_In which handicaps are dropped_
A WOMAN'S ILLS
"THE FEMALE OF THE SPECIES"
If ever there was a man who wished himself a woman, he has hidden away
the desire within the recesses of his own heart. But one does not have
to wait long to hear a member of the female sex exclaim with evident
emotion, "Oh, dear, I wish I had been born a man!" It is probable that
if these same women were given the chance to transform themselves
overnight, they would hesitate long when it actually came to the
point. The joys of being a woman are real joys. However, in too many
cases these joys seem hardly to compensate for the discomforts of the
feminine organism. It is the body that drags. Painful menstrual
periods, the dreaded "change of life," various "female troubles" with
a number of pregnancies scattered along between, make some of the
daughters of Eve feel that they spend a good deal of their lives
paying a penalty merely for being women. Brought up to believe
themselves heirs to a curse laid on the first woman, they accept their
discomforts with resignation and try to make the best of a bad
business.
="Since the War."= Nothing is quite the same since the war. Among
other things we have learned that many of our so-called handicaps were
nothing but illusions,--base libels on the female body. Under the
stern necessity of war the women of the world discovered that they
could stand up under jobs which have until now been considered quite
beyond their powers. Society girls, who were used to coddling
themselves, found a new joy in hard and continuous work; middle-aged
women, who were supposed to be at the time of life when little could
be expected of them, quite forgot themselves in service. Ambulance
drivers, nurses, welfare workers, farmerettes, Red-Cross workers,
street-car conductors and "bell-boys," revealed to themselves and to
the world unsuspected powers of endurance in a woman's body. Although
some of the heavier occupations still seem to be "man's work," better
fitted for a man's sturdier body, we know now that many of these
disabilities were merely a matter of tradition and of faulty training.
There still remains, however, a goodly number of women who are
continuously or periodically below par because of some form of
feminine disability. Some of these women are suffering from real
physical handicaps, but many of them need to be told that they are
disabled not by reason of being women but by reason of being nervous
women.
="Nerves" Again.= Despite the organic disturbances which may beset the
reproductive organs, and despite the havoc wrought by venereal
diseases, it may be said with absolute assurance that the majority of
feminine ills are the result neither of the natural frailty of the
female body, nor even of man's infringement of the social law, but are
the direct result of false suggestion and of false attitudes toward
the facts of the reproductive life. The trouble is less a difficulty
with the reproductive organs than a difficulty with the reproductive
instinct. "Something wrong" with the instinct is translated by the
subconscious mind into "something wrong" with the related generative
organs, and converted into a physical pain.
That this relation has always been dimly felt is shown by the fact
that the early Greeks called nervous disorders _hysteria_, from the
Greek word for womb. It is only lately, however, that the blame has
been put in the right place and the trouble traced to the _instinct_
rather than to the _organs_ of reproduction.
=Why Women Are Nervous.= Although women hold no monopoly, it must be
conceded that they are particularly prone to "nerves." The reason is
not hard to find. Since the leading factor in a neurosis is a
disturbance of the insistent instinct of reproduction, a disturbance
usually based on repression, then any class of persons in whom the
instinct is particularly repressed would, in the very nature of the
case, be particularly liable to nervousness.
No one who thoroughly knows human nature would attempt to deny that
woman is as strongly endowed as man with the great urge toward the
perpetuation of the race, or that she has had to repress the instinct
more severely than has man. The man insists on knowing that the
children he provides for are his own children. Whatever the degree of
his own fidelity, he must be sure that his wife is true to him. Thus
has grown up the insistence that, no matter what man does, woman, if
she is to be counted respectable, shall control the urge of the
instinct and live up to the requirements of continence set for her by
society.
Unfortunately, however, there is more often blind repression than
rational control. The measures taken to prevent a girl's becoming a
tom-boy are measures of sex-repression quite as much as of
sex-differentiation. Over-reaction of sensitive little souls to
lessons in modesty often causes distortion of normal sex-development.
Ignorance concerning the phenomena of life is commended as innocence,
while it really implies a sex-curiosity which has been too severely
repressed. The young woman blushes at thoughts of love, while the
young man is filled with a sense of dignity. We smile at the picture
of "Miss Philura's" confusion as she hesitatingly sends up to her
Creator a petition for the much-desired boon of a husband. But really,
why shouldn't she want one? Many a young woman, in order to deaden her
senses to the unsuspected lure of the reproductive instinct by what is
really an awkward attempt at _sublimation_, makes a fetish of dress
and social position and considers only the marriage of convenience;
or, on the other hand, she scorns men altogether and throws herself
into a "career."
Young men are not so often taught to repress, but neither are they
taught to swing their vital energies into altruistic channels through
sublimation. Since the woman of his class will not marry him until he
has money, the young man too often satisfies his undirected instincts
in a commercial way. The statistics of venereal diseases prove that
here, as elsewhere, goods subject to barter are subject to
contamination. In a late marriage, too often a contaminated body
accompanies the material possessions which the standards of society
have demanded of a husband.
But the woman pays in still other coin for the repressions arising
from faulty childhood training. Unable to find expression for herself
either in marriage or in devotion to work, because some old childish
repression is still denying all outlet to her legitimate desire, she
frequently falls into a neurosis; or if she escapes a real breakdown,
she gives expression to unsatisfied longings in some isolated nervous
symptoms which in many cases center about the organs of generation.
There then results any one of the various functional disturbances
which are only too often mistaken for organic disease. What is needed
in cases like this is not a gynecologist nor a surgeon, but a
psycho-pathologist--or perhaps only a grasp of the facts. Let us look
at the more common of these disturbances in order to gain an
understanding of the situation.
THE MENSTRUAL PERIOD
=Potential Motherhood.= Among the normal phenomena of a woman's life
is the recurring cycle of potential motherhood. Every three or four
weeks a new ovum or egg matures in the ovary and undergoes certain
chemical changes, which send into the blood a substance called a
hormone. This hormone is a messenger, stimulating the mucous membrane
of the womb into making its velvet pile longer and softer, and its
nutrient juices more abundant in readiness for the ovum.
The same stimulus causes the whole organism to make ready for a new
life. As in hunger, the chemistry of the body produces the
muscle-tension that is felt as a craving for food, so this recurring
chemical stimulus produces a definite craving in body and mind. This
craving brings about an increased irritability or sensitiveness to
stimuli which may result either in a joyous or a fretful mood.
During sleep the social inhibitions are felt less distinctly and the
sleeper dreams love-dreams woven from messages coming up from all the
minute nerve-endings in the expectant reproductive organs. But if no
germ-cell travels up the womb-canal and tube to meet and impregnate
the ovum, the womb-lining rejects the egg as chemically unfit. All the
furbishings are loosened from the walls and slowly cast out,
constituting the menstrual flow. The phenomenon as a whole is a
physiological function and should be accompanied by a sense of
well-being and comfort as is the exercise of any other function, such
as digestion or muscular activity. Only too often, however, it is
dreaded as an unmitigated disaster, a time for giving up work or fun
and going to bed with a hot-water bottle until "the worst is over."
Let us see how this perversion comes about.
=Why Menstruation Is Painful.= What sort of atmosphere is created for
the young girl as she attains puberty? Most girls get their first
inkling of the menstrual period from the periodic "sick spells" of
mother or sister. This knowledge comes without conscious thought and
is a direct observation of the subconscious mind, which records
impressions with the accuracy and completeness of a photographic
plate. Hearing the talk about a "sick-time" and observing the signs of
"cramps" among older friends, the young girl's subconscious mind plays
up to the suggestion and recoils with fear from the newly experienced
sensations in the maturing organs of reproduction.
This recoil of fear interferes with the circulation in the functioning
organs, just as fear blanches the face or hinders digestion. There is
several times as much blood in the stomach when it is full of food as
there is between meals, but we do not for this reason fancy that we
have a pain after each meal. There is more blood in the generative
organs during their functioning, but this means pain only when fear
ties up the circulation and causes undue congestion. Fear acts further
on the sturdy muscle of the womb, tying it up into just such knots as
we feel in the esophagus when we say that we have a lump in the
throat. It is safe to say that ninety-five cases of painful
menstruation out of every hundred are caused by fear and by the
expectation of pain. The cysts and tumors responsible for pain are so
rare as to be fairly negligible, when compared with these other
causes.
Dr. Clelia Duel Mosher of Stanford University has for many years
carried on careful investigations among the students of the
university. After describing in detail certain physical exercises
which she has found of value, she continues:
But more important even than this is an alteration of the morbid
attitude of women themselves toward this function; and almost
equally essential is a fundamental change in the habit of mind on
our part as physicians; for do we not tend to translate too much,
the whole of a woman's life into terms of menstruation? If every
young girl were taught that menstruation is not normally a "bad
time" and that pain or incapacity at that period is as
discreditable and unnecessary as bad breath due to decaying
teeth, we might almost look for a revolution in the physical life
of women.... In my experience the traditional treatment of rest
in bed, directing the attention solely to the sex-zone of the
body, and the accepted theory that it is an inevitable illness
while at the same time the mind is without occupation, produces a
morbid attitude and favors the development and exaggeration of
whatever symptoms there may be.[56]
[Footnote 56: Clelia Duel Mosher: _Health and the Woman Movement_, pp.
25, 26, 19.]
=Pre-Menstrual Discomfort.= If it be objected that women often feel
badly for a day or two before the period begins, before they know that
it is due, and that this feeling of discomfort could not be caused by
fear and expectation, it is easy to reply that the subconscious mind
knows perfectly what is happening within the body. The emotion of
fear, working within the subconscious, is able to translate all the
varying bodily sensations into feelings of distress without any
knowledge on the part of the conscious mind.
Sometimes before the period begins, a girl feels blue and upset for a
day or two, a sign that the instinct is getting discouraged. The whole
body is saying, "Get ready, get ready," but it has gotten ready many
times before, and to no purpose. Unsatisfied striving brings
discouragement. What reaches consciousness is a feeling of pessimism
and a general dissatisfaction with life as a whole. If, instead of
giving in to the blues or going to bed and predicting a pain, the girl
finds other outlets for her energy, she finds that after all, her
instinct may be satisfied in indirect ways and that she has strangely
come into a new supply of _vim_.
=The Purpose of the Pain.= Although suggestion is behind all nervous
symptoms, there is a deeper reason for the disturbance. When an
unhealthy suggestion is seized and acted upon, it is because some
unsatisfied part of the personality sees in it a chance for
accomplishing its own ends. The pre-menstrual period is the
blooming-time, the mating-time, the springtime of the organism. That
means eminently a time for coming into notice, that one's charms may
attract the desired complement. But if the rightfully insistent
instinctive desires are held in check by unnatural repressions and
misapplied social restrictions, the starved instinct can obtain
expression only by a concealment of purpose. The disguise assumed is
often one of indifference or positive distaste for the allurements of
the other sex. But, as we know, an instinctive desire will not be
denied. In this case, the misguided instinct which has been given the
suggestion that menstruation means illness, fits this conception into
the scheme of things and obtains notice in a roundabout way by the
attention given to the invalid.
=The Treatment.= To find that the symptom has a purpose rather than a
cause gives the indication for the treatment. Judicious neglect causes
the symptom to cease by defeating its very purpose,--that of drawing
attention to itself. The person who never mentions her discomfort,
thinks about it as little as possible, and goes about her business as
usual, is likely to find her trouble gone before she realizes it.[57]
[Footnote 57: Violent exercise at this time is unwise, but continuing
one's usual activity helps the circulation and keeps the mind from
centering on the affected part. The physiological congestion is unduly
intensified by standing; therefore all employments should afford
facilities for the woman to sit at least part of the time while
continuing work.]
A little explanation gives the patient insight into the workings of
her own mind, and usually causes the pain to disappear in short order.
Astonished, indeed, and filled with gratitude have been some of my
young-women patients who had all their lives been unable to plan any
work or social engagements for the time of this functioning. Many of
them were the worst kind of doubters when they were told that to go to
bed and center their attention on the generative organs only made the
muscles tighten up and the circulation congest. They could not
conceive themselves up and around, pursuing their normal life during
such a time. However, as they have found by experience that this point
of view is not an optimistic dream, they have broken up the
confidence-game which their subconscious had been playing on them, and
have gone on their way rejoicing.
There was one young girl, a doctor's daughter, who suffered
continuously from pain in the abdomen, and from back-pain which
increased so greatly at the time of the menses that she was in the
habit of going to bed for several days, to be waited on with
solicitous care by her family. In an attempt to cure the trouble she
had undergone an operation to suspend the uterus, but the pain had
continued as before. When she came to me, I explained to her that
there was no physical difficulty and that her trouble was wholly
nervous. I made her play tennis every day and she had just finished a
game when her period came on. She stayed up for luncheon, went for a
walk in the afternoon, ate her dinner with the family, and behaved
like other people. Her mother telephoned that evening and when I told
her what her daughter had been doing, she gasped in astonishment. She
had difficulty in believing that the new order was not miracle but
simply the working out of natural law. Since that time her daughter
has had no more trouble.
=The Ounce of Prevention.= If young girls had wiser counselors in
their mothers and physicians, the misconception would never occur, and
such an indirect outlet would not be needed; the organic sensations
incident to puberty and the recurring menstrual period would have
something of the significance of the annunciation to Mary, bringing
wonder and a sense of well-being.
When your little daughter arrives at maturity, give her a joyous
initiation into the noble order of women. She will welcome the new
function as a badge of womanhood and as a harbinger of wonderful
things to come.
A girl of fifteen came under my care to be helped out of a mood of
increasing depression and uneasiness. Her glance was furtive, yet
anxiously expectant. Tears came unbidden as she sat alone or fingered
the keys of the piano. Tactful questioning elicited no response as to
reasons for her unhappiness. Opportunities for giving confidence were
not accepted. At a chance moment our talk drifted to the subject of
menstruation. "Your periods are regular and easy; and do you know what
they are for?" Then I painted for her a picture of the preparations
that are made throughout the whole organism, for the germ-cell that
comes each month and has in it all the possibilities of a new little
life.
The result of this confidential talk may seem fanciful to any one but
an eye-witness. We had only a week's association, but the depression
ceased, the furtive look and deprecatory manner were replaced by a
joyous buoyancy. In a few weeks the thin neck and awkward body rounded
out into the symmetry which usually precedes the establishment of
puberty, but which was delayed in this case until the unconscious
conflict resolved itself.
=In the Large.= Looked at from any angle, this subject is an important
one. There are involved not only the physical comfort and convenience
of the sufferers themselves, but also the economic prospects of women
as a whole. If women are to demand equal opportunity and equal pay,
they must be able to do equal work without periodic times of illness.
When employers of women tell us that they regularly have to hire extra
help because some of their workers lose time each month, we realize
how great is the aggregate of economic waste, a waste which would
assuredly be justified if the health of the country's womanhood were
really involved, but which is inefficient and unnecessary when caused
merely by ignorant tradition. "Up to standard every day of every
week," is a slogan quite within the range of possibility for all but
the seriously ill. When reduced to their lowest terms, the
inconveniences of this function are not great and are not too dear a
price to pay for the possibilities of motherhood.
THE "CHANGE OF LIFE"
=Another Phantom Peril.= As the young girl is taught to fear the
menstrual period, so the older woman is taught to dread the time when
the periods shall cease. Despite the general enlightenment of this day
and age, the menopause or "change of life" is all too frequently
feared as a "critical period" in a woman's life, a time of distressing
physical sensations and even of danger to mental balance.
As a matter of fact, the menopause is a physiological process which
should be accomplished with as little mental and physical disturbance
as accompanies the establishment of puberty. The same internal
secretion is concerned in both. When the function of ovulation ceases
the body has to find a new way to dispose of the internal secretion of
the ovary. Its presence in the blood is the cause of the sudden
dilatation of the blood-vessels that is known as the "hot flash."
The matter is altogether a problem of chemistry, with the necessity
for a new adjustment among the glands of internal secretion. The body
easily manages this if left to itself, but is greatly interfered with
by the wrong suggestion and emotion. We have already seen how quickly
emotion affects all secretions and how easily the adrenal and thyroid
glands are influenced by fear. This is the root of the trouble in many
cases of difficult "change." If an occasional body is not quite able
to regulate the chemical readjustment, we may have to administer the
glands of some other animal, but in the majority of cases, the body,
unhampered by an extra burden of fear, is quite able to make its own
adjustments. The hot flash passes in a moment, if not prolonged by
emotion or if not converted into a habit by attention.
One source of trouble in the menopause is that it comes at a time in a
woman's life when she is likely to have too much leisure. In no way
can a woman so easily handicap her body at this time as by stopping
work and being afraid. Those women who have to go on as usual find
themselves past the change almost before they know it,--unless they
consider themselves abused, and worry over the necessity for working
through such a "critical time."
=Three Rules.= Here are a few pointers which have have been of help to
a number of women:
1 Remember that this is a physiological process and therefore
abundantly safeguarded by Nature. If you don't expect trouble you will
not be likely to find it.
2 Remember that the sweating and flushing are made worse by notice.
3 Do everything in your power to keep from the public the knowledge
that you are no longer a potential mother. If you are past forty, do
not mop your face or gasp for breath or carry a fan to the theater!
Shun attention and fear, and you will be surprised at the ease with
which the "change" is effected.
=Nature's Last Chance.= While we are on the subject of the middle-aged
woman, it may be well to mention a phenomenon sometimes noticed in the
early forties. Often an "old maid" who has considered herself settled
for life in her bachelor estate, suddenly takes to herself a husband.
(I use the verb advisedly!) Mothers who have thought their
child-bearing days long past sometimes find themselves pregnant. "The
child of her old age" is not an uncommon occurrence. Unmarried women
who have "kept straight" all their lives sometimes go down before
temptation at this late time. There is a reason. It is as though
Nature were making a last desperate attempt to produce another life
before it is too late, speeding up all the internal secretions and
flashing insistent messages throughout the whole organism.
It may help some woman who feels herself inexplicably impelled toward
the male sex to know that she is not being "tempted by the devil" but
merely driven by the insistent chemicals within her body. She is
likely to rationalize and tell herself that it is too bad for a
worth-while person like herself to leave no progeny behind her; or she
may say, as one of my patients did when contemplating running away
with another woman's husband,--that she could make that man so much
happier than his wife did, and that she really owed it to him as well
as to herself. When a woman knows what is the matter with her, it
makes it easier to bide her time and wait for the demands of Nature to
subside. Chemicals may not be so romantic as love, but neither are
they so melodramatic!
OTHER TROUBLES
="Speaking of Operations."= Physicians are often called upon to
diagnose some such vague symptom as pain in the abdomen, back and
head; ache in the legs; constipation, or loss of appetite. Since the
patient is very insistent that something shall be done, the physician
may be driven to operate, even when he has an uneasy feeling that the
trouble is "merely nervous." Sixty per cent. of the operations on
women are necessitated by the results of gonorrheal infection. Next in
frequency up to recent date, have been operations for nervous symptoms
which could in no way be reached by the knife. Only too often a
nerve-specialist hears the tale of an operation which was supposed to
cure a certain pain but which left it worse rather than better. It is
a pleasure to see some of these pains disappear under a little
re-education, but one cannot help wishing that the re-education had
come before the knife instead of after it.
A skilled surgeon can cut almost anything out of a person's body, but
he cannot cut out an instinct. It sometimes takes great skill to
determine whether the trouble is an organic affection or a functional
disturbance caused by the misdirected instinct of reproduction. Often,
however, the clinical pictures are so different as to leave no room
for doubt, provided the diagnostician has his eyes open and is not
over-persuaded by the importunity of the poor neurotic, who insists
that the surgeon shall remove her appendix, her gall-bladder, her
genital organs, and her tonsils, and who finally comes back that he
may have a whack at the operation scar.
=The Bearing of Children.= A number of years ago I became acquainted
with a charming young married woman who had all her life recoiled with
fear from the phenomena of sex. She had been afraid of menstruation
and of marriage, and had at this time almost a phobia for pregnancy
and childbirth. Before long she came to me in terror, telling me that
she had become pregnant. I explained to her that pregnancy is the time
when most women are at their best, that the nausea which is often
troublesome in the beginning is caused merely by a mixing of messages
from the autonomic nerves, which refer new sensations in the womb to
the more usual center of activity in the stomach; and that after the
body has become accustomed to these sensations, most women experience
a greater sense of well-being and peace than at any other time in
life. We had a conversation or two on the subject and everything
seemed to go well for a while.
As it happened, this young woman and her husband came to call on me
one afternoon just before the baby was expected. During the visit she
began to show signs of being in labor. Again she was in terror. Again
I explained the phenomena of labor, telling her that the
womb-contractions are caused by the presence in the blood of a
chemical secretion (hormone) which continues its good work as long as
there is a state of confidence, but which sometimes stops under fear
or apprehension. I explained that these womb-efforts are a peristaltic
movement, a contraction of the upper muscles and a letting go of the
purse-string muscle at the mouth of the womb, and that fear only tends
to tie up this purse-string muscle, making a difficult process out of
one which was intended by Nature to be much more simple. She seemed to
understand and to lose a good deal of her fright.
About six o'clock the couple went home on the street car from the
upper end of Pasadena to the far end of Los Angeles. The next morning
I had a jubilant telephone message from the happy father, announcing
that the boy-baby had arrived at midnight and that, wonderful to
relate, he had come without the mother's experiencing any pain
whatever.
I give this account for what it is worth, without of course contending
that labor could always be as easy as this. It happened that this girl
was a normal, healthy woman and that there were no complications of
any kind in the process of childbirth. A right attitude of mind could
not have corrected any physical difficulty, but it did seem to help
her let go of her fear, which would of itself have caused long and
painful labor.
A patient once told me that when her first baby came, she happened to
be out in the country where she had to call in a doctor whom she did
not know. He was an uncouth sort of fellow who inspired fear rather
than confidence. She soon found that labor stopped whenever he came
into the room, and started again when he went out. She had the good
sense to send him out and complete her labor with only the help of her
mother. Unfortunate is the obstetrician who does not know how to
inspire a feeling of confidence in his patients. Even childbirth may
be mightily helped or hindered by the mother's state of mind.
SUMMARY
A woman's body has more stability than she knows. It is sometimes out
of order, but it is more often misunderstood; usually it is an
unobtrusive and satisfactory instrument, quite fit for its daily
tasks. The average woman is really well put together. We hear about
the ones who have difficulty, but not about the great majority who do
not. We notice the few who are upset during the menopause, and forget
all the others. To be comfortable and efficient most of the time is,
after all, merely to be "like folks."
The special functions which Nature has been perfecting in a woman's
body are as a rule, easily carried through unless complicated by false
ideas or by fear.
If the woman who has no organic difficulty but who still finds herself
handicapped by her body, will cease being either resigned to her
languishing lot or envious of her stalwart brothers; if instead she
will set out to learn how to be efficient as a woman, she will find
that many of her ills are not the blunders of an inefficient Creator,
but are home-made products, which quickly vanish in the light of
understanding.