CAUSES WHICH ARE AVOIDABLE.
Most of them are the penalties inflicted by stern nature on infractions of her laws. Hence the great, the unspeakable, importance of women being made aware of the dangers to which they are exposed, and being fully informed how to avoid them. This task we now a.s.sume.
There is, we concede, a tendency in the changes which take place during pregnancy and parturition to expose the system to such accidents. But this tendency can be counteracted by care, and by the avoidance of certain notorious and familiar infractions of the laws of health. It is usually not until she gets up and commences to go about the house, that the woman feels any pain referable to a displaced womb. Very frequently the origin of it is leaving the bed too soon, or attempting to do some work, too much for her strength, shortly after a premature birth or a confinement. Not only should a woman keep her bed, as a rule, for nineteen days after every abortion and every confinement, but for weeks after she commences to move about she should avoid any severe muscular exertion, especially lifting, long walks, straining, or working on the sewing-machine. Straining at stool is one of the commonest causes. Many women have a tendency to constipation for weeks or months after childbirth. They are aware that it is unfavorable to health, and they seek to aid nature by violent muscular effort. They cannot possibly do a more unwise act. Necessarily the efforts they make press the womb forcibly down, and its ligaments being relaxed, it a.s.sumes either suddenly on some one well-remembered occasion, or gradually after a succession of efforts, some unnatural position. The same reasoning applies to relieving the bladder, which is connected in some persons with undue effort.
Constipation, if present, must, and almost always can, be relieved by a judicious diet, and the moderate use of injections. These simple methods are much to be preferred to purgative medicines, which are rarely satisfactory if they are continued for much time. When anything more is needed, we recommend a gla.s.s of some laxative mineral water, which should be taken before breakfast.
For the difficulty with the bladder we mentioned, diet is also efficacious. It is familiarly known that several popular articles of food have a decided action in stimulating the kidneys: for instance, asparagus and water-melon. Such articles should be freely partaken, and their effect can be increased by some vegetable infusion, taken warm,--as juniper-tea or broom-tea. The application to the parts of a cloth wrung out in water as hot as it can conveniently be borne, is also a most excellent a.s.sistant to nature.
Similar strains on the muscles of the abdomen are consequent on violent coughing and vomiting. Therefore these should be alleviated, as they always can be, by some anodyne taken internally. Any medical man is familiar with many such preparations, so that it seems unnecessary to give any formula, particularly as it would have to be altered, more or less, to suit any given case.
OTHER CAUSES OF INWARD WEAKNESS.
Women of languid disposition and relaxed muscles are frequently urged to "take exercise," and to "go to work." Their condition sometimes excites censure rather than commiseration, because it is thought that they do not exert, and thus strengthen, themselves as much as they should. We are quite as much in favour of work and vigorous muscles as any one. But often it were the most foolish advice possible to give a woman, to tell her to seek active exercise. It is just what she should avoid, as it may ultimately give rise to that very trouble which, now only threatening, is the cause of her listlessness. Many instances are familiar to every physician of extensive experience, where a long walk, a hard day"s work, a vigorous dance in the evening, or a horseback ride, has left behind it a uterine weakness which has caused years of misery. Especially after confinement or premature delivery it is prudent for a woman to avoid any such exertion for months and months. Moderate employment of her muscles in any light avocation, short walks and drives, fresh air, with judicious exercise,--these are well enough in every instance, but beyond them there is danger. We know too well that advice like this will sound like mockery to some who read these lines. They have to work, and work hard; they have no opportunity to spare themselves; the iron hand of necessity is upon them, and they must obey. We can but sympathize with them, and cheer them with the consolation that many a woman has borne all this and lived to a healthy and happy old age. Nature has surrounded the infinitely delicate machinery of woman"s organization with a thousand safeguards, but for all that, the delicacy remains; and it is because so many women are forced to neglect their duties to their ownselves, that so many thousands walk the streets of our great cities, living martyrs.
But no. We must modify what we have just written. In justice to our own s.e.x, and in all truthfulness, we cannot allow the blame to be removed altogether from women themselves. They alone are responsible for one of the most fruitful causes of their wretchedness. The theme is a threadbare one. We approach it without hardly any hope that we shall do good by repeated warnings utterly monotonous and tiresome. But still less can we feel comfortable in mind to pa.s.s it over in silence. We refer to the foolish and injurious pressure which is exerted on the lower part of the chest and the abdomen by tight corsets, belts, and bands to support the under-clothing; in other words,
TIGHT LACING.
Why it is, by what strange freak of fashion and blindness to artistic rules, women of the present day think that a deformed and ill-proportioned waist is a requisite of beauty, we do not know.
Certainly they never derived such an idea from a contemplation of those monuments of perfect beauty bequeathed to posterity by the chisels of Attic artists, nor from those exquisite figures which lend to the canvas of t.i.tian and Raphael such immortal fame. Look, for instance, at that work of the former artist, now rendered so familiar by the chromo-lithographic process, called "t.i.tian"s Daughter." It is the portrait of a blonde-haired maiden holding aloft a trencher heaped with fruits. She turns her face to the beholder, leaning slightly backward to keep her equilibrium. Her waist is encircled by a zone of pearls; and it is this waist we would have our readers observe with something more than an aesthetic eye. It is the waist of health as well as beauty. Narrower than either the shoulders or the hips, it is yet anything than that "wasplike waist," which is so fashionable a deformity. With such a waist, a woman is fitted to pa.s.s through her married state with health and pleasure. There is little fear that she will be the tenant of doctors" chairs, and the victim of drugs and instruments. Let women aim at beauty, let them regard it as a matter of very high importance, worth money and time and trouble, and we will applaud them to the echo. But let them not mistake deformity, vicious shape, unnatural and injurious att.i.tudes, and hurtful distortions for beauty. That not only degrades their physical nature, but it lowers their tastes, and places them in aesthetics on a level with the Indian squaw who flattens her head and bores her nose, and with the Chinese woman who gilds her teeth, and compresses her foot into a shapeless ma.s.s. True beauty is ever synonymous with health; and the woman who, out of subservience to the demands of fashion, for years squeezes her waist and flattens her breast, will live to rue it when she becomes a mother. Away, then, with tight corsets and all similar contrivances.
Of a similar objectionable character are many of the devices which ignorant men connected with the medical profession urge upon the public for the sake of remedying curvature of the spine, restoring the figure, or supporting the abdomen. Not a few of such braces and supporters are seriously dangerous. A good brace, well-fitting, carefully adjusted, suited to the particular case, is often of excellent service; but the majority of them do not answer this description. Our advice is, that no girl, and still more no mother, should wear one of these without it is fitted upon her by an experienced hand. We have known more than one instance where the binder put on after childbirth has been wrongly placed, and pinned so firmly that it has resulted in producing falling of the womb. This, too, should be sedulously looked after.
All these are causes which are strictly under the control of the woman herself. They are therefore such as she should have in mind and be on her guard against. There are others, but they are less frequent, which are beyond her power; and it would be labor lost, therefore, for us to mention them.
Equally vain would it be for us to speak of the various means by which difficulties of this nature are removed. Probably no one branch of medical surgery has been more a.s.siduously cultivated than this; and the number of supporters, pessaries, braces, and levers which have been recently brought before the medical profession for this purpose is simply appalling. There are women and men who make it their business to carry them through the country and sell them on commission. We distinctly warn our readers against this cla.s.s. They are almost invariably ignorant and unscrupulous, rich in promises, and regardless of performances. She who patronizes them will be sure to lose her money, and will be lucky if she does not forfeit her health also.
The most we shall do is to give some advice how to treat such complaints on principles of hygiene. And indeed this means nearly one-half the battle. For without these simple cares, treatment of any kind is useless, and sure to fail; and with them, many complaints are remedied as well as avoided.
THE HYGIENIC TREATMENT OF INWARD WEAKNESS.
The first point we would urge is, that the woman who finds herself thus afflicted should seek to have such a position that she can _rest_. If she is burdened with family cares, let her, if possible, diminish or escape them for a time. A rest of a month or two, not at a fashionable watering-place, nor at a first-cla.s.s hotel in some noisy city, but in quiet lodgings, or with some sympathizing friend, will be of great advantage. This she should obtain without travelling too far. Prolonged motion in railway carriages is in every instance injurious. If it must be undertaken, for instance, in order to consult a qualified physician or to reach some friends, the modern appliances of comfort, such as air-cushions, foot-rests, and head-supports, should be provided. They cost but little, and to the invalid their value is great. No such journey should be undertaken at or near the time when the monthly illness might come on, as the suffering is always greater at these periods.
The pleasant a.s.sociations which group themselves around a _happy home_ are an important element in the treatment of diseases which, like these, are so intimately connected with the mind and nervous system. It will not do heedlessly to throw such advantages away. When the home _is_ pleasant, and rest can there be had, the patient, in the majority of instances, will do well to abide there. But when this is not the case, for any reason, be it domestic infelicities, in which the husband has a share,--be it disagreeable relatives, or importunate and tedious visitors,--then the sooner such a mental weight is removed or avoided the better.
The _diet_ is a very common subject of error. It is popularly supposed that everybody who is weak should eat a "strengthening" diet,--meat three times a day,--eggs, ale, and beef-tea to any extent. This is a great error. Frequently such a diet has just the contrary effect from what is expected. The patient becomes dyspeptic, nervous, and more debilitated than ever. The rule is, that only that diet is strengthening which is thoroughly digested, and taken up in the system. Frequently, we may say in the majority of cases, a small amount of animal food, especially game, fowls, fish, and soups, with fresh vegetables, and ripe fruits, will be far more invigorating than heavier foods. Pastry, cakes, and confectionery should be discarded, and great regularity in the hours of meals observed. Stimulants of all kinds are, as a rule, unnecessary, and highly spiced food is to be avoided. There is an old German proverb which says, "Pepper helps a man on his horse, and a woman to her grave."
This is much too strong; but we may avail ourselves, in this connection, of the grain of truth that it contains.
_Cleanliness_, in its widest sense, is an important element in the treatment. Not only should the whole surface of the body be thoroughly washed several times a week, but the whole person should be _soaked_ by remaining in the water for an hour or more. This has an excellent effect, and is far from unpleasant. It was regarded in the days of ancient Rome as such a delightful luxury, and such a necessity, indeed, that every munic.i.p.ality erected public bathing establishments, with furnaces to heat the water to such a temperature that persons could remain in it for several hours without inconvenience.
The use of public baths is almost unknown in this country; but, in place of them, every modern house of even moderate pretensions has its own bath-room, so that the custom of cleanliness might appear to be hardly less general among all cla.s.ses than in old Rome.
The difficulty is, that so few people appreciate that to thoroughly cleanse the skin, still more for the bath to have a medicinal effect, it must be prolonged far beyond the usual time we allow it. The European physicians, who, as a rule, attach much greater importance to this than ourselves, require their patients to remain immersed two, three, four, and occasionally even ten or twelve hours daily! This is said to have most beneficial results; but who would attempt to introduce it in this country?
Local cleanliness is of equal importance. This is obtained by means of----
INJECTIONS AND IRRIGATIONS
of simple water, or of some infusion or solution. The use of the syringe as an article of essential service in preserving the health of married women should never be overlooked. Even when they are aware of no tendency to weakness or unusual discharge, it should be employed once or twice a week; and when there is debility or disease of the parts actually present, it is often of the greatest service.
There are many varieties of female syringes now manufactured and sold, some of which are quite worthless. Much the most convenient, cleanly, and efficient is the self-injecting india-rubber syringe, which is worked by means of a ball held in the hand, and which throws a constant and powerful stream. They come neatly packed in boxes, occupying small s.p.a.ce, and readily transported from place to place. Much depends on knowing how to apply them. The patient should be seated on the edge of a low chair or stool with a hard seat, immediately over a basin. The tube should then be introduced as far as possible without causing pain, and the liquid should be thrown up for five or ten minutes. About one or two quarts may be used of a temperature, in ordinary cases, a little lower than that of the apartment. Water actually cold is by no means to be recommended, in spite of what some physicians say to the contrary. It unquestionably occasionally leads to those very evils which the judicious use of the syringe is intended to avoid.
No fluid but water should be used in ordinary cases. When, however, there is much discharge, a pinch of powdered alum can be dissolved in the water; and when there is an unpleasant odor present, a sufficient amount of solution of permanganate of potash may be added to the water, to change it to a light pink color. This latter substance is most admirable in removing all unpleasant odors; but it will stain the clothing, and must on that account be employed with caution.
We will add a few warnings to what we have just said about injections.
There are times when they should be omitted,--as for instance during the periodical illness, when the body is either chilled or heated, and generally when their administration gives pain. There are also some women in whom the mouth of the womb remains open, especially those who have borne many children. In such cases, the liquid used is liable to be thrown into the womb itself, and may give rise to serious troubles.
These should either omit the use of the syringe altogether, or obtain one of those which throw the water backward and not forward. This variety is manufactured and sold by various dealers.
_Irrigations_ are more convenient in some respects than injections. They are administered in the following manner:--A jar holding about a gallon of water, simple or medicated, as may be advisable, is placed upon a table or high stand. A long india-rubber tube is attached to the bottom of the jar, ending in a metallic tube, and furnished with a stopc.o.c.k.
The patient seats herself on the edge of a chair over a basin, introduces the tube, and turns the stopc.o.c.k. The liquid is thus thrown up in a gentle, equable stream, without any exertion on her part. No a.s.sistant is required, and the force and amount of the liquid can be exactly graduated by elevating or lowering the jar, or by turning the stopc.o.c.k. When there is much debility, or when it is desirable to apply the liquid for a long time, this method is much preferable to syringing.
The necessary apparatus can readily be obtained in any large city. It has, however, the drawback that the jar is large, and not convenient to carry on journeys.
We shall close this chapter on Health in Marriage by a few words on some of the _ailments to which mothers are subject while nursing._
GATHERED b.r.e.a.s.t.s.
Gathering of the b.r.e.a.s.t.s may occur at any time during the period of nursing, but it is most frequently met with within the first three months after childbirth, and is more common after the first than after subsequent confinements. All women are more or less liable to it, but those who are weakly, and particularly those who are scrofulous, are most p.r.o.ne to its attacks.
The _causes_ of inflammation of the breast are numerous. It may be created by a blow or fall, by a cold, by mental excitement, by indiscretions in eating or drinking, and by moving the arms too much when the b.r.e.a.s.t.s are enlarged, but its most common cause is undue acc.u.mulation of milk in the b.r.e.a.s.t.s. Dr. Bedford is of the opinion that in nineteen cases out of twenty it is the result of carelessness--of neglect in not having the b.r.e.a.s.t.s properly drawn. "For example, the child may be delicate, and not able to extract the milk; or the nurse, in the gratification of some ancient prejudice derived from a remote ancestry, does not think it proper to allow the infant to be put to the breast for two or three days after its birth. In this way, the milk ducts become greatly distended, inflammation ensues, which, if not promptly arrested, terminates in suppuration."
Often the love of pleasure brings with it this punishment to the nursing mother who neglects her maternal duties. During an evening spent in society or at the theatre the b.r.e.a.s.t.s cannot be relieved in the manner required for the preservation of their health.
Soreness of the nipples, which renders suckling painful, often leads the mother to avoid putting the child to the breast as often as she should.
It is only when forced by the pain in the over-distended parts that she can summon courage to permit of their being emptied. This partial and irregular nursing is very dangerous, and cannot fail, in most cases, to lead to the very painful affection of which we are now speaking.
No nursing mother is safe whose b.r.e.a.s.t.s are not properly and daily emptied. If this cannot be done by the child, another infant should be applied, or a small puppy, either of which expedients is preferable to a breast-pump, which, however, is much better than neither. If the tender or chapped condition of the nipples interferes with free nursing, this condition must be promptly remedied. When undue acc.u.mulation of milk is threatened gentle friction of the b.r.e.a.s.t.s with sweet oil and camphor is also of service; and they should be supported by means of a handkerchief placed under them and tied over the shoulders.
It must not be forgotten, however, that though _gentle_ rubbing afford relief to the b.r.e.a.s.t.s when they are hard, knotty, and over-distended, any friction is injurious if gathering has actually commenced. In all cases, therefore, it is of importance to distinguish between over-distension (which may _lead_ to inflammation) and a condition of already established gathering of the b.r.e.a.s.t.s. This it is not difficult to do. In the former case the skin is pale, there is little or no tenderness, and the hardness is evenly diffused over the whole of the breast; whereas, when gathering has taken place there is a blush of redness on some portion of the breast, which is always painful to the touch, and which will be found to be particularly hard and sore in some one spot.
The _symptoms_ of gathered b.r.e.a.s.t.s we have just described in part. The severity of the symptoms will depend upon the extent and depth of the inflammation. The affection is always ushered in by shivering, followed by fever and a shooting pain in the b.r.e.a.s.t.s. A small, hard, painful swelling will be noticed in the breast even before the skin shows any sign of redness. This swelling increases in size and the suffering becomes very great and difficult to bear, preventing sleep and prostrating the whole system. The secretion of milk is suspended at least during the first active stage of the disease.
The object of _treatment_ is to prevent the formation of an abscess by subduing the inflammation as speedily as possible. This is to be sought first by keeping the breast as nearly empty as possible. For this reason the child should be a.s.siduously applied to the affected rather than to the well side, although suckling will be painful. Indeed, it is better, if it can be done, to procure an older child and let it keep the milk under. When, however, the inflammation is fully established, the pain will compel the restriction of the child to the well side. The application of warmth is both grateful to the part and beneficial. This may be done by means of poultices or fomentations, or by immersing a wooden bowl in hot water and putting the breast, wrapped in flannel, within it. This latter means will be found an easy and agreeable one of keeping up the application of dry heat. The bowels should be briskly purged by a dose of citrate of magnesia or cream of tartar. The diet must be mild, and the b.r.e.a.s.t.s supported in a sling. If, in spite of all these efforts, an abscess actually forms, the attending physician will doubtless advise its immediate opening, to which advice the patient should accede, as that is the course which will afford her quicker and more effectual relief than she can hope for from nature"s unaided efforts at effecting a discharge of the pent-up matter.
It is interesting for the mother to know that if her child be still-born, or if unfortunately she be unable from any of the reasons mentioned in our chapter on Hindrances to Nursing to give the breast at all to her child, she is not liable to gathering on this account. This is contrary to what might be expected. It is not the mother who is unable to nurse at all who suffers, but she who does so in an unsatisfactory manner and who fails to have her b.r.e.a.s.t.s properly emptied.
The first milk which makes its appearance in the breast towards recovery from inflammation is likely to be stringy and thick, and should, therefore, be rejected before nursing is resumed.
THE SINGLE LIFE.