IMPROPRIETIES OF DRESS AN IMPORTANT ETIOLOGICAL FACTOR IN MANY OF THE DISEASES PECULIAR TO WOMEN. BY Sebastian J. Wimmer, M.A., M.D., OF ST. MARY’S, PA., FELLOW OF THE NEW YORK COLLEGE OF PHYSICIANS AND SURGEONS. Reprint from The Medical Register, November 24, 1888. PHILADELPHIA: RECORDS, McMULLIN & CO., Limited. 1888. IMPROPRIETIES OF DRESS AN IMPORTANT ETIOLOGICAL FACTOR IN MANY OF THE DISEASES PECULIAR TO WOMEN. By SEBASTIAN J. WIMMER, M.A., M.D., OF ST. MARY’S, PA. ALL styles of apparel for the female, which are so related to it as in any way to cause an inter- ference with the circulation of the blood in its differ- ent courses, with the natural movements of the chest, abdomen, and extremities are unhealthful, and tend directly to cause pathological conditions and changes in the sexzial system, an outcome of the many serious alterations to which the human female system is heir, resulting from the improprieties of dress. All these disturbances have but the one goal to reach, and that destination is centred in the uterus, which is not irrelevant to this sympathy in the woman subjecting her body to such a martyrdom. This organ reflects the “germs of disease” so faithfully by this very sympathy that it likewise enkindles and fans into ex- istence the rapidly devouring flames of newly-created diseases, so that finally the entire organism becomes a victim, and succumbs sooner or later, to the inevi- table onslaught, placing the patient fate to face with 2 incurable, or at least intractable and lasting affec- tions. It is not my intention nor my desire to write a new dissertation on this subject, it being one that has been taken up by the ablest men in the profession, who have said so much already that nothing remains for me to do but recapitulate. Therefore, it may seem to many as if I were undertaking a useless task ; but, when one sees so much distress, sickness, etc., accruing from the abuse of the very first laws of nature, then it seems to me that a few more words— nothing of a novelty, though—may still at least keep afresh in the minds of the proiession the necessity of admonishing and pointing out to our female patients the gravity resulting from an ignorance of the immu- table laws of nature, or when they are known, that their salient points may become clearer to them by constant demonstration, to teach them the absurdity as well as the dangers of this pernicious custom, now so universally adopted. One of the most harmful practices at present is the tightness of the corset worn by ladies of the present day. Our times are by no means the source of this freak. Bouvier tells us that the Roman lady was as susceptible to the supposed imagination, so prevalent nowadays, that the figure depended entirely for its beautiful (?) contour upon the intricate bandaging and strapping, as it were, to which it was subjected, that her ambition solely was to devise, by taxing her in- genuity as much as possible, appliances, by which she could overcome this seeming neglect on the part of nature. This same observer remarks that these women could bring about crowding of the abdominal contents and controlling the chest, as well as a curv- 3 ature of the spinal column with the same ease as our own devotees to the follies of this fashion can do now. The Greek women, who were averse to prominent abdomens and hanging mammae bandaged, supported them. These accomplishmenis lasted until the dark ages, when Western Europe discarded this vice for the time being, which was fast becoming an epidemic, resulting in the production of frightfully deformed thoraces, and, instead of lessening the abdominal prominences, actually caused an increase in their size, thus thwarting the very object in view, of diminish- ing it. This would naturally take place on account of the pressure exerted downwards from the already overtaxed thorax, which might have been encased— for all we know—in a Catherine de Medici corset, or one of those equally severe, the so-called “terrible engine ” of Elizabeth, both of which were constructed of rigid, unyielding metal. Imagine, if you could, a more deplorable condition of the apathy of these women, when they went so far, regardless of con- sequences, as to submit their bodies to such a disas- trous test, challenging the very vitality of their organs to a contest to be for victory or defeat. The breach in the continuity of this fashion rapidly healed over, by granulations of recklessness, goaded on by the dupes of fashion, for they cared no more for the inevitable results which would surely follow, be- cause a renewal began again, and the older devotees might have been even more eager than ever to wor- ship at this ruinous shrine, before which one pays so dearly, by all sorts of ailments, particularly uterine, received in return for this homage. At this time ‘ ‘ the wasp-like waist” became fashionable, and young 4 ladies spared nothing in their power to aid them in diminishing their waists to a ridiculously small circum- ference, which resulted in much disease, such as dis- placements with their sequelae, retained menstrual blood, and flexions, etc., of the uterus. Where were the mothers of the future generation to come from ? No woman with such an outfit could possibly bear healthy children when the very organs which play so important a part in the period of pregnancy wrere cruelly subjected to the roughest treatment by this vicious practice. The uterus, which is, properly speaking, the organ of gestation, which retains and supports the fecundated or impregnated ovum during the development of foetal life, is such a movable body, that it is verj' easily displaced, and I might well preface my subsequent remarks by quoting from the work of that eminent gynecologist and teacher, Prof. T. Gaillard Thomas (“Diseases of Women,” fifth edition, Philadelphia): “The dress adopted by the women of our times may be very graceful and becoming, it ma}' possess the great advantage of developing the beauties of the figure and concealing its defects, but it certainly is conducive to the development of uterine diseases, and proves not merely a predisposing, but an exciting cause of them. For the proper performance of the function of respiration, an entire freedom of action should be given to the chest, and more especially is this needed at the base of the thorax, opposite the attachment of the important respiratory muscle, the diaphragm. The habit of contracting the body at the waist by tight clothing confines this part, as if by splints; indeed, it may accomplish just what th 5 surgeon does who bandages the chest for a fractured rib, with the intent of limiting thoracic, and substi- tuting abdominal respiration.” Here we see what results from this craze, for such it is, because those suffering from these deleterious effects have been strict adherents to a folly—worse than many crimes— which is inexorable and unyielding, though the con- sequences which are* fairly known by them become lasting complaints, if persisted in. Uterine diseases are so commonly caused by this very reason that it may well be styled an important etiological factor in their development. The thorax, which is made up of a bony frame- work, welded together by cartilage and muscles, is conical in form, and has as boundaries, anteriorly, the sternum costal cartilages, and the ribs; posteri- orly, the twelve dorsal vertebrae and ribs; and, later- ally, the ribs. The scapulae are situated posteriorly. This large cavity lodges the important organs con- cerned in the acts of respiration and circulation, being the vital centre, in fact. It also contains the organs of the principal vessels and nerves, which sympathize with others throughout the organism. A lesion as- serting itself in one part of the body usually affects other parts by the sympathy which the continuity and contiguity of tissues afford, and transmits this morbidness through the circulation, etc., to the more distant parts, sowing seeds which grow and ripen into constitutional affections. The thorax suffers in- tensely from the constriction to which it is subjected by tight clothing, lacing, etc., that great deformity results, by lessening gradually the capacity of the thorax, the pressure imposed exerting its influence 6 on other and more distant parts, endangering them likewise. We have, as a consequence of this thoracic trouble, shortness of breath, palpitation, and irregular action of the heart, spinal irritation, uterine displace- ments, and ulcerations, brought on entirely by the pressure exerted upon heart, spinal column, lungs, uterus, etc. Constriction of the chest excites all the organs contained therein to an activity, at first, which is due to the extra amount of labor that they are called upon to perform. They soon are encroached more and more upon until they lose their inherent strength, and we have then a retardation of the proper respiratory movements, the lungs having no longer the amount of space originally allotted to them, and lateral expansion is almost entirely suspended; suffi- cient air is not inhaled; it cannot penetrate the mi- nute lobules, and the blood is not sufficiently aerated, for want of oxygen, and it loses its characteristic hue, and such females suffer from anaemia, because the surrounding tissues and organs have lost their tone, therefore lighting up many serious diseases, indeed, which soon manifest themselves. This continuous thoracic pressure, after having disabled the organs of the chest, spends its remain- ing force upon the abdominal contents, as referred to before. The chest soon manifests its disapproval by assuming a new form. The lower ribs are soon made to encroach towards the median line of the chest, suspending all the normal lateral movements, and the lungs suffer markedly by their fruitless efforts in trying to regain their former position. All this tends to affect the thoracic bones, and we have one shoulder higher than the other, the spine more or less affected 7 in different ways. Distortion going on we see, hips interfered with, displacing their bones, particularly influencing the spinal system, which is now exerted to its utmost tension. When corsets are worn, their upper “steels” are usually brought snugly under the arms, causing great pressure on the scapulae, which, encroaching on the ribs and spine, restrict their free use. The right arm and hand, however, being stronger and more powerfully manipulated than the left, have a greater freedom under the circumstances, and are thereby enabled to move from the unnatural restraint to which they are sub- jected ; whilst the left arm and hand continue com- paratively motionless, causing elevation of the right shoulder and a consequent depression of the left. We have here the commencement, then, of a deformity which becomes more and more apparent with the elapse of time and a continuance in wearing the corset. The left scapula is forced against the ribs, and they are, in turn, in contact with the spinal column, pushing it to the right side, occasionally causing a displacement of the bones mentioned. To recapitulate, we have, then, distortion of the shoulder, the bones forming the chest-wall and those of the hip and spine. To enumerate all the other bodily displacements and ailments caused by inju- diciously dressing would fill many books; so I will refer readers to other works for more extended infor- mation upon the subject. This habit is the chief cause which is undermining the health of our women, and it incapacitates them for performing those ma- ternal acts which require such a regularity and nicety of her system. The ability to nurse her children is 8 destroyed, because all the laws of physical develop- ment and health are violated to a great extent. Only the conscientious and observing physician, who regards the safety and welfare of his patients as sacred, can vouch for the veracity of these state- ments, and the nature of this growing evil can only be appreciated by him, who knows the hold it has upon our females of the present generation. The caricatures of the female form found in our “ fashion plates” are miserably grotesque, but still they are sad reflections, true in that respect of the “wasp- like” conditions of the girls and young women of the present day, for do not these very females simu- late them, and are not these publications found throughout the length and breadth of the land ? Fashion and folly indeed travel together, are in- separable companions, and pervert and destroy our young girls and women. Constriction of the waist not only crowds all the thoracic organs, but it causes the abdominal organs to seek new and unsuitable quarters. The liver is displaced sometimes, accord- ing to Murchison (“ Clinical Lectures on Diseases of the Liver,” third edition, 1887), and even the pan- creas may be placed in this category, as the stomach and uterus surely are, not commenting at all upon the other organs found here. The uterus bears the brunt of all, being so movable, it readily yields to the pressure spent upon it and descends to the pelvic floor, and, according to Thomas: “The act of sexual intercourse, which, in one whose organs maintain a normal position, is a physiological process devoid of pathological results, becomes an absolute and positive source of disease. The axis of the uterus is not 9 identical with that of the vagina. While the latter has an axis coincident with that of the inferior strait, the former has one similar to that of the superior. This arrangement provides for the passage of the male organ below the cervix into the posterior cul- de-sac, the cervix thus escaping injury. But let the uterus be forced down, as it is by the prevailing styles of fashionable dress, even to the distance of one inch, and the natural relation of the parts is altered. The cervix is directly injured, and thus a physiological process is insensibly merged into one productive of pathological results. How often do we see uterine disease occur just after matrimony, even where no excesses have been committed. It is not an exces- sive indulgence in coition which so often produces this result, but the indulgence to any degree on the part of a woman who has distorted the natural rela- tions of her organs. But this is by no means the only method by which displacement of the uterus may induce diseases of its structures. It disorders the circulation in the displaced organ and produces passive congestion and its resulting hypertrophy, prevents the free escape of menstrual blood by pressing the os against the vagina, creates flexion, causes friction of the cervix against the floor of the pelvis, and stretches the uterine ligaments and de- stroys their power and efficiency.” The muscles of the abdomen are also affected, and lose their sustain- ing power, and the woman feels lost without the arti- ficial support which has taken the place of nature’s supply. It is a well-known fact that most females constrict their thoraces so firmly as to preclude the possibility 10 of performing the perfect and natural respiratory movements, and the muscles which should assist in performing these respirations atrophy, lose their char- acteristic elasticity, and fail to comfort the sufferer without the aid of the artificial support. Tight cor- sets cause, as before mentioned, a thinning of the ab- dominal muscles, and some observers mention an entire atrophy of all the surface situated beneath the obnoxious instrument. I might go on dilating upon this subject, but sufficient comment has been made already. It is, however, so momentous that something should be done to check this abuse, for and beyond all doubt it is, in the writer’s estimation, a most pernicious as well as an universal custom. It even takes hold of the child before it has seen the light of day, by interfering with its development, and often brings it prematurely to an untimely birth, and frequently deprives it of the natural nourishment to which it is justly entitled, because the mother has distorted her figure and made herself unfit for child- bearing. Physicians can readily appreciate how un- fortunate it is when pregnancy occurs under such cir- cumstances, because these women are so perverted in their ideas that they do not hesitate to lace tightly, fully aware of its dangers, not only to themselves, but to the life of the child, which many, under the circumstances, would be glad to lose. We cannot ignore the existence of these evils, for “the light of this new day is too strong for that.”