The Mother and Her Child

To every physician in every community, sooner or later in his experience there come thoughtless women making requests that we even hesitate to write about. Their excuses for the crime which they seek to have the physician join them in committing, range all the way from "I don't want to go to the trouble," to "Doctor, I've got seven children now, and I can't even educate and dress them properly;" or, maybe, "I nearly lost my life with the last one."

EMBRYOLOGICAL IGNORANCE

One little woman came to us the other day from the suburbs, and honestly, frankly, related this story:

"We've been married just six months, I have continued my stenographic work to add the sixty-five dollars to our monthly income. Doctor, we must meet our monthly payments on the home, I must continue to work, or we shall utterly fail. I am perfectly willing a baby shall come to us two years from now, but, doctor, I just can't allow this one to go on, you must help me just this once. Why doctor, there can't be much form or life there, it's only three months now, or will be next week, and you know it's nothing but a mass of jelly."

She had talked with a "confidential friend" in her neighborhood, had been told that she "could do it herself," but fearing trouble or infection, had come to the conclusion she had better go to a "clean, reputable physician," to have the abortion performed.

This is not the place to narrate the experiences of the unfortunate victims of habitual criminal abortion, but we would like to impress upon the reader some realization of the untimely deaths, the awful suffering, and the life-long remorse and sorrow of the poor, misguided women who listen to the criminal advice of neighborhood "busybodies." The infections, the invalidism, the sterility that so often follow in the wake of these practices, are well known to all medical people.

THE STREAM OF LIFE

And so after the patient's last statement, "It's nothing but a mass of jelly," we began the simple but wonderfully beautiful story of the development of the "child enmothered." Just as all vegetables, fruits, nuts, flowers, and grains come from seeds sown into fertile soil, and just as these seeds receive nourishment from the soil, rain, and sunshine, so all our world of brothers and sisters, of fathers and mothers, came from tiny human seeds, and in their turn received nourishment from the peculiarly adapted stream of life, which flows in the maternal veins for the nourishment and upbuilding of the unborn embryo.

Every little girl and boy baby that comes into the world, has stored within its body, in a wonderfully organized capsule, a part of the ancestral stream of life that unceasingly has flowed down through the centuries from father to son and from mother to daughter. This "germ plasm" is a divine gift to be held in trust and carefully guarded from the odium of taint, to be handed down to the sons and daughters of the next generation. Any young man who grasps the thought that he possesses a portion of the stream of life, that he holds it in sacred trust for posterity, cannot fail to be impressed with a sense of solemn responsibility so to order his life as to be able to transmit this biologic trust to succeeding generations free from taint and disease.

THE PROCESS OF FERTILIZATION

Just as within the body of "Mother Morning Glory" (See Fig. 18) may be found the ovary or seed bed, so there are two wonderfully organized bodies about the size of large almonds found in the lower part of the female abdomen on either side of the uterus, and connected to it by two sensitive tubes. There ripens in one of these bodies each month a human baby-seed, which finds its way to the uterus through the little fallopian tube and is apparently lost in the debris of cells and mucus which, with the accompanying hemorrhage go to make up the menstrual flow. This continues from puberty to menopause, each gland alternatingly ripening its ovum, only to lose it in the periodical phenomenon of menstruation, which is seldom interrupted save by that still more wonderful phenomenon of conception.

At the time of conception, countless numbers of male germ-cells (sperms) are lost—only one out of the multitude of these perfectly formed sperms made up of the mosaics of hereditary depressors, determiners, and suppressors that so subtly dictate and determine the characteristics and qualifications of the on-coming individual—I repeat, only one of these wonderful sperms finds the waiting ovum (Fig. 1). In this search for the ovum, the sperm propels itself forward by means of its tail—for the male sperm in general appearance very much resembles the little pollywog of the rain barrel (Fig. 1).

The fateful meeting of the sperm and the ovum takes place usually in the upper end of one of the fallopian tubes. It is a wonderful occasion. The wide-awake, vibrating lifelike sperm plunges head first and bodily into the ovum. The tail, which has propelled this bundle of life through the many wanderings of its long and perilous journey, now no longer needed, drops off and is lost and forgotten. This union of the male and female sex cells is called "fertilization." There immediately follows the most complete blending of the two germ cells—one from the father and one from the mother—each with its peculiar individual, family, racial, and national characteristics. Here the combined determiners determine the color of the eyes, the characteristics of the hair, the texture of the skin, its color, the size of the body, the stability of the nervous system, the size of the brain, etc., while the suppressors do a similar work in the modification of this or that family or racial characteristic.

The fertilized ovum remains in the tube for about one week, when it slowly makes its way down into the uterus, all the while rapidly undergoing segmentation or division. It does not grow much in size during this first week, but divides and subdivides first, into two parts, then four, then eight, then sixteen and so on, until we have a peculiar little body made up of many equally divided parts, and known as the "Mulberry Mass" (Fig. 1). The blending of the sperm and ovum has been perfect, the division of the original body multitudinous.

While this division of the united sex cells is progressing, a wonderful change is also taking place in the inside lining of the uterus. Instead of the usual thin lining, it has greatly thickened and has become highly sensitized, and as the ovum enters the uterus from the fallopian tube, this sensitized lining catches it and holds it in its folds—actually covers it with itself—holding the precious mass much as the cocoon, you have so often seen fastened to the side of a plant or leaf, holds its treasure of life.

Just as soon as the new uterine home is found the baby heart begins to make its appearance, as also do many other rudimentary parts. By the end of the third week, our round mass has flattened and curved and elongated, and the nervous system and brain begin to develop, while the primitive ears begin to appear. At this time, the alimentary canal presents itself as one straight tube which is a trifle larger at the head end. And it is interesting to note that at this early date, even the arms and legs are beginning to bud and push out from the body.

LATER EMBRYONIC DEVELOPMENT

In the fourth and fifth weeks, the lungs and the pancreas may be found, the heart develops, the nervous system has taken on more definite form, and several of the larger blood-vessels are appearing.

By the eighth week, by the most wonderful and complicated processes of overlapping, pushing out, indentation, enfolding, budding, pressing, and curving, the majority of the important structures are formed—the eyes, ears, nose, hands, feet, abdominal organs, and numerous glands. Thus, at the end of two months, almost every structure and organ necessary to life is present in a rudimentary state.

AT THE END OF THREE MONTHS

By the close of the third month, witness the work of creation! From the blending of the two germ cells there has come forth a beautifully formed body (Fig. 1). True, it is but three and one half inches in length, but it is nevertheless a perfect body. About this time, the sex may be determined. The eyes, nose, ears, chin, arms and legs and even the fingers and toes may all be clearly distinguished.

A "jelly mass" at three months? No, by no means! No! Life and form and features are all there. It really has a face, whose features may easily be delineated.

In all my experience, I have yet to find the woman who wished to continue in her wicked and criminal intent after she had listened to this story of the creative development of the first three months of her "child enmothered."

During the next four months, which take us to the close of the seventh, rapid growth and farther development take place to the extent, that, should birth occur at that time, life may continue under proper conditions.

LAST WEEKS OF PREGNANCY

Everything is now nearing completion—only awaiting further growth, development, and strength—except some of the bone development, which takes place during the remaining two months. Growth is rapid, strength is doubled, and as the two hundred and seventy-three days draw to a close, everything has been completed. It has all taken place according to the laws of creation in an infinite way and with clock-like precision.

With the developmental growth of the product of conception, the uterus or room that had been particularly prepared for the "big reception" of the second week, has also grown to great dimensions. It fills almost the entire abdomen and as a result of the pressure against the diaphragm the breathing is somewhat embarrassed.

The door of this "room" has been closed by a special mechanism, while, in the fullness of time, Mother Nature begins the delicate work of opening the door, through whose portals passes out into the world the completed babe.

The authors feel that this discussion of, and protest against, abortions, should be accompanied by an appropriate consideration of the control of pregnancy. We are never going to eliminate the abortion curse of present-day civilization by merely preaching against it—warnings and denouncements alone will not suffice to remove the stain. Notwithstanding our feelings and convictions in this respect, we are also well aware of the fact that public sentiment is not now sufficiently ripe to welcome such a full and frank discussion of the subject of the prevention of conception as the authors would feel called upon to present; we are equally cognizant of the fact that existing postal regulations and other Federal laws are of such a character (at least capable of such interpretation) as possibly to render even the scientific and dignified consideration of such subjects entirely out of question.

In the preceding chapter we learned that when the two germ cells came together, there occurred a complete blending of two separate and distinct hereditary lines, reaching from the present away back into the dim and distant past. By the union of these two ancestral strains a new personality is formed, a new individual is created, with its own peculiar characteristics.

HEREDITARY TRAITS

Probably none of the laboriously acquired accomplishments of the present generation can be directly—and as such—handed down to our children. What we are to be and what we will do in this world was largely determined by the laws of heredity by the time we were well started on our development experience en-utero during the third or fourth week of our prenatal existence, as outlined in a former chapter.

It is now generally accepted in scientific circles that acquired characteristics are not transmissible. Someone has aptly stated this truth by saying that "wooden heads are inherited, but wooden legs are not." This does not by any means imply that we do not have power and ability to fashion our careers and carve out our own destiny, within the possible bounds of our hereditary endowment and environmental surroundings. Heredity does determine our "capital stock," but our own efforts and acts determine the interest and increase which we may derive from our natural endowment. From the moment conception takes place—the very instant when the two sex cells meet and blend—then and there "the gates of heredity are forever closed." From that time on we are dealing with the problems of nutrition, development, education, and environment; therefore, so-called prenatal influence can have nothing whatever to do with heredity.

A father may have acquired great talent as a physician or a surgeon, in fact he may hold the chair of surgery in a medical college, but each of his children come into the world without the slightest knowledge of the subject, and, as far as direct and immediate heredity is concerned, will have to work just about as hard to master the subject as will the same average class of children whose parents were not surgeons. This must not be taken to mean that certain abilities and tendencies are not inheritable—for they are; but they are inherited through the parents—and not from them—directly. These transmitted characteristics are largely "stock" traits, and usually have long been present in the "ancestral strain."

MATERNAL IMPRESSIONS

A mother may sing and pray all through the nine months of expectancy, or she may weep and scold, or even curse. In neither case can she influence the spiritual or moral tendencies of her child and cause it, through supposed prenatal influence, to be born with criminal tendencies or to grow up a pious lad or become a devout minister. These tendencies and characteristics are all largely determined by the "depressors," "suppressors," and "determiners" which were present in the two microscopic and mosaic germ cells which united to start the embryo at the time of conception.

The child is destined to be born, endowed, and equipped with the mental, nervous, and physical powers which his line has fallen heir to all through the past ages. Down through the ages education, religion, environment, and other special influences have no doubt played a small part in influencing and determining hereditary characteristics; just as environment in the ages past changed the foot of the evolving horse from a flat, "cushiony" foot with many toes (much needed in the soft bog of his earlier existence) into the "hoof foot" of later days, when harder soil and necessity for greater fleetness, assisted by some sort of "selection" and "survival," conspired to give us the foot of our modern horse, and this story is all plainly and serially told in the fossil and other remains found in our own hemisphere. It would appear that many, many generations of education and environment are required to influence markedly the established and settled train of heredity regarding any particular element or characteristic in any particular line or lines of hereditary tendencies.

EUGENIC SUPERSTITION

There is probably more misinformation in the minds of the people on the subject of "maternal impressions" and "birthmarks" than any other scientific or medical subject. The popular belief that, if a pregnant woman should see an ugly sight or pass through some terrifying experience, in some mysterious way her unborn child would be "marked," deformed, or in some way show some blemish at birth, is a time-honored and ancient belief.

Such unscientific and unwarranted teaching has been handed down from mother to daughter through the ages, while the poor, misguided souls of expectant women have suffered untold remorse, heaped blame upon themselves, lived lives literally cursed with fear and dread—veritable slaves to superstition and bondage—all because of the simple fact that a certain percentage of all children born in this world have sustained some sort of an injury or "embryological accident" during the first days of fetal existence. For instance, take the common birthmark of a patch of reddened skin on the face, brow, or neck. As soon as the baby is born, the worried mother asks in anxious tones: "Doctor, is it all right, is it perfect, has it got any birthmarks?" On being told that the baby has a round, red patch on its left brow, the ever-ready statement of the mother comes forth: "Yes, I knew I'd mark it, I was picking berries one day about three months ago, and I ate and ate, until I suddenly remembered I might mark my baby, and before I knew what I was doing, I touched my brow and I just knew I had marked my baby." Do you know, reader, that that birthmark was present fully four months before she passed through that experience in the berry patch? And yet so worried and apprehensive has been the pregnant mother, that, although she can never successfully predict the "birthmarks" and blemishes of her child, nevertheless when these defects are disclosed at birth she is unfailingly able immediately to recall some extraordinary experience which she has carefully stored away in her memory and which, to her mind, most fully explains and accounts for the defect.

Is it much wonder that in the very early days of embryonic existence, during the hours of delicate cell division, indentation, outpushing, elongation, and sliding of young cells—is it much wonder, I repeat—that there occur a few malformations, blemishes, or other accidents which persist as "birthmarks?"

CAUSES OF BIRTHMARKS

There are many factors which may enter into the production of birth-blemishes, deformities, monstrosities, etc. These influences are all governed by certain definite laws of cause and effect. A pre-existent systemic disease in the father, or a coexistent disorder in the mother, may be a leading factor. A mechanical injury, such as a sudden fall, a blow, or a kick, or certain kinds of prolonged pressure, not to mention restrictions and contractions of the maternal bony structures, may all possibly contribute something to these prenatal miscarriages of growth and development. Maternal or prenatal embryonic infections could bring about many sorts of birthmarks and malformations. These defects might also be caused by certain types of severe inflammatory disorders in the uterus during the early days of pregnancy.

The same factors that produce the accidents of embryology resulting in malformations or monstrosities in the human family, are also operative in the case of our lesser brethren of the animal kingdom, for monstrosities and birth-defects are very common among the lower animals, notwithstanding the fact that the animal mother probably does not "believe in birthmarks."

"It is a striking fact that during the nineteenth century, the teratologists, those who have scientifically investigated the causes of monstrosities and fetal morbid states, have almost without exception, rejected the theory of maternal impressions." Scientists and physicians are coming to recognize the fact that fears and frights do not in any way act as causes in the production of monstrosities and deformities. Let us seek forever to liberate all womankind from the common and harassing fear and the definite dread and worry that, because they failed to control themselves at the instant of some terrifying sight or experience, they were directly responsible for the misfortune of their abnormal offspring.

It should be remembered that there exists no direct connection whatsoever between the nervous system of the unborn child and the nervous system of the mother. The only physiological or embryological relationship is of a nutritional order, and even that is indirect and remote.

ROLE OF THE PLACENTA

By the end of the third month, the "cocoon" attachment described in chapter two has disappeared; the fetus is slowly pushed away from the uterus which has so snugly held it for more than eleven weeks; while upon the exact site of its previous attachment the thickened uterine membrane undergoes a very interesting and important change—definite blood vessels begin to form—which begin indirectly to form contact with the maternal vessels, and thus it is that the placenta, or "after birth" is formed; and then, by means of the umbilical cord, nourishment from the mother's blood-stream is carried to the growing and rapidly developing child. In exchange for the nourishing stream of life-giving fluid by which growth and development take place, the embryo gives off its poisonous excretions which are carried back to the placenta, from which they are absorbed into the veinous circulation of the mother; so, while the mother does, through the process of nutrition, influence growth and development in the embryo, she is wholly unable to produce specific changes and such definite developmental errors as birthmarks and other deformities.

Just as truly as it would be impossible so to frighten a setting hen as to "mark" or otherwise influence the form or character of the chicks which would ultimately come forth from the eggs in her nest, it is just as truly impossible to frighten the pregnant mother and thereby influence the final developmental product of the human egg which is so securely tucked away in its uterine nest; for, when conception has occurred, the human embryo is just as truly an egg—fashioned and formed—as is the larger and shell-contained embryo of the chick which lies in the nest of the setting hen.

And so we are compelled to recognize the fact that there is little more danger to the unborn child when the mother is frightened than when the father is scared. The one contributes as much as the other to the general character of the child, while neither is to blame for development errors and defects.

SUGGESTION AND HEREDITY

Certain fears are suggested to children. For twenty years I lived under the delusion that I was terribly afraid of snakes—more so than any other human being; for I was told when a mere child that I had been "marked with the fear of snakes," that just two months before I saw the peep of day, my esteemed mother had been terrified by a snake. Everywhere I went, I announced to sympathizing and ofttimes mischievous friends, that "I was marked with the fear of snakes and must never be frightened with them." It is needless to add in passing, that I was teased and frightened all through my girlhood days. I was a veritable slave to the bondage of snake-fear. Everywhere I went I looked for my dreaded foe, expecting to sit on one, step on one, or to have one drop into my lap from the roof.

The day of deliverance came after marriage, when in a supreme effort to deliver me from the shackles of fear, the goodman of the house tenderly, but firmly, maneuvered a morning walk so that it halted in front of a large plate-glass window of the Snake Drug Store in San Francisco. Just back of this plate glass, and within eighteen inches of my very nose, were fifty-seven varieties of the reptiles, big and small, streaked and checkered, quiet and active. After much remonstrance and waiting, I came-to—gazed at the markings, beautiful in their exactness—while slowly the change of mind took place. Faith took the place of fear, calmness subdued panic, and I was wondrously delivered from the veritable bondage of a score of years. And so it is that the mother suffers and then the child suffers, ofttimes a living death, because of the superstition "I'm marked," while there is ever present the fear or dread that "something is going to happen, because I'm different from all other individuals—because 'I'm marked!'"

As soon as a woman discovers that she is pregnant, she should sit down and quietly think out the plan for the nine months of expectancy.

The cessation of the menses may come as a surprise to her, and for a while she is more or less confused; she must go over the whole situation and adjust future plans to fit in with this new and all important fact. From a large experience with maternity cases, I have reached the conclusion that the larger percentage of pregnancies do come as a surprise, and in many instances a complete change of program must be painstakingly thought out. This is especially true of the business woman, the professional woman, the busy club woman, or the active society woman.

EARLY PLANNING

Let me say to the woman who is pregnant for the first time, the experiences of the pregnant state should cause you no fear, worry, or anxiety. Giving birth to a baby is a perfectly natural, normal procedure, and if you are in reasonable health—if your physician tells you you are a fairly normal woman—then you can dismiss further thought of danger and go on your way rejoicing. For thousands of years maternity has been women's exclusive profession and no doubt will continue to be many ages hence.

By far the most important and the first thing to do is carefully to select the best physician your means will allow, and place yourself under his or her care. Your doctor will help you to plan wisely and intelligently during the waiting time, for physicians have learned from experience that the better care the pregnant woman receives, the easier will be her labor, and the more speedy and uneventful the recovery.

And now, we proceed to take up one by one the particular phases of the hygiene of pregnancy which touch the comfort, convenience, and health of both the mother and her unborn child.

THE CLOTHING

At all times and under all circumstances the pregnant woman's clothing should be comfortable, suitable for the occasion, artistic, and practical. And to be thus beautifully clothed is to be as inconspicuous as is possible. Of all times, occasions, and conditions, that of pregnancy demands modesty in color, simplicity in style, together with long straight lines (Fig. 2). For the "going out" dress, select soft shades of brown, blue, wine, or dark green. Let the house dresses be simple, easy to launder, without constricting waist bands, of the one-piece type, in every way suitable for the work at hand. Under this outer dress, a princess petticoat should cover a specially designed maternity corset (if any corset at all be worn), to which is attached side hose-supporters. A support for the breasts may be worn if desired, it should be loose enough to allow perfect freedom in breathing.

The union suit may be of linen, silk, or cotton, with the weight suitable for the season. Stockings and shoes should be of a comfortable type, straight last, low or medium heel and at least as wide as the foot. There are two or three shoes on the market that are particularly good, whose arches are flexible, heels comfortable, straight last, and whose soles look very much like the lines of the foot unclothed. This style is particularly good during the maternity days. Painful feet are a great strain upon the general nervous system. Who of us has not seen women with strained, tense faces hobbling about in high-heeled, narrow-toed shoes? And if we followed them we would not only see tenseness and strain in the features of the face, but could hear outbursts of temper on the least provocation. Aching feet produce general irritability. If ease of body and calmness of spirit is desired, wear shoes that are comfortable, and the surprising part of it is that many of them are very good looking.

Toward the end of pregnancy ofttimes the feet swell, in which instance larger shoes should be worn in connection with the bandaging of the ankles and legs.

During the latter days of expectancy an abdominal supporter may be worn advantageously. Much of the backache and heaviness in the pelvis is entirely relieved by the supporting of the pendulous abdomen with a well-fitted binder. An ordinary piece of linen crash may be fitted properly by the taking in of darts at the lower front edge; or elastic linen, or silk binder may be secured; in fact, any binder that properly supports the abdomen will answer the purpose.

It should be within the means of every pregnant woman to have a neat, artistic out-door costume, for social, club and church occasions (Fig. 2). For no reason but illness should an expectant mother shut herself up in doors.

True men and true women hold the very highest esteem for the maternal state, and the opinion of all others matters not; so joyfully go forth to the club, social event, concert, or church; and to do this, you must have a well-designed, artistic dress. The material does not matter much, but the shade and style are important.

DIET

There are certain laws which govern the diet at all times; for instance, the man who digs ditches requires more of a certain element of food and more food in general, than does the man who digs thoughts out of his brain. The growing child requires somewhat different elements of food than does an adult. In other words, "The diet should suit the times, occasions, occupations, etc."

In the case of the expectant mother it should be remembered that the child gains nine-tenths of its weight after the fifth month of pregnancy, and it is, therefore, not necessary that a woman shall begin "eating for two" until after the fifth month. And since it is also true that the baby doubles its weight during the last eight weeks of pregnancy, it follows that then is the time when special attention must be given to the quantity as well as the quality of "mothers' food."

During the first five months, if the urine and blood-pressure are normal, the "lady in waiting" should follow her usual dietetic tastes and fancies so long as they do not distress or cause indigestion. Because of the additional work of the elimination of the fetal wastes, much water, seven or eight glasses a day, should be taken; while one of the meals—should there be three—may well consist largely of fruit. All of the vegetables may be enjoyed; salads with simple dressings and fruits may be eaten liberally. Of the breads, bran, whole wheat, or graham are far better for the bowels than the finer grain breads, or the hot breads.

Something fresh—raw—should be taken every day, such as lettuce, radishes, cabbage salad, and fresh fruits.

If the prospective mother is accustomed to the liberal use of meat, providing the blood-pressure and urine are normal, she may be able to indulge in meat once a day. Many physicians believe that the maternal woman should eat meat rather sparingly—from once a day to once or twice or three times a week.

Of the desserts, gelatine, junket, ice cream, sponge cake, and fruit are far better than the rich pastries, which never fail even in health to encourage indigestion and heart burn. The fruitades are all good. Candies and other sweets may be eaten in moderation. Alcohol should be avoided. Tea and coffee should be restricted, and in many cases abandoned. For many, two meals and a lunch of fruit or broth are better than three full meals. There is a continual and increased accumulation of waste matter which must be thrown off by the lungs, kidneys bowels, and skin; so that clogging of one channel of elimination makes more work for one or more of the other eliminative organs.

Sometimes the craving for food is excessive, and the desire to nibble between meals is quite troublesome. These unusual feelings should be controlled or ignored. A glass of orangeade will sometimes satisfy this unnatural craving. Save your appetite for meal time—for a good appetite means good digestion —all things equal. The woman who habitually eats between meals is the sluggish, constipated individual who needs to acquire self-control and learn self-mastery.

WATER DRINKING

Water is the circulating medium of the body, from which the digestive secretions are formed, and by which the food is assimilated and distributed to individual cells. And, finally, water is the agent for dissolving and removing waste products from the body through the various eliminating organs. We literally live, think, and have our being, as it were, under water. The tiny cell creatures of our bodies, from the humble bile workers of the liver to the exalted thinking cells of the brain, all carry on their work submerged. Accordingly, the amount of water we drink each day, determines whether the liquids circulating through our tissues shall be pure, fresh, and life-giving, or stagnant, stale, and death-dealing.

Thirst is the expression of the nervous system, constituting a call for water, the same as hunger represents a call for food. Pure water, free from all foreign substances, is the best liquid with which to quench this thirst.

It is just as important to supply abundance of water for the proper bathing and cleansing of the internal parts of the body, as it is to wash and bathe the external skin frequently. The living tissues are just as literally soiled and dirtied by their life action and their poisonous excretions, as is the skin soiled by its excretions of sweat and poisonous solids. Thus the regular drinking of water is absolutely necessary to enable the body to enjoy its internal bath, and this internal cleansing is just as grateful and refreshing to the cells and tissues, as is the external bath to the nerves which exist in the skin.

The total amount of water necessary varies according to the nature of one's work, the amount of sweating from the skin, the moisture of the atmosphere, the amount of water in the food, etc. We believe the average person requires about eight glasses of liquid a day; that is, about two quarts. By the word "glass" we refer to the ordinary glass or goblet, two of which equal one pint. This amount of water should be increased, if anything, throughout pregnancy; while, during the later months, the amount of water taken each day should be at least doubled.

In the condemnation of so-called artificial beverages, an exception should be made of the fruit juices. The fresh, unfermented juices of various fruits come very near being pure, distilled water, as they consist of only a little fruit sugar and acid, together with small amounts of flavoring and coloring substances, dissolved in pure water. None of these substances contained in pure fruit juice needs to be digested.

Lemonade not too sweet, and taken in moderate quantities, is certainly a beverage free from objection when used by the average pregnant woman. Unripe or overripe fruits frequently cause bowel disturbances; as also do the millions of germs which lurk upon the outside of fruits, and which find their way into the stomach and bowels when these fruits are eaten raw without washing or paring. Otherwise, the juices of fruits and melons are wholesome food beverages when consumed in moderation.

EXERCISE

It should be the regular practice of every expectant mother to spend a portion of each day in agreeable, suitable exercise or physical work of some description. This exercise will be far more beneficial if it can be taken in the open air. The weather and the strength of the patient must be taken into consideration and the necessary modifications of the daily exercise should be made.

An expectant mother living in the city and enjoying the average health and strength, should engage in such agreeable exercise as the raising of flowers, the training of vines, with brisk walks in the fresh air. As much time as possible should be spent in the parks.

The rural "mother in waiting," may do light gardening, raising of chickens, or pigeons, training of vines, or other outdoor work she may enjoy.

No matter what kind of weather prevails, a daily brisk walk should be taken, out of doors, on the porch or in a room with open windows. A daily sweat, as well as the daily prayer, is good for the well-being of the expectant mother. All forms of light housework are commendable. Keep out of crowds. Spend more time in the parks than in the department stores. An occasional evening at the concert or theater is diversion and harmless provided the ventilation is good. Such exercises as horseback riding, bicycling, dancing, driving over rough roads, lifting and straining of any kind, and all other forms of fatiguing exercise should be avoided.

REST

Rest and relaxation are quite necessary for men and women even in the best of health. A kind providence has arranged that we spend a large portion of our time resting, and sleeping. In addition to unbroken rest at night it is well for the prospective mother quietly to withdraw from the family circle, when the first signs of fatigue begin to appear, and indulge in a little rest, before she gets into a state of nervousness—where nerves twitch and she becomes irritable.

I have told many women whose household duties press hard: "Your husband would rather see a cold lunch on the table, or 'go out' for dinner, while his wife rested, smiling and happy, than to have a most sumptuous meal spread before him and the wife tired, and fretful." Every woman should make it the rule of her life to stop just this side of the outburst of words, and lie down long enough, breathing deeply, to calm the spirit.

FRESH AIR

"With all persons plenty of fresh air, night and day, is indispensable to health, and to none more than the pregnant woman. She should sleep with the windows open, or out of doors, at all seasons of the year; of course, making due allowance for the severity of the winters in the North. It is not only necessary to provide for the adequate ventilation of sleeping-rooms, but also for that of the living-rooms of the house.

Many persons, who are quite particular to open wide the windows of the bedrooms, forget that the other rooms need it quite as much. All the rooms of the house which are occupied should be thoroughly ventilated by throwing doors and windows open every morning; at night when the family is assembled the air must be changed now and then or it will become unfit for human lungs."

Men and women are outdoor animals. They were made to live in a garden, not a house. Remember that each person requires one cubic foot of fresh air every second. Don't allow the temperature of living-rooms, during the winter season, to go above sixty-eight degrees. If your home has no system of ventilation, open wide the windows and doors several times a day and enjoy the blessings of a thorough-going flushing with fresh air.

Oxygen is the vital fire of life. Our food, however well digested and assimilated, is just as useless to the body without oxygen, as coal is to the furnace without air. It is equally important to keep up the proper degree of moisture in the air of the living-rooms.

BATHING

Bathing is made necessary by the clothes we wear and by our indoor life. If the skin were daily exposed to sunshine and fresh air, it would seldom be necessary to bathe. The neglect of regular bathing results in overworking the liver and kidneys, and debilitates the skin. Regular bathing—ofttimes sweating baths—is very essential to the hygiene of pregnancy.

The neutral bath (97 F.) is excellent to quiet the nerves and induce sleep. Morning bathing is an exceedingly valuable practice. If properly taken before breakfast or midway between breakfast and lunch, it is found to be refreshing and tonic in nature. The feet should be in warm water, the application of cold should be short and vigorous. A rough mit dipped in cold water, rubbed over the body until the skin is pink, is a splendid tonic.

Warm cleansing baths should be taken twice a week at night. There is no good reason for the use of the vaginal douche during pregnancy.

THE TEETH

Because the mother's system is drained of the lime salts which aid in building up the bones of the child, along with other metabolic changes which cause the retention of certain acids which ofttimes affect the teeth, they should be frequently examined and carefully guarded. Severe dental work should be avoided, but all cavities should receive temporary fillings while the teeth are kept free from deposits.

As a preventive to this tendency of the teeth to decay, a simple mouth wash of one of the following may be used after meals:

1. One teaspoon of milk magnesia.
2. One tablespoon of lime water.
3. One-half teaspoon common baking soda.

Any one to be dissolved in a glass of water.

DIRECTIONS FOR SAVING URINE SPECIMENS

Beginning with the second voiding of urine after rising on the morning of the day you are to save the specimen, save all that is passed during the following twenty-four hours, including the first voiding on the second morning. Measure carefully the total quantity passed in the twenty-four hours. Shake thoroughly so that all the sediment will be mixed, and immediately after shaking take out eight ounces or thereabouts for delivery to the physician the same forenoon. The following items should be noted, and this memoranda should accompany the specimen:

1. Patient's name.

2. Address.

3. This specimen was taken from a twenty-four hour voiding of urine, which began at .... a. m. ...., and ended at .... a. m. ....

4. The total quantity voided during this twenty-four hours was .... pints.

This specimen should reach the laboratory by ten o'clock the same morning.

It is of utmost importance the specimen should be taken to your physician every two weeks, and oftener if conditions indicate it. Take it yourself at the appointed time.

THE BOWELS

Owing to the increasing pressure exerted upon the intestines, most expectant mothers experience a tendency to sluggish bowels and constipation. This unpleasant symptom is usually increased during the later months.

In the first place, a definite time must be selected for bowel action. It may ofttimes be necessary, and it is far less harmful, to insert a glycerine suppository into the rectum, than to get into the enema habit. The injection of a large quantity of water into the lower bowel will mechanically empty it; but the effects are atonic and depressing as regards future action.

Before we take up the advisability of taking laxatives let us consider what foods will aid in combating constipation. The following list of foods are laxative in their action and will be found helpful in overcoming the constipation so often associated with pregnancy:

1. All forms of sugar, especially fruit sugar, honey, syrup, and malt. All the concentrated fruit juices. Sweet fruits, such as figs, raisins, prunes, fruit jellies, etc.

2. All sour fruits, and fruit acids: Apples, grapes, gooseberries, grape fruit, currants, plums, and tomatoes.

3. Fruit juices, especially from sour fruits: Grape juice, lemonade, fruit soup, etc.

4. All foods high in fat: Butter, cream, eggs, eggnog, ripe olives, olive oil, nuts—especially pecans, brazil nuts, and pine nuts.

5. Buttermilk and koumiss.

6. All foods rich in cellulose: Wheat flakes, asparagus, cauliflower, spinach, sweet potatoes, green corn and popcorn, graham flour, oatmeal foods, whole-wheat preparations, bran bread, apples, blackberries, cherries, cranberries, melons, oranges, peaches, pineapples, plums, whortleberries, raw cabbage, celery, greens, lettuce, onions, parsnips, turnips, lima beans, and peanuts.

White bread should be tabooed, and in its place a well-made bran bread should be used. Two recipes for bran bread follow, one sweetened and containing fruit, the other unsweetened:

BRAN BREAD RECIPES

1. Two eggs, beaten separately; three-fourths cup of molasses, plus one round teaspoon of soda; one cup of sour cream; one cup of sultana seedless raisins; one cup of wheat flour, plus one heaping teaspoon baking powder; two cups of bran; stir well and bake one hour.

2. One cup of cooking molasses; one teaspoon of soda; one small teaspoon of salt, one pint of sour milk or buttermilk, one quart of bran, one pint of flour. Stir well, and bake for one hour in a very slow oven. It may be baked in loaf, or in gem pans, as preferred. The bread should be moist and tender, and may be eaten freely, day after day, and is quite sure to have a salutary effect if used persistently.

The drinking of one-half glass of cold water on rising in the morning often aids in keeping the bowels active. Of the laxative drugs which may be used at such a time, cascara sagrada and senna are among the least harmful. Two recipes of senna preparation follow, and may be tried in obstinate cases:

1. Senna Prunes. Place an ounce of senna leaves in a jar and pour over them a quart of boiling water. After allowing them to stand for two hours strain, and to the clear liquid add a pound of well-washed prunes. Let them soak over night. In the morning cook until tender in the same water, sweetening with two tablespoons of brown sugar. Both the fruit and the sirup are laxative. Begin by eating a half-dozen of the prunes with sirup at night, and increase or decrease the amount as may be needed.

2. Senna with prunes and figs. This recipe does not call for cooking. Take a pound of dried figs and a pound of dried prunes, wash well. Remove the stones from the prunes and if very dry soak for an hour. Then put both fruits through the meat chopper, adding two ounces of finely powdered senna leaves. Stir into this mixture two tablespoons of molasses to bind it together, the result being a thick paste. Begin by eating at bedtime an amount equal to the size of an egg, and increase or decrease as may be necessary. Keep the paste tightly covered in a glass jar in a cool place. If the senna is distasteful a smaller quantity may be used at first.

CARE OF THE BREASTS

The breasts are usually neglected during the months of pregnancy, and as a result complications occur after the baby comes which cause no end of discomfort to the mother. If, during the pregnancy, the breasts are washed daily with liquid soap and cold water, and rubbed increasingly until all sensitiveness has disappeared, they may be toughened to the extent that no pain whatsoever is experienced by the mother when the babe begins to nurse. During the last month of pregnancy a solution of tannin upon a piece of cotton may be applied after the usual vigorous bathing. If the nipples are retracted they should be massaged until visible results are attained.

THE MENTAL STATE

Keep the mind occupied with normal, useful, and healthy thoughts. Listen to no tales of woe. Stay away from the neighborhood auntie dolefuls. Keep yourself happy and free from all worry, care, and anxiety.

"Put no faith in fables of cravings, markings, signs, or superstitions. They are all unfounded vagaries of ignorant old women and will not bear investigation."

Don't take drugs for worry and sleeplessness. Take a bath.

The secret of deliverance from worrying is self-control. Minimize your difficulties. Cultivate faith and trust.

The conditions which favor sound sleep are: Quiet, mental peace, pure blood, good digestion, fresh air (the colder the better), physical weariness (but not fatigue), mental weariness (but not worry).

When tempted to borrow trouble, when harassed by fictitious worries, remember the old man who had passed through many troubles, most of which never happened. Train the mind to think positive thoughts. Replace worry-thought with an opposite thought which will occupy the mind and enthuse the soul. Drive out fear-thought by exercising faith-thought. Cultivate the art of living with yourself as you are, and with the world as it is. Learn the art of living easily. Associate with children and learn how to forget the vexing trifles of everyday life.

There is something decidedly wrong with one's nerves when everybody is constantly "getting on them." They are either highly diseased or abnormally sensitive. Every woman is a slave to every other that annoys her.

Fear is capable of so disarranging the circulation as to contribute to the elevation of blood-pressure—which will be more fully considered in a later chapter.