prevails regarding the normal prevalence of illegitimacy in England. It
is not necessarily the product of either poverty or of city life. It is
far more common in rural districts than in urban areas, and, even in
cities, it is by no means the poorest parishes that produce the most
illegitimate children. The urban artisan class as a whole is far more
rigid in observing the sanctities and prescriptions of marriage than
any other section of the community. In the country there are many more
families who live comfortably with the illegitimate baby in their midst,
and only a minimum of shame or compunction is experienced either by the
mother or grandparents.
The fact that some 60,000 illegitimate children annually appear
in England is well calculated to destroy some of our pharisaical
complacency. In such a godly country, one would somehow have expected
better things. It is true that in Germany, where the population is to
that of England as 5 to 3, the illegitimate births are as 5 to 1—and
that in Austria, the illegitimate birth-rate in 1916 was as high as 50
per cent., but both these countries, like many others, are burdened with
impossible marriage-laws, and many are the obstacles in the way of a
legal union for every citizen, rich or poor.
“God sends not ill; if rightly understood, all partial ill is universal
good.” We must economize our babies; whether born in wedlock or out of
it, every child has a right to some share of our consideration, and every
mother, whether married or single, should have the right to demand such
care as will save the children she bears from death in infancy.
It is estimated that 70,000 children are actually still-born each year,
and there is little doubt that a very large proportion of these could be
saved by a national scheme for the protection of mother and child. What
we need is a kind of institution which would ensure that undesired male
infants were privately removed from their surroundings and brought up
under proper supervision and care. Thus only could we save the greater
part of those boy lives at present thrown away, and which ought to go to
fulfil the needs of our under-populated dominions, crying for settlers.
The girl-babies could more safely be left with their mothers, or to the
hazard which seems to regard bastard girls more kindly than boys.
It may seem something of a digression to add that, with regard to the
causes of illegitimacy a very potent factor might be found in the
countless public-houses of every town and village in the country. Remove
excessive drink, and two-thirds of the immorality in the world will
likewise disappear. This would prove especially true in Great Britain,
where the ideals of morality are high, and religion is still a real
safe-guard.
Shakespeare said: “A man who goes to bed drunk begets a daughter.”
Whatever the theory on which he based this assertion, there remains
very little doubt that many unwanted lives are brought into existence
as a direct result of over-indulgence. It has often been stated that
the ill-kept public-house is one of the greatest disseminators of
consumption. How much might also be said of drink in connection with the
spread of venereal disease!
But my main point is that intemperance means a high illegitimate
birth-rate, which in its turn is the direct cause of the preponderance
of girl-babies which survive and so accentuate this unfortunate
disproportion.
VII
STERILITY
“Sterility does not necessarily prove that the sexual organs
or functions in either the male or the female must be in an
abnormal condition.”—A. W. EDDIS.
The causes of sterility are so multiple and diverse, and such countless
volumes have been written on the subject, that I do not consider it
necessary here to enter fully into all the particulars connected with the
condition. According to Chavasse one wife out of every eight is barren,
and the majority of these are to be found among the richer members of
society.[9] Mr. Arthur Eddis reckons that in Great Britain alone there
are over 500,000 sterile married women.[10] Only 7 per cent. of the
fertile bear their first children after the third year of marriage.
Therefore, if the first year has gone by with no sign of pregnancy,
the young wife should bestir herself to examine the possible causes of
failure in this direction.
Dr. Marion Sims, who devoted much attention to the treatment of
sterility, laid down several general rules as essential to fecundity. One
of the most important is that “Semen with living spermatozoa should be
deposited in the vagina at the proper time,” or, in simple words, healthy
fluid or seed from the male should be deposited at the proper time in
the passage of the female. Now it may seem at first sight extraordinary,
but many a childless couple remain so for the simple reason that never
once in their connubial life have they hit on the suitable day on which,
rather than any other, they could beget offspring. And that is precisely
why so much help can be obtained _from a suitable choice of days_.
One lady I was asked to treat had been married nine years and at
thirty-eight still remained childless. She was a healthy woman, but had
complained of severe pains in her back and right side at certain times.
Her periods were regular, so that it was easy to ascertain and utilize
the _day before the period was actually due_. A slight flow ensued, but
stopped on the third day—the patient went off to the seaside immediately
and stayed there alone for some time. In three weeks she experienced
much nausea, and the usual signs of pregnancy were soon detected. At the
end of nine months from the day mentioned, she gave birth to a very fine
little girl.
I would like to emphasise the marvellous effects of sea-air on the health
of certain women. I have known the most obstinate childlessness cured
simply by four to six weeks spent by the seaside.
A lady came to see me once who had been married for fifteen years
without—so far as she knew—having ever conceived; she was over forty, her
health was indifferent and she slept and ate little. The first thing to
attend to was the regulation of a faulty diet, and certain other changes
in her mode of living were recommended. A few weeks later I chose the
sixth day of menstruation as most favourable in her particular case, and
afterwards packed her off to rest and enjoy the sea-breezes alone at
Margate.
Within nine months she gave birth to a girl weighing close on 10 lbs. I
should add that in both of the above cases I considered as a result of my
experience that there was little likelihood of a healthy male pregnancy,
and deemed it preferable to make sure of a girl to begin with.
The mother who can bear children early and late and is most prone to
male issue is the wide-hipped, deep-chested woman, who has shouldered
her share of out-door work or regular exercise, whose digestive organs
are unimpaired by rich food, and whose arteries are sound and young even
into old age. The little woman who holds herself erect, slight yet agile
and well-built, may have a son or two, but the bent-over, “crumpled up,”
delicate, nervy, and small-made mother will be far more subject to female
issue.
The young girl, who from childhood has been ashamed of her
sex-development and who, to look more “boyish,” reduces her hips and
chest to a minimum, will never have a healthy and normal motherhood.
There are thousands of British girls (and it is in these islands that
the species flourish most noticeably) who deliberately try to look
mannish, by shoving forward their hips, shoulders and head. With sunken
breasts and rounded backs they “slouch” along, mere shadows of what a
well-developed woman should be.
Where a surgeon finds “nothing apparently wrong” in a woman who is still
young and whose husband is normal, it may mean that everything about
her and her way of living is “not quite right.” She may be suffering
from habitual constipation and malnutrition. She may simply need good
nourishing food in the shape of plentiful fruit, milk, vegetables, eggs,
etc., with fresh meat once a day, instead of unwholesome “made dishes,”
and rich dainties three times a day.
It is often noticed that fat women are inclined to sterility. They
usually imbibe great quantities of liquid, and seem to hanker after thick
soups, milk and cream, and all such fattening diet. Their digestion is
naturally good, but their nerves are bad, and they suffer from perpetual
attacks of extreme exhilaration or depression. Their confinements are
difficult and rarely normal, recovery being slow. If they happen to
conceive a boy, miscarriages are more than likely to occur.
Another type of woman who is prone to sterility is the lymphatic, lazy
and intensely selfish female, who is wrapped up in herself. If she has a
child it will be in the early twenties and rarely is the effort repeated.
Sterility may of course occur in both the fat and flabby woman, and
the thin and weakly one. The chances of impregnation in both types
are encouraged by a healthy mode of living, the avoidance of rich
indigestible food, moderation in the consumption of strong tea and
coffee, and extreme temperance in the matter of alcohol.
How much ill-health in the married woman is due to the lack of care taken
by young girls during their early periods! To be on the safe side, it
is often desirable every month to take a day or two off, either in bed
or lying on a sofa. This precaution, if made a regular habit, may well
help to prolong a woman’s life by ten years or more. In the young girl
a little rest at such times might prevent much illness in later years,
and add enormously to her chances of child-bearing by giving the virgin
organs every opportunity of development without let or hindrance.
On looking into certain cases one often finds that trouble is due to
irregularity or prolonged absence of periods, accompanied by a more or
less continuous white discharge. Pregnancy is not likely to take place
while this is allowed to continue, and it is astonishing how many
women suffer it to go on without troubling to effect a cure. When this
condition becomes chronic, professional advice is most necessary, and
should immediately be resorted to.
A fact which I believe has not hitherto been recorded, but is fully
substantiated by my own experience, is that women who habitually suffer
from profuse and too frequent periods are more inclined to produce female
children, while conversely those women whose periods tend to be scanty
and arrive late more generally have male children.
In this connection, I might quote a letter which a lady wrote to me two
years ago from India:
I have three little girls and my periods are quite four or five
days before the fourth week and always very profuse. I am very
anæmic, partly owing to the climate out here. I do so long for
a son....
I sent her the advice she requested. Last year she had her wish
fulfilled, and, since his birth, the periods are much more normal and
rather inclined to be “late” than “early.”
On the other hand I received a letter from another lady saying:
My periods are usually every five or six weeks. Yet I am quite
healthy and have never had a miscarriage. I have five sons ...
my periods are always rather “late,” but I am very strong and
well.
And this leads me to the subject of menstruation, which is generally
so closely allied to that of ovulation. In England most girls begin
menstruating at 13 years, though large numbers start at 14 or 15, or even
later. But according to the record kept by Mr. Robertson of 450 cases, 10
menstruated in their 11th year, 19 in their 12th and 53 in their 13th. He
also gives us particulars of great numbers of women menstruating well on
to the age of 55, two cases of women doing so till 60, and one of a woman
menstruating up to her 70th year.[11]
In cold climates, women frequently menstruate three or four times a year
only, and they begin later and end later. In Russia it is not unusual
for women to bear children as late as 60, whereas with us it is rare to
have a child after 45. Capuron quotes several cases of child-bearing in
advanced age. Among these he gives the case of Cornelia, as recorded in
Pliny. She was a member of the family of Scipio, and at the age of 60
she bore a son, Volusius Saturinus. Another case he quotes is that of a
Venetian physician named Marsa, who treated a woman of 60 for pregnancy,
having previously, owing to her age, diagnosed her trouble as dropsy. He
adds that a woman in Paris bore a daughter at the age of 63 and nursed
it.[12]
It is rare in England to conceive for the first time at 45, but I have
known three women who had a _first child_ at 47, and two at 48. Yet so
great is the latitude in the ages of women’s fruitful period that a girl
may be a mother at 12, or even earlier in hot climates.
La Motte delivered of a child a girl who had not completed her 13th year,
and who had not menstruated.[13] Dr. Paris states that during the year
1816 some girls of 13 were admitted into the Maternité at Paris,[14] and
recently the Matron of a London home has given me particulars of two or
three cases of mothers of 13 and 14.
Dr. Rowlett, of Kentucky, reports the case of a certain Sally Deweese,
born in 1824, who began to menstruate at a year old. At nine years old
she became pregnant, and in 1834 gave birth to a female child weighing 7¼
lbs., the mother then being 4 ft. 7 in. in height.[15] It should be noted
that in cases where the mother is quite elderly or where she is a mere
child, the progeny is rarely healthy or strong. In the former category
the child more often suffers from lack of full mental development, and in
the latter it rarely survives its birth.
Having made a brief survey of the question of sterility in women, I
may now state my conclusion that most disabilities are remediable,
or at least capable of great modification. Much depends on the woman
herself—her health, mode of life and temperament. Conditions and the
proper choice of a day can help, but where there is some organic or
anatomical disability, the advice of a surgeon or a doctor should
immediately be sought. In few cases, from my experience, is sterility
absolutely hopeless, though in many instances where a girl-child can be
conceived, a boy would be impossible, and the attempt should not be made,
as it might cause lasting injury to the mother.
I must confess that when the causation of sex loomed large on the horizon
of my mind I little thought that the simple natural laws I had discovered
would prove such an efficient aid in the treatment of sterility as has
since been shown so abundantly to be the case.
VIII
SEX-CAUSATION
“The sex of the child is fixed before it is fertilised.”—LENHOSICK.
Before I go on to describe the simple law of nature on which the
pre-determination of sex depends, it is essential that a few anatomical
details should be explained and understood. A fundamental truth to be
borne in mind is the absolute completeness of the maternal organs. They
harbour from the first moment of actual existence the potentialities of
both sexes alike, _entirely independent of the fertilisation of the male
parent_. Of what then do the uterine organs consist? Let us first treat
of the position of the _uterus_ or _womb_. This organ begins to develop
with the first beginning of menstruation, and it goes on growing until
the twenty-first year. Once it has borne a fœtus it never entirely
regains its virgin form, but remains slightly enlarged. It lies rather
to the right, so that when a woman is on her back, the right ovary and
the uterine opening of the right oviduct or Fallopian tube are lower down
in the pelvis than the left ovary and oviduct. On either side of the
womb are the _Fallopian tubes_, their average length being four inches.
These tubes are dilatable, smaller at the uterine opening and thicker
at the abdominal opening near the ovary. Each tube is lined with mucous
membranes which, containing special hair-like fibres called “cilia,”
impel the ovum, or egg, onwards down the tube by a movement always in one
direction, towards the uterus. These tubes are the excretory ducts of the
ovaries.
The _ovaries_ grow and mature earlier than the womb. Each ovary is a
solid oval-shaped organ more or less encircled by the outer end of its
corresponding Fallopian tube, and each enlarges when about to discharge
an ovum. The right ovary is larger than the left. In each are a large
number of cysts known as ovisacs or “Graafian follicles,” so called after
R. de Graaf, a Dutch anatomist, who died in 1673. Each Graafian follicle
contains an ovum floating in a clear albuminous fluid, called “liquor
folliculi.” At birth there are thousands of ova in the ovaries, but by
the time of puberty only one-third remain. Each follicle contains an ovum
and each ovum a vital structure called the germinal vesicle or nucleolus.
This, when fertilised by the corresponding contribution from the male,
grows and develops into the ultimate child.
Ovulation, i.e. the discharge of a ripe ovum from an ovary, is brought
about by the development and maturing of a Graafian follicle, its rupture
and the discharge of the ovum it contained. The enlarged follicle having
gradually approached the ovarian surface, its walls become congested and
thinned at one part. It then bursts; the “liquor folliculi” is poured
out, and the ripened ovum set free. Ova, one or more at a time, are
expelled from the ovary at regular monthly intervals, from puberty to
the climacteric, for some 35 years. Before puberty a girl’s ovaries are
pearl-grey and smooth, but later each ovulation leaves a little scar. For
every monthly period a scar remains, and, as there are some 500 menstrual
periods in a woman’s life, there should be in all some 250 scars on each
ovary, though most of these are entirely obliterated in the course of
time.
As the ovaries are formed in the embryo fœtus so is their sex determined,
and they are potentially male or female from the start. The ova, in
their thousands, lie latent in each ovary of the female until puberty
supervenes. Then, alternately, every month or thereabouts, starting
always from the left, each ovary expels its ovum, and does so with
increasing regularity as adolescence ripens into womanhood. _According to
the sex_, if at any time the ovum be fertilised and pregnancy ensues, an
indelible scar will be left on the _one ovary or the other_.
It is only of late years that the theory of the alternate action of
the ovaries has been recognised by certain eminent gynæcologists. The
evidence afforded by the ovaries themselves admits of little possible
doubt as to the fact of equal division of activity between right and
left side of the womb. Such action is not simultaneous, but definitely
alternating in character.
A woman doctor in Geneva, 35 years ago, made a close study of the fact
that young girls frequently complained of pains one month in the right
side and the next month in the left. She also pointed out a dissimilarity
between the two periods for two months running. These observations
combined with others, carried weight in the minds of many prominent
doctors, hitherto sceptical of the alternate working of the ovaries, and
the theory of “sides.”
To my mind, as the result of long and close investigation, the conclusion
is definitely established that the side theory cannot be seriously
questioned, and any attempt to overthrow it would result only in putting
back the hands of the clock.
Dr. Rumley Dawson’s clearly stated account of the alternate working of
the ovaries is too well known to need reiteration in this treatise.[16]
It is entirely consistent with the principle, by which as Professor
Gamble lately stated, Nature makes provision for all parts of the human
body to rest at intervals while other parts are employed, thereby
enabling the organs to “work in shifts.”[17] The theory in itself is
time-honoured, and many authors can be quoted in support of it. The left
side is the first to operate in the young girl, and it is usually the
first to push forward the work of conception in the woman. Hence the
preponderance of _females_ among all _first_-born creatures.
In the early stages of life most children are left-handed, they even
start walking left foot foremost. As they grow, however, the right side
in time takes precedence. The right leg is the strong one to jump from,
the right arm wields the weapon with which we work or fight. Similarly
the whole right side of the human body is definitely superior in enduring
power to the side where beats the heart. In more ways than one must
this organ be held responsible for the weaker fibre of the position it
dominates.
If there is one exception to this rule it is the brain, of which the left
side gets a more rapid supply of blood, and thus shows more activity than
the right.
On the other hand in tubercular hip-disease, the left leg is affected in
80 per cent. of cases. Congenital dislocation of the hip is seven times
more common in female children than in male. Prenatal and spontaneous
amputation of fœtus limbs is usually to be found in girls only. The
disaster of being joined together, like the Siamese Twins, is more often
suffered by girl-twins, only a very few similar cases among boys being
mentioned in medical records at any time. In phthisis, the left lung is
the first to be affected in 80 per cent. of all cases recorded. The teeth
on the left jaw are the first to arrive, and likewise the first to decay
or drop out, with but few exceptions. Again the right hip, leg, foot and
hand are almost always larger than the corresponding members of the left
side.
So, too, it comes about that the right ovary, the seat of the male ova,
is also the more developed, the larger, and the best able to nourish
the fertilised embryo. It can afford fuller space and freedom for male
offspring than the left ovary can do for the female ova it produces.
As regards the reason _why_ there should be one side for each sex, one
might as well inquire why the heart is on the left and the liver on the
right. _Galen_ has said that “the right side in both parents produces
boys, because it is warmer.” But many people would have judged the side
governed by the heart to be the warmest. Be that as it may, the fact
remains that in France brides are seriously advised to sleep on the
right side if they desire sons, and in 1870 the _Lancet_ observed that
“habitual sleeping on the right side produces boys.”
And so we come to my conclusion. With an organism entirely self-contained
and independent, as I have endeavoured to show the female anatomy to
be, the only reasonable inference is that _the male is in no way a
determining factor in the sex of the ovum_ fertilised by him. On woman
and woman alone does the sex of the unborn child depend.
IX
FOR A BOY
“Laws wise as nature, and as fixed as Fate.”—POPE.
Just as the male ovum proceeds from the larger ovary, so does the
development of the male fœtus take place in the larger and more expansive
side of the uterus. The male ovary, being more perfectly developed, and
more self-contained than the left, throws out its ovum on the third day
of the menstrual period, _never before_. The earliest boy-pregnancy ever
recorded started on the third day of the period. It was the notable
case reported by Dr. Guérin, of Anne of Austria, wife of Louis XIII of
France, who thus conceived her eldest son. Again we are told by Jourdain
that Henri II consulted the eminent Fernel as to a means of rendering
his Queen Catherine de Medici, fruitful. Fernel advised intercourse
“immediately after the period,” and his advice proved successful. After
years of disappointment, the Queen gave birth to a son.