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diff --git a/24001.txt b/24001.txt new file mode 100644 index 0000000..01367be --- /dev/null +++ b/24001.txt @@ -0,0 +1,13275 @@ +Project Gutenberg's The Physical Life of Woman:, by Dr. George H Napheys + +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 Physical Life of Woman: + Advice to the Maiden, Wife and Mother + +Author: Dr. George H Napheys + +Release Date: December 24, 2007 [EBook #24001] + +Language: English + +Character set encoding: ASCII + +*** START OF THIS PROJECT GUTENBERG EBOOK THE PHYSICAL LIFE OF WOMAN: *** + + + + +Produced by Joseph R. Hauser, Marcia Brooks and the Online +Distributed Proofreading Team at http://www.pgdp.net + + + + + + + + + +THE PHYSICAL LIFE OF WOMAN: + +ADVICE TO THE MAIDEN, WIFE AND MOTHER. + + + + +PUBLISHERS' NOTICE. + + +The extraordinary popularity achieved and maintained by Dr. GEO. H. +NAPHEYS' _Physical Life of Woman_, places it beyond question among the +classics of the English language. Convinced of its high literary as well +as medical value, the present publishers have spared no pains or expense +to place it before the public in the most attractive style. + +The _text_ has been most carefully revised and rewritten by the eminent +author himself; extensive additions of important matter the fruit of +three more years devoted to the study of the subject and the wants of +readers, have been incorporated. In type, paper and binding, the most +appropriate materials have been selected. And, to satisfy the repeated +requests of purchasers, permission has been obtained from the author to +insert his portrait, engraved on steel by one of the most skilful London +artists. + +With these additions, the _Physical Life of Woman_ comes before the +public with all the novelty and freshness of a new book, and also with +the solid and substantial reputation for practical worth which its sales +of nearly _fifty thousand_ copies a year for _three_ years guarantee to +it. + +We add a + + +SYNOPSIS OF THE BOOK. + +It treats of woman in her three great positions in life, as the MAIDEN, +the WIFE, and the MOTHER. + +Under the first of these is discussed the mysterious change she +undergoes when ripening from the indifferent girl to the tender and +sensitive virgin. The dangers she runs at this critical epoch are +carefully noted, and the rules to prevent and remedy them clearly set +forth. The all-absorbing topic of _Love_, is next treated of in a pure +and elevated style, but strictly from the physician's point of view, and +many salutary hints are given to direct the passion to noble ends and in +proper channels, and to teach the youthful reader how to shun +unfortunate unions. + +In the part addressed to _Wives_ the health of the married couple is +first considered as being essential to their happiness. Plainly, yet +delicately, the rules that should govern them are laid down; the absence +of children and their excessive numbers are both mentioned, as requiring +appropriate correction, and an unsparing hand is laid upon certain +prevalent social vices. A full discussion of the important topic of the +inheritance of physical and mental traits will be found, and two most +thorough and practical chapters on Pregnancy and Confinement are added, +most invaluable to every young wife. + +The duties of the _Mother_ are next set forth, in nursing her child, and +taking proper care of it, in training its budding powers, and also in +giving her own attention to it in some of the more common diseases to +which children are subject. + +The sections devoted to _Health in Marriage_ will be peculiarly welcome +to many women suffering in health from they know not what exact cause, +but really from some of those inward or local weaknesses which are here +described. While to very many others who are approaching or about +passing through the critical epoch of the _Change of Life_, the full and +well-considered views of the author in the part devoted to that period +will be read with benefit and gratitude. + +A carefully prepared Index and a copious list of authorities close the +volume. + + +[Transcriber's Note: In the Biographical Sketch section, an "a" with a +macron has been marked as [=a] in this file.] + + + + +THE +PHYSICAL LIFE OF WOMAN: +ADVICE TO THE +MAIDEN, WIFE AND MOTHER. + +by +GEORGE H. NAPHEYS, A.M., M.D. + +MEMBER OF THE PHILADELPHIA COUNTY MEDICAL SOCIETY; CORRESPONDING MEMBER +OF THE GYNECOLOGICAL SOCIETY OF BOSTON; LATE CHIEF OF MEDICAL CLINIC OF +THE JEFFERSON MEDICAL COLLEGE; AUTHOR OF "THE TRANSMISSION OF LIFE," +"THE PREVENTION AND CURE OF DISEASE," "MODERN MEDICAL THERAPEUTICS," +"LETTERS FROM EUROPE," ETC. + + +"Je veux qu'une femme ait des clartes de tout."--Moliere. + +New Edition. + +WITH THE FINAL CORRECTIONS OF THE AUTHOR, AND A BIOGRAPHICAL SKETCH. + +PHILADELPHIA: +DAVID McKAY, PUBLISHER, +23 SOUTH NINTH STREET. +1889. + + +Entered according to Act of Congress, in the year 1878, BY D. G. +BRINTON, in the Office of the Librarian of Congress, at Washington. All +rights reserved. + + + + +EDITOR'S PREFACE. + + +In presenting a third edition of this work to the public, with the final +changes and improvements of the author, the publishers have felt it a +duty to attach to it a brief sketch of his life, which drew to so early +and lamented a termination. The whole has also been submitted to a +careful revision, in order that it might be brought down to the latest +advances in the department of science of which it treats, and also to +include in it the final suggestions of the author. + +While Dr. Napheys evidently considered the second edition of the present +work as meeting closely the requirements of readers, and therefore left +behind him no notes which would alter the general plan, a number of +corrections and minor changes have been made in the text, various +paragraphs have been materially modified, and the Appendix referring to +authorities more or less altered. + +The continued popularity of the work has been shown, not only by the +steady demand for it, but by the efforts of various authors to write +imitations of it, and various publishers to issue mutilated and +imperfect editions. Against these the present publishers would warn +innocent purchasers. The present is the only edition containing the +important additions and corrections made by the author during the latter +years of his life; and none other was authorized by him. + +In its present form, _The Physical Life of Woman_ may justly claim to +count among the classics of American literature. Its popularity +increases with time, and none of the many similar works which have +appeared have approached it in public estimation. It is believed that in +the present edition no important scientific fact bearing upon the +subject has been omitted, and the most recent developments of hygiene +will be found discussed. + +1878. + + + + +PREFACE TO THE SECOND STEREOTYPE EDITION. + + +Three years have passed since the author of the present work ventured to +lay it before the public, not without unusual anxiety as to the manner +in which he had fulfilled a task he knew to be so fruitful of good +results if well done. Those years of trial are over, and they have +brought a recognition of his labors beyond his most sanguine dreams. +Nearly _one hundred and fifty thousand copies_ of the work have been +sold in that period; it has been separately republished both in Canada +and England; it has been honored by a translation into German; the +imitations of it which have been written form almost a small library; +and, more to the satisfaction of the author than all this, it has +received the highest praise both at home and abroad, from both the +medical profession and the general learned world. + +The present new stereotype edition contains the result of three more +years of study and experience, enlightened and aided by very many +letters from readers, which served to point out wherein the previous +edition fell short of their wants. The text has been carefully revised, +and in large part wholly rewritten; nearly one hundred and fifty pages +of selected new matter have been added; and the latest steps of medical +science in this direction have been followed. + +Of the parts which are quite new, and which from the inquiries of +numerous readers will add greatly to the value of the work, are the +sections on the disturbances of the monthly function in girls, the care +of the child, the management of diseases of children, the diseases +incident to pregnancy, childbed, and nursing, etc. + +Indeed, in the present edition the author has aimed to omit nothing +which can aid Woman in performing her full duty to herself and others, +so far as that duty lies in the sphere of her Physical Life, whether she +is called upon to act as Wife, Mother, Teacher, or Guide. His most +ardent desire continues to be that the work will be found a sure and +safe monitor amid the difficult duties of Maidenhood and Maternity. + +LONDON, ENGLAND, October, 1872. + + + + +PREFACE TO THE FIRST EDITION. + + +It seems well to offer, at the outset, a few words explanatory of the +nature and object of this book. The author feels that its aim is novel, +is daring, and will perhaps subject him to criticism. He therefore make +his plea, _pro domo sua_, in advance. + +The researches of scientific men within the last few years have brought +to light very many facts relating to the physiology of woman, the +diseases to which she is subject, and the proper means to prevent those +diseases. Such information, if universally possessed, cannot but result +in great benefit to the individual and the commonwealth. The difficulty +is to express one's self clearly and popularly on topics never referred +to in ordinary social intercourse. But as the physician is obliged daily +to speak in plain yet decorous language of such matters, the author felt +that the difficulty was not unsurmountable. + +He is aware that a respectable though diminishing class in the community +maintain that nothing which relates exclusively to either sex should +become the subject of popular medical instruction. With every +inclination to do this class justice, he feels sure that such an opinion +is radically erroneous. Ignorance is no more the mother of purity than +she is of religion. The men and women who study and practise medicine +are not the worse, but the better, for their knowledge of such matters. +So it would be with the community. Had every person a sound +understanding of the relations of the sexes, one of the most fertile +sources of crime would be removed. + +A brief appendix has been added, directed more especially to the +professional reader, who may desire to consult some of the original +authorities upon whom the author has drawn. And here he would ask from +his fellow-members of the medical profession their countenance and +assistance in his attempt to distribute sound information of this +character among the people. None but physicians can know what sad +consequences are constantly occurring from the want of it. * * * + + + + +BIOGRAPHICAL SKETCH OF GEORGE HENRY NAPHEYS, M.D. + + +Were man's life measured by his deeds, as the poet suggests, how brief +would be the long years of many an octogenarian, and how extended the +short span which has been allotted to not a few of the world's famous +heroes! + +This oft-repeated thought strikes us forcibly in considering the +biography of the subject of this sketch. Closing his life at an age when +most professional men are but beginning theirs, he had already studied +broadly, had traveled widely over two continents, had gained credit and +fame by the sword and the pen, and had amassed a fund of erudition and +experience which the more lethargic lives of most men fail to approach +after twice his length of days. It is eminently appropriate that a +record of his busy career should be attached to the works on which his +celebrity is chiefly bound, and in which he most conspicuously displays +that command of language and happy facility of imparting instruction +for which he was so remarkable. + +GEORGE HENRY NAPHEYS (pronounced N[=a]'feez, the [=a] as in _fate_) was +born in the city of Philadelphia, March 5th, 1842. His parents died +while he was still at a tender age, and he was placed with some +relatives who resided in the city. From early years he was characterized +by quick perceptions and a retentive memory. In the Philadelphia High +School, from which he received the academic degree of Master of Arts, he +was considered the best scholar in his class, a marked distinction in +view of the large numbers which attend that institution. Besides +acquiring the usual studies of the High School, he gave considerable +time to phonography, in which he became so skilled that he could report +any ordinary speaker with entire accuracy. This subsequently proved a +great advantage to him in his medical career. + +After his graduation he repaired to Hartford, Conn., where he was +offered and accepted the position of private secretary to a gentleman of +prominence in the literary and religious world. + +Thus he was engaged when the civil war broke out. With his natural +warmth of feeling and strong emotions, he entered the fray among the +first, and went out as Lieutenant, and subsequently as Captain, Company +F, 10th Connecticut State Volunteers. The regiment was enlisted for nine +months, and was dispatched to Louisiana, General Banks then commanding +the Department. It participated in engagements near Baton Rouge and on +the Red River, in which Captain Napheys always acquitted himself with +bravery and credit. + +At the time the regiment was disbanded, an early preference for medical +subjects led him to devote a year to the preliminary studies of that +profession, but not waiting the full period required for a degree, he +was appointed assistant medical officer on the U. S. steamer Mingo, of +the South Atlantic Blockading Squadron. On her he passed a number of +months, cruising off the coast of the Carolinas and Georgia, and +ascended the St. John river. + +These active duties prevented him from receiving his degree of Doctor of +Medicine until after the close of the war, when, in 1866, his diploma +was conferred upon him by the Jefferson Medical College of Philadelphia, +one of the most renowned institutions of our country. + +After graduation, he opened an office in Philadelphia, and connected +himself with the clinics which are held at the College for the purpose +of supplying medicine and medical advice to the poor gratuitously, as +well as for giving students an opportunity of witnessing various forms +of disease. The practical experience he gained in this manner was +considerable, and his natural ability soon recommended him to the +authorities of the institution, who appointed him Chief of Medical +Clinic of the College, a position he held for several years. + +One of the advantages of this post was that it brought him into constant +communion with many eminent medical men, and rendered him practically +acquainted with their treatment of disease. His skill in phonography +enabled him to take abundant notes of their lectures, and this led to +his early connection with the periodical literature of the profession. +Most of the reports he drew up were published in the _Medical and +Surgical Reporter_, a weekly journal, devoted to medical science, +published in Philadelphia. The series of reports commenced in April, +1866, and continued, with slight interruptions, until June, 1870. They +are characterized by a clear and correct style, and a manifestly +thorough grasp of the numerous topics treated. + +The success which these ephemeral writings obtained turned his thoughts +in the direction of authorship. His tastes and associations led him to +employ his powers in two directions: first, in preparing for the general +public a series of works which would acquaint them with anatomy, +physiology, hygiene, sanitary science, nursing, and the management of +disease, to the extent that intelligent general readers can and ought to +know about these subjects; and secondly, in writing for professional men +several treatises on the means of alleviating and curing diseases. + +In the prosecution of the first mentioned of these plans, he was early +impressed with the utter absence of any treatise on the hygiene of the +sexual life in either sex, written in the proper spirit by a scientific +man. The field had been left to quacks or worse, who, to serve their +own base ends, scattered inflammatory and often indecent pamphlets over +the land; or else, had one or more of the points been handled by +reputable writers, it was in such a vague and imperfect manner that the +reader gained little benefit from the perusal. While all agreed that a +sound treatise on these topics was most desirable, it had been openly +averred that it could not be written in a proper style for the general +public. + +Strong in the conviction that pure motives, literary tact, and the +requisite scientific knowledge qualified him to undertake this difficult +task, Dr. Napheys prepared, in the early months of 1869, his work on +"The Physical Life of Woman." Proceeding with caution, he first +submitted the MSS. to some professional friends, and profited by their +suggestions. After the work was in type, and before publication, he sent +complete copies to a number of gentlemen, eminent as medical teachers, +clergymen, educators, and literateurs. Their replies left him in no +doubt but that he had succeeded even beyond his anticipations. Almost +unanimously the opinions were complimentary in the highest degree, and +evidently written after a close examination of the book. As many of +these have been printed to accompany the work, in the last and previous +editions, it is needless to do more in this connection than to say that +they were penned by such judges as Dr. W. A. Hammond, late +Surgeon-General U. S. Army; Dr. Harvey L. Byrd, Professor in the Medical +Department of Washington University, Md.; Dr. Edwin M. Snow, Health +Officer of the City of Providence, R. I.; Rev. Henry Ward Beecher, Rev. +Horace Bushnell, D.D., Rev. George A. Crooke, D.D., D.C.L., and others. + +On its appearance, the work was received with enthusiasm by both the +medical press and the public. While a few journals and individuals were +inclined to condemn it and censure the author, the intelligent and the +pure-minded, on all sides, recognized in him the only writer who had yet +appeared able to treat these delicate subjects with the dignity of +science and the straightforwardness necessary for popular instruction. + +Satisfied that he had chosen the proper exercise for his talents, he +composed and placed in the hands of his publisher, the following year, +his not less extraordinary work, "The Transmission of Life," a treatise +addressed to the male, as his previous one had been to the female sex. +It was dedicated to the late Rev. John Todd, so well known for his +interest in young men, and his "Student's Manual" and other works +addressed to them. He accepted the dedication and addressed the author a +letter, in which occurs the following high compliment to his work: "I am +surprised at the extent and accuracy of your reading; the judiciousness +of your positions and results; the clear, unequivocal, yet delicate and +appropriate language used; and the amount of valuable information +conveyed." Similar expressions poured in from many other distinguished +critics, as, for instance, Dr. Noah Porter, President of Yale College; +the Rev. Henry Clay Trumbull, the Rev. Abner Jackson, President of +Trinity College, Hartford, etc. + +In the same year (1870) he brought out the first edition of his "Modern +Therapeutics," a technical work, addressed to physicians. This was +enlarged in successive editions, until in its present form, as continued +by other hands in its latest editions, it comprises two parts of 600 +pages each. Although the author claimed little other originality in this +work than the selection and arrangement of known facts, yet in these +respects he displayed the strongly practical and original turn of his +mind. As a student of the art of Therapeutics in large hospitals, +clinics, and dispensaries, he had convinced himself that it is not by +experiments on lower animals, nor yet on the human body in health, that +the physician can attain the glorious power of alleviating pain and +curing disease; it is only through the daily combat with sickness, by +the bedside and in the consulting room. Chemistry and physiology, he +believed, could teach but little in this branch; observation and +experience everything. Hence, in his work on Therapeutics he announced +himself as "aiming at a systematic analysis of all current and approved +means of combating disease," selecting his formulae and therapeutical +directions from the most eminent living physicians of all nations. + +This work was most favorably received by medical men; and, edited and +revised by competent hands, continues to be regarded as one of the most +valuable works in American medical literature. The unanimous opinion of +the leading medical journals, as well as of its numerous purchasers, +have testified to its real and great worth to the practitioner of +medicine. + +Having thus established a wide, popular and professional reputation, one +which would have guaranteed him a lucrative practice, it would have +tempted another, no doubt, to make the most of this opportunity, so +rarely granted a young physician. Not so was it with Dr. Napheys. No +sooner had the three works mentioned been completed than he sailed for +Europe, in order to familiarize himself with the famed schools of +learning of the Old World and its rich stores of material for culture. +The summer was that of the Franco-German war; and spending most of it in +Paris, he was witness of several of the most exciting scenes which +attended the dethronement of the Emperor. These he would describe +afterwards with a vividness and power of language rarely excelled. + +The excitement of the period did not, however, withdraw his attention +from the studies he had in view. These were partially indicated in a +series of letters he contributed to various periodicals during his +absence. While these letters were principally of a scientific character, +it is noteworthy how the relations of medicine to the welfare of man +always occupied his attention. Thus we find, in one sent from England, +June, 1870, a description of the Liverpool Medical Missionary Society, +a charity which combines religious instruction with medical advice; and +again, he comments on the popular instruction in hygiene which was +supplied at that period to the English workingmen by a committee of +competent physicians, organized for that purpose. It was the author's +purpose to collect and expand these letters into a volume, but the +project was not carried out. + +The siege of Paris, which city he left in one of the last trains before +the blockade commenced, and the prolongation of the war, induced him to +return home. In the United States he found offers from several +publishers awaiting him, which would more than occupy him for a full +year. There was a new edition of his "Therapeutics" demanded, and a +revision of both "The Physical Life of Woman" and "The Transmission of +Life." A New England firm urgently pressed him to superintend the +production of several hygienic works, and secured him as literary +adviser to their house. He assumed the editorship of the "Half-Yearly +Compendium of Medical Science," and also of a "Physician's Annual," +besides undertaking a number of articles for the periodical press, both +scientific and popular. + +To this active literary life he devoted the year 1871; but at its close +felt more strongly than ever that he must give himself several years of +studious quiet, in order to accomplish his best. Refusing, therefore, +any further engagements, he sailed for Europe again, late in 1871, and +did not return this time until the spring of 1875. In this period, of +more than three years, he visited almost all the principal cities of +Europe, and enjoyed the friendship of many eminent men at London, St. +Petersburg, Vienna, and Paris. Reading, visiting hospitals, and +attending clinics, he accumulated a mass of material which he designed +to work up into future literary enterprises. + +With these collected stores he returned to the United States early in +1875, and set to work with his wonted energy. A new and much enlarged +edition of the "Therapeutics" was sent to press; a "Handbook of Popular +Medicine," designed to give, in simple language, the domestic treatment +of disease, the rules for nursing the sick, selected receipts for diet +and medicinal purposes, and the outlines of anatomy and physiology, was +put in the hands of a publisher; a Synopsis of Pharmacy and Materia +Medica, a work of enormous labor, was well under way; and other literary +projects were actively planned; when, suddenly, the summons came which, +in an instant, with the shears of fate, slit the strand of this +activity. The rest of the story may be told in the words of the +biographer appointed by the Medical Society of the County of +Philadelphia to prepare a memoir of his life:-- + +"While earnestly laboring to prepare for the press his literary +collections, he suffered a severe blow by the sudden death of a person +to whom he was deeply attached. Over-work and this emotional shock +produced a result likely enough to occur in one of his ardent +temperament. One afternoon, while engaged in writing, he fell, +unconscious, from his chair, and for several days lay in a very critical +condition. On recovering his powers, it was evident his brain had +suffered a serious lesion. The old energy and love of labor had +completely gone; even the capacity for work seemed absent. Marked +melancholy followed, characterized before long by avoidance of friends +and the loss of a desire of life. This occurred with increasing force +until it led to his death, on July 1, 1876, through some toxic agent, +the nature of which was not ascertained. + +"Thus early, and thus sadly, terminated a career of unusual brilliancy +and promise. + +"It is probable that much that he has written will be read with pleasure +and instruction by future generations; and the memory of his genial +disposition, his entertaining conversation, and earnest sense of +professional honor, will long be cherished by those of his +contemporaries who enjoyed his friendship."--_Transactions of the +Medical Society of the State of Pennsylvania_, vol. xi, p. 720. + +Various tributes were paid to his memory by the societies with which he +was connected, and by the scientific journals to which he had been a +contributor. One of these, after narrating some of the circumstances +attending his decease, spoke as follows:-- + +"Thus did our unfortunate associate close his short but brilliant +career. The emotions, the tender sentiments he has described with such a +magical pen, he felt himself with an unmatched keenness. They mastered +his whole frame with an intensity surpassing all romance. His +descriptions of the passions, descriptions which have been the wonder of +thousands, such is their fire and temper, were not rhetorical studies, +but the ebullition of a soul sensitive to their lightest breath, and not +shunning their wildest tempests. + +"The genius which dictated the lines he has left us is not to be judged +by the conventionalities which suit the cold temperaments of ordinary +men; there is a strong vein of egotism in most devotion; but here was +one who felt, 'all is lost, when love is lost.'" + +This extract well sets forth the extraordinary depth of his sentiments, +and the fervor of his feelings. It may be added that these mental traits +were not generally ascribed to him by casual or ordinary associates. He +was, in manners and bearing, evidently not one who sought friendships or +displayed to the general gaze the current of his thoughts. Consequently, +of intimates he had but few, and was considered by those whose +intercourse with him was superficial, to be much more of an intellectual +than of an emotional type of character. + +This impression was doubtless increased by the strongly practical turn +of his mind, which is conspicuous in all his works. He was the reverse +of a dreamer and had little patience with theorists. In his professional +study he always aimed at bringing into the strongest light the +utilitarian aspect of medicine, its ameliorating power on humanity, its +real efficacy in preserving or restoring health and limiting human +misery. On this his theory of therapeutics was based, and, inspired by +the same opinions, he was one of the most earnest advocates of the day +of popularizing medical science in all its branches among the masses. In +this effort he was at times severely criticized by that class of +physicians--and they are by no means extinct--who think that medicine +should be wrapped in mystery, and that the people should be kept in +ignorance of themselves and of their own physical frailties, to the +utmost possible extent. With these learned obscurantists Dr. Napheys had +no patience, and naturally found but slight favor. Fortunately, they +were in the decided minority, and, we are happy to add, even that +minority is daily decreasing. + +Of the various learned societies to which he was attached may be +mentioned the Philadelphia County Medical Society, the Franklin +Institute of Philadelphia, and the Gynecological Society of Boston. His +election as Corresponding Member to the latter body (which is an +association of scientific men who make an especial study of the hygiene +and diseases of women) took place shortly after the first publication of +the _Physical Life of Woman_, and was meant as a direct tribute of +respect to him as the author of that work, thus obtaining for it the +testimony of the highest body in that specialty then existing in our +land. + +The general plan on which Dr. Napheys prepared his sanitary writings was +one eminently calculated to reconcile those who were most opposed to +instructing the general public in such branches. While he confidently +believed that vastly more harm than good is done by a prudish +concealment of the physiology of sex and its relations to health, he +also clearly recognized that such instruction should be imparted at the +proper age and under certain limitations; while the general facts common +to the species cannot be taught too generally, or made too familiar. +Hence, he projected three books, one to be placed in the hands of young +women, a second for youths, and a third for a general household book of +reading and reference on medicine and hygiene. These three he completed +in "The Physical Life of Woman," "The Transmission of Life," and the +"Handbook of Popular Medicine." + +This plan, he believed, met all the objections to popular medical +instruction, at least all well-grounded objections, while at the same +time it did away with any necessity for concealing truths important to +be known, for fear they should come to the knowledge of those for whom +they were not designed, and on whose minds they might have a disturbing +tendency. + +There can be no doubt but that both the plan and its execution were +successful. The many letters he received, filled with thanks from +private parties who had gained inestimable knowledge from these works, +made rich compensation for the occasional severe strictures he received +from those wedded to ancient ways, and who often condemned without even +reading his works. + +The intelligent reading public, on whom, after all, the writer must +depend for a verdict on his works, were unanimous in his favor. They +bought them in quantities, and the writer of his life in the +_Transactions of the Pennsylvania State Medical Society_, above quoted, +who wrote in 1877, estimates that by that time over _a quarter of a +million_ copies had been printed and sold. Translations were made into +the German, and several editions pirated and printed in Canada and +England. In fact, the works may now be considered to rank as classics in +the language, and many years must go by before another such series can +be written, on topics of this nature, with equal delicacy of touch and +accuracy of knowledge. + + + + +CONTENTS. + + +INTRODUCTORY. + PAGE + + Knowledge is safety--The peculiarities of sex--Examples of + individuals belonging to both sexes and to neither sex--The + sphere of woman 15-22 + + +Part I. THE MAIDEN. + +PUBERTY 22-52 + + What it means--Age when it arrives--Causes that hasten it--Causes + that delay it--Brunettes mature early--The signs of puberty--Its + dangers--Spinal disease--Green sickness--Hysterics--Secret bad + habits--Hygiene of puberty--Diet--Exercise--Clothing--Precautions + during the monthly changes--Between the monthly changes--What to + do when the changes are delayed--When they are painful--The age + of nubility. + + +LOVE 52-89 + + Its power in life--What it is--It is necessary and it is + eternal--Of second marriages and of divorce--Courtship--Love at + first sight--How to choose a husband--Shall cousins marry?--Marriage + between different races and different nations--The proper age of a + husband--His temperament--His moral and mental character--Words of + warning--Signs of character on the body--The engagement--Concerning + long engagements--The right time of year to marry--The right time + in the month to marry--The wedding tour. + + +Part II. THE WIFE. + + +HINTS TO YOUNG WIVES 90-132 + + The wedding night--Should husband and wife sleep together or + apart?--The most healthful bed--The dignity and propriety of the + sexual instinct--The proper indulgence and the restraint + of sexual desire--Marital relations, when they should be + suspended--When they are painful--Barrenness, its causes and its + cures--Advice to wives who desire children--The limitation of + offspring--When it is proper--Justifiable means--Injurious + means--The crime of abortion--The nature of conception--Signs of + conception--How to retain the affections of a husband. + + +INHERITANCE 132-166 + + The varieties of inheritance--The legacy of beauty--The + complexion--What physical qualities each parent bestows--The + inheritance of fertility and longevity--Even deformities + sometimes transmitted--How to have beautiful children--Talent and + genius may be transmitted--The physical traits of fathers in + daughters, and of mothers in sons--Examples--Influence of + education on inherited qualities--Transmission of disease--Of + mutilations--How to avoid inherited ill tendencies--The excess of + women--How to have boys or girls at will--Twins and triplets. + + +PREGNANCY 167-218 + + Veneration of the pregnant woman--Signs of pregnancy--Quickening + --Mental changes--Miscarriage, its causes, symptoms, and + prevention--Mother's marks--What makes them?--How to avoid + them--Education of the child in the womb--Are double pregnancies + possible?--Instances of double children--Can a child cry in the + womb?--Is it a son or a daughter?--Are there twins present?--The + duration of pregnancy--How to calculate when the confinement will + come--Care of health during pregnancy--The food, clothing, + exercise, bathing, ventilation, and sleep--Effect on health of + body and mind--Relations of husband and wife during pregnancy. + + +THE CONFINEMENT 219-242 + + Preparations for childbirth--The signs of approaching labor--The + symptoms of actual labor--Attention is required during labor--To + the mother--To the child--To have labor without pain--The risks + of childbed--Weight and length of new-born children--The duration + of labor--Stillborn children--Imprudence after childbirth--To + preserve the form after childbirth. + + +Part III. THE MOTHER. + + +NURSING 243-270 + + The duties and privileges of a mother--Hindrances to nursing, and + when it is improper--Rules for nursing--Influence of diet on the + mother's milk--Influence of pregnancy on the milk--The mother's + mind and her infant--Striking examples--Position of the mother + while nursing--Qualities of a good nursing mother--Excess and + deficiency of the milk--Wet-nursing by virgins, aged women, and + men--Rules for care of health while nursing--Relations of + husband and wife at this time--Over-nursing and the signs + of it--Directions for mothers who cannot nurse their own + children--How to select a wet-nurse. + + +Part IV. THE CHILD. + + +THE CARE OF INFANCY 271-324 + + The causes of infant mortality--Bringing up by hand--Weaning, + when and how to do it--Teething--Vaccination and re-vaccination + --The food of infants and children--Concerning sleep in + early life--The clothing of children, its pattern, amount, + and quality--Bathing, ventilation, and exercise in early + childhood--On learning to walk--The advantages of games and + plays--On training the sight and hearing. + + +THE MANAGEMENT OF SOME DISEASES OF CHILDHOOD 325-350 + + How to recognize and treat croup--Head colds--Fits--Nose-bleed-- + Worms--Bed-wetting--Looseness of the bowels--Indigestion--Hints + on home government--Is the race physically weaker? + + +Part V. HEALTH IN MARRIAGE. + + +DISEASES INCIDENT TO PREGNANCY 352-360 + + Morning sickness--Pain in the abdomen--Varicose veins--Piles-- + Diarrhoea--Constipation--Cough--Wakefulness. + + +DISEASES INCIDENT TO CHILDBED AND NURSING 361-385 + + Puerperal mania--White-flowing--Milk-leg--Inward weakness-- + Various causes of weakness--Tight lacing one of them--Their + treatment--Gathered breasts--Cracked nipples. + + +Part VI. THE SINGLE LIFE. + + +ADVANTAGES AND DRAWBACKS OF 386-388 + + +Part VII. THE CHANGE OF LIFE. + + +DISEASES AND HYGIENE OF 389-404 + + What it is--Age when it comes--Signs and symptoms--Effects on the + character--Those who suffer most--Diseases and discomforts + attending--Precautions and remedies. + +NOTES 405-420 + +INDEX 420-426 + + + + +THE PHYSICAL LIFE OF WOMAN. + + +_KNOWLEDGE IS SAFETY._ + +'Knowledge is power,' said the philosopher. The maxim is true; but here +is a greater truth: 'Knowledge is safety,'--safety amid the physical +ills that beset us,--safety amid the moral pitfalls that environ us. + +Filled with this thought, we write this book. It is the Revelation of +Science to Woman. It tells her, in language which aims at nothing but +simplicity, the results which the study of her nature, as distinct from +that of man, has attained. We may call it her physical biography. + +It is high time that such a book were written. The most absorbing +question of the day is the 'Woman Question.' The social problems of +chiefest interest concern her. And nowhere are those problems more +zealously studied than in America, which has thrown aside the trammels +of tradition, and is training its free muscles with intent to grapple +the untried possibilities of social life. Who can guide us in these +experiments? What master, speaking as one having authority, can advise +us? There is such a guide, such a master. The laws of woman's physical +life shape her destiny and reveal her future. Within these laws all +things are possible; beyond them, nothing is of avail. + +Especially should woman herself understand her own nature. How many +women are there, with health, beauty, merriment, ay, morality too, all +gone, lost for ever, through ignorance of themselves! What spurious +delicacy is this which would hide from woman that which beyond all else +it behooves her to know? We repudiate it; and in plain, but decorous +language,--truth is always decorous,--we purpose to divulge those +secrets hidden hitherto under the technical jargon of science. + + +THE DISTINCTION OF THE SEXES. + +The distinction of the sexes belongs neither to the highest nor to the +lowest forms of existence. Animals and vegetables of the humblest +character have no sex. So it is with spirits. Revelation implies that +beyond this life sexual characteristics cease. On one occasion the +Sadducees put this question to Christ: There was a woman who lawfully +had seven husbands, one after the other; now, at the resurrection, which +of these shall be her husband? or shall they all have her to wife? He +replied that hereafter there shall be neither marrying nor giving in +marriage, but that all shall be 'as the angels which are in heaven.' +Sexuality implies reproduction, and that is something we do not +associate with spiritual life. + +It further implies imperfection, which is equally far from our hopes of +happiness beyond the grave. The polyp, which reproduces by a division of +itself, is in one sense more complete than we are. The man is in some +respects inferior to the woman; the woman in others is subordinate to +man. A happy marriage, a perfect union, they twain one flesh, is the +type of the independent, completed being. Without the other, either is +defective. 'Marriage,' said Napoleon, 'is strictly indispensable to +happiness.' + +There is, in fact, a less difference between the sexes than is generally +believed. They are but slight variations from one original plan. +Anatomists maintain, with plausible arguments, that there is no part or +organ in the one sex but has an analogous part or organ in the other, +similar in structure, similar in position. Just as the right side +resembles the left, so does man resemble woman. + +Let us see what differences there really are: + +The frame of woman is shorter and slighter. In the United States the men +average five feet eight inches in height, and one hundred and forty-five +pounds in weight; the women, five feet two and a half inches in height, +and one hundred and twenty-five pounds in weight. Man has broad +shoulders and narrow hips; woman has narrow shoulders and broad hips. +Her skull is formed of thinner bones, and is in shape more like that of +a child. Its capacity, in proportion to her height, is very little less +than in man,--about one-fiftieth, it is said,--which, so far as +brain-power is concerned, may readily be made up by its finer texture. +Her shoulders are set farther back than in the other sex, giving her +greater breadth of chest in front. This is brought about by the +increased length of her collar-bone; and this is the reason why she can +never throw a ball or stone with the accuracy of a man. Graceful in +other exercises, here she is awkward. + +Her contour is more rounded, her neck is longer, her skin smoother, her +voice softer, her hair less generally distributed over the body, but +stronger in growth than in man. She breathes with the muscles of her +chest--he with those of his abdomen. He has greater muscular force--she +more power of endurance. Beyond all else she has the attributes of +maternity,--she is provided with organs to nourish and protect the child +before and after birth. + + +PERSONS OF BOTH SEXES AND OF NEITHER SEX. + +Nature is very sedulous in maintaining these differences. It is the +rarest thing in the world to find a human being of doubtful sex. Many a +physician disbelieves that there ever has been a person of both sexes--a +true hermaphrodite. They are very scarce, but they do exist. There is +one now living in Germany. It bears a female name, Catherine Hohmann. +She was baptised and brought up a female; but Catherine is as much man +as woman. The learned professor of anatomy, Rokitansky, of Vienna, +asserts most positively that this is a real hermaphrodite. Her history +is sad. Born in humble circumstances, when of marriageable age she loved +a man, who wished her to emigrate with him to America. But when she +disclosed to him her deformity, he broke off the engagement and deserted +her. Then her affection became fixed on a young girl; but how could she +make her suit to one apparently of her own sex? With passions that +prompt her to seek both sexes, she belongs to neither. 'What shall I do +here on earth?' she exclaimed, in tears, to a man of science who +recently visited her. 'What am I? In my life an object of scientific +experiment, and after my death an anatomical curiosity.' + +There are also persons--very few indeed--who have no sex at all. They +are without organs and without passions. Such creatures seem to have +been formed merely to show us that this much-talked-of difference of sex +is, after all, nothing inherent in the constitution of things, and that +individuals may be born, live and thrive, of both sexes, or of neither. + + +THE SPHERE OF WOMAN. + +Our province lies within the physical sphere of woman. But we will here +allow ourselves a momentary digression. It will be seen that while these +differences are not radical, yet they are peculiarly permanent. They +hint to us the mental and intellectual character of woman. What opinion +should we hold on this much-vexed question? + +To this effect: The mental faculties of man and woman are unlike, but +not unequal. Any argument to the contrary, drawn from the somewhat less +weight of the brain of woman, is met by the fact that the most able men +are often undersized, with small heads. The subordinate place which +woman occupies in most states, arises partly from the fact that the part +she plays in reproduction prevents her from devoting her whole time and +energies to the acquisition of power, and partly from the fact that +those faculties in which she is superior to man have been obscured and +oppressed by the animal vigor and selfishness of the male. As +civilisation advances, the natural rights of woman will be more and more +freely conceded, until the sexes become absolutely equal before the law; +and, finally, her superiority in many respects will be granted, and she +will reap the benefits of all the advantages it brings, without desiring +to encroach on those avocations for which masculine energy and strength +are imperatively needed. + +The most peculiar features of woman's life are hers for a limited period +only. Man is man for a longer time than woman is woman. With him it is a +lifetime matter; with her it is but for a score of years or so. Her +child-bearing period is less than half her life. Within this time she +passes through all the phases of that experience which is peculiarly her +own. + +And these phases, what are they? Nature herself defines them. They are +three in number,--the Maiden, the Wife, and the Mother. In one and then +another of this triad, her life passes. Each has its own duties and +dangers; each demands its own precautions; each must be studied by +itself. + +Let us at once commence this important study, and proceed in the order +of time. + + + + +THE MAIDEN. + + +_PUBERTY._ + +At a certain period in the life of the female, she ceases to be a girl, +and becomes a _woman_. Hitherto she has felt no distinction between +herself and the boys, her playmates. But now a crisis takes place, which +is for ever after to hedge her round with a mysterious, invisible, but +most real barrier from all _man_kind. + +This period is called _the age of puberty_. Its sign is a flow of blood +recurring every month; its meaning, that the female has entered upon +that portion of her life whose peculiar obligations are to the whole +race--no longer to herself alone. The second part of her twofold nature +is opened. Why is it that on her, the weaker sex, this extra burden is +laid? Why this weakness, these pains, this recurring loss of vital +fluid? + +Perhaps, as has been observed, it is a wise provision that she is thus +reminded of her lowly duty, lest man should make her the sole object of +his worship, or lest the pride of beauty should obscure the sense of +shame. But this question concerns rather the moralist than the +physician, and we cease asking _why_ it is, and shall only inquire +_what_ it is. + +To this science returns a clear reply. In the anatomy of woman there are +two small bodies, in shape and size like large almonds, called the +ovaries. They lie one on each side of the womb, and are connected with +it by tubes about four inches in length. These bodies are solid, but +contain a great number of diminutive vesicles, which, by some mysterious +law of nature, mature one at a time, every thirty days, for thirty years +of woman's life. When mature, the vesicle separates from the ovary, +traverses the tube into the womb, and is thence expelled and lost, or +becomes, by contact with the other sex, the germ of a living being. This +process is accompanied by a disturbance of the whole system. Wandering +pains are felt; a sense of languor steals over the mind; the blood +rushes with increased violence through the vessels, and more or less of +it escapes from the veins, causing that change which we term +_menstruation._ + +The ancients had a tradition that in the beginning of things the world +was made from an egg; the naturalists of past generations had this +maxim: Everything living comes from an egg; and science to-day says the +same. For this vesicle we have mentioned is in fact an _egg_, similar in +structure to those which birds, fish, and turtles deposit. The only +differences are, that the one is developed out of the body, the other +within; the one has a shell, the other has none. + +Therefore physiologists give this definition: Menstruation is +ovulation,--it is the laying of an egg. + + +WHAT IS THE AGE OF PUBERTY? + +This has been a matter of careful study by physicians. They have +collected great numbers of observations, and have reached this +conclusion: In the middle portion of the temperate zone, the average age +when the first period appears in healthy girls is fourteen years and six +months. If it occurs more than six months later or earlier than this, +then it is likely something is wrong, or, at least, the case is +exceptional. + +Exceptional cases, where this average is widely departed from in +apparently perfect health, are rare. But they do occur. We have known +instances where the solicitude of parents has been excited by the long +delay of this constitutional change, and others in which it has taken +place at an almost tender age, without causing any perceptible injury to +the general health. + +There is an instance recorded, on good authority, where a French child +but three years old underwent all the physical changes incident to +puberty, and grew to be a healthy woman. But what children can surpass +the American in precocity? This French child-woman is quite left in the +shade by one described in a recent number of a western medical journal, +who _from her birth_ had regular monthly changes, and the full physical +development which marks the perfect woman! + +Thus, sometimes, a wide deviation from the average age we have stated +occurs, without having any serious meaning. Yet at no time is such a +deviation to be neglected. In nine out of ten instances it is owing to +some fault in the constitution, the health, or formation, which should +be ascertained and corrected. Otherwise years of broken health and +mental misery may be the sad results. Mothers, teachers, it is with you +this responsibility rests. The thousands of wretched wives, who owe +their wretchedness to a neglect of proper attention at this +turning-point of their lives, warn you how serious is this +responsibility. + +The foundation of old age, says a distinguished author, is laid in +childhood; but the health of middle-life depends upon puberty. Never was +there a truer maxim. The two years which change the girl to the woman +often seal for ever the happiness or the hopeless misery of her whole +life. They decide whether she is to become a healthy, helpful, cheerful +wife and mother, or a languid, complaining invalid, to whom marriage is +a curse, children an affliction, and life itself a burden. + +We reiterate our warning: Mothers, teachers, you to whom children are +confided at this crisis of their lives, look well to it that you +appreciate, understand, and observe the duties you have assumed. Let no +false modesty prevent you from learning and enforcing those precautions, +so necessary at this period of life. + + +WHAT HASTENS AND WHAT RETARDS PUBERTY? + +As a rule, we find that those who develope early, fade early. A short +childhood portends a premature old age. It often foreshadows, also, a +feeble middle-life. + +Having ascertained, therefore, what is the average age at which puberty +takes place with us, let us see what conditions anticipate or retard +this age. + +The most important is _climate._ + +In hot climates, man, like the vegetation, has a surprising rapidity of +growth. Marriages are usual at twelve or fourteen years of age. Puberty +comes to both sexes as early as at ten and eleven years. We even read in +the life of Mohammed, that one of his wives, when but ten years of age, +bore him a son. Let another dozen years pass, and these blooming maidens +have been metamorphosed into wrinkled, faded old women. The beauty of +their precocious youth has withered almost literally like a flower which +is plucked. + +Very different is it in the cold and barren regions of the far north. +There man, once more partaking of the nature of his surroundings, yields +as slowly to the impulses of his passions as does the ice-bound earth to +the slanting rays of the summer sun. Maturity, so quick to come, so +swift to leave in the torrid heats, arrives, chilled by the long +winters, to the girls of Lapland, Norway, and Siberia, only when they +are eighteen and nineteen years of age. But, in return for this, they +retain their vigor and good looks to a green old age. + +Between these extremes, including as they do the whole second decade of +existence, this important change takes place normally in different +latitudes. We have said that in the middle temperate zone the proper age +is fourteen years and six months. Let us now see what conditions lead to +deviations from this age in our climate. + +First on the list is that sacred fire handed down to us from our +ancestors, which we call, in our material language, the _constitution._ + +The females of certain races, certain families, it is often noticed, +mature earlier than their neighbours. Jewesses, for example, are always +precocious, earlier by one or two years. So are colored girls, and those +of creole lineage. We can guess the reasons here. No doubt these +children still retain in their blood the tropic fire which, at +comparatively recent periods, their forefathers felt under the vertical +rays of the torrid zone. + +Nor is this all. It is well ascertained, from numerous observations, +that brunettes develope sooner than their blonde sisters; that those who +will grow to be large women are slower than those whose stature will be +small; that the dark-haired and black-eyed are more precocious in this +respect than the light-haired and blue-eyed; that the fat, sluggish girl +is more tardy than the slender, active one; that, in general, what is +known as the nervo-bilious temperament is ever ahead of that called the +lymphatic or phlegmatic. + +It is a familiar fact, that it is not a good sign to see this change +before the usual average time. It betokens a weakly, excitable, +diminutive frame. Hard labor, vigorous, regular muscular exertion--prime +health, in other words--never tends to anticipate this epoch, but rather +to retard it. + +With this warning fresh in our ears, let us now rehearse what causes +constantly incline unduly to hasten puberty, and thus to forestall wise +Nature in her plans for health and beauty. They are of two +kinds,--physical and mental. + +Idleness of body, highly-seasoned food, stimulating beverages, such as +beer, wine, liqueurs, and, in a less degree, coffee and tea, irregular +habits of sleep,--these are the physical causes of premature +development. But the mental causes are still more potent. + +Whatever _stimulates the emotions_ leads to an unnaturally early sexual +life. Late hours, children's parties, sensational novels, 'flashy' +papers, love stories, the drama, the ball-room, talk of beaux, love, and +marriage,--that atmosphere of riper years which is so often and so +injudiciously thrown around childhood,--all hasten the event which +transforms the girl into the woman. A particular emphasis has been laid +by some physicians on the power of music to awaken the dormant +susceptibilities to passion, and on this account its too general or +earnest cultivation by children has been objected to. Educators would do +well to bear this caution in mind. + +How powerfully these causes work is evident when we compare the average +age of puberty in large cities and in country districts. The females in +the former mature from six to eight months sooner than those in the +latter. This is unquestionably owing to their mode of life,--physically +indolent, mentally over-stimulated. The result, too, is seen with +painful plainness in comparing the sturdy, well-preserved farm-wife of +thirty, with the languid, pale, faded city lady of the same age. + + +THE CHANGES IT WORKS. + +Two short years change the awkward and angular girl of fourteen into the +trim and graceful maiden of sweet sixteen. Wonderful metamorphosis! The +magic wand of the fairy has touched her, and she comes forth a new +being, a vision of beauty to bewitch the world. + +Let us analyze this change. + +The earliest sign of approaching puberty is a deposit of fat in the +loose cellular tissue under the skin. This gives roundness to the form, +and grace to the movements. According to a distinguished naturalist +(Buffon), it is first observable by a slight swelling of the groins. +Thence it extends over the whole body. The breasts especially receive +additions, and develope to form the perfect bust. + +Parts of the body previously free from hair become covered with a soft +growth, and that which covers the head acquires more vigor and gloss, +usually becoming one or two shades darker. The eyes brighten, and +acquire unwonted significance. These windows of the soul betray to the +close observer the novel emotions which are arising in the mind within. + +The voice, too, shares in the transformation. The piping, slender +articulation of the child gives way to the rich, melodious, soft voice +of woman--the sweetest music man ever hears. To the student of humanity, +to the observant physician, nothing is more symbolical of the whole +nature than the voice. Would you witness a proof of its power? Watch +how a person born blind unerringly discriminates the character of those +he meets by this alone. + +Beyond all external modifications, we find others, which indicate how +profound is the alteration now taking place. The internal organs of the +body assume new functions and new powers. The taste for food changes, +hinting that the system has demands hitherto unknown. Those organs we +have adverted to, called the ovaries, increase in size, as also does the +uterus. The very framework of the structure does not escape. The bones +increase in weight, and those around the hips expand, and give the +female her distinctive form, upon the perfection of which her life and +that of her children depend. + + +MENTAL CHANGES. + +Such are the changes which strike the eye. But there are others which +are not less significant, and which demand far more urgently our +watchful heed. New thoughts, strange desires, are invading the soul. A +novel relation is assumed to the world. It is vague, misunderstood, but +disturbing all the same. + +The once light-hearted girl inclines to reveries; she seeks solitude; +her mother surprises her in causeless tears; her teacher discovers an +unwonted inattention to her studies, a less retentive memory, a +disinclination to mental labor; her father misses her accustomed +playfulness; he, perhaps, is annoyed by her listlessness and inertia. +What does it all mean? What is the matter with the girl? + +Mother, teacher, father, it is for you to know the answers to these +questions. You have guarded this girl through years of helpless infancy +and thoughtless childhood. At the peril of her life, and of what is of +more value than life, do not now relax your vigilance. Every day the +reaper Death reaps with his keen sickle the flowers of our land. The +mothers weep, indeed; but little do they realize that it is because they +have neglected to cherish them as was their duty, that the Lord of +Paradise has taken them back unto Himself. + + +THE COMPLETION OF PUBERTY. + +The symptoms increase until at length the system has acquired the +necessary strength, and furnished itself with reserve forces enough to +complete its transformation. Then the monthly flow commences. + +In thoroughly healthy girls it continues to recur at regular intervals, +from twenty-five to thirty days apart. This is true of about three out +of four. In others, a long interval, sometimes six months, occurs +between the first and second sickness. If the general health be not _in +the least_ impaired, this need cause no anxiety. Irregularities are +found in the first year or two, which often right themselves afterwards. +But whenever they are associated with the _slightest_ signs of mental or +bodily disorder, they demand instant and intelligent attention. + +It used to be supposed that the periods of the monthly sickness were in +some way connected with the phases of the moon. So general is this +belief even yet in France, that a learned Academician not long since +thought it worth while carefully to compare over four thousand +observations, to see whether they did bear any relations to the lunar +phases. It is hardly worth while to add that he found none. + +We have known perfectly healthy young women who were ill every sixteen +days, and others in whom a period of thirty-five or thirty-six days +would elapse. The reasons of such differences are not clear. Some +inherited peculiarity of constitution is doubtless at work. Climate is +of primary importance. Travellers in Lapland, and other countries in the +far north, say that the women there are not regulated more frequently +than three or four times a year. Hard labor and a phlegmatic temperament +usually prolong the interval between the periodical illnesses. + +An equal diversity prevails in reference to the _length of time_ the +discharge continues. The average of a large number of cases observed in +healthy women, between the ages of fifteen and thirty-five, is four days +and a fraction. In a more general way, we may say from two to six days +is the proper duration. Should it diverge widely from this, then it is +likely some mischief is at work. + +In relation to the _amount_ of the discharge, every woman is a law unto +herself. Usually, it is four or five ounces in all. Habits of life are +apt to modify it materially. Here, again, those exposed to prolonged +cold and inured to severe labor escape more easily than their sisters +petted in the lap of luxury. Delicate, feeble, nervous women--those, in +other words, who can least afford the loss of blood--are precisely those +who lose the most. Nature, who is no tender mother, but a stern +step-mother, thus punishes them for disregarding her laws. Soft +couches, indolent ease, highly spiced food; warm rooms, weak +muscles,--these are the infractions of her rules which she revenges with +vigorous, ay, merciless severity. + +It is well known, too, that excitement of the emotions, whether of +anger, joy, grief, hatred, or love increases the discharge. Even the +vulgar are aware of this, and, misinterpreting it as half-knowledge +always does, suppose it a sign of stronger animal passions. It bears no +such meaning. But the fact reads us a lesson how important it is to +cultivate a placid mind, free from strong desire or fear, and to hold +all our emotions in the firm leash of reason. + +Physicians attach great importance to the _character_ of the discharge. +It should be thin, watery, dark-coloured, and never clot. If it clots, +it is an indication that something is wrong. + + +THE DANGERS OF PUBERTY. + +We have shown that there are constantly individual deviations, quite +consistent with health, from any given standard. They only become +significant of disease when they depart decidedly from the average, +either in the frequency of the illness, its duration, the amount of the +discharge, or the character. More or less pain, more or less prostration +and general disturbances at these epochs, are universal and inevitable. +They are part of the sentence which at the outset He pronounced upon the +woman, when He said unto her, 'I will greatly multiply thy sorrow and +thy conception.' Yet with merciful kindness He has provided means by +which the pain may be greatly lessened, and the sorrow avoided; and +that we may learn and observe these means, their neglect often increases +a hundred-fold the natural suffering. + +At this critical period, the seeds of hereditary and constitutional +diseases manifest themselves. They draw fresh malignancy from the new +activity of the system. The first symptoms of tubercular consumption, of +scrofula, of obstinate and disfiguring skin diseases, of hereditary +insanity, of congenital epilepsy, of a hundred terrible maladies, which +from birth have lurked in the child, biding the opportunity of attack, +suddenly spring from their lairs, and hurry her to the grave or the +madhouse. If we ask why so many fair girls of eighteen or twenty are +followed by weeping friends to an early tomb, the answer is, chiefly +from diseases which had their origin at the period of puberty. + +It is impossible for us here to rehearse all the minute symptoms, each +almost trifling in itself, which warn the practised physician of the +approach of one of these fearful foes in time to allow him to make a +defence. We can do little more than iterate the warning, that whenever, +at this momentous epoch, any disquieting change appears, be it physical +or mental, let not a day be lost in summoning _skilled_, _competent_ +medical advice. + +There is, however, a train of symptoms so frequent, so insidious, so +fruitful with agony of mind and body, that we shall mention them +particularly. They illustrate, at once, how all-important is close +observation, and how significant to the wise physician are trifles +seemingly light as air. + +If you notice a girl of fourteen or sixteen, who, in walking, always +gives one arm in preference to the other to her companion; if, in +sleeping, she mostly lies on the same side; if, in sitting, she is apt +to prefer a chair with a low back, and throws one arm over its back; if +you perceive that she always sits with one foot a little in advance of +the other; if she, on inquiry, confesses to slight, wandering pains in +one side of her chest,--do not chide her for awkwardness. These are +ominous portents. They mean _spinal disease_, than which a more fearful +malady is hardly known to medicine. + +Not less stealthy is the approach of disease of the hip-joint, of white +swelling of the knee, of consumption,--all curable if taken in hand at +the very first, all well-nigh hopeless when they have once unmasked +their real features. + +Apart from these general dangers, to which those of thoroughly sound +constitutions are not exposed, there are disorders called functional, to +which all are subject. + + +GREEN SICKNESS. + +When we speak of the 'green sickness,' we mention perhaps the most +common of all, and one of which every mother has heard. Doctors call it +_chlorosis_, which also means _greenness_; for one of its most common +and peculiar symptoms is a pale complexion with a greenish tinge. + +It never occurs except at or near the age of puberty, and was long +supposed to be merely an impoverishment of the blood. Now, however, we +have learned that it is a disease of the nervous system, and one very +often confounded by physicians with other complaints. + +Its attack is insidious. A distaste for exertion and society, a fitful +appetite, low spirits,--these are all the symptoms noticed at first. +Then, one by one, come palpitation of the heart, an unhealthy +complexion, irregularity, dyspepsia, depraved tastes,--such as a desire +to eat slate-pencil dust, chalk, or clay,--vague pains in body and +limbs, a bad temper; until the girl, after several months, is a peevish, +wretched, troublesome invalid. + +Then, if a physician is called in, and gives her iron, and tells her +nothing is the matter, or is himself alarmed, and imagines she has heart +disease or consumption, it is a chance if she does not rapidly sink, out +of mere fright and over-much dosing, into some fatal complaint. Let it +be well understood that chlorosis, though often obstinate and obscure, +is always curable if properly and promptly treated. The remedies must be +addressed to the nervous system, and can be administered with +intelligence only by a competent medical adviser. It can be prevented by +a hygienic mode of life, and, as its most common causes are anxiety, +home-sickness, want of exercise, or overwork at school, nothing is so +salutary in its early stages as a change of air and scene, cheerful +company, a tour to the mountains or some watering-place, and regular +exercise. + +Many young women suffer considerable pain during their monthly illness. +This may arise from many different causes, such as, congestion, +inflammation, malformation, or a wrong position of the parts, or +over-sensitive nerves. They can only be successfully treated when the +cause is known; and they may rest assured that this suffering, in nearly +every case, can be removed. + +Sometimes a girl grows to the age of eighteen or twenty without having +her periodical changes. We have already said that this is not unusual in +some climates and in some families; so, as long as the general health is +good and the spirits cheerful,--always an important point,--it need +cause no anxiety. But if the health grow poor, and especially if there +be pains and weakness recurring monthly without discharge, then +something is wrong, and the doctor should be consulted. + + +HYSTERICS. + +There is a disease of the nerves to which girls about the age of puberty +are very subject, particularly in the higher circles of society, where +their emotions are over-educated and their organization delicate. It is +called hysteria, and more commonly _hysterics_. Frequently it deceives +both doctor and friends, and is supposed to be some dangerous complaint. +Often it puts on the symptoms of epilepsy, or heart disease, or +consumption. We have witnessed the most frightful convulsions in girls +of fourteen or fifteen, which were brought on by this complaint. +Sometimes it injures the mind; and it should always receive prompt and +efficient attention, as it is always curable. + +This disease is apt to produce a similar affection in other girls of the +same age who see the attacks. For this reason, hysterical girls should +not be sent to large schools, but cured at home. Often a strong mental +impression restores them. The anecdote is told of a celebrated surgeon +(Boerhaave) who was called to a female seminary where there was a number +of hysterical girls. He summoned them together, heated a number of iron +instruments before their eyes, and told them that the first one who had +a fit should be cauterized down the spine. They all recovered +immediately. + + +SECRET BAD HABITS. + +We now approach a part of our subject which we would gladly omit, did +not constant experience admonish us of our duty to speak of it in no +uncertain tone. We refer to the disastrous consequences on soul and body +to which young girls expose themselves by exciting and indulging morbid +passions. Years ago, Miss Catherine E. Beecher sounded a note of warning +to the mothers of America on this secret vice, which leads their +daughters to the grave, the madhouse, or, worse yet, the brothel. + +Gladly would we believe that her timely admonition had done away with +the necessity for its repetition. But though we believe such a habit is +more rare than many physicians suppose, it certainly exists to a degree +that demands attention. Surgeons have recently been forced to devise +painful operations to hinder young girls from thus ruining themselves; +and we must confess that, in its worst form, it is absolutely incurable. + +The results of the constant nervous excitement which this habit produces +are bodily weakness, loss of memory, low spirits, distressing +nervousness, a capricious appetite, dislike of company and of study, +and finally, paralysis, imbecility, or insanity. Let it not be supposed +that there are many who suffer thus severely; but, on the other hand, +let it be clearly understood that any indulgence whatever in these evil +courses is attended with bad effects, especially because they create +impure desires and thoughts, which will prepare the girl to be a willing +victim to the arts of profligacy. There is no more solemn duty resting +on those who have the charge of young females than to protect them +against this vice. + +But, it is exclaimed, is it not dangerous to tell them anything about +it? Such a course is unnecessary. Teach them that any handling of the +parts, any indecent language, any impure thought, is degrading and +hurtful. See that the servants, nurses, and companions with whom they +associate are not debased; and recommend scrupulous cleanliness. + +If the habit is discovered, do not scold nor whip the child. It is +_often_ a result of disease, and induced by a disagreeable local +itching. Sometimes this is connected with a disorder of the womb, and +very frequently with worms in the bowels. Let the case be submitted to a +judicious, skilful medical adviser, and the girl will yet be saved. But +do not shut your eyes, and refuse to see this fact when it exists. +Mothers are too often unwilling to entertain for a moment the thought +that their daughters are addicted to such a vice, when it is only too +plain to the physician. + + +THE HYGIENE OF PUBERTY. + +Concerning the maladies of puberty, we may broadly say, that if we are +obliged to have recourse to medicine, it is because we have neglected +hygiene. That the period requires assiduous care, we grant; but given +that care, drugs will be needless. + +In a general way, we have already emphasized the danger of indolence and +the benefits of exercise or labor; the perils of exciting the emotions, +and the advantages of a placid disposition; the impropriety of premature +development, and the wisdom of simplicity and moderation. This is an old +story--a thrice-told tale. Let us go more into minutiae. + +One of the most frequent causes of disease, about the age of puberty, is +_starvation_. Many a girl is starved to death. Food is given her, but +not of the right quality, or in insufficient quantity, or at improper +hours. The system is not nourished, and, becoming feeble, it is laid +open to the attacks of disease, and to no form of disease more readily +than to consumption. + +To correct this, let the food be varied, simply prepared, and abundant. +Good fresh milk should be used daily, while tea and coffee should be +withheld. Fat meats and vegetable oils, generally disliked by girls at +this age, are exactly what they need; and were they partaken of more +freely, there would be less inquiry at the druggists for cod-liver oil. + +A modern writer of eminence lays it down as one of the most common +causes of consumption in young people, that just at the age when their +physical system is undergoing such important changes, that invaluable +article of diet, _milk_, is generally dropped, and nothing equally rich +in nitrogen substituted in its place. + +_Exercise_, whether as games, the skipping rope, croquet, walking, +dancing, riding, and calisthenics, or as regular labor, is highly +beneficial, especially when it leads one into the fresh air, the +sunshine, and the country. A particular kind of exercise is to be +recommended for those whose chests are narrow, whose shoulders stoop, +and who have a hereditary predisposition to consumption. If it is +systematically practised along with other means of health, we would +guarantee any child, no matter how many relatives have died of this +disease, against its invasion. It is voluntary inspiration. Nothing is +more simple. Let her stand erect, throw the shoulders well back, and the +hands behind; then let her slowly inhale pure air to the full capacity +of the lungs, and retain it a few seconds _by an increased effort_; then +it may be slowly exhaled. After one or two natural inspirations, let her +repeat the act, and so on for ten or fifteen minutes, twice daily. Not +only is this simple procedure a safeguard against consumption, but, in +the opinion of some learned physicians, it can even cure it when it has +already commenced. + +At first the monthly loss of blood exhausts the system. Therefore, +plenty of food, plenty of rest, plenty of sleep, are required. That +ancient prejudice in favour of early rising should be discarded now, and +the girl should retire early, and if she will, should sleep late. Hard +study, care, or anxiety should be spared her. This is not the time for +rigid discipline. + +_Clothing_ is a matter of importance, and, if we were at all sure of +attention, there is much we would say of it. The thought seriously +troubles us, that so long as women consent to deform themselves and +sacrifice their health to false ideas of beauty, it is almost hopeless +to urge their fitness for, and their right to a higher life than they +now enjoy. No educated painter or sculptor is ignorant of what the model +of female beauty is; no fashionable woman is content unless she departs +from it as far as possible. + +Now beauty implies health, and ugliness of form is attained not only at +the expense of aesthetics, but of comfort. The custom of fastening +growing girls in tight corsets, of flattening their breasts with pads, +of distorting their feet in small high-heeled shoes, and of teaching +them to stoop and mince in gait, is calculated to disgust every observer +of good sense and taste, and, what is of more consequence, to render +these girls, when they become women, more liable to every species of +suffering connected with child-bearing. + +The monthly change is the prelude to maternity. On its healthful +recurrence depends present comfort and future health; and not these +alone, but also happiness in marriage, easy child-beds, and the +constitution of children to a degree the thoughtless girl and even the +mature woman rarely understand. She, therefore, who neglects the due +care of her own condition, violates a duty owed to others as well as +herself. We would have mothers impress this on their daughters. Let no +mistaken modesty prevent them. + +Especially at their commencement should the monthly changes be carefully +watched. The mother should prepare her daughter's mind betimes for such +an expected incident in her life, thus preventing a useless fright, or +the employment of injurious means to stop what the child may look upon +as an accident. + +Nor should the maternal care cease here. Such tender sympathy should +exist on the one side, such trusting confidence on the other, that the +mother should acquaint herself with every detail of each recurring +period until the function is thoroughly established. She should inquire +into the duration of each epoch, the abundance of the discharge, the +presence of pain, and its effects on the general health. She should +convince herself that all these do not vary from the standards of health +we have previously laid down. Or should they do so, she should not delay +to use the proper means to bring them to that standard. + +Long observation proves that if, during the first two or three years +which follow the attainment of puberty, the health of the girl is +successfully guarded, and this, her most important physical distinction, +meets with no derangement, her life-long health is well-nigh secured; +but, on the contrary, if she commences her sexual life with pain and +disorder, she is likely to be a life-long sufferer. + +We are about to approach a topic of vital importance, therefore, in +summing up as briefly as may be, the precautions necessary to attain +this end. They can most conveniently be divided into those to be +observed during the monthly changes, and those more general rules of +health to be obeyed in the intervals of the periods. + + +PRECAUTIONS DURING THE MONTHLY CHANGES. + +At the head of all cautions and warnings which we could give about the +care of the health at these monthly periods, we put _rest_, _rest_, +bodily and mental. _Do less than usual_, we say to all, whether the +necessity for it is manifest or not. Over-exertion is a most fruitful +cause of disease. Long walks, shopping, dancing, riding, hard work +whether for pleasure or profit, should be avoided to the utmost. + +The advantages of rest cannot be over-estimated. A striking example of +it occurs to our mind. Most readers are aware how toilsome are the lives +of the Indian women among our Western tribes, and also how singularly +easy and almost painless is their child-bearing. The pangs of travail +are almost unknown to them. The cause of this has puzzled even +physicians. We can tell them. It is because it is an inviolable, a +sacred rule among all those tribes, for the woman, when having her +monthly sickness, to drop all work, absent herself from the lodge, and +remain in perfect rest as long as the discharge continues. + +Traces of this wide-spread custom among primitive people, extended +themselves, are discoverable among civilized lands. The famous general +council of the Christian Church held at Nice in the fourth century, +passed a rule disapproving of women coming to church at the times of +their menstrual sickness. The cold and dampness of large edifices, the +mental excitement and its unfavourable effects and the exertion +requisite for long walks to and fro, would justify this rule on purely +hygienic grounds, and such may have caused its adoption. + +A moderate and uniform temperature favors health at such epochs; while +exposure to heat or cold, and the drinking freely of iced water or +stimulants should be shunned. + +The popular belief that bathing is hurtful, is correct so far as either +cold or hot baths are concerned; but it is well to know, in the +interests of comfort and cleanliness, that a moderately warm-bath, about +80 deg. Fahr., _will do no injury_. Such a bath can be taken without any +hesitation. + +We sanction, also, another well-known rule, and that is, that no +purgative medicine should be taken immediately before or during the +change. If called for by some other disorder, a mild laxative is all +that should be administered, unless by the direction of a physician. + + +PRECAUTIONS IN THE INTERVALS OF THE MONTHLY CHANGES. + +If girls suffer from irregularities in this respect, the causes can +generally be found either in some affection threatening the general +health, such as scrofula, consumption, green sickness, etc., or else in +their mode of life. For the former, the family physician must be +consulted; but if it is the latter which is at fault, the remedy is in +the hands of the parents. + +Boarding-school life, city life, mental troubles--these are the three +fertile sources of disturbances in the sexual functions of girlhood. + +No one rates at higher value than ourselves the training of the mind; +but we do not hesitate a moment to urge that if perturbations of the +functions become at all marked in a girl at school, she should be _taken +away_. Better live at home in seeming idleness a year at that time of +life, than become a dead-weight, through constant ill health, on her +husband in after life. + +So of the unwholesome excitement of a city life. There is a poison in +crowds, and it acts in a thousand unseen ways. With the ceaseless noise, +the broken sleep, the late hours, the impure air, and the nervous +tension which all these produce, it requires no strength of imagination +to perceive that the city is not the best place for the delicate girl. + +We have mentioned _mental troubles_. Perhaps there are, among those who +read this, some superficial enough to smile at the possibility of +serious mental troubles in girlhood. There are, we know, many unfeeling +enough to give them no attention when they do see them. But we have an +unfailing witness in the sympathetic heart of the mother. She has not +forgotten how bitter were the crosses of her own younger years; she +knows that the sensitive soul of woman wakes early to the keenest +appreciation of grief as well as joy. If anything, years blunt us, and +the sorrows of youth are often the bitterest of our lives. + +Let the mother, therefore, read with her wondrous maternal instinct the +trials of her daughter; let her become her most intimate confidant, and +pour upon the wounded spirit that balm which none but a woman, and that +woman a mother, knows how to apply. Such a relationship of mother and +daughter is no less natural and wholesome than it is beautiful. + + +WHEN THE CHANGES ARE DELAYED. + +In health an equal interval, or one nearly equal, elapses between the +monthly illnesses. Often in the spring, however, their appearance +anticipates the expected date of their occurrence, and in the autumn +they are frequently a day or two late. These variations are owing to the +temperature, heat accelerating and cold retarding the process of +ovulation. + +Such slight irregularities need not give rise to anxiety; but if there +is an unwonted delay, combined with other symptoms of ill-health, as +headache, pain in the side and back, a sense of languor and exhaustion, +loss of appetite, and nausea, and fitful sleep, then it is important +that some steps be taken to bring on the courses. For this purpose, +soaking the feet in hot-mustard water, a tumbler of hot ginger or +camomile-tea, a brisk walk, or a gentle laxative will generally be found +sufficient. Gently kneading the lower abdomen and loins is a familiar, +and if intelligently done, a safe means for the same purpose. + +More violent means than these should be eschewed. Whichever are used +subsequent to their employment, rest, in a recumbent position, in a +warm room should be secured. + + +WHEN THE CHANGES ARE PAINFUL. + +There are wide individual differences in this respect. Some young women +suffer much from local pains, headache and languor at such epochs, +without apparently losing anything in general health; others experience +no distress whatever. + +The causes of painful periods are various. Sometimes they depend on a +tendency to rheumatism or to ague. Over-work, or excessive devotion to +social duties and pleasures, is often their source. Cold and damp are +common incidental causes. Green sickness and general debility are +sometimes to blame. + +Of course the treatment must depend on which one of these is present. It +is a good rule, however, always to wear flannel next the skin; also, to +avoid exposure to the weather for several days before the change is +expected. A large, hot, linseed-meal poultice, over which a +dessert-spoonful of laudanum has been sprinkled, or a large +mustard-plaster, spread on the lower abdomen, will afford much relief. A +hot brick or bottle of hot water wrapped in flannel, and applied to the +small of the back, is often of great service. Rest in bed is always to +be recommended. A tea-spoonful of sweet spirits of nitre will sometimes +bring early relief. + +But if these simple means are not sufficient, it would be better to +consult a physician. + +A common belief is that such troubles are cured by marriage. Sometimes +they are, but we do not approve the remedy. The state of marriage +should be entered upon in perfect health and full vigor. Upon it +depends the health of future generations, and it were better for them +did only those assume its bonds who are able to endow their children +with sound physical frames. + + +THE AGE OF NUBILITY. + +It does not follow, because a girl is capable of marriage, that she is +fit for it. Science teaches us many valid objections to too early +unions. It goes farther, and fixes a certain age at which it is wisest +for woman to marry. This age is between twenty and twenty-five years. + +Anatomists have learned that after puberty the bones of a woman's body +undergo important modifications to fit her for child-bearing. This +requires time, and before twenty the process is not completed. Until the +woman is perfect herself, until her full stature and completed form are +attained, she is not properly qualified to assist in perpetuating the +species. + +We might urge that up to this moment neither does her self-knowledge +qualify her to choose a life-companion, nor can her education be +finished, nor is her experience sufficient for her to enter on the +duties of a matron. But we do not appeal to these arguments. There are +others still more forcible. If her own health, life, and good looks are +of value to her, if she has any wish for healthy, sound minded children, +she will refrain from premature nuptials. + +A too youthful wife finds marriage not a pleasure but a pain. Her +nervous system is prostrated by it; she is more liable to weakness and +diseases of the womb; and if of a consumptive family, she runs great +risk of finding that fatal malady manifest itself after a year or two of +wedded life. It is very common for those who marry young to die young. + +From statistics which have been carefully compiled, it is proven that +the first labors of very young mothers are much more painful, tedious, +and dangerous to life, than others. As wives, they are frequently +visited either with absolute sterility, and all their lives must bear +the reproach of barren women, or, what to many is hardly less +distasteful, they have an excessively numerous family. + +What adds to their sufferings in the latter event, is that the children +of such marriages are rarely healthy. They are feeble, sickly, +undersized, often with some fault of mind or body, which is a cross to +them and their parents all their lives. They inherit more readily the +defects of their ancestors, and, as a rule, die at earlier years than +the progeny of better-timed unions. + +These considerations are formidable enough, it would seem, to prevent +young girls from marrying, without the need of a law, as exists in some +countries. Moreover, they are not imaginary, but real, as many a woman +finds out to her cost. + +The objections to marriage after the age of twenty-five are less cogent. +They extend only to the woman herself. She should know that the first +labors of wives over thirty are nearly _twice_ as fatal as those between +twenty and twenty-five. Undoubtedly nature points to the period between +the twentieth and twenty-fifth year as the fittest one for marriage in +the woman. + + + + +_LOVE._ + + +ITS POWER ON HUMANITY. + +Love, pure love, true love, what can we say of it? The dream of youth; +the cherished reminiscence of age; celebrated in the songs of poets; +that which impels the warrior to his most daring deeds; which the +inspired prophet chooses to typify the holiest sentiments,--what new +thing is it possible to say about this theme? + +Think for a moment on the history or the literature of the world. Ask +the naturalist to reveal the mysteries of life; let the mythologist +explain the origin and meaning of all unrevealed religions; look within +at the promptings of your own spirit, and this whole life of ours will +appear to you as one grand epithalamium. + +The profoundest of English poets has said-- + + 'All thoughts, all passions, all delights, + Whatever stirs this mortal frame, + All are but ministers of Love, + And feed his sacred flame.' + +That life which is devoid of love is incomplete, sterile, +unsatisfactory. It fails of its chiefest end. Nature, in anger, blots it +out sooner, and it passes like the shadow of a cloud, leaving no trace +behind. Admirable as it may be in other respects, to the eye of the +statesman, the physician, the lover of his species, it remains but a +fragment, a torso. + +Love is one thing to a woman, another to a man. To him, said Madame de +Stael, it is an episode; to her, it is the whole history of life. A +thousand distractions divert man. Fame, riches, power, pleasure, all +struggle in his bosom to displace the sentiment of love. They are its +rivals, not rarely its masters. But woman knows no such distractions. +One passion only sits enthroned in her bosom; one only idol is enshrined +in her heart, knowing no rival, no successor. This passion is love! This +idol is its object. + +This is not fancy, not rhetoric; it is the language of cold and exact +science, pronounced from the chair of history, from the bureau of the +statistician, from the dissecting table of the anatomist. We shall +gather up their well-weighed words, and present them, not as fancy +sketches, but as facts. + +This deep, all-absorbing, single, wondrous love of woman, is something +that man cannot understand. This sea of unfathomed depth is to him a +mystery. The shallow mind sees of it nothing but the rippling waves, the +unstable foam-crests dashing hither and thither, the playful ripples of +the surface, and, blind to the still and measureless waters beneath, +calls woman capricious, uncertain,--_varium et mutabile_. But the +thinker and seer, undeceived by such externals, knows that beneath this +seeming change is stability unequaled in the stronger sex, a power of +will to which man is a stranger, a devotion and purpose which strike him +with undefined awe. + +Therefore, in the myths and legends which the early races framed to +express their notions of divine things,--the Fates, who spin and snip +the thread of life; the Norns, who + + Lay down laws, + And select life + For the children of time-- + The destinies of men,-- + +are always females. The seeresses and interpreters of oracles--those +who, like the witch of Endor, could summon from the grave the shades of +the departed--were women. + +Therefore, also, modern infidelity, going back, as it ever does, to the +ignorance of the past, and holding it up as something new, makes woman +the only deity. Comte and his disciples, having reasoned away all gods, +angels, and spirits, and unable to still the craving for something to +adore, agree to meet once a week to worship--woman. The French +revolutionists, having shut up the churches and abolished God by a +decree of the Convention, set up in His stead--a woman. + +We could never exhaust this phase of world-history. Everywhere we see +the unexpected hand of Love moulding, fashioning all things. The +fortunes of the individual, the fate of nations, the destinies of races, +are guided by this invisible thread. Let us push our inquiries as to the +nature of this all-powerful agent. + + +WHAT IS LOVE? + +It has a divided nature. As we have an immortal soul, but a body of +clay; as the plant roots itself in decaying earth, but spreads its +flowers in glorious sunlight,--so love has a physiological and a moral +nature. It is rooted in that unconscious law of life which bids us +perpetuate our kind; which guards over the conservation of life; which +enforces, with ceaseless admonition, that first precept which God gave +to man before the gates of Eden had been closed upon him: 'Be thou +fruitful, and multiply, and replenish the earth.' Nothing but a spurious +delicacy, or an ignorance of facts, can prevent our full recognition +that love looks to marriage, and marriage to offspring, as a natural +sequence. + +Do we ask proofs of this? We have them in abundance. Those unfortunate +beings who are chosen by Oriental custom to guard the seraglios undergo +a mutilation which disqualifies them from becoming parents. Soon all +traces of passion, all regard for the other sex, all sentiments of love, +totally disappear. The records of medicine contain not a few cases where +disease had rendered it necessary to remove the ovaries from women. At +once a change took place in voice, appearance, and mind. They spoke like +men, a slender beard commenced on their faces, a masculine manner was +conspicuous in all their motions, and every thought of sexual love +passed away for ever. These are the results in every case. What do they +signify? Undoubtedly that the passion of love is dependent upon the +capacity of having offspring, and that such was the intention of Nature +in implanting in our bosom this all-powerful sentiment. + +But this is not all. Nature, as beneficent to those who obey her +precepts as she is merciless to those who disregard them, has added to +this sentiment of love a physical pleasure in its gratification,--an +honourable and proper pleasure, which none but the hypocrite or the +ascetic will affect to condemn, none but the coarse or the lewd will +regard as the object of love. There is, indeed, a passion which is the +love of the body. We call it by its proper name of _lust_. There is +another emotion, for which the rich tongue of the ancient Greeks had a +word, to which we have nothing to correspond. Call it, if you will, +Platonic love, and define it to be an exalted friendship. But understand +that neither the one nor the other is _love_, in the true sense of the +word, and that _both_ are inferior to it. + +Does the father, watching, with moistened eyes, his child at its +mother's breast; does the husband, bending with solicitude over the +sick-bed of his wife; does the wife, clinging to her husband through +evil report and good report, through broken fortunes and failing health, +indicate no loftier emotion than _lust_, no warmer sentiment than +_friendship_? What ignorance, what perversity is so gross as not to +perceive something here nobler than either? Do you say that such scenes +are, alas, rare? We deny it. We see them daily in the streets; we meet +them daily in our rounds. Admitted, by our calling, to the sacred +precincts of many houses in the trying hours of sickness and death, we +speak advisedly, and know that this is the prevailing meaning of love in +domestic life. + +A warm, rich affection blesses the one who gives and the one who +receives. Character developes under it as the plant beneath the +sunlight. Happiness is an unknown word without it. Love and marriage are +the only normal conditions of life. Without them, both man and woman for +ever miss the best part of themselves. They suffer more, they sin more, +they perish sooner. These are not hasty assertions. As a social law, let +it be well understood that science pronounces that + + +LOVE IS A NECESSITY. + +The single life is forced upon many of both sexes, in our present social +condition. Many choose it from motives of economy, from timidity, or as +a religious step, pleasing to God. The latter is a notion which probably +arose from a belief that, somehow, celibacy, strictly observed, means +chastity. It simply means continence. The chastest persons have been, +and are, not the virgins and celibates, but the married. When this truth +is known better, we shall have fewer sects and more religion. + +We know women who refrain from marrying to keep out of trouble. The old +saying is, that every sigh drives a nail in one's coffin. They are not +going to worry themselves to death bearing children and nursing them! It +is too great a risk, too much suffering. How often have we been told +this! Yet how false the reasoning is! Very carefully prepared statistics +show that between the ages of twenty and forty-five years, more +unmarried women die than married, and few instances of remarkable +longevity in an old maid are known. The celebrated Dr. Hufeland, +therefore, in his treatise on the _Art_ _of Prolonging Life_, lays it +down as a rule, that to attain a great age, one must be married. + +As for happiness, those who think they can best attain it outside the +gentle yoke of matrimony are quite as wide of the mark. Their selfish +and solitary pleasures do not gratify them. With all the resources of +clubs, billiard-rooms, saloons, narcotics, and stimulants, single men +make but a mock show of satisfaction. At heart every one of them envies +his married friends. How much more monotonous and more readily exhausted +are the resources of woman's single life! No matter what 'sphere' she is +in, no matter in what 'circle' she moves, no matter what 'mission' she +invents, it will soon pall on her. Would you see the result? We invoke +once more those dry volumes, full of lines and figures, on vital +statistics. Stupid as they look, they are full of the strangest stories; +and what is more, the stories are all true. Some of them are sad +stories, and this is one of the saddest: Of those unfortunates who, out +of despair and disgust of the world, jump from bridges, or take arsenic, +or hang themselves, or in other ways rush unbidden and unprepared before +the great Judge of all, _nearly two-thirds_ are unmarried, and in some +years nearly _three-fourths_. And of those other sad cases--dead, yet +living--who people the madhouses and asylums, what of them? Driven crazy +by their brutal husbands, do you suggest? Not at all! In France, +Bavaria, Prussia, Hanover, four out of every five are unmarried; and +throughout the civilised world there are everywhere three or four single +to one married woman in the establishments for the insane, in +proportion to the whole number of the two classes above twenty-one years +of age. + +Other women decline to marry because they have, forsooth, a 'life work' +to accomplish. Some great project fills their mind. Perchance they +emulate Madame de Stael, and would electrify the country by their novel +views in politics; or they have a literary vein they fain would exploit; +or they feel called upon to teach the freedmen, or to keep their +position as leaders of fashion. A husband would trammel them. If they +did marry, they would take the very foolish advice of a contemporary, +and go through life with an indignant protest at its littleness. Let +such women know that they underrate the married state, its powers and +its opportunities. There are no loftier missions than can there be +carried out, no nobler games than can there be played. When we think of +these objections, coming, as they have to us, from high-spirited, +earnest girls, the queens of their sex, our memory runs back to the +famous women of history, the brightest jewels in the coronet of time, +and we find as many, ay, more, married women than single who pursued to +their ends mighty achievements. + +If you speak of Judith and Joan of Arc, who delivered their fatherlands +from the enemy by a daring no man can equal, we shall recall the +peaceful victories of her, wife of the barbarian Chlodwig, who taught +the rude Franks the mild religion of Nazareth, and of her who extended +from Byzantium the holy symbol of the cross over the wilds of Russia. +The really great women of this age, are they mostly married or single? +They are mostly married, and they are good wives and tender mothers. + +What we have just written, we read to an amiable woman. + +'But,' she exclaimed, 'what have you to say to her whom high duties or a +hard fate condemns to a single life, and to the name of the old maid?' + +Alas! what can we say to such? We feel that + + 'Earthlier happy is the rose distilled, + Than that which, withering on the virgin thorn, + Grows, lives, and dies in single blessedness.' + +Yet there is ever a blessing in store for those who suffer here, and the +hope of the future must teach them to bear the present. + + +LOVE IS ETERNAL. + +We have said love is a necessity in the life of either man or woman to +complete their nature. Its effects, therefore, are eternal. We do not +intend this as a figure of speech. It is a sober statement of +physiology. + +From the day of marriage the woman undergoes a change in her whole +structure. She is similar to her former self, but not the same. It is +often noticed that the children of a woman in her second marriage bear a +marked resemblance to her first husband. In the inferior races and lower +animals this obscure metamorphosis is still more apparent. A negress who +has borne her first child to a white man, will ever after have children +of a color lighter than her own. Count Strzelewski, in his Travels in +Australia, narrates this curious circumstance: A native woman who has +once had offspring by a white man, can never more have children by a +male of her own race. Dr. Darwin relates that a male zebra was once +brought to England, and a hybrid race, marked by the zebra's stripes, +was produced from certain mares. Always after, the colts of those mares +bore the marks of the zebra on their skins. In some way the female is +profoundly altered throughout her whole formation, and entirely +independent of her will, by the act of marriage, and the alteration is +never effaced. + +If the body is thus influenced, shall not the far more susceptible mind +and spirit be equally impressed? + +Another common observation supports what we say, and extends it farther. +Not the woman alone,--the man also undergoes a change, and loses a +portion of his personality in his mate. They two are one, not merely in +a moral sense. We constantly notice a decided resemblance in old couples +who have passed, say, two score years together. They have grown to look +alike in form, feature, and expression. That for so long a time they +have breathed the same air, eaten the same fare, and been subjected to +the same surroundings, explains this to some extent. But the greater +part of the change flows from mental sources. They have laughed and wept +together; they have shared the same joys and pleasures; a smile or a +tear on the face of one has evoked a corresponding emotion and +expression on the face of the other. Their co-partnership has become a +unity. Even without speaking, they sympathize. Their souls are +constantly _en rapport_. The man is as different as the woman from his +former self. + + +OF SECOND MARRIAGES. + +Science, therefore, seems to say to woman, 'Your first husband is your +eternal husband.' How, then, about second marriages? Are we to say that +they are not advisable? + +Let us not answer hastily. It is yet to be seen whether ill-assorted +marriages produce those impressions we have mentioned. They may, indeed, +on the body, while the mind is free. One must remember, also, that the +exigencies of social life must be consulted. If a woman cannot love two +men equally,--and she cannot,--other motives, worthy of all respect, +justify her in entering the marriage life a second time. Then, the +higher refinements of the emotions are not given to all alike, nor do +they come at the same age to all. True love may first dawn upon a woman +after one or two husbands have left her a widow. Orphan children, +widow-hood, want of property, or the care of property,--these are sad +afflictions to the lonely woman. Do not blame her if she accepts a +husband as a guardian, a protector, whom she can no longer receive to +her arms as a lover. She is right. + +We cherish the memory of a lady of strong character, who died past +eighty. She had survived three husbands. 'The first,' she said, 'I +married for love, the second for position, the third for friendship. I +was happy with them all.' But when, in her mortal illness, this +venerable friend sank into the delirium which preceded death, she +constantly called out the name of her first husband only. More than +half a century had not effaced the memory of those few years of early +love. This is fidelity indeed. + + +OF DIVORCE. + +He of Nazareth laid down the law that whoever puts away his wife for any +cause except adultery, and marries again, commits adultery; and that +whatever woman puts away her husband for any cause save adultery, and +marries again, herself commits adultery. + +This has been found a hard saying. + +John Milton wrote a book to show that the Lawgiver did not mean what He +said, but something quite different. Modern sects, calling themselves +_Christians_, after this Lawgiver, dodge the difficulty, and refer it to +State legislatures. State legislatures, not troubling themselves at all +about any previous law or lawgiver, allow dozens of causes--scores of +them--as perfectly valid to put asunder those whom God has joined +together. + +Science, which never finds occasion to disagree with that Lawgiver of +Nazareth, here makes His words her own. + +Whether we look at it as a question in social life, in morals, or in +physiology, the American plan of granting absolute divorces is +dangerous, and destructive to what is best in life. It leads to hasty, +ill-assorted matches, to an unwillingness to yield to each other's +peculiarities, to a weakening of the family ties, to a lax morality. +Carry it a trifle farther than it now is in some of the Western States, +and marriage will lose all its sacredness, and degenerate into a +physical union, not nobler than the crossing of flies in the air. + +Separation of bed and board should always be provided for by law; and +whether single, married, or separated, the woman should retain entire +control of her own property. But in the eyes of God and nature, a woman +or a man with two faithful spouses living, to each of whom an eternal +fidelity has been plighted, is a monster. + + +OF A PLURALITY OF WIVES OR HUSBANDS. + +What has been said of divorce applies with tenfold force to the custom +of a woman living as wife to several men, or of a man as husband to +several women. We should not speak of these customs, but that we know +both exist in America, not among the notoriously wicked, but among those +who claim to be the peculiarly good--the very elect of God. They +prevail, not as lustful excesses, but as religious observances. + +It is worth while to say that such practices lead to physical +degradation. The woman who acknowledges more than one husband is +generally sterile; the man who has several wives has usually a weakly +offspring, principally males. Nature attempts to check polygamy by +reducing the number of females, and failing in this, by enervating the +whole stock. The Mormons of Utah would soon sink into a state of Asiatic +effeminacy were they left to themselves. + + +COURTSHIP. + +A wise provision of nature ordains that _woman shall be sought_. She +flees, and man pursues. The folly of modern reformers, who would annul +this provision, is evident. Were it done away with, man, ever prone to +yield to woman's solicitations, and then most prone when yielding is +most dangerous, would fritter away his powers at an early age, and those +very impulses which nature has given to perpetuate the race would bring +about its destruction. + +To prevent such a disaster, woman is endowed with a sense of shame, an +invincible modesty, her greatest protection, and her greatest charm. Let +her never forget it, never disregard it; for without it she becomes the +scorn of her own sex and the jest of the other. + +The urgency of man and the timidity of woman are tempered by the period +of courtship. + +This, as it exists in the United States, is something almost peculiar to +Americans. On the continent of Europe, girls are shut up in convents or +in seminaries, or are kept strictly under the eyes of their parents +until marriage, or, at any rate, betrothal. The liberty usual in America +is something unheard-of and inconceivable there. In Spain a duenna, in +France some aunt or elderly cousin, in Germany some similar person, +makes it her business to be present at every interview which a young +lady has with an admirer. He never dreams of walking, driving, or going +out of an evening with her alone. It is taken for granted that, should +he invite her for such a purpose, the mother or aunt is included in the +party. They would look on the innocent freedom of American girls as +simply scandalous. + +We have had opportunities to see society in these various countries, and +have failed to perceive that the morality of either sex is at all +superior to what it is with us, while the effect of cloister-like +education on young women is to weaken their self-reliance, and often +prepare them for greater extravagances when marriage gives them liberty. + +With us, the young woman is free until her wedding day. After that +epoch, she looks forward to withdrawing more or less from society, and +confining her thoughts to family matters. In France, Spain, or Italy, in +the wealthier classes, precisely the contrary is the rule. Marriage +brings deliverance from an irksome espionage and numberless fetters; it +is the avenue to a life in public and independent action. How injurious +to domestic happiness this is, can readily be imagined. + +It is true that the liberty of American girls occasionally leads to +improprieties. But, except in certain great cities, such instances are +rare. The safeguards of virtue are knowledge and self-command, not +duennas and _jalousies_. Let mothers properly instruct their daughters, +and they need have no apprehension about their conduct. + +The period of courtship is one full of importance. A young woman of +unripe experience must decide from what she can see of a man during the +intercourse of a few months, whether he will suit her for a +life-companion. She has no knowledge of human nature; and what would it +avail her if she had, when at such a time a suitor is careful only to +show his eligible traits? 'Go a-courting,' said old Dr Franklin, in his +homely language, 'in your everyday clothes.' Not one man out of a +thousand is honest enough to take his advice. + +It is useless for her to ask aid of another. She must judge for herself. +What, then, is she to do? + +There is a mysterious instinct in a pure-minded woman which is beyond +all analysis,--a tact which men do not possess, and do not readily +believe in. At such a crisis this instinct saves her. She feels in a +moment the presence of a base, unworthy nature. An unconscious repulsion +is manifest in her eye, her voice. Where a suitor is not a man of low +motive, but merely quite incongruous in temper and disposition, this +same instinct acts, and the man, without being able to say just why, +feels that he is laboring in vain. If he blindly insists in his wooing, +he has no one to chide but himself when he is finally discarded. + +But if the man is worthy, and suitable, does this blessed instinct +whisper the happy news with like promptness to the maiden's soul? Ah! +that raises another issue. It brings us face to face with that difficult +question of + + +LOVE AT FIRST SIGHT. + +Jung Stilling, a German author of note, a religious enthusiast, and full +of queer fancies, was, when young, a tutor in a private family. On one +occasion his employer took him to a strange house, and introduced him +to a roomful of company. Stilling had not contemplated marriage; but, in +the company, he saw, for the first time, a young woman who he felt was +his destined wife. Walking across the room, he addressed her with the +utmost simplicity, telling her that an inward monitor advised him that +she, of all womankind, was his predestined helpmeet. She blushed, was +confused, but presently confessed that she had experienced the same +conviction on first beholding him. They married, and the most curious +part of the tale remains to tell,--it is, that they proved a happy, +well-matched couple. + +We do not advise others to follow their example. Not many souls are +capable of such reciprocity. Choosing an associate for life is too +serious a business to be made the affair of a moment. Reason, +reflection, thought, prayer,--these are aids in such a momentous +question not to be lightly thrown aside. Many a passing fancy, many an +evanescent preference, catches for a moment the new-fledged affections. +But for the long and tedious journey of life we want a love rooted in +knowledge. + +We are not blind to the fact, that often from the first interview the +maiden feels an undefined spell thrown around her by him who will become +her husband. She feels differently in his presence; she watches him with +other eyes than she has for the rest of men. She renders no account to +herself of this emotion; she attempts no analysis of it; she does not +acknowledge to herself that it exists. No matter. Sooner or later, if +true to herself, she will learn what it is, and it will be a guide in +that moment, looked forward to with mingled hopes and fears, when she +is asked to decide on the destiny, the temporal and eternal destiny, of +two human lives. + +That she may then decide aright, and live free from the regrets of a +false step at this crisis of life, we shall now rehearse what medical +science has to say about + + +HOW TO CHOOSE A HUSBAND. + + 'Choose well. Your choice is + Brief, and yet endless.' + +Woman holds as an inalienable right, in this country, the privilege of +choice. It is not left to notaries, or parents, to select for her, as is +the custom in some other parts of the world. + +First comes the question of relationship. A school-girl is apt to see +more of her cousins than of other young men. Often some of them seek at +an early hour to institute a far closer tie than that of blood. Is she +wise to accept it? + + +SHALL COUSINS MARRY? + +Hardly any point has been more warmly debated by medical men. It has +been said that in such marriages the woman is more apt to be sterile; +that if she have children, they are peculiarly liable to be born with +some defect of body or mind,--deafness, blindness, idiocy, or lameness; +that they die early; and that they are subject, beyond others, to fatal +hereditary diseases, as cancer, consumption, scrofula, etc. + +An ardent physician persuaded himself so thoroughly of these evils +resulting from marriage of relatives, that he induced the Legislature +of Kentucky to pass a law prohibiting it within certain degrees of +consanguinity. Many a married couple have been rendered miserable by the +information that they had unwittingly violated one of nature's most +positive laws. Though their children may be numerous and blooming, they +live in constant dread of some terrible outbreak of disease. Many a +young and loving couple have sadly severed an engagement, which would +have been a prelude to a happy marriage, when they were informed of +these disastrous results. + +For all such we have a word of consolation. We speak it authoritatively, +and not without a full knowledge of the responsibility we assume. + +The risk of marrying a cousin, even a first cousin, is greatly +diminished, provided there is no decided hereditary taint in the family. +And when such hereditary taint does exist, the danger is little more +than in marrying into any other family where it is also found. Indeed, a +certain German author has urged the propriety of such unions, where the +family has traits of mental or physical excellence, as a means of +preserving and developing them! + +So far as sterility is concerned, an examination of records shows, that +whereas in the average of unions one women in _eight_ is barren, in +those between relatives but one in _ten_ is so. And as for the early +deaths of children, while, on an average, fifteen children in a hundred +die under seven years, in the families of nearly-related parents but +twelve in a hundred is the mortality as shown by French statistics. + +The investigations about idiotic and defective children are by no means +satisfactory, and are considered by some of the most careful writers as +not at all proving a greater tendency to such misfortunes in the +offspring of cousins. Among a thousand idiotic children recently +examined in Paris, not one was descended from a healthy consanguinity. + +But as few families are wholly without some lurking predisposition to +disease, it is not well, as a rule, to run the risk of developing this +by too repeated unions. Stock-breeders find that the best specimens of +the lower animals are produced by crossing nearly-related individuals a +certain number of times; but that, carried beyond this, such unions lead +to degeneracy and sterility. Such, also, has been the experience of many +human families. + +How slight a cause even of that most insidious disease, consumption, +such marriages are, may be judged from the fact, that of a thousand +cases inquired into by Dr. Edward Smith, in only six was there +consanguinity of parents. + + +THE MIXTURE OF RACES. + +Mankind, say the school geographies, is divided into five races, each +distinguished by its own color. They are the white, the black, the red, +the yellow, and the brown races. In this country, practically, we have +to do with but the white and black races; and the question is constantly +asked, Shall we approve of marriages between them? Shall a white woman +choose a black man to be her husband? + +We are at the more pains to answer this, because recently a writer--and +this writer a woman, and this woman one of the most widely known in our +land--has written a novel intended to advocate the affirmative of this +question. Moreover, it is constantly mooted in certain political +circles, and is one of the social problems of the day. + +The very fact that it is so much discussed, shows that such a union runs +counter to a strong prejudice. Such aversions are often voices of +nature, acting as warnings against acts injurious to the species. In +this instance it is not of modern origin, created by peculiar +institutions. Three centuries ago, Shakspeare, who had probably never +seen a score of negroes in his life, with the divination of genius, felt +the repugnance which a refined woman would feel to accepting one as her +husband. The plot of one of his plays turns on it. He makes Iago say of +Desdemona: + + 'Not to affect many proposed matches + Of her own clime, complexion, and degree; + Whereto, we see, in all things nature tends: + Foh! one may smell in such a will most rank, + Foul disproportions, thoughts unnatural.' + +It is, indeed, 'nature erring from itself' which prompts to these +marriages. They are not sterile, but the children are sickly and +short-lived. Very few mulattoes reach an old age. + +Then it is well known that the black race cannot survive a northern +climate. Dr. Snow, of Providence, Rhode Island, who has given great +attention to the study of statistics, says emphatically that, in New +England, the colored population inevitably perish in a few generations, +if left to themselves. This debility no woman should wish to give to +her children. + +A mental inferiority is likewise apparent. Friends of the negro are +ready to confess this, but attribute it to his long and recent period of +servitude. We deal with facts only. The inferiority is there, whatever +be its cause; and she who would willingly curse her offspring with it, +manifests indeed 'thoughts unnatural.' + +The children born of a union of the black and red race, negroes and +Indians, are on the contrary, remarkable for their physical vigor and +mental acuteness; though, of course, the latter is limited to the +demands of a semi-barbarous life. + + +SHOULD NATIVE WOMEN MARRY FOREIGNERS? + +When we narrow the question of race to that of nationality, entirely new +elements come in. + +In speaking of the intermarriage of relatives, we showed that a certain +number of such unions in healthy stocks was advantageous rather than +otherwise, but that too many of them lead to deterioration. This law can +be applied to nations. Historians have often observed that the most +powerful states of the world arose from an amalgamation of different +tribes. Rome, Greece, England, are examples of this. On the other hand, +France, Russia, Spain, China, Persia, which have suffered no such +crosses of blood, are either stationary, or depend for their progress on +foreigners. + +Physicians have contributed other curious testimony on this point, the +bearing of which they themselves have not understood. Marriages between +nationalities of the same race are more fertile, and the children more +vigorous, than those between descendants of the same nation. For +instance, it has been proved that if two descendants of the Pilgrim +Fathers in Massachusetts marry, they will probably have but three +children; while, if one of them marries a foreigner, the children will +number five or six. + +So it is well ascertained that in the old and stationary communes of +France, where the same families have possessed their small farms for +generation after generation, the marriages have become gradually less +and less productive, until it has seriously interfered with the quota +those districts send to the army. + +American women have suffered many hard words because they do not have +more children. Several New England writers have accused them of very bad +practices, which we shall mention hereafter. But the effect of the law +of production just now laid down has been quite overlooked. + +As it is best that there should be four or five children in a family in +ordinary circumstances, the union of American and foreign blood is very +desirable. We need to fuse in one the diverse colonies of the white race +annually reaching our shores. A century should efface every trace of the +German, the Irish, the Frenchman, the English, the Norwegian, and leave +nothing but the American. To bring about this happy result, free +intermarriage should be furthered in every possible way. + + +THE AGE OF THE HUSBAND. + +The epoch of puberty comes to a boy at about the same age as it does to +a girl,--fourteen or fifteen years. And an even greater period passes +between this epoch and the age it is proper for a man to marry,--his age +of nubility. + +Not only has he a more complete education to obtain, not only a +profession or trade to learn, and some property to accumulate, some +position to acquire, ere he is ready to take a wife, but his physical +powers ripen more slowly than those of woman. He is more tardy in +completing his growth, and early indulgence more readily saps his +constitution. + +We have placed the best age for woman to marry between twenty and +twenty-five years; for similar reasons, man is best qualified to become +a husband between twenty-three and thirty-three years. + +Previous to the twenty-third year, many a man is incapable of producing +healthy children. If he does not destroy his health by premature +indulgence, he may destroy his happiness by witnessing his children a +prey to debility and deformity. An old German proverb says, 'Give a boy +a wife, and a child a bird, and death will soon knock at the door.' Even +an author so old as Aristotle warns young men against early marriage, +under penalty of disease and puny offspring. + +From the age of thirty-three to fifty years, men who carefully observe +the laws of health do not feel any weight of years. Nevertheless, they +are past their prime. Then, also, with advancing years, the chances of +life diminish, and the probability increases that they will leave a +young family with no natural protector. The half-century once turned, +their vigor rapidly diminishes. The marriages they then contract are +either sterile, or yield but few and sickly children. Many an old man +has shortened his life by late nuptials; and the records of medicine +contain accounts of several who perished on the very night of marriage. + +The relative age of man and wife is next to be considered. Nature fits +woman earlier for marriage, and hints thereby that she should, as a +rule, be younger than her husband. So, too, the bard of nature speaks: + + 'Let still the woman take + An elder than herself; so wears she to him, + So sways she level in her husband's heart.' + +The woman who risks her happiness with a man many years younger than +herself, violates a precept of life; and when her husband grows +indifferent, or taunts her with her years, or seeks companions of more +suitable age, she is reaping a harvest sown by her own hand. + +So commonly do such matches turn out badly, that in 1828 the kingdom of +Wuertemberg prohibited unions where the woman was more than twelve years +the senior, except by special dispensation. + +After forty-five years, most women cannot hope for children. A marriage +subsequent to this period can at best be regarded as a close friendship. +Marriage in its full meaning has no longer an existence. + +The relative age of man and wife has another influence, and quite a +curious one. It influences the sex of the children. But this point we +reserve for discussion on a later page. + +The folly of joining a young girl to an old man is happily not so common +in America as in Europe. It would be hard to devise any step more +certain to bring the laws of nature and morality into conflict. + + 'What can a young lassie do wi' an auld man?' + +What advice can we give to a woman who barters her youthful charms for +the fortune of an aged husband? Shall we be cynical enough to agree with +'auld Auntie Katie?' + + 'My auld Auntie Katie upon me takes pity; + I'll do my endeavor to follow her plan: + I'll cross him, and rack him, until I heart-break him, + And then his auld brass will buy me a new pan.' + +No! She has willingly accepted a responsibility. It is her duty to bear +it loyally, faithfully, uncomplainingly to the end. + +Let us sum up with the maxim, that the husband should be the senior, but +that the difference of age should not be more than ten years. + + +WHAT SHOULD BE HIS TEMPERAMENT? + +It is often hard to make out what doctors mean by _temperaments_. It is +supposed that our mental and physical characters depend somehow on the +predominance of some organ or system which controls the rest. Thus a +person who is nervous, quick, sensitive to impressions, is said to have +a _nervous_ temperament; one who is stout, full-blooded, red-faced, has +a _sanguine_ temperament; a thin, dark-featured, reticent person, is of +a _bilious_ temperament; while a pale, fat, sluggish nature, is called +_phlegmatic_, or _lymphatic._ + +In a general way these distinctions are valuable, but they will not bear +very exact applications. They reveal in outline the constitution of mind +and body; and what is to our present purpose, they are of more than +usual importance in the question of selecting a husband. + +Nature, hating incongruity, yet loves variety. She preserves the limits +of species, but within those limits she seeks fidelity to one type. +Therefore it is that in marriage a person inclines strongly to one of a +different temperament--to a person quite unlike himself. + +So true is this, that a Frenchman of genius, Bernardin de St. Pierre, +vouches for this anecdote of himself. He was in a strange city, visiting +a friend whom he had not seen for years. The friend's sister was of that +age when women are most susceptible. She was tall, a blonde, deliberate +in motion, with blue eyes and fair hair. In a jesting way, St. Pierre, +who had never seen her before, and knew nothing of her personal life, +said,-- + +'Mademoiselle, you have many admirers. Shall I describe him on whom you +look with most favor?' + +The lady challenged him to do so. + +'He is short in stature, of dark complexion, dark hair and eyes, slight +in figure, active and nervous in all his movements.' + +The lady blushed to her eyes, and cast a glance of anger at her brother, +who, she thought, had betrayed her secret. But no! St. Pierre's only +informant was his deep knowledge of the human heart. + +This instinct is founded upon the truth that the perfect temperament is +that happily balanced one which holds all the organs in equilibrium,--in +which no one rules, where all are developed in proportion. Nature ever +strives to realize this ideal. She instills in the nervous temperament a +preference for the lymphatic; in the sanguine, a liking for the bilious +constitution. The offspring should combine the excellencies of both, the +defects of neither. We do well to heed her admonitions here, and to bear +in mind that those matches which combine opposite temperaments, are, as +a rule, the most fortunate. + + +THE MORAL AND MENTAL CHARACTER. + +Very few words are necessary here. We have already said we speak as +physicians, not as moralists. But there are some false and dangerous +ideas abroad, which it is our duty as physicians to combat. + +None is more false, none more dangerous, than that embodied in the +proverb, 'A reformed rake makes the best husband.' What is a rake? A man +who has deceived and destroyed trusting virtue,--a man who has entered +the service of the devil to undermine and poison that happiness in +marriage, which all religion and science are at such pains to cultivate. +We know him well in our capacity as physicians. He comes to us +constantly the prey to loathsome diseases, the results of his vicious +life; which diseases he will communicate to his wife, for they are +contagious, and to his children, for they are hereditary; and which no +reform can purge from his system, for they are ineradicable. + +Is this the man a pure woman should take to her arms? Here repentance +avails nothing. We have witnessed the agony unspeakable which +overwhelmed a father when he saw his children suffering under horrible +and disgusting diseases, the penalty of his early sins. + +Very few men of profligate lives escape these diseases. They are +alarmingly prevalent among the 'fast' youths of our cities. And some +forms of them are incurable by any effort of skill. Even the approach of +such men should be shunned,--their company avoided. + +A physician in central Pennsylvania lately had this experience: A young +lady of unblemished character asked his advice for a troublesome +affection of the skin. He examined it, and to his horror recognised a +form of one of the loathsome diseases which curse only the vilest or the +most unfortunate of her sex. Yet he could not suspect this girl. On +inquiry, he found that she had a small but painful sore on her lip, +which she first noticed a few days after being at a picnic with a young +man. Just as he was bidding her good-night, he had kissed her on the +lips. + +At once everything was clear. This young man was a patient of the +physician. He was a victim to this vile disease, and even his kiss was +enough to convey it. + +The history of the sixteenth century contains the account of an Italian +duke, who on one occasion was forced by his ruler to reconcile himself +with an enemy. Knowing he could not escape obedience, he protested the +most cheerful willingness, and in the presence of the king embraced his +enemy, and even kissed him on the lips. It was but another means of +satisfying his hatred. For he well knew that his kiss would taint his +enemy's blood with the same poison that was undermining his own life. + +How cautious, therefore, should a woman be in granting the most innocent +liberties! How solicitous should she be to associate with the purest +men! + +Would that we could say that these dangerous and loathsome diseases are +rare! But, alas! daily professional experience forbids us to offer this +consolation. Every physician in our large cities, and even in smaller +towns, knows that they are fearfully prevalent. + +We have been consulted by wives, pure, innocent women, for complaints +which they themselves, and sometimes their children, suffered from, the +nature of which we dared not tell them, but which pointed with fatal +finger to the unfaithfulness of the husband. How utterly was their +domestic happiness wrecked when they discovered the cause of their +constant ill-health! + +Nor are such occurrences confined to the humbler walks of life. There, +perhaps, less than in any other do they occur. It is in the wealthy, the +luxurious, the self-indulgent class that they are found. + +Are we asked how such a dreadful fate can be averted? + +There are, indeed, certain signs and marks which such diseases leave +with which physicians are conversant. As if nature intended them as +warnings, they are imprinted on the most visible and public parts of the +body. The skin, the hair, the nose, the voice, the lines on the face, +often divulge to the trained observer, more indubitably than the +confessional, a lewd and sensual life. + +Such signs, however, can only be properly estimated by the medical +counselor, and it would be useless to rehearse them here. Those women +who would have a sure guide in choosing a man to be their husband, have +they not Moses and the prophets? What is more, have they not Christ and +the apostles? Rest assured that the man who scoffs at Christianity, who +neglects its precepts and violates its laws, runs a terrible risk of +bringing upon himself, his wife, and his children, the vengeance of +nature, which knows justice but not mercy. Rest assured that the man who +respects the maxims of that religion, and abstains from all uncleanness, +is the only man who is worthy the full and confiding love of an +honorable woman. + + +THE SYMBOLISM OF THE HUMAN BODY. + +Philosophers say that every idle word which is spoken continues to +vibrate in the air through all infinity. So it is with the passions and +the thoughts. Each impresses on the body some indelible mark, and a long +continuance of similar thoughts leaves a visible imprint. + +Under the names of phrenology, physiognomy, palmistry, and others, +attempts have been made at divers times to lay down fixed principles by +which we could judge of men by their outsides; but only vague results +have been obtained. A learned German author, of high repute in exact +science, has gone a different way to work. He has studied the body as a +whole, and sought with the eye of an anatomist how different avocations, +passions, temperaments, habits, mould and fashion the external parts of +man. His results are embraced in a curious volume which he entitles _The +Symbolism of the Human Body_. We shall borrow some hints from it, +germane to our present theme. + +As to size, large-bodied and large-boned men possess greater energy, a +more masculine character, but often less persistence, and are usually +devoid of the more delicate emotions. Fat people are good-tempered, but +indolent; thin people, full of life, but irascible. + +The neck is a significant part of the body. View it from in front, and +it discloses the physical constitution. There are the conduits of the +food and the air; there, the great blood-vessels pass to the head, and +its base is modified by their form as they pass from the heart. When +broad and full, it denotes a vigorous physical life,--a plethoric +constitution. A distinguished teacher of midwifery, Professor Pajot of +Paris, says that when he sees one of those necks full in front, like +that of Marie Antoinette, as shown in her portraits, he prepares himself +to combat childbed convulsions. That queen, it is well-known, nearly +perished with them. + +The back of the neck contains the vertebral column, and is close to the +brain. It reveals the mental constitution. The short round neck of the +prize-fighter betrays his craft. The slender, arched, and graceful neck +of the well-proportioned woman is the symbol of health and a +well-controlled mind. Burke, in his _Essay on the Beautiful_, calls it +the most beauteous object in nature. It is a common observation, that a +sensual character is shown by the thick and coarse development of this +portion of the body. + +The hair, also, has a significance. Fine whitish hair, like that of a +child, goes with a simple, child-like disposition; black hair denotes a +certain hardness of character; red hair has long been supposed to be +associated with a sensual constitution, but it rather indicates a +physical weakness,--a tendency to scrofula. This is, however, a tendency +merely. Thin hair is often the result of protracted mental labor, though +many other causes produce it. + +Every great man, says Herder, has a glance which no one can imitate. We +may go farther, and say that every man of decided character reveals it +in his eyes. They are the most difficult organs for the hypocrite to +control. Beware of the man who cannot look you in the eyes, and of him +in whose eyes there lurks an expression which allures yet makes you +shudder. The one has something he dares not tell you, the other +something you dare not listen to. + +Symmetry, strength, grace, health,--these are admirable qualities in a +man. From the remotest ages they have been the marks of heroes. +Secondary though they are to moral and mental qualities, they should be +ever highly valued. A _manly_ man! Nature designs such to be the sires +of future generations. No danger that we shall fall to worshiping +physical beauty again. The only fear is that in this lank, puny, scrawny +generation of ours, we shall, out of vanity, underrate such beauty. Let +it be ever remembered that this is the ideal, from which any departure +is deterioration. + + +THE ENGAGEMENT. + +When our grandmothers were engaged, the minister rose in his pulpit on +Sunday morning, before the assembled congregation, and proclaimed the +'banns,' stating that if any one knew just cause or lawful impediment +why the lovers should not be married, he should state it there and then. +Sometimes a great hubbub was created when some discarded suitor rose, +forbidding the banns, and claimed that the capricious maiden had +previously promised herself to him. Perhaps it was to avoid such an +uncomfortable check on the freedom of flirtation that the ancient custom +was dropped. + +Certain it is, that to be 'engaged' sits very lightly on the minds of +both young men and maidens now-a-days. We know some of either sex who +make it a boast how often they have made and unmade this slender tie. It +is a dangerous pastime. 'The hand of little use hath the daintier +touch,' and they who thus trifle with their affections will end by +losing the capacity to feel any real affection at all. + +Undoubtedly there occur instances where a woman has pledged herself in +all seriousness, and afterwards sees her affianced in a light which +warns her that she cannot be happy with him,--that the vows she will be +called upon to pronounce at the altar will be hollow and false. What is +she to do? + +We are not inditing the decrees of the Court of Love. Here is the advice +of another to her hand: + + 'First to thine own self be true, + And then it follows, as the night the day, + That thou canst ne'er be false to any man.' + + +CONCERNING LONG ENGAGEMENTS. + +They are hurtful, and they are unnecessary. Is love so vagrant that it +must be tied by such a chain? Better let it go. True love asks no oath; +it casteth out fear, and believes without a promise. + +There are other reasons, sound physiological reasons, which we could +adduce, if need were, to show that the close personal relations which +arise between persons who are engaged should not be continued too long a +time. They lead to excitement and debility, sometimes to danger and +disease. Especially is this true of nervous, excitable, sympathetic +dispositions. + +If we are asked to be definite, and give figures, we should say that a +period not longer than a year, nor shorter than three months, should +intervene between the engagement and the marriage. + + +THE RIGHT TIME OF YEAR TO MARRY. + +Woman, when she marries, enters upon a new life, and a trying one. Every +advantage should be in her favour. The season is one of those +advantages. Extreme heat and extreme cold both wear severely on the +human frame. Mid-winter and mid-summer are, therefore, alike +objectionable, especially the latter. + +Spring and fall are usually chosen, as statistics show, and the +preference is just. On the whole, the spring is rather to be recommended +than the autumn. In case of a birth within the year, the child will have +attained sufficient age to weather its period of teething more easily +ere the next summer. + + +THE RIGHT TIME IN THE MONTH TO MARRY. + +We mean the woman's own month, that which spans the time between her +periodical sicknesses, be it two or five weeks. Let her choose a day +about equidistant from two periods. The reasons for this we shall +specify hereafter. + + +THE WEDDING TOUR. + +Custom prescribes a journey immediately after marriage, of a week or a +month or two. It is an unwise provision. The event itself is disturbance +enough for the system; and to be hurried hither and thither, stowed in +narrow berths and inconvenient carriages, troubled with baggage, and +annoyed by the importunities of cabmen, waiters, and hangers-on of every +description, is enough, in ordinary times, to test the temper of a +saint. + +The foundation of many an unhappy future is laid on the wedding tour. +Not only is the young wife tried beyond all her experience, and her +nervous system harassed, but the husband, too, partakes of her weakness. +Many men, who really love the women they marry, are subject to a slight +revulsion of feeling for a few days after marriage. 'When the veil +falls, and the girdle is loosened,' says the German poet Schiller, 'the +fair illusion vanishes.' A half regret crosses their minds for the jolly +bachelorhood they have renounced. The mysterious charms which gave their +loved one the air of something more than human, disappear in the prosaic +sunlight of familiarity. + +Let neither be alarmed, nor lose their self-control. Each requires +indulgence, and management, from the other; both should demand from +themselves patience and self-command. A few weeks, and this danger is +over; but a mistake now is the mistake of a lifetime. More than one +woman has confessed to us that her unhappiness commenced from her +wedding tour; and when we inquired more minutely, we have found that it +arose from an ignorance and disregard of just such little precautions as +we have been referring to. + +Yet it is every way advisable that the young pair should escape the +prying eyes of friends and relatives at such a moment. Let them choose +some quiet resort, not too long a journey from home, where they can +pass a few weeks in acquiring that more intimate knowledge of each +other's character as essential to their future happiness. + + + + +THE WIFE. + + +_THE WEDDING NIGHT._ + +We now enter upon the consideration of the second great period in the +life of Woman. The maiden becomes a Wife. She is born into a new world. +She assumes new relationships,--the sweetest, and, at the same time, the +most natural of which she is capable. + +The great object of the conjugal union is the transmission of life,--a +duty necessary in order to repair the constant ravages of death, and +thus perpetuate the race. In the fulfilment of this sublime obligation, +woman plays the more prominent part, as she is the source and depositary +of the future being. It is of moment, therefore, that she should not be +altogether ignorant of the nature and responsibilities of her position. +Ignorance here means suffering, disease, and sometimes death. Let us +then interrogate science in regard to these matters, among the most +interesting of all human concerns. + +The initiation into marriage, like its full fruition, maternity, is +attended with more or less suffering. Much, however, may be done to +avert and to lessen the pain which waits upon the first step in this new +life. For this purpose, regard must be had to the selection of the day. +We have said that a time about midway between the monthly recurring +periods is best fitted for the consummation of marriage. As this is a +season of sterility, it recommends itself on this account, in the +interest of both the mother and offspring. The first nuptial relations +should be fruitless, in order that the indispositions possibly arising +from them shall have time to subside before the appearance of the +disturbances incident to pregnancy. One profound change should not too +quickly succeed the other. About the tenth day after menstruation should +therefore be chosen for the marriage ceremony. + +It sometimes happens that marriage is consummated with difficulty. To +overcome this, care, management, and forbearance should always be +employed, and anything like precipitation and violence avoided. Only the +consequences of unrestrained impetuosity are to be feared. In those rare +cases in which greater resistance is experienced than can be overcome by +gentle means, the existence of a condition contrary to nature may be +suspected. Violence can then only be productive of injury, and is not +without danger. Medical art should be appealed to, as it alone can +afford assistance in such an emergency. + +Although the first conjugal approaches are ordinarily accompanied by +slight flooding, a loss of blood does not always occur. Its absence +proves nothing. The appearance of blood was formerly regarded as a test +of virginity. The Israelites, Arabs, and others carefully preserved and +triumphantly exhibited the evidence of it as an infallible sign of the +virtue of the bride. They were in error. Its presence is as destitute of +signification as its absence; for it is now well known that widows, and +wives long separated from their husbands, often have a like experience. +The temperament is not without its influence. In those of lymphatic +temperament, pale blondes, who often suffer from local discharge and +weakness, the parts being relaxed, there is less pain and little or no +haemorrhage. In brunettes, who have never had any such troubles, the case +is reversed. The use of baths, unguents, etc., by the young wife, +however serviceable they might prove, is obviously impracticable. This +great change sometimes also produces swelling and inflammation of the +glands of the neck. + +Marital relations ordinarily continue during the first few weeks to be +more or less painful. General constitutional disturbance and disorders +of the nervous system often result. These troubles are all increased by +the stupid custom of hurrying the bride from place to place, at a time +when the bodily quiet and the mental calmness and serenity so desirable +to her should be the only objects in view. Too frequent indulgence at +this period is a fruitful source of various inflammatory diseases, and +often occasions temporary sterility and ill-health. The old custom +requiring a three days' separation after the first nuptial approach was +a wise one, securing to the young wife the soothing and restoring +influence of rest. Nothing was lost by it, and much gained. + +In a little while, however, all irritation should subside, and no +suffering or distress of any kind, whether general or local, should +attend upon the performance of this important function. The presence of +suffering now becomes indicative of disease. Of this we will speak +hereafter. + + +SHALL HUSBAND AND WIFE OCCUPY THE SAME ROOM AND BED? + +One-third of life is passed in sleep. This period of unconsciousness and +rest is necessary for the renewal of vital strength, and upon its proper +management depends much of the health not merely of the husband and +wife, but of their offspring. A great deal has been written upon the +effect on health and happiness of occupying separate apartments, +separate beds in the same apartment, or the same bed. This vexed +question it is impossible to settle by absolute rules, suitable to all +cases. In general, it may be asserted that there are no valid +physiological reasons for desiring to change the custom which now +prevails in this and most other countries. When both parties are in good +health, and of nearly the same age, one bed-chamber, if sufficiently +roomy, may be used without any disadvantage to either. Such an +arrangement is also to be commended, because it secures closer +companionship, and thus developes and sustains mutual affection. + +It is said that in Zurich, in the olden time, when a quarrelsome couple +applied for a divorce, the magistrate refused to listen to them at +first. He ordered that they should be shut up together in one room for +three days, with one bed, one table, one plate, and one cup. Their food +was passed in by attendants, who neither saw nor spoke to them. On the +expiration of the three days, it was usual to find that neither of them +wanted a separation. + +As before stated, there are conditions under which sleeping together is +prejudicial to the health. A certain amount of fresh air during the +night is required by every one. Re-breathed air is poisonous. During +sleep constant exhalations take place from the lungs and from the skin, +which are injurious if absorbed. A room twelve feet square is too small +for two persons, unless it is so thoroughly ventilated that there is a +constant change of air. In fact, a sleeping apartment for two persons +should contain an air-space of at least twenty-four hundred cubic feet, +and the facilities for ventilation should be such that the whole amount +will be changed in an hour,--that is, at the rate of forty cubic feet +per minute; for it has been ascertained that twenty cubic feet of fresh +air a minute are required for every healthy adult. + +Very young and very old people should never occupy the same bed. When +the married couple hold the relation to each other, in regard to age, of +grandfather and granddaughter, separate apartments should be insisted +upon. + +Certain diseases can be produced by sleeping together. The bed of a +consumptive, it is well known, is a powerful source of contagion. In +Italy it is the custom, after death, to destroy the bed-clothes of +consumptive patients. Tubercular disease has, within the past few years, +been transferred from men to animals by inoculation. Authentic cases are +upon record of young robust girls of healthy parentage, marrying men +affected with consumption, acquiring the disease in a short time, and +dying, in some instances, before their husbands. In these significant +cases, the sickly emanations have apparently been communicated during +sleep. When, therefore, either husband or wife is known to have +consumption, it would be highly imprudent for them to pass the long +hours of the night either in the same bed or in the same room. + + +WHAT KIND OF BED IS MOST HEALTHFUL? + +Feather-beds are not conducive to the health of either sex. Mattresses +made of wool, or of wool and horsehair, are much better. The bed should +be opened, and its contents exposed to the air and sunlight, once every +year. Beds long saturated with the night exhalations of their occupants +are not wholesome. A number of ancient writers have alleged--and it has +been reasserted by modern authorities--that sleeping on sponge is of +service to those who desire to increase their families. The mattresses +of compressed sponge recently introduced, therefore, commend themselves +to married people thus situated. Hemlock boughs make a bed which has a +well-established reputation for similar virtues. + +The odor of cone-bearing trees has a well-known influence upon the +fruitfulness of wedlock. Those who live in pine forests have ordinarily +large families of children. + +Excessive clothing at night is highly injurious. So also is a fire in +the bed-room, except in case of sickness. If the body be too much heated +during sleep, perspiration occurs, or the action of the heart is +increased, and the whole economy becomes excited. Either condition +prevents sound sleep and reinvigoration of the body. Wives in feeble +health, and those liable to attacks of flooding, should therefore have a +particular regard to the quantity of clothing on their beds. + + +THE DIGNITY AND PROPRIETY OF THE SEXUAL INSTINCT. + +A distinguished medical writer has divided women into three classes in +regard to the intensity of the sexual instinct. He asserts that a larger +number than is generally supposed have little or no sexual feeling. A +second class of women, more numerous than these, but still small as +compared with the whole of their sex, are more or less subject to strong +passion. Those of the first class can no more form an idea of the +strength of the impulse in other women, than the blind can of colors. +They therefore often err in their judgments. The third class comprises +the vast majority of women, in whom the sexual appetite is as moderate +as all other appetites. + +It is a false notion, and contrary to nature, that this passion in a +woman is a derogation to her sex. The science of physiology indicates +most clearly its propriety and dignity. There are wives who plume +themselves on their repugnance or their distaste for their conjugal +obligations. They speak of their coldness and of the calmness of their +senses, as if these were not defects. Excepting those afflicted with +vices of conformation, or with disorders of sensibility,--which amount +to the same thing,--all wives are called upon to receive and pay the +imposts of love; and those who can withdraw themselves from the +operation of this mysterious law without suffering and with +satisfaction, show themselves by that fact to be incomplete in their +organization, and deficient in the special function of their being. +There should be no passion for one which is not shared by both. +Generation is a duty. The feeling which excites to the preservation of +the species is as proper as that which induces the preservation of the +individual. Passionate, exclusive, and durable love for a particular +individual of the opposite sex, it has been well said, is characteristic +of the human race, and is a mark of distinction from other animals. The +instinct of reproduction in mankind is thus joined to an affectionate +sentiment, which adds to its sweetness and prolongs infinitely its +duration. + +Many physiologists have assigned to the feelings an important _role_ in +conception, the possibility of which has even been doubted if there be +no passion on the side of the woman. Although this extreme view is not +tenable in the light of modern research, yet all recent authorities +agree that conception is more assured when the two individuals who +co-operate in it participate at the same time in the transports of which +it is the fruit. It is also without doubt true that the disposition of +the woman at that time has much power in the formation of the foetus, +both in modifying its physical constitution and in determining the +character and temperament of its mind. The influence, long ago +attributed by Shakspeare to 'a dull, stale, tired bed' in creating a +'tribe of fops,' is not a mere poet's fancy. + +In this manner also may be explained the results of prolonged continence +upon the offspring, for desires are usually vivid in proportion to the +previous period of rest. The father of Montaigne, returning after an +absence of thirty-two years, during which he was engaged in the wars of +Italy, begot his son, so justly celebrated in French literature. The +father of J. J. Rousseau, after a considerable absence in +Constantinople, brought to his wife the reward of a long fidelity. + +Sexual passion exerts, therefore, a marked influence upon the future +being before conception, by the impression made upon the elements which +come together to form it. The question now occurs; What effect does its +presence and gratification produce upon the parents? We answer; It is a +natural and healthful impulse. Its influence is salutary. A marked +improvement in the physical condition of delicate women often follows a +happy marriage. This sometimes occurs even in those cases where, from +the nature of the disorder, the reverse might be expected. The utility +of the passions, well directed, has become a maxim in medicine as in +morality. And what passion is more important and fervent than that of +which we write? The fathers in medicine, and their modern followers, +agree in ascribing to the pleasures of love, indulged in with +moderation, activity and lightness of the body, vigor and vivacity of +the mind. + +Music, apart from its immense influence on the nervous system in +general, seems sometimes to exercise a special action on the sexual +instinct. Science possesses at the present day some facts beyond +dispute, which prove the great power of music in this respect. + + +ON THE INDULGENCE AND THE RESTRAINT OF SEXUAL DESIRE. + +The act of generation is a voluntary one. But nature has so placed it +under the empire of pleasure, that the voice of discretion is no longer +heard, and the will is often led captive. Hence it is well, for hygienic +reasons, to consider its laws. + +The too frequent repetition of the reproductive act is known to be +followed by consequences injurious to the general health. Too rigid +continence is not unattended, in many constitutions, with danger, for +the victory over passion may be dearly bought. Science recommends the +adoption of a wise mean between two extremes equally destructive. By +following her counsel, women may escape from the hysterical and other +disorders which often wait as well upon excess as upon too great denial +of that passion, which claims satisfaction as a natural right. + +As men have made laws upon all subjects, we need not be surprised to +learn that they have legislated upon this. History informs us that the +legislators of ancient times have not failed to occupy themselves with +this grave question of conjugal economy. The ordinances of Solon +required that the married should acquit themselves of their duties at +least three times a month; those of Zoroaster prescribed once a week. +Mohammed ordered that any wife neglected by her husband longer than a +week could demand and obtain a divorce. It is not, however, in these, +and other enactments which might be quoted, that guidance is to be +sought. The principles derived from nature and experience are more +valuable than human laws, however venerable; for these too often serve +only to reflect the profound ignorance of their makers. + +Moderation should here prevail. Health is thus preserved and +strengthened, and the gratification doubled. The art of seasoning +pleasures in general, consists in being avaricious with them. To abstain +from enjoyment, is the philosophy of the sage, the epicurism of reason. + +Proper self-denial in the gratification of the wants of physical love is +a source of good, not only to the individual practising it, but to the +community, as we shall show hereafter. It may be observed for one's own +profit only, or for the benefit of another. The latter is in the end +more conducive to self-interest than the former. A double advantage is +derived therefrom,--gratitude and sympathy returned, and increase of +appetite and of power for future enjoyment. Excess of indulgence results +in the pain of surfeit and the extinction of affection. Earnest love, +satisfying itself with small gratifications, is a more copious source of +happiness than that frequently quenched by full gratification. + +What, then, is this moderation which both Hygeia and Venus command? +Here, again, invariable rules are not possible. Science rarely lays down +laws so inflexible as those of the Medes and Persians. She designates +limits. The passage between Scylla and Charybdis is often a wide one. +The folly of the ancient statutes which have been referred to, consists +mainly in their failure to recognise the diverse influence of age, +temperament, seasons, etc. + +It almost appears as if there were but one _season_ for generation, that +in which the sun re-warms and vivifies the earth, trees dress in +verdure, and animals respire the soft breath of spring. Then every +living thing reanimates itself. The impulse of reproduction is excited. +Now, also, its gratification is most beneficial to the individual and to +the species. Children conceived in the spring time have greater +vitality, are less apt to die during infancy, than those conceived at +any other time of the year. The statistics of many thousand cases, +recently carefully collated in England, prove this beyond peradventure. +It is well known that a late calf, or one born at the end of the summer, +is not likely to become a well-developed and healthy animal. This has +been attributed to the chilling influence of approaching winter; but it +is capable of another and, perhaps, a truer explanation. Nature's +impulses, therefore, in the spring of the year are for the good of the +race, and may then be more frequently indulged without prejudice to the +individual. Summer is the season which agrees the least with the +exercise of the generative functions. The autumn months are the most +unfruitful. Then, also, derangements of the economy are readily excited +by marital intemperance. + +The _temperaments_ exert over reproduction, as over all the other +functions of the body, a powerful influence. Love is said to be the +ruling passion in the sanguine temperament, as ambition is in the +bilious. There is also in some cases a peculiar condition of the nervous +system which impels to, or diverts from, sexual indulgence. In some +women, even in moderation, it acts as a poison, being followed by +headache and prostration, lasting for days. + +With advancing years, the fading of sexual desire calls attention to the +general law, that animals and plants, when they become old, are dead to +reproduction. What in early life is followed by temporary languor, in +matured years is succeeded by a train of symptoms much graver and more +durable. + +Those who are in feeble health, and particularly those who have delicate +chests, ought to be sober in the gratification of love. Sexual +intercourse has proved mortal after severe haemorrhages. + +All organized beings are powerfully affected by propagation. Animals +become depressed and dejected after it. The flower which shines so +brilliantly at the moment of its amours, after the consummation of that +act, withers and falls. It is wise, therefore, in imparting life, to +have a care not to shorten one's own existence. Nothing is more certain +than that animals and plants lessen the duration of their lives by +multiplied sexual enjoyments. The abuse of these pleasures produces +lassitude and weakness. Beauty of feature and grace of movement are +sacrificed. When the excess is long continued, it occasions spasmodic +and convulsive affections, enfeeblement of the senses, particularly that +of sight, deprivation of the mental functions, loss of memory, +pulmonary consumption and death. One of the most eminent of living +physiologists has asserted that 'development of the individual and the +reproduction of the species stand in a reverse ratio to each other,' and +that 'the highest degree of bodily rigor is inconsistent with more than +a very modest indulgence in sexual intercourse.' + +The general principles we have just enunciated are of great importance +in the regulation of the health. They are more suggestive and useful +than the precise rules which have from time to time been laid down on +this subject. + + +TIMES WHEN MARITAL RELATIONS SHOULD BE SUSPENDED. + +There are times at which marital relations are eminently improper. We +are told, I Cor. vii. 3, 4, that neither husband nor wife has the power +to refuse the conjugal obligation when the debt is demanded. But there +are certain legitimate causes for denial by the wife. + +A condition of intoxication in the husband is a proper ground for +refusal. Fecundation taking place while either parent has been in this +state has produced idiots and epileptics. This has happened again and +again. The cases on record are so numerous and well-authenticated, as to +admit of no doubt in regard to the fatal effect upon the mind of the +offspring of conception under such circumstances. + +Physical degeneracy is also often a consequence of procreation during +the alcoholic intoxication of one or both parents. A peculiar arrest of +growth and development of body and mind takes place, and, in some +instances, the unfortunate children, although living to years of +manhood, remain permanent infants, just able to stand by the side of a +chair, to utter a few simple sounds, and to be amused with childish +toys. + +During convalescence from a severe sickness, or when there is any local +or constitutional disease which would be aggravated by sexual +intercourse, it should be abstained from. There is reason for believing +that a being procreated at a period of ill-humour, bodily indisposition, +or nervous debility, may carry with it, during its whole existence, some +small particles of these evils. When there exists any contagious +disease, refusals are of course valid, and often a duty to the unborn. +Poverty, or the wish to have no more children, can only be exceptionally +allowed as a reason for the denial of all conjugal privileges. + +The opinion that sexual relations practised during the time of the +menses engender children liable to scrofulous disease, is a mere popular +prejudice. But there are other and better-founded reasons for continence +during these periods. + +The question of intercourse during pregnancy and suckling will come up +for consideration when speaking of these conditions hereafter. + + +CONDITIONS WHEN MARITAL RELATIONS ARE PAINFUL. + +Nature has not designed that a function of great moment to the human +race--one involving its very existence--should be attended with pain. +The presence of pleasure is indicative of health, its absence of +disease. But to a woman who has systematically displaced her womb by +years of imprudence in conduct or dress, this act, which should be a +physiological one, and free from any hurtful tendencies becomes a source +of distress and even of illness. The diseases of the womb which +sometimes follow matrimony are not to be traced to excessive indulgence +in many cases, but to indulgence _to any extent_ by those who have +altered the natural relation of the parts before marriage. A prominent +physician, Prof. T. Gaillard Thomas, of New York, has said that 'upon a +woman who has enfeebled her system by habits of indulgence and luxury, +pressed her uterus entirely out of its normal place, and who perhaps +comes to the nuptial bed with some marked uterine disorder, the result +of imprudence at menstrual epochs, sexual intercourse has a _poisonous_ +influence. The taking of food into the stomach exerts no hurtful +influence on the digestive system; but the taking of food by a +dyspeptic, who has abused and injured that organ, does so.' + +When excessive pain exists, and every attempt occasions nervous +trepidation and apprehension, it is absolutely certain that there is +some diseased condition present, for which proper advice should be +secured at once. Delay in doing so will not remove the necessity for +medical interference in the end, while it will assuredly aggravate the +trouble. Prompt intelligent aid, on the contrary, is usually followed by +the happiest results in such cases. + + +STERILITY. + +Wives who never become mothers are said to be sterile or barren. This +condition is frequently a cause of much unhappiness. Fortune may favor +the married couple in every other respect, yet if she refuse to accord +the boon of even a single heir to heart and home, her smiles will bear +the aspect of frowns. It is then of some interest to inquire into the +causes of this condition, and how to prevent or remedy their operation. + +Dr. Duncan, of Edinburgh, has shown, by elaborate research, that in +those wives who are destined to have children, there intervenes, on the +average, about seventeen months between the marriage ceremony and the +birth of the first child, and that the question whether a woman will be +sterile is decided in the first three years of married life. If she have +no children in that time, the chances are thirteen to one against her +ever having any. In those cases, therefore, in which the first three +years of married life are fruitless, it is highly desirable for those +wishing a family to ascertain whether or not the barrenness is dependent +upon any defective condition capable of relief. + +The age of a wife at the time of marriage has much to do with the +expectation of children. As the age increases over twenty-five years, +the interval between the marriage and the birth of the first child is +lengthened. For it has been ascertained that not only are women most +fecund from twenty to twenty-four, but that they begin their career of +child-bearing sooner after marriage than their younger or elder sisters. +Early marriages (those before the age of twenty) are sometimes more +fruitful than late ones (those after twenty-four). The interesting +result has further been arrived at in England, that about one in +fourteen of all marriages of women between fifteen and nineteen are +without offspring; that wives married at ages from twenty to twenty-four +inclusive, are almost all fertile; and that after that age the chances +of having no children gradually increases with the greater age at the +time of marriage. + +There are two kinds of sterility which are physiological, natural to all +women,--that of young girls before puberty, and that of women who are +past the epoch of the cessation of the menses. In some very rare cases, +conception takes place after cessation. In one published case, it +occurred nine months afterwards, and in another eighteen months. In some +very rare cases, also, conception has taken place before the first +menstruation. + +The older a woman is at the time of her marriage, the longer deferred is +the age at which she naturally becomes sterile. She bears children later +in life, in order to compensate, as it were, for her late commencement. +But although she continues to have children until a more advanced age +than the earlier married, yet her actual child-bearing period is +shorter. Nature does not entirely make up at the end of life for the +time lost from the duties of maternity in early womanhood; for the +younger married have really a longer era of fertility than the older, +though it terminates at an earlier age. + +A wife who, having had children, has ceased for three years to conceive, +will probably bear no more, and the probability increases as time +elapses. After the first, births take place with an average interval, in +those who continue to be fertile, of about twenty months. + +Nursing women are generally sterile, above all, during the first months +which follow accouchement, because the vital forces are then +concentrated on the secretion of the milk. In a majority of instances, +when suckling is prolonged to even nineteen or twenty months, pregnancy +does not take place at all until after weaning. + +Climate has also an influence upon the fertility of marriages. In +southern regions more children are born, fewer in northern. The number +of children is in inverse proportion to the amount of food in a country +and in a season. In Belgium, the higher the price of bread the greater +the number of children, and the greater the number of infant deaths. + +The seasons exert a power over the increase of population. The spring of +the year, as has already been stated, is the most favourable to +fecundity. It is not known whether day and night have any effect upon +conception. + +The worldly condition seems to have much to do with the size of a +family. Rich and fashionable women have fewer children than their poor +and hard-worked neighbours. Wealth and pleasure seem to be often gladly +exchanged for the title of mother. + +But it is our more particular object now to inquire into the _causes of +absolute sterility_ in individual cases, rather than to discuss the +operation of general laws upon the fertility of the community at large, +however inviting such a discussion may be. When marriages are fruitless, +the wife is almost always blamed. It is not to be supposed that she is +always in fault. Many husbands are absolutely sterile; for it is a +mistake to consider that every man must be prolific who is vigorous and +enjoys good health. Neither does it follow, because a woman has never +given birth to a living child, that she has not conceived. About one +marriage in eight is unproductive of living children, and therefore +fails to add to the population. The seeds of life have, however, been +more extensively sown among women than these figures would seem to +indicate. If the life of an infant for a long time after birth is a +frail one, before birth its existence is precarious in the extreme. It +often perishes soon after conception. A sickness, unusually long and +profuse, occurring in a young married woman a few days beyond the +regular time, is often the only evidence she will ever have that a life +she has communicated has been ended almost as soon as begun. A tendency +to miscarriage may therefore be all that stands in the way of a family. +This is generally remediable. + +It is a well-known fact that frigidity is a frequent cause of +barrenness, as well as a barrier to matrimonial happiness. Its removal, +so desirable, is in many cases possible by detecting and doing away with +the cause. The causes are so various, that their enumeration here would +be tedious and unprofitable, for most of them can only be discovered +and remedied by a practical physician who has studied the particular +case under consideration. So also in regard to the various displacements +and diseases of the womb preventing conception. Proper medical treatment +is usually followed by the best results. + +While the fact that pleasure is found in the marital relation is a +favourable augury for impregnation, it has been long noticed that +Messalinas are sterile. It was observed in Paris, that out of one +thousand only six bore children in the course of a year, whereas the +ordinary proportion in that city for that time is three and a half +births for every one hundred of the population. + +In some women, nothing seems amiss but too intense passion. Such cases +are much more rare than instances of the opposite extreme producing the +same effect. + +A condition of debility, or the presence of certain special poisons in +the blood, may prevent conception, or, what is to all intents the same +thing, cause miscarriage. Many apparently feeble women have large +families. But in numerous instances a tonic and sometimes an alternative +constitutional treatment is required before pregnancy will take place. +On the contrary, there are well-authenticated cases of women who were +stout and barren in opulence becoming thin and prolific in poverty. + +The stimulus of novelty to matrimonial intercourse imparted by a short +separation of husband and wife, is often salutary in its influence upon +fertility. + +To show upon what slight constitutional differences infertility often +depends, it is merely necessary to allude to the fact, known to every +one, that women who have not had children with one husband often have +them with another. This condition of physiological incompatibility is +evidently not altogether one of the emotional nature, for it is observed +in animals, among whom it is by no means rare to find certain males and +females who will not breed together, although both are known to be +perfectly fruitful with other females and males. The ancients, believing +that sterility was more common with couples of the same temperament and +condition, advised, with Hippocrates, that blonde women should unite +with dark men, thin women with stout men, and _vice versa._ + +Barren women should not despair. They sometimes become fecund after a +long lapse of years. In other words, they are sterile only during a +certain period of their lives, and then, a change occurring in their +temperament with age, they become fruitful. History affords a striking +example of this eccentricity of generation, in the birth of Louis XIV., +whom Anne of Austria, Queen of France brought into the world after a +sterility of twenty-two years. Catherine de Medicis, wife of Henry II., +became the mother of ten children after a sterility of ten years. Dr. +Tilt, of London, mentions the case of a woman who was married at +eighteen, but although both herself and her husband enjoyed habitual +good health, conception did not take place until she was forty-eight, +when she bore a child. Another case is reported where a well-formed +female married at nineteen, and did not bear a child until she had +reached her fiftieth year. + +Families often suffer from the effects of sterility. Civilised nations +never do. Recent researches have been carefully instituted in several +countries to determine the exact power of the human race to preserve its +numbers against the ravages of death. It has been ascertained that +during periods of peace the population can be maintained to the same +point by the additions made to it through the procreating capacity of +only one-half of the women in the community. Nature, therefore, has made +ample provision for preventing a decrease of population through failure +of reproduction. + +She has also instituted laws to prevent its undue increase. It would +seem as if the extension of material mental and social comfort and +culture has a tendency to render marriage less prolific, and population +stationary or nearly so. So evident is this tendency, that it has been +laid down as a maxim in sociology by Sismondi, that 'where the number of +marriages is proportionally the greatest, where the greatest number of +persons participate in the duties and the virtues and the happiness of +marriage, the smaller number of children does each marriage produce.' +Thus, to a certain extent, does nature endorse the opinions of those +political economists who assert that increase of population beyond +certain limits is an evil happily averted by wars, famines, and +pestilences, which hence become national blessings in disguise. She, +however, points to the extension of mental and moral education and +refinement as gentler and surer means of reducing plethoric population +than those suggested by Malthus and Mill. + +Many causes of sterility, it will therefore be seen, are beyond the +power of man to control. They operate on a large scale for the good of +the whole. With these we have little concern. But there are others which +may be influenced by intelligent endeavor. Some have been already +alluded to, and the remedy suggested; but we will proceed to give more +specific + + +ADVICE TO WIVES WHO DESIRE TO HAVE CHILDREN. + +It has long been known that menstruation presents a group of phenomena +closely allied to fecundity. The first eruption of the menses is an +unequivocal sign of the awakening of the faculty of reproduction. The +cessation of the menstrual epochs is a sign equally certain of the loss +of the faculty of reproduction. When conception has taken place, the +periodical flow is interrupted. Labor occurs at about the time in which +the menses would have appeared. In short, it is a fact, now completely +established, that the time immediately before, and particularly that +after the monthly sickness, is the period the most favorable to +fecundation. It is said that, by following the counsel to this effect +given him by the celebrated Fernel, Henry II., the King of France, +secured to himself offspring after the long sterility of his wife before +referred to. Professor Bedford, of New York, says that he can point to +more than one instance in which, by this advice, he has succeeded in +adding to the happiness of parties who for years had been vainly hoping +for the accomplishment of their wishes. + +Repose of the woman, and, above all, sojourn on the bed after the act of +generation, also facilitates conception. Hippocrates, the great father +of medicine, was aware of this, and laid stress upon it in his advice to +sterile wives. + +The womb and the breasts are bound together by very strong sympathies: +that which excites the one will stimulate the other. Dr. Charles Loudon +mentions that four out of seven patients, by acting on this hint, became +mothers. A similar idea occurred to the illustrious Marshall Hall, who +advised the application of a strong infant to the breast. Fomentations +of warm milk to the breasts and the corresponding portion of the spinal +column, and the use of the breast-pump two or three times a day, just +before the menstrual period, have also been recommended by good medical +authorities. Horseback exercise, carried to fatigue, seems occasionally +to have conduced to pregnancy. + +The greatest hope of success against sterility is to change the dominant +state of the constitution. But this can only be effected under suitable +medical advice. The treatment of sterility--thanks to the recent +researches of Dr. Marion Sims--is much more certain than formerly; and +the intelligent physician is now able to ascertain the cause, and point +out the remedy, where before all was conjecture and experiment. The +sterile wife should, herefore, be slow in abandoning all hope of ever +becoming a mother. + + +ON THE LIMITATION OF OFFSPRING. + +No part of our subject is more delicate than this. Very few people are +willing to listen to a dispassionate discussion of the propriety or +impropriety of limiting within certain bounds the number of children in +a family. On the one side are many worthy physicians and pious +clergymen, who, without listening to any arguments, condemn every effort +to avoid large families; on the other, are numberless wives and +husbands, who turn a deaf ear to the warnings of doctors and the +thunders of divines, and, eager to escape a responsibility they have +assumed, hesitate not to resort to the most dangerous and immoral means +to accomplish this end. + +We ask both parties to lay aside prejudice and prepossession, and +examine with us this most important social question in all its bearings. + +Let us first inquire whether there is such a thing as +_over-production_--having _too many_ children. Unquestionably there is. +Its disastrous effects on both mother and children are known to every +intelligent physician. Two-thirds of all cases of womb disease, says Dr. +Tilt, are traceable to child-bearing in feeble women. Hardly a day +passes that a physician in large practice does not see instances of +debility and disease resulting from over-much child-bearing. Even the +lower animals illustrate this. Every farmer is aware of the necessity of +limiting the offspring of his mares and cows. How much more severe are +the injuries inflicted on the delicate organization of woman! A very +great mortality, says Dr. Duncan of Edinburgh, attends upon +confinements when they become too frequent. + +The evils of a too rapid succession of pregnancies are likewise +conspicuous in the children. There is no more frequent cause, says Dr. +Hillier,--whose authority in such matters none will dispute,--of rickets +than this. Puny, sickly, short-lived offspring follows over-production. +Worse than this, the carefully compiled statistics of Scotland show that +such children are peculiarly liable to idiocy. Adding to an already +excessive number, they come to over-burden a mother already overwhelmed +with progeny. They cannot receive at her hands the attention they +require. Weakly herself, she brings forth weakly infants. 'Thus,' +concludes Dr. Duncan, 'are the accumulated evils of an excessive family +manifest.' + +Apart from these considerations, there are certain social relations +which have been thought by some to advise small families. When either +parent suffers from a disease which is transmissible, and wishes to +avoid inflicting misery on an unborn generation, it has been urged that +they should avoid children. Such diseases not unfrequently manifest +themselves after marriage, which is answer enough to the objection that +if they did not wish children they should not marry. There are also +women to whom pregnancy is a nine months' torture, and others to whom it +is nearly certain to prove fatal. Such a condition cannot be discovered +before marriage, and therefore cannot be provided against by a single +life. Can such women be asked to immolate themselves? + +It is strange, says that distinguished writer, John Stuart Mill, that +intemperance in drink, or in any other appetite, should be condemned so +readily, but that incontinence in this respect should always meet not +only with indulgence but praise. 'Little improvement' he adds, 'can be +expected in morality until the producing too large families is regarded +with the same feeling as drunkenness, or any other physical excess.' A +well-known medical writer, Dr. Drysdale, in commenting on these words, +adds: 'In this error, if error it be, I also humbly share.' + +'When dangerous prejudices,' says Sismondi, the learned historian of +southern Europe, 'have not become accredited, when our true duties +towards those to whom we give life are not obscured in the name of a +sacred authority, no married man will have more children than he can +bring up properly.' + +Such is the language of physicians and statesmen; but a stronger appeal +has been made for the sake of morality itself. The detestable crime of +_abortion_ is appallingly rife in our day; it is abroad in our land to +an extent which would have shocked the dissolute women of pagan Rome. +Testimony from all quarters, especially from New England, has +accumulated within the past few years to sap our faith in the morality +and religion of American women. This wholesale, fashionable murder, how +are we to stop it? Hundreds of vile men and women in our large cities +subsist by this slaughter of the innocents, and flaunt their ill-gotten +gains--the price of blood--in our public thoroughfares. Their +advertisements are seen in the newspapers; their soul and body +destroying means are hawked in every town. With such temptation strewn +in her path, what will the woman threatened with an excessive family +do? Will she not yield to evil, and sear her conscience with the +repetition of her wickedness? Alas! daily experience in the heart of a +great city discloses to us only too frequently the fatal ease of such a +course. + +In view of the injuries of excessive child-bearing on the one hand, and +of this prevalent crime on the other, a man of genius and sympathy, Dr. +Raciborski of Paris, took the position that the avoidance of offspring +to a certain extent is not only legitimate, but should be recommended as +a measure of public good. 'We know how bitterly we shall be attacked,' +he says, 'for promulgating this doctrine; but if our ideas only render +to society the services we expect of them, we shall have effaced from +the list of crimes the one most atrocious without exception, that of +child-murder, before or after birth, and we shall have poured a little +happiness into the bosoms of despairing families, where poverty is +allied to the knowledge that offspring can be born only to prostitution +or mendicity. The realization of such hopes will console us under the +attacks upon our doctrines.' + +It has been eagerly repeated by some, that the wish to limit offspring +arises most frequently from an inordinate desire of indulgence. We reply +to such, that they do not know the human heart, and that they do it +discredit. More frequently the wish springs from a love of children. The +parents seek to avoid having more than they can properly nourish and +educate. They do not wish to leave their sons and daughters in want. +'This,' says a writer in _The Nation_ (of New York), in an article on +this interesting subject,--'this is not the noblest motive of action, of +course, but there is something finely human about it.' + +'Very much indeed is it to be wished,' says Dr. Edward Reich, after +reviewing the multitudinous evils which result to individuals and +society from a too rapid increase in families, 'that the function of +reproduction be placed under the dominion of the will.' + +Men are very ready to find an excuse for self-indulgence; and if they +cannot get one anywhere else, they seek it in religion. They tell the +woman it is her duty to bear all the children she can. They refer her to +the sturdy, strong-limbed women of early times, to the peasant women of +northern Europe, who emigrate to America, and ask and expect their wives +to rival them in fecundity. Such do not reflect that they have been +brought up to light indoor employment, that their organization is more +nervous and frail, that they absolutely have not the stamina required +for many confinements. + +Moreover, they presume too much in asking her to bear them. 'If a woman +has a right to decide on any question,' said a genial physician in the +Massachusetts Medical Society a few years since, 'it certainly is as to +how many children she shall bear.' 'Certainly,' say the editors of a +prominent medical journal, 'wives have a right to demand of their +husbands at least the same consideration which a breeder extends to his +stock.' 'Whenever it becomes unwise that the family should be +increased,' says Sismondi again, '_justice_ and _humanity_ require that +the husband should impose on himself the same restraint which is +submitted to by the unmarried.' + +An eminent writer on medical statistics, Dr. Henry MacCormac, says: 'The +brute yields to the generative impulse when it is experienced. He is +troubled by no compunction about the matter. Now, a man ought not to act +like a brute. He has reason to guide and control his appetites. Too +many, however, forget, and act like brutes instead of as men. It would, +in effect, prove very greatly conducive to man's interests were the +generative impulses placed absolutely under the sway of right reason, +chastity, forecast, and justice.' + +There is no lack of authorities, medical and non-medical, on this point. +Few who weigh them well will deny that there is such a thing as too +large a family; that there does come a time when a mother can rightfully +demand rest from her labours, in the interest of herself, her children, +and society. When is this time? Here again the impossibility meets us of +stating a definite number of children, and saying, 'This many and no +more.' As in every other department of medicine, averages are of no +avail in guiding individuals. There are women who require no limitation +whatever. They can bear healthy children with rapidity, and suffer no +ill results. There are others--and they are the majority--who should use +temperance in this as in every other function; and there are a few who +should bear no children at all. It is absurd for physicians or +theologians to insist that it is either the physical or moral duty of +the female to have as many children as she possibly can have. It is +time that such an injurious prejudice was discarded, and the truth +recognised, that while marriage looks to offspring as its natural +sequence, there should be inculcated such a thing as marital continence, +and that excess here as elsewhere is repugnant to morality, and is +visited by the laws of physiology with certain and severe punishment on +parent and child. + +Continence, self-control, a willingness to deny himself,--that is what +is required from the husband. But a thousand voices reach us from +suffering women in all parts of our land that this will not suffice; +that men refuse thus to restrain themselves; that it leads to a loss of +domestic happiness and to illegal amours, or that it is injurious +physically and mentally,--that, in short, such advice is useless, +because impracticable. + +To such sufferers we reply that Nature herself has provided to some +extent against over-production, and that it is well to avail ourselves +of her provisions. It is well known that women when nursing rarely +become pregnant, and for this reason, if for no other, women should +nurse their own children, and continue the period until the child is at +least a year old. Be it remembered, however, that nursing, continued too +long, weakens both mother and child, and, moreover, ceases to accomplish +the end for which we now recommend it. + +Another provision of nature is, that for a certain period between her +monthly illnesses every woman is sterile. The vesicle which matures in +her ovaries, and is discharged from them by menstruation, remains some +days in the womb before it is passed forth and lost. How long its stay +is we do not definitely know, and probably it differs in individuals. +From ten to twelve days at most are supposed to elapse after the +_cessation_ of the flow before the final ejection of the vesicle. For +some days after this the female is incapable of reproduction. But for +some days _before_ her monthly illness she is liable to conception, as +for that length of time the male element can survive. This period, +therefore, becomes a variable and an undetermined one, and even when +known, its observation demands a large amount of self-control. + +There is one method widely in use in this country for the limitation of +offspring which deserves only the most unqualified condemnation, which +is certain to bring upon the perpetrators swift and terrible +retribution, and which is opposed to every sentiment of nature and +morality. We mean + + +THE CRIME OF ABORTION. + +_From the moment of conception_ a new life commences; a new individual +exists; another child is added to the family. The mother who +deliberately sets about to destroy this life, either by want of care, or +by taking drugs, or using instruments, commits as great a crime, is just +as guilty, as if she strangled her new-born infant, or as if she +snatched from her own breast her six-months' darling and dashed out its +brains against the wall. Its blood is upon her head, and as sure as +there is a God and a judgment, that blood will be required of her. The +crime she commits is _murder_, _child-murder_,--the slaughter of a +speechless, helpless being, whom it is her duty, beyond all things else, +to cherish and preserve. + +This crime is common; it is fearfully prevalent. Hundreds of persons are +devoted to its perpetration. It is their trade. In nearly every village +its ministers stretch out their bloody hands to lead the weak woman to +suffering, remorse, and death. Those who submit to their treatment are +not generally unmarried women who have lost their virtue, but the +mothers of families, respectable _Christian_ matrons, members of +churches, and walking in the better classes of society. + +We appeal to all such with earnest and with threatening words. If they +have no feeling for the fruit of their womb, if maternal sentiment is so +callous in their breasts, let them know that such produced abortions are +the constant cause of violent and dangerous womb diseases, and +frequently of early death; that they bring on mental weakness, and often +insanity; that they are the most certain means to destroy domestic +happiness which can be adopted. Better, far better, to bear a child +every year for twenty years than to resort to such a wicked and +injurious step; better to die, if needs be, in the pangs of childbirth, +than to live with such a weight of sin on the conscience. + +There is no need of either. By the moderation we have mentioned, it is +in the power of any woman to avoid the evils of an excessive family, +without injury and without criminality. + +We feel obliged to speak in plain language of this hidden sin, because +so many are ignorant that it is a sin. Only within a few years have +those who take in charge the public morals spoken of it in such terms +that this excuse of ignorance is no longer admissible. + +Bishop Coxe, of New York, in a pastoral letter, the late Archbishop +Spaulding, Catholic Primate of the United States, in an address at the +close of a recent Provincial Council at Baltimore, the Old and New +School Presbyterian Churches, at a meeting in Philadelphia, have all +pronounced the severest judgments against those guilty of antenatal +infanticide. Appeals through the press have been made by physicians of +high standing, and by eminent divines, which should be in the hands of +every one. + +The chiefest difficulty hitherto has been, that while women were warned +against the evils of abortion, they were offered no escape from the +exhaustion and dangers of excessive child-bearing. This difficulty we +have fully recognised and fairly met, and, we believe, in such a manner +that neither the accuracy of our statements nor the purity of our +motives can be doubted. Should our position be attacked, however, the +medical man must know that in opposing our views, he opposes those of +the most distinguished physicians in Europe and in America; and the +theologian should be warned that, when a neglect of physical laws leads +to moral evil, the only way to correct this evil is to remedy the +neglect. In this case the neglect is over-production; the evil is +abortion. + + +NATURE OF CONCEPTION. + +The theories which have been advanced to explain the manner in which the +human species is continued and reproduced are very numerous. Including +the hypotheses of the ancient philosophers, some two hundred and fifty +have been promulgated by the greatest thinkers of all times. The older +ones do not deserve mention, as they are replete with absurdities. Such, +for instance, is that of Pythagoras, which supposed that a vapor +descended from the brain and formed the embryo. The Scythians therefore +took blood from the veins behind the ears to produce impotence and +sterility. Modern science has shown the total error of this and many +other views formerly entertained on this subject. Has galvanism or +electricity any share in the mysterious function? Some among the modern +physiologists have supposed that there is an electrical or magnetic +influence which effects generation. Even within a few months, Dr. Harvey +L. Byrd, Professor of Obstetrics in the Medical Department of Washington +University of Baltimore, has asserted that he has 'every reason for +believing that fecundation or impregnation is always an electrical +phenomenon; ... it results from the completion of an electric +circle,--the union of positive and negative electricities.' This, +however, is not accepted by all as the dictum of modern science. +Physiology has clearly established that the new being is the result of +contact between the male element, an independent, living animal, on the +one part, and the female element, a matured egg, on the other, involving +the union of the contents of two peculiar cells. Without such contact, +fecundation cannot take place. + +The only matter of practical moment in connection with this most +interesting function which we have to announce, is the influence of the +mind on the offspring at the time of generation. This influence has long +been remarked in regard to animals as well as men. Jacob was aware of it +when he made his shrewd bargain with Laban for 'all the speckled and +spotted cattle' as his hire. For we are told that then 'Jacob took him +rods of green poplar, and of the hazel and chestnut tree, and pilled +white strakes in them, and made the white appear which was in the rods. +And he set the rods which he had pilled before the flocks in the gutters +in the watering-troughs, when the flocks came to drink, that they should +conceive when they came to drink. And the flocks conceived before the +rods, and brought forth cattle ringstraked, speckled, and spotted. And +Jacob did separate the lambs, and set the faces of the flocks towards +the ringstraked and all the brown in the flock of Laban; and he put his +own flocks by themselves, and put them not unto Laban's cattle. And it +came to pass, whenever the stronger cattle did conceive, that Jacob laid +the rods before the eyes of the cattle in the gutters, that they might +conceive among the rods. But when the cattle were feeble, he put them +not in: so the feebler were Laban's, and the stronger Jacob's.' + +The impressions conveyed to the brain through the sense of sight are +here asserted by the writer of Genesis to have influenced the system of +the ewes so that they brought forth young marked in the same manner as +the rods placed before their eyes. It is not said that there was any +miraculous interposition; but the whole account is given as if it were +an everyday, natural, and well-known occurrence. + +The Greeks, a people renowned for their physical beauty, seemed to be +aware of the value of mental impressions; for in their apartments they +were lavish of statues and paintings representing the gods and +goddesses, delineated in accordance with the best models of art. + +Dionysus, tyrant of Syracuse, caused the portrait of the beautiful Jason +to be suspended before the nuptial bed, in order to obtain a handsome +child. + +The following is related of the celebrated Galen:--A Roman magistrate, +little, ugly, and hunch-backed, had by his wife a child exactly +resembling the statue of AEsop. Frightened at the sight of this little +monster, and fearful of becoming the father of a posterity so deformed, +he went to consult Galen, the most distinguished physician of his time, +who counseled him to place three statues of love around the conjugal +bed, one at the foot, the others, one on each side, in order that the +eyes of his young spouse might be constantly feasted on these charming +figures. The magistrate followed strictly the advice of the physician, +and it is recorded that his wife bore him a child surpassing in beauty +all his hopes. + +The fact that the attributes of the child are determined to an important +extent by the bodily and mental condition of the parents at the time of +conception, explains the marked difference almost constantly observed +between children born to the same parents, however strong the family +likeness may be among them. The changes constantly going on in the +physical, intellectual, and emotional states of the parents, produce a +corresponding alteration in offspring conceived at successive intervals. +Twins generally resemble each other very closely in every respect. + +Inasmuch, therefore, as the moment of generation is of much more +importance than is commonly believed in its effect upon the moral and +physical life of the future being, it is to be wished that parents would +pay some attention to this subject. It is the moment of creation,--that +in which the first vital power is communicated to the new creature. Not +without reason has nature associated with it the highest sensual +exaltation of our existence. Dr. Hufeland, the author of _The Art of +Prolonging Life_, has said, 'In my opinion it is of the utmost +importance that this moment should be confined to a period when the +sensation of collected powers, ardent passion, and a mind cheerful and +free from care, invite to it on both sides.' + + +SIGNS OF FRUITFUL CONJUNCTION. + +There are some women in whom the act of conception is attended with +certain sympathetic affections, such as faintness, vertigo, etc., by +which they know that it has taken place. + +Swelling of the neck was regarded in ancient times as a sign of +conception. Its truthfulness has been reaffirmed by modern authorities. + +It has also been asserted that impregnation generally excites a +universal tremor in all parts of the body, and that it is associated +with more than an ordinary degree of pleasure. + +It must not be supposed, however, that enjoyment and impregnation bear +necessarily to each other the relation of cause and effect, although +this is the popular opinion. From too implicit a reliance upon this +current belief, wives are often incredulous as to their true condition. + +It is a fact that in some cases sickness at the stomach manifests itself +almost simultaneously with the act of fecundation. Authentic instances +are on record of wives reckoning their confinement nine months from the +first feeling of nausea, without ever making a mistake. + +In conclusion, it may be said that peculiar sensations are often +experienced, frequently of a character difficult to explain; and many +modern authors attach to them a marked value. In this manner it is +possible for a woman to be satisfied at the moment as to the change +which has taken place; yet the evidence is often deceptive, and +sometimes nothing peculiar is noticed. + +From the period of conception the mother has no direct knowledge of the +process that is going on within, excepting by the effects of the +increasing pressure upon other parts, until 'quickening' takes place, +which belongs to another part of our subject. + +The signs and symptoms of pregnancy will be explained in full when we +come to treat of the pregnant condition in a future chapter. + + +HOW TO RETAIN THE AFFECTIONS OF A HUSBAND. + +Ah! this is a secret indeed!--worth the wand of the magician, the lamp +of Aladdin, or the wishing-cap of the fairy. What could any of these +give in exchange for the love of a husband? Yet this pearl of great +price, how often is it treated as lightly and carelessly as if it was +any bauble of Brummagem! + +'My husband,' we have heard young wives say, 'why, it is his duty to +love me. Why did he marry me if he is not going to love me, love me +fondly, love me ever?' + +Yes, we all know + + Love the gift, is love the debt. + +But in this world of ours it is often hard to get one's own; and when +got, our care must never cease, lest it be wrested from us. The plant +you bought at the greenhouse, and that now blossoms on your window-sill, +became yours by purchase, but it has required your daily care to keep it +alive and persuade it to unfold its blossoms. Infinitely more delicate +is this plant of love. It, too, you purchased. You gave in exchange for +it your own heart. It too, you must daily tend with constant solicitude, +lest it wither and die. + +In this country, some women think that anything is good enough to wear +at home. They go about in slatternly morning dresses, unkempt hair, and +slippers down at heel. 'Nobody will see me,' they say 'but my husband.' +Let them learn a lesson from the wives of the Orient. + +In those countries a married woman never goes abroad except in long +sombre robes and thick veil. An English lady visiting the wife of one of +the wealthy merchants, found her always in full dress, with toilet as +carefully arranged as if she were going to a ball. + +'Why!' exclaimed the visitor, at length, 'is it possible that you take +all this trouble to dress for nobody but your husband?' + +'Do, then,' asked the lady in reply, 'the wives of Englishmen dress for +the sake of pleasing other men?' + +The visitor was mute. + +Not that we would wish our women to be for ever in full costume at home. +That would be alarming. But she who neglects neatness in attire, and, +above all, cleanliness of person, runs a great danger of creating a +sentiment of disgust in those around her. Nothing is more repugnant to +the husband's senses than bad odors, and, for reasons which every woman +knows, women who neglect cleanliness are peculiarly liable to them. When +simple means do not remove them, recourse should be promptly had to a +medical adviser. + +So it is with bad breath. This sometimes arises from neglect of the +teeth, sometimes from diseases of the stomach, lungs, etc. A man of +delicate olfactories is almost forced to hold at arm's length a wife +with a fetid breath. + +There are some women--we have treated several--who are plagued with a +most disagreeable perspiration, especially about the feet, the arms, +etc. Such should not marry until this is cured. It is a rule among army +surgeons, to be chary about giving men their discharge from military +service on surgeon's certificate. But fetid feet are at times so +horribly offensive, that they are considered an allowable cause for +discharge. No doubt, in some of our States they would be received as a +valid ground for divorce!--certainly with quite as much reason as many +of the grounds usually alleged. + +In short, the judicious employment of all the harmless arts of the +toilet, and of those numerous and effective means which modern science +offers, to acquire, to preserve, and to embellish beauty, is a duty +which woman, whether married or single, should never neglect. With very +little trouble, the good looks and freshness of youth can be guarded +almost to old age; and, even when hopelessly gone, simple and harmless +means are at hand to repair the injuries of years, or at least to +conceal them. But this is an art which would require a whole volume to +treat of, and which we cannot here touch upon. + + +INHERITANCE. + +We now come to the consideration of a very wonderful subject,--that of +inheritance. It is one of absorbing interest, both because of the +curious facts it presents, and of the great practical bearing it has +upon the welfare of every individual. + +In order to the better understanding of this matter, it is necessary +at the outset to make a distinction between four kinds or varieties of +inheritance. The most generally recognised is _direct inheritance_,--that +in which the children partake of the qualities of the father and +mother. But a child may not resemble either parent, while it bears a +striking likeness to an uncle or aunt. This constitutes _indirect_ +inheritance. Again, a child may be more like one of its grandparents +than either its father or mother. Or, what is still more astonishing, +it may display some of the characteristics possessed only by a +remote ancestor. This form of inheritance is known by the scientific +term _atavism_, derived from the Latin word _atavus_, meaning an +ancestor. It is curious to note in this connection that sometimes a son +resembles more closely his maternal than his paternal grandsire in some +male attribute,--as a peculiarity of beard, or certain diseases confined +to the male sex. Though the mother cannot possess or exhibit such male +qualities, she has transmitted them through her blood, from her father to +her son. + +The fourth variety of inheritance is that in which the child resembles +neither parent, but the first husband of its mother. A woman contracting +a second marriage, transmits to the offspring of that marriage the +peculiarities she has received through the first union. Breeders of +stock know this tendency, and prevent their brood-mares, cows, or sheep +from running with males of an inferior stock. Thus the diseases of a man +may be transmitted to children which are not his own. Even though dead, +he continues to exert an influence over the future offspring of his +wife, by means of the ineffaceable impress he had made in the conjugal +relation upon her whole system, as we have previously mentioned. The +mother finds in the children of her second marriage + + '... the touch of a vanished hand, + And the sound of a voice that is still.' + +A child may therefore suffer through the operation of this mysterious +and inexorable law, for sins committed not by its own father, but by the +first husband of its mother. What a serious matter, then, is that +relation between the sexes called marriage! How far-reaching are its +responsibilities! + +A distinction must here be drawn between hereditary transmission and the +possession of qualities at birth, which have not been the result of any +impression received from the system of father or mother, but due to +mental influences or accidents operating through the mother. A child may +be born idiotic or deformed, not because either parent or one of its +ancestors was thus affected, but from the influence of some severe +mental shock received by the mother during her pregnancy. This subject +of maternal impressions will come up for separate consideration in the +discussion of pregnancy. Again, a child may be epileptic, although there +is no epilepsy in the family, simply because of the intoxication of the +father or mother at the time of the intercourse resulting in conception. +Such cases are not due to hereditary transmission, for that cannot be +hereditary which has been possessed by neither the parents nor any other +relatives. + +In considering the effects of inheritance, we will first pass in review +those connected with the physical constitution. These are exceedingly +common and universally known. Fortunately, not merely are evil qualities +inherited, but beauty, health, vigor, and longevity also. + + +BEAUTY. + +Good looks are characteristic of certain families. Alcibiades, the +handsomest among the Grecians of his time, descended from ancestors +remarkable for their beauty. So well and long has the desirable +influence of inheritance in this respect been recognised, that there +existed in Crete an ancient law which ordained that each year the most +beautiful among the young men and women should be chosen and forced to +marry, in order to perpetuate the type of their beauty. Irregularities +of feature are transmitted from parent to child through many +generations. The aquiline nose has existed some centuries, and is yet +hereditary in the Bourbon family. The hereditary under-lip of the House +of Hapsburg is another example. When the poet Savage speaks of + + 'The tenth transmitter of a foolish face,' + +he scarcely exaggerates what is often seen in families where some +strongly-marked feature or expression is long predominant or reappears +in successive generations. + + +NECK AND LIMBS. + +The form and length of the neck and limbs are frequently hereditary, as +is also the height of the body. The union of two tall persons engenders +tall children. The father of Frederick the Great secured for himself a +regiment of men of gigantic stature, by permitting the marriage of his +guards only with women of similar height. A tendency to obesity often +appears in generation after generation of a family. Yet such cases are +within the reach of medical art. + + +COMPLEXION. + +Even the complexion is not exempt from this influence. Blondes +ordinarily procreate blondes, and dark parents have dark-skinned +children. An union in marriage of fair and dark complexions results in +an intermediate shade in the offspring. Not always, however; for it has +been asserted that the complexion chiefly follows that of the father. +The offspring of a black father and a white mother is much darker than +the progeny of a white father and a dark mother. In explanation of this +fact, it has been said that the mother is not impressed by her own +color, because she does not look upon herself, while the father's +complexion attracts her attention, and thus gives a darker tinge to the +offspring. Black hens frequently lay dark eggs; but the reverse is more +generally found to be the case. + + +PHYSICAL QUALITIES TRANSMITTED BY EACH PARENT. + +In general, it may be said that there exists a tendency on the part of +the father to transmit the external appearance, the configuration of the +head and limbs, the peculiarities of the senses and of the skin and the +muscular condition; while the size of the body, and the general +temperament or constitution of the child, are derived from the mother. +Among animals, the mule, which is the produce of the male ass and the +mare, is essentially a modified ass having the general configuration of +its sire, but the rounded trunk and larger size of its dam. On the other +hand, the hinny, which is the offspring of the stallion and the she-ass, +is essentially a modified horse, having the general configuration of the +horse, but being a much smaller animal than its sire, and therefore +approaching the dam in size as well as in the comparative narrowness of +its trunk. The operation of this principle, though general, is not +universal. Exceptions may easily be cited. In almost every large family +it will be observed that the likeness to the father predominates in some +children, while others most resemble the mother. It is rare to meet with +instances in which some distinctive traits of both parents may not be +traced in the offspring. + + +HAIR. + +Peculiarities in the colour and structure of the hair are transmitted. +Darwin mentions a family in which, for many generations, some of the +members had a single lock differently coloured from the rest of the +hair. + + +TEMPERAMENT. + +The law of inheritance rules in regard to the production of the +temperament. The crossing of one temperament with another in marriage, +produces a modification in the offspring generally advantageous. + + +FERTILITY. + +A peculiar aptitude for procreation is sometimes hereditary. The +children of prolific parents are themselves prolific. It is related that +a French peasant woman was confined ten times in fifteen years. Her +pregnancies, always multiple, produced twenty-eight children. At her +last confinement she had three daughters, who all lived, married, and +gave birth to children,--the first to twenty-six, the second to +thirty-one, and the third to twenty-seven. On the contrary, sometimes a +tendency to sterility is found fixed upon certain families, from which +they can only escape by the most assiduous care. + + +LONGEVITY. + +In the vegetable kingdom, the oak inherits the power to live many years, +while the peach-tree must die in a short time. In the animal kingdom, +the robin becomes grey and old at ten years of age; the rook caws +lustily until a hundred. The ass is much longer-lived than the horse. +The mule illustrates in a striking manner the hereditary tendency of +longevity. It has the size of the horse, the long life of the ass. The +weaker the ass, the larger, the stronger, and the shorter-lived and more +horse-like the mule. It is also a curious and instructive fact, that +this animal is the toughest after it has passed the age of the horse: +the inherited influence of the horse having been expended, the vitality +and hardiness of the ass remain. + +It is universally conceded, that longevity is the privileged possession +of some lineages. That famous instance of old age, Thomas Parr, the +best authenticated on record, may be mentioned in illustration. It is +vouched for by Harvey, the distinguished discoverer of the circulation +of the blood. Parr died in the reign of Charles the First, at the age of +152, after having lived under nine sovereigns of England. He left a +daughter aged 127. His father had attained to a great age, and his +great-grandson died at Cork at the age of 103. + + +DEFORMITIES. + +Deformities are undoubtedly sometimes transmitted to the progeny. It is +by no means rare to find that the immediate ancestors of those afflicted +with superfluous fingers and toes, club-feet, or hare-lips, were also +the subjects of these malformations. There are one or two families in +Germany whose members pride themselves upon the possession of an extra +thumb; and there is an Arab chieftain whose ancestors have from time +immemorial been distinguished by a double thumb upon the right hand. +Darwin gives many similar instances. A case of curious displacement of +the knee-pans is recorded, in which the father, sister, son, and the son +of the half-brother by the same father, had all the same malformation. + + +PERSONAL PECULIARITIES. + +Gait, gestures, voice, general bearing, are all inherited. Peculiar +manners, passing into tricks, are often transmitted, as in the case, +often quoted, of the father who generally slept on his back with his +right leg crossed over the left, and whose daughter, whilst an infant +in the cradle, followed exactly the same habit, though an attempt was +made to cure her. Left-handedness is not unfrequently hereditary. It +would be very easy to go on multiplying instances, but we forbear. + + +HOW TO HAVE BEAUTIFUL CHILDREN. + +A practical question now naturally suggests itself. How can the vices of +conformation be avoided, and beauty secured? The art of having handsome +children, known under the name of _callipaedia_, has received much +attention, more, perhaps, in years gone by than of late. The noted Abbot +Quillet wrote a book in Latin on the subject. Many other works, in which +astrology plays a prominent part, were written on this art in the +sixteenth and seventeenth centuries. + +We have already stated that well-formed parents will transmit these +qualities to their children, with scarcely an exception. Like begets +like. Unfortunately, all parents are not beautiful. Yet all desire +beautiful offspring. The body of the child can be influenced by the mind +of the parent, particularly of the mother. A mind habitually filled with +pleasant fancies and charming images is not without its effect upon the +offspring. + +The statues of Apollo, Castor and Pollux, Venus, Hebe, and the other +gods and goddesses which were so numerous in the gardens and public +places in Greece, reproduced themselves in the sons and daughters of the +passers-by. We know also that marriages contracted at an age too early +or too late, are apt to give imperfectly-developed children. The +crossing of temperaments and of nationalities beautifies the offspring. +The custom which has prevailed, in many countries, among the nobility, +of purchasing the handsomest girls they could find for their wives, has +laid the foundation of a higher type of features among the ruling +classes. To obtain this desired end, conception should take place only +when both parents are in the best physical condition, at the proper +season of the year, and with mutual passion. (We have already hinted how +this can be regulated.) During pregnancy the mother should often have +some painting or engraving representing cheerful and beautiful figures +before her eyes, or often contemplate some graceful statue. She should +avoid looking at, or thinking of ugly people, or those marked with +disfiguring diseases. She should take every precaution to escape injury, +fright, and disease of any kind, especially chicken-pox, erysipelas, or +such disorders as leave marks on the person. She should keep herself +well nourished, as want of food nearly always injures the child. She +should avoid ungraceful positions and awkward attitudes, as by some +mysterious sympathy these are impressed on the child she carries. Let +her cultivate grace and beauty in herself at such a time, and she will +endow her child with them. As anger and irritability leave imprints on +the features, she should maintain serenity and calmness. + + +INHERITANCE OF TALENT AND GENIUS. + +The effects of inheritance are perhaps more marked upon the mind than +upon the body. This need not surprise us. If the peculiar form of the +brain can be transmitted, the mental attributes, the result of its +organization, must necessarily also be transmitted. + +It is a matter of daily observation, that parents gifted with bright +minds, cultivated by education, generally engender intelligent children; +while the offspring of those steeped in ignorance are stupid from birth. +It may be objected, that men the most remarkable in ancient or modern +times, as Socrates, Plato, Aristotle, Shakspeare, Milton, Buffon, +Cuvier, etc., have not transmitted their vast intellectual powers to +their progeny. In explanation, it has been stated that what is known as +genius is not transmissible. The creation of a man of genius seems to +require a special effort of Nature, after which, as if fatigued, she +reposes a long time before again making a similar effort. But it may +well be doubted whether even those complex mental attributes on which +genius and talent depend are not inheritable, particularly when both +parents are thus endowed. That distinguished men do not more frequently +have distinguished sons, may readily be accounted for when it is +recollected that the inherited character is due to the combined +influence of both parents. The desirable qualities of the father may +therefore be neutralized in the offspring by the opposite or defective +qualities of the mother. That contrasts in the disposition of parents +are rather the rule than the exception, we have already shown. Every one +tends to unite himself in friendship or love with a different character +from his own, seeking thereby to supplement the qualities in which he +feels his own nature to be deficient. The mother, therefore, may weaken, +and perhaps obliterate, the qualities transmitted by the father. Again, +the influence of some remote ancestors may make itself felt upon the +offspring through the operation of the law of atavism, before alluded +to, and thus prevent the children from equaling their parents in their +natural endowments. Notwithstanding the workings of these opposing +forces, and others which might be mentioned, we find abundant +illustration of the hereditary nature of talent and character. + +Of six hundred and five names occurring in a biographical dictionary +devoted to men distinguished as great founders and originators, between +the years 1453 and 1853, there were, as has been pointed out by Mr. +Galton, no less than one hundred and two relationships, or one in six. +Walford's _Men of the Time_ contains an account of the distinguished men +in England, the Continent, and America, then living. Under the letter A +there are eighty-five names, and no less than twenty-five of these, or +one in three and a half, have relatives also in the list; twelve of them +are brothers, and eleven fathers and sons. In Bryan's _Dictionary of +Painters_, the letter A contains three hundred and ninety-one names of +men, of whom sixty-five are near relatives, or one in six; thirty-three +of them are fathers and sons, and thirty are brothers. In Fetis's +_Biographie Universelle des Musiciens_, the letter A contains five +hundred and fifteen names, of which fifty are near relatives, or one in +ten. Confining ourselves to literature alone, it has been found that it +is one to six and a half that a very distinguished literary man has a +very distinguished literary relative; and it is one to twenty-eight that +the relation is father and son, or brother and brother, respectively. +Among the thirty-nine Chancellors of England, sixteen had kinsmen of +eminence; thirteen of them had kinsmen of great eminence. These thirteen +out of thirty-nine, or one in three, are certainly remarkable instances +of the influence of inheritance. A similar examination has been +instituted in regard to the judges of the Supreme Court of +Massachusetts, and other American States, with like results. The Greek +poet AEschylus counted eight poets and four musicians among his +ancestors. The greater part of the celebrated sculptors of ancient +Greece descended from a family of sculptors. The same is true of the +great painters. The sister of Mozart shared the musical talent of her +brother. As there are reasons, to be detailed hereafter, for believing +that the influence of the mother is even greater than that of the +father, how vastly would the offspring be improved if distinguished men +united themselves in marriage to distinguished women for generation +after generation! + + +INFLUENCE OF FATHERS OVER DAUGHTERS; OF MOTHERS OVER SONS. + +We have already called attention to the parts of the physical +organization transmitted by the father and by the mother. It would seem, +moreover, that each parent exercises a special influence over the child +according to its sex. The father transmits to the daughters the form of +the head, the framework of the chest and of the superior extremities, +while the conformation of the lower portion of the body and the inferior +extremities is transmitted by the mother. With the sons this is +reversed. They derive from the mother the shape of the head and of the +superior extremities, and resemble the father in the trunk and inferior +extremities. From this it therefore results, that boys procreated by +intelligent women will be intelligent, and that girls procreated by +fathers of talent will inherit their mental capacity. The mothers of a +nation, though unseen and unacknowledged in the halls of legislation, +determine in this subtle manner the character of the laws. + +History informs us that the greater part of the women who have been +celebrated for their intelligence, reflected the genius of their +fathers. Arete, the most celebrated woman of her time, on account of the +extent of her knowledge, was the daughter of the distinguished +philosopher Aristippus, disciple of Socrates. Cornelia, the mother of +the Gracchi, was a daughter of Scipio. The daughter of the Roman emperor +Caligula was as cruel as her father. Marcus Aurelius inherited the +virtues of his mother, and Commodus the vices of his. Charlemagne shut +his eyes upon the faults of his daughters, because they recalled his +own. Genghis-Khan, the renowned Asiatic conqueror, had for his mother a +warlike woman. Tamerlane, the greatest warrior of the fourteenth +century, was descended from Genghis-Khan by the female side. Catherine +de Medicis was as crafty and deceitful as her father, and more +superstitious and cruel. She had two sons worthy of herself,--Charles +IX., who shot the Protestants, and Henry III., who assassinated the +Guises. Her daughter, Margaret of Valois, recalled her father by her +gentle manners. The cruel deeds of Alexander VI., the dark records of +which will for ever stain the pages of history, are only rivaled in +atrocity by those of his children, the infamous Borgias. Arete, Hypatia, +Madame de Stael, and George Sand,--all four had philosophers for their +fathers. The mother of Bernardo Tasso had the gift of poetry. Buffon +often speaks of the rich imagination of his mother. The poet Burns, +'Rare Ben Jonson,' Goethe, Walter Scott, Byron, and Lamartine,--all were +born of women remarkable for their vivacity and brilliancy of language. +Byron, in his journal, attributes his hypochondria to a hereditary taint +derived from his mother, who was its victim in its most furious form; +and her father 'was strongly suspected of suicide.' He was said to have +resembled more his maternal grandfather than any of his father's family. +The daughter of Moliere was like her father in her wit and humor. +Beethoven had for a maternal grandmother an excellent musician. The +mother of Mozart gave the first lessons to her son. A crowd of composers +have descended from John Sebastian Bach, who long stood unrivaled as a +performer on the organ, and composer for that instrument. It may be +remarked here, that it is almost invariably true that the ability or +inability to acquire a knowledge of music is derived from the ancestry. +Parents who cannot turn a tune or tell one note from another, bring +forth children equally unmoved 'with concord of sweet sounds.' Examples +could easily be adduced at still greater length, illustrating the direct +influence of the father over the daughter, and of the mother over the +son. Those given will suffice. + + +INFLUENCE Of EDUCATION OVER INHERITED QUALITIES. + +In correcting the evil effects of inheritance on the mind, education +plays a very important part. A child born with a tendency to some vice +or intellectual trait, may have this tendency entirely overcome, or at +least modified, by training. So, also, virtues implanted by nature may +be lost during the plastic days of youth, in consequence of bad +associations and bad habits. + +Education can therefore do much to alter inherited mental and moral +qualities. Can it be invoked to prevent the transmission of undesirable +traits, and secure the good? Everything that we have at birth is a +heritage from our ancestors. Can virtuous habits be transmitted? Can we +secure virtues in our children by possessing them ourselves? Science +sadly says, through her latest votaries, that we are scarcely more than +passive transmitters of a nature we have received, and which we have no +power to modify. It is only after exposure during several generations to +changed conditions or habits, that any modification in the offspring +ensues. The son of an old soldier learns his drill no more quickly than +the son of an artisan. We must therefore come to the conclusion with Mr. +Galton, that to a great extent our own embryos have sprung immediately +from the embryos whence our parents were developed, and these from the +embryos of their parents, and so on for ever. Hence we are still +barbarians in our nature. We show it in a thousand ways. Children, who +love to dig and play in the dirt, have inherited that instinct from +untold generations of ancestors. Our remote forefathers were barbarians, +who dug with their nails to get at the roots on which they lived. The +delicately-reared child reverts to primeval habits. In like manner, the +silk-haired, parlor-nurtured spaniel springs from the caressing arms of +its mistress, to revel in the filth of the roadside. It is the breaking +out of inherited instinct. + + +TRANSMISSION OF DISEASE. + +Perhaps the most important part of the subject of inheritance, is that +which remains for us to consider in relation to the transmission of +disease, or of a predisposition to it. + +Consumption,--that dread foe of modern life,--is the most frequently +encountered of all affections as the result of inherited predisposition. +Indeed some of the most eminent physicians have believed it is never +produced in any other way. Heart disease, disease of the throat, +excessive obesity, affections of the skin, asthma, disorders of the +brain and nervous system, gout, rheumatism, and cancer, are all +hereditary. A tendency to bleed frequently, profusely and +uncontrollably, from trifling wounds, is often met with as a family +affection. + +The inheritance of diseased conditions is also _influenced by the sex_. +A parent may transmit disease exclusively to children of the same sex, +or exclusively to those of the opposite sex. Thus, a horn-like +projection on the skin peculiar to the Lambert family was transmitted +from the father to his sons and grandsons alone. So mothers have through +several generations transmitted to their daughters alone supernumerary +fingers, color-blindness, and other deformities and diseases. As a +general rule, any disease acquired during the life of either parent, +strongly tends to be inherited by the offspring of the same sex rather +than the opposite. We have spoken of the apparently reverse tendency in +regard to the transmission of genius and talent. + + +ARE MUTILATIONS INHERITABLE? + +How, it may be inquired, is it in regard to the inheritance of parts +mutilated and altered by injuries and disease during the life of either +parent? In some cases mutilations have been practised for many +generations, without any inherited result. Different races of men have +knocked out their upper teeth, cut off the joints of their fingers, made +immense holes through their ears and nostrils, and deep gashes in +various parts of their bodies, and yet there is no reason for supposing +that these mutilations have been inherited. The _Comprachicos_, a +hideous and strange association of men and women, existed in the +seventeenth century, whose business it was to buy children and make of +them monsters. Victor Hugo, in a recent work, has graphically told how +they took a face and made of it a snout, how they bent down growth, +kneaded the physiognomy, distorted the eyes, and in other ways +disfigured 'the human form divine,' in order to make fantastic +playthings for the amusement of the noble-born. But history does not +state that these deformities were inherited; certainly no race of +monsters has resulted. The pits from small-pox are not inherited, though +many successive generations must have been thus pitted by that disease +before the beneficent discovery of the immortal Jenner. Children born +with scars left by pustules have had small-pox in the womb, acquired +through the system of the mother. On the other hand, the lower animals, +cats, dogs, and horses, which have had their tails and legs artificially +altered or injured, have produced offspring with the same condition of +parts. A man who had his little finger on the right hand almost cut off, +and which in consequence grew crooked, had sons with the same finger on +the same hand similarly crooked. The eminent physiologist Dr. +Brown-Sequard mentions, that many young guinea-pigs inherited an +epileptic tendency from parents which had been subjected to an operation +at his hands resulting in the artificial production of fits; while a +large number of guinea-pigs bred from animals which had not been +operated on were not thus affected. At any rate, it cannot but be +admitted that injuries and mutilations which cause disease, are +occasionally inherited. But many cases of deformities existing at birth, +as hare-lip, are not due to inheritance, although present in the father. +They arise from a change effected in the child while in the womb, +through an impression made upon the mind of the mother, as will be shown +hereafter. + + +LATE MANIFESTATIONS OF THE EFFECTS OF INHERITANCE. + +Not only are diseases inherited which make their appearance at birth, +but those which defer their exhibition until a certain period of life +corresponding with that at which they showed themselves in the parents. +Thus in the Lambert family, before referred to, the porcupine +excrescence on the skin began to grow in the father and sons at the same +age, namely, about nine weeks after birth. In an extraordinary hairy +family, which has been described, children were produced during three +generations with hairy ears: in the father, the hair began to grow over +his body at six years old; in his daughter somewhat earlier, namely, at +one year; and in both generations the milk teeth appeared late in life, +the permanent teeth being deficient. Greyness of hair at an unusually +early age has been transmitted in some families. So, also, has the +premature appearance of baldness. + + +HOW TO AVOID THE TENDENCY OF INHERITANCE. + +These facts suggest the practical consideration, that in those diseases +the predisposition to which alone is inherited, and which break out only +after a lapse of time, it is often altogether possible to prevent the +predisposition being developed into positive disease. Thus, for +instance, the inherited tendency to _consumption_ remains asleep in the +system until about the age of puberty, or later. Therefore, by the use +of a diet in which animal food forms a large portion, properly +regulated, and systematic exercise in the open air, the practice of the +long inhalations before recommended, warm, comfortable clothing, +together with a residence, if practicable, during the changeable and +inclement seasons of the year, in an equable climate, we can often +entirely arrest the development of the disease. Prevention here is not +only better than cure, but often all that is possible. Those in whom the +disease has become active, must too often, like those who entered +Dante's infernal regions, 'abandon hope.' Let our words of caution +therefore be heeded. + +When there is reason to believe that an individual possesses an inherent +tendency to any disease, it is the duty of the medical adviser to study +the constitution of the patient thoroughly, and after such study to +recommend those measures of prevention best suited to avert the +threatened disorder. Above all, let the physician look closely to the +child at the period of life when any grave constitutional inheritable +disease attacked the parent. This supervision should be carried into +adult years, for there are instances on record of inherited diseases +coming on at an advanced age, as in that of a grandfather, father, and +son, who all became insane and committed suicide near their fiftieth +year. Gout, apoplexy, insanity, chronic disease of the heart, epilepsy, +consumption, asthma, and other diseases, are all more or less under the +control of preventive measures. Some hereditary diseases, such as idiocy +and cancer, we are impotent to prevent, in the present state of our +knowledge. + +A singular fact in connection with the transmission of disease is the +readiness with which a whole generation is passed over, the affection +appearing in the next. A father or mother with consumption may in some +instances have healthy children, but the grandchildren will die of the +disease. Nature kindly favors one generation, but only at the expense of +the next. + +Some diseases require, in addition to the general means of prevention to +be found in a strict observance of the laws of health, some special +measures in order to effectually ward off their appearance. But the +extent of this work will not admit of their discussion. Already, indeed, +have we unduly, perhaps, extended our remarks upon inheritance. The +interest and importance of the facts must be our justification. + + +WHY ARE WOMEN REDUNDANT? + +It cannot be without interest to look into the relative proportion of +men and women now living. It will interest us still more to inquire into +the reason why one sex preponderates over the other in numbers. This +done, we will answer the question; Is the production of sex at all under +the influence of the human will? + +The female sex is the more numerous in all thickly populated parts of +the world where we have trustworthy statistics. In Austria, England, and +Wales, there are nearly one hundred and five women for every one hundred +men. In Sweden they are as one hundred and nine to one hundred. In all +cities the disproportion is greater than in the country. In London there +are one hundred and thirteen women to every one hundred men; and in the +large towns of Sweden they stand as one hundred and sixteen to one +hundred. + +This is not true, however, of newly-populated regions. The relative +difference is reversed in recent and thinly-settled localities. In our +Western States, for instance, the number of the men exceeds that of the +women. In California they are as three to one; in Nevada as eight to +one; in Colorado, twenty to one. In the State of Illinois there were, +according to a recent United States census, ninety-three thousand more +men than women. In Massachusetts, on the contrary, there are between +fifty and sixty thousand more women than men. + +The disproportion of men to women in new countries is due to the +disinclination of women to emigrate. They are also unfitted for the +hardships of pioneer life. + +How is this general preponderance in the number of women produced? Is it +because there are more girls born than boys? Not at all. The statistics +of over fifty-eight millions of persons show that there are one hundred +and six living boys born to every one hundred girls. In the state of +Rhode Island, for instance, the proportion for three years, from 1853 to +1855, was one thousand and sixty-four boys born to one thousand girls. +But now we meet with the wonderful arrangement of nature, that a larger +proportional number of male infants die during the first year of their +lives than of females. In the second year, the mortality, though less +excessive, still remains far greater on the male side. It subsequently +decreases, and at the age of four or five years is nearly equal for both +sexes. In after life, from the age of fifteen to forty, the mortality is +something greater among women, but not sufficiently so to make the +number of the two sexes equal. The greater tendency of male offspring to +die early is seen even before birth, for more male children are +still-born than female,--namely, as three to two. For this reason, the +term 'the stronger sex,' applied to men, has been regarded by some +authors as a misnomer. They are physically weaker in early life, and +succumb more readily to noxious influences. + +Having thus pointed out that there are more women actually living in the +world than men, although a larger number of boys are born than girls, we +will consider for a moment some of the laws of nature which determine +the number of the sexes. Without giving the figures,--which would make +dry reading,--we will state in brief the conclusions derived from many +observations, extending over many years and many nationalities. The +relative age of the parents has an especial influence upon the sex of +the children. Seniority on the father's side gives excess of male +offspring. Equality in the parents' age gives a slight preponderance of +female offspring. Seniority on the mother's side gives excess of female +offspring. This tallies with the fact that in all civilized countries, +as has been stated, the proportion of male births is greater than that +of females; for, in accordance with the customs of society, the husband +is generally older than the wife. A curious instance, in confirmation +of this law, has recently come under our observation. A patient, married +for the second time, is ten years older than her husband. She has two +children by him, both girls. Singular to relate, her former husband was +ten years older than herself, and by him she had four children, of whom +three were boys, the fourth (a girl) having a twin brother. + +Still, the relative age is not the sole cause which fixes the sex of the +child. Its operation is sometimes overruled by conflicting agencies. In +some districts of Norway, for example, there has been a constant +deficiency in boys, while in others the reverse has been the case. The +circumstance is well known, that after great wars, and sometimes +epidemics, in which a disproportionate number of men have died, more +boys are born than usual. Men who pass a sedentary life, and especially +scholars who exhaust their nervous force to a great extent, beget more +girls than boys. So, also, a very advanced age on the man's side +diminishes the number of males among the offspring. The quantity and the +quality of the food; the elevation of the abode; the conditions of +temperature; the parents' mode of life, rank, religious belief, +frequency of sexual intercourse,--have all been shown to be causes +contributing to the disproportion of the sexes, besides the relative +ages of the parents. + +Some writers have stated that a southerly or warm and humid constitution +of the year is most favorable to the birth of female infants, while in +cold and dry years most males are produced. This statement has not been +supported by trustworthy statistics in regard to the human race, but in +respect of domestic animals the agriculturists of France have long +observed that the season has much to do with the sex. When the weather +is dry and cold, and the wind northerly, mares, ewes, and heifers +produce more males than when the opposite meteorological condition +prevails. + +The saying among nurses, that 'This is the year for sons or daughters,' +is based upon the erroneous supposition that mothers bring forth more +male infants in one year than in another. + +That, however, which concerns us the most in this connection, is the +question: + + +CAN THE SEXES BE PRODUCED AT WILL? + +This question was asked many centuries ago. It was a hard one, and +remained without a satisfactory answer until quite recently. Science has +at last replied to it with authority. M. Thury, Professor in the Academy +of Geneva, has shown how males and females may be produced in accordance +with our wishes. + +Some families are most anxious for male offspring, others ardently +desire daughters. And would it not often be a matter of national concern +to control the percentage of sexes in the population? Is it not a +'consummation most devoutly to be wished,' to bring about that Utopian +condition when there would be no sighing maids at home, nor want of +warriors in the field? The discussion of this subject is therefore +important and allowable. + +It has been observed that queen-bees lay female eggs first, and male +eggs afterwards. So with hens: the first-laid eggs give female, the +last male products. Mares shown the stallion late in their periods, drop +horse-colts rather than fillies. + +Professor Thury, from the consideration of these and other like facts, +formed this law for stock-raisers: 'If you wish to produce females, give +the male at the first signs of heat; if you wish males, give him at the +end of the heat.' But it is easy to form a theory. How was this law +sustained in practice? We have now in our possession the certificate of +a Swiss stock-grower, son of the President of the Swiss Agricultural +Society, Canton de Vaud, under date of February 1867, which says: + +'In the first place, on twenty-two successive occasions I desired to +have heifers. My cows were of Schurtz breed, and my bull a pure Durham. +I succeeded in these cases. Having bought a pure Durham cow, it was very +important for me to have a new bull, to supersede the one I had bought +at great expense, without leaving to chance the production of a male. So +I followed accordingly the prescription of Professor Thury, and the +success has proved once more the truth of the law. I have obtained from +my Durham bull six more bulls (Schurtz-Durham cross) for fieldwork; and +having chosen cows of the same color and height, I obtained perfect +matches of oxen. My herd amounted to forty cows of every age. + +'In short, I have made in all twenty-nine experiments after the new +method, and in every one I succeeded in the production of what I was +looking for--male and female. I had not one single failure. All the +experiments have been made by myself, without any other person's +intervention; consequently, I do declare that I consider as real and +certainly perfect the method of Professor Thury.' + +A perfectly trustworthy observer communicates by the _Medical and +Surgical Reporter_ of Philadelphia for May 2, 1868, the results of +similar experiments on animals, with like conclusions. + +The plan of M. Thury was also tried on the farms of the late Emperor of +the French, with, it is asserted, the most unvarying success. + +What is the result of the application of this law to the human race? Dr. +F. J. W. Packman, of Wimborne, has stated in the _Lancet_, that, 'in the +human female, conception in the first half of the time between menstrual +periods produces female offspring, and male in the latter. When a female +has gone beyond the time she calculated upon, it will generally turn out +to be a boy.' + +In the Philadelphia _Medical and Surgical Reporter_ for February 8, +1868, a respectable physician writes that, in numerous instances that +have come under his observation, Professor Thury's theory has proved +correct, 'Whenever intercourse has taken place in from two to six days +after the cessation of the menses, girls have been produced; and +whenever intercourse has taken place in from nine to twelve days after +the cessation of the menses, boys have been produced. In every case I +have ascertained not only the date at which the mother placed +conception, but also the time when the menses ceased, the date of the +first and subsequent intercourse for a month or more after the +cessation of the menses,' etc. + +Again, a physician writes to the same journal for June 20, 1868, +recording the result of his own experience. + +A farmer in Louisiana states, in the _Turf, Field, and Farm_, in support +of this law, that 'I have already been able in many cases to guess with +certainty the sex of a future infant. More than thirty times, among my +friends, I have predicted the sex of a child before its birth, and the +event proved nearly every time that I was right.' + +The wife, therefore, who would wish, as Macbeth desired of his, to + + 'Bring forth men-children only,' + +should avoid exposing herself to conception during the early part of the +time between her menstrual periods. + +The prediction of the sex of the child before birth can now be with some +accuracy made by the intelligent and skilful physician. The method of +doing so will be mentioned in treating of pregnancy. + + +TWIN-BEARING. + +As a rule, a woman has one child at a time. Twins, when they occur, are +looked upon with disfavor by most people. There is a popular notion that +they are apt to be wanting in physical and mental vigor. This opinion is +not without foundation. A careful scientific examination of the subject +has shown, that of imbeciles and idiots a much larger proportion is +actually found among the twins born than in the general community. In +families where twinning is frequent, bodily deformities likewise occur +with frequency. Among the relatives of imbeciles and idiots, +twin-bearing is common. In fact, the whole history of twin-births is of +an exceptional character, indicating imperfect development and feeble +organization in the product, and leading us to regard twins in the human +species as a departure from the physiological rule, and therefore +injurious to all concerned. Monsters born without brains have rarely +occurred except among twins. + +The birth of twins occurs once in about eighty deliveries. A woman is +more apt to have no children than to have more than one at a time. In +view of the increased danger to both mother and child, this rarity of a +plural birth is fortunate. + + +WHY ARE TWINS BORN? + +What are the causes or favouring circumstances bringing about this +abnormal child-bearing? For it is brought about by the operation of +laws. It is not an accident. There are no accidents in nature. By some +it is supposed to be due to the mother, by some to the father. There are +facts in favour of both opinions. Certain women married successively to +several men have always had twins, while their husbands with other wives +have determined single births. Certain men have presented the same +phenomenon. We can scarcely cite an example more astonishing than that +of a countryman who was presented to the Empress of Russia in 1755. He +had had two wives. The first had fifty-seven children in twenty-one +confinements; the second, thirty-three in thirteen. All the confinements +had been quadruple, triple, or double. A case has come under our own +observation in which the bearing of twins has seemed to be due to a +constitutional cause. The wife has nine children. The first was a single +birth, a girl; the others were all twin-births, and boys. + +It has been asserted that compound pregnancies are more frequent in +certain years than in others. But that which seems to exert the greatest +actual influence over the production of twins is the age of the mother. +Very extensive statistics have demonstrated that, from the earliest +child-bearing period until the age of forty is reached, the fertility of +mothers in twins gradually increases. Between the ages of twenty and +thirty, fewest wives have twins. The average age of the twin-bearer is +older than the general run of bearers. It is well known that by far the +greater number of twins are born of elderly women. While three-fifths of +all births occur among women under thirty years of age, three-fifths of +all the twins are born to those over thirty years of age. Newly-married +women are more likely to have twins at the first labour the older they +are. The chance that a young wife from fifteen to nineteen shall bear +twins is only as one to one hundred and eighty-nine; from thirty-five to +thirty-nine the chance is as one to forty-five,--that is, the wives +married youngest have fewest twins; and there is an increase as age +advances, until forty is reached. + +Race seems to have some influence over plural births. They occur +relatively oftener among the Irish than among the English. + + +INFLUENCE OF TWIN-BEARING ON SIZE OF FAMILIES. + +Do women bearing twins have in the end larger families than those never +having but one at a time? Popular belief would answer this question in +the affirmative. Such a reply would also seem to receive support from +the fact, well established, that twins are more frequently additions to +an already considerable family than they are either the first of a +family or additional to a small family. But statistics have not answered +this question as yet positively. They seem, however, in favour of the +supposition that twin-bearing women have larger families than their +neighbors. + +Women are more apt to have twins in their first pregnancy than any +other, but after the second confinement the bearing of twins increases +in frequency with the number of the pregnancy. It becomes, therefore, an +indication of an excessive family, and is to be deplored. + + +MORE THAN TWO CHILDREN AT A BIRTH. + +Cases of the birth of more than two children at a time are still less +frequently met with than twins. They are scarcely ever encountered, +excepting in women who have passed their thirtieth year. Such cases are +all more or less unfortunate both for the mother and the children. + + +THREE AT A BIRTH. + +The births of triplets are not exclusively confined to women above +thirty years, but in those younger they are so rare as to be great +curiosities. Neither are they apt to occur in the first pregnancy. In +this respect they differ from twins, who, as has just been said, are +peculiarly prone to make their appearance at the first childbirth. Only +four cases of treble births occurred among the 36,000 accouchements +which have taken place in the Hospice de Maternite of Paris in a +determined time. Out of 48,000 cases of labor in the Royal Maternity +Charity in London, only three triplets occurred. History informs us that +the three Roman brothers, the Horatii, were triplets. They fought and +conquered the three Curiatii of Alba (667 B. C.) who were likewise +triplets. + +As an interesting fact in connection with this subject, we may mention +that in the St. Petersburg Midwives' Institute, between 1845-59, there +were three women admitted, who, in their fifteenth pregnancies, had +triplets, and each had triplets three times in succession. Happily, the +fifteenth pregnancy is not reached by most women. + + +FOUR AT A BIRTH. + +Instances of quadruplets are fewer than triplets. But four vigorous +infants have been born at one birth. + + +FIVE AT A BIRTH. + +The birth of _five_ living children at a time is very exceptional, and +is usually fatal to the offspring. A remarkable case of this kind is +reported in a late medical journal. A woman aged thirty, the wife of a +laborer, and the mother of six children, was taken in labor about the +seventh month of her pregnancy. Five children, and all alive, were given +birth to,--three boys and two girls. Four of the children survived an +hour, and died within a few moments of each other. The fifth, a female, +and the last born, lived six hours, and was so vigorous that, +notwithstanding its diminutive size, hopes were entertained of its +surviving. + +Another case is reported in a recent French medical journal. The woman +was forty years old. She had had twins once, and single children five +times. On her seventh pregnancy, when five months gone, she was as large +as women usually are at the end of their full term. At the close of the +month she was delivered of five children. They were all born alive, and +lived from four to seven minutes. All five children were males, well +built and as well developed as foetuses of five and one-half months +usually are in a single birth. The woman made a good recovery. Other +cases of five at a birth might be quoted. They are known to medical +science as very singular and noteworthy occurrences. + + +INCREDIBLE NUMBERS. + +Some books speak of seven, eight, nine, ten, and more, children at a +birth. But these statements are so marvelous, so incredible, and +unsupported by proper testimony, that they do not merit any degree of +confidence. The climax of such extraordinary assertions is reached, and +a good illustration of the credulity of the seventeenth century +furnished, by a writer named Goftr. This traveller, in 1630, saw a +tablet in a church at Leusdown (Lausdunum), about five miles from the +Hague, with an inscription stating that a certain illustrious countess, +whose name and family he records, brought forth at one birth, in the +fortieth year of her age, in the year 1276, 365 infants. They were all +baptized by Guido, the Suffragan. The males were called John, and the +females Elizabeth. They all, with their mother, died on the same day, +and were buried in the above-mentioned church. This monstrous birth was +said to have been caused by the sin of the countess in insulting a poor +woman with twins in her arms, who prayed that her insulter might have at +one birth the same number of children as there were days in the year. Of +course, notwithstanding the story being attested by a tablet in a +church, it must be placed among the many other instances of superstition +afforded by an ignorant and credulous era. + +We may remark, in closing this subject, that fewer plural births come to +maturity than pregnancies with single children. Miscarriages are +comparatively more frequent in such pregnancies than in ordinary ones. + + + + +PREGNANCY + + +_VENERATION FOR THE PREGNANT._ + +We have been considering woman hitherto as maiden and wife. She now +approaches the sacred threshold of maternity. She is with child. In no +period of her life is she the subject of an interest so profound and +general. The young virgin and the new wife have pleased by their grace, +spirit, and beauty. The pregnant wife is an object of active benevolence +and religious respect. It is interesting to note how, at all times and +in all countries, she has been treated with considerate kindness and +great deference. She has been made the subject of public veneration, and +sometimes even of religious worship. At Athens and at Carthage the +murderer escaped from the sword of justice if he sought refuge in the +house of a pregnant woman. The Jews allowed her to eat forbidden meats. +The laws of Moses pronounced the penalty of death against all those who +by bad treatment or any act of violence caused a woman to abort. +Lycurgus compared women who died in pregnancy to the brave dead on the +field of honour, and accorded to them sepulchral inscriptions. In +ancient Rome, where all citizens were obliged to rise and stand during +the passage of a magistrate, wives were excused from rendering this mark +of respect, for the reason that the exertion and hurry of the movement +might be injurious to them in the state in which they were supposed to +be. In the kingdom of Pannonia all enceinte women were in such +veneration, that a man meeting one on the road was obliged, under +penalty of a fine, to turn back and accompany and protect her to her +place of destination. The Catholic Church has in all times exempted +pregnant wives from fasts. The Egyptians decreed, and in most Christian +countries the law at the present time obtains, that if a woman shall be +convicted of an offence the punishment of which is death, the sentence +shall not be executed if it be proved that she is pregnant. + + +SIGNS AND SYMPTOMS OF PREGNANCY. + +1. The sign most commonly relied upon is the _cessation of the monthly +sickness_. The wife who misses the expected return of her illness, is +apt to conclude that conception has taken place. This sign is far from +being an infallible one. + +It should be borne in mind that young married women sometimes have a +slight show for two or three periods after their first impregnation. +Ignorance of this fact has very frequently led to a miscalculation of +the time of confinement. On the other hand, the menses will sometimes +become arrested soon after marriage, and continue so for one or two +months, without there existing any pregnancy. The temporary +disappearance of the monthly sickness in such cases is due to the +profound impression made upon the system by the new relations of the +individual. + +It not unfrequently happens that menstruation continues with regularity +during the whole period of pregnancy. Exceptional cases are given by +distinguished writers on midwifery, of women menstruating during their +pregnancy, and at no other time. + +As a general rule, when a healthy wife misses her monthly sickness, she +is pregnant. But this symptom, though a strong one, must be supported by +others before it can be regarded as establishing anything. + +2. _Morning sickness_ is a very common, a very early, and, in the +opinion of most mothers, a very conclusive symptom of pregnancy. We have +already had occasion to remark that it sometimes makes its appearance +almost simultaneously with conception. It usually comes on in the first +few weeks, and continues until the third or fourth month or until +quickening. This symptom is apt to be a troublesome one. Often the +vomiting is slight, and immediately followed by relief. But it may +produce violent and ineffectual straining for some time. It is, however, +not to be called a disease: unless it proceeds to an exhausting degree, +it must be looked upon as favorable and salutary. There is an old and +true proverb, that 'a sick pregnancy is a safe one.' The absence of +nausea and vomiting is a source of danger to the mother and child. Women +who habitually fail to experience them, are exceedingly apt to miscarry. +In such cases medical skill should be invoked to bring about the return +of these symptoms, of such importance to healthful pregnancy. + +Morning sickness is therefore a very general, almost constant, +accompaniment of the pregnant condition; and great dependence may be +placed upon it as a sign. + +3. _Changes in the breasts_ are valuable as symptoms. They become larger +and firmer, and the seat of a pricking or stinging sensation. The +nipples are swollen, prominent, and sometimes sore or painful. The veins +beneath the skin appear more conspicuous, and of a deeper blue than +ordinary. The peculiar circles of rose-coloured skin which surround the +nipples increase in extent, change to a darker color, and become covered +with a number of little elevations. Subsequently, numerous mottled +patches, or round spots of a whitish hue, scatter themselves over the +outer part of this circle. + +The time at which these changes make their appearance is variable. They +may begin to develope themselves in two or three weeks, oftener not +until the second or third month, and in women of a delicate build, +sometimes not until the latter end of pregnancy. Occasionally no +alteration whatever occurs in the breasts until after confinement, in +which cases the secretion of milk is delayed for several days after the +birth of the child. In some rare instances the breasts never assume +maternal proportions, and the mother is debarred from the pleasure and +duty of nursing her own child. + +4. _Quickening_ is the next symptom we will consider. By this term is +meant the arrival of that time when the mother first becomes conscious +by the movements of the child of its presence. The ancients thought that +then life was imparted to the new being. Modern physiology emphatically +condemns this absurdity. The embryo is as much alive in the very +earliest moments of pregnancy as at any future stage of its existence. +Let every woman therefore remember that she who produces abortion is +equally guilty in the eyes of science and of Heaven, whether the act be +committed before or after the period of quickening. + +How is quickening produced? Undoubtedly by the movements of the child. +So soon as its nervous and muscular systems become sufficiently +developed to enable it to move its limbs, the mother, if the movements +be sufficiently active, is rendered sensible of her situation. But the +muscular contractions may not be strong enough to impart any sensation +to the mother. In many cases in which they are too feeble to be noticed +by herself, the skilled accoucheur is capable of recognizing them. And +the movements of the foetus may be excited in various ways known to +physicians. + +_Time of quickening._--This symptom usually occurs about the middle of +pregnancy, near the eighteenth week. Some women feel the movements of +the foetus as early as the third month of pregnancy, others not till the +sixth month. Cases occur in which no movement whatever is felt until the +eighth or ninth month, or even not at all. It has been suggested that a +foetus which does not indicate its presence in this way is a kind of +'Lazy Lawrence,' too indolent to move. Certainly, many of both sexes +exhibit after birth such indomitable love of repose, that it can readily +be supposed they were equally passive in foetal life. + +The non-occurrence of this sign may, however, be due to the debility of +the young child, or to a want of sensibility in the walls of the womb +itself. + +A woman may be deceived, and suppose she has quickened, when her +sensations are to be traced to flatulence of the bowels, or perhaps a +dropsical effusion. Many ludicrous instances of self-deception are on +record. The historian Hume states that Queen Mary, in her extreme desire +to have issue, so confidently asserted that she felt the movements of +the child, that public proclamation was made of the interesting event. +Despatches were sent to foreign courts; national rejoicings were had; +the sex of the child was settled, for everybody was certain it was going +to be a male; and Bonner, Bishop of London, made public prayers, saying +that Heaven would pledge to make him beautiful, vigorous, and witty. But +all those high hopes and eager expectations were destined never to be +realized. The future disclosed that the supposed quickening was merely a +consequence of disordered health, and commencing dropsy. + +Some women possess the power of imitating the movements of a foetus, by +voluntary contraction of the abdominal muscles. A well-known colored +woman of Charleston, 'Aunt Betty,' had a great reputation as having +'been pregnant for fifteen years.' She made a good deal of money, by +exhibiting to physicians and medical students who were curious, the +pretended movements of her unborn child. She was repeatedly presented to +the medical classes in the city. No pregnancy existed, as was revealed +by a _post-mortem_ examination. She imposed upon the credulous by the +habit she had acquired of jerking her muscles at pleasure, and thus +closely simulating the movements of an embryo. + +5. _Changes in the abdomen._--In the first two months of pregnancy the +abdomen is _less_ prominent than usual: it recedes, and presents a flat +appearance. The navel is also drawn in and depressed. About the third +month a swelling frequently shows itself in the lower part of the +abdomen, and then diminishes, thus leading the wife to suppose that she +was mistaken in her condition, for she finds herself at the fourth month +smaller than at the third. After this, however, there is a gradual +increase in the size and hardness of the abdomen. What is of more value, +is the peculiar form of the swelling. It is pear-shaped, and is thus +distinguished from the swelling of dropsy and other affections. The +navel begins to come forward, and finally protrudes. The pouting +appearance it then presents is very characteristic. + +In this connection it may be remarked that, towards the change of life, +childless married women often think they perceive that 'hope deferred' +is about to be gratified. An enlargement of the abdomen takes place at +this time, from a deposit of fatty matter. The nervous perturbations and +the cessation of the menses, which are natural to this period, are +looked upon as confirmations of the opinion that pregnancy exists. But +the day of generation with them has passed. These symptoms herald the +approach of the winter of life, which brings with it death to the +reproductive system. + +6. _Changes in the skin._--The alterations occurring in the skin are +worth observing. Those women who have a delicate complexion and are +naturally pale take a high color, and vice versa. In some cases a +considerable quantity of hair appears on those parts of the face +occupied by the beard in men; it disappears after labor, and returns on +every subsequent pregnancy. Oftentimes the skin becomes loose and +wrinkled, giving a haggard, aged air to the face, and spoiling good +looks. Women who ordinarily perspire freely, have now a dry, rough skin; +whereas those whose skin is not naturally moist, have copious +perspiration, which may be of a peculiarly strong odor. Copper-colored +or yellow blotches sometimes appear upon the skin, mole spots become +darker and larger, and a dark ring developes itself beneath the eyes. +The whole appearance is thus in many cases altered. On the other hand, +obstinate, long-existing skin affections sometimes take their departure +during pregnancy, perhaps never to return. These alterations do not +occur in all women, nor in all pregnancies of the same woman. + +7. We may now group together a number of less important and less +constant signs, such as _depraved appetite_, _longings for unnatural +food_, _excessive formation of saliva in the mouth_, _heartburn, loss of +appetite_ in the first two or three months, succeeded by a voracious +desire for food, which sometimes compels the woman to rise at night in +order to eat, _toothache_, _sleepiness_, _diarrhoea_, _palpitation of the +heart_, _pain in the right side_, etc. These, when they occur singly, +are of little value as evidence. + +Among these, that of _depraved appetite_ is by far the most important, +and may be regarded as quite significant. A married woman in her +ordinary health, suddenly feeling this morbid taste for chalk, charcoal, +slate pencil, and other unusual articles of food, may look upon it as a +strong presumptive evidence of impregnation. + +When any or all of this group of symptoms accompany the ceasing to be +'regular,' the morning sickness, the changes in the breasts and the +other signs which have been enumerated, the wife may be quite sure that +she is pregnant. + +8. _Changes in the mind._--The most wonderful of all the changes which +attend pregnancy are those in the nervous system. The woman is rendered +more susceptible, more impressible. Her character is transformed. She is +no longer pleasant, confiding, gentle, and gay. She becomes hasty, +passionate, jealous, and bitter. But in those who are naturally fretful +and bad-tempered a change for the better is sometimes observed, so that +the members of the household learn from experience to hail with delight +the mother's pregnancy as a period when clouds and storms give place to +sunshine and quietness. In some rare cases, also, pregnancy confers +increased force and elevation to the ideas, and augmented power to the +intellect. + +As this book is written for women only, we do not mention any of the +signs or symptoms of pregnancy which medical men alone can recognize. We +will merely state that there are many other signs besides these referred +to, of great value to the doctor. One, the sound of the heart of the +child, which the practised ear can detect at about the fifth month, is +positive and conclusive. + + +MISCARRIAGE. + +Miscarriage is a fruitful source of disease, and often of danger, to +wives. It also causes a frightful waste of human life. Unborn thousands +annually die in this manner. + +_Frequency._--Miscarriage is by no means a rare occurrence. Statistics +show that thirty-seven out of one hundred mothers miscarry before they +attain the age of thirty years. But this accident is much more apt to +occur during the latter than during the first half of the child-bearing +period; and therefore it is estimated that ninety out of one hundred of +all women who continue in matrimony until the change of life, miscarry. + +_Influence of age of mother._--A woman who marries at forty is very much +disposed to miscarry; whereas, had she married at thirty, she might have +borne children when older than forty. As a mother approaches the end of +her child-bearing period, it is likely that she will terminate her +career of fertility with a premature birth. The last pregnancies are not +only most commonly unsuccessful, but there is also reason to believe +that the occurrence of idiocy in a child may be associated with the +circumstance of its being the last-born of its mother. It has been +asserted, in this connection, that men of genius are frequently the +first-born. First pregnancies are also fraught with the danger of +miscarriage, which occurs more often in them than in others, excepting +the latest. A woman is particularly apt to miscarry with her first +child, if she be either exceedingly nervous or full-blooded. + +_Influence of period of pregnancy._--Miscarriage is most frequent in the +earlier months of pregnancy--from the first to the third. It is also +very prone to happen about the sixth month. Habit makes itself felt +here; for women who have many times experienced this sad accident, +encounter it nearly always at the same epoch of their pregnancy. + +_How early can the child live?_--The infant is incapable, as a rule, of +an independent existence, if brought into the world before the end of +the sixth month. The law of France regards a child born one hundred and +eighty days after wedlock as not only capable of living, but as +legitimate and worthy of all legal and civil rights. There are many +cases mentioned, by the older medical writers, of children born previous +to this period living. One of the most curious is that recorded by Van +Swieten. The boy Fortunio Liceti was brought into the world before the +sixth month, in consequence of a fright his mother had at sea. When +born, it is said, he was the size of a hand, and his father placed him +in an oven, for the purpose, probably, it has been suggested, of making +him _rise_. Although born prematurely, he died late, for we are told +that he attained his seventy-ninth year. Professor Gunning S. Bedford of +New York records the case of a woman in her fourth confinement, who, +before she had completed her sixth month, was delivered of a female +infant weighing two pounds nine ounces. The surface of the body was of a +scarlet hue. It breathed, and in a short time after birth cried freely. +After being wrapped in soft cotton, well lubricated with warm sweet-oil, +it was fed with the mother's milk, by having a few drops at a time put +into its mouth. At first it had great difficulty in swallowing, but +gradually it succeeded in taking sufficient nourishment, and is now a +vigorous, healthy young woman. + +_Dangers to mother._--Wives are too much in the habit of making light of +miscarriages. They are much more frequently followed by disease of the +womb than are confinements at full terms. There is a greater amount of +injury done to the parts than in natural labor. While after confinement +ample time is afforded by a long period of repose for the bruised and +lacerated parts to heal, after a miscarriage no such rest is obtained. +Menstruation soon returns; conception may quickly follow. Unhappily, +there is no custom requiring husband and wife to sleep apart for a month +after a miscarriage, as there is after a confinement. Hence, especially +if there be any pre-existing uterine disease, or a predisposition +thereto, miscarriage is a serious thing. + +_Causes._--The irritation of hemorrhoids or straining at stool will +sometimes provoke an early expulsion of a child. Excessive intercourse +by the newly married is a very frequent cause. Bathing in the ocean has +been known to produce it. Nursing is exceedingly apt to do so. It has +been shown by a distinguished medical writer, that, in a given number of +instances, miscarriage occurred in seventeen per cent. of cases in which +the woman conceived while nursing, and in only ten per cent. where +conception occurred at some other time. A wife, therefore, who suspects +herself to be pregnant, should wean her child. The extraction of a +tooth, over-exertion and over-excitement, a fall, a blow, any violent +emotion, such as anger, sudden and excessive joy, or fright, running, +dancing, horseback exercise, or riding in a badly-built carriage over a +rough road, great fatigue, lifting heavy weights, the abuse of purgative +medicines, disease or displacement of the womb, small-pox, or a general +condition of ill-health, are all fruitful and well-known exciting causes +of this unfortunate mishap, in addition to those which have been before +mentioned. + +_Prevention._--The eminent practitioner, Dr. Tilt, says, 'The way to +prevent miscarriage is to lead a quiet life, particularly during those +days of each successive month when, under other circumstances, the woman +would menstruate; and to abstain during those days not only from long +walks and parties, but also from sexual intercourse.' + +It is especially desirable to avoid a miscarriage in the first +pregnancy, for fear that the habit of miscarrying shall then be set up, +which it will be very difficult to eradicate. Therefore newly-married +women should carefully avoid all causes which are known to induce the +premature expulsion of the child. If it should take place in spite of +all precautions, extraordinary care should be exercised in the +subsequent pregnancy, to prevent its recurrence. Professor Bedford of +New York has said he has found that an excellent expedient in such cases +is, as soon as pregnancy is known to exist, 'to interdict sexual +intercourse until after the fifth month; for if the pregnancy pass +beyond this period, the chances of miscarriage will be much diminished.' + +If the _symptoms of miscarriage_, which may be expressed in the two +words _pain_ and _flooding_, should make their appearance, the doctor +ought at once to be sent for, the wife awaiting his arrival in a +recumbent position. He may even then be able to avert the impending +danger. At any rate, his services are as necessary, and often even more +so, as in a labor at full term. + + +MOTHER'S MARKS. + +It is a popular belief that the imagination of the mother affects the +child in the womb. It is asserted that infants are often born with +various marks and deformities corresponding in character with objects +which had made a vivid impression on the maternal mind during pregnancy. +This is a subject of great practical interest. We shall therefore give +it the careful attention which it deserves. + +We have already discussed the operation of the laws of inheritance. It +was then stated that the whole story of maternal influence had not been +told--that the mother could communicate qualities she never possessed. +The potency of imagination at the time of conception over the child has +been mentioned. It is now our design to consider its effects, during the +period of pregnancy, upon the physical structure and the mental +attributes of the offspring. We shall have occasion hereafter, in +speaking of nursing, to illustrate the manner in which the child may be +affected by maternal impressions acting through the mother's milk. What +can be more wonderful than this intimate union between the mother and +her child? It is only equaled by that mysterious influence of the +husband over the wife, by which he so impresses her system that she +often comes in time to resemble him both in mental and physical +characteristics, and even transmits his peculiarities to her children by +a second marriage. Father, mother, and child are one. + +We wish here to premise that our remarks will be based upon the +conclusions of skilled and scientific observers only, whose position and +experience no medical man will question. All the instances to be related +are given upon unimpeachable authority. They are not the narrations of +ignorant, credulous people; they are all fully vouched for. We record +here, as elsewhere, only the sober utterances of science. The great +importance and utility of an acquaintance with them will be patent to +every intelligent man and woman. + +The effect of the mind upon the body is well known. Strong, +long-continued mental emotion may induce or cure disease. Heart disease +may be produced by a morbid direction of the thoughts to that organ. +Warts disappear under the operation of a strong belief in the efficacy +of some nonsensical application. In olden time, scrofula, or the 'king's +evil', was cured by the touch of the king. The mind of the patient, of +course, accomplished the cure. Under the influence of profound mental +emotion, the hair of the beautiful Marie Antoinette became white in a +short time. During the solitary voyage of Madame Condamine down the wild +and lonely Amazon, a similar change took place. Many other instances +might be adduced; but those given are sufficient to show that strong and +persistent mental impressions will exert a mysterious transforming power +over the body. These facts will pave the way to the consideration of +corresponding effects, through the mother's mind, upon the development +of the unborn child, forming a part of herself _in utero._ + +_Influence of mind of mother on form and color of infant._--There are +numerous facts on record which prove that _habitual_, long-continued +mental conditions of the mother at an early period of pregnancy, induce +deformity or other abnormal development of the infant. + +Professor William A. Hammond of New York relates the following striking +case, which occurred in his own experience, and which scarcely admits of +a doubt as to the influence of the maternal mind over the physical +structure of the foetus. + +A lady in the third month of her pregnancy was very much horrified by +her husband being brought home one evening with a severe wound of the +face, from which the blood was streaming. The shock to her was so great +that she fainted, and subsequently had a hysterical attack, during which +she was under Dr. Hammond's care. Soon after her recovery she told him +that she was afraid her child would be affected in some way, and that +even then she could not get rid of the impression the sight of her +husband's bloody face had made upon her. In due time the child, a girl, +was born. She had a dark red mark upon the face, corresponding in +situation and extent with that which had been upon her father's face. +She also proved to be idiotic. + +Professor Dalton of New York states that the wife of the janitor of the +College of Physicians and Surgeons of that city, during her pregnancy, +dreamed that she saw a man who had lost a part of the ear. The dream +made a great impression upon her mind, and she mentioned it to her +husband. When her child was born, a portion of one ear was deficient, +and the organ was exactly like the defective ear she had seen in her +dream. When Professor Dalton was lecturing upon the development of the +foetus as affected by the mind of the mother, the janitor called his +attention to the foregoing instance. The ear looks exactly as if a +portion had been cut off with a sharp knife. + +Professor J. Lewis Smith of Bellevue Hospital Medical College, New York, +has met with the following cases:--An Irishwoman, of strong emotions and +superstitions, was passing along a street, in the first months of her +pregnancy, when she was accosted by a beggar, who raised her hand, +destitute of thumb and fingers, and in 'God's name' asked for alms. The +woman passed on, but, reflecting in whose name money was asked, felt +that she had committed a great sin in refusing assistance. She returned +to the place where she had met the beggar, and on different days, but +never afterwards saw her. Harassed by the thought of her imaginary sin, +so that for weeks, according to her statement, she was distressed by it, +she approached her confinement. A female infant was born, otherwise +perfect, but lacking the fingers and thumb of one hand. The deformed +limb was on the same side, and it seemed to the mother to resemble +precisely that of the beggar. In another case which Professor Smith met, +a very similar malformation was attributed by the mother of the child to +an accident occurring, during the time of her pregnancy, to a near +relative, which necessitated amputation. He examined both of these +children with defective limbs, and has no doubt of the truthfulness of +the parents. In May, 1868, he removed a supernumerary thumb from an +infant, whose mother, a baker's wife, gave the following history:--No +one of the family, and no ancestor, to her knowledge, presented this +deformity. In the early months of her pregnancy she sold bread from the +counter, and nearly every day a child with a double thumb came in for a +penny roll, presenting the penny between the thumb and the finger. After +the third month she left the bakery, but the malformation was so +impressed upon her mind, that she was not surprised to see it reproduced +in her infant. + +In all these cases the impression was produced in the early months of +pregnancy; but many have been recorded in which malformations in the +infant appeared distinctly traceable to strong mental emotions of the +mother only a few months previous to confinement, these impressions +having been persistent during the remaining period of the pregnancy, and +giving rise to a full expectation on the part of the mother that the +child would be affected in the particular manner which actually +occurred. Professor Carpenter, the distinguished physiologist, is +personally cognisant of a very striking case of the kind which occurred +in the family of a near connection of his own. + +All the above instances have been those of the effects of persistent +mental emotion. But it is also true that _violent and sudden emotion_ in +the mother leaves sometimes its impress upon the unborn infant, although +it may be quickly forgotten. + +It is related on good authority that a lady, who during her pregnancy +was struck with the unpleasant view of leeches applied to a relative's +foot, gave birth to a child with the mark of a leech coiled up in the +act of suction on the intended spot. + +Dr. Delacoux of Paris says that, in the month of January 1825, he was +called to attend a woman in the village of Batignoles, near Paris, who +the evening before had been delivered of a six months' foetus, horribly +deformed. The upper lip was in a confused mass with the jaw and the +gums, and the right leg was amputated at the middle, the stump having +the form of a cone. The mother of this being, who was a cook, one +morning, about the third month of her pregnancy, on entering the house +where she was employed, was seized with horror at the sight of a porter +with a hare-lip and an amputated leg. + +At a meeting of the Society of Physicians at Berlin, in August 1868, +Herr Dupre stated that a woman saw, in the first weeks of her third +pregnancy, a boy with a hare-lip; and not only was the child she then +carried born with a frightful hare-lip, but also three children +subsequently. Another one, a woman in the fifth week of pregnancy, saw a +sheep wounded, and with its bowels protruding. She was greatly shocked, +and did not recover her composure for several days. She was delivered at +term of a child, in other respects well developed, but lacking the walls +of the abdomen. + +Many remarkable instances have been collected of the power of +_imagination_ over the unborn offspring. + +Ambrose Pare, the illustrious French surgeon of the sixteenth century, +in one of his treatises devotes a chapter to the subject of 'monsters +which take their cause and shape from imagination,' and was evidently a +strong believer in this influence. + +A black child is generally believed to have been born to Marie Therese, +the wife of Louis XIV., in consequence of a little negro page in her +service having started from a hiding-place and stumbled over her dress +early in her pregnancy. This child was educated at the convent of Moret, +near Fontainebleau, where she took the veil, and where, till the shock +of the Revolution, her portrait was shown. + +Examples are given by authors of the force of _desires_ in causing +deformities in infants, and the formation upon them of fruits, such as +apples, pears, grapes, and others, which the mother may have longed for. + +The following is related upon excellent medical authority:--A woman gave +birth to a child with a large cluster of globular tumours growing from +the tongue, and preventing the closure of the mouth, in color, shape, +and size exactly resembling our common grapes; and with a red +excrescence from the chest, as exactly resembling in figure and +appearance a turkey's wattles. On being questioned before the child was +shown to her, she answered, that while pregnant she had seen some +grapes, longed intensely for them, and constantly thought of them; and +that she was also once attacked and much alarmed by a turkey-cock. + +Dr. Demangeon of Paris quotes, in his work on the Imagination, the +_Journal de Verdun_, as mentioning the case of a child, born at Blois, +in the eyes of which the face of a watch was distinctly seen. The image +was situated around the pupil, and the figures representing the hours +were plainly perceived. The mother had experienced a strong desire to +see a watch while she was pregnant with this child. + +Professor Dalton says, in his _Human Physiology_, that 'there is now +little room for doubt that various deformities and deficiencies of the +foetus, conformably to the popular belief, do really originate in certain +cases from nervous impressions, such as disgust, fear, or anger, +experienced by the mother.' We will now consider the + +_Influence of the mind of the mother on the mind of the infant_; which +subject we have not yet touched upon, having confined ourselves to the +influence of the maternal mind over the form and color of the unborn +child. It will not be necessary to illustrate at length this branch of +our topic. Instances are sufficiently common and well known. Dr. Seguin +of New York, in his work on Idiocy, gives several cases in which there +was reason to believe that fright, anxiety, or other emotions in the +mother, had produced idiocy in the offspring. As he remarks, +'Impressions will sometimes reach the foetus in its recess, cut off its +legs or arms, or inflict large flesh wounds before birth,--inexplicable +as well as indisputable facts, from which we surmise that idiocy holds +unknown though certain relations to maternal impressions.' + +We have given many strong cases and most excellent authority for the +doctrine that the _purely mental_ influence of the mother may produce +bodily and mental changes in the unborn infant. But the child is also +affected by _physical impressions_ made upon the mother. + +Dr. Russegger reports that a woman, who had already borne four healthy +children, was, in the seventh month of her pregnancy, bitten in the +right calf by a dog. The author saw the wound made by the animal's +teeth, which wound consisted of three small triangular depressions, by +two of which the skin was only slightly ruffled; a slight appearance of +blood was perceptible in the third. The woman was at the moment of the +accident somewhat alarmed, but neither then nor afterwards had any fear +that her foetus would be affected by the occurrence. Ten weeks after she +was bitten, the woman bore a healthy child, which, however, to the +surprise of every person, had three marks corresponding in size and +appearance to those caused by the dog's teeth in the mother's leg, and +consisting, like those, of one large and two smaller impressions. The +two latter, which were pale, disappeared in five weeks; the larger one +had also become less, and was not so deep colored as it was at birth. At +the time of writing, the child was four months old. + +Dr. S. P. Crawford of Greenville, Tennessee, reports in a recent number +of the _Nashville Journal of Medicine_, the following sad case:--A lady, +in the last stage of pregnancy, was burned by the explosion of a +kerosene-oil can. She lived twelve hours after the accident. The face, +legs, arms, and abdomen were badly burned. The movements of the child +were felt three or four hours after the accident. A short time before +the death of the mother she gave birth to the child at full maturity, +but still-born. It bore the mark of the fire corresponding to that of +the mother. Its legs, arms, and abdomen were completely blistered, +having all the appearance of a recent burn. + +These instances of a decided influence exerted upon the body and mind of +the child in the womb, by physical and mental impressions made upon the +mother, might be doubled or trebled. They are as numerous as they are +wonderful. Physiologists of the present day do not hesitate to admit the +existence of the influence we have been discussing. Reason also comes to +the support of facts, to demonstrate and establish its reality. For, if +a sudden and powerful emotion of the mind can so disturb the stomach and +heart as to cause vomiting and fainting, is it not probable that it can +affect the womb and the impressible being within it? Pregnancy is a +function of the woman as much as digestion or pulsation of the heart; +and if the latter are controlled by moral and mental impressions, why +should not the former be also? + +_In what manner does this influence of the maternal mind act?_--Through +the blood of the mother. Only a very delicate membrane separates the +vital fluid of the mother from that of the infant in her womb. There is +a constant interchange of the blood in its body with that in hers +through this exceedingly thin membrane; and thus all nervous impressions +which have produced an alteration of either a temporary or permanent +character in the circulating fluid of the mother, are communicated to +the child. Since the mother, as has been shown, can transmit through her +blood certain characteristics of mind and body not her own,--for +instance, a disease peculiar to a male from her father to her son, or +the physical and mental traits of her first husband to the children by +her second,--it does not seem at all strange that she should through +this same medium, her blood, impart other peculiarities which have made +a strong impression upon her mind. Anatomy and physiology therefore +fully explain and account for this seemingly mysterious influence. + +The view here stated, and indorsed by modern science, is one which ought +to have great weight with the mother, her relatives and friends. The +_practical conclusion_ which it suggests is, that as during pregnancy +there is unusual susceptibility to mental impressions, and as these +impressions may operate on the fragile structure of the unborn being, +this tendency should be well considered and constantly remembered, not +only by the woman herself, but by all those who associate or are thrown +in contact with her. Upon the care displayed in the management of the +corporeal and mental health of the mother during the whole period of +pregnancy, the ultimate constitution of the offspring greatly depends. +All the surroundings and employments of the pregnant woman should be +such as conduce to cheerfulness and equanimity. Above all, she should +avoid the presence of disagreeable and unsightly objects. Vivid and +unpleasant impressions should be removed as soon as possible by quiet +diversion of the mind. All causes of excitement should be carefully +guarded against. + +In leaving the subject of maternal impressions, we will call attention +to the manifest difference in extent and degree between the influence of +the father and that of the mother over the offspring. That of the father +ceases with impregnation. That of the mother continues during the whole +term of pregnancy, and, as we shall shortly see, even during that of +nursing. + + +EDUCATION OF THE CHILD IN THE WOMB. + +The outlines drawn by the artist Flaxman are esteemed the most perfect +and graceful in existence. From earliest childhood he manifested a +delight in drawing. His mother, a woman of refined and artistic tastes, +used to relate that for months previous to his birth she spent hours +daily studying engravings, and fixing in her memory the most beautiful +proportions of the human figure as portrayed by masters. She was +convinced that the genius of her son was the fruit of her own +self-culture. What a charming idea is this! What an incentive to those +about to become mothers, to cultivate refinement, high thoughts, pure +emotions, elevated sentiments! Thus they endow their children with what +no after education can give them. + +The plastic brain of the foetus is prompt to receive all impressions. It +retains them, and they become the characteristics of the child and the +man. Low spirits, violent passions, irritability, frivolity, in the +pregnant woman, leave indelible marks on the unborn child. So do their +contraries; and thus it becomes of the utmost moment that during this +period all that is cheerful, inspiring, and elevating should surround +the woman. Such emotions educate the child: they form its disposition, +they shape its faculties, they create its mental and intellectual +traits. Of all education, this is the most momentous. + + +CAN A WOMAN BECOME AGAIN PREGNANT DURING PREGNANCY? + +Can a woman during pregnancy conceive, and add a second and younger +child to that already in the womb? + +It is not uncommon in the canine race for a mother to give birth at the +same time to dogs of different species, showing conclusively the +possibility, in these animals, of one conception closely following +another. So a mare has been known to produce within a quarter of an +hour, first a horse, and then a mule. And in the human race cases are +on record in which women have had twins, of which the one was white and +the other colored, in consequence of intercourse on the same day with +men of those two races. Dr. Henry relates that in Brazil a Creole woman, +a native, brought into the world at one birth three children of three +different colors,--white, brown, and black,--each child exhibiting the +features peculiar to the respective races. + +In all such instances the two conceptions followed each other very +rapidly, the offspring arriving at maturity together, and being born at +the same accouchement. But more curious and wonderful examples of second +and concurrent pregnancies have been published than these--as, for +instance, those in which a child bearing all the attributes of a foetus +at full term is born two, three, four, and even five, months after the +first, which appeared also to have been born at full term. Marie Anne +Bigaud, aged thirty-seven, gave birth, April 30, 1748, to a living boy +at full term, and on the ensuing September 16, to a living girl, which +was recognised, by the size and well-developed condition of its body and +limbs, to have been also carried until full term. This fact was observed +by Professor Eisenman, and by Leriche, surgeon-major of the military +hospital of Strasbourg. It will be noticed that there was an interval of +four and a half months between the two accouchements. The first child +lived two and a half months, and the second a year. In this instance +there was not a double womb, as might perhaps be supposed, for after +the mother's death an examination proved that the uterus was single. + +Another case of this kind is the following:--Benoite Franquet of Lyons +brought into the world a girl on January 20, 1780, and five months and +six days afterwards a second girl, also apparently at term, and well +nourished. Two years later these two children were presented, with their +certificates of baptism, to two notaries of Lyons, MM. Caillot and +Desurgey, in order that the fact might be placed on record and vouched +for, because of its value in legal medicine. + +The number of the entirely authenticated cases now known of the birth of +fully developed children within from two to five months of each other, +can leave no doubt as to the possibility of such an occurrence. The only +question which remains is in regard to the periods of conception. Are +the two children in such cases twins, conceived at the same time, but +the growth of the last-born so retarded that it did not arrive at +maturity until a number of months after its fellow? or, Has a second +conception taken place at an interval of several months after the first? +If this latter view be true, then, in the instance of Marie Anne Bigaud, +above related, the second child must have been conceived after the first +had quickened. Then, also, two children of different ages, the offspring +of different fathers, may exist in the womb at the same time. The weight +of scientific observation and authority has now established the fact +that, in very rare instances, a second conception may take place during +pregnancy. It must not be understood as necessarily following from this +statement, that when two children are born at the same time,--one fully +developed, and the other small and apparently prematurely born,--the two +were conceived at different times. The smaller may have been blighted +and its growth hindered by the same causes which bring about such +effects in cases of single births of incompletely developed children. A +similar supposition may account for the birth of a second child within a +month or two after the first, for the first may have been prematurely +born, and the second carried to full term. But no such supposition can +explain the cases referred to, and others which might be mentioned, in +which the interval has been five or six months, each child presenting +every indication of perfect maturity. The only explanation possible in +such instances, which, as has been said, are well authenticated, +although few in number, is, that a second pregnancy has occurred during +the first. + +The above facts would seem sufficiently wonderful. There are others, +however, of the same nature still more so. In some instances, the +product of the second conception, instead of developing independently of +the first, has become attached to it, and the phenomenon has been +presented of the growth of a child within a child--a foetus within a +foetus. Such a singular occurrence has been lately recorded in a German +journal. A correspondent of the _Dantzic Gazette_ states that on Sunday, +February 1, 1869, at Schliewen, near Dirschau, 'a young and blooming +shepherd's wife was delivered of a girl, otherwise sound, but having on +the lower part of her back, between the hips, a swelling as big as two +good-sized fists, through the walls of which a well-developed foetus may +be felt. Its limbs indicate a growth of from five to six months, and its +movements are very lively. The father called in the health commissioner, +Dr. Preuss, from Dirschau, and begged him to remove the swelling +together with the foetus. The doctor, however, after a careful +examination, declared that there was a possibility in this extraordinary +case of the child within the swelling coming to fruition. Its existence +and active motions were palpable to all present. No physician could be +justified in destroying this marvelous being. It ought rather to be +protected and cherished. The new-born girl, notwithstanding her strange +burden, is of unusual strength and beauty, and takes the breast very +cheerfully.' + +We find something further in regard to this singular birth in the _Weser +Zeitung_ of February 20, 1869. It quotes from the _Dantzic Gazette_ some +remarks by the health commissioner, Dr. Preuss of Dirschau, in which the +doctor declares the facts contained in the report given above to be +correct. He was summoned on the 1st of February to the child, and saw +the vigorous movements, and felt the members of a foetus within the +swelling, as described. It was evidently a double creation. The case +thus far, though rare, is not unique. 'But what is novel, and hitherto +perfectly unnoticed in medical literature, is the fact that not only the +girl, which has been carried its full term, is alive to-day, but the +foetus within the swelling has also, in the eleven days after birth, +further developed, and palpably increased in size. The swelling is now +four and a half inches long, three and a half inches wide, and high and +pear-shaped; the head lies underneath on the left, the body towards the +right.' + +Further particulars and the latest intelligence we have concerning the +progress of this case are to the effect that the child was brought by +special request before the Natural History Society of Dantzic, and +thence the mother went to Berlin for medical advice. + + +MORAL ASPECTS OF THIS QUESTION. + +Upon proper judgment and discrimination in the application of the facts +we have just been dwelling upon, may depend a wife's honor, and the +happiness of the dearest social relations. We will suppose an example. A +husband, immediately after the impregnation of his wife, is obliged to +quit her, and remains absent a year. In the meanwhile she gives birth to +two children, at an interval of a number of weeks. The question will +then come up, Whether, under such circumstances, it is possible for her +to do so consistently with conjugal purity. + +It will be recollected that, in speaking of twins, we remarked that it +was not very uncommon for an interval of days or weeks to elapse between +the births, and it has just been stated that impregnation during +pregnancy is extremely rare. The presumption, therefore, in the case +supposed, is as very many to one that the two births were the result of +a twin pregnancy. In the absence of any other evidence against the +wife's chastity, it should not even be called in question. This decision +receives the support of the maxim in law that a reasonable doubt is the +property of the accused, and of the Christian principle that it is +better that ninety-nine guilty should escape than that one innocent +should be condemned. Hence the teachings of science and of human and +divine law all coincide to protect the sacred rights and the precious +interests at stake against an unjust suspicion, which even the doctrine +of chances would render untenable. + + +CAN A CHILD CRY IN THE WOMB? + +There are some cases, recorded on undoubted authority, in which the +child has been heard to cry while in the womb. These are very +exceptional. Under ordinary circumstances, it is impossible for the +child either to breathe or cry, because of the absence of air. It is +only when the bag of membranes has been torn, and the mouth of the child +is applied at or near the neck of the uterus, that this can take place. +The infant is not unfrequently heard to cry just before birth, after +labor has commenced, but before the extrusion of the head from the womb, +in consequence of the penetration of air into the uterine cavity. + + +IS IT A SON OR DAUGHTER? + +It is a common saying among nurses, that there is a difference in the +size and form of the pregnant woman, according to the sex she carries. +This may well be doubted. Neither is it true that one sex is more +active in its 'movements' than the other. It is quite possible, however, +for a wife to know the sex of the foetus, if she can tell about what time +in her month conception took place. If it occurred directly after a +monthly sickness, the child is a girl; if directly before, it is a boy. +When a woman is 'out' in her reckoning, and goes beyond the period of +her expected confinement, it will ordinarily turn out to be a boy. The +skilful doctor can, in the later months of pregnancy, settle the +question of sex in some cases. The beats of the foetal heart are more +frequent in females than in males. The average frequency of pulsations +of twenty-eight female foetuses has been found to be one hundred and +forty-four in the minute, the lowest figure being one hundred and +thirty-eight; of twenty-two male foetuses, one hundred and twenty, the +lowest figure being one hundred and twelve. Therefore, when the +pulsations of the heart of the child in the womb are counted,--as can +easily be done by a practised medical ear during the last months of +pregnancy,--and are found to be over one hundred and thirty in a minute, +it is a daughter; if under one hundred and thirty, a son. In this +manner, the sex of an unborn child can be predicted with tolerable +accuracy, excepting only when illness of the foetus has deranged the +action of its heart. + + +ARE THERE TWINS PRESENT? + +Certain signs lead to the suspicion of twins, such as being unusually +large, and the fact that the increase in size has been more than +ordinarily rapid. Sometimes also the abdomen is divided into two +distinct portions by a perpendicular fissure. In other cases the +movements of a child can be felt on each side at the same time. And in +twin pregnancies the morning sickness is apt to be more distressing, and +all the other discomforts incident to this condition increased. But +these signs and symptoms, when present in any given case, are not +conclusive, for they may be noticed when there is only one child. The +doctor has one characteristic and infallible sign by which he can +ascertain whether the woman be pregnant with twins. It is furnished to +him again by the art of listening,--or auscultation, as it is +technically called,--the same that, as we have already seen, may enable +him to determine the sex of the child. When the beatings of two foetal +hearts are heard on opposite portions of the abdomen, the nature of the +pregnancy is apparent. + + +LENGTH OF PREGNANCY. + +What is the ordinary duration of pregnancy? Almost every woman considers +herself competent to make the answer--nine months. She may be surprised +to learn, however, that such an answer is wanting in scientific +precision. It is too indefinite, and is erroneous. There is a great +difference between the calendar and the lunar month. Each lunar month +having twenty-eight days, the period of nine lunar months is two hundred +and fifty-two days. Nine calendar months, including February, represent, +on the contrary, two hundred and seventy-three days. Now the average +duration of pregnancy is two hundred and eighty days, that is forty +weeks, or ten lunar months. + +While most extended observations have shown that as a general rule, +forty weeks, or two hundred and eighty days, is the true period of +pregnancy, are we justified in the conclusion that this is its +invariable duration? This important question, upon the answer to which +so often depend the honor of families, the rights of individuals, and +sometimes the interests of nationalities, has been in all times the +subject of careful research by physicians, philosophers, and +legislators. On the one side, have been those who contend that the laws +of nature are invariable, and that the term of pregnancy is fixed and +immutable. On the other side, have been those who assert that the epoch +of accouchement can be greatly advanced or retarded by various causes, +some of which are known, and others not yet appreciated. Abundant and +satisfactory testimony has proved that the prolongation of pregnancy +beyond the ordinary period of two hundred and eighty days, or forty +weeks, is possible. Nor is this contrary to what is observed in regard +to other functions of the human body. There is no process depending upon +the laws of life which is absolutely invariable either as to the period +of its appearance or duration. It is known, as we have already pointed +out, that puberty may be advanced or retarded; the time at which the +change of life occurs in women, as we shall have occasion hereafter to +show, is also subject to variation; and it is a matter of common +observation with mothers, that the period of teething is sometimes +strangely hurried or delayed. A certain degree of variability, +therefore, being frequently observed, and entirely compatible with +health, in the various other natural processes, why should that of +pregnancy form an exception, and be invariably fixed in its duration? +And observation upon the lower animals affords most convincing evidence +that nature is not controlled by any uniform law in reference to the +length of pregnancy. In the cow, the usual period of whose pregnancy is +the same as in the human female, instances of calving six weeks beyond +the ordinary term are not at all uncommon. + +As an illustration of the great interest sometimes attaching to the +inquiry under discussion, we may cite the celebrated Gardner Peerage +Case, tried by the House of Lords in 1825. Allen Legge Gardner +petitioned to have his name inscribed as a peer on the Parliament Roll. +He was the son of Lord Gardner by his second wife. There was another +claimant for the peerage, however,--Henry Fenton Iadis,--on the ground, +as alleged, that he was the son of Lord Gardner by his first and +subsequently divorced wife. Medical and moral evidence was adduced to +establish that the latter was illegitimate. Lady Gardner, the mother of +the alleged illegitimate child, parted from her husband on the 30th of +January, 1802, he going to the West Indies, and not again seeing his +wife until the 11th of July following. The child whose legitimacy was +called in question was born on the 8th of December of that year. The +plain medical query therefore arose, Whether this child born either +three hundred and eleven days after intercourse (from January 30th to +December 8th), or one hundred and fifty days (from July 11th to December +8th), could be the son of Lord Gardner. As there was no pretence that +there was a premature birth, the child having been well developed when +born, the conception must have dated from January 30th. The medical +question was therefore narrowed down to this: Was the alleged protracted +pregnancy (three hundred and eleven days) consistent with experience? +Sixteen of the principal obstetric practitioners of Great Britain were +examined on this point. Eleven concurred in the opinion that natural +pregnancy might be protracted to a period which would cover the birth of +the alleged illegitimate child. Because, however, of the moral evidence +alone, which proved the adulterous intercourse of Lady Gardner with a +Mr. Iadis, the House decided that the title should descend to the son of +the second Lady Gardner. + +There is on record one fact, well observed, which establishes beyond +cavil the possibility of the protraction of pregnancy beyond two hundred +and eighty days, or forty weeks. The case is reported by the learned Dr. +Desormeaux of Paris, and occurred under his own notice in the Hopital de +Maternite of that city. A woman, the mother of three children, became +insane. Her physician thought that a new pregnancy might re-establish +her intellectual faculties. Her husband consented to enter on the +register of the hospital each visit he was allowed to make her, which +took place only every three months. So soon as evidence of pregnancy +showed itself, the visits were discontinued. The woman was confined two +hundred and ninety days after conception. + +The late distinguished Professor Charles D. Meigs of Philadelphia +published a case, which he deems entirely trustworthy, of the +prolongation of pregnancy to four hundred and twenty days, or sixty +weeks. Dr. Atlee reports two cases, which nearly equaled three hundred +and fifty-six days each. Professor Simpson of Edinburgh records, as +having occurred in his own practice, cases in which the period reached +three hundred and thirty-six, three hundred and thirty-two, three +hundred and twenty-four, and three hundred and nineteen days. In the +Dublin _Quarterly Journal of Medical Science_ a case of protracted +pregnancy is related by Dr. Joynt. The evidence is positive that the +minimum duration must have been three hundred and seventeen days, or +about six weeks more than the average. Dr. Elsaesser found, in one +hundred and sixty cases of pregnancy, eleven protracted to periods +varying from three hundred to three hundred and eighteen days. + +In treating of the subject of miscarriage, we mentioned instances, +recorded by physicians of skill and probity, proving beyond a shade of +doubt that a woman may give birth to a living child long before the +expiration of the forty weeks. The Presbytery of Edinburgh, Scotland, +some time since decided in favor of the legitimacy of an infant born +alive, within twenty-five weeks after marriage, to the Rev. Fergus +Jardine. + +One of the most enlightened countries in Europe has, in view of the +facts in reference to the extreme limits of pregnancy, enacted, in the +Code Napoleon, that a child born within three hundred days after the +departure or death of the husband, or one hundred and eighty days after +marriage, shall be considered legitimate. The law further states that a +child born after more than three hundred days shall not be necessarily +declared a bastard, but its legitimacy may be contested. The Scotch +legislation on this subject is very similar to the French. + + +CAUSES OF PROTRACTED PREGNANCY. + +It has been asserted by some that an infant is born at ten or eleven +months because at nine months it has not acquired the growth which +is necessary in order to induce the womb to dislodge it. The popular +notion is, that a child carried beyond the usual term must necessarily +be a large one. Rabelais has reflected this common opinion in his +celebrated romance entitled 'Gargantua,' in which he represents the +royal giant of that name as having been carried by his mother, +Gargamelle, eleven months. When born, the child was so vigorous that he +sucked the milk from ten nurses. He lived for several centuries, and at +last begot a son, Pantagruel, as wonderful as himself. Such reasoning +cannot, however, be seriously maintained, as many children carried +longer than nine months have not been more fully developed than some +born a few weeks prematurely; and the size of the child has nothing to +do with the bringing on of labor, as we shall show hereafter. Protracted +pregnancies are caused by a defect in the energy of the womb, induced +by moral as well as physical influences. As a rule, a woman who leads a +regular life, and observes the physiological laws of her being, which +laws it has been our aim to point out, will be confined at the term that +nature usually marks out, that is, at the expiration of two hundred and +eighty days, or forty weeks, from conception. + +This brings us to the consideration of the question, + + +HOW TO CALCULATE THE TIME OF EXPECTED LABOR. + +Many rules for this purpose have been laid down. We shall merely give +one, the most satisfactory and the most easily applied. It was suggested +by the celebrated Professor Naegele of Heidelberg, and is now generally +recommended and employed by physicians. The point of departure in making +the calculation is _the day of the disappearance of the last monthly +sickness_; three months are subtracted, and seven days added. The result +corresponds to the day on which labor will commence, and will be found +to be two hundred and eighty days from the time of conception, if that +event has occurred, as ordinarily, immediately after the last menstrual +period. Suppose, for instance, the cessation of the last monthly +sickness happened on the 14th day of January; subtract three months, and +we have October 14; then add seven days, and we obtain the 21st day of +the ensuing October (two hundred and eighty days from January 14) as the +time of the expected confinement. This method of making the 'count' may +be relied upon with confidence, and only fails, by a few days, in those +exceptional cases in which conception takes place just before the +monthly period, or during the menstrual flow. + + +CARE OF HEALTH DURING PREGNANCY. + +This subject, the proper management of the health from conception to +childbirth, is worthy of careful consideration. The condition of +pregnancy, though not one of disease, calls for peculiar solicitude, +lest it should lead to some affection in the mother or in the child. For +it ought to be remembered that the welfare of a new being is now in the +balance. The woman has no longer an independent existence. She has +entered upon the circle of her maternal duties. She became a mother when +she conceived. The child, though unborn, lives within her; its life is a +part of her own, and so frail, that any indiscretion on her part may +destroy it. The danger to the child is not imaginary, as the large +number of miscarriages and still-births proves. + +All mothers desire to have healthy, well-formed, intelligent children. +How few conduct themselves in such a manner as to secure a happy +development of their offspring! Puny, deformed, and feeble-minded +infants are daily ushered into the world because of a want of knowledge, +or a sinful neglect of those special measures imperatively demanded in +the ordering of the daily life, by the changed state of the system +consequent upon pregnancy. We shall therefore point out those laws which +cannot be infringed with impunity, and indicate the diet, exercise, +dress, and, in general, the conduct most favorable to the mother and +child during this critical period, in which the wife occupies, as it +were, an intermediate state between health and sickness. + + +FOOD. + +The nourishment taken during pregnancy should be abundant, but not, in +the early months, larger in quantity than usual. Excess in eating or +drinking ought to be most carefully avoided. The food is to be taken at +shorter intervals than is common, and it should be plain, simple, and +nutritious. Fatty articles, the coarser vegetables, highly salted and +sweet food, if found to disagree, as is often the case, should be +abstained from. The flesh of young animals--as lamb, veal, chicken, and +fresh fish--is wholesome, and generally agrees with the stomach. Ripe +fruits are beneficial. The diet should be varied as much as possible +from day to day. The craving which some women have in the night or early +morning may be relieved by a biscuit, a little milk, or a cup of coffee. +When taken a few hours before rising, this will generally be retained, +and prove very grateful, even though the morning sickness be +troublesome. Any food or medicine that will confine or derange the +bowels is to be forbidden. The taste is, as a rule, a safe guide, and it +may be reasonably indulged. But inordinate, capricious desires for +improper, noxious articles, should of course, be opposed. Such longings, +however, are not often experienced by those properly brought up. It is a +curious fact, that the modification in the digestive system during +pregnancy is sometimes so great that substances ordinarily the most +indigestible are eaten, without any inconvenience, and even with +benefit, while the most healthful articles become hurtful, and act like +poison. + +As pregnancy advances, particularly after the sixth month, a larger +amount of food, and that of a more substantial character, will be +required. The number of meals in the day should then be increased, +rather than the quantity taken at each meal. + + +CLOTHING. + +The dress during pregnancy should be loose and comfortable, nowhere +pressing tightly or unequally. The word _enceinte_, by which a pregnant +woman is designated, meant, originally, without a cincture,--that is, +unbound. The Roman matrons, so soon as they conceived, were obliged to +remove their girdles. Lycurgus caused the enactment of the Spartan law, +that pregnant women should wear large dresses, so as not to prejudice +the free development of the precious charges of which nature had +rendered them the momentary depositaries. Stays or corsets may be used, +in a proper manner, during the first five or six months of pregnancy, +but after that they should either be laid aside, or worn very loosely. +Any attempt at concealing pregnancy, by tight lacing and the application +of a stronger busk, cannot be too severely condemned. By this false +delicacy the mother is subjected to great suffering, and the child +placed in jeopardy. The shape of the stays should be moulded to that of +the changing figure, and great care should be taken that they do not +depress the nipple or irritate the enlarging breasts. + +The amount of clothing should be suited to the season, but rather +increased than diminished, owing to the great susceptibility of the +system to the vicissitudes of the weather. It is especially important +that flannel drawers should be worn during advanced pregnancy, as the +loose dress favors the admission of cold air to the unprotected parts of +the body. A neglect of this precaution sometimes leads to the +establishment of the painful disease known as rheumatism of the womb. + +Pressure upon the lower limbs, in the neighborhood of the knee or the +ankle joint, should be avoided, more particularly towards the last +months. It is apt to produce enlargement and knotting of the vein, +swelling and ulcers of the legs, by which many women are crippled during +their pregnancies, and sometimes through life. Therefore the garters +should not be tightly drawn, and gaiters should not be too closely +fitted, while yet they should firmly support the ankle. + + +EXERCISE. + +Moderate exercise in the open air is proper and conducive to health +during the whole period of pregnancy. It should never be so active nor +so prolonged as to induce fatigue. Walking is the best form of exercise. +Riding in a badly-constructed carriage, or over a rough road, or upon +horseback, as well as running, dancing, and the lifting or carrying of +heavy weights, should be scrupulously avoided, as liable to cause +rupture, severe flooding, and miscarriage. During the early months, in +particular, extraordinarily long walks and dancing ought not to be +indulged in. Journeys are not to be taken while in the pregnant state. +Railway travelling is decidedly objectionable. The vibratory motion of +the cars is apt to produce headache, sickness at the stomach, faintness, +and premature labor. All these precautions are especially to be observed +in the first pregnancy. + +We must not be understood as condemning exercise and fresh air. They are +of the greatest importance to mother and child. But the amount of +exercise should be regulated by the dictates of common sense and the +woman's own sensations. If she can only walk a short distance each day +with comfort, let that suffice. She should not force herself to go to a +certain place nor to promenade during a certain time in the twenty-four +hours. So soon as fatigue is felt, the walk should cease. Let the walks +be frequent and short, rather than few and long. They should also be +made as pleasant as possible, by companionship and surroundings that +will occupy the feelings and imagination in an agreeable manner with new +and cheerful impressions. A tendency to indolence is to be combated. A +gently active life is best calculated to preserve the health of the +mother and her unborn child. But with even the most robust a moderation +of the ordinary pursuits and avocations is called for. The nervous and +delicate cannot make with safety their customary daily exertions in the +performance of their household or social duties and pleasures. + +Towards the end of pregnancy the wife should economize her forces. She +should not remain long standing or kneeling, nor sing in either of these +postures. + + +BATHING. + +Those who have not been accustomed to bathing should not begin the +practice during pregnancy, and in any case great care should be +exercised during the latter months. It is better to preserve cleanliness +by sponging with tepid water than by entire baths. Foot-baths are always +dangerous. Sea-bathing sometimes causes miscarriage, but sea air and the +sponging of the body with salt water are beneficial. The shower-bath is +of course too great a shock to the system, and a very warm bath is too +relaxing. In some women of a nervous temperament, a lukewarm bath taken +occasionally at night during pregnancy has a calming influence. This is +especially the case in the first and last month. But women of a +lymphatic temperament and of a relaxed habit of body are always injured +by the bath. + + +VENTILATION. + +We have spoken of the benefits of outdoor air during pregnancy. +Attention should also be directed to keeping the atmosphere in the +sitting and sleeping rooms of the house fresh. This can only be +accomplished by constantly changing it. The doors and windows of every +room, while unoccupied, should be kept thrown open in the summer-time, +and opened sufficiently often in the winter to wash out the apartments +several times a day with fresh air. The extremes of heat and cold are +to be, with equal care, avoided. The house should be kept light. Young +plants will not grow well in the dark. Neither will the young child nor +its mother flourish without sunlight. The ancients were so well aware of +this, that they constructed on the top of each house a solarium, or +solar air-bath, where they basked daily, in thin attire, in the direct +rays of the sun. + + +SLEEP. + +During pregnancy a large amount of sleep is required. It has a sedative +influence upon the disturbed nervous system of the mother. It favors, by +the calmness of all the functions which attends it, the growth of the +foetus. Neither the pursuit of pleasure in the evening, nor the +observance of any trite maxims in regard to early rising in the morning, +should be allowed to curtail the hours devoted to slumber. Pregnant +women have an instinctive desire to lie abed late, which, like the other +promptings of nature during this period, should not be disregarded. At +least eight hours out of the twenty-four can be profitably spent in bed. +No night-watching ought ever to be undertaken during pregnancy. + +Feather beds should be avoided. The heat which they maintain about the +body is inconvenient and dangerous, predisposing to flooding and +exhausting perspirations. The hair or sponge mattress is to be +preferred. The bed-clothing should not be too heavy. Blankets are to be +employed rather than coverlids, as they are lighter and more permeable +to perspiration. The mattress and cover should be well aired during the +day. The sleeping-room should be capacious and well ventilated, and no +curtains permitted about the bed. + +Occasional rest is also necessary in the daytime. A nap of an hour or +two upon a sofa or lounge will then prove very refreshing. In the +earlier months of pregnancy it will tend to prevent miscarriage, and in +the latter months to relieve the distress consequent upon the increased +size of the womb. It is not unusual, as the close of pregnancy +approaches, for a feeling of suffocation to ensue when the woman +attempts to lie down. This may be overcome by supporting the back and +shoulders with cushions and pillows. Or a bed-chair may be employed. +This, if well constructed and covered, will often be found very grateful +at night, in the last few weeks of pregnancy. + + +THE MIND. + +A tranquil mind is of the first importance to the pregnant woman. Gloomy +forebodings should not be encouraged. Pregnancy and labor are not, we +repeat, diseased conditions. They are healthful processes, and should be +looked upon as such by every woman. Bad labors are very infrequent. It +is as foolish to dread them, as it is for the railway traveller to give +way to misgivings in regard to his safety. Instead of desponding, +science bids the woman to look forward with cheerfulness and hope to the +joys of maternity. + +The bad effects of fear upon the mother's mind are illustrated by +Plutarch, who, in his Life of Publicola, mentions that, 'at a time when +a superstitious fear overran the city of Rome, all the women then +pregnant brought forth imperfect children, and were prematurely +delivered.' But we have already spoken, in treating of mothers' marks, +of the influence of mental emotions over the unborn child, and the +necessity of avoiding their exciting causes. + +Because of their deleterious tendency, severe study as well as arduous +and protracted manual labor ought to be avoided. The nervous systems of +many women are also injuriously affected during pregnancy by perfumes, +which at other times are agreeable and innocuous. It is therefore +prudent not only to exclude all offensive scents, but also to abstain +from the strong odors of various strong perfumes, eau-de-cologne, and of +flowers. Large bouquets often cause feelings of faintness, and sometimes +temporary loss of consciousness. The extreme liability of the nervous +system of the pregnant woman to be affected injuriously to herself and +child by scenes of suffering or distress, and by disgusting or frightful +objects, cannot be too strongly impressed upon every one. She should be +protected from all that will disturb her, and should be constantly +treated with soothing and encouraging kindness. Her manifestations of +irritability, her caprices, her melancholy anticipations, are not to be +scoffed at, but combated with a mixture of reasoning and patient +forbearance. On her part, she should endeavour to co-operate with those +around her, in sedulously shunning all injurious influences, and in +banishing as quickly as possible all improper longings. She should +remember that, although she herself may escape mischief from them, her +child may suffer. She is the custodian of interests dearer to her than +her own. + + +RELATION OF HUSBAND AND WIFE DURING PREGNANCY. + +During those days when the wife, if she were not pregnant, would have +been 'unwell,' marital intercourse should be abstained from. It is then +injurious to the mother, and dangerous to the life of the child, as it +is liable to excite miscarriage. But if this habitual epoch of the +monthly sickness be avoided, there is no reason why passion should not +be gratified in moderation and with caution during the whole period of +pregnancy. There is one exception to be made to this general course of +conduct. In those cases in which a miscarriage has occurred in the first +pregnancy, every precaution should be employed--for reasons which have +been dwelt upon in a previous article--to prevent its happening again +after the second conception. Under such exceptional circumstances, +therefore, the husband and wife should sleep apart during the first five +months of pregnancy. After that period their ordinary relations may be +resumed. When a miscarriage has taken place, intercourse should not be +permitted within a month of the accident. The observance of this +direction is of the utmost importance. Its neglect is the frequent cause +of severe and intractable diseases of the womb. + + +EFFECT OF PREGNANCY ON HEALTH. + +We have had occasion to remark that pregnancy is not a condition of +disease. It is not only an evidence of health, but during its +continuance it confers increased physical vigor. As a rule, a woman +enjoys _better health_ during her pregnancy than at any other time; she +is less liable to contagious and other maladies; she is less apt to die +than at any other period of her life; and her general constitution seems +also then to receive a favorable impress, for wives and mothers live +longer than celibates. It is wisely decreed that when woman is engaged +in this, to her, anxious stage of reproduction, she shall not be exposed +to the pains and dangers of disease, and that those great covenants of +nature--marriage and child-bearing--shall be rewarded by added strength +and length of days. + +There are certain disorders incident, in exceptional cases, to +pregnancy, of which we shall shortly speak. In general, however, we +repeat that this condition is one of extraordinary health. More than +this, in numerous instances it exerts an ameliorating influence upon +pre-existing diseases, suspending their march, or bringing about a +decidedly curative effect. Thus, various obstinate chronic affections of +the skin, of the womb and ovaries, and of the brain and nervous system, +frequently get well during pregnancy; and it is well known to every +physician, that by the judicious management of this state, and of the +lying-in period, troublesome displacements of the womb may be arrested. + +It should nevertheless ever be recollected that the condition of +pregnancy is one of excitement and enhanced susceptibility to +impressions of all kinds. For this reason a change in the habits of +life is necessary; and the importance of the directions laid down for +the care of the health during this period, cannot be too strongly +insisted upon. + +The diseases to which the wife is exposed during pregnancy will be +treated of in the chapter on 'Health in Marriage.' + + + + +CONFINEMENT. + + +_PREPARATIONS FOR CHILDBIRTH._ + +Certain foolish preparations are sometimes made by wives, with the best +intentions. Perhaps one of the most common and absurd of these is the +local use of sweet oil, in order to facilitate the dilatation of the +parts, for which purpose it is perfectly inert. There are, however, some +wise and even necessary precautions which every wife should know and +employ, to guard against unpleasant and dangerous complications in +childbirth. + +In particular, _the condition of the breasts_ towards the close of +pregnancy demands attention. Scarcely any pain in the lying-in chamber +is greater or more difficult to bear than that which the young mother +suffers from excoriated nipples. This troublesome and often very +intractable affection is nearly always the consequence of the want of +care previous to confinement. During the latter part of pregnancy the +nipples sometimes become sunken or flat, being retracted as the breasts +increase in size, because of the want of elasticity on the part of the +milk tubes. In order to remedy this fault, we have known a breast-pump +or puppy to be applied. Such treatment is dangerous, as it may excite +premature contraction of the womb, and miscarriage. Nipple-shields, +with broad bases and openings, should always be obtained. They are safe, +and effectually secure the prominence of the nipples, when worn +constantly, day and night, during the last month or so of pregnancy. +Wives who have never had children ought to take special care to +ascertain before labor whether this depressed condition of the nipples +exists, and to correct it in the manner indicated. + +In the first pregnancy it is also important to _harden the nipples_. +This may be done by occasionally gently rubbing them between the thumb +and finger, and by bathing them twice a day during the last six weeks +with tincture of myrrh, or with a mixture of equal parts of brandy and +water, to which a little alum has been added. This procedure will render +the surfaces less sensitive to the friction of the child's mouth, and +thus avert the distress so often occasioned in the first confinement by +tenderness of the nipples. + +If the nipples be rough or nodulated in appearance, like a strawberry or +a raspberry, they are more apt to become excoriated or fissured than if +they present a smooth surface. Under such circumstances, make a solution +of the sulphate of zinc, of the strength of one grain to the ounce of +rose water, in a wide-mouthed bottle, then tilt the bottle upon the +nipple, and allow it to remain there for a few minutes several times a +day. Simple tenderness of the nipples and slight fissures may be averted +by the application either of a lotion of borax (two scruples of borax in +three ounces of water, and an ounce of glycerine), of the honey of +borax, or of the tincture of catechu, and by protecting the parts from +the pressure of the stays and the friction of the flannel vest. + +It is of the greatest moment to the comfort of the mother, that all +affections of the nipples should be prevented or remedied before labor; +for the treatment of sore nipples when the child is at the breast is +often unsatisfactory, while the suffering they occasion is very great, +even sometimes giving rise to mammary abscess. + +There are certain _articles of clothing_ and _dressings for the bed_ +which should be cared for in advance, in order that they may be ready +when required. + +The mother should be provided with short-gowns, to be worn over the +chemise instead of the ordinary night-gowns. It is of consequence to +procure a proper _bandage_. It should be made of heavy muslin, neither +too coarse nor too fine; an ordinarily good quality of unbleached muslin +is the best. The material is to be cut bias, about one and a quarter +yard in length, and from twelve to eighteen inches in breadth, varying, +of course, with the size of the person. It should be just large enough +to encircle the body after confinement, with a margin of a couple of +inches, and to extend down below the fulness of the hips. The +measurement should be taken, and the bandage made to fit, when four and +a half months advanced. It should be narrow above, wider below, and +gored in such a manner that it will be a little narrower at the lower +extremity than a few inches above, so as to prevent it, when adjusted, +from sliding upwards. A bandage constructed in this manner will be very +comfortable; and is not apt to become displaced, after application, as +is invariably the case when a towel or a straight piece of muslin is +used. The way in which it is to be applied will be detailed hereafter. + +The _child's clothing_ should consist first of a piece of flannel or +some woollen material for a binder. This should be from four to six +inches in width, and from twelve to sixteen inches in length; that is to +say, wide enough to extend from the armpits to the lower part of the +abdomen, and long enough to go once and a half times around the child, +having the double fold to come over the abdomen. There should be no +embroidery about this. A shirt, which it is desirable should be woollen, +is to be provided to place over the binder. It should be made to come up +tolerably high in the neck, and to extend down the arm. Neither it nor +any other portion of the child's clothing should be starched. The +petticoat, which may be open its whole length behind, is to be put over +the shirt; two may be used--a short and a long one. Next comes the +child's ordinary frock or slip, and above this an apron to protect the +dress from the frequent discharges from the stomach. Then a shawl, of +flannel or any other warm material, is to be provided, to throw over the +shoulders if the weather be cold. Socks, and pieces of old soft linen, +free from stiffening, for napkins or diapers, complete the child's +outfit. + +For the _permanent and temporary dressing of the bed_ there should be +provided a piece of impervious cloth (oiled silk is the neatest) about a +yard square; a piece of ordinary table oil-cloth or rubber-cloth; a +number of old sheets and comfortables, and a piece of thick carpet. The +manner in which these are to be used will be explained shortly. + +A pair of small rounded scissors; a package of large pins, one and a +half inches in length, for the bandage of the mother, and smaller ones +for that of the child; some good linen bobbin for the doctor to tie the +navel-string; good toilet soap and fine surgical sponge for washing the +child; a piece of soft linen or muslin for dressing the navel; a box of +unirritating powder; and a pile of towels,--should all be had and laid +aside many weeks before they are wanted. These, together with the +material for dressing the bed, the child's clothing, and the mother's +bandage, ought to be placed together in a basket got for the purpose, in +order that they may all be easily and certainly found at a time when +perhaps the hurry and excitement of the moment would render it difficult +otherwise to collect them all immediately. + + +SIGNS OF APPROACHING LABOR. + +One of the earliest of the preliminary signs of the coming on of +confinement occurs about two weeks before that event. It is a dropping +or subsidence of the womb. The summit of that organ then descends, in +most cases, from above to below the umbilicus, and the abdomen becomes +smaller. The stomach and lungs are relieved from pressure, the woman +breathes more freely, the sense of oppression which troubled her +previously is lost, and she says she feels 'very comfortable.' This +sensation of lightness and buoyancy increases, and a few days before the +setting in of labor she feels so much better that she thinks she will +take an extra amount of exercise. The mother of a number of children is +acquainted with this sign, but the wife with her first child may exert +herself unduly in the house or outdoors, and induce labor when in the +street or away from home. Hence the importance of a knowledge of this +premonitory symptom. + +A second precursory sign of labor is found in the increased fulness of +the external parts, and an augmented mucous secretion, which may amount +even to a discharge resembling whites, and requiring the wearing of a +napkin. This symptom is a good one, indicating a disposition to +relaxation, and promising an easy time. + +The third preliminary sign which we shall mention, is the change in the +mental state of the pregnant woman. She has a feeling of anxiety and of +fidgetiness, sometimes accompanied with depression of spirits. This +condition of emotional distress, modified in particular cases by reason, +self-control, and religion, may continue for several days, perhaps, when + + +THE SYMPTOMS OF ACTUAL LABOR + +make their appearance. The first of these is generally the 'show.' It is +the discharge of the plug of mucus which has occupied the neck of the +womb up to this time, and is ordinarily accompanied by a little blood. +Perhaps before this, or perhaps not for some hours after, the 'pains' +will develope themselves. These recur periodically, at intervals of an +hour or half an hour at the outset, and are 'grinding' in character. +_True_ labor pains are distinguished from _false_ by the fact that they +are felt in the back, passing on to the thighs, while false pains are +referred to the abdomen; by their intermittent character, the spurious +pains being more or less continuous; and by the steady increase in their +frequency and severity. In case of doubt as to their exact nature, the +doctor should be summoned, who will be able to determine positively +whether labor has begun. + +The other symptoms which point to the actual commencement of labor are a +frequent desire to empty the bowels and bladder, nausea and vomiting, +which, in the early part of confinement, is a good sign; shiverings, +unattended with any sensation of cold; and, finally, the rupture and +discharge of the contents of the 'bag of waters.' + +Before passing on to the consideration of the management of the +confinement into which the wife has now entered, a few words may be +appropriately said upon the + + +CAUSE OF LABOR. + +Neither the size nor the vigor of the child has any influence in +bringing about delivery at full term. The ancient theory--which received +the support of the distinguished naturalist Buffon--that the infant was +the active agent in causing its own expulsion, is an exploded one. It +was asserted by some that hunger excited the foetus to struggle to free +itself from the womb; others were disposed to attribute its efforts to +accomplish its entrance into the world, to the need of respiration which +it experienced. But all these ingenious theories, which presupposed the +embryo to be actuated by the same feelings which would influence a grown +person if shut up in such a confined abode, are unsatisfactory, and not +tenable. It is well known that the child may die in the womb, without +retarding or interfering in any way with the coming on of the process of +labor. This fact alone shows that the foetus is, or at any rate may be, +absolutely passive either in regard to the induction or advancement of +delivery. The determining cause of labor is seated in the womb itself. +The contractions of this organ occasion the 'pains' and expel the child, +assisted by the muscles of the abdomen and the diaphragm. That the +assistance of the latter forces is not necessary, is conclusively proved +by the occurrence of childbirth after the decease of the mother. For +instance, a case is on record in which labor commenced and twins were +born after the mother had been dead for three days. + + +CARE DURING LABOR. + +We will suppose labor to have commenced. The _preparation of the bed_ +for the occupancy of the mother is now to be attended to. As she is to +lie on the _left side_ of the bed, this is the side, and the only one, +which is to be dressed for the occasion. In order to do so, remove the +outer bed-clothes one at a time, folding them neatly on the right side +of the bed so that they can easily be drawn over when desired. The +_permanent dressing_ is to be placed beneath the lower sheet and upon +the mattress. A soft impervious cloth--which, in speaking of the +preparation for confinement, we directed to be procured--is placed next +to the surface of the bed. The upper edge should be nearly as high as +the margin of the bolster, and it should extend down to a distance at +least a foot below the level of the hips, so as to certainly protect the +bed from the discharges. Upon the top of this a blanket or sheet is +laid, and the whole fastened by pins. The lower sheet of the bed, which +had been turned over to the right side, to permit the application of the +dressing, is now to be replaced. Over the position of this permanent +dressing, on the top of the bed-sheet, a neatly-folded sheet, with the +folded edge down, is adjusted and pinned in its place. It is upon this +sheet that the patient is to be drawn up after her confinement, which +will take place upon the _temporary dressing_ of the bed now to be +arranged. It consists of an oil-cloth, which should extend up beyond the +lower edge of the permanent dressing, overlapping the folded sheet which +has been placed above it, and should fall over the side and bottom of +the bed. A comfortable or any soft absorbent material is placed over +this impervious cloth and covered with a folded sheet, completing the +temporary dressing. The bed-clothes may now be adjusted, concealing the +dressings from view until they are wanted. The valances at the foot of +the bed should be raised, and a piece of carpet placed on the floor. The +bed should have no foot-board, or a very low one. + +_The dress of the mother._--Either a folded sheet should be adjusted +around the waist as the only skirt, so as not to interfere with the +walking, or a second chemise should be put on, with the arms outside the +sleeves, to extend from the waist to the feet. Then the chemise next the +body should be drawn up and folded high up around the breast. It should +be plaited neatly along the back, and brought forward and fastened by +pins. This should be thoroughly done, so that the linen may not be found +wet nor soiled when it is drawn down after confinement. A wrapper or +dressing-gown may be worn during the first stage of labor, before it is +necessary to go to bed. When, however, that time comes, the wife will +take her place on her left side on the temporary dressing, with a sheet +thrown over her, her head on a pillow so situated that her body will be +bent well forward, and her feet against the bed-post. A sheet should be +twisted into a cord and fastened to the foot of the bed, for her to +seize with her hands during the accession of the 'bearing-down pains.' +Care should be taken to have a number of napkins, a pot of fresh lard, +and the basket containing the scissors, ligature, bandage, etc.--which +have been previously enumerated in the remarks on preparations for +childbirth--at hand, for the use of the doctor. + +We have now noted all that it is useful for the wife to know in regard +to the preparation for and management of confinement, when a physician +is in attendance, as, for obvious reasons, he should always be. In some +instances, however, the absence of the doctor is unavoidable, or the +labor is completed before his arrival. As a guide to the performance of +the necessary duties of the lying-in room under such circumstances, we +give some + + +HINTS TO ATTENDANTS. + +The room during confinement should be kept quiet. Too many persons must +not be allowed in it, as they contaminate the air, and are apt by their +conversation to disturb the patient, either exciting or depressing her. +So soon as the head is born, it should be immediately ascertained +whether the neck is encircled by the cord; if so, it should be removed +or loosened. The neglect of this precaution may result fatally to the +infant, as happened a short time since in our own practice; the infant, +born a few minutes before our arrival, being found strangled with the +cord about its neck. It is also of importance at once to allow of the +entrance of air to the face, to put the finger in the mouth to remove +any obstruction which may interfere with respiration, and to lay the +babe on its right side, with the head removed from the discharges. The +cord should not be tied until the infant is heard to cry. The ligature +is to be applied in the following manner:--A piece of bobbin is thrown +around the navel-string, and tied with a double knot at the distance of +three fingers' breadth from the umbilicus; a second piece is tied an +inch beyond the first, and the cord divided with the scissors between +the two, care being taken not to clip off a finger or otherwise injure +the unsuspecting little infant, as has occurred in careless hands more +than once. When the child is separated from the mother, a warm blanket +or a piece of flannel should be ready to receive it. In taking hold of +the little stranger, it may slip out of the hands and be injured. To +guard against this accident, which is very apt to occur with awkward or +inexperienced persons, always seize the back portion of the neck in the +space bounded by the thumb and first finger of one hand, and grasp the +thighs with the other. In this way it may be safely carried. It should +be transferred, wrapped up in its blanket, to some _secure_ place, and +never put in an arm-chair, where it may be crushed by some one who does +not observe that the chair is already occupied. The head of the child +should not be so covered as to incur any danger of suffocation. + + +ATTENTION TO THE MOTHER. + +When the after-birth has come away, the mother should be drawn up a +short distance--six or eight inches--in bed, and the sheet which has +been pinned around her, together with the temporary dressing of the bed +removed, a clean folded sheet being introduced under the hips. The parts +should be gently washed with warm water and a soft sponge or a cloth, +after which an application of equal parts of claret wine and water will +prove pleasant and beneficial. We have also found the anointing of the +external and internal parts with goose grease, which has been thoroughly +washed in several hot waters, to be very soothing and efficient in +speedily allaying all irritation. This ought all to be done under cover, +to guard against the taking of cold. The chemise pinned up around the +breast should now be loosened, and the woman is ready for the +application of the bandage, which is to be put on next the skin. If +properly and nicely adjusted, it will prove very grateful. The +directions for making it have already been given. In order to apply it, +one half of its length should be folded up into plaits, and the mother +should lie on her left side; lay the plaited end of the bandage +underneath the left side of the patient, carrying it as far under as +possible, and draw the loose end over the abdomen; then let the mother +roll over on her back upon the bandage, and draw out the plaited end. If +the abdominal muscles are much relaxed and the hip-bones prominent, a +compress of two or three towels will be wanted. The bandage should be +first tightened in the middle by a pin applied laterally, for strings +should never be employed. The pins should be placed at intervals of +about an inch. The lower portion of the bandage should be made quite +tight, to prevent it slipping up. The mother is now ready to be drawn up +in bed upon the permanent dressing: this should be done without any +exertion on her part. A napkin should be laid smoothly _under_ the hips +(never folded up), to receive the discharges. If she prefer to lie on +her left side, place a pillow behind her back. + + +ATTENTION TO THE CHILD. + +The baby may now be washed and dressed. Before beginning, everything +that is wanted should be close at hand, namely a basin of warm water, a +large quantity of lard or some other unctuous material, soap, fine +sponge, and a basket containing the binder, shirt, and other articles of +clothing. First rub the child's body thoroughly with lard. The covering +can only be removed in this way; the use of soap alone will have no +effect unless the friction be so great as to take off also the skin. The +nurse should take a handful of lard and rub it in with the palm of the +hand, particularly in the flexures of the joints. In anointing one part, +the others should be covered, to prevent the child from taking cold. If +the child is thus made perfectly clean, do not use any soap and water, +because the skin is left in a more healthful condition by the lard, and +there is risk of the child's taking cold from the evaporation of the +water. But the face may be washed with soap and water, great care being +taken not to let the soap get into the child's eyes, which is one of the +most frequent causes of sore eyes in infants. The navel-string is now to +be dressed. This is done by wrapping it up in a circular piece of soft +muslin, well oiled, with a hole in its centre. The bandage is next to be +applied. The object of its use is to protect the child's abdomen against +cold, and to keep the dressing of the cord in its position. The nature, +shape, and size of the binder have been described. It should be pinned +in front, three pins being generally sufficient. The rest of the +clothing before enumerated is then put on. + +The child is now to be _applied to the breast at once_. This is to be +done, for three reasons. First, it very often prevents flooding, which +is apt otherwise to occur. Secondly, it tends to prevent milk fever, by +averting the violent rush of the milk on the third day, and the +consequent engorgement of the breast and constitutional disturbance. +The third reason is, that there is always a secretion in the breast from +the first, which it is desirable for the child to have; for it acts as a +cathartic, stimulating the liver, and cleansing the bowels from the +secretions which fill them at the time of birth. There is generally +sufficient nourishment in the breasts for the child for the first few +days. The mother may lie on the one side or the other, and receive the +child upon the arm of that upon which she is lying. If the nipple be not +perfectly drawn out so that the child can grasp it in its mouth, the +difficulty may be overcome by filling a porter-bottle with hot water, +emptying it, and then placing the mouth of the bottle immediately over +the nipple. This will cause, as the bottle cools, a sufficient amount of +suction to elevate the sunken nipple. The bottle should then be removed +and the child substituted,--a little sugar and water or sweetened milk +being applied, if necessary, to tempt the child to take the breast. + + +FURTHER ATTENTION TO THE MOTHER. + +The patient should be cleansed every _four or five hours_. A soft +napkin, wet with warm soap and water, should for this purpose be passed +underneath the bed-clothing, without exposing the surface to a draft of +air. After using the soap and water, apply again the dilute claret wine +and the goose grease. Much of the safety of the mother depends upon the +observation of cleanliness. The napkin should not be allowed to remain +so long as to become saturated with the discharges. + +The mother should maintain rigidly the recumbent position for the first +few days, not raising her shoulders from the pillow for any purpose, and +should abstain from receiving visitors, and from any social conversation +for the first twenty-four hours. + +For the first three or four days, until the milk has come and the milk +fever passed, the mother should live upon light food,--oatmeal gruel, +tea and toast, panada, or anything else of little bulk and unstimulating +character. Afterwards the diet may be increased by the addition of +chicken, lamb, mutton or oyster broth, buttered toast, and eggs. The +object of light nourishment at first is to prevent the too rapid +secretion of milk, which might be attended with evil local and +constitutional effects. If, however, the mother be in feeble health, it +will be necessary from the outset that she shall be supported with +nourishing concentrated food. _Beef-tea_ will then be found very +serviceable, particularly if made according to the following +recipe:--Take a pound of fresh beef from the loins or neck. Free it +carefully from all fat. Cut it up into fine pieces, and add a very +little salt and five grains of unbroken black pepper. Pour on it a pint +of cold water, and _simmer_ for forty minutes. Then pour off the liquor, +place the meat in a cloth, and, after squeezing the juice from it into +the tea, throw it aside. Return to the fire, and boil for ten minutes. + +After the first week, the diet of the lying-in woman should always be +nutritious, though plain and simple. The development of the mammary +glands, the production of the mammary secretion, and the reduction which +takes place in the size of the womb, all require increased nourishment, +that they may be properly performed. + +After the third or fourth day _the dress should be changed_. The dress +worn during labor, if our directions have been carried out, will not +have been soiled. The clothing should be changed without uncovering the +person, and without raising the head from the pillow. Pull the bed-gown +from over each arm, and draw it out from under the body. Then unfasten +the chemise in front and draw it down underneath her so that it can be +removed from below, as it should not be carried over the head. Place her +arms in the sleeves of the clean chemise, throw its body over her head, +and, without lifting her shoulders from the bed, draw it down. Then +change the bed-gown in the same manner. + +In changing the upper sheet, it should be pulled off from below, and the +clean one carried down in its place from above, underneath the other +clothing, which can be readily accomplished by plaiting the lower half. +In introducing a clean under-sheet, one side of it should be plaited and +placed under the patient, lying on her left side; when she turns on her +back, the plaits can then be readily drawn out. These directions, though +apparently trivial, are important. The object is to guard against the +great danger to which the mother is exposed by sitting up in bed for +even a few minutes during the first week. + +_Cathartic medicine_ should not be administered the first, the third, or +any other day after confinement, unless it is needed. If the patient is +perfectly comfortable, has no pain in the abdomen, no headache, and is +well in every respect, she should be let alone, even if her bowels have +not been moved. If a laxative be called for, citrate of magnesia is much +pleasanter and equally as efficacious as the castor-oil so frequently +administered on this occasion. + + +TO HAVE LABOR WITHOUT PAIN. + +Is it possible to avoid the throes of labor, and have children without +suffering? This is a question which science answers in the affirmative. +Medical art brings the waters of Lethe to the bedside of woman in her +hour of trial. Of late years chloroform and ether have been employed to +lessen or annul the pains of childbirth, with the same success that has +attended their use in surgery. Their administration is never pushed so +as to produce complete unconsciousness, unless some operation is +necessary, but merely so as to diminish sensibility and render the pains +endurable. These agents are thus given without injury to the child, and +without retarding the labor or exposing the mother to any danger. When +properly employed, they induce refreshing sleep, revive the drooping +nervous system, and expedite the delivery. + +They should never be used in the absence of the doctor. He alone is +competent to give them with safety. In natural, easy, and short labor, +where the pains are readily borne, they are not required. But in those +lingering cases in which the suffering is extreme, and, above all, in +those instances where instruments have to be employed, ether and +chloroform have a value beyond all price. + + +MORTALITY OF CHILDBED. + +_The number of the pregnancy_ affects the danger to be expected from +lying-in. It has been declared by excellent authority, that the +mortality of first labors, and of childbed fever following first labors +is about twice the mortality attending all subsequent labors +collectively. After the ninth labor the mortality increases with the +number. A woman having a large family, therefore, comes into greater and +increasing risk as she bears her ninth and successive children. + +_The age of the woman_ also affects the mortality accompanying +confinement. The age of least mortality is near twenty-five years. On +either side of this, mortality increases with the diminution or increase +of age. The age of the greatest safety in confinement therefore +corresponds to the age of greatest fecundity. And during the whole of +child-bearing life, safety in labor is directly as fecundity, and _vice +versa_. Hence modern statistics prove the correctness of the saying of +Aristotle, that 'to the female sex premature wedlock is peculiarly +dangerous, since, in consequence of anticipating the demands of nature, +many of them suffer greatly in childbirth, and many of them die.' As the +period from twenty to twenty-five is the least dangerous for childbirth, +and as first labors are more hazardous than all others before the ninth, +it is important that this term of least mortality be chosen for entering +upon the duties of matrimony. This we have already pointed out in +speaking of the age of nubility. + +_The sex of the child_ is another circumstance affecting the mortality +of labor. Professor Simpson of Edinburgh has shown that a greater +proportion of deaths occurs in women who have brought forth male +children. + +_The duration of labor_ also influences the mortality of lying-in. The +fatality increases with the length of the labor. It must be recollected, +however, that the duration of labor is only an inconsiderable part of +the many causes of mortality in childbirth. + + +WEIGHT AND LENGTH OF NEW-BORN CHILDREN + +The average weight of infants of both sexes at the time of birth is +about seven pounds. The average of male children is seven and one-third +pounds; of female, six and two-thirds pounds. Children which at full +term weigh less than five pounds are not apt to thrive, and usually die +in a short time. + +The average length at birth, without regard to sex, is about twenty +inches, the male being about half an inch longer than the female. + +In regard to the relation between the size of the child and the age of +the mother, the interesting conclusion has been arrived at, that the +average weight and length of the mature child gradually increases with +the age of the mother up to the twenty-fifth year. Mothers between the +ages of twenty-five and twenty-nine have the largest children. From the +thirtieth year they gradually diminish. The first child of a woman is of +comparatively light weight. The first egg of a fowl is smaller than +those which follow. + +The new-born children in our Western States seem to be larger than the +statistics show them to be in the various States of Europe, and +apparently even than in our Eastern States. In the Report on Obstetrics +of the Illinois State Medical Society for 1868, it is stated that +Quincy, Ill., produced during the year six male children whose average +weight at birth was thirteen and a quarter pounds, the smallest weighing +twelve pounds, and the largest seventeen and a half, which was born at +the end of four hours' labor, without instrumental or other +interference. A recent number of a Western medical journal reports the +birth at Detroit, in February last, of a well-formed male infant +twenty-four and a-half inches long, weighing sixteen pounds. The woman's +weight, _after labor_, is stated as only ninety-two pounds. An English +physician delivered a child by the forceps which weighed seventeen +pounds twelve ounces, and measured twenty-four inches. These are the +largest well-authenticated new-born infants on record. + + +DURATION OF LABOR. + +The length of a natural labor may be said to vary between two and +eighteen hours. The intervals between the pains are such, however, that +the actual duration of suffering, even in the longest labor, is +comparatively very short. The first confinement is much longer than +subsequent ones. + +The _sex_ of the child has some influence on the duration of labor. +According to Dr. Collins of the Lying-in Hospital of Dublin, the average +with _male_ births is one hour and four minutes longer than with +_female_. The _weight_ of the child also affects the time of labor. +Children weighing over eight pounds average four hours and eight minutes +longer in birth than those of less than eight pounds weight. + + +STILL-BIRTHS. + +The statistics of nearly fifty thousand deliveries which occurred at the +Royal Maternity Charity, London, show a percentage of nearly five +still-born, or one in twenty-seven. + +There are more boys still-born than girls. We have already spoken of the +fact that male births are more tedious, and that a larger number of +males die in the first few years of life than females. This series of +misfortunes has been attributed to the large size which the male foetus +at birth possesses over the female. + + +IMPRUDENCE AFTER CHILDBIRTH. + +After the birth of the child at full term, or at any other period of +pregnancy, the womb, which had attained such wonderful proportions in a +few months, begins to resume its former size. This process requires at +least six weeks after labor for its full accomplishment. Rest is +essential during this period. A too early return to the ordinary active +duties of life retards or checks this restoration to normal size, and +the womb being heavier, exposes the woman to great danger of uterine +displacements. Nor are these the only risks incurred by a too hasty +renewal of active movements. The surface, the substance, and the lining +membrane of the womb are all very liable, while this change from its +increased to its ordinary bulk is occurring, to take on inflammation +after slight exposure. The worst cases of uterine inflammation and +ulceration are thus caused. A 'bad getting-up,' prolonged debility, +pain, and excessive discharge, are among the least penalties consequent +upon imprudence after confinement. It is a mistake to suppose that +hard-working women in the lower walks of life attend with impunity to +their ordinary duties a few days after confinement. Those who suffer +most from falling of the womb and other displacements are the poor, who +are obliged to get up on the ninth day and remain upright, standing or +walking for many hours with an over-weighted womb. Every physician who +has practised much among the poor, has remarked upon the great frequency +of diseases of the womb, which is to be attributed to the neglect of +rest, so common among them, after childbirth. If this be true of +vigorous women accustomed to a hardy life, how much more apt to suffer +from this cause are the delicately nurtured, whose systems are already, +perhaps, deteriorated, and little able to resist any deleterious +influences! + +A mother should remain in bed for at least two weeks after the birth of +the child, and should not return to her household duties under a month; +she should also take great pains to protect herself from cold, so as to +escape the rheumatic affections to which at this time she is +particularly subject. If these directions were generally observed, there +would be less employment for physicians with diseases peculiar to +women, and fewer invalids in our homes. + + +TO PRESERVE THE FORM AFTER CHILDBIRTH. + +This is a matter of great anxiety with many women; and it is proper that +it should be, for a flabby, pendulous abdomen is not only destructive to +grace of movement and harmony of outline, but is a positive +inconvenience. + +To avoid it, be careful not to leave the bed too early. If the walls of +the abdomen are much relaxed, the bed should be kept from two to three +weeks. Gentle frictions daily with spirits and water will give tone to +the muscles. But the most important point is to wear for several months +a _well-fitting_ bandage--not a towel pinned around the person, but a +body-case of strong linen, cut bias, setting snugly to the form, but not +exerting unpleasant pressure. The pattern for this has already been +given. + + + + +THE MOTHER. + + +_MATERNAL DUTIES AND PRIVILEGES._ + +It has been well said by Madame Sirey, that women who comprehend well +their rights and duties as mothers of families, certainly cannot +complain of their destiny. If there exists any inequality in the means +of pleasure accorded to the two sexes, it is in favor of the woman. The +mother who lives in her children and her grandchildren has the peculiar +privilege of not knowing the grief of becoming old. + +'So low down in the scale of creation as we can go,' says Professor +Laycock of Edinburgh, 'wherever there is a discoverable distinction of +sex, we find that maternity is the first and most fundamental duty of +the female. The male never in a single instance, in any organism, +whether plant or animal, contributes nutrient material.' + +Among the Romans, it was enacted that married women who had borne three +children, or if freed-women, four, had special privileges of their own +in cases of inheritance, and were exempted from tutelage. Juvenal has +recorded the reverence paid in Rome to the newly-made mother, and the +sign by which her house was designated and protected from rude +intruders, namely, by the suspension of wreaths over the door. + +At various times, and in different countries, legislators have made laws +discriminating in favor of matrons, justly regarding the family as the +source of the wealth and prosperity of the State. + +Louis XIV. granted, by the edict of 1666, certain pensions to parents of +ten children, with an increase for those who had twelve or more. + + +NURSING. + +So soon as the infant is born, it ought to be placed at the breast. From +this source it should receive its _only_ nourishment during the first +four or six months, and in many cases the first year, of its life. The +child which the mother has carried for nine months and brought with +suffering into the world, still depends upon her for its existence. At +the moment of its birth her duties to the infant, instead of ceasing, +augment in importance. The obligation is imposed upon her of nourishing +it with _her own_ milk, unless there are present physical conditions +rendering nursing improper, of which we are about to speak. It is well +known that the artificial feeding of infants is a prominent cause of +mortality in early life. The foundlings of large cities furnish the most +striking and convincing proof of the great advantages of nursing over +the use of artificially-prepared food. On the continent of Europe, in +Lyons and Parthenay, where foundlings are wet-nursed from the time they +are received, the deaths are 33.7 and 35 per cent. In Paris, Rheims, and +Aix, where they are wholly dry-nursed, their deaths are 50.3, 63.9, and +80 per cent. In New York city, the foundlings, numbering several hundred +a year, were, until recently, dry-nursed, with the fearful and almost +incredible mortality of nearly one hundred per cent. The employment of +wet-nurses has produced a much more favorable result. Therefore, if for +any reason the mother cannot nurse her own child, a hired wet-nurse +should be procured. This brings us to the consideration of + + +HINDRANCES TO NURSING, AND WHEN IT IS IMPROPER. + +Women who have never suckled often experience difficulty in nursing, on +account of the sunken and flat condition of the nipple. We have pointed +out the causes of this depression, and how by early attention before the +birth of the infant it may be prevented. If, however, these precautions +have been neglected, and it is found that the nipple is not sufficiently +prominent to be grasped by the child's mouth, it may be drawn out by a +common breast-pump, by suction with a tobacco-pipe, by the use of the +hot-water bottle in the manner described, or by the application of an +infant a little older. Neither the child nor the mother should be +constantly fretted in such cases by frequent ineffectual attempts at +nursing. Such unremitting attention and continual efforts produce +nervousness and loss of sleep, and result in a diminution of the +quantity of the milk. The child should not be put to the breast oftener +than once in an hour and a half or two hours. By the use of the +expedients mentioned, the whole difficulty will be overcome in a few +days. + +_Delay in applying the child to the breast_ is a common cause of +trouble. After it has been fed for several days with the spoon or +bottle, it will often refuse to suck. When nursing is deferred, the +nipple also becomes tender. For these reasons, as well as the others +detailed in our directions for the care of the new-born infant, the +child should always, in say from two to three hours after labor, be +placed at the breast. + +_Ulcerated and fissured nipples_ should be treated by the doctor in +attendance. As it is highly desirable, and nearly always possible, to +avoid them, we would again call attention to the manner of doing so, +indicated in a previous article. Fissured nipples sometimes do harm to +the infant, by causing it to swallow blood, disturbing in this way the +digestion. But all these local interferences with nursing can generally +be obviated in the course of a few weeks, and rarely entirely prevent +the exercise of this maternal pleasure and duty. + +But there are certain _physical conditions which necessitate the +employment of a hired wet-nurse_, or weaning. If the mother belongs to a +consumptive family, and is herself pale, emaciated, harassed by a cough, +and exhausted by suckling, wet-nursing is eminently improper. A +temporary loss of strength under other circumstances should not induce a +mother at once to wean her child; for it is often possible, by the +judicious use of tonics, nourishing food, and stimulants, to entirely +restore the health with the child at the breast. It should always be +recollected, however, that the milk of those in decidedly infirm health +is incapable of properly nourishing the child. Professor J. Lewis Smith +of New York quotes, in his recent work on Diseases of Children, several +instructive cases which show the danger sometimes attending suckling, +and which may imperatively demand its discontinuance. 'A very +light-complexioned young mother, in very good health, and of a good +constitution, though somewhat delicate, was nursing for the third time, +and, as regarded the child, successfully. All at once this young woman +experienced a feeling of exhaustion. Her skin became constantly hot; +there were cough, oppression, night-sweats; her strength visibly +declined, and in less than a fortnight she presented the ordinary +symptoms of consumption. The nursing was immediately abandoned, and from +the moment the secretion of milk had ceased, all the troubles +disappeared.' Again: 'A woman of forty years of age having lost, one +after another, several children, all of which she had put out to nurse, +determined to nurse the last one herself. This woman being vigorous and +well built, was eager for the work, and, filled with devotion and +spirit, she gave herself up to the nursing of her child with a sort of +fury. At nine months she still nursed him from fifteen to twenty times a +day. Having become extremely emaciated, she fell all at once into a +state of weakness, from which nothing could raise her, and two days +after the poor woman died of exhaustion.' + +It does not always follow, that because the mother is sick the child +should be taken from the breast. It is only necessary in those +affections in which there is great depression of the vital powers, or +in which there is danger of communicating the disease to the child. In +the city, where artificially-fed infants run great risks, extreme +caution should be exercised in early weaning. + +_Inflammation of either of the breasts_ necessitates the removal of the +infant from the affected side, and its restriction to the other. As the +inflammation gets well and the milk reappears, the first of it should +always be rejected, as it is apt to be thick and stringy, after which +nursing may be resumed. + + +RULES FOR NURSING. + +The new-born child should be nursed about every second hour during the +day, and not more than once or twice at night. Too much ardor may be +displayed by the young mother in the performance of her duties. Not +knowing the fact that an infant quite as frequently cries from being +overfed as from want of nourishment, she is apt to give it the breast at +every cry, day and night. In this manner her health is broken down, and +she is compelled perhaps to wean her child, which, with more prudence +and knowledge, she might have continued to nurse without detriment to +herself. It is particularly important that the child shall acquire the +habit of not requiring the breast more than once or twice at night. +This, with a little perseverance, can readily be accomplished, so that +the hours for rest at night, so much needed by the mother, may not be +interfered with. Indeed, if the mother does not enjoy good health, it is +better for her not to nurse at all at night, but to have the child fed +once or twice with a little cow's milk. For this purpose, take the +upper third of the milk which has stood for several hours and dilute it +with water, in the proportion of one part of milk to two of water. + +In those cases in which the milk of the mother habitually disagrees with +the infant, the attention of the doctor should at once be called to the +circumstance. A microscopic examination will reveal to the intelligent +practitioner the cause of the difficulty, and suggest the remedy. + +It may be well here to mention--as, judging from the practice of many +nurses and mothers, it seems to be a fact not generally known or +attended to--that human milk contains _all that is required_ for the +growth and repair of the various parts of the child's body. It should +therefore be the sole food in early infancy. + + +INFLUENCE OF DIET ON THE MOTHER'S MILK. + +Certain articles of food render the milk acid, and thus induce colicky +pains and bowel complaints in the child. Such, therefore, as are found, +in each individual case, to produce indigestion and an acid stomach in +the mother, should be carefully avoided by her. + +_Retention of the milk in the breasts_ alters its character. The longer +it is retained, the weaker and more watery it becomes. An acquaintance +with this fact is of practical importance to every mother; for it +follows from it, that the milk is richer the oftener it is removed from +the breast. Therefore, if the digestion of the child is disordered by +the milk being too rich, as sometimes happens, the remedy is to give it +the breast less frequently by which not only is less taken, but the +quality is also rendered poorer. On the contrary, in those instances in +which the child is badly nourished and the milk is insufficient in +quantity, it should be applied oftener, and the milk thus rendered +richer. + +The milk which last flows is always the richest. Hence, when two +children are nursed, the first is the worse served. + + +INFLUENCE OF PREGNANCY ON THE MILK. + +Menstruation is ordinarily absent, and pregnancy therefore impossible, +during the whole course of nursing, at least during the first nine +months. Sometimes, however, mothers become unwell at the expiration of +the sixth or seventh month; in rare instances, within the first five or +six weeks after confinement. When the monthly sickness makes its +appearance without any constitutional or local disturbance, it is not +apt to interfere with the welfare of the infant. When, on the contrary, +the discharge is profuse, and attended with much pain, it may produce +colic, vomiting, and diarrhoea in the nursling. The disturbance in the +system of the child ordinarily resulting from pregnancy in the mother is +such that, as a rule, it should be at once weaned so soon as it is +certain that pregnancy exists. The only exceptions to this rule are +those cases in the city, during the hot months, in which it is +impossible either to procure a wet-nurse or to take the child to the +country to be weaned. In cold weather an infant should certainly be +weaned, if it has attained its fifth or sixth month, and the mother has +become pregnant. + + +INFLUENCE OF THE MOTHER'S MIND OVER THE NURSING CHILD. + +We have spoken, in treating of mothers' marks, of the influence of the +mother's mind upon her unborn offspring. The influence of the maternal +mind does not cease with the birth of the child. The mother continues +during the whole period of nursing powerfully to impress, through her +milk, the babe at her breast. It is well established, that mental +emotions are capable of changing the quantity and quality of the milk, +and of thus rendering it hurtful, and even dangerous, to the infant. + +_The secretion of milk may be entirely stopped_ by the action of the +nervous system. Fear, excited on account of the child which is sick or +exposed to accident, will check the flow of milk, which will not return +until the little one is restored in safety to the mother's arms. +Apprehension felt in regard to a drunken husband, has been known to +arrest the supply of this fluid. On the other hand, the secretion is +often augmented, as every mother knows, by the _sight_ of the child, +nay, even by the _thought_ of him, causing a sudden rush of blood to the +breast known to nurses as the _draught_. Indeed a strong desire to +furnish milk, together with the application of the child to the breast, +has been effectual in bringing about its secretion in young girls, old +women, and even men. + +Sir Astley Cooper states that 'those passions which are generally +sources of pleasure, and which when moderately indulged are conducive to +health, will, when carried to excess, alter, and even entirely check the +secretion of milk.' + +But the fact which it is most important to know is, that _nervous +agitation may so alter the quality of the milk as to make it poisonous_. +A fretful temper, fits of anger, grief, anxiety of mind, fear, and +sudden terror, not only lessen the quantity of the milk, but render it +thin and unhealthful, inducing disturbances of the child's bowels, +diarrhoea, griping, and fever. Intense mental emotion may even so alter +the milk as to cause the death of the child. A physician states, in the +_Lancet_, that, having removed a small tumour from behind the ear of a +mother, all went on well until she fell into a violent passion. The +child being suckled soon afterwards, it died in convulsions. Professor +Carpenter records in his Physiology two other fatal instances: in one, +the infant put to the breast immediately after the receipt of +distressing news by the mother, died in her arms in the presence of the +messenger of the ill-tidings; in the other, the infant was seized with +convulsions on the right side and paralysis on the left, on sucking +directly after the mother had met with an agitating occurrence. Another +case of similar character may be mentioned. A woman while nursing became +violently excited on account of a loss she had just met with from a +theft. She gave her child the breast while in an intense passion. The +child first refused, but ultimately took it, when severe vomiting +occurred. In the course of some hours the child took the other breast, +was attacked at once with violent convulsions, and died in spite of all +that could be done for it. + +The following cases are related by Professor Carpenter as occurring +within his own knowledge. They are valuable as a warning to nursing +mothers to avoid all exciting or depressing passions. A mother of +several healthy children, of whom the youngest was a vigorous infant a +few months old, heard of the death from convulsions of the infant child +of an intimate friend at a distance, whose family had increased in the +same manner as her own. The unfortunate circumstance made a strong +impression on her mind, and being alone with her babe, separated from +the rest of her family, she dwelt upon it more than she otherwise would +have done. With her mind thus occupied, one morning, shortly after +nursing her infant, she laid it in its cradle, asleep and apparently in +perfect health. Her attention was soon attracted to it by a noise. On +going to the cradle she found it in a convulsion, which lasted only a +few moments, and left it dead. In the other case, the mother had lost +several children in early infancy, from fits. One infant alone survived +the usually fatal period. While nursing him, one morning she dwelt +strongly upon the fear of losing him also, although he appeared to be a +very healthy child. The infant was transferred to the arms of the nurse. +While the nurse was endeavouring to cheer the mother by calling her +attention to the thriving appearance of her child, he was seized with a +convulsion, and died almost instantly in her arms. Under similar +circumstances, a child should not be nursed by its mother, but by one +who has reared healthy children of her own and has a tranquil mind. + +An interesting illustration of the powerful sedative action of the +mother's milk--changed in consequence of great mental distress--upon the +impressible nervous system of the infant, is furnished by a German +physician. 'A carpenter fell into a quarrel with a soldier billeted in +his house, and was set upon by the latter with his drawn sword. The wife +of the carpenter at first trembled from fear and terror, and then +suddenly threw herself furiously between the combatants, wrested the +sword from the soldier's hand, broke it in pieces, and threw it away. +During the tumult, some neighbors came in and separated the men. While +in this state of strong excitement, the mother took up her child from +the cradle, where it lay playing and in the most perfect health, never +having had a moment's illness. She gave it the breast, and in so doing +sealed its fate. In a few minutes the infant left off sucking, became +restless, panted, and sank dead upon its mother's bosom. The physician, +who was instantly called in, found the child lying in the cradle as if +asleep, and with its features undisturbed; but all his resources were +fruitless. It was irrevocably gone.' + +Professor William A. Hammond of New York mentions, in a recent number of +the _Journal of Psychological Medicine_, several instances, from his own +practice, of affections in the child caused by the mother's milk. 'A +soldier's wife, whilst nursing her child, was very much terrified by a +sudden thunderstorm, during which the house where she was then quartered +was struck by lightning. The infant, which had always been in excellent +health, was immediately attacked with vomiting and convulsions, from +which it recovered with difficulty.' 'A lady, three weeks after +delivery, was attacked with puerperal insanity. She nursed her child but +once after the accession of the disease, and in two hours subsequently +it was affected with general convulsions, from which it died during the +night. Previous to this event it had been in robust health.' + +Again, Dr. Seguin of New York relates, in his work on Idiocy, a number +of cases of _loss of mind_ produced by the altered state of the mother's +milk. 'Mrs. B. came out from a ball-room, gave the breast to her baby, +three months old: he was taken with spasms two hours after, and since is +a confirmed idiot and epileptic.' + +'In a moment of great anxiety Mrs. C. jumped into a carriage with her +suckling, a girl of fifteen months, so far very intelligent and +attractive. The child took the breast only once in a journey of twenty +miles, but before arriving at destination she vomited several times, +with no interruption but that of stupor, and after an acute fever the +little girl settled down into the condition of a cripple and idiot.' + +The celebrated physician Boerhaave mentions the milk of an angry nurse +as among the causes of _epilepsy._ + +These facts show the importance of a placid mind and cheerful temper in +the mother while nursing. + + +POSITION OF THE MOTHER WHILE NURSING. + +The habit of nursing a child while sitting up in bed or half reclining +upon a lounge is a wrong one. Such a position is injurious to the +breasts, hurtful to the woman's figure, and apt to cause backache. When +in bed, the mother ought always to be recumbent while the child is at +the breast, held upon the arm of the side upon which she lies. When out +of bed, she should sit upright while nursing. + + +QUANTITY OF MILK REQUIRED BY THE INFANT. + +The amount of milk furnished every day by a healthy woman has been +estimated at from a quart to three pints. An infant one or two months of +age takes about two wine-glassfuls, or three ounces, every meal; that +is, as it sucks every two hours, excepting when asleep, about five +half-pints during the twenty-four hours. When it attains the age of +three months, it thrives well on five meals a day, the quantity taken at +each meal then, the stomach being more capacious, amounting to about +half a pint. A child above three months of age ordinarily requires three +pints daily. + +A healthy mother is fully capable of furnishing this quantity of milk +per day, and of affording the child all the nourishment it needs until +four or six months after birth. + +The quantity of the mother's milk varies according to many +circumstances. It is most abundant and also most nutritious in nursing +women between the ages of fifteen and thirty; least so, in those from +thirty-five to forty. There is likewise a great difference in different +women in this respect; and in the same woman varying conditions of +health influence the amount of milk secreted. + + +THE QUALITIES OF A GOOD NURSING MOTHER + +are well described by Professor J. Lewis Smith. 'The best wet-nurses are +usually robust, without being corpulent. Their appetite is good, and +their breasts are distended, from the number and large size of the +blood-vessels and milk-ducts. There is but a moderate amount of fat +around the gland, and tortuous veins are observed passing over it. Such +nurses do not experience a feeling of exhaustion, and do not suffer from +lactation. The nutriment which they consume is equally expended on their +own sustenance and the supply of milk. There are other good wet-nurses +who have the physical condition described, but whose breasts are small. +Still the infant continues to suck till it is satisfied, and it thrives. +The milk is of good quality, and it appears to be secreted mainly during +the time of suckling. Other mothers evidently decline in health during +the time of nursing. They furnish milk of good quality and in abundance, +and their infants thrive; but it is at their own expense. They +themselves say, and with truth, that what they eat goes to milk. They +become thinner and paler, are perhaps troubled with palpitation, and are +easily exhausted. They often find it necessary to wean before the end of +the usual period of lactation. There is another class whose health is +habitually poor, but who furnish the usual quantity of milk without the +exhaustion experienced by the class just described. The milk of these +women is of poor quality. It is abundant, but watery. Their infants are +pallid having soft and flabby fibre.' + + +OVER-ABUNDANCE OF MILK. + +An excessive amount of milk often distends the breasts of those women +who are prone to have long and profuse monthly sickness. It is also apt +to occur in those subject to bleeding piles. It may be produced by any +excitement of the womb or ovaries, and by over-nursing. In these cases +there is usually a constant oozing away and consequent loss of milk. The +mother is troubled by this over-flow, because it keeps her clothing wet; +and the child suffers because of the unnutritious, watery character of +the milk under such circumstances. + +This over-abundant supply may be moderated and the quality improved by +diminishing the quantity of drink, and by the use of preparations of +iron. Fifteen drops of the muriatic tincture of iron, taken three times +a day in a little sweetened water, through a glass tube, will be useful. +It will lessen the amount of the milk, and make it richer. So soon as +these objects are accomplished, the medicine should be discontinued; as, +if taken too long, it may so much diminish the milk as to necessitate +weaning. The application of a cloth, wrung out in cold water, around the +nipples is also of value. It is to be removed so soon as it becomes +warm, and reapplied. In those cases in which the trouble seems to be not +so much an over-supply as an inability to retain the milk, the +administration of tonics addressed to the nervous system, and the local +use of astringents and of collodion around the nipples, will overcome +the difficulty; but these remedies can only be employed successfully by +the physician. And to him alone should be entrusted the use of those +medicines which directly diminish the amount of milk secreted within the +breasts. The expedients we have mentioned are the only ones which can be +safely employed by the mother herself in this annoying affection. + + +SCANTINESS OF MILK. + +Some mothers have habitually an insufficiency of milk. They are most +numerous in large cities, and among working women whose daily +occupations require a separation from the infant. Indigestion, and the +want of a proper amount of nourishing food, cause a diminution in the +quantity of milk. So also do over-feeding and gormandizing. Age lessens +the secretion of milk, as has been already mentioned. Those who first +bear children late in life, have less milk for them than they who begin +earlier. In some cases want of milk in the breasts seems to be due to +its reabsorption. In such instances it may make its appearance at +distant parts. Thus, a case has been recorded of the coughing up of milk +following sudden arrest of the secretion, and others in which it +presented itself as an exudation in the groins. + +In the treatment of a scanty formation of milk, one of the best measures +which can be resorted to is the frequent application of the child to the +breast. In addition, the flow may be increased by milking the breasts by +means of the thumb and finger, suction through a tobacco-pipe, or the +breast-pump, or by the use of another infant. Friction of the breasts, +and forcible drawing upon the nipples, will make them sore, and so +irritate them as to defeat the object in view. A change of scene, fresh +air, and outdoor exercise, attention to personal cleanliness, and the +improvement of the general health, all increase the quantity, and +produce a favourable effect upon the quality, of the milk. A sojourn at +the sea-side often promotes an abundant secretion of milk. The diet +should be regulated by the condition of the constitution. By those who +are weak and pale, a large proportion of meat is required. On the +contrary, those who are full-blooded and corpulent should restrict the +amount of their animal food, and take more exercise in the open air. +Oatmeal gruel enjoys a reputation for increasing the flow of milk. A +basin of it sometimes produces an immediate effect. The same is true of +cow's milk. Porter or ale once or twice a day, in those with reduced +systems and impaired digestion and appetite, will be found useful. +Anise, fennel, and caraway-seeds, given in soup, act sometimes as +stimulants upon the secretion of milk. The application of a poultice +made from the pulverized leaves of the castor-oil plant is a most +efficient remedy when milk fails to make its appearance in the breast in +sufficient quantity after confinement. + + +WET-NURSING BY VIRGINS, AGED WOMEN, AND MEN. + +As a rule, the secretion of milk is limited to one sex, and in that is +confined to a short period after childbirth. But there are many cases on +record of the flowing of milk in women not recently mothers, in girls +before the age of puberty, in aged women, and even in individuals of the +male sex. In such instances, the secretion is induced by the combined +influence, acting through the nervous system, of a strong desire for its +occurrence, of a fixed attention towards the mammary glands, and of +suction from the nipples. + +Travellers among savage nations report many examples of such unnatural +nursing. Dr. Livingstone says he has frequently seen in Africa a +grandchild suckled by a grandmother. Dr. Wm. A. Gillespie, of Virginia +records, in the _Boston Medical and Surgical Journal_, the case of a +widow, aged about sixty, whose daughter having died, leaving a child two +months old, took the child and tried to raise it by feeding. The child's +bowels became deranged, and being unable to procure a nurse, and her +breasts being large and full, he advised her to apply the child, in hopes +milk would come. She followed his advice perseveringly, and, to her +astonishment, a plentiful secretion of milk was the result, with which +she nourished the child, which afterwards became strong and healthy. A +similar instance, still more remarkable, is recorded of a woman at +seventy years, who twenty years wet-nursed a grandchild after her last +confinement. + +Cases of nursing in the opposite extreme of life are also well +authenticated. The distinguished French physician Baudelocque has +related that of a deaf and dumb girl, eight years old, who, by the +repeated application to her breast of a young infant, which her mother +was suckling, had sufficient milk to nourish the child for a month, +while the mother was unable to nurse it on account of sore nipples. The +little girl was shown to the Royal Academy of Surgery on the 16th of +February, 1783. The quantity of milk was such, that by simply pressing +the breast it was made to flow out in the presence of the Academy, and +on the same day, at the house of Baudelocque, before a large class of +pupils. Again, an interesting case is known of a young woman, who, in +consequence of the habit of applying the infant of her mistress to her +breast in order to quiet it, caused a free secretion of milk. In the +Cape de Verde Islands, it is stated that virgins, old women, and even +men, are frequently employed as wet-nurses. Humboldt speaks of a man, +thirty-two years old, who gave the breast to his child for five months. +Captain Franklin saw a similar case in the Arctic regions. Professor +Hall presented to his class in Baltimore a negro, fifty-five years old, +who had been the wet-nurse of all the children of his mistress. + +Instances of powers of _prolonged nursing_ in mothers are not uncommon. +Indeed it is the habit among some nations to suckle children until they +are three or four years of age, even though another pregnancy may +intervene, so that immediately one child is succeeded at the breast by +another. In those who have thus unnaturally excited the mammary glands, +an irrepressible flow sometimes continues after the demand for it has +ceased. Dr. Green published, some years ago, in the _New York Journal of +Medicine and Surgery_, the case of a woman, aged forty-seven, the +mother of five children, who had had an abundant supply of milk for +_twenty-seven years_ consecutively. A period of exactly four years and a +half occurred between each birth, and the children were permitted to +take the breast until they were running about at play. At the time when +Dr. G. wrote, she had been nine years a widow, and was obliged to have +her breasts drawn daily, the secretion of milk being so copious. When, +therefore, it is desirable, on account of the feebleness of the child, +to protract the period of nursing, a wet-nurse should relieve the mother +at the end of twelve or fifteen months. + + +RULES FOR CARE OF HEALTH WHILE NURSING. + +From what we have previously said of the influence of the nervous system +over the quantity and quality of the milk, and the instances we have +adduced of the danger to the infant of all violent passions--such as +anger, terror, anxiety, and grief--on the part of the mother, it will be +apparent that it is of the greatest moment, during the whole course of +nursing, to maintain a tranquil state of mind. Pleasing and peaceful +emotions favor the normal secretion of milk, and go far towards securing +the health of the child. When strongly affected by any powerful +feelings, mothers should not give the breast, but should wait until they +have calmed down to their usual tenor of temper. A case is related of a +woman who was always excited by a highly electrical state of the +atmosphere, and particularly during stormy weather. If when thus +influenced she nursed her child he was sure to fall into convulsions; +while, if she delayed doing so until this nervous excitement had passed, +no unpleasant symptoms occurred. But we have already dwelt at length +upon this subject in speaking of the influence of the mind of the mother +over the child at her breast, and need not therefore recur to it. The +_food_ while nursing must be nutritious and varied, though simple and +unstimulating; and should consist both of meat and vegetables, soups, +fish, flesh, and fowl, either in combination or succession. When the +digestion requires stimulation and aid, a glass of mild ale twice a day +will be useful. Wines, brandy, and whisky should not be taken without +the advice of a physician. Moderate exercise in the open air and regular +habits are necessary. A defective or excessive diet, fatigue, loss of +rest at night, and irregularities and excesses of all kinds are +unfavorable to mother and child. The proper methods of combating a +tendency to over-abundance or to scantiness of milk have been alluded +to. Medicines, unless prescribed by the medical attendant, should rarely +or never be taken during this period, as many of them enter the milk and +may thus affect the child. + + +RELATIONS OF HUSBAND AND WIFE DURING NURSING. + +After a natural and healthful confinement, the nurse usually remains +with the mother for a period of four weeks. During the whole of this +time the husband should occupy a separate apartment, and, according to +some physicians, this separation should be protracted during the entire +period of nursing. But this is unusual, and in most cases unnecessary. +Only those women who are warned by the recurrence of their monthly +illness that they are liable to another pregnancy immediately, should +insist on such an ascetic rule as this. + +Unquestionably the quality of the milk is much deteriorated by a +conception; and therefore, both in the interest of the mother and child, +the husband should renounce his usual privileges at such times. + +Most women do not have their periodical illness, and consequently are +not liable to a second pregnancy, before seven months have elapsed after +childbirth. There are, however, numerous exceptions to this rule, and it +is impossible to foretell who will and who will not be the exception. + +Moreover, as any excitement of the passions alters to some extent the +secretion of the breasts, often to the injury of the child, it is every +way advisable that great temperance be exercised in all cases in the +marital relations at these epochs. + + +SIGNS OF OVER-NURSING. + +The symptoms of over-nursing may be enumerated as follows:--Aching pain +in the back; often, pain across the shoulders, and on the top of the +head or forehead; marked paleness of the face; inability to sleep; +frightful dreams when sleep does come; great debility; extreme +depression of the spirits; disorders of the sight, and mental +disturbances, which take on the form of melancholia, the delusions +relating mostly to subjects of a religious character, to the effect that +the unpardonable sin has been committed, and the like. The headache is +situated on the top of the head, and this spot may be noticed to be +perceptibly hotter to the touch than other parts of the head. These +symptoms indicate that the process of nursing is making too great a +drain upon the system. + +A woman in ordinary health will generally be able to suckle her child +for twelve months without experiencing any bad effects. When the child +is kept at the breast much beyond this time, most mothers render +themselves liable to the injurious consequences we have mentioned. Some, +indeed, cannot furnish the child all the nourishment it needs longer +than three or four months, without detriment to themselves. In such +cases, by feeding the child two or three times a day, the mother may be +relieved of the burden of its entire support, and may thus be enabled to +continue nursing. The proper food for infants, under these +circumstances, will be shortly mentioned. The prostrating effects of +nursing upon the body and mind of the mother are in some, though +comparatively rare, instances so marked, as to render it altogether +improper from the commencement. + +The treatment of the condition of system described as resulting from +over-nursing is, if it cannot be remedied by partially feeding the +infant and the use of tonics, to remove the child from the breast +altogether, and either procure a wet-nurse for it, or wean it. The +wet-nurse is greatly to be preferred; and the preference is the +stronger, the younger the child. We have already alluded to the great +difficulty of rearing children from birth by the hand. But after the +infant has attained the age of several months, the danger of artificial +feeding is much lessened, provided that the weaning does not take place +during hot weather. This brings us to the consideration of the regimen +of the mother who cannot nurse her own child, of the rules for the +selection of a wet-nurse, of the directions for bringing up by hand, and +of the proper method of weaning. These subjects we will now take up in +the order mentioned. + + +DIRECTIONS FOR MOTHERS WHO CANNOT NURSE THEIR OWN CHILDREN. + +There are many reasons why a mother should, if possible, nurse her own +child. 'One of the principal is,' says the distinguished Dr. Tilt, 'that +as nursing, generally speaking, prevents conception up to the tenth +month, so it prevents the ruin of the mother's constitution by the too +rapid bringing forth of children, and, we might even add, prevents a +deterioration of the race, by the imperfect bringing up of this +too-fast-got family.' + +The same author appropriately adds: 'But while advocating maternal +nursing, we must not forget that woman is not now the Eve of a primeval +world; that human nature, wherever it is now met, in barbarous tribes or +in civilised communities, is frequently so deteriorated, so diseased or +prone to disease, that, by nursing, a mother may sometimes undermine her +own frail constitution for the sake of giving an imperfect sustenance, +and perhaps a poisonous heritage, to her babe.' + +Some mothers, however anxiously they may wish to do so, cannot nurse +their children. They are shut out from this charming and tender +experience in the life of a woman. The milk that comes is not +sufficient, and quickly disappears. Because of the influence of the mind +of the mother over the child at her breast, to which we have before +called attention, women who are very hysterical and nervous, subject to +violent perturbations of the mind, should not, particularly if there be +any family tendency to insanity, expose the child to the mischievous +effects latent in their milk. So, also, the presence of certain diseases +forbids wet-nursing. Thus it is ordinarily prohibited by consumption, +scrofula, skin affections of long standing, and cancer. In consumption, +all efforts to suckle are frequently equally fatal to the mother and +child. Even a strong hereditary predisposition to this disease may +render it advisable, in the opinion of the family physician,--who should +always be consulted in such a case,--to counteract the family taint by +giving the milk of the healthiest nurse that can be procured. The +condition of the nipples and of the breast may not permit of nursing. We +have pointed out how best to guard against such an occurrence, in +treating of the care of the nipples during pregnancy. + +She who is to be debarred from nursing her own child should take care +that it is not allowed to approach her breasts, as sometimes the mental +and physical excitement caused by such an approach is of an injurious +and lasting character. + +Ordinarily, if this direction be followed out, the mother will have +little trouble in regard to herself. Under such circumstances, the +chief danger is to the child. Hence the importance of knowing + + +HOW TO SELECT A WET-NURSE. + +The choosing of a wet-nurse is a matter of great moment and +responsibility. She should not be over thirty years of age, and should, +if possible, be one who has previously suckled and had charge of +children. Her own infant should be under the age of six months, for when +above that age the milk sometimes disagrees with her new-born charge. +One who has had several children should be preferred, because her milk +is richer than after the first confinement. + +The doctor should always examine carefully into the condition of the +nurse's health, and into the quality and quantity of her milk. Various +diseases and taints of the system are so hidden, while yet communicable +to the child, that the knowledge and skill of a professional expert are +required for their detection, and the protection of the nursling. In +testing the quality of the milk, the experienced physician allows a +little to rest on his finger nail, and by its examination readily +decides as to its richness and fitness to nourish the little applicant +for food. It is not necessary that the breasts should be large, as those +of moderate size often furnish a sufficient amount of milk. But it is +important that the nipples should be well developed. Those wet-nurses +should be preferred in whom large blood-vessels are seen prominently +passing in blue lines over the surface of the breasts. The possession of +a vigorous, healthful infant is a good recommendation for a nurse, but +care should be taken to ascertain that it is her _own_, as nurses have +been known to borrow for such an occasion and so obtain credit not +justly their due. + +The moral and mental as well as physical characteristics should be +considered. Temperance and cleanliness are indispensable in a wet-nurse, +and the want of either should be an imperative reason for rejection. +Equanimity of temper, cheerfulness, and an open, frank, affectionate +disposition, are of course greatly to be desired. + +If the nurse becomes 'unwell,' shall the child be taken from her? Should +the monthly sickness reappear early, and both nurse and child be in good +health, suckling may be continued. But when the return happens about the +ninth or tenth month, the child should be weaned or the nurse changed. +There is no physiological reason for preventing the nurse from living +matrimonially; but if pregnancy occurs, the child should be taken from +her. + +The same rules that we have laid down for the mother for the care of her +health while nursing, are of course applicable to the hired wet-nurse, +and should be insisted upon and enforced. + +_Changing a nurse._--When it becomes necessary to change a nurse, for +any of the reasons above mentioned, it may be done without injury to the +child. For fear of the effect of the unwelcome tidings upon the mind of +the nurse, and the possible influence upon the milk, she should not be +informed of the projected change until a successor has been secured to +take her place at once. In choosing the second nurse, the same +precautions should be had as in the selection of the first. + + + + +THE CHILD. + + +_THE CARE OF INFANCY._ + +By infancy we mean that portion of the life of the child between birth +and the completion of the teething--about two and a half years. The care +of this period of human life is entrusted to the mother. It forms an +important era in the physical life of woman. Its discussion is therefore +germane to our subject. In order that the young mother may fully +appreciate the responsibilities of her position, she should know +something of the liability of infants to sickness and death. + +Out of one thousand children born, one hundred and fifty die within the +first year, and one hundred and thirteen during the next four years. +Thus two hundred and sixty-three, or _more than one-fourth, die within +five years after birth_. Between the ages of five and ten, thirty-five +die. During the next five years eighteen more are recorded on the +death-list. Hence, at fifteen years of age only six hundred and +eighty-five remain out of the one thousand born. When these figures are +considered, and the additional fact that out of those who survive very +many bear permanent marks of imperfect nourishment or of actual disease, +the consequence of maladies contracted in early life, the importance of +our present inquiry--the care of infancy--will be apparent to all +mothers. + +The younger the infant, the greater the danger of death. _One-tenth of +all children born die within the first month after birth_, and four +times as many as during the second month. + +The mortality is much larger in cities than in the country. In Dublin, +during 1867, very nearly one-third of all the persons who died were +under five years of age. In the same year forty-three per cent. of those +who died in the eight principal towns of Scotland were children below +the age of five. In Philadelphia, during the same year, forty-five per +cent. of all the deaths were of children under five years of age. In New +York fifty-three per cent. of the total number of deaths occur under the +age of five years, and twenty-six per cent. under the age of one year. + +The danger of death lessens as the period of puberty approaches. Yet, +even in the last years of childhood there is a greater liability to +disease and a larger proportionate loss of life than during youth or +middle age. + + +CAUSES OF INFANT MORTALITY. + +What are the causes of this startling mortality of infant life? Why does +one child out of ten die in the first month, and only three out of four +live to be five years old? And what are the means of prevention? + +Some of the causes which are active in producing this mortality among +the little ones cannot be successfully opposed after birth. Such, for +instance, are imperfect and vicious developments of internal organs +existing when born. These malformations often result from inflammation +while in the womb, excited by some taint of the mother's blood, or by +some agitation of her nervous system. Means of prevention in those cases +are therefore to be directed to the mother, in the manner indicated in +treating of pregnancy. But other causes of death begin to act only after +birth, and are to a greater or less extent avoidable. These are largely +traceable to ignorance, negligence, and vice. + +One cause of death to which infants are peculiarly liable, and which +alone is said to have destroyed forty thousand children in England +between the years 1686 and 1799, is being _overlain_ by the parents. For +this reason, some physicians caution the mother against having the +infant in bed with her while she sleeps. + +The frightful waste of life caused by bringing children up by hand has +been mentioned, and the importance of avoiding it when possible. + +The natural feebleness of the system of infants is the reason why they +succumb so easily to any malady. Deaths from any given disease are more +numerous among infants than children, and among children than adults. +Hence the importance of timely corrective measures in infantile +affections; hence, also, the need that mothers should know and practise +the means best adapted to preserve the health of their frail charges. + +These means we shall proceed to give in detail, commencing with +directions for + + +BRINGING UP BY HAND. + +We have already alluded to the great danger to the child, particularly +in a city, that is artificially fed from birth. But as there are many +mothers who are unable, on account of the expense, to have a wet-nurse +for the child they cannot suckle themselves, we will give such +directions in regard to the diet as are best calculated to lessen the +risk invariably incurred under such circumstances. + +The child's food should be of the best quality, and prepared with the +most scrupulous attention to cleanliness. The milk of the cow is +preferable to that of the ass or of the goat, the former of which it is +difficult to procure, and the latter having a disagreeable odour. For a +child under three months of age, cow's milk should be used as the only +food. It should be fresh, and if possible from one cow. When of the +ordinary richness, it is to be diluted with an equal quantity of water +or thin barley-water. If, however, the first milking can be obtained, +which is more watery, and bears a closer resemblance in its chemical +composition to human milk, but little dilution will be required. If +green and acrid stools make their appearance, accompanied by emaciation +and vomiting, the milk must be more diluted, and given less frequently. +If the symptoms of indigestion do not yield, milk containing an excess +of cream should be used. To procure it, allow fresh milk to stand for +two or three hours, and remove the upper third, to which add two or +three parts of warm water or barley-water, after having dissolved in it +a little sugar of milk. Should this food also disagree, any of the +preparations we are about to mention may be prepared and tried. + +Professor Falkland recommends the following method of preparing milk for +infants, as affording a product more nearly like the natural +secretion:--'One third of a pint of pure milk is allowed to stand until +the cream has risen. The latter is removed, and to the blue milk thus +obtained about a square inch of rennet is to be added, and the +milk-vessel placed in warm water. In about five minutes the curd will +have separated, and the rennet, which may again be repeatedly used, +being removed, the whey is carefully poured off, and immediately heated +to boiling, to prevent it becoming sour. A further quantity of curd +separates, and must be removed by straining through calico. In +one-quarter of a pint of this hot whey three-eighths of an ounce of milk +sugar are to be dissolved; and this solution, along with the cream +removed from the one-third of a pint of milk, must be added to half a +pint of new milk. This will constitute the food for an infant from five +to eight months old for twelve hours; or, more correctly speaking, it +will be one-half of the quantity required for twenty-four hours. It is +absolutely necessary that a fresh quantity should be prepared every +twelve hours; and it is scarcely necessary to add, that the strictest +cleanliness in all the vessels used is indispensable.' + +Dr. J. Forsyth Meigs directs the following article of diet as one which +he has found to agree better with the digestive system of the infant +than any other kind of food:--'A scruple of gelatine (or a piece two +inches square of the flat cake in which it is sold) is soaked for a +short time in cold water, and then boiled in half a pint of water, until +it dissolves--about ten or fifteen minutes. To this is added, with +constant stirring, and just at the termination of the boiling, the milk +and arrowroot, the latter being previously mixed into a paste with a +little cold water. After the addition of the milk and arrowroot, and +just before the removal from the fire, the cream is poured in, and a +moderate quantity of loaf sugar added. The proportions of milk, cream, +and arrowroot must depend on the age and digestive powers of the child. +For a healthy infant, within the month, I usually direct from three to +four ounces of milk, half an ounce to an ounce of cream, and a +tea-spoonful of arrowroot to half a pint of water. For older children, +the quantity of milk and cream should be gradually increased to a half +or two-thirds milk, and from one to two ounces of cream. I seldom +increase the quantity of gelatine or arrowroot.' + +The egg is a valuable article of food for infants and young children, +especially in conditions of debility. It should be given nearly raw, and +is best prepared by placing it in boiling water for two minutes. It is +then easily digested. + +Beef-tea, prepared in the manner described on page 234, is highly +nutritious and useful as a food for infants: if it produce a laxative +effect, it should be discontinued. When the child shows signs of +weakness or of a scrofulous condition its nutrition will be improved by +mingling with its food a small piece of butter or mutton suet. + +During the first four or five months the food should be thin, and taken +through a teat, thus preventing the stuffing of the infant. + +On attaining the age of twelve or fifteen months, infants are usually +able to digest ordinary wholesome solid food, neatly and well cooked, +when mashed or cut into fine pieces. + +An article of food employed for the diarrhoea of infants is prepared as +follows:--'A pound of dry wheat flour of the best quality is packed +snugly in a bag and boiled three or four hours. When it is taken from +the bag it is hard, resembling a piece of chalk, with the exception of +the exterior, which is wet, and should be removed. The flour grated from +the mass should be used the same as arrowroot or rice.' + +Infants nourished by prepared food thrive well enough during cool +weather, but during the warm months of the year they are exceedingly +liable to bowel complaint, of which large numbers of the spoon-fed +infants of cities die each summer season. Hence the importance of taking +them into the country; and keeping them there until the return of cool +weather lessens the danger of city life. + + +WEANING. + +This should take place when the child is about twelve months of +age--sometimes a few months earlier, often a few later. If the mother's +health be good, and her milk abundant, it may be deferred until the +canine teeth appear--between the fifteenth and twentieth month. The +child will then have sixteen teeth with which it can properly masticate +soft solid food. + +_Time of the year for._--The infant should not be taken from the breast +during or immediately preceding warm weather. If the mother, either on +account of sickness or failure in her breast-milk, is obliged during the +summer to give up nursing, she should at once procure a wet-nurse. If +she cannot, the child must be sent into the country. To wean an infant +in the city in hot weather, is to expose it to almost certain death. + +_Proper method._--The process of weaning should be a very slow one. No +definite day should be fixed for it. Little by little, from week to +week, the amount of spoon-food is to be increased and the nursing +lessened--being first given up at night. The breast should never be +suddenly denied to a child unaccustomed to artificial food, but be +displaced by degrees, by the bottle and the spoon. This gradual change +will neither fret the child nor annoy the mother, as sudden weaning +always does. + +The infant may begin to be accustomed to artificial food at the age of +four months. At first, only diluted cow's milk should be given it +occasionally between the times of nursing. In a tumbler one-third full +of water dissolve a tea-spoonful of sugar of milk; add to the sweetened +water an equal quantity of fresh cow's milk; then, if the child's stools +are at all green, mix with this two tea-spoonfuls of lime water. Instead +of pure water, barley-water made in the usual way, and boiled to the +consistency of milk, may be employed in this preparation--being added, +while still warm, to an equal amount of milk. Or, toast-water may be +substituted as a diluter of the milk. Cow's milk should not be boiled, +if it can be preserved in any other way. As the infant advances in +months, some solid food may be allowed. After six months, pap, made with +stale bread and tops and bottoms, is proper once or twice a day. +Beef-tea, made according to the recipe we have given, and chicken, lamb, +or mutton broth, may now also be occasionally taken. As the quantity of +milk diminishes towards the close of the first year, the spoon-food +should be resorted to more frequently to supply the want. Solid food +ought not to be given before the child is a year old. + +The breasts usually cause little trouble when the weaning is performed +in the gradual manner which has been recommended. The mother should +during this time drink as little as possible, refrain from stimulating +food, and take occasionally a little cream of tartar, citrate of +magnesia, or a seidlitz powder. If the breasts continue to fill with +milk, _they should not be drawn_. The 'drying up of the milk' may be +facilitated by gently rubbing the breasts several times a day with +camphorated oil, made by dissolving over the fire, in a saucer of sweet +oil, as much camphor as it will take up. Tea made from the marshmallow +has also been recommended for this purpose. + + +TEETHING. + +The period at which the teeth first make their appearance is not a fixed +one. It varies considerably even within the limits of perfect health. +It may be said, as a rule, that the babe begins to cut its teeth at the +age of six or seven months. Quite frequently, however, the first teeth +appear as early as the fourth month, or are delayed until the eighth. In +some instances children come into the world with their teeth already +cut. This is said to have been the case with Louis XIV. and with +Mirabeau. King Richard the Third is another example. Shakspeare makes +the Duke of York refer to this circumstance in these words: + + 'Marry, they say my uncle grew so fast, + That he could gnaw a crust at two hours old: + 'Twas two full years ere I could get a tooth.' + +It does not follow that children whose teeth show themselves early, will +have, therefore, a quicker general development. Such cases are merely +instances of irregularity in the time of dentition, and carry with them +no particular significance. Irregularities in regard to the order in +which the teeth are cut are also of frequent occurrence. + +While, therefore, it cannot be maintained that all healthy children cut +their teeth in a certain regular order and time, yet it is certain that +those children who follow the general rule which prevails in this +respect, suffer least from the difficulties and effects of dentition. As +all mothers desire to know at what time they may expect the teeth, we +will state the rule of their development in the great majority of cases. + +The lower teeth generally precede those of the upper jaw by two to three +months. + +The twenty milk-teeth usually appear in the five following groups:-- + +_First_, Between the fourth and eighth months of life the two lower +front middle teeth appear almost simultaneously; then a pause of from +three to nine weeks ensues. + +_Second_, Between the eighth and tenth months of life the five upper +front teeth appear, following shortly upon each other, the two central +preceding the two on each side of them. Another pause of from six to +twelve weeks succeeds. + +_Third_, Between the twelfth and sixteenth months of life six teeth +appear nearly at once. They are first the two front grinding teeth in +the upper jaw, leaving a space between them and the front teeth which +before appeared; next the two lower front teeth, situated one on each +side of the central ones, which were the first to appear; and, lastly, +the two front grinders of the lower jaw. A pause until the eighteenth +month now ensues. + +_Fourth_, Between the eighteenth and twenty-fourth months of life the +canine teeth cut through (the upper ones are called eye-teeth). Again a +pause until the thirtieth month. + +_Fifth_, Between the thirtieth and thirty-sixth months the second four +grinders finally make their appearance. + +This concludes the first teething. The child has now twenty milk-teeth. + +We have mentioned that children are sometimes born with teeth. It is +also true that sometimes they never acquire any. Instances are on record +of adults who have never cut any teeth. Dentition has been known to +take place very late in life. A case is related, on excellent authority, +of an old lady aged eighty-five, who cut several teeth after attaining +that age. + + +APPEARANCE OF THE PERMANENT TEETH. + +Between the fifth and sixth years of life the second dentition begins. +The front grinders are the ones first cut through. Between the sixth and +tenth years all the front teeth appear, followed by the canines before +the twelfth year. At this time the second grinders show themselves; and +finally, between the sixteenth and twenty-fourth year, the wisdom-teeth +complete the dental furniture of the mouth. + + +VACCINATION. + +This operation, to which every infant should be subjected, is one of +great practical importance. The attempt has been made of late to shake +the public faith in its efficacy, and to revive the old fabulous stories +and foolish notions as to the production of serious affections of the +blood and skin in this manner. At the same time, the increasing +frequency and virulence of small-pox are becoming only too evident. We +therefore consider it our duty, in treating of the maternal management +of infancy, to lay some stress upon the necessity for vaccination as a +preservative of life and health. If observation and experience ever +taught anything, they have taught the protective power of this operation +against the most loathsome and one of the most fatal diseases that ever +afflicted the human race. And that mother who is careless and +indifferent in this matter neglects for her children a means of +preventing disfigurement and saving life, compared with which all other +means are scarcely worthy of mention. + +In order to appreciate the value of vaccination, it is only necessary to +consider what small-pox was before its discovery,--to look at that +disease through the eyes of our fathers and grandfathers. Until the +close of the last century it was the most terrible of all the ministers +of death. It filled the churchyards with corpses. When Jenner published +his great discovery, about seventy years ago, the annual death-rate from +small-pox in England was estimated at three thousand in the million of +population. In other countries of Europe the rate reached as high as +four thousand in the million. And these fatal cases must be multiplied +by five or six, to give the entire number of persons annually attacked +by the disease. It spared neither high nor low. Macaulay informs us that +Queen Mary, the wife of William III., fell a victim to it. Those in whom +the disease did not prove fatal, carried about with them the hideous +traces of its malignity; for it 'turned the babe into a changeling at +which the mother shuddered,' and made 'the eyes and cheeks of the +betrothed maiden objects of horror to the lover.' Few escaped being +attacked by this fell disease. Nearly one-tenth of all the persons who +died in London during the last century died of this one cause. Children +were peculiarly its victims. In some of the great cities of England more +than one-third of all the deaths among children under ten years of age +arose from small-pox. Two-thirds of all the applicants for relief at +the Hospital for the Indigent Blind had lost their sight by small-pox. +The number of hopeless deafened ears, crippled joints, and broken-down +constitutions from the same cause cannot be accurately computed, but was +certainly very large. Vaccination is all that now stands between us and +all these horrors of the last century. + +Is the strength of this barrier doubted?--Its efficacy is readily +proved. In England, during the twelve years (1854-1865) in which +vaccination has been to a certain extent compulsory, the average annual +rate of deaths by small-pox has been two hundred and two in the million +of population. Contrast this with the annual death-rate of three +thousand to the million, which was the average of thirty years previous +to the introduction of vaccination. Mr. John Simon, medical officer of +Her Majesty's Privy Council, one of the best statisticians in England, +has collected a formidable array of figures, 'to doubt which would be to +fly in the face of the multiplication-table.' From his mountain-height +of statistics Mr. Simon says: 'Wheresoever vaccination falls into +neglect, small-pox tends to become again the same frightful pestilence +it was in the days before Jenner's discovery; and wherever it is +universally and properly performed, small-pox tends to be of as little +effect as any extinct epidemic of the Middle Ages.' + +Are other diseases ever produced by vaccination?--The popular belief +would answer this question in the affirmative. All affections of the +skin and swelling's of the glands noticed in children soon after +vaccination, are attributed by parents in many cases to this operation. +They forget that such diseases are met with constantly in infancy and +childhood, as often among the unvaccinated as the vaccinated. +Observation does not show that they occur with greater frequency among +the vaccinated. An English physician has been at the trouble to examine +and record a thousand cases of skin disease in children: he found no +evidence whatever that vaccination disposes the constitution to such +affections. It has been stated with apparent justness, that parental +complaints of this kind frequently arise from their unwillingness to +believe there is anything wrong in their offspring. Hence, when other +diseases follow, vaccination gets blamed for what is really and truly +due to other causes. So far from doing any harm to the system, it has +been observed in those countries where vaccination has been most +thoroughly practised, that, leaving small-pox out of the question, there +have been fewer deaths from other maladies. This is especially true of +two of the most important classes of diseases, namely, scrofulous +affections and low fever. For this reason, some medical statisticians +have attributed to vaccination an indirect protective influence against +these disorders. + +At what _age_ should the child be vaccinated?--If the health permit, the +operation should always be performed in very early infancy. The chief +sufferers from small-pox are young children. One-fourth of all who die +from this fatal disease in England are children under the age of one +year. In Scotland, where until recently vaccination has been much more +neglected than in England, the proportion even amounted to nearly +one-third; and of these, one-fourth were under the age of three months. +The great risk, particularly in large towns, where small-pox is seldom +absent, of delaying vaccination is obvious. City children, if hearty, +should be vaccinated when a month or six weeks old. Rarely or never +ought it to be delayed beyond two or three months. This early period of +life is also particularly suitable to vaccination, because the +accompanying fever will then be over before the disturbing influence of +teething begins. + + +RE-VACCINATION. + +If the first vaccination be found imperfect in character, that is, if it +has not properly 'taken,' the operation should be repeated at the +earliest opportunity. It has been recommended, in all cases, to perform +a second vaccination not later than the sixth or eighth year. If +small-pox be prevailing, it is proper to vaccinate all who have not been +vaccinated within three or four years. In any event, re-vaccination at +or after the period of puberty is of extreme importance. It will give +additional security even to those whose original vaccination was +perfect. In some cases, the susceptibility to small-pox is not wholly +exhausted by one vaccination. Inasmuch as it is desirable for every one +to escape this disease, even in its most modified form, re-vaccination +should always be performed, as it affords a very sure and trustworthy +means of such escape. After successful re-vaccination, small-pox, even +in its mildest shape, is rarely met with. In girls especially, in whom +the changes which occur at puberty are most marked, re-vaccination +should be performed about the age of fourteen. + + +GROWTH AND DEVELOPMENT. + +During infancy the body grows with great rapidity. About the end of the +third year one-half of the adult height of the body is attained. After +this period growth is more gradual; for in order to reach the remaining +half, about eighteen years more are required. At twenty years of age the +height is somewhat more than three and a half times that at birth, and +the weight about twenty times. Development does not go on at an equal +rate in all parts of the body. The lower limbs, small at birth, increase +proportionally more rapidly, while the head, relatively large at birth, +developes more slowly. The muscular system is gradually strengthened. At +the end of the third month the infant is able, if in good health, +readily to support its head; at the fourth month it can be held upright; +at the ninth month it crawls about the floor; by the end of the year it +is able with assistance to step; and between one and two years, at +different times, according to its vigor and activity, it acquires the +power of standing and walking alone. The periods of greatest and least +growth of the child are, on the one hand, spring and summer; on the +other, autumn and winter. It has long been known that animals grow more +rapidly in the spring than at any other season of the year. This has +been attributed to the abundance of herbage they are then able to +obtain. It has been ascertained by actual measurement, that children +grow chiefly in the spring. + +At six months of age the child begins to lisp, and at twelve months it +is usually able to utter distinct and intelligible sounds of one or two +syllables. The development of the senses and of the mind proceeds +gradually. The sense of hearing is more active and further advanced than +that of sight. Sounds are appreciated sooner than light or bright +colored objects. The next sense which is developed is perhaps that of +taste; then follow smell and touch. + + +THE FOOD OF INFANTS AND CHILDREN. + +The diet of children is frequently improper either in regard to +quantity, quality, or variety. In 1867, a committee, of which Professor +Austin Flint, Jr., was chairman, was appointed in New York city to +revise the 'Dietary Table of the Children's Nurseries on Randall's +Island.' In the report rendered, attention was forcibly called to the +fact that in childhood 'the demands of the system for nourishment are in +excess of the waste, the extra quantity being required for growth and +development. If the proper quantity and variety of food be not provided, +full development cannot take place, and the children grow up, if they +survive, into young men and women, incapable of the ordinary amount of +labor, and liable to diseases of various kinds. This is frequently +illustrated in the higher walks of life, particularly in females; for +many suffer through life from improper diet in boarding schools, due to +false and artificial notions of delicacy or refinement. After a certain +period of improper and deficient diet in children, the appetite becomes +permanently impaired, and the system is rendered incapable of +appropriating the amount of matter necessary to proper development and +growth.' + +Charlotte Bronte has drawn, in _Jane Eyre_, a graphic and +physiologically true picture of the effects upon young girls of +long-continued insufficiency of food. Let mothers bear in mind that +proper food cannot be too abundantly eaten by children, and that the +greatest danger to which they are exposed arises from defective +nutrition. We would again urge the value of a large amount of _milk_ in +the dietary of young people. The disorders of the bowels, which are not +uncommon in infancy and childhood, are due to errors in diet by which +improper food is supplied, and not to an excess of simple and proper +nourishment. + +We have already given some directions for the preparation of infants' +food in treating of 'bringing-up by hand.' In addition to the various +substitutes for the mother's milk there mentioned, we wish to note that +known as _Liebig's soup_. This great chemist thus describes the method +of making it: + +'Half an ounce of wheat flour, half an ounce of malt meal, and seven and +a half grains of bicarbonate of potass, are weighed off. They are first +mixed by themselves, then with the addition of one ounce of water, and +lastly, of five ounces of milk. This mixture is then heated upon a slow +fire, being constantly stirred until it begins to get thick. At this +period the vessel is removed from the fire, and the mixture is stirred +for five minutes, is again heated and again removed when it gets thick, +and, lastly, it is heated till it boils. This soup is purified from bran +by passing it through a fine sieve (a piece of fine muslin), and now it +is ready for use.' + +Barley-malt can be obtained at any brewery. First, it is separated from +the impurities, and then ground in an ordinary coffee-mill to a coarse +meal. Care should be taken to get the common fresh wheat-flour, _not the +finest_, because the former is richest in starch. + +In practice, the troublesome weighing of the materials may be dispensed +with, as a heaped table-spoonful of wheat-flour weighs pretty nearly +half an ounce, and a like table-spoonful of malt-meal, not quite as +heaped, weighs also half an ounce. The bicarbonate of potass can be +obtained from the druggist put up in powders of seven and a half grains, +each ready for use. The amount of water and of milk prescribed can be +attained with sufficient accuracy by means of the table-spoon; two +table-spoonfuls will give the quantity of water (one ounce), and ten +table-spoonfuls the quantity of milk (five ounces). These directions +will enable any sensible mother to make the preparation without +difficulty. The soup tastes tolerably sweet, and, when diluted with +water, may be given to very young infants. + +Although the method of preparing Liebig's soup is a somewhat tedious +one, yet, as it is a combination which has long been so highly +recommended by physicians of the largest experience for having visibly +saved the lives of many wasting children, it deserves a trial in all +cases in which the ordinary kinds of food disagree. + +On page 276 are recorded the directions given by Dr. J. Forsyth Meigs +for an article of diet, consisting of gelatine and arrowroot, which he +prefers to all other kinds of artificial infant food. Another method of +preparing a useful arrowroot mixture is as follows:-- + +Place a tea-spoonful of arrowroot in a porcelain vessel, with as much +cold water as will make it into a fine dough; then add a cupful of +boiling milk or of beef-tea; stir the mixture a little, and allow it to +boil for a few minutes until the whole acquires the consistency of a +fine light jelly. + +The _manner_ in which nutriment is administered to infants is not +immaterial. The custom of feeding them from a small spoon, or from a cup +with a snout, is objectionable. The use of a sucking-bottle most nearly +imitates the way in which nature designed the nursling to obtain its +nourishment. By the act of sucking, the muscles of the face are +exercised in an equal manner, and the saliva is mixed with the food to +an extent which is not possible if any other mode of feeding be resorted +to. Children drink very readily out of the perforated rubber nipples, +which are now so popular for this purpose: they are made to fit over the +mouth of the bottle, and are especially to be recommended on account of +their cleanliness. The bottle should never be refilled until both it and +the rubber cap have been thoroughly cleansed in warm water. A white +glass bottle only should be employed in order that any want of +cleanliness may readily be detected. It should be recollected that milk +very quickly sours when kept in this way in a warm room; it is therefore +better always to empty the bottle and fill it afresh each time it is +given to the child, rather than to wait until its contents are exhausted +before replenishing it. + +We have hitherto been treating mainly of the diet proper for the first +year of life. In the second year children may be permitted to have soft, +finely-cut meat. Fresh ripe fruit in season ordinarily agrees +excellently well. But boiled green vegetables and husk fruits are very +apt to cause indigestion and diarrhoea. Fruit for children should be +freed from the stones and skins; which latter are indigestible, and +often do harm. + +As an example of a diet suitable for a child two years of age we append +the following:--In the mornings, between six and seven o'clock in +summer, or between seven and eight in winter, milk-gruel; between nine +and ten o'clock, a piece of wheat bread with a little butter on it; at +twelve o'clock, well-prepared beef-tea, or chicken, lamb, mutton broth, +or meat with a little gravy; or in place of the meat, a meal-broth +prepared with eggs, but with very little fat; green vegetables to be +allowed very rarely, and in very small quantities. At this noon meal a +mealy well-mashed potato is unobjectionable; so also is rice pudding for +a change. In the afternoon, between three and four, bread and milk, with +the addition in summer of fresh ripe fruit; in the evening, at seven, +bread and milk. + +It will be observed that this dietetic table calls for five meals a day. +Should the child eat so frequently? We answer yes. But the meals should +be at regular intervals. A child, in order to replace the waste of the +system, and to furnish over and above sufficient material to build up +the growing body, requires a much larger proportionate amount of food +than an adult. It also requires its food at shorter intervals. By +observing the hours for meals stated above, _regularity_, which is of so +much importance to the health of the digestive organs, will be secured. +If a young child be allowed only the three ordinary meals of the family, +it will crave for something between times, and too often have its +craving met with a piece of cake or other improper food. Its appetite +for dinner or supper will in this manner be destroyed, and the stomach +and the general health suffer. + +After the third or fourth year children are able to eat all kinds of +vegetables. They may then very appropriately be allowed to eat at the +table with the family. It is only necessary to refuse them very salt, +sour, and highly-spiced victuals. Of all others they may partake in +moderation. Neither wine nor any malt liquor should be given them. Tea +and coffee are also, to say the least, unnecessary. They should have a +regular luncheon between the meals which are furthest apart. This must +be at a regular hour, and consist of bread and butter, with milk or +water. + +Pains should be taken to see that children do not fall into the habit +of eating rapidly. Too often this pernicious habit, so destructive to +healthy digestion, is formed in early life, and becomes the source of +that dyspepsia which is the bane of so many lives. Food that is gulped +down enters the stomach unmasticated, and unmixed with the secretions of +the mouth. A dog may bolt his food without injury, but a human being +cannot. + +A child should be taught to eat everything that is wholesome, and not be +permitted to become finical or fastidious in its appetite. It ought not, +however, to be forced to eat any particular article for which it is +found that there is an invincible dislike. Variety of diet is good for a +child, after the second or third year. + + +THE POSITION OF THE CHILD WHEN FED. + +An infant, no matter how young, should not receive its meals when lying. +Its head should always be raised in the nurse's arm, if it be too young +to support it itself. The practice of _jolting_ and _dandling_ the +infant after eating is a wrong one. Rest of the body should be secured +by placing the child on a bed, or holding it on the mother's knee, for a +half hour or so. Observe the inclination which all animals show for +repose and sleep after a full repast, and respect the same inclination +in the infant. + +In our remarks upon bathing we pointed out the importance of the mother +herself performing for her child this office. So again, in connection +with children's food, we must notice the necessity of the mother being +always present at their meals, in order that they may be taught to take +them quietly, with cleanliness and without hurry. Such advice is not +needed by the poor nor by women of moderate fortune, who ordinarily have +their children constantly under their eyes. But affluence brings with it +many occupations which are frequently deemed of more moment than +presiding over a child's dinner. + + +CONCERNING SLEEP IN EARLY LIFE. + +There is a natural desire for much sleep during infancy, childhood, and +youth; and there is reason for its free indulgence. Infants pass the +greater portion of both day and night in sleep. Children up to the age +of six years require, as a rule, twelve hours of repose at night, +besides an hour or more in the middle of the day. About the sixth year +the noon nap may be discontinued, but the night sleep ought not to be +abridged before the tenth year, and then only to a moderate extent until +the age of puberty. From this time the period of slumber may be +gradually reduced to nine or ten hours. No further diminution should be +attempted until the completion of growth, when another hour or two may +be taken away, leaving about eight hours of daily sleep as the proper +amount during middle life. + +It is wrong, therefore, to wake a young child in the morning. It should +be allowed to sleep as long as it will, which will be until the wants of +the system are satisfied, if it be not aroused by noise or light. + +When after a few months the infant is awake a considerable portion of +the day, it should be brought into the habit of taking its second sleep +near the middle of the day, say from eleven to one o'clock, and again, +from half an hour to an hour, about three o'clock. It should not be +permitted a nap later than this in the afternoon, as it would be very +apt to cause a disturbed night. Although some physicians recommend that +the sleep during the day be discontinued after the infant has attained +the age of fifteen months, the wisdom of such advice may well be +doubted. As soon as the child begins to walk, not only are its movements +very constant and active, but its mind is busily employed and its +nervous system excited. It therefore thrives better if its day be +divided into two by sleep for an hour or two. + +_Should the infant sleep alone?_--We have mentioned the danger of being +overlain to which it is exposed when in bed with its mother or nurse. On +the other hand, it must be remembered that an infant keeps warm with +difficulty even when well covered, and that contact with the mother's +body is the best way of securing its own warmth. Hence, during the first +months the child had better be allowed to sleep with its mother. How, +then, can the risk of being suffocated, which is no imaginary one, be +lessened? The following rules are those given by a physician of +reputation, to prevent an infant from being accidentally overlain. + +'Let the baby while asleep have plenty of room in the bed. Do not allow +him to be too near, or, if this be unavoidable from the small size of +the bed, let his face be turned to the opposite side. Let him lie +fairly, either on his side or on his back. Be careful to ascertain that +his mouth be not covered with the bed-clothes. Do not smother his face +with clothes, as a plentiful supply of pure air is as necessary as when +he is awake. Never let him lie low in the bed. Let there be no pillow +near the one his head is resting on, lest he roll to it and bury his +head in it. Remember a young child has neither the strength nor the +sense to get out of danger; and if he unfortunately either turn on his +face or bury his head in a pillow that is near, the chances are that he +will be suffocated, more especially as these accidents usually occur at +night, when the mother or the nurse is fast asleep. Never entrust him at +night to a young, giddy, and thoughtless servant. A foolish mother +sometimes goes to sleep while allowing her child to continue sucking. +The unconscious babe, after a time, loses the nipple, and buries his +head in the bed-clothes. She awakes in the morning, finding, to her +horror, a corpse by her side! A mother ought therefore never to go to +sleep until her child has ceased sucking.' + +When a couple of months have elapsed, the child, if a healthy one, may +sleep alone. What the child sleeps in is not a matter of great moment, +provided it has a sufficiency of clothing, and be not exposed to +currents of air. A large clothes-basket will serve all the purposes of a +crib. The mistake is often made of burying the child under too heavy a +mass of bed-clothes in a warm room when asleep. And this inconsistency +is committed by the very mothers who scantily clad the child during the +day in order to inure it to the cold. The great transition from its +wrappings by night to those by day is injurious to the health and +comfort of the infant. + +'In arranging night coverings, the soft feather-bed is very often +estimated as nothing; or, in other words, the same provision of blankets +is considered indispensable, whether we lie upon a hard mattress or +immersed in down. The mother, looking only to the covering laid over the +child, forgets those on which it lies, although in reality the latter +may be the warmer of the two. An infant deposited in a downy bed has at +least two-thirds of its body in contact with the feathers, and may thus +be perspiring at every pore, when, from its having only a single +covering thrown over it, the mother may imagine it to be enjoying the +restorative influence of agreeable slumber. In hot weather much mischief +might be done by an oversight of this kind.' + +It is of course essential to the health and comfort of the infant that +its bed and bed-clothing be kept perfectly dry and sweet. They should +frequently be taken out and exposed to the air. + +A child should be accustomed early to sleep in a darkened room. Plutarch +praises the women of Sparta for, among other things, teaching their +children not to be afraid in the dark. He says they 'were so careful and +expert, that without swaddling-bands their children were all straight +and well proportioned; and they brought them up not to be afraid in the +dark or of being alone, and never indulged them in crying, fretfulness, +and ill-humour; upon which account Spartan nurses were often bought by +people of other countries.' + +_Position in sleeping._--It has long been a popular opinion that the +position of our bodies at night, with reference to the cardinal points +of the compass, has some influence on the health. This belief has +recently been corroborated by some observations made by a prominent +physician, Dr. Henry Kennedy. In an essay on the 'Acute Affections of +Children,' published in the Dublin _Quarterly Journal of Medical +Science_, he states that for several years he has put in force in his +practice a plan of treatment by means of the position of the patient, +and often with very marked results. He asserts that, in order to ensure +the soundest sleep, the head should lie to the north. Strange as this +idea may at first sight appear, it has more in it than might be +supposed. There are known to be great electrical currents always +coursing in one direction around the globe. In the opinion of Dr. +Kennedy there is no doubt that our nervous systems are in some +mysterious way connected with this universal agent, as it may be called, +electricity. He relates several cases of acute diseases in children, in +which, by altering the position of the body so that the patient should +lie from north to south instead of from east to west, quiet sleep was +induced. This plan of invoking sleep is often successful; but not always +so, for all are not equally susceptible. It applies likewise to adults. +It is not so striking in its effects on the poorer as on the richer +classes of society. This is what might be expected, for it cannot be +doubted that the nervous system in the middle and upper ranks is always +in a much more sensitive state than with their poorer brethren. It is +worth noting, that even in healthy persons sleep will often be absent or +of a broken kind, from the cause of which we are now speaking. It is +very common to hear people saying they can never sleep in a strange bed. +Although many causes may conspire to this, Dr. Kennedy cannot doubt that +amongst these ought to be placed the one to which we are now drawing +attention. + + +THE CLOTHING OF INFANTS AND YOUNG CHILDREN. + +A fertile cause of disease and death is to be found in the negligence or +ignorance displayed in regard to the dress of children. And it is not +the poorly attired, but nearly always the fashionably robed child, which +suffers the most. To parental vanity can be traced many a catarrh on the +chest or the inflammation of the bowels which has resulted in death. +Most mothers appear to be ignorant of the fact that children are +exceedingly susceptible to the influence of cold. The returns of the +Registrar-General of England show that a very cold week always greatly +increases the mortality of the very young. While adults carefully +protect themselves against every change of the weather, and against +currents of air, children, who most need such protection, are too often +neglected. + +The warmth of the infant's body is best secured by that of the nurse, +and by warm clothing. It is more effectually and healthfully provided +for in this manner than by confining the child to a warm atmosphere. +Young children should never be dressed _decollete_--in low necks and +short sleeves. That fashion is a dangerous one which leaves the neck, +shoulders, and arms uncovered. To this irrational custom may be traced a +vast amount of the suffering and many of the deaths of early life; +doubtless, also, in many cases it lays the foundation of consumption, +which manifests itself a little later. But, it is said, the child will +be 'hardened' by having its chest and limbs thus exposed. The surest and +safest way to harden the child is to so care for it that it shall pass +through its first months and years of life without any ailment. Every +mother should see to it, that her charge is so clothed that every part +of the body is effectually protected from dampness and cold. She can +then best secure for it a hardened constitution by carrying it daily +into the sunlight of the open air. + +_The material_ of the clothing should be such as will unite lightness +with warmth. Flannel and calico are therefore to be preferred. At first, +as the skin of the child is very delicate, a shirt of fine linen may be +interposed between it and the flannel. But, after the first few months, +the gentle friction of fine soft flannel next the skin is desirable, as +it stimulates the circulation of the blood on the surface of the body, +and promotes health. Flannel under-clothing should be continued all the +year, during the summer months a very light texture being used. When the +dress of the child is shortened, care must be taken that the feet are +well covered with soft stockings of cotton or woollen (which in winter +should extend up above the knees), and with light leather shoes. + +The _night-dress_, at least during cold weather, is best made of +flannel, thin or thick according to the climate. It has been recommended +that, after the child is somewhat advanced, the night-clothes be +constructed in the form of night-pants, so that it may not be exposed if +the bed-clothing be thrown off. Every article of dress worn during the +day ought to be removed at night. + +The rule in regard to the _quantity of clothing_ is, that it should be +in sufficient amount to preserve due warmth. It must therefore be +regulated by the season of the year and the state of the weather. We +have mentioned the fatal practice of leaving bare at all seasons of the +year the upper part of the chest and arms of the little one, while the +rest of the body is warmly clad. We can scarcely speak too emphatically +nor too often of the danger to which the mother thus exposes that life, +which it is her duty to wisely and safely conduct through the period of +dependent infancy and childhood. It is of course possible for the child +to be too closely enveloped, and the skin thus rendered highly +susceptible to the impressions of cold. The prevalent error, however, at +the present time, is in the direction of too scanty clothing. + +_The make of the dress_ should be loose and easy, so as to permit of the +free movement of all portions of the body; it should be cut high in the +neck, and with sleeves to the wrists; its construction should be simple, +so that it may be quickly put off and on; and the fastenings employed +should, as far as possible, be tapes, not pins. In the clothing of +children the laws of hygiene, and not the code of fashion, should direct +the shape and style. + + +THE BATHING OF INFANTS AND YOUNG CHILDREN. + +Many advantages attach to the daily use of the bath for infants. It +secures cleanliness, strengthens the nervous system, and preserves from +colds and coughs. + +We have already endeavoured to impress upon the mind of the reader the +great susceptibility to cold which exists in early life. On this account +the water for the bath should be warm (96 deg. or 98 deg.) for the first few +weeks of infancy, especially during the winter season. Gradually the +temperature may be reduced to that of the apartment, never to actual +coldness. It is as foolish and hazardous to attempt to 'harden' infants +by plunging them into cold water, as it is by carrying them with +uncovered necks, chests, and limbs into the keen and damp air. Knowledge +of these facts would bring safety to many children who now suffer, +because of the dangerous ignorance of mothers in regard to the +susceptibility of the infant organisation. + +An infant should be immersed in its tub every morning. Besides the +regular morning bath, it is often advisable to put the child for a few +minutes in tepid water in the evening. This will quiet the nervous +system, and induce sleep. The bath should not be too long a one, for +fear of exciting perspiration; nor, for the same reason, should the +water be too warm. If the child be of a delicate constitution, the +evening bath will be especially useful, and can be made more so by the +addition of two table-spoonfuls of salt to the water necessary for the +bath. + +The time immediately after nursing or feeding is not proper for bathing. +An hour or two after a meal should be allowed to elapse. Neither should +a bath ever be given in a cold room. Even in a warm atmosphere, care +should be taken, both after and during the ablution, that the wet skin +of the infant be not exposed to the air. Its body should be completely +immersed; it should not be held up out of the water, nor, if it be old +enough, allowed to stand or sit in the tub. It is well also to have a +warm blanket in which to receive the child as it comes dripping from the +bath. It should be wrapped up in this for a few minutes, to absorb a +part of the moisture. Then a portion of the body should be uncovered at +a time, and dried before exposing the rest. + +_Drying the skin._--For this purpose a piece of soft flannel will be +found serviceable. By gently rubbing the surface of the body with it the +skin will be warmed and stimulated, and the resulting glow will be as +agreeable to the child as is that in the adult which follows the Turkish +bath. The actual grooming of the human body is very useful to improve +the health of scrofulous children. + +At first from three to five minutes will be a sufficiently long +immersion. In a little while, however, this period may be lengthened, +all the precautions mentioned against injurious exposure being observed. + +The lukewarm daily bath, taken either in the morning or evening, ought +to be continued until at least the age of four years. If, after the +fourth or fifth year, ablutions of the entire body be resorted to only +every second or third day, the practice should be commenced of sponging +the chest every morning with cold, or alternately with cold and hot +water, followed by brisk frictions. + +Soap is to be used but sparingly in the bath of young children. It must +be of the blandest and purest quality. Various eruptions are caused by +the employment of impure soaps, and even by the excessive application of +the best kind. + +In illustration of the importance of our present subject, we may state +that Dr. Hufeland, to whose admirable work on the art of prolonging life +we have before alluded, lays down, as one of the means which lengthen +life, the care of the skin. He dwells upon the benefit of paying such +attention to it from infancy that it may be kept in a lively, active, +and useful condition. + +The power of the bath to ward off disease in childhood is not +sufficiently appreciated by parents. Properly managed, it soothes, but +never increases, any internal irritation which may exist, and often does +away with the necessity of resorting to the administration of drugs. If +due attention were paid to the condition of the skin in early life, many +of the most common ailments of childhood would be averted. The daily +employment of the bath, and scrupulous attention to cleanliness of the +person and clothing, would materially lessen the demand both for +purgative medicines and for soothing syrups. + +One word more in regard to the washing of the infant. The mother +herself, if she be in health, should always perform this office, and not +entrust it to the child's nurse. Plutarch awards high praise to Cato +the censor, for his invariable custom of being present when his child +was washed. Every mother, at least, would do well to follow the example +of this old Roman. It will give her the opportunity to detect many +incipient affections which would for a long while escape her attention +if she saw the child only when dressed. The mother will also take pains +to engage the mind of the little one, and render the bath a source of +amusement to it. + +After the fourth or fifth year, two or three baths a week during the +colder seasons of the year will be sufficient to keep the skin clean, +and properly active. During the summer, however, a daily bath is of +great advantage to children, and ought not to be neglected. + +Swimming is very useful and very invigorating to the health of both +sexes. It is desirable that children be taught this art. + +The importance of the _culture of the skin_ to the well-being of infancy +and childhood cannot be brought too prominently to the notice of all +mothers. We have therefore endeavoured to give some useful hints in +regard both to the preservation of its cleanliness, and to the +prevention, by means of garments and warming, of its exposure to too +great changes of temperature. + +By proper attention to the skin in the manner pointed out, many of the +eruptions with which children are afflicted might be prevented. The +appearance of these the mother ought to regard as a great calamity, for +they are often difficult of cure, and render the child an object of +disgust. She ought also to look upon them as the mischievous +consequences of the neglect of those laws of health which it is her duty +to learn and observe. + + +AIR AND VENTILATION IN CHILDHOOD. + +Fresh air is necessary for the robust development of infancy and +childhood. Infants born in the summer season should be carried out daily +when the weather is pleasant, from the second or third day after birth. +Those born in the winter should be kept in the house for two or three +months before being introduced to the outer world on some sunny noonday. +Older children can scarcely pass too much time in the open air. + +A change in the dress must, of course, be made before exposing the child +to the outdoor air. The head should be covered, and the chest and limbs +well protected from the cold. + +As a rule, a child ought to be carried out, or permitted, when old +enough, to walk out, at least once every pleasant day during the year. +The time of the day is to be varied with the season. In the winter, the +middle of the day is to be chosen; in summer, the early portion of the +forenoon, a few hours after sunrise. + +Children show very quickly, even when in ill-health, the beneficial +results of a ride or walk. It quiets the irritability to which they are +liable, more effectually than any other procedure. For a delicate child, +or one recovering from sickness, fresh air and sunshine are the best +tonics which can be administered. A fretful, peevish child will soon +learn to look forward to its daily jaunt on the street or road, and will +be quieted by it for the rest of the day. + +At all times of the year regard must be had to the state of the weather. +The infant ought never to be taken out on a wet day. Exposure to a damp +atmosphere is one of the most powerful causes of catarrh on the chest +and inflammation of the lungs, to which young children are so subject. A +very high wind, even though the day be bright and dry, is injurious to a +young infant, as it has been known to suspend its breathing for a time, +which accident might, if not at once observed, bring about a fatal +result. + +Besides fresh air, _light_ is an indispensable requisite to the health +of children. Nothing can compensate for the absence of its beneficial +effects. It is to be remembered, however, that during the first week or +two the eyes of the new-born babe are not strong enough to bear the full +glare of light. The first eight days of its existence should be spent in +a half-darkened room. Gradually the apartment may be brightened, until +finally, after about two weeks, the young eyes become entirely +accustomed to the light, and may be exposed to it without injury. A +neglect of this precaution is one of the most common causes of the bad +inflammation of the eyes so frequently met with among young infants. +After the sight has become quite strong, a bright room will strengthen +the eyes, not weaken them; for light is the natural stimulant of the +eye, as exercise is of the muscles, or food of the stomach. + +Scrofulous diseases are the heritage of those children who are deprived +of a plentiful supply of pure air and light. A distinguished writer upon +the laws of health ascribes to the careful avoidance of the salutary +influence of air and light by so many young girls, who are fearful of +walking out while the sun is powerful, much of their sickly appearance, +the loss of consistency of their bones, and their being able to afford +but a deformed temple to the immortal soul. + +Humboldt states that, during a five years' residence in South America, +he never saw any national deformity amongst the men or women belonging +to the Carif, Muyscas, Indian, Mexican, or Peruvian races. If parents in +our own country were to accustom their daughters from an early age to +daily exercise in the open air and sunlight, there would be fewer weak +backs requiring the support of apparatus from the surgical-instrument +maker, and less pallor in lips and cheeks to be remedied by iron from +the shop of the apothecary. + + +EXERCISE IN CHILDHOOD. + +The first exercise which a child obtains, is had of course in its +nurse's arms. Are there any directions, then, to be noticed in regard to +the _manner of carrying an infant_?--Dr. Eberle gives the following +useful advice upon this subject:--'The spine and its muscles seldom +acquire sufficient strength and firmness before the end of the third +month to enable the child to support its body in an upright position +without inconvenience or risk of injury. Until this power is manifestly +acquired, the infant should not be carried or suffered to sit with its +body erect, without supporting it in such a manner as to lighten the +pressure made on the spine, and aid it in maintaining the upright +posture of its head and trunk; therefore, at first (a few days after +birth), the infant should be taken from its cradle or bed two or three +times daily and laid on its back upon a pillow, and carried gently about +the chamber. After the third or fourth week, the child may be carried in +a reclining posture on the arms of a careful nurse, in such a manner as +to afford entire support both to body and head. This may be done by +reclining the infant upon the forearm, the hand embracing the upper and +posterior part of the thighs, whilst its body and head are supported by +resting against the breast and arm of the nurse. When held in this way, +it may be gently moved from side to side, or up and down, while it is +carefully carried through a well-ventilated room.' + +After the child is three months old, it will probably have become strong +enough to maintain itself in a sitting position. It may then be carried +about in this upright posture, with the spine and head carefully +supported by the nurse, which aid ought not to be withdrawn until the +age of six or seven months. + +'In _lifting_ young children,' as has been well observed by Dr. Barlow, +'the nurse should be very careful never to lay hold of them by the arms, +as is sometimes thoughtlessly done; but always to place the hands, one +on each side of the chest, immediately below the armpits. In infancy the +sockets of the joints are so shallow, and the bones so feebly bound +down and connected with each other, that dislocation and even fracture +of the collar-bone may easily be produced by neglecting this rule. For +the same reason, it is a bad custom to support a child by one or even by +both arms, when he makes his first attempt to walk. The grand aim which +the child has in view, is to preserve his equilibrium. If he is +partially supported by one arm, the body inclines to one side, and the +attitude is rendered most unfavorable to the preservation of his natural +balance; and consequently, the moment the support is in the least +relaxed, the child falls over and is caught up with a jerk. Even when +held by both arms, the attitude is unnatural and unfavorable to the +speedy attainment of the object. To assist the child, we ought to place +one hand on each side of the chest in such a way as to give the +slightest possible support, and to be ready instantly to give more if he +lose his balance. When this plan is followed, all the attitudes and +efforts of the child are in a natural direction; and success is attained +not only sooner, but more gracefully, than by any ill-judged support +given to one side. + +'There is one very common mode of exercising infants, which we think +deserves particular notice: we mean the practice of hoisting or raising +them aloft in the air. This practice is of such venerable antiquity, and +so universal, that it would be vain to impugn it. The pleasure, too, +which most children evince under it, seems to show that it cannot be so +objectionable as a cursory observer would be disposed to consider it. +Still there are hazards which ought not to be overlooked. The risk of +accident is one of some amount: children have slipped from the hands, +and sustained serious injury. Some people are so energetic as to throw +up children and catch them in descending. This rashness there can be no +hesitation in reprobating; for, however confident the person may be of +not missing his hold, there must ever be risks of injury from the +concussion suffered in the descent, and even from the firmness of the +grasp necessary for recovering and maintaining the hold. The motion of +the body, too, has a direct tendency to induce vertigo; and when the +liability of the infant brain to congestion and its consequences is +considered, when the frequency of hydrocephalus in infants is borne in +mind, an exercise which impels blood to the brain will not be regarded +as wholly insignificant. There is one more objection which seems not to +have attracted attention. The hold taken of the child in the act of +hoisting him is by the hand grasping the chest. The fingers and thumb, +placed on each side of the breast-bone, compress the ribs; and any one +with the hand so placed will at once perceive that if the pressure were +strong, and the resistance from the elasticity of the ribs weak, the +impression on the chest resulting would correspond exactly with the +deformity named chicken-breast. That any force is ever used capable of +inducing speedily such a change, is in the highest degree improbable; +but that reiterated pressure of this kind, however slight, would in a +weakly child have power to impress and distort the chest, few, we +imagine, will doubt.' + + +LEARNING TO WALK. + +When two or three months old, the infant may be placed on a soft +mattress upon the floor or on the carpet. He can then toss his limbs +about without danger, and develope the powers of his muscular system. + +'The best mode of teaching a child how to walk,' says Dr. Bull, 'is to +let it teach itself; and this it will do readily enough. It will first +learn to crawl: this exercises every muscle in the body, does not +fatigue the child, throws no weight upon the bones, but imparts vigor +and strength, and is thus highly useful. After a while, having the +power, it will wish to do more. It will endeavor to lift itself upon its +feet by the aid of a chair; and though it fail again and again in its +attempts, it will still persevere until it accomplish it. By this, it +learns first to raise itself from the floor; and secondly, to stand, but +not without keeping hold of the object on which it has seized. Next it +will balance itself without holding, and will proudly and laughingly +show that it can stand alone. Fearful, however, as yet of moving its +limbs without support, it will seize a chair or anything else near it, +when it will dare to advance as far as the limits of its support will +permit. This little adventure will be repeated day after day with +increased exultation; when, after numerous trials, he will feel +confident of his power to balance himself, and he will run alone. Now +time is required for this gradual self-teaching, during which the +muscles and bones become strengthened; and when at last called upon to +sustain the weight of the body, are fully capable of doing so.' + +It is not merely want of strength which prevents an infant from walking +at first. The natural shape of the legs renders it impossible. The feet +are turned in so that the inner sides look upwards. When placed upon its +feet, therefore, the soles will not rest upon the ground. In a short +time the position of the feet changes, and they become fitted for the +purposes of support and locomotion. When he begins to walk, the child +should have shoes with tolerably broad soles, which ought to be at least +half an inch longer than the foot. + +The first efforts of the little one to support and propel itself are to +be carefully watched, but not unnecessarily interfered with; neither +frightened by expressions of fear, nor rendered timid by too frequent +warnings. + + +ADVANTAGES OF GAMES AND PLAYS. + +The first seven years of life should be one grand holiday for all sports +and amusements which will bring into play the muscles, and divert at the +same time the mind. Time cannot be more usefully employed than in thus +laying the foundation of health, upon which alone can rest the physical, +mental, and moral well-being of after-life. + +No greater mistake can be made by parents than to deprive the young of +the innocent pleasures of childhood. Yet there are persons occasionally +met with who think it their duty to check the natural lightness and +gaiety of heart of their children for fear that they shall become too +fond of pleasure. In this way great harm is done to both mind and body, +and the very fault created which it is desired to avoid. + +The wise parent sees in the games and plays of childhood not only +necessary recreation and exercise, but a valuable means of education--of +moral, mental, and physical training. He also seeks to impress early +upon the young mind that play is most enjoyed when it has been earned by +work, and that pleasure flies from those who continually pursue it. + +The faculties of _memory_ and _attention_ can be called upon and +developed by proper games in a most satisfactory manner. These exercises +are all the more effective because the pleasure conceals, as it were, +the mental labor, and the intellectual efforts are made, in a sense, +unconsciously, though none the less efficiently. + +Certain plays form a valuable means of educating the eyes and other +senses. Such, for instance, are the toys which represent objects of +natural history or of different trades and arts; the pictures which +teach through the quick eye of the child what no dry descriptions could +ever convey; and the games which develope closeness of observation and +habits of order. A genial French physician has happily said, 'Every time +I see a toy based on the reproduction of a scientific fact or of an +industrial process, and which pleases while it enlightens, I feel a +sentiment of real gratitude to him who has designed it.' + +We are glad to see that each year more and more attention is being paid +to the utilization, as it were, of the games of infancy. Although all +education can never be made a play, all play can be made an effective +education. Do not therefore, reader, restrict the games of your +children, but direct them; do not render them less amusing, but seek to +make them more instructive. + +The schooling afforded by instructive plays should be the only schooling +of the first seven years of life. Late springs produce the most abundant +harvests in the mind as in the field. Precocious and delicate children +especially should be kept from a too early and close application to +books. By means of healthful and instructive games and sports; by visits +to workshops and factories where familiar objects are made; and by a +cultivation of the sense of the beautiful in nature and art, more can be +done towards securing a sound mind in a sound body than by the easier +and more common method of sending the child to school almost as soon as +it can walk. + + +IMPORTANCE OF TEACHING CHILDREN HYGIENIC HABITS. + +The force of habits should never be lost sight of by those having the +charge of children. They constitute a power of which parents should +early avail themselves. J. J. Rousseau has said, 'The only habit which +one ought to permit the child, is of not contracting any.' But this is +impossible and undesirable. When it is remembered that _a good habit is +just as hard to break as a bad one_, the importance of seeking from the +very cradle to frame good habits is evident. It is easy to create, but +difficult to reform. What then are some of the principal hygienic habits +which it is desirable to teach children? + +First we will mention, _a liking for proper food at regular times_. The +indigestion, or weakness of digestion, from which many children suffer, +is in some cases hereditary or the result of feeble health. But most +frequently it is the effect of bad management. The giving to the child +of pastry and cakes at meals instead of simple and nutritious food, the +encouragement of capriciousness of appetite instead of teaching it to +like everything that is healthful, and the neglect to inculcate the +habit of eating at regular hours, these are the principal causes of many +cases of diarrhoea, vomitings, weak appetite, colicky pains, and +indigestion among children. + +The daily use of at least a sponge-bath of the entire person is an +excellent habit. Cold water should be employed after the fifth or sixth +year. This simple practice of a cold sponge-bath every morning, if more +generally taught children, would avert many a cold and rheumatic attack +in after life. + +The habit of quenching the thirst with only simple drinks, milk and +water, should be early and thoroughly formed. No American mother would +think of giving spirits to her child, excepting under medical advice; +but many permit almost from infancy the use of tea and coffee. These +drinks are not only unnecessary in childhood, but to a certain extent +injurious. They excite the nervous system and disorder the digestion. +Before the age of puberty, neither tea nor coffee should be allowed. + + +ON THE TRAINING OF THE SPECIAL SENSES. + +The special senses, sight, hearing, smell, taste, and touch, have been +called the windows of the soul, by which it observes what passes +without. The most noble and intellectual of these are the sight and +hearing. Neither of them receives the attention at the hands of parents +and educators which it should. Indeed, the Indians who yet inhabit our +western plains, have better eyes and ears than we. The reason of this is +evident. The savage is obliged to make other use of his eyes than to +dreamily admire the beautiful landscape, and other use of his ears than +to listen to the singing of birds and the murmuring of wind and stream. +These senses are the defenders of his life. He depends upon them for +food, clothing, and protection against his enemies. Hence, urged by +necessity, he trains them from infancy, and brings them to a perfection +which astonishes us. It will be said, however, that we in our civilized +life, have no need of any such acuteness of sense. True, but we cannot +avoid the consciousness that our organs of sight and hearing do not +afford us the service they ought, and that they commence to fail us too +early. The remedy is to be sought in the training of the special senses +in early life. These senses, which are the first of our faculties to +form and develope, should be the first to be educated; yet, as has been +well said, they are nearly the only ones which are forgotten, or at +least they are the most neglected. + +The education of a sense has been compared to the education of a +child,--it has its physical, its intellectual, and its moral side. It is +necessary to maintain the organ in a condition of health in order that +it may perform its work well; this is the physical education of the +sense. The mind must learn to properly elaborate the impressions thus +conveyed to it, this is the intellectual education of the sense. +Finally, in the service of morality and justice, these impressions ought +to be turned to the advantage of the good and the beautiful, this is the +moral education of the sense. The subject of the training of the special +senses is therefore, when properly viewed, a serious and most important +one. It might well demand more attention at our hands than we have space +to give it here. We will make our remarks as concise and practical as +possible commencing first with + + +THE TRAINING OF THE SENSE OF SIGHT. + +A recent French writer on the hygiene of the sight has brought forward +striking evidence in support of his statement, that in our time the +sense of sight is growing markedly weaker. The number of the +near-sighted is augmenting, as is also the number of those who become +'far-sighted' before old age. Cases of debility and disease of the eyes +seem to be multiplying at a rate which should awaken general attention +to this matter. The causes are to be found in the neglect, often the +hurtful management, of the eyesight of children; in the influence of +improperly regulating artificial light; and in the injury done by bad +printer's ink and paper. + +In the education of the child's eyesight, _acuteness_ of vision is one +of the first objects to be sought for. That this is largely a matter of +training is apparent from the fact that persons in certain professions +can readily distinguish objects too small or too distant for ordinary +eyes. Children brought up in the country or at the sea-side, have a +power of vision unknown to city children, with their limited range of +observation. But it is not only necessary that the eyes should be able +to make out the forms of distant or small objects, but that they should +be quick to detect shades of color and delicacies of outline. The child +should be stimulated and encouraged to make efforts in this direction. +Here, also, there is room for the skill of the intelligent toy-maker, +for toys can be made very useful educators. + +One of the forms of sensorial _memory_ which it is most desirable to +develope is that of objects seen, that is to say, the fixing in the +thoughts, to be brought up before the mind's eye when wanted, the +recollection of visual impressions. This embraces the memory of forms, +of dimensions, of the relations between various objects and between +different parts of the same object, and of colors. When applied to +places it is what is known as _local_ memory, applied to the human face, +it is the memory of _physiognomy_; applied to objects, it is _graphic_ +or _descriptive_ memory; applied to colors, it is _chromatic_ memory. + +_Local_ memory is sometimes developed to an extraordinary degree. It is +only necessary for some persons to have once traversed a locality, a +street, a city, in order to preserve of it a most minute and vivid +recollection. This topographical memory is enjoyed by a number of the +inferior animals; the elephant, the dog, and the horse, for instance, +are well-known as being capable of noticing a road taken and of +returning by it, of recognising readily a place once seen, and of +showing a tendency to stop of their own accord at places where they have +been arrested or kept. This local memory, useful as it is to every one, +is necessary to the painter who draws upon it for the elements of his +artistic creations. + +The faculty of recollecting faces is a peculiar one, and possessed by +different persons in vastly different degrees. There are those who +recognise invariably every face they have once seen, and who by a simple +effort can at any time recall with the utmost distinctness the features +of the absent. On the other hand, there are those so wanting in this +special form of memory that they are constantly exposed to serious +social inconveniences, and, for fear of failing in politeness, often +salute perfect strangers. The ancient Greeks possessed to an +extraordinary degree the power of seizing and retaining types of face +and form; it is to this, doubtless, that they owe, to a great extent, +their unapproached excellence in sculpture and painting. + +_Graphic_ or _descriptive_ memory is that which photographs, as it were, +upon the brain the visual impressions that objects have made upon the +retina, in such a manner that the thought can reconstruct them ideally. +This, in particular, is the form of memory required by designers of all +kinds, and, like the other forms of visual memory, is susceptible of +education. The child is first taught to copy with his pencil and produce +exact _imitations_ of the objects about him. Then, little by little, he +is to be taught in closing his eyes to reconstruct mentally the contours +of objects, at first simple, then more complicated, and finally to +penetrate into their details and give to the fictitious mental image all +the relief of reality. This exercise not merely trains the child in +correct observation, but quickly leads to the conquest of descriptive +memory. + +_Chromatic_ memory, or the memory of colors, is a form of visual memory +different from those we have enumerated. It is more difficult, perhaps, +and technical than the others. The attention of the child should early +be directed to the colors of natural and artificial objects, and he +should be encouraged to imitate them. + +But it is not our intention to go further into this important subject, +the education of the sense of sight. Our space will not permit it. By +these few elementary remarks, we have merely wished to remind parents +that they can do much towards the development of this important faculty +in their children. + + +TO PREVENT NEAR-SIGHTEDNESS. + +Near-sightedness is, as we have said, greatly increasing. In Germany, +this is particularly the case, and has led there to a careful study of +the subject within the last few years. + +Near-sightedness, like most of the disorders of the eyesight, is to be +traced to causes which act during childhood, _and which causes are all +entirely preventable_. Imperfect lighting of rooms in which children +study or play is one of the chief among these preventable causes. When +the windows are improperly constructed or placed, or when the artificial +light is faulty in school-rooms, the book is naturally brought close to +the eyes in order that it may be more easily read. The consequence of +this is either that near-sightedness is quickly produced, or that the +eyes soon become fatigued and permanently weakened. No less injurious is +the effort to read 'between the lights' or before the fire. School-books +with too small type, and school-desks which are too low or too far from +the seats, are the direct cause of much mischief to many young eyes. Let +parents, therefore, see to it that the school-rooms to which they send +their children are clearly and properly lighted, that the books which +they study are printed in a bold, clear type, and that no reading or +study is permitted by a flickering or a dim light, nor before a desk or +table which forbids a tolerably erect position of the head and +shoulders. + + +THE EDUCATION OF THE SENSE OF HEARING. + +The education of this sense is second only in importance to that of the +sight. First of all, attention should be directed to the preservation of +the _health_ of the organ. + +Many cases of deafness among children originate in long standing +diseases of the nose and throat; others in obstinate skin affections; +while not a few are caused by a want of cleanliness, which permits of +the accumulation of wax in the passage of the ear. + +The sensibility of the nerve which conveys impressions of sound from the +ear to the brain can be greatly increased by exercise and training, when +the organ is in a condition of health. It can be so highly developed +that the ear will readily catch very feeble sounds. + +A learned physician has recently pointed out with some force that +sufficient attention is not paid to the conformation of the pavilion of +the ear. Upon this conformation much of the delicacy of hearing depends. +The hats which children wear, usually compress and deform the pavilion. +Physiologists have shown that it ought to make an angle of about thirty +degrees with the skull, in order to best collect sonorous vibrations. +This angle is very much diminished by our artificial head-dresses, and +to the detriment of acuteness of hearing. + +Can education do much for the improvement of hearing? Everyday +experience answers in the affirmative. There is an exercise which cannot +be too highly commended to parents, which consists in inducing in play +their children, even those very young, to detect from as far as they can +faint and fading sounds. It is a game which amuses them much, and it is +a pleasing sight to see the rivalry of several young children, each of +whom with head bent forward, is earnestly trying to distinguish a +receding sound longer than its fellows. A little ingenuity will readily +devise amusing and useful plays with this object in view. + +The training of the remaining special senses is of comparatively minor +importance to that of those we have been considering, and need not +detain us. We will only remind the reader of the wonderful adroitness +and delicacy of touch possessed by the blind as an example of what this +sense is capable of when educated. + + + + +HOME MANAGEMENT OF SOME COMMON DISEASES OF CHILDREN. + + +CROUP. + +Although this disease is said to be more severe in Europe than in our +own country, and more frequent in our northern than in our southern +States, most American mothers, in all parts of the country, know and +dread its alarming and often fatal attacks. It is a disease of +childhood, but not of early infancy, being rarely met with under the +first or after the tenth year of life. + +Children who have once had this affection are very liable to another +attack upon exposure to any of the causes which excite it. It has been +noticed also that croup runs in certain families, and not unfrequently, +children of a ruddy complexion and of a fleshy and apparently vigorous +appearance are those most subject to it. + +Among the _causes of croup_, which should be specially guarded against +by mothers of croupy children, are checking of the perspiration, sudden +alterations in the dress, change of climate, and even in some cases a +residence at the sea-side. Croup also often follows measles, and at +times is epidemic. + +The unmistakable _symptoms of croup_ quickly show themselves at the +outset of the disease. Sometimes a sore throat, a short, dry cough, and +a slight harshness of breathing, usher in the affection; in other +instances, that which first attracts attention is hoarseness in the cry +or tone of the voice, attended with, or quickly followed by, +feverishness, thirst, and dulness, or fretfulness; while in another +class of cases the disease suddenly developes itself without any +noticeable premonitory signs. In all these cases the characteristic +symptoms of the disease commonly make their appearance at night. The +child's sleep is disturbed by a peculiar clanging cough, which, when +once heard, will ever afterwards be remembered and easily recognised. +The skin becomes hot and dry, the breathing difficult, the cough more +frequent, and the child is soon awakened, frightened, and struggling for +breath. With flushed face and staring eyes, the little sufferer starts +up, grasping the throat with the hand as if seeking to remove some +encircling pressure which is choking it. Each drawing in of the breath +is attended with a hissing sound, the redness of the face and neck +increases, and speech becomes impossible. This attack may pass off in a +few minutes, or be prolonged, with varying degrees of intensity, for an +hour. Almost invariably, however, it is followed by a period of relief, +in some instances so complete as to deceive the anxious relatives into +the belief that the disease is over and the child safe. This false +confidence is, unfortunately, generally soon rudely dissipated by a +return of the attack in all its first violence. + +The disease attains its height by the end of the second, or at the +latest the close of the third day. The fever is now the hottest, the +tongue becomes white, the face and forehead red and covered with +perspiration, the lips at times purple, the veins of the neck and +temples distended, the countenance distressed, and the voice whispered +or suppressed. The cough is now also most frequent and noisy; its +peculiar sound has been compared to that made by a fowl when caught in +the hand. The thirst is great, but swallowing difficult. The child often +inserts its fingers in the mouth as if trying to clutch something which +closes the air passages. These symptoms may either increase to the rapid +exhaustion of the patient or take a favorable turn. One of the first +evidences of the latter is a change in the character of the cough, +which, although it may not lessen in force or frequency, becomes lower +in tone, less dry, and finally moist. + +The _treatment_ should be most prompt, active, and energetic. Few +diseases require, for the safety of the patient, such quick and +efficient aid at the outset. Prepare at once sufficient hot water for a +bath, and make a fire in the room. In the meanwhile, immerse the child's +arms in some hot water, and apply cloths, wrung thoroughly dry from it, +to the throat. Give the child a tea-spoonful of powdered alum in a +little syrup, molasses and water, or honey. Repeat the dose in a quarter +of an hour if full vomiting be not excited by the first tea-spoonful. So +soon as the warm bath is ready (the water should have the temperature +of 98 deg. Fahrenheit), place the child in it, and keep up the heat of the +bath by the occasional addition of hot water. Have hot towels in +readiness to dry the skin completely, and a warm blanket in which to +wrap the patient. See that the temperature of the room is raised to +about 66 deg. Fahrenheit, and that it does not fall below this. Moisten the +air by putting a kettle of boiling water on the fire and diffusing the +steam from it by means of a long roll of paper fixed to the spout. + +The warm bath and the emetic will usually relieve the breathing; but no +matter how complete this relief may appear to be, nor how quietly the +little one may sleep, it must be carefully watched all night, so that +the first return of unfavorable symptoms may be promptly treated. In all +instances also, however favorably the case may progress, the patient +must be confined to bed for several days, and the temperature of the +room, and the moisture of the air, carefully maintained, as directed for +the first treatment of the attack. If the child has had previous +attacks, or if the weather be cold and inclement, it should be kept in +this warm moist atmosphere for two weeks. Were these precautions known +and heeded we should have to lament fewer fatal cases of croup. + +Of course in this, as in all other serious diseases, skilled medical +advice should be secured as quickly as possible. We have given the above +directions, not only for those so situated that they cannot secure +medical aid, but also for all others, in order that no valuable time may +be lost in commencing the treatment, that the efforts of the physician +may be intelligently seconded and carried out, and that the importance +of _promptness_ at the outset, and _prolonged care_ during +convalescence, maybe impressed upon every mother who consults these +pages. + + +HEAD COLDS. + +Young infants are very liable to take cold when being washed, or carried +about the house into rooms and passages of different temperatures. This +cold often shows itself by sneezing and "snuffles" in the nose. In a +short time a discharge from the nostrils appears, the eyes become +watery, and the voice sounds "through the nose." The skin is hotter than +natural, and the infant cross. If the child be able to talk, it will +complain of headache, some soreness in the limbs and back, and of a +burning, uncomfortable feeling in the nose. These symptoms last for +three or four days, when in mild ordinary cases they begin to disappear. +After one or more attacks of this kind the child is very liable to a +return on every slight exposure to cold. + +The _treatment_ required in these cases is mild and simple, but must not +be neglected. A warm bath should be taken at bed-time for a number of +days; the patient should be kept in an even temperature and out of +draughts. The best relief to the distress in the nose, from which the +child suffers, is afforded by dipping a hollow sponge in hot water, +squeezing it nearly dry, and applying it over the nose and forehead. The +common domestic practice of greasing the nose is also beneficial. The +wearing of a flannel cap until the disease is cured is a remedy +strongly recommended by the late Dr. Meigs. A flannel cap will also +often prevent the recurrence of the complaint in those very subject to +it. + + +FITS. + +Infants and young children are much more liable to fits and convulsions +than adults. The causes which excite them are numerous, and should be +generally known, that they may be as far as possible avoided. + +Many infants are born with a tendency to fits. The children of feeble +parents, or of those who have married very early or very late in life, +are apt to be afflicted with a predisposition to them. Great fright or +severe shock received by the mother during the latter months of her +pregnancy may give rise to convulsions in the child soon after birth. + +Pale, badly nourished, soft, flabby children, and those of a sensitive, +nervous temperament, are more liable to fits than those who are ruddy +and hardy. Hence we find convulsions more common and fatal among the +poor and miserable than among the 'well-to-do' and comfortable. City +children are more subject to the complaint than the country born and +bred. + +Fits are very frequent among infants while teething. In such cases +lancing the gum secures immediate relief. Another cause of fits, and one +which every mother should know, is the giving of meat to the child +before its teeth are cut. In such cases the attack is sudden, and often +very severe. Children most affected in this way by animal food are those +with water on the brain, and those of a very delicate constitution. The +juice or broth of meat is in some such instances sufficient to produce +fits. The remedy consists in the institution of a milk diet. In all +doubtful cases avoid a meat diet in any form, and watch the result. + +Strong mental emotions, such as fright, shame, or anger, may cause a fit +in a child. A nurse in England threatened to throw a child out of the +window if he did not stop crying; the little boy fell at once into +convulsions, from which he died. + +Among other known causes of fits are confinement to heated, badly +ventilated rooms, tight bandaging, and sudden exposure to severe cold or +heat. + +In treating of the influence of the mother's mind over the nursing child +(p. 251), we mentioned a number of instances of children thrown into +convulsions by changes in the quality of the milk caused by the mental +emotion of the mother. The importance of the subject induces us to quote +here the corroborating remarks of Dr. Churchill, in the last edition of +his standard work on diseases of children. 'During the first year of +life, convulsions may not unfrequently be traced to the milk of the +mother or nurse disagreeing with the infant, or having been disordered +temporarily by fright, passion, or suffering. Soemmering mentions a +curious case of a woman whose milk agreed with her own child, but caused +convulsions in all others. M. Guersant relates the instance of a woman +deserted by her husband, and in her distress her infant had an attack +each time it took the breast. Dr. Underwood mentions a mother who nursed +her child immediately after witnessing a sudden death; the child was +attacked by convulsions, after which it remained comatose for thirty-six +hours, but ultimately recovered. Numerous cases are on record of +convulsions supervening upon violent passion in the nurse. I have +witnessed more than one case resulting from the mother suckling her +child during a time of severe affliction and distress.' + +We deem it useless to describe a fit. Almost every one has seen it, and +at once recognises it. We shall proceed, therefore, at once to the +_treatment._ + +When a child is attacked with a fit the dress should be loosened, all +tight bandages and pins removed, and plenty of fresh air admitted into +the room. It should not be held upright in the arms, but placed in a +lying position. A warm bath (that most useful remedy in so many of the +ailments of children) should be speedily prepared, and the child +immersed for a few minutes, then removed, dried, and wrapped in a +blanket. A hot mustard foot-bath is also of service. The cause of the +fit should be at once sought, for upon it will of course depend to a +great extent the treatment required. If the child be teething, and the +gums be found to be red and swollen, they should be lanced. If the child +has eaten too much, or of improper food, an emetic should be given. A +little mustard and salt mixed in a tumbler of warm water affords a +ready, safe, and effectual emetic. + +The dashing of cold water upon the face will sometimes promptly end the +fit. The application of powdered ice in a bladder, or of cold water +cloths to the head, is of service where the face is much flushed and the +movements very violent. + +Children subject to fits should live in a well warmed house. By this we +do not mean that the rooms and hall ways should be kept hot, still less +that they should be close and improperly ventilated. The temperature of +the bed-room should not be lower than 70 degrees, and great care should +be taken during cold weather to avoid chilling the child outdoors. + +Rubbing of the child's body once a day with good salad oil is an +excellent and readily applied remedy in these cases. The little patients +do not ordinarily object to it. As it is a procedure calculated to +improve the general health, we strongly recommend every mother whose +child has frequent fits, to try it. + +The dress of the child should be warm, loose, and comfortable. Perfect +quietness is important for a time after attacks. Do not excite the child +by seeking to amuse it. Let it sleep as much as it will. + +In those cases in which a fit has been followed by weakness of the +limbs, medical assistance will of course be procured. As a rule, +recovery in such instances is slow, but, when properly directed, +perfect. Change of scene, country air, and exercise, friction of the +body with a flesh-brush or salt towel, salt water baths, and +electricity, are all valuable agents towards cure. + + +NOSE-BLEED. + +Bleeding from the nose may be produced by a blow or by over-exercise of +the child at play. In either case the trouble is usually a trifling +one. Some children, however, are liable to attacks of nose-bleed coming +on without any assignable causes. One of the consequences of scarlet +fever and whooping cough is sometimes a tendency to repeated and serious +spells of bleeding from the nose. + +The _treatment_ in these cases consists in quieting the alarm of the +child if it be frightened, and in applying cold water or pounded ice to +the nose and forehead and to the back of the neck. It is because of its +coldness that the key placed down the back, as so commonly advised in +domestic practice, does good. + +An exaggerated idea of the amount of blood lost is often a cause of +distress to parents. They forget that the child has been bleeding in a +vessel of water, and that a very little blood darkly colors a large +quantity of water. + +Bleeding from the nose is sometimes a favorable symptom, as when it +occurs during a fever, or when in girls approaching womanhood it +precedes the expected signs of puberty. It is an unfavorable symptom, +however, in scrofulous children and in girls affected with +green-sickness, as in these instances it aggravates the existing +disorders. + +In those rare cases of protracted bleeding which resist the remedies we +have mentioned, it may be necessary for the surgeon to plug the +nostrils, both in front and at their opening into the throat. + +This extreme measure is fortunately scarcely ever called for, and can +only be carried out by the physician. + + +WORMS. + +Children are often thought to have worms when entirely free from them. +There is hardly a symptom of any disease which has not been supposed by +some to be a sign of the presence of worms. A child suffering from some +other complaint is, therefore, not unfrequently dosed with vermifuges to +its injury. We can give the mother one symptom of worms which is +infallible. It is the only one upon which she can rely, namely, the +detection of worms in the stools of the child. Until these expelled +intruders are actually found she should be slow to believe that the +child is thus affected, and still slower to give worm medicine. Before +beginning treatment, let the mother wait until the need of it is made +out by the result of the examination we have mentioned. + +The _treatment_ of the ordinary worms to which children are subject is +simple and usually speedily efficacious. Commence with a dose of Epsom +salts, of magnesia, or of cream of tartar, as may be preferred. The next +day administer a vermifuge, of which the best and pleasantest is +_santonine_. Obtain from the druggist three or four three-grain powders +of this medicine. Give the half or the whole of one of these powders, +according to the age of the child, at bed-time. The next morning +administer a purgative dose of oil or salts. Repeat this treatment every +other day until three doses of santonine have been taken. Or, from two +to six grains, according to the age of the patient, may be dissolved in +two table-spoonsful of castor-oil, and a tea-spoonful given every hour +until it operates. + +An excellent domestic remedy for worms, one which was a great favorite +with the celebrated Dr. Rush of Philadelphia, is common salt. For a +child two or three years old, the proper dose is a tea-spoonful mixed in +a wine-glassful of water. When the child can be got to take it in +sufficient quantity, this remedy is a very efficient one. + +Most cases of supposed worms in children are best treated by regulating +the diet, by attention to the air and exercise of the child, by warm +baths, and by endeavoring to improve the appetite, the digestion, and +the strength. The food should be plain and unirritating (bread, milk, +rice, arrowroot, chicken, lamb or mutton broth, beef-tea, mutton chop, +young chicken); the meals should be taken in smaller quantities than +usual, and at regular intervals. Sweets and confectionery should be +forbidden, and but few vegetables permitted for awhile. A perseverance +in this regimen for a short time will usually cure the little patient +without the necessity of resorting to any vermifuge. + +Worms are most frequent between the ages of three and ten years. Girls +are oftener affected than boys. A tendency to worms is hereditary. Cases +occur more frequently during the spring and autumn than during the other +seasons. A residence in cold, damp, unhealthy situations leads to their +production in many instances. + + +BED-WETTING. + +This troublesome disorder is not unfrequently met with in children--more +especially boys--under twelve years of age. It is a mistake to suppose, +as is done by some parents, that slothfulness or negligence is the +invariable and only cause of this infirmity; on this point Dr. Vogel +says:--'In most cases which I have observed, the children through their +own sense of honor or on account of repeated punishments, had a lively +interest in avoiding the accident, and yet were unable to do this +without appropriate treatment pursued for months, and even years.' Dr. +Tanner states:--'Very frequently this affection is the consequence of +bad habits; being favored by the free use of fluids during the after +part of the day, by exposure to cold in the night, and by lying on the +back.' + +The presence of worms in the bowels is one of the causes of this +annoying ailment, and they should be sought for in all cases. Stone in +the bladder sometimes occasions the affection, but in such instances +other symptoms will soon point to the true nature of the trouble. + +This subject is one of an importance which demands some attention from +us in a work for parents. In the language of Dr. Vogel, 'the effects of +this malady are unpleasant, for the psychical development in particular +suffers. The repeated punishments which these children undergo blunt +their sense of honor considerably; they become cowardly and deceitful, +and have no personal spirit. If great and expensive cleanliness is not +practised, the bed, and even the whole room, acquires a urinous odor, +which contaminates the atmosphere and begets conditions by no means +favorable to healthy growth. Such children may be ultimately attacked by +indolent ulcers on the nates and lower extremities, the results of +urinous excoriations.' + +The only _symptom_ ordinarily present is that the child towards morning +or in the middle of the night wets the bed without waking. This may +happen several times during the sleep, and recur every night. In some +cases the act takes place only every other night, but it is rare that +there is an interval of more than one night. + +The _cause_ of this failing is sometimes very simple and one easily +remedied; for it is often the result of neglecting to take young +children up once during the many hours they require for sleep. By +attention to this matter and to the diet, the habit may be speedily +broken. Unfortunately most cases are not so quickly amenable to +treatment. + +In the _treatment_ of this infirmity, corporal punishment should not be +thought of. It is useless, cruel, and unnatural. The child might as well +be punished because it squints or has club-foot. + +Care must be taken to see that the little patient eats or drinks nothing +for several hours before bed-time. The child should also be awakened a +little before midnight, and at a very early hour in the morning, and +made to empty its bladder. It is of great importance to get the child to +sleep upon its side or face, as lying upon the back is sure to increase +the trouble. Indeed, it is frequently observed that the child always +remains clean when it is prevented from turning upon its back during +sleep. The difficulty lies in the prevention. The plan of tying a cloth +or towel around the child with a knot over the spinal column, to awaken +it by the pain when it rolls over upon the back, so often proposed, +seems good advice easily followed. But practically it fails, as it is +impossible, without making the bandage too tight, to keep it in place. +The benefit which, in some instances, has followed the employment of a +succession of small blisters directly over the lower part of the spinal +column, is doubtless due to their forcing the child to sleep upon the +face or side. The remedy is somewhat a painful one, but should be tried +in obstinate cases. + +The child's general health, if enfeebled, should be improved by cold +baths, bitter tonics, and if possible a change of air. In no case should +any mechanical means be employed to arrest the infirmity. Serious and +even fatal results have followed such attempts. + +If the precautions and simple remedies we have mentioned fail, recourse +must be had to the family physician. The drugs which are of benefit are +too powerful to be entrusted to any other hands. The hygienic method of +cure we have pointed out will, if instituted early, be effectual in all +excepting very obstinate cases, which latter indeed sometimes resist for +a long time the best efforts of medical skill. + + +LOOSENESS OF THE BOWELS. + +Children under one year of age should have two movements of the bowels +in the twenty-four hours, and those from one to three years at least +one stool a day. + +A slight attack of looseness is often beneficial if it passes away +within a day or two. It is easy, however, for such an attack to become +hurtful, especially if the food be improper, or the weather warm. A +looseness which is of no consequence in the winter may well excite +uneasiness during the summer months. + +Diarrhoea in a healthy child is ordinarily preceded by vomiting. If the +diarrhoea persist long, the little patient is much prostrated by it, and +rapidly reduced in flesh. Such an attack should never, therefore, be +neglected. + +In the case of an infant not weaned, it should be removed from the +breast for half a day or more, that the stomach may have little or +nothing to do. Barley or rice water, or ordinary water, may be given in +small quantities at a time to relieve the thirst. This in many cases +will be all the treatment required. + +In the case of an elder child, all meat and vegetables should be at once +forbidden, and the only food allowed for a day or two must be rice and +milk, arrowroot, or milk and water. + +The dose of castor oil which is so frequently given by nurses in these +cases under the impression that the oil is 'healing,' is only of service +when the diarrhoea has been caused by food of improper quality or +quantity. It then aids nature in her efforts to get rid of the offending +matter, which by its irritation is doing the mischief. In such instances +one dose of the oil is quite sufficient. It has no 'healing' virtues, +and should not be repeated from day to day. + +Children who are teething are frequently affected with looseness. A warm +bath every evening, and attention to the gums, will be ordinarily all +that is required in these cases, at least during the cold months. It is +of the utmost importance, however, during the summer that such patients, +if living in the city, should be at once removed into the country; +otherwise their lives are in danger. + +Looseness of the bowels in children is usually best treated by careful +management of the clothing and diet, by attention to all that affects +the health, and by avoiding as much as possible the administration of +medicines. No case should be allowed, however, to run on without seeking +competent medical advice. + +An excellent remedy for the diarrhoea of children is the subnitrate of +bismuth. + +This medicine may be disguised in the food, as in a case narrated by Dr. +Inmann. A lad about ten years old was brought to him by an aunt, who +stated that the boy suffered much from diarrhoea, and was emaciating +visibly; that he would not try any domestic remedy, was an obstinate +fellow, and determined to take no medicine. After sending the lad to +another room the doctor recommended the lady to get some white bismuth +and give it to the cook, telling her to mix a large pinch of it with +some butter, and to send in the bread and butter so arranged that the +lady would know which was for the boy. This was done. The lad was duly +drugged without his knowledge, and the diarrhoea stopped in two days. + + +INDIGESTION. + +Infants and young children suffer often from indigestion, or +_dyspepsia_, as well as adults. One of the most frequent signs of this +disorder is vomiting. But every infant which throws up its milk is not +suffering from indigestion. Vomiting is sometimes a sign of health, and +shows that the stomach is vigorous enough to free itself promptly from +excess of food. The child is thus saved from the effects of +over-feeding. The obvious remedy is to diminish the quantity of milk +taken at each nursing or meal. + +But vomiting from over-feeding is very different from that caused by +irritation of the stomach, which causes it to reject proper food. The +common sense of the mother will enable her easily to distinguish between +the two sorts. In the former, the child remains cheerful, happy, and +well nourished, scarcely changing countenance even while the +superabundant milk is being returned from its stomach. In the latter, +the child soon becomes pale, feeble, and distressed looking. +Over-feeding, if persisted in, may occasion indigestion. + +Indigestion during the first year of life shows itself by languor, +pallor, and evident discomfort. The child wishes to be constantly at the +breast, and suckles eagerly, but vomits the milk shortly after, usually +curdled. The bowels are either constipated or too loose. The most +prominent and often the only symptoms are this alternation of vomiting +and an eager desire to take the breast, associated with loss of flesh +and strength. The child is evidently not nourished by the food it takes, +and if relief be not afforded it sinks, and dies from starvation in the +course of a month or two. + +Children who are _weaned abruptly, and at a very early period_, are +liable to a serious form of indigestion, which may come on in a few days +after weaning, or not for several weeks. + +Older children are liable to slight attacks of indigestion, which are +attended with vomiting or purging, or both, for a few days, when the +stomach recovers its health. In some cases, however, the derangement +continues longer, the child then losing its appetite, and suffering from +colic, and becoming fretful, pale, and weak. The breath becomes sour, +and the passages green. Such cases require careful watching and +treatment, especially during the hot weather of the summer. + +In infants at the breast indigestion is usually caused by giving the +breast too often or by an excess or change in the quality of the milk. +Errors in diet on the part of the mother, and other faults which we have +pointed out in our chapter on nursing, are the most frequent causes of +this ailment. In children who are weaned the causes are almost +invariably improper food or food taken too frequently, or in too large +quantities. The hint should be taken when a child rejects its food, to +change it, or give it less. Instead of this, too frequently the child is +urged to take more, and thus derange the stomach. + +The _treatment_ of indigestion in childhood is usually easy and +satisfactory. The first thing is to look to and regulate the quantity +and quality of the food. If it be due to excess of food, this is easily +remedied. If due to improper quality, change it promptly. When the +mother's health is such that her milk is found to frequently or +constantly disagree with her child, a suitable wet-nurse must be +procured. + +In most cases the attack is mild, and readily yields to a few hours' +abstinence from food. As it often happens, especially in +artificially-fed infants, that the gastric juice is more acid than it +should be, great benefit is derived from the use of _precipitated chalk +or carbonate of soda_. A few grains of either of these, given several +times a day for a few days, will be found to effect a surprising change +and alone restore the appetite and digestion. + +In older children an attack of indigestion should be the signal for +putting them upon a simpler and more restricted diet for a time. Milk, +eggs, arrowroot, tapioca, sago, panada, &c., are better than animal +food. If the child becomes much weakened, jellies, chicken, lamb, +mutton, or oyster broth, beef tea, or wine whey, should be given to +check the tendency to exhaustion. + +We repeat, that most cases of indigestion in infants and children yield +promptly to an immediate change in the diet, without medicine. + + +HINTS ON HOME GOVERNMENT. + +On this subject, as it may be regarded as outside of our domain of +hygiene, we have but few words to say. We wish, however, in the +interests of medicine and hygiene, to insist upon the necessity of +training children to prompt, implicit obedience to the parental voice. +As physicians, we have seen the spoilt, undisciplined child, when sick, +rebellious alike to persuasion and command, refusing food and medicine, +revolting against the slightest examination, and by its violence and +capriciousness, converting a slight illness into a dangerous one. For a +child unaccustomed to obedience there is no proper treatment possible +when sick; nor when well is there any proper care possible for the +preservation of the health. What it wants, and not what it ought to +have, is given it, and every one knows that a child's instincts are no +guide to health. With health, happiness is sacrificed also. There is no +surer way of making a child miserable than by accustoming it to obtain +all it wishes, and to encounter no will but its own. Its desires grow by +what they feed upon. As a French writer on education has well expressed +it: 'At first it will want the cane you hold in your hand, then your +watch, then the bird it sees flying in the air, and then the star +twinkling overhead. How, short of omnipotence, is it possible to gratify +its ever-growing wants?' Accustom the child to hear 'no' and 'must,' but +let these hard words be softened by voice and manner--an art in which +every true mother excels. + +But, on the other hand, do not harass the child by needless +restrictions, nor worry it by excess of management. We desire to call +attention here to the words of an eminent English divine and learned +writer, Archbishop Whately:-- + +'Most carefully should we avoid the error which some parents, not +(otherwise) deficient in good sense commit, of imposing gratuitous +restrictions and privations, and purposely inflicting needless +disappointments, for the purpose of inuring children to the pains and +troubles they will meet with in after life. Yes; be assured they _will_ +meet with quite _enough_ in every portion of life, including childhood, +without your strewing their paths with thorns of your own providing. And +often enough you will have to limit their amusements for the sake of +needful study, to restrain their appetites for the sake of health, to +chastise them for faults, and in various ways to inflict pain or +privations for the sake of avoiding some greater evils. Let this always +be explained to them whenever it is possible to do so; and endeavor in +all cases to make them look on the parent as never the _voluntary_ giver +of anything but good. To any hardships which they are convinced you +inflict reluctantly, and to those which occur through the dispensation +of the All-wise, they will more easily be trained to submit with a good +grace, than to any gratuitous sufferings devised for them by fallible +man. To raise hopes on purpose to produce disappointment, to give +provocation merely to exercise the temper, and, in short, to inflict +pain of any kind, merely as a training for patience and fortitude--this +is a kind of discipline which man should not presume to attempt. If such +trials prove a discipline not so much of cheerful fortitude as of +resentful aversion and suspicious distrust of the parent as a capricious +tyrant, you will have only yourself to thank for the result.' It is a +matter of common observation that those who complain of their fortune +and lot in life have often to complain only of their own conduct. The +same is true of those who complain of their children. They have +themselves only to blame in each case. + +Parents who do not appreciate the responsibilities of their position +usually err on the side of over-indulgence to their children; on the +contrary, those fully alive to the importance of home discipline often +err on the side of over-regulation. To the latter, we commend the reply +of an old lady to the anxious inquiry made by the mother of a too +rigorously disciplined child as to what course should be pursued, 'I +recommend, my dear, a little wholesome neglect.' + +Lessons of truthfulness; of fortitude in bearing pain and +disappointment; of the duty of right doing, because it is right and not +because it is the best policy; of frugality and industry; of +self-denial, contentment, and charity, should be early impressed upon +the plastic mind of infancy. We wish also, in this connection, to quote +the words of a wise physician and observer of men, that 'the little +child who is brought up to repeat short and simple prayers at his +mother's knees, has a rule of conduct thereby instilled into him which +will probably never be forgotten; and, in after life he may not only +look back to these beginnings with feelings of reverence and love, but +the recollection of them may serve to strengthen him in some good +resolution, and help him to resist many a powerful temptation.' + +We have had occasion frequently in various parts of this work to point +out the intimate relations which exist between the physical and mental +nature of parents and their offspring. Like parent, like child. The same +close connection and sympathy extends to the moral and religious +character; hence that direction and training which relies largely upon +the _force of parental example_ is the most effective method of home +government. Virtuous precepts, or rigidly enforced rules of conduct, +avail little unless the parent keeps the path to which he points the +child. + +'Well, upon my word, Mrs. Primrose, you have the handsomest children in +the whole country.' 'Ah! neighbor,' replied the wife of the Vicar of +Wakefield, 'they are as heaven made them--handsome enough if they be +good enough--handsome is that handsome does.' + + +IS THE RACE DEGENERATING? + +This is a question which perplexes some minds in our times. A German +author of note has recently written a volume to prove that each +generation is feebler than the preceding. Old physicians say that in +their youth diseases of exhaustion were rarer than now-a-days. For this +our habits of life, the pressure on our nervous systems, the prevalence +of hereditary diseases, and the excessive use of narcotics and +stimulants, are held responsible. 'The fathers,' say these croakers, +'have eaten sour grapes, and the children's teeth are set on edge.' + +We attach little weight to these gloomy views. There are plenty of facts +on the other side. The suits of old armour still preserved in our +museums prove that, as a rule, we have slightly gained in weight and +size. Tables of life insurance companies and reports of statistics show +that the average length of human life is greater than it ever was. Dr. +Charles D. Meigs used to state in his lectures that the size of the head +of American infants at birth is somewhat greater than in the Old World. + +That there are more numerous diseases than formerly, is not true; but it +is true that we know more, for we have learned to detect them more +readily and to examine them more minutely. This is especially true of +such as are peculiar to women. Within the last ten or twenty years so +much that is of sovereign importance has been contributed to this +department of medical science, that it is hardly possible for one to +become an expert in it unless he gives it his whole attention. + +To avoid the tendency to debilitated frames and chronic diseases, woman +should therefore learn not only the laws of her own physical life, but +the relations in which she stands to the other sex. Thus she can guard +her own health, and preserve her offspring from degeneracy. It is only +by enlightenment, and the extension of knowledge on the topics relating +to soundness of body and mind, that we can found rational hopes of a +permanent and wide-spread improvement of the race. + +Some have maintained, not understanding the bearing of the facts, that +such degeneracy is more conspicuous in the frame of woman than anywhere +else. They quote the narratives of travellers, who describe with what +fortitude--we might almost say with what indifference--the Indian women, +and those of other savage races, bear the pangs of childbirth, and how +little the ordeal weakens them. A squaw will turn aside for an hour or +two when on the march, bear a child, wash it in some stream, bind it on +the top of her load, and shouldering both, quietly rejoin the vagrant +troop. Our artificial life seems indeed, in this respect, to be to +blame; but if we look closer, we can learn that these wild women often +perish alone, that they are rarely fertile, that unnatural labors are +not unknown, and that the average duration of their life is decidedly +less than among the females in civilised States. + + + + +HEALTH IN MARRIAGE. + + +_THE PERILS OF MATERNITY._ + +In the early part of this work we quoted some authorities to show that +those women who choose single life as their portion do not escape the +ills of existence, nor do they protract their days, but, on the +contrary, as shown by extensive statistics, are more prone to affections +of the mind, and die earlier. While, therefore, nature thus rewards +those who fulfil the functions of their being, by taking part in the +mysterious processes of reproduction, and perpetuating the drama of +existence, it is true also that she associates these privileges with +certain deprivations and suffering. We do not wish to throw around the +married state any charms which are not its own. Rather is it our aim to +portray with absolute, and therefore instructive, fidelity all that this +condition offers of unfavorable as well as favorable aspects. + +Let us say at once, maternity has its perils,--perils as peculiar and as +inevitable as those which pertain to single life. Our present purpose is +to mention these, and by stating their nature and what are their causes, +so far as known, to put married women on their guard against them. Some +are almost trifling, at least not involving danger to life; others most +harassing to the sufferer and to her friends. + +We shall now consider the principal diseases to which married women are +exposed from pregnancy, from childbirth, and from nursing. + + +DISEASES OF PREGNANCY. + +In treating of pregnancy we have pointed out that it was a healthy and +happy condition to most women. The exceptional cases are mainly those in +which the health is injured by mental trouble or anxiety. Thus the young +and delicate girl newly married is full of vague alarms in regard to the +pains and dangers of her untried path to maternity. She frets herself +and embitters her life during those months in which tranquility is of +the utmost importance. Is it surprising, then, that her health should be +disordered, and that she should suffer from some of the diseases +incident to the pregnant state? + +Again, the mother of a large family, but the mistress of a small income, +is distressed by the thought of additional expense, which it seems to +her, particularly in her nervous state, impossible to meet. This +condition of protracted anxiety is ill fitted to enable her to resist +any tendency to disease to which she may be exposed. Indeed, prolonged +vexation from these and other causes not unfrequently tend to _puerperal +mania_ (a disease of which we shall shortly have something to say), or +to some other nervous affection. + +The wife during pregnancy should therefore be treated with unusual +kindness by those about her, and every attempt made to soften her lot. +The erroneous impression prevails among some that the pregnant wife +should enure herself to toil and hardship. This notion is doubtless due +to the observation that domestic animals that are subjected to a life of +labor bring forth their young with little suffering. 'The cow in the +country farm living unfettered in the meadow until the day of calving, +has in general a safe and easy labor. The poor beast, on the contrary, +which is kept in a town dairy, has a time so incredibly dangerous that +the proprietor generally sells off his stock every year, and replaces it +with cows in calf; such cows not being put into the stalls till within +six or eight days of the expected period of labor. The deduction from +this is that an artificial mode of life--a life maintained by improper +food, and without a sufficient supply of pure air, or a due amount of +exercise--has a most deleterious influence upon the process of labor; +and not that a toilsome existence, embittered with all the pains and +anxieties of poverty, gives comparative immunity from danger in the hour +of childbirth.' One of the discomforts of pregnancy is-- + + +MORNING SICKNESS. + +This affection, when confined, as is usually the case, to the morning +and early part of the day, rarely requires much medical care. Its +absence, which, as we have said, is a frequent cause of miscarriage, is +more to be regretted than its presence especially as it is apt to be +replaced by more serious troubles. + +Relief will be afforded by washing the face and hands in cold water, and +taking a cup of milk or a little coffee and a biscuit or sandwich, +_before raising the head from the pillow_ in the morning, remaining in +bed about a quarter of an hour after this early meal; then dressing +quickly, and immediately going out for a half-hour's walk. Rest in a +half-recumbent posture during the day, particularly after meals, is +beneficial. The affection is mostly a nervous one, and is best combated +by eating. The food should be plain and unirritating, but nutritious, +and should be taken frequently, in small quantities at a time. + +When the nausea and vomiting are excessive, and continue during the day, +there is generally some disordered condition of the digestive apparatus. + +This may be corrected by taking at night a tea-spoonful of the +confection of senna, a pleasant preparation of this ordinarily +disagreeable medicine, and by drinking three times a day, before each +meal, a wine-glassful of a tea made with columbo. Half an ounce of +powdered columbo should be added, for this purpose, to a pint of boiling +water. + +Dr. John H. Griscom of New York recommends the bromide of potassium, +which is a harmless medicine for domestic practice, as affording the +most useful means of arresting the nausea attendant on pregnancy. + +The following prescription may be compounded by any druggist, and will +often be found very effective: + + Take of Bromide of Potassium, two drachms, + Cinnamon water, three fluid ounces. + +Of this a dessert spoonful may be taken two or three times a day. It may +be used with confidence as an entirely safe and harmless remedy in this +troublesome affection. + +A prescription frequently ordered for the nausea of pregnancy by the +late distinguished Dr. Meigs, consisted of equal parts of sweet tincture +of rhubarb and compound tincture of gentian--a dessert spoonful to be +taken after meals. + +_Pain in the abdomen_, caused by the distension of its walls, may be +relieved by the application of equal parts of sweet oil and laudanum. + +Another common and annoying, but rarely dangerous, trouble during +pregnancy is-- + + +VARICOSE VEINS. + +The veins of the legs become distended, knotted, and painful. Women who +have borne a number of children suffer most from this affection. It +seldom attacks those passing through their first pregnancies. It +ordinarily first shows itself during the second pregnancy, and becomes +rapidly worse during the third or fourth. + +Although it is difficult to cure this disease during the continuance of +the pregnancy, much can be done to prevent its occurrence, and to +relieve it when present. Tight garters worn below the knee, and closely +laced corsets, tend to cause and increase this swollen condition of the +veins. Neither should be used during pregnancy. + +Relief is best afforded to the suffering parts by means of a well-made +and adjusted _elastic stocking_, which may be readily procured from a +druggist or surgical instrument maker. In severe cases it may be +necessary for the patient to keep herself as much as possible in the +recumbent position on the bed or sofa. In all cases the feet should be +supported when seated, so as to keep the blood from further distending +the already swollen veins. + + +PILES. + +That painful condition of the veins of the lower bowel known as +haemorrhoids, or piles, is a not unfrequent annoyance to pregnant women. +Sometimes it is caused by prolonged constipation. During the period of +pregnancy, therefore, constipation should be guarded against. + +Ordinarily the piles are small, and of little consequence beyond the +slight uneasiness they occasion. The trifling loss of blood from them is +of no account, and often beneficial. The case is different, however, +when the piles are large and painful, and give rise to much pain and +copious bleeding. They then require prompt treatment. + +In the _treatment_ of piles the first point to be aimed at is to keep +the bowels moderately open. It must not be forgotten, however, that +during pregnancy only the mildest of purgatives are ever to be given. +Castor oil, although a disagreeable, is a most excellent prescription in +these cases. A small dose, repeated when necessary, will be found to +act most kindly. If this remedy be too repugnant to the patient, small +quantities of citrate of magnesia, or of cream of tartar, or of some of +the natural mineral waters, may be employed. Small injections of +lukewarm water are also of great service, and may be tried instead of +laxatives. + +After every movement the parts should be well sponged with cold water, +and an ointment of galls and opium, procured from the druggist, applied. + +If the parts become very much inflamed, warm poultices or hot chamomile +solutions should be used, and the patient kept in bed until the +inflammation subsides. + +No attempt is to be made to effect the radical cure of piles during +pregnancy. Any such attempt, besides being dangerous, is unnecessary, +for the piles usually disappear of their own accord after the +confinement. Every effort to make the sufferer more comfortable in the +manner we have suggested is, however, right and safe. + + +DIARRHOEA. + +Some women always suffer from looseness of the bowels during pregnancy; +others are very liable to attacks of it during this period, either +coming on without any assignable cause or easily excited by any slight +indiscretion in eating. In many instances these attacks alternate with +constipation or with morning sickness. + +The diarrhoea, if at all severe or prolonged, should not be allowed to go +on unchecked, for it quickly weakens the patient and predisposes her to +abortion. The foetus is especially endangered when the passages are +attended with much bearing-down pain. In some exceptional cases, +however, a slight diarrhoea seems to be beneficial, for every attempt to +remove it appears to do harm; but these instances are very rare. + +The _treatment_ required is a simple, and must be a cautious one. +Ordinarily no medicine will be needed. If the patient will merely +confine herself to milk and arrowroot and rice for twenty-four hours a +cure will be effected in mild cases. When it is apparent that the attack +has been caused by improper food, a table-spoonful of castor-oil or a +tea-spoonful or two of tincture of rhubarb will remove the offending +material in the bowels, upon the presence of which the diarrhoea depends. +A small injection of a tea-spoonful of rice water and thirty or forty +drops of laudanum will often speedily arrest the excessive discharges, +and relieve the pain. + + +CONSTIPATION. + +No woman while pregnant should allow several days to elapse without a +movement from the bowels. The symptoms of constipation, slight at the +outset, soon cause great inconvenience. Among the effects, which, sooner +or later, show themselves, may be feverishness, sleeplessness, headache, +distressing dreams, sickness at the stomach, severe bearing-down pains, +and piles. + +Medicines are rarely required in the treatment of constipation, and the +pregnant woman should never take an active purgative, excepting under +medical advice. Outdoor exercise and regularity in soliciting nature's +calls, together with a change in the diet, will usually have the desired +effect. Brown bread, wheaten grits, oatmeal gruel, ripe fruits, fresh +vegetables, stewed prunes, or prunes soaked in olive oil, baked apples, +figs, tamarinds, honey, and currant jelly, are all laxative articles +which should be tried. + +In some instances a tumbler of cold water drunk the last thing at night, +and another the first thing in the morning, will act in a most +satisfactory manner. If the constipation should resist these safe and +homely remedies, which will rarely be found the case, then medical +assistance should be called in. On no account should the wife herself, +or in accordance with the counsel of any non-medical friend, resort to +purgative drugs. + + +COUGH. + +A troublesome cough sometimes affects delicate, nervous women during the +early months of pregnancy. If it be not very frequent nor severe, it +requires no attention, as it will pass away of itself in a short time. +When, however, it disturbs the sleep at night, renders the patient +anxious, and causes headache and weariness, it is time to do something +for it. It may, indeed, be so violent as to threaten abortion on account +of the forcible concussion of the abdomen it produces. + +A tea-spoonful of paregoric occasionally repeated during the day will be +found a most efficient soothing remedy. + + +WAKEFULNESS. + +Sleeplessness, always distressing, is particularly so to pregnant women. +If prolonged, it leads to serious consequences. It should receive, +therefore, the most prompt attention. + +The _causes_ of sleeplessness during pregnancy are numerous. Dyspepsia +is one of them. Whenever indigestion is present the diet should be plain +and simple, and everything avoided which produces heartburn, sourness, +or flatulency. It is important also not to take tea or coffee late in +the afternoon or evening--a late cup of either being a frequent cause in +itself of sleeplessness. + +Sometimes the reason for the wakefulness will be found in a want of +exercise or too constant confinement to closely-heated rooms. Or, it may +be that exciting novels are read late in the evening. Perhaps the +evening meal is too heavy and taken too late. + +The _treatment_ of sleeplessness consists first, of course in the +removal of the apparent cause. The patient should have a regular hour +for retiring, which should be an early one. The bed-room should be +quiet, well ventilated, and slightly warmed. The bed coverings must not +be too heavy nor the pillows too high. + +A warm bath of the temperature of 90 to 96 degrees Fahrenheit, taken +just before going to bed, often invites sleep. A rapid sponging of the +body with warm water may have the same effect. A tumbler of cold water, +when the skin is hot and dry, swallowed at bed-time, sometimes affords +relief. If the bowels are constipated relief should be sought in the +manner we have just mentioned in speaking of constipation. + +When there is nervous excitement at night, and the means we have advised +fail to propitiate 'nature's soft nurse,' there is a sedative medicine +which may be used with safety and effect--it is bromide of potassium. +The same proportion which we have given for the treatment of morning +sickness (see page 355) may be now used. Have the three-ounce mixture +put up by the druggist, and take a dessert-spoonful or a table-spoonful +just before bed-time. It frequently acts almost as if by magic. On no +account should recourse be had to opiates or dangerous sedative drugs. + + +DISEASES OF CHILDBED. + +Childbirth being a healthful physiological condition, is usually neither +attended nor followed by mischievous results. Occasionally, however, the +mother suffers in consequence of the prolonged or difficult character of +her labor. The longer the labor the greater the danger to both mother +and child. Thus childbirth pangs prolonged beyond twenty-four or +thirty-six hours are much more apt to be attended with danger or +followed by disease than those terminated within a few hours. + +The following aphorisms were laid down by the late distinguished +Professor James Y. Simpson, namely:-- + +The mother is more liable to suffer under diseases of the womb after +long than after short labors. The child for some time after birth is +more liable to disease and death, in proportion as the labor has been +longer in its duration. First labors are longer in duration than +subsequent ones, and in a proportionate degree more complicated and +dangerous to mother and child. Male births are longer in duration than +female births, and in a proportionate degree more complicated and +dangerous to mother and child. + +Many tedious confinements, however, are happily terminated without the +slightest injury to mother or child. Whenever the labor has been +unusually prolonged, unusual care and caution should be exercised in the +treatment of the mother and infant for many weeks after the event. + +One of the most distressing affections to which women are exposed from +childbirth is + + +PUERPERAL MANIA. + +This is a variety of insanity which attacks some women shortly after +childbirth, or at the period of weaning a child. The period of attack is +uncertain, as it may manifest itself first in a very few days, or not +for some months after the confinement. Its duration is likewise very +variable. In most instances a few weeks restore the patient to herself; +but there are many cases where judicious treatment for months is +required, and there are a few where the mental alienation is permanent, +and the wife and mother is never restored to her sanity. + +The question has been much discussed, Whether such a condition is to be +imputed to a hereditary tendency to insanity in the family, and also +whether a mother who has had such an attack is liable to transmit to +her children, male or female, any greater liability to mental disease. +We are well aware what deep importance the answers to these inquiries +have to many a parent; and in forming our replies, we are guided not +only by our own experience, but by the recorded opinion of those members +of our profession who have given the subject close and earnest +attention. To the first query, the reply must be made that in one-half, +or nearly one-half, of the cases of this variety of insanity there is +traceable a hereditary tendency to aberration of mind. Usually one or +more of the direct progenitors, or of the near relatives of the patient, +will be found to have manifested unmistakable marks of unsoundness of +mind. In the remaining one-half cases no such tendency can be traced, +and in these it must be presumed that the mania is a purely local and +temporary disorder of the brain. The incurable cases are usually found +in the first class of patients, as we might naturally expect. + +The likelihood of the children, in turn, inheriting any such +predisposition, depends on the answer to the inquiry we first put. If +the mania itself is the appearance of a family malady, then the chances +are that it will pass downward with other transmissible qualities. But +if the mania arise from causes which are transitory, then there is no +ground for alarm. + +An inquiry still more frequently put to the physician by the husband and +by the patient herself after recovery, is, Whether an attack at one +confinement predisposes her to a similar attack at a subsequent similar +period. There is considerable divergence of opinion on this point. Dr. +Gooch, an English physician of wide experience, is very strenuous in +denying any such increased likelihood, while an American obstetrician of +note is quite as positive in taking the opposite view. The truth of the +matter undoubtedly is, that where the mania is the exhibition of +hereditary tendency, it is apt to recur; but where it arises from +transient causes, then it will only occur again if such causes exist. + + +THE IMPORTANCE OF PREVENTION. + +Here, therefore, we perceive the importance of every woman, who has had, +or who fears to have, one of these distressing experiences, being put on +her guard against disregarding those rules of health the neglect of +which may result so disastrously. One of the most powerful of these +causes is _exhaustion_. We mean this in its widest sense, mental or +physical. In those instances where mania appears at weaning, it is +invariably where the child has been nursed too long, or where the mother +has not had sufficient strength to nourish it without prostrating +herself. It should be observed as a hygienic law, that no mother should +nurse her children after she has had one attack of mania. The mere +nervous excitement is altogether too much for her. She must once and for +ever renounce this tender pleasure. We even go so far as to recommend +that no woman in whose family a mental taint is hereditary shall nurse +her children. + +Anxiety, low spirits, unusual weakness from any cause, are powerful +predisposing causes; and therefore in all cases, especially in those +where the family or personal history leads one to fear such an attack, +they should be avoided. The diet should be nourishing and abundant, but +not stimulating. Cheerful society and surroundings should be courted, +and indulgences in any single train of ideas avoided. As for directions +during the attack, they are unnecessary, as to combat it successfully +often tasks the utmost skill of the physician; and it will be for him to +give these directions. + + +WHITE-FLOWING. + +This affection, though not confined to married women, is quite common +during pregnancy and after confinement. There are few married women who +pass through their lives without at some time or other having suffered +from it. + +We will consider first that _form of white discharge which affects +pregnant women_. It ordinarily comes on during the latter half of +pregnancy. Not only does it occasion much inconvenience, but it may, +when copious, seriously weaken the system and impair the health. + +The best treatment consists in a regulated, but supporting, diet without +stimulants, the avoidance of all marital relations, plenty of rest in +bed or on a sofa, a warm hip bath every morning, and the use of +injections. One of the best injections for this purpose is made by +adding a table-spoonful of lead-water to a pint of water, and injecting +the whole twice a day, by means of a rubber, hard-ball syringe. As this +solution will stain the body-linen, due precautions should be taken. +Instead of this injection, a small tea-spoonful of alum dissolved in a +pint of water and injected once a day may be used. + +We will now say a few words upon the _form of white-flowing which +affects women after childbirth_. It is a common result of too frequent +confinements or of successive abortions. In women of a tendency to +consumption it has been observed that white-flowing is more apt to arise +in connection with child-bearing. Prolonged nursing, resulting in great +debility of the mother, often produces very profuse white discharges. + +In warm countries this affection is much more frequent than elsewhere. +Moist and damp climates are said also to render women particularly prone +to it. + +The _treatment_ must have regard to the general health of the patient. +The mode of life must be regulated. A change of scene, if it can be +procured, is often of the greatest benefit. Baths are also very useful. +They may be taken in the form of a 'sponge bath,' or 'hip bath.' If the +former be preferred, the patient should every morning, in a warm room, +sponge the whole body, at first with tepid water and, after a time, with +cold, the skin being well dried and rubbed with a coarse towel. The +hip-bath may be employed either of simple, or of salt, or of medicated +water. It should be at first warm, and afterwards cold. The skin is to +be well rubbed after the hip as after the sponge-bath. The hip-bath may +be medicated with three or four table-spoonfuls of alum, or with a +quarter of a pound of common household soda. + +In connection with this treatment, injections should be employed in the +manner just directed for the white-flowing of pregnancy. + + +MILK-LEG. + +This affection usually appears about ten days or two weeks after +confinement. The first symptoms which show themselves are general +uneasiness, chills, headache, and a quickened pulse. Then pains in the +groin, extending down the thigh and leg of that side are complained of. +Soon the whole limb becomes enlarged, hot, white, and shining. +Feverishness and sleeplessness now naturally show themselves. + +The disease rarely lasts more than two or three weeks, although the limb +remains stiff, perhaps, for a number of weeks longer. It is painful, but +not dangerous--rarely proving fatal. + +When one leg is recovering, the disease sometimes attacks the other, and +runs through the same course. + +The treatment consists in enveloping the limb in turpentine stupes, +followed by the application of poultices to the groin and a light diet +at first. So soon as the severity of the attack is over, tonics and a +generous diet should be given. The limb is then to be painted with +tincture of iodine, or rather a mixture of one part of the tincture of +iodine with two parts of alcohol, and afterwards wrapped in a flannel +bandage. + +The term 'milk-leg' has been applied to this inflammation, for such it +is, from the notion that in some way the milk was diverted from the +breasts to the limb causing the white swelling. It is scarcely +necessary to say this theory is entirely erroneous. + + +INWARD WEAKNESS. + +Many, we may say most, married women whose health is broken down by some +disease peculiar to their sex, refer the commencement of their suffering +to some confinement or premature birth. Perhaps, in four cases out of +five, this breaking down is one of the symptoms of a displacement of the +internal organs,--a malposition, in other words, of the uterus. This is +familiarly known as an 'inward weakness;' and many a woman drags through +years of misery caused by a trouble of this sort. + +It is true that these malpositions occur in unmarried women, and +occasionally in young girls. But it is also true that their most +frequent causes are associated with the condition of maternity. The +relaxation of the ligaments or bands which hold the uterus in its place, +which takes place during pregnancy and parturition, predisposes to such +troubles. It requires time and care for these ligaments to resume their +natural strength and elasticity after childbirth. Then, too, the walls +of the abdomen are one of the supports provided by nature to keep all +the organs they contain in proper place by a constant elastic pressure. +When, as in pregnancy, these walls are distended and put on the strain, +suddenly to be relaxed after confinement, the organs miss their support, +and are liable to take positions which interfere with the performance of +their natural functions. Therefore we may rightly place the greater +tendency of married women to this class of diseases among the perils of +maternity. + +Within the last fifteen years, probably no one branch of medical science +has received greater attention at the hands of physicians than this of +diseases of women. Many hitherto inexplicable cases of disease, much +suffering referred to other parts of the system, have been traced to +local misfortunes of the character we have just described. Medical works +are replete with cases of the highest interest illustrative of this. We +are afraid to state some of the estimates which have been given of the +number of women in this country who suffer from these maladies; nor do +we intend to give in detail the long train of symptoms which +characterize them. Such a sad rehearsal would avail little or nothing to +the non-medical reader. It is enough to say, that the woman who finds +herself afflicted by manifold aches and pains, without obvious cause; +who suffers with her head and her stomach and her nerves; who discovers +that, in spite of the precepts of religion and the efforts of will, she +is becoming irritable, impatient, dissatisfied with her friends, her +family, and herself; who is, in short, unable any longer to perceive +anything of beauty and of pleasure in this world, and hardly anything to +hope for in the next,--this woman, in all probability, is suffering from +a displacement or an ulceration of the uterus. Let this be relieved, and +her sufferings are ended. Often a very simple procedure can do this. We +recall to mind a case described in touching language by a distinguished +teacher of medicine. It is of an interesting young married lady, who +came from the Southern States to consult him on her condition. She could +not walk across the room without support, and was forced to wear, at +great inconvenience to herself, an abdominal supporter. Her mind was +confused, and she was the victim of apparently causeless unpleasant +sensations. She was convinced that she had been, and still was, +deranged. + +The physician could discover nothing wrong about her system other than a +slight falling of the womb. This was easily relieved. She at once +improved in body and mind, soon was able to walk with ease and freedom, +and once more enjoyed the pleasure of life. In a letter written soon +after her return home, she said, 'This beautiful world, which at one +time I could not look upon without disgust, has become once more a +source of delight.' How strongly do these deeply felt words reveal the +difference between her two conditions! + +There is one source of great comfort in considering these afflictions. +It is, that they are in the great majority of cases traceable to + + +CAUSES WHICH ARE AVOIDABLE. + +Most of them are the penalties inflicted by stern nature on infractions +of her laws. Hence the great, the unspeakable, importance of women being +made aware of the dangers to which they are exposed, and being fully +informed how to avoid them. This task we now assume. + +There is, we concede, a tendency in the changes which take place during +pregnancy and parturition to expose the system to such accidents. But +this tendency can be counteracted by care, and by the avoidance of +certain notorious and familiar infractions of the laws of health. It is +usually not until she gets up and commences to go about the house, that +the woman feels any pain referable to a displaced womb. Very frequently +the origin of it is leaving the bed too soon, or attempting to do some +work, too much for her strength, shortly after a premature birth or a +confinement. Not only should a woman keep her bed, as a rule, for +nineteen days after every abortion and every confinement, but for weeks +after she commences to move about she should avoid any severe muscular +exertion, especially lifting, long walks, straining, or working on the +sewing-machine. Straining at stool is one of the commonest causes. Many +women have a tendency to constipation for weeks or months after +childbirth. They are aware that it is unfavorable to health, and they +seek to aid nature by violent muscular effort. They cannot possibly do a +more unwise act. Necessarily the efforts they make press the womb +forcibly down, and its ligaments being relaxed, it assumes either +suddenly on some one well-remembered occasion, or gradually after a +succession of efforts, some unnatural position. The same reasoning +applies to relieving the bladder, which is connected in some persons +with undue effort. + +Constipation, if present, must, and almost always can, be relieved by a +judicious diet, and the moderate use of injections. These simple methods +are much to be preferred to purgative medicines, which are rarely +satisfactory if they are continued for much time. When anything more is +needed, we recommend a glass of some laxative mineral water, which +should be taken before breakfast. + +For the difficulty with the bladder we mentioned, diet is also +efficacious. It is familiarly known that several popular articles of +food have a decided action in stimulating the kidneys: for instance, +asparagus and water-melon. Such articles should be freely partaken, and +their effect can be increased by some vegetable infusion, taken +warm,--as juniper-tea or broom-tea. The application to the parts of a +cloth wrung out in water as hot as it can conveniently be borne, is also +a most excellent assistant to nature. + +Similar strains on the muscles of the abdomen are consequent on violent +coughing and vomiting. Therefore these should be alleviated, as they +always can be, by some anodyne taken internally. Any medical man is +familiar with many such preparations, so that it seems unnecessary to +give any formula, particularly as it would have to be altered, more or +less, to suit any given case. + + +OTHER CAUSES OF INWARD WEAKNESS. + +Women of languid disposition and relaxed muscles are frequently urged to +'take exercise,' and to 'go to work.' Their condition sometimes excites +censure rather than commiseration, because it is thought that they do +not exert, and thus strengthen, themselves as much as they should. We +are quite as much in favour of work and vigorous muscles as any one. But +often it were the most foolish advice possible to give a woman, to tell +her to seek active exercise. It is just what she should avoid, as it may +ultimately give rise to that very trouble which, now only threatening, +is the cause of her listlessness. Many instances are familiar to every +physician of extensive experience, where a long walk, a hard day's work, +a vigorous dance in the evening, or a horseback ride, has left behind it +a uterine weakness which has caused years of misery. Especially after +confinement or premature delivery it is prudent for a woman to avoid any +such exertion for months and months. Moderate employment of her muscles +in any light avocation, short walks and drives, fresh air, with +judicious exercise,--these are well enough in every instance, but beyond +them there is danger. We know too well that advice like this will sound +like mockery to some who read these lines. They have to work, and work +hard; they have no opportunity to spare themselves; the iron hand of +necessity is upon them, and they must obey. We can but sympathize with +them, and cheer them with the consolation that many a woman has borne +all this and lived to a healthy and happy old age. Nature has surrounded +the infinitely delicate machinery of woman's organization with a +thousand safeguards, but for all that, the delicacy remains; and it is +because so many women are forced to neglect their duties to their +ownselves, that so many thousands walk the streets of our great cities, +living martyrs. + +But no. We must modify what we have just written. In justice to our own +sex, and in all truthfulness, we cannot allow the blame to be removed +altogether from women themselves. They alone are responsible for one of +the most fruitful causes of their wretchedness. The theme is a +threadbare one. We approach it without hardly any hope that we shall do +good by repeated warnings utterly monotonous and tiresome. But still +less can we feel comfortable in mind to pass it over in silence. We +refer to the foolish and injurious pressure which is exerted on the +lower part of the chest and the abdomen by tight corsets, belts, and +bands to support the under-clothing; in other words, + + +TIGHT LACING. + +Why it is, by what strange freak of fashion and blindness to artistic +rules, women of the present day think that a deformed and +ill-proportioned waist is a requisite of beauty, we do not know. +Certainly they never derived such an idea from a contemplation of those +monuments of perfect beauty bequeathed to posterity by the chisels of +Attic artists, nor from those exquisite figures which lend to the canvas +of Titian and Raphael such immortal fame. Look, for instance, at that +work of the former artist, now rendered so familiar by the +chromo-lithographic process, called 'Titian's Daughter.' It is the +portrait of a blonde-haired maiden holding aloft a trencher heaped with +fruits. She turns her face to the beholder, leaning slightly backward to +keep her equilibrium. Her waist is encircled by a zone of pearls; and it +is this waist we would have our readers observe with something more than +an aesthetic eye. It is the waist of health as well as beauty. Narrower +than either the shoulders or the hips, it is yet anything than that +'wasplike waist,' which is so fashionable a deformity. With such a +waist, a woman is fitted to pass through her married state with health +and pleasure. There is little fear that she will be the tenant of +doctors' chairs, and the victim of drugs and instruments. Let women aim +at beauty, let them regard it as a matter of very high importance, worth +money and time and trouble, and we will applaud them to the echo. But +let them not mistake deformity, vicious shape, unnatural and injurious +attitudes, and hurtful distortions for beauty. That not only degrades +their physical nature, but it lowers their tastes, and places them in +aesthetics on a level with the Indian squaw who flattens her head and +bores her nose, and with the Chinese woman who gilds her teeth, and +compresses her foot into a shapeless mass. True beauty is ever +synonymous with health; and the woman who, out of subservience to the +demands of fashion, for years squeezes her waist and flattens her +breast, will live to rue it when she becomes a mother. Away, then, with +tight corsets and all similar contrivances. + +Of a similar objectionable character are many of the devices which +ignorant men connected with the medical profession urge upon the public +for the sake of remedying curvature of the spine, restoring the figure, +or supporting the abdomen. Not a few of such braces and supporters are +seriously dangerous. A good brace, well-fitting, carefully adjusted, +suited to the particular case, is often of excellent service; but the +majority of them do not answer this description. Our advice is, that no +girl, and still more no mother, should wear one of these without it is +fitted upon her by an experienced hand. We have known more than one +instance where the binder put on after childbirth has been wrongly +placed, and pinned so firmly that it has resulted in producing falling +of the womb. This, too, should be sedulously looked after. + +All these are causes which are strictly under the control of the woman +herself. They are therefore such as she should have in mind and be on +her guard against. There are others, but they are less frequent, which +are beyond her power; and it would be labor lost, therefore, for us to +mention them. + +Equally vain would it be for us to speak of the various means by which +difficulties of this nature are removed. Probably no one branch of +medical surgery has been more assiduously cultivated than this; and the +number of supporters, pessaries, braces, and levers which have been +recently brought before the medical profession for this purpose is +simply appalling. There are women and men who make it their business to +carry them through the country and sell them on commission. We +distinctly warn our readers against this class. They are almost +invariably ignorant and unscrupulous, rich in promises, and regardless +of performances. She who patronizes them will be sure to lose her money, +and will be lucky if she does not forfeit her health also. + +The most we shall do is to give some advice how to treat such complaints +on principles of hygiene. And indeed this means nearly one-half the +battle. For without these simple cares, treatment of any kind is +useless, and sure to fail; and with them, many complaints are remedied +as well as avoided. + + +THE HYGIENIC TREATMENT OF INWARD WEAKNESS. + +The first point we would urge is, that the woman who finds herself thus +afflicted should seek to have such a position that she can _rest_. If +she is burdened with family cares, let her, if possible, diminish or +escape them for a time. A rest of a month or two, not at a fashionable +watering-place, nor at a first-class hotel in some noisy city, but in +quiet lodgings, or with some sympathizing friend, will be of great +advantage. This she should obtain without travelling too far. Prolonged +motion in railway carriages is in every instance injurious. If it must +be undertaken, for instance, in order to consult a qualified physician +or to reach some friends, the modern appliances of comfort, such as +air-cushions, foot-rests, and head-supports, should be provided. They +cost but little, and to the invalid their value is great. No such +journey should be undertaken at or near the time when the monthly +illness might come on, as the suffering is always greater at these +periods. + +The pleasant associations which group themselves around a _happy home_ +are an important element in the treatment of diseases which, like these, +are so intimately connected with the mind and nervous system. It will +not do heedlessly to throw such advantages away. When the home _is_ +pleasant, and rest can there be had, the patient, in the majority of +instances, will do well to abide there. But when this is not the case, +for any reason, be it domestic infelicities, in which the husband has a +share,--be it disagreeable relatives, or importunate and tedious +visitors,--then the sooner such a mental weight is removed or avoided +the better. + +The _diet_ is a very common subject of error. It is popularly supposed +that everybody who is weak should eat a 'strengthening' diet,--meat +three times a day,--eggs, ale, and beef-tea to any extent. This is a +great error. Frequently such a diet has just the contrary effect from +what is expected. The patient becomes dyspeptic, nervous, and more +debilitated than ever. The rule is, that only that diet is strengthening +which is thoroughly digested, and taken up in the system. Frequently, we +may say in the majority of cases, a small amount of animal food, +especially game, fowls, fish, and soups, with fresh vegetables, and ripe +fruits, will be far more invigorating than heavier foods. Pastry, cakes, +and confectionery should be discarded, and great regularity in the hours +of meals observed. Stimulants of all kinds are, as a rule, unnecessary, +and highly spiced food is to be avoided. There is an old German proverb +which says, 'Pepper helps a man on his horse, and a woman to her grave.' +This is much too strong; but we may avail ourselves, in this connection, +of the grain of truth that it contains. + +_Cleanliness_, in its widest sense, is an important element in the +treatment. Not only should the whole surface of the body be thoroughly +washed several times a week, but the whole person should be _soaked_ by +remaining in the water for an hour or more. This has an excellent +effect, and is far from unpleasant. It was regarded in the days of +ancient Rome as such a delightful luxury, and such a necessity, indeed, +that every municipality erected public bathing establishments, with +furnaces to heat the water to such a temperature that persons could +remain in it for several hours without inconvenience. + +The use of public baths is almost unknown in this country; but, in place +of them, every modern house of even moderate pretensions has its own +bath-room, so that the custom of cleanliness might appear to be hardly +less general among all classes than in old Rome. + +The difficulty is, that so few people appreciate that to thoroughly +cleanse the skin, still more for the bath to have a medicinal effect, it +must be prolonged far beyond the usual time we allow it. The European +physicians, who, as a rule, attach much greater importance to this than +ourselves, require their patients to remain immersed two, three, four, +and occasionally even ten or twelve hours daily! This is said to have +most beneficial results; but who would attempt to introduce it in this +country? + +Local cleanliness is of equal importance. This is obtained by means +of---- + + +INJECTIONS AND IRRIGATIONS + +of simple water, or of some infusion or solution. The use of the syringe +as an article of essential service in preserving the health of married +women should never be overlooked. Even when they are aware of no +tendency to weakness or unusual discharge, it should be employed once or +twice a week; and when there is debility or disease of the parts +actually present, it is often of the greatest service. + +There are many varieties of female syringes now manufactured and sold, +some of which are quite worthless. Much the most convenient, cleanly, +and efficient is the self-injecting india-rubber syringe, which is +worked by means of a ball held in the hand, and which throws a constant +and powerful stream. They come neatly packed in boxes, occupying small +space, and readily transported from place to place. Much depends on +knowing how to apply them. The patient should be seated on the edge of a +low chair or stool with a hard seat, immediately over a basin. The tube +should then be introduced as far as possible without causing pain, and +the liquid should be thrown up for five or ten minutes. About one or two +quarts may be used of a temperature, in ordinary cases, a little lower +than that of the apartment. Water actually cold is by no means to be +recommended, in spite of what some physicians say to the contrary. It +unquestionably occasionally leads to those very evils which the +judicious use of the syringe is intended to avoid. + +No fluid but water should be used in ordinary cases. When, however, +there is much discharge, a pinch of powdered alum can be dissolved in +the water; and when there is an unpleasant odor present, a sufficient +amount of solution of permanganate of potash may be added to the water, +to change it to a light pink color. This latter substance is most +admirable in removing all unpleasant odors; but it will stain the +clothing, and must on that account be employed with caution. + +We will add a few warnings to what we have just said about injections. +There are times when they should be omitted,--as for instance during the +periodical illness, when the body is either chilled or heated, and +generally when their administration gives pain. There are also some +women in whom the mouth of the womb remains open, especially those who +have borne many children. In such cases, the liquid used is liable to be +thrown into the womb itself, and may give rise to serious troubles. +These should either omit the use of the syringe altogether, or obtain +one of those which throw the water backward and not forward. This +variety is manufactured and sold by various dealers. + +_Irrigations_ are more convenient in some respects than injections. They +are administered in the following manner:--A jar holding about a gallon +of water, simple or medicated, as may be advisable, is placed upon a +table or high stand. A long india-rubber tube is attached to the bottom +of the jar, ending in a metallic tube, and furnished with a stopcock. +The patient seats herself on the edge of a chair over a basin, +introduces the tube, and turns the stopcock. The liquid is thus thrown +up in a gentle, equable stream, without any exertion on her part. No +assistant is required, and the force and amount of the liquid can be +exactly graduated by elevating or lowering the jar, or by turning the +stopcock. When there is much debility, or when it is desirable to apply +the liquid for a long time, this method is much preferable to syringing. +The necessary apparatus can readily be obtained in any large city. It +has, however, the drawback that the jar is large, and not convenient to +carry on journeys. + +We shall close this chapter on Health in Marriage by a few words on some +of the _ailments to which mothers are subject while nursing._ + + +GATHERED BREASTS. + +Gathering of the breasts may occur at any time during the period of +nursing, but it is most frequently met with within the first three +months after childbirth, and is more common after the first than after +subsequent confinements. All women are more or less liable to it, but +those who are weakly, and particularly those who are scrofulous, are +most prone to its attacks. + +The _causes_ of inflammation of the breast are numerous. It may be +created by a blow or fall, by a cold, by mental excitement, by +indiscretions in eating or drinking, and by moving the arms too much +when the breasts are enlarged, but its most common cause is undue +accumulation of milk in the breasts. Dr. Bedford is of the opinion that +in nineteen cases out of twenty it is the result of carelessness--of +neglect in not having the breasts properly drawn. 'For example, the +child may be delicate, and not able to extract the milk; or the nurse, +in the gratification of some ancient prejudice derived from a remote +ancestry, does not think it proper to allow the infant to be put to the +breast for two or three days after its birth. In this way, the milk +ducts become greatly distended, inflammation ensues, which, if not +promptly arrested, terminates in suppuration.' + +Often the love of pleasure brings with it this punishment to the nursing +mother who neglects her maternal duties. During an evening spent in +society or at the theatre the breasts cannot be relieved in the manner +required for the preservation of their health. + +Soreness of the nipples, which renders suckling painful, often leads the +mother to avoid putting the child to the breast as often as she should. +It is only when forced by the pain in the over-distended parts that she +can summon courage to permit of their being emptied. This partial and +irregular nursing is very dangerous, and cannot fail, in most cases, to +lead to the very painful affection of which we are now speaking. + +No nursing mother is safe whose breasts are not properly and daily +emptied. If this cannot be done by the child, another infant should be +applied, or a small puppy, either of which expedients is preferable to a +breast-pump, which, however, is much better than neither. If the tender +or chapped condition of the nipples interferes with free nursing, this +condition must be promptly remedied. When undue accumulation of milk is +threatened gentle friction of the breasts with sweet oil and camphor is +also of service; and they should be supported by means of a handkerchief +placed under them and tied over the shoulders. + +It must not be forgotten, however, that though _gentle_ rubbing afford +relief to the breasts when they are hard, knotty, and over-distended, +any friction is injurious if gathering has actually commenced. In all +cases, therefore, it is of importance to distinguish between +over-distension (which may _lead_ to inflammation) and a condition of +already established gathering of the breasts. This it is not difficult +to do. In the former case the skin is pale, there is little or no +tenderness, and the hardness is evenly diffused over the whole of the +breast; whereas, when gathering has taken place there is a blush of +redness on some portion of the breast, which is always painful to the +touch, and which will be found to be particularly hard and sore in some +one spot. + +The _symptoms_ of gathered breasts we have just described in part. The +severity of the symptoms will depend upon the extent and depth of the +inflammation. The affection is always ushered in by shivering, followed +by fever and a shooting pain in the breasts. A small, hard, painful +swelling will be noticed in the breast even before the skin shows any +sign of redness. This swelling increases in size and the suffering +becomes very great and difficult to bear, preventing sleep and +prostrating the whole system. The secretion of milk is suspended at +least during the first active stage of the disease. + +The object of _treatment_ is to prevent the formation of an abscess by +subduing the inflammation as speedily as possible. This is to be sought +first by keeping the breast as nearly empty as possible. For this reason +the child should be assiduously applied to the affected rather than to +the well side, although suckling will be painful. Indeed, it is better, +if it can be done, to procure an older child and let it keep the milk +under. When, however, the inflammation is fully established, the pain +will compel the restriction of the child to the well side. The +application of warmth is both grateful to the part and beneficial. This +may be done by means of poultices or fomentations, or by immersing a +wooden bowl in hot water and putting the breast, wrapped in flannel, +within it. This latter means will be found an easy and agreeable one of +keeping up the application of dry heat. The bowels should be briskly +purged by a dose of citrate of magnesia or cream of tartar. The diet +must be mild, and the breasts supported in a sling. If, in spite of all +these efforts, an abscess actually forms, the attending physician will +doubtless advise its immediate opening, to which advice the patient +should accede, as that is the course which will afford her quicker and +more effectual relief than she can hope for from nature's unaided +efforts at effecting a discharge of the pent-up matter. + +It is interesting for the mother to know that if her child be +still-born, or if unfortunately she be unable from any of the reasons +mentioned in our chapter on Hindrances to Nursing to give the breast at +all to her child, she is not liable to gathering on this account. This +is contrary to what might be expected. It is not the mother who is +unable to nurse at all who suffers, but she who does so in an +unsatisfactory manner and who fails to have her breasts properly +emptied. + +The first milk which makes its appearance in the breast towards recovery +from inflammation is likely to be stringy and thick, and should, +therefore, be rejected before nursing is resumed. + + + + +THE SINGLE LIFE. + + +A few words, ere we pass to another branch of our subject, on the +physical relations of her who by choice or other reasons never marries. +It is a common observation among physicians who have devoted themselves +to the study of woman's physical nature, that, in spite of those perils +of maternity which we have taken no pains to conceal, the health of +single women during the child-bearing period is, as a general rule, not +better, not even so good, as that of their married sisters. Those +insurance companies who take female risks, do not ask any higher premium +for the married than the unmarried. + +Various suggestions have been made to account for this unexpected fact. +Some writers have pointed out that in many diseases marriage exerts a +decidedly curative influence, especially in chronic nervous ailments. +Chorea, for instance, or St. Vitus's dance, as it is popularly termed, +has been repeatedly cured by marriage. As a rule, painful menstruation, +which always arises from some defect or disease of the ovaries or +adjacent organs, is improved, and often completely removed, by +the same act. There are, as is well known, a whole series of +emotional disorders,--hysteria, and various kinds of mania and +hallucination,--which are almost exclusively confined to single persons, +and only occur in the married under exceptional circumstances. An +instance has lately been detailed in the medical journals by a Prussian +physician, of a case of undoubted hereditary insanity which was greatly +benefited--indeed temporarily cured--by a fortunate nuptial relation. Few +who have watched a large circle of lady acquaintances but will have +observed that many of them increased in flesh and improved in health when +they had been married some months. An English writer of distinction +accounts for these favourable results in a peculiar manner. Success, he +says, is always a tonic, and the best of tonics. Now, to women, marriage +is a success. It is their aim in social life; and this accomplished, +health and strength follow. We are not quite ready to subscribe to such a +sweeping assertion, but no doubt it is applicable in a limited number of +cases. Our own opinion is, that nature gave to each sex certain +functions, and that the whole system is in better health when all parts +and powers fulfil their destiny. + +Common proverbs portray the character of the spinster as peevish, +selfish, given to queer fancies, and unpleasant eccentricities. In many +a case we are glad to say this is untrue. Instances of noble devotion, +broad and generous sympathy, and distinguished self-sacrifice, are by no +means rare in single women. But take the whole class, the popular +opinion, as it often is, must be granted to be correct. Deprived of the +natural objects of interest, the sentiments are apt to fix themselves on +parrots and poodles, or to be confined within the breast, and wither +for want of nourishment. Too often the history of those sisterhoods who +assume vows of singleness in the interest of religion, presents to the +physician the sad spectacle of prolonged nervous maladies, and to the +Christian that of a sickly sensibility. + +In this connection we may answer a question not unfrequently put to the +medical attendant. Are those women who marry late in their sexual life +more apt to bear living children than the married of the same age; and +are they more likely to prolong their child-bearing period by their +deferred nuptials? To both these inquiries we answer No. On the +contrary, the woman who marries a few years only before her change of +life, is almost sure to have no children who will survive. She is +decidedly less apt to have any than the woman of the same age who +married young. If, therefore, love of children and a desire for +offspring form, as they rightly should, one of the inducements to marry, +let not the act be postponed too long, or it will probably fail of any +such result. + + + + +THE CHANGE OF LIFE. + + +After a certain number of years, woman lays aside those functions with +which she had been endowed for the perpetuation of the species, and +resumes once more that exclusively individual life which had been hers +when a child. The evening of her days approaches; and if she has +observed the precepts of wisdom, she may look forward to a long and +placid period of rest, blessed with health,--honored, yes, loved with a +purer flame than any which she inspired in the bloom of youth and +beauty. Those who are familiar with the delightful memoirs of Madame +Swetchine or Madame Recamier will not dispute even so bold an assertion +as this. + +But ere this haven of rest is reached, there is a crisis to pass which +is ever the subject of anxious solicitude. Unscientific people, in their +vivid language, call it _the change of life_; physicians know it as the +_menopause_--the period of the cessation of the monthly flow. It is the +epoch when the ovaries cease producing any more ova, and the woman +becomes therefore incapable of bearing any more children. + +The age at which it occurs is very variable. In this country from +forty-five to fifty is the most common. Instances are not at all +unusual when it does not appear until the half century has been turned; +and we have known instances where women past sixty still continued to +have their periodical illnesses. + +Examples of very early cessation are more rare. We do not remember to +have met any, in our experience, earlier than thirty years, but others +have observed healthy women as young as twenty-eight in whom the flow +had ceased. + +The physical change which is most apparent at this time is the tendency +to grow stout. The fat increases as the power of reproduction decreases. +And here a curious observation comes in. We have said that when the girl +changes to a woman, a similar deposit of fat takes place (though less in +amount), which commences at the loins. This is the first sign of +puberty. In the change of life the first sign is visible at the lower +part of the back of the neck, on a level with the bones known as the two +lowest cervical vertebrae. Here commences an accumulation of fat, which +often grows to form two distinct prominences, and is an infallible index +of the period of a woman's life. + +The breasts do not partake of this increase, but become flat and hard, +the substance of the gland losing its spongy structure. The legs and +arms lose their roundness of outline, and, where they do not grow fat, +dry up, and resemble those of the other sex. The abdomen enlarges, even +to the extent occasionally of leading the wife to believe that she is to +be a mother,--a delusion sometimes strengthened by the absence of the +monthly sickness. Finally, a perceptible tendency to a beard at times +manifests itself, the voice grows harder, and the characteristics of the +female sex become less and less distinct. + +Some who are more fortunate than their neighbours do not experience the +least discomfort at the change of life. They simply note that at the +expected time the illness does not appear, and for ever after they are +free from it. These are the exceptions. More commonly, marked +alterations in the health accompany this important crisis, and call for +sedulous hygienic care. It is gratifying to know that nearly all these +threatening affections can be avoided by such care, as they depend upon +causes under the control of the individual. Another fact, to which we +have already referred, is full of consolation. It is an unexpected +fact--one that we should hardly credit, did it not rest on statistical +evidence of the most indisputable character. The popular opinion, every +one knows, is, that the period of the change of life is one peculiarly +dangerous to women. If this is so, we might expect that, if the number +of deaths between the ages of forty and fifty years in the two sexes be +compared, we should find that those of females far exceed those of +males. This is, however, not the case. On the contrary, the deaths of +the males exceed in number those of the females. + +Hasty readers may draw a false conclusion from this statement. They may +at once infer that the change of life merits little or no attention, if +it thus in nowise increases the bills of mortality. This would be a +serious error. All intelligent physicians know that there are in very +many cases a most unpleasant train of symptoms which characterize this +epoch in the physical life of woman. They are alarming, painful, often +entailing sad consequences, though rarely fatal. All physicians are, +however, not intelligent; and there are too many who are inclined to +ridicule such complaints, to impute them to fancy, and to think that +they have done their full duty when they tell the sufferer that such +sensations are merely indicative of her age, and that in a year or two +they will all pass away. Such medical attendants do not appreciate the +gravity of the sufferings they have been called to relieve. Says a +distinguished writer on the subject, after entering into some details in +the matter: 'I would not dwell on things apparently so trivial as these, +had I not seen some of the worst misery this world witnesses induced +thereby.' Such a conviction should be in the mind of the physician, and +lead him to attach their full weight to the vague, transitory, unstable, +but most distressing symptoms described to him. + + +SIGNS AND SYMPTOMS. + +We shall speak of the various signs and symptoms which occur at and mark +the change; and in commencing so to do, we call attention to an +interesting illustration of the rhythm which controls the laws of life. +As in old age, when we draw near the last scene of all, we re-enter +childhood, and grow into second infancy, so the woman, finishing her +pilgrimage of sexual life, encounters the same landmarks and stations +which greeted her when she first set out. She obeys at eve the voice of +her own nature which she obeyed at prime. The same diseases and +disorders, the same nervous and mental sensations, the same pains and +weaknesses which preceded the first appearance of her monthly illness, +will in all probability precede its cessation. Even those affections of +the skin or of the brain, as epilepsy, which were suffered in childhood, +and which disappeared as soon as the periodical function was +established, may be expected to reappear when the function has reached +its natural termination. Therefore if a woman past the change notices +that she suffers from bleeding at the nose, headache, boils, or some +skin disease, let her bethink herself whether it is not a repetition of +some similar trouble with which she was plagued before the eventful +period which metamorphosed her from a girl into a woman. + +So true is what we have just said, that in detailing the symptoms which +frequently occur at the change of life, we could turn back to the +previous pages where we discussed the dangers of puberty, and repeat +much that we there said as of equal application here. For instance, the +green-sickness, _chlorosis_, is by no means exclusively a disease of +girls. It may occur at any period of child-bearing life, but is much +more frequent at the _beginning_ and the _end_ of this term. Hardly any +one has watched women closely without having observed the peculiar tint +of skin, the debility, the dislike of society, the change of temper, the +fitful appetite, the paleness of the eye, and the other traits that show +the presence of such a condition of the nervous system in those about +renouncing their powers of reproduction. The precautions and rules which +we before laid down, can be read with equal profit in this connection. + +In addition to these symptoms, which in a measure belong to the +individual's own history, there are others of a general character which +betoken the approaching change. One of them is an increasing +irregularity in the monthly appearance. This is frequently accompanied +with a sinking sensation,--a 'feeling of goneness,' as the sufferer +says--at the pit of the stomach, often attended by flushes of heat, +commencing at the stomach and extending over the whole surface of the +body. The face, neck, and hands are suffused at inopportune moments, and +greatly to the annoyance of the sufferer. This is sometimes accompanied +by a sense of fulness in the head, a giddiness, and dulness of the +brain, sometimes going so far as to cause an uncertainty in the step, a +slowness of comprehension, and a feeling as if one might fall at any +moment in some sort of a fit. + +This is not the worst of it. These physical troubles react upon the +mind. An inward nervousness, intensely painful to bear, is very sure to +be developed. She fears she will be thought to have taken liquor, and to +be overcome with wine; she grows more confused, and imagines that she is +watched with suspicious and unkind eyes, and often she worries herself +by such unfounded fancies into a most harassing state of mental +distress. Society loses its attractions, and solitude does but allow her +opportunity to indulge to a still more injurious extent such brooding +phantasms. Every ache and pain is magnified. Does her heart palpitate, +as it is very apt to do? Straightway she is certain that she has some +terrible disease of that organ, and that she will drop down dead some +day in the street. Is one of her breasts somewhat sore, which, too, is +not unusual? She knows at once it is a cancer, and suffers an agony of +terror from a cause wholly imaginary. + +Vibrating between a distressing excitement and a gloomy depression, her +temper gives way; and even the words of the Divine Master lose their +influence over her. She becomes fretful, and yet full of remorse for +yielding to her peevishness; she seeks for sympathy, without being able +to give reasons for needing it; she annoys those around her by +groundless fears, and is angered when they show their annoyance. In +fine, she is utterly wretched, without any obvious cause of +wretchedness. + +This is a dark picture, but it is a true one--inexorably true. Let us +hasten to add that such a mental condition is, however, neither a +necessary nor a frequent concomitant of the change. We depict it, so +that friends and relatives may better appreciate the sufferings of a +class too little understood, and so that women themselves, by knowing +the cause of such complaints, and the sad results which flow from them, +may make the more earnest efforts to avoid them. + +Other symptoms are, a sense of choking, a feeling of faintness, shooting +pains in the back and loins, creepings and chilliness, a feeling as if a +hand were applied to the back or the cheek, a fidgety restlessness, +inability to fix the mind on reading or in following a discourse, and a +loss of control over the emotions, so that she is easily affected to +tears or to laughter. All these merely indicate that nature is employing +all her powers to bring about that mysterious transformation in the +economy by which she deprives the one sex for ever of partaking in the +creative act after a certain age, while she only diminishes the power of +the other. + + +EFFECTS ON THE CHARACTER. + +The effects on the character of this 'grand climacteric' are often +marked. Not unfrequently the woman becomes more masculine in thought and +habit, as has been admirably described by Dr. Tilt:--'There are almost +always while the change is progressing various forms of nervous +irritability and some amount of confusion and bewilderment, which seem +to deprive women of the mental endowments to which they had acquired a +good title by forty years' enjoyment. They often lose confidence in +themselves, are unable to manage domestic or other business, and are +more likely to be imposed on either within or without the family circle. +When the change is effected, the mind emerges from the clouds in which +it has seemed lost. Thankful that they have escaped from real +sufferings, women cease to torture themselves with imaginary woes, and +as they feel the ground grow steadier underfoot, they are less dependent +on others--for, like the body, the mental faculties then assume a +masculine character. The change of life does not give talents, but it +often imparts a firmness of purpose to bring out effectively those that +are possessed, whether it be to govern a household, to preside in a +drawing-room, or to thread and unravel political entanglements. When +women are no longer hampered by a bodily infirmity periodically +returning, they have more time at their disposal, and for obvious +reasons they are less subject to be led astray by a too ardent +imagination, or by wild flights of passion.' + +Changes in the moral character also frequently show themselves, and for +a time astonish friends and relatives. These shades of moral insanity +all disappear in a little while, if there be no family tendency to +insanity to prolong and intensify them. + + +THOSE WHO SUFFER MOST. + +Those women especially may anticipate serious trouble at this epoch in +whom the change at puberty was accompanied by distressful and obstinate +disorders,--those in whom the menstrual periods have usually been +attended with considerable pain and prostration, and those in whose +married life several abortions or several tedious and unnatural labors +have occurred; also those who from some temporary cause are reduced in +health and strength,--as from repeated attacks of intermittent fever, or +disorders of the liver and digestive organs. Still more predisposed are +they who are subject to some of those displacements or local ulcerations +which we have mentioned in our chapter on Health in Marriage. It becomes +of great consequence, that any such deviation from the healthy standard +shall be corrected before a woman reaches this trying passage in her +career. + +The constitution and temperament have much to do with the liability to +disease and suffering during the change of life. Those of weak +constitutions sometimes fail of the necessary stamina to carry them +easily through the trials of this transition period. It has been +remarked that the _lymphatic_ temperament is the most favorable to an +easy change. Women with this temperament suffer less from nervous or +bilious disorders, and quickly show signs of having been benefited by +what has occurred. Those of a _sanguine_ temperament are more liable to +floodings and to head symptoms; but such disorders with them usually +readily yield to treatment. The _bilious_ temperament predisposes to +disorders of the stomach and liver at this epoch; while the union of the +nervous with the bilious temperament seems to predispose to mental +diseases. The most suffering at this time of life is experienced by +women of a _nervous_ temperament. + +The social position exerts an influence on the pain and the tendency to +disease at this epoch. The poor who are forced to labor beyond their +strength and who are exhausted by fatigue, anxiety, and want, suffer +much. So also do those who have recently been exposed to some great +sorrow. As the poet says:-- + + Danger, long travel, want, or woe, + Soon change the form that best we know---- + For deadly fear can time out-go, + And blanch at once the hair. + Hard toil can roughen form and face, + And want can quell the eye's bright grace, + Nor does old age a wrinkle trace + More deeply than despair. + +The occupations of women also have an influence upon the change of life. +Washerwomen are said in particular to suffer more than others on account +of the exposure to which they are subject by their trade. Those who are +confined many hours a day in close or damp rooms are unfavorably +situated for passing through the various stages of the 'grand +climacteric.' The rich, with plenty of time and means to care for +themselves, often blindly or obstinately create an atmosphere about them +and follow a mode of life, quite as deleterious as the enforced +surroundings of their poorer sisters. + + + + +DISEASES AND DISCOMFORTS. + +In rather more than one out of every four cases the change of life is +either ushered in or accompanied by considerable flooding. When this +occurs at the regular period, and is not in sufficient quantity to cause +debility, and is not associated with much pain, it need not give rise to +any alarm. It is an effort of nature to relieve the impending plethora +of the system, to drain away the excessive amount of blood which would +otherwise accumulate by the cessation of the flow. When it is remembered +that every month, for some thirty years of life, the woman of forty-five +has been moderately bled, we need not wonder that suddenly to break off +this long habit would bring about a plethora, which would in turn be the +source of manifold inconveniences to the whole system. Therefore this +flooding may be regarded as a wise act of nature, and, as such, allowed +to take its course so long as it is not attended with the symptoms +mentioned above. When this is the case, however, the doctor should be +consulted, as then the bleeding may be from inflammation or ulceration, +or even from that dreaded foe to life, cancer. + +Instead of finding this exit, the blood occasionally is thrown off by +bleeding at the nose, or is spat up from the lungs, or is passed from +bleeding piles. Due caution must be used about stopping such discharges +too promptly. Rest, cool drinks, and the application of cold to the +parts, are generally all that is needed. + +We have just spoken of cancer. This is a subject of terror to many +women, and their fears are often increased and deliberately played upon +by base knaves who journey about the country calling themselves 'cancer +doctors,' and professing to have some secret remedy with which they work +infallible cures. It should be generally known that all such pretensions +are false. It is often a matter of no little difficulty, requiring an +experienced eye, to pronounce positively whether a tumour or ulcer is +cancerous. These charlatans have no such ability; but they pronounce +every sore they see a cancer, and all their pretended cures are of +innocent, non-malignant disorders. Cancers are more apt to develope +themselves at this period. Their seat is most frequently in the womb or +the breast, and they are said to be especially liable to arise in those +women who have suffered several abortions or unnatural labours. +Undoubtedly they are more frequent in the married than the unmarried, +and they evidently bear some relation to the amount of disturbance which +the system has suffered during childbirth, and the grief and mental pain +experienced. For this reason a celebrated teacher of obstetrics insists +upon classing them among nervous diseases. The surgeon alone can cure +them, and he but rarely. Medicine is of no avail, however long and +painstaking have been its searches in this direction. A touching story +is related in this connection of Raymond Sully, the celebrated +philosopher. When a young man, he was deeply impressed with the beauty +of a lady, and repeatedly urged his suit, which she as persistently +repelled, though it was evident she loved him. One day, when he insisted +with more than usual fervor that she should explain her mysterious +hesitation, she drew aside the folds of her dress and exposed her +breast, partly destroyed by a cancer. Shocked and horrified, but unmoved +in his affection, he rushed to the physicians and demanded their aid. +They replied they could give none. He determined to find a cure, if he +had to seek in all parts of the earth. He visited the learned doctors of +Africa and Asia, and learned many wonderful things--even, it was said, +the composition of the philosopher's stone itself; but what he did not +find, and what has never yet been found, was what he went forth to +seek--a cure for cancer. + +At this time, too, tumors or swellings of the ovaries are apt to +commence. They are nearly always preceded by scanty or painful +menstruation; and this, therefore, it is the duty of every woman, as she +values the preservation of her future health, to remedy by every means +in her power. + +Generally, from the commencement of the change of life commences also a +steady diminution of the sexual passions, and soon after this period +they quite disappear. Sometimes, however, the reverse takes place, and +the sensations increase in intensity, occasionally exceeding what they +even were before. This should be regarded with alarm. It is contrary to +the design of nature, and can but mean that something is wrong. +Deep-seated disease of the uterus or ovaries is likely to be present, or +an unnatural nervous excitability is there, which, if indulged, will +bring about dangerous consequences. Gratification, therefore, should be +temperate, and at rare intervals, or wholly denied. + + +PRECAUTIONS AND REMEDIES. + +To guard against the dangers of this epoch, those general rules of +health which we have throughout insisted upon should be rigidly +observed. If during the whole of her sexual life the woman has been +diligent in observing the laws of health, she has little to fear at this +period. Some simple remedies will suffice to allay the disagreeable +symptoms; and the knowledge that most of them are temporary, common to +her sex, and not significant of any peculiar malady, will aid her in +opposing their attacks on her peace of mind. When plethora, flooding, +or congestion is apparent, the food should be light, chiefly vegetable, +and moderate in quantity. Liquors, wines, strong tea, coffee, and +chocolate should be avoided; an occasional purgative or a glass of some +laxative mineral water should be taken, and cool bathing regularly +observed. Exercise should be indulged in with caution, and care taken to +avoid excitement, severe mental or bodily effort, and exhaustion. If the +system is debilitated, and the danger is rather from a want of blood +than too much blood, nourishing food, tonic medicines, and perhaps some +stimulant, are called for. When the perspiration is excessive, flannel +should be worn next the skin in the daytime, and a flannel night-dress +at night. A tepid bath before retiring is also useful. The 'goneness' +and other unpleasant sensations referred to the pit of the stomach may +be much relieved by wearing a well-made spice-plaster over the stomach, +or binding there a bag of gum camphor; or if these fail, an opium +plaster will hardly fail to be of service. Internally, we think, nothing +at all is needed; but as something must be taken, let it not be spirits +or wine, but half a tea-spoonful of aromatic spirits of ammonia in a few +table-spoonfuls of water. There is too much of a tendency among some +women to seek alleviation in intoxicating compounds, 'bitters,' +'tonics,' and so forth, at such times. They can only result in injury, +and should be shunned. The pains in the back and loins often +experienced, can generally be removed by rubbing the parts with hot +mustard-water and taking a gentle purgative, or by placing against the +lower part of the spine a hot brick wrapped in a flannel cloth wrung +out in warm water or laudanum and water. + +Once safely through this critical period, the woman has a better chance +for long life and a green old age than the man of equal years. Tables of +human life show this conclusively. With the sweet consciousness of duty +performed, she is now prepared to assist others by intelligent advice, +cheerful counsel, and tender offices; she can now surround herself with +that saintly halo of kind words and good works which wins a worthier +love than passion offers; and, passing onward to the silence of eternal +rest, she will leave in the memory of all who knew her, pleasant +impressions and affectionate reminiscences. + + + + +NOTES. + + +P. 20. HERMAPHRODITES AND ASEXUALISM.--Rokitansky decides Hohmann to be +a case of _hermaphrodita vera lateralis_, and all who examine her say +the same. See _Wiener Medicin. Wochenschrift_, October, 1868, and the +_Medical and Surgical Reporter_, vol. xix. p. 487. A marked case of +asexualism, proven so by a _post mortem_ examination, is reported in the +_Buffalo Medical and Surgical Journal_ for April, 1869, p. 338; and +another in the _Medical Times and Gazette_ of about the same date. We +might refer to many more recent and authentic cases. + +P. 25. AGE OF PUBERTY.--See case by Dr. T. H. Twiner, in the _Richmond +and Louisville Medical Journal_, March, 1869, Raciborski, _De la +Menstruation et de l'Age Critique chez la Femme_, p. 130. The quotation +(p. 26) is from Dr. Edward Smith, _Cyclical Changes in Health and +Disease_,--a profound work. Raciborski is the principal authority for +this and the following section. Our own inquiries fully confirm his +statements. + +P. 32. INFLUENCE OF THE MOON ON MENSTRUATION.--On this question, see the +researches of M. Parchappe, _Comptes Rendus de l'Academie des Sciences_, +tom. xvi. p. 550. See also Dr. Shrye, _Tractatus de Fluxu Menstruo_, in +the _Acta Lipsiensia_ for 1686, p. 111; Dr. W. Charleton, _Inquisitio +Physica de Causis Catameniorum_, p. 78; and Galen, _De Diebus +Decretoriis_, lib. iii., for other curious particulars. + +P. 37. CHLOROSIS.--For the pathology of this disease, see Dr. Gaillard +Thomas, _Diseases of Women_, p. 625, and Dr. C. H. Bauer, in the +_Weiner Medicin. Zeitung_, No. 33, 1868. Occasionally the change at +puberty leads to an affection very closely resembling typhoid fever, but +which is strictly due to the sexual crisis; and often goitre commences +at this period. See a review of Raciborski, in the _Bulletin de +Therapeutique_, June, 1869. + +P. 39. MASTURBATION IN GIRLS.--See Miss Catherine E. Beecher, _Letters +to the People on Health and Happiness_, p. 159. The late medical +literature on the subject is abundant. See _Ueber die Behandlung der +Masturbation bei kleinen Maedchen, Journal juer Kinderkrankheiten_, Bd. +li. p. 360; H. R. Storer, _Western Journal of Medicine_, July, 1868; and +_Journal of the Gynecological Society_, vol. i. No. 1. + +Pp. 50, 51. PREMATURE MARRIAGES.--See Dr. Duncan, _Fecundity, +Fertility_, etc., p. 241; Reich, _Natur und Gesundheitslehre des +Ehelichen Lebens_, p. 518. + +P. 56. HOLY LOVE.--The distinction between [Greek: haghape] and [Greek: +irhohe] is too familiar to all scholars to need extended mention. See +Trench, _Synonyms of the New Testament, sub voce._ + +Pp. 57, 58. SINGLE LIFE IN ITS RELATION TO SANITY AND MORTALITY.--The +extraordinary statements in the text are vouched for by Dr. Casper, +_Medicinische Statistik_, vol. ii. p. 164, and Dr. Reich, _Geschichte, +Natur, und Gesundheitslehre des Ehelichen Lebens_, pp. 510, 511. We have +compared the reports of a number of asylums for the insane, and find the +proportions very nearly as great as stated by these authorities. + +P. 70. INTERMARRIAGE OF RELATIVES.--The view we advocate on this point, +we know, is neither the received nor the popular one. In the middle ages +it was forbidden to intermarry within the seventh degree of +consanguinity; but this and all other regulations were based on +theological and political, not physiological, grounds. Among others, Dr. +Nathan Allen has insisted on the danger of consanguineous marriages +(_Journal of Psychological Medicine_, Volume ii). But other very careful +and recent students adopt the view of our text: for instance, Dr. F. J. +Behrend, _Journal fuer Kinderkrankheiten_, December, 1868, p. 316; Dr. A. +Voisin, in the reports of the _Paris Academie de Medecin_,1864, 1865, +and 1868; and Dr. H. Gaillard, in the last edition (1868) of the +_Dictionnaire de Medecine et de Chirurgie Pratique_. All the statements +in the text are supported with incontrovertible evidence by these +writers. If we are asked how to meet the seemingly alarming array of +allegations by Dr. Bemiss, the Kentucky physician referred to in the +_Transactions of the American Medical Association_ for 1859, we would +refer to Dr. Behrend's articles, where the researches of Bemiss are +severely criticised. For Dr. Edward Smith's assertion, see his _Essay on +Consumption_, p. 244 (Philadelphia, 1865). + +P. 80. COMMUNICATION OF VENEREAL DISEASES.--Many instances are recorded +where a drinking-glass, a spoon, a fork, or a handkerchief has infected +innocent persons with these terrible diseases (see Cullerier, _Atlas of +Venereal Diseases_, p. 43). They are communicated from the male to the +female, or from the female to the male, with equal facility, and either +parent can transmit them to the children. The physician referred to is +Dr. Sigmund, in the _Humboldt Medical Archives_, 1868. + +P. 83. SYMBOLISM.--See Dr. Carus, _Symbolik der Menschlichen Gestalt_, +the most scientific work ever written on physiognomy, phrenology, and +allied subjects. + +Pp. 90, 91.--See Raciborski, _De la Puberte et de l'Age Critique chez la +Femme_, p. 133; Tilt, _Uterine Therapeutics_, p. 315. + +P. 94. CONTAGION OF PHTHISIS.--See Dr. William A. Hammond's _Treatise on +Hygiene_, p. 438, for air-space required by a healthy person. The +contagion of phthisis is maintained by many authorities--among others, +Dr. W. W. Gerbard (see Pennsylvanian Hospital Reports for 1868, p. +266). Professor Castan has recently collected, in the _Montpelier +Medicale_, a variety of facts, which seem to show that tuberculosis may +be communicated from a diseased to a healthy person by transpiration, +breathed air, and living together (_Press and Circular_, March 10, +1869). In regard to the inoculation of tubercle, we have reference to +the well-known experiments of M. Villemin, of the Hopital Val-de-Grace, +Paris. In this connection we may record an instance of recent medical +heroism. M. Lespiaud, attached to the surgical department of the +Val-de-Grace, in presence of several of his colleagues, extracted +granular matter from the body of a phthisical subject, and introduced it +under his own integument. This zealous investigator into the etiology of +tuberculosis has thus exposed himself in a courageous way for the +benefit of science, to the effects of a most dangerous and merciless +disease. + +P. 96. THE DIGNITY AND PROPRIETY OF THE SEXUAL INSTINCT.--Dr. Edward +John Tilt is the medical writer referred to (see _Uterine Therapeutics_, +pp. 95, 313). See also Bosquet, _Noveau Tableau de l'Amour Conjugal_, +vol. ii. p. 2, etc.; Rousel, _Systeme Physique et Moral de la Femme_, p. +211; Menville, _Histoire Medicale et Philosophique de la Femme_, vol. i. +p. 36 et seq.; Raciborski, _De la Puberte_, etc., p. 45. + +P. 99. ON THE INDULGENCE AND RESTRAINT OF SEXUAL DESIRE.--Menville, vol. +ii. p. 91; Bosquet, vol. ii. p. 280; _Economy of Life--or, Food, Repose, +and Love_, by George Miles. Dr. Edward Smith, in his valuable work on +_Cyclical Changes in Health and Disease_, has collected extensive +statistics showing the effect of the time of conception on the viability +of the foetus. The quotation is from Carpenter's _Human Physiology_, p. +753. + +P 103. See _Lancet_ for March 6, 1869, p. 337, for report of discussion +in the Pathological Society of London upon the physical degeneracy +resulting from procreation during intoxication. Authorities could be +cited at length upon this subject, but it is not necessary. See +Huleland's _Art of Prolonging Life_, p. 207. + +Pp. 106-114. STERILITY.--For statistics referred to, see Dr. Matthews +Duncan, _Fecundity, Fertility, and Sterility_ (Edinburgh, 1866), p. 181 +_et seq._; Dr. Tilt, _Uterine Therapeutics_, p. 291; Dr. Edward Reich, +_Gesundheitslehre des Ehelichen Lebens_, Th. ii. + +Dr. J. Marion Sims, _On the Microscope as an Aid in the Diagnosis and +Treatment of Sterility_, _New York Medical Journal_, January 1869, p. +406; Charles Darwin, _The Variation of Animals and Plants under +Domestication_, vol. ii. p. 198; _Philadelphia Medical and Surgical +Reporter_, November 2, 1867, p. 384; A. Debay, _Hygiene et Physiologie +du Mariage_, p. 288 (Paris, Quarante-quatrieme edition); Raciborski, _De +la Puberte_, etc., p. 451; Virey, _De la Femme sous ses Rapports Phys._, +etc., p. 332; Dr. Gunning S. Bedford, _The Principles and Practice of +Obstetrics_, p. 107. + +P. 115. THE LIMITATION OF OFFSPRING.--We have taken great pains to avoid +giving false or dangerous impressions in this section. The references in +the order of quotation are:--Dr. Tilt, _Hand-Book of Uterine +Therapeutics_, p. 317; Dr. Duncan, _Fecundity, Fertility, Sterility, and +Allied Topics_, pp. 289, 290; Dr. Hillier, _Diseases of Children_, p. +114; John Stuart Mill, _Principles of Political Economy_, p. 591; Dr. +Drysdale, _London Medical Press and Circular_, December, 1868, p. 478; +Raciborski, _De l'Age Critique chez la Femme_, p. 484; _The Nation_, +June 1869; Dr. Edward Reich, _Natur und Gesundheitslehre des Ehelichen +Lebens_, p. 493; _Boston Medical and Surgical Journal_, February 1867; +_Philadelphia Medical and Surgical Reporter_, vol. xix. p. 305; +Sismondi, _Principles of Political Economy_, book vii. chap. v.; Dr. +MacCormac, in _London Medical Press and Circular_, March 1869, p. 244; +Dr. Gaillard Thomas, _Diseases of Women_, p. 58; _Leavenworth Medical +Herald_, April, 1867; Dr. N. K. Bowling, in _The Nashville Journal of +Medicine and Surgery_, October 1868. We have rather let others speak +than spoken ourselves, and have collected the opinions of many most +distinguished physicians and statesmen, who thus pronounce against +excessive child-bearing. Any intelligent physician will acknowledge the +weight to be assigned to such names. + +P. 128. SIGNS OF FRUITFUL CONJUNCTION.--Carpenter, _Human Physiology_, +p. 772; Dr. Gunning S. Bedford, _Principles and Practice of Obstetrics_, +p. 304; Menville, vol. i p. 295; Montgomery, _Signs and Symptoms of +Pregnancy_, p. 90. + +P. 132. INHERITANCE.--Darwin, _Animals and Plants under Domestication_, +pp. 42, 473; Sir Henry Holland's _Medical Notes and Reflections_, p. 30; +Pritchard, _Researches into the Physical History of Mankind_, vol. ii. +p. 551; Carpenter, _Human Physiology_, p. 779; A. Debay, _Hygiene et +Physiologie du Mariage_, p. 173; Fleurens, _De la Longevite et de la +Quantie de Vie sur le Globe_, p. 256 (Paris, 1860); Hufeland, _Art of +Prolonging Life_, pp. 91, 206; Hammond's _Hygiene_, p. 116; _American +Journal of Medical Sciences_, July, 1865, p. 82; Francis Galton, _On +Hereditary Talent and Character_, in _Macmillan's Magazine_, vol. xii. +pp. 157, 318; Madden, _The Infirmities of Genius_, vol. ii. p. 107; +_Lancet_, December 22, 1868, p. 825; _The British Medical Journal_, +January 11, 1868, p. 25; Dr. Prosper Lucas, _Traite de l'Heredite +Naturelle_; Victor Hugo, _L'Homme qui Rit_, le seconde chapitre +preliminaire; Watson's _Practice_, p. 1153; Dr. Daniel G. Brinton, +_Guide-Book to Florida and the South_, Pt. iii.; Dr. J. V. C. Smith, +_Physical Indications of Longevity in Man._ + +P. 163. PLURAL BIRTHS.--Duncan, _Fecundity, Fertility, and Sterility_, +p. 69; Ramsbotham, _System of Obstetrics_, p. 461; _Philadelphia Medical +and Surgical Reporter_, vol. xix. p. 508, xx. p. 98. + +P. 167. PREGNANCY.--Menville, i. p. 299; Dr. Gunning S. Bedford, _System +of Obstetrics_, p. 144 et seq.; Montgomery, _Signs and Symptoms of +Pregnancy_; Dr. Edward Rigby, _System of Midwifery_, p. 47. + +P. 180. MOTHERS' MARKS.--See a very interesting article by Professor Wm. +A. Hammond, in _The Quarterly Journal of Psychological Medicine and +Medical Jurisprudence_, January, 1868, p. 1, in which he says, in +regard to the influence of the maternal mind over the foetus _in utero_: +'The chances of these instances, and others which I have mentioned, +being due to coincidence, are infinitesimally small; and though I am +careful not to reason upon the principle of _post hoc ergo propter hoc_, +I cannot--nor do I think any other person can, no matter how logical may +be his mind--reason fairly against the connection between cause and +effect in such cases. The correctness of the facts only can be +questioned: if these be accepted, the probabilities are thousands of +millions to one, that the relation between the phenomena is correct.' +See also Dr. J. Lewis Smith, _Diseases of Infancy and Childhood_, 1869, +p. 21; _Philadelphia Medical and Surgical Reporter_, vol. xix. p. 359. + +Pp. 192-197. CONCURRENT PREGNANCIES.--Raciborski, _De la Puberte_, etc., +p. 491; Dr. Gunning S. Bedford, _System of Obstetrics_, p. 442; _Dict. +des Sciences Medicales_, t. L. iii.; _Lancet_, August, 1856, p. 131; +Carpenter, _Human Physiology_, p. 779; Beck's _Elements of Medical +Jurisprudence_, art. 'Superfoetation;' Rokitansky, _Pathological +Anatomy_; _Philadelphia Medical and Surgical Reporter_, May 1, 1869, p. +335.--Professor Pancost removed some years since, from the cheek of a +child some months old, a rudimentary second child. + +P. 198. CAN THE FOETUS CRY IN UTERO?--Dr. Bedford Obstetrics, p. 264; +_Lancet_, January 23, 1869. + +P. 199. IS IT A SON OR DAUGHTER?--_Philadelphia Medical and Surgical +Reporter_, vol. xvii. p. 495; Dr. Frankenhauser, in the _Monatschrift +fuer Geburtskunde_; Dr. Packman, _On Impregnation_, _Lancet_, July 18, +1863. + +P. 202. GARDNER PEERAGE CASE.--Dr. Bedford, _System of Obstetrics_, p. +299. + +P. 204. PROLONGED PREGNANCIES.--Taylor, _Medical Jurisprudence_, p. 586; +_Report of Proceedings against the Rev. Fergus Jardine_ (Edinburgh, +1839). + +P. 207. CARE OF HEALTH DURING PREGNANCY.--Churchill, _On Women_, p. 451; +Menville, ii. 114; Tilt's _Elements of Health_, p. 271. + +P. 236. TO HAVE LABOR WITHOUT PAIN.--Professor T. Gaillard Thomas says, +'The rule should be to employ an anaesthetic in every case of labor, +_during the second stage_, unless some contra-indication exists. After a +delivery, under its influence patients recover more rapidly, are freer +from complications, and show fewer signs of prostration.' See _Lecture +on the Management of Women after Parturition_, in the _Richmond and +Louisville Medical Journal_, February, 1869, p. 145. + +P. 238. WEIGHT AND LENGTH OF NEW-BORN CHILDREN--_Philadelphia Medical +and Surgical Reporter_, vol. xix. p. 388; Carpenter, _Human Physiology_, +p. 810; Ramsbotham, _Obstetrics_, p. 111; _Detroit Review of Medicine +and Pharmacy_, March, 1869, p. 150. + +P. 271. THE CHILD.--Dr. J. Lewis Smith, _A Treatise on the Diseases of +Infancy and Childhood_, 1869, p. 28 _et seq._; Dr. Thomas Hillier, +_Clinical Treatise on the Diseases of Children_, p. 17; Dr. Edward +Smith, _Cyclical Changes in Health and Disease_; Dr. John Marshall, +_Outlines of Physiology, Human and Comparative_, pp. 761, 765, 998; Dr. +Charles A. Cameron, _Lectures on the Preservation of Health_, 1868, p. +174; Dr. Charles J. B. Williams, _Principles of Medicine_, p. 480; Dr. +J. Forsyth Meigs, _Diseases of Children_; Dr. E. J. Tilt, _Elements of +Health and Principles of Female Hygiene_, p. 50 _et seq._; Dr. Andrew +Combe, _The Management of Infancy_, p. 73 _et seq._ (ninth ed. +Edinburgh, 1860), _Report of Board of Health of Philadelphia_ for 1868, +p. 43; _British and Foreign Medico-Chirurgical Review_, April 1868, pp. +382, 454; _Southern Journal of the Medical Sciences_, November, 1867, p. +555; Dr. Thomas Hawkes Tanner, _Practice of Medicine_, p. 108; Dr. +William A. Hammond, _Treatise on Hygiene_, p. 95 _et seq._; +_Philadelphia Medical and Surgical Reporter_, vol. xvi. p. 530, xix. pp. +37, 59, 119, 134, 382; Edward C. Seaton, M.D., _A Hand-Book of +Vaccination_; Professor J. B. Fonssagrives, _L'Education Physique des +Filles; Le Role des meres dans les maladies des Enfants_; Sir James Y. +Simpson, _Selected Obstetrical and Gynecological Works_, etc., etc. + + + + +INDEX. + + +Abdomen, changes in, during pregnancy, 173 + pain in, during pregnancy, 355 + +Abortion, crime of, how to stop, 122 + evils of, 123 + +Advantages of the games and plays of children, 314 + +Advice to wives who desire to have children, 113 + +After birth, 230 + +Age of husband, 75 + nubility, 50 + puberty, 23, 25 + +Air and ventilation during infancy, 307 + +Air space required in bed-room, 94 + +Anger, effect of, on the mother's milk, 252 + +Appetite, depraved, a sign of pregnancy, 175 + +Approaching labor, signs of, 223 + +Arrowroot, how to prepare, for children, 275, 291 + +Articles wanted for confinement, 221 + +Atavism explained, 133 + +Attendants during confinement, hints for, 229 + +Avoidance of hereditary tendencies, 151 + + +'Bad-getting-up,' causes of, 241 + +Bandage after confinement, how to make, 221 + how to apply, 230 + +Barrenness, its causes and cure, 106 + +Bath, hour of, for infants, 303 + drying of the skin after, 304 + during pregnancy, 212 + value of, in infantile diseases, 305 + +Beautiful children, how to have, 140 + +Beauty, inheritance of, 135 + +Bedroom, size of, for the married, 94 + +Bed-wetting, causes and cure, 337 + +Bed, for married persons, 95 + clothing, 96 + the most healthful, 95 + in confinement, how to 'dress it', 222 + +Binder, how to make, 221 + +Births, relative proportion of male to female, 54 + +Blondes, age of puberty of, 28 + +Boarding school life, effect of, on girls, 47, 289 + +Body, changes in, at puberty, 30 + symbolism of, 83 + +Bowel complaints of children, 339 + +Boys, more born than girls, 154 + +Braces, abdominal, 376 + +Breasts, attention required towards the end of pregnancy, 219 + changes in, during pregnancy, 170 + first application of child to, 232 + inflammation and abscess of, 382 + management after confinement, 246 + +Bringing up by hand, 274 + +Brunettes, age of puberty of, 28 + + +Care of infancy, 271 + +Carrying an infant, manner of, 309 + +Celibacy not chastity, 57 + results of, 58 + +Change of life, regimen and perils of, 389 + +Changes, the monthly, precautions during, 45 + precautions in the intervals of, 46 + when delayed, 48 + painful, 49 + worked by puberty, 30 + +Child, the, 271 + attention to, at birth, 231 + can it cry before birth?, 198 + education, of before birth, 191 + +Child-bearing, excessive, 115 + +Childbed, diseases of, 361 + mortality of, 237 + +Childbirth, imprudence after, 240 + preparations for, 219 + to preserve form after, 242 + +Children, bathing of, 303 + bed for, 297 + clothing of, 300 + decreased number of, 73 + diet for, 288 + new-born, weight and length of, 238 + three and more at a birth, 164 + +Children's diseases, home management of, 325 + +Chlorosis, 36 + +Choice of a husband, 69 + +City life, effect of, on puberty, 29, 47 + +Cleanliness, curative influence of, 378 + importance of, to wives, 131 + +Climate, effect of, on puberty, 27 + +Clothing at puberty, 43 + at confinement, 227 + during pregnancy, 209 + of new-born infants, 222 + of young children, 300 + +Cold, effect of, on infants, 300 + +Color of infant, influence of mind of mother on, 182 + +Completion of puberty, 32 + +Complexion, 136 + inheritance of, 125 + +Conception, is it possible during pregnancy?, 192 + nature of, 125 + signs of, 128 + +Confinement, bed for, 226 + day of, how to calculate, 206 + dress for, 227 + hints for attendants at, 229 + imprudence after, 240 + preparations for, 219 + +Constipation of pregnancy, 358 + +Constitution, effect of the, on puberty, 21 + on change of life, 398 + +Consumption, 41, 71, 94, 148, 151 + +Continence demanded from husbands, 121 + +Cough of pregnancy, 359 + +Count, how to make the, 206 + +Country life, effect of, on puberty, 29 + +Courtship, 65 + +Cousins, shall they marry?, 69 + +Crime of abortion, 122 + +Croup, home treatment of, 325 + +Culture of the skin, 306 + + +Dangers of puberty, 35 + +Daughters, influenced by fathers, 144 + +Deformities, are they hereditary?, 139 + +Degeneracy, cause of, 349 + of the human race, a query, 348 + +Diet for infants, 274, 288 + children, 292 + the pregnant, 208 + +Diarrhoea during pregnancy, 357 + of infants, 339 + +Directions for mothers who cannot nurse their own children, 267 + +Dignity and propriety of the sexual instinct, 96 + +Disease, communication of, 80 + +Diseases, hereditary, 148 + of children, home management of, 325 + of wives and mothers, 352 + +Distinction of the sexes, 18 + +Divorce, unnatural and improper, 63 + +Dress, attention to, during pregnancy, 209 + for confinement, 227 + +Dressing of the new-born child, 231 + +Drying up of the milk, 258, 279 + +Duration of labor, 239 + +Dyspepsia of children, 342 + + +Ear, the hygiene of, in childhood, 323 + +Education, influence of, over hereditary qualities, 147 + of the child in the womb, 191 + special senses in children, 318 + +Emotion, influence of, on unborn child, 185 + +Emotions, stimulation of, effects of, on puberty, 29 + +Engagement, the, 85 + +Engagements, long, 86 + +Epilepsy, a cause of, 255 + +Eruptions of childhood, how to prevent, 106 + +Eternity of love, 60 + +Exercise at puberty, 42 + during pregnancy, 210 + of children, 309 + +Excessive child-bearing, 115 + +Eyes, the education of, in childhood, 319 + + +Falling of the womb, 368 + +False labor pains, 225 + +Fathers, influence of, on daughters, 144 + +Feeding of infants, manner of, 291 + +Fertility, hereditary, 138 + laws of, 109 + +First application of child to breasts, 232 + cares to the child newly born, 231 + mother after childbirth, 230 + labors, 51 + seven years of life, 314 + +Fits of children, home treatment of, 330 + +Flat nipples, how to remedy, 245 + +Food, during pregnancy, 207 + of infants and children, 288 + bill of fare for, 292 + +Foreigners, should native women marry, 73 + +Form, to preserve after confinement, 242 + +Frigidity, 109 + + +Galen, anecdote of, 127 + +Games and plays, advantages of, 314 + +Gardner, Lord, the case of, 202 + +Garters, danger of, during pregnancy, 355 + +Gathered breasts, 382 + +Goftr, story of, 166 + +Government of children, hints on, 344 + +Green sickness, 36 + +Growth of children, 287 + + +Habits, dangers and advantages of, 316 + +Hair, its significance, 84 + transmission of, 137 + +Hardening of infants, dangerous theories on the, 303 + +Hearing, the training of, in children, 323 + +Head colds of children, home treatment of, 329 + +Health, care of, during pregnancy, 207 + effect of pregnancy on, 216 + in marriage, 351 + +Hereditary diseases, 148 + qualities influenced by education, 147 + +Hermaphrodite, a true, 20 + +Hindrances to nursing, 245 + +Hints for attendants at confinement, 229 + +Home government, hints on, 344 + management of some common children's diseases, 325 + treatment of female ailments, 377 + +Husband, age of, 75 + and wife, during pregnancy, 216 + shall they occupy same room and bed, 93 + character of, 79 + how to choose, 69 + retain the affections of, 130 + +Husbands, plurality of, 64 + +Hygiene of puberty, 41 + the monthly periods, 45 + pregnancy, 207 + of infancy, 271 + of the special senses, 318 + +Hygienic habits, importance of teaching children, 316 + treatment of inward weakness, 377 + +Hysterics, 38 + + +Imagination of mother, influence of, on unborn child, 186 + +Imprudence after childbirth, 240 + +Indigestion of childhood, 342 + +Indulgence and restraint of sexual desire, 99 + +Infancy, care of, 271 + deaths in, 272 + +Infant, first clothing of, 222 + washing of, 231 + how to carry, 309 + lift, 310 + teach to walk, 313 + +Infants' food, 288 + +Inheritance, 132 + how to avoid evil tendencies of, 151 + how to have beautiful children, 140 + influence of education over, 147 + each parent over, 144 + of beauty, 135 + of diseases, 148 + of longevity, 138 + of mutilations, 149 + of personal qualities, 139 + of physical " , 136 + of talent and genius, 141 + of temperament, 137 + late manifestations of, 151 + the effects of, 151 + +Injections, 379 + +Injurious exercises for infants, 311 + +Intemperance, of several kinds, 117 + +Intermarriage of relatives, 69 + +Inward weakness, 368 + +Irregularities, causes of, 46 + +Irrigations, 381 + + +Knowledge, safety in, 17 + + +Labor, cause of, 225 + duration of, 239 + dress during, 227 + false and true, 225 + how to calculate time of, 170 + how to have, without pain, 236 + mortality of, 237 + signs of approaching, 223 + symptoms of actual, 224 + +Late manifestations of the effects of inheritance, 151 + +Late marriages, offspring of, 388 + +Length of pregnancy, 200 + +Liebig's soup for infants, 289 + +Lifting an infant, manner of, 310 + +Light, necessity of, for children, 308 + +Limitation of offspring, 115 + +Long engagements, 86 + +Longevity, hereditary, 138 + +Longings in pregnancy, 186 + +Love, at first sight, 67 + differs from lust, 50 + is a necessity, 57 + is eternal, 60 + its power on humanity, 52 + what is it?, 54 + +Looseness of bowels in children, 339 + during pregnancy, 357 + +Lying-in room, the management of, 226 + + +Maiden, the, 23 + +Manner of feeding infants, 291 + +Mania, puerperal, 362 + +Marital relations, times to suspend, 103 + when painful, 92, 104 + +Marriage, age for, 50 + health in, 351 + time of month for, 87 + year for, 87 + +Marriages, second, 62 + +Maternity, duties and privileges of, 243 + perils of, 352 + +Matrimony, necessity of, for happiness, 58 + +Matron, the happy, 243 + +Memory, visual, cultivation of, in childhood, 320 + +Men, as wet-nurses, 260 + +Menstruation explained, 24 + +Mental impressions, effect of, on hysterics, 39 + on unborn children, 180 + troubles of girlhood, 47 + +Milk, mother's, effect of anger on, 253 + effect of retention in the breasts, 249 + influence of diet on, 249 + pregnancy on, 250 + over-abundance of, 258 + scantiness of, 259 + quantity required by infant, 256 + when poisonous, 252 + value as food, 42 + +Milk-leg, causes and treatment of, 367 + +Mind, changes in, at puberty, 31 + during pregnancy, 175, 214 + influence of over conception, 126 + nursing child, 251 + unborn child, 182 + +Miscarriage, 176 + causes and dangers of, 178 + frequency of, 176 + influence of age of mother on, 177 + prevention of, 179 + symptoms of, 180 + +Mixture of races by marriage, 71 + +Month, right time of the, to marry, 87 + +Monthly changes, precautions in the intervals of, 46 + precautions during, 45 + when delayed, 48 + when painful, 49 + +Moon, connection of monthly periods with, 32 + +Morning sickness of pregnancy, 169, 353 + +Mortality of childbed, 237 + comparative, of the two sexes in early life, 154 + +Mortality of infants, causes of, 271 + relative to married life, 57 + +Mother, the, 243 + diseases of, 361 + duties of, towards daughters at puberty, 44 + influence of, over sons, 144 + position in nursing, 225 + who is unable to nurse her child, 267 + +Mothers' marks, 180 + +Music, influence of, 99 + +Mutilations, are they inheritable?, 149 + + +Native women, shall they marry foreigners?, 73 + +Near-sightedness, how to prevent, 322 + +Neck, form of, 83 + its significance, 84 + +New-born babe, first cares for, 231 + weight and length of, 238 + +Night dress of children, 301 + covering of children, 298 + the wedding, 91 + +Nipples, how to harden, 220 + +Nose-bleed in childhood, 333 + +Nubility, the age of, 50 + +Nursing, 244 + care of health during, 263 + diseases of, 382 + hindrances to, 245 + position during, 225 + prolonged, 262 + rules for, 248 + when improper, 245 + +Nursing mother, qualities of good, 257 + + +Offspring, the limitation of, 115 + influenced by the mind, 126 + +Over-nursing, signs of, 265 + +Overlaying of children, deaths from, 273 + +Over-production, evils of, 115 + remedies for, 121 + +Ovulation, the meaning of, 24 + + +Painful monthly changes, causes and treatment, 49 + +Pains of labor, true and false, 225 + +Painless labors, how to have, 236 + +Parr, Thomas, the long life of, 139 + +Pendulous abdomen after confinement, how to escape, 242 + +Perils of maternity, 352 + +Persons of both sexes, and of neither sex, 20 + +Perspiration, fetid, 131 + +Phases, the three, of woman's life, 22 + +Piles, during pregnancy, 356 + +Plays, the, of children, advantages of, 314 + +Plural births, 163 + +Plurality of wives or husbands, 64 + +Position of child while eating, 294 + of child while sleeping, 299 + +Position of mother while nursing, 255 + +Precautions necessary at the time of the monthly changes, 45 + +Precocity, remarkable instances of, 25 + +Pregnancy, 167 + bathing during, 212 + care of health during, 207 + causes of protracted, 205 + can a woman again become pregnant during, 192 + clothing during, 209 + diseases of, 352 + double, 192 + effect of, on the health, 216 + exercise during, 210 + food during, 208 + influence of, on the milk of nursing mother, 250 + length of, 200 + relation of husband and wife during, 216 + signs and symptoms of, 168 + sleep during, 213 + ventilation of sleeping-room during, 212 + +Premature marriages, 50 + +Preparations for confinement, 219 + +Prolific wives, 115 + +Puerperal mania, 362 + + +Qualities transmitted by parents, 132 + +Quantity of milk required by infant, 256 + +Quickening, as a sign of pregnancy, 170 + flatulence mistaken for, 172 + how caused, 171 + time of, 171 + + +Race, the human, is it degenerating?, 348 + +Races, mixture of, 71 + +Relation of husband and wife during pregnancy, 216 + nursing, 264 + +Relative age of man and wife, 76 + proportion of men and women living, 153 + +Religion, mistaken notions of, 57 + +Rest, after delivery, 241 + during pregnancy, 211 + +Re-vaccination, 286 + +Right time of the month to marry, 87 + time of the year to marry, 87 + + +Schooling, the, of the first seven years of life, 316 + +Scrofulous diseases, a cause of, 309 + +Second marriages, 62 + +Secret bad habits, 39 + +Self-deceptions regarding pregnancy, 172 + +Senses, training of the special, in childhood, 318 + +Sex of child, how to predict before birth, 198 + +Sexes, distinction of, 18 + laws which determine the relative numbers of the, 155 + persons of both and of neither, 20 + production of, at will, 157 + +Sexual desire, indulgence and restraint of, 99 + moderation in, 100 + instinct, dignity and propriety of, 96 + false notions about, 97 + desire, influence of on offspring, 98 + +Sexuality, what it implies, 18 + +Sickness, morning, during pregnancy, 353 + during labor, 225 + +Signs of approaching labor, 223 + puberty, 30 + conception, 128 + over-nursing, 265 + pregnancy, 168 + +Sight, the training of, in childhood, 319 + +Single life, the, 386 + in its relation to sanity and mortality, 57 + +Skin, changes in, during pregnancy, 174 + culture, of, in infancy, 306 + +Sleep, amount required in early life, 295 + at puberty, 42 + during pregnancy, 213 + position in, 299 + +Sleeplessness during pregnancy, 360 + +Small pox, death rate from, 283 + the only preventive against, 284 + +Son or daughter?, 198 + +Sore nipples, 246 + +Soup, Liebig's, 289 + +Sphere of woman, 21 + +Spinal disease, 36 + +Spring-time, 101 + +Spurious labor pains, 225 + +Stages of labor, 123 + +Starvation of girls, 41 + +Sterility, 106 + how to remedy, 113 + +Still-births, 240 + +Stilling Jung, anecdote of, 67 + +Stimulation of the emotions, dangers of, at puberty, 29 + +St. Pierre, anecdote of, 78 + +Sully Raymond, anecdote of, 401 + +Swimming, benefit of, 306 + +Symbolism of the human body, 83 + +Syringes, and how to use them, 379 + + +Talent, hereditary, 141 + +Teething, period of, 279 + +Temperament, transmission of, 137 + +Temperaments, explained, 77 + influence of, 101 + in marriage, 77 + +Things wanted during confinement, 221 + +Tight-lacing, 43, 374 + +Time of expected labor, how to calculate it, 206 + of the year to marry, 87 + of the month to marry, 87 + +Times when marital relations should be suspended, 103 + +Toilet, innocent arts of, 132 + +Tour, the wedding, 87 + +Toys, a mean of infantile education, 315 + +Twins, how to predict, 199 + why born, 161 + +Twin-bearing, 160 + influence of, on size of families, 163 + +Thury, Prof., discovery of, 157 + + +Unborn child, education of, 191 + + +Vaccination, age for, 285 + importance of, 282 + +Varicose veins of pregnancy, 355 + +Ventilation of sleeping rooms during pregnancy, 212 + +Virgins, wet-nursing by, 260 + +Voice, change in, at puberty, 30 + + +Wakefulness of pregnancy, 360 + +Walk, how to teach a child to, 313 + +Washing of the new-born infant, 231 + +Weakness, inward, 368 + +Weaning, 277 + +Wedding tour, the, 87 + night, the, 91 + +Weight and length of new-born children, 238 + +Wet-nurse, how to select, 269 + +Wet-nursing by virgins and men, 260 + +White-flowing, 365 + +Wives famous in history, 59 + plurality of, 64 + +Woman, the three phases in the life of, 22 + physical differences from man, 19 + sphere of, 21 + to be sought, 65 + +Womb, falling of, 368 + +Worms of children, home treatment of, 335 + +Women, diseases peculiar to, 352 + treatment of, 377 + why redundant, 153 + + +Young wives, 50 + mothers, 51 + +Year, right time of, to marry, 87 + + +Zurich, curious custom in, 93 + + + + +TESTIMONIALS + +OF + +EMINENT MEN AND OF THE PRESS + +TO THE + +PHYSICAL LIFE OF WOMAN + +AND ITS AUTHOR. + + +Of the _very numerous_ testimonials in our hands we select those of +earlier date in preference, as showing the acumen of the writers and the +warmth with which they welcomed the book. + + +FROM WILLIAM A. HAMMOND, M.D., + +Late Surgeon-General of U. S. Army; Professor of Diseases of the Mind +and Nervous System and of Clinical Medicine in the Bellevue Hospital +Medical College, New York. + + +NEW YORK, Aug. '69. + +DR. NAPHEYS-- + +_Dear Sir_: I have read with much interest and satisfaction your very +admirable book on "The Physical Life of Woman." I am glad that the +subject has been taken up by one who shows himself so thoroughly +qualified for the task, and I trust the instruction and advice contained +in the volume will reach every woman in the land. + +Yours, sincerely, + +WILLIAM A. HAMMOND. + + * * * * * + +FROM REV. HENRY WARD BEECHER. + +BROOKLYN, N. Y., Sept. 1869. + +DR. GEO. H. NAPHEYS-- + +_Dear Sir_: I have examined your volume: "The Physical Life of Woman," +and desire to thank you for performing a work so long needed, so +difficult to perform, and now, at length, so well done by you. Every +mother should have this book, nor should she suffer a child to be +married without the knowledge which this work contains. Thousands have +dragged through miserable lives and many have perished for want of such +knowledge. It is to be hoped, too, now that these delicate topics have +been so modestly and plainly treated, that your work will supersede the +scores of ill-considered and often mischievous treatises addressed "to +the married," which too often serve the lusts of men under the pretence +of virtue. + +HENRY WARD BEECHER. + + * * * * * + +FROM REV. HORACE BUSHNELL, D.D. + +HARTFORD, CONN., Sept. 1869. + +GEO. H. NAPHEYS, M.D.-- + +_Dear Sir_: I have read a large part of your book with interest. I +shrink from expressing any estimate of it as respects its physiological +merit, but it seems to be a book well studied, and it is written with +much delicacy and a careful respect, at all points, to the great +interests of morality. It will certainly be a great help to intelligence +on the subject, and ought, therefore, to be correspondingly useful. + +Very respectfully yours, + +HORACE BUSHNELL. + + * * * * * + +FROM HARVEY L. BYRD, M.D., + +Professor of Obstetrics in the Medical Department of Washington +University of Baltimore, Maryland. + +BALTIMORE, Sept. 1869. + +DR. GEO. H. NAPHEYS, Philadelphia-- + +_Dear Sir_: I have examined with much pleasure and satisfaction your +work on "The Physical Life of Woman," and do not hesitate to commend it +most warmly to our countrywomen, for whose benefit it is intended. I +congratulate you on the felicitous manner in which you have treated so +difficult a subject, and would recommend it to the public as supplying a +want that has long been felt in this country. + +_Omne verum utile dictu_, and what can be more proper or more useful +than that woman should be made acquainted with the great laws of her +being and the duties for which she was created? + +Very respectfully, your obed't servant, + +HARVEY L. BYRD. + + * * * * * + +EXTRACT FROM LETTER RECEIVED FROM EDWIN M. SNOW, M.D., OF PROVIDENCE, +RHODE ISLAND. + +PROVIDENCE, Sept. 1869. + +DR. NAPHEYS-- + +_Dear Sir_: I have examined with much interest the advance sheets of +your book, "The Physical Life of Woman:" I am highly pleased with it. +The advice given seems to me to be generally correct, and judiciously +expressed; and, in my opinion, the wide circulation of the book would be +a benefit to the community, + +Truly yours, + +EDWIN M. SNOW. + + * * * * * + +FROM REV. GEORGE ALEX. CROOKE, D.D., D.C.L. + +PHILADELPHIA, Sept. 1869. +DR. GEO. H. NAPHEYS-- + +_Dear Sir_: I have carefully read your work entitled "The Physical Life +of Woman," and, as the result, I must candidly say that I believe the +information it contains is well calculated to lessen suffering and +greatly benefit the human race. I know there are some falsely fastidious +persons who would object to any work of the kind, but "to the pure all +things are pure." You have done your part fearlessly and well, and in a +popular manner, and I trust that your work may be productive of all the +good you design by its publication. + +Very faithfully, +GEO. ALEX. CROOKE. + + * * * * * + +OPINION OF LLOYD P. SMITH, Esq. + +Librarian Philadelphia Library. + +LIBRARY CO. OF PHILADELPHIA, FIFTH ST. BEL. CHESTNUT, PHILADELPHIA, +Sept. 1869. + +It is an open question whether books de _secretis mulierum_ should be +written for the general public; but there is no doubt that, when they +are written, it should be done by the regular faculty, and not by +ignorant quacks. Dr. Napheys' "Physical Life of Woman" shows not only +the scientific attainments of the author, but also a wide range of +miscellaneous reading. The delicate subjects treated of are handled with +a seriousness and earnestness becoming their importance, and the +author's views are expressed in excellent English. + +LLOYD P. SMITH. + + * * * * * + +OPINION OF S. W. BUTLER, M.D. + +Editor of the Philadelphia "Medical and Surgical Reporter." + +I have carefully examined "The Physical Life of Woman," and find it a +work at once thoroughly representing modern science, and eminently +adapted for family instruction. It is well suited to female readers, to +whom it is especially addressed both in the matter it contains and in +the delicacy with which points relating to their physiological life are +mentioned. + +S. W. BUTLER. + + * * * * * + +EXTRACT FROM LETTER RECEIVED FROM JOHN H. GRISCOM, M.D. + +NEW YORK, Sept. 1869. +DR NAPHEYS-- + +_My Dear Sir_: The "Physical Life of Woman" is a very scientific and +intellectually written work, and contains almost all the physiological +and sanitary facts and directions needed for the preservation of the +health and longevity of the maiden, wife, and mother. It must prove +attractive and useful for any lady who reads it. + +Your sincere friend, +JOHN H. GRISCOM. + + * * * * * + +FROM THE NATIONAL BAPTIST, PHILA., DEC. 30, 1869 + +We join in the cordial welcome which this book has received. There is no +other work which tells so well just what every woman--and every +considerate man also--ought to know. Maternity is the one great function +of woman, according to God's ordinance, and for this marvelous and holy +mission her physical, intellectual, and moral constitution has been +designed. Dr. Napheys, in his wise "Advice to maiden, wife, and mother," +passes in review the cardinal facts respecting woman's physical life. +The book is written in a very clear and simple style, so that no one can +misunderstand it, while there is nothing to disturb or offend the most +sensitive. A judicious mother would do her maturing daughters great +service by first carefully reading this volume herself, and then have +them read it under her guidance. + + * * * * * + +OPINION OF MRS. R. B. GLEASON, M.D. + +ELMIRA, N. Y., Sept. 1869. + +The advance sheets of "The Physical Life of Woman" have been read with +much interest. In this book Dr. Napheys has well met a real need of the +age. There are many things incident to woman's physical organization +which she needs to know, and concerning which she still does not want to +ask a physician, and may not have one at hand when she most desires the +information. This book can be easily read and perfectly understood by +those not familiar with medical terms. All matters of delicacy are +treated with freedom, and still with a purity of thought and expression +which is above criticism. + +For many years we have been often asked for just such a book, and shall +gladly commend it to the many wives and mothers who want for themselves +and grown-up daughters such a book of helps and hints for home life. + +MRS. R. B. GLEASON. + + * * * * * + +FROM PROFESSOR JOHN S. HART, LL.D. + +STATE NORMAL SCHOOL, TRENTON, N. J. +GEO. H. NAPHEYS, M.D.-- + +_Dear Sir_: I have read with attention the advance sheets of your book, +"The Physical Life of Woman:" and take pleasure in saying that you have +handled a most difficult and important subject with equal delicacy and +ability. + +Yours truly, +JOHN S. HART. + + * * * * * + +OPINION OF MARK HOPKINS, D.D., LL.D., + +President of Williams College. + +"Your book is conscientiously written, and will be likely to do good." + + * * * * * + +FROM THE N. Y. EVANGELIST, NOV. 18, 1869. + +This is a plain and practical treatise, prepared by a physician of skill +and experience, in which he aims to furnish information to women, in +their peculiar conditions and relations, married and single, so as to +enable them to preserve their own health, and perform their duties to +themselves and their children. The most delicate subjects are treated in +language so chaste as not to offend any pure mind. + + * * * * * + +OPINION OF DR. R. SHELTON MACKENZIE. + +PHILADELPHIA, Oct. 1869. + +"Believing that such a work as Dr. Napheys' 'Physical Life of Woman,' +giving a great deal of valuable information, explicitly and delicately, +is likely to be of very essential importance to the fair sex, I cannot +hesitate to express my favorable opinion of its object and execution." + + * * * * * + +LETTER RECEIVED FROM REV. GEO. BRINGHURST, + +Rector of the P. E. Church of the "Messiah," Philadelphia. + +PHILADELPHIA, Sept. 1869. +DR. GEO. H. NAPHEYS-- + +_My Dear Sir_: I have perused with considerable care and pleasure the +work on the "Physical Life of Woman," and feel no hesitation in +pronouncing it admirably composed, honest, succinct, refined, and worthy +of the companionship of every lady of this age. I hail its appearance +with gratitude, and look upon it as a valuable contribution to those +efforts which are making in various directions to elevate the tone of +morals of the nineteenth century, and to enable mothers to discharge +faithfully the duties they owe their children. + +Sincerely yours, +GEORGE BRINGHURST. + + * * * * * + +FROM H. N. EASTMAN, M.D., + +Professor of Practical Medicine in Geneva Medical College. + +GENEVA, Sept. 1869. +GEO. H. NAPHEYS, M.D.-- + +_Dear Sir_: I have just completed a careful reading of your advance +sheets of "The Physical Life of Woman," and I unhesitatingly pronounce +it an admirable work, and one especially needed at this time. The book +is written in a chaste, elevated, and vigorous style, is replete with +instruction indispensable to the welfare and happiness of woman, and +should be placed in the hands of every mature maiden and matron in our +land. + +H. N. EASTMAN. + + * * * * * + +EDITORIAL FROM PHILADELPHIA MEDICAL AND SURGICAL REPORTER. + +It is a singular fact, that in this country, most of the works on +medical and hygienic matters have been written by irregular +practitioners in order to help on its legs some ism or pathy of their +own. The public is really desirous of information about the great +questions of life and health. It buys whatever is offered it, and cannot +tell of course the tares from the wheat. In fact, as we have said, there +has been very little wheat offered it. Scientific physicians do not seem +to have taken the pains in this country, as in Germany, to expand sound +medical information among the people. + +We therefore welcome all the more warmly a work which, under any +circumstances, would command our praise, advance sheets of which are now +before us. The author is Dr. George H. Napheys, of this city, well +known to all the readers of the "Reporter" as a constant contributor to +its pages for a number of years, a close student of therapeutics, and a +pleasing writer. The title of the book is "The Physical Life of Woman: +advice to the Maiden, Wife, and Mother." It is a complete manual of +information for women, in their peculiar conditions and relations, +married and single. + +The style is simple, agreeable, and eminently proper and delicate, +conspicuously so when treating of such difficult topics to handle in a +popular book, yet so necessary to be handled, as the marital relations +of husband and wife, the consummation of marriage, etc. + +We do not doubt that this work will find as large a sale both in and out +of the profession in this country, as the works of Bock and Klencke in +Germany, and of Tilt and Chavasse in England. + + * * * * * + +FROM THE NASHVILLE JOURNAL OF MEDICINE AND SURGERY FOR NOVEMBER, 1869. + +The outside of this book is more stylish and artistic than any the +market has owed to the press this season. The type and paper of the +inside are in keeping with the elegant exterior. The work contains much +valuable matter, in a style peculiarly attractive. It is intended to +treat woman as a rational being, to let her know much about herself as a +woman, that from this knowledge she may prevent and therefore escape +much of the suffering endured by her sex. + +And who can do this but a physician? This may be regarded as the first +attempt of the kind in this country. + + * * * * * + +FROM THE MEDICAL RECORD, NEW YORK, JAN. 15, 1870. + +Doctor Napheys, in his work on "The Physical Life of Woman," has +acquitted himself with infinite credit. The subject, which for a work of +its size takes a very wide range, is treated in choice, nay elegant +language, and we have not noticed a single expression upon the most +delicate matter that could offend the most refined taste. There are, +too, a great many interesting historical facts connected with the +general topic, both in an ethical and physiological point of view, which +show much discrimination in their production, and a good amount of +sterling scholarship. To the medical reader there are many points in the +book that are worthy of attention, prominent among which are remarks +bearing upon the right of limitation of offspring. We sincerely hope +that, for the real benefit of American women, it may meet with a hearty +reception, and be productive of great good, in preventing many of those +disorders now so rife in the community, which are solely the result of +ignorance of the ordinary laws of female hygiene. + +No one, however scrupulous, need fear to admit the work within the pale +of his family circle, and place it, with confidence, in the hands of his +daughters. + + * * * * * + +FROM THE NEW YORK MEDICAL GAZETTE, JAN. 8, 1870. + +Though professedly written for popular instruction, this little book +will not fail to instruct as well the professional reader. We cordially +recommend the perusal of Dr. Napheys' book to every woman seeking a +fuller acquaintance with her physical organism. + + * * * * * + +FROM THE BOSTON MEDICAL AND SURGICAL JOURNAL, NOV. 25, 1869. + +Most valuable for the perusal of mothers, and of those fathers who may +be equal to the task of advising sons liable to commit matrimony. The +style--of the text--is unexceptionable. Words are not wasted, and those +used are to the point. The volume is not a mere _resume_ of others' +opinions; but the author has made the topics of which he treats his own. + + * * * * * + +FROM THE CHICAGO MEDICAL EXAMINER OF NOV. 1869. + +This work is written in a plain and pleasing style, well calculated both +to please and instruct. There is nothing of the _sensational_ or +imaginative character in it. On the contrary, its teachings are in +strict accordance with scientific facts and good sense. Though designed +specially for females, yet a careful perusal would be productive of much +benefit to both sexes. + + * * * * * + +FROM THE METHODIST HOME JOURNAL, DEC. 4, 1860. + +Hitherto, the subjects so honestly and so skilfully treated in this +volume have, to a very great extent, been ruled out of the realm of +popular knowledge, and information of this class sought only in a +clandestine manner. The people have suffered by deplorable ignorance on +those topics, which should be as familiar to us as the alphabet. Dr. +Napheys, by his scientific handling of the physiological points which +relate to health, training, and development, has rendered a great +service to the world. This, the press, and public men, have not been +slow to acknowledge. The book has gained unqualified praise, and well +deserves it. + + * * * * * + +FROM THE PRESBYTERIAN, OF PHILADELPHIA, DEC. 4, '69. + +A book which treats wisely and delicately of very important subjects, +and subjects which ought to be treated by competent hands, instead of +being left to quacks and the venders of nostrums. Dr. Napheys is +evidently a conscientious and intelligent physician, and his counsels +are such as may be put in the hands of all persons needing such +counsels. We commend it for its judicious exposition of the laws of +nature. + + * * * * * + +FROM THE NEW YORK CHRISTIAN UNION, JAN. 8, 1870. + +Society owes a debt of gratitude to this brave and scientific physician +for the unexceptionable way in which he has performed a work that has, +up to the publication of this book, been a paramount need, not to be +satisfied anywhere in the English language. If the volume contained only +the chapter on the influence of the mother's mind upon her unborn child, +we would recommend its purchase by every family in the United States. + + * * * * * + +FROM THE PHILA. EVENING TELEGRAPH, OCT. 6, 1869. + +This is a work by a physician of reputation on the hygiene of woman, +designed for popular use, and introducing a variety of topics not +generally discussed outside of regular scientific medical works. Dr. +Napheys writes with dignity and earnestness, and there is not a chapter +in his book that may not be read by persons of both sexes. Of course +such a work as this is intended for men and women of mature years, and +it is not suitable to be left lying about for the gratification of idle +curiosity. The author has been careful to write nothing that can +possibly give offence, and he conveys much sound instruction that, if +heeded by those to whom it is particularly addressed, will save much +suffering. + + * * * * * + +FROM THE INDEPENDENT, NEW YORK, NOV. 11, 1869. + +It required a brave but sensitively pure man to provide for the want +which existed for some reliable medical instruction upon points which +every woman and every married man ought to know, and few do. Dr. Napheys +we do not know personally. But his book is at once brave and pure. It is +written in such a spirit that she who really desires to learn the truths +of which she cannot with justice to herself or others be ignorant, may +do so without being shocked; while he who hopes to stimulate a vicious +imagination by its perusal will turn from its pages disappointed away. + + * * * * * + +FROM REV. HENRY CLAY TRUMBULL, + +Secretary of New England Department of Missions of the American +Sunday-school Union. + +HARTFORD, CT., Oct. 1869. + +GEO. H. NAPHEYS, M.D.-- + +_My Dear Sir_: Understanding, from my long acquaintance with you, your +thoroughness of mental culture, your delicacy of sentiment, and your +sound good sense, I was prepared to approve heartily the tone and style +of your new work, "The Physical Life of Woman," when its advance sheets +were first placed in my hands. + +A close examination of it convinces me that it is a book which can be +read by every woman to her instruction and advantage. Its manner is +unexceptionable. Its style is remarkably simple. Its substance evidences +your professional knowledge and your extensive study. I believe it needs +only to be brought to notice to commend itself widely. I think you have +done an excellent work in its preparation. + +Sincerely your friend, + +H. CLAY TRUMBULL. + + * * * * * + +FROM THE REV. W. H. H. MURRAY, + +Pastor of the Park Street Church, Boston, Mass. + +DEC. 2, 1871. + +It is with sincere gratitude to the author that I give my endorsement to +the book entitled "The Physical Life of Woman." Never was such a work +more needed anywhere, or in any age, than it is in America at this time. +I should rejoice at its introduction among the people until every wife +and mother in the country and the world had a copy in her possession. In +it the author has indeed given needed instruction and warning. He +deserves the thanks of every Christian and well-wisher of the race. + +W. H. H. MURRAY. + + + + + +End of the Project Gutenberg EBook of The Physical Life of Woman:, by +Dr. George H Napheys + +*** END OF THIS PROJECT GUTENBERG EBOOK THE PHYSICAL LIFE OF WOMAN: *** + +***** This file should be named 24001.txt or 24001.zip ***** +This and all associated files of various formats will be found in: + http://www.gutenberg.org/2/4/0/0/24001/ + +Produced by Joseph R. 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