He is capable of better + work and the school efficiency is advanced.</p> + + <p>"The third reason is concerned with irremediable physical defects. The + cripples, the deformed and the delinquents whose incapacitating defects + are permanent should be found and classified. This enables special + instruction and opens up educational possibilities otherwise + unattainable, besides removing retarding factors in the progress of the + normal pupil.</p> + + <p>"The fourth reason is concerned with the development of hygienic + habits in the school child, and through the child, of the community. + Medical inspection which influences the health habits of the masses is a + matter of supreme importance. The teacher will have pupils of cleaner + habits and healthier, with fewer interruptions and disturbances from + absences.</p> + + <p>"To make medical inspection successful physical examinations should + uncover the anatomic, physiologic, and hygienic conditions. Every piece + of advice given to a pupil that can be followed up should be followed up + and the result recorded. No system of medical inspection in schools can + be complete and permanently successful which does not eventually educate + the parent and child to a sympathetic and coöperative relationship with + the system. Medical inspection is a force working for a better general + education in personal hygiene and should coördinate with the class room + instruction. Hence it <!-- Page 27 --><span class="pagenum"><a + name="page27"></a>[27]</span> must be a system in sympathetic + relationship with the general management of the school, and should be + under the same responsible control. Since it is an educational influence + and so directly related to the success of the school, it ought to be a + part of the school organization."</p> + + <p>A paper was read by Dr. Helen C. Putnam of Providence, R. I., on "The + Teaching of Hygiene for Better Parentage." She said:</p> + + <p>"Life is a trust from fathers and mothers beginning before history; to + be guarded and bettered in one's turn, and passed along to children's + children. A definite conception of this trust is essential to right + living. Educators are finding that well directed correlation of human + life, with phenomena of growing things in school gardens and nature + studies, develops a wholesome mental attitude. Since tens of millions of + our population have only fractions of primary schooling, there is where + the teaching must begin. These primary years are the time to lay + foundations before a wrong bias is established.</p> + + <p>"Education for parenthood cannot be completed at this early age. The + strategic years for making it most effective are from sixteen to + twenty-four, when home-making instincts are waking and strongest. We have + 15,000,000 young people of these ages in no schools, and eligible for + such instruction. All state boards of education were recently petitioned + by the American Association for Study and Prevention of Infant Mortality + to urge the appointment of commissions on continuation schools of + home-making, to investigate conditions and needs in their respective + states and to report plans for meeting them effectively through such + continuation schools or classes."</p> + + <p><b>Difficulty in Devising a Satisfactory Educational + System.</b>—It will be observed that each of these authoritative + writers criticises the system of education now in vogue. The criticism is + not, nor could it justly be, specialized. It is simply an expression, + from different viewpoints, of the feeling that we are not doing ourselves + justice as yet, we are groping after something better. It <!-- Page 28 + --><span class="pagenum"><a name="page28"></a>[28]</span> may be, as I + have previously stated, that no satisfactory system of education will be + evolved until the laws of kindred sciences, which have organic + relationship to what we understand as education, are fixed and better + understood. We are just beginning to appreciate the true meaning of + environment. We know little about heredity, but enough to appreciate its + vital importance. Psychology is a realm of much hope, but we have only + tasted of its surface promise and know little of the mysteries it may + unfold. Eugenics, the infant giant of science, promises to establish the + race on an enduring foundation. These sciences have laws which we do not + yet understand; they relate to that part of human evolution which mind + dominates. The quality of the mind's dominion depends upon the mind's + education and environment, and since the laws of these sciences, upon + which a perfect system of education depends, have not been revealed, it + is quite evident that all past systems of education have been more or + less deficient. It is further evident that evolution has suffered as a + result of the mind's imperfect education,—a condition that is + manifest all around us.</p> + + <p>It must be appreciated, however, that we are discussing a large + subject. If we understood all there is to know about environment; if we + knew the laws of heredity, and psychology, and eugenics, and then could + apply them, and educate the product of this combination of forces, we + would be very near to the super-man. One must have a sober mental horizon + to evolve the picture which would be the product of the above solution + and then to estimate its meaning on human happiness and progress. We are + approaching the ethics of right living,—of justice and + truth,—the divine in man. At no time in the history of man has + civilization been so near a solution of life's supreme problem as at the + present moment.</p> + + <p>Education is an important function in life's scheme, and while we may + regret that it is not possible to formulate a system that would be + perfect and capable of immediate application, we can continue to work + patiently and hopefully, with assurance that in the near future the + problem will be satisfactorily solved. When heredity, <!-- Page 29 + --><span class="pagenum"><a name="page29"></a>[29]</span> psychology, and + eugenics combine to dictate the system, we shall doubtless find, that, in + the beginning, it will be a system of individualization. In the interest + of health and of justice, and consequently of efficiency, this would seem + to be the natural and the logical lead.</p> + + <p>So long as human nature is as it is, we must meet conditions as they + exist. We know as parents, and some of us know as physicians, that a task + easily performed by one individual, without any apparent harmful results, + will tax the capacity of another individual to the very utmost. Any + educational system which does not recognize this law, is vicious. Yet + such is the system in vogue to-day in America. We must adapt the burden + to the endurance of the pupil. The administration of an educational + machinery must solve this problem from the individual standpoint.</p> + + <p>In the departmental work in our public schools there seems to be no + system. Each teacher prescribes home work without any knowledge of what + others of the same grade do, and without any apparent consideration in + favor of the individual pupil. The result is that the total amount for + each night is absurdly in excess of the capacity of the ordinary, or for + that matter the extraordinary, pupil. This engenders nervousness and + irritability, and is contrary to the ethics of education,—the + fundamental law of which should be the preservation of good health. We + must have regard for the physical and mental health of each pupil, and as + the capacity of each pupil is different, the system is committing an + egregious wrong by sacrificing the weaker instead of adapting the burden + according to the strength and endurance of the bearer.</p> + + <p><b>The High School System Fallacious.</b>—Even the high schools + do not seem to be wisely availing themselves of their opportunity from + the eugenic or economic standpoint. According to the report of the + Commissioner of Education of the United States the percentage of pupils + studying some of the more important subjects in the year 1909-1910 is + stated as follows: <!-- Page 30 --><span class="pagenum"><a + name="page30"></a>[30]</span></p> + +<pre> +Latin, French and German 83 per cent. +Algebra and Geometry 88 " " +English Literature 57 " " +Rhetoric 57 " " +History 55 " " +Domestic Economy,--including + sewing, cooking and household + economies 4 " " +</pre> + <p>If only barely four per cent. of the girls in our high schools are + studying subjects which directly contribute to their efficiency as + home-makers, what are the prospects for worthy parenthood in the light of + the fact that seventy-five per cent. of all women between the ages of + twenty and twenty-four are married?</p> + + <p>The function of the high school, so far as girls are concerned, is to + conserve health, to train for domestic efficiency and motherhood, and if + necessary for economic independence. It must also furnish the stimulus + for mental culture and direct a proper aspiration for social + enlightenment. The curriculum should include biology, hygiene, + psychology, home beautifying, the story-telling side of literature, music + and a few other studies tending to make woman more like woman than she is + to-day. When we have this, teaching for mothercraft will be more nearly + realized.</p> + + <p>From the eugenic standpoint the present system of education is not + satisfactory. To attain our end it is essential to devise other means of + education. It must be remembered, however, that no system of education + alone can ever enable us to achieve our end, no matter how perfect the + system may be. Education can only draw out what is in the child; it + cannot draw out what is not there. What the child is, depends upon its + heredity. The pedagogic ability of the school-master will never make a + genius.</p> + + <p>A child's mind may be likened to a block puzzle, each block + representing a part of a picture, which can only be completed when they + are all arranged in their correct places. Each block is an ancestral + legacy,—the child's heritage—and to find its proper place in + order to <!-- Page 31 --><span class="pagenum"><a + name="page31"></a>[31]</span> complete the character picture—to + solve the riddle of the jumbled blocks,—is the duty of the + educator. He can only manipulate what is there, and the test of his + system will depend upon his ability to solve the puzzle of the ancestral + blocks. We must divorce ourselves from the idea that a child's mind, at + the beginning, is an empty space, to be filled in with knowledge + according to the ability of the teacher; or that it is like a sheet of + paper, to be written upon. Education, and the educator, is absolutely + limited to "drawing out" what heredity put there. Education frequently is + given credit which rightly belongs to nature. A child cannot do certain + things until nature intends that it should. A baby cannot possibly walk + until the nervous mechanism which controls the function of walking is + developed. Many children walk at the first attempt, simply because they + did not make the first attempt until after nature had perfected the + mechanism and the innate ability to walk was already there. Suppose we + tried to teach that baby to walk a month before nature was ready; each + day we patiently coax it to "step out," we guide it from support to + support, and we protect it from stumbling. Some day it walks, and we + congratulate ourselves on the victory, when as a matter of fact, we not + only had nothing to do with it but were impertinent meddlers, not + instructors. Nature was the teacher and she was quite capable of + completing the task without our aid. It is reasonable also to assume that + any effort to force a natural function is quite likely to do much harm. + We have found this to be so in various departments of education when the + system was wrongly conceived. In physical culture this principle has been + demonstrated over and over again.</p> + + <p>If our ancestral legacy is a good one, our picture blocks will be + numerous and it will be possible for the proper system of education, + aided by a suitable environment, to arrange them into many designs. If, + on the other hand, our heredity did not endow us abundantly the number of + our picture blocks may be limited to three or four, and they will be + easily arranged so as to form a simple picture. The one represents a + child whom heredity has richly endowed, the other one whom it has <!-- + Page 32 --><span class="pagenum"><a name="page32"></a>[32]</span> + meagerly supplied with innate possibilities. Heredity therefore dictates + the function of education; and the school-master can only fashion the + picture put there. If the ancestral blocks are not there with which to + make an elaborate picture he must content himself with what is + there,—he or his art cannot create others. When he congratulates + himself on achieving a wonderful result in graduating a particularly + brilliant student, he is taking to himself unmerited honors. If his + individual ability is responsible in one instance, why not apply the same + system to all pupils? If this system is responsible for the brilliancy of + one pupil, why does not the same system make all brilliant? The reader + knows the answer,—because heredity did not endow them equally. Men + are not born equal, despite the Declaration of Independence.</p> + + <p>The school-master is not responsible for the apt and the inapt pupil. + He is responsible for his system which dictates how he will differentiate + between the apt and the inapt pupil, in order to achieve the best results + without injustice to either.</p> + + <p>The inefficient teacher is a dangerous equation in the school system. + I mean by inefficiency, the quality of being temperamentally unsuited to + the profession. There are a large number of anemic, hysterical young + women teaching in the public schools of our cities who should not be + there. They should not be there in justice to themselves, nor should they + be there in justice to their pupils. A strict, yearly medical examination + should be made of the teachers to decide their physical and psychical + fitness to fill their positions adequately. One teacher, physically or + psychically inefficient, can do an inconceivable amount of harm in one + school term. We cannot afford to experiment along this line. It means too + much, and even at the price of one unhappy child it is too much to pay. + The teacher who feels that she is not suited to the work; who has + constantly to hold herself and her temper under control; whose nerves are + such that she cannot do justice to herself, whose sense of justice is + capable of perversion on purely sentimental grounds; or who has + lost—or never possessed—the gift of maintaining discipline, + should promptly find another <!-- Page 33 --><span class="pagenum"><a + name="page33"></a>[33]</span> position. She is earning her salary under + false pretenses, and that alone condemns her. I believe, that a large + percentage of the inefficiency of the New York Schools is due, not to the + academic or scholastic inability of the average teacher, but to the + average female teacher's physical, and especially her psychical unfitness + to teach. We must concede, however, that in many instances the teacher's + unfitness is a direct product of the pernicious system itself.</p> + + <div class="figcenter" style="width:50%;"> + <a href="images/v1fig002l.jpg"><img width="100%" src="images/v1fig002l.jpg" + alt="Evidence of a Feeble Mind" /></a> + <p><i>From "The Village of a Thousand Souls," Gesell, American + Magazine</i></p> + + <h4>Evidence of a Feeble Mind</h4> + + <p>A dirty shack in a mud hole in the country is merely another + reflection of the same condition that causes the slums of the city. In + our glowing spirit of humanity we cry out to raise up "the submerged + tenth." Rather, should we not stamp them out of existence—treat + them as a menace, and not as a thing of pity?</p> + + <p>Men, in general, rise; their minds are subjectively or objectively + educated to their mental limit. They cannot go beyond it. "The + submerged tenth" exists because its mental limit is low—often + close to the upper margins of feeble-mindedness—and because it is + mentally incapable of rising to anything else.</p> + </div> + <div class="figcenter" style="width:50%;"> + <a href="images/v1fig002r.jpg"><img width="100%" src="images/v1fig002r.jpg" + alt="Evidence of a Vigorous Mind" /></a> + <p><i>From "The Village of a Thousand Souls," Gesell, American + Magazine</i></p> + + <h4>Evidence of a Vigorous Mind</h4> + + <p>The family that is vigorous, healthy in mind and body, "up and + coming," reflects itself in a hundred different ways. Small matter + whether or not it is "an old family," has wealth, social position, a + college education. A daughter's or a son's happiness, the real, + deep-down-inside happiness that is worth while, may be more certainly + insured by marrying with an eye to mentality and stock than by a + marriage into a so-called "first family."</p> + + <p>Eugenics hath its reward.</p> + </div> + <p>Under an ideal system of education the child would be left absolutely + free until the age of seven. We do not believe that the physical + apparatus of the mind is prepared for educational interference before + that age, and we know that the growth of the brain, physiologically and + anatomically, is not complete until after the seventh year.</p> + + <p>The greater portion of a child's education necessarily depends upon + its environment. Heredity and environment, therefore, are the two factors + which determine the characters of any living thing. Heredity gives to the + child its potential greatness,—its promise of greatness. Whether + these potential qualities ever become real depends upon environment. A + child may have the hereditary (innate) ability to become a Shakespeare, + but if his environment is not suitable to the development of this + potential greatness, he will never realize his hereditary promise. In + other words, the innate qualities which he has, and which will make of + him a Shakespeare are never "drawn out" or educated. Hence he can never + become great until environment furnishes the means to him.</p> + + <p>Environment, including education, does not add to the potential + qualities of inheritance. Education can only educate what heredity gives; + it can give or add nothing itself; it simply educates what is there + already. There is plenty of material, but it is not the right material. + What educators want is the right kind of material—the material + which the eugenists will eventually supply. Or as Mr. Havelock Ellis has + expressed it:</p> + + <p>"Education has been put at the beginning, when it ought to have been + put at the end. It matters <!-- Page 34 --><span class="pagenum"><a + name="page34"></a>[34]</span> comparatively little what sort of education + we give children; the primary matter is what sort of children we have to + educate. That is the most fundamental of questions. It lies deeper even + than the great question of Socialism versus Individualism, and indeed + touches a foundation that is common to both. The best organized social + system is only a house of cards if it cannot be constructed with sound + individuals; and no individualism worth the name is possible unless a + sound social organization permits the breeding of individuals who count. + On this plane Socialism and Individualism move in the same circle."</p> + + <p>Education, then, as an exclusive factor, cannot achieve our ideal of + race-culture. In order that education may achieve a large measure of + success, it must have the proper material, and the right material can + only come as a result of the working out of the eugenic principle. + Then—in the aftertime—our educational efforts will not be + wasted and misdirected, as they are almost wholly to-day.</p> + + <p>If we could transmit our acquired characteristics, education would + have a relatively smaller, and a much more fixed function in the "general + scheme," but we cannot. We can only transmit what was inherent in us when + created. This simply means that, at the moment of conception, the child + is created,—it is a completed whole,—what it is to be is + fixed at that moment, its inherent capacities are formed. Nothing can + affect it, in this sense, after that moment. No act of either parent can + have any influence on it. Whatever ability the father or mother possessed + of an innate character is transmitted to the child at the instant of + conception and that innate legacy constitutes the working instrument of + the child for all time. It cannot be added to by education, or by + environment, but both of these may have a large influence in deciding + whether it will be developed to its highest possible limit of + attainment.</p> + + <p>Education, mental, moral and physical, is limited by this inability to + transmit acquired character to the persons educated. Each generation + must, therefore, begin, not where their parents left off, but at the + point where <!-- Page 35 --><span class="pagenum"><a + name="page35"></a>[35]</span> they began. The same difficulties and the + same problems must be met at the beginning of each generation.</p> + + <p><b>The True Province of Education.</b>—Education may justly be + the instrument, however, which will educate public opinion to a true + appreciation of the function of race culture. In this way the cause of + the eugenist will greatly prosper, and the race will profit through the + effort which will further the conservation of the best and most fit + specimens for parenthood. So also may education, through the molding of + public opinion, create sound opinion,—when each individual will be + a center of eugenic enthusiasm. Especially does this responsibility fall + upon parents and those who are in charge of childhood. The young must be + taught the supreme sanctity of parenthood. They must be instructed in + eugenic principles in a way that will impart to them the definite + knowledge that it is the highest and holiest science. The eugenic + education of children is the real beginning at the beginning, the + indispensable necessity, if race culture is to assume its transcendent + role in modern civilization. It is urgently necessary for both sexes but + more especially for girls. "Urgently necessary," because, though Herbert + Spencer wrote the following criticism nearly fifty years ago, the + conditions are much the same to-day:—</p> + + <p>... "But though some care is taken to fit youth of both sexes for + society and citizenship, no care whatever is taken to fit them for the + position of parents. While it is seen that, for the purpose of gaining a + livelihood, an elaborate preparation is needed, it appears to be thought + that for the bringing up of children, no preparation whatever is needed. + While many years are spent by a boy in gaining knowledge of which the + chief value is that it constitutes 'the education of a gentleman'; and + while many years are spent by a girl in those decorative acquirements + which fit her for evening parties; not an hour is spent by either in + preparation for that gravest of all responsibilities—the management + of a family. Is it that this responsibility is but a remote contingency? + On the contrary, it is sure to develop on nine out of ten. Is it that the + discharge of it is easy? Certainly not. Of all functions which the adult + has to fulfill, this is the <!-- Page 36 --><span class="pagenum"><a + name="page36"></a>[36]</span> most difficult. Is it that each may be + trusted by self-instruction to fit himself, or herself, for the office of + parent? No; not only is the need for such self-instruction unrecognized, + but the complexity of the subject renders it the one of all others in + which self-instruction is least likely to succeed."</p> + + <p>It must be our highest educational aim to cultivate or create the + eugenic sense. In this way, and in this way only, may we feel satisfied + that the foundation, upon which shall be erected the generations that are + yet to come, will be of an enduring character.</p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 37 --><span class="pagenum"><a name="page37"></a>[37]</span></p> + +<h3>CHAPTER IV</h3> + +<blockquote class="b1"> + + <p>"It is only because we are accustomed to this waste of life and are + prone to think it is one of the dispensations of Providence that we go on + about our business, little thinking of the preventive measures that are + possible."</p> + + <p class="author"><font class="sc">Charles E. Hughes</font>.</p> + +</blockquote> + +<h3>EUGENICS AND THE UNFIT</h3> + +<blockquote class="b1"> + + <p><b>The Deaf and Dumb—The Feeble-minded—A New York + Magistrate's Report—Report of the Children's Society—The + Segregation and Treatment of the Feeble-Minded—What the Care of the + Insane Costs—The Alcoholic—Drunkenness.</b></p> + +</blockquote> + + <p>In order to achieve success in eugenics we must strive to encourage + the parenthood of the worthy or fit, and to discourage the parenthood of + the unworthy or unfit. The unfit are those, as previously explained, who, + because of mental or physical disability, are unable to create fit or + healthy children.</p> + + <p><b>The Deaf and Dumb.</b>—The condition known as deaf-mutism is + due to innate defect in about half of all cases. Deaf children have one + or two deaf parents or grandparents. There may be two or three such + children in a family. That the deaf should not marry is generally + conceded by those who work amongst them. It should be our aim to + discourage the intimate association of the adolescent deaf and dumb in + institutions. It has been found that such intimate association frequently + results in marriage. They should be educated and instructed in the + knowledge that they cannot marry. When they understand the eugenic + principle upon which this social law is constructed they will be amenable + to reason. No process of suasion will be necessary, however, if their + intimate association is prevented.</p> + + <p><b>The Feeble-Minded.</b>—This includes the criminal, the + imbecile, the insane, and the epileptic. The feeble-minded, technically + speaking, belong to the degenerate <!-- Page 38 --><span + class="pagenum"><a name="page38"></a>[38]</span> class. They enter life + mentally deficient, not necessarily diseased. They should, therefore, be + regarded as fit subjects for educational modification rather than for + penal correction or punishment. It is conservatively estimated that there + are five million feeble-minded people in the United States to-day and not + one-eighth of them are receiving adequate treatment or education. Recent + statistics, from various countries, show that the percentage of deficient + or feeble-minded children is decidedly on the increase. According to a + bulletin issued by the United States Bureau of Education (August, 1912) + there are 15,000,000 school children suffering from physical defects + which need immediate attention and which are prejudicial to health. It + would seem as though the time had passed for anything other than radical + measures in the interest of the race.</p> + + <p>Apart from the eugenic fact that these feeble-minded children are not + fit subjects for parenthood, they are a constantly contaminating + influence on society morally, and are a detriment and a hindrance to + social and economic advancement. One illustration of this contaminating + process, which is of serious eugenic import, is the presence of these + deficient children in our public schools. By reason of their lack of + attention and concentration, their mental or psychic insufficiency, their + moral delinquency, and uncontrollable instincts and impulses, they are a + menace to the well-being and to the progress of the normal or fit pupils; + they retard and undermine the discipline of the schoolroom, and they + affect the efficiency of the teachers. They are allowed to stay in school + because of the indifference of the authorities, or because of the + influence and social standing, or political "pull" of the parents, + despite the recognition of the injustice done. Many of the parents of + these children seek medical advice but, because of absurdly inadequate + civic or state provision for such cases, the physician is practically + helpless. Most of these irresponsible children are allowed to wander + through the years unrestrained and unprotected. They easily become the + victims of vice and crime, and eventually they become degenerates and end + their lives in insane institutions. Because of the stigma <!-- Page 39 + --><span class="pagenum"><a name="page39"></a>[39]</span> of degeneration + these feeble-minded individuals fall into the hands of the law and are + thereby robbed of the medical assistance which society should afford them + in the early years when improvement is yet possible.</p> + + <p>The following report which recently appeared in one of the daily + papers is interesting and suggestive in this connection. One of the New + York City Magistrates, in his annual report, said: "There is growing up + in this city a menacing army of boys and young men who are the most + troublesome element we have to deal with.... From the ranks of these + rowdies that are organized in bands, or bound up with chums or pals, come + most of the crop of burglars, truck thieves, holdup men, gun-bearers, + so-called 'bad men' and other criminals and dangerous characters. Without + reverence for anything, subject to no parental control, cynical, + viciously wise beyond their years, utterly regardless of the rights of + others, firmly determined not to work for a living, terrorizing the + occupants of public vehicles and disturbing the peace of the + neighborhoods, they have no regard for common decency."</p> + + <p>But it is to the records of the Children's Society that one must go + for reliable statistics of the potential criminal, as there the only + systematic study of their conditions is made and recorded by one of the + greatest neurologists in the country, Dr. Max Schlapp, of New York. As a + specialist in nervous diseases he has been connected with the Children's + Society and the Children's Court, where he has had wide opportunities for + observing the relation between delinquence and mental defectiveness. In + cases of viciousness or feeble-mindedness exhaustive studies have been + made by Dr. Schlapp. And the extent to which society is daily at the + mercy of uncontrolled potential criminality is alarming.</p> + + <p>"Feeble-minded children and feeble-minded men," says Dr. Schlapp, "are + roaming about the streets of New York to-day as free agents. Parents are + not compelled by law to put a feeble-minded child in custody. Yet that + feeble-minded child unsuspected as such, amiable and care-free as he + usually is, is potentially a criminal, and at any moment may commit a + crime. That child is permitted <!-- Page 40 --><span class="pagenum"><a + name="page40"></a>[40]</span> to grow up without restraint, except such + as the parents exercise, and this has no effect whatever in these cases. + The child is allowed to marry and bring forth children of his own kind, + more feeble-minded and more dangerous. There is no system designed to + pick out from the community persons so afflicted, and no law whatever to + prevent their untrammelled movements.</p> + + <p>"The city street is a recruiting ground for the <ins + class="correction" title="'ganster' in original">gangster</ins> because + it is full of defective children, mental and moral, who are potential + criminals. This question has never been seriously considered. When + brought under corrective restraint it has hitherto long been the custom + to herd all the cases together while serving time. But in 1894 the German + Government woke up to the fact that 3 to 7 per cent. of city children and + those of isolated rural communities contain the 'moron,' or + intellectually defective type, together with the moral imbecile."</p> + + <p>Investigation showed recently that in a reformatory near Berlin 63 per + cent. of the inmates were abnormal, while over 50 per cent. were + seriously defective or menaces to society. This has since been shown to + exist in all the leading nations—England, France, Italy, where, by + the way, the Camorrist type is the equivalent for our New York gangster. + In the Elmira Reformatory 38 per cent. are, as a rule, feeble-minded and + consist of types that repeat their offense against society or commit some + other crime.</p> + + <p>There is only one way to prevent these types from becoming a menace. + Restrain them while they are still developing; keep them from becoming + free agents in the community they menace. Types continually come up in + the Children's Society and the Children's Court. They are carefully + studied. From the actions of the child, from his parents and family + history, from the frequency with which he repeats some offense + particularly pleasing to him, and by virtue of psychological tests and + careful medical examinations the examiners are able to pick out children + who should receive scientific care and treatment.</p> + + <p>"The characteristics of the feeble-minded are usually deceiving. One + expects to find them with low brows and furtive looks and more or less + vicious in appearance <!-- Page 41 --><span class="pagenum"><a + name="page41"></a>[41]</span> after they develop criminal tendencies. One + would expect them to show stupidity at a glance. On the contrary, they + are sometimes bright on the surface, amiable, good-tempered under trying + conditions, and almost likeable for their external social side. This is + particularly true of the high grade defectives. The lower order may be + taciturn, gloomy and retiring, and these traits may be noticed almost + from infancy. But as they grow up their social nature may be developed, + and they too may give the appearance of amiableness. One notable thing + about them is their pose of frank innocence. In this they are engaging, + and almost convincing.</p> + + <p>"The street type that makes a gangster is practically the same if + cruder in development. These children usually exhibit absolutely no sign + of affection for their parents, no sympathy, and are notably cruel toward + animals. One boy we had in the Children's Society persistently killed all + the dogs and cats his family kept. Finally, when they ceased keeping the + animals he got at the canary cage and killed the bird by pulling the + feathers out singly. He had no compunction about lying, and looked you + right in the eye when he lied. Otherwise he was charming and + natural."</p> + + <p>While moral insanity is hereditary, yet it can be produced in one + generation. An alcoholic man with clean antecedents may leave tainted + descendants. The only way to combat these conditions in the city is to + have strict registration of all feeble-minded and insane. The state + should discover them, examine them through public officials, and + segregate them. Not only physicians, but school teachers and officials in + public institutions should detect them. There should be in each state an + institution for feeble-minded delinquents.</p> + + <p>The history of the average "gangster" shows a taint of alcoholism. + This is further aggravated by living under immoral surroundings, where + petty crimes like stealing and lying are considered "smart." This is the + starting point of the New York "gangster." He is handicapped, and under + ancestral disabilities and the disadvantages of environment that is + pernicious, he cannot get very far. A boy usually qualifies with a gang + on his <!-- Page 42 --><span class="pagenum"><a + name="page42"></a>[42]</span> own personality and tastes. He will often + wander from one gang to another until he has found his particular + atmosphere. The best will never find any one gang congenial enough to + hold him, and he finally emerges a decent citizen. It is all a process of + finding himself. The aim of the police should be to discount as much as + possible any swaggering and false hero worship.</p> + + <p>The time has come when this great nation should take national + cognizance of this problem. There should be a national institution on + some isolated island. Civilization is coming to recognize such a + necessity. With a close eye on the tide of immigration and a careful + segregation of these defective types, we should soon rid ourselves of + what is now growing to be a serious menace to the home and the + nation.</p> + + <p><b>The Segregation and Treatment of the Feeble-Minded.</b>—Dr. + John Punton, of Kansas City, Mo., in an able and exhaustive article on + "The Segregation and Treatment of the Feeble-Minded," writes as + follows:</p> + + <p>"Your attention is directed to a recent report issued by Wentworth E. + Griffin, Chief of Police of Kansas City, Mo., in which he claims that + recently within six months' time no less than 2,480 juveniles were + arrested charged with crimes ranging from vagrancy to murder and that the + majority of these boys and girls were not normal children, but + degenerates who required medical rather than penal treatment. 'Boys and + girls,' says he, 'should not receive correction in the city jails, the + work house or reformatories. These should be the last resort. To correct + a boy you must have an idea of his mental processes. It is natural that + the parents understand something of the child and use that knowledge to + make a good boy out of him. Certainly it cannot be done in the + reformatories, for although the authorities there are competent, they are + hardly medical psychologists. In my opinion, if any progress is to be + made it is the parent and the doctor that must do the work, not the + police and the courts.'</p> + + <p>"That our Chief of Police deserves credit for not only publishing this + report, but also for the advanced position he takes in recognizing the + appropriate care and treatment <!-- Page 43 --><span class="pagenum"><a + name="page43"></a>[43]</span> of the juvenile offender, is certain, for + he understands the fact that the parents are often the chief culprits in + the child's delinquency and that medical rather than penal treatment is + more often indicated than is at present allowed or practiced.</p> + + <p>"When we come to inquire into the cause of feeble-mindedness, + alcoholic heredity, syphilitic heredity, and consanguineous marriages are + found to be the chief etiological factors. Bourneville claims that 48 per + cent. of the idiots and imbeciles are the offspring of alcoholic + parents.... Acute and chronic diseases in the parents, fright, shock, + injuries, parental neglect, faulty education, poverty, malnutrition, + social dissipation and lack of proper control are all well-known factors + in the production of feeble-mindedness.</p> + + <p>"Segregation of the feeble-minded is advocated by medical authority + the world over, and when this is done they can be made under appropriate + medico-pedagogic treatment to become largely self-supporting.</p> + + <p>"As an economical as well as a humane measure, the various States can + well afford to make such provision, more especially for the large body of + feeble-minded who are now without any medical care whatever. Moreover, + where it is possible, laws prohibiting the marriage of such as well as + all other defectives should be passed and enforced."</p> + + <p><b>What the Care of the Insane Costs.</b>—The total cost of the + care of the insane, in this country, has been estimated to be + $165,000,000 a year. In estimating the cost of the insane we must take + into account the value or worth of each adult to the State. This value + has been computed to be $700 a year. If, upon this basis, we count the + adult membership of the insane class between the ages of eighteen and + forty-five, we find that their worth is roughly about $132,000,000.</p> + + <p>The cost of maintenance in the various insane institutions is about + thirty-three millions of dollars a year. It would be quite possible to + justly increase this total by estimating the worth of the help whose + whole time is devoted to the care of the insane. If these individuals + worked at some other trade or profession, their time <!-- Page 44 + --><span class="pagenum"><a name="page44"></a>[44]</span> would. be of + value to the state in general—not to a class who should be + non-existent. The cost to the state of the potential criminal is not + included in this estimate.</p> + + <p>From the above figures it may be observed that it costs more to simply + maintain the insane each year than it costs to work the Panama Canal; or + to pay for the total cost of the Executive, Legislative and Judicial + departments of our government. The total cost is more than the entire + value of the wheat, corn, tobacco, and dairy and beef products exported + each year from this country.</p> + + <p><b>Alcoholic Drunkenness.</b>—Alcoholism is a sign and a symptom + of degeneracy and is a distinct indication of unfitness for parenthood. + The only cure for alcoholism is to prohibit parenthood. It has been + proved that alcohol taken into the stomach can be demonstrated in the + testicle or ovary within a few minutes, and, like any other poison, may + injure the sperm or the germ element therein contained. As a result of + this intoxication of the primary elements, children may be conceived and + born who become idiots, epileptics or feeble-minded. It is asserted that + 48 per cent. of all the idiots and imbeciles are the offspring of + alcoholic parents.</p> + + <p>Recent experiments show that parental alcoholism alone can determine + degeneration. Mr. Galton quoted the case of a man who, "after begetting + several normal children became a drunkard and had imbecile offspring"; + and another case has been recorded of a healthy woman who, when married + to a drunkard, had five sickly children, dying in infancy, but in a later + union with a healthy man bore normal and vigorous children.</p> + + <p>Dr. Sullivan found on inquiry that:</p> + + <p>.... "Of 600 children born of 120 drunken mothers 335 died in infancy + or were still-born, and that several of the survivors were mentally + defective, and as many as 4.1 per cent. were epileptic. Many of these + women had female relatives, sisters or daughters, of sober habits and + married to sober husbands. On comparing the death rate amongst the + children of the sober mothers with that amongst the children of the + drunken women of the same stock, the former was found to be 23.9 per + cent., the latter 55.2 per cent., or nearly two and <!-- Page 45 --><span + class="pagenum"><a name="page45"></a>[45]</span> a half times as much. It + was further observed that in the drunken families there was a progressive + rise in the death rate from the earlier to the later born children."</p> + + <p>Dr. Sullivan cites as a typical alcoholic family one in which the + first three children were healthy, the fourth was of defective + intelligence, the fifth was an epileptic idiot, the sixth was dead born, + and finally the productive career ended with an abortion.</p> + + <p>The nervous systems of many children of alcoholic parents are wrecked + for life; many die in convulsions as infants. Many, however, who do not + die, live as epileptics. This action of alcohol on the health and + vitality of the race is the most serious of the evils that intemperance + brings on the community. The tendency of all children of alcoholics is + toward nervous disorders of a grave type.</p> + + <p>Statistics show a very high rate of still-births and abortions among + the children of drunken mothers, show that drunken women must not be + permitted to become mothers.</p> + + <p>Dr. Branthwaite in a lecture stated: "In my judgment, habitual + drunkenness, so far as women are concerned, has materially increased, + during the last twenty-five years, which I have spent entirely amongst + drunkards and drunkenness. These people are not in the least affected by + orthodox temperance efforts; they continue to propagate drunkenness, and + thereby nullify the good results of temperance energy. Their children, + born of defective parents, and educated by their surroundings grow up + without a chance of decent life, and constitute the reserve from which + the strength of our present army of habitual drunkards is maintained. + Truly we have neglected in the past, and are still neglecting, the main + source of drunkard supply—the drunkard himself; crippled that and + we should soon see some good results from our work."</p> + + <p>Dr. Fleck, another authority, says: "It is my strong conviction that a + large percentage of our mentally defective children, including idiots, + imbeciles and epileptics, are the descendants of drunkards."</p> + + <p>Therefore the chronic inebriate must not become a parent.</p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 47 --><span class="pagenum"><a name="page47"></a>[47]</span></p> + +<h3>CHAPTER V</h3> + +<blockquote class="b1"> + + <p>"The real undermining of health is not seen. It is done in an + insidious way. It has to be carefully ferreted out."</p> + + <p class="author"><font class="sc">Dr. Harvey W. Wiley</font>.</p> + +</blockquote> + +<h3>WHAT EVERY MOTHER SHOULD KNOW +ABOUT EUGENICS</h3> + + <p>In the preceding pages we have written about eugenics as a science; it + is our intention now to point out briefly in just what way eugenics + directly concerns the mothers of to-day. In the first place let us try to + appreciate what it will mean to the race if "the fit only are born." + "Fit" children, it will be recalled, means children born healthy of + healthy, selected parents, parents with a good ancestral history, + conveying to their offspring a reasonably adequate legacy. If the "fit + only are born" we start with a healthy stock. What a significant and + tremendous advantage this is. At once we rid the world of the potential + inefficients—the feeble-minded, the insane, the criminal, the + deaf-mute, the drunkard. If we are correct in assuming that the reason + why all former civilizations have failed and passed away, was because + they bred a race of people physically and mentally unfit to survive, the + demand of the eugenist that only "fit children shall be born" will strike + at the very root of this evil. If we uproot the cause of racial + degeneration we begin the building of a race that should not degenerate. + If we establish a race that will not degenerate, it must gain strength + and virility with each generation.</p> + + <p>This assumption is logically correct, but we must do more than breed + "fit" children. We must take care of them after they are born. We must + furnish them with a good environment (see page <a href="#page3">3</a>). + Heredity without favorable environment counts for very little,—we + must never forget that. Heredity and environment are the two important + determining factors in the life of every <!-- Page 48 --><span + class="pagenum"><a name="page48"></a>[48]</span> child born. If eugenics + furnishes the heredity by ensuring the birth of the "fit" only, it + depends upon the mothers of the race to provide the environment. Every + mother must know how to take the best care of herself and of her child. + This book is devoted to instructing her in the details of this duty.</p> + + <p>We cannot hope, however, to reach this high altruistic plane by simply + taking the first step in the right direction. We who are alive to-day + must begin the work, and leave it to posterity to carry forward. We must + do our part. Every mother must become an enthusiastic eugenist. If she + begins to teach, and preach, and practise its principles now, she will + contribute to the heredity of unborn generations. To those of us who are + alive to-day, environment is the vastly more important consideration, for + our heredity is fixed and beyond the power of control. The question of + eugenics for the present generation, therefore, is a question of + environment.</p> + + <p>All our efforts must be directly in developing what heredity gives our + children. We are wholly responsible for that. We must feed and clothe + them properly; we must provide air spaces and playgrounds for exercise; + we must educate them, and protect them from disease; and we must + safeguard the birth of future generations by keeping our race stream + pure. This is no small task, and the only way it will ever be + satisfactorily accomplished is for each mother to realize her individual + trust. The average individual does not realize the actual conditions that + prevail. When recently the question of the public health was investigated + by competent authorities, and the report furnished to the United States + Senate, it caused a tremendous sensation. If that is possible in a body + composed of men who are supposed to be intelligent and wide-awake to + existing conditions, how much more significant and appalling it should be + to the average mother whose interest is centered in her own home.</p> + + <p>According to the statistics and statements given in that document the + annual financial loss from needless deaths and accidents alone amounted + to $3,000,000,000. <!-- Page 49 --><span class="pagenum"><a + name="page49"></a>[49]</span></p> + + <p>Acute diseases are held responsible for a large part of the loss. + Chronic diseases are responsible for the greatest part of the waste of + life, and they are believed to be increasing in their ravages. Minor + ailments, believed to be nine-tenths preventable, are now costing the + nation many dollars through incapacitation of persons and through leading + to serious illness. Industrial accidents, largely preventable, are also + exacting a heavy toll annually.</p> + + <p>That this great waste of life and health and the national economic + loss that results can be modified by national action is asserted. Here + are to be found the reasons advanced for a great national department of + health. The work of this department would be varied. It would include + direct work in promoting health on the part of the government, such as + administering the food and drug act; aiding the healing and educational + agencies, both city and State; obtaining information concerning the cause + and prevention of diseases, and disseminating scientifically proved + information on all health subjects.</p> + + <p>It is maintained that the movement for the conservation of health is + the most momentous of the conservation movements in this country, and + that of all the national wastes which are to be condemned, this waste of + health is the gravest.</p> + + <p>Many startling statements are set forth in the document. Dr. Charles + Wardell Stiles, of the United States Public Health and Marine Hospital + Services, declares that "The United States is seven times dirtier than + Germany and ten times as unclean as Switzerland." He declares that: "Lack + of interest in preventive measures against diseases is slaughtering the + human race." He takes the position that the real trouble is not so much + race suicide as race slaughter, and that it is rather that too many + children are allowed to die than that not enough children are born.</p> + + <p>It is estimated that tuberculosis, a preventable disease, costs the + nations $1,000,000,000 annually. Typhoid fever is estimated by Dr. George + M. Kober, dean of the medical department of Georgetown University, to + cost over $300,000,000 annually. <!-- Page 50 --><span class="pagenum"><a + name="page50"></a>[50]</span></p> + + <p>In connection with acute diseases this statement is made: "The loss + from tuberculosis has been reduced to half of what it was thirty years + ago. Nevertheless, of the 90,000,000 people now living in the United + States at least 5,000,000 will be lost through this disease because + adequate effort is not made to prevent it. Besides the economic waste + through deaths from any disease, the waste through sickness from the same + disease is also colossal."</p> + + <p>Great as are the reductions in the rates of infant mortality by + improved milk and water supplies and by educational campaigns, the + present rate is still enormous.</p> + + <p>"If some witch or wizard could conjure up the unnecessary babies' + funerals annually occurring in this country it would be found that the + little hearses would reach from New York to Chicago. If we should add the + mourning mothers and friends, it would make a cortége extending across + the continent."</p> + + <p>While the death rates from acute diseases have been greatly reduced, + the rates from chronic diseases have been steadily increasing. Cancer is + one of the chronic diseases apparently on the increase.</p> + + <p>That the annual death toll and the 3,000,000 constant sick beds could + be reduced from one-fourth to one-half by proper measures is asserted. In + other words, there might be saved every day, as many lives as perished on + the <i>Titanic</i>, with the consequent enormous economic saving.</p> + + <p>These are surely impressive statements. It would seem as though it + should be a simple task to pass a Public Health Bill, establishing a + bureau in Washington, with a representative in the cabinet, whose sole + duty it would be to preserve the public health. It has proved rather the + reverse, however. We have been able to inaugurate various species of + conservation,—of lands, of forests, of water,—but the + conservation of human life is not important enough. Even though states + and empires depend upon their people for their very existence, our + statesmen feel that human life is too cheap, too common, to take + immediate steps in this direction.</p> + + <p>If women—especially mothers—would devote <!-- Page 51 + --><span class="pagenum"><a name="page51"></a>[51]</span> themselves to + the eugenic end of legislation, men would soon obey. The application of + eugenics to the human species, coming, almost in the spirit of an + inspiration, at the time when women are about to be enfranchised, is + significant. It may be that destiny has decreed that the one shall be the + complement of the other; it is certainly beyond contradiction that in + eugenics the women of the earth have a divine weapon with which to wage a + righteous and an awaking propaganda of truth.</p> + + <p>A mother should be interested in every phase of the subject. Her + daughter's success in marriage should intimately concern her. Her health + and her happiness in that sphere should elicit her deepest maternal + consideration. She may rightly hope to be proud of her daughter's + offspring, and to find pleasure in the society of her grandchildren. She + should, therefore, devote all her efforts to ascertain the truth, with + reference to the physical and mental equipment of her future son-in-law; + his ability adequately to support a family; his sobriety, his + disposition, associates, etc., should all be carefully considered and + pondered over. This is not going far enough, however; we must know + positively that he is not diseased,—that he is not a victim of + gonorrhoea or syphilis.</p> + + <p>When parents weigh in the balance the possibility of a wrecked life, + of destroying the right to have children, or of bringing them into the + world blind or diseased; of permanently destroying the hope of happiness, + peace, and success, no combination of advantages in a son-in-law is + deserving of the slightest consideration. We are treating of the sacred + things of life—of life itself. If parents combine to crucify and + betray their daughters—to sell them body and soul into bondage for + social or other advantages; if they preserve silence when they should + speak and thereby take all the sunshine, for all eternity, out of one + existence; then, if on their death-beds these daughters should accuse + them, the guilty knowledge that they were responsible will be the sting + that will blast their hope of peace and forgiveness here and in the + worlds to come.</p> + + <p>When mothers realize that, every day, in every large hospital in every + city in the civilized world some woman <!-- Page 52 --><span + class="pagenum"><a name="page52"></a>[52]</span> (a daughter of some + mother) is being unsexed because of these unjustly obtained diseases, + surely their voices shall speak in no uncertain way.</p> + + <p>Another eugenic suggestion that should deeply concern every good + mother is, that the mother's milk is the private property of the babe, + and whoever deprives the babe of this, the sole right it possesses, is + not only a thief but a scoundrel. A curious and significant fact was + discovered by investigators when studying the question of infant + mortality a few years ago. It was found from a mass of statistics that + there were two recent instances when the death rate of infants decreased + suddenly and quite decidedly. The first instance was when the Civil War + in this country caused a cotton famine in England. As a result of the + famine the factories of Lancashire were all closed and the employees + being then without work remained at home. As a large percentage of the + workers were married women with children they had the time and the + opportunity to nurse their children regularly. Despite the fact that + these women were starved and badly clad and deprived of the comforts of + home, the death rate of the infants dropped steadily to an unprecedently + low mark.</p> + + <p>A number of years later, when the German army surrounded Paris during + the Franco-Prussian War the besieged inhabitants of the capital suffered + from hunger and disease. The death rate of the adult population increased + enormously while the death rate of the infants dropped markedly.</p> + + <p>The explanation of this curious phenomenon was simply that while times + were normal the women labored outside of their homes and as a consequence + the babies were not fed regularly and when fed were not fed mothers' + milk. It demonstrated a truth that we are apt to lose sight of, that + mothers' milk, even the milk from badly-nourished, poverty-stricken + mothers is infinitely better than an abundant supply of artificial food + combined with neglect. In view of the fact that there is a distinct + tendency to evade this maternal duty these facts should be suggestive and + important. It is the duty of the mother with any eugenic sense to preach + and to practise <!-- Page 53 --><span class="pagenum"><a + name="page53"></a>[53]</span> this gospel. Paris learned the lesson of + the siege because though she has the smallest birth-rate to-day, she + nevertheless has the smallest infant death-rate of any large city in + Europe.</p> + + <p>The writer believes that in eugenics the women of the race have the + instrument wherewith to save the world. He is assured that it is the + supreme potential agency for the betterment of the race, and that mankind + will never be inspired with a holier cause. He believes that through all + the ages the human race has been growing better, coming nearer the truth, + and that as a result of this patient progress, there has been evolved the + eugenic idea that is to solve the problems of the human family. If the + "fit only are born" think of the possibilities of education and of + environment. Each child is born with a great potential promise, and + endowed with a reasonably good heredity, the whole effort of that child + will be toward a higher moral attainment. If the effort of the + individuals of the race is to achieve a high moral success, the quality + of the civilization of future generations will be far superior to the + type with which we are familiar.</p> + + <p>Eugenics gives to women the supreme civilizing instrument of the + future. It places the burden of the morality of the home and of the race + on their shoulders. If we deny the writing on the wall it does not render + the warning negative. The signs of the times are epochal. The great + political parties are realizing, for the first time in history, that new + and important issues concerning the family, the home, and the children, + in other words the nation's manhood and womanhood, must be considered and + included in their platforms. They know that the time has gone when + statesmen will exclusively decide what shall be done with the sons and + daughters which women bring into the world. They know that the mothers of + the race must have a voice in deciding for peace or war since they create + every soldier that will lie dead when war is over. Women will help decide + the question of taxation by government and by trusts, because they know + that it comes out of their incomes and they need it all for their + children. Women know that their cause is the cause of freedom, and + freedom is the <!-- Page 54 --><span class="pagenum"><a + name="page54"></a>[54]</span> cause of the eugenist. They know that the + function of government should be justice and no code of justice can have + higher ethics than the ethics of eugenism.</p> + + <p><b>Mothers' Eugenic Clubs.</b>—There should be established in + every community a mothers' eugenic club. The object of the club should be + to further the eugenic idea. Papers should be prepared, read, and + discussed on subjects having a eugenic interest.</p> + + <p>One of the main aims of these clubs should be to interest the local + Congressman and the member of the State Legislature in eugenics. In all + probability they will know nothing specific about + race-culture—unless they are exceptional men—in which case it + will be the duty of the members of the club to educate them. The object + of such education of course would be to ensure that they will act + intelligently when any legislative proposal is made having a eugenic + interest. Find out what they know about the public health as contained in + the report on page <a href="#page48">48</a>, and if they will vote in + favor of a Public Health Bureau. You should know how your representatives + stand on the Pure Food and Drugs Act; if they really appreciate the + significance of the measure; if they would be in favor of pensioning + mothers and widows who have children depending upon them; what their + views are regarding compulsory marriage licenses; the reporting of + venereal diseases to the local health authorities; if they would favor + the segregation of the feeble-minded and their maintenance and treatment + by the state; if they endorse the eugenic principle that "the fit only + shall be born," and if they really understand just what that means.</p> + + <p>If the mothers in every community would take this step, they could + control the legislation affecting such subjects in a comparatively short + time. If the various States concede to women the right to vote—as + they will sooner or later—such mothers' clubs would have a large + and intelligent share in educating the women's votes on questions which + directly concern their own immediate and remote welfare.</p> + + <p>The question of education would concern these clubs and much could be + done by mothers to direct the authorities as to just what is needed to + educate for <!-- Page 55 --><span class="pagenum"><a + name="page55"></a>[55]</span> parenthood, along the lines suggested + elsewhere in this book.</p> + + <p>A mothers' eugenic club would rightly become an instrument for good in + all local sociological interests. It could maintain a trained nurse to + care for the sick and helpless, to teach the people how to live, and how + to care for their homes and their children. The members themselves could + visit the poor, the needy, and the sick.</p> + + <p>There are so many people in the world who are near the brink of + failure,—so many who need a little hope infused into their + lives,—and so many who are really deserving of help and sympathy + and inspiration. The women who do this work for the work's sake are amply + repaid by the good they find to do. The doing of such work is a + consecration and an education. Life means more, and the whole temperament + reflects a truer sympathy and a stronger purpose.</p> + + <p>There are many mothers, for example, who are willing to do what is + essential in the interest of their children, but they do not know what + should be done. These people cannot afford a physician or a nurse to + teach them, nor do they even know that their methods are wrong or that + they need any instruction. We must carry the information and the + explanation to them. We must show them the need for a change of methods. + This is the work for those charitably disposed women who desire some + worthy purpose in life, who really wish to do some genuine good. All the + equipment they need is good common sense. They will explain why it is + essential to pasteurize the milk before feeding it to the baby because + most of the milk used by the poor is unfit for use as a baby food. They + will show how to keep the nipples and the bottles clean, and they will + give them lessons on how to prepare the food to the best advantage. They + will instruct them how to dress the baby in hot weather, and they will + explain why it is necessary to provide the baby with all the fresh air + possible. They will gain the confidence of these mothers and they will + tell them all they know, in tactful and diplomatic and common-sense + language so that they may appreciate the eugenic reasons for everything + they do regarding the care and well-being of the baby. In every city in + the country this work is needed and is <!-- Page 56 --><span + class="pagenum"><a name="page56"></a>[56]</span> waiting for the + missionaries who will volunteer. To teach mothers the need for boiled + water as a necessary drink for baby and older children is alone a worthy + avocation. To impress upon one of these willing but ignorant mothers the + absolute necessity for washing her hands before preparing baby's food, + that she must keep a covered vessel in which the soiled napkins are + placed until washed, that she should frequently sponge her baby in hot + weather,—and explain thoroughly why these are important + details,—is a work of true religious charity. They should be taught + to rid their houses of flies, and especially to keep them from the baby + and from its food, bottles, and nipples. They should be instructed to + discontinue milk at the first sign of intestinal trouble, to give a + suitable dose of castor oil, and to put the child on barley water as a + food until the danger is passed. They should be taught to know the + serious significance of a green watery stool, that it is the one danger + signal in the summer time that no mother can ignore without wilfully + risking the life of her baby. They should be shown how to prepare special + articles of diet when they are needed. If every mother were educated to + the extent as indicated in the above outline the appalling infant + mortality would fall into insignificance. It is not a difficult task, nor + would it take a long time to carry out; it is the work for willing women + who have time and who perhaps spend that time in less desirable but more + dramatic ways. It is education that is needed, and it is education that + is willingly received, as all mothers are ready to devote their time in + the acquirement of knowledge that will help them save their offspring. + This is the eugenic opportunity and it is an opportunity that should + devolve upon the women of the race.</p> + + <p>Such a mothers' club would receive the willing financial support of + the men of the community. It should be placed upon a sound financial + basis because, to be successful, it would have to bestow much material + aid. I know of clubs that are self-supporting, however. Each club needs a + leader to begin it; will the reader be that one in her Community?</p> + + <p>A Mothers' Eugenic Club would of course discuss <!-- Page 57 --><span + class="pagenum"><a name="page57"></a>[57]</span> the practical side of + the eugenic question: the proper feeding and clothing of children; + hygiene, sanitation, housekeeping and homemaking, and the efficiency and + health of each member of the home, and all other topics of interest to + every wife and mother. The writer believes that in the very near future + we shall have a Mothers' Eugenic Club in every community in the United + States; that these clubs will be guided by, and be an instrument of, a + National Eugenic Bureau, composed of women, that will coöperate and + harmonize the work as a whole, so that the conservation of human life + will be effected to its maximum extent; that the excessive infant + mortality will be overcome, because ignorant and incompetent + mothers—the greatest cause of infant mortality—will be + educated and instructed in the rudiments of eugenics and will + consequently, to a large extent, cease to be ignorant and incompetent; + that the desecration of young wives will stop, and stop forever, because + vice and disease will be branded and exposed; that the feeble-minded, the + deaf-mute, the imbecile, and the insane, will no longer be allowed to + propagate their kind, to the permanent detriment of the race.</p> + + <p>When such clubs are established, and when all mothers do their + individual duty in the interest of the race, we shall begin to see the + dawn of a promise that will achieve its supreme success in the + generations that will people the earth in the eugenic aftertime.</p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 61 --><span class="pagenum"><a name="page61"></a>[61]</span></p> + +<h2>CHILD-BIRTH</h2> + +<h3>CHAPTER VI</h3> + +<blockquote class="b1"> + + <p>"Solicitude for children is one of the signs of a growing + civilization. To cure is the voice of the past; to prevent, the divine + whisper of to-day."</p> + + <p class="author"><font class="sc">Kate Douglas Wiggin</font>.</p> + +</blockquote> + +<h3>PREPARATIONS FOR THE CONFINEMENT</h3> + +<blockquote class="b1"> + + <p><b>The Birth Chamber—What to Provide for a + Confinement—Ready to Purchase Obstetrical Outfits—Position + and Arrangement of the Bed—How to Properly Prepare the Accouchment + Bed—The Kelly Pad—The Advantages of the Kelly + Pad—Should a Binder Be Used?—Sanitary Napkins—How to + Calculate the Probable Date of the Confinement—Obstetrical + Table—When Should a Pregnant Woman First Call Upon Her + Physician—Regarding the Choice of a Physician—How to Know the + Right Kind of a Physician for a Confinement—The Selection of a + Nurse—The Difference Between a Trained and a Maternity + Nurse—Duties of a Confinement Nurse—The Requisites of a Good + Confinement Nurse—The Personal Rights of a Confinement + Nurse—Criticizing and Gossiping About Physicians.</b></p> + +</blockquote> + +<h4>THE BIRTH CHAMBER</h4> + + <p>The room in which the confinement is to take place should be selected + with care. In many cases there will be no choice for the reason that + there will be only one suitable bedroom available. Where practicable + however a room having the following accessories, or as many of them as is + possible, should be given the preference.</p> + +<blockquote class="b1"> + + <p>1.—Good light, and a southern exposure.</p> + + <p>2.—Capable of being well ventilated and well heated if + necessary.</p> + + <p>3.—Running water if plumbing is modern.</p> + + <p>4.—Fairly large size (not a hallroom).</p> + + <p>5.—A quiet room, free from street noises.</p> + +</blockquote> + + <p>If the house is a private one the room should be on the second floor. + If the home is in an apartment house <!-- Page 62 --><span + class="pagenum"><a name="page62"></a>[62]</span> the confinement chamber + should be as far removed from the living-room as circumstances will + permit,—especially if there are other children who will make more + or less continuous noise.</p> + + <p>All unnecessary furniture, pictures and draperies should be taken out + of the room a few days before the confinement is due; the room itself, + and everything left in it, should be thoroughly cleaned and aired. A + small table for holding instruments, sterilizing basins, etc., should be + provided and in readiness.</p> + + <p><b>What to Provide For a Confinement.</b>—The following articles + should be in readiness at all confinements:—</p> + +<blockquote class="b1"> + + <p>1.—Douche pan.</p> + + <p>2.—Bed pan.</p> + + <p>3.—Douche bag (fountain syringe) with glass douche tube.</p> + + <p>4.—One rubber sheet 1½ yards square.</p> + + <p>5.—Two bed pads, one yard square, made of absorbent cotton or + old clean cloths, covered with washed cheese cloth and stitched here and + there to hold in place.</p> + + <p>6.—One dozen clean towels.</p> + + <p>7.—One-half dozen clean sheets.</p> + + <p>8.—A hot water bottle.</p> + + <p>9.—One pound absorbent cotton (good quality).</p> + + <p>10.—Five yards sterile gauze.</p> + + <p>11.—Four quarts of hot, and as much cold water, that has been + boiled.</p> + + <p>12.—One-half dozen papers assorted safety pins.</p> + + <p>13.—One box sanitary pads.</p> + + <p>14.—Four pieces of unbleached cotton or muslin, one and + one-quarter yards long.</p> + + <p>15.—Four ounces powdered boracic acid.</p> + + <p>16.—Four ounces of brandy or whisky.</p> + + <p>17.—One jar of white vaseline (unopened).</p> + + <p>18.—One cake of castile soap.</p> + + <p>19.—Two or three agate or china hand basins.</p> + + <p>20.—One slop jar.</p> + + <p>21.—One pan under bed for after birth.</p> + +</blockquote> + + <p>The physician will direct that certain additional articles be provided + according to his individual taste and <!-- Page 63 --><span + class="pagenum"><a name="page63"></a>[63]</span> custom. These will + include an antiseptic and ergot; any other requisite found necessary can + be sent for, or the physician can supply it, as he invariably has in his + bag whatever may be required in complicated cases or in an emergency. All + the items enumerated in the above list are absolutely essential, they may + not all be used but it would not be safe to undertake a confinement + without providing the essential requisites. Many maternity outfits are + prepared ready for use and can be obtained at the larger drug stores, + costing from $10 to $25. The articles in the above list can be bought for + about $6, not including those articles which the patient is assumed to + have. The following are samples of the ready-to-purchase outfits:</p> + +<h4>READY-TO-PURCHASE OBSTETRICAL OUTFITS</h4> + + <div class="poem"> + <div class="stanza"> + <p class="i8">OUTFIT NO. 1</p> + <p>1 Sterilized Bed Pad (30 inches square).</p> + <p>2 dozen Sterilized Vulva Pads.</p> + <p>2 Sterilized Mull Binders (18 inches wide).</p> + <p>5 yards Sterilized Gauze.</p> + <p>1 pound Sterilized Absorbent Cotton (½ pound).</p> + <p>Rubber Sheet, 1½ yards by 2 yards, Sterilized.</p> + <p>Douche Pan, Sterilized.</p> + <p>1 Tube K-Y Lubricating Jelly.</p> + <p>Sterilized Nail Brush.</p> + <p>Boric Acid, Powdered.</p> + <p>Tinct. Green Soap.</p> + <p>Bichloride Tablets.</p> + <p>Lysol.</p> + <p>Tube Sterilized Tape.</p> + <p class="i8">PRICE $10.00.</p> + </div> + + <div class="stanza"> + <p class="i8">OUTFIT NO. 2.</p> + <p>2 Sterilized Bed Pads (30 inches square).</p> + <p>2 dozen Sterilized Vulva Pads.</p> + <p>2 Sterilized Mull Binders (18 inches wide).</p> + <p>6 Sterilized Towels.</p> + <p>10 yards Sterilized Gauze.</p> +<!-- Page 64 --><span class="pagenum"><a name="page64"></a>[64]</span> + <p>1 pound Sterilized Absorbent Cotton (½ pound).</p> + <p>Rubber Sheet, 1 yard by 1½ yards, Sterilized.</p> + <p>Rubber Sheet, 1½ yards by 2 yards, Sterilized.</p> + <p>4 quart Sterilized Douche Bag with glass nozzle.</p> + <p>Douche Pan, Sterilized.</p> + <p>Sterilized Nail Brush.</p> + <p>2 Agate Basins, Sterilized.</p> + <p>Safety Pins.</p> + <p>2 Tubes Sterilized Petrolatum.</p> + <p>1 Tube K-Y Lubricating Jelly.</p> + <p>Boric Acid, Powdered.</p> + <p>100 grms. Chloroform (Squibb's).</p> + <p>Fl. Ext. Ergot.</p> + <p>Tinct. Green Soap.</p> + <p>Bichloride Tablets.</p> + <p>Lysol.</p> + <p>Tube Sterilized Tape.</p> + <p>Sterilized Soft Rubber Catheter.</p> + <p>Sterilized Glass Catheter.</p> + <p>Stocking Drawers, Sterilized.</p> + <p>Talcum Powder.</p> + <p>Bath Thermometer.</p> + <p class="i8">PRICE $19.50.</p> + </div> + </div> + <p>These materials, being cleansed and sterilized, are ready for use at + any time.</p> + + <p>These complete outfits are packed in neat boxes, thus enabling the + contents to be kept intact until needed.</p> + + <p><b>The Position and Arrangement of the Bed.</b>—The bed should + be a substantial single bed. If a double one is used, prepare the side + for the confinement which will permit the physician to use his right + hand,—that will be the right side of the patient as she lies in + bed. One objection to a double bed is its tendency to sag. This tendency + can be obviated however by placing an ironing board under the spring from + side to side, or by using shelves from a book case. This expedient will + support the mattress, thereby rendering the bed firm and free from any + sagging tendency. The position of the bed in the room should be such that + the patient will not directly face the window light, nor be in a direct + draught <!-- Page 65 --><span class="pagenum"><a + name="page65"></a>[65]</span> between the window and the door. It should + be so arranged that the nurse can get easily to either side, consequently + it must not be pushed against the wall.</p> + + <p><b>How to Prepare the Accouchment Bed.</b>—Over the mattress + place the rubber sheet so that its center will be exactly under the hips + of the patient. Pin with large safety pins each corner of the rubber + sheet to the mattress; now put the sheet on exactly as you do when making + an ordinary bed. On top of the sheet, and in the middle of the bed (again + where the patient's hips will rest), place a draw sheet. A draw sheet is + a sheet folded once, placed across the bed, and pinned tightly with large + safety pins to the mattress at each side. The advantage of this sheet is, + that it can be removed when necessary, leaving the original clean sheet + on the bed, without disturbing the patient. Be particular not to have the + top of the draw sheet higher than the middle of the patient's back. Place + the pad,—previously prepared for the purpose,—on the draw + sheet and level with the top of the draw sheet.</p> + + <p>Most physicians carry with them to all confinements a <i>Kelly + pad</i>. A Kelly pad is a rubber pad with inflated sides, which is put + under the patient's hips, and which retains all the discharges incident + to a <ins class="correction" title="'confiement' in original" + >confinement</ins> so that when it is removed the bed is clean and fresh. + The advantage of the Kelly <ins class="correction" title="'paid' in original" + >pad</ins> is twofold; first, it ensures a clean, compact, systematic + confinement; second, its use subjects the patient to the least necessary + movement at a time when movement is distressing, painful, and frequently + dangerous. If a Kelly pad is not used, it is desirable to place under the + pad (between the pad and the draw sheet) a piece of oil cloth or rubber + sheeting, or a number of newspapers will do. This will prevent, to a + considerable degree, the discharges from soaking through the pad on to + the draw sheet and sheet and mattress below.</p> + + <p>After the confinement is over and the patient is clean, remove the + Kelly pad, and the pad below if necessary, or the pad and newspapers if + these are used,—place a clean pad under the patient and you are + ready to place the binder on if a binder is to be used. <!-- Page 66 + --><span class="pagenum"><a name="page66"></a>[66]</span></p> + + <p><b>Should a Binder be Used?</b>—Medically a binder is not + necessary, neither is it objectionable from a medical standpoint. It is + supposed to hold the flaccid, empty womb in place. This it does not do + and we are of the opinion, that it, in many instances, according to how + it is put on, compresses the womb out of place. The binder is certainly + appreciated by most patients because of its snug, comfortable feeling; + and in cases when the abdominal wall is fat and the muscles soft, it + holds them together in a way that is impossible by the use of any other + device. To claim that the binder prevents hemorrhages is absurd. Our + personal rule is to put one on if the patient wants one, or if she has + previously had one. To be effective, in any sense, the binder should + extend from the waist line down to halfway between the hips and knees and + should be snugly, but not too tightly pinned.</p> + + <p><b>Sanitary Napkins.</b>—These can be purchased already prepared + in most drug stores, or they can be made in the following manner: Take an + ordinary grade of cheese cloth, wash it, and when dry, cut it into half + yard squares. In the center of each square place a strip, six or eight + inches long, of absorbent cotton and fold the gauze lengthwise over it so + as to make a pad. These can be used as napkins, and after they are soiled + can be burned. It is absolutely wrong to use rags or any old cloths for + napkins, as the patient can be infected and made seriously sick by this + procedure.</p> + + <p><b>How to Calculate the Probable Date of the + Confinement.</b>—The duration of pregnancy extends for 280 days + from the end of the last menstruation. Add seven days to the date of the + last menstruation, and from that date count ahead nine months, or + backward three months and you may have the probable date of the + confinement. Should you pass this time you will probably go on for two + additional weeks. The reason for this is that the most susceptible time + for conception to occur is either during the week following menstruation + or a few days before menstruation. If, therefore, you pass the above + probable date which was calculated from the end of the last menstruation, + it shows that conception did not take <!-- Page 67 --><span + class="pagenum"><a name="page67"></a>[67]</span> place during the week + following that menstruation; and the assumption will be that it took + place a few days before the next menstruation, which will be about two + weeks later than the date as calculated above.</p> + + <p>If, for example, a pregnant woman was last sick from January 1st to + 5th we add seven days to the 5th, which is the 12th, to which we add nine + months, which will give us, as the probable date of confinement, October + 12th. Should she go a few days over the 12th, the probability is that the + confinement will take place on October 26th.</p> + +<pre> +TABLE FOR CALCULATING THE DATE OF CONFINEMENT +--------------------------------------------------------------------------------------------------------- +JAN. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 +OCT. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 NOV. +--------------------------------------------------------------------------------------------------------- +FEB. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 +NOV. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 DEC. +--------------------------------------------------------------------------------------------------------- +MAR. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 +DEC. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 JAN. +--------------------------------------------------------------------------------------------------------- +APR. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 +JAN. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 FEB. +--------------------------------------------------------------------------------------------------------- +MAY. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 +FEB. 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1 2 3 4 5 6 7 MAR. +--------------------------------------------------------------------------------------------------------- +JUNE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 +MAR. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 APR. +--------------------------------------------------------------------------------------------------------- +JULY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 +APR. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 MAY +--------------------------------------------------------------------------------------------------------- +AUG. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 +MAY 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 JUNE +--------------------------------------------------------------------------------------------------------- +SEPT. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 +JUNE 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 JULY +--------------------------------------------------------------------------------------------------------- +OCT. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 +JULY 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 AUG. +--------------------------------------------------------------------------------------------------------- +NOV. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 +AUG. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 SEPT. +--------------------------------------------------------------------------------------------------------- +DEC. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 +SEPT. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 OCT. +--------------------------------------------------------------------------------------------------------- +</pre> +<p><!-- Page 68 --><span class="pagenum"><a name="page68"></a>[68]</span></p> + + <p>The foregoing table affords us a handy means of finding the probable + date of confinement at a glance.</p> + + <p>Find the date of the last day of the last menstrual period in the + upper row; the date immediately below it is the probable date of + confinement.</p> + + <p>For example if the last menstrual period was from Jan. 1st to 5th, we + find January 5th and below it we note October 12th as the probable date + of confinement.</p> + + <p><b>When Should a Pregnant Woman First Call Upon Her + Physician?</b>—The earliest indication of pregnancy is the + interruption of menstruation. When menstruation fails to appear at its + regular time in a young married woman whose past menstrual history is + good,—i.e., she has been sick every month regularly and without + pain since she began menstruating as a girl,—the assumption would + naturally be that she was pregnant. Menstruation may however "miss" one + month for other reasons than pregnancy just at this time, as is explained + elsewhere, so it is wise to defer a positive assumption on such an + important matter. When the second menstruation does not appear, and there + are no specific reasons for its failure to appear, it may be safely + assumed that pregnancy has taken place. A visit to the family physician + one week after the second menstruation should have appeared, or at least + long enough to feel absolutely certain that the sickness is not coming + around, is not only necessary, but is the essential and correct step to + take for a number of very good reasons. If a woman for example has not + had a baby, how does she know she can have one? It is quite possible to + become pregnant and yet it may be wholly impossible to give birth to a + child. It is necessary to be constructed normally, or as near what is + regarded as normal as is possible, in order safely to assume the + responsibility of carrying a pregnancy to a successful completion. No one + but a physician, who is skilled and familiar in the knowledge of what + constitutes the proper size, and shape, and quality, and relations, one + with another, of <!-- Page 69 --><span class="pagenum"><a + name="page69"></a>[69]</span> your bones, and ligaments, and muscles, can + tell whether you can safely be permitted to carry a pregnancy to term or + not. If the anatomical conditions are not just right; if circumstances + from a medical standpoint are not favorable; if your personal risk is too + hazardous; if, in other words, medical science should decide that you are + one of the very few women who cannot have a baby, is it not of very great + importance that you should know this as soon as possible? Does not that + fact alone render your early call upon your physician imperative? A + physician can bring out facts, relating to the personal and family + history, and habits, of the prospective mother, which will enable him to + formulate advice which will prove of the highest value from the very + beginning of pregnancy. Instructions carried into effect at this early + date, as to personal conduct, exercise, diet, etc., will have a + distinctly beneficial influence, not only on the patient's health and the + character of her confinement, but on the physical vitality of the coming + baby.</p> + + <p><b>Regarding the Choice of a Physician.</b>—This is a matter + that should receive the most careful consideration. While it is just to + admit that every physician is capable of successfully conducting + maternity cases, there are certain characteristics in the individual + temperament that would seem to indicate that some physicians are better + adapted to this special work.</p> + + <p>Trustworthiness is an imperative essential in a physician who assumes + the responsibility of confinement engagements. He must be clean in his + personal habits as well as morally. He should possess the virtue of + patience and be tactful, and above all he should be made to feel that he + has your implicit confidence. If you will analyze these qualifications + you will understand just what they imply. The physician who has the + reputation of having the largest practice is not necessarily the man you + want, nor does it imply that he is the best fitted to conduct your case + to your satisfaction. The fact that he is a very busy man may be + distinctly detrimental to your best interests. If the physician has the + reputation of being an excellent doctor, but, "You can't always depend on + him,—he may be out of town, or he may send his assistant, or <!-- + Page 70 --><span class="pagenum"><a name="page70"></a>[70]</span> + substitute," you don't want him; it is too important an event to you to + take a chance with. Rely rather upon the man who, though his charge may + be a little higher, is known to be trustworthy; who will take a personal + interest in you, and is known to be patient and capable.</p> + + <p><b>The Selection of a Nurse.</b>—A choice must be made between + having a trained nurse and what is known as a maternity, or monthly, + nurse. The choice may be dictated by the financial means of the patient. + A trained nurse is paid from $25 to $30 per week, while a maternity nurse + usually gets $15 per week.</p> + + <p>A trained nurse is a graduate from a hospital where she has + successfully completed a course of training. She is to be preferred, if + she can be afforded, for the reason that she has been trained to obey + absolutely the orders of a physician, and because she has the requisite + knowledge to detect emergencies, and the necessary skill and experience + to enable her to act intelligently of her own initiative in any + emergency.</p> + + <p>The maternity nurse, on the other hand, has not had an adequate + training and is absolutely helpless, so far as medical knowledge is + concerned, in a real emergency. Her experience is limited to what she has + picked up in the various cases she has had. She, as a rule, has chosen + this means of obtaining a living as a result of some domestic financial + affliction. She does not understand the laws of sterilization and has not + been trained to obey, without question, the instructions of a physician. + The maternity nurse follows a routine which she is incapable of modifying + to suit the particular case. She has old-fashioned ideas and notions + which she carries out as a matter of course, and she overestimates the + great importance of her experience to the extent of wholly disregarding + the advice of the physician. She assumes the care of the patient and + baby, and regards this as her right, and as a result she is frequently + responsible for much injury to the mother and child. Despite these + objections we have worked with many of these nurses who were to be + preferred to trained nurses. It is the individual after all that counts, + and if a maternity nurse, though technically untrained, is adaptable, + tactful, and will consent <!-- Page 71 --><span class="pagenum"><a + name="page71"></a>[71]</span> to be instructed to the extent of obeying + without argument, she can become invaluable, and her skill and experience + will carry her creditably over many trying incidents. The objection of + the medical profession to an untrained nurse is based, not so much on her + lack of ability, as upon her propensity to indiscriminate and indiscreet + talk,—they have not been trained to know the value of professional + silence, nor have they had the necessary education which would have + enabled them to acquire through their experience the knowledge that + "silence is golden" at all times. A trained nurse possesses the requisite + knowledge, but may have an objectionable individuality. An untrained + nurse may have sufficient knowledge, and what she lacks she may make up + for in being congenial and adaptable. While the trained nurse strictly + attends exclusively to the mother and the baby, a maternity nurse as a + rule attends to the household duties in addition. She cooks the meals of + the entire family, and dresses and cares for the other children if there + is no one else to do it. The duties of a maternity nurse can be specified + and agreed upon, and the terms arranged when she is engaged. The duties + of a trained nurse are fixed by nursing laws and medical rules and cannot + be changed or modified by private agreement. These laws and rules, + however, are not sufficiently arbitrary to make it impossible for the + nurse to be obliging, courteous, and sincere,—qualifications which + every patient has a right to expect, and a right to insist upon from + every graduate nurse.</p> + + <p>The selection of a nurse should receive careful consideration. She + should be known to be honest, honorable, competent, healthy, and + personally clean in habits and dress, and she should be tactful, + obliging, and she should attend to her own affairs strictly. She should + not be a gossip; she should not shirk her work or pry into family affairs + that do not concern her; and she should not drag into the conversation + her own personal or family secrets.</p> + + <p>The nurse has certain rights which the patient should willingly + recognize. She is entitled to a comfortable bed, sufficient sleep, good + food, and exercise in the open air <!-- Page 72 --><span + class="pagenum"><a name="page72"></a>[72]</span> every day. These are + essential in order that she maintain her own health, as well as keep at + the highest point of efficiency.</p> + + <p>When you select your physician consult with him regarding your nurse. + If you know personally a capable nurse, there is no objection to + selecting her, and no physician will oppose this procedure if you assume + the responsibility of her capability.</p> + + <p>There are many advantages, however, in permitting the physician to + provide a nurse. He assumes the responsibility of the nurse's capability, + and it is safe to assume he will not recommend one whom he knows to be + personally objectionable, or professionally incapable. Every physician + acquires certain individual methods in the conduct of maternity cases, + which experience has taught him to be successful. A competent knowledge + of these methods by the nurse greatly facilitates the details and ensures + a harmonious conduct of the entire case,—facts which accrue to the + comfort and the well-being of the patient.</p> + + <p>It is not out of place here to warn a young wife against being advised + by a neighbor or a busybody, as to whom she should select as physician or + nurse. You must not depend upon the gossip of the neighborhood. The + physician or nurse whom you are told by one of these irresponsible + individuals not to take, may be the one above all others whom you should + take. When you hear a gossiping woman decry a physician, depend upon it, + she owes him something,—most often it is a bill, but it may only be + a grudge. There is no class of men in any community who are maligned and + abused so much as are physicians. They seem to be the choice victims of + the enmity and spite of every malicious feminine tongue. A woman should + think twice before she utters a criticism regarding the work of a + physician. She would, if she but knew how quickly she brands and + advertises herself as irresponsible and lacking in ordinary courtesy and + good breeding, as she is not qualified to criticise the professional + capability of a physician, nor is she qualified to estimate the extent of + the wrong she perpetrates. There is no class of men who do more + conscientious work, day <!-- Page 73 --><span class="pagenum"><a + name="page73"></a>[73]</span> after day, than do physicians, and there is + no class of men who are more deserving of the commendation of the entire + community than the thousands of self-sacrificing, underpaid members of + the medical profession. Be suspicious therefore when you hear a + criticism, and be very, very sure before you utter one,—rather give + him the benefit of the doubt and you will do no wrong, and it may be at + some future date you will be thankful you did not criticise.</p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 75 --><span class="pagenum"><a name="page75"></a>[75]</span></p> + +<h3>CHAPTER VII</h3> + +<h3>THE HYGIENE OF PREGNANCY.</h3> + +<blockquote class="b1"> + + <p><b>Daily Conduct of the Pregnant Woman—Instructions Regarding + Household Work—Instructions Regarding Washing and + Sweeping—Instructions Regarding Exercise—Instructions + Regarding Passive Exercise—Instructions Regarding Toilet + Privileges—-Instructions Regarding Bathing—Instructions + Regarding Sexual Intercourse—Clothing During Pregnancy—Diet + of Pregnant Women—Alcoholic Drinks During Pregnancy—The + Mental State of the Pregnant Woman—The Social Side of + Pregnancy—Minor Ailments of Pregnancy—Morning Nausea, or + Sickness—Treatment of Morning Nausea, or Sickness—Nausea + Occurring at the End of Pregnancy—Undue Nervousness During + Pregnancy—The 100 Per Cent. Baby—Headache—Acidity of + the Stomach, or Heartburn—Constipation—Varicose Veins, + Cramps, Neuralgias—Insomnia—Treatment of + Insomnia—Ptyalism, or Excessive Flow of Saliva—Vaginal + Discharge, or Leucorrhea—Importance of Testing Urine During + Pregnancy—Attention to Nipples and Breasts—The Vagaries of + Pregnancy—Contact with Infectious Diseases—Avoidance of + Drugs—The Danger Signals of Pregnancy.</b></p> + +</blockquote> + +<h4>CONDUCT OF THE PREGNANT WOMAN</h4> + + <p>The young wife will arrange her daily routine according to the + physician's instructions, which, by the way, she should faithfully carry + out. If you are one of the fortunate many who enjoy reasonably good + health, you have doubtless been told to follow a plan very similar to the + one we shall now briefly outline.</p> + + <p>For the first six months she can safely continue to do her household + work. It is to her advantage to do so for many reasons, but especially + because it helps to keep her physically in good condition, and because it + keeps her mind engaged, thus avoiding a tendency to nervous worry. After + the sixth month it is desirable to give up the heavier part of the work. + Washing and sweeping should be absolutely prohibited. Moving furniture or + heavy trunks must not be done by the prospective mother, but all light + <!-- Page 76 --><span class="pagenum"><a name="page76"></a>[76]</span> + work can and should be indulged in to the very end. Find time to spend at + least one hour and a half in the open air every day. Unless there is a + medical reason against active exercise there is nothing so beneficial to + the pregnant woman as walking, nor is there any substitute for it. A + drive or motor ride into the country, or a car ride around town, is an + excellent device against ennui and is highly desirable during this time, + but not as a substitute for the daily long walk. A pregnant woman must + keep her muscles strong and in good tone if she hopes to do her share + toward having a short and easy confinement. She must keep active to + ensure perfect action of all her organs—the stomach must digest; + the bowels and kidneys must act perfectly; the heart, and lungs, and + nerves must be supplied with good blood and fresh air; the appetite must + be keen, and the sleep sound. Walking in the open air will do all this + and nothing else can, to the same satisfactory degree.</p> + + <p>Light passive exercise at home is desirable to those very few who + cannot walk in the open air, but at best it is a poor substitute. It is + necessary to avoid any exercise or any labor of the following character + from the very beginning of pregnancy: stretching, lifting, jarring, + jumping, the use of the sewing machine, bicycling, riding, and + dancing.</p> + + <p>She should continue to employ the same toilet privileges she has been + accustomed to except the use of the vaginal douche, which must be stopped + from the date of the first missed menstrual period. This is the only safe + rule to follow and no exception should be made to it except upon the + advice of a physician.</p> + + <p>Bathing during the entire course of pregnancy is a highly necessary + duty. It is particularly advantageous during the later months because it + relieves the kidneys at a time when they are called upon to perform an + excess of work. The temperature of the bath should be warm and rapidly + cooled at the finish. Brisk rubbing with a course towel will ensure the + proper reaction.</p> + + <p>Sexual intercourse must be restricted during pregnancy; and it should + be wholly abstained from during what would have been the regular + menstrual periods, if <!-- Page 77 --><span class="pagenum"><a + name="page77"></a>[77]</span> pregnancy had not occurred, for the reason + that abortion is apt to take place. It is most harmful during the early + and late months of pregnancy. Sexual intercourse is distasteful to most + and harmful to every pregnant woman.</p> + + <p><b>Clothing During Pregnancy.</b>—The clothing should be so + constructed as to relieve any undue pressure on the breasts or abdomen. + For this reason it should be suspended from the shoulder. When it is + appreciated that clothing supported by the waist crowds the growing womb, + and exerts pressure upon the kidneys, and is responsible for many of the + kidney complications that occur during pregnancy, no further reason need + be given for discarding all clothing, except very light garments, that + are not held by some device whose support is from the shoulders. A + specially constructed linen waist is made and sold for this purpose. It + is fashioned so that all the lower garments and the garters can be + fastened to, and supported by it. Corsets should be absolutely discarded + from the very first day of pregnancy.</p> + + <p>In a large woman with a lax abdomen, a properly made abdominal support + will not only be a great comfort but of real advantage. It should exert a + support upward by lifting the abdomen, not by constricting it. It should + therefore be obtained from a reliable dealer and be made and applied to + effect the above object,—otherwise it may do more harm than + good.</p> + + <p><b>Diet of Pregnant Women.</b>—Some degree of digestive + disturbance and loss of appetite is the rule early in pregnancy. By the + fourth month these conditions invariably cease, and the appetite and the + ability to digest will greatly improve. The diet from the very beginning + of pregnancy should be plain and easily digested. It is not possible to + formulate an absolute table of what or what not to eat, as the same foods + do not agree equally well with all patients. The individual taste should + be catered to within, reason, and the meals should be taken at regular + intervals. Articles of diet that experience shows do not agree with the + patient should be rigidly excluded from the menu. A varied diet of + nutritious character is essential during pregnancy in order to ensure + good blood, health, and strength. A monotonous diet, or a diet composed + largely <!-- Page 78 --><span class="pagenum"><a + name="page78"></a>[78]</span> of stale tea, coffee, and cake, is not + permissible, and may do untold harm. Pastries and desserts of all kinds + should be excluded. In the later weeks of pregnancy, because of the large + size of the womb, the diet should be cut down as the stomach is + interfered with in the process of digestion. Should the patient at any + time during pregnancy experience a loss of appetite, or an actual disgust + for food as sometimes occurs, it is preferable to suggest a change of + scene and surroundings rather than the use of medicine. A short vacation, + a change of table, new scenery, will promptly effect a cure. This + condition is mental rather than physical; the patient allows herself to + become introspective; the daily routine becomes monotonous and stale; + hence a change of a few days will be all that is necessary. If it is not + possible for the patient to obtain a change of scene, a complete change + of diet for a few days will often tide over the difficulty. We have known + patients to take kindly to an exclusive diet of kumyss, or matzoon, or + predigested foods, with stale toast or zwieback, to which can be added + stewed fruits. Alcoholic drinks should be left out entirely.</p> + + <p><b>The Mental State of the Pregnant Woman.</b>—The coming baby + should be the text of many interesting, spontaneous talks between the + young couple from the time when it is first known that a new member of + the family is on its way. The husband should feel that he is a party to + the successful consummation of the little one's journey. He can + contribute enormously to this end. It should be his duty, born of a + sincere affection and love, to formulate the programme of events which + has for its main object the wife's entire mental environment. He should + encourage her to live up to the physician's instructions, and arrange + details so that she will obtain the proper exercise daily. He should read + to her in the evening, and arrange his own business affairs so that he + will be with her as much as is possible. In many little ways he can + impress upon her the fact that they both owe something to the unborn babe + and that each must sacrifice self in its behalf. His principal aim, of + course, will be that she will not worry or have cause to worry. He will + so direct her mental attitude that she will dwell <!-- Page 79 --><span + class="pagenum"><a name="page79"></a>[79]</span> only upon the bright + side of the picture; she will thus strive to realize the hope that the + baby will be strong and healthy, and she will, prompted by his + encouragement and devotion, try to do her duty faithfully. Working + together in this way, much can be done that means far more than we know + of, and in the end the little one comes into the world a welcome baby, + created in love and born into the joy of a happy, harmonious, contented + home.</p> + + <p><b>The Social Side of Pregnancy.</b>—The social side of the + question should not be overlooked or neglected at this time. Here again + the imperative necessity arises to warn the young wife against certain + individuals who seem to have a predilection toward recounting all the + terrible experiences they have heard regarding confinements. It is + astonishing to learn how diversified a knowledge some women burden + themselves with in this connection. They can recount case after case, + with the harrowing details of a well-told tale, and seem to delight in so + doing. Every physician has met these women. The young wife must not + permit or encourage any reference to her condition. Simply refusing to + discuss the question is the only sure method of preventing its + discussion. She will find among her friends a few who have her best + interests at heart, and these few will strive sincerely to be of real + usefulness to her. If she will keep in mind that the most important + element in the success of the whole period, and consequently the degree + of her own health, happiness, and comfort, as well as that of her unborn + baby, is the character of her own thoughts from day to day, and month to + month, she will be complete master of the situation. By constantly + dwelling on happy thoughts, reading encouraging and inspiring books, + admiring and studying good pictures, working with cheerful colors in + sunny rooms, exercising, dieting, and sleeping in a well-aired room, she + will have no cause to regret her share in the task before her, or the + kind of baby she will bring into the world.</p> + + <p><b>Minor Ailments of Pregnancy.</b>—There are certain minor + ailments which it would be well to be familiar with lest a little worry + should creep into the picture.</p> + + <p>Maternity is not only a natural physiological function, <!-- Page 80 + --><span class="pagenum"><a name="page80"></a>[80]</span> but it is a + desirable experience for every woman to go through. The parts which + participate in this duty have been for years preparing themselves for it. + Each month a train of congestive symptoms have taxed their working + strength; pregnancy is therefore a period of rest and + recuperation,—a physiological episode in the life history of these + parts. If any ailment arises during pregnancy it is a consequence of + neglect, or injury, for which the woman herself is responsible,—it + is not a natural accompaniment of, or a physiological sequence to + pregnancy. Find out, therefore, wherein you are at fault, rectify it, and + it will promptly disappear.</p> + + <p><b>Morning Nausea or Sickness.</b>—So-called morning nausea or + sickness is very frequently an annoying symptom. It is present as a rule + during the first two or three months of pregnancy. How is it produced and + how can it be remedied?</p> + + <p>It is produced most frequently by errors in diet. It may be caused by + an unnatural position of the womb or uterus, by nervousness, + constipation, or by too much exercise or too little exercise. The + physician should be consulted as soon as it is observed to be a regular + occurrence. He will eliminate by examination any anatomical condition + which might cause it; or will successfully correct any defect found. When + the cause is defined his instructions will help you to avoid any error of + diet, constipation, or exercise. Many cases will respond to a simple + remedy,—a cup of coffee, without milk, taken in bed as soon as + awake will often cure the nausea. The coffee must be taken while still + lying down,—before you sit up in bed. If coffee is not agreeable + any hot liquid, tea, beef tea, clam bouillon, or chicken broth, or hot + water may answer the purpose, though black coffee, made fresh, seems to + be the most successful. Ten drops of adrenalin three times daily is a + very certain remedy in some cases, though this should be taken with your + physician's permission only. If the nausea occurs during the day and is + accompanied with a feeling of faintness, take twenty drops of aromatic + spirits of ammonia in a half glass of plain water or Vichy water. + Sometimes the nausea is caused by the gradual increase of the womb <!-- + Page 81 --><span class="pagenum"><a name="page81"></a>[81]</span> itself. + This is not usually of a persistent character and disappears as soon as + the womb rises in the abdominal cavity at the end of the second + month.</p> + + <p>Nausea frequently does not occur until toward the end of pregnancy. In + these cases the cause is quite different. Because of the size of the womb + at this time the element of compression becomes an important + consideration. The function of the kidneys, bowels, bladder, and + respiration may be more or less interfered with, and it may be desirable + to use a properly constructed abdominal support, or maternity corset. + These devices support and distribute the weight, and prevent the womb + from resting on or compressing, and hence interfering with, the function + of any one organ. If the womb sags to one side, thereby retarding the + return circulation of the blood in the veins from the leg, it may cause + cramps in the leg, especially at night, or it may cause varicose veins, + or a temporary dropsy. The correct support will prevent these troublesome + annoyances; a properly constructed maternity corset is often quite + effective. The diet should receive some special attention when these + conditions exist. Any article of diet which favors fermentation + (collection of gas) in the stomach or bowel should be excluded. These + articles are the sugars, starches, and fats. It can readily be understood + that if the bowels should be more or less filled with gas, or if they + should be constipated, it will cause, not only great distress, but actual + pain. Regulation of the diet, therefore, and exercise (walking best of + all) will contribute greatly to the avoidance of these unnecessary + sequelae.</p> + + <p>It must be kept in mind that the entire apparatus of the body is + accommodating a changed condition, and though that condition is a natural + one, it requires perfect health for its successful accomplishment. This + means a perfect physical and mental condition,—a condition that is + dependent upon good digestion, good muscles, healthy nerves, clean + bowels, and so on. The slightest deviation from absolute health tends to + change the character of the body excretions, the quality of the blood, + etc. If the excretions are not properly eliminated, the blood becomes + impure, and so we sometimes get itching of the body <!-- Page 82 --><span + class="pagenum"><a name="page82"></a>[82]</span> surfaces, especially of + the abdomen and genitals; neuralgias, especially of the exposed nerves of + the face and head; insomnia and nervousness. These are all amenable to + cure, which again means, as a rule, correct diet and proper exercise as + the principal remedial agencies.</p> + + <p><b>Undue Nervousness During Pregnancy.</b>—This is very largely + a matter of will power. Some women simply will not exert any effort in + their own behalf. They are perverse, obstinate, and unreasonable. The + measures which ordinarily effect a cure, they refuse to employ. It is + useless to argue with them; drugs should never be employed; censure and + affection are apparently wasted on them; they cannot even be shamed into + obedience. The maternal duty they owe to the unborn child does not seem + to appeal to them. We do not know of any way to handle these women and to + our mind they are wholly unfit to bring children into the world. + Fortunately these women are few in number. The maternal instinct will, + and does, guide most women into making sincere efforts to restrain any + undue nervous tendency, and to be obedient and willing to follow + instructions. There is nothing so beneficial in these cases as an + absolutely regulated, congenial, daily routine, so diversified as to + occupy their whole time and thought to the exclusion of any introspective + possibility. Frequent short changes to the country or seashore to break + the monotony, give good results in most of these cases. The domestic + atmosphere must also be congenial and the husband should appreciate his + responsibility in this respect.</p> + + <p>Women of this type should have their attention drawn to the following + facts in this connection: While the most recent investigations of + heredity prove that a woman cannot affect the potential possibilities of + her child, she can seriously affect its physical vitality. The following + illustration may render our meaning clear: suppose your child had the + inborn qualities necessary to attain a 100 per cent. record of + achievement in the struggle of life; anything you may or may not do + cannot affect these qualities—the child will still have the ability + to achieve 100 per cent. Inasmuch, however, as a mother can affect the + health or physical qualities of her <!-- Page 83 --><span + class="pagenum"><a name="page83"></a>[83]</span> child she is directly + responsible, through her conduct, as to whether her child will ever + attain the 100 per cent. record, or if it does, she is responsible for + the character of its comfort, its health, its enjoyment, all through its + life's struggle toward the 100 per cent. achievement record. She may so + compromise its physical efficiency that it will succumb to disease as a + consequence of the ill health with which its mother unjustly endowed it, + even though it possess the ability to attain the 100 per cent. if it + lived.</p> + + <p>We often see brilliant children who are nervous and physically unfit, + and we see others of more ordinary mental achievement who are healthy and + robust animals. The one is the offspring of parents possessing unusual + mental qualities but who are physically unable or unwilling to render + justice to their progeny; the other parents may be less gifted mentally, + but they are healthy and they are willing to give their best in conduct + and in blood to their babies. Many of these brilliant children never + achieve their potential greatness because they fall by the wayside owing + to physical inability, while the healthy little animals achieve a greater + degree of success because of the physical vitality which carries them + through. To achieve a moderate success and enjoy good health is a better + eugenic ideal than the promise of a possible genius never attained + because of continuous physical inefficiency.</p> + + <p>The nervous and willful mother should therefore consider how much + depends upon her conduct. It cannot be too frequently reiterated and + emphasized that every mother should do her utmost to guard and retain her + good health. Good health means blood of the best quality and this is + essential to the nourishment of the child. To keep in good health does + not mean to obey in one respect and fail in other essentials. It means + that you must obey every rule laid down by your physician, willingly and + freely in your own interest and in the interest of your unborn babe. In + no other way may you hope to creditably carry out the eugenic ideal that + "the fit only shall be born."</p> + + <p><b>Headache.</b>—This is a symptom of great importance. <!-- + Page 84 --><span class="pagenum"><a name="page84"></a>[84]</span> If it + occurs frequently, without apparent cause, the physician should be + consulted at once, as it may indicate a diseased condition of the + kidneys, and necessitate immediate treatment. Headaches may, of course, + be caused in many ways and most frequently they do not have any serious + significance, but they must always be brought to the attention of the + physician. As a rule they are caused by errors of diet,—too much + sugar, candy, for instance, late and indigestible suppers, indiscriminate + eating of rich edibles, etc.,—or they may be products of nervous + excitement (too little rest), as shopping expeditions, strenuous social + engagements, late hours, etc.</p> + + <p><b>Acidity of the Stomach, and So-Called Heartburn.</b>—These + are sometimes in the early months of pregnancy annoying troubles. The + following simple means will relieve temporarily: A half-teaspoonful of + bicarbonate of soda or baking soda in a glass of water or Vichy water; or + a half teaspoonful of aromatic spirits of ammonia in Vichy, or plain + water; or a tablespoonful of pure glycerine. The best remedy is one + tablespoonful of Philip's Milk of Magnesia taken every night for some + time just before retiring.</p> + + <p>Heartburn is the result of eating improper food, or a failure to + digest the food taken. Starchy foods should be avoided. Meats and fats + should be taken sparingly. Avoid also the et ceteras of the table, as + pickles, sauces, relishes, gravies, mustard, vinegar, etc. Good results + follow dry meals,—meals taken without liquids of any kind. Live on + a simple, easily digested, properly cooked diet. Chew the food + thoroughly, take plenty of time and be cheerful.</p> + + <p><b>Constipation During Pregnancy.</b>—Most women are as a rule + more or less constipated during pregnancy. It is caused by failure to + take the proper amount of outdoor exercise, to take enough water daily, + to live on the proper diet, to live hygienically, or because of wrong + methods of dress. It is most important that the bowels should move + thoroughly every day. Pregnancy no doubt aggravates constipation by + diminishing intestinal activity. Consequently there is a greater need for + activity on the part of the woman, and open air exercise is the best way + <!-- Page 85 --><span class="pagenum"><a name="page85"></a>[85]</span> to + accomplish this. She should eat fruits, fresh vegetables, brown or Graham + bread, or bran muffins, figs, stewed prunes, and any article of diet + which she knows from experience works upon her bowel. She should drink + water freely; a glass of hot water sipped slowly on arising every morning + or one-half hour before meals, is good. Mineral waters, Pluto, Apenta, + Hunyadi, or one teaspoonful of sodium phosphate, or the same quantity of + imported Carlsbad salts in a glass of hot water one-half hour before + breakfast, answers admirably. If the salts cannot be taken a three- or + five-grain, chocolate-coated, cascara sagrada tablet, may be taken before + retiring, but other cathartics should not be taken unless the physician + prescribes them. Rectal injections should be avoided as a cure of + constipation during pregnancy. They are very apt to irritate the womb and + if taken at a time when the child is active, they may annoy it enough to + cause violent movement on its part, and these movements may cause a + miscarriage. See article on "Constipation in Women."</p> + + <p><b>Varicose Veins, Cramps, and Neuralgia of the Limbs.</b>—When + cramps or painful neuralgia occur repeatedly in one or both legs, some + remedial measures should be tried. Inasmuch as the cause of this + condition is a mechanical one, it would suggest a mechanical remedy. The + baby habitually seeks for the most comfortable position, and having found + it stays there until conditions render it uncomfortable. He does not + consult you in the matter, but he may be subjecting you to untold misery + and pain. The child may rest on the mother's nerves or blood-vessels as + they enter her body from her lower limbs. If the pressure is sufficient, + it can interfere quite seriously with the return blood supply, because + veins which carry back to the heart the venous or used blood, are vessels + with thin, soft, compressible walls, while arteries which carry blood + away from the heart cannot be compressed easily, because their walls are + hard and tense. The condition therefore is that more blood is being sent + into the limb than is being allowed to return; in this way are produced + varicose veins. If these varicose veins burst or rupture we have ulcers, + which <!-- Page 86 --><span class="pagenum"><a + name="page86"></a>[86]</span> may quickly heal, or they may refuse to + heal, and become chronic. A dropsical condition of the leg may follow, + and because of interference with the circulation of the blood we get + cramps and neuralgias. How can we remedy this painful condition?</p> + + <p>Sometimes we don't succeed, but at least we can try. So long as the + cause exists, it is self-evident that rubbing the limb with any external + application, will not give any permanent relief, though it is well to + try. When rubbing, to relieve cramps at night, always rub upward. It is + not a condition that calls for medicine of any kind, while hot baths and + hot applications will only make the trouble worse. The remedy that + promises the quickest and longest relief is for the patient to assume the + knee-chest position for fifteen minutes, three times a day, till relief + is permanently established. The patient rests on her knees in bed, and + bends forward until her chest rests on the bed also. The incline of the + body in this position is reversed; hips are highest, the head lowest. The + baby will seek a more comfortable position and this new position may + relieve the pressure and cure the condition. Doing this three times daily + for fifteen minutes gives relief to the leg by reestablishing a normal + blood circulation, and very soon the baby finds a new position that does + not interfere with its mother's blood supply, and the cramps, and + neuralgia and dropsy, and maybe the varicose veins will soon show + improvement. Wearing the proper kind of abdominal support may help, as + explained on page <a href="#page77">77</a>. If the varicose veins are + bad, it is desirable to wear silk rubber stockings or to bandage the + limbs.</p> + + <p><b>Insomnia During Pregnancy.</b>—Insomnia or sleeplessness is + sometimes a vexatious complication during pregnancy. It seldom if ever + becomes of sufficient importance or seriousness to interfere with the + pregnancy or the health of the patient. Nevertheless, a period of + sleeplessness lasting for two or three weeks is not a pleasant experience + to a pregnant woman. It is most often met with during the latter half of + pregnancy.</p> + + <p>There can be no question that every case of insomnia has definite + cause, and can be relieved if we can find the <!-- Page 87 --><span + class="pagenum"><a name="page87"></a>[87]</span> cause. The only way to + find it is to systematically take up the consideration of each case, and + this is best done by the physician. He must have patience and tact; you + must answer each question truthfully and fully. Your diet, personal + conduct, exercise, condition of bowels, mental environment, domestic + atmosphere, everything, in fact, which has any relation to you or your + nerves, must be inspected with a magnifying glass. Some little + circumstance, easily overlooked, of seemingly no importance, may be the + cause of the trouble. You may need more outdoor exercise, or you may need + less outdoor exercise. You may need more diversion, more variety, or you + may need less. You may need a sincere, honest, tactful, patient confidant + and friend, or you may need to be saved from your friends. You may be + exhausting your vitality and fraying your nerves by social + exigencies,—those empty occupations which fill the lives of so many + fussy, loquacious females,—echoless, wasted, babbling moments, of + supreme important to the social bubbles who ceaselessly chase them but of + no more interest to humanity than the wasted evening zephyrs that play + tag with the sand eddies on the surface of the dead and silent desert. + You may have wandered from the narrow limitations of the diet allowable + in pregnancy, or you may be the victim of an objectionably sincere + relation who pesters you with solicitous inquiries of a needless + character. Whatever it is, rectify it. A good plan to follow on general + principles is to take a brisk evening walk with your husband just before + bedtime, and at least two hours after the evening meal. Follow this with + a sitz bath as soon as you return from the walk.</p> + + <p>A sitz bath is a bath taken in the sitting position with the water + reaching to the waist line. It should last about fifteen minutes and the + water should be comfortably hot. It is sometimes found that this form of + bath creates too much activity on the part of the child and defeats the + purpose in view. This is apt to be the case in very thin women when the + abdomen is not covered by a sufficient layer of fatty tissue. These women + will find it advisable to take, in place of the sitz bath, a sponge bath + in a warm room, using the water rather cool than hot but in <!-- Page 88 + --><span class="pagenum"><a name="page88"></a>[88]</span> a warm room. + Rub your skin briskly but waste no time in getting into bed. A glass of + hot milk, before going to bed, or when wakeful during the night, may + serve as a preventive. When these measures fail the physician should be + called upon to advise and prescribe.</p> + + <p><b>Ptyalism, or an Excessive Flow of Saliva.</b>—This is a + common condition in pregnancy, but cannot be prevented. It is of no + importance other than that it is a temporary annoyance.</p> + + <p>Itching of the abdomen can usually be allayed by a warm alcohol rub, + followed by gently kneading the surface of the abdomen with warm melted + cocoa butter, just before retiring.</p> + + <p><b>A Vaginal Discharge.</b>—Soon after pregnancy has taken place + the woman may notice a discharge. It may be very slight or it may be + quite profuse. In some cases it does not exist at all during the entire + period. As a rule the discharge is more frequent and more profuse toward + the end of pregnancy.</p> + + <p>If the discharge exists at any time,—and it is no cause for + worry or alarm if it does exist,—inform your physician. He will + advise you what to do, because it is not wise for you to begin taking + vaginal douches or injections without his knowledge, and at a time when + they may do you serious harm. Should itching occur as a result of any + vaginal discharge the following remedial measures may be employed:</p> + + <p>A solution of one teaspoonful of baking soda to a douche bag of tepid + water may be allowed to flow over the parts, or cloths saturated with + this mixture may be laid on the itching part. A solution of carbolic acid + in hot water (one teaspoonful to one pint of hot water), is also useful, + or a wash followed by smearing carbolic vaseline over the itching parts. + If your physician should suggest a mild douche for itching of the vagina + as the result of a discharge, it may be promptly relieved by using + Borolyptol in the water. Buy a bottle and follow directions on the + label.</p> + + <p><b>Testing Urine In Pregnancy—Importance of.</b>—One of + the most important duties, if not the most important, of both the + physician and the patient is to have the <!-- Page 89 --><span + class="pagenum"><a name="page89"></a>[89]</span> urine of the pregnant + woman examined every month during the first seven months and every two + weeks during the last two months. The urine examined during the first + seven months should be the first urine passed on the day it is sent for + examination. During the last two months of pregnancy the <ins + class="correction" title="'pateint' in original">patient</ins> should + pass all her water into a chamber for an entire day, and take about three + ounces of this mixed water for examination. She should measure the total + quantity passed during these days and mark it with her name on the label + of the bottle. The physician will thus have an absolute record and guide + of just how the kidneys are acting, and as they are the most important + organs to watch carefully during every pregnancy, the greatest care + should be taken to see that failure to note the first symptom of trouble + does not take place.</p> + + <p><b>Attention to Nipples and Breast.</b>—The physician should + inspect the breasts and nipples of every pregnant woman when she first + visits his office. Frequently the nipples are found to have been + neglected, probably subjected to pressure by badly fitting corsets or too + tight clothing. Instructions gently to pull depressed nipples out once + daily, if begun early, will result in marked improvement by the end of + pregnancy. During the latter part of pregnancy the breasts should be + carefully and thoroughly bathed daily in addition to the daily bath. This + special bath should be with a solution of boric acid (one teaspoonful to + one pint of water). After the bath apply a thin coating of white vaseline + to the nipples. It may be necessary to resort to the following mixture to + harden the nipples and to make them stand out so that the child can get + them in its mouth: Alcohol and water, equal parts into which put a pinch + of powdered alum; this mixture should be put in a saucer and the nipples + gently massaged with it twice daily. A depressed nipple may also be drawn + out by means of a breast pump. If the nipples are not pulled out the + child will be unable to nurse. It may then be necessary to put the child + on the bottle and when the nipples are ready he may not take them after + being used to the rubber nipple. The breasts may become caked and as a + caked breast is a very painful <!-- Page 90 --><span class="pagenum"><a + name="page90"></a>[90]</span> and serious ailment it is wise to attend to + this matter in time.</p> + + <p><b>The Vagaries of Pregnancy.</b>—Certain foolish, old-fashioned + ideas, have crept into the minds of impressionable people regarding + pregnancy, which are aptly termed vagaries. It is believed by some that + if the pregnant woman is the victim of fright, or is badly scared, or + witnesses a terrifying or tragic sight, her child will be, in some way, + affected by it. If the incident is not of sufficient gravity to cause an + abortion or a miscarriage it will not, in any way mark, or affect the + shape of the child in the womb.</p> + + <p>It is believed by some that a child can be marked by reason of some + event occurring to the mother while carrying it. This is not so; a child + cannot be marked by any experience or mental impression of the mother. + Some believe that the actual character of a child can be changed by + influences surrounding the mother while carrying it. The character of a + child cannot be changed one particle after conception takes place, no + matter how the mother spends her time in the interim.</p> + + <p>It should be carefully understood that the character of the baby is + entirely different from the physical characteristics of the baby. Were + this not so it would be futile on the part of the mother to discipline or + sacrifice herself in the interest of her baby. The baby's character will + reflect the qualities of the combined union of mother and father. The + baby's physical characteristics will largely depend upon the treatment + accorded it by the mother during its intro-uterine life. Hence we lay + down rules of conduct, diet and exercise in order to produce a good, + sturdy animal, while the character or mind of the animal is a part of the + fundamental species already created. In other words, no matter how much + care you bestow upon a rose bush, its flower will still be a + rose,—it may be a better rose, a stronger, sturdier rose, a better + smelling and a more beautiful rose, but it is still a rose.</p> + + <p><b>Contact With Infectious Diseases.</b>—The pregnant woman + should be warned against the danger of coming in contact with any person + suffering from any infectious or contagious diseases. To become the + victim of one <!-- Page 91 --><span class="pagenum"><a + name="page91"></a>[91]</span> of these diseases near the time of labor + would be a dangerous complication not only to the mother, but to the + child. A woman is more liable to catch one of these diseases during the + last month of pregnancy than at any other time. The most dangerous + diseases at this period are Scarlet Fever, Diphtheria, Erysipelas, and + all diseased conditions where pus is present.</p> + + <p><b>Avoidance of Drugs.</b>—It is a safe rule during pregnancy to + avoid absolutely the taking of all medicines unless prescribed by a + physician.</p> + + <p><b>The Danger Signals of Pregnancy.</b>—The following conditions + may be of very great importance and may be the danger signals of serious + coming trouble. They must not therefore be neglected or lightly + considered. When any of them make their appearance send for the physician + who has charge of your case, at once, and follow his advice whatever it + may be.</p> + +<blockquote class="b1"> + + <p>1. Any escape of blood from the vagina, whether in the form of a + sudden hemorrhage or a constant leaking, like a menstrual period.</p> + + <p>2. Headache, constant and severe.</p> + + <p>3. Severe pain in the stomach.</p> + + <p>4. Vertigo or dizziness.</p> + + <p>5. Severe sudden nausea and vomiting.</p> + + <p>6. A fever, with or without a chill.</p> + +</blockquote> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 93 --><span class="pagenum"><a name="page93"></a>[93]</span></p> + +<h3>CHAPTER VIII</h3> + +<h3>THE MANAGEMENT OF LABOR</h3> + +<blockquote class="b1"> + + <p><b>When to Send for the Physician in Confinement Cases—The + Preparation of the Patient—The Beginning of Labor—The First + Pains—The Meaning of the Term "Labor"—Length of the First + Stage of Labor—What the First Stage of Labor Means—What the + Second Stage of Labor Means—Length of the Second + Stage—Duration of the First Confinement—Duration of + Subsequent Confinements—Conduct of Patient During Second Stage of + Labor—What a Labor Pain Means—How a Willful Woman Can Prolong + Labor—Management of Actual Birth of Child—Position of Woman + During Birth of Child—Duty of Nurse Immediately Following Birth of + Child—Expulsion of After-birth—How to Expel + After-birth—Cutting the Cord—Washing the Baby's Eyes + Immediately After Birth—What to Do with Baby Immediately After + Birth—Conduct Immediately After Labor—After Pains—Rest + and Quiet After Labor—Position of Patient After Labor—The + Lochia—The Events of the Following Day—The First Breakfast + After Confinement—The Importance of Emptying the Bladder After + Labor—How to Effect a Movement of the Bowels After + Labor—Instructing the Nurse in Details—Douching After + Labor—How to Give a Douche—"Colostrum," Its Uses—<ins + class="correction" title="'Adantages' in original">Advantages</ins> of + Putting Baby to Breast Early After Labor—The First Lunch—The + First Dinner—Diet After Third Day.</b></p> + +</blockquote> + + <p><b>When to Send for the Physician in Confinement Cases.</b>—The + physician should be notified just as soon as it is known that labor has + begun. The adoption of this course is necessary for a number of reasons. + It is only just that he should have an opportunity to arrange his work so + that he may be at liberty to give his whole time to your case when he is + wanted. He may not be at home at the moment, but can be notified, and can + arrange to be on hand when your case progresses far enough to need his + personal attention. It will relieve your mind to be assured that he will + be with you in plenty of time. <!-- Page 94 --><span class="pagenum"><a + name="page94"></a>[94]</span></p> + + <p>Don't worry unnecessarily if he does not come immediately when you + notify him, provided you notify him at the beginning of labor. There is + plenty of time. You have a lot of work to do before he can be of any + help. Many women entertain the idea that a physician can immediately + perform some kind of miracle to relieve them of all pains at any stage in + labor. This is a mistaken idea. No physician can hasten, or would if he + could, a natural confinement. He waits until nature accomplishes her + work, and he simply watches to see that nature is not being interfered + with. If something goes wrong, as it does now and again; or if the pains + become too weak, or if the proper progress is not being made, he may help + nature or take the case out of her hands and complete the confinement. If + it is thought best to do this, there will be plenty of time.</p> + + <p><b>The Preparation of the Patient and the Conduct of Actual + Labor.</b>—It is assumed that the patient has adhered to the + instructions of the physician given during the early days of her + pregnancy. These instructions included directions as to exercise, diet, + bathing, etc.</p> + + <p>Having calculated the probable date of the confinement, it is the + better wisdom to curtail all out-of-door visiting, shopping, social + engagements, etc.,—everything in fact out-of-doors except actual + exercise, for two weeks previous to the confinement date. The usual walk + in the open air should be continued up to the actual confinement day. The + daily bath may be taken, and it is desirable that it should be taken, up + to and on the confinement day.</p> + + <p><b>The Meaning of the Term "Labor."</b>—By labor is meant, the + task or work involved in the progress by means of which a woman expels + from her womb the matured ovum or child. After the child has been carried + in the womb for a certain time (estimated to be 280 days) it is ripe, or + fully matured, and is ready to be born. The womb itself becomes irritable + because it has reached the limit of its growth and is becoming + overstretched. Any slight jar, or physical effort on the part of the + patient, or the taking of a cathartic, is apt to set up, or begin the + contractions which nature has devised as the process of "labor" by which + the womb empties itself. <!-- Page 95 --><span class="pagenum"><a + name="page95"></a>[95]</span></p> + + <p><b>The Beginning of Labor.</b>—When the first so-called pains of + actual labor begin they are not always recognized as such. The + explanation of this seeming paradox is that the "pains" are not always + painful. A woman will experience certain undefined sensations in her + abdomen; to some, the feeling is as if gas were rumbling around in their + bowels; to others, the feeling is as if they were having an attack of not + very painful abdominal colic; while others complain of actual pain. The + fact that these sensations continue, and that they grow a little worse; + and that the day of the confinement is due, or actually here, impresses + them that something unusual is taking place; then, and not till then, + does the knowledge that labor is really approaching dawn upon them.</p> + + <p>In due time one of these new sensations, which constitute the first + stage of labor, will be more emphatic; there will be a little actual pain + so that she will feel like standing still, holding her breath and bearing + down. That is the first real labor pain and marks the beginning of the + second stage of labor, and may be the first absolute sign that will leave + no doubt in her mind that labor has begun.</p> + + <p>The nurse will now inquire into the condition of the patient's bowels. + If they have not already moved freely that day, she will give the patient + a rectal injection of one pint of warm soap suds into which one + teaspoonful of turpentine is put. After the bowels have been thoroughly + cleansed, the patient will be made ready for the confinement. The + clothing necessary consists of dressing gown, night gown, stockings and + slippers. These are worn as long as the patient is out of bed, when all + but the night gown will be discarded. The entire body of the patient, + from the waist line to the knees, should be thoroughly cleansed, paying + particular attention to the private parts; first with warm water and + castile soap, and then rendered aseptic by washing with four quarts warm + boiled water into which has been put one teaspoonful of Pearson's + Creolin. A soft napkin is then wrung out of water that has been boiled + and cooled to a suitable temperature, and laid over the genital region, + and held <!-- Page 96 --><span class="pagenum"><a + name="page96"></a>[96]</span> in place by a dry clean napkin, and allowed + to remain there until the physician takes personal charge of the + case.</p> + + <p><b>Length of the First Stage of Labor.</b>—There is no definite + or even approximate length of time for the first stage of + labor,—that, you may recall, was the more or less painless stage, + or as it has been termed, the "getting-ready" stage. Inasmuch as it is an + unimportant and practically painless stage, most patients do not mind it. + They continue to be up and around and work as usual.</p> + + <p>The first stage of labor is utilized by nature in opening the mouth of + the womb.</p> + + <p>The second stage of labor is utilized by nature in expelling the child + into the outer world.</p> + + <p><b>Length of the Second Stage of Labor.</b>—After the second + stage has begun, the length of time necessary to end the labor, assuming + everything is normal, depends upon the strength and frequency of the + pains. The stronger and more frequent the pains, the quicker it will be + over. First confinements necessarily take longer, because the parts take + more time to open up, or dilate, to a degree sufficient to allow the + child to be born. In subsequent confinements, these parts having once + been dilated yield much easier, thus shortening the time and the pains of + this, the most painful, stage of labor. The average duration of labor is + eighteen hours in the case of the first child, and about twelve hours + with women who have already borne children. The time, however, is subject + to considerable variation, in individual cases, as has been pointed + out.</p> + + <p><b>Conduct of the Patient During the Second Stage of + Labor.</b>—She should remain up, out of bed, as long as she + possibly can. The object of this is because experience shows that the + labor pains are stronger, and more frequent, when in the upright + position. Even though this procedure would seem to invite more constant + suffering, it must be remember that labor is a physiological, natural + process, that there is nothing to fear or dread; and if the patient is in + good health, it is to her advantage to have it over soon, rather than to + encourage a long drawn out, exhausting labor. When the pains come <!-- + Page 97 --><span class="pagenum"><a name="page97"></a>[97]</span> she + should be told to hold on to something, to hold her breath as long as + possible, and to bear down. A good plan is to roll up a sheet lengthwise, + and throw it over the top of an open door and let her grasp both ends + tightly and bear down; or she can put her arms over the shoulders of the + nurse and bear down. Instruct her to hold her breath as long as she can, + bearing down all the time, and when she can't hold it any longer, tell + her to let up, and then take a quick deep breath and bear down again, + repeating this programme until the pain ceases. Tell her specifically to + be sure to keep bearing down till the end of the pain, because the most + important time, and the few seconds during which each pain does most of + its work during the second stage of labor, is at the very end of each + pain. When a woman understands that these instructions are for her good, + and that they are given with the one purpose of saving her pain, and + shortening the length of labor, she will try to obey. Each pain is + intended by nature to do a certain amount of work, and each pain will + accomplish that work if the woman does not prevent it; and if she does + prevent it, she is only fooling herself, because the next pain will have + to do what she would not allow the former to do, and so on according to + how she acts.</p> + +<h4>THE CARRIERS OF HERITAGE</h4> + + <div class="figcenter" style="width:50%;"> + <a href="images/v1fig003.jpg"><img width="100%" src="images/v1fig003.jpg" + alt="The Carriers of Heritage" /></a> + <p>Here is the actual bridge from this generation to the next.</p> + + <p>Into these two little bodies—the larger not over + one-twenty-fifth of an inch in diameter—is condensed the + multitude of characteristics transmitted from one generation to + another.</p> + + <p>The vital part of the <i>Ovum</i> is the <i>Nucleus</i>, which + contains the actual bodies that carry heritage—the little grains + that are the mother's characteristics—<i>Chromosomes</i>. This + nucleus is nourished by oils, salts and other inclusions, known as + <i>Cytoplasm</i>. Floating in the cytoplasm may be found a tiny body + known as the <i>Centrosome</i>, which acts as a magnet in certain + phases of cell development. Around this whole mass is a <i>Cell + Wall</i>, more or less resisting and protective.</p> + + <p>The <i>Spermatozoan</i> is structurally much different from the + ovum, but it also has its nucleus and chromosomes, which carry to the + child the transmittable characteristics of the father.</p> + + <p>The ovum is usually comparatively large and stationary, and whatever + motion is therefore necessary to bring it into contact with the male + cell devolves upon the latter, which possesses what is known as a + <i>locomotor tail</i>. In addition there are usually many sperms to one + ovum, so that the chances are that at least one male cell will reach + the egg and effect fertilization, and the beginning of a new life.</p> + + <p>The diagrams on the opposite page show the actual steps by which the + spermatozoan unites with the ovum. It is the very first stage of the + process of cell multiplication that results in the offspring.</p> + </div> +<h4>THE FORMATION OF A NEW LIFE</h4> + + <div class="figcenter" style="width:66%;"> + <a href="images/v1fig015.jpg"><img width="100%" src="images/v1fig015.jpg" + alt="The Formation of a New Life" /></a> + <i>Reproduced by permission from "Genetics," Walters, The Macmillan + Co.</i> + </div> + <p><b>How a Willful Woman Can Prolong Labor.</b>—For a certain + time, during the second stage of labor, a willful, unreasonable woman, + can work against nature and save herself a little pain by prolonging the + issue; but there will come a time when, the head having reached a certain + position, the expulsive pains will be so great that she won't be able to + control them and nature then seems to take her revenge. So if a woman + holds back, and begins to cry, and scream, when she feels a pain coming, + she renders the pain to a large degree negative, she prolongs her labor, + adds to the total number of pains, exhausts herself, and endangers the + life of her child. It must, however, be remembered in all justice that + this is a time when it is much easier to preach than to practice.</p> + + <p>Every confinement is a new experience; no matter how many a physician + may have seen, there are no two <!-- Page 98 --><span class="pagenum"><a + name="page98"></a>[98]</span> alike. It is one of the interesting + psychological problems in medicine to observe the conduct of women during + their first confinement.</p> + + <p>Some are calm, exhibiting a degree of self-control that is admirable. + They are willing to be instructed, and they recognize that the advice is + given for their benefit. They conscientiously try to obey suggestions, + and they make praiseworthy efforts to keep themselves under control. They + are stoics.</p> + + <p>Others collapse at once; they go to pieces under the slightest excuse, + and frequently without as much as an excuse. As soon as the pain begins, + they willfully ignore all the instructions given and desperately and + foolishly try to escape what they cannot escape. In this unreasonable + selfishness they resent advice, and at the same time they implore you to + "do something" for them. There is absolutely no excuse for this kind of + conduct; and any prospective mother who, because of a willful trait in + her disposition, refuses to profit by the kindly professional advice of + her physician or nurse, should at least have some consideration for her + unborn babe. It may seem unkind to criticise the conduct of any woman at + such a time. It is not prompted by a lack of patience or justice however. + These women permit, in spite of every assurance to the contrary, an + unreasonable fear to overwhelm them; and because of this fear they refuse + to be guided into a path of conduct that will save them suffering and + shorten the pains which they complain of. It is our conviction that if a + woman would try to follow the advice of the physician at this time, at + least half of all the seeming suffering would be avoided. We are glad to + be able to truthfully state that this type of woman is vastly in the + minority.</p> + + <p>When the second stage has advanced far enough, the patient will decide + to go to bed. It may be necessary to put her in bed earlier, if her pains + are very strong, as there is always a possibility of suddenly expelling + the child under the influence of a strong pain. She will, as previously + stated, discard all clothing, except her night gown, which can be folded + up to her waist line and let down as far as necessary after the + confinement is over. The obvious advantage of this arrangement is <!-- + Page 99 --><span class="pagenum"><a name="page99"></a>[99]</span> that + the gown remains unsoiled, and saves what would be needless trouble if it + proved necessary to change the night gown at a time when the tired-out + patient needs rest. Much aid may be afforded the woman at this stage by + twisting an ordinary bed sheet and putting it around one of the posts or + bars of the foot of the bed. The patient may then pull on the ends during + the pain; she may also find much comfort and aid by bracing her feet on + the foot of the bed while pulling. It is desirable to instruct the nurse + to press on the small of the back during these pains. Some women + appreciate a hot water bottle in this region. If the pains are hard the + patient may perspire freely; it is always refreshing occasionally to wipe + the face and brow off with a cloth wrung out of cold water. Cramps of the + limbs may be relieved by forcibly stretching the leg and pulling the foot + up toward the knee. From this time until the child and after-birth are + born the physician will take active charge of the case.</p> + + <p><b>The Management of the Actual Birth of the Child.</b>—Near the + end of the second stage of labor it will be observed that the pains have + grown strong, expulsive, and more frequent. Very soon the advancing head + will begin to push outward the space between the front and back passage; + the rectum is pushed outward and the lips of the vagina open. If an + anesthetic is to be used these are the pains that call for it. A few + drops may be dropped singly on a small clean handkerchief held up by the + middle over the nose, its ends falling over the face. A few drops will + just take the edge off the pains, and render them quite bearable. As soon + as the pain is over the patient should rest, relax completely, and not + fret and exhaust herself worrying about the pains to come. It is + astonishing how much actual rest a woman can get between pains if she + will only try; and it is astonishing how much concentrated mischief a + willful, unreasonable woman can do in the same time. She will not try to + rest, but cries and moans and pleads for chloroform, until she succeeds + in giving everyone except the physician and nurse the impression that she + is suffering unnecessarily. Her husband or her mother, <!-- Page 100 + --><span class="pagenum"><a name="page100"></a>[100]</span> whichever is + present, gets nervous; they begin to wonder if the physician is really + trying to help; assume a long, sad, serious face! forget their promise to + look cheerful, and mayhap offer sympathy to the woman. It is a trying + moment and needs infinite patience and tact. The physician attends + strictly to his duty, which will now be to guard the woman against + exerting too great a force during the last few pains. About this time, or + before it in many instances, the "waters will break." This means simply + that the bag or membrane in the contents of which the child floated burst + because of the pressure of a pain. This is a perfectly natural procedure + and should not cause any worry: simply ignore it as if it had no bearing + on the labor in any way. As soon as the oncoming head has dilated the + passage sufficiently, so that the edges of the entrance to the vagina + will slip over the head without tearing, the physician allows the head to + be born. It takes some time to do this, and he must hold the head back + until just the right moment. It is best not to let the head slip through + at the height of a pain, or rupture is sure to occur. Wait till it will + slip through as a pain is dying out, and if you have waited long enough + and handled the head skillfully, the conditions will be just right at a + certain moment to permit this without tearing the parts. There are some + cases where a tear, and a good tear, is impossible to guard against. It + is not a question of patience, or tact, or skill; it is a combination of + conditions which patience, tact, and skill are powerless against.</p> + + <p><b>Position of Woman During Birth of Child.</b>—The position of + the woman is a matter of choice and is not contributory to the results at + all. She can lie on her back, which is the ordinary way, or on her side, + as the physician or the patient prefer. As soon as the head is born the + physician should see that the cord is not round the child's neck; if it + is, release it. The shoulders will most likely be born with the next or + succeeding pain. The physician will permit the lower shoulder to slip + over the soft parts first; this is done by retarding the upper shoulder + by pushing it gently behind the pubic bone of the mother. When the + shoulders are through, the <!-- Page 101 --><span class="pagenum"><a + name="page101"></a>[101]</span> rest of the body of the child slips out + without effort.</p> + + <p><b>Duty of Nurse Immediately Following Birth of Child.</b>—As + soon as the child is born the nurse should sit by the side of the mother + and hold the womb until the after-birth is expelled. The womb can be + easily felt in the lower part of the woman's abdomen as a hard mass. It + feels about the size of an extra large orange. The object of holding it + is to prevent the possibility of an internal hemorrhage. It can be + readily appreciated that the interior of a womb, immediately after a + child is born, is simply a large bleeding wound. So long as the womb + remains firmly contracted there is very little chance for an extensive + bleeding to take place. As a rule the womb remains sufficiently + contracted to preclude a hemorrhage until the after-birth is out. After + the after-birth is expelled, the womb usually closes down firmly and the + liability to bleed is very much reduced. Because there is a distinct + chance or tendency for the womb to bleed freely during the time the + after-birth remains in, it is customary, as stated above, to watch it + closely and to hold it securely. It is best held with the right hand. The + fingers should surround the top of the womb and exert a slight downward + pressure. Should it show any tendency to dilate or fill with blood, get + it between the fingers and the thumb and squeeze it, pushing downward at + the same time.</p> + + <p><b>Expulsion of After-Birth.</b>—The after-birth is usually + expelled in about twenty minutes after the child is born. Great care + should be experienced in its expulsion. It should not be pulled at any + stage of its expulsion. If it does not come easily give it a longer + time,—it takes time for the womb to detach itself from the + after-birth; and some after-births are very firmly attached. Eventually + it will come out with a little encouragement in the way of frictional + massage of the womb through the abdominal walls. If the membranes remain + in the womb after the body of the after-birth is out, do not pull on + them. Take the after-birth up in the palm of your hand and turn or twist + it around, and keep turning it around gently, thereby loosening the + membranes from the womb instead of pulling them, which would surely break + them, leaving <!-- Page 102 --><span class="pagenum"><a + name="page102"></a>[102]</span> the broken ends in the womb, and, as a + result, the chance of developing serious trouble.</p> + + <p>The patient should now be given one teaspoonful of the fluid extract + of ergot, which should be repeated in an hour. Should there be an + excessive flow of blood after this period it may be again repeated at the + third hour.</p> + + <p><b>Cutting the Cord.</b>—As soon as the child is born, and of + course long before the after-birth is expelled, the physician will tie + the cord. This is best done at two places, one about two inches from the + child, and the other two or three inches nearer the mother. Cut the cord + about one-half inch beyond the first ligature, which will be between the + two ligatures. The cord should be tied with sterile tape made for the + purpose, or heavy twisted ligature silk, or a narrow, ordinary, strong + tape, previously boiled. It should be tied firmly and inspected a number + of times within one hour of its birth. It is possible for a baby to lose + enough blood from a cord badly tied to cause its death. A very good way + to ensure against such an accident is to cut the cord one inch from the + ligature nearest the baby, then turn this inch backward and retie with + the same ligature, thus making a double tie at the same spot. Cut the + cord with scissors that have been boiled and reserved for this + purpose.</p> + + <p><b>Washing Baby's Eyes and Mouth Immediately After Birth.</b>—As + soon after birth as is practicable, wash the baby's eyes with a saturated + solution of boracic acid.</p> + + <p>Immediately after the eyes have been washed the physician will drop + into them a solution of silver nitrate, three drops of a two per cent. + solution in each eye, or argyrol, three drops 20 per cent. solution. This + precaution is taken against possible infection during labor and, as + explained elsewhere, it is a preventive against certain diseased + conditions which, if present, would result in blindness.</p> + + <p>The physician should then wind a little sterile cotton round his + moistened little finger, dip it in the boracic solution, and holding the + baby up by the feet head down, insert this finger into the throat, thus + clearing it of mucus. The tongue and mouth may be gently washed with the + same solution. <!-- Page 103 --><span class="pagenum"><a + name="page103"></a>[103]</span></p> + + <p>After the baby has cried lustily as an evidence of life and strength, + he should be wrapped up in a warm blanket quickly, and immediately put in + a cozy basket in a warm place, and left there undisturbed, with his eyes + shaded from the light until the nurse is ready to attend to him. The baby + should be laid on his right side.</p> + + <p><b>Conduct Immediately Following Labor.</b>—As soon as the + physician is satisfied that the patient is well enough to be left in care + of the nurse or attendant, every effort should be made to favor a long, + refreshing sleep. Nothing will contribute to the patient's well-being so + much as a quiet, restful sleep after labor. The nurse will therefore take + the baby into another room, fix the mother comfortably, and give her a + glass of warm milk,—draw the shades or lower the light and tell the + tired-out mother to go to sleep. As a rule she will sleep easily, as she + is sore and exhausted.</p> + + <p><b>After-Pains.</b>—In women who have had children the womb does + not as a rule contract down as firmly as after the first confinement. + This condition permits of slight relaxation of the muscular wall, at + which times there is a slight oozing of blood. This blood collects and + forms clots in the uterine cavity which acts as irritants, exciting + contractions in the effort to expel them. These contractions cause what + are commonly known as "after-pains." These pains last until the womb is + free from blood-clots. They may be severe the first twenty-four hours and + then gradually die out during the following two or three days. Ordinarily + in uncomplicated confinements they rarely annoy the patient longer than a + few hours. It is a rare exception to observe them after the first + confinement.</p> + + <p><b>Rest and Quiet After Labor.</b>—Sometimes the birth chamber + is the rendezvous for all the inquisitive ladies in the neighborhood. No + one should be permitted in the lying-in chamber until the patient is + sitting up, except the husband and the mother. This should be made an + absolute rule in every confinement. This is a period that demands the + maximum of uninterrupted rest and repose. The world and all its concerns + should remain a blank to a woman during the whole period of her + confinement. This is the only successful means of <!-- Page 104 --><span + class="pagenum"><a name="page104"></a>[104]</span> obtaining mental rest. + The husband and mother should be instructed to present themselves just + often enough to demonstrate their interest in the welfare of the patient + and the baby.</p> + + <p><b>Position of the Patient After Labor.</b>—After delivery a + woman should be instructed to lie on her back, without a pillow, for the + first night. On the following morning she may have a pillow, but she must + remain on her back for the first week. Sometimes an exception may be made + to this rule by letting the patient move around on the side, with a + pillow supporting the back, on the fourth day. These exceptional cases + are those whose womb has contracted firmly, as shown by the quick change + in the amount and color of the lochia. Women should be told why they must + remain on their backs as explained in the chapter: "How long should a + woman remain in bed?"</p> + + <p><b>The Lochia.</b>—The discharge which occurs after every labor + is called the lochia. Its color is red for the first four or five days; + for the succeeding two or three days it is yellow; for the remainder of + its existence it is of a whitish color. It lasts from ten days to three + weeks.</p> + + <p>The odor of the lochia is at first that of fresh blood; later it has + the odor peculiar to these parts. If at any time the odor should become + foul or putrid it is a danger signal to which the nurse should + immediately draw the physician's attention.</p> + + <p>If the amount of the lochia should be excessive it should be + investigated.</p> + + <p><b>The Events of the Day Following Labor.</b>—We will assume + that the patient enjoyed a long sleep and wakes up refreshed, and with a + thankful feeling that all is over and that baby is safely here. She will + want to see and caress baby, of course. Lay the baby down in bed beside + her and let her love and mother it. Tell her not to lift it, for the + strain might injure her, then quietly steal away for ten or fifteen + minutes, for these are precious, sacred moments. Motherhood—that + angel spirit, whose influence every human heart has felt—that + guards and guides the world in its sheltering arms—is born in its + divine sense, into the heart of every woman for the <!-- Page 105 + --><span class="pagenum"><a name="page105"></a>[105]</span> first time, + as she gazes in ecstasy and wonder at her first-born. She feels that she + has begotten a trust,—a trust direct from her Creator, and she + makes a silent resolve, as she gently and timidly feels the softness of + baby's cheek, that she will watch over it, and guide it, and do all a + mother can for it, with God's help. It is good for the race that mothers + do feel this way: and it is good for all concerned that they be given the + opportunity to be so inspired.</p> + + <p>Just as gently take the baby away at the expiration of the allotted + time. Take it with a cheerful, smiling word, and do not comment upon + mother's happy, thoughtful face, she will quickly collect herself and + enter into the spirit of quiet congratulation that should now permeate + the home.</p> + + <p><b>The First Breakfast After Labor.</b>—If the patient has + passed a comfortable night, feels well, and is free from temperature, and + has a normal pulse, breakfast will consist of a cup of warm milk, or a + cup of cocoa made with milk, a piece of toasted bread, and a light boiled + egg; or if preferred a cereal with milk and toasted bread. This will be + the breakfast for the two following days also. The milk, or the cocoa + (whichever is taken), must be sipped, while the attendant supports the + patient's head. The cereal, or the egg (whichever is taken), must be fed + to the patient out of a spoon. The patient must not make any physical + effort to help herself; she must remain relaxed. Even when she sips her + milk, or cocoa, she must not make any effort to raise her head; the nurse + must support its entire weight. This will be the absolute routine of + every meal until the physician gives permission to change the procedure. + It is a waste of time to formulate rules only to disobey them.</p> + + <p>Shortly after breakfast the patient's toilet should be attended to. + She should have her hair combed, and her face and hands washed. The hair + on the right half of her head should be combed while the head rests on + the left side, and vice versa. The water used for washing the hands and + face should be slightly warmed. It is best to keep the hair braided and + to consult the wishes of the patient as to the frequency of combing it. + <!-- Page 106 --><span class="pagenum"><a + name="page106"></a>[106]</span></p> + + <p><b>The Importance of Emptying the Bladder After Labor.</b>—An + effort should be made now to have the patient urinate. This is very + important at this time, as it is not an uncommon experience to find that + the abdominal muscles are so worn out and overstrained with the fatigue + of labor that they refuse to act when an effort is made to urinate. As a + consequence the bladder becomes distended and may have to be emptied by + other means. This condition is a temporary and a painless one, and will + rectify itself in a day or two; meantime, if this accident has occurred, + it is essential that the bladder should be emptied from time to time + until the patient can do it herself. To test this function place the + patient on the bed pan into which a pint of hot water has been put, and + give her a reasonable time to make the effort to pass her water. Should + she fail, take an ordinary small bath towel and wring it out of very hot + water, just as hot as she can tolerate, and spread it over the region of + the bladder and genitals: if there is running water in the room, turn it + on full and let it run while the towel is in position as above. If the + bladder is full, there is a peculiar, irresistible desire to urinate when + one hears running water. If this effort fails, report the fact to the + physician when he makes his daily call; he will draw the urine and it + will be part of his daily duty to give specific instructions regarding + this function until nature reëstablishes it.</p> + + <p>No particular attention need be paid to the bowels for the first two + days. On the morning of the third day, if they have not acted of their + own accord, the physician will give the necessary instructions to move + them. The means necessary to accomplish the first movement after a + confinement is a matter of choice. The old-time idea was to use castor + oil, and while other remedies are now more or less fashionable, castor + oil is still an excellent agent. Enemas are frequently used, but their + use is questionable in this instance, inasmuch as a movement has not + taken place for three days, the object is to clean out the whole length + of the intestinal tract, and an enema is limited to part of the large + intestine only,—according to how it is given. If the small <!-- + Page 107 --><span class="pagenum"><a name="page107"></a>[107]</span> + intestines are not thoroughly emptied, particles of food may remain + there, and if so, they will putrify and the patient runs the risk of + developing gas,—sometimes to an enormous extent. This affliction is + painful, and dangerous, and nearly always unnecessary. It is always, + therefore, more safe, and more desirable, to use some agent by the mouth, + and we know of no better one than castor oil; and as castor oil can be so + masked as to be practically tasteless at any drug-store soda fountain + there can be small objection to it. My custom is to send the nurse or + husband with an empty glass to the drug store to have the mixture made + there and brought back ready for use. We have frequently obtained it in + this way and given it to the patient without her knowing what it was. The + best time to give castor oil is two hours after a meal, and two hours + before the next meal—i.e., on an empty stomach. It works quicker + and does not nauseate when the stomach is empty.</p> + + <p><b>Instructing the Nurse in Details.</b>—The nurse will attend + to the patient's discharges by changing the napkins frequently. The + bruised parts should be washed twice daily, for the first three or four + days. If the nurse is a trained graduate nurse a few directions will + suffice. If she is not a trained nurse the physician should be explicit + in his instructions. It would be better if he actually showed her just + how he wanted this work done. The best way to cleanse the vulvæ or + privates is to take an ordinary douche bag at the proper height (about + three feet) and allow the solution (1 to 2,000 bichlorid) to run over the + parts into the douche pan, but do not touch any part of the patient with + the nozzle of the douche bag. While she is directing the water with the + left hand she should have a piece of sterile cotton in the right hand + with which she will gently mop the parts. This method ensures disengaging + any clotted blood and is aseptic. Dry the parts afterwards with a soft + sterile piece of gauze and apply a clean sterile napkin.</p> + + <p><b>Douching After Labor.</b>—A nurse should never give a vaginal + douche without instructions from the physician. Douches are not necessary + in the convalescence of ordinary uncomplicated confinement cases. When it + is <!-- Page 108 --><span class="pagenum"><a + name="page108"></a>[108]</span> necessary to give vaginal douches after a + confinement, there are good reasons why they should be given, and it is + therefore absolutely essential that they should be given properly, and + with the highest degree of aseptic precautions. If these rules are not + observed, the danger of causing serious trouble is very great, and as the + physician is directly responsible for the conduct of the case, he should + in justice to himself and his patient, do the douching himself.</p> + + <p><b>How to Give a Douche.</b>—The proper way to give a vaginal + douche after a confinement, when the parts are bruised and lacerated, and + when, as a consequence, the possibility of infection is very great, is as + follows:</p> + + <p>Instruct the nurse to boil and cool about two quarts of water and have + another kettle of water boiling. Boil the douche bag and its rubber + tubing and the glass douche tube (do not use the hard rubber nozzle that + comes with the ordinary douche bag). Drain off the water after it has + boiled for ten minutes, but instruct the nurse not to touch the bag or + tube, to leave them in the pan, covered, till the physician uses them. + When the physician calls, place the patient on a clean warm douche pan + while he is sterilizing his hands and making the solution ready. While he + is douching the patient the nurse will hold the bag. The bag should not + be held higher than two feet above the level of the patient.</p> + + <p><b>Advantages of Putting Baby to the Breast Early After + Birth.</b>—The patient can now take, and will likely be ready for, + an hour's nap. After the rest it is desirable to put the baby to the + nipple, first carefully cleaning the nipple with a soft piece of sterile + gauze dipped in a saturated solution of boracic acid. The reasons for + this are as follows:</p> + + <p>1st. There is in the breasts of every woman after confinement a + secretion known as "colostrum" which has the property of acting as a + laxative to the child, in addition to being a food.</p> + + <p>2nd. It is advisable that the child's bowels should move during the + first twenty-four hours and the colostrum was put there partly for that + purpose.</p> + + <p>3rd. The act of suckling has a well-known influence <!-- Page 109 + --><span class="pagenum"><a name="page109"></a>[109]</span> on the womb, + in that it distinctly aids in contracting it, and thereby expelling + blood-clots and small shreds of the after-birth which might cause trouble + if left in.</p> + + <p>4th. By nursing the colostrum out of the breasts, it will favor and + hasten the secretion of milk.</p> + + <p>5th. It is frequently easier for the baby to get the nipple before the + breast is full of milk, and having once had the nipple it will be easier + to induce him to take it again when it is more difficult to get.</p> + + <p><b>The First Lunch After Labor.</b>—Lunch will be next in order, + and that should consist of a clear soup,—chicken broth, mutton + broth, beef broth with a few Graham wafers or biscuits, and a cup of + custard or rice pudding. This will be the lunch for the two following + days also. The same precautions are to be observed in giving this as were + observed with breakfast and as will be observed with all other meals as + clearly stated before, and repeated again, so that no mistake may be + made. In the middle of the afternoon the patient can take a cup of beef + tea or a cup of warm milk.</p> + + <p><b>The First Dinner After Labor.</b>—Dinner will consist of more + broth, or a plate of clear consomme with a dropped egg, or a cereal, a + little boiled rice with milk, and stewed prunes, or a baked apple.</p> + + <p>After the bowels have moved, on the third day, and provided the + temperature and pulse have been normal since the confinement, the patient + can be put on an ordinary mixed diet, particulars regarding which are + given on page <a href="#page121">121</a> under the heading "Diet for the + nursing mother."</p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 111 --><span class="pagenum"><a name="page111"></a>[111]</span></p> + +<h3>CHAPTER IX</h3> + +<h3>CONFINEMENT INCIDENTS</h3> + +<blockquote class="b1"> + + <p><b>Regarding the Dread and Fear of Childbirth—The Woman Who + Dreads Childbirth—Regarding the Use of Anesthetics in + Confinements—The Presence of Friends and Relatives in the + Confinement Chamber—How Long Should a Woman Stay in Bed After a + Confinement?—Why Do Physicians Permit Women to Get Out of Bed + Before the Womb Is Back in Its Proper Place?—Lacerations, Their + Meaning and Their Significance—The Advantage of an Examination Six + Weeks After the Confinement—The Physician Who Does Not Tell All of + the Truth</b></p> + +</blockquote> + + <p><b>Regarding the More or Less Prevalent Dread or Fear of + Childbirth.</b>—Much has been written, and much more could be + written upon this subject. Inasmuch as this book is largely intended for + prospective mothers to read and profit thereby, and is not for physicians + and nurses whose actual acquaintance with confinement work would render + such comments superfluous, it will not be out of place to consider this + phase of the subject briefly, from a medical standpoint. When one + considers that "a child is born every minute" as the saying goes, and + which is approximately true, and at the same time remembers that + statistics prove, as near as can be estimated, that there is only one + death of a mother in twenty thousand confinements, it would really seem + as though we were "looking for trouble" to even regard the subject as + worthy of the smallest consideration. It is much more dangerous to ride + five miles on a railroad, or on a street car, or even take a two-mile + walk,—the percentage possibility of accident is decidedly in your + favor to stay at home and have a baby. Almost any disease you can mention + has a higher, a much higher fatality percentage than the risks run by a + pregnant <!-- Page 112 --><span class="pagenum"><a + name="page112"></a>[112]</span> woman. The real justification for actual + fear of serious trouble is so small that it barely exists. These are + facts that cannot be argued away by any specious if or and. Why, + therefore, should there be any real fear?</p> + + <p>Did you ever hear of the remarks made by a famous philosopher who was + given a dinner by his friends in celebration of his 85th birthday? In + replying to the eulogisms of his friends he said in part:</p> + + <p>"As I look back into those blessed years that have faded away, I can + recall a lot of troubles and many worries as well as much happiness and + pleasure, and thinking of it all this evening I can truthfully say my + worst troubles and worries never happened."</p> + + <p>So it is with the woman who for weeks or months has made her own life + wretched, and possibly the life of her husband and friends, the same in + imagining all kinds of dreadful things that never take place. It is + undoubtedly an exhibition of weakness, an evidence of failure in the + development of self-control. Childbirth is a natural process,—there + is nothing mysterious about it. If you do your part you have no cause to + fear,—the very fact, however, that you entertain a dread of it, + shows that you are not doing your part. One of the saddest parts of life, + one of the real tragedies of living, is the fact that most of us have to + live so long before we really begin to profit by our experiences. Could + we only be taught to learn the lesson of experience earlier, when life is + younger and hope stronger, we would have so much more to live for and so + many more satisfied moments to profit by. One of the most valuable + lessons experience can teach any human being is not to worry and fret + about the future. You can plant ahead of yourself a path of roses and be + cheerful, or you can plant a bed of thorns and reap a thorny reward. + Cultivate the spirit of contentment, devote all your energy to making the + actual present comfortable. Don't fret about what is going to bother you + next week, because, as the philosopher said, most of the troubles we + anticipate and worry about never occur, but the worry kills.</p> + + <p><b>Regarding the Use of Anesthetics in + Confinements.</b>—Anesthetics are as a rule given in all <!-- Page + 113 --><span class="pagenum"><a name="page113"></a>[113]</span> + confinements that are not normal. To make this statement more plain it + may be said, that, when it is necessary to use instruments, or to perform + any operation of a painful character, it is the invariable rule to give + anesthetics. As to the wisdom of giving an anesthetic when labor is + progressing in a normal and satisfactory manner, there is a difference of + opinion. Much depends upon the disposition of the patient and the + viewpoint of the physician in charge of the case. It is a fact that a + large number of confinements are easy and are admitted to be so, by the + patients themselves, and in which it would be medically wrong to give an + anesthetic. In a normal confinement, however, when the pains are + particularly severe and the progress slow, there is no medical reason why + an anesthetic could not be given to ease the pain. In these cases it is + not necessary to render the patient completely unconscious. Sufficient + anesthetic to dull each pain is all that is necessary, and as this can be + accomplished with absolute safety by the use of an anesthetic mixture of + alcohol, ether and chloroform, there can be no possible objection to it. + The use of an anesthetic, however, is a matter that must be left entirely + to the judgment of the physician as there are frequently good reasons why + it should not be given under any circumstances.</p> + + <p><b>The Presence of Friends and Relatives in the Confinement + Chamber.</b>—It is a safe rule to exclude every one from the + confinement room during the later stages of labor. Sometimes it is + desirable to make an exception to this rule in the interest of the + patient, by permitting the mother or husband to remain. If this exception + is made, however, they must be told to conduct themselves in a way that + will tend to keep the patient in cheerful spirits. They must not + sympathize, or go around with solemn, gloomy faces. Cheerfulness and an + encouraging word will tide over a trying moment when the reverse might + prove disastrous.</p> + + <p>Practically the same rule applies to the entire period of + convalescence during which time the patient is confined to bed. This is a + very important episode in a woman's life and the consequences may be + serious if it is misused in any way. Friends and relatives do not + appreciate the <!-- Page 114 --><span class="pagenum"><a + name="page114"></a>[114]</span> absolute necessity of guarding the + patient from small talk and gossip, and an unwitting remark may cause + grave mental distress, which may retard the patient's convalescence and + disastrously affect the quality and quantity of her milk, thereby + injuring the child.</p> + + <p><b>How Long Should a Woman Stay in Bed After a + Confinement?</b>—To answer this question by stating a specific + number of days would be wrong, because, few women understand the need for + staying in bed after they feel well enough to get up. If any answer was + given, it should be at least fourteen days, and it would be nearer the + truth medically to double that time. Let us consider what is going on at + this period. The natural size of the unimpregnated womb is three by one + and three-quarter inches, and its weight is one to two ounces. The + average size of the pregnant womb just previous to labor is twenty by + fourteen inches, and its weight about sixteen ounces. We have, therefore, + an increase of about 600% to be got rid of before it assumes again its + normal condition. This decrease cannot be accomplished quickly by any + known medical miracle. Nature takes time and she will not be hurried: she + will do it in an orderly, perfect manner if she is allowed to. The womb + will again find its proper location and will resume its work, in a + painless, natural way, in due time, if all goes well. The uterus or womb + is held in its place by two bands or ligaments, one on either side, and + is supported in front and back by the structures next to it. These bands + keep the womb in place in much the same way as a clothes pin sits on a + clothes line, and it will retain its proper place provided everything is + just right. After labor, it is large and top heavy. If you put a weight + on the top of a clothes pin as it sits on a clothes line, what will take + place? It will tilt one way or the other, and if the weight is heavy, it + will turn completely over. So long as the woman lies in bed the womb will + gradually shrink back to its proper size and place; if she sits up or + gets out of bed too soon, the weight of the womb, being top heavy, will + cause it to tilt and sag out of its true position. As soon as it does + this the weight of the bowels and other structures above will push and + crowd it further <!-- Page 115 --><span class="pagenum"><a + name="page115"></a>[115]</span> out of place. This crowding and tilting + interferes with the circulation in the womb and its proper contraction is + interfered with, and thus is laid the foundation for the multitude of + womb troubles that exist.</p> + + <p>It is a mechanical as well as a medical problem. Being partly + mechanical, it is subject to the rules that govern mechanical problems. + The importance of this dual process will be appreciated by considering + the following fact. Many medical conditions tend to cure or rectify + themselves because nature is always working in our behalf if we give her + a chance. Take for example an ordinary cold. You can have a very severe + cold and you can neglect it, and in spite of your neglect you will get + well. It is not wise to neglect colds, nevertheless, it is true that + nature will cure, unaided, a great many diseased conditions, if she has + half a chance. This, to a very large extent, is the secret of Christian + Science, yet the principle is known to everyone. A mechanical condition, + on the other hand, has absolutely no tendency to get well of its own + accord, or without mechanical aid. This is why Christian Science cannot + cure a broken leg. It is this principle that makes diseases of the womb + so persistent, and so stubborn of cure. When a womb once becomes slightly + displaced, the tendency always is for it to grow worse and never to cure + itself. The longer it lasts the worse it gets. Its cure depends upon + mechanically putting it back in place and holding it long enough there to + permit nature to reëstablish its circulation, and by toning and + strengthening it so that when the mechanical support is taken away it + will retain its position. There is no other possible way of doing it. Now + since it has been proved that nature takes many days to contract a + pregnant womb, a woman is taking a risk, and inviting trouble by getting + out of bed before that time.</p> + + <p><b>Why Do Physicians Permit Women to Get Up Before the Womb is Back in + its Proper Place?</b>—Without offering the excuse that a woman will + not stay in bed as long as a physician knows she should, there is, + however, a large degree of truth in this excuse. And we are of the + opinion that, if a physician made it a rule to keep all his confinement + cases in bed for one month, <!-- Page 116 --><span class="pagenum"><a + name="page116"></a>[116]</span> he would very soon find himself without + these patients.</p> + + <p>Experience has taught us, however, that it is safe, under proper + restrictions, and in uncomplicated confinements, to allow patients to sit + up in bed on the 12th and in certain cases on the 10th day, and to get + out of bed on the 12th or 14th day. When the patient is allowed to sit + up, out of bed, it should not be for longer than one or two hours, and + during that time she should sit in a comfortable rocking or Morris chair, + which should be placed by the side of the bed. Each day the time can be + lengthened, and the distance of the chair from the bed increased. This + procedure gives her the opportunity to walk a little further each day, + thereby to test her strength and ability to use her limbs. On the fourth + day, if all has gone well, she may stay up all day and she may walk more + freely about the room. She should be just to herself, however. As soon as + she is fatigued she should not make any effort to try to "work it off." + When a feeling of fatigue appears she should rest completely. If she has + any pain or distress she should acquaint the physician with it at once. + She should not try to hide anything on the mistaken idea that "it isn't + much." She does not know, and she is not supposed to know what the pain + may mean; it may be exceedingly significant. Many women have saved + themselves needless suffering, and their husbands unnecessary expenditure + of money, by calling the physician's attention to conditions, which in + time would have been serious, and would have necessitated long, expensive + treatment.</p> + + <p><b>Lacerations During Confinement, Their Meaning and Their + Significance.</b>—The only interest a laceration or a tear has to a + physician, is whether the laceration or tear is of sufficient importance + to need surgical interference. The laceration can take place at the mouth + of the womb, or on the outside, between the vagina and rectum.</p> + + <p>Those of the mouth of the womb always take place, in every + confinement, to some degree. They are never given any attention at the + time of the confinement, unless under extraordinary circumstances, such + as a more or less complete rupture of the womb, and this is such a <!-- + Page 117 --><span class="pagenum"><a name="page117"></a>[117]</span> rare + accident that most physicians practice a lifetime and never see or hear + of one single case. Those on the outside are always attended to + immediately after labor, or should be, unless they are very extensive and + the patient is not in condition to permit of any immediate operative + work. In such a case it is best to leave it alone until the patient is in + condition to have it operated on at a later date.</p> + + <p>It is distinctly preferable to have it attended to immediately after + labor when it is possible, and it is possible in a very large percentage + of the cases. The explanation of this is because it is practically + painless then, owing to the parts having been so stretched and bruised + that they have little or no feeling. If it is left for a day or two and + then repaired, it will be more painful, because the parts will have + regained their sensitiveness. Another good reason in favor of immediate + repair is that a much better and quicker union will take place than if + postponed.</p> + + <p>When a patient is torn, but not to the degree necessary to stitch, it + is to her advantage to be told to lie on her back and keep her knees + together for twelve hours, thus keeping the torn edges together and at + rest, thereby favoring quick and healthy repair of the tear. Some + physicians go as far as to bind the patient's knees together so she + cannot separate them during sleep.</p> + + <p>It is the custom of every conscientious physician to request every + woman he confines to report at his office six or eight weeks after labor. + The reason for this is to find out by examination the character and + extent of the lacerations of the mouth of the womb. No physician can tell + at the time of labor just how much damage has been done, because the + mouth of the womb, at the time of labor, is so stretched and thinned out, + that it is impossible to tell. After the womb has contracted to about its + normal size, it is a very simple matter for any physician to tell exactly + the character and extent of the lacerations. Most of these tears need + absolutely no attention; there are a few however that do. This is a very + important matter for two very good reasons.</p> + + <p>1st. Every woman should know, and is entitled to <!-- Page 118 + --><span class="pagenum"><a name="page118"></a>[118]</span> know, just + what condition she is in, because if she has been torn to an extent that + needs attention, and is left in ignorance of it, her physical health may + be slowly and seriously undermined and the cause of it may not be + understood or even guessed at. A woman who becomes nervous and irritable, + loses vim and vitality, has headaches, backaches and anemia, and no + symptoms, or few, that point to disease of the womb, will suffer a long + time before she seeks relief of the right kind, and will be astonished + and outraged when she is told that it all results from a bad tear of her + womb that she knew nothing about.</p> + + <p>2nd. A physician should in justice to himself insist on this late + examination, because if a woman is told, at some subsequent time, by + another physician that she is badly torn, and she was not told of it by + the physician who confined her, she is very apt to form an unjust opinion + of his work and to entertain an unfriendly feeling toward him as a + man.</p> + + <p>Some physicians also, to their discredit, are not slow in permitting + an unjust opinion of a colleague to be spread around, by preserving a + silence, when an explanation would result in an entirely different + opinion by the patient. They permit it to be inferred that the physician + was responsible for the tear, when such is not the case. No physician on + earth can prevent a tear of the mouth of the womb and this should be + explained to the patient. Where the physician is at fault is in the + failure to examine his patients when it is possible to tell that a tear + of any consequence exists. If such an examination is made, he is in a + position to state that a tear exists of sufficient extent to justify + careful attention. Immediate operation is seldom necessary, and if the + patient is comparatively young, it may not be wise to operate, because if + pregnancy takes place within a reasonable time the womb will again tear. + She should be told, however, that should she not become pregnant during + the next three years she should be examined from time to time, and if the + condition of her womb, or her health suggest it, she should have the tear + attended to. If after this explanation she neglects herself she must + blame <!-- Page 119 --><span class="pagenum"><a + name="page119"></a>[119]</span> herself, she will at least have no cause + to harbor any resentment against her physician who has done all any + physician is called upon to do under the circumstances. Another important + reason for finding out the character of the laceration is because these + lacerations of the mouth of the womb frequently cause sterility.</p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 121 --><span class="pagenum"><a name="page121"></a>[121]</span></p> + +<h3>CHAPTER X</h3> + +<h3>NURSING MOTHERS</h3> + +<blockquote class="b1"> + + <p><b>The Diet of Nursing Mothers—Care of the Nipples—Cracked + Nipples—Tender Nipples—Mastitis in Nursing + Mothers—Inflammation of the Breasts—When Should a Child Be + Weaned?—Method of Weaning—Nursing While + Menstruating—Care of Breasts While Weaning Child—Nervous + Nursing Mothers—Birth Marks—Qualifications of a Nursery + Maid.</b></p> + +</blockquote> + + <p><b>The Diet of Nursing Mothers.</b>—A nursing mother should eat + exactly the same diet as she has always been accustomed to before she + became pregnant. If any article of diet disagrees with her she should + give up that particular article. She should not experiment; simply adhere + to what she knows agreed with her in the past. More, rather than less, + should be taken, especially more liquids as they favor milk-making. It is + sometimes advisable to drink an extra glass of milk in the mid-afternoon + and before retiring. If milk disagrees, or is not liked, she may take + clear soup or beef tea in place of it. In a general way milk in + quantities not over one quart daily, eggs, meat, fish, poultry, cereals, + green vegetables, and stewed fruit constitute a varied and ample dietary + to select from.</p> + + <p>Every nursing mother should have one daily movement of the bowels; she + should get three or four hours' exercise in the open air every day; and + she should nurse her child regularly.</p> + + <p>The diet of the nursing mother during the period immediately after + confinement is given elsewhere.</p> + + <p>Alcohol, of all kinds, should be absolutely avoided during the entire + period of nursing.</p> + + <p>Drugs of every variety, or for any purpose, should never be taken + unless by special permission of her physician.</p> + + <p><b>Care of the Nipples.</b>—As soon as the mother has had a good + sleep after the confinement the nipples should be <!-- Page 122 --><span + class="pagenum"><a name="page122"></a>[122]</span> washed with a + saturated solution of boracic acid, and the child allowed to nurse. The + milk does not come into the breast for two or three days, but the child + should nurse every four hours during that time. There is secreted at this + time a substance called colostrum. This is a laxative agent which nature + intends the child should have as it tends to move the bowels and at the + same time it appeases the hunger of the infant. It also accustoms the + child to nursing and gradually prepares the nipples for the work ahead of + them.</p> + + <p>After each nursing the nipples should be carefully washed with the + same solution and thoroughly dried.</p> + + <p><b>Cracked Nipples.</b>—Cracked nipples often result from lack + of care and cleanliness. If they are not cared for as described above + they are very apt during the first few days to crack. They should never + be left moist. They should be washed and dried after every feeding. If + the breasts are full enough to leak they should be covered with a pad of + sterile absorbent gauze.</p> + + <p>Nursing mothers should guard against cracked nipples, as they are + exceedingly painful; frequently necessitating a discontinuance of + nursing; and may produce abscess of the breast.</p> + + <p><b>Treatment of Cracked Nipples.</b>—In addition to washing the + nipples, drying them thoroughly, and placing a pad of dry gauze over them + after each feeding, they should be painted with an 8 per cent. solution + of nitrate of silver twice daily. Before the next feeding, after the + silver has been used, they should be washed with cooled boiled water. If + the cracks are very bad it may be necessary to use a nipple-shield over + them while nursing for a few days.</p> + + <p><b>Tender Nipples.</b>—Many women complain of the pain caused by + the baby when it is first put to the breast. These nipples are not + cracked, they are simple hypersensitive. They should be thoroughly + cleansed and dried as above and painted with the compound tincture of + benzoin. They should be washed off with the boracic acid solution before + each feeding. After a few days under this treatment the tenderness will + leave them.</p> + + <p><b>Mastitis in Nursing Mothers.</b>—When inflammation of <!-- + Page 123 --><span class="pagenum"><a name="page123"></a>[123]</span> the + breast takes place in a nursing mother it is the result of exposure to + cold, or it may result from injury. If infection occurs and an abscess + develops, it results from the entrance, through the nipples, or cracks, + or fissures in the nipple, of bacteria into the breast. There is fever, + with chills and prostration, and very soon it is impossible to nurse the + child because of the pain. Nursing should be immediately discontinued, + the breast supported by a bandage and the milk drawn, with a breast pump, + at the regular nursing intervals. An ice-bag should be constantly applied + to the painful area and the bowels kept freely open with a saline + laxative. When the fever and the pain subside nursing may be resumed.</p> + + <p>If the gland suppurates in spite of treatment it must be freely opened + and freely drained.</p> + +<h4>WEANING</h4> + + <p><b>When to Wean the Baby.</b>—Medically there is no exact time + at which the baby should be weaned. Certain conditions indicate when it + should be undertaken. It is desirable to wean the baby between the tenth + and twelfth months. A month or two one way or another will not make much + difference if the mother and child are in good condition. It should be + weaned between the periods of dentition rather than when it is actively + teething. The time of year is important. It would be better to wean it + before the hot weather if it is strong and has been accustomed to taking + other food than the breast milk. On the other hand it would be decidedly + better to defer the weaning until the fall, rather than risk weaning at + the tenth or twelfth months if these fall during the height of the hot + weather.</p> + + <p><b>Methods of Weaning.</b>—The best way to wean is to do it + gradually. It is not desirable to take the mother's milk away suddenly + unless there is a very good reason for it. The child should be fed small + portions of suitable other food at the beginning of the tenth month. By + the end of the tenth month he should be taking a feeding two or three + times a day of food other than the breast milk. This feeding may be given + in a bottle. In some cases <!-- Page 124 --><span class="pagenum"><a + name="page124"></a>[124]</span> the mother may be able to feed the child + with a spoon instead of the bottle. The substitute feedings allowable at + this age are given in another chapter.</p> + + <p><b>Times When Rapid Weaning is Necessary.</b>—There are times + when the child must be weaned suddenly, as, for example, at the death of + the mother, serious sickness of the mother, or in cases where for any + cause the mother suddenly loses her milk. In these cases it is best to + wean at once. If an infant refuses to take the bottle under such + circumstances, the best plan to adopt, and the wisest one in the long + run, is to starve the child into submission. If he gets absolutely + nothing but the bottle he will shortly take it without protest. If a + meddling individual attempts to feed the child some other food and tries + to coax it to take the bottle in the meantime, much harm may result; it + is safe only to fight it out for a day or two and win than to half starve + the child and lose in the end.</p> + + <p>The child should be weaned if it is not gaining in weight. This may + indicate a deficient quality of the mother's milk, or it may indicate a + lack of proportion between the child and mother. If a robust child is + depending upon the nourishment furnished by a mother who is not in good + physical condition the milk may not be adequate in quality and quantity. + The child will not therefore develop normally and it may be necessary to + wean it.</p> + + <p>If the mother becomes pregnant it will be necessary to wean, because + pregnancy invariably affects the quality of the milk. It is a very good + habit to accustom the child to take its daily supply of water from a + bottle from a very early age. This procedure will make it easier to wean + at any time.</p> + + <p>Menstruation is not an indication for weaning as has been explained. + If, however, the return of menstruation affects the milk so that it + disagrees with, or fails to satisfactorily nourish the child, it may be + necessary to wean, but not unless.</p> + + <p>The best reason for weaning a child at the twelfth month is that a + mother's milk after that time is not adequate in quality for a child of + that age. A child at one year of age has grown beyond the capability of + its <!-- Page 125 --><span class="pagenum"><a + name="page125"></a>[125]</span> mother to nurse it: nature demands a + stronger and a more substantial food than any mother can supply. A mother + who nurses her child beyond that period is not only injuring herself, but + she is cheating her child. The exception to this rule is, as has been + explained, the second summer.</p> + + <p>The child will evidence its dissatisfaction with the breast supply if + it is not enough; it will not gain in weight, it will be irritable and + fretful, it will tug long and tenaciously at the nipple, it will be + unwilling to cease nursing after it should have finished, and it will + drop the nipple frequently with a dissatisfied cry. These are all signs + of insufficient nourishment, and to the observant mother they will at + once indicate that the child must be weaned and fed upon a mixed + diet.</p> + + <p><b>Care of Breasts While Weaning Child.</b>—The process of + weaning should cause little or no discomfort. If the weaning is gradual + it is necessary to press out enough milk to relieve the tension from time + to time. It usually takes three or four days.</p> + + <p>If it is necessary to wean abruptly, as it is occasionally, there may + be considerable distress. In these cases it is necessary to massage the + breasts completely,—until all the milk is out, or as much as it is + possible to get out,—then rub the breasts with warm camphorated + oil, and bind them firmly. When the breasts are massaged for any reason, + the rubbing should be toward the nipple and it should be done gently. If + there are any hard lumps, or caked milk, in the breasts, they must be + massaged until soft, and the binding renewed. It may be necessary to + repeat this process for a number of days. In binding the breasts use a + large wad of absorbent cotton at the sides, under the arms, to support + the breasts, and another wad between the breasts. This renders the + binding more effective; permits the binder to be put on tighter; and + prevents it from cutting into the skin. When weaning has to be done + quickly the patient should absolutely abstain from all liquids. A large + dose of any saline, Pluto, Apenta, or Hunyadi Water, or Rochelle salts, + or Magnesium Citrate, should be given every morning for four or five + days. <!-- Page 126 --><span class="pagenum"><a + name="page126"></a>[126]</span></p> + + <p>If the weaning is gradually undertaken the child should be allowed to + nurse less frequently. One less nursing every second day until two + nursings daily are given. Keep the two daily nursings up for one week and + then discontinue them, after which the above measures may be adopted. To + dry the milk up, the breasts may be anointed with the following mixture: + Ext. Belladonna, 2 drams; Glycerine, 2 ounces; Oil of Wintergreen, 10 + drops.</p> + + <p><b>Nervous Nursing Mothers.</b>—Nervousness, considered not as + the product of a diseased condition, but as a temperamental quality, is + an unfortunate affliction in some nursing mothers. Let us illustrate just + how this characteristic is detrimental to the helpless baby. A mother was + instructed to give her baby a half teaspoonful of medicine one-half hour + after each feeding. She was told how to give it, and how to hold the baby + when giving it. She was also told that the baby would not like it, and + would try to eject it from its mouth rather than swallow it, and that + when it did swallow it, it would make a little choking noise in its + throat, but not to mind these, to go ahead and give it, as the baby could + not strangle or choke. It was essential to give the baby this medicine, + and hence the physician explicitly instructed her in these details. What + was the result? On the following day when the physician called, and found + the baby much worse, the mother said: "Oh, doctor! I couldn't give the + medicine, the baby wouldn't take it, she nearly strangled to death when I + tried to give it." The physician asked for the medicine and placing the + baby over his knee, gave it without the slightest trouble, much to the + mother's amazement. The servant girl who was a hard-headed, cool, Scotch + girl, was instructed and shown how to give the medicine, which she did + successfully. The mother was temperamentally nervous, was easily excited + and became helpless the moment the baby objected, though she was a + strong, robust, healthy woman.</p> + + <p>Another mother was carefully instructed to drop into the eye of her + baby two drops of medicine every four hours. She was told and apparently + appreciated the <!-- Page 127 --><span class="pagenum"><a + name="page127"></a>[127]</span> urgent necessity of the medication as her + baby's eye was badly infected. She was further told that if she did + exactly as shown, the eye would be better in two or three days, and if + she did not, the other eye would become infected, and blindness might + result. She undertook to carry out the directions faithfully. She + absolutely failed, however, to carry out the instructions. Her husband + informed the physician on the following day that she became so nervous + and excited that she utterly failed to treat the eye once, and when he + and a sister offered their assistance she became so unreasonable in her + fear that "they might hurt the baby" that it was impossible to do + anything with her. Her sister was finally shown how to do it and carried + the case through quite successfully.</p> + + <p>Inasmuch as this book is intended to convey helpful instruction to + every mother, the author would suggest to those of this type the + necessity of resisting this tendency. It is a matter of will power, just + make up your mind not to be silly and if you find that you cannot trust + yourself to follow instructions, let someone else do it. When the + physician tells you a certain thing must be done, and that no harm can + result, do it, and don't imagine all kinds of impossible happenings.</p> + + <p>So much anguish and <ins class="correction" title="'anoyance' in original" + >annoyance</ins> is caused in this world by imagining and anticipating + trouble, that half the pleasure of life is denied us. You cannot do your + whole duty by a helpless baby if you do not reason and act upon sound + judgment. Many babies are lost by mothers being afraid to do what should + be done, and what they know should be done. It is not what the doctor + does that brings a baby through a dangerous sickness; it is the + faithfulness of the nurse in carrying out his instructions that is + responsible for the outcome. A timid, halting, doubting nurse can quickly + undo all a physician hopes to accomplish; while a prompt, faithful nurse, + with initiative, and good judgment, can save a little life in a crisis, + even in the absence of the physician. Follow instructions implicitly, + even though the carrying out of the instructions seem to cause the baby + pain and suffering,—it is for the baby's best interest.</p> + +<p><!-- Page 128 --><span class="pagenum"><a name="page128"></a>[128]</span></p> + + <p><b>Birth Marks.</b>—Much has been written on this subject which + a later study of biology and eugenics have shown to be utterly false. Let + us consider the actual facts. The baby is already a baby, floating in a + fluid of its own manufacture. It has absolutely no connection with its + mother except by means of its umbilical cord,—which is composed of + blood vessels. The blood in these vessels is the child's blood and never + at any time does it even mix with the blood of the mother. It is sent + along these vessels into the placenta, or after-birth, in which it + circulates in small thin vessels, so close to the mother's blood that + their contents can be interchanged. Yet the two streams never actually + mix. The carbonic acid and waste products, in the child's blood, are + taken up by the mother's blood, and given in exchange oxygen and food, + which is returned to nourish the child. There is absolutely no nervous + connection between the mother and the child. How then is it possible for + the mother to affect her child in any way except insofar as the quality + of its nourishment is concerned? Nor can a mother affect her child in any + other sense. If the intermingling of blood could affect a child's + education we would frequently resort to surgery. In the article on + Eugenics, under the heading, "Education and Eugenics," it is explained + that the child is "created" at the moment of conception; that absolutely + nothing can affect it after it is created; that no influence of the + mother or father can in any way affect it for better or worse. A mother + cannot create in her child any quality which she may desire no matter how + she conducts herself. It was formerly thought that a mother could for + example create a musical genius by devoting all her time to the study of + music while she carried the unborn child; or that she could make a + historian of it if she studied history; or an artist if she studied + paintings. We now know this to be wholly wrong and for very excellent + reasons.</p> + + <p>The mother must realize that the only aid she can bestow upon her + unborn child is to give it the best possible nourishment. She must + provide good blood because the quality of the maternal blood stream + bespeaks a healthy or unhealthy, a fit or unfit, child. Whatever the <!-- + Page 129 --><span class="pagenum"><a name="page129"></a>[129]</span> + child is to be is already fixed, its innate characteristics art part of + itself. Whether it will have the vitality to develop its inherent + possibilities depends, to a great degree, upon its intra-uterine + environment,—and its intra-uterine environment depends upon the + health of its mother and the quality of the blood she is feeding it upon. + After birth its health, its success, its efficiency, depends upon the + care it gets and the quality of its mother's milk. A mother therefore + must be in good physical and mental health if she hopes to do her full + duty as a mother.</p> + + <p><b>Qualifications of a Nursery Maid.</b>—When a helper, or maid, + is employed to aid in caring for the baby, much precaution should be + exercised in selecting her. The association of the nursery maid and the + child, is necessarity an intimate one, and she should be willing to + submit to a medical examination to prove her physical fitness. Her lungs + should be examined thoroughly, so also should the condition of her mouth, + throat and nose be known. An observant and tactful mother will also find + out if there are any other objectionable conditions existing, which would + render her unfit for the position. A nursery maid should be naturally + fond of children, she should be industrious, and sensible; of quiet + tastes and good disposition. Her work should be a pleasure not a + task.</p> + + <br clear="all" /> +<hr class="full" /> + +<p><!-- Page 131 --><span class="pagenum"><a name="page131"></a>[131]</span></p> + +<h3>CHAPTER XI</h3> + +<h3>CONVALESCING AFTER CONFINEMENT</h3> + +<blockquote class="b1"> + + <p><b>The Second Critical Period in the Young Wife's Life—The + Domestic Problem Following the First Confinement.</b></p> + +</blockquote> + + <p>The first three or four months following the first confinement is the + second important period in the young wife's life. In one sense it is the + most critical period. The first important period you will remember we + stated to be the first few months after marriage. During these months the + young wife passed through the period of adaptation. She found out that + matrimony was not all sunshine and happiness. She learned that her + husband was not the paragon she had idealized. She discovered his human + side. She met daily trials and annoyances incident to domestic life. She + found her level, and, in finding it, she discovered herself. She is not + very safely anchored yet but she is trying to succeed and the future + promises well. Some day she awakes to the knowledge that she is pregnant + and a multitude of new speculations enter into the situation. She finds + she must go on striving and hoping and praying that she may have the + strength and courage to do her part. Time passes, and if she is an + ordinary woman she scarcely does justice to herself. Her duties are + exacting, and her physical condition is not given the study and care + which she ought to give it. She does not understand the importance of the + hygiene of pregnancy, and the day of the confinement finds her more or + less exhausted, and worn out. She passes through the crisis of maternity, + however, and spends the customary ten days in bed. At the end of that + period the nurse and physician leave her to face the most important + problem of life alone. She is a mother, and has in her exclusive charge a + human life.</p> + + <p>Let us exactly understand what the real situation is. It would not + further the object of this book or help in the solution of the problem + the author has in mind to depict <!-- Page 132 --><span + class="pagenum"><a name="page132"></a>[132]</span> a false situation. We + must concede the following facts to be true, if we understand the + subject:</p> + + <p>1. That the mothers of the human race are, in the vast majority, the + poor.</p> + + <p>2. That they are uneducated in the sense that they are not versed in + the science of hygiene and sanitation, and consequently health + preservation.</p> + + <p>3. That even the fairly well educated are innocently ignorant of the + science of heredity, environment, hygiene, sanitation and health + preservation.</p> + + <p>4. That to benefit the majority we must depict conditions as they + exist among the poor, and reason from that standard.</p> + + <p>Such books as have been written on this subject have based their facts + upon too high a plane. Their remedies are beyond the means and the + understanding of the average poor mother. Their analogies are based upon + conditions that exist among the better class. The average poor housewife + gets no practical assistance or help from their deductions, because her + environment precludes any utilization of the data furnished; the data is + not practical in her particular case.</p> + + <p>Our young mother is in all probability a physically and mentally + immature girl. She most likely entered the marriage relationship without + a real understanding of its true meaning, or even a serious thought + regarding its duties or its responsibilities. She was not taught the true + meaning of motherhood before actual maternity was thrust upon her. She + has probably innocently acquired habits which are detrimental to her + health and her morals; and she has no conception of the fundamental + duties of a homemaker. Yet into the keeping of this woman a human life + has been given.</p> + + <p>Her home surroundings are not such as to inspire confidence or from + which to elicit encouragement. It has been a struggle to make ends meet; + to keep the peace; to be hopeful and cheerful. If she has succeeded in + keeping her home neat and clean and comfortable, it has been at the + expense of her not too robust constitution. If she has made efforts to + observe the amenities of life, to be true as wife, companion and + confidant, it <!-- Page 133 --><span class="pagenum"><a + name="page133"></a>[133]</span> has taxed her nerves, her courage and her + vitality. She has frequently been at the breaking point but she has kept + up because she felt it was her duty, and because there was nothing else + to do.</p> + + <p>As she rests from her weary labor during the first long days after + getting out of bed, the loneliness of it all crushes her. She is weak, + nervous, and discouraged, and her white, wan face, with its tired, + appealing eyes, bespeaks her anemic and hopeless condition. She is only a + child herself, yet fate has crowned her with the holy diadem of + motherhood. There are thousands of such mothers and yet posterity need + not despair. This is just the beginning, and from such beginnings have + sprung the heroes of the race. If the reader has carefully read the + chapter on Heredity she will understand that the temporary condition of + this mother is not important so far as the destiny of the child is + concerned. The really important question is, How will this mother + develop? The environment of the child depends upon the conditions with + which its mother surrounds it. If she is a failure, the child's + environmental influences will be unfavorable; if she proves worthy of her + trust, if she progresses and masters her difficulties; if she is a good + mother and a good homemaker the child's surroundings and influences will + be favorable to the full development of its hereditary endowment. But it + must be remembered that even an unfavorable environment need not prevent + the hereditary promise from dominating the life of the individual.</p> + + <p>To return to our girl mother, upon whose slender shoulders the weight + of a great responsibility rests,—we wish to concede that her burden + is great. Her home duties are rendered more onerous because of her + physical weakness and disability. The strain of nursing her fretful child + is taxing her vitality and her nerves to the limit. Her disposition is + imposed upon by the exactions of an uncomprehending husband. She is + inclined to fretfulness and melancholia by the seeming uncharitableness + of fate and fortune. Her moments of introspection are almost bitter. It + is a critical period,—she has reached the breaking point. <!-- Page + 134 --><span class="pagenum"><a name="page134"></a>[134]</span></p> + + <p>Such moments are apt to be epochal. The turning of the wheel of + fortune will decide the destiny of a human soul.</p> + + <p>It may be a friend who will supply the needed inspiration that will + revitalize hope, and courage, and the determination to succeed. Or it may + be a prayer, breathed in the silence of despair that will inspire the + courage to fight on, and change the complexion of life.</p> + + <p>Once again we would advise such a young wife to calmly think matters + over; to find out "what she is working for"; to assemble her ideals and + to "know what she wants." There is nothing organically wrong. It is a + condition, not a disease. She is discouraged, despondent, nervous and + weak. The discouragement, despondency, and nervousness is a result of + reduced physical vitality and lack of system. She is not efficient + because she is not a trained worker. She is easily discouraged because + anemia or bloodlessness fails to supply the oxygen necessary to a fight. + There is no period in a woman's life when she is more apt to fall into a + rut than at this time. Every element, spiritual and physical, which is + necessary to stagnation and indifference is present, and it will take a + bold and brave effort to resist the temptation to failure which has + encompassed her.</p> + + <p>How can we suggest a remedy? She must first regain her health. She has + simply a condition to combat, not a disease, and a definite system, a + well laid out plan strictly adhered to will effect the result. She must + regain her health, because, without health, she cannot hope to be + efficient in work or agreeable in disposition, and she owes both to + herself, to her husband and to her child. She must get out of doors. She + must walk in the open air. There is absolutely nothing in life that will + effect so miraculous a transformation in a discouraged, tired, weary and + sick woman, as systematic daily walks in the open air. She must walk + briskly, however, and she must desire to get well. We cannot get well if + we do not wish to get well. One who walks with a purpose will walk erect, + firmly and briskly; she will hold her chest up, and will breathe deeply, + and she will drink in hope, and health, and happiness. It takes time to + regain strength after <!-- Page 135 --><span class="pagenum"><a + name="page135"></a>[135]</span> the strain of pregnancy and labor. Many + women complain that they feel weak and do not regain strength quickly, + but they make no effort. They must make a beginning. Sitting around + waiting for it to come will not bring it. If they cannot walk a mile, + they must walk half that distance to begin with; the five mile walk will + follow in time. Many young mothers get into the habit of taking baby out + in his carriage for an airing, and regard this as exercise for + themselves. They join the baby brigade and parade up and down the block, + or select a sunny spot where there are others on a like quest, and sit + around exchanging confidences. These outings usually degenerate into + gossiping parties and are a dangerous and questionable practice. They are + no doubt good for the baby, but they are morally and physically bad for + the young mother. This daily habit is called exercise, but it is in no + sense physical exercise. The young mother should select a certain time + each day, immediately after a nursing when baby is likely to sleep, and + devote this period to walking. One hour each day will accomplish much in + regaining and establishing health and strength, and appetite for the + mother. No indoor work can take the place of a walk out of doors. It is a + duty on the part of the nursing mother to do this. It will enable her to + supply better milk; it will banish her tendency to nervousness; it will + ensure a good appetite, good spirits, and sound sleep. It will make her a + better mother and a better wife. Many young wives sow the first seeds of + discontent, and ultimate failure during the natural depression that + follows maternity.</p> + + <p>She must adopt system in the performance of her household duties. A + good plan is to set aside a certain definite time for meals, when to + begin cooking and when to end washing the dishes. Then arrange regarding + the general household duties. Make a schedule for a week devoting each + day to a certain task so that at the end of the week all the essential + work will have been completed. By systematizing work in this way a great + deal of ground can be covered and as time passes it will become easier, + as many helpful ways will suggest themselves whereby time will be + economized. <!-- Page 136 --><span class="pagenum"><a + name="page136"></a>[136]</span></p> + + <p>Adopt a system with the baby. Many mothers are worn-out, nervous + wrecks for no other reason than a lack of system in the management of the + daily life of their offspring. If system is not adopted in feeding and + caring for an infant it becomes irritable. To a sick, tired, weary mother + an irritable child is an unspeakable torture. Begin right. Give it + adequate, but no unnecessary attention. Nurse it every two hours, and at + no other time. Wake it to nurse at its regular time. It will in a few + days acquire the habit of feeding regularly and will sleep between + feedings. Do not overfeed it. Remember babies never die from starvation, + but many do by overkindness, and overfeeding is the most prolific cause + of infant mortality known. Read the article on "How long should a baby + nurse?" Keep the baby clean, comfortable and happy and you will not have + a fretful child, but one that will be a constant inspiration and + incentive to you.</p> + + <p>Find time to rest, take a mid-day nap. Get off occasionally to the + country or the sea shore for a day or two. Keep up your interest in your + personal appearance, be neat and clean, and invite the attention of your + husband during the evening hour. Don't let him grow away from you. Be + cheerful, encourage him to tell of his hopes and plans, and show an + interest in his health and in his work. Do not forget the dominating + influence on your efficiency, and on your happiness which the study habit + possesses. Interest yourself in some art, cultivate your mind, and soon, + sooner than you think, you will have forgotten your troubles and you will + have regained your health.</p> + + <p>There is no other way to do it. There is no royal way in which it can + be done which is not open to the poorest mother.</p> + + <p>An ocean voyage, a trip to Europe, a society Doctor, a professional + masseur, beauty experts and miracle workers cannot accomplish more than + you can in your poor apartment, if you "go about it in the right way and + in the right spirit." Keep in mind always, that: "failure exists only in + acknowledging it." Every task that is worth while is won by + self-sacrifice, by self-abnegation, by patient, persistent, enthusiastic + effort, and in no other way. The joy of consummation is reward enough for + all human sacrifice.</p> + + + + + + + + +<pre> + + + + + +End of the Project Gutenberg EBook of The Eugenic Marriage, Volume I. (of +IV.), by W. 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