CHIEFLY CLINICAL.
"Et l'on nous persuadera difficilement que lorsque les hommes
ont tant de peine à être hommes, les femmes puissent, tout en
restant femmes, devenir hommes aussi, mettant ainsi la main
sur les deux rôles, exerçant la double mission, résumant le
double caractère de l'humanité! Nous perdrons la femme, et
nous n'aurons pas l'homme. Voila ce qui nous arrivera. On nous
donnera ce quelque chose de monstreux, cet être répugnant, qui
déjà parait à notre horizon."--LE COMTE A. DE GASPARIN.
"Facts given in evidence are premises from which a conclusion
is to be drawn. The first step in the exercise of this duty is
to acquire a belief of the truth of the facts."--RAM,
_on Facts_.
Clinical observation confirms the teachings of physiology. The sick
chamber, not the schoolroom; the physician's private consultation, not
the committee's public examination; the hospital, not the college,
the workshop, or the parlor,--disclose the sad results which modern
social customs, modern education, and modern ways of labor, have
entailed on women. Examples of them may be found in every walk of
life. On the luxurious couches of Beacon Street; in the palaces of
Fifth Avenue; among the classes of our private, common, and normal
schools; among the female graduates of our colleges; behind the
counters of Washington Street and Broadway; in our factories,
workshops, and homes,--may be found numberless pale, weak, neuralgic,
dyspeptic, hysterical, menorrhagic, dysmenorrhoeic girls and women,
that are living illustrations of the truth of this brief monograph. It
is not asserted here that improper methods of study, and a disregard
of the reproductive apparatus and its functions, during the
educational life of girls, are the sole causes of female diseases;
neither is it asserted that all the female graduates of our schools
and colleges are pathological specimens. But it is asserted that the
number of these graduates who have been permanently disabled to a
greater or less degree by these causes is so great, as to excite the
gravest alarm, and to demand the serious attention of the community.
If these causes should continue for the next half-century, and
increase in the same ratio as they have for the last fifty years, it
requires no prophet to foretell that the wives who are to be mothers
in our republic must be drawn from trans-atlantic homes. The sons of
the New World will have to re-act, on a magnificent scale, the old
story of unwived Rome and the Sabines.
We have previously seen that the blood is the life, and that the loss
of it is the loss of so much life. Deluded by strange theories, and
groping in physiological darkness, our fathers' physicians were too
often Sangrados. Nourishing food, pure air, and hæmatized blood were
stigmatized as the friends of disease and the enemies of
convalescence. Oxygen was shut out from and carbonic acid shut into
the chambers of phthisis and fever; and veins were opened, that the
currents of blood and disease might flow out together. Happily, those
days of ignorance, which God winked at, and which the race survived,
have passed by. Air and food and blood are recognized as Nature's
restoratives. No physician would dare, nowadays, to bleed either man
or woman once a month, year in and year out, for a quarter of a
century continuously. But girls often have the courage, or the
ignorance, to do this to themselves. And the worst of it is, that the
organization of our schools and workshops, and the demands of social
life and polite society, encourage them in this slow suicide. It has
already been stated that the excretory organs, by constantly
eliminating from the system its effete and used material, the measure
and source of its force, keep the machine in clean, healthy, and
working order, and that the reproductive apparatus of woman uses the
blood as one of its agents of elimination. Kept within natural limits,
this elimination is a source of strength, a perpetual fountain of
health, a constant renewal of life. Beyond these limits it is a
hemorrhage, that, by draining away the life, becomes a source of
weakness and a perpetual fountain of disease.
The following case illustrates one of the ways in which our present
school methods of teaching girls generate a menorrhagia and its
consequent evils. Miss A----, a healthy, bright, intelligent girl,
entered a female school, an institution that is commonly but oddly
called a _seminary_ for girls, in the State of New York, at the age of
fifteen. She was then sufficiently well-developed, and had a good
color; all the functions appeared to act normally, and the catamenia
were fairly established. She was ambitious as well as capable, and
aimed to be among the first in the school. Her temperament was what
physiologists call nervous,--an expression that does not denote a
fidgety make, but refers to a relative activity of the nervous system.
She was always anxious about her recitations. No matter how carefully
she prepared for them, she was ever fearful lest she should trip a
little, and appear to less advantage than she hoped. She went to
school regularly every week, and every day of the school year, just as
boys do. She paid no more attention to the periodical tides of her
organization than her companions; and that was none at all. She
recited standing at all times, or at least whenever a standing
recitation was the order of the hour. She soon found, and this history
is taken from her own lips, that for a few days during every fourth
week, the effort of reciting produced an extraordinary physical
result. The attendant anxiety and excitement relaxed the sluices of
the system that were already physiologically open, and determined a
hemorrhage as the concomitant of a recitation. Subjected to the
inflexible rules of the school, unwilling to seek advice from any one,
almost ashamed of her own physique, she ingeniously protected herself
against exposure, and went on intellectually leading her companions,
and physically defying nature. At the end of a year, she went home
with a gratifying report from her teachers, and pale cheeks and a
variety of aches. Her parents were pleased, and perhaps a little
anxious. She is a good scholar, said her father; somewhat over-worked
possibly; and so he gave her a trip among the mountains, and a week or
two at the seashore. After her vacation she returned to school, and
repeated the previous year's experience,--constant, sustained work,
recitation and study for all days alike, a hemorrhage once a month
that would make the stroke oar of the University crew falter, and a
brilliant scholar. Before the expiration of the second year, Nature
began to assert her authority. The paleness of Miss A's complexion
increased. An unaccountable and uncontrollable twitching of a
rhythmical sort got into the muscles of her face, and made her hands
go and feet jump. She was sent home, and her physician called, who at
once diagnosticated chorea (St. Vitus' dance), and said she had
studied too hard, and wisely prescribed no study and a long vacation.
Her parents took her to Europe. A year of the sea and the Alps, of
England and the Continent, the Rhine and Italy, worked like a charm.
The sluiceways were controlled, the blood saved, and color and health
returned. She came back seemingly well, and at the age of eighteen
went to her old school once more. During all this time not a word had
been said to her by her parents, her physician, or her teachers, about
any periodical care of herself; and the rules of the school did not
acknowledge the catamenia. The labor and regimen of the school soon
brought on the old menorrhagic trouble in the old way, with the
addition of occasional faintings to emphasize Nature's warnings. She
persisted in getting her education, however, and graduated at
nineteen, the first scholar, and an invalid. Again her parents were
gratified and anxious. She is overworked, said they, and wondered why
girls break down so. To insure her recovery, a second and longer
travel was undertaken. Egypt and Asia were added to Europe, and nearly
two years were allotted to the cure. With change of air and scene her
health improved, but not so rapidly as with the previous journey. She
returned to America better than she went away, and married at the age
of twenty-two. Soon after that time she consulted the writer on
account of prolonged dyspepsia, neuralgia, and dysmenorrhoea, which
had replaced menorrhagia. Then I learned the long history of her
education, and of her efforts to study just as boys do. Her attention
had never been called before to the danger she had incurred while at
school. She is now what is called getting better, but has the delicacy
and weaknesses of American women, and, so far, is without children.
It is not difficult, in this case, either to discern the cause of the
trouble, or to trace its influence, through the varying phases of
disease, from Miss A----'s school-days, to her matronly life. She was
well, and would have been called robust, up to her first critical
period. She then had two tasks imposed upon her at once, both of which
required for their perfect accomplishment a few years of time and a
large share of vital force: one was the education of the brain, the
other of the reproductive system. The schoolmaster superintended the
first, and Nature the second. The school, with puritanic
inflexibility, demanded every day of the month; Nature, kinder than
the school, demanded less than a fourth of the time,--a seventh or an
eighth of it would have probably answered. The schoolmaster might have
yielded somewhat, but would not; Nature could not. The pupil,
therefore, was compelled to undertake both tasks at the same time.
Ambitious, earnest, and conscientious, she obeyed the visible power
and authority of the school, and disobeyed, or rather ignorantly
sought to evade, the invisible power and authority of her
organization. She put her will into the education of her brain, and
withdrew it from elsewhere. The system does not do two things well at
the same time. One or the other suffers from neglect, when the attempt
is made. Miss A---- made her brain and muscles work actively, and
diverted blood and force to them when her organization demanded
active work, with blood and force for evolution in another region. At
first the schoolmaster seemed to be successful. He not only made his
pupil's brain manipulate Latin, chemistry, philosophy, geography,
grammar, arithmetic, music, French, German, and the whole
extraordinary catalogue of an American young lady's school curriculum,
with acrobatic skill; but he made her do this irrespective of the
periodical tides of her organism, and made her perform her
intellectual and muscular calisthenics, obliging her to stand, walk,
and recite, at the seasons of highest tide. For a while she got on
nicely. Presently, however, the strength of the loins, that even
Solomon put in as a part of his ideal woman, changed to weakness.
Periodical hemorrhages were the first warning of this. As soon as loss
of blood occurred regularly and largely, the way to imperfect
development and invalidism was open, and the progress easy and rapid.
The nerves and their centres lacked nourishment. There was more waste
than repair,--no margin for growth. St. Vitus' dance was a warning not
to be neglected, and the schoolmaster resigned to the doctor. A long
vacation enabled the system to retrace its steps, and recover force
for evolution. Then the school resumed its sway, and physiological
laws were again defied. Fortunately graduation soon occurred, and
unintermitted, sustained labor was no longer enforced. The menorrhagia
ceased, but persistent dysmenorrhoea now indicates the neuralgic
friction of an imperfectly developed reproductive apparatus. Doubtless
the evil of her education will infect her whole life.
The next case is drawn from different social surroundings. Early
associations and natural aptitude inclined Miss B---- to the stage;
and the need of bread and butter sent her upon it as a child, at what
age I do not know. At fifteen she was an actress, determined to do her
best, and ambitious of success. She strenuously taxed muscle and
brain at all times in her calling. She worked in a man's sustained
way, ignoring all demands for special development, and essaying first
to dis-establish, and then to bridle, the catamenia. At twenty she was
eminent. The excitement and effort of acting periodically produced the
same result with her that a recitation did under similar conditions
with Miss A----. If she had been a physiologist, she would have known
how this course of action would end. As she was an actress, and not a
physiologist, she persisted in the slow suicide of frequent
hemorrhages, and encouraged them by her method of professional
education, and later by her method of practising her profession. She
tried to ward off disease, and repair the loss of force, by consulting
various doctors, taking drugs, and resorting to all sorts of
expedients; but the hemorrhages continued, and were repeated at
irregular and abnormally frequent intervals. A careful local
examination disclosed no local disturbance. There was neither
ulceration, hypertrophy, or congestion of the os or cervix uteri; no
displacement of any moment, of ovarian tenderness. In spite of all her
difficulties, however, she worked on courageously and steadily in a
man's way and with a woman's will. After a long and discouraging
experience of doctors, work, and weaknesses, when rather over thirty
years old, she came to Boston to consult the writer, who learned at
that time the details just recited. She was then pale and weak. A
murmur in the veins, which a French savant, by way of dedication to
the Devil, christened _bruit de diable_, a baptismal name that science
has retained, was audible over her jugulars, and a similar murmur over
her heart. Palpitation and labored respiration accompanied and impeded
effort. She complained most of her head, which felt "queer," would not
go to sleep as formerly, and often gave her turns, in which there was
a mingling of dizziness, semi-consciousness, and fear. Her education
and work, or rather method of work, had wrought out for her anemia and
epileptiform attacks. She got two or three physiological lectures,
was ordered to take iron, and other nourishing food, allow time for
sleep, and, above all, to arrange her professional work in harmony
with the rhythmical or periodical action of woman's constitution. She
made the effort to do this, and, in six months, reported herself in
better health--though far from well--than she had been for six years
before.
This case scarcely requires analysis in order to see how it bears on
the question of a girl's education and woman's work. A gifted and
healthy girl, obliged to get her education and earn her bread at the
same time, labored upon the two tasks zealously, perhaps over-much,
and did this at the epoch when the female organization is busy with
the development of its reproductive apparatus. Nor is this all. She
labored continuously, yielding nothing to Nature's periodical demand
for force. She worked her engine up to highest pressure, just as much
at flood-tide as at other times. Naturally there was not nervous power
enough developed in the uterine and associated ganglia to restrain
the laboring orifices of the circulation, to close the gates; and the
flood of blood gushed through. With the frequent repetition of the
flooding, came inevitably the evils she suffered from,--Nature's
penalties. She now reports herself better; but whether convalescence
will continue will depend upon her method of work for the future.
Let us take the next illustration from a walk in life different from
either of the foregoing. Miss C---- was a bookkeeper in a mercantile
house. The length of time she remained in the employ of the house, and
its character, are a sufficient guaranty that she did her work well.
Like the other clerks, she was at her post, _standing_, during
business hours, from Monday morning till Saturday night. The female
pelvis being wider than that of the male, the weight of the body, in
the upright posture, tends to press the upper extremities of the
thighs out laterally in females more than in males. Hence the former
can stand less long with comfort than the latter. Miss C----, however,
believed in doing her work in a man's way, infected by the not
uncommon notion that womanliness means manliness. Moreover, she would
not, or could not, make any more allowance for the periodicity of her
organization than for the shape of her skeleton. When about twenty
years of age, perhaps a year or so older, she applied to me for advice
in consequence of neuralgia, back-ache, menorrhagia, leucorrhoea, and
general debility. She was anemic, and looked pale, care-worn, and
anxious. There was no evidence of any local organic affection of the
pelvic organs. "Get a woman's periodical remission from labor, if
intermission is impossible, and do your work in a woman's way, not
copying a man's fashion, and you will need very little apothecary's
stuff," was the advice she received. "I _must_ go on as I am doing,"
was her answer. She tried iron, sitz-baths, and the like: of course
they were of no avail. Latterly I have lost sight of her, and, from
her appearance at her last visit to me, presume she has gone to a
world where back-ache and male and female skeletons are unknown.
Illustrations of this sort might be multiplied but these three are
sufficient to show how an abnormal method of study and work may and
does open the flood-gates of the system, and, by letting blood out,
lets all sorts of evil in. Let us now look at another phase; for
menorrhagia and its consequences are not the only punishments that
girls receive for being educated and worked just like boys. Nature's
methods of punishing men and women are as numerous as their organs and
functions, and her penalties as infinite in number and gradation as
her blessings.
Amenorrhoea is perhaps more common than menorrhagia. It often happens,
however, during the first critical epoch, which is isochronal with the
technical educational period of a girl, that after a few occasions of
catamenial hemorrhage, moderate perhaps but still hemorrhage, which
are not heeded, the conservative force of Nature steps in, and saves
the blood by arresting the function. In such instances, amenorrhoea is
a result of menorrhagia. In this way, and in others that we need not
stop to inquire into, the regimen of our schools, colleges, and social
life, that requires girls to walk, work, stand, study, recite, and
dance at all times as boys can and should, may shut the uterine
portals of the blood up, and keep poison in, as well as open them, and
let life out. Which of these two evils is worse in itself, and which
leaves the largest legacy of ills behind, it is difficult to say. Let
us examine some illustrations of this sort of arrest.
Miss D---- entered Vassar College at the age of fourteen. Up to that
age, she had been a healthy girl, judged by the standard of American
girls. Her parents were apparently strong enough to yield her a fair
dower of force. The catamenial function first showed signs of activity
in her Sophomore Year, when she was fifteen years old. Its appearance
at this age[13] is confirmatory evidence of the normal state of her
health at that period of her college career. Its commencement was
normal, without pain or excess. She performed all her college duties
regularly and steadily. She studied, recited, stood at the blackboard,
walked, and went through her gymnastic exercises, from the beginning
to the end of the term, just as boys do. Her account of her regimen
there was so nearly that of a boy's regimen, that it would puzzle a
physiologist to determine, from the account alone, whether the subject
of it was male or female. She was an average scholar, who maintained a
fair position in her class, not one of the anxious sort, that are
ambitious of leading all the rest. Her first warning was fainting
away, while exercising in the gymnasium, at a time when she should
have been comparatively quiet, both mentally and physically. This
warning was repeated several times, under the same circumstances.
Finally she was compelled to renounce gymnastic exercises altogether.
In her Junior Year, the organism's periodical function began to be
performed with pain, moderate at first, but more and more severe with
each returning month. When between seventeen and eighteen years old,
dysmenorrhoea was established as the order of that function.
Coincident with the appearance of pain, there was a diminution of
excretion; and, as the former increased, the latter became more
marked. In other respects she was well; and, in all respects, she
appeared to be well to her companions and to the faculty of the
college. She graduated before nineteen, with fair honors and a poor
physique. The year succeeding her graduation was one of
steadily-advancing invalidism. She was tortured for two or three days
out of every month; and, for two or three days after each season of
torture, was weak and miserable, so that about one sixth or fifth of
her time was consumed in this way. The excretion from the blood, which
had been gradually lessening, after a time substantially stopped,
though a periodical effort to keep it up was made. She now suffered
from what is called amenorrhoea. At the same time she became pale,
hysterical, nervous in the ordinary sense, and almost constantly
complained of headache. Physicians were applied to for aid: drugs were
administered; travelling, with consequent change of air and scene, was
undertaken; and all with little apparent avail. After this experience,
she was brought to Boston for advice, when the writer first saw her,
and learned all these details. She presented no evidence of local
uterine congestion, inflammation, ulceration, or displacement. The
evidence was altogether in favor of an arrest of the development of
the reproductive apparatus, at a stage when the development was nearly
complete. Confirmatory proof of such an arrest was found in examining
her breast, where the milliner had supplied the organs Nature should
have grown. It is unnecessary for our present purpose to detail what
treatment was advised. It is sufficient to say, that she probably
never will become physically what she would have been had her
education been physiologically guided.
This case needs very little comment: its teachings are obvious. Miss
D---- went to college in good physical condition. During the four
years of her college life, her parents and the college faculty
required her to get what is popularly called an education. Nature
required her, during the same period, to build and put in
working-order a large and complicated reproductive mechanism, a matter
that is popularly ignored,--shoved out of sight like a disgrace. She
naturally obeyed the requirements of the faculty, which she could see,
rather than the requirements of the mechanism within her, that she
could not see. Subjected to the college regimen, she worked four years
in getting a liberal education. Her way of work was sustained and
continuous, and out of harmony with the rhythmical periodicity of the
female organization. The stream of vital and constructive force
evolved within her was turned steadily to the brain, and away from the
ovaries and their accessories. The result of this sort of education
was, that these last-mentioned organs, deprived of sufficient
opportunity and nutriment, first began to perform their functions with
pain, a warning of error that was unheeded; then, to cease to
grow;[14] next, to set up once a month a grumbling torture that made
life miserable; and, lastly, the brain and the whole nervous system,
disturbed, in obedience to the law, that, if one member suffers, all
the members suffer, became neuralgic and hysterical. And so Miss
D---- spent the few years next succeeding her graduation in conflict
with dysmenorrhoea, headache, neuralgia, and hysteria. Her parents
marvelled at her ill-health; and she furnished another text for the
often-repeated sermon on the delicacy of American girls.
It may not be unprofitable to give the history of one more case of
this sort. Miss E---- had an hereditary right to a good brain and to
the best cultivation of it. Her father was one of our ripest and
broadest American scholars, and her mother one of our most
accomplished American women. They both enjoyed excellent health. Their
daughter had a literary training,--an intellectual, moral, and
æsthetic half of education, such as their supervision would be likely
to give, and one that few young men of her age receive. Her health did
not seem to suffer at first. She studied, recited, walked, worked,
stood, and the like, in the steady and sustained way that is normal to
the male organization. She _seemed_ to evolve force enough to acquire
a number of languages, to become familiar with the natural sciences,
to take hold of philosophy and mathematics, and to keep in good
physical case while doing all this. At the age of twenty-one she
might have been presented to the public, on Commencement Day, by the
president of Vassar College or of Antioch College or of Michigan
University, as the wished-for result of American liberal female
culture. Just at this time, however, the catamenial function began to
show signs of failure of power. No severe or even moderate illness
overtook her. She was subjected to no unusual strain. She was only
following the regimen of continued and sustained work, regardless of
Nature's periodical demands for a portion of her time and force, when,
without any apparent cause, the failure of power was manifested by
moderate dysmenorrhoea and diminished excretion. Soon after this the
function ceased altogether; and up to this present writing, a period
of six or eight years, it has shown no more signs of activity than an
amputated arm. In the course of a year or so after the cessation of
the function, her head began to trouble her. First there was headache,
then a frequent congested condition, which she described as a "rush
of blood" to her head; and, by and by, vagaries and forebodings and
despondent feelings began to crop out. Coincident with this mental
state, her skin became rough and coarse, and an inveterate acne
covered her face. She retained her appetite, ability to exercise and
sleep. A careful local examination of the pelvic organs, by an expert,
disclosed no lesion or displacement there, no ovaritis or other
inflammation. Appropriate treatment faithfully persevered in was
unsuccessful in recovering the lost function. I was finally obliged to
consign her to an asylum.
The arrest of development of the reproductive system is most obvious
to the superficial observer in that part of it which the milliner is
called upon to cover up with pads, and which was alluded to in the
case of Miss D----. This, however, is too important a matter to be
dismissed with a bare allusion. A recent writer has pointed out the
fact and its significance with great clearness. "There is another
marked change," says Dr. Nathan Allen, "going on in the female
organization at the present day, which is very significant of
something wrong. In the normal state, Nature has made ample provision
in the structure of the female for nursing her offspring. In order to
furnish this nourishment, pure in quality and abundant in quantity,
she must possess a good development of the sanguine and lymphatic
temperament, together with vigorous and healthy digestive organs.
Formerly such an organization was very generally possessed by American
women, and they found but little difficulty in nursing their infants.
It was only occasionally, in case of some defect in the organization,
or where sickness of some kind had overtaken the mother, that it
became necessary to resort to the wet-nurse or to feeding by hand. And
the English, the Scotch, the German, the Canadian French, and the
Irish women now living in this country, generally nurse their
children: the exceptions are rare. But how is it with our American
women who become mothers? To those who have never considered this
subject, and even to medical men who have never carefully looked into
it, the facts, when correctly and fully presented, will be surprising.
It has been supposed by some that all, or nearly all, our American
women could nurse their offspring just as well as not; that the
disposition only was wanting, and that they did not care about having
the trouble or confinement necessarily attending it. But this is a
great mistake. This very indifference or aversion shows something
wrong in the organization as well as in the disposition: if the
physical system were all right, the mind and natural instincts would
generally be right also. While there may be here and there cases of
this kind, such an indisposition is not always found. It is a fact,
that large numbers of our women are anxious to nurse their offspring,
and make the attempt: they persevere for a while,--perhaps for weeks
or months,--and then fail.... There is still another class that cannot
nurse at all, _having neither the organs nor nourishment_ requisite
even to make a beginning.... Why should there be such a difference
between the women of our times and their mothers or grandmothers? Why
should there be such a difference between our American women and those
of foreign origin residing in the same locality, and surrounded by the
same external influences? The explanation is simple: they have not the
right kind of organization; there is a want of proper development of
the lymphatic and sanguine temperaments,--a marked deficiency in the
organs of nutrition and secretion. You cannot draw water without good,
flowing springs. _The brain and nervous system have, for a long time,
made relatively too large a demand upon_ the organs of digestion and
assimilation, while the exercise and _development of certain other
tissues in the body have been sadly neglected_.... In consequence of
the great neglect of physical exercise, and the _continuous
application to study_, together with various other influences, large
numbers of our American women have altogether an undue predominance
of the nervous temperament. If only here and there an individual were
found with such an organization, not much harm comparatively would
result; but, when a majority or nearly all have it, the evil becomes
one of no small magnitude."[15] And the evil, it should be added, is
not simply the inability to nurse; for, if one member suffers, all the
members suffer. A woman, whether married or unmarried, whether called
to the offices of maternity or relieved from them, who has been
defrauded by her education or otherwise of such an essential part of
her development, is not so much of a woman, intellectually and morally
as well as physically, in consequence of this defect. Her nervous
system and brain, her instincts and character, are on a lower plane,
and incapable of their harmonious and best development, if she is
possessed, on reaching adult age, of only a portion of a breast and an
ovary, or none at all.
When arrested development of the reproductive system is nearly or
quite complete, it produces a change in the character, and a loss of
power, which it is easy to recognize, but difficult to describe. As
this change is an occasional attendant or result of amenorrhoea, when
the latter, brought about at an early age, is part of an early arrest,
it should not be passed by without an allusion. In these cases, which
are not of frequent occurrence at present, but which may be evolved by
our methods of education more numerously in the future, the system
tolerates the absence of the catamenia, and the consequent
non-elimination of impurities from the blood. Acute or chronic
disease, the ordinary result of this condition, is not set up, but,
instead, there is a change in the character and development of the
brain and nervous system. There are in individuals of this class less
adipose and more muscular tissue than is commonly seen, a coarser
skin, and, generally, a tougher and more angular make-up. There is a
corresponding change in the intellectual and psychical condition,--a
dropping out of maternal instincts, and an appearance of Amazonian
coarseness and force. Such persons are analogous to the sexless class
of termites. Naturalists tell us that these insects are divided into
males and females, and a third class called workers and soldiers, who
have no reproductive apparatus, and who, in their structure and
instincts, are unlike the fertile individuals.
A closer analogy than this, however, exists between these human
individuals and the eunuchs of Oriental civilization. Except the
secretary of the treasury, in the cabinet of Candace, queen of
Ethiopia, who was baptized by Philip and Narses, Justinian's general,
none of that class have made any impression on the world's life, that
history has recorded. It may be reasonably doubted if arrested
development of the female reproductive system, producing a class of
agenes,[16] not epicenes, will yield a better result of intellectual
and moral power in the nineteenth century, than the analogous class of
Orientals exhibited. Clinical illustrations of this type of arrested
growth might be given, but my pen refuses the ungracious task.
Another result of the present methods of educating girls, and one
different from any of the preceding, remains to be noticed. Schools
and colleges, as we have seen, require girls to work their brains with
full force and sustained power, at the time when their organization
periodically requires a portion of their force for the performance of
a periodical function, and a portion of their power for the building
up of a peculiar, complicated, and important mechanism,--the engine
within an engine. They are required to do two things equally well at
the same time. They are urged to meditate a lesson and drive a machine
simultaneously, and to do them both with all their force. Their
organizations are expected to make good sound brains and nerves by
working over the humanities, the sciences, and the arts, and, at the
same time, to make good sound reproductive apparatuses, not only
without any especial attention to the latter, but while all available
force is withdrawn from the latter and sent to the former. It is not
materialism to say, that, as the brain is, so will thought be. Without
discussing the French physiologist's dictum, that the brain secretes
thought as the liver does bile, we may be sure, that without brain
there will be no thought. The quality of the latter depends on the
quality of the former. The metamorphoses of brain manifest, measure,
limit, enrich, and color thought. Brain tissue, including both
quantity and quality, correlates mental power. The brain is
manufactured from the blood; its quantity and quality are determined
by the quantity and quality of its blood supply. Blood is made from
food; but it may be lost by careless hemorrhage, or poisoned by
deficient elimination. When frequently and largely lost or poisoned,
as I have too frequent occasion to know it often is, it becomes
impoverished,--anemic. Then the brain suffers, and mental power is
lost. The steps are few and direct, from frequent loss of blood,
impoverished blood, and abnormal brain and nerve metamorphosis, to
loss of mental force and nerve disease. Ignorance or carelessness
leads to anemic blood, and that to an anemic mind. As the blood, so
the brain; as the brain, so the mind.
The cases which have hitherto been presented illustrate some of the
evils which the reproductive system is apt to receive in consequence
of obvious derangement of its growth and functions. But it may, and
often does, happen that the catamenia are normally performed, and that
the reproductive system is fairly made up during the educational
period. Then force is withdrawn from the brain and nerves and
ganglia. These are dwarfed or checked or arrested in their
development. In the process of waste and repair, of destructive and
constructive metamorphosis, by which brains as well as bones are built
up and consolidated, education often leaves insufficient margin for
growth. Income derived from air, food, and sleep, which should
largely, may only moderately exceed expenditure upon study and work,
and so leave but little surplus for growth in any direction; or, what
more commonly occurs, the income which the brain receives is all spent
upon study, and little or none upon its development, while that which
the nutritive and reproductive systems receive is retained by them,
and devoted to their own growth. When the school makes the same steady
demand for force from girls who are approaching puberty, ignoring
Nature's periodical demands, that it does from boys, who are not
called upon for an equal effort, there must be failure somewhere.
Generally either the reproductive system or the nervous system
suffers. We have looked at several instances of the former sort of
failure; let us now examine some of the latter.
Miss F---- was about twenty years old when she completed her technical
education. She inherited a nervous diathesis as well as a large dower
of intellectual and æsthetic graces. She was a good student, and
conscientiously devoted all her time, with the exception of ordinary
vacations, to the labor of her education. She made herself mistress of
several languages, and accomplished in many ways. The catamenial
function appeared normally, and, with the exception of occasional
slight attacks of menorrhagia, was normally performed during the whole
period of her education. She got on without any sort of serious
illness. There were few belonging to my clientele who required less
professional advice for the same period than she. With the ending of
her school life, when she should have been in good trim and well
equipped, physically as well as intellectually, for life's work,
there commenced, without obvious cause, a long period of invalidism.
It would be tedious to the reader, and useless for our present
purpose, to detail the history and describe the protean shapes of her
sufferings. With the exception of small breasts, the reproductive
system was well developed. Repeated and careful examinations failed to
detect any derangement of the uterine mechanism. Her symptoms all
pointed to the nervous system as the _fons et origo mali_. First
general debility, that concealed but ubiquitous leader of innumerable
armies of weakness and ill, laid siege to her, and captured her. Then
came insomnia, that worried her nights for month after month, and made
her beg for opium, alcohol, chloral, bromides, any thing that would
bring sleep. Neuralgia in every conceivable form tormented her, most
frequently in her back, but often, also, in her head, sometimes in her
sciatic nerves, sometimes setting up a tic douloureux, sometimes
causing a fearful dysmenorrhoea and frequently making her head ache
for days together. At other times hysteria got hold of her, and made
her fancy herself the victim of strange diseases. Mental effort of the
slightest character distressed her, and she could not bear physical
exercise of any amount. This condition, or rather these varying
conditions, continued for some years. She followed a careful and
systematic regimen, and was rewarded by a slow and gradual return of
health and strength, when a sudden accident killed her, and terminated
her struggle with weakness and pain.
Words fail to convey the lesson of this case to others with any thing
like the force that the observation of it conveyed its moral to those
about Miss F----, and especially to the physician who watched her
career through her educational life, and saw it lead to its logical
conclusion of invalidism and thence towards recovery, till life ended.
When she finished school, as the phrase goes, she was considered to be
well. The principal of any seminary or head of any college, judging
by her looks alone, would not have hesitated to call her rosy and
strong. At that time the symptoms of failure which began to appear
were called signs of previous overwork. This was true, but not so much
in the sense of overwork as of erroneously-arranged work. While a
student, she wrought continuously,--just as much during each
catamenial week as at other times. As a consequence, in her
metamorphosis of tissue, repair did little more than make up waste.
There were constant demands of force for constant growth of the system
generally, equally constant demands of force for the labor of
education, and periodical demands of force for a periodical function.
The regimen she followed did not permit all these demands to be
satisfied, and the failure fell on the nervous system. She
accomplished intellectually a good deal, but not more than she might
have done, and retained her health, had the order of her education
been a physiological one. It was not Latin, French, German,
mathematics, or philosophy that undermined her nerves; nor was it
because of any natural inferiority to boys that she failed; nor
because she undertook to master what women have no right to learn: she
lost her health simply because she undertook to do her work in a boy's
way and not in a girl's way.
Let us learn the lesson of one more case. These details may be
tedious; but the justification of their presence here are the
importance of the subject they illustrate and elucidate, and the
necessity of acquiring a belief of the truth of the facts of female
education.
Miss G---- worked her way through New-England primary, grammar, and
high schools to a Western college, which she entered with credit to
herself, and from which she graduated, confessedly its first scholar,
leading the male and female youth alike. All that need be told of her
career is that she worked as a student, continuously and
perseveringly, through the years of her first critical epoch, and for
a few years after it, without any sort of regard to the periodical
type of her organization. It never appeared that she studied
excessively in other respects, or that her system was weakened while
in college by fevers or other sickness. Not a great while after
graduation, she began to show signs of failure, and some years later
died under the writer's care. A post-mortem examination was made,
which disclosed no disease in any part of the body, except in the
brain, where the microscope revealed commencing degeneration.
This was called an instance of death from over-work. Like the
preceding case, it was not so much the result of over-work as of
un-physiological work. She was unable to make a good brain, that could
stand the wear and tear of life, and a good reproductive system that
should serve the race, at the same time that she was continuously
spending her force in intellectual labor. Nature asked for a
periodical remission, and did not get it. And so Miss G---- died, not
because she had mastered the wasps of Aristophanes and the Mécanique
Céleste, not because she had made the acquaintance of Kant and
Kölliker, and ventured to explore the anatomy of flowers and the
secrets of chemistry, but because, while pursuing these studies, while
doing all this work, she steadily ignored her woman's make. Believing
that woman can do what man can, for she held that faith, she strove
with noble but ignorant bravery to compass man's intellectual
attainment in a man's way, and died in the effort. If she had aimed at
the same goal, disregarding masculine and following feminine methods,
she would be alive now, a grand example of female culture, attainment,
and power.
These seven clinical observations are sufficient to illustrate the
fact that our modern methods of education do not give the female
organization a fair chance, but that they check development, and
invite weakness. It would be easy to multiply such observations, from
the writer's own notes alone, and, by doing so, to swell this essay
into a portly volume; but the reader is spared the needless
infliction. Other observers have noticed similar facts, and have
urgently called attention to them.
Dr. Fisher, in a recent excellent monograph on insanity, says, "A few
examples of injury from _continued_ study will show how mental strain
affects the health of young girls particularly. Every physician could,
no doubt, furnish many similar ones."
"Miss A---- graduated with honor at the normal school after several
years of close study, much of the time out of school; never attended
balls or parties; sank into a low state of health at once with
depression. Was very absurdly allowed to marry while in this state,
and soon after became violently insane, and is likely to remain so."
"Miss A---- graduated at the grammar school, not only first, but
_perfect_, and at once entered the normal school; was very ambitious
to sustain her reputation, and studied hard out of school; was slow to
learn, but had a retentive memory; could seldom be induced to go to
parties, and, when she did go, studied while dressing, and on the way;
was assigned extra tasks at school, because she performed them so
well; was a _fine healthy girl in appearance_, but broke down
permanently at end of second year, and is now a victim of hysteria and
depression."
"Miss C----, of a nervous organization, and quick to learn; her health
suffered in normal school, so that her physician predicted insanity if
her studies were not discontinued. She persevered, however, and is now
an inmate of a hospital, with hysteria and depression."
"A certain proportion of girls are predisposed to mental or nervous
derangement. The same girls are apt to be quick, brilliant, ambitious,
and persistent at study, and need not stimulation, but repression. For
the sake of a temporary reputation for scholarship, they risk their
health at the _most susceptible period_ of their lives, and break down
_after the excitement of school-life has passed away_. For _sexual
reasons_ they cannot compete with boys, whose out-door habits still
further increase the difference in their favor. If it was a question
of school-teachers instead of school-girls, the list would be long of
young women whose health of mind has become bankrupt by a
_continuation_ of the mental strain commenced at school. Any method of
relief in our school-system to these over-susceptible minds should be
welcomed, even at the cost of the intellectual supremacy of woman in
the next generation."[17]
The fact which Dr. Fisher alludes to, that many girls break down not
during but _after_ the excitement of school or college life, is an
important one, and is apt to be overlooked. The process by which the
development of the reproductive system is arrested, or degeneration of
brain and nerve-tissue set a going, is an insidious one. At its
beginning, and for a long time after it is well on in its progress, it
would not be recognized by the superficial observer. A class of girls
might, and often do, graduate from our schools, higher seminaries,
and colleges, that appear to be well and strong at the time of their
graduation, but whose development has already been checked, and whose
health is on the verge of giving way. Their teachers have known
nothing of the amenorrhoea, menorrhagia, dysmenorrhoea, or leucorrhoea
which the pupils have sedulously concealed and disregarded; and the
cunning devices of dress have covered up all external evidences of
defect; and so, on graduation day, they are pointed out by their
instructors to admiring committees as rosy specimens of both physical
and intellectual education. A closer inspection by competent experts
would reveal the secret weakness which the labor of life that they are
about to enter upon too late discloses.
The testimony of Dr. Anstie of London, as to the gravity of the evils
incurred by the sort of erroneous education we are considering, is
decided and valuable. He says, "For, be it remembered, the epoch of
sexual development is one in which an enormous addition is being made
to the expenditure of vital energy; besides the continuous processes
of growth of the tissues and organs generally, the sexual apparatus,
with its nervous supply, is making _by its development heavy demands_
upon the nutritive powers of the organism; and it is scarcely possible
but that portions of the nervous centres, not directly connected with
it, should proportionally suffer in their nutrition, probably through
defective blood supply. When we add to this the abnormal strain that
is being put on the brain, in many cases, by a forcing plan of mental
education, we shall perceive a source not merely of exhaustive
expenditure of nervous power, but of secondary irritation of centres
like the medulla oblongata that are probably already somewhat lowered
in power of vital resistance, and proportionably _irritable_."[18] A
little farther on, Dr. Anstie adds, "But I confess, that, with me, the
result of close attention given to the pathology of neuralgia has been
the ever-growing conviction, that, next to the influence of neurotic
inheritance, there is no such frequently powerful factor in the
construction of the neuralgic habit as mental warp of a certain kind,
the product of an unwise education." In another place, speaking of the
liability of the brain to suffer from an unwise education, and
referring to the sexual development that we are discussing in these
pages, he makes the following statement, which no intelligent
physician will deny, and which it would be well for all teachers who
care for the best education of the girls intrusted to their charge to
ponder seriously. "I would also go farther, and express the opinion,
that peripheral influences of an extremely powerful and _continuous_
kind, where they concur with one of those critical periods of life at
which the central nervous system is relatively weak and unstable, can
occasionally set going a non-inflammatory centric atrophy, which may
localize itself in those nerves upon whose centres the morbific
peripheral influence is perpetually pouring in. Even such influences
as the psychical and emotional, be it remembered, must be considered
peripheral."[19] The brain of Miss G----, whose case was related a few
pages back, is a clinical illustration of the accuracy of this
opinion.
Dr. Weir Mitchell, one of our most eminent American physiologists, has
recently borne most emphatic testimony to the evils we have pointed
out: "Worst of all," he says, "to my mind, most destructive in every
way, is the American view of female education. The time taken for the
more serious instruction of girls extends to the age of eighteen, and
rarely over this. During these years, they are undergoing such organic
development as renders them remarkably sensitive." ... "To show more
precisely how the growing girl is injured by the causes just
mentioned" (forced and continued study at the sexual epoch) "would
carry me upon subjects unfit for full discussion in these pages; but
no thoughtful reader can be much at a loss as to my meaning." ...
"To-day the American woman is, to speak plainly, physically unfit for
her duties as woman, and is, perhaps, of all civilized females, the
least qualified to undertake those weightier tasks which tax so
heavily the nervous system of man. She is not fairly up to what Nature
asks from her as wife and mother. How will she sustain herself under
the pressure of those yet more exacting duties which now-a-days she is
eager to share with the man?"[20]
In our schools it is the ambitious and conscientious girls, those who
have in them the stuff of which the noblest women are made, that
suffer, not the romping or lazy sort; and thus our modern ways of
education provide for the "non-survival of the fittest." A speaker
told an audience of women at Wesleyan Hall not long ago, that he once
attended the examination of a Western college, where a girl beat the
boys in unravelling the intracacies of Juvenal. He did not report the
consumption of blood and wear of brain tissue that in her college way
of study correlated her Latin, or hint at the possibility of arrested
development. Girls of bloodless skins and intellectual faces may be
seen any day, by those who desire the spectacle, among the scholars of
our high and normal schools,--faces that crown, and skins that cover,
curving spines, which should be straight, and neuralgic nerves that
should know no pain. Later on, when marriage and maternity overtake
these girls, and they "live laborious days" in a sense not intended by
Milton's line, they bend and break beneath the labor, like loaded
grain before a storm, and bear little fruit again. A training that
yields this result is neither fair to the girls nor to the race.
Let us quote the authority of such an acute and sagacious observer as
Dr. Maudsley, in support of the physiological and pathological views
that have been here presented. Referring to the physiological
condition and phenomena of the first critical epoch, he says, "In the
great mental revolution caused by the development of the sexual system
at puberty, we have the most striking example of the intimate and
essential sympathy between the brain, as a mental organ, and other
organs of the body. The change of character at this period is not by
any means _limited to the appearance of the sexual feelings_, and
their sympathetic ideas, but, when traced to its ultimate reach, will
be found to extend to the highest feelings of mankind, social, moral,
and even religious."[21] He points out the fact that it is very easy
by improper training and forced work, during this susceptible period,
to turn a physiological into a pathological state. "The great mental
revolution which occurs at puberty may go beyond its physiological
limits in some instances, and become pathological." "The time of this
mental revolution is at best a trying period for youth." "The monthly
activity of the ovaries, which marks the advent of puberty in women,
has a notable effect upon the mind and body; wherefore it may become
an important cause of mental and physical derangement."[22] With
regard to the physiological effects of arrested development of the
reproductive apparatus in women, Dr. Maudsley uses the following plain
and emphatic language: "The forms and habits of mutilated men approach
those of women; and women, whose ovaries and uterus remain for some
cause in a state of complete inaction, approach the forms and habits
of men. It is said, too, that, in hermaphrodites, the mental
character, like the physical, participates equally in that of both
sexes. While woman preserves her sex, she will necessarily be feebler
than man, and, having her special bodily and mental characters, will
have, to a certain extent, her own sphere of activity; where she has
become thoroughly masculine in nature, or hermaphrodite in
mind,--when, in fact, she has pretty well divested herself of her
sex,--then she may take his ground, and do his work; but she will have
lost her feminine attractions, and probably also her chief feminine
functions."[23] It has been reserved for our age and country, by its
methods of female education, to demonstrate that it is possible in
some cases to divest a woman of her chief feminine functions; in
others, to produce grave and even fatal disease of the brain and
nervous system; in others, to engender torturing derangements and
imperfections of the reproductive apparatus that imbitter a lifetime.
Such, we know, is not the object of a liberal female education. Such
is not the consummation which the progress of the age demands.
Fortunately, it is only necessary to point out and prove the existence
of such erroneous methods and evil results to have them avoided. That
they can be avoided, and that woman can have a liberal education that
shall develop all her powers, without mutilation or disease, up to the
loftiest ideal of womanhood, is alike the teaching of physiology and
the hope of the race.
In concluding this part of our subject, it is well to remember the
statement made at the beginning of our discussion, to the following
effect, viz., that it is not asserted here, that improper methods of
study and a disregard of the reproductive apparatus and its functions,
during the educational life of girls, are the _sole_ causes of female
diseases; neither is it asserted that _all_ the female graduates of
our schools and colleges are pathological specimens. But it is
asserted that the number of these graduates who have been permanently
disabled to a greater or less degree, or fatally injured, by these
causes, is such as to excite the _gravest alarm_, and to demand the
serious attention of the community.
The preceding physiological and pathological data naturally open the
way to a consideration of the co-education of the sexes.
FOOTNOTES:
[13] It appears, from the researches of Mr. Whitehead on this point,
that an examination of four thousand cases gave fifteen years six and
three-quarter months as the average age in England for the appearance
of the catamenia.--WHITEHEAD, _on Abortion, &c._
[14] The arrest of development of the uterus, in connection with
amenorrhoea, is sometimes very marked. In the New-York Medical Journal
for June, 1873, three such cases are recorded, that came under the eye
of those excellent observers, Dr. E.R. Peaslee and Dr. T.G. Thomas. In
one of these cases, the uterine cavity measured one and a half inches;
in another, one and seven-eighths inches; and, in a third, one and a
quarter inches. Recollecting that the normal measurement is from two
and a half to three inches, it appears that the arrest of development
in these cases occurred when the uterus was half or less than half
grown. Liberal education should avoid such errors.
[15] Physical Degeneracy. By Nathan Allen, M.D., Journal of
Psychological Medicine. October, 1870.
[16] According to the biblical account, woman was formed by
subtracting a rib from man. If, in the evolution of the future, a
third division of the human race is to be formed by subtracting sex
from woman,--a retrograde development,--I venture to propose the term
agene (+a+ without, +genos+ sex) as an appropriate designation for the
new development. Count Gasparin prophesies it thus: "Quelque chose de
monstreux, cet être répugnant, qui déjà parait à notre horizon," a
free translation of Virgil's earlier description:--
"Monstrum horrendum, informe, ingens, cui lumen ademtum." _3d, 658
line_.
[17] Plain Talk about Insanity. By T.W. Fisher, M.D. Boston. Pp. 23,
24.
[18] Neuralgia, and the Diseases that resemble it. By Francis E.
Anstie, M.D. Pp. 122. English ed.
[19] Op. cit., p. 160.
[20] Wear and Tear. By S. Weir Mitchell, M.D.
[21] Body and Mind. By Henry Maudsley, M.D. Lond. p. 31
[22] Op. cit., p. 87.
[23] Op. cit., p. 32.