Consumption Is Chiefly Caused by the Filthy Habit of Spitting.—Consumption is a disease of the lungs, which is taken from others, and is not simply caused by colds, although a cold may make it easier to take the disease. It is caused by very minute germs, which usually enter the body with the air breathed. The matter which consumptives cough or spit up contains these germs in great numbers—frequently millions are discharged in a single day. This matter, spit upon the floor, wall or elsewhere, dries and is apt to become powdered and float in the air as dust. The dust contains the germs, and thus they enter the body with the air breathed. This dust is especially likely to be dangerous within doors. The breath of a consumptive, except when he is coughing or sneezing, does not contain the germs and will not produce the disease. A well person catches the disease from a consumptive only by in some way taking in the matter coughed up by the consumptive.Consumption can often be cured if its nature be recognized early and if proper means be taken for its treatment. In a majority of cases it is not a fatal disease.It is not dangerous to live with a consumptive, if the matter coughed up by him be promptly destroyed. This matter should not be spit upon the floor, carpet, stove, wall, or sidewalk, but always, if possible, in a cup kept for that purpose. The cup should contain water so that the matter will not dry, or better, carbolic acid in five per cent. watery solution (six teaspoonfuls in a pint of water). This solution kills the germs. The cup should be emptied into the water closet at least twice a day, and carefully washed with boiling water.Great care should be taken by consumptives to prevent their hands, face, and clothing from becoming soiled with the matter coughed up. If they do become thus soiled, they should be at once washed with soap and hot water. Men with consumption should wear no beards at all, or only closely cut mustaches. When consumptives are away from home, the matter coughed up should be received in a pocket flask made for this purpose. If cloths must be used, they should be immediately burned on returning home. If handkerchiefsbe used (worthless cloths, which can be at once burned, are far better), they should be boiled at least half an hour in water by themselves before being washed. When coughing or sneezing small particles of spittle containing germs are expelled, so that consumptives should always hold a handkerchief or cloth before the mouth during these acts; otherwise the use of cloths and handkerchiefs to receive the matter coughed up should be avoided as much as possible, because it readily dries on these and becomes separated and scattered into the air. Hence, when possible, the matter should be received into cups or flasks. Paper cups are better than ordinary cups, as the former with their contents may be burned after being used. A pocket flask of glass, metal, or pasteboard is also a most convenient receptacle to spit in when away from home. Cheap and convenient forms of flasks and cups may be purchased at many drug stores. Patients too weak to use a cup should use moist rags, which should at once be burned. If cloths are used they should not be carried loose in the pocket, but in a waterproof receptacle (tobacco pouch), which should be frequently boiled. A consumptive should never swallow his expectoration.A consumptive should have his own bed, and, if possible, his own room. The room should always have an abundance of fresh air—the window should be open day and night. The patient's soiled wash-cloths and bed linen should be handled as little as possible when dry, but should be placed in water until ready for washing.Rooms should be cleaned daily, but in order to prevent the raising of dust, all floors must be well sprinkled before sweeping, and all dusting, etc., done with damp cloths.If the matter coughed up be rendered harmless, a consumptive may frequently not only do his usual work without giving the disease to others, but may also thus improve his own condition and increase his chances of getting well.Rooms which have been occupied by consumptives should be thoroughly cleaned, scrubbed, and whitewashed, painted, or papered before they are again occupied. Carpets, rugs, bedding, etc., from rooms which have been occupied by consumptives, should be disinfected. Such articles, if the Department of Health be notified, will be sent for, disinfected, and returned to the owner free of charge, or, if he so desires, they will be destroyed.When consumptives move they should notify the department of health. Consumptives are warned against the many widely advertised cures, specifics, and special methods of treating consumption. No cure can be expected from any kind of medicine or method except the regularly accepted treatment, which depends upon pure air, an out-of-door life, and nourishing food.Consumptives having an opportunity of entering a sanatorium, should do so at once.
Consumption Is Chiefly Caused by the Filthy Habit of Spitting.—Consumption is a disease of the lungs, which is taken from others, and is not simply caused by colds, although a cold may make it easier to take the disease. It is caused by very minute germs, which usually enter the body with the air breathed. The matter which consumptives cough or spit up contains these germs in great numbers—frequently millions are discharged in a single day. This matter, spit upon the floor, wall or elsewhere, dries and is apt to become powdered and float in the air as dust. The dust contains the germs, and thus they enter the body with the air breathed. This dust is especially likely to be dangerous within doors. The breath of a consumptive, except when he is coughing or sneezing, does not contain the germs and will not produce the disease. A well person catches the disease from a consumptive only by in some way taking in the matter coughed up by the consumptive.
Consumption can often be cured if its nature be recognized early and if proper means be taken for its treatment. In a majority of cases it is not a fatal disease.
It is not dangerous to live with a consumptive, if the matter coughed up by him be promptly destroyed. This matter should not be spit upon the floor, carpet, stove, wall, or sidewalk, but always, if possible, in a cup kept for that purpose. The cup should contain water so that the matter will not dry, or better, carbolic acid in five per cent. watery solution (six teaspoonfuls in a pint of water). This solution kills the germs. The cup should be emptied into the water closet at least twice a day, and carefully washed with boiling water.
Great care should be taken by consumptives to prevent their hands, face, and clothing from becoming soiled with the matter coughed up. If they do become thus soiled, they should be at once washed with soap and hot water. Men with consumption should wear no beards at all, or only closely cut mustaches. When consumptives are away from home, the matter coughed up should be received in a pocket flask made for this purpose. If cloths must be used, they should be immediately burned on returning home. If handkerchiefsbe used (worthless cloths, which can be at once burned, are far better), they should be boiled at least half an hour in water by themselves before being washed. When coughing or sneezing small particles of spittle containing germs are expelled, so that consumptives should always hold a handkerchief or cloth before the mouth during these acts; otherwise the use of cloths and handkerchiefs to receive the matter coughed up should be avoided as much as possible, because it readily dries on these and becomes separated and scattered into the air. Hence, when possible, the matter should be received into cups or flasks. Paper cups are better than ordinary cups, as the former with their contents may be burned after being used. A pocket flask of glass, metal, or pasteboard is also a most convenient receptacle to spit in when away from home. Cheap and convenient forms of flasks and cups may be purchased at many drug stores. Patients too weak to use a cup should use moist rags, which should at once be burned. If cloths are used they should not be carried loose in the pocket, but in a waterproof receptacle (tobacco pouch), which should be frequently boiled. A consumptive should never swallow his expectoration.
A consumptive should have his own bed, and, if possible, his own room. The room should always have an abundance of fresh air—the window should be open day and night. The patient's soiled wash-cloths and bed linen should be handled as little as possible when dry, but should be placed in water until ready for washing.
Rooms should be cleaned daily, but in order to prevent the raising of dust, all floors must be well sprinkled before sweeping, and all dusting, etc., done with damp cloths.
If the matter coughed up be rendered harmless, a consumptive may frequently not only do his usual work without giving the disease to others, but may also thus improve his own condition and increase his chances of getting well.
Rooms which have been occupied by consumptives should be thoroughly cleaned, scrubbed, and whitewashed, painted, or papered before they are again occupied. Carpets, rugs, bedding, etc., from rooms which have been occupied by consumptives, should be disinfected. Such articles, if the Department of Health be notified, will be sent for, disinfected, and returned to the owner free of charge, or, if he so desires, they will be destroyed.
When consumptives move they should notify the department of health. Consumptives are warned against the many widely advertised cures, specifics, and special methods of treating consumption. No cure can be expected from any kind of medicine or method except the regularly accepted treatment, which depends upon pure air, an out-of-door life, and nourishing food.
Consumptives having an opportunity of entering a sanatorium, should do so at once.
When Delay Is Dangerous.—Inasmuch as it is mother's duty to watch over the health and the efficiency of all members of the household, she would do well to establish a rule to err on the safe side in every case of sickness. That rule should be never to delay too long in obtaining medical aid.
In nearly twenty years of active general practice I have had hundreds of "hurry" calls to "come at once." In not over a dozen of these calls did any of the cases demand immediate attention from a medical standpoint. Most of them, however, should have had earlier aid. People wait too long in the hope of spontaneous recovery, and when, instead of recovery, they realize that the patient is quite sick, they become conscience-stricken and send a "rush" call for the doctor. After delaying from day to day they decide to get professional advice and send a messenger for a physician with instructions to "go for another if he can't come at once." It is imperative he should come instantly, though they have delayed for a week in requesting his services. Every physician has these calls every week of his life. If an individual has survived a week's neglect, it is quite within reason to assume that he will survive another hour,—and during that hour the physician may have time to complete whatever he may be doing when the call comes.
If you have been guilty of bad judgment in not sending earlier for aid, don't add discourtesy to your sins. The world demands of us, and every person has the right to expect, a certain degree of consideration and courtesy. If we do not give it, we only harm ourselves because the lack of cultivation is a detriment which limits growth and happiness. The degree of attainable happiness is limited by the degree of "goodness" that is in us. If you are not considerate, depend upon it, there is an element of happiness which escapes you, and you cannot attain it till you are considerate.
It is inconsiderate and it is discourteous to send an immediate demand for a physician "to come at once" if there is no urgent need for his services, and if you have just been inspired for aid after a week's blindness, thereis no urgency in the matter. A call in an hour would do just as well.
Take the following case: A mother discovers a small quantity of blood in the diaper of her two months old baby. There is a larger quantity in the afternoon and she decides to give the baby a dose of castor oil. During the night it slept fitfully and in the morning it has a large stool as a result of the castor oil and there is a large quantity of blood in the stool. She sends a "rush" call for a physician. The physician discovers the following facts: The baby is being artificially fed; it has been vomiting its food for a week; its stools have been green, foul and contained mucus; it had a fever for a number of days; it has lost much weight and looked pale and sickly. The physician obtained this history from the mother—she therefore knew the baby's condition. Why did she delay sending for a physician? How sick did she want the child to be before the need for aid seemed justifiable to her? Why didn't the sight of blood in the stool suggest the need of assistance? What do the public expect of physicians in such cases? But why ask questions? Many mothers will doubt the existence of such a mother as is described above. They need not; she was one of my own patients. I do not understand such women; I only know that such mothers exist in quite large numbers. This particular mother has other children; she is a good housekeeper, is personally attractive, and is thought well of in the community. If such seemingly heartless conduct can spring from such a source is it not evidence of the fact that the average mother needs instruction, needs education, and does it not bespeak the need of eugenics being sown broadcast throughout the land?
Delays are dangerous in all sicknesses that last, despite a thorough cleaning out of the bowels. To wait, hoping that "things will change," is bad practice. It is unjust to the medical profession, and it is infinitely more unjust to the victim.
There are two kinds of surgical operations—those of choice and those of necessity.
Every one knows about the operations of necessity,most of which must be performed as a result of accident, but few people understand the dangers of delaying what are termed "operations of choice." These are for such conditions as appendicitis, cancer, and stomach and bowel troubles.
Delaying an operation of choice lessens the chances of living, and really makes an operation of necessity with fewer chances of recovery than from the operations that must promptly follow injuries.
When we feel that an operation is needed, or are in doubt about it, the wise thing to do is to consult medical authority. Then, if it is found there should be an operation, there is plenty of time to make every arrangement. We can begin to diet, which is generally necessary and there is every chance for speedy recovery.
If a man breaks a leg and it has been set badly, the surgeons do not rebreak it at once, but allow it to heal and the patient to regain his strength, when it is again broken and reset properly. This is an operation of choice.
But if a terrible fracture of the leg results from a fall, with the shattered bone protruding, an operation of necessity must follow to mend torn arteries.
It has been learned through recently gathered statistics that about thirty per cent. of the people operated on for appendicitis die simply because they delay the operation. This should have been an operation of choice, when every arrangement could have been made long beforehand; the delay makes it an operation of necessity, with the victim in such poor physical condition that he has not half the strength to recover that he would have had if he had been wise enough to consult a physician when he first suspected that something was wrong.
These same statistics go to show that fully 99 per cent. of the appendicitis cases, when taken in time, are cured by means of the operation, thus affording the strongest proof of the folly of delaying such things.
The total number of deaths from appendicitis each year, due to delay in operating, is greater than the number of deaths during the Spanish-American War. There are instances where the doctors do not advise operations soon enough.
Above all things, when a reputable physician advises operation, do not think you know more than the physician, but have the operation performed at once. Nine times out of ten this will be the means of saving your life.
No faith should be placed in the so-called "hot-weather" foods. The cereals and other manufactured foods advertised as possessing marvelous qualities, have in reality no advantage. Some of them have more or less value as ordinary food, but they certainly possess no unusual superiority. Home cooking is the best in summer or any other time.
Great care should be taken to keep the system in the best possible condition. This will prove the most effectual safeguard against the heat. Some foods do not agree with certain individuals, and these should be carefully avoided in summer. Every person will have to judge for himself in this matter. Otherwise the diet should be balanced carefully so that enough, and yet not too much, is eaten. As much fruit as possible should be eaten, and meat never more than once a day. It is not well, however, to omit it entirely.
Food sustains the body through the heat it generates chemically, and it is therefore impossible to eliminate a certain heating effect. If the system is kept normal, however, and the diet properly balanced, this should not be felt. Work is performed by the body and energy expended. This must be replaced with the heat value of food. A certain amount of fat, starch, and the other constituents of a well-balanced diet is essential.
Fat meats and other forms of fat are the most heating of all foods and may be minimized in summer. The amount of food necessary is, of course, largely governed by the nature of the work performed by the individual. Brain workers can eat very little in the morning and during the day, reserving until evening the single heavy meal. If they have been doing this the year around they probably will be cooler during the morning and afternoonif a light breakfast and luncheon are eaten. It is not well, however, to make any radical change from one's regular habits.
Manual workers require more food, and the heavy meal had best be eaten in the middle of the day. All three meals should be substantial. There is no danger of eating too much if the system is not overburdened.
Not only is pork rich and fat, and therefore very heating, but it is the quickest of all meats to spoil. Veal also spoils very quickly if not kept at the proper temperature. Of all meats mutton has the best keeping qualities. Beef also keeps well and is a safe meat to eat in summer.
Flies are dangerous under any conditions, but particularly should they be avoided where meat is kept. The bacteria they carry thrive particularly on meat, and therefore are apt more rapidly to multiply than if deposited on some other food. Care should be taken to buy meat only from places where adequate protection is provided against flies.
It is of the greatest importance to keep the meat at a uniform cold temperature. It should not be allowed to become heated, and then cooled again. Some meat shops still keep the meat on open counters or hooks and replace it in the refrigerators at the close of the day. These shops should be carefully avoided. Modern methods provide glass-covered refrigerating counters which keep the meat cool while it is on display.
Meat should be kept at as low a temperature as possible. The ordinary refrigerator is at a little above freezing and temperatures at or below zero are preferable.
Scientific Dressing.—By dressing scientifically it is possible to minimize the effect of the heat. The heat from the sun must be kept away from the body and the heat generated by the body permitted to escape. These results can best be accomplished by having the clothes very loose fitting, so as to leave ample air space, and by having the outer clothes of a good non-conductor of heat. The cloth, of course, should be as light in weight as possible, but it is more important to have it a good non-conductor of heat and of porous weave.
Not enough attention is paid to the selection of colorsfor resisting the heat. Two cloths identical except in color will show a great difference in the comparative amount of heat they let through. Light shades should be chosen, but care should be taken to see that they are not glaring, so as to irritate the eye and increase the mental effect of heat.
Linen and silk are better non-conductors than wool. And the weave of a cloth has a great deal to do with the amount of heat it lets through. Smooth, hard weaves absorb much less heat than fuzzy weaves. For this reason, serge is much cooler than worsted of the same shade and weight. A mistake is often made, however, in getting serge of a dark blue. It should be of as light a color as possible; gray is much cooler than blue. A white serge is much cooler than white flannel, because it is less fuzzy.
Linen is much cooler than woolens, because it is a better non-conductor and is of more porous weave. The linen thread is rough, which causes inequalities in the weave, permitting a more thorough circulation of air. Cotton is a still better non-conductor than linen, and would be preferable for summer clothes but for the fact that it neither wears nor holds its shape so well.
Mohair is very light in weight and cool looking. As a matter of fact, however, it is a fairly good conductor of heat, is closely woven, and usually comes in dark shades. It is a woolen cloth, and any woolen has its threads woven more closely on account of the process of manufacture than linens, cotton, and silk cloths. Linen is perhaps the best material for summer wear. It is porous in weave, light in color, and of fairly light weight.
It is well to remember that the safety valve of the body in hot weather is the evaporation of perspiration, not the act of perspiring. If the hand is put in a glove, for instance, it will perspire much more than if in the open air, but it will not be as cool. It is the evaporation that is a cooling process. If the perspiration is absorbed it cannot evaporate. That is why loose fitting undergarments are cooler than tight ones. It is also the reason why cotton is cooler next to the skin than linen or silk; it absorbs moisture less freely.
Drink Plenty of Water.—Water, and a great deal ofit, is desirable at any time during the summer. It should be drunk freely during the day. Lemonade also is good, the slight acid being an aid to digestion. It is best to have beverages cooled only to a moderate temperature. Ice water is not bad, but it would be preferable if it were not at so extreme a temperature. Ice is resorted to only as a convenient means of securing a palatable temperature; the system does not crave extreme cold. Water at the temperature of the air is nauseating, so ice is put into it and the other extreme secured. Sixty degrees is the ideal temperature for drinking water. If this could be conveniently obtained it would be preferred to a greater degree of cold. Not only is it less harmful to the system, but it is more satisfying and thirst-quenching. Water put in bottles and left in a refrigerator until properly chilled is the best way of preparing a summer beverage. When any beverage is sufficiently cold to cause a pain in the head or throat when drinking it the result may be harmful. Cold water poured on the wrist or head has a cooling effect and tends to reduce the ice water habit.
If one could afford it, it would be well to drink nothing but mineral water in the summer. Not only does it assure purity, but the gas is an aid to digestion and serves to render the water more palatable. This results in more of it being drunk than if it were flat water, and it is desirable to drink as much water as possible in hot weather. By mineral water I mean carbonated bottled waters intended for table use. Care should be taken that the water is only lightly impregnated with salt.
It is much safer to drink a well-known water. The water may not be bottled at the spring or it may be bottled under unsanitary conditions. In many cases mineral water is not all that it should be in cleanliness. Unless one is sure of the purity of a bottled water good hydrant water supplied through the city pipes is safer.
In traveling, however, and at summer resorts it would be well to drink nothing but mineral water of a well-known brand. Only by doing this and by being certain that the bottle has not been refilled can one be safe. The supplied on trains and in resorts frequently is not as pure as that supplied in large cities.
On the whole, however, mineral water has no particular advantage over ordinary water except that the well-known brands are sure to be pure, and the carbonization makes it more tasty and so increases the amount consumed. It is much safer and more healthful to drink a well-known mineral water than the so-called soft drinks, many of which are unclean and harmful.
Importance of Diseases of Women—The Beginning of Female Disease—Ailing Women Are Inefficient—As Home-makers, as Wife, as Mother—Few Ailing Women Become Pregnant—The Chief Cause of Female Disease—The Existence of the Average Mother—Female Diseases Are Avoidable—The Story of the Wife—Women Who Don't Want Children—Abuse of the Procreative Function—What the Woman with Female Disease Should Do—Cancer in Women—Cancer of the Breast—Cancer of the Womb—What Every Woman Should Know About Cancer—Change of Life—The Menopause—The Climacteric—The Average Age at Which the Change of Life Occurs—Symptoms of the Change of Life—Importance of a Correct Diagnosis—Danger Signals of the Change of Life—Conduct During the Change of Life.
Importance of Diseases of Women—The Beginning of Female Disease—Ailing Women Are Inefficient—As Home-makers, as Wife, as Mother—Few Ailing Women Become Pregnant—The Chief Cause of Female Disease—The Existence of the Average Mother—Female Diseases Are Avoidable—The Story of the Wife—Women Who Don't Want Children—Abuse of the Procreative Function—What the Woman with Female Disease Should Do—Cancer in Women—Cancer of the Breast—Cancer of the Womb—What Every Woman Should Know About Cancer—Change of Life—The Menopause—The Climacteric—The Average Age at Which the Change of Life Occurs—Symptoms of the Change of Life—Importance of a Correct Diagnosis—Danger Signals of the Change of Life—Conduct During the Change of Life.
No conscientious physician can give thought to this subject without being profoundly stirred. It may justly be said that all types of disease affecting the general health, the happiness, and the efficiency of the people are equally important, and should elicit the same degree and quality of kindly consideration. For many reasons this is not so, as I will endeavor to show. The dominating reason which renders diseases of women an exception to this rule may be mentioned here, however, so that the reader will keep its supreme significance prominently in mind while considering the subject in its various other aspects. "Diseases of women" rank first as a eugenic problem. They have a direct and far-reaching influence on posterity. They affect the environment of the home and thereby the health and the efficiency of all concerned.
The diseases which form the basis of the statements in this article are as follows: leucorrhea, displacements, or malpositions of the internal organs; lacerations, ulcers, tumors, sexual incompetency, and the venereal complications.
It is not possible or desirable to tabulate the symptoms which result from these conditions. They would not convey to the average individual a just picture or an intelligent summary of the life of a victim of these ailments. An actual description of the life of a patient will be more effective because it will depict the incidental domestic atmosphere in which most of these patients live.
The Beginning of Female Disease.—When a woman first begins to feel the effects of so-called "female weakness" she is conscious of not feeling "fit." She wonders what the matter is. She may not have actual pain at this time, simply the consciousness that "she is not what she used to be." Her work seems harder and more tedious, she worries without cause, she begins the day with less energy and ambition than she used to, her disposition is more uneven, more irritable and she tires easier and is more willing to retire earlier than formerly. After a time she has more or less undefined pains. It may be an occasional headache, or backache, or she may have various severe neuralgic twinges. She gets nervous and moody; her appetite is not good and she is troubled with constipation. A little later, the general condition growing worse, her nervous system suffers most. So she drifts into neurasthenia and has fits of crying and periods of melancholia. She is more irritable, more impatient, more dissatisfied with herself, her family, and her friends. She loses faith in herself, in the future, and even in her religion, and she may contemplate self-destruction.
There are thousands and thousands of just such women in the world, and the pity is that many of them are mothers. It is surely self-evident that these women must be failures as efficient factors in many ways.
From a first glance at the chart it would appear that Daniel was an accidental case of feeble-mindedness. His progenitors were, however, decidedly neuropathic. The presence of apoplexy, paralysis, alcoholism in a family should be watched for with vigilance because of their possible effect upon the nervous system of the offspring.
Parents would do well to scrutinize the man who "led a fast life" before allowing him marry their daughter. The world would be shocked if it knew how many men with disease enter into conjugal relations. David's father had syphilis. David's feeble-mindedness was probably only one of the awful results.
[C]"Feeble-mindedness; Its Causes and Consequences," Goddard, The Macmillan Company.
[C]"Feeble-mindedness; Its Causes and Consequences," Goddard, The Macmillan Company.
First of All as Home-makers.—No woman can possibly be expected to successfully conduct a home if she is not enjoying a reasonable degree of good health. A home inefficiently supervised is an instrument for evil. It engenders discord and discontent, and it is lacking in the spirit which is essential to the cultivation of good-fellowship and which encourages harmony.
As Wife.—Most men resent the burden and the discomfort and the expense of an ailing wife, no matter how well-intentioned they may be. It is a failing of the male species to be cursed with the inability to understand any type of nervousness in a wife. Being inexplicable to him he attributes the symptoms to an evil imagination or to a bad disposition. He believes he is being imposed upon and proceeds to resent it. Many homes are rendered permanently miserable and unhappy by a failure to comprehend the real source of the trouble and to apply the remedy. Being inefficient as a home-maker the wife is not able to carry out her part as housekeeper. The home atmosphere is wrecked, the husband seeks comfort and congenial fellowship elsewhere. His efficiency is compromised and his earning capacity interfered with.
As Mother.—Anyone familiar with the exacting obligations and responsibilities of motherhood can well appreciate that normal health is an essential requisite to its successful consummation. The success of motherhood depends upon the proper exercise of many diversified qualities, and those in turn primarily depend upon an adequate degree of physical fitness, otherwise failure is certain to ensue. A woman, therefore, cannot exercise her function of motherhood if she is a neurasthenic.
Inasmuch as it has been proved that the regeneration of the race is dependent upon the maintenance of mentally and physically fit mothers, any condition that interferes with this standard is contrary to the eugenic requirement. Children sent out into the word unfit physically or morally are factors detrimental to the best interests of society and to their own progress and prosperity. A mother rendered incapable through sickness is, therefore, a menace to the home and to the eugenic promise.
Few Ailing Women Become Pregnant.—Nature fortunately seems to apprehend the true condition because few of these women become pregnant. This suggests an inquiry into the cause, or causes, underlying this unfortunate situation.
Are women responsible for these ailments?
Most married women whose health is broken down by some disease peculiar to their sex refer the commencement of their suffering to a confinement or premature birth. The large majority of those women whose health is affected, because of some "female weakness," suffer from a displacement, or malposition of the internal organs, and as this condition is most frequently a product of maternity, there would seem to be some reasonable degree of justification for the assumption that the wrecked health is the result of a legitimate physiological act, and consequently a natural phenomenon. This is not, however, altogether true. A displacement is not, under any circumstances, a natural process. It is the result of causes which are avoidable. Most of them are the penalties imposed by nature because of the infraction of her laws. We will not consider those causes which have their beginning in wrong methods of dress or conduct during the years prior to maternity. Many such cases exist, but they are too few in number to justify consideration at this time. They are frequent enough, however, to suggest to mothers that it is always wise to keep a close watch over the tendencies and conduct of their daughters.
The Chief Cause of Female Diseases.—When a woman has given birth to a child her womb begins to contract and in a very brief space of time will resume its normal position, provided nothing interferes with the process. Nature will do exactly what is right if she is permitted to work in her own way. In another part of this book I have explained why it takes time for the recently pregnant womb to contract to its normal size. There is a 600 per cent. increase in volume to be got rid of by absorption. This takes time and nature can not be hurried without "taking chances." This is just where the "cause" exists which we have been looking for. Women do take chances.
Every woman should stay in bed for at least three weeks after confinement and should spend another three weeks convalescing before she assumes any domestic duty. This is a reasonable proposition when one considers the actual situation. There is an enormous amountof readjustment to be undertaken, and there is no way of hastening this process. There is, however, a way to assist nature and to prevent mistakes. That way is to remain in bed a sufficient length of time to allow proper contraction of the womb. While the ligaments and muscles are still lax, to not undertake any muscular effort that will overtax or overstrain them,—a condition that favors displacement by weakening the support of the womb. A woman cannot understand why she should stay in bed when she feels well enough to get up. It is, however, unjust to censure the sex on this account. I am convinced the fault lies with the medical profession who do not take time to explain, in language which a woman may understand, the important reasons why they should stay longer in bed despite the fact that they do feel well.
The Existence of the Average Mother.—In considering this subject it is necessary to give some serious thought to the domestic and financial circumstances of the thousands and thousands of average mothers. Every observing, thinking person knows that the average mother's existence is more or less of a never-ending tragedy. Physically, mentally, and spiritually, they are victims of unalterable economic and social exigencies. They are compelled, because of ignorance, to live an unsanitary and unhygienic existence. The care of home and children, and maybe the unappreciative and inconsiderate attention of a careless and vindictive husband, add to the incidental worries,—fraying her nerves and disposition,—of the ordinary routine of a cheerless, hopeless life. Add to this experience the enormous drain of frequent child bearing upon her vitality, and we have a picture with which every physician is familiar.
Can such a woman possibly observe the essential rules of the hygiene of pregnancy? Has she the time and the means to build up her reserve energy and strength to competently undertake the duties of maternity or motherhood? Is she physically fit to give birth to a child? After it is all over can she devote the time to permit nature to do her share of the physical readjustment? Can she afford, or will she be permitted to remainin bed long enough to allow conditions to be favorable to getting up without "taking a chance"? Inasmuch as her muscular tone is poor, her strength depleted, her vitality wasted, her ambition and hope at a low ebb, nature should be given a longer time, under the most favorable hygienic and domestic conditions, to help in the problem of readjustment, because her whole future, as an efficient machine, as wife, as mother, as home-maker, and as an economic individuality, is dependent upon how this crisis is met. This is the most important problem which an enlightened civilization has before it. It is the supreme eugenic task, and it is the most pressing and the most vital question for statesmen to solve. No man can deny that the permanency of the state is dependent upon the function of motherhood, yet motherhood is conducted by unskilled labor—labor, the quality of which no business would tolerate. We also know that the health of the workman has become an economic problem. Capital finds that labor is of better quality, and consequently more remunerative in every sense, if the environment is conducive to happiness and health. Yet motherhood, the most important labor in the world, upon which the very existence of the state depends, in addition to being performed by unskilled labor, is undertaken by physically unfit and frequently unwilling laborers, in an environment which is a disgrace to civilization and which cannot be duplicated in the whole realm of the brute world. This is the quality of labor, the products of which constitute the state.
If anyone is disposed to believe that this is an over-drawn picture, let him study the facts brought out in the recent patent medicine investigation. It was found that one small, unimportant, quack medical company had under treatment at one time (the day the government closed it up) 200,000 women, suffering exclusively from female diseases. How many similar cases must there be to support the large advertising concerns, whose tentacles reach to the remotest corners of the country and who limit their activity and cater to "diseases of women" only. Let him also give some thought to the fact that no specialty in the whole field of legitimate medical practicehas grown with such enormous strides, or is as remunerative to the ordinary physician as the department of "diseases of women."
Female Diseases Are Avoidable.—If, as has been asserted, the great majority of these ailments are traceable to causes which are avoidable, what is the remedy? In one word it is "Enlightenment." We must educate the ordinary mother who is so busy over her wash tubs and babies that she has no time to seek information upon subject which she doesn't even know exist, who does not even know how to feed her baby as well as the scrubbiest cat does her kitten, who does not know what eugenics means and is interested in it even less. We must stop limiting our talks to theorizing in clubs and societies. We must carry the tidings to the firesides of those hundreds of thousands of women who would listen and act, but who do not know what to do or how to correct their faults.
There is another feature of this subject which should be recalled in this connection. It has already been gone into in detail in the article on eugenics. There are many thousands of women who are compelled to fight the battle of life, upon whom an unjust disease has been grafted, which is sapping their strength and vitality, and which they do not appreciate or understand. Husbands infect wives unwittingly, wreck their constitutions, blast their hope of ever having a child, and then heap upon them abuse for an inability for which they are themselves directly responsible. Many homes are desecrated in this way and the real culprit is never suspected. Many women, who begin their married life under the most auspicious conditions so far as physical fitness or temperamental quality is concerned, have their health, and happiness, and success utterly ruined, and after spending a miserable, wretched existence, have their hope of maternity forever blasted on the operating table. The story of "the wife" has never been told. It is God's riddle.
Women Who Don't Want Children.—Sometimes the woman is at fault. Many young wives begin married life with the intention of not having a child for a yearor two. They don't want to be tied down too soon. They want some fun themselves. They are willing to become the legal mistress of a man, but they are not willing to assume the responsibilities of married life. It is difficult to understand the ethics of this type of morality. I have always given these young wives credit with simply not knowing what they were doing. Either their education or their common sense is lamentably deficient, or what is still worse, their mother was the wrong kind of a woman. If these unfortunate young wives have no regard for the cultivation of a good conscience, they should at least have some regard for their own health. From a purely selfish standpoint,—the standpoint of efficiency and success,—one would imagine these women would be unwilling to risk their whole future physical welfare on the chance of immunity—and it is a small chance.
Abuse of the Procreative Function.—In order to carry out this programme, various means are brought into requisition. In many cases I have known the wife has compelled the husband to wear devices which rendered conception impossible. This is a highly reprehensible procedure. If continued for any length of time it will seriously affect the husband's nervous system and general health, as this act is simply a form of self-abuse. Any husband who will tolerate such imposition is beginning married life wrong. He will pay a high price for his complacency. Any woman who suggests or acquiesces in such an arrangement is a moral degenerate and is absolutely unworthy of ever becoming a mother.
Some women buy expensive and fantastic syringes and proceed to abuse themselves with strong antiseptic solutions. This will result in killing the sensitiveness of the terminal nerves and end in depriving themselves of the pleasure with which a wise Providence endowed the procreative act. If the element of sexual incompetency enters the home of a young couple, it is the beginning of the end and each chapter of the story will be a worse hell than the one just ended. The wise husband will see that its cause will not be tolerated or begun in his family.
If pregnancy should unwittingly occur they do not hesitate to adopt drastic means to "bring themselves around." They will procure some prescription which may have gone the rounds as a "marvel" but which always fortunately fails when they need it most. Thus they subject their system to the shock of violent medication and lay up for themselves in the future untold miseries. If these means fail, they go to "a woman whom they know" who "brings them around." If these young wives only knew what they were doing they could not be bought at any price to submit to such surgical tragedies. The least probable result will be that when the time arrives and circumstances are opportune to have a baby, and when it is their dearest wish to be a mother, they will discover that they no longer possess the ability to conceive. Many homes have been rendered childless in just this way. You cannot violate the laws of nature without paying the penalty in some way, and it is usually a sad reckoning.
What the Woman With Female Disease Should Do.—To those wives who are suffering with "female weakness," or who are in poor health without apparent or known cause, I would strongly advise a visit to their family physician or to an expert in diseases of women. Tell him exactly how you feel and submit to a thorough examination. Most of the diseases of women are readily curable, and if treated right all the symptoms which have rendered life miserable will disappear. It may be stated with the strongest emphasis, however, that no treatment from an advertising concern, or any patent medicine ever made, will in any sense cure any of these ailments. Every cent invested in any of these nostrums is money wasted. Medicine by the mouth is never necessary to affect a cure of the actual ailment. A physician will doubtless prescribe a tonic for your general rundown condition. But even this would totally fail if the cause of the ill health was not removed, and this necessitates an examination and special local treatment. For any advertising concern to assert that it can tell what ails a patient by simply filling out a symptom blank is utter nonsense. It is worse. It is obtaining money underfalse pretenses, and should be punishable by imprisonment at hard labor for a long term.
My only object in referring to this disease is to direct the attention of women to its symptoms.
The only cure for cancer at the present time is the knife. If the disease can be reached it can be cured, if taken in hand early.
In women, cancer occurs most frequently in the breast and in the womb.
Cancer of the Breast.—Of all the tumors which affect the breast, cancer is the most frequent. Any tumor in the breast of a woman forty years of age or more is quite likely to be a cancer. A tumor (or lump) which has remained small for years and then begins to grow rapidly has changed its type and become cancerous. Many such tumors change in this way during the "change of life." Any tumor of the breast, at any age, which remains despite effort to dissipate it should be removed by operation. A physician is not justified in assuring a woman that a lump in the breast is harmless. It should be cut into and examined to positively decide its character. Early operation of tumors of the breast has greatly reduced the percentage of deaths from cancer.
Cancer of the Womb.—Occasional slight hemorrhages becoming more frequent, and later more abundant and offensive, constitute one of the first symptoms of cancer of the womb. Between the actual bleedings there is a discharge resembling dish-water. This discharge has a foul odor. Pain is as a rule a late symptom. Sometimes a severe pain extending into the hip or abdomen is an early symptom but it is very infrequent. Every woman over thirty who has a persistent leucorrhea, or any irregularity of the menstrual function, should be examined for cancer.
What Every Woman Should Know About Cancer.—Inasmuch as cancer is curable if taken early, every woman should take steps to be on the safe side.
If cancer is not taken early, it is certain death. Avery large number die who could have been saved.
Every lump in the breast should be positively diagnosed by cutting into it and examining it. It would be safer to remove every tumor of the breast at an early date.
Any discharge from the privates of a woman which has a bad or foul odor is suspicious; any irregular bleeding is more than suspicious. Any woman having these symptoms should be examined by a competent physician. Every woman over thirty-five years of age should be examined by a physician every six months. No woman should enter the change of life without a very thorough examination. Cancer is a disease which does not permit "taking a chance" with. It is far better to be certain, since it is curable if caught early, than to find out about it when too late, because, "too late" means death.
The average period of life during which a woman menstruates is from thirty to thirty-two years. When this period is about to expire she enters what is termed the "change of life," or the menopause, or the climacteric.
The average age at which "change of life" occurs in this country is about the forty-sixth year. It may normally occur, however, at any time between the fortieth and fiftieth year. There are cases on record when it has occurred earlier than the fortieth and later than the fiftieth year. When menstruation in a girl begins early, the menopause occurs late. On the other hand, if a girl does not have her regular monthly periods until she is older than usual,—about the eighteenth or twentieth year,—the "change of life" will set in at a very early age. Women who are victims of certain exhausting diseases, as, consumption, Bright's disease of the kidney, diabetes, or whose health is poor because of general physical debility from any cause, or who have had a large number of children in rapid succession, enter the "change of life" earlier than they otherwise would if their health was good. In women who are excessively fat the menopause is apt to occur at an early age. Onthe other hand disease of the generative organs, or the presence of tumors of the womb may retard the process. Women in the higher walk of life, those living in cities those who do not labor or exercise sufficiently will enter this period at an earlier date than those who live in the country, who work and are physically more healthy.
Symptoms of "Change of Life."—When the menopause begins, the monthly periods are less profuse, the flow is scanty. As the months pass, menstruation becomes less and less until it ceases entirely. In a certain number of cases it stops abruptly and never appears again. Sometimes a period misses altogether, or a number of periods are passed over without any sign of menstruation, after which it may reappear either as a scanty flow, or as a profuse discharge. This may be followed for a number of months by irregular appearances of the menstrual phenomenon and then by its total cessation.
These may be the only symptoms or signs of the "change of life," and this is the normal state if the health is good. It cannot, however, be said that this is the average experience. Unfortunately the women of the present time do not live lives which conduce to robust health at this period of life. We find as a rule that the general health is below par. So they suffer from headache, "flushes," digestive disturbances, and many nervous symptoms which appear to be directly caused by the process through which they are passing. The "flushes" are disagreeable experiences. They consist of a feeling of heat which spreads over the entire body as if the blood was rushing to the surface and to the head. These flushes are followed by sweating and chilly sensations. The nervous symptoms may be quite marked. The woman loses her interest in the daily happenings. She may have mental vagaries, she is irritable and often melancholy and periods of seeming insanity may occur.
Importance of a Correct Diagnosis.—It is a mistake to attribute every symptom a woman may have at this time of life to the menopause. She is just as liable to develop conditions at this time, which she would at any age, and which have no relation to the "change of life." Every symptom should, therefore, be carefully investigated,because serious conditions may complicate the menopause, and if attributed to it and neglected, may end disastrously.
During the "change of life," the generative organs become smaller or, as it has been termed, "dry up." The breasts also are involved in the shrinking process. It is quite a common experience for women to "lay on" fat, to become "flabby," at this age.
It is important that women should become familiar with the ordinary symptoms of the "change of life," in order that they may be constantly on guard against conditions that may indicate danger. Medical investigation has conclusively proved that many women lose their lives because they regarded the presence of certain symptoms as common to the "change of life." There is a tendency to disease at this time which must be intelligently considered, and if women are not posted to note unusual signs or symptoms they may neglect or ignore them, only to find when too late that these signs and symptoms were no part of the "change of life."
The Danger Signals of the Change of Life.—There are certain "danger signals" which should warn every woman that something is amiss, these are:—
(1) Profuse bleeding during the process of the "change."
(2) Bleeding occurring between the regular menstrual periods.
(3) The reappearance of slight bleedings or hemorrhages after menstruation has ceased for a number of months.
These symptoms are always suggestive of the presence of conditions that should not exist. They may indicate cancer, or some less serious condition that is amenable to cure by prompt and efficient treatment. Inasmuch as they may mean the beginning of cancer,—as explained in the preceding chapter on cancer, and which should be read in this connection,—immediate steps should be taken to find out the actual facts. Delay means death if it is cancer, while the most recent statistics show that in many cases a complete cure is possible if the surgeon gets the case early.
Conduct During "Change of Life."—When a woman enters the "change of life" she is approaching a crisis that demands the most conscientious attention on her own part, and the sincerest consideration by all around her. She has reached the time of life when she owes herself something, and if she is wise she will willingly pay the debt. If she is not in good health she must make every effort to regain it promptly, even if radical measures must be employed in doing so. Nothing will contribute to her mental and physical comfort more than robust health during this period.
She must employ every hygienic measure that experience has taught us contributes to our well being. She must live an outdoor life as much as possible, taking sufficient exercise to keep the muscles and bodily functions in good condition. If she cannot exercise enough she should sit out of doors, dressed in seasonable clothing, and she should make up the deficiency in exercise by employing a competent masseuse. A thorough massage twice a week is sufficient. If her physician recommends an occasional Turkish bath it is a desirable aid as it helps the skin to throw off any excess of waste matter that may be circulating in the blood.
The home environment of these women should be congenial, and they should be relieved of the work and worry incident to domestic life. The nervous condition demands this degree of consideration, and the husband should make it his business to see that the wife, who has toiled to aid him during all the long years of married companionship, is accorded every possible help through the most trying and important period of her life. It is not to be understood, however, that she should be left without occupation. It is possible to indulge in congenial work which will occupy her time and attention without overtaxing her strength or fraying her nerves. A certain amount of amusement is desirable, and helps to tide over periods that might lag and encourage introspection and worry. An entire change of scenery and surroundings. A visit to the seashore or to the mountains is to be commended.
During this period the diet should be simple and thebowels should be kept open regularly. Inasmuch as these patients frequently suffer from digestive disturbances, it is wise to refrain from those articles of diet that ordinarily cause indigestion. Such articles are, sweet dishes, pies, pastries, candies, fresh bread, fried food, sugars, and the relishes and seasoning extras which constitute the et ceteras of the table. Meat should never be taken to excess, alcohol and all stimulants are to be avoided. Water may be taken freely to advantage.