The Normal Standard of Wo 
for Propagation. 
Hv tHft K w. 
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// BY 
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NATHAN ALLEN, M.D., LL.D. 
LOWELL, MASS. 
Reprinted from the American Journal of Obstetrics and Diseases of 
Women and Children, Vol. IX., No. I., April, 1876. 
NEW YORK: 
WILLIAM WOOD & CO., 27 GREAT JONES STREET. 
1876. THE NORMAL STANDARD OF WOMAN FOR PROPAGATION.* 
By NATHAN ALLEN, M.D., LL.D. 
Lowell, Mass. 
Before entering upon the discussion of the subject, it may 
be proper to give a brief definition of the leading terms used 
in the heading of this paper. The term normal implies that 
there exists some rule or guide for reference. In anatomy and 
physiology it implies sound structure and healthy function, but 
in medicine, generally, the term is used to designate a state of 
health, and the term abnormal is applied to deviations from 
that state. As there may be different degrees of health, or 
*In the perusal of this paper, we would bespeak the ''good-will" of the 
reader on three considerations : 1st. The whole subject is so large and com- 
plicated that only a mere outline of facts and arguments can be presented in 
a short article ; 2d. Though the topics discussed may be familiar, the stand- 
points for examination are quite different from what are usually taken in lec- 
tures and books; and 3d. The line of discussion here pursued, in favor of a 
general law of propagation, constitutes only one out of many others connected 
with the laws of physiology, in their relations to the various questions affect- 
ing the great subject of population. 2 
Allen: The JTormctl Standard of 
slight deviations from a perfect state, standards artificial or 
imperfect may be set up, and the term normal may, with much 
propriety, be applied to them. So in the application of physi- 
ology to propagation, there may be differences in organization, 
or in the objects to be obtained, as there may be different phy- 
siological standards or types. While custom and convenience 
might sometimes allow such use and interpretation of language, 
the phrase normal standard is here intended to mean strictly 
the highest standard or most perfect development which physi- 
ology can present. Moreover, the phrase normal standard, as 
here used, is not intended to apply simply to this or that organ 
in its best or highest development, but to all parts of the body 
-to every organ in the human system-that each should be 
perfect in structure, and each perform its complete function. 
This standard, that it may be normal both in structure and 
function throughout, must be based upon a physical system 
evenly and well developed in every part or organ, so that each 
can perform its respective functions in harmony with all the 
rest. While we may not find this perfect physiological stand- 
ard, we find approximations to it in great numbers-some much 
nearer than others ; but deviations from it may be found in 
endless variety. Still, the general law, the normal standard, 
must have its basis in the highest or most perfect developments 
of the body as regards its anatomy and physiology. That there 
does exist a great difference in organization amongst women, 
with reference to propagation, all experience proves. All books 
treating upon this subject admit it, and give particular instruc- 
tions founded upon those peculiarities. That, in these differ- 
ences of organization, one kind of development, one form of 
body, or one class of organs being better developed than 
another, is more favorable for the fulfilment of this law of 
propagation, requires no long array of arguments to prove. 
What then is the anatomical or physiological development most 
favorable ? Does it consist wholly in the construction of the 
pelvis or of the organs of that region ? In the great law of 
propagation are there not many other conditions or objects to 
be considered, besides parturition or the mere mechanism of 
labor ? And may not these other considerations have been too 
much overlooked, on account of the great prominence given to 
one particular part of the physical system ? In order to under- Woman for Propagation. 
3 
stand correctly and observe properly a general law of nature, 
all its conditions, requirements, and objects must be carefully 
taken into the account, that the designs of each may be fully 
secured. Not only the constitution and health of woman, the 
peculiar effects of gestation and the physical changes occasioned 
by it, must be considered, but her qualifications for nursing and 
taking care of offspring, together with the organization and 
character of that offspring. This last-named point is one of 
no small moment in the account: it cannot be ignored without 
invalidating, more or less, the premises or theories upon which 
it is attempted to base a law of this character. For in all great 
organic law's or processes of nature, she is universally thought- 
ful to make provision for the interests of all, so that no one 
part suffers without due compensation to some other part. In 
our investigations on this subject, and attempts to arrive at 
some definite results, many things must therefore be taken into 
consideration. 
In this field of inquiry may be found twTo extremes. A class 
of writers, commencing with Malthus, about one hundred years 
ago, in discussing the subject of population, attempted to define 
its laws and account for all its changes, without much regard 
to the structure or agency of the human system. In their view, 
nearly all the causes that lead to an increase or decrease in 
population, existed independently of, and outside of the body 
itself, such as food, climate, government, etc. 
According to their theories, man, the most important agent, 
and factor of all, had but little or no power in directing and 
controlling these causes. But great changes have of late taken 
place in the views and theories of writers on population. The 
teachings of modern science, especially of physiology, have 
turned the attention of inquirers more and more to the human 
body, and have led to the conclusion that the laws which gov- 
erned its existence and continuation, must surely have their 
origin and support from this source. 
Another and much larger class of writers have taken an ex- 
treme position in physiology, confining their attention almost 
wholly to the first principles of life, and the exclusive agency 
of the generative organs. Aristotle and Harvey may be 
named as proper representatives of this class. And, since 
Harvey, nearly all writers on this subject have dwelt chiefly 4 
Allen: The Normal Standard of 
upon the nature and agency which the reproductive organs 
alone exercised in the matter of propagation. Very little con- 
sideration has ever been given to the relations or agency which 
other parts of the system, or the whole organism of the body 
bear to them. In considering the designs of nature in the 
matter of propagation, it would naturally be expected that all 
parts of the system must sustain important relations to it, but 
most medical winters on generation, pregnancy, parturition, 
etc., have devoted their attention too exclusively to the re- 
productive organs and the pelvic region. So in that part of 
physiology represented under gynaecology, or rather obstetrics, 
writers and teachers have confined their observations to, and 
discussed the subject principally from, one point of view, viz., 
the pelvic region. However important may be the agency of 
these organs, they sustain most intimate relations to other parts 
of the system, and cannot, it is believed, perform their func- 
tions completely without calling to their aid, more or less, the 
assistance of other organs. Thus, in attempting to ascertain 
and define the highest standard required for propagation, it 
may be found necessary to consider, not only these organs, 
whose peculiar province it seems to be, and which are most in- 
timately concerned in the process, but also all other parts of 
the system; for, as all the members constitute but one whole, 
and each is linked to the others by a chain of sympathy, if by 
no stronger tie, so the full development of all must be essential 
to the perfection and full play of each. Besides, it is not the 
mere continuation of the race that should be sought, but its im- 
provement and perfection. Moreover, in determining the best 
type or standard of the physiology of woman for child-bearing, 
it should constantly be borne in mind that this is her normal 
state- that this harmonizes with her whole organization. The 
leading features and controlling forces of her organism were 
evidently intended for this purpose. Not only her physiology, 
but the history and character of her diseases, her comparative 
health and longevity, demonstrate that the production of off- 
spring is among the primary objects of her creation. The ob- 
servance of this law has, moreover, been found absolutely 
necessary for the most complete development and perfection of 
woman's organization. All this might be inferred from her 
physiology alone; but it has been abundantly confirmed by sta- Woman for Propagation. 
5 
tistics gathered upon a large scale, and by comparing a large 
number of married women who have had families, with both 
married and single women, who never have had offspring. 
This is also deducible from the fact that, wherever barrenness 
or sterility exists among married women, it indicates something 
wrong, some defect in structure or irregularity in function. 
Whether this arises from imperfection in structure, or some 
weakness or settled disease, it is considered abnormal; and the 
greater and more extended these difficulties are, the less likely 
is recovery, and the wider is their divergence from a true type. 
In seeking, therefore, after the best and most perfect develop- 
ment of woman, with reference to propagation, all such com- 
plaints as accompany barrenness or sterility must be left out 
of the question. 
If, then, the production of offspring is a primary design in 
the organization of woman, upon what particular type or de- 
velopment, condition or feature of the system is the law found 
to operate best, or in its highest degree ? That there is a differ- 
ence, a wide difference, in the fecundity of women, must be 
admitted ; a difference, physiologically, in the susceptibility to 
conception, in the effects of pregnancy, in the ease and safety 
of delivery, in the physical qualities for nursing, in the consti- 
tutional healthiness of offspring. In what, then, does this dif- 
ference consist ? Can it be confined wholly to the reproductive 
organs or to the pelvic region alone ? To settle the question 
we naturally seek some standard to which we may appeal; and 
both nature and analogy would lead us to the conclusion that 
such a standard or model certainly exists somewhere, and that 
we shall not seek for it in vain. Reasoning, d priori, we 
should naturally infer that it would be found in the highest 
type or most perfect organization in structure and function; 
for such is the nature, importance and complication of forces 
required in propagation, that, for its successful results, it seems 
to demand the aid of every part of the system. This is cer- 
tainly the first, the highest, and the most important law in the 
whole animal economy. 
If we study the operations of nature in the framing and 
government of organic bodies, we never find great principles 
or laws based upon any particular parts of the system or class 
of organs, neither upon inferior or imperfect structures. All 6 
Allen : The Normal Standard of 
the primary laws of nature and the fundamental principles of 
science, are exemplified in, and illustrated by models of fault- 
less forms and full development. The laws that govern the 
human system cannot be an exception to this rule. If nature 
has established such a law of propagation, it is of the highest 
importance that it be known and understood. While the recog- 
nition and knowledge of it would be fraught with the greatest 
possible interest and benefit to the community at large, it must 
prove of incalculable value to the medical profession. The law 
here proposed will be found, we believe, to rest, not upon mere 
theory or vague speculation, but upon positive facts; and, if so, 
to lead, in the broadening of our knowledge and our researches 
to results of a practical and most valuable character. 
In considering the foundation of this law, and the advanta- 
ges to be derived from it, our remarks will be confined to a few 
points of view only, presenting a meagre outline or brief sy- 
nopsis of the subject. As the field of inquiry is comparatively 
new, and but little can be gleaned from medical works bearing 
directly on the subject, we would bespeak, in its discussion, the 
charitable consideration of our brethren. 
While many facts and arguments may be deduced from the 
general principles of physiology in favor of such a law, there 
are four distinct points of view around which they may pro- 
perly be gathered, and, in this way, be brought out and illus- 
trated in a clear and more forcible manner. These points are : 
The pregnant state,parturition, or the mechanism of labor ; 
the qualifications of a nurse, and the character of offspring. 
If there is a general law of propagation, a normal standard in 
the organization of woman, based upon the principles of physi- 
ology, it will certainly aid us in a better understanding and 
knowledge of those important changes through which she 
must pass in child-bearing. Let us then briefly review the 
leading facts or phenomena in each of these changes, and see 
what lessons they teach. 
One of the most eventful and trying changes the human sys- 
tem can possibly pass through, is that of 
PREGNANCY. 
This state causes many physical changes-some simple and 
safe, others complicated and occasionally dangerous. The pri- Woman for Propagation. 
7 
mary changes cannot properly be considered actual disease, but 
rather functional derangements. In works treating of diseases 
of women, we generally find a long chapter, headed " Diseases 
of Pregnancy," discussing from forty to fifty distinct com- 
plaints arising from this source. But pregnancy in itself can- 
not be considered strictly a morbid or diseased state, inasmuch 
as propagation, in its normal effects, must harmonize with the 
principles of physiology. Montgomery, one of the most distin- 
guished writers on this subject, makes this significant remark: 
'' If, with a few, pregnancy has deserved the name of a nine 
months' malady, fully an equal number suffer little or no in- 
convenience, and with some it is a period of decided improve- 
ment in health ; moreover, it appears, from all experience, that 
women who bear children generally enjoy more even health, 
and are less disposed to disease, than those who lead a life of 
celibacy, or who, having married, remain unfruitful." Now, 
why should there be this difference ? why should some women 
suffer so much from the pregnant state-others so little-and 
others still improve by it in their health permanently ? It may 
be said that this depends upon difference in constitution-the 
pregnant state, in one sense, agrees with the constitution of 
some women, but disagrees with that of others. What, then, 
is that agreement-what is the type or character of those con- 
stitutions with which the pregnant state harmonizes? Is there 
not some law or standard by which these can be tested or ex- 
plained ? In the very nature of things, there must be, in these 
things, the observance, or violation of law. Such changes can- 
not come from chance. 
Every experienced physician knows full well that there is a 
great difference in women as to the effects of pregnancy, and 
that these effects are various and occasionally very marked. 
Sometimes the change may affect this organ-sometimes that; 
and again, almost every organ in the system becomes more or 
less affected. In some cases the very first stage of this change 
operates unfavorably ; it may induce a little nausea or slight 
headache, or it may result in the most violent inflammation or con- 
vulsions. While some women may be benefited in their health 
from the change, and their constitutions actually improved by 
child-bearing, with others it is the commencement of suffering 
and disease, resulting in impaired health and not unfrequently 8 
Allen : The Normal Standard of 
a broken-down constitution. Now why should there be these 
differences, why these disturbances ? What are the causes, the 
constitutional weaknesses, the particular predispositions? If 
propagation is physiologically a normal function of woman, 
why these pathological changes ? What laws have been vio- 
lated ? and why should there be such a marked relation or sym- 
pathy between this change in the reproductive organs and other 
parts of the body ? The very fact that one organization is found 
more favorable for child-bearing than another, implies that there 
may be another still more favorable; and, if so, let this change 
or improvement be carried to a standard of organization, where 
the least bad effects possible arise from the pregnant state. 
What, then, is that standard, and where is it to be found ? Is.it 
not based upon perfection of structure and harmony of function ; 
or, in other words, upon the perfect anatomy and physiology of 
the whole system, and that on this basis is founded a great 
general law of propagation ? 
Let us make an application of this principle to different types 
or kinds of organization. In tracing out the 
EFFECTS OF THE PREGNANT STATE, 
we find some difficulty, from the fact that by this change in the 
uterus, it works in three ways-by attraction, by sympathy, and, 
gradually, by mechanical pressure. One of its effects is to 
change the circulation and the direction of the nutritive force. 
Thus, where in certain parts of the system there has been over- 
action or excessive excitability, perhaps a strong predisposition 
to, if not the actual existence of disease, the pregnant state, in 
changing the circulation by withdrawing from these organs a 
certain amount of blood and nutrition, actually improves the 
health, and in some instances undoubtedly prolongs life. Here 
an attempt is made by a natural law to correct weaknesses and 
restore health, or in other words, to bring about a more even 
balance or better harmony of action in the whole organization. 
There are other cases where the weaknesses or excesses are 
so great, or the disease has been carried so far, that pregnancy 
makes the attempt to change this state of organization ; and 
not only fails in so doing, but, perhaps, indirectly aggravates 
the difficulty. In al] those cases, however, where the health Wman for Propagation. 
9 
of women is improved by pregnancy, it is accomplished, we 
believe, by so changing the current of the vital forces of the 
system as to bring about a more equal circulation, a better 
balance of organization, as well as harmony of function through- 
out the whole body. What, then, is the inference, or what lesson 
does this class of facts teach ? Is it not clearly this : that the 
better and more evenly balanced the structure of the whole 
body is, and the more perfect the action of its machinery, the 
less disturbance will be produced by pregnancy, and the less 
harm or inconvenience result from it ? 
Let us look at different types of organization. The more 
nervous and sensitive a person is, the greater and more marked 
is the effect of pregnancy. In such cases, generally, the change 
is sooner discovered, and the signs or indications arising from 
it are more decided and positive. In some cases, where there 
is a great preponderance of the nervous temperament, preg- 
nancy, by changing and equalizing the action of the nervous 
system, may improve the general health and constitution. In 
other cases it may increase and intensify the nervous activity 
or excitability, and thus affect, more or less, the disposition and 
temper of the individual. Now and then a case occurs where 
pregnancy has a singular effect upon a nervous temperament, 
to disturb and excite the patient, and sometimes even cause 
mental derangement. In all such cases, if the exact physiology 
and pathology of the brain and nervous system could be ascer- 
tained, we should find some peculiar sympathy in the relations 
of the nervous system, or some singular idiosyncracy of organ- 
ization in these persons. But such cases do not often occur, 
and are exceptions to the genera] rule. Such changes of con- 
duct or exhibitions of character do not occur without a cause; 
and when the cause can be ascertained and satisfactorily ex- 
plained, instead of conflicting with, or furnishing evidence 
against general laws or principles, their history and explanation 
will rather serve to confirm and strengthen the law. 
There are many slight disturbances occasioned by pregnancy 
in the action of the stomach, bowels, heart, lungs and nervous 
system, which, as far as they prove anything, show a very well 
balanced organization in those cases, and also that no marked 
weaknesses, defects or disease existed. But occasionally the 
stomach is greatly disturbed, which leads to serious and danger- 10 
Allen : The Normal Standard of 
ous disease. A careful examination into such cases, will show, 
we believe, a remarkable sympathy or sensitiveness, between 
the state of the stomach and the action of the uterus or other 
organs. It may show, too, that the individual had suffered 
more or less, for a long time previous, from dyspepsia or indi- 
gestion. 
Sometimes great physical changes are occasioned by the 
pregnant state: the woman occasionally losing flesh and 
strength, continues to waste away till she can scarcely go 
through the regular periods of gestation, the nutrition going 
mostly to the child, and the whole change being caused by 
some defective, or unnatural action of the digestive organs; 
but, more often, the woman gains in flesh and strength, becom- 
ing plethoric, and, as it may be said, corpulent. In such cases, 
the stomach and digestive organs act too vigorously,-manufac- 
ture too much nutrition and blood, certainly for the mother, 
though perhaps at the expense somewhat of the child. This 
change is decidedly unfavorable, resulting not unfrequently in 
convulsions or violent inflammation. The causes of such a 
change are not easy always to understand, but indicate that 
there must have been some radical defect in the organization, 
or something wrong in the habits of the individual. 
Sometimes the liver and kidneys are so affected by preg- 
nancy as to change the quality of the blood, resulting in 
anasarca, thereby enhancing the danger of the condition, and 
sometimes resulting in loss of life. In some cases, it is thought 
that pregnancy, by sympathy or by some singular influence 
upon these organs, connected with the process of digestion, 
produces albuminuria, causing the most dangerous convulsions, 
and, in some instances, resulting fatally. This disease, whether 
caused wholly by the pregnant state or not, is one of the most 
obscure and dangerous of all diseases. It is not easy to trace 
out its exact relation to pregnancy, or to describe just what pa- 
thological changes had taken place in its preliminary stage. 
Future researches in pathology will undoubtedly explain 
these causes and changes-and, we are confident, it will also 
show, that there were some conditions in the organization, or in 
the habits and health of the individual,existing prior topreg- 
nancy, predisposing to this disease, so that this state of the sys- Woman for Propagation. 
11 
tem operated only as an exciting cause. As yet pathological 
inquiries have not been carried far enough in this direction ; 
but, when thoroughly prosecuted, we believe they will show 
that the sad results of this morbific state or diathesis may be, 
in a great measure obviated, and, perhaps, show that it is not 
chargeable to pregnancy alone. 
There is another class of complaints, arising from pregnancy, 
caused by mechanical pressure, interfering with the circulation 
especially, in the lowrer extremities; and sometimes this pres- 
sure operates unfavorably upon the natural action of the 
bowels and stomach, as well as upon the functions of the liver, 
heart and lungs. This result of the pregnant state cannot well 
be obviated, or much relieved by any medical treatment, as it 
arises from a want of proper development of the whole body, 
or from the too close relations of the internal organs, one to 
another. The disturbances from this source are more numer- 
ous, and their results more serious, we believe, than what are 
generally supposed. 
Again: Is there not a wide difference in the effects of preg- 
nancy as found in different classes, nations and races ? Are 
they not, as a whole, more marked and serious among the 
higher classes of society than the lower; in cities, than rural 
districts; and less striking and troublesome still among women 
living even in a semi-civilized and barbarous state ? In fact, 
wherever the female organization is the most perfectly de- 
veloped in all its parts, and the functions of every organ are 
performed in accordance with its own inherent laws, are not 
the diseases of pregnancy the least marked and serious ? 
Now in all these changes and diseases, a careful investigation 
will show, that in case there was always a well-balanced organi- 
zation and a healthy performance of the functions of the inter- 
nal organs, we should have very few diseases arising from the 
pregnant state. And all these complaints are found to dimin- 
ish in number and severity, just in proportion as we find organi- 
zations approximating to more perfect standards. If, there- 
fore, propagation is the normal state of woman ; and the more 
perfect her organization is, anatomically and physiologically, 
the less are the disturbances or diseases of pregnancy, it cer- 
tainly points to the fact, or affords evidence that there exists in 12 
Allen : The Normal Standard of 
nature what may be denominated a great general law of propa- 
gation based upon such standards of the system. 
For a proper understanding of this law, it is highly import- 
ant to bear constantly in mind, not only the striking differences 
in female organization, but to notice particularly the great 
changes it has undergone in different races, and at succes- 
sive periods of time. This fact will appear more obvious in 
the consideration of the next step or process in the development 
of the law, viz: 
PARTURITION. 
That there are wide differences among women, in the ease 
and safety with which they go through this process, all will 
admit. Now if this process of labor or delivery is natural to 
woman, is normal physiologically, why is it attended frequently 
with so much pain and difficulty, and not unfrequently with 
danger to life ? In no other department of the animal economy, 
where the laws of nature, in a normal state, are observed, do 
we find such pain, distress, and suffering. Do not these symp- 
toms, therefore, indicate that the laws of organic beings, or 
the designs of nature, have been in some way violated or 
perverted ? It is true, some women go through the process 
without much suffering or loss of strength, while to others are 
allotted nights and days of pain, anguish and distress ; and, 
it would seem that the latter class constitute, at present, the 
exception to the general rule. Teachers and writers on this 
subject have taken great pains to ascertain and describe 
what wTere the causes of so much difficulty and suffering in 
parturition, and to inquire what human means or resources of 
art could be employed to remove these difficulties, and assist 
nature in this work. To this end the anatomy and physiology 
of the pelvis have been carefully studied. The relations each 
part sustains to this process,-what were the precise functions 
of the uterus,-what should be the presentation of the child,- 
what obstructions, points of resistance, etc., existed. 
No part of the body, probably, has been more carefully studied 
than that of the female pelvis, and no organs in the whole system 
perform such important functions as those located in this region. 
For better understanding and treatment, parturition has been Woman for Propagation. 
13 
divided into different stages, and its phenomena classified-such 
as natural and protracted, tedious and laborious, difficult and 
complicated labors, etc., etc. Special attention has been given 
to difficulties attending labor, such as position or wrong presen- 
tation of the child, the disproportion between its head and the 
pelvis of its mother, the imperfect and irregular action of the 
uterus, the rigidity of the os uteri and the soft parts, the neces- 
sity of using instruments, the danger from exhaustion, convul- 
sions, haemorrhage, etc. These are the points or sources of pain, 
distress, suffering, and danger. In these eccentric or extreme 
organizations, the greater are these marked peculiarities of the 
system, and where we encounter a large part of the difficulties 
in obstetrics ; and the wider these divergences go in any one 
direction, or the more marked these peculiarities are, the greater 
these difficulties. On the other hand, the nearer we approach 
a sound, well-balanced, organization in all its parts, the greater 
the ease and safety in delivery. Every physician occasionally 
finds patients that go through this process with comparatively 
little trouble or difficulty. We find also among women all 
manner of differences in the process of labor ; and these depend 
mainly upon the kind or type of organization, together with the 
habits and health of the individual. Now, why these differ- 
ences, why these peculiarities ? Are they not deviations, more or 
less, from a perfect standard of organization ; or in other words, 
are they not to a great extent abnormal ? Are they not the 
effects or penalties of a law violated, or the result of an artificial 
-in some respects, an unnatural life ? 
If a test or direct application of the principles of physiology 
be here made, it may throw some light upon the subject. 
Should any class of organs, or some one temperament, such as 
the nervous, sanguine, or lymphatic, greatly predominate, its 
effects as a whole will in parturition be found unfavorable. If 
there is an undue predominance of the nervous system, there 
will exist far greater sensitiveness or susceptibility to pain ; and 
the process of parturition may produce such a shock upon 
the brain and nerves, as to render recovery doubtful, if not 
impossible ; if there is an excess of the sanguine temperament, 
there will probably ensue a greater strain upon the action of 
the heart, and sudden change in the circulation of the blood, 
with increased danger of hemorrhage and inflammation. If 14 
Allen : The Normal Standard of 
the lymphatic temperament abounds, there is a sluggish state 
of the system, a lack of force and regularity in the contractions 
of the uterus, such a deficiency in general vitality and strength, 
as to render parturition tedious, if not sometimes dangerous 
from exhaustion. If the muscular tissue greatly predominates 
in the system, then we find, with violent pains, powerful resis- 
tance and rigidity of all the soft parts. It may be, these defects 
or peculiarities of organization will not show themselves so 
much in pain and difficulty of delivery, but their effects may 
become more manifest upon the system afterwards, or upon 
the character of the offspring. 
There is a physiological condition or principle involved in 
labor or parturition, that is not, we believe, properly considered. 
We refer to a union or correlation of forces in nature, so that all 
parts of the system should act in harmony with each other, and 
in one single direction, when the object to be accomplished re- 
quires it. This principle in the study and practice of obste- 
trics, has been, if we are not mistaken, very much overlooked. 
Such is the nature and object of propagation in importance 
and magnitude, that we should expect aid from every part of 
the system, from every tissue, nerve, tendon and muscle. 
Parturition is certainly one of the most important and compli- 
cated processes in the fulfilment of the law. Now, while certain 
organs are called on to perform their natural functions, there 
should be no conflict or resistance from the action of any other 
part or class of organs. But in an imperfectly developed, and 
unevenly balanced body, with a want of harmony in the action 
of all its parts, it is difficult, if not impossible to obtain a union 
or conjunction of all the forces of nature in the most favorable 
manner. If the organization of woman, as now found, is a 
deviation from the normal, perfect standard, it could not be ex- 
pected that all the forces of nature or the whole organism would 
aid in the process of parturition, so favorably or to the same 
extent as they would in a perfectly healthy or normal state. 
Hence, in considering the causes of pain, the difficulties attend- 
ing delivery, the force and relations of the whole system should 
be taken into account, and our attention should not be confined 
wholly to the pelvic region. It should be borne in mind, too, 
that we are dealing with imperfect organizations, where a 
general law cannot be fully applied. Woman for Propagation. 
15 
There is another class of facts that have an important bear- 
ing upon the subject. It has been remarked that there are not 
only wide differences among women as to pain and difficulty 
in parturition, but there are some women, in every community, 
who suffer comparatively little at child-birth. Now, a careful 
examination into the structure and functions of the whole 
organism of such women, we venture to assert, will show few 
excesses or defects, but, on the contrary, unusually well-bal- 
anced, sound, and healthy conditions in every part and organ. 
Now let this same principle be borne in mind, as applied to 
different classes, races, localities, and states of society. It may 
be difficult to collect here facts upon so large a scale, or to in- 
stitute such comparisons as would settle any general laws or 
principles ; but still information may, in this way, be gleaned, 
that will throw much light on the subject. One general fact is 
very obvious ; from medical writers and travellers we learn 
that woman, living in what is termed a state of nature, suffers 
comparatively but little pain or trouble in parturition ; whereas 
all history testifies that this pain and suffering increases just 
about in proportion as civilization advances. Thus, in what 
may be considered a high state of civilization and refinement, 
not only more pain and distress are attendant on parturition, 
but increased difficulty and danger. 
Among the North American Indians, the inhabitants of 
Greenland, of Labrador, of the South Sea Islands, and among 
various classes in South America, of the numerous tribes of 
Africa and South-Eastern Asia, child-bearing, we are informed, 
is accompanied at the present day with but little suffering or dif- 
ficulty. There are undoubtedly individual cases in all these 
countries attended with distress and danger, but then these 
are the exceptions. In this general statement we do not deem it 
necessary to go into details of evidence by giving facts, making 
quotations from different writers, or furnishing various kinds 
of evidence. Many writers on obstetrics admit the correctness 
of these statements; in fact, they are nowhere called in ques- 
tion.1 Now why should there exist these distinctions or differ- 
It is more than, probable that pain and difficulty in parturition are artifi- 
cial, and are the consequences of civilization and refinement. For the human 
constitution, when not under the influences of these causes, will, cateris pari- 16 
Allen : The Normal Standard of 
ences in pain, suffering and danger attending a process that is 
considered a natural, normal condition or function of physi- 
ology ? In a primitive state of society, among a people living 
in a plain, simple manner, with habits rude and uncultivated, 
we find but little distress or trouble attending propagation ; but 
in society advanced in civilization, refinement and culture, we 
find much difficulty, and not unfrequently danger, attending the 
fulfilment of this law, and the higher the degree, or the more 
advanced the state of this civilization, the more painful and 
hazardous are the chances. The question returns upon us, why 
this difference ? What are its causes ? Are they necessary ? 
Can they be explained ? Can anything be done to modify or 
to remove them ? The inquiry naturally arises, what is the 
physiology of women living in the countries referred to, where 
the law of propagation is so easily complied with ? May there 
not be found among them a better developed physical system 
more evenly balanced in all its parts or organs, a greater har- 
mony in the performance of all their functions, especially in 
reference to what may be termed the primary laws of nature? 
Writers admit that there may be found, at the same time, indi- 
vidual cases of women living in these countries subjected to 
great suffering and difficulty in parturition, and sometimes dan- 
ger in the process or from its effects. If an examination could 
be made into those particular cases by a good physiologist, it is 
presumed that some malformation, some defect in organization, 
bus, be found capable of meeting and overcoming without any difficulty the 
ordinary changes produced by gestation and delivery. Of this abundant proof 
might be given; for the female savage, wherever found, whether under the 
scorching heat of an African sun or beneath the rigorous sky of the unfriendly 
Labrador, brings forth her young without the assistance of an accoucheur or 
midwife ; but the reverse of this almost universally obtain among the females 
of the civilized world. These differences are most probably occasioned by 
the changes produced on the human constitution by civilization and refine- 
ment. 
The mischiefs derived from the sources just mentioned are found to consist 
in the disposition to or existence of diseases, either general or local or both ; 
in those which may affect the system in general, or those which may be con- 
fined to the uterus or pelvis in particular, in the introduction and continuance 
of certain pernicious customs, habits or modes of life, thereby inducing a pre- 
ternatural degree of irritability, sensibility,- laxity or rigidity-and hence the 
physical necessity of pain and difficulty in parturition among the greater part 
of women in a state of civilization and refinement.-Dewees' Essays p. 25. Woman for Propagation. 
17 
or wrong presentation of the foetus, would be found, which 
might at once explain the difficulty. If sufficient facts could 
be obtained and comparisons instituted, it would be found, we 
believe, that it is not in the extremes of savage life or in the 
lowest stages of barbarism, but among the semi-barbarous or 
half-civilized, where this law of propagation is most easily or 
successfully carried out. For there must be certain modes of 
living, certain states of society, certain types of organization, 
more favorable to the development of this law than others. 
The question might arise, what was the organization of man 
at his creation ? What were the designs, provisions, conditions, 
etc., with reference to his continuance? Whether we adopt the 
Scripture account of his creation, or the Darwinian theory, so- 
called, of his origin, what evidence can there be found that will 
explain or throw light upon any such general law of propa- 
gation ? When man was created, according to the Scripture 
account, there is reason to believe that it was with a perfect 
anatomical and physiological structure in all its parts or organs, 
and that there was a perfect harmony in the performance of all 
their functions. And when the command was enjoined upon 
the original pair " to be fruitful, to multiply and replenish the 
earth," the fulfilment of this command, with a perfect organ- 
ization on the part of the woman, it is presumed was not at- 
tended with much pain or difficulty. 
But afterwards, in consequence of the disobedience of our 
first parents, the sacred Scriptures relate that the Almighty 
said to the woman, " in sorrow shalt thou bring forth thy chil- 
dren." The term sorrow, as here used, has received various 
interpretations. Some writers maintain that it refers exclu- 
sively to the mind-to mental acts-such as anxiety, fear, sus- 
pense, distress, etc., while others maintain that it implies also 
physical pain and suffering. 
Then, again, the whole transaction is regarded by some as a 
judgment or curse pronounced upon woman for disobedience, 
which was to become universal, and continue through all time, 
without much relief or change : while by others this declaration 
of the Almighty is interpreted as somewhat conditional in its 
application,-that sorrow and pain would follow child-bearing, 
because the laws of the physical system were violated, and that 
the amount of this sorrow and suffering would depend upon 18 
Allen : The Normal Standard of 
the manner and extent to which these laws had been violated. 
This view of the Scripture narrative is the most natural inter- 
pretation. It harmonizes not only with the character of God, 
and our own moral sense of justice, but is confirmed by all 
the facts of history, as well as the principles of physiology. It 
implies distinctly that some change would take place in the 
operation of this law, which would bring sorrow and suffering 
to woman. It is inferred that there was none or but little trouble 
of this kind in her primeval state. This change in the law re- 
sulted not from an arbitrary or vindictive spirit on the part 
of the Creator, but depended wholly upon the violation of 
physical laws by human agency, that, just in proportion as 
man violated the laws of his own being, in the same proportion 
would there be sorrow attending his birth. Thus, in the various 
changes and deviations from this perfect physiological stand- 
ard, to which the human body in all ages has been subjected, 
do we find an endless variety of sorrow, suffering and hardship 
accompanying child-birth. 
If we adopt the evolution or Darwinian theory of the origin 
of man, the law of propagation proposed in this paper, instead 
of opposing or conflicting with the doctrines of this theory, we 
believe very strong evidence in its support may be derived 
from this source. Without entering into a detailed discussion 
as to points of evidence, or harmony, we refer only to two 
topics. The two leading doctrines of this theory are that of 
" Natural Selection," and the " Law of Variability." Now the 
principle, or doctrine of natural selection described as applic- 
able to man in a variety of ways, such as the constant " struggle 
for existence," "the survival of the fittest," etc., corresponds 
with, in fact, is nothing more nor less than a normal law of 
propagation. And the doctrine of " variability," or " laws of 
variation," may be clearly and fully explained by the laws of 
inheritance. Unless we admit that nature has established 
some general law of propagation, and set up a normal standard 
of appeal, it is difficult, if not impossible to understand the 
almost endless changes taking place in human organization. 
The laws of variation or inheritance become, then, full of mean- 
ing and instruction, and without such a law, or theory, they 
are to a great extent enigmas. 
A careful investigation will show that great changes, or Woman for Propagation. 
19 
deviations from a perfect standard, both in structure and func- 
tion, have taken place, particularly in woman's organization. 
For illustration, in a high state of refinement and culture, the 
nervous temperament becomes predominant, thereby greatly 
increasing the individual sensitiveness to changes, and suscepti- 
bility to pain, while at the same time, other parts or organs 
become so enervated or reduced in vitality, as not to afford the 
assistance which nature requires in child-birth. Then as to the 
muscular tissue, so indispensable in such a process, it may be- 
come excessive as well as deficient: take individuals or fami- 
lies where, by inheritance and constant exercise, this tissue has 
become a very prominent portion of the system, great resist- 
ance, as well as rigidity will be found in the uterus, and some- 
times in the soft parts. Artificial habits continued through 
several generations may not only have reduced the vital ener- 
gies of the system, but changed the size and structure of the 
pelvis itself, so as to interfere seriously with parturition. In 
what is considered a high state of civilization, there is a large 
amount of indolence, luxury, false modes of living, injurious 
styles of dress, and other evil practices, that interfere not only 
with a natural development and a healthy state of tire whole 
body, but concentrate, in their bad effects particularly, upon 
the organs in the pelvic regicm. Much may be done by 
individuals even in one generation to bring about unfavorable 
changes in these respects; but when evil habits and injurious 
practices are continued through several generations, the effects 
by inheritance become greatly increased and intensified in 
their form and extent. 
There is another point of view from whence important 
evidence may be gleaned. It is well known that there is a 
great difference in women as to the amount of prostration 
produced by the effects of labor, as well as in the length of 
time and manner of recovery. This depends much on the 
strength of the constitution, and also on the character of the 
labor. With some women, the shock is so great, and the ex- 
haustion so excessive, that it requires weeks and sometimes 
months to recover, and occasionally there are cases which 
never regain their former strength and health. There are 
others who go through the process of pregnancy and labor 
without much exhaustion, or even fatigue, and it is with great 20 
Allen : Tlib Normal Standard of 
difficulty that they can be confined, after delivery, a week oi 
ten days in bed. And they will go through this process ten, 
twelve or fifteen times without apparently any injury to health 
or constitution-in fact, with scarce any loss of time, and 
not unfrequently, after having a large family, they maintain 
remarkable health and live to great age. Now, why are there 
such differences, such exhaustions, such slow recoveries, and, 
sometimes, permanent injuries of constitution? Why do some 
women rally so easily and so soon after confinement, and seem- 
ingly improve, or at least hold their way, by every repetition 
of the process? From a careful examination into a large 
number of such cases we have always found, that such women 
possessed a remarkably well balanced organization,-not 
merely good health, devoid of any particular weakness or dis- 
ease, but a sound body, fully developed in all its parts and 
organs. 
Some striking facts bearing upon these points may be found 
in a Report (1871) on the Gynaecology of Iceland, by J. F. 
Reykjavick, its chief physician.1 The inhabitants of this island 
having originated from Scandinavia, Scotland, Ireland and the 
Western Islands, are represented to possess remarkably sound, 
healthy bodies, uninjured by the refinements, fashions and 
luxuries of life. The women are described as of " average 
height," " rather tall than stout," " are generally well propor- 
tioned and well formed," and " have for the most part very 
regular pelves, although exceptions sometimes occur." " The 
women are probably the most fertile of any in Europe," and 
" their delivery is in general easy and without danger." " The 
most frequent cause of difficulty and protracted labor is 
the rather common rigidity of the uteri and soft parts." In- 
struments " are seldom necessary;" convulsions and puerperal 
disease, rare; "easy and speedy recoveries" are attributed 
mainly to a favorable constitution and the forces of nature. 
Some marked illustrations on this point of difference in partu- 
rition may also be found in an article in this Journal,3 by Dr. 
Joseph Taber Johnson. It was the testimony of Dr. Livingstone, 
and others, that the women of South Africa " generally suffer less 
in parturition than Europeans, and, principally, as it appears, 
1 Journal of the Gynaecological Society, Boston, Jan., 1871. 
2 May Number, 1875. Woman for Propagation. 
21 
because they consider it to be an act of nature, and less of dis- 
ease than do the latter." Dr. Johnson says that this remark 
of Dr. Livingston " applies almost as forcibly to the negro 
women in the United States." From the facts and statements 
presented in this article by Dr. J., it would seem that, in re- 
spect to duration of labor, presentation, easy delivery, convales- 
cence, nursing, etc., the negro women have great advantage ; 
in other words, there is found among them much less pain, 
difficulty, and complication in labor, less call for aid or instru- 
ments, less exhaustion, less puerperal disease than among the 
whites. Says Dr. J.: " Labor seems to progress in these women 
naturally, and few of them regard themselves as sick, as we 
understand that word, when they are confined. Their previous 
inodes of life having been so healthful and natural, they have 
the requisite strength and endurance when the time of need 
comes. The labor, ft seems to me, is normal, the period of con- 
valescence short and uncomplicated, as a consequence of or 
in proportion to their previous simple and vigorous habits of 
living." 
From remarks made respecting mulattoes, quadroons, and 
those negro women who have made more progress in refine- 
ment, culture and education, though the statement is not posi- 
tively made, the inference is clearly drawn, that this class ex- 
perience greater pain and complication of difficulties in par- 
turition. 
The differences in size and form of the female pelvis in 
different nations, and the changes in the form and character of 
this structure, in the same race through successive generations, 
from a rude to a highly civilized state, are very important con- 
siderations. It is maintained that the foetal head also differs in 
form and shape ; that among a people highly educated the 
anterior lobes of the brain are larger, and that such change 
gradually takes place, just in proportion to the advance of 
civib'zation. Von Franque, who has perhaps devoted more 
attention to this subject than any other writer, in accounting 
for the quick and easy labor in uncivilized nations, says, " we 
must not forget, in this question, the influence of culture, which 
certainly cannot be estimated too highly ; so that, with increase 
of culture, and super-refinement of customs, not only the most 
various diseases appear more numerously, but that also, in the 22 
Allen : The Normal Standard of 
same measure, the labors become more difficult and of longer 
duration; that, especially, complications step in, which are con- 
ditioned by anomalies of the bony pelvis, and which are in gen- 
eral met with but rarely, almost not at all in uncivilized 
nations." 
While we admit that the changes in the shape and diameters 
of the pelvis effected by culture, refinement, habits, fashions, 
etc., of civilization, do greatly increase the difficulties of par- 
turition, may not the changes in other tissues, or parts of the 
body, from the same causes, increase also these difficulties? 
The muscular power of the uterus is certainly not dependent 
upon the size and shape of the pelvis, neither is the strength 
or power of endurance of the whole body. As the quotation 
from Von Franque states, " various diseases and other compli- 
cations''-and may we not add weaknesses too?-have been in- 
troduced by these causes, and which greatly increase the pain, 
difficulty and danger of parturition. In fact, if all these dif- 
ficulties, including the suffering, exhaustion, hemorrhage, con- 
vulsion, puerperal disease, etc., were carefully analyzed, what 
proportion of these originate solely from the bony structure ? 
While no distinct line can be drawn between a portion of these 
and their primary cause, yet if a survey of the whole could be 
correctly made, and their causes defined, we question whether 
one half of them would be found to arise exclusively from the 
pelvic bones. But it is in the matter of conception, pregnancy, 
gestation, lactation, etc., that these changes produce their 
greatest effects on the physical system, to which allusion will be 
made at the close of this paper. 
It should be borne in mind that the changes here referred to 
do not grow out of a true healthy civilization, but from an 
artificial type, from wrong habits, pernicious customs and 
fashions, from an unnatural culture and refinement, where 
the laws of health and life are altogether too much violated. 
It should also be borne in mind that these changes have not 
been the growth of one generation but of many ; and thus, 
by the laws of inheritance, they have become greatly increased 
and their effects intensified. 
Without going further into details on these points, let us 
sum up what seems to be the general facts upon the subject. 
It is admitted that there are wide differences among women as Woman for Propagation. 
23 
to the amount of pain and difficulty in parturition. It is found 
that in the ruder portions of society, and among the semi-civil- 
ized and semi-barbarous nations, very little pain or trouble, 
comparatively, is experienced in child-bearing. From the 
Scripture narrative, we have good reason to believe the organi- 
zation of woman at creation was such that she suffered little 
pain from this source; but afterwards a change occurred 
whereby her liability to pain and suffering was greatly in- 
creased. All history shows, that in proportion as the human 
body has been changed by artificial habits and vicious prac- 
tices, woman has been subjected to greater and severer pain, as 
well as difficulty, in child-birth. Facts also show that the 
further artificial habits, luxuries and fashions are carried, the 
greater the distress, difficulty and danger in child-birth. Now 
what lessons do these facts teach ? Do they* not plainly indi- 
cate that there exists somewhere a normal standard, established 
by physiology for propagation ? Do they not teach that the 
nearer the physical system of woman approaches that standard, 
the less pain and suffering she endures ? If there is, then, such 
a standard, wdiat is it-in what does it consist? We answer, a 
well-balanced organization, sound in structure and harmonious 
in function, where every tissue and organ is found developed 
to the highest extent that is compatible with the healthy per- 
formance of all their functions. 
The next stage in the observance of this law is the depen- 
dence of the infant for nutrition upon the mother, or, in other 
words, 
THE QUALIFICATIONS OF A GOOD NURSE. 
There must be in this respect, between the two, a natural 
adaption or harmony of relation. According to the laws of 
nature, when properly observed, we find, that wherever she 
makes a demand, she is also sure to furnish a supply. Iler 
laws, too, when correctly interpreted are found not only to 
harmonize with each other, but, are always complete in design- 
never disjointed or fragmentary. Thus, lactation, in the natural 
order of things, must follow parturition, as much as that pro- 
cess must necessarily follow the pregnant state. It was evi- 
dently intended by the laws of nature that the child, for months 
at least, should be supplied with nutrition wholly from this 24 
Allen : The Normal Standard of 
source. No fact in vital statistics is more firmly established 
than that, in order to save life and promote health, the infant 
should be nursed at its mother's breast. The ingenuity of 
nurses and physicians lias been taxed to the utmost, the prin- 
ciples of chemistry and the results of experiments have been 
brought into frequent requisition; but no substitute can be pro- 
vided equal to pure breast milk. Nature, in her normal state 
or highest development, we believe, has made ample provision, 
in the organization of woman, for nursing her offspring. But 
in order to provide this nourishment pure in quality and abun- 
dant in quantity, she must have a well-balanced organization, 
especially a good development of the lymphatic and sanguine 
temperaments, together with vigorous and healthy digestive 
organs. The mammary and other glands should be neither too 
large nor too small; the powers of mastication, digestion and as- 
similation must not be deficient, must be equal to the demands 
which nature makes upon them in this direction. If there is a 
great predominance of the brain and nervous system, and a 
constant strain is made upon those parts, thus requiring a large 
amount of nutrition and exhausting the vitality of the system, 
there must be a failure in lactation. On the other hand, if the 
organization of woman partakes too much of the lower animal 
nature-abounds in flesh-if she is physically large and unduly 
corpulent-the powers of lactation here fail, the organs of 
digestion and assimilation may work vigorously, but the nutri- 
tion will go to the mother, and not to the child. A careful 
examination into the physical qualities of women who nurse 
their offspring best, will show a natural fitness or adaptation for 
this purpose. This same law holds good in the animal crea- 
tion. There, it has been made a special study for a hundred 
years or more. There, experiments have been tried without 
number, and observations made upon the largest scale; no pains 
or expense have been spared in devising ways and means 
whereby the best and largest quantity of milk could be ob- 
tained from domestic animals for the use of man. But how 
little interest or attention has been devoted to the subject of 
obtaining a proper supply of human milk for infantile life ? 
Is not the life of the infant as valuable as that of the adult ? 
As to this matter of nursing, a variety of opinions has been 
entertained by different writers. It has long been observed Woman for Propagation. 
25 
that there were great differences among women as to their 
qualifications for nursing ; some furnish an abundance of milk, 
some only a partial supply, while others are unable to furnish 
any. Instead of studying into the physiology of women, and 
inquiring what there was in their organization that made these 
differences, attention has been devoted almost exclusively to 
the means of providing an artificial supply. Upon examina- 
tion into the instructions and directions on this subject, as found 
in books and lectures, there seems to be something wanting:- 
the obvious principles or teachings of physiology have not been 
properly expounded in their application to this function; 
neither has it seemed to be considered that the laws which 
govern, in this respect, the animal creation, are precisely the 
same as those that govern the human race. In confirmation 
of our statement, we will make a quotation from an address 
before a large body of physicians, by a professor of obstetrics 
and diseases of women in one of the oldest and largest medical 
schools in the country. Says this professor: " Why do American 
born females make such poor wet-nurses compared with the 
immigrant from Ireland or Germany ? After nearly thirty years 
of practice I cannot answer the question. That it is the fact, 
few practitioners in our large townsand cities doubt. Allow 
that some women with us, as with foreigners, object to being 
bound to their children's calls, yet the mass of American 
females are totally unable to act the wet-nurse with suc- 
cess." It is not three years since this statement was made and 
published. This is, we imagine, a more candid comparison 
than many medical teachers or writers would care to make. 
But it is the truthfulness of statement, and the explanation 
offered, to which special attention is here called. Why should 
there be, in this respect, such difference between American 
women and the Irish or German immigrant ? Why should New 
England women of the present day differ from their mothers 
and grandmothers, who found but little difficulty in nursing 
their offspring ? Formerly, it was a rare thing in New Eng- 
land for a mother to be obliged to resort to a wet-nurse or to 
feeding by hand. But now it is certainly within bounds to 
state, that not half the New England women in cities and large 
towns can properly nurse their offspring. It has been supposed, 
however, by some that all or nearly all our American women 26 
Allen : The Normal Standard of 
can nurse their offspring just as well as not-that the dis- 
position only was wanting. But this is found practically a 
great mistake. While there may be cases, here and there, 
of this indisposition to nurse, it is a fact, that large num- 
bers who are anxious to nurse, make the attempt, but fail. 
They find, after repeated attempts, that their milk does not 
satisfy the child, or that it does not thrive-that there must 
be deficiency in the quantity or defects in the quality of the 
nourishment. In many cases, after trying the experiment for 
weeks or months, they are compelled to give up nursing 
entirely, while others, depending partly upon nursing, resort 
also to artificial means for feeding the child. So impressed 
have writers been on this subject, and also practitioners of 
medicine, that the nursing of offspring harmonizes with the 
laws of physiology, and, as a general rule, proves beneficial to 
the health of the mother, they uniformly advise that the 
mother should by all means, nurse her child. This has always 
been a favorite theory with obstetricians, and its correctness 
has been confirmed by the results of experience and observation 
gathered from all quarters. Such we should expect from 
the obvious teachings of physiology, and it certainly accords 
with the common judgment of professional nurses and mothers 
themselves. But if the principle here laid down is correct, 
why should nursing be so often attended with pain and diffi- 
culty ? That there is sometimes a defect in the form of the nipple, 
and the act of nursing becomes very painful, we easily under- 
stand. There are some cases where the act of nursing causes 
the most painful sensations, extending through the breast to 
the spine, and, from thence, through almost every part of the 
body. There are cases, too, where, after a most faithful trial, 
nursing actually disagrees with a woman and proves, in a 
variety of ways, unfavorable to her health, so much so that 
she is compelled to give it up for the preservation of her own 
life. There are other women, at the same time, with whom it 
agrees-is found to improve the health through the whole 
process-that they were never so well as when nursing, even 
though this process should be repeated from the tenth to the 
twentieth time. Now, why do we find such difference in the 
effects of nursing? Why should it ever be attended with pain 
and difficulty? Why should it injure the health of one and W9man for Propagation. 
27 
improve that of another? There must be causes or reasons for 
those various differences. 
Now, while these facts as to the inability for nursing may be 
found, perhaps, more obvious and common in New England, 
cases of this kind are not wantingin other portions of our coun- 
try, both among the immigrant as well as native-born women. 
Such incapacity has been found to exist, more or less, in all 
countries, and among all classes and all races. It has not been 
confined to any age, climate or country, or to any tribe, race or 
color. But formerly this inability was not so common-oc- 
curred only occasionally, and, when partial, did not attract any 
attention. As long as such cases constituted exceptions to the 
general practice, they did not create much interest, or lead to 
remarks or observations on the subject. The same fact is 
true at the present day in respect to the German, French, Eng- 
lish and Irish ; a large majority of these women nurse their off- 
spring-those who cannot or do not, constitute the exception. 
But in New England a gradual change has been taking place : 
the fact has become more and more apparent that large num- 
bers of women cannot nurse their children, so much so, that in 
certain localities or classes those who do are beginning to con- 
stitute the exception. 
The question may very pertinently be asked, why this change ? 
Why this anomalous state of things? Why do we find so many 
exceptions in the observance of one of the most important func- 
tions of the system ? What is there here abnormal and unnatu- 
ral ? These iniquries open up the whole question as to what 
constitutes the physical qualities of a good nurse-not merely 
in New England, but in all countries, and among all classes and 
people. 
It is evident that this whole matter of the mother's affording 
proper nutriment to her offspring at birth, and afterwards as 
long as its nature requires, is governed by some fixed laws. 
The fact is indisputable, and there can be no question or hap- 
hazard about it. In the very nature of things these laws 
must have their foundation and support in physiology. As in 
other organic functions, so in the secretion of milk, there must 
exist the requisite organs in good development, and these must 
have their proper share of aliment and support. 
The organs classified particularly under the Lymphatic and 28 
Allen : The Normal Standard of 
Sanguine Temperament must be not only well developed, but 
other parts or organs of the system must not be found alto- 
gether disproportionate to these. In this case those portions of 
the body that are predominant require an undue share of nour- 
ishment, if it should happen to be the nervous system, and par- 
ticularly the brain-as this tissue requires relatively a much 
larger proportion of nutriment than any other-such an organ- 
ization would be poorly fitted to afford proper aliment for off- 
spring. The more carefully all the physiological developments 
or conditions requisite for a good nurse are investigated, the 
more convinced we shall be that they depend not merely upon 
what may be considered a sound and healthy body, but upon 
one well-balanced, evenly developed in all its parts. As far, 
then, as lactation is concerned, this type must be considered its 
normal standard. 
That the human body has undergone changes from time to 
time, all will readily admit. Many of these changes, occa- 
sioned by the artificial habits of life as well as by the fash- 
ions of the day, are found not only unfavorable to female 
health, but must prove decidedly injurious to the race. Nearly 
forty years ago Sir Astley Cooper made this statement: " It is 
melancholy to reflect that a life of high civilization and refine- 
ment renders the female less able to bear the shock of parturi- 
tion ; it has a tendency to lessen her attention to her offspring 
and really diminishes her power of affording it nourishment, 
so that she is often a worse mother in these respects than the 
female of the middle ranks of life, or even the meanest cot- 
tager." This remark was undoubtedly made as the result of ex- 
tended observation and long experience many years ago ; and it 
implies not merely a change of disposition, but also a change in 
organization, from the fact that such mothers could not prop- 
erly nurse their offspring. Sir Astley Cooper observes that the 
proper development of the mammary glands is often prevented 
by a constant pressure. We might go further, and say that 
continued compression of the chest and abdomen is calculated 
to impair the development and healthy action of the lungs, the 
heart and digestive organs, as well as those in the pelvis. 
If we consider that this compression commences with the girl 
or young woman, when the system is in a state of growth and 
most susceptible of change-that it may be continued for a Woman for Propagation. 
29 
series of years, and, by the laws of inheritance, intensified, it 
shows very clearly how such effects upon the system disqualify 
women for some of the most important duties of maternity. 
A great variety of causes, other than those here stated, might 
be adduced to account for physical changes of constitution, or 
changes which might especially interfere with the lacteal func- 
tions. Among these causes may be mentioned, educational 
pressure, constant excitement, depression of spirits, too much 
society, hard work, great exhaustion, etc. 
In the matter of nursing much depends upon the daily 
habits of the individual, the kinds and quantity of food con- 
sumed, the nature of drinks taken, etc. While these agencies 
have, for the time being, a marked influence upon lactation, it 
is the particular type or standard of organization most favor- 
able to nursing, that constitutes the present object of our in- 
quiry. We have stated that in the matter of nursing, there was 
a great difference between the women of New England at the 
present day and the early settlers. That there has been here 
a decided change in female organization within fifty or a hun- 
dred years, there can be no question. Formerly, there was 
more muscle, a larger frame, greater fulness of form, and a 
better development of all those organs that are classed under 
the sanguine and lymphatic temperaments. The brain and 
nervous system relatively were not especially predominant; 
neither were they taxed continuously or excessively above any 
other class of organs. Those of the Germans, English and 
Irish who best nurse their offspring at the present day, pos- 
sess an organization similar to the one here described. If an 
inquiry could be thoroughly prosecuted in any tribe, race or 
people, and the individuals or classes that were found most 
successful in nursing their offspring could be picked out, we 
should find that they possessed an organization much alike, 
and not dissimilar to the one already described. 
There is another point worthy of notice. In all medical 
works treating of nursing we find very minute descriptions of 
physical qualities requisite for a good wet-nurse. Certain con- 
ditions are insisted upon as indispensable, such as well devel- 
oped mammary glands, strong digestive organs, good health, 
freedom from diseases, or any particular weakness; she must 
be neither too thin and spare, nor too fleshy and corpulent; the 30 
Allen : The Normal Standard of 
nervous temperament is described by several writers as particu- 
larly unfavorable. We find a similarity, a correspondence in 
qualities everywhere described-nowhere opposite or contra- 
dictory qualities. In fact, if we should quote the various de- 
scriptions or directions given for selecting a suitable wet-nurse, 
from different writers, in their own language, we should find 
that they correspond almost precisely with that normal standard 
of organization upon which we believe the law of propagation 
is based. 
The evidence derived from this source is valuable for two 
reasons : first, these writers have drawn those descriptions (of 
what constitutes a good " wet-nurse ") from their own experi- 
ence and observation, without any theory of their own, or any 
design of contributing evidence to establish a general law ; and 
secondly, these descriptions of what constitutes a good wet-nurse 
come from a large number of medical writers of diverse charac- 
ter, living in different countries and writing at different periods. 
Such a remarkable agreement or uniformity in all their state- 
ments shows, that the great facts or truths of science wherever 
carefully studied and collected, not only harmonize with each 
other, but must have a basis or foundation in the primary laws 
of nature. And further, in regard to the matter of nursing or 
affording natural support to the infant, it should be carefully 
observed, that it bears most intimate relations to other laws. 
As the laws of nature come to be more correctly and fully 
understood, we always discover a natural harmony, consistency, 
or adaptation to specific ends. Scarcely any truth or general 
principle is more firmly established, than that where nature 
makes a demand, she invariably furnishes a supply, and vice 
versa. The existence and character of the one presuppose that 
of the other. There may, it is true, be grades or different 
degrees, in the matter of demand and supply: but wherever 
the supply is the most ample or pure, the inference or indica- 
tion is clearly manifest, that it points to where the law of 
demand, in its best estate, has its basis and support. The 
natural necessary inference then is, that the organization which 
is found best adapted to afford proper nutriment to the infant, 
must be the best for its production ; or, in other words, must be 
regarded as the true physiological or normal standard upon 
which is engrafted a general law of propagation. The con Woman for Propagation. 
31 
ditions best calculated or indispensable to support life must 
exist necessarily in the organization that produces it. This is a 
universal law of nature, supported by all experience and obser- 
vation. Let us repeat it: the physiological conditions in nature 
found necessary for furnishing the proper nutriment for its 
productions, must also constitute the same standard of organi- 
zation upon which nature, in her normal state or highest devel- 
opment, has established the law of production. If, then, all 
the conditions or qualifications of a good nurse in the best or 
highest state, are brought together, they furnish virtually the 
physiological or normal standard of woman for propagation. 
The fourth topic for consideration is the 
CHARACTER OF OFFSPRING. 
While this might be considered a sequel or consequence of 
the former conditions, arguments may be deduced from this 
source also to establish the doctrine already laid down. It is 
scarcely necessary to state, that wonderful differences exist at 
birth in the physical qualities or constitution of the infant,- 
that many are born into the world with the seeds of disease, 
with weaknesses, imperfections, deficient vitality, organs poorly 
balanced, etc., etc.,-while others inherit a sound healthy con- 
stitution,-free, comparatively, from weakness or any actual 
predisposition to disease, with an organization adapfed to enjoy 
good health and long life ? Now what makes this difference? 
Why are some children born with feeble and diseased bodies, 
or predisposed to disease and premature death? Why, in 
civilized society should nearly one-third of all infants die the 
first year of their existence, and almost one-half under five 
of years age? Is there not something abnormal, unnatural, 
in such mortality of infantile life ? How, on the other hand, 
does it happen that large numbers are born into the world 
with strong, vigorous and healthy bodies, scarcely ever sub- 
jected to disease or suffering, and live till they die from old 
age ? Now, what makes the difference in these two classes ? 
Evidently the difference in the physical stamina or constitutions 
of the parents. Which, then, of these two classes harmonizes 
best with the laws of physiology in its normal state? Most 
clearly the latter class. 32 
Allen : The Normal Standard of 
The question naturally arises, then, as far as the character of 
offspring is concerned, upon what type or feature of physiology, 
should we expect to find a general law of propagation based ? 
Would it not be upon one sound, well-balanced and healthy in 
all its parts and functions, instead of one imperfect and de- 
ranged, possessing the seeds of disease and decay? Such an 
inference surely accords not only with all our experience and 
observation, but with the established laws in the orders of the 
lower animal economy. All the primary laws of nature, or the 
fundamental principles of science, have their start from, and 
foundation upon perfect standards. The laws that govern the 
human system cannot be an exception to this general rule. 
There is another view that may be taken from this point. 
Wherever in nature, we find derangements, imperfections, the 
seeds of disease, decay and destruction, does it not clearly in- 
dicate that some laws have been violated, that there have been 
deviations from a more perfect standard, or, in other words, 
that such a state is abnormal, unnatural? As we study the 
present developments of human nature, we find not only a vast 
amount of pain and difficulty attending pregnancy and parturi- 
tion, but that pain, disease and premature decay follow their 
production. These, too, we find, are to a great extent the 
common, uniform results and not exceptions to a general rule. 
A careful review of all the facts connected with the state and 
organizatidh of infants at birth, with the nature and character 
of their diseases, together with the early decay and premature 
deaths of so many, all go to show that if there is a general law 
of propagation, it is certainly not based upon present standards 
or models. 
This topic-character of offspring-might be greatly en- 
larged upon, as connected with the law of propagation, and 
the designs of nature. It has been well remarked that the two 
strongest instincts of man are, 1st, that of preserving life, and 
2d, that of transmitting life to others. Now, if nature has es- 
tablished some general law for this purpose, as she undoubtedly 
has, it should result in the highest development of offspring. 
It should produce sound, healthy structures, and not an organi- 
zation, impregnated so much from its very origin with the 
seeds of disease and premature decay. It is unnecessary here 
to follow out the argument, that in order to perpetuate the Woman for Propagation. 
33 
race as it should be, there must be sound and healthy stock. 
There is no one thing so important at the present day in the 
progress of the race, or in the advancement of civilization, as 
that greater attention should be paid to the observance of this 
law. 
We have now passed in review four distinct points or topics, 
viz.: pregnancy, parturition, lactation and offspring, which 
constitute the leading stages, or more prominent events con- 
nected with the law of propagation. The facts and inferences 
gathered from each of these sources, all go, we believe, to show 
that there exists in physiology a normal standard for this pur- 
pose. Now, if by gathering .up all the facts and indications to 
be found in each of these stages or events, we find them all in 
the main pointing in one direction,-all agreeing with each 
other, and aiming at the same result, it certainly strengthens 
the argument, and affords an accumulation of evidence on the 
subject. As the four heads above mentioned seem to cover the 
whole ground, if not a single conflicting fact or argument can 
be gathered from any one of these sources-particularly when 
the four heads are brought together-it furnishes strong evi- 
dence in favor of a general law of propagation. 
Several reflections naturally grow out of the present discus- 
sion. The subject is altogether too large and complicated to 
be unfolded in one short paper; all that can possibly be at- 
tempted at the present time, is to present a few thoughts and 
suggestions upon a thesis that would require volumes for a full 
and thorough discussion. Inasmuch as this essay opens new 
views on questions which are obscure in their nature, far- 
reaching in extent, and upon some of which there has long 
existed a great variety of opinions, the sentiments here ad- 
vanced should not be judged of hastily; we could wish that no 
preconceived opinion or prejudice should be allowed to inter- 
fere with their calm and dispassionate consideration. The only 
just and fair method of testing their correctness or falsity is 
by some definite knowledge of the subject-a knowledge ob- 
tained from the study of nature, and the deductions of facts, 
collected from one's own experience and observation.. 
The process, by which many of the leading principles of 
science were first established, has been slow, and attended 
with oppposition and difficulty. The more radical these prin- 34 
Allenj The Normal Standard of 
ci pies were, and the more sweeping in their application, the 
greater the contention and the strife, and the slower their growth. 
But, whenever in the history of science any theories or princi- 
ples had a sure basis in nature, though they might for a time 
be opposed and be controverted, they were sure ultimately to 
prevail. 
So in reference to the doctrines contained in the present pa- 
per, if they constitute a part and parcel of the laws of physi- 
ology, opposition and prejudice will in time give way, and their 
truth and worth will come to be universally acknowledged. In 
fact, the history of medicine furnishes instances of new dis- 
coveries or modes of practice, which, on their first promulga- 
tion or introduction, were bitterly opposed and even ridiculed, 
whose truth and value came in time to be admitted, and which 
are now acknowledged according to their real worth and im- 
portance. 
If the views presented in this paper are true, any candid per- 
son acquainted at all with the laws of physiology or the princi- 
ples of medicine, must admit that they are of priceless value. 
For illustration: In all studies, whether of nature, science or 
art, there are great advantages in having leading principles or 
fixed standards to guide us in our inquiries, and present beacon 
lights in every direction. If, while investigating the facts con- 
nected with propagation, such as the complaints of pregnancy, 
the difficulties of parturition and infantile diseases, we can 
more clearly understand their causes and what particular laws 
have been violated, it must afford immense satisfaction, and 
might, perhaps, enable us to devise new means or agencies for 
relief. It will show what types or models of female organiza- 
tion are best adapted for propagation, most exempt from pain 
and trouble, best qualified to nurse their offspring and trans- 
mit a sound, healthy stock. It will throw new light on the 
laws of inheritance, explaining changes which the body may 
have undergone in past generations, and suggesting what are 
some of the most fruitful sources of improvement. When we 
have formed a just conception of the original or normal standard 
of human nature, according to physiology, and keeping this 
standard constantly in view-when we see the endless devia- 
tions from it, and find that these changes have all taken place in 
accordance with the laws of inheritance,-then we begin to real- Woman for Propagation. 
35 
ize their power, value and importance. Within a few years 
great interest has arisen in reference to these laws, and inquir- 
ies are being pushed in every direction for more light, more in- 
struction in relation to them. No one thing will infuse such 
interest into these inquiries and furnish so valuable a guide, as 
the fact that there is fixed in physiology a normal standard of 
propagation, from which all these laws emanate, and around 
which they all cluster. In fact, in order to understand cor- 
rectly those hereditary influences, and trace them out in all 
their bearings, some such chart or guide is indispensable. For, 
in default of a standard or of some general principles to guide 
us, the powerful agencies of heredity cannot be fully com- 
prehended or accurately defined, or judiciously and advanta- 
geously applied. Nor does social life, or life in any of its phases, 
constrain or invoke attention to any sources or agencies affect- 
ing the well-being of mankind, at least physically, which oper- 
ate for good or evil, more powerfully than the laws of inherit- 
ance. In fact, while it is impossible to estimate the advantages 
of these laws when applied to human improvement, their value 
and application must always be limited, unless we have a per- 
fect normal standard as a guide. 
Another reflection connected with this-subject is that in at- 
tempting to account for the sufferings and difficulties attending 
child-bearing, and finding that they arise in a great measure 
from changes in the human body brought about by artificial 
life and the violation of physical laws, the inquiry naturally 
arises, what are their remedies? What can be done to relieve 
or remove them ? While we cannot easily or hastily reform the 
present artificial state of society, or improve the physical de- 
velopments of the human body, as it would require several 
generations to make any radical changes in this direction, 
yet, by understanding the true causes or sources of these pains 
and difficulties, it may enable us to give instructions or exer- 
cise an influence that, in process of time, will tend to improve 
or modify these agencies, including the laws of inheritance. 
Inasmuch as all sanitary agencies, such as regular exercise, 
wholesome food, pure air, good sleep-in fact, every influence, 
mental and physical, which is calculated to improve the gen- 
eral health of woman-these should all be encouraged as tend- 
ing to, nay, as essential to the realization of nature's plan und Allen : The Normal Standard oj 
36 
design. The more perfect the health of woman is, the more 
evenly balanced her organization, the fewer weaknesses and 
predispositions to disease will occur, the better is she prepared 
for the pregnant state, for the process of labor and the duties 
of maternity. All preparations or treatment that are calcu- 
lated in any way to bring about a normal standard of woman- 
hood, should by all means be encouraged and brought into 
requisition. There is no doubt but that much has been and 
may be done in this way to prepare the system for these 
changes, and that more or less suffering, disease and danger con- 
nected with child-bearing arises from the want of such pre- 
cautions. 
It should, however, be borne in mind that inasmuch as most 
of these causes of pain and difficulty are the results of violated 
laws, extending back for several generations, they cannot at 
once be removed, and the idea that we can have "parturition 
without pain" (as is claimed by some reformers)-especially 
in the present state of society-is perfectly preposterous. No 
such desirable boon can be obtained by any "course of diet" 
or " rules of hydropathy." It has been advocated by some that 
if the pregnant woman subsisted upon food entirely free from 
phosphate of lime, the osseous portion of the infant-especially 
the skull-will become very much modified in hardness-thus 
making its passage through the pelvis much easier. While in 
some instances experiments of this kind may have proved 
apparently successful, in other cases, they have not been at- 
tended with the same result, and as to offspring, we believe 
such a course of diet must prove decidedly injurious. 
But attention has not alone been confined to this kind of 
preparation and treatment: expedients, in great numbers and 
variety, such as anaesthetics, medicines, instruments, etc., have 
been resorted to, in order to relieve the pain and difficulties 
of child-birth. This is all well, but these are all artificial 
helps, relieving only for the time being ; how much better is it 
to go further back, and remove, if possible, first causes ? Let 
us understand the particular changes in certain parts of the 
body, from a normal to an abnormal state, whereby the suffer- 
ings and dangers of child-birth have been greatly enhanced; 
let the laws of inheritance be correctly taught, and our duties 
in relation to them be properly enjoined; let these laws be Woman for Propagation. 
37 
generally observed-and, in the course of a few generations, we 
should undoubtedly perceive a great diminution of these evils, 
and the condition of woman greatly ameliorated in child-birth. 
One of the most beneficent features-and we might say, 
almost the leading object-of the medical profession, is the re- 
lief of pain-the amelioration of human suffering. Whether, 
under medical treatment, disease can be cured and life pro- 
longed, or not-one thing is certain, pain and suffering, in 
all cases, can be more or less relieved. 
While hitherto, in medical practice, cure has been the 
watchword of the profession, let, hereafter, another term, ex- 
pressing a higher if not a nobler object, stand alongside of it 
-that is, prevention. 
A gold medal was very properly awarded lately in London 
to the writer of an essay on " The Therapeutical Means for 
the Relief of Pain ; " but a richer and more enduring reward, in 
the thanks of great multitudes, awaits the advanced guard of the 
medical profession who are laboring to expound sanitary laws, 
and diffuse a knowledge of hygiene for theprevention of pain. 
So in obstetric practice: while the most protracted study and 
greatest skill and ingenuity have for years been exhausted in 
devising means to relieve pain, and save human life, in the most 
critical periods of woman's existence, let us turn our attention 
more to the primary causes of this suffering and danger, and 
earnestly inquire for preventive as well as curative treatment. 
Let us fully realize that, if a normal standard of physiology 
generally prevailed, if its principles and developments were 
perfectly exemplified at the present day in the human system, 
woman would suffer comparatively but little pain or danger at 
such periods. 
In bringing this paper to a close, we wish to enlist in its be- 
half the attention particularly of that portion of the profes- 
sion engaged in obstetric practice and teaching. The history 
of physiology and pathology, in reference to the diseases of 
women, together with the improvements in obstetrics, should 
prepare the mind of every practitioner of medicine for new dis- 
coveries or suggestions in this direction. In no other depart- 
ment can the correctness or advantages of the views here pre- 
sented be so well tested as here-by individual experience and 
observation. Let every obstetric case be tested by the standard 38 
Allen : The Normal, Standard of 
of organization here described ; let the changes through which 
the system of each woman passes in pregnancy, parturition and 
lactation, be compared with the doctrines set forth in this 
paper, and let the results of such observations in a large number 
of cases be brought together, analyzed and compared; then 
from these data some correct and rational conclusions can be 
deduced. 
Partly by way of illustrating the principles of physiol- 
ogy, as here set forth, but more particularly to show their 
bearings on population, we present a few facts which first di- 
rected our attention to this subject. Many years since, while 
attending obstetric cases in a mixed population, including 
English, Irish, Scotch, German, French and American, we 
were struck with the great differences in the fertility of these 
women, as well as in the difficulties accompanying parturition. 
Comparisons were instituted, treatises on obstetrics, works on 
population, census returns, etc., were examined, and then 
changes in population. It was found by an examination of 
town records, genealogical histories, registration reports, etc., 
that the birth-rate in New England had steadily diminished in 
every generation, but more rapidly in the last one or two ; that, 
commencing with an average of eight or more children in each 
family, it averaged at the present time in Massachusetts only 
about three ; and that with the strictly American the birth-rate 
and the death-rate were approximating nearer and nearer to- 
gether. If one-third of those born die before reaching adult life, 
and a portion of the living never enter the marriage relation, 
the question arose, in view of such a record, what will be the 
result on the increase or decrease of population? With such a 
diminution of numbers among the native American, and an in- 
crease of offspring in the foreign element of more than double, 
what could make this change and this difference ? How can 
we account for such anomalies ? On the other hand, a careful 
examination disclosed great differences in the organization of 
these women, which might account in some measure for such 
a state of things; the causes of these differences were analyzed 
as far as practicable, and the relations which they might sus- 
tain to an increase of population. It was found that a great 
change had taken place in the physiology of our New England 
women, that there had been a marked loss of muscular power Woman for Propagation. 
39 
and a great increase of the nervous temperament; that weak- 
nesses, diseases or complaints of one kind and another had 
greatly increased and become so common, that good health and 
sound constitutions were the exceptions. 
Again, uterine diseases and complaints were found particu- 
larly to have greatly multiplied, for which there must be spe- 
cial causes. Among these the compression of the chest and 
abdomen, from the style of dress and fashions of the day-com- 
menced early and long continued-had had a very injurious 
effect apon the interna] organs, especially upon those in the pel- 
vis, thereby causing displacements, weaknesses and diseases. 
With a general loss of muscular strength and an increase of 
nerve tissue, aggravated, too, by other causes, the reproductive 
organs had become abnormal, incapacitated to perform healthy 
functions, which, of course, must seriously interfere with con- 
ception, gestation and parturition. Add to this a constant strain 
upon the brain and nervous system, requiring relatively too 
large an amount of nutrition, we have as a result an undue 
predominance of the nervous temperament, which in some of 
its aspects is decidedly unfavorable to the domestic relations, 
as well as to the laws of maternity. Thus it will be seen that, 
as far as physiology is concerned, the true law of population 
must be based upon the same general principles as that of pro- 
pagation, and that a correct knowledge of the former cannot 
be obtained without reference to the latter.