change, as habits, temperament, constitutional tendency, education,
and idiosyncrasy.
Habits of vigorous physical exercise tend to delay the access of puberty.
For this reason, together with others, country boys and girls generally
mature later than those living in the city by several months, and even
a year or two. Anything that tends to excite the emotions hastens
puberty. The excitements of city life, parties, balls, theaters, even
the competition of students in school, and the various causes of
excitement to the nervous system which occur in city life, have a
tendency to hasten the occurrence of the change which awakens the sexual
activities of the system into life. Hence, these influences cannot but
be considered prejudicial to the best interests of the individual,
mentally, morally, and physically, since it is in every way desirable
that a change which arouses the passions and gives to them greater
intensity should be delayed rather than hastened.
Influence of Diet on Puberty.--The dietary has a not unimportant
influence in this respect. Stimulating food, such as pepper, vinegar,
mustard, spices, and condiments generally, together with tea and coffee,
and an excess of animal food, have a clearly appreciable influence in
inducing the premature occurrence of puberty. On this account, if on
no other, should these articles be prohibited to children and youth,
or used very sparingly. Those who advocate the large use of meat by
children and youth have not studied this matter closely in all its
bearings. While it is true that children and growing youth require an
abundance of the nitrogenous elements of food which are found
abundantly in beefsteak, mutton, fish, and other varieties of animal
food, it is also true that in taking those articles of food they take
along with the nutrient elements properties of a stimulating character,
which exert a decidedly detrimental influence upon the susceptible
systems of children and youth. At the same time, it is possible to obtain
the same desirable nitrogenous elements in oatmeal, unbolted wheat
flour, peas, beans, and other vegetable productions, which are wholly
free from injurious properties. We are positive from numerous
observations on this subject, that a cool, unstimulating, vegetable
or farinaceous diet would deter the development of the sexual organism
for several months, and perhaps for a year or two.
While it might not be in all cases desirable to do this, it would at
least be wise to adopt such measures in cases in which the child is
unavoidably exposed to influences which have a tendency to hasten the
change.
It is important to add in this connection a word of caution against
the adoption of a dietary too abstemious in character. It is necessary
that an abundance of good, wholesome food, rich in the elements of
nutrition, should be taken regularly. There is no doubt that many young
ladies have induced conditions of serious disease by actual starvation
of the system. A young woman who attempts to live on strong tea or coffee,
fine-flour bread, and sweet cake, is as certainly starving herself as
though she were purposely attempting to commit suicide by means of
starvation, and with as much certainty of the same result.
Brunettes Naturally Precocious.--It has been observed that in girls
the occurrence of puberty is earlier in brunettes than in blondes; and
in general it makes its appearance earlier in persons of a nervous or
nervo-bilious temperament than in persons of a lymphatic temperament
or phlegmatic nature.
Certain nationalities and families are marked by the earlier occurrence
of puberty than in others. In Jews, the change is commonly a year or
two in advance of other nationalities in this country. It also occurs
somewhat sooner in negroes and creoles than in white persons, the
African race seeming to retain something of the precocity occasioned
by the tropical influence of its native clime.
Remarkable Precocity.--Cases occasionally occur in which puberty makes
its appearance at the age of three or four years. Indeed, a case has
been reported in this country in which a female child possessed all
the characteristics which are usually developed at puberty, from birth.
In this case the regular periodical changes began at birth.
Premature Development Occasions Early Decay.--A fact which is of too
great importance to allow to pass unnoticed, is that whatever occasions
early or premature sexual development, also occasions premature decay.
Females in whom puberty occurs at the age of ten or twelve, by the time
their age is doubled, are shriveled and wrinkled with age. At the time
when they should be in their prime of health and beauty, they are
prematurely old and broken. Those women who mature late retain their
beauty and their strength many years after their precocious sisters
have become old, decrepit, and broken down. Thus, the matrons of thirty
and forty years in colder climates are much more attractive in
appearance than the maidens of sixteen; while quite the reverse is true
in this and other countries where sexual development is unduly
hastened.
Early Puberty a Cause for Anxiety.--The unnaturally early appearance
of puberty is a just cause for apprehension, since it usually indicates
an inherent weakness of the constitution. When there are reasons for
fearing its occurrence, active measures should be taken to occasion
delay if possible. We call especial attention to this point, since there
are many who erroneously suppose the early occurrence of puberty to
be a sign of superior vigor.
Changes which Occur at Puberty.--The changes which occur in the two
sexes at this period have been thus described:--
"In both sexes, hair grows on the skin covering the _symphysis pubis_,
around the sexual organs, and in the axillae (armpits). In man, the
chest and shoulders broaden, the larynx enlarges, and the voice becomes
lower in pitch from the elongation of the vocal cords; hair grows upon
the chin, upper lip, and cheeks, and often exists upon the general
surface of the body more abundantly than in woman." The sexual organs
undergo enlargement, and are more frequently excited. The testicles
first begin the secretion of the seminal fluid.
"In woman, the pelvis and abdomen enlarge, but the whole frame remains
more slender, the muscles and joints less prominent, the limbs more
rounded and tapering [than in the male]. Locally, both external and
internal organs undergo a considerable and rapid enlargement. The
mammae enlarge, the ovarian vesicles become dilated, and there is
established a periodical discharge of one or more ova, accompanied,
in most cases, by a sanguineous fluid from the cavity of the uterus."
These changes, so varied and extraordinary, often occur within a very
short space of time; and as they are liable to serious derangement,
especially in the female, great care should be taken to secure for the
individual the most favorable conditions until they are successfully
effected. It is, however, a fact deserving of mention, that many of
the ills which are developed at this particular period are quite as
much the result of previous indiscretions and mismanagement as of any
immediate cause. A few suggestions with regard to the proper treatment
of individuals at this age may be in place.
1. Do not allow the boy or girl to be overworked, either mentally or
physically. Great and important changes are occurring within the body,
and nature should not be overtaxed.
2. Keep the mind occupied. While excessive labor should be avoided,
idleness should be as carefully shunned. Some light, useful employment
or harmless amusement--better some kind of work--should keep the mind
fully occupied with wholesome subjects.
3. Abundant exercise out-of-doors is essential for both sexes. Sunshine
and fresh air are as necessary to the development of a human being as
for the expanding of a flower bud.
4. Watch carefully the associations of the youth. This should be done
at all times, but especially just at the critical period in question,
when the general physical disturbances occurring in the system react
upon the mind and make it peculiarly susceptible to influences,
especially those of an evil character.
5. None too much care can be exercised at this important epoch of human
life, provided it is properly applied; but nothing could be more
disastrous in its consequences than a weak solicitude which panders
to every whim and gratifies every perverted appetite. _Such_ care is
a fatal error.
Menstruation.--The functional changes which occur in the female are
much more marked than those of the male. As already intimated, the
periodical development and discharge of an ovum by the female, which
occurs after puberty, is accompanied by the discharge of a bloody fluid,
which is known as the _flowers_, _menses_, or _catamenia_. The
accompanying symptoms together are termed the process of
_menstruation_, or _being unwell_. This usually occurs, in the human
female, once in about four weeks. In special cases, the interval may
be a week less or a week longer; or the variation may be even greater.
Dalton describes the process as follows:--
"When the expected period is about to come on, the female is affected
by a certain degree of discomfort and lassitude, a sense of weight in
the pelvis, and more or less disinclination to society. These symptoms
are in some cases slightly pronounced, in others more troublesome. An
unusual discharge of vaginal mucus then begins to take place, which
soon becomes yellowish or rusty brown in color, from the admixture of
a certain proportion of blood; and by the second or third day, the
discharge has the appearance of nearly pure blood. The unpleasant
sensations which were at first manifest, then usually subside; and the
discharge, after continuing for a certain period, begins to grow more
scanty. Its color changes from a pure red to a brownish or rusty tinge,
until it finally disappears altogether, and the female returns to her
ordinary condition."
The menstrual function continues active from puberty to about the
forty-fifth year, or during the period of fertility. When it finally
disappears, the woman is no longer capable of bearing children. The
time of disappearance is termed the "change of life," or _menopause_.
Exceptional cases occur in which this period is greatly hastened,
arriving as early as the thirty-fifth year, or even earlier. Instances
have also been observed in which menstruation continued as late as the
sixtieth year, and even later; but such cases are very rare; and if
procreation occurs, the progeny is feeble and senile.
With rare exceptions, the function is suspended during pregnancy, and
usually, also, during the period of nursing.
Nature of Menstruation.--There has been a great amount of speculation
concerning the cause and nature of the menstrual process. No entirely
satisfactory conclusions have been reached, however, except that it
is usually accompanied by the maturation and expulsion from the ovary
of an ovum, which is termed ovulation. But menstruation may occur
without ovulation, and, _vice versa_.
Menstruation is not peculiar to the human female, being represented
in the higher animals by what is familiarly termed the "rut." This is
not usually a bloody discharge, however, as in the human female, though
such a discharge has been observed in the monkey.
It has been quite satisfactorily settled that the discharge of the ovum
from the ovary generally takes place about the time of the cessation
of the flow. Immediately after the discharge, the sexual desires of
the female are more intense than at other times. This fact is
particularly manifest in lower animals. The following remark by Prof.
Dalton is especially significant to those who care to appreciate its
bearing:--
"It is a remarkable fact, in this connection, that the female of these
[domestic] animals will allow the approaches of the male only during
and immediately after the oestrual period [rut]; that is, just when
the egg is recently discharged, and ready for impregnation. At other
times, when sexual intercourse would be necessarily fruitless, the
instinct of the animal leads her to avoid it; and the concourse of the
sexes is accordingly made to correspond in time with the maturity of
the egg and its aptitude for fecundation."
The amount of fluid lost during the menstrual flow varies greatly with
different individuals. It is estimated at from three ounces to half
a pint. In cases of deranged function, it may be much greater than this.
It is not all blood, however, a considerable portion being mucus. It
is rather difficult to understand why the discharge of so considerable
a quantity of blood is required. There is no benefit derived from a
very copious discharge, as some suppose. Facts seem to indicate that
in general those enjoy the best health who lose but small quantities
of blood in this manner.
A Critical Period.--As the first occurrence of menstruation is a very
critical period in the life of a female, and as each recurrence of the
function renders her especially susceptible to morbid influences, and
liable to serious derangements, a few hints respecting the proper care
of an individual at these periods may be acceptable.
Important Hints.--1. Avoid taking cold. To do this, it is necessary
to avoid exposure; not that a person must be constantly confined in
a warm room, for such a course would be the surest way in which to
increase the susceptibility to cold. Nothing will disturb the menstrual
process more quickly than a sudden chilling of the body when in a state
of perspiration, or after confinement in a warm room, by exposure,
without sufficient protection, to cold air. A daily bath and daily
exercise in the open air are the best known means of preventing colds.
2. Intense mental excitement, as well as severe physical labor, is to
be sedulously avoided during this period. At the time of its first
occurrence, special care should be observed in this direction. Intense
study, a fit of anger, sudden grief, or even great merriment, will
sometimes arrest the process prematurely. The feeling of _malaise_
which usually accompanies the discharge is by nature intended as a
warning that rest and quiet are required; and the hint should be
followed. Every endeavor should be made to keep the individual
comfortable, calm, and cheerful. Feelings of apprehension arising from
a continual watching of symptoms are very depressing, and should be
avoided by occupying the mind in some agreeable manner not demanding
severe effort, either mental or physical.
There is no doubt that many young women have permanently injured their
constitutions while at school by excessive mental taxation during the
catamenial period, to which they were prompted by ambition to excel,
or were compelled by the "cramming" system too generally pursued in
our schools, and particularly in young ladies' seminaries. It is not
to be supposed, however, that the moderate amount of sound study
required by a correct system of teaching would be injurious to a healthy
young woman at any time, and we have no doubt that a very large share
of the injury which has been attributed to over-study during the
catamenia has been induced by other causes, such as improper dress,
exposure to taking cold, keeping late hours, and improper diet.
If there is any class of persons deserving of pity it is that large
class of girls and young women who are in every large city employed
as clerks, seamstresses, flower makers, and in other taxing and
confining occupations. In order to keep their situations they are
required to be on hand daily, being allowed no opportunity for rest
at the menstrual period. In many cases, too, they are compelled to
remain upon their feet all day behind a counter, or at a work table,
even at periods when a recumbent position is actually demanded by nature.
There should be less delicacy in relation to this subject on the part
of young women, and more consideration on the part of employers. Here
is a field for philanthropic effort which is well worthy of the best
efforts of any person of influence who will engage in it.
Custom of Indian Women.--The ease with which Indian women perform the
parturient act is proverbial. They suffer scarcely at all from the pains
of childbirth; and without doubt one reason of this is the preservation
of their sexual health by rest during the menstrual period. At those
seasons they invariably absent themselves from the lodge, and enjoy
absolute rest. We may readily suppose, from the nature of some of the
Mosaic laws, that a custom somewhat similar prevailed among the ancient
Hebrew women. If the hardy women of the forest are benefited by rest,
certainly our more delicate females may be thus benefited. All need
a degree of rest; with some it should be absolute.
The reckless manner in which some young women treat themselves at the
menstrual period, is quite appalling to one who is acquainted with the
painful and inveterate character of the evils which arise from such
abuse. It is no uncommon thing for young ladies to attend balls, visit
skating rinks, and otherwise expose themselves to the influences in
every way the best calculated to do them the most harm at this particular
period, observing not the slightest precaution. Such recklessness is
really criminal; and the sad consequences of physical transgression
are sure to follow. A young lady who allows herself to get wet or chilled,
or gets the feet wet, just prior to or during menstruation, runs the
risk of imposing upon herself life-long injury. Mothers should look
carefully after their daughters at these periods, and impress upon them
the importance of special care.
3. A third hint, which is applicable to both sexes and at all times,
is the necessity of attending promptly to the demands of nature for
relief of the bowels and bladder. School-girls are often very negligent
in this respect; and we have seen the most distressing cases of disease
which were entirely attributable to this disregard of the promptings
of nature. Obstinate constipation and chronic irritation of the bladder
are common effects. When constipation results, purgatives in the shape
of pills, salts, or "pleasant purgative pellets," are resorted to with
the certain result of producing only temporary relief, and permanent
damage.
To escape these evil consequences, do this: 1. Establish a regular habit
of relieving the bowels daily at a certain hour; 2. Discard laxative
and cathartic drugs of every kind; 3. To aid in securing a regular
movement of the bowels, make a liberal use of oatmeal, wheat-meal, fruit,
and vegetables, avoiding fine-flour bread, sweetmeats, and condiments;
4. Take daily exercise, as much as possible short of fatigue; if
necessarily confined indoors, counteract the constipating influence
of sedentary habits by kneading and percussing the bowels with the hands
several minutes each day; 5. Never resist the calls of nature a single
moment, if possible to avoid it. In this case, as in numerous others,
"delay is dangerous." Ladies who desire a sweet breath--and what lady
does not--should remember that retained feces are one of the most
frequent causes of foul breath. The foul odors which ought to pass out
through the bowels find their way into the blood and escape at the lungs.
A medical man whose sense of smell is delicate soon learns to know a
constipated person by the breath. As one says, "What is more offensive
than the breath of a costive child?"
Boerhaave, a famous old Dutch physician, left to his heirs an elegantly
bound volume in which, he claimed, were written all the secrets of the
science of physic. After his death, the wonderful book was opened, when
it was found to contain only the following sentence:--
"Keep the head cool, the feet warm, and the bowels open."
An old Scotch physician once gave the following advice to Sir Astley
Cooper for the preservation of health:--
"Keep in the fear of the Lord, and your bowels open."
4. Perhaps nothing tends more directly to the production of menstrual
derangements--as well as uterine diseases of every sort--than
fashionable modes of dress. We have not space here to give to the subject
the attention it deserves; it will be found treated of in works devoted
to the subject of dress exclusively. Some of the most glaring evils
are,--
(1) Unequal distribution of clothing. The trunk, especially the abdomen
and pelvis, is covered with numerous layers of clothing, an extra amount
being caused by the overlapping of the upper and lower garments. Very
frequently, the amount of clothing upon these, the most vital parts,
is excessive. At the same time, the limbs are sometimes almost in a
state of nudity. A single cotton garment, or at most one of thin flannel,
is the only protection afforded to the limbs beneath the skirts, which
often serve no better purpose than to collect cold air and retain it
in contact with the limbs. A thin stocking is the only protection for
the ankles, and a thin shoe is the only additional covering afforded
the feet. Under such circumstances, it is no wonder that a woman catches
cold if she only steps out-of-doors on a chilly or damp day.
(2) Another glaring fault is in the manner of suspending the skirts.
Instead of being fastened to a waist or suspended so as to give them
support from the shoulders, they are hung upon the hips, being drawn
tight at the waist to secure support. By this means, the organs of the
pelvis are pressed down out of place. The uterus becomes congested,
and painful menstrual derangements ensue.
(3) Tight lacing, or compressing the waist with a corset, is a barbarous
practice which produces the same results as the one last mentioned.
Reform in all of these particulars is an imperative necessity for every
woman who desires to secure or retain sexual health.
It is of the greatest importance that careful attention should be given
to the proper establishment of the menstrual function at the outset
of a woman's life of sexual activity. The first two years will be quite
likely to have a deciding influence respecting her health during her
whole future life. If a woman can get through the first two years after
puberty without acquiring any serious uterine or ovarian disease, she
will stand a good chance of enjoying a good degree of sexual health
during the balance of her life. The foundation of a great share of the
many thousands of cases of uterine disease is laid during this period.
At this early period the daughter is usually too young to appreciate
the importance of observing slight deviations from the standard of
health, even if she were able to recognize them. Hence it is a duty
which no mother should neglect, to inquire into the exact frequency
of the periods, the amount and character of the discharge, and other
points necessary to ascertain whether or not there is any deviation
from the natural condition of health. If there is pain, it is a certain
evidence of something seriously wrong. If there is irregularity in any
particular, it is a matter well deserving of serious attention.
Menorrhagia.--This condition is that in which there is a too profuse
discharge of blood. The system is weakened by the loss, and, so much
so, in many cases, that the individual does not recover her accustomed
strength before the occurrence of the next period, when she becomes
weakened still more. By a continuance of this periodical loss, the
person may be reduced to a state of almost utter helplessness. A deathly
pallor of the countenance, extreme emaciation, loss of strength, and
general debility mark the effects of the constant drain upon the system.
Thousands of young women continue to suffer in this way year after year,
until their constitutions are almost hopelessly wrecked, being
deterred by false notions of modesty or delicacy from consulting a
proper medical adviser and finding relief.