There is some slight difference of opinion among authorities as to the precise nature and causation of the sickness of pregnancy. Barnes, Horrocks and others regard it as physiological; but many consider it pathological; this is, for instance, the opinion of Giles. Graily Hewitt attributed it to flexion of the gravid uterus, Kaltenbach to hysteria, and Zaborsky terms it a neurosis. Whitridge Williams considers that it may be (1) reflex, or (2) neurotic (when it is allied to hysteria and amenable to suggestion), or (3) toxaemic. It really appears to lie on the borderland between healthy and diseased manifestations. It is said to be unknown to farmers and veterinary surgeons. It appears to be little known among savages; it is comparatively infrequent among women of the lower social cla.s.ses, and, as Giles has found, women who habitually menstruate in a painless and normal manner suffer comparatively little from the sickness of pregnancy.
We owe a valuable study of the sickness of pregnancy to Giles, who a.n.a.lyzed the records of 300 cases. He concluded that about one-third of the pregnant women were free from sickness throughout pregnancy, 45 per cent. were free during the first three months. When sickness occurred it began in 70 per cent. of cases in the first month, and was most frequent during the second month. The duration varied from a few days to all through. Between the ages of 20 and 25 sickness was least frequent, and there was less sickness in the third than in any other pregnancy. (This corresponds with the conclusion of Matthews Duncan that 25 is the most favorable age for pregnancy.) To some extent in agreement with Gueniot, Giles believes that the vomiting of pregnancy is "one form of manifestation of the high nervous irritability of pregnancy." This high nervous tension may overflow into other channels, into the vascular and excretory system, causing eclampsia; into the muscular system, causing ch.o.r.ea, or, expending itself in the brain, give rise to hysteria when mild or insanity when severe. But the vagi form a very ready channel for such overflow, and hence the frequency of sickness in pregnancy. There are thus three main factors in the causation of this phenomenon: (1) An increased nervous irritability; (2) a local source of irritation; (3) a ready efferent channel for nervous energy. (Arthur Giles, "Observations on the Etiology of the Sickness of Pregnancy," Transactions Obstetrical Society of London, vol. xxv, 1894.)
Martin, who regards the phenomenon as normal, points out that when nausea and vomiting are absent or suddenly cease there is often reason to suspect something wrong, especially the death of the embryo. He also remarks that women who suffer from large varicose veins are seldom troubled by the nausea of pregnancy. (J. M. H. Martin, "The Vomiting of Pregnancy," British Medical Journal, December 10, 1904.) These observations may be connected with those of Evans (American Gynaecological and Obstetrical Journal, January, 1900), who attributes primary importance to the undoubtedly active factor of the irritation set up by the uterus, more especially the rhythmic uterine contractions; stimulation of the b.r.e.a.s.t.s produces active uterine contractions, and Evans found that examination of the b.r.e.a.s.t.s sufficed to bring on a severe attack of vomiting, while on another occasion this was produced by a v.a.g.i.n.al examination. Evans believes that the purpose of these contractions is to facilitate the circulation of the blood through the large venous sinuses, the surcharging of the relatively stagnant pools with effete blood producing the irritation which leads to rhythmic contractions.
It is on the basis of the increased vascular and glandular activity and the heightened nervous tension that the special psychic phenomena of pregnancy develop. The best known, and perhaps the most characteristic of these manifestations, is that known as "longings." By this term is meant more or less irresistible desires for some special food or drink, which may be digestible or indigestible, sometimes a substance which the woman ordinarily likes, such as fruit, and occasionally one which, under ordinary circ.u.mstances, she dislikes, as in one case known to me of a young country woman who, when bearing her child, was always longing for tobacco and never happy except when she could get a pipe to smoke, although under ordinary circ.u.mstances, like other young women of her cla.s.s, she was without any desire to smoke. Occasionally the longings lead to actions which are more unscrupulous than is common in the case of the same person at other times; thus in one case known to me a young woman, pregnant with her first child, insisted to her sister"s horror on entering a strawberry field and eating a quant.i.ty of fruit. These "longings" in their extreme form may properly be considered as neurasthenic obsessions, but in their simple and less p.r.o.nounced forms they may well be normal and healthy.
The old medical authors abound in narratives describing the longings of pregnant women for natural and unnatural foods. This affection was commonly called pica, sometimes citra or malatia. Schurig, whose works are a comprehensive treasure house of ancient medical lore, devotes a long chapter (cap. II) of his Chylologia, published in 1725, to pica as manifested mainly, though not exclusively, in pregnant women. Some women, he tells us, have been compelled to eat all sorts of earthy substances, of which sand seems the most common, and one Italian woman when pregnant ate several pounds of sand with much satisfaction, following it up with a draught of her own urine. Lime, mud, chalk, charcoal, cinders, pitch are also the desired substances in other cases detailed. One pregnant woman must eat bread fresh from the oven in very large quant.i.ties, and a certain n.o.ble matron ate 140 sweet cakes in one day and night. Wheat and various kinds of corn as well as of vegetables were the foods desired by many longing women. One woman was responsible for 20 pounds of pepper, another ate ginger in large quant.i.ties, a third kept mace under her pillow; cinnamon, salt, emulsion of almonds, treacle, mushrooms were desired by others. Cherries were longed for by one, and another ate 30 or 40 lemons in one night. Various kinds of fish-mullet, oysters, crabs, live eels, etc.-are mentioned, while other women have found delectation in lizards, frogs, spiders and flies, even scorpions, lice and fleas. A pregnant woman, aged 33, of sanguine temperament, ate a live fowl completely with intense satisfaction. Skin, wool, cotton, thread, linen, blotting paper have been desired, as well as more repulsive substances, such as nasal mucus and feces (eaten with bread). Vinegar, ice, and snow occur in other cases. One woman stilled a desire for human flesh by biting the nates of children or the arms of men. Metals are also swallowed, such as iron, silver, etc. One pregnant woman wished to throw eggs in her husband"s face, and another to have her husband throw eggs in her face.
In the next chapter of the same work Schurig describes cases of acute antipathy which may arise under the same circ.u.mstances (cap. III, "De Nausea seu Antipathia certorum ciborum"). The list includes bread, meat, fowls, fish, eels (a very common repulsion), crabs, milk, b.u.t.ter (very often), cheese (often), honey, sugar, salt, eggs, caviar, sulphur, apples (especially their odor), strawberries, mulberries, cinnamon, mace, capers, pepper, onions, mustard, beetroot, rice, mint, absinthe, roses (many pages are devoted to this antipathy), lilies, elder flowers, musk (which sometimes caused vomiting), amber, coffee, opiates, olive oil, vinegar, cats, frogs, spiders, wasps, swords.
More recently Gould and Pyle (Anomalies and Curiosities of Medicine, p. 80) have briefly summarized some of the ancient and modern records concerning the longings of pregnant women.
Various theories are put forward concerning the causation of the longings of pregnant women, but none of these seems to furnish by itself a complete and adequate explanation of all cases. Thus it is said that the craving is the expression of a natural instinct, the system of the pregnant woman really requiring the food she longs for. It is quite probable that this is so in many cases, but it is obviously not so in the majority of cases, even when we confine ourselves to the longings for fairly natural foods, while we know so little of the special needs of the organism during pregnancy that the theory in any case is insusceptible of clear demonstration.
Allied to this theory is the explanation that the longings are for things that counteract the tendency to nausea and sickness. Giles, however, in his valuable statistical study of the longings of a series of 300 pregnant women, has shown that the percentage of women with longings is exactly the same (33 per cent.) among women who had suffered at some time during pregnancy from sickness as among the women who had not so suffered. Moreover, Giles found that the period of sickness frequently bore no relation to the time when there were cravings, and the patient often had cravings after the sickness had ceased.
According to another theory these longings are mainly a matter of auto-suggestion. The pregnant woman has received the tradition of such longings, persuades herself that she has such a longing, and then becomes convinced that, according to a popular belief, it will be bad for the child if the longing is not gratified. Giles considers that this process of auto-suggestion takes place "in a certain number, perhaps even in the majority of cases."[184]
The d.u.c.h.ess d"Abrantes, the wife of Marshal Junot, in her Memoires gives an amusing account of how in her first pregnancy a longing was apparently imposed upon her by the anxious solicitude of her own and her husband"s relations. Though suffering from constant nausea and sickness, she had no longings. One day at dinner after the pregnancy had gone on for some months her mother suddenly put down her fork, exclaiming: "I have never asked you what longing you have!" She replied with truth that she had none, her days and her nights being occupied with suffering. "No envie!" said the mother, "such a thing was never heard of. I must speak to your mother-in-law." The two old ladies consulted anxiously and explained to the young mother how an unsatisfied longing might produce a monstrous child, and the husband also now began to ask her every day what she longed for. Her sister-in-law, moreover, brought her all sorts of stories of children born with appalling mother"s marks due to this cause. She became frightened and began to wonder what she most wanted, but could think of nothing. At last, when eating a pastille flavored with pineapple, it occurred to her that pineapple is an excellent fruit, and one, moreover, which she had never seen, for at that time it was extremely rare. Thereupon she began to long for pineapple, and all the more when she was told that at that season they could not be obtained. She now began to feel that she must have pineapple or die, and her husband ran all over Paris, vainly offering twenty louis for a pineapple. At last he succeeded in obtaining one through the kindness of Mme. Bonaparte, and drove home furiously just as his wife, always talking of pineapples, had gone to bed. He entered the room with the pineapple, to the great satisfaction of the d.u.c.h.ess"s mother. (In one of her own pregnancies, it appears, she longed in vain for cherries in January, and the child was born with a mark on her body resembling a cherry-in scientific terminology, a naevus.) The d.u.c.h.ess effusively thanked her husband and wished to eat of the fruit immediately, but her husband stopped her and said that Corvisart, the famous physician, had told him that she must on no account touch it at night, as it was extremely indigestible. She promised not to do so, and spent the night in caressing the pineapple. In the morning the husband came and cut up the fruit, presenting it to her in a porcelain bowl. Suddenly, however, there was a revulsion of feeling; she felt that she could not possibly eat pineapple; persuasion was useless; the fruit had to be taken away and the windows opened, for the very smell of it had become odious. The d.u.c.h.ess adds that henceforth, throughout her life, though still liking the flavor, she was only able to eat pineapple by doing a sort of violence to herself. (Memories de la d.u.c.h.esse d"Abrantes, vol. iii, Chapter VIII.) It should be added that, in old age, the d.u.c.h.ess d"Abrantes appears to have become insane.
The influence of suggestion must certainly be accepted as, at all events, increasing and emphasizing the tendency to longings. It can scarcely, however, be regarded as a radical and adequate explanation of the phenomenon generally. If it is a matter of auto-suggestion due to a tradition, then we should expect to find longings most frequent and most p.r.o.nounced in multiparous women, who are best acquainted with the tradition and best able to experience all that is expected of a pregnant woman. But, as a matter of fact, the women who have borne most children are precisely those who are least likely to be affected by the longings which tradition demands they should manifest. Giles has shown that longings occur much more frequently in the first than in any subsequent pregnancy; there is a regular decrease with the increase in number of pregnancies until in women with ten or more children the longings scarcely occur at all.
We must probably regard longings as based on a physiological and psychic tendency which is of universal extension and almost or quite normal. They are known throughout Europe and were known to the medical writers of antiquity. Old Indian as well as old Jewish physicians recognized them. They have been noted among many savage races to-day: among the Indians of North and South America, among the peoples of the Nile and the Soudan, in the Malay archipelago.[185] In Europe they are most common among the women of the people, living simple and natural lives.[186]
The true normal relationship of the longings of pregnancy is with the impulsive and often irresistible longings for food delicacies which are apt to overcome children, and in girls often persist or revive through adolescence and even beyond. Such sudden fits of greediness belong to those kind of normal psychic manifestations which are on the verge of the abnormal into which they occasionally pa.s.s. They may occur, however, in healthy, well-bred, and well-behaved children who, under the stress of the sudden craving, will, without compunction and apparently without reflection, steal the food they long for or even steal from their parents the money to buy it. The food thus seized by a well-nigh irresistible craving is nearly always a fruit. Fruit is usually doled out to children in small quant.i.ties as a luxury, but we are descended from primitive human peoples and still more remote ape-like ancestors, by whom fruit was in its season eaten copiously, and it is not surprising that when that season comes round the child, more sensitive than the adult to primitive influences, should sometimes experience the impulse of its ancestors with overwhelming intensity, all the more so if, as is probable, the craving is to some extent the expression of a physiological need.
Sanford Bell, who has investigated the food impulses of children in America, finds that girls have a greater number of likes and dislikes in foods than boys of the same age, though at the same time they have less dislikes to some foods than boys. The proclivity for sweets and fruits shows itself as soon as a child begins to eat solids. The chief fruits liked are oranges, bananas, apples, peaches, and pears. This strong preference for fruits lasts till the age of 13 or 14, though relatively weaker from 10 to 13. In girls, however, Bell notes the significant fact from our present point of view that at mid-adolescence there is a revived taste for sweets and fruits. He believes that the growth of children in taste in foods recapitulates the experience of the race. (S. Bell, "An Introductory Study of the Psychology of Foods." Pedagogical Seminary, March, 1904.)
The heightened nervous impressionability of pregnancy would appear to arouse into activity those primitive impulses which are liable to occur in childhood and in the unmarried girl continue to the nubile age. It is a significant fact that the longings of pregnant women are mainly for fruit, and notably for so wholesome a fruit as the apple, which may very well have a beneficial effect on the system of the pregnant woman. Giles, in his tabulation of the foods longed for by 300 pregnant women, found that the fruit group was by far the largest, furnishing 79 cases; apples were far away at the head, occurring in 34 cases out of the 99 who had longings, while oranges followed at a distance (with 13 cases), and in the vegetable group tomatoes came first (with 6 cases). Several women declared "I could have lived on apples," "I was eating apples all day," "I used to sit up in bed eating apples."[187] Pregnant women appear seldom to long for the possession of objects outside the edible cla.s.s, and it seems doubtful whether they have any special tendency to kleptomania. Pinard has pointed out that neither Lasegue nor Lunier, in their studies of kleptomania, have mentioned a single shop robbery committed by a pregnant woman.[188] Brouardel has indeed found such cases, but the object stolen was usually a food.
A further significant fact connecting the longings of pregnant women with the longings of children is to be found in the fact that they occur mainly in young women. We have, indeed, no tabulation of the ages of pregnant women who have manifested longings, but Giles has clearly shown that these chiefly occur in primiparae, and steadily and rapidly decrease in each successive pregnancy. This fact, otherwise somewhat difficult of explanation, is natural if we look upon the longings of pregnancy as a revival of those of childhood. It certainly indicates also that we can by no means regard these longings as exclusively the expression of a physiological craving, for in that case they would be liable to occur in any pregnancy unless, indeed, it is argued that with each successive pregnancy the woman becomes less sensitive to her own physiological state.
There has been a frequent tendency, more especially among primitive peoples, to regard a pregnant woman"s longings as something sacred and to be indulged, all the more, no doubt, as they are usually of a simple and harmless character. In the Black Forest, according to Ploss and Bartels, a pregnant woman may go freely into other people"s gardens and take fruit, provided she eats it on the spot, and very similar privileges are accorded to her elsewhere. Old English opinion, as reflected, for instance, in Ben Jonson"s plays (as Dr. Harriet C. B. Alexander has pointed out), regards the pregnant woman as not responsible for her longings, and Kiernan remarks ("Kleptomania and Collectivism," Alienist and Neurologist, November, 1902) that this is in "a most natural and just view." In France at the Revolution a law of the 28th Germinal, in the year III, to some extent admitted the irresponsibility of the pregnant woman generally,-following the cla.s.sic precedent, by which a woman could not be brought before a court of justice so long as she was pregnant,-but the Napoleonic code, never tender to women, abrogated this. Pinard does not consider that the longings of pregnant women are irresistible, and, consequently, regards the pregnant woman as responsible. This is probably the view most widely held. In any case these longings seldom come up for medico-legal consideration.
The phenomena of the longings of pregnancy are linked to the much more obscure and dubious phenomena of the influence of maternal impressions on the child within the womb. It is true, indeed, that there is no real connection whatever between these two groups of manifestations, but they have been so widely and for so long closely a.s.sociated in the popular mind that it is convenient to pa.s.s directly from one to the other. The same name is sometimes given to the two manifestations; thus in France a pregnant longing is an envie, while a mother"s mark on the child is also called an envie, because it is supposed to be due to the mother"s unsatisfied longing.
The conception of a "maternal impression" (the German Versehen) rests on the belief that a powerful mental influence working on the mother"s mind may produce an impression, either general or definite, on the child she is carrying. It makes a great deal of difference whether the effect of the impression on the child is general, or definite and circ.u.mscribed. It is not difficult to believe that a general effect-even, as Sir Arthur Mitch.e.l.l first gave good reason for believing, idiocy-may be produced on the child by strong and prolonged emotional influence working on the mother, because such general influence may be transmitted through a deteriorated blood-stream. But it is impossible at present to understand how a definite and limited influence working on the mother could produce a definite and limited effect on the child, for there are no channels of nervous communications for the pa.s.sage of such influences. Our difficulty in conceiving of the process must, however, be put aside if the fact itself can be demonstrated by convincing evidence.
In order to ill.u.s.trate the nature of maternal impressions, I will summarize a few cases which I have collected from the best medical periodical literature during the past fifteen years. I have exercised no selection and in no way guarantee the authenticity of the alleged facts or the alleged explanation. They are merely examples to ill.u.s.trate a cla.s.s of cases published from time to time by medical observers in medical journals of high repute.
Early in pregnancy a woman found her pet rabbit killed by a cat which had gnawed off the two forepaws, leaving ragged stumps; she was for a long time constantly thinking of this. Her child was born with deformed feet, one foot with only two toes, the other three, the os calcis in both feet being either absent or little developed. (G. B. Beale, Tottenham, Lancet, May 4, 1889).
Three months and a half before birth of the child the father, a glazier, fell through the roof of a hothouse, severely cutting his right arm, so that he was lying in the infirmary for a long time, and it was doubtful whether the hand could be saved. The child was healthy, but on the flexor surface of the radial side of the right forearm just above the wrist-the same spot as the father"s injury-there was a naevus the size of a sixpence. (W. Russell, Paisley, Lancet, May 11, 1889.)
At the beginning of pregnancy a woman was greatly scared by being kicked over by a frightened cow she was milking; she hung on to the animal"s teats, but thought she would be trampled to death, and was ill and nervous for weeks afterwards. The child was a monster, with a fleshy substance-seeming to be prolonged from the spinal cord and to represent the brain-projecting from the floor of the skull. Both doctor and nurse were struck by the resemblance to a cow"s teats before they knew the woman"s story, and this was told by the woman immediately after delivery and before she knew to what she had given birth. (A. Ross Paterson, Reversby, Lincolnshire, Lancet, September 29, 1889.)
During the second month of pregnancy the mother was terrified by a bullock as she was returning from market. The child reached full term and was a well-developed male, stillborn. Its head "exactly resembled a miniature cow"s head;" the occipital bone was absent, the parietals only slightly developed, the eyes were placed at the top of the frontal bone, which was quite flat, with each of its superior angles twisted into a rudimentary horn. (J. T. Hislop, Tavistock, Devon, Lancet, November 1, 1890.)
When four months pregnant the mother, a multipara of 30, was startled by a black and white collie dog suddenly pushing against her and rushing out when she opened the door. This preyed on her mind, and she felt sure her child would be marked. The whole of the child"s right thigh was encircled by a shining black mole, studded with white hairs; there was another mole on the spine of the left scapula. (C. F. Williamson, Horley, Surrey, Lancet, October 11, 1890.)
A lady in comfortable circ.u.mstances, aged 24, not markedly emotional, with one child, in all respects healthy, early in her pregnancy saw a man begging whose arms and legs were "all doubled up." This gave her a shock, but she hoped no ill effects would follow. The child was an encephalous monster, with the extremities rigidly flexed and the fingers clenched, the feet almost sole to sole. In the next pregnancy she frequently pa.s.sed a man who was a partial cripple, but she was not unduly depressed; the child was a counterpart of the last, except that the head was normal. The next child was strong and well formed. (C. W. Chapman, London, Lancet, October 18, 1890.)
When the pregnant mother was working in a hayfield her husband threw at her a young hare he had found in the hay; it struck her on the cheek and neck. Her daughter has on the left cheek an oblong patch of soft dark hair, in color and character clearly resembling the fur of a very young hare. (A. Mackay, Port Appin, N. B., Lancet, December 19, 1891. The writer records also four other cases which have happened in his experience.)
When the mother was pregnant her husband had to attend to a sow who could not give birth to her pigs; he bled her freely, cutting a notch out of both ears. His wife insisted on seeing the sow. The helix of each ear of her child at birth was gone, for nearly or quite half an inch, as if cut purposely. (R. P. Roons, Medical World, 1894.)
A lady when pregnant was much interested in a story in which one of the characters had a supernumerary digit, and this often recurred to her mind. Her baby had a supernumerary digit on one hand. (J. Jenkyns, Aberdeen, British Medical Journal, March 2, 1895. The writer also records another case.)
When pregnant the mother saw in the forest a new-born fawn which was a double monstrosity. Her child was a similar double monstrosity (cephalothora copagus). (Hartmann, Munchener Medicinisches Wochenschrift, No. 9, 1895.)
A well developed woman of 30, who had ten children in twelve years, in the third month of her tenth pregnancy saw a child run over by a street car, which crushed the upper and back part of its head. Her own child was anencephalic and acranial, with entire absence of vault of skull. (F. A. Stahl, American Journal of Obstetrics, April, 1896.)
A healthy woman with no skin blemish had during her third pregnancy a violent appet.i.te for sunfish. During or after the fourth month her husband, as a surprise, brought her some sunfish alive, placing them in a pail of water in the porch. She stumbled against the pail and the shock caused the fish to flap over the pail and come in violent contact with her leg. The cold wriggling fish produced a nervous shock, but she attached no importance to this. The child (a girl) had at birth a mark of bronze pigment resembling a fish with the head uppermost (photograph given) on the corresponding part of the same leg. Daughter"s health good; throughout life she has had a strong craving for sunfish, which she has sometimes eaten till she has vomited from repletion. (C. F. Gardiner, Colorado Springs, American Journal Obstetrics, February, 1898.)
The next case occurred in a b.i.t.c.h. A thoroughbred fox terrier b.i.t.c.h strayed and was discovered a day or two later with her right foreleg broken. The limb was set under chloroform with the help of Rontgen rays, and the dog made a good recovery. Several weeks later she gave birth to a puppy with a right foreleg that was ill-developed and minus the paw. (J. Booth, Cork, British Medical Journal, September 16, 1899.)
Four months before the birth of her child a woman with four healthy children and no history of deformity in the family fell and cut her left wrist severely against a broken bowl; she had a great fright and shock. Her child, otherwise perfect, was born without left hand and wrist, the stump of arm terminating at lower end of radius and ulna. (G. Ainslie Johnston, Ambleside, British Medical Journal, April 18, 1903.)
The belief in the reality of the transference of strong mental or physical impressions on the mother into physical changes in the child she is bearing is very ancient and widespread. Most writers on the subject begin with the book of Genesis and the astute device of Jacob in influencing the color of his lambs by mental impressions on his ewes. But the belief exists among even more primitive people than the early Hebrews, and in all parts of the world.[189] Among the Greeks there is a trace of the belief in Hippocrates, the first of the world"s great physicians, while Sora.n.u.s, the most famous of ancient gynaecologists, states the matter in the most precise manner, with instances in proof. The belief continued to persist unquestioned throughout the Middle Ages. The first author who denied the influence of maternal impressions altogether appears to have been the famous anatomist, Realdus Columbus, who was a professor at Padua, Pisa, and Rome at the beginning of the sixteenth century. In the same century, however, another and not less famous Neapolitan, Della Porta, for the first time formulated a definite theory of maternal impressions. A little later, early in the seventeenth century, a philosophic physician at Padua, Fortunatus Licetus, took up an intermediate position which still finds, perhaps reasonably, a great many adherents. He recognized that a very frequent cause of malformation in the child is to be found in morbid antenatal conditions, but at the same time was not prepared to deny absolutely and in every case the influence of maternal impression on such conditions. Malebranche, the Platonic philosopher, allowed the greatest extension to the power of the maternal imagination. In the eighteenth century, however, the new spirit of free inquiry, of radical criticism, and unfettered logic, led to a sceptical att.i.tude toward this ancient belief then flourishing vigorously.[190] In 1727, a few years after Malebranche"s death, James Blondel, a physician of extreme acuteness, who had been born in Paris, was educated at Leyden, and practiced in London, published the first methodical and thorough attack on the doctrine of maternal impressions, The Strength of Imagination of Pregnant Women Examined, and exercised his great ability in ridiculing it. Haller, Roederer, and Sommering followed in the steps of Blondel, and were either sceptical or hostile to the ancient belief. Blumenbach, however, admitted the influence of maternal impressions. Erasmus Darwin, as well as Goethe in his Wahlverwandtschaften, even accepted the influence of paternal impressions on the child. By the beginning of the nineteenth century the majority of physicians were inclined to relegate maternal impressions to the region of superst.i.tion. Yet the exceptions were of notable importance. Burdach, when all deductions were made, still found it necessary to retain the belief in maternal impressions, and Von Baer, the founder of embryology, also accepted it, supported by a case, occurring in his own sister, which he was able to investigate before the child"s birth. L. W. T. Bischoff, also, while submitting the doctrine to acute criticism, found it impossible to reject maternal impressions absolutely, and he remarked that the number of adherents to the doctrine was showing a tendency to increase rather than diminish. Johannes Muller, the founder of modern physiology in Germany, declared himself against it, and his influence long prevailed; Valentin, Rudolf Wagner, and Emil du Bois-Reymond were on the same side. On the other hand various eminent gynaecologists-Litzmann, Roth, Hennig, etc.-have argued in favor of the reality of maternal impressions.[191]
The long conflict of opinion which has taken place over this opinion has still left the matter unsettled. The acutest critics of the ancient belief constantly conclude the discussion with an expression of doubt and uncertainty. Even if the majority of authorities are inclined to reject maternal impressions, the scientific eminence of those who accept them makes a decisive opinion difficult. The arguments against such influence are perfectly sound: (1) it is a primitive belief of unscientific origin; (2) it is impossible to conceive how such influence can operate since there is no nervous connection between mother and child; (3) comparatively few cases have been submitted to severe critical investigation; (4) it is absurd to ascribe developmental defects to influences which arise long after the ftus had a.s.sumed its definite shape[192]; (5) in any case the phenomenon must be rare, for William Hunter could not find a coincidence between maternal impressions and ftal marks through a period of several years, and Bischoff found no case in 11,000 deliveries. These statements embody the whole of the argument against maternal impressions, yet it is clear that they do not settle the matter. Edgar, in a manual of obstetrics which is widely regarded as a standard work, states that this is "yet a mooted question."[193] Ballantyne, again, in a discussion of this influence at the Edinburgh Obstetrical Society, summarizing the result of a year"s inquiry, concluded that it is still "sub judice."[194] In a subsequent discussion of the question he has somewhat modified his opinion, and is inclined to deny that definite impressions on the pregnant woman"s mind can cause similar defects in the ftus; they are "accidental coincidences," but he adds that a few of the cases are difficult to explain away. At the same time he fully believes that prolonged and strongly marked mental states of the mother may affect the development of the ftus in her uterus, causing vascular and nutritive disturbances, irregularities of development, and idiocy.[195]
Whether and in how far mental impressions on the mother can produce definite mental and emotional disposition in the child is a special aspect of the question to which scarcely any inquiry has been devoted. So distinguished a biologist as Mr. A. W. Wallace has, however, called attention to this point, bringing forward evidence on the question and emphasizing the need of further investigation. "Such transmission of mental influence," he remarks, "will hardly be held to be impossible or even very improbable," (A. W. Wallace, "Prenatal Influences on Character," Nature, August 24, 1893.)
It has already been pointed out that a large number of cases of ftal deformities, supposed to be due to maternal impressions, cannot possibly be so caused because the impression took place at a period when the development of the ftus must already have been decided. In this connection, however, it must be noted that Dabney has observed a relationship between the time of supposed mental impressions and the nature of the actual defect which is of considerable significance as an argument in favor of the influence of mental impressions. He tabulated 90 carefully reported cases from recent medical literature, and found that 21 of them were concerned with defects of structure of the lips and palate. In all but 2 of these 21 the defect was referred to an impression occurring within the first three months of pregnancy. This is an important point as showing that the a.s.signed cause really falls within a period when a defect of development actually could produce the observed result, although the person reporting the cases was in many instances manifestly ignorant of the details of embryology and teratology. There was no such preponderance of early impressions among the defects of skin and hair which might well, so far as development is concerned, have been caused at a later period; here, in 7 out of 15 cases, it was distinctly stated that the impression was made later than the fourth month.[196]
It would seem, on the whole, that while the influence of maternal impressions in producing definite effects on the child within the womb has by no means been positively demonstrated, we are not ent.i.tled to reject it with any positive a.s.surance. Even if we accept it, however, it must remain, for the present, an inexplicable fact; the modus operandi we can scarcely even guess at. General influences from the mother on the child we can easily conceive of as conveyed by the mother"s blood; we can even suppose that the modified blood might act specifically on one particular kind of tissue. We can, again, as suggested by Fere, very well believe that the maternal emotions act upon the womb and produce various kinds and degrees of pressure on the child within, so that the apparently active movements of the ftus may be really consecutive on unconscious maternal excitations.[197] We may also believe that, as suggested by John Thomson, there are slight incoordinations in utero, a kind of developmental neurosis, produced by some slight lack of harmony of whatever origin, and leading to the production of malformations.[198] We know, finally, that, as Fere and others have repeatedly demonstrated during recent years by experiments on chickens, etc., very subtle agents, even odors, may profoundly affect embryonic development and produce deformity. But how the mother"s psychic disposition can, apart from heredity, affect specifically the physical conformation or even the psychic disposition of the child within her womb must remain for the present an insoluble mystery, even if we feel disposed to conclude that in some cases such action seems to be indicated.
In comprehending such a connection, however at present undemonstrated, it may well be borne in mind that the relationship of the mother to the child within her womb is of a uniquely intimate character. It is of interest in this connection to quote some remarks by an able psychologist, Dr. Henry Rutgers Marshall; the remarks are not less interesting for being brought forward without any connection with the question of maternal impressions: "It is true that, so far as we know, the nervous system of the embryo never has a direct connection with the nervous system of the mother: nevertheless, as there is a reciprocity of reaction between the physical body of the mother and its embryonic parasite, the relation of the embryonic nervous system to the nervous system of the mother is not very far removed from the relation of the pre-eminent part of the nervous system of a man to some minor nervous system within his body which is to a marked extent dissociated from the whole neural ma.s.s.
"Correspondingly, then, and within the consciousness of the mother, there develops a new little minor consciousness which, although but lightly integrated with the ma.s.s of her consciousness, nevertheless has its part in her consciousness taken as a whole, much as the psychic correspondents of the action of the nerve which govern the secretions of the glands of the body have their part in her consciousness taken as a whole.
"It is very much as if the optic ganglia developed fully in themselves, without any closer connection with the rest of the brain than existed at their first appearance. They would form a little complex nervous system almost but not quite apart from the brain system; and it would be difficult to deny them a consciousness of their own; which would indeed form part of the whole consciousness of the individual, but which would be in a manner self-dependent." It must, if this is so, be said that before birth, on the psychic side, the embryo"s activities "form part of a complex consciousness which is that of the mother and embryo together." "Without subscribing to the strange stories of telepathy, of the solemn apparition of a person somewhere at the moment of his death a thousand miles away, of the unquiet ghost haunting the scenes of its bygone hopes and endeavors, one may ask" (with the author of the address in medicine at the Leicester gathering of the British Medical a.s.sociation, British Medical Journal, July 29, 1905) "whether two brains cannot be so tuned in sympathy as to transmit and receive a subtile transfusion of mind without mediation of sense. Considering what is implied by the human brain with its countless millions of cells, its complexities of minute structure, its innumerable chemical compositions, and the condensed forces in its microscopic and ultramicroscopic elements-the whole a sort of microcosm of cosmic forces to which no conceivable compound of electric batteries is comparable; considering, again, that from an electric station waves of energy radiate through the viewless air to be caught up by a fit receiver a thousand miles distant, it is not inconceivable that the human brain may send off still more subtile waves to be accepted and interpreted by the fitly tuned receiving brain. Is it, after all, mere fancy that a mental atmosphere or effluence emanates from one person to affect another, either soothing sympathetically or irritating antipathically?" These remarks (like Dr. Marshall"s) were made without reference to maternal impressions, but it may be pointed out that under no conceivable circ.u.mstance could we find a brain in so virginal and receptive a state as is the child"s in the womb.
On the whole we see that pregnancy induces a psychic state which is at once, in healthy persons, one of full development and vigor, and at the same time one which, especially in individuals who are slightly abnormal, is apt to involve a state of strained or overstrained nervous tension and to evoke various manifestations which are in many respects still imperfectly understood. Even the specifically s.e.xual emotions tend to be heightened, more especially during the earlier period of pregnancy. In 24 cases of pregnancy in which the point was investigated by Harry Campbell, s.e.xual feeling was decidedly increased in 8, in one case (of a woman aged 31 who had had four children) being indeed only present during pregnancy, when it was considerable; in only 7 cases was there diminution or disappearance of s.e.xual feeling.[199] Pregnancy may produce mental depression;[200] but on the other hand it frequently leads to a change of the most favorable character in the mental and general well-being. Some women indeed are only well during pregnancy. It is remarkable that some women who habitually suffer from various nervous troubles-neuralgias, gastralgia, headache, insomnia-are only free from them at this moment. This "paradox of gestation," as Vinay has termed it, is specially marked in the hysterical and those suffering from slight nervous disorders, but it is by no means universal, so that although it is possible, Vinay states, to confirm the opinion of the ancients as to the beneficial action of marriage on hysteria, that is only true of slight cases and scarcely enables us to counsel marriage in hysteria.[201] Even a woman"s intelligence is sometimes heightened by pregnancy, and Tarnier, as quoted by Vinay, knew many women whose intelligence, habitually somewhat obtuse, has only risen to the normal level during pregnancy.[202] The pregnant woman has reached the climax of womanhood; she has attained to that state toward which the periodically recurring menstrual wave has been drifting her at regular intervals throughout her s.e.xual life[203]; she has achieved that function for which her body has been constructed, and her mental and emotional disposition adapted, through countless ages.
And yet, as we have seen, our ignorance of the changes effected by the occurrence of this supremely important event-even on the physical side-still remains profound. Pregnancy, even for us, the critical and unprejudiced children of a civilized age, still remains, as for the children of more primitive ages, a mystery. Conception itself is a mystery for the primitive man, and may be produced by all sorts of subtle ways apart from s.e.xual connection, even by smelling a flower.[204] The pregnant woman was surrounded by ceremonies, by reverence and fear, often shut up in a place apart.[205] Her presence, her exhalations, were of extreme potency; even in some parts of Europe to-day, as in the Walloon districts of Belgium, a pregnant woman must not kiss a child for her breath is dangerous, or urinate on plants for she will kill them.[206] The mystery has somewhat changed its form; it still remains. The future of the race is bound up with our efforts to fathom the mystery of pregnancy. "The early days of human life," it has been truly said, "are entirely one with the mother. On her manner of life-eating, drinking, sleeping, and thinking-what greatness may not hang?"[207] Schopenhauer observed, with misapplied horror, that there is nothing a woman is less modest about than the state of pregnancy, while Weininger exclaims: "Never yet has a pregnant woman given expression in any form-poem, memoirs, or gynaecological monograph-to her sensations or feelings."[208] Yet when we contemplate the mystery of pregnancy and all that it involves, how trivial all such considerations become! We are here lifted into a region where our highest intelligence can only lead us to adoration, for we are gazing at a process in which the operations of Nature become one with the divine task of Creation.
[169]
See, e.g., Groos, aesthetische Genuss, p. 249. "We have to admit," Groos observes, "the entrance of another instinct, the impulse to tend and foster, so closely connected with the s.e.xual life. It is seemingly due to the co-operation of this impulse that the little female bird during courtship is so often fed by the male like a young fledgling. In man "love" from the biological standpoint is also an amalgamation of two needs; when the tender need to protect and foster and serve is lacking the emotion is not quite perfect. Heine"s expression, "With my mantle I protect you from the storm," has always seemed to me very characteristic." Sometimes the s.e.xual impulse may undergo a complete transformation in this direction. "I believe there is really a tendency in women," a lady writes in a letter, "to allow maternal feeling to take the place of s.e.xual feeling. Very often a woman"s feeling for her husband becomes this (though he may be twenty years older than herself); sometimes it does not, remaining purely s.e.x feeling. Sometimes it is for some other man she has this curious self-obliterating maternal feeling. It is not necessarily connected with s.e.x intercourse. A prost.i.tute, who has relations with dozens of men, may have it for some feeble drunken fool, who perhaps goes after other women. I once saw the change from s.e.x feeling to mother feeling, as I call it, come almost suddenly over a woman after she had lived about four years with a man who was unfaithful to her. Then, when all real s.e.x feeling, the hatred of the woman he followed, the desire he should give her love and tenderness, had all gone, came the other feeling, and she said to me, "You don"t understand at all; he"s only my little baby; nothing he does can make any difference to me now." As I grow older and understand women"s natures better, I can see almost at once which relation it is a woman has to her husband, or any given man. It is this feeling, and not s.e.x pa.s.sion, that keeps woman from being free." Not only is there a s.e.xual a.s.sociation in the impulse to foster and protect, there would appear to be a similar element also in the response to that impulse. Freud has especially insisted on the partly s.e.xual character of the child"s feelings for those who care for it and tend it and satisfy its needs. It is begun in earliest infancy; "whoever has seen the sated infant sink back from the breast, to fall asleep with flushed cheeks and happy smile, must say that the picture is adequate to the expression of the s.e.xual satisfaction of later life." The lips, moreover, are the earliest erogenous zone. "There will, perhaps, be some opposition," Freud remarks (Drei Abhandlungen zur s.e.xualtheorie, pp. 36, 64), "to the identification of the child"s feelings of tenderness and appreciation for those who tend it with s.e.xual love, but I believe that exact psychological a.n.a.lysis will place the ident.i.ty beyond doubt. The relationship of the child with the person who tends it is for it a continual source of s.e.xual excitement and satisfaction flowing from the erogenous zones, especially since the fostering person-as a rule the mother-regards the child with emotions which proceed from her s.e.xual life; strokes it, kisses it, rocks it, and very plainly treats it as a compensation for a fully valid s.e.xual object." Freud remarks that girls who retain the childish character of their love for their parents to adult age are apt to make cold wives and to be s.e.xually anaesthetic.
[170]
Esbach (in his These de Paris, published in 1876) showed that even the finger nails are affected in pregnancy and become measurably thinner.
[171]
C. H. Stratz, Die Schonheit des Weiblichen Korpers, Chapter VI.
[172]