NOTE A.
VIEWS OF MEDICAL WRITERS
The American Woman’s Educational Association has for its object “the establishment of institutions having endowed departments supporting ladies of superior character and education who shall add to a collegiate course both scientific and practical training, in all relating to the distinctive duties of woman as housekeeper, wife, mother, nurse of infants and the sick, trainer of servants, and chief religious minister of the family state.” As Secretary of this Association, the author requested the views of Mrs. Dr. Gleason, of the Elmira Water-cure, on the topics that follow. This lady, as wife, mother, and highly-educated physician, during over twenty years has had patients of her own sex, probably counting by thousands, and has often, by request, lectured to graduating classes in the Ingham University, the Elmira College, and other popular institutions for women. The following are extracts from her reply:
Treatment of Pelvic Diseases.
“The pelvic organs, when diseased, all have so many symptoms in common, that it requires not only good anatomical, pathological, and physiological knowledge, but close and well-cultivated diagnostic powers to decide which organ is diseased, and how it is diseased. For example, sometimes a displacement of the uterus will cause a sense of weight, dragging, and throbbing, accompanied by pain in the back and in front of the hips. But inflammation, ulceration, and induration of this organ will produce precisely the same results; and sometimes mere nervous debility in these parts will induce these symptoms, especially when the imagination is excited in reference to the subject. It also is often the case that extreme prolapsus occurs in which there is no pain at all.
“So also disease of the urinary cyst is indicated by symptoms precisely similar to those which mark the disease of the adjacent organ. These organs lying in close proximity, and supplied with nerves from the same source, would necessarily sympathize, and show disease by similar symptoms. Just as in the toothache, many a one has been unable to point out the diseased tooth. How much more difficulty exists in a case where most women are profoundly ignorant on the subject!
“It has become a very common notion that when any local displacement of the pelvic organs occurs, a woman must cease to use her arms, cease to exercise vigorously, and keep herself on the bed much of her time. All which, in most cases, is exactly the three things which she ought not to do. And thus it is that, when from want of fresh air and exercise, and from the many pernicious practices that debilitate the female constitution, the pelvic organs indicate debility, and these nerves begin to ache. Immediately a harness is put on for local support, and the bed becomes the constant resort; and thus the muscular debility and nervous irritability are increased. And yet, all that is needed is fresh air, exercise, simple diet, and proper mental occupation.
“In this condition, perhaps, resort is had to some ignorant or inexperienced practitioner, who has some patent supporter to sell, or who has some secret and wonderful method of curing such diseases. Then commences, in many cases, a kind of local treatment most trying to the feelings, which is but seldom required, and which, in a majority of cases, results in no benefit.
“Many a one has recited to me the mental and physical suffering she has endured for months in such a course of treatment, and all to no purpose. A touching case of this kind recently occurred, in the case of a beautiful young lady who was a listener to a course of lectures on the pelvis and its diseases, given by me to the graduating class of a female seminary. At the close she came to me, and, with tearful eyes and a quivering lip, said, ‘I see now why all I have suffered, in body and mind is worse than useless. I see now that I have never had the disease for which I have been treated.’
“Woman’s trusting, confiding nature is beautiful; but oh, how much it needs to be protected by an intelligence on such subjects that will enable her properly to exercise her own judgment! And surely, in such cases, above all others, a woman should be sure that her medical adviser has had a proper education, and possesses a well-established moral character.
Effects of Imagination in Reference to these Diseases.
“Besides the evils of misunderstanding and mistreating these affections, we have a host of evils from the effects of imagination. Multitudes of women, who hear terrific accounts of the nature of these complaints, and of the treatment that is inevitable, have their imagination so excited that aches and pains that are really trifling become magnified into all the symptoms of the dreaded evil. They betake themselves to bed, become more and more nervous as they give up air, exercise, and occupation, and thus drag out a useless life, a burden to themselves and to their families. Again and again I have had such cases brought to me, where for years they could not leave their beds or walk at all, when I had nothing to do but make them understand their own organism, and convince them that they needed little else except to get up and go to work, in order to be healthy women. It is such cases that furnish a large portion of the ‘wonderful cures’ that attract patients into the hands of poorly-qualified practitioners.
“It is probable that thousands of women who are suffering from pain in the back and pelvic evils, and who either will soon be invalids or imagine themselves so, could be relieved entirely by obeying these directions:
“Wash the whole person, on rising, in cool water, and, if nervous or debilitated, by a fire; dress loosely, and let all the weight of clothing rest on the shoulders; sleep in a well-ventilated room; exercise the muscles a great deal, especially those of the arms and trunk, taking care to lie down and rest as soon as fatigue is felt; eat simple food, at regular hours; pursue useful employments, with intervals of social and healthful amusement; sleep enough, and at the proper hours; and sit often in the sun.
Peculiar Instruction needed by Young Children.
“Through information gained from my husband, from other physicians, from teachers, from medical writers, and from the reports of insane hospitals, it has become clear to my mind that there are secret and terrific causes preying extensively upon the health and nervous energy of childhood and youth of both sexes such as did not formerly exist, and such as demand new efforts to eradicate and prevent.
“Parents and teachers all over the land need to be made aware that a secret vice is becoming frequent among children of both sexes that is taught by servants and communicated by children at school. Indeed, it may result from accident or disease, with an innocent unconsciousness of the evil done, on the part of the child, while the practice may thus ignorantly be perpetuated to maturity. This practice leads to diseases of the most horrible description, to mania, and to fatuity. Death and the mad-house are the last resort of these most miserable victims.
“To protect childhood and youth from this, it is not only needful to cultivate purity of mind and personal modesty, but to teach them while quite young that any fingering of the parts referred to involves terrible penalties. No such explicit information should be given as would tempt the incautious curiosity of childhood, but the child should be impressed with a sense of guilt and awful punishment as connected with any thing of this kind, that would instantly recur to mind, if led by accident or instruction to this vice.
“In regard to those who have already become victims, to a greater or less degree, to this vice, one caution is very important. Medical writers and others who have attempted to guard the young in this direction have painted not only the danger but the wickedness of this practice in such strong colors that, when a young person first discovers the nature of a practice that has been indulged with little conception of the danger or wrong, overaction on the fears and the conscience is not unfrequently the result. Such horror and despair sometimes ensue as almost paralyze any effort on the part of medical advisers to remedy the evil.
“In all such cases, it is safest and best to assume that the sin is one of ignorance, and that the cure is almost certain, if the directions given are strictly obeyed. Unstimulating diet, a great deal of exercise in the open air, daily ablution of the whole person, control of the imagination, and occupation of the mind in useful pursuits, will usually remedy the evil, after its nature is understood.”
[A lady, after reading the above, stated that within the last year a little boy under her care, of very delicate mind and susceptible temperament, was sent to the country to a private boarding-school, under the care of a most excellent gentleman and his wife, who were eminently faithful, so far as they knew how to be. The child staid only six weeks, and returned sick, depressed, and with a burden on his mind that could not be discovered. After learning that he would not be sent back, he revealed the shocking story, and also the fact that the boys had threatened to kill him if he ever told any one.
Another lady, after reading this article, related a similar story of a large and highly respected boarding-school for boys, and gave several mournful incidents to show the effects of such evils on the health of the pupils. Parents whose young sons are at boarding-school can not be too much alarmed on this subject.]
Instructions at a more Mature Age.
“You wish my views and experience in reference to instructions that should be communicated to the young, on such topics, at a more mature age.
“The terrible effects I have seen from simple ignorance, both on individual and domestic happiness, convince me that a great work is to be attempted in this direction. More than half the cases of extreme suffering which have come under my care could have been saved, had the course that is aimed at by you and your associates have been secured by them. I have been called repeatedly to lecture to young ladies, near the close of a school education, on subjects so important to their future health and happiness, and I never found the least difficulty, either on their part or my own.
“When the proper discriminations are made between true delicacy and propriety, and a fastidious and mawkish imitation of them, there is no difficulty in making them understood and appreciated. I have found, on such occasions, if a person was present known to be wanting in purity and delicacy, it was such only who made very offensive protestations against the course pursued in such instructions.
“In reference to social as well as secret vices of this description, it seems to me the protection of ignorance should be preserved as long as possible, and yet so that, when such knowledge dawns, there shall immediately recur the needful impression of danger and sin. These duties belong especially to parents and teachers; and the circulation of books and papers with the gross and pernicious information that many have recommended and practiced involves, as it seems to me, most hazardous results.
“The implanted principles which establish the family state are connected with the highest rewards when rightly regulated, and with most dreadful penalties when perverted or abused. And the prosperity of individuals, of families, and of nations, for this life and the life to come, depends more on the proper control and regulation of these principles than on any other social or moral duty.
“And yet there is no point of morals and religion so widely abused and so fruitful of misery and sin as much that is connected with these principles. Instead of being regulated by correct knowledge and well-formed habits of thought and action, all seems left to the mistakes of ignorance or the control of worldly fashion.
“One cause of this state of things is want of consistent rules and customs as to what constitutes true modesty. These are all dependent on a general principle of physiology either rarely recognized or inconsistently regarded. The principle is this:
“When the mind directs thought and volition toward any organ of the body the blood and nervous fluid tend to that organ. Thus, when the brain is used, or the eye, or the hand, the nervous fluid and blood tend to the organ to stimulate its action. If this stimulation is too frequent, or too long continued, or produced by unnatural methods, then debility or disease are the result. The capillaries of the misused organ become engorged, producing temporary or chronic inflammation or congestion.
“The same is true of those organs consecrated to marriage. Excess or unnatural abuse causes an engorgement of the capillaries, and then a resulting increase of excitement, and to a degree that sometimes baffles all efforts at self-control.
“It is owing to this physiological principle that the rules of personal modesty, of decorum, and of propriety in social intercourse have been established.
“On the principle above stated these sensibilities demand the control of the thoughts. For this reason it is that certain topics which lead to such thoughts are excluded from general conversation, or, if they are alluded to, are veiled in expressions that children do not understand. It is for this cause that novels, poetry, and pictures which direct the imagination to such topics are deemed objectionable, especially for the young.
“It is owing to this physiological fact that Jesus Christ declares that the guilt of adultery commences in the indulgence of the thoughts.
“Marriage is not allowable until there has been due instruction and a habit formed of regulating these sensibilities by rules of modesty, decency, and propriety, and also knowledge imparted as to the dangers consequent on neglecting these rules. And here is the place where the customs and practices of society are most inconsistent, false, and destructive to health and morals. For in one direction there is excessive and dangerous laxness, and in another false and dangerous strictness and fastidiousness.
“The rule to guide is this, that whenever health, life, or duty demand it, all connected with these topics should be spoken of and done without restraint or embarrassment; but when there are no such demands, they are to be excluded. Thus all these topics are spoken of plainly in the Bible and read in public worship, and also in medical, surgical, and hospital practice; and it is deemed false modesty and false delicacy to express opposition or disapproval. But when there are no such demands to serve health or life, or to protect from future dangers, conversation, poetry, jokes, or coarse expressions on such topics are vulgar, indecent, and sinful.
“Direct violation of these rules are now pervading not only our popular amusements, our poetry, and novels, but extensively the weekly and daily press is every day drawing attention to topics dangerous and forbidden except for necessary instruction and wanting. The Bible as read in families and churches comes with solemn simplicity as instruction from God, and sins of all kinds are made known for warning and instruction. Very different in style and influence are the details of vices and crimes presented daily in newspapers, magazines, poetry, and novels.
“It would seem as if the Prince of Darkness had sent forth his minions to hide all that knowledge that would save from sin and suffering, and to expose all that tempts to danger and sin.
“In addition to the dangers of our popular literature, there is a wide-spread assumption that such is the constitution of man, that the unsullied purity of thought and conduct demanded of the weaker sex is not to be expected or scarcely required of the stronger. This pernicious opinion is not unfrequently implied in medical writers, especially those residing in the centres of European licentiousness.
“Therefore it is very important for parents to know, in the first place, that constitutional diversities exist, involving more temptations to some than to others; and in the next place, that every child is so organized, that strict obedience to the laws of health, knowledge of danger from uncontrolled thoughts, useful occupation, and suitable moral and religious training, will secure the regulation of ordinary temptations, and self-control under extraordinary ones. Where in maturity this has not been the case, it has been owing to excess either in forbidden or in legal indulgence.
“There is nothing more difficult than to change customs and prejudices, especially in matters of delicacy and propriety. And it is woman more than man who has controlling influence in these respects. Whatever the cultivated and conscientious women of our country decide ought to be done, and will use their influence to have done, will surely be accomplished.
“The evils here indicated can never be appreciated until mothers and teachers gain that knowledge of the construction of the body and the dangers connected with the duties of the family state, which now is confined to the medical profession, while physicians, by the false customs and false modesty of women, are constrained to a dangerous reticence.
“I believe that the method proposed by your Association, of securing by endowments well-qualified ladies whose official duty it shall be to train the young to be healthy, and to communicate all the knowledge that will fit them to fulfill healthfully and happily all their future duties and relations, will, so far as it is carried out, effectually remedy the evils, and secure the benefits designed.
“Oh, that all parents and teachers who are to train the next generation could be made to understand these intimations, and save their daughters from the abounding anguish which has come upon such multitudes of those now upon the stage! Very truly yours,
R. B. Gleason.”
These views of Mrs. Dr. Gleason are in accordance with those of the most influential, learned, and benevolent medical men.
Dr. George T. Elliott, late President of the New York County Medical Society, says of muscular exercise (or, as Mrs. Gleason would say, “getting up and going to work”): “If this were properly carried out, the local treatment now so much in vogue, and the ever-ready resort to the speculum, might commonly be dispensed with.”
Dr. Thomas suggests similar views in an address before the Medical Society of New York County, in which he speaks of “the wonderful improvement exerted on cases which have long resisted local means, by sea-bathing, or a few months passed in the country. He also says: “The fact is notorious that the local treatment of these diseases is not as successful as we could wish;” and of uterine injections he says: “My impression is, they have done, and are going to do, a great deal of harm. I see no necessity for them.”
Dr. Peasely, of New York City, says: “Medical applications to the uterus are often used in conditions not justifying them.”
The senior editor of the Pacific Medical Journal says: “It is hoped that the fashion of women having recourse to local treatment has passed to its culmination. The highest authorities have taken the back course, and condemn their own uterine surgery in some respects.”
The editor of the Medical Record, of New York City, says: “In a majority of cases the speculum is used only because it is the fashion. The natural tendency of this is certainly demoralizing.”
Dr. George H. Taylor, author of an original work on diseases of women, says: “A large portion of the women treated by me for pelvic disease would, in certain stages, be cured by loose dresses supported from the shoulders, domestic exercise, and proper diet. And the Movement Cure, to a great extent, consists of exercises that would in many cases be as successful, and more useful, if performed in domestic labor. Moreover, in my experience, not more than one case in twenty of cures by movements requires either local examination or local treatment. A large portion of my patients could, by obeying my directions, cure themselves at home.”
Most medical men now agree that the modes of dress, and the excessive mental taxation of schools, unaccompanied by the healthful domestic labor of former days, largely account for the prevalence of diseases among young girls which formerly were confined to married women, and also for the alarming increase of such diseases.