j THE YOUNG WOMAN'S • T BOOK OF HEALTH. BY DR. WM. A. ALCOTT, »•*»♦ AUTHOR OP THE HOUSE I LIVE IN, YOUNG HOUSEKEEPER, LIBRARY OP HEALTH, TEACHER OP HEALTH, YOUNG MOTHER, YOUNG MAN'S GUIDE, YOUNG WOMAN'S GUIDE, LETTERS TO YOUNG MEN, LETTERS TO A__&I&TJERt~EXO,~EXC--------- LIBRARY SURGEON G£NERA(J» OFFICE BOSTON " AUC.-ia*1898 TAPPAN, WHITTEMORE AND MASON. 1850. WP A355y \°>$o Entered according to Act of Congress, in the year 1851, by William A. Alcott, in the Clerk's Office of the District Court of the District of Massachusetts. STEREOTYPED AT THE BOSTON STEREOTYPE FOUNDRY. PREFACE. Prefaces, though fashionable, are seldom read, and are, therefore, of little value. Mine shall be short. Indeed, the little I have to say will be said far less in compliance with fashion than to apologize for presenting to the public another work in the department of Female Health. They, however, who will take the trouble to read attentively my preliminary chapter, will find, first, that neither in my own numerous works, nor in those of any other writer who has given us his views in a popular shape, has much been said on the special means of preserving the health of /females. He will find, secondly, that if the facts contained in that chapter are not what Dr. Cullen used to call " false facts," the subject itself is one of amazing and paramount importance. It is in this belief that I again appear before the American public on my favorite subject — that of prevention. I have now been a student of the 4 PREFACE. laws of health and disease for more than mirty years. The following pages are, therefore, the result of long experience, and of much patient and laborious — I would fain hope careful — observa- tion. Concerning the real, practical value of the volume, however, it is not for me to speak. I can only speak of its general purpose and intention. It is designed as a legacy — possibly a last one — to that sex through whose instrumentality sin and disease came upon the world, and through whose obedience to the divine law, as an efficient instru- ment, they are, in the end, to be removed. WM. A. ALCOTT. West Newton, Mass., April, 1850. CONTENTS. CHAPTER I. PRELIMINARY REMARKS. PAGE. Young Women should be trained to endure hardness. Study of hygiene. Females buoyant in their nature, and thoughtless. Beauty. Its dependence on health. An error about beauty. Few healthy females. Statistics of female disease. Analysis of beauty. Seeking happiness. The true road to it. Physical education and elevation. The views of Solomon. Appeal to young women .......................................... 13—22 CHAPTER II. ERRORS IN THE PHYSICAL EDUCATION OF YOUNG WOMEN. WHERE FEMALE MISEDUCATION BEGINS. Section 1. Too great Delicacy and Tenderness. Means of be- coming so frail. An object truly pitiable................. 23—28 Section 2. Nervousness. Its causes. Its forms. Fidgets. St. Vitus's dance. Epilepsy. A nameless disease............ 28—32 Section 3. Want of Muscular Power. Manifestations of this cardinal defect........................................... 32—33 Section 4. Want of Appetite. Causes of this condition. Eat- ing too often. Food usually too stimulating. Hint to mothers and housekeepers....................................... 33—36 Section 5. Feeble Powers of Digestion. A mistake about diges- tion. Remarks and appeal............................... 36—38 CHAPTER III. WHAT THE PHYSICAL EDUCATION OF FEMALES SHOULD BE. General Remarks............................................. 39 Section 1. The Laws of Exercise. The bones — their union. The muscles — their character and use. First law of the lo- comotive system. Second law. Third law. Sitting too much. Effect on the lower limbs. Standing. Walking. Walking to do good. Reasons why walking to do good is preferable.........................................•.....40—49 Section 2. The Laws of Respiration. Description and uses of 1* > 6 CONTENTS. the lungs. Breathing bad air. Health of employments. Po- sition, &c............................................... 49—57 Section 3. The Laws of Bodily Purity; or, Cleanliness. The skin. Its structure and offices. When and. how it is injured. Who suffer most by its neglect. Its laws. Cleanliness. Must be exposed to the light. Must not be compressed. Should not be irritated. External and internal irritation. Must have free access to the air. Dangers of confining the skin. Illustra- tions. Hints on clothing and dress. Remarks on bathing..57—77 Section 4. Diet and Regimen. What a well-regulated diet is. Hints. Rules given. 1. Eat what relishes. 2. Masticate your food well. 3. Avoid eating too often. 4. Avoid excess in quantity. 5. Have due regard to quality. Simplicity. Ease of digestion. Nutrition. 6. Food should not be diseased. Vegetable food. Animal food. 7. Should not be medicated. 8. Should not be improperly cooked...................... 77—100 Section 5. Latos of the Circulation. Proportion of the solids and fluids. How the fluids are retained in the body. Philoso- phy and physiology of the circulation. Object and end of circulation. Its laws. Quality of the blood. How to have good blood. Strong and large heart, and other machinery. A good supply, at all times, of pure air................... 100__104 Section 6. Laws of the Mind. Connection between health of the mind and health of the body. Phrenology needed. Objec- tions considered. More knowledge would bring with it more health. Ignorance is neither bliss nor health............104__106 Section 7. Laws of the Heart. Connection of the passions and affections with health. The elevating passions. Physi- ology of their influence. The centrifugal and centripetal ten- dencies................................................106—108 CHAPTER IV. PRECOCITY. Definition of terms. Dependence on scrofula. What scrofula is. Latent and active scrofula. The difference between bodily activity and bodily strength. Particular errors in the education of scrofulous children. Necessity of having them obey the physical laws. " Too bright to live long." Prodigies in learn- ing usually scrofulous persons. Errors in the schools. Physi- cal and mental precocity usually accompany each other. Some- times they are accompanied by moral precocity.......... 109—118 CHAPTER V. PRECOCIOUS DEVELOPMENT. Social precocity. Its characteristics. Changes at pubertv 1 nr the cranium and pelvis. 2. Of the moving powers of thi body 3. Of the skin. 4. Of the form of the hmbs QUota tion from Dr. Morrill. The standard of health and beauty Premature development. Development of certain diseases" Another development. Testimony of Dr. Morrill o£ Ms suS CONTENTS. 7 ject. Consequences of solitary indulgence. The causes of this form of depravity. Its treatment as a disease. Objections to the use of medicine in these cases. What should be done. Putting "under law." Food and drink. The restorative power of Nature. Views of an able writer. Difficulties. Bet- ter late than never..................................... 119__133 CHAPTER VI. TARDY DEVELOPMENT. Various subdivisions of this disease. These subdivisions are of little practical use. Tardy development sometimes depends on disease. If so, the first thing to be done is to remove, if we can, the disease. Thoughts on perfect health. A great mis- take about what health is. Living too high and too fast. Factory stimulation. Anecdote of a kind mother and a spoiled daughter. Other anecdotes. Further directions. Tardy de- velopment from malformation.......................... 137—147 CHAPTER VII. SUPPRESSION. At what periods of life this'is most common. 1. Moral causes of the disease. Their effects physiologically considered. Review of the curious structure and character of the skin. The cen- trifugal and centripetal tendencies again referred to. Conges- tions in the system. They fall, most frequently, on the weak- ened part. Particular tendency of particular forms of depres- sion. 2. Physical causes. Sudden exposure. Errors in diet. Errors of dress. Anecdote, from my own practice as a phy- sician. Suppression produced by design. Deplorable effects of ignorance. Symptoms of this disease. Its treatment. The iet-alone practice. How far it will succeed. When and where we should resort to medicine. Universal obedience, morally and physically, the only certain panacea for this and all other human ills............................................. 148—160 CHAPTER VIII. VICARIOUS DISEASE. What is meant by vicarious disease. Its various forms. Not dangerous. Falls usually on the weakest part. This points to the proper mode of treatment. Other particulars in regard to treatment............................................. 161—lo4 CHAPTER IX. EXCESS, OR MENORRHAGIA. Definition of terms. Various forms of menorrhagia. Induced by various causes. The depressing passions. Their centripe- 8 CONTENTS. tal tendency. Effects of medicine. Evils of maternal dosing and drugging. An anecdote. Evils of a bad diet. Sleeping in warm beds. An error exploded. Bad air. Treatment. Ob- jections to bleeding. Quiet, and a recumbent position. Drinks. Application of cold. Exclusion of croakers. What the food should be. Remarks on crude vegetables. Quotation from Dr Morrill............................................ 165—177 CHAPTER X. DYSMENORRHEA, OR PAINFUL MENSTRUATION. Why I speak of this disease so briefly. With what complaints it is usually coupled. Some of its causes. Treatment of the disease. " Whiling away " the time. Treatment during the in- terval. Showering with cold water. Sponging the body. Ex- ercise. The mind should have relief from exercise as well as the body. A cheerful companion. Walking. Walking to do good. A generous diet. What I mean by it. Water the best drink................................................. 178—180 CHAPTER XI. CHLOROSIS. Chlorosis a disease of the general system. How sometimes in- duced. Often the result of constipation. Marshall Hall on the causes of chlorosis. Miseducation prepares for chlorosis. Other provocatives. Almost always connected with disordered digestion. Other symptoms of the disease. Treatment. Put- ting under law. Pure air. Diet plain, but nutritious. Toma- toes. A mistake about digestion. Exercise — its good effects. Passive exercise. Bathing and swimming. Sleep. Evening amusements. Reading romances. Physical education.. 181—189 CHAPTER XII. LEUCORRHEA. Universality of this complaint. What Dr. Meigs says. Descrip- tion. Symptoms. Origin. Sometimes it is constitutional. Foot-stoves. Warm bathing. Bad air and improper gases. Effects of masturbation. Medicine and medicated food. French views of leucorrhea. City and country. Effects of tea and coffee. Treatment of the disease............... 190—196 CHAPTER XIII. HYSTERIA. Imagination Its influence on hysteria. Seat of the disease. Origin. Various conjectures. Falls most readily on th« pre- cocious and scrofulous. Quotation from Dr. Hooper. Charac- CONTENTS. 9 ter of the disease. Its causes. The depressing passions. This disease often inherited. Light literature. Hysteria in- creasing among us. Influence of climate. General debility. Idiosyncracies. Gases in the stomach. Sympathy. Odors. Treatment. Placeboes. Moral placeboes. No medicine need- ed during the paroxysm. Prevention our sheet anchor. Train- ing to hardness. Cold bathing. Objections answered. Par- ticular directions about cold bathing. Walking and riding. Retiring early. Treatment of the bowels. Band-box educa- tion. Eating and drinking............................ 196__214 CHAPTER XIV. UTERINE MADNESS. This a rare disease. The name suggestive of its nature. Predis- posing and exciting causes. Those which act on special organs. Bathing. In general, cooling treatment. Food and drink. Avoid medicine. Surgical treatment. Treatment of the mind. Feather beds. Late hours. Artificial heat .. 215—219 CHAPTER XV. HYSTERALGIA. Neuralgia in general. A disease of modern times. Hysteralgia one form of it. Involves continual suffering. At what age it attacks. Causes of the disease. Injudicious emetics and ca- thartics. Palliation. Open air. Warm bathing. Generous diet. Iron. The path of obedience....................220—223 CHAPTER XVI. STERILITY. Causes of sterility. Personal causes. Abuse of the appetites. Obscure causes. Disparity of age. Treatment. This indi- cated by the causes. What should be done in case of malfor- mation. Good living. Sterility tends to general ill health 224—229 CHAPTER XVII. EXTERNAL DISEASES. INFLAMMATION, ABSCESS, AND ADHESION. Slight inflammation very common. The final tendencies. The local treatment. Treatment when it goes on to abscess. An error in regard to external applications. Examples of this error. Medical error. Adhesion. How treated. Importance of cleanliness. Directions for the period of puberty. Bath- ing ...................................................230—234 10 CONTENTS. CHAPTER XVIII. PRURITUS. Severity of some forms of this disease. Not very frequent with young women. Causes. Treatment. Tepid bathing. ^xer- cise. Friction of the skin —its evil tendency. Borax a"^_23- other medicaments.................................... •*wo CHAPTER XIX. INTERNAL DISEASE. INFLAMMATION OF THE UTERUS AND OTHER PARTS. fc Definition of terms. Complication with other diseases. Symp- toms, especially mental and moral changes. Causes. Treat- ment. Diet and drink, &c............................. 238—241 CHAPTER XX. PROLAPSUS UTERI. Tendencies of modern miseducation. Why it is so. What pro- lapsus uteri is. Its causes. The treatment. Evils of con- cealment and delay. Early attention to the subject recom- mended. Putting under law. Effects of maternity. Treat- ment of severer cases. Life a burden. Treatment under these circumstances. The recumbent position. Pessaries. Other medical treatment. Study of hygiene. A desideratum. .242—252 CHAPTER XXI. INVERSION OF THE UTERUS. Difference between this disease and prolapsus uteri. What in- version is, and who are liable to it. Treatment. Spontaneous recoveries. Prevention, after all, the great thing to be aimed at.................................................... 253—255 CHAPTER XXII. RETROVERSION AND ANTEVERSION. Definition of terms. What retroversion is. What anteversion is. Causes of retroversion. Causes of anteversion. Symptoms of this disease ........................................ 256—259 CHAPTER XXIII. HEMORRHOIDS, OR PILES. AND PROLAPSUS OF THE RECTUM. Description of the disease. Two kinds of it. Who are most liable to it. Remarks on old age. Causes of premature de- CONTENTS. 11 cline. Causes of so much disease of the kind before us. Quo tations and remarks. Treatment. Necessity of law, here, rather than medicine. Danger of flying to purgatives. Other popular errors. Cases to illustrate. Gentle treatment by med- icine externally. Protest against fine flour bread, especially eaten while new and hot...............................260—272 CHAPTER XXIV. UTERINE DROPSY. Definitions and explanations. Extreme cases. Obscurity of its causes. One general cause well known. When medical advice is needed. A caution or two...........................273—275 CHAPTER XXV. MOLES AND HYDATIDS. What moles are. Fleshy moles. Their causes. Hydatids. Treatment of moles. Caution against over-anxiety and fear. Caution against ignorance and quackery................ 276—279 CHAPTER XXVI. UTERINE POLYPUS. This a serious disease. Description. Symptoms which arise early. Later symptoms. Spontaneous cure. Treatment of other cases. In order to know how to treat it, we must know the causes. Medical advice. Hygiene..................280—284 CHAPTER XXVII. FIBROUS UTERINE TUMOR. Distinction between this and polypus. Causes. Symptoms Treatment 285—286 CHAPTER XXVIII. CAULIFLOWER EXCRESCENCE OF THE UTERUS. Description. Whom it most affects. Causes. Symptoms. Treatment. Extirpation. Palliation to be sought, even when we cannot cure. In what this palliation consists........W—*W CHAPTER XXIX. CANCER OF THE UTERUS. Fearful character of this disease. Its first symptoms. Its course and termination. Dr. Morrill's views. Dr. Lambe on the diet. The views of others. Difference between a low diet and a mild 12 CONTENTS. one. Necessity of cleanliness. Impotence of medicine in these cases............................................291—^w CHAPTER XXX. CORRODING ULCER. What it is. Causes. How it compares with cancer. First symp- toms and appearances. Treatment. The laws of hygiene com- prise nearly the whole treatment........................ 297—299 CHAPTER XXXI. CANCER OF THE OVARIA. Peculiarities of this disease. How it differs, in its symptoms, from cancer of the uterus. Treatment...................... 300 CHAPTER XXXII. OVARIAN DROPSY. In what the disease consists. Character of the fluid secreted. Symptoms of the disease. How it should be managed. Med- ical treatment as a last resort. Tapping. An anecdote.. 301—303 CHAPTER XXXIII. CANCER OF THE BREAST. Popular fears. Their evil tendency. The workings of imagina- tion. What is the truly wise course. Description of cancer in the breast. When there is danger. Prevention the great thing in these cases. Improper food, drink, &c. Tight dress. "Scattering" medicines. A long list of causes. Advice of Dr. Lambe. In general, we must'obey. A word about plas- ters................................................... 304—308 CHAPTER XXXIV. REFLECTIONS. Why I have written on disease. Caution against an error. Con- cluding remarks ...................................... 339—311 THE YOUNG WOMAN'S BOOK OF HEALTH. CHAPTER I. PRELIMINARY REMARKS. If female agency is but half as important in this world as many suppose, and as I think has been shown in my other works, particularly the ''Young Woman's Guide " and the " Letters to a Sister," then should woman, by all means, possess »a firm constitution, and the best of health. She should not only know her duty, and have a disposition to perform it, but she should possess the requisite power and energy. If she is virtually a missionary, both in the nature of things and by virtue of a divine commission, then she should be trained accordingly. She should be trained to all that firmness of nerve, as many call it, — but which means, more properly, firmness of bone and muscle,—which, to the missionary, at home or abroad, is so necessary. 2 14 YOUNG WOMAN'S BOOK OF HEALTH. And it is in this point of view, more than any other, that the careful study of the laws of health, or, as the French call it, hygiene, becomes so im- portant to the female world, especially to young females. How greatly to be desired, that they should be aware of its importance ! Young women, however, in general, are not enough inclined to sober thought, especially on a subject, to them, of such immeasurable value. They have little apprehension of evil of any kind. They feel no pain, and they fear none. Their whole nature is buoyant. Indeed, God the Creator meant it should be so. He meant they should be free, in a good degree, from that care and over anxiety which too often weigh down the feelings and impair the health in more advanced years. But it is not necessary, that, in order to be cheer- ful, we should be reckless, or thoughtless. Because the young are designed by Providence to be as gay and sportive as the lark, it does not follow that they should be mere larks. Admit, if you please, the importance of music and other fashionable accom- plishments ; yet a young woman should possess something else besides mere accomplishments. Though taught the piano, she should not be wholly piano. She desires to appear well — to be regarded as beautiful. Perfectly right. It should be so. Beauty is almost a virtue. Adam and Eve, as some say, BEAUTY AND HEALTH. 15 were exceedingly beautiful. Why, then, should not the restoration of the world restore the beauty of the world ? And why should not every step 4ve take upward, in a moral point of view, as a race, be also a step upward physically, — an advance not only towards primeval innocence, but primeval beauty ? One thing, however, woman should be told, — and the lesson should be repeated, till it is fully remembered, — that beauty of form and feature depend very much on bodily health. I once wrote an article, entitled, " Crooked Spines and 111 Tem- per." * But there are other connections and de- pendencies of mind and body besides that which was indicated and discussed in the above-mentioned essay. But many young women are beautiful, it may be said, who do not enjoy health. And one eminent foreign traveller has affirmed of a whole class of diseased females in the United States, — the scrofu- lous, I mean, with their transparent skins, light blue eyes, and nervous temperaments, — that they are remarkably beautiful. The mistake of Mr. Combe arises from the fact that we have set up among us a wrong standard of beauty, not only of feature, but of form. The human female frame should not differ essentially * See one of the volumes of the Library of Health. 16 YOUNG WOMAN'S BOOK OF HEALTH. from that of the male. Or, rather, it should never, in these respects, come to imitate either the wasp or the white lily. It will doubtless be objected, on the other hand, that many young women, not at all remarkable for beauty, are as far removed from health as are the scrofulous and nervous. But this fact only serves to confirm the truth of my position, — that we have set up a false standard of beauty, instead of the true. These last persons, after all, are more really and truly beautiful than the others; and their beauty is much more likely to be permanent. We are greatly liable to be deceived in this whole matter. Few young women, even among those whose health is so often boasted of, are really healthy ; and yet very few, during the earlier years of their ex- istence, are the subjects of much pain. The greater part, therefore, are reckoned healthy, both by them- selves and their friends. Let us consider this sub- ject, for a moment ; and if it be admitted, that, as a general principle, beauty is dependent on health, let us see whether much beauty in this world ought to be expected. Nearly every individual among us, during life, has more or fewer colds. This is especially true of early life. Most persons have many. Now, a cold is as truly a disease as the small-pox or the cholera ; and, when often repeated, is found to im- pair, in a degree, human beauty. COLDS AND CONSUMPTION. 17 These colds — diseases of themselves — often terminate in other diseases, such as fevers, pleuri- sies, consumption, asthma, bowel complaints, and diseases of the kidneys, bladder, uterus, &c. Half our race, at least in this country, die of fevers; and many suffer greatly from this class of diseases, who do not finally die of them. It is yet unsettled whether a larger proportion of females than of males fall victims to the various kinds of fevers which prevail. Colds, I have said, lead to consumption. Be it remembered, also, that a large number of our race — say about one fourth of us — inherit a consump- tive tendency.* More than half who die of this disease are females. It is, however, worthy of re- mark, that very few consumptive people are subject to fever, except, perhaps, lung fever. Nervous complaints, again, are so common among us, that you will seldom find a family that has not one or more nervous females in it. By nervous complaints, however, I do not mean mere fidgets, or something which is only-imaginary, but real disease.-f I suppose that one half of our females are thus afflicted. Many who are liable to con- sumption and fever are, also, greatly nervous. * We lose yearly in the United States, from the various forms of consumption, some 60,000 or 70,000 persons; from fevers of all kinds, more than 200,000. t See Chap. II. 2* 18 YOUNG WOMAN'S BOOK OF HEALTH. When we consider all this, is it not manifest that few females among us escape disease, either heredi- tary or acquired? And is it not equally plain that most, if not all of us, must be the descendants of those who were diseased before us ? — and that it is scarcely possible there can be a healthy drop of blood in any human veins ? In this view, then, will any individual, who assents to the proposition that beauty is dependent on health, be apt to wonder that there is so little true beauty to be found among us ? Will he won- der that the little which remains is daily and hourly diminishing ? Every young woman who desires to be hand- some — to appear well — should desire to be healthy; not merely to be free from pain, — for that were, comparatively, a small matter, — but to have vigor- ous muscles, a good brain and healthy nerves, a strong heart, capacious lungs, a sound stomach, and a good skin. And no young woman is so healthy now that she should not desire to be more healthy. While it is true, generally, that beauty is depend- ent on health, it is particularly true that it depends on the health of the mucous membranes.* Let but the skin of the face, and the lining of the eyes, mouth and nose, be healthy, and you may almost * For a definition of the term mucous membrane, see Chap. III., under the head of Cold Bathing. FACE —MARKS OP HEALTH. 19 be sure of beauty. The teeth, I admit, have some- thing to do in this matter ; but then the teeth, too, are more or less dependent for their beauty on a good set of mucous membranes. On the one hand, for example, find a person with red or inflamed eyes, lips, &c, or with their opposite, — viz., an habitual paleness, — and you will be apt to find a bad stomach and bad teeth, and most cer- tain to find a bad complexion ; that is, one which does not at all comport with our ideas of the beau- tiful and the true. On the other hand, point out to me a young woman who has a good eye, a flesh-colored — not a fiery red, nor yet a clay-colored — lip and cheek, with good breath, indicating a good state of lungs and stomach, and we shall generally find good teeth, and almost always a good share of beauty. For to good eyes, cheeks, lips, and teeth, few will fail to apply the term beautiful, whatever may be the particular contour of the face, or, I had almost said, the kind of complexion. Indeed, I have not the slightest doubt, that, in the world's "better day coming," there will be a much wider range of the beautiful, in human form and feature, than we have, at present, any idea of, or could possibly conceive. As well might we limit the beautiful of the vegetable world to a par- ticular color of the rainbow, — to a particular kind of grass, or plant, or fruit, or tree, or flower, and 20 YOUNG WOMAN'S BOOK OF HEALTH. that, too, of the same size, — as narrow down the beautiful, in the " human face divine," to a par- ticular set of features, or a single favorite hue of complexion. Young women, like the rest of us, seek happi- ness. Perhaps it is not in human nature not to seek it. But happiness, when sought only in the way of pleasing others, is not always secured. She who, to gain it, eagerly seeks to please and charm those around her by her beauty, considered as beauty, may or may not succeed. She certainly will not, if she mistakes the road that leads to it. It needs to be clearly understood by young women, as well as by every body else, that the only road to true and permanent happiness lies through the regions of truth and virtue ; or, if you please, those of holiness. Just in proportion as the whole body, soul and spirit, as Paul calls them, are constituted and preserved blameless, just in the same proportion will you be happy. No one, who is a believer in reason or revelation, will dare to reject this proposition ; while not one in a thousand, as it is presumed, wall follow it, in practice. This is partly because, though they have received it, they do not really believe it; and partly because the doctrine has never been sufficiently proclaimed, of physical sanctification. It is also, in part, owing to a perversity of our nature, more easily proved than accounted for. THE TRUE WAY TO HAPPINESS. 21 For the sanctification and perfection of the body require not only freedom from absolute disease, but that high degree of vigor in all its parts which can only be secured by a high degree of cultivation, faithfully, and for a long time, persevered in. Let the young woman, then, as she is inclined, by all means seek happiness. Let her seek it; but let her seek it in God's own appointed way. It may be paradoxical to some, when I affirm it, — but it is a truth from which I must not dare to shrink, — that she who aims at health or beauty, or at the former in order to secure the latter, can only be permanently successful when she seeks it in the path of holiness. In order to have per- manent health or beauty of the whole system, or any considerable part of that system, it must be baptized into the name of the Father, the Son, and the Holy Ghost. Remember what Solomon says to young men, for it is alike applicable to both sexes: " Rejoice, O young man, in thy youth, and let thy heart cheer thee in the days of thy youth, and walk in the way of thy heart, and in the sight of thine eyes." Re- member the sacred injunction, moreover, to obey it. But remember, too, there is something appended to the injunction: " But know thou, that, for all these things, God will bring thee into judgment." In other words, Rejoice ; pursue happiness, as in thy nature thou art inclined j but remember to 22 YOUNG WOMAN'S BOOK OF HEALTH. pursue it in the right way, — in the way in which thou wilt wish thou hadst pursued it, in the judg- ment of the last day. Learn, therefore, O young woman, that life, in order to give you happiness from beginning to end, must be regarded as a serious matter. It requires the development, and cultivation, and sanctification of thy whole nature. It requires, as I have said already, not only the sanctification of the mind and heart, but also of the body. You must labor to be healthy, and healthy thence again, and healthier still, in almost infinite progression. Health for the mind and spirit's sake — for God's sake — no less than for happiness' sake, must be made a study. It must be the first duty of our lives, in point of order ; though, except it were on account of past neglect, I should not dare to call it first in point of importance. It must be commenced now, continued in good faith, and persevered in to the last day and hour of life. CHAPTER II. ERRORS IN THE PHYSICAL EDUCATION OF YOUNG WOMEN. In the progress of my remarks concerning the diseased condition of young women, in the fore- going chapter, I have alluded to a few of the errors connected with the present system of female edu- cation, both in the family and in the school. For we live in a world of cause and effect. None of our troubles are the result of chance or haphaz- ard, or of fatality. None of them spring out of the ground, or are forced upon us by arbitrary in- fliction or malevolent agencies. Female miseducation begins with the beginning, __at the very threshold of life. In a world where wrong tendencies are so numerous, it seems almost idle to particularize. And yet I will seize on a few leading errors, on which to make my com- ments. Section 1. Too great Delicacy and Tenderness. Very few of our young women are trained to hardness. " Thou, therefore, my son, endure hard- ness," was scarcely more necessary, as an apostolic injunction, in the days of Paul and Timothy, than 24 YOUNG WOMAN'S BOOK OF HEALTH. Thou, my daughter, endure hardness, now is. And such is the state of society, as the consequence of long transgression, that immediate obedience to the apostolic injunction would be as impracticable now, as it would have been to Timothy, eighteen hundred years ago. And yet something may be done, as I shall hereafter show. The delicacy and tenderness to which I refer, are manifest, in the first place, by great suscepti- bility to the extremes of heat and cold. Infants, at first, have feeble powers of generating heat; and are hence dependent, at least very largely, on ex- ternal supplies, through the medium of a heated atmosphere, the body of a mother, nurse, &c. This, I say, is the general condition of infancy; but it is peculiarly the condition of those infants whose inheritance is, at best, a feeble constitution. The greater their feebleness and dependence, the more likely they are to suffer in one direction or another. Strength and independence enable a child to bear extremes of temperature in either direction, because they are accompanied by an increase of power in the calorific function. The latter can endure hardness ; the former can- not. The strong may become feeble, and tender, and delicate; the others are already so. They hold not only their warmth and vigor, but their life itself, by a very feeble tenure. They demand the open air; and yet, the mo- GREAT MORTALITY OF INFANTS. 25 ment you remind the mother or nurse of the fact, you are told, in reply, that they cannot endure it. The softest whisper, almost, of the gentlest zephyr, is too much for them. Even with the most assid- uous care to preserve an equal temperature in the nursery, they are frequently taking cold. Nor is the child's susceptibility to cold much greater than to many other diseases to which infan- tile life is liable. The mother has quite as much as she can do to conduct it through the stormy season of teething. It hardly lives through the whooping cough, and perhaps dies of measles* Two fifths, or nearly so, of all that are born, die under the age of five years. Or, if it survives the period of teething, as well as all the other usual complaints of infancy, its great susceptibility in other particulars renders it almost impossible it should pass the second ordeal, which is usually met about the seventh or eighth year. Nearly half our race perish before the com- pletion of the tenth year. And if it survive this period, it is still delicate and tender. It has probably suffered from fifty colds — perhaps a hundred — and in the next ten years, should it live so long, will have at least fifty * Seventeen children died of measles, in Boston, in one week of March, 1849. This, in a population, of about 100,000, and from this single disease, is a very great mortality. 3 26 YOUNG WOMAN'S BOOjx ur nEALTH. more. Besides this, — what is not so well known as it should be, — every cold increases the suscep- tibility of the system to similar impressions. But the system is susceptible in regard to all other impressions. Flannel cannot be worn next the skin, perhaps; and yet, from its exceeding thinness and feebleness, such is the sensibility to changes of the atmosphere, and so unequal the per- spiration,— now very free, now almost suppressed, — that flannel seems particularly demanded. The feet are easily chilled; and so of the hands. Yet the warmer the dress which you apply to any part of the body, the greater the difficulty of keeping up a steady impression by it. And then again, in regard to food and drink, the same difficulty is experienced. Such delicate children are apt to have an irregular appetite, often quite feeble, but sometimes very voracious. When feeble, moreover, it is quite common for the mother or other friends to be indulgent, and to give them many little delicacies; and the more feeble they are, the more they are indulged. This, though the result of kindness, is a great error ; for it only aggravates, in the end, the very evil these friends would gladly remove. If there are individuals among us who can bear these little " nice things" with safety, which I very much doubt, it certainly is not those delicate and tender children. AN OBJECT TRULY PITIABLE. 27 Hot drinks are often supposed to be quite neces- sary to delicate and tender young persons, especially females. But these, if taken, soon increase their susceptibility to sudden changes. And their evil tendency is increased in proportion as they contain other ingredients beyond simple water, which is very commonly the fact. So that, as a final re- sult, they come to the age of womanhood in a condition of body as diametrically opposed to that hardness which Paul recommends to our sex, — but which is equally important to both, — as can possibly be. There is not on earth, as it seems to me, a more pitiable thing, than one of these very tender and delicate young women. They are come to the size and years, it may be to the character, physical and moral, of maturity; and yet their condition of body almost entirely unfits them for the duties of that maturity. The potato stem, which, having grown up tall, slender, and delicate, in a dark cellar, is utterly un- fit for a sudden exposure to the vicissitudes of the open air, seems to be pitiable enough. But there is a difference in the two cases, and the difference is in favor of the potato stem, for it is insensible to its condition. The lobster, which, by a law instamped upon it by the great Creator, sheds its crusty covering — the house it lives in — every month, and, for a 28 YOUNG WOMAN'S BOOK OF HEALTH. time, is more exposed than almost any other ani- mal, may, and indeed must, excite the pity of the beholder. But, then, what does the lobster know of its sufferings—compared, I mean, with the hu- man being ? The child, whether delicate and tender, or not, is so helpless at its first introduction to the great the- atre of human existence, as to call forth the sym- pathies of all around it; and with those who have not reflected on the subject, to excite their commis- eration. Yet to say nothing of the diminution of its sufferings from its very feebleness and inexpe- rience, it has a parent to watch over it. But the young woman of adult years, I again say, who is destitute of adult strength and effi- ciency, and utterly unable to withstand the peltings of life's storms, is to be pitied much more,—as much more as her nature and capabilities are more elevated. Section 2. Nervousness. Our modern miseducation condemns young wo- men every where to great nervousness. Woman is designed, no doubt, to have greater nervous suscep- tibility than man. But then she should not be so painfully sensible of every impression on her ner- vous system, as to be constantly a sufferer from every atmospheric change or impression. Her ner- MISCHIEFS FROM MEDICINE. 29 vousness was designed to render her more happy, not more miserable. It is unnecessary that I should dwell at very great length on this topic, because whatever ren- ders woman delicate and susceptible, renders her, at the same time, nervous. But there are a few other causes in operation tending to render her nervous, which do not operate so directly to make her ten- der and delicate. One of these is the use — the abuse, rather — of medicine. Every particle of active medicine, whether liquid or solid, whether in the shape of elixir paragoric, Godfrey's cordial, spirits of laven- der, hot drops, or any thing else which is given to the infant or child, when not in the judgment of the physician* absolutely indispensable, besides doing much other more direct and obvious mischief, tends to render it nervous and excitable. Even tea and coffee, and most of the seasonings of our food, are liable to this charge. Some of these actually make us tender, f but all of them * Many things given by the physician have also this effect. It is the belief of the writer, that most physicians give too much medicine ; while not a few give those kinds which do more harm than good. t How common is the remark, that calomel and certain other active medicines predispose us to take cold ! and how frequently is the patient put on his guard in relation to them! But it should be more widely known than it is, that all active medicme has a degree of the same tendency. 2* 30 YOUNG WOMAN'S BOOK OF HEALTH. make us nervous. Thousands among us, of both sexes, are placed in a condition to be nervous dur- ing their whole lives, by this strange error of early education. But I am speaking, all this while, of nervous- ness, without fully defining my term. There is a great variety of nervous derangement and disease. Many people seem to think nervousness is some- thing wholly imaginary. Now, that there is such a thing as imagining what does not really exist, no sensible and intelligent student of the laws of health will deny, though even this is disease. Often it is hypochondria. But in nervousness, as I use the term, there is usually something more than a diseased imagination. One form of nervousness, as was suggested in the preceding chapter, has received the name of fidgets. Children, especially female children, are often fidgety. They are unable to sit still, for example, at church or school; hardly at home. This restlessness is, by the ignorant, often construed into wilfulness, and sometimes punished. And I have no doubt that, in a few instances, the judg- ment is just. But there are children of this de- scription who are not more at fault, on account of their conduct, than their parents; nor indeed so much. Occasionally this fidgety condition of the system becomes the first stage of St. Vitus's dance. I have VARIOUS FORMS OF DISEASE. 31 had female pupils in school, who seemed, at times, to have their nervousness excited to this alarming degree. Happy the parent who knows, betimes, what the matter is, and prevents such sad results. St. Vitus's dance is not always curable. Epilepsy, or, as it is usually called, "falling sick- ness," is another form of nervousness. The num- ber of those who suffer from this disease is not large, for which we ought to be thankful. Still. no one who is nervous can be quite sure she shall not, one day, become epileptic. She has entered upon the high road that leads to epilepsy. For one class of sufferers from nervousness, w^e have hardly a name. I have usually found them confined to their beds — bed-ridden, as it is termed — in which state I have known them remain for many years. Indeed, it sometimes happens that they remain in this condition for life, be that life longer or shorter. I have known but one or two of this description to recover. However, for one young female who suffers seri- ously, in any of these ways, hundreds suffer in a degree quite short of what is usually called fidgets. In a word, they have large and active brain and nerves, and not enough of bone and muscle to bal- ance their over-activity. And worse than all, and most to be deplored, this nervousness of the female world is daily and hourly increasing. For, most unhappily, all the causes 32 YOUNG WOMAN'S BOOK OF HEALTH. which have conspired to produce the present state of things, in this particular, are still operative; while many other causes are continually, in civic life, coming into vogue. And all things, I say again, which make us delicate and tender, are of this description. Section 3. Want of Muscular Power. Modern education is continually depriving the young, and this more and more every day, of mus- cular or motive power and energy. It is not quite a mere fancy or whim of the old, that the human race, as a race, is physically deteriorating. It is, alas! too true. Not that the young are not tall enough, nor that they are not sufficiently active. They have the usual number of bones, and muscles, and tendons. But they have not the necessary amount of vigor. Here is the main difficulty. The muscles do not answer their original purpose and design. I grant, indeed, that no kind of education, how- ever excellent, would give to the scrofulous or dis- eased that muscular power they might otherwise have possessed. But with the remaining three fourths of the community, the case is different. Their muscles are slender, and feeble, and power- less, from miseducation. They have not been properly used. Can it be otherwise than that the muscles have WANT OF APPETITE. 33 been neglected, when we find hundreds and thou- sands of young women, arrived at fifteen, six- teen, or eighteen years of age, and yet unable to work half the day, even at light work ? Can it be otherwise, when we find them unable, at any age, to go through with the necessary labors of the fam- ily for a single day, without making themselves sick ? Can it be otherwise when, without any serious lung or heart complaint, they cannot walk a mile, or half a mile, or even up two or three flights of stairs, without getting out of breath ? Can it be otherwise, when they find themselves unable to stand during the time occupied in making a short petition to the throne of divine grace ? Section 4. Want of Appetite. I have been for a long time in the habit of say- ing, that a good appetite, like a good conscience, is rarely to be found. And I must still say, that I know of, but few persons of either sex, or at any age, who possess what I call a good appetite. They eat, it is true; and they eat enough, and too much. And they eat often enough. But the present question is not, whether they actually eat, or whether they eat little or much ; but whether they have a good appetite. In the first place, people eat too often to have a good appetite. Time should be allowed for the system to dispose of a first meal Defore we can have a true appetite for the second. 34 YOUNG WOMAN'S BOOK OF HEALTH. Not one person in a hundred waits long enough after the reception of a meal, before he eats again. Not one in a hundred, I mean, does this habitually. " Always drink before you are dry, and you' 11 never be dry," was a quaint saying of a clownish, half-insane man, who vegetated, rather than lived, some forty or fifty years ago. It was a recipe of his, which he was ever and anon thrusting into the faces of people, for preventing thirst. But if it were the settled purpose of most people who live in this land of abundance, and can do as they please, to prevent hunger, I do not know that they could well devise a better plan than that which so extensively, in fact almost universally, prevails, of eating so often as always to eat before they are hungry, and thus never to know what true hunger — or, as I now mean, a good appetite — is. Whether our daughters are worse trained, in this particular, than our sons, I am unable to say. Of one thing, at least, I am pretty sure — that most mothers contrive so to manage their children of both sexes, that a good appetite for food, or drink, or any thing else, is a very rare thing. Now, a good appetite — I might, in truth, say good appetites — is of the utmost importance to the young, especially to our daughters. And one reason why our daughters have no physical energy, or, when compared with their grandmothers and great-grandmothers, almost none, is, that the latter had good appetites, while the former have not. NOBODY RELISHES PLAIN FOOD. 35 And, in the second place, the food in common use among us is too stimulating to permit of a good appetite in those who use it. Nobody is willing to use plain food. Who does not admit, for example, that good bread is good food, — the very staff of life ? And yet who could relish an entire meal of bread, however excellent in its quality ? Some few, indeed, there might be found, who could relish, for once, a full meal of hot bread, es- pecially if it were new. But here they have the stimulus of the extra heat. Let the same bread be a day or two old, and it will no longer be relished. No ; bread, in order to be relished and enjoyed as a full meal, by most, must be heated, or buttered, or soaked, in one way or another; or it must be ac- companied with certain other things of a highly stimulating character, so that the morsel of plain bread may be seasoned, or at least atoned for, by the morsel of something which is more savory. It is so with many other things. Place before people plain rice, or pudding, or steak. Be it so, if you please, that plain salt has been added. One individual in six might relish a few mouthfuls of either of them ; but not half enough for an ordinary meal. She would require a condiment with it, liquid or solid, sweet, sour, or aromatic. Or, if nothing more, she would desire to wash it down with a stimulating mixture of some sort, as tea or coffee. 36 YOUNG WOMAN'S BOOK OF HEALTH. This part of my subject might be illustrated in a great variety of ways; but it can hardly be ne- cessary that I should say more. If I have estab- lished my position, that few can relish a whole meal of plain food, I have, as I suppose, at the same time shown that few have a correct appetite. A true appetite ought to be satisfied with plain bread, or any other plain and wholesome article. Now, our children, females among the rest, are trained by a community which is thus destitute of a true appetite. How can they be better, in this respect, than their fathers and mothers ? How can the stream rise higher than its head or fountain ? Section 5. Feeble Power of Digestion. This is usually closely connected with the feeble appetite to which I have just alluded. And yet, as it is not always thus connected, it deserves a pass- ing notice. There are thousands among us, who, though considered, in a general sense, healthy persons, have not the power of digesting, in a proper man- ner, some of the most common articles of daily use, such as potatoes, apples, pudding, milk, &c. They have, indeed, the power of dissolving them, or at least of mixing them with the gastric juice ; * * By gastric juice, I mean the liquid which is furnished by the stomach for the purpose of changing our food into chyme. GENERAL REFLECTIONS. 37 but, in order to healthy digestion, food should not only be dissolved or permeated by the gastric juice, it should also undergo a great and important change, called chymification; a change without which there can be no truly healthy blood. Now, this change it is which is so seldom ef- fected ; and it is to the want of this change that I would direct my present remarks. Many of our young women have what is called lientery* all their lives. Think, now, of a whole generation of young women, trained as a whole, to tenderness, delicacy, nervousness, feebleness of muscle, want of appetite, and imperfect digestion. What can be our hope ? Shall we not be almost driven to the conclusion of the late Hon. William Sullivan, of Boston, that if female education is to be conducted, for three hun- dred years to come, as it has been for a century past, our race must become extinct ? Think, also, of the malign tendency of all those feelings, passions, and affections, which, like so many fiends from the pit that is bottomless, cluster round the subjects of our miseducation. Satan holds sway, in this world, by virtue of those dark and depressing passions, and depraved appetites, which miseducation — especially maternal mis- * See Chap. HI, where this subject is explained. 3 38 YOUNG WOMAN'S BOOK OF HEALTH. education — continually fosters. Nor will he flee till our sons and daughters are far removed from temptation, instead of being, as they now are, led daily and hourly into it. I might have added to the dark catalogue of causes which are exerting an unfavorable influence, during the course of female miseducation, a long train of debilitating complaints, induced, perhaps, by the foregoing errors, but, when once set in mo- tion, possessing the power to increase the congre- gated host of unhappy tendencies. But of these I mean to speak in another place. It is now time for me to treat of the means of changing the pres- ent aspect of things, by the substitution of right influences for those which are so doubtful and de- teriorating. CHAPTER III. WHAT THE PHYSICAL EDUCATION OF FEMALES SHOULD BE. It is always painful, to the true friend of his species, to point to their errors; and, above all, to dwell long upon them. And yet, as the faithful surgeon, in attending to a wound, must needs, in some instances, probe it to the bottom, so the faith- ful friend of a thorough reform in our education and habits should show us, in the first place, wherein they are wrong. This, in a very brief manner, I have attempted to do, in Chapter II. I have there shown that the present condition of female character and health is far enough from being what it should be ; and that it is perverted by miseducation. My purpose, in this chapter, is to point out to the educators of the rising generation •• a more excellent way." Let me, then, proceed to speak of the laws of Exercise, Respiration, Cleanliness, Diet, Circula- tion, Mind and Heart, and to enjoin on the reader their most rigid observance. 40 YOUNG WOMAN'S BOOK OF HEALTH. Section 1. The Laws of Exercise. These derive their authority from the great fact that every human being is provided with an appa- ratus for locomotion, and the consideration that neither this apparatus nor the general system can attain to or preserve the best condition, unless properly developed and used. The framework of the human body consists of about two hundred and fifty bones. Some of these are united in the living subject in one way, and some in another. Most of them, however, except the teeth and jaws, and, perhaps, a very few others, are united in such a way as to permit of consider- able motion. To prevent " wear and tear " at the points of union from the necessary friction, they are covered at these points with a hard, firm, smooth substance, called cartilage. The bones are then tied together by strong, flat substances, called liga- ments. These numerous bones, thus fastened together and coated over by a smooth, firm substance, called periosteum, serve as a support to the apparatus which the Author of Nature has contrived for putting them in motion. This consists of about four hundred and fifty muscles, or bundles of lean flesh, usually arranged in pairs. When we will to perform some desired motion, these muscles shrink ; and, being fastened by their ends to the bones, the LAWS OF THE MUSCLES. 41 result is to make the parts to which they are at- tached approach each other. For example : when I will to bring my hand to my head, the muscles (for here several muscles, closely packed together, perform one office) between the shoulder and elbow immediately shrink, which tends to draw the ends towards each other. One of these ends is fastened to the shoulder, the other to the elbow. Now, since it is easier for the hand to go towards the shoulder than for the shoulder to go towards the hand, the former is the result. It is a well-established law of the human system, — the female, as well as the male, — that, if these bones and muscles are properly and sufficiently used, they retain their various properties and pow- ers, just as the great Creator designed ; but, if otherwise, their properties and powers are varied. The bones, which are made up of a certain propor- tion of gelatine and phosphate of lime, if not used enough, may become too brittle, by containing a larger proportion of the lime than they ought; or, if used too much, as sometimes happens, they become exposed to injury of another kind. The muscles, if not used, become smaller, feebler, and, in various respects, less healthy. The indi- vidual with a broken arm, having carried it in a sling five, six, or eight weeks, finds it growing weaker, and softer, and smaller than the other. On the contrary, if used too violently, the muscles, or 4* 42 YOUNG WOMAN'S BOOK OF HEALTH. their ends, called tendons, may become painful or inflamed, or cramps may arise. As a general rule, the bones and muscles are made for a vast amount of motion; and hence a great deal of exercise is necessary, in order to keep them in health. Few (that is, comparatively) err by using them too much ; probably not one in twenty, at least in the United States. Children require much more exercise than adults; and, as a general rule, except in manufacturing regions, and in large cities and towns, they are permitted to enjoy it. Females require as much as males, and rather more. Such an assertion may be contrary, I know, to the generally received opinion ; but this does not make it the less true. But there is another and higher law of the hu- man locomotive system ; which is, that the more it is used, — provided no violence is done to any part of it, — the firmer and stronger it becomes. It is not only kept in health and strength by such use, but its health and strength are increased by it. To this increase of locomotive power and vigor there are, at present, no known limits. I do not say there is no limit to muscular power; for I believe there is. If Milo, the Greek, by proper training, was at length able to carry the ox as easily as he had done the calf, it does not thence follow that he could ever have been able to carry the elephant or the mastodon. MUSCULAR FORCE IN FEMALES. 43 ^Nor do I mean to affirm that the young woman, in every instance, should cultivate her locomotive powers to the highest possible pitch. But this I do say, that she ought not to be, in this respect, dete- riorating, as most certainly she is. Woman ought to possess at least twice as much muscular power as she now does. It is said, I well know, that woman is not made for the same purposes as man — that she has com- paratively little use for large and strong bones and muscles. Activity and power of endurance are what she needs, it is added, rather than strength. This objection has some weight; but not so much as it would have if there were not another law of the bony and muscular system to rise up against it. This is, that, while we are developing and strengthening this part of the human machine- ry, we are also developing and increasing the strength of the heart, and arteries, and lungs, and, indeed, of almost all other parts of the system. Because a young woman should possess great muscular power, it does not thence follow that she should use it frequently. She should, indeed, use it enough to keep it from diminishing : but then I do not like to see her performing the hardest labor of the farm, or the mechanic's shop, or the factory ; or lugging trunks, as a porter ; or carrying heavy bur- dens on her head, or otherwise, as a menial or a slave. One more law in regard to exercise — I mean in 44 YOUNG WOMAN'S BOOK OF HEALTH. regard to the bony and muscular system — must be noticed. It is, that all its parts should have their due share of motion. Thus the muscles of the back, if used just enough, and no more than enough, become strong and vigorous. If used too much, however, — that is, too much in proportion to the rest of the muscles, — they suffer in various ways. And yet, if used proportionally too little, they suffer much more. The great mass of our young women — such, at least, as are likely to read this volume — are trained to sit too much. For though, even in sitting, a part of the muscles of the back are called into action, it is seldom right action. It is better to sit erect than to rest the back, or breast, or sides against any thing. Or, if we have any support to the body while we sit, it should be very low. It should not rise higher, at most, than the lower or short ribs. But it is still true, that females should be more on their feet, and less in the posture of sitting, than they usually are, even though that posture were in every respect favorable. One of the greatest errors in modern female edu- cation is found in a fact to which the remarks of the last paragraphs have reference. They have too little exercise of the lower limbs, and very unequal exercise of the muscles of the back. The former become feeble from disease ; the latter from wrong use. EVILS OF SITTING TOO MUCH. 45 Is it asked whether I would never have young women sit; or whether they would never be fa- tigued ? Most certainly they are liable to fatigue, as well as other people ; but a recumbent or reclin- ing posture, in case of much fatigue, is by far the best. Even when this last is not convenient or practicable, and sitting becomes necessary, they should retain this position but a few minutes at a time. When I speak of the standing position as being preferable to much sitting, I do not mean to go to the extreme of recommending standing still; for that, if long continued, might be still worse. Stand- ing still, however, as it is commonly called, is not standing still, after all. We are obliged to exert ourselves, at every instant, to preserve the centre of gravity; and hence, even in standing, a consid- erable number of muscles are called into exercise. We can little better stand still on our feet — per- fectly so — than on stilts. In a few instances in this country, and in the old world in many, young women are condemned to the standing position. More generally, however, as has been before admitted, they are condemned to sitting. Whether at school, or at home, at study, at work, or at amusement, or even at church, it is still, for the most part, sit, sit, sit. This remark, of course, does not apply to infan- cy and childhood, generally; but only to that 46 YOUNG WOMAN'S BOOK OF HEALTH. period of life when girls are thought to be too large to play and romp about. Happily for nature and our fallen race, there are a few years — from two to seven or eight — when the young are not taught that to run, skip, hop, jump, climb, or prattle, is a vice ; while to sit most of the day at the writing desk, drawing desk, or piano, or walk with meas- ured, snail-like pace, and staid or woe-begone coun- tenance, is a virtue. I have seen children who were naturally of feeble constitution, but whose backs, having never been injured, were able to be on their feet from morning to evening, with less of fatigue and suffering than usually falls to the lot of those who are sitting half the day. Nay, more: I have seen feeble and scrof- ulous children grow healthy on this plan; while those who were naturally healthy and robust have sunk under the opposite system. And I have seen a few young females, who, hav- ing been feeble all their lifetime, up to sixteen, eighteen, twenty, or twenty-five years of age, have entirely changed their constitution, in a very few years, by appropriate exercise. This was not done, however, in a week, or a month ; but, as I have already intimated, it was the work of years. Nor was it done by mere walking. Walking is good exercise ; but much better when done as a means to an end, than when we walk merely for the sake of walking. Walking to a cer- WALKING —TO DO GOOD. 47 tain corner, or brook, or hill, or post, every day, is worth something ; but Walking to do good is worth much more. One young woman of feeble health, who had long sought, in vain, for aid at the hands of phy- sicians and medicine, at length came a long distance to consult me. I recommended walking ; but it was walking to do good. My prescription was suc- cessful, and her health soon began to improve. Whenever the circumstances in which young women are placed will possibly permit it, there is nothing better for them than to walk a few miles every day to comfort or relieve the sick, to feed the hungry in body or mind, or to clothe the naked. The healthy will thus become more healthy; while the feeble will gain something — much more than by medical treatment of any sort. But to those whose circumstances do not admit of walking to do good, (if there are any such,) other things, quite within the range of human self- ishness, might be beneficial. Such are several kinds of house work ; light work in the garden ; and even light, mechanical employment. Few of these last, however, admit of constant and regular walking. Let every young woman fully understand that the proper, and regular, and healthful exercise of all her muscular and bony system is indispensable to health ; and that, the more this matter has been 48 YOUNG WOMAN'S BOOK OF HEALTH. neglected in her earlier or later education, the greater the necessity that it should be attended to in all time to come. I have not yet fully set forth the reasons why exercise in the way of doing good is preferable to mere exercise as an end in itself, rather than as a means to some end. This shall now briefly be done. 1. In walking to do good, the mind is, as it were, carried out of and away from itself, and fixed on other objects ; whereas, in mere walking to the same place, '■— perhaps alone, — it follows the same mill-horse track, and is apt to prey upon itself. 2. Walking abroad, especially by the feeble, is done, for the most part, in the light; and, perhaps, in a majority of cases, in the light of the sun. Now, sunlight has much more to do with health, especially the health of those who are from ten to twenty years of age, than most of us are aware. 3. The reflection of the rays of the sun from living green, during a great part of the year, is highly salutary to the eyes, and, through the me- dium of the eyes, to the rest of the system. In- deed, I do not know that we are able to explain, in the present state of science, why we are so much benefited by exercise when the mind, ceasing to prey upon itself, is diverted and led to the contem- plation of surrounding green objects; but the fact is undeniable, whether we can explain it or not. THE LUNGS —THEIR CONSTRUCTION. 49 4. In walking abroad to do good, we walk more briskly; consequently respiration is more brisk, and the purposes of respiration better accomplished. But this brings us to another division of my subject. 5. In walking to do good, we imitate Heaven's own plan ; and this, of course, must be the best for soul and body. Who was ever more healthy than He who descended from heaven to walk about and perform kind offices ? Section 2. The Laws of Respiration. Young women cannot enjoy the high health they desire, and to which, by virtue of the great Crea- tor's arrangements, they are entitled, till they un- derstand more fully, and obey more perfectly, the laws of respiration or breathing. It is no part of my purpose, in a work like this, to give a full account of any part of the living human machine. For this, I must refer the reader to works on anatomy and physiology. A few par- agraphs, in connection with each set of laws, is all for which I have room. The lungs are, essentially, hollow air bags, the capacity of which varies, in different individuals, from five to ten pints ; though we seldom inhale more than a pint of air at once. A great change is wrought in the air we inhale, and a corresponding one on the blood which is brought into close con- 5 50 YOUNG WOMAN'S BOOK OF HEALTH. tact with it, in the cells or little bladders of the lungs. This change is, essentially, the following: The blood in the small arteries that spread themselves over the air cells of the lungs, is changed, while there, from a dark red color and an impure state, to a bright red color and a comparatively pure condition. Its temperature is at the same time slightly increased. It also loses some of its carbon, and gains oxygen. In any event, the air we inhale, after being thrown out again, is found to have lost, by some means or other, a part of its oxygen; and in place of the lost oxygen, we find a portion of carbonic acid gas. So that during every breath, the air we inhale is at once made less pure by the abstraction of a part of its oxygen, and rendered absolutely noxious or poisonous by the addition of carbonic acid gas; while the blood is purified. This process of using up the vital air or oxygen to purify the blood, is of immense importance to human happiness. The more freely and uninter- ruptedly it goes on, the more vigorous and healthy we are. Whereas, the slightest interruption of the process is attended with more or less of injury to every living individual. Atmospheric air, when pure, contains about twenty-one per cent, of oxygen, and seventy-eight per cent, of nitrogen, with a little carbonic acid BREATHING BAD AIR. 51 gas. Each act of inspiration so changes the whole mass in the lungs, as to leave but sixteen or eighteen per cent, of the former ; and in its place we find an increased quantity of carbonic acid. Now this change is effected by all breathing, whether of man or other animals. It is also effected, in some de- gree, by all the varied forms of combustion. It hence follows that if we breathe air the second time, which has been breathed before, whether by man or other animals, or even that which has been, so to speak, burned, we breathe a deteriorated at- mosphere. Or if we inhale any thing else mingled with pure atmospheric air, we breathe an imperfect article. For we furnish to the lungs, in such case, an improper and unhealthy kind of food. And the blood not being regularly purified, the different parts of the system, which are nourished or built up by it, are not properly fed, and hence are not in the best and healthiest condition of which they are susceptible. And then again, as a matter of fact, few among us are healthy, because few breathe the air in a pure state. We begin to inhale impurities as soon as we are born; and to a large proportion of our community, the error is continued through life. In truth, none wholly escape. They who live much in the open air, however, suffer far less than other persons, because they 52 YOUNG WOMAN'S BOOK OF HEALTH. breathe the air twice or three times over far less frequently; whereas they who cannot go much into the open air, or to whom custom denies the privilege, are, in proportion to the degree of their confinement, very great sufferers. Now, farmers, carpenters, surveyors, engineers, soldiers, sailors, gardeners, &c, are much more in the open air than tailors, shoemakers, teachers, manufacturers, and housekeepers. And what we might suppose, in reasoning from our principles, to be the case, we actually find, from daily observa- tion, to be true, viz., that the former are the most healthy. There are, indeed, numerous reasons for this, but air and exercise are principally concerned. Observe, if you will, that I have classed house- keepers among the less healthy classes. By this, I do not mean that they are less healthy than tailors and shoemakers ; for they are far more so. I was only comparing them with those persons who live most in the open air. The truth is, that house- keeping stands highest in the list of female employ- ments, with respect to health; and yet, compared with what is desired, —compared with farming and gardening, — it is quite unfavorable and unhealthy. Who does not see, on the slightest inspection of the facts in the case, that even if our houses were ventilated in the best possible manner, those females who have the care of them must breathe a great deal of deteriorated air ? Their office is to keep BAD AIR IN OUR HOUSES. 53 the occupants, furniture, &c, in a cleanly condi- tion ; and can they do this, and escape wholly un- scathed ? It were practically impossible. It does not follow that because housekeepers can- not wholly escape suffering, they can have noth- ing done for their relief. Much may be done. If they must inhale twice, in some degree, the same atmosphere, especially in their kitchens, cellars, pantries, and sleeping-rooms, it does not follow that they must inhale it three or four times ; or that they must receive the breath of other persons, or of dogs and cats. Nor does it follow that they must breathe the putrid or semi-putrid emanations from decaying and decayed substances, vegetable or animal; or that they must be always amid the din of pots and kettles, and never see the pleasant light of the sun. It is not necessary that they should always live amid the impurities caused by lamps or candles burning all night, in the apartments even of the healthy. However, if females, under the best circumstances with which, in general, they are favored, are so obnoxious to the occasions of ill health from dete- riorated air, how is it with those who have never been trained to this same employment, or, per- chance, have been trained to despise it ? How is it with those who spend their hours in dwellings and sleeping-rooms wholly unventilated ? 5* 54 YOUNG WOMAN'S BOOK OF HEALTH. How with those who sleep on beds which are made of improper materials, and with one or two asso- ciates or companions, and in unventilated, that is, unchanged clothing ? How is it with those who sit ten, twelve, or six- teen hours a day at some mechanical employment, with perhaps half a dozen fellow-laborers in the same room ? How is it when the employment which is pursued is even comparatively healthy ? How is it when the dress is even loose, and free, and unembarrassing ? How is it with those who, after spending eight or nine hours in a bad sleeping-room, pass six or eight hours in a school-room, which is little better; and their evenings, till ten or twelve o'clock at night, where none should be who expect to add five per cent, yearly to their general physical vigor, or to increase, by ten, or twelve, or fifteen years, life's whole duration ? Position of the body greatly injures young w'o- men. They are trained, from the first, to compress their chests so as to prevent free access to the small amount of air they naturally contain. But the capacity of the chest would be much greater than it actually is, in our females, if they were better trained". Instead of being able to hold no more than from five to eight pints of air, the lungs might be made to hold from seven to eight or ten, possibly a dozen. EVILS OF A STOOPING POSITION. 55 They are first injured by swathing too tightly. Next we injure them by encouraging them to sit, stand, &c, before the hips are strong enough to bear up the superincumbent head, arms, and body. As a result, the head bends forward too much, the collar bone is shortened, the arms are thrown for- ward, and the person made round-shouldered. And is there any doubt about the actual condition of the lungs, all this while ? Nor ought I to omit, in this connection, the other suffering organs. The same process of bending forward not only cramps the lungs, but also the heart and its numerous large vessels, the stomach and its appendages, and the liver and gall-bladder. No one of these important organs can do its work well when under the influence of compression — whether that compression consists wholly in wear- ing a ligature about the body or a limb, or in sitting, standing, &c, in a stooping position. After all, the most obvious and immediate mis- chief done by tight lacing, or by studying or labor- ing in a bad position, consists in the distortion of the chest, and the compression of its contents, the lungs, heart, aorta, &c. The lungs are not well inflated with air, and the blood is neither freely circulated, nor well purified. I hope the time is not far distant when public opinion will neither encourage nor permit young women to confine themselves, whether at their 56 YOUNG WOMAN'S BOOK OF HEALTH. desks or their needle, in such a manner as shall tend to defeat all the Creator's plans, and instead of rendering them healthy and beautiful, make them ugly, sickly, and miserable; and their poster- ity a little worse than themselves. Happy if I shall be able to aid — were it but a little — in hastening this golden period ! Mr. Thackrah, an eminent surgeon of Leeds, England, in a work of his on the " Effects of Em- ployments on Health," has these remarkable words : " Be it remembered that man subsists more on air, than on his food and drink." A bold, not to say startling assertion ; yet not more bold than true. For, though our systems are supported by our blood, and the blood is made of food and drink, yet that food and drink can never make good and perfect blood, without the aid of good and perfect lungs, and the action of these on good and pure air. We may, it is true, live, and move, and breathe ; we may "drag our slow length" along for years, and, with a good constitutional inheritance, go on, perchance, to threescore and ten, even if digestion and respiration are not well performed, and exercise is neglected. Yet this is a very different thing from the enjoyment of all that buoyancy of feel- ing and high health, of which God has made us capable whenever we duly regard his laws and the transmission of the same tendencies to other, and, we may hope, better generations. CONSTRUCTION OF THE SKIN. 57 But I must hasten to the consideration of another class of physical laws, of little less importance than those to which I have adverted, and much more neglected. I mean, now, Section 3. The Laws of Bodily Purity; or Cleanliness. Nothing in physiology or hygiene is plainer to the common mind, when once presented and clearly explained, than the great law of cleanliness. The necessity of breathing pure air is not so easily per- ceived, because air is less tangible than some other things with which we are wont to come in contact. But a foul skin may be detected by more than one of the senses. Did mankind but know the exact construction and true laws of the skin — young females, espe- cially — I am quite sure they would take better care of it. Not that they would, at once, act up to their knowledge ; but they would do somewhat more, as I am well persuaded, in proportion as their standard of knowledge was raised. They would not expect to atone for the neglect of twelve or fourteen square feet of surface, by washing, and brushing, and painting a few small patches of it. The skin is composed of several layers. The first is a mere cuticle or covering. It has no more life to it, than if it were made of bone or horn. It is very thin, except on the palms of the hands 58 YOUNG WOMAN'S BOOK OF HEALTH. and soles of the feet. In this membrane, i. e., in certain little sacs attached to the under side of it, is found the coloring matter. The interior and principal layer of the skin is the most important. This is made up of vast num- bers of nerves, arteries, veins, capillaries, lymphatic vessels and glands, perspiratory glands and tubes, and glands containing a kind of oil, called seba- ceous glands. If we examine a small portion of the living skin by means of a microscope of great power, the mind is almost overwhelmed at the sight of such a vast amount of machinery as is found even in the compass of a square quarter of an inch of surface. Thus constructed and fitted out with machinery, the skin performs a number of highly important offices or functions. It is not a mere wrapper; it is vastly more than a covering to the parts be- neath it. 1. It aids the lungs in their great work of puri- fying the blood. 2. From the impurities of the body, it contrives to manufacture a new fluid, the matter of perspiration, and spread it over its sur- face, in order that it may be evaporated, and the skin thereby cooled. 3. It furnishes, by means of the sebaceous glands, a sort of oil, that the skin may be kept supple. 4. It is an absorbent surface. 5. It is an organ of sympathy. In the performance of these various functions, THE SKIN MUST BE KEPT CLEAN. 59 the skin, as we may have seen, becomes coated over with a mixture of the oil and the sediment of the fluid of perspiration. This, again, is thickened and rendered more adhesive, as well as more foul, and more inclined to putrescence, by the dust which is continually settling upon it. There is hardly a moment of our waking hours, when the dust does not reach it. Many who are employed in the house, shop, study, or school-room, appear to think dust does not reach them ; but they are mistaken. Seldom, if ever, is the atmosphere free from it, or our clothes impervious to it. In truth, those very persons who sit most in the house, shop, factory, or school-room, and appear to be quite secluded, are most likely, of all others, to become varnished over with the mixture of which I have spoken above. Females, therefore, from the known habits of fashionable life, are as liable to have their skins become impure as the other sex ; and, consequently, as liable to suffering, if they do not keep them clean. Hence the first great law or condition of health of the skin, that it must be kept clean. This may be done by occasional washing with warm water ; by frequent washing with cold water; or by fre- quent friction of the whole surface. The latter method, however, is somewhat imperfect. It is truly surprising to look abroad on the face of society, and observe how generally this law is 60 YOUNG WOMAN'S BOOK OF HEALTH. neglected. Not one fourth of the people of New England ever bathe their whole bodies in water of any temperature once a year. Many never bathe in their whole lives. And yet I know not but the people of these states are as careful in this particu- lar as those of any other region this side of the Atlantic. Among those who do bathe occasionally, a part of them wash themselves in warm water, on Sat- urday night or Sunday morning of each week. This is chiefly done by a few females and chil- dren. Another portion, men and boys, go into the ponds or rivers about once a week ; partly for cleanliness' sake, but more for the sake of the amusements of diving, swimming, &c. This occasional going into cold water, however, answers but very poorly the purposes of cleanliness, to say nothing of its inci- dental and rather frequent dangers. There is, however, a still smaller number, who, within a quarter of a century,* have adopted, on principle, the practice of daily ablution. Some of them use the warm, or tepid, or vapor bath ; but a far greater proportion use the cold shower bath, or the sponge bath, and follow it by friction. * Some of the ancient families of New England, especially about Boston, Salem, and Providence, have been in the habit of bathing ever since the first settlement of the country. SHOULD HAVE THE SUN'S LIGHT. 61 We shall see, by and by, which of these meth- ods of bathing is, on the whole, to be preferred, and the reasons why. Meanwhile, another law of health, relating to the skin, should be announced. It is, that it should be exposed, freely, to the light of the sun. But will not this rule clash with the former ? I shall doubtless be asked. In going abroad, shall we not be exposed to dust, in the same proportion ? And shall we not be rendered swarthy, or tanned, by the blaze of the sun ? My reply may be in part anticipated from the remarks of a preceding page, where I have said that the sedentary suffer more from neglecting their skins than others. The reason, however, was not there clearly stated. It is, that active exercise in the open air has a tendency to break up the crust or varnish on the surface, and leave the skin to act freely and unfettered. Hence, as may be easily seen, all these views harmonize. I might say even more than this; that they harmonize with the laws of exercise and respiration already set forth. Is not this, of itself, an evidence of their correctness ? For example, he who walks, or labors, or sports in the open air and sunshine, at once secures the benefit of pure food for the lungs, proper exercise for the bones and muscles, and proper activity and hardihood to the skin. Even if a little more dust 6 62 YOUNG WOMAN'S BOOK OF HEALTH. attaches to the surface from being abroad, the evil is more than compensated by the hardening effects of light, air, and motion. The sun's light thickens the human skin, and at the same time renders it more strong and active. It is otherwise when this thickening is produced by mere attrition or friction, or by an undue indul- gence of the appetites and passions. There is great deception here. Thousands who have their skins grow dark and thick, and, to the unscientific, appear more healthy, are in this respect deteriorating. The capillary vessels, having be- come debilitated, no longer propel the blood as rap- idly as they ought, and it remains in the skin. What, therefore, is sometimes supposed to indicate an increase of hardihood and vigor, actually indi- cates debility and disease. Neither a very dark nor a very brown skin — I mean in the European race — nor its opposite, a light and almost transparent one, is a sure sign of health. Still less are red cheeks a sign of health. A healthy skin is one in which the various func- tions I have ascribed to it are properly, and natu- rally, and regularly performed. A third law of the skin is, that it must not be compressed. This rule, it seems to me, is too plain to require either explanation or illustration. If it has but half the machinery and offices I have as- cribed to it, is any thing more obvious, than that SHOULD NOT BE COMPRESSED. 63 its motions must be perfectly free and unembar- rassed ? What, now, would be the result of compressing, had we power to do so, the walls or roof of a large cotton factory ? Let us, in imagination, apply our compress, and bring two stories into the thickness or space of one. Will there not be displacement and derangement ? Can the machinery go on ? Now, when we compress the skin by our dress, or by any other means, so as to reduce it to half its natural thickness, we cause much more derange- ment than when we only compress a factory one half; inasmuch as the former contains much more machinery than the latter. Is it possible that they who understand this matter as it really is, can make the dangerous experiment? True it is, that when we remove compression from the human skin, it resumes its offices much more readily than the cotton factory, with its crushed wheels, and jennies, and looms. And yet, while the compression remains, as I must still main- tain, the derangement of the skin-machinery is much the greatest. There is one point even, in which the living skin suffers more than the dead machinery. The latter may, in due time, be wholly repaired, at least in some instances ; whereas, according to the strict laws of physiology, that skin which has once suf- fered long by compression, has lost a portion of its 64 YOUNG WOMAN'S BOOK OF HEALTH. vitality, and can never be wholly and completely restored. Young women may say — some of them prob- ably will say — " All this comes too late. Had our mothers and grandmothers been taught your doc- trines, and had they lived up to them, it would have been of some service to us. The injury is already inflicted; and the storm, though dreadful, has passed by. — We do not compress our surface by dress now-a-days." Would it were true, that there was no compres- sion of the skin now-a-days ; though even then, I should fear the fashion might come round again. But it is not so. Corsets and stays may be aban- doned, and the dress may have been much im- proved ; but females, in many, perhaps most in- stances, still dress so as to compress and injure the skin.* Is it asked what all this about compressing the skin, and its evil consequences, has to do with bodily purity or cleanliness ? My reply is, It has much to do with it; very much indeed. For have we not seen, again and again, that the skin, next to the lungs, is the great depurator, so to speak, of the system ? * A friend of mine, in this commonwealth, told me, this very year, of a young lady in Groton, or near it, whose dress was so tight that it required two women to fasten it; and sometimes a male assistant was absolutely required. IT MUST NOT BE IRRITATED. 65 All the laws of the skin, when duly obeyed, have this same tendency; but not all of them so directly. The laws of absorption and of sympathy, which I have already named, but on which it was no part of my plan to dwell, could be shown to have a connection, even intimate, with bodily pu- rity. But there is another law, whose connection with cleanliness is so direct, that I cannot repress the desire to announce and comment upon it. It is, that the skin must not be irritated. By irritation, however, I do not mean external irritation ; though that is a subject of considerable importance. But there is a species of internal irri- tation, which not only robs the skin, in a great measure, of its power to depurate the system, but even loads that great membrane with some of the vilest impurities which can well be tolerated ; and, indeed, with some which ought not to be tolerated at all. You have seen people use rum and tobacco. Now, I am not about to place these twro articles in the same category, as regards their deadly influence. But both of them, when taken into the system, are compelled to pass out of it, in large proportion, through the skin. Do you think they leave it unscathed ? Ask those who have bathed and champooed them, or who have watched over them when ill. But there are other things that cause a foul skin, 6* 66 YOUNG WOMAN'S BOOK OF HEALTH. besides drinking spirits and smoking and chewing tobacco. Besides, I suppose it will be said that females — young women, at least — have little to do with these things. It is forgotten, however, by those who say this, that snuff is but pulverized tobacco, which, if not taken very often by young women, is much used by older ones, (and young women are destined one day to become old,) and which, when taken, finds its way into the skin. We will pass from these, however, to saleratus, pepper, salted butter, coffee, tea, &c. These sub- stances, most of them, are much used by women, old and young, and their use is increasing. Yet they are never taken without filling the skin with impurities, besides doing a world of other mischief, of which it does not come within the scope of my present plan to speak. One excellent young woman whom I knew, was troubled, at times, with a rough skin. Occasional- ly, there were even carbuncles and phlegmonous swellings on it. Suspecting salted butter might be the cause, she abstained entirely from its use a few months, and her skin became as soft and smooth as that of a little child. The experiment was re- peated, till she found she was not mistaken in regard to the cause ; upon which she abandoned it forever. And her experience is not a solitary one. Many have made the same experiment, with similar SHOULD HAVE ACCESS TO AIR. 67 results; and many more might very profitably do so. One more law of the skin with reference to bodily purity, and I shall have done. It is, that it should have free access to the air. I have dwelt at con- siderable length on the evils of compressing the skin, as well as barely alluded to the influence of air upon it; but the subject deserves a more par- ticular consideration under the present head. For nothing is more obvious than that the skin may be effectually excluded from the air, without compress- ing it. Thus you may clothe yourself, almost from head to foot, in soft leather ; or bury yourself, by night, in down or feathers ; and yet there may be no con- siderable compression by either, especially the lat- ter. Yet that there is confinement in the case, will not be doubted by those who have ever made the experiment of wearing wash-leather for under- clothes, or India rubber on the feet. There can be no doubt that if our clothing, by night or by day, at once confines and compresses the skin, the evil consequences are far greater than if either exists alone. Tight India rubber shoes or clothes, or tight wrappers or drawers, are, of course, worse than loose ones. Still, either of them is bad enough, without the aid of the other. The fact is, that the skin, in order to aid the lungs most efficiently in forming and renewing the 68 YOUNG WOMAN'S BOOK OF HEALTH. blood, should have almost constant access to free and pure air. It should not be shut in by tight or even by firm clothing, in any of the circumstances of life. The air should always circulate, both through and beneath the clothing. For it should be well known to all who do not know it already, that the skin, like the lungs, so long as we are in health, is continually using up the vital part of the air, and giving out carbonic acid. The process is indeed slow, but effectual. If there were room for a doubt on this point, it could be easily removed by the following experi- ment : Let a person sleep, as some nations do, between two feather beds, or, what is essentially the same thing, on a feather bed, with a thick com- fortable over her. Let all ingress or egress of air be carefully prevented. When she has slept or lain in this condition a few hours, let a lighted lamp or candle be suddenly placed near the body, under the clothes. What will be the consequence ? If no fresh air is introduced at the same time, it will go out immediately. But why does it go out ? Let us recur, for a moment, to first principles. Combustion, like res- piration, is supported by oxygen. Where there is no oxygen, of course lights and fires go out, and breathing stops. Hence, if a well'' or low place is filled with other gases, to the exclusion of oxygen, combustion and respiration will both cease. SLEEPING WITH THE HEAD COVERED. 69 Now apply the principle. A well or cave is sus- pected of danger, and a lamp is let down into it. The lamp goes out. We now know that life can- not be sustained in it, and therefore we do not venture down. But the reason why the lamp will not burn under the bed-clothes is nearly the same. The oxygen is used up, and its place is supplied by azote and carbonic acid.* This experiment proves, incontestably, that a great change goes on at the surface of the body, — at least, w^hile we sleep, probably at all times, — and that this change is unfavorable both to health and cleanliness. For, in the moment that the quan- tity of oxygen in the air which is in contact with the body is diminished, that same moment the power of that air to lick up, as it were, the carbonic acid and other impurities which are constantly being formed on the skin, is diminished also, and neither the general system nor the skin itself is properly depurated or cleansed. I grant, indeed, that when the skin ceases to per- form its office effectually, the lungs attempt to labor in its behalf. So the liver, also, and the kidneys ; both of which are, to some extent, depurating or- gans. Even the alimentary canal, when this skin is in fault, makes an effort on their behalf. But * Will not this fact account for a part of the sudden deaths which occur in beds ? How many there are who sleep with their heads covered! 70 YOUNG WOMAN'S BOOK OF HEALTH. this state of things cannot last long. The organs are not made to do more than their own work, and yet continue in health. Sooner or later, therefore, when compelled to do the work of other organs, they become diseased. It must now be plain to every considerate and careful reader, that, in order to the best condition of the skin, and, consequently, of the whole sys- tem, that dress is best which is at once the lightest, loosest, and of the most porous material. We must, it is true, avoid the extreme of being perma- nently or continually chilly ; but, with this caution, the remark is of general application. Nearly all our clothing is too firm in its texture, and too closely applied. For cleanliness' sake, and, indeed, for all the purposes of health, it should not rest with an ounce of weight on any part of the body. It should, moreover, be frequently changed. The same clothing should not be worn during the night which has been worn in the daytime. For various reasons, I would make much use of light, porous flannel, in the education of young women, especially in their infancy and childhood.* I would not, indeed, prefer to have it worn next * In the warm days of the opening spring, when the air is moist, and hence liable to conduct the heat and electricity from the body too rapidly, silk next the skin is desirable. Thomas G. Fessenden, of the New England Farmer, had much to say, in his day, on this subject. DRESSING TOO WARM. 71 the skin, but would interpose one layer of fine linen. With most, the irritation is too great when it touches the skin. Most parents, in that part of the education of their children which relates to dress, run into one very serious practical error. It is that of clothing their infants too warmly. In the belief that they are tender and delicate, and unable to generate heat for themselves very rapidly, — which is certainly true, — they load them with so much and such thick clothing, that, w^hen they become warm, they are too warm — the heat being unable to escape from the body fast enough. And then, what happens with regard to the superfluous caloric, takes place, also, with regard to the emanations and other impurities of the skin. These are retained so long as to become sources of much irritation. Another thing may also happen, which is still worse. The skin, as I have already said, has the power of absorption. It will not only take up, with a good deal of readiness, acrid or poisonous substances, but it will absorb a small quantity even of plain water. Now, a confined skin, if not frequently bathed or brushed, soon accumulates, in flakes or layers, a large amount of filthy substance on its surface, — a compound of grease, salt, &c, — which may, by possibility, be absorbed into the body. But can a vile compound of dirt, grease, and saline substance 72 YOUNG WOMAN'S BOOK OF HEALTH. pass from the skin into the circulating vessels and heart, and not do mischief ? The bare thought of it is, at the least, disgusting. A few, however, in this day of new things and notions, go to the other extreme, and dress their infants and children too thinly. They wish, they say, to avoid the debilitating consequences of too much heat; and they ought. But then, in avoid- ing Charybdis, it is not necessary to run on Scylla. There may be difficulty in the case ; but surely there is nothing in the shape of necessity. They wish to harden their children. Very well; it is right to do so. But then we ought not to kill them in the process. Besides, these parents, more than the former class, overlook the great truth, that young children generate caloric much more slowly than older persons. Because too much clothing is universally used, they are determined to correct the error, by beginning right. This, then, — this beginning right, — is the very thing I would have done. But herein is the great difficulty — how to begin right. Grant that we use double the amount of clothing that we ought; grant, even, Avhat some suppose, that, in the best state of human nature, no clothing at all would be necessary ; how shall we attain to that enviable state ? The children of each succeeding generation, in consequence of the errors of their predecessors, — THE LAW OF DRESS. 73 wearing too much clothing, among the rest, — are becoming more and more feeble. They have sunk to their present condition, not at once, but step by step. Why should they not return in the same way ? Can they do it by one large leap ? Or must it be step by step, like the departure ? As regards dress, my method is to keep children warm in winter, and cool in summer. I would, however, avoid with great care too much clothing, by night and day both, in order that the system may be compelled to generate all the heat for itself which it ought. The more we are compelled to generate our own heat, when the surrounding temperature is low, as in winter, the more we are able to do in this way. And the contrary is equally true, that the less we have to do for ourselves in the way of generating heat, and the more we depend on external resources, the less are we able to do, and the more dependent do we become. In sum- mer, too, when our systems should be able to throw off all excess of heat, they are equally unable to do so. Children may be hardened by attention to dress; but never by overheating them on the one hand, or by keeping them chilly on the other. Nor can we do much iu any way to harden them, while very young. But as soon as they are old enough to walk and run, and exercise all their machinery, we may begin the har^ning process. This consists, 7 74 YOUNG WOMAN'S BOOK OF HEALTH. essentially, in diminishing the clothing very grad- ually, by the gradual substitution of due activity of body and mind in its place. To aid in this great work, I would pay proper regard to their sleep, sleeping-rooms, and bed clothing. I have already said that there should always be a change of clothing for the night. We should also avoid, for their use, feather beds and comfortables. These, as you must have already seen, do not permit a free circulation of the air; besides which, they do not favor a proper degree of cleanliness. I promised to say something more about bathing. The subject has been deferred till now, to avoid digression. The fact is, that ablution with cold water may be so managed as to accomplish one or two very important objects, besides that of keeping the skin clean. 1. It may be made to invigorate the skin, which is a matter of very high importance. I have already remarked on the weakness and feebleness, and even thinness, of the skin; * and shall dwell at still greater length on it, in the chapter on Suppression. Now, any thing which will remove or even di- minish this downward tendency of the cutaneous system is worthy of our attention. Occasional warm bathing will do something towards it; and * See Chap. II. THE LAW OF COLD BATHING. 75 so will friction, especially when it immediately follows the warm bath. But cold bathing, properly applied, as regards time and circumstances, will accomplish much more. 2. Cold bathing, when judiciously managed, not only invigorates the skin, and renders it more and more healthy, but the lungs, also, and the whole alimentary canal. Do you ask' how this can be ? It will be my aim briefly to tell you. All parts of the body, internally, which have any communication — the slightest — with the open air, are lined by a membrane, continued from the skin, and slightly resembling it, only thinner and more delicate, and without color. This lining of the lungs, stomach, alimentary canal, nasal cavities, eyes, ears, throat, &c, is called mucous membrane. These mucous membranes have such a strong sympathy with the skin, that, if the latter under- goes any change of circumstances, whether favor- able or adverse, the former feel it. If the skin rejoices, so to speak, all the mucous membranes rejoice with it; if the skin suffers, all of them suffer with it. Hence it is that cold bathing, properly applied, so as to invigorate the skin, always and inevitably invigorates the whole system, and particularly those parts which are lined by mucous membrane. It even does more; it tends to prevent disease of every kind. Or, if disease from other causes must 76 YOUNG WOMAN'S BOOK OF HEALTH. arise, it tends, at least, to mitigate the suffering, and to render it less fatal. But what is the judicious application of cold water ? It is such an application as will secure a reaction; — in other words, will leave us with a warm glow on the surface, and with increased activity and strength of body and mind. Unless this reaction is secured, cold bathing, as a general rule, does us no good. Any method of applying cold water, — any quantity, and any hour, and place, and form of apparatus, — if it readily brings with it a reaction, is safe ; and, if practised daily, will keep the skin clean. The feeble, however, will best bear it about two or three hours after breakfast ; and next best in the morning, when they rise. The worst time is at the close of the day and of the week. For those, again, who are feeble, the sponge, wet writh cold water, and applied to the chest; afterward to the chest and arms ; and, still later, to the whole body, is greatly to be preferred. For those who have nothing better at hand, a wet cloth or towel will do very well. Still, I must insist, that, after the lapse of a few weeks, when the system becomes able to bear it, the cold shower bath will be preferable. The water may be allowed to fall on the head first, or on the shoulder, back, hips, or arms, as may be most agreeable. DIET OF REGIMEN. 77 If young women will begin cautiously, proceed rapidly, wipe dry very quickly, and rub well with a flesh brush, or with very coarse mittens, or even with the naked hand,* they need not be afraid of evil consequences in any climate, or at any season of the year. I speak, however, of those who are tolerably healthy, and not of the nervous and feeble. If the rising generation of young women is to be rendered less susceptible to colds and other dis- eases, as well as less delicate and nervous, than the generations which preceded it, the change must be principally — or, at least, very largely — accom- plished by cold bathing, especially shower bathing. And if this world is ever to become a happier and better world, by human agency, it is to be elevated, in no small degree, by the appropriate action of pure cold water on the surface of the body, and by the healthful, life-giving tendencies which are transmitted, by sympathy, from the ren- ovated skin to other parts. We come now to the consideration of Section 4. Diet and Regimen. Important as air, water, and exercise are to the * Many attach great importance to friction with the hand. Nor am I quite certain, that, in the case of the feeble, the strong, healthy hand of a friend — full, so to speak, of fresh vitality — may not have an efficacy of which most of us are not aware. 78 YOUNG WOMAN'S BOOK OF HEALTH. health of young women, they are hardly more in- fluential than their food and drink. Dr. Morrill, (a late writer on the physiology and diseases of woman,) in speaking of the stormy period of human life, as he calls it, thus observes: "A carefully regulated diet is, of all means, the most appropriate for moderating the excitement and disorder resulting from the momentary pleni- tude of the circulatory system." Nor is it much less important at every other period. The great practical question here is, Of what shall this well-regulated diet consist ? Is there one prescription for all, or do some require one kind of food and drink, and some another ? Now, while it is most cheerfully conceded that there is a difference of original constitution, and a still greater difference from acquired habits, so that there is not a little practical wisdom in the old ad- age, •• What is meat for one is poison for another," it is also maintained, that most of what are called constitutional differences, are only so from the mere force of habit. For who does not know that the food of the first year or two of human life is essentially the same ; that all children like it; and that it agrees with all ? Who ever heard of the application of the above mentioned adage to this early period of existence ? Who ever heard that the milk assigned to infancy was meat for one, and poison for another ? FOOD WHICH AGREES WITH ALL. 79 So it is, in no small degree, with many other articles which follow it. Thus good milk from domestic animals, good bread of various kinds, which are plain, good mealy potatoes, rice, apples, pears, peaches, strawberries, raspberries, blackber- ries, whortleberries, boiled chestnuts, &c, are always agreeable to the young. In regard to most, or all of these, we hear nothing said about what is food for one being poison to another; no such thing. The same remark might be extended to many other plain articles. Yet these plain articles constitute the substance, after all, of a well-ordered female diet. The dif- ferences, about which so much is said, and which are so often regarded as constitutional, are such as relate to second-rate articles ; things, in truth, which are of comparatively little importance. I might mention one thing more. In the matter of drink, all are at first fond of pure cold, or at least cool, water; and not fond of other drinks, such as tea, coffee, beer, &c. " What is meat for one is poison for another," will not surely apply here, at least so far as the first years of life are concerned. It may become applicable, after a time, when habit has changed the whole natural order of things. It is not difficult, therefore, if we recur to early experience and first principles, to determine what is and what is not a healthy diet for young women. 80 YOUNG WOMAN'S BOOK OF HEALTH. True, it is one thing to prescribe a correct diet for those who are already perverted in their habits, and quite another to induce them to prefer and relish it keenly. And yet this preference and keen relish is a very important preliminary to all healthy digestion. In truth, this is the first rule, as regards diet, for young women to observe, — to eat that which is agreeable to them, or which relishes. One reason for this rule is, that when we relish our food, we are apt to retain it longer in the mouth, and chew it better. Besides, the saliva, in these circumstances flows more freely, and probably has more of vitality. It will be seen, however, that, if correctly trained, every young woman would be most fond of plain, healthy aliment. And it should here be added, that, even when we have been miseducated, we can easily be brought back to truth and nature, pro- vided we have strong confidence or faith that the ways of truth and nature are best for us. In other words, we may, in time, easily bring ourselves to prefer that which we know to be best. The second rule may be inferred from what has been said in the preceding paragraphs. It is, that our food, should be well masticated and insalivated. One reason for this is found in the fact that food in large lumps — bolted, as it is called — does not change very readily in the intestines and stomach. Another reason is, that liquid food, which of RULES ABOUT EATING. 81 course does not undergo mastication and insaliva- tion, is known to be exceedingly difficult of diges- tion. Another reason still is the following : All mashed, or bruised, or soft pasty food, such as slips down the throat easily, is apt to be imperfectly digested. A fourth reason is found in the fact that they who drink with their meals, and thus substitute other liquids for saliva, have their digestion very much injured thereby, especially when the habit is long continued. Fifthly and finally, they who do not use their teeth properly, are known to have them decay the sooner for it. Hence one reason for that premature decay of these instruments, which now generally prevails. They who chew their food best, other things being equal, have the best teeth. A third rule is, not to eat too frequently. Once a day, as some physiologists tell us, is sufficient for the healthy adult; but probably twice is better. Three times a day is the most which is compatible with good health, after we have passed the age of ten or twelve years. This remark is of more im- portance to young women than to other people, but is of importance to all. Whether, however, we eat once,* twice, or three * O. S. Fowler, the phrenologist, thinks once a day is suf- ficient. Others may think so ; but among the physiologists, Mr. Fowler, I believe, stands nearly alone. 82 YOUNG WOMAN'S BOOK OF HEALTH. times a day, whatever we eat should be taken at our regular meals. Unless we need medicine, which, of course, ought to be taken as far from our food as possible, nothing should be taken between our regular meals but water. Many who do not believe in eating between meals, in general, are in the daily but erroneous habit of allowing themselves to taste a great variety of small substances, whenever they feel an inclina- tion to do so. Among these are fruits, aromatic seeds, bits of sugar, cloves, wafers, &c. Even the common nutritious drinks, such as milk and water, molasses and water, &c, should, at these seasons, be carefully avoided. For the human stomach, like other human organs, needs its seasons of rest; but these substances set the stomach at work, and keep it in such constant motion, that it soon becomes a seat of irritation and disease. But the reasons for this rule are too nu- merous to be mentioned here. No rule, however, in dietetics, is more liable to be perpetually violated by young women than this. They are nervous, and these little things gratify them. They have moments when they have noth- ing to do, or rather, know not what to do, and they eat something to while away the time. They have uneasy sensations, and they eat something in order to feel better; though some of them believe, most fully, they shall suffer for it in the end. DANGER OF EATING TOO MUCH. 83 The teacher of one of our best female schools was compelled, some time since, to make a law that no pupil of her school should spend more than twelve and a half cents a week for candy. What a comment is this upon depraved, misguided, mis- educated appetite! I have even known women of general good sense, who set the example of eating something continually, while at the heads of their respective families. And one of the savans of our country — one, too, who was ever and anon pressing the claims both of physiological and moral law, and of this law, among the rest — was frequently found eating between his meals. A fourth rule in regard to eating is, not to eat too much. Young women do not so often violate this rule, as they do the preceding one ; perhaps for the very reason, that as a consequence of eating often they have very little appetite. And yet the smaller quantity they eat, may amount to greater excess in them, than a much larger quantity in those who have appetites. For they who are habitually tasting little nice things, such as cloves, seeds, &c, between their meals, seldom have a good firm appetite for the reg- ular meal when it comes. And this irregularity soon grows, with them, into permanent and habitual derangement. They who give directions in regard to the quan- 84 YOUNG WOMAN'S BOOK OF HEALTH tity of food, sometimes tell us about weights and measures. But such have been the perversions of education, and such is our inheritance from a de- praved ancestry, that no given quantity would be exactly adapted to all persons. Twelve mouthfuls of food, though it may be sufficient for a Japanese student, or even for a Dr. Dwight, in his early life, is not by any means enough for an Irish laborer. Nor would Cornaro's rule of twelve ounces of solid food, and a small quantity of liquid substance, or Mr. Graham's, of one pound of dry bread, or what is equivalent thereto, in twenty-four hours, be adapted to the health and habits of all. Nor would the contrary extreme be desirable to all. I mean, the indulgence of the stomach in all it can receive. The Scotch peasantry, in some instances, are expected to consume the food of two and a half pounds of oatmeal a day. This must be equal, in bulk and nutriment, to at least four pounds of common bread, or four or five of com- mon butcher's meat. If this is not too much for young men, it is certainly a great deal too much for young women. Children are, in this particular, most unhappily trained. From the cradle all the way upward, and indeed through life, they are expected, and even encouraged, to eat too much; till their stomachs, following the general law that all parts endowed with muscular fibres are enlarged and strengthened QUALITY OF FOOD. 85 by use, become gigantic, and demand, if they do not even require, a giant's rations. And as for this species of education, our females come in for a pretty large share. They are, from the first, not only urged to take more, and made literally to overflow with excess, and, as soon as they come to the table, tempted, by variety of dishes and the great law of imitation, to exceed nature's true bounds, but they are also taught, much more than males, to add another piece of pie, cake, or the like, to what already amounts to satiety, just to see how very nice it is, and to gratify the foolish pride of the cook or housekeeper. They see, too, what is going on around them, in the preparation for and reception of guests. For, despite of the great Christian law against causing our neighbor to offend — transgress, rather — most young women have the frequent privilege of seeing their seniors make every possible effort, by deed and word, to have their guests eat too much. Why, a young woman would almost be shocked to hear the mistress of a table say to her guest, in the true Christian spirit, " My dear friend, are you not going a little too far? " or, " Will you not injure yourself, if, in addition to what you have eaten al- ready, you take that piece of pie ?" But I must confine myself more closely to my subject. Let me, then, introduce a fifth rule — that our food should be of proper quality. 8 86 YOUNG WOMAN'S BOOK OF HEALTH. 1. It should be simple. What I mean by simpli- city may be best understood if I state, negatively, what I do not mean. By simple food, then, I do not mean mince pies, especially such as those men- tioned by Mrs. Leslie, one kind of which contains no less than eighteen ingredients, a part of which are not merely diverse in character, but exact op- posites. Nor do I mean by simple food, a mass of potato, dressed up in modern style, so that it can hardly be told whether it was originally a potato or a dump- ling. A potato, boiled or baked only, might be a simple article. But when to this we add, besides bruising and beating, not only a little salt, but a good deal of butter and gravy, or a large amount of pepper, mustard, or vinegar, or several of these combined, it is no longer within the bounds of simplicity. And there is no better reason for com- plication in the cookery of a potato, except what is found in the law of conventionalism, than there is in the cookery of an apple, or a peach, or a straw- berry. 2. Food should not be very difficult of digestion. It should, indeed, task the digestive organs, but not unreasonably. All parts and organs of the human system are made, so to speak, to be working men; and when they perform their duty faithfully and energetically, all goes on well. They may, how- ever, be ewer-tasked; and they often are so. MISTAKE ABOUT DIGESTION. 87 Take the potato and apple, as examples. I mean, now, the uncooked apple. No human being can digest them as easily as plain meats, bread, rice, eggs, milk, &c. Still, there are not a few strong laboring men who require them, especially at their breakfast. They task their giant powers of diges- tion, in just about the right degree and proportion. I have said, elsewhere, that digestion is some- thing more than mere solution. Food, in order to be made into good blood, must first be changed by the gastric juice into chyme. This last then • passes into the small intestines, where it receives two new fluids, the bile and pancreatic juice, where it becomes, in part, chyle; which is then taken up by the lacteals, carried into the circulation and to the lungs, and made into blood, after which the residuum (or at least what is insoluble and un- changeable) is conducted out of the body. Now, when I speak of digestion, I refer to the whole of this important and highly complicated process ; and so do most of the books on this subject. When, therefore, you tell me, as doubtless you will, that you can digest the potato, or the apple, or the peach, or some other article which I might men- tion as being difficult of digestion, remember it is solution you are talking about, and not digestion. Few persons can be found among us — perhaps none at all — who know what they can and what they cannot digest. If a substance is dissolved, 88 YOUNG WOMAN'S BOOK OF HEALTH. and passes out of the system without giving them pain, I say again, they talk about their experience, and call it digestion.* A thousand things are in common use, and are believed by most people to be easy of digestion, when they are the reverse. They are wrought into chyme, and chyle, and blood, with great diffi- culty ; and often make but very poor blood, after all. They nourish the system, it is true, at some rate or other ; but it is not well nourished. Besides this, their imperfect action, and the imperfect re- sults, are the means of exciting, or, it may be, of generating, disease. Among the classes of substances which are diffi- cult of digestion, is that of "made dishes." Dr. Dunglison, in the course of his remarks on the sub- ject before us, says, " Every made dish is more or less rebellious ; " f that is, more or less difficult of digestion. What he means by '•made dishes," I hardly need to tell housekeepers, or even young women. He had been speaking of the present complex condi- tion of the culinary art, and saying that we were constantly taking such substances as eggs, butter, lard. &c, without being aware of it. He then added, "All dishes, as a general rule, that contain a large * And yet all this is compatible with a state of disease called lientery. Indeed, it is that disease. See Chaps. I. and II. t Elements of Hygiene, p. 283. EVILS OF MADE DISHES. 89 amount of nutriment in a small space, are more unmanageable by the stomach; and hence every preparation of eggs,* and every made dish, are more or less rebellious." I hope my readers will give to this part of my subject, if to no other, proper reflection. I have quoted from Dr. Dunglison, because he is among the last of the physiologists to be suspected of en- tertaining visionary or premature views. He is an old man, and a little disposed, withal, to reject new notions about diet. Yet he is compelled by the force of truth to give this testimony. Let every young woman consider well what a vast amount of food, if Dr. D. is correct, must be more or less difficult of digestion. It is not merely a few strange compounds, here and there, as mince pies, sausages, and fritters; it is all our made dishes. It is every thing into which we put sea- sonings, whether eggs, lard, or butter. What, then, shall be said of the frequent and growing practice of making rich pies, cakes, sweet- meats, and preserves ? What shall be said of all that class of articles, into which go rich sauces, wines, sirups, &c. ? But I must not omit to make particular mention of one great class of substances, which are distin- * The French are said to have no less than six hundred and eighty-five dishes into which eggs enter as a component part. — Elements of Hygiene, p. 283. 8 * 90 YOUNG WOMAN'S BOOK OF HEALTH. guished for their " rebellion; " I mean preserved substances. Of this genus there are many species. Among them are salted meats, long salted butter, ham, sausages, pickles, and the like. It makes much less difference than many of you may suppose, how a substance is preserved from decay, whether by salt, vinegar, spirits, sugar, or spices. The evil lies in the preservation from pu- trefaction, or decomposition, or decay, more than in the substance which accomplishes the object. What chiefly renders this whole tribe of dietetic preparations more or less noxious, is the fact that whatever process prevents chemical change in their interior, — i. e. prevents a tendency to corruption or putrefaction, — impedes also the process of di- gestion. Observe, however, I am not comparing the digestive system to a chemical laboratory, but only stating a law of physiology. If this view should shut the door, so far, at least, as young women are concerned, to salted pork, beef, fish, butter, &c, as well as to pickles, sauces, preserves, jams, jellies, sweetmeats, and gravies, I am sure I cannot help it, how much soever I may regret it. I am not the maker of the law, but only the interpreter. I have no doubt, however, that the law is holy, just, and good; and as such, I have long yielded to it my own strict obedience.* * See "A System of Vegetable Diet," second edition, p. 83. FOOD WHICH IS TOO NUTRITIOUS. 91 3. Food must not be too nutritious. Here, again, I must remind the reader of what I have before quoted from Dr. Dunglison. He says that, as a general rule, all dishes containing a large amount of nutriment in a small space, are more or less " rebellious." What, then, are these dishes ? They are quite too numerous to be mentioned here. I will only refer to a few of them. You may guess at the rest. In the animal kingdom, and on its immediate borders, are fat, butter, eggs, cream, cheese, &c. In the vegetable kingdom are rice, peas, beans, lentils, sugar, starch, arrow-root, sago, tapioca, and a few of the nuts and grains. It will be said, perhaps, that we seldom confine ourselves wholly to any of the articles of food mentioned in the last paragraph; and it will be asked, whether we may not make our meals partly of some of these articles, and partly of something else, which contains but little nutriment. We certainly may do this. Instead of making a whole meal of an article, as highly nutritious, for example, as rice, we may use a part rice, and a part potatoes, apples, turnips, or beets; or, in short, some article containing but little nutriment. Or, if we have an innutritious meal, for once, we can follow it by one more highly nutritious. Or we may combine with such articles as peas, 92 YOUNG WOMAN'S BOOK OF HEALTH. beans, or rice, a portion of coarse bread, or a still larger portion of some plain vegetable. Or, when- ever we wish to use sugar, or honey, or sirup, we may, at the same time, use a pretty large amount of baker's bread, or rice, or something which has but little sugar in its internal structure. The customs of society, however, tend wholly, or almost wholly, the other way. Just as surely as we have before us, as a principal dish, some highly nutritious substance, we add to it another of the same general quality, or perhaps several of them. Thus, if we have rice, we add to it molasses, or sugar, or honey, or butter; or perhaps a combina- tion of two or three of these. Or, if we have peas, it is ten to one but we add to them a quantity of butter. Or, if we have rich, new, wheaten bread, we eat it with butter or cream. Or, if our bread is of full age, we add milk, or butter, and make toast. It is of exceeding great importance to young women, that they avoid the extremes of a diet too highly nutritious, and one which is deficient in point of nutriment. Good bread, rice, and milk form an excellent diet for them, especially till they are past fifteen. Or, if they use a little flesh once a day, it should be neither too fat, on the one hand, nor too coarse, and indigestible, and innutritions, on the other. But I wish to be understood. I do not think flesh or fish, to young women, at all necessary. DISEASED FOOD. 93 It is commonly thought that flesh and fish—the former in particular — are much more nutritious than vegetables. I suspect, however, that this no- tion has arisen from comparing animal food with coarse or crude vegetable productions, such as pota- toes, turnips, greens, asparagus, celery, and the like. It has been almost forgotten that bread, rice, peas, beans, sago, &c, are vegetables. Yet all these, except, perhaps, the last, are much more nutritious, pound for pound, than flesh or fish.* A sixth rule, in regard to the quality of food, requires that it should be free from disease. The slightest inspection of the subject is suffi- cient, one would think, to convince every body that diseased food must be hurtful, particularly to the young. Let us, then, inquire what diseased food is. Vegetables are sometimes diseased. I have known the apple, in certain locations and in certain years, more or less diseased. The disease was manifested by apparent veins and streaks in the pulp, supposed by some to be the paths or great thoroughfares of communities of animalculae. But this apple disease is not very common. * Other mistakes, in great numbers even, have been made concerning the quality of flesh and fish, as compared with vege- table food. It has been little known, till the days of Liebig, that vegetable food contains all the essential elements of living bodies. 94 YOUNG WOMAN'S BOOK OF HEALTH. The potato disease is well known ; and no one presumes to eat the article when it has absolutely yielded to decay. Yet are there not stages of this decay? Does the potato, or any other vegetable, become deeply diseased at once ? Is it perfectly innocuous up to a certain moment, and then greatly injurious beyond that moment ? These questions are worthy of serious consideration. Rye, corn, and wheat are sometimes diseased, especially the former. With the poisonous charac- ter of ergot (spurred rye) most of my readers are doubtless well acquainted. It is regarded as a power- ful medicinal agent, especially in female diseases. Several other vegetables are occasionally found diseased. The potato, for example, when it grows partly out of the ground, and has a green appear- ance, is slightly poisonous. Fruits, in a state of decay, are more or less noxious; and, when unripe, they are little better. But animal food is more frequently diseased than vegetable. Most of our meats, as they come from the market, are in a state of incipient disease. It is not eggs alone, nor eggs and sausages* alone, that, in a semi-putrescent or otherwise irritating condition, disturb digestion and poison the system. Every stall-fed animal is believed to be more or less unhealthy, and its flesh more or less diseased. * The allusion here is to the blood sausages of Europe, par- ticularly of Germany, so often exceedingly poisonous. POISONOUS ANIMAL FOOD. 95 The swine, as now usually fattened, is always diseased. The goose almost always is.* Beef cattle frequently are so. There is measles, as it is called, in the swine ; and liver complaint, both in the swine and other animals. I repeat it, no living being can be treated long as we are wont to treat fattening animals, without developing disease. Aged animals, moreover, especially cows, when they have been long fed with unnatural and heated food, become diseased, even without fattening. The milch cows of Paris are said to be generally tuberculous; f that is, consumptive. Old cows very often are so. Certain parts of animals, I grant, are much more apt to be diseased by fattening than others. Among these are the fat, the liver, and the blood. If it should be said that the people of the United States are not accustomed to use blood, I reply, that it is difficult, if we use flesh at all, to get wholly rid of it. The veins, if not the arteries, are but partially emptied. Whole gallons of blood must be retained, in this way, in the flesh of a large animal. Be- * The story of the manufacture of the diseased livers of geese into the famous Strasbourg pies, is no fiction. The goose and every other animal, treated as the geese of Strasbourg are treated, would become diseased in their fivers. Want of exercise, high temperature, unhealthy air and food, are enough to cause disease even in the hardiest animals. t See Dr. Clark on Consumption, 96 YOUNG WOMAN'S BOOK OF HEALTH. sides, it is now well known that blood enters largely into the very structure of muscular fibre. It will doubtless recur to the minds of the in- quisitive that there is a large class of animals used for food not affected by the force of the above re- marks. All wild animals and fowls, and most fishes, might yet be free from disease ; at least, in most instances. This is certainly so. And yet these animals occasionally become diseased. The flesh of the partridge is sometimes poisonous. So the lobster and oyster. I have seen a whole neighborhood made sick by oysters. They are said to be un- wholesome in certain months of the year ; but on this point I have no certain information. The late Noah Webster, in his work on Pestilen- tial Diseases, states that the fish in general, on some parts of our Atlantic coast, have, in certain years, been found sickly. And it is well known that sailors, when they cook the dolphin, if not other fishes, and are afraid of disease, boil along with it a piece of silver, which, they fancy, purifies it. But I have dwelt quite long enough on this part of my subject, though it would be easy to show how food is poisoned in a thousand ways. On poisoning by modern cookery I shall say something more, presently. The seventh rule in regard to the quality of food is, that it should not have medicine in it. By med- MEDICINE IN FOOD. 97 icine, I mean here what has been, time immemorial, laid down as such in our books. I mean, in short, pepper, spice, mustard, saleratus, vinegar, saltpetre, ketchup, and the like. If we except salt, and, per- haps, ginger and cinnamon, all condiments, properly so called, should be considered as medicine. Now, it is a law in hygiene, that medicine and food do not harmonize. If, by collision, or the play of new chemical affinities in the stomach, they do not actually cause pain, their tendency is to cause biliary derangement, and, in the end, stomach and bowel disease. If taken at all, they should be taken apart from each other. This reminds me of another class of medicinal substances that properly belong to popular diet and regimen. I refer to beer, tea, coffee, chocolate, &c. The Orientals, in their comparative simplicity, often use these substances separately. Coffee, for exam- ple, is often taken in small quantity, very strong, and served up as a meal by itself. So is tea, at times by various nations. They should be thus taken, no doubt, if taken at all. Medicine and food, I say again, are, in their very nature, incompatible with each other. Indeed, no medicinal substance ought to be taken by young women, either at meal time or otherwise, except by direction of the family physician. One rule more under this head. Food should not be injured by cookery. Of course, I do not 9 98 YOUNG WOMAN'S BOOK OF HEALTH. intend to take the high doctrine of Schlemmer and his disciples, that all cookery is wrong; for I do not believe it. But I will mention a few things that I do believe. Food is sometimes injured by half cooking it. Thus rice, only half boiled, — that is, so boiled as to leave the kernel hard, — seems to be almost, if not altogether, insoluble in the gastric juice, and, therefore, indigestible. It has been known to pro- duce a good deal of disturbance in the system. The same is true of a few other articles. Many would be better without any cooking at all, than when only half cooked. Other things which might be mentioned, and, perhaps, these very same, are often injured by ex-* cess of cookery. Such are eggs, meat, potatoes, &c. Why they are injured in this way, I have neither time nor room to say. I will only say of eggs, that, when cooked at a heat above 165°, the white or albuminous part is coagulated, by which process it is rendered insoluble in water, and solu- ble with great difficulty in the gastric juice — at least if healthy.* We are particularly liable to injure our food, and thus impair the health of our families, by unscien- tific methods of cookery. The common method of cooking eggs, just alluded to, is an example. See the "Young Housekeeper," 8th edition, p. 277. ILLEGITIMATE COOKERY. 99 Here we set ourselves against a plain law of chemistry. The same thing is usually done in bread-making. Our mixed or " made " dishes, as Dr. Dunglison calls them, are of this description. By the various mistakes which occur in this way, thousands of lives are lost yearly, and other ten thousands rendered less valuable, and even less desirable. The compound dishes into which sale- ratus enters, as free saleratus, destroy alone their thousands of children, and some adults, every year.* Not only do we run the risk of developing or producing new or poisonous combinations, when we "perpetrate" these mixtures,—and this just about in proportion to their complexity of charac- ter, — but we also render them, in nearly the same proportion, difficult of digestion. Thus cheese (should we escape the evil of forming a poisonous compound, of which we can never be certain be- forehand, at least while ignorant of chemistry) is always more difficult of digestion than the milk from which we form it. And then, once more, our food, much oftener * In New Brunswick, contiguous to Maine, the physicians are wont to say that half the children are killed by saleratus. Par- ticulars I have not room to give. The evil is fast spreading, not only in Maine and Massachusetts, but throughout the Union. Families of moderate size already use from ten to twenty-five pounds of saleratus yearly. 100 YOUNG WOMAN'S BOOK OF HEALTH. than we are aware, is poisoned through chemical changes, which have their origin in the unsuitable- ness of the materials from which our cooking uten- sils are made. Sometimes we are forewarned of the danger by a change of color in the contents of the vessel thus employed. I have seen these ves- sels almost as black, after cooking in them, as common ink, and have known people poisoned by eating their contents. Section 5. Laws of the Circulation. The human body is made up of solids and fluids, in the proportion of something like one sixth of the former, and five sixths of the latter. And these solids and fluids are all arranged in a particular manner; or, in other words, according to law. There is no such thing as chance or haphazard among them. One of the fluids has a peculiar color, as well as peculiar properties, and is called the blood. In an adult, there are from three to three and a half gal- lons of it. This blood is not diffused through the system, like water through a sponge ; but is con tained in a large number of tubes, or pipes, of varying dimensions, uniting in one at the centre or, as we should say, at the heart. Nor does the blood in these pipes stand still. It is ever performing a double circuit. Thus, begin- ning at the left division or chamber of the heart, it THE HUMAN CIRCULATION. 101 passes into what is called the aorta, a very large pipe, which, by means of branches given off at various distances, like branches from the trunk of a tree, distributes the blood or contained fluid to every part of the living system. The branches of this great tube, thus distributing blood, are called arteries. These arteries, terminating by very minute branch- es in the extremities of the body and in the skin, pour their contents into another set, much more numerous, which, instead of ending very small, begin small, like the sources of our streams of water. These are called veins. They carry the blood back from all parts of the body to the heart, and pour it into its right side or chamber. The blood is next propelled from the right side of the heart into the lungs, by means of large ves- sels, which subdivide till they are beyond the reach and ken of the naked eye. They are distributed in great numbers in the coats of the air cells or air bladders which exist there. From the lungs, after having undergone an im- portant change, the same blood is carried back to the left side or chamber of the heart, whence it again performs the double circuit already described. This blood is made from our food and drink. The food is first masticated and mingled with the saliva ; then changed to chyme in the stomach, by means of the gastric juice and other agencies; 9* 102 YOUNG WOMAN'S BOOK OF HEALTH. then carried along into the small intestines ; and, lastly, conducted — portions of it, I mean — through the lacteals and thoracic duct, in the form of chyle, to be mingled with the returning current of blood, and sent with it to the lungs and heart. I have intimated that portions only of the chyme ever make a component part of the human system. This substance, soon after it leaves the stomach, receives from the liver and the pancreas the bile and pancreatic juice, upon which a separation of the mass takes place, as the result of which we have chyle on one hand, and waste portions, which, in due time, are rejected from the body, on the other. How the chyle, thus formed, and afterward car- ried into the circulation, ever becomes blood, it is impossible to say with certainty. My own belief — and I am not alone — is, that it is changed in the lungs when the spoiled blood is, and by the same means. The great leading purpose of the blood is to nourish and sustain the body. In the first place, all parts are built up from it; and, secondly, as we are continually wasting away, both in our solids and our fluids, this waste is continually restored through the same medium. We are now prepared, as I think, to deduce from the above great facts in anatomy and physiology the following laws. Like all other laws of health, they are as certain as the mathematical sciences. LAWS OF THE CIRCULATION. 103 1. In order to health, we must have a proper supply of healthy food ; and this food must be properly manufactured into good and healthy blood. If the material we receive into our stomachs is bad, or if any part of what we call the digestive process is imperfect, the intentions of nature are not per- fectly fulfilled, and perfect health cannot be the result. 2. It is further necessary, in order to the best of health, that the heart, arteries, and veins should be of sufficient strength and capacity, and should have sufficient freedom of motion ; for, if otherwise, the circulation of the blood cannot be perfect. A quantity of blood equal to that contained in the whole system should pass through the heart, as well as through every important part of the body, every three or four minutes. 3. The lungs should be capacious and strong, in order that the chyle and blood may circulate freely therein, — the former to be made into perfect blood, the latter to be renewed. They should also have free and unrestrained motion. 4. There must also be a full supply of perfect atmospheric air constantly in the lungs. The least adulteration or change in this air, whether by res- piration, combustion, or in any other way, unfits it, in the same degree, for the great work of forming and renewing, or purifying the blood. There are other laws pertaining to, or connected 104 YOUNG WOMAN'S BOOK OF HEALTH. with, the circulation ; but the foregoing are among the more important. What female cannot see, at a single glance, that if the violation of these laws, on the one hand, tends to deterioration and ill health, then obedience to the same laws, on the other hand, tends to improve her health and advance her whole character and that of her race ? Is it not, then, high time these laws were duly under- stood and obeyed ? Section 6. The Laivs of Mind. The mind has a closer connection with the body, in respect to health, than most persons are aware. It is not, as I suspect, generally known that the higher and more harmonious the cultivation of the intellect, other things being equal, the better is the health. Dr. Sweetser, in his great work on " Mental Hy- giene," has endeavored to diffuse light on this subject; but his book has been but little read. Every young woman should have her mind well stored and disciplined, were it only for the sake of improving her own health. I will not, indeed, go so far as to say that it is necessary, in this point of view, to study every thing. The mental facul- ties may be disciplined without mathematics or languages. But I will say — for truth compels me — to all who would be as healthy as possible, that every faculty of the mind should be, in some way, highly developed, cultivated, and disciplined. DOES KNOWLEDGE PROMOTE HEALTH? 105 What should be the particular routine or course of education and instruction for young women, I am not now to determine. I will only say, that it should be extended and thorough. It should also be such as will call into activity, and bring-to their full strength, each faculty, according to its respec- tive importance. To this end, and in this view, it appears to me that the indications of phrenology — and, in truth, of physiology generally — should be duly regarded. Many, I know, have strong prejudices against these subjects. I have had mine ; but they are, at length, giving way. I am well aware, that, to this late hour, there are prejudices in the vulgar public mind against any thing, which, in a female, would approximate to a liberal course of education. The more ignorance, the more health, as well as " bliss ; " so we seem to say. Those to whom I refer do not hesitate to tell us that the day laborer who can hardly write his name, or read his Bible, is far more healthy than the pro- fessional or literary man, or the man of mere leisure, who, it may be, lords it over them. The farmer, it is said, is more healthy than other men ; and yet he is far enough from being more intellectual. But it ought to be remembered, that, if the farmer and laborer are, indeed, somewhat healthier than other men, it is not by virtue of their comparative 106 YOUNG WOMAN'S BOOK OF HEALTH. ignorance, but in spite of it. They would be much healthier than we now find them, if to their many advantages, such as being much in the open air, and having a large amount and variety of exercise, were added a better intellectual cultivation. On this head, I should be glad to extend my remarks to many pages, did my plan permit. Section 7. Laws of the Heart. Under this head, which I use for the sake of brevity, I propose to say something of the impor- tance of a due regulation of the affections and passions, with a view to their right influence on the physical system. Few have any adequate or correct idea of the amazing power exerted by the passions and affec- tions on the bodily functions. The elevating pas- sions and affections increase and exalt bodily vigor, quite as much as the depressing ones lower or im- pair it. That many diseases among us are either caused or aggravated by the latter, is, I believe, generally admitted ; but that the former promote health in the same degree, is seldom either under- stood or believed. Who has not observed the condition of the skin when under the influence of fear ? Who has not noticed its roughness — its hill-and-dale appear- ance ? The truth is, it is shrunk every where except at the roots of the hairs which pierce it, and HEALTHY AFFECTIONS AND PASSIONS. 107 on some of the papillae, or eminences which abound in it. At these points, it seems, to the unpractised eye, to rise up. Now, this condition of the skin, studded as it is with small pimples, is discovered in all the circum- stances of fear, not only when it is excessive, but also when we are but a little fearful, or even mod- erately timid. And so it is, in a degree, with every other depressing passion or affection. If we grieve, worry, hate, envy, or even remain much in doubt or suspense, the skin is the less plump for it. And the less full and plump we find it, the more subject it is to the influence of the extremes of heat and cold, and to an habitual dryness and scurfiness, and the more liable are we to colds and to cutaneous diseases. On the contrary, the more we become emanci- pated from the power of the depressing passions and affections, and dwell habitually in the world of faith, hope, love, joy, peace, contentment, and cheerfulness, the more our perfect love casts out our native selfishness, — our " don't-care " spirit,— the better the condition of the organs of the body generally, and of the skin above all the rest. It is plump, warm, duly moist, and habitually active.* * Some have smiled at the naked statement that perfection of the Christian life would insure the health not only of the skin, but of all the bodily organs ; and that, other things being eqnul, such as natural inheritance, education, climate, and acquired habits, our piety might be tested by our health. But such per- sons have studied religion more than they have physiology. 108 YOUNG WOMAN'S BOOK OF HEALTH. And is there not a natural, physiological reason for this ? The skin, by its healthy action, is a pu- rifier — a depurator,- as the books say — of the whole system. In a state of health, it brings to its surface, and changes into other forms, — the fluid of perspiration, the sebaceous matter, &c, —avast amount of waste and impure substance, that would otherwise poison the internal organs and promote disease. It keeps up, or should keep up, in the system, a kind of centrifugal tendency. When it does this most effectually, we are most healthy. Hence the amazing importance — aside from religious considerations — of living under the habitual dominion of those influences to which I have alluded above ; I mean the whole family of elevating passions and affections. A centripetal ten- dency in the skin is equally unfavorable to health of soul and body. In a system like the human, invested with a shrunk skin, and accompanied by cold extremities, religion and health will both, ere long, die out — first, individually ; then, of course collectively. But I must close this chapter — already much too long. In future pages, I shall have frequent occasion to advert to the great principles I have here so briefly announced, and sometimes to illus- trate and amplify. CHAPTER IV. PRECOCITY. From the great, and general, and increasing neg- lect of those laws to which I have referred in the preceding chapter, arise many of the evils, physical and moral, to which our youth of both sexes — especially our young women — are subjected. Some of their diseases and diseased tendencies are inher- ited ; but a very large number, perhaps quite a majority, are either acquired or aggravated by per- sonal transgression. Closely connected with that delicacy, tenderness, and nervousness which were described in Chapter II., is a greater or less degree of precocity. This shows itself in various ways. The body alone may be prematurely and precociously developed, or the diseased condition * may extend to the intellectual and moral department. When the physical system alone is affected, I have much more expectation from the future than * Precocity is as truly a disease as any thing else; and I know of few diseases of the young which call more loudly for medical attention. 10 110 YOUNG WOMAN'S BOOK OF HEALTH. when all the departments of our nature are involved by the disease. This condition is usually known by rapid growth, especially in height, and a pecu- liar brightness and prominence of the eye. In other words, and in plain language, the pre- cocity, so common in these days, is frequently dependent on scrofula. From one fourth to one half of our school children are constitutionally affected in this way. I do not say that every scrofulous child is necessarily precocious, for some are the reverse ; but I believe it will be found, on examination, that every precocious child is more or less scrofulous. In most it is only latent; in some it is active, i. e., accompanied by king's evil. But I must define my terms. The word scrofula is used so loosely, in common life, that, without an appropriate definition, I might almost as well be silent as speak. I use the definition adopted in my Young Mother's Medical Guide, at p. 229. The scrofulous habit, or latent scrofula, is shown by a peculiar delicacy and languor of the counte- nance, with a soft, rosy tint of the lips and cheeks; or a pale, soft, flaccid, and apparently tumid or swelled aspect of the face, with a dull, lead-colored circle round the mouth, and a swollen appearance of the upper lip. The hair is generally fair, with the eyes blue or black.* • There is another cast of features which sometimes accom- panies both the scrofulous and tuberculous constitution. I refer SCROFULOUS PERSONS DESCRIBED. Ill The head, particularly at the posterior part, is usually large, and the temples flattened, or some- what depressed. There is, in general, an aptness to take a catarrhal affection, during which the wings or sides of the nose are apt to become enlarged or swelled. The edges of the eyelids are very much disposed to become inflamed ; and, where the scrof- ulous tendency is very strong, the thick cartilagi- nous edges of the eyelids are apt to become red and very tender. The digestive powers are usually weak and irregular, and the bowels are apt to be either con- stipated or affected with painful mucous diarrhoea. The appetite, of course, is variable ; being at times very feeble, at others very strong. A leucorrheal affection in females is apt to occur from time to time, and to prove more or less debilitating. In very young children, excoriations behind the ears, scabby eruptions about the head and lips, obstinate ophthalmia, with a fretful and irritable temper, are among the more common and sure signs of latent scrofula. The growth of the body is usually slow, and sometimes, for a long period, is scarcely percepti- ble ; but the mind is apt to be exceedingly active, even to precocity. Many a child has owed his to the dark but clear skin, black, glossy hair, shining dark or pearly eyes, and an unnatural redness — almost like painting — on the cheeks. 112 YOUNG WOMAN'S BOOK OF HEALTH. success, in bearing away the palm at school, to his latent scrofula. The tumors, swellings, ulcers, &c, which appear about the neck, armpit and groin, at the knee, &c, belong to a later stage of the disease. The ravages of this fell destroyer are terrible. Many diseases, moreover, between which and scrofula there is no natural connection, become fatally severe in conse- quence of the scrofulous habit. But it is the former, or latent scrofula which is so often connected with precocity; or, rather, upon which precocity almost always depends. These cases of precocity are to be found all over the com- munity. I suppose it is understood by most persons, that, as a general rule, the whole period of existence in any species of animals bears about a definite and certain proportion to the time required to reach bodily maturity. Thus, if an animal is six years in reaching a particular point of maturity, his whole existence will be about twenty-four or twenty-five. To prolong his existence to thirty-two, we must endeavor to prolong the period required to bring him to maturity ; and to shorten the whole duration of existence, as a general thing, we have but to shorten each stage of it, especially the first. The last is exactly what we have, as a race, for a long time, been doing. We have taken a course with our young women which has brought them to PRECOCITY —WHAT IT IS. 113 a species of maturity one, two, or three years earlier than Nature intended, and, at the same time, ren- dered them short lived. Even when they escape consumption and the other diseases to which scrof- ula tends, their existence is greatly abridged. Nor is this all, nor the worst. Their great in- crease of activity, both of body and mind, is often — perhaps I might say usually—mistaken for strength. Strange that it should be so, when it must be ob- vious to the most careless observer that the preter- naturally active-minded almost always die early. But so it is ; and the consequences are fearful. Here I allude to intellectual and moral con- sequences rather than to any other; for it is exceedingly rare to find scrofulous young people predisposed to over-exercise of the body. They are generally of the contrary character. Their muscles are both slender and feeble ; and they act as if they were conscious of their feebleness. They are almost always disinclined to labor, and some- times averse to amusement. The piano, the novel, and, perhaps, the assembly, or the dance, become favorites with scrofulous and precocious young women. They are especially fond of music and literature. Frequently they have a turn for poetry. In all these things, — music, poetry, and learning, — in general, they readily excel. They are hence praised a good deal, and 10* 114 YOUNG WOMAN'S BOOK OF HEALTH. praise leads them to persevere in a mode of life which is already injuring their health. The more they are praised, the more they perse- vere in their unnatural course of life ; and the more they follow, in this respect, the bent of their incli- nation, the more they are inclined to do so. Then, again, the more they neglect healthy exercise, and only obtain it at improper hours, and under im- proper influences, the more disinclined they are to that exercise which is proper for them, and which their nature and habits so imperatively demand. For there is no individual who so much requires a large — not indeed excessive, but large — amount of muscular exercise, in the open air, as the preco- cious and the scrofulous. The reasons for this will appear by recurring to the remarks I have made on the skin, lungs, &c, in Chapter III. It is the same precocious and scrofulous young woman who is so apt to have a rough skin, and especially a rough face. This may be attributed to certain articles of food or drink, and no doubt with good reason. And yet these same ingesta — such as long salted meats, especially fat meats, pastry, preserves, pickles, cider, coffee, &c — do not pro- duce their legitimate effects half as soon on other persons as on the scrofulous ; showing, most plain- ly, that there is a connection between their use and the eruptions. It is the scrofulous individual that is almost PRODIGIES OF LEARNING. 115 always afflicted with sore throat or weak eyes, or a cold of some sort, or with chilblains or canker. So common has canker in the mouth and throat be- come, on Cape Cod and in many other parts of Massachusetts, that, wherever it prevails, it is called scrofula ; as if this were the whole of the disease. Let me say, however, that I am not quite certain there is no such thing to be found as precocity without scrofula; for it is certainly possible that such cases, here and there, may exist. But one thing I must say, viz., that I have never yet seen them. Would it were possible to impress upon the minds of our whole community the truth I am inculcating. Would that it were distinctly understood that all our prodigies of learning are diseased persons, and must die early. For, in that case, it would be a matter of grief, rather than of joy, when a young woman is two or three years more forward than her associates. That some persons already understand the matter correctly, I readily admit. They tell us, of such or such a child, " She is too bright, to live long ; " and the old adage, that " Death loves a shining mark," is ever and anon on their lips. And yet there is-not a little confusion, in the minds even of the more intelligent, on the subject. They do not see every thing clearly. It must be diligently impressed on all, especially 116 YOUNG WOMAN'S BOOK OF HEALTH. on all young women, that not only excessive pre- cocity, every degree of it, is the result of ill health, as a general rule, but that it also tends to impair health and shorten life in those who may have been supposed to be healthy at the outset. It is, more- over, transmissible, inevitably so, to other genera- tions. In another paragraph, I have alluded to the differ- ence between mental activity and mental strength, and have shown that the precocious are usually possessed of the former rather than the latter. It is this mental activity, grafted upon a peculiar tem- perament, that gives them such a brilliant appear- ance. All who are concerned in this matter — and who are more so than our young women ? — should remember to depress rather than excite the forward ; and to encourage, on the other hand, the backward and the dull. They should be the more careful to do so, be- cause the palm, almost every where, is awarded to brilliancy. In what school does not the nervous, scrofulous, precocious youth wear most of the badges of honor, and carry off most of the prizes ? It should be understood that the course of con- duct which is implied by these remarks, on the part of parents and teachers, is but offering a premium for mental debility and disease ; and that it is daily and. hourly adding to the mighty aggregate of MORAL PRODIGIES. 117 nervousness and feebleness among us, and to the vast amount of epilepsy, chorea, brain fever, insan- ity, scrofula, and consumption. We have seen, from the spirit of the foregoing paragraphs, that physical and mental precocity usually accompany each other. The prodigy is generally as tall and slender, if not as agile, in body, as she is brilliant in mind. It is to the bodily and mental manifestations, taken as a whole, that we refer, when we use the appellation of " shining mark." But it should not be forgotten that there is another department in the trinity of man's complicated nature —viz., the moral. Is the moral nature ever found to be precociously developed ? And if so, what are the marks by which it may be known ? I believe it to be a very common thing for the moral character to be developed prematurely, es- pecially in this day of pushing forward prematurely the intellect. I believe we have almost as many moral prodigies as intellectual ones. Reasoning a priori, I should expect to find it so. I should expect the precocious in body and mind to be pre- cocious also in heart. And what I should be led to expect from reasoning on the subject, I have found to be true as matter of fact. Nor is this moral precocity confined to those countries which abound in nunneries and convents. It is found, too, in the midst of Protestantism. 118 YOUNG WOMAN'S BOOK OF HEALTH. The world of religion will gain quite as much as the world of mere intellect, when piety shall have a slower, but more certain growth. I would not be misunderstood. But it is well known to those who have studied this matter, of late, that many a pious child — of scrofulous pa- rents and scrofulous habits — has been made to speak, at four or five years old, the language of adults, in regard to his religious experience. Such precocity is by no means desirable. The kingdom of God needs no prodigies, arid should have none. CHAPTER V. PRECOCIOUS DEVELOPMENT. Of one species of precocity, quite common among us, I have thus far said nothing. It is, in truth, somewhat difficult to treat of it, or even to give it a name. For distinction's sake, however, we may call it social precocity. This kind of precocity, though extremely com- mon in many parts of our own country, is still more so in England, especially in its manufacturing regions; but most of all so in tropical or frigid regions, such as those of Eastern or Northern Asia. But before I treat further on this subject, it may be well for me to state, as briefly as possible, what are the characteristics of this precocious condition. To this end, it will be useful to show, in the first place, what are the marks of perfect development, that we may be able to learn the other by con- trast. Were every thing as it should be in regard to the female; did she inherit a sound constitution; and were her whole education, physical, intellectual, and moral, such as is desirable, — the following would be among the natural and healthy developments of character. 120 YOUNG WOMAN'S BOOK OF HEALTH. The changes which, in our climate, and where there is no precocity, take place at about the age of fourteen,* are numerous and striking. They are physical, intellectual, and moral. Let me speak, first, of those which are more purely physical. Till the approach of the age above mentioned, it would not be very easy to distinguish the two sexes, by external form and appearance, unless it were by their dress. At this time, however, the following remarkable changes begin to be visible. First, a sudden expansion of the cranium and the pelvis, owing to the fact that those portions of the human machinery which are contained within those cavities, have been suddenly enlarged. Es- pecially is there an expansion of the lower part of the brain, and the upper part of the chest. Doubt- less there is a determination of the blood, in greater quantity than before, to these parts. As a consequence of this change in the system, the female head becomes larger in proportion to the body than that of the male, and is much more elongated backward. The chest also becomes * In hot climates, and also in very cold ones, — for extremes seem to meet here, as well as elsewhere, — puberty takes place as early as eleven, and, as some say, even at ten. So it is oc- casionally among us; and this is what I mean by physical precocity. It is not unfrequent at eleven or twelve years of age. FEMALE PHYSICAL CHANGES. 121 larger, though it must not be forgotten, that by the arrangement of the ribs with respect to it, it becomes, at the same time, rather shorter. But, although the head is larger, the nerves are smaller and more delicate than those of the male. The sensibility and the imagination, moreover, be- come of a sudden greatly developed and increased. As a necessary result, there is an increased suscep- tibility to impressions. In the second place, the muscular or moving powers of the body also differ. The muscles and bones are, relatively, smaller. Their activity is, at the same time, increased. What makes the muscles appear smaller than they really are, however, is the fact that the spaces between them are better filled with cellular substance, and sometimes, also, with fat, giving to the parts a more rounded appearance. Thirdly, the skin undergoes changes. It was delicate before ; but now it suddenly becomes much more so. It is not only finer, but more polished and transparent. It is at once exquisitely sensitive and beautiful. Its sympathies are equally remark- able, as well as equally rapid in their development. Finally, there is even a change in the form of the limbs. The hips appear not only broader, but larger; and what, in our own sex, would be a deformity, becomes in woman a beauty. In man, the shoulders are much broader than the hips. In adult woman, the reverse is true. 11 122 YOUNG WOMAN'S BOOK OF HEALTH. The shoulders, in woman, may indeed sometimes appear enlarged, but it is in consequence of an expansion of the fore part of the chest, externally, or as a consequence of fashion in dress. On the whole, the organization, especially that of the nervous and muscular systems, is such as to impart a tendency to nervous and spasmodic dis- eases, and to render them peculiarly liable to be excited and moved by extra stimulants, external and internal, and both moral and physical. In summing up these changes, allow me to quote from Dr. Morrill, in his work on the Physiology of Woman, and her Diseases, at p. 41. " The young girl who, till now, was an equivo- cal, non-sexual creature, becomes a woman, in her countenance, and in all the parts of her body, in the elegance of her stature, and beauty of her form, the delicacy of her features, in her constitution, in the sonorous and melodious tones of her voice, in her sensibility and affections, in. her character, her inclinations, her tastes, her habits, and even her maladies. Very soon, all the traits of resemblance between the two sexes are found to be effaced. " The physiognomy of the young woman has now acquired a new expression ; her gestures bear the stamp of her feelings ; her language has be- come more touching and pathetic ; her eyes, full of life, but languishing, announce a mixture of desires and fears, of modesty and love. NATURE'S BEAU IDEAL. 123 " Her tastes, her enjoyments, and her inclina- tions, are modified, like the rest; her most pressing want is to experience frivolous emotions; she is passionately given to the dance, shows, and com- pany ; the curiosity so natural to her sex, acquires new force and activity. She devours books, of romance, or more than ever fervent in devotion, is excited by the expansive passions, and particularly by religious piety, which is to her a sort of love. " At this brilliant period of her life, her moral, which depends upon her physical condition, under- goes great mutation. The young girl becomes more tender-hearted, more sensitive, more compas- sionate, and appears to attach herself to every thing about her. The new sensations of her soul make her timid in approaching the companions of her childhood; a strange trouble, a sort of restless- ness, an agitation, before unknown, are the heralds of a power, whose existence she does not even suspect." Let this, then, be regarded as the standard of healthy development and healthy womanhood,— the beau ideal of healthy female existence, beyond the age of fourteen or fifteen. Instead, however, of the regular developments above mentioned, we have numerous irregularities. In extreme cases of diseased tendency, puberty seems to commence almost in infancy, — some- times as early as the third year of life. More 124 YOUNG WOMAN'S BOOK OF HEALTH. commonly, however, our cases of precocity are found all the way from four or five years to four- teen or fifteen. But this precocious puberty rarely extends, so to speak, to the general system. The internal organs — indeed, the whole of the organism, except what is peculiar to the sex — are like those of other children. They are, indeed, as I have before said, often tall, slender, and delicate ; but -sometimes short and deformed. The limbs, in proportion to the body, are apt to be very short. The sexual func- tion becomes active, and the periodical evacuation is too early, and has every appearance of excess. The mental faculties are, also, apt to suffer. They are often prematurely developed, so far as mere activity is concerned ; but occasionally they are the reverse. The individual, in the last case, is not only childish, — a mere woman infant, — but she is dull and stupid, and apt to be short lived. She becomes prematurely old and wrinkled. Of the connection of premature or precocious development with scrofula, I have already spoken. But scrofula is developed in many ways. Some- times it appears in the form of spinal disease, of which there are many degrees and varieties. Some- times it appears as asthma, bronchitis, mesenteric fever, or rickets. But scrofula is not the only disease to which pre- cocious puberty is subjected. It seems to render SOURCES OF VICIOUS CONDUCT. 125 one vulnerable at every point. While peculiarly liable to the effects of taking cold, it often subjects the individual to troublesome and even severe affec- tions of the ovaries, bladder, and uterus. Another serious evil sometimes arises It may grow out of the diseased condition of the system, — the precocity and its concomitants, — or it may only be increased by it. Young females who are precocious, though naturally reserved and pure, sometimes, under abnormal circumstances and the influence of bad associates, become the very reverse. The erratic conduct to which they are thus led, by the combined influence of bodily and mental disease and miseducation, appears in two different forms — solitary vice and social. I do not mean that these are not the result of a great variety of causes ; but precocity will often account for them. Instances occur, no doubt, in which there is both action and reaction. What I have spoken of as a mere effect, becomes, also, a cause. And this cause exists, as a cause, much earlier, I say again, as well as much more frequently, than is usually supposed. Dr. Morrill speaks of solitary vice as existing among youth of both sexes to an alarming extent, and apologizes for mentioning it. But his apology is by no means necessary, if his broad statement is trUe, — and what medical man of large experience doubts it ? — that thousands of our youth are being sacrificed to its shrine. 11* 126 YOUNG WOMAN'S BOOK OF HEALTH. The consequences of this vice, whether we re- gard it in the light of cause or effect, are dreadful, both to the individual herself, and to society gen- erally. For, if woman deteriorates, all deteriorate. In reft rence, moreover, to its deteriorating effects, Boerhaave thus remarks: " It causes convulsions, emaciation, and pain in the membranes of the brain ; it deadens the senses, particularly the sight; gives rise to dorsal consumption, and various other mental and bodily disorders." He might have added much more. It makes the young unsocial, timid, shamefaced, unhappy. Con- scious of guilt, they seem to imagine every one they meet with ready to suspect them. Imagining themselves unable to resist the impulses which they know are urging them downward, they gradually and insensibly become helpless in reality, and suffer themselves to be swept along in the downward current. The result is, that, if healthy, — that is, by in- heritance,— most persons go on in their mad career, for some time, without much fear; till of a sudden, unless something from without changes the current, they begin to verge towards insanity. Soon, if the cause continues in full operation, they pass, with rapidity, to absolute and remediless idiocy. Nor is it easy to arrest their progress, even if we remove the cause, when once they have begun to CONSEQUENCES OF VICE. 127 approach the region of insanity. Few, indeed, are the cases found to be within the reach of the heal- ing art. Or if, perchance, a few are recovered, it is, for the most part, with a shattered constitution. But the far greater part of our young men and young women, who fall into this destructive vice, termi- nate their usefulness and their days in a very differ- ent manner. Most persons, as I have shown in the beginning of this work, inherit a tendency to one or more diseases. In other words, they have, in this respect, some weak part or point. The penalty for the transgression in question will be sure to fall on that weak part. Thus, if the devotee to solitary vice inclines to consumption, her error hastens on apace that dis- ease ; only it will assume the dorsal form.* If it is dyspepsia which is inherited, or to which she tends, it will aggravate that. If it is gout, or rheu- matism, or chorea, or epilepsy, this will be hurried to a dangerous or fatal termination. Dr. Morrill says this vice unfits for the marital relation, and for being the progenitor of healthy offspring. This last clause awakens a train of thought, on which I greatly desire, on many ac- counts, to expatiate. It is a field of immense importance to the young, even to young women. * Tabes dorsalis, or consumption of the back. 128 YOUNG WOMAN'S BOOK OF HEALTH. But enough, and more than enough. The facts being well known, let us inquire concerning the cause ; for it is with this that we are chiefly con- cerned. Here let me quote the language of a celebrated French physician. " Various causes," says he, " calculated to ren- der the play of the vital forces more active, have the effect either of retarding or precipitating the age of puberty : thus abundant and stimulating food and drinks, manners, habits, and climate exercise a marked influence upon this vital phenomenon. " Certain moral causes may likewise accelerate its arrival; but the artificial maturity thus resulting always acts injuriously upon the organization. Among these circumstances may be enumerated premature passions and pleasures, the arts of imita- tion, music, painting, the perusal of obscene ro- mances, the inspection of lascivious pictures, the theatre and ball-room, the bad examples of pre- mature libertinism, of which too many examples are unfortunately furnished, in great cities. The specimens of premature puberty, the miserable consequences of too great vivacity of the imagina- tion, are sometimes met with as early as the eighth or tenth year." One of the most efficient causes of a precocious sexual development is a highly heated atmosphere. Next to these, in my own estimation, are bad gases, exciting food and drink, exciting and improper TREATMENT OF THE VICIOUS. 129 conversation, and improper clothing and beds. Scrofula is, indeed, at the foundation ; but it is only as a predisposing cause that it operates. Concerning exciting conversation, it ought to be observed, that much of this is found even within the precincts of our families. Mothers make a sad mistake in hurrying their young daughters into company; but a still greater mistake is made in favoring a species of conversation on the great sub- jects of courtship and marriage, which is calculated to lower them in the general estimation, if not to cast ridicule upon them, and even reproach. I am now to present a few thoughts on the proper treatment of cases of premature or preco- cious development. Many a disease and diseased tendency would disappear soonest — or, if not soonest, in the best manner — when let entirely alone. In the present case, the let-alone treatment is hardly sufficient, because there is often a feverish tendency and con- siderable nervous irritation. This condition is known by a frequent pulse, weariness and languor of body, dulness of mind, disturbed sleep, and a very free perspiration. These symptoms, which always exist in'some degree, are greatly increased just before and after menstruation. The perspiration or moisture of the skin is of a peculiar kind ; but the peculiarity cannot be easily described. It conveys to the mind the idea of 130 YOUNG WOMAN'S BOOK OF HEALTH. great nervous weakness, as well as muscular relax- ation. No medical man can be long among his younger female patients without coming in contact with this species of skin, especially in cities and towns. Now, any attempt to improve this condition of the system by medicine will be worse, if possible, than the let-alone system. And yet how common it is to find these poor, precocious creatures, in very early life, subjected to all the mischiefs of dosing and drugging ! And the greater the ignorance with which they are surrounded, — ignorance, I mean, of the laws of health and life, — the greater the drugging. " But if we must not neglect the case on the one hand, and must not give medicine on the other, what shall be done ? " This is a question which will be asked by many, and it deserves our attention. Observe, in the first place, I do not say that no medicine, in any possible case of this kind, should be administered. What I would dissuade the un- fortunate young woman and her friends from, is the customary dependence they feel on this species of influence. They have no hope from any other quarter. Whereas the first, and, in general, the only thing to be done, is to place the individual, so to speak, under law. What I mean by law must be gathered from Chap. III. It cannot be needful or desirable that I ON GIVING MEDICINE. 131 should repeat here those varied principles and items. But the reader will be under the necessity of recur- ring to them, and of making them her study. For, in the present case, if medicine of any kind were indicated, it must be something of the kind usually called tonic. No sound or sensible phy- sician would think of giving any thing else. But what if the same results can be produced by steady obedience, for a sufficient time, to all law, physical and moral ? Is there one in ten that would resort to medicine, in preference to the other course ? Is it asked, what will be the difference, pro- vided we attain to the same results ? I answer, the difference is immense. In the one case, we are liable to sow the seeds — and actually often do sow them — of numerous other diseases ; in the other, where successful, i. e., where Nature succeeds, we simply cure the disease. Granted that medicine, such as carbonate of iron aud the like, may sometimes hasten the cure, and thus apparently save time ; it may still be doubtful whether time is really saved. Indeed, it is my belief that we actually lose, in the end, by the ^ medicine. For when we seem to aid nature, what are we really doing ? Are we adding one drop to the vital current ? Can we do this ? We can, indeed, by our instrumentality, effect an interchange in the system. That energy which is needed in the 132 YOUNG WOMAN'S BOOK OF HEALTH. various parts of the system may be withdrawn from some parts, and concentrated on others. That is to say, one division of the confederacy lends its vital- ity to the weakened, diseased division, for a time. But the borrowed energy must be repaid with large interest — an interest that will, in the end, be fol- lowed by bankruptcy. But though I have no faith in active medicine in such cases, I have great faith in obedience to all law, moral and physical. I have never yet seen a case so hopeless as to be quite beyond the reach of cheerfulness, hope, and confidence, aided by abun- dant exercise of the right kind in the open air, and by plain and simple food and drink in only mod- erate quantity. If there is costiveness, and exercise and a plain but coarse diet, with fruit, will not remove it, I would use mild efforts of a mechanical kind. But they should not be often repeated, and they should never be relied on. Obedience, still, should be our sheet anchor. If the individual is employed in a factory, — immured in bad air, at a high temperature, — she must be withdrawn immediately. The necessity is greater in proportion as the conversation of her associates, and the other influences by which she is surrounded, are more deteriorating in their ten- dency. If, once more, her food and drink are taken hot, OBEDIENCE TO ALL LAW. 133 at unseasonable or irregular hours; if her bread is always new and hot, and soaked with old salted butter; if her meats are high seasoned; and if she indulges herself with pies, cakes, pastry, pre- serves, coffee and tea, — here, too, a change will be indispensable, and cannot long be neglected. In one word, — to repeat what has been already repeated, — the great thing to be done is to study and obey the Creator's laws, physical and moral, especially the former. I am the more anxious to impress this great truth on the minds of my readers, because it is so com- mon to depend on mere medicine. For, after all, the strange belief still lingers about them that something more powerful than mere obedience to law is sometimes necessary. In the language of a late American writer, Dr. Dixon,— " Most probably the poor child is under the daily influence of a doting and fashionable mother, who has called to her aid all the appliances of our mod- ern system of education. With the eloquent exam- ple of all animated nature before her, — the feathered and brute tribes, aided by unrestrained freedom of motion, natural food, fresh air, and healthful sleep, carrying out the plan of their own being, and exciting the envy of the poor invalid, — she, alas ! is subjected to the irksome discipline of the school- room, with its repulsive and dry details, and, often, its daily jargon of sound, without sense, — her body 12 134 YOUNG WOMAN'S BOOK OF HEALTH. clothed with fashionable garments, the preservation of which seems the most important object of her life, _ while every free and healthful movement is restrained, and every natural impulse checked, be- cause it oversteps some absurd idea of gentility." Of the power of nature, when miseducation has not defeated the great aim of nature, to set all right without medicine, at least as a general rule, we have the following assurance of the same interest- ing and able writer : — " From what we have already said on this sub- ject, the reader will understand that healthy men- struation is only compatible with a good constitution; that the developing and sustaining of this function require the action of the constitutional powers in all their plenitude of vigor ; that Nature, unembar- rassed by art and the carelessness of the female, is able, by her own silent forces, to attain her grand object, viz., the perfect development of the ovaria, upon which menstruation depends. " No one suspects that medicine exerts any influ- ence in producing menstruation in those countless thousands of cases that occur in classes of society where no solicitude is awakened, — where the female each day rises, and, after a hasty, and per- haps insufficient meal, commences her labors, often continued into the proper hours of sleep. Here every circumstance that can exercise a tendency to hinder the attainment of the great end is brought NATURE THWARTED. 135 into action ; and, amidst all sorts of depressing influences, the young female at length becomes regular. It is thus evident that Nature is all-power- ful ; she means to compass her purposes, and no slight circumstance will prevent it. " Now, suppose any of the exhausting causes we have enumerated are brought to bear upon a young girl; suppose her nervous system to be constantly taxed by too much excitement of stimulating food, spices, wine, &c, her body debilitated by excessive quantities of clothing, perhaps ill made, and im- peding the healthful expansion of the lungs, whilst she is severely taxed by the absurd requisition of a schoolmistress, depriving her of a healthy exercise at a period of life when she most requires it; the inevitable result will be, that the blood, instead of an equal distribution over the surface of the body, will be thrown upon the internal organs, and it will most certainly go in increased quantity to those most immediately intended to be brought forward by nature. A premature establishment of the menses is the consequence ; and the pale and sickly plant (grown under the influence of too much heat and water, and too little light) is but an emblem of the young female. In neither have the requisitions of nature been fulfilled ; and both present the same consequences, viz., great exhaustion and debility, that can only be overcome by a careful attention to nature's demands. 136 YOUNG WOMAN'S BOOK OF HEALTH. " The class of medicines called tonics, in ju- dicious hands, may aid her restoration ; but they never can effect it without carefully retracing and remedying, as far as possible, the errors of early life. Nutritious and unstimulating food, free exer- cise in the open air, with a hearty enjoyment of all innocent recreation, should be the means chiefly relied on." I have made this long quotation, just for once, to show how well the views of a thorough-going medicine-man harmonize, in this particular, with my own ; and how he comes, after much preamble, to the conclusion that " nutritious and unstimu- lating food, free exercise in the open air, with a hearty enjoyment of all innocent recreation, should be the means chiefly relied on." All this, it may be said by some reader, — already a sufferer, — comes quite too late. I grant it comes late, but not too late, absolutely so. It is never too late for woman — the young woman especially — to know the laws of truth and nature, especially in their application to the condition and design of her own sex. It is never too late to study woman's mission. But on the mission of woman I have already written.* A subject of kindred nature to the above will be pursued in the next chapter. * " Letters to a Sister ; or, the Mission of Woman," 1850. CHAPTER VI. TARDY DEVELOPMENT. In the last chapter, I have shown that those changes in the female system which, in our climate, should not appear till fourteen or fifteen years of age, are sometimes premature — the result of mis- education. But development may also be retarded by various causes. This tardiness is sometimes known by — or at least included under — the general name of suppression. The latter term, however, is, with more propriety, applied to another disease, of which I shall speak in the next chapter. In treating of the slow appearance of the menses, some authors make no less than three or four divis- ions of the subject. 1. Tardiness, properly so called. 2. Slow development. 3. When the nat- ural development is interrupted by some other dis- ease, either inherited or acquired. 4. When the signs of maturity do not appear, although the con- stitution seems to be perfect. To which they might have added a fifth cause, viz., malformation. All these, however, except, perhaps, the last two, may, for simplicity's sake, be just as well consid- 12* 138 YOUNG WOMAN'S BOOK OF HEALTH. ered under a single head. Nor is the treatment of any of them essentially different. All are depend- ent on debility, or peculiar temperament or tenden- cy ; and, in our management, we must be governed accordingly. When we find disease of long standing, such as scrofula, consumption, epilepsy, liver complaint, &c, young women need not wonder—nor need their mothers — why the intentions of nature are not well fulfilled. And yet, in their ignorance, mothers often are very much surprised, and greatly anxious. If any thing peculiar is required in the treatment of those whose case has been described in the pre- ceding paragraph, it consists, simply, in removing the disease which hinders Nature from performing her office. If it be consumption, for example, pure air and proper exercise are especially necessary ; if liver complaint, flannel and the warm bath ; if scrofula, the cold shower bath, plain food, &c. There is little need of medicine, even here. When the individual seems to be strong and healthy, and yet there are no appearances of matu- rity, it will be much more difficult to persuade either mothers or daughters that no medicine is necessary, than in the former case. Surely, it will be said, you will not direct us to rely solely on invigorating means and measures in this case, for the individual is already as healthy as she can be. But stop a little, just at this point, and let us see WHAT ARE MARKS OF HEALTH. 139 if a mistake is not made. What! healthy as she can be, and yet not healthy! Perfectly healthy, and yet in one considerable portion of the system no healthy action at all! Strong and vigorous, and yet one whole function — and that a highly im- portant one — entirely quiescent! There is an utter mistake abroad in regard to what are the marks of high or perfect health. Great muscular development and power alone, though desirable enough, do not always indicate high health. Neither does fatness ; nor even inor- dinate plumpness. Nor does a red skin ; nor, above all, red cheeks. It is, at least, ten to one that the young woman of whom I am now speaking is living too high. She uses coffee, flesh, or high-seasoned dishes. These, with her temperament and constitution, give her, for a time, that appearance which most persons regard as indicative of high health. Yet it is not apt to be permanent. So that, even in such cases as these, what is most needed is a return to nature's plain path. We are, therefore, able to say, — not empirically, but as sound physiologists, — that there is but one course to be pursued in all these varieties of tardy develop- ment ; and that course is universal obedience. She is in the factory, perhaps; her exercise doubtful and stinted ; the air she breathes damp and unventilated ; her diet warm and liquid, and 140 YOUNG WOMAN'S BOOK OF HEALTH. too stimulating. Or, worse still, if possible, she is under the eye of some doting friend, who keeps her shut up, as it were, in a band-box. Now, if to the fires thus created within there have been added no external immolation, still it is highly probable that medicine has been used. Per- haps she has been made the victim of three or four, or half a dozen methods of treatment at the same time, unknown to any but the patient herself and her friends. From all these things she must be forthwith emancipated. If she cannot bear horseback exer- cise, or walking, or moderate labor in the garden, she may ride in a chaise, or a sail-boat; or she may spin a short time, every day, at the old-fashioned high wheel ; * or she may jump the rope, or play at battledoor. And even when she is able to exercise abroad in the open air, bad weather may sometimes drive her to in-door exercises or amusements. Three things, in any event, in addition to the above, must be secured : cheerfulness, warmth of the skin, and plain, unstimulating food. In saying that warmth of the skin is indispensa- ble, let me caution you against the extreme of * In visiting (as a missionary of health) a thousand families, during the last three months, I have found but two females spin- ning at the high wheel. Thanks, many thanks, for civilization; but I cannot be thankful that high wheels are out of fashion. AN ANECDOTE. 141 dressing in too much flannel, especially next the skin, and of sleeping in warm apartments, and on feathers. Of going much to the fire, at least sud- denly, and especially of soaking, as it were, in hot rooms, I could not say too much, nor with too much severity. Against taking medicine, my warning voice has already been raised. I knew a most remarkable instance, some twenty- five years ago, which will serve to illustrate this subject, and, if needful, to show the folly of dosing and drugging young women, in order to " aid Nature." The individual in question was the only daugh- ter of an over-kind mother, and received all that care and attention which it were better to divide among at least half a dozen. She was naturally healthy enough ; but the mother was afraid she would not continue so. She was scarcely twelve years of age when she was placed in a shop, which denied her both pure air and exercise. Her frame was not robust enough, her mother thought, for housework, and other comparatively healthy employments; and so she undertook to favor her. A thousand flaws in her constitution had already been discovered, or at least imagined ; and no pains had been spared which could be applied, by means of medicine, to mend them. But, in her new situ- ation, a more fearful evil still, was anticipated. 142 YOUNG WOMAN'S BOOK OF HEALTH. The young woman, though comparatively healthy, at about thirteen or fourteen began to be a sufferer. She was, indeed, corpulent enough, and her cheeks were sufficiently red ; but she was not quite healthy. Nature was evidently laboring to get forward, but without success. At the earnest entreaty of her mother, physician after physician was called ; and sirup after sirup, and pill after pill, and bolus after bolus, swallowed; all to no purpose whatever. Indeed, the more medicine she took, the more nervous, languid, soft, and transparent she became. The first physicians who saw her gave the same advice I should have given. But this did not satis- fy the mother at all ; and other physicians were sought, some of whom were more willing to save the patient to themselves than to state the plain truth. They accorded, in their views, exactly with the mother ! The dosing and drugging system, with a few short seasons of remission, was continued about ten years, when a matrimonial connection was entered into, which almost separated the mother and the daughter, and gave promise, for a time, of her emancipation from medicine. But her husband, alas ! was an apothecary, who was somewhat given to dosing and drugging his own system. Himself and his wife became, of course, among his best customers ; and scarcely had THE REFORMATION. 143 six months elapsed before it would have puzzled one to tell which had the best assortment of drugs and medicines, he in his shop, or she in her closet. Doubtless the husband had the largest parcels ; but the wife had a little of almost every thing belong- ing to the shop, in addition to some articles which were made and vended solely by the mother. Nor did she have them on hand merely that they might be taken occasionally ; — she took some of them every day, I might almost say every hour. I have even seen them on the table, especially at breakfast. Stoughton's bitters, for example, be- came, as it were, an indispensable accompaniment. In these circumstances, a young physician became a boarder in the family, who immediately set about reclaiming them from their error. It was not so difficult to reclaim the husband ; but the wife, for a time, seemed incorrigible. But times, at length, altered. One after another, the phials, and boxes, and bottles went back to the apothecary's shop, till the closet became partially emptied of all but its needful contents, and the wife, as well as husband, were nearly emancipated. The news reached the mother. Greatly alarmed, she came to her daughter and endeavored to per- suade her to return to the old path. But it was too late ; the Rubicon was passed. Some slight con- cessions were, indeed, made, for the sake of peace; but they were only temporary in their character. 144 YOUNG WOMAN'S BOOK OF HEALTH. From the condition of a poor, exhausted, nervous creature, scarcely able to sit up half a day at a time, or perform any labor but the lightest, this young wife became able, in a few years, to sit up the whole day. More than even this is true. Instead of being unable to walk or ride, she could stand on her feet almost as well and as long as her neighbors. Her appetite returned, as well as her mental energy. And after having been, for many years, " written childless," she became the mother of a family. One thing should be understood — that some- thing more had been done besides abstaining from medicine. She had been put under law ; and had, in some good measure, yielded obedience. And now, at the end of twenty-four years from her emancipation, she is still quite healthy. Dr. Dixon mentions the case of a young woman, whose silly and faithless mother came to him and urged him to prescribe medicine for her daughter; and, on his refusal, she went to a man of drugs, (probably a quack,) procured a powerful dose, ad- ministered it with her own hands, and lost her daughter. Dr. Dewees also mentions a case somewhat simi- lar. Though already fifteen or sixteen years of age, the young woman had, as yet, experienced no indications of change of constitution ; and some- thing, it was thought, must be done. The physician CARE IN TAKING EXERCISE. 145 explained, and seemed to convince both the mother and daughter, not only that medicine was unneces- sary, but that it was wholly unsafe. About six months afterwards he was called in, just in time to see her expire. She had taken, of a quack, some oil of savin : the consequence was a fever and vomiting of blood, under which her sys- tem, though naturally strong, could not rally. There are few medical men who have not been pained at similar results within the range of their own experience. The world is, as it were, full of them. Not that they are all of a character as aggravated as the above ; but they belong to the same general tribe or family. They belong to the hosts of ignorance, and mystery, and superstition. Dr. Morrill, who, though fond of medicine in urgent cases, appears also fond of placing " under law," whenever it can well be done, very justly observes, concerning these cases of tardy develop- ment, — " All exercise should be taken before evening, and care should be taken not to carry it to the point of fatigue. The practice of invalids riding out before breakfast, or after tea, should not be per- mitted, unless great care be taken to preserve an even temperature, and equable warmth of the skin. The invalid should retire to rest at the first approach of drowsiness, never suffering herself to be detained 13 146 YOUNG WOMAN'S BOOK OF HEALTH. by visitors. If it be understood that she is an in- valid, no person can be annoyed at her departure. " Particular attention must be given to ventilation without danger from a current of air. An open door or fireplace must be principally relied on for this purpose. Tepid water and a rough towel should be used for frequent ablution, — only a part of the body being exposed at a time in cold weather, with care to dry thoroughly, and rub into a glow, before resuming the garments." Great faith, I must again say, is wanted, above all, in Nature and her laws. Were it not for the little faith which has been so often the subject of complaint by the wise, time immemorial, there would be many more healthy mothers at thirtf than now, as well as fewer cases of destruction by medicine. There is one other case of tardy development to which I ought to advert in this connection : it is that which is caused by malformation. The vagina may be wanting, or its sides may have adhered from inflammation or some other cause ; or, in still more rare cases, the neck of the uterus or its orifice, or the mouth of the uterus, may be unnaturally closed. In some of these cases, no menstrual fluid is secreted. Where this is the fact, nothing need be done. The health may continue unimpaired for' many years, — perhaps for life, — in defiance of OF SURGICAL AID. 147 the malformation. But where there is a secretion, and the uterus becomes distended, as at times it does, resort must be had to the surgeon. Those few cases in which surgical aid is demand- ed, as well as the others to which I have alluded above, where there is a bare possibility that reme- dial means must be resorted to, I leave to the family physician, — only observing, that, even in the latter case, the milder the treatment, or, in other words, the nearer it approaches to no treatment at all, the better ; provided, however, at all times, that the medical adviser can carry along with him the faith pf his patient. CHAPTER VII. SUPPRESSION. This may take place at almost any period of female life, from puberty to forty-five ; but I shall treat of it, chiefly, as occurring early in life. It is commonly divided into acute and chronic ; but, to most readers, the division is of very little practical importance ; and will, in the present work, be wholly disregarded. Menstruation, after having been established, may be interrupted in various ways. First, by gestation. ^ Here there is nothing to do ; for though, with some, the course of nature continues, the latter is the dis- eased condition of the system, rather than the for-r, mer. Secondly, by suckling. Here a similar , remark will apply. Thirdly, from other causes. What, then, let us inquire, are these other causes ? They may be moral or physical; and, in both these departments, may be, and are, exceedingly numerous. 1. Moral Causes. — Foremost in the list of ., moral causes are the depressing passions — fear, grief, discontent, anger, hatred, over-anxiety, mel- EFFECTS OF FEAR. 149 • ancholy, and despair. Excess of the elevating passions * may even have a similar effect. Few things are more hurtful by their general moral influence on the physical system than fear. But while almost all mankind are wont to suffer, more or less, in this way, the penalty of transgres- * sion seems to fall most heavily on young women. £& Let us examine, for a moment, the physiological effects of fear. Under its influence, the cutaneous system, next to the cerebral and nervous, becomes a theatre of suffering. Pale and contracted, — shrunk To half, or less than half, its original thick- ness, — it cannot perform, with ease and freedom, its various and wonted offices. As a medium of communication with the external world through the nerves, — as the seat of several important secre- tions and excretions, — as an absorbent surface, — ^ and as an organ of sympathy, — in-'each and all of these its movements are embarrassed and crippled. It is as if borne down, at every point, with a heavy *" load. Filled, as this curious membrane is, with living V machinery, is it not obvious that injury must at •%k once arise from the superincumbent load, or what j's* is equivalent to it? Confined within half their natural space, can the wheels of nature move on ' "■"*? * Extremes, it is said, sometimes meet; and there would seem -**"..*;. to be truth in the saying. The above is an instance of the kind. 13* 150 YOUNG WOMAN'S BOOK OF HEALTH. freely, and perform fully their mission ? Commor sense would declare it to be impossible. But ] must refer the reader who desires further illustra- tions of this subject to what I have said elsewhere, Is it said, that, in the case of compressing the cutaneous system, other parts of the system, such as the lining membrane of the alimentary canal and the mucous lining of the lungs, being roused to sympathy, act as substitutes for the skin ; and that, by means of this vicarious effort, serious disease is prevented ? The statement is admitted, but not the inference. For it is this vicarious action or effort, of which I have just spoken, whose effects we have to dread. It is this very result that produces disease. Or, more properly, it is this which constitutes the dis- ease itself. Human health cannot be long maintained with- out preserving a proper balance of the centrif- ugal and centripetal tendencies. In the great mass of mankind, the latter predominate. In other words, the voluntary power, nervous energy, audi waste matter which ought to be expended or thrown out by the muscles of the skin, are expend- ed on or determined to the internal cavities and organs. These last, being overtasked by labor which does not belong to them, become exhausted and crippled; and hence congestions and other forms of disease. WHAT DISEASES FEAR INDUCES. 151 These congestions, &c, fall with most force on the mucous membranes, especially those of the lungs, alimentary canal, and uterus. At this very moment, half the world are sufferers from this cause. The undue centripetal tendencies are, very generally, directed to these organs or systems. And to this source, in particular, may we refer a very large share of the sufferings of our females. Most of this class of persons are so exceedingly sensitive to the extremes of heat and cold, as well as to all other causes which affect the cutaneous surface, that the centrifugal tendencies of our nature are checked a dozen times a day, and a determina- tion given to the interior of the system. Now, when, in addition to all this, they are much and often under the dominion of the depressing passions, it is scarcely possible they should not, sooner or later, become sufferers from various dis- eases of the reproductive system, in some of its numerous forms. And among these we find sup- pression, or amenorrhea, coming in for a very large share. It is not the influence of momentary fears, in their action on the skin, so much as that of fear habitual- ly indulged. The momentary impulse may, indeed, cause the skin to shrink ; but there will be an im- mediate reaction before a new and unnatural de- termination has fairly taken place. But whenever that rough, pimpled condition of the skin, to which 152 YOUNG WOMAN'S BOOK OF HEALTH. I have referred, is continued for hours and days together, the consequences, very often, are of a serious character. But it is not excess of fear alone, whether of longer or shorter continuance ; it is every degree of it, when permanent. Those who are only timorous or trembling have their skins less plump and active than those who are under the influence of assur- ance, confidence, boldness, and courage. Grief, when prolonged, has nearly the same effect on the cutaneous surface that fear has, as well as produces the same tendencies towards the interior of the body. And the same is true of the whole tribe of depressing affections and passions. Even the slighter degrees of melancholy, fretfulness, or discontent, have their centripetal tendency. One thing more. Even when no such thing as actual disease arises, there is often much mischief done. The skin, when active, plump, and healthy, greatly aids the lungs, both in purifying the blood and in originating and diffusing heat. But the moment it becomes permanently crippled, all the organs of the body operate more feebly and lan- guidly. The temperature, in particular, becomes unequal. Cold extremities, and even a general chilliness of the whole surface, are not at all un- common. I do not, by any means, affirm that there are no other physiological effects of the depressing passions OTHER MORAL CAUSES OF DISEASE. 153 than the contracted skin of which I have spoken, for there are many. But this centripetal tendency is that which always strikes me as most obvious and important, and most easy to be guarded against. The reader who cares at all for the future, and especially for the future good of her race, should also know, most distinctly, that, aside from and be- yond the immediate evil effects of fear and its co- workers, the skin is gradually losing its natural pow- er of resuming its wonted plumpness and activity; and, as a consequence, she is becoming permanently liable to disease, and is placing herself in a con- dition to transmit a deteriorated skin, with its diseased tendencies, to posterity. But I must hasten to speak of some of the other numerous moral causes of pathological disturbance to young women, which are either coupled with fear, — I mean in their evil effects, — or exist inde- pendently of it. -.1 have already said that excess, even of the elevating passions, may produce similar results to those of depression. Thus excess of joy, from the sudden reception of good news which was wholly » unexpected, has not only produced disease of vari- ous kinds, but instant death. It may not be true, that excess of joy has often had the effect to induce suppression. And yet, I repeat, it might have this effect. Whether the transports of love, or especially those of hope, — 154 YOUNG WOMAN'S BOOK OF HEALTH. if such there be, — ever rise high enough for this purpose, is not so certain. But I have not yet done with the list of depress- ing passions. Discontent, fretfulness, envy, jeal- ousy, disappointed love, despair, &c, may produce great and permanent derangement of the female system ; and, whether or not we can explain the pathology of the thing, are liable to produce sup- pression. 2. Physical Causes. — These are numerous. One of the most frequent which has come under my own observation is sudden exposure, by delicate persons, to cold and damp air, or to cold water. I have not, however, seen any evil results follow from personal ablution of the whole body, even during the progress of menstruation. But partial exposures, when sudden and long continued, are a source of much and frequent evil. Especially is this true of applications to the lower parts of the abdomen, and to the breasts, wrists, ankles; and feet. Eating and drinking that which is excessively £ cold, — as ice creams, &c, —especially when the body is in a state of perspiration, has been loudly and largely condemned, and, I doubt not, with good reason. So might sudden bleedings, large blisters, harsh emetics and purgatives, strong odors, and excessive indulgence of any of the three appetites. The custom of wearing thin shoes, and. in par- PHYSICAL CAUSES OF DISEASE. 155 ticular, of going abroad in them, in cold weather, after having been all day in hot rooms, is one of the pernicious customs of modern times, and has cost the life of many an excellent female. In the year 1827, I was called ten or twelve miles to visit a young female friend, about eighteen years of age. She had fallen and wet herself one morning, in going to the factory where she was employed ; and, being too proud or too industrious to acknowledge it, or dry her clothes, had sat in them all the forenoon, and I believe all day. The result was suppression and a long fit of sickness, from which she hardly recovered. But the worst cases I have ever known are those in which the suppression is produced by design, in order to be ready for. a party of pleasure, or some previous engagement. Dr. Frank speaks of a young woman who brought on an inflammation of the uterus in this way. which came near destroying her. And I might mention, here, some of the deplora- ble results of ignorance — an ignorance for which the mother should have been responsible. Young women have attempted ablution at the precise period when, had they been informed of the change which awaited them at that particular age, they might have saved themselves not only much anx- iety, but much subsequent suffering. One more catalogue of physical causes, and only 156 YOUNG WOMAN'S BOOK OF HEALTH. one, shall be mentioned. Suppression may have its origin in diseases of the ovaria, uterus, and other parts of the body. It may arise from inflammation of the brain, lungs, stomach, spleen, liver, spinal marrow, and uterus. It may also have its origin in induration, ulceration, hydatids, anteversion, retro- version, and incomplete prolapsus of the uterus. Pulmonary consumption, heart disease, scrofula, especially of the bones, and even dyspepsia, may produce it. Of the symptoms of suppression it would be entirely unnecessary to speak, were this work de- signed for the medical profession. In a book, however, which is prepared exclusively for mothers and daughters, the whole case is altered. " The features," says Dr. Morrill, " heretofore brilliant with freshness and health, are observed to assume the impress of feebleness, depression, and languor ; the roses upon the countenance fade ; the fire of the eyes is extinguished, and a dark circle surrounds them : finally, the most frequent symp- toms are habitual headache, dyspnoea, dizziness, pains in the back, sides, limbs, and joints, deficient appetite, and a general failure of the vital powers, ending in a confirmed state of ill health. " The moral alteration is, also, great. Some- times there is an excessive sensibility, which ren- ders the female impatient and irascible ; at others her ideas are sad, and her imagination sombre. AN'IMPORTANT RULE. 157 Sometimes the patient seeks for solitude, and sheds causeless tears; again she becomes passionately fond of music and amusements of all kinds. The general health rarely suffers before three or four successive periods have passed, unless it be accom- panied by considerable leucorrhea." The reader will act wisely in taking special notice of the closing part of the preceding para- graph. Thousands, alarmed at a temporary sus- pension of a few months, resort to medicine ; which, coupled with their fears, prevents that restoration to perfect health which would have followed, almost immediately, had not the health been tampered with. Let me quote here one paragraph more from Dr. Morrill. " It may happen with hale, robust young women, that a temporary suspension takes place from colds, or from passions or emotions of the mind, which, after a certain time, will return without medical treatment. The rule on this point should always be, Never interfere, unless there be some evidence that the health is suffering from the absence of this discharge." This brings us, at once, to the treatment of this troublesome affection. I call it troublesome, for two reasons. 1. Because it is sometimes so, es- pecially when it is the sequel of protracted debility, or of other diseases. 2. Because its universal, or almost universal, mismanagement renders that meas- 14 158 YOUNG WOMAN'S BOOK OF HEALTH. ure of disease difficult or troublesome which might otherwise be light or trifling. I have seen a woman in this commonwealth, in whom the most obstinate suppression had existed for many years. Her health seemed to be nearly perfect. I found, however, on inquiry, that she had never been very anxious about it, or taken much medicine. Now, if our young women and their female friends were all as quiet — as truly the disciples of William Penn * — as she was, I verily believe that full three fourths of them would, in a greater or less time, recover from suppression, without the least difficulty, or even the slightest. More than three fourths violate Dr. Morrill's rule. They in- terfere before the health begins to suffer, in two ways — by their perpetual anxiety, agitation, and alarm ; a/*«*«Jby dosing and drugging. When\ :y that three fourths would recover, if let alone, I do not forget the other fourth. The reader has a right to know what I would advise them to do. The far greater part of them would require some attention, but not the kind of attention which is usually given. They have nothing to do, more or less, but to cease to do evil, morally and physically, * She was of the denomination called Friends, whose quiet- ness of soul has become proverbial. TREATMENT OF SUPPRESSION. 159 and learn to do well; unless it be to have faith in those laws which they should zealously and care- fully obey. My advice then is, in substance, the following : If your troubles depend on some other disease, let your attention be directed to that other complaint, rather than to one which has grown out of it. If that is of a character or degree to be overcome, then this will probably follow in the same train. If your general health is good, endeavor to keep it good. In the first place, determine to be well. Make no calculation to be sick. In the second place, do what you know to be right. Obey, in one word, all known, righteous law. If you are feeble, still have faith in law. It may be that your transgressions have been so great, that, notwithstanding your return, your health will not come again. A few such cases in a tb^sand — perhaps one or two in a hundred — theA ould be, most undoubtedly. The number of those who are, so to speak, beyond pardon, is very few in- KL'fdeed. You can hardly suppose yourself one of *^them. At the time when Nature's efforts should begin to be made, it will be advisable to use warm bath- ing, both local and general; and also fomentations, by means of hot flannel. A warm flannel bandage may be worn day and night. The feet, above all, should be kept habitually warm ; and there must not be habitual costiveness. 160 YOUNG WOMAN'S BOOK OF HEALTH. In any event, your only hope will be in obedience to all law ; not only all known law, but also much that you may, if you desire it, yet find out. If there are twenty-five in each hundred whose gen- eral health has really begun to suffer, it may safely be expected that judicious obedience would save twenty of them, and restore them to their friends, their families, and the world. And the five that remain will hardly be saved by medicine. This word judicious reminds me of the necessity of adding, that, if you can find the right sort of man, the advice of a judicious physician will be of inestimable worth to you. But then you may learn much from books. Only be careful, in all your efforts, to " make haste slowly." I might say much more under this head; but besides that the reader might be referred to Chapter III., and to the general directions about health in future chapters, especially that on leucorrhea, what good purpose would it answer ? For those who are wise enough to cease to do evil and learn to do well, as the only safe way of recovering lost health^ of any kind, I have said all that is necessary; I while for those who still retain a blind faith in mere % remedial agents, volumes themselves would be in- sufficient. CHAPTER VIII. VICARIOUS DISEASE. In some few instances, when Nature has been unsuccessful in her efforts, and yet the system is rather plethoric than otherwise, a new order of things appears to be set up, for a time. This con- sists in a discharge of blood from some other part, usually one which is already enfeebled. This is called vicarious menstruation. My principal reason for adverting briefly to this disease, is, that it is wont to excite alarm, and tempt the sufferer to resort to medicine, where no medicine is generally needed. The discharge makes its appearance, for the most part, very suddenly, and continues, at short inter- vals, for some time. It may proceed from the eyes, ears, nostrils, gums, lungs, armpits, breasts, stomach, fingers, toes, bladder, open ulcers, and the stumps of amputated limbs. It has, also, in a few in- stances, proceeded from the surface of the skin. It is most frequent from the skin and the larger mucous membranes. *' A less frequent case is that of the substitution of leucorrhea for natural menstruation. This is occa- sionally very troublesome and severe. The most 14* 162 YOUNG WOMAN'S BOOK OF HEALTH. dangerous form of vicarious menstruation is that of the lungs. In general, this disease is attended with little or no danger, unless it is tampered with. Most unfor- tunately, however, the unnecessary fears of mothers and daughters lead to a course of conduct which may involve a long series of suffering, if not the actual loss of life. And yet I will not undertake to say there is no cause of alarm in any of the forms of vicarious menstruation. Indeed, I have admitted already that there is danger, when speaking of those cases where it falls on the lungs. I have said that the vicarious action falls usually on some enfeebled or debilitated part* This points * As I may possibly have frequent occasion to advert to this law of human pathology, it may not be amiss to present it a little more in detail. It is well known that colds are seated always on some portion of the great membrane which I have told you, elsewhere, is called mucous. Now, then, it is a law of the system that this disease will seat itself, as a general rule, on the weakened or crippled part of that membrane. Thus, if, by any cause, the <*.%tM mucous membrane (the lining) of the lungs is weakened or .-'■■*$ enfeebled, the colds will be apt to fall upon that. If the mucous membrane of the nasal organs is feeble, then I shall have what is called a cold in the head; if that of the intestines, then I shall have diarrhoea, or dysentery, or inflammation of those parts ; for a large proportion of our bowel complaints, like those of the lungs, begin with a cold. Again: rheumatism is a disease of the moving powers of the system. Apply the exciting causes of this complaint to an AN IMPORTANT LAW. 163 out the first important thing to be done in the treatment of the disease — which is, to strengthen that weak part. Not that this is the first thing to be don?, during the progress of the discharge ; for the most which can be done then, is to wait in quiet until the irregular effort ceases. When this is over, it is then time to make every reasonable effort to invig- orate the weak part. individual whose muscles and tendons of the back have become greatly weakened by some cause or other, and he will have rheumatism of the back. Or, if he has a weakened shoulder, the rheumatism will seat itself there. Another thing should be noticed. A thousand things, in daily use, which do not appear to injure us immediately, are yet silently producing mischief by virtue of a law similar to the above. That is to say, their poisonous or other ill effects are applied to the weakened parts or organs of the system, whatever they may be. Thus, suppose a tobacco-chewer, or a drinker of fermented liquors, or an opium or saleratus eater, has a weakened liver or stomach, or weak lungs, — the inflammatory or poisonous effects of these substances will, from day to day, whenever used, go to those weak parts ; and, if those parts are already seriously diseased, they will either hasten the progress of the disease to- wards a crisis, or render it more severe and dangerous. J I grant that, at first view, these laws seem to be partial, or rather unfair, in their operation ; since it would seem as if they ought to fall rather on a part which was more able to bear it. For wise reasons, however, it was ordered otherwise. And if any one should still be unreconciled to such an arrangement, I can only say, in the way of reply, that I am not the author of the law. I only proclaim what was written long before I existed. I am at most an interpreter of nature and law. 164 YOUNG WOMAN'S BOOK OF HEALTH. But to point out the particular means to be pur- sued, with a view to invigorate the weakened portion of the system, would be to direct to reme- dial measures in a great number of the most trou- blesome — and some of the most dangerous — diseases to which human nature is exposed; such as consumption, scrofula, diseases of the spine, heart, stomach, liver, brain, &c. In exact proportion as the debilitated part can be invigorated, during the intervals of menstruation, just in the same proportion will the liability to a return of the disease be diminished. Whatever may be our individual opinions of the value of medicine in particular cases, it is more than doubt- ful here ; it is positively and greatly injurious. One thing may profitably be done at the approach of the natural period of menstruation. Fomen- tations of the abdomen, half baths,* and even the foot bath, will all be useful. The water used should be about the temperature of the blood, that is, 98°, or perhaps a very little less. For remedial measures, where the reader has not faith enough in Nature to trust her, I must refer her to her family physician. Mine is, as you have already seen, a very different office. Besides, as I have already observed, the disease before us is, most happily, not very common. I mean the immersion of the lower half of the system. CHAPTER IX. EXCESS, OR MENORRHAGIA. There are various forms, or at least degrees, of what is properly called excessive menstruation; some of more, others of less importance. In the first place, we have the menstrual dis- charge as usual, except that it is increased in quan- tity. This is a very common form of the disease. Secondly, it may recur too frequently. Thirdly, we have occasional hemorrhages, arising from acci- dental causes, and especially from pregnancy and parturition. Of the latter, it is not my purpose, at present, to speak. My remarks, in this chapter, will be confined to the former two. And even with regard to these, there is an ex- ceeding great variety. Sometimes there is an ad- mixture of other fluids with the natural secretion ; ►sometimes there is not. Sometimes the discharge will be sudden and violent, and then, in a few moments, cease; at others, it may commence and go on in the usual manner, but continue much too long, perhaps two or three weeks, instead of three or four days. The same variety is found, also, in regard to the causes. In many cases, it does not appear, or, at 166 YOUNG WOMAN'S BOOK OF HEALTH. worst, is not troublesome, till late in life, — when to natural susceptibility are added those abuses which are so frequently connected with domestic and matrimonial life. With these last, however, it is not my purpose, in the present chapter, to meddle. My main object is to meet the wants of young women. The causes, then, to which I would now direct attention, are very nearly allied to those which act on other temperaments to produce suppression. I say on other temperaments, because, according to my own observation, the very same causes which, when applied to the nervo-sanguine temperament,* produce excessive menstruation, may, and indeed must, in others, produce suppression. Among the more prominent causes of excess are the influence of the depressing passions, such as discontent, envy, fretfulness, grief, fear, &c.; dosing and drugging with medicine; heated and impure air ; and a bad diet. Concerning the manner in which the depressing passions operate to produce constitutional disturb- ance in the female system, I have said much in the.^ * The doctrine of the temperaments, though containing much of fancy, and not a little of error, embraces, also, gre*at and im- portant truths. But the limits of a work like this do not permit us to explain every thing. I will only say, that there are usually reckoned about four or five leading temperaments; that mankind have usually a mixture of all, or nearly all of them; but that, in most, one or two predominate; giving to the world the great variety which we see of character. TOO MUCH DOSING AND DRUGGING. 167 preceding chapter. But it is needful to add a few words, in this place, on the manner in which it is supposed to act, to produce excessive menstruation; which is, by determining the blood to the uterus. In those of the temperament above alluded to, the uterine system being susceptible, if not weak, the centripetal tendency I have mentioned in Chap- ter III. is directed to the weak and excited part; and hence excess. Whereas, in those who suffer from suppression, it is probable that other internal parts, such as the liver, stomach, &c, are excitable and weak, and the centripetal tendency is towards them, producing that inflammatory or sub-inflam- matory action, which, added to a somewhat tor- pid condition of the uterus, only makes things worse than they were before. Concerning what I have called dosing and drug- ging, as a cause of excessive menstruation, it is needful that I should be a little more explicit than I have before been, especially as other writers in general are not so. < Few young women reach the age of puberty without much injury to the constitution from med- icine. This may have been given by quackery, in some of its ten thousand forms, or it may have been given by the regular family physician, or it may have been administered by the mother. Dr. Morrill says, concerning the disease in ques- tion, "A prominent cause, in this physic-taking 168 YOUNG WOMAN'S BOOK OF HEALTH. community, of this disease, as well as of many other ills in both sexes, is the enormous consump- tion of quack pills, and potions of every variety." I grant this, as has already been seen. I grant that the wisest physicians sometimes err, and that those who attempt to follow out their directions — the apothecaries, nurses, and attendants — err still more ; but there is another source of much more mischief than both these put. together. I refer here, of course, to maternal error. This begins at the beginning. If the child, whether male or female, is not injuriously affected by med- icine at the first date of his existence, he begins to be soon afterwards. Even at this late period of the world's history, not a few mothers give their cor- dials, elixirs, paregorics, &c, &c.; and this through a large part of infancy and childhood.* But it is of comparatively little consequence, at this period of human existence, whether the medi- cine is given directly to the child, or indirectly through the mother. For to medicine, in one or other of its forms, every child, or nearly every one, that nurses a living mother, is subjected. * We find these cordials, &c, on board steamboats and rail- road cars, as if it were unsafe to go from post to post without them. And should it come to pass, that we are able to travel through the '• fields of air," propelled either by gas or electricity, it is by no means certain that mothers would not still dose their children on the road. MEDICINE AT THE TABLE. 169 True it is, that not quite every mother takes al- cohol, or calomel, or opium, or wine, or beer, or even elixir paregoric. She may take nothing worse than tea or coffee. She may not go so far, even, as this would indicate. She may take nothing worse than saleratus, pepper, spice, mustard, gin- ger, &c. It is not improbable that, after throwing all the blame we ought — all that ever has been thrown, and much more — on quacks, apothecaries, and physicians, it will be found that mothers and house- keepers are the unintentional authors of ten times as much disease as all the rest. The physicians of New Brunswick do not hesi- tate to affirm, that the mothers of that province destroy half their children by means of saleratus. They use it in such quantities that, besides neutral- izing the acidity which it is partly intended to correct, a portion of it, greater or less, remains in the form of free alkali. Now, the effect of free alkali on the mucous membrane of the alimentary canal is most dread- ful. True, it seldom kills directly ; but it pro- duces such a state of inflammation and ulceration, that when other diseases come, especially the bowel complaints of summer and autumn, the poor pa- tients cannot withstand what they might otherwise have survived. Added to all this, the medicine 15 170 YOUNG WOMAN'S BOOK OF HEALTH. administered in such cases usually only aggravates the disease. But if saleratus kills one half the children of New Brunswick, does it no mischief to those of Maine, Massachusetts, Connecticut, New York, and so on ? And if a part are killed by it, is no harm done to the survivors — the young men and young women ? And how old is a child before it begins to be introduced into his system ? The other medicines used in connection with our food — and we usually have a medicine chest, well furnished, on our tables, if not more than one — may not be so efficient as saleratus. Neverthe- less, they are medicines, and always were so ; and they have the usual effect of medicines. They sow the seeds, in one way or another, of thousands and tens of thousands of diseases. I have, indeed, thrown the responsibility of this home and table dosing and drugging on the mother and housekeeper ; but I do not forget that the father and master has something to do with it. If a husband and father, when he comes from his labor, and finds a dish not quite high seasoned enough, refuses to eat, he may expect, of course, that more seasoning will be applied to the next dish. And should he bear no part of the responsi- bility ? But to apply this to the case before us. If we scarcely partake of a meal that has not more or less IMPROPER BEDS. 171 of medicine mingled with it; if all medicine is incompatible with, or at least unfriendly to, healthy digestion ; and it acts especially to cripple the skin, (and both of these last doctrines could be proved,) and thus to cause uterine disease in females, then is it to be wondered at that excessive menstruation has become so common and so enfeebling among us ? There are other kinds of bad diet, besides that which is medicated. A watery diet is of evil ten- dency, especially to females. The mischief is still greater when it is of high temperature. So is a diet in which saccharine matter or grease greatly predominates. So, also, one in which corned, salted, or preserved food forms a component part. So, finally, a diet consisting largely of tea or coffee, whether cold or hot. One thing to be studiously avoided by those who are liable to excess, is the custom of sleeping in very warm beds. All judicious writers on this disease recommend hard beds, or, rather, cool ones, during the menorrhagic attack. But it is of at least equal importance during the interval. I say cool, rather than hard, for the public have sometimes been greatly maltreated in this particu- lar. I have heard public lecturers on the laws of health condemn soft beds, and jocosely tell their hearers that the soft side of a plank was better than feathers. Now, I will go as far as any reasonable man in 172 YOUNG WOMAN'S BOOK OF HEALTH. / opposition to feather beds; but I have yet to learn that mere softness is objectionable, if we could have it without the heat. Indeed, I am quite of opinion that if some material could be found which was at once soft, elastic, porous, and a good con- ductor of heat and electricity, it would be found preferable to those beds which are so very hard. I admit, indeed, with Locke,* that he who gets good, sound sleep seems to have the right sort of bed, whether it be hard or soft; but then I also maintain that the softer the bed, other things being equal, the more soundly any person will sleep. But warm comfortables are as bad as warm beds, for aught I know, — perhaps worse. They do not permit a free circulation of the air in the bed. Besides, it is not so easy to proportion our bed cov- ering to the weather, when it consists of one, or two, or more comfortables, as when it is made up of thinner materials. * On most accounts, therefore, I prefer blankets to comfortables. I say on most, for I know that the first cost of the former would seem to render them cheapest. But they may be dearer in the end, if we value time, or even money. Many a physi- cian's bill has had its origin in the use of com- fortables. More pains should be taken, when we lie down * See his Thoughts on Education, p. 27. COVERING THE HEAD IN BED. 173 at night, to see that we do not sleep under an amount of clothing entirely unnecessary. We are apt to cover ourselves too closely, as well as too thickly, when we first lie down, and to fall asleep before we discover our mistake. Now, it is desira- ble to ascertain, before we sleep, how much cloth- ing we really need for the night, and throw off the remainder. Covering the head, while we sleep, is also ener- vating to menorrhagic patients, and is therefore to be deprecated. It is injurious to all, as may be seen by a recurrence to the plainest principles of science. But it is of peculiar danger to the valetu- dinarian of either sex. I wish these things were regarded more by the feeble, instead of fastening their faith so exclusively on medicine. Of the evil tendency of bad air I shall speak more fully in Chapter XI. The errors in physical education, on which I might dwell at great length, have been briefly described already. The causes of this disease, at a more advanced period of life, I purposely omit. Let us come now to treatment — for symptoms I need not surely so much as mention by them- selves. All that is needful will be involved in the former. The first thing to be done — whether during an attack or at any other time — is to remove, if pos- sible, the cause. This is said, however, on the 15* 174 YOUNG WOMAN'S BOOK OF HEALTH. presumption that the cause is still in operation. But to remove the cause is not all. This is a disease which, when it makes its at- tacks, should be immediately attended to. I will not speak of the necessity of bleeding immedi- ately, as some recommend, for I have as little faith in bleeding as Dr. Danforth * had; although I am conscious some men will bleed every body, and yet their patients will, many of them, get well — so much common sense have they in their general treatment, in spite of the bleeding. Still I main- tain that the bleeding is injurious in the end. In general, the first thing to be done, is to place the body in a horizontal position, on the back, if this position is not painful, with the hips slightly elevated. The mind should, if possible, have as perfect rest as the body. A mattress or straw bed is the best, and feathers are wholly inadmissible. For drink, cold water is the best; to which may be added, when there is very much thirst, a little soda water, or lemonade. Food, properly so called, * Dr. Danforth was an eminent physician of Boston, who flourished about fifty years ago. He would never bleed in any possible case, and yet was eminently successful. On a certain occasion, he was called to see a number of men who had been injured by the fall of a building. A young physician, who was on the ground before him, had bled some of them. "Doctor," said he, when Dr. Danforth arrived, " I am doing your work for you." ••Then," said Dr. D., "if you are at work for me, put the blood you have taken from those men's veins back again." TREATMENT OF MENORRHAGIA. 175 during the attack, is hardly needed. Should any be found necessary, a little dry bread is the best. Liquid food of every kind should be scrupulously avoided. Much has been said about applying cold in these cases. Now, if the cold can be applied so as to make none but a local impression, it is useful; but if, while you are cooling the abdomen, the tem- perature of the rest of the system, especially the feet, legs, hands, wrists, &c, is lowered, the loss is greater than the gain. The feet and legs must be kept Warm at all hazards. On the whole, I think the best way of applying cold is to half fill a bag with pounded ice, taking care not to have any part of the system kept wet which should not be. If the clothes underneath the body are to be removed at any time, the patient should be lifted. She should not be allowed to help herself in the smallest degree. While lying in this position, — that is, on the back, with the hips a very little raised, — injections of cold water, or cold water with alum dissolved in it, may be used ; and water may be poured from a height upon the parts, if it can be done without wetting the rest of the clothes. Plugging, as it is called, is a last resort, and may in general be omit- ted till the arrival of a medical adviser. One thing must be observed in regard to society. Let there be no melancholic persons in the room, if 176 YOUNG WOMAN'S BOOK OF HEALTH. it be possible to exclude them, nor any of that class of persons who are always looking on the dark side of things, and predicting evil. These croakers should be avoided every where, but especially in the circumstances we are considering. These measures will usually be sufficient. The patient will, however, be greatly liable to a recur- rence of the disease, even after two or three months have elapsed. This makes it necessary, as soon as the discharge ceases, to resort to the appropriate measures for restoring general health and vigor. These I need not repeat; for, besides what I have said in Chapter III., the remarks made about the means of restoring health, in case of suppression, are adapted to the present circumstances. Caution will be necessary here, more than any where else, to " make haste slowly " in our curative efforts. One thing may be added to the general direction above alluded to. " The food, in these cases," says Dr. Morrill, " especially in those who are of sanguine temperament, should be exclusively vege- table." If he means by vegetable food what I do, when I speak of it,—that is, a diet partaking very largely of bread, rice, and other farinacea, and not one consisting chiefly of potatoes, beets, tur- nips, radishes, and fruits, — then I most fully agree with him. Indeed, I have never yet met with a case of any kind, whatever the temperament may have been, FOOD AND REGIMEN. 177 in which the disease was not soonest arrested, as well as kept longest at bay, under the use of a farinaceous and fruit diet. Dr. Morrill himself even adds, in reference to treatment during the intervals, " It is of the greatest importance that the bowels be kept open, which must be done mostly by a laxative diet, as stewed fruit, bran bread, &c." I do not like to hear of bran bread ; but good bread, made of meal, (neither flour nor bran,) especially wheat meal, I should be ready to endorse to the fullest possible extent. CHAPTER X. DYSMENORRHEA, OR PAINFUL MENSTRUATION. Op this disease it is not my wish to say much, both because I have not had much experience .in it, and because it is one of those diseases which gen- erally receive the attention of medical men, and for which medicine is prescribed. And yet it is a disease which medicine seldom cures permanently; and which, therefore, demands, more than most others, a due regard to the laws of health. I must not therefore omit it entirely. This complaint may attend both suppression and excess; indeed, no condition of female health, except the most perfect regularity, will afford entire exemption from it. It differs in its character, ac- cording to difference of habit and temperament; and yet the causes and treatment —and it is chiefly with these that the young woman should be made familiar—are nearly the same in all. Cold taken during menstruation is one of the most prolific causes of dysmenorrhea ; though it may be the result of nearly every cause which has been mentioned in previous chapters as giving rise to other forms of female derangement, especially the depressing passions and abuses of appetite. COLD BATHING. 179 Much is said by medical authors of the necessity of medicine under the attacks of this disease ; but I have never done much good with it. I have in former times gone to the strange extent of giving half an ounce of laudanum at a time, and yet even this did but temporary good. The best course appears to me to while away the time, as long as the pain continues, by occa- sional warm bathing, both local and general, and by fomentations with cloths wrung out in hot water, or a strong infusion or decoction of poppy leaves. But during the interval of health we may exert ourselves to much better advantage. Here much may be done in various ways to invigorate the general system ; and along with the rest, to dimin- ish, if possible, the local irritability. Here I think the cold shower bath should be our sheet anchor. To some, however, who think they cannot possibly get a " reaction," cold sponge bathing may be preferable. But I would by no means use warm bathing, either local or general, except when actually laboring under the pain. Great reliance is also to be placed on exercise. The young woman should make it a rule to use her muscles every day as much as possible short of great fatigue ; or perhaps I should say, short of over fatigue. I am compelled to attach great importance to the last direction. This muscular exercise should be, if possible, in 180 YOUNG WOMAN'S BOOK OF HEALTH. the open air. I care less about its form, though the active exercises are always better, when they can be borne, than the passive. It is desirable alco that the mind should be pleasantly employed, at the time, if it can be. Hence the value of a cheerful companion on these occasions. Perhaps walking about and doing good, or at least seeking to do it, is among the best forms of exercise for most people ; but if generally useful, it is particularly so — perhaps I should say doubly so — to young women who are troubled with dys- menorrhea. Many talk about the necessity of a generous diet. The diet should certainly be generous, in the sense in which I use the term ; but in order to a generous diet, I do not believe it necessary we should have wine or high-seasoned meats. Good bread and rice, with milk, if it agrees, and plainly cooked fruits, are generous enough. Water is the best drink. I might here repeat my old direction about studying and obeying the laws of health. But why should I ? Obedience is always our duty. The healthy — those who have the largest measure of health already — can do most in this particular ; though all can and should do something. Still I must confess that the little which the feeble can do is of importance to them in just proportion to their feebleness and their diminished capacity for removing or preventing it. CHAPTER XI. CHLOROSIS. Chlorosis, or " green sickness," takes its name from the pale greenish countenances of those who suffer from it. Like "excess," and "suppression," — indeed most female diseases, — it is a disease which affects the general system ; and not, as many appear to suppose, a mere local affection. Some have confounded this disease with that which I have denominated suppression. Nor is the mistake a very unnatural one, when it is duly considered how often it comes on as the sequel of the latter. But then it follows excess also, in many instances, and sometimes leucorrhea. The seat of this disease may often be found in derangement of the digestive and assimilating organs. In many, if not most, instances of chloro- sis, constipation of long continuance will be found to have preceded it. Dr. Morrill says it occasion- ally appears in the male as well as the female. In regard to the general causes of this disease, Dr. Marshall Hall has the following excellent and timely remarks: — " It is quite obvious, on tracing the succession of symptoms, that the first link in the chain is 16 182 YOUNG WOMAN'S BOOK OF HEALTH. constipation, and that the subsequent links are the effects of the continued operation of this cause. Servants, and especially cooks, are particularly liable to chlorosis. But the delicate and inert habits of the rich not less frequently lead to this affection. In all these there is the same defective assimila- tion, and formation of blood. " Under the many exciting and depressing influ- ences of society, as constituted in our country, and the unexampled rapidity with which children be- come men and women, constant derangements of health are occurring; and although years are ad- vancing, the constitution suffers great drawbacks ; the body does not advance to its full and proper evolution, at the time nature intended it to attain that condition. During these intervals of sickness, the powers of digestion are feeble; and very deli- cate and careful preparation of the food is necessary, if we would not oppress them and greatly hinder recovery. "If this be true when comparative facilities exist, what shall we say of the condition of those who constitute the working classes of our population, whose every day brings with it its stern demands of Nature for attention to all her laws, and the entire time is occupied with toilsome labor ? The damp cellar, and the stifling attic chamber, in the foul atmosphere of some by-lane or street, are not adapted to produce appetite ; and the wretched EFFECTS OF MISEDUCATION. 183 occupant, even if for the time possessing the means, has no leisure to pay attention to the wants of the body. Thus it is, from day to day, that inattention to the unalterable laws of nature is followed by a condition of listless and wretched indifference, and the final appearance of this melancholy disease." Young people are prepared for this disease by miseducation. I grant, indeed, that scrofula, joined to a melancholic, lymphatic, or nervous tempera- ment, has much to do with it. I grant that natural tenderness and delicacy of constitution predispose to it. So does precocity of body or mind; so do all the depressing passions, and the abuse of all the appetites, as well as hemorrhages, masturba- tion, &c. Being thus prepared for the disease, another set of circumstances is found ready to execute it, or, when executed, to hurry it on. These are all those circumstances which are apt to surround factory people in low, damp, unwholesome streets, in towns and cities. Among them are damp, cold, impure air, heavy and indigestible food, and crude sub- stances, such as pickles, preserves, vinegar, green fruit, &c. To these should be added hot tea, coffee, chocolate, &c There could hardly be more full and complete evidence that the disease in question has its origin in, or is at least closely connected with, derange- ment of the digestive system, than the fact that the 184 YOUNG WOMAN'S BOOK OF HEALTH. patient, whether male or female, — but I am speak- ing now principally of young women, — always has a perverted appetite. Sometimes the desire for food is exceedingly strong, almost insatiable; at others the appetite gradually disappears. A fondness arises for very acrid salt or acid substances, such as vinegar, long salted meats, very old — perhaps mouldy — cheese, and strong pickles. There are cases, even, in which the patient seeks with the keenest and most unconquerable relish for clay, coal, brick, chalk, ashes, spiders, flies, &c. When these symptoms are either preceded or accompanied by dull, heavy sensations ; unwilling- ness to move ; fatigue on the least exercise ; palpita- tion ; pain in the back, loins, and hips; swelling about the ankles ; involuntary sighing, weeping, &c, with a tendency to avoid company, and seek soli- tude, and to crown all, an appearance of the skin of which I have already spoken ; there can no longer be any doubt concerning the nature of the disease. The question which comes home to us is, What is to be done ? And here, again, the same reply, in general, is to be given, which I have given in the treatment of other diseases, viz. : First place the patient under law. But then it is needful also to particularize, because some of the laws of health are more im- portant to be observed in one disease than in others. REMARKS ON DIET. 185 Thus, while, in mere painful menstruation, I would advise, as I have already done, walking abroad, even if it must be done in solitude, the direction in the present case would be highly inju- dicious. For although exercise is greatly needed, and indeed cannot be dispensed with in either case, yet it should be taken even alone. Yet cheerful company, while it is being taken, is here almost, if not quite, indispensable. But pure air, — the unconfined, uninjured atmos- phere, — to the chlorotic patient, as to every body else, is indispensable. Let air, then, have on the system its perfect work. Let it, moreover, be as dry as possible. The diet should be plain, but nutritious. The tomato has been recommended — I know not on what ground ; probably, however, on account of its laxative and supposed anti-bilious properties. I grant the necessity of preserving, with much care, a soluble state of the bowels. But this effect may be produced by coarse bread, and, if needful, by cooked fruits, quite as well as by tomatoes. I wish to be understood on this point. I have no objection to tomatoes, in themselves considered ; but when we find writers on this subject insisting strongly, as most do, on a generous, nutritious, and highly digestible diet, and then, in the next breath, recommending such innutritious and ungenerous articles of food as tomatoes, onions, and potatoes, I 16* 186 YOUNG WOMAN'S BOOK OF HEALTH. cannot easily refrain from expressing my astonish- ment. Having said that I would gladly preserve a solu- ble state of the bowels, it is needful for me to observe that such a state is not quite synonymous with good and perfect digestion. And yet this confusion — this speaking and writing as if solution included digestion — is often made by good men, and often does great mischief. This subject has been explained elsewhere. It is needful only to add here, that what is wanted in the present case is such food as is both soluble and digestible. Tomatoes, potatoes, puddings, toasts, &c, are soluble, but not very easy of digestion. Bread, on the other hand, good wheat meal bread, and even coarse rye and Indian bread, oatmeal cake and barley bread, with rice, stewed prunes, and baked sweet apples, are not only soluble, but easily digestible. Exercise, for the chlorotic, is a matter of con- siderable importance. Horseback and carriage ex- ercises have been much recommended, and are undoubtedly well adapted to most cases of chlorosis. They have the full benefit of the open and pure air; in addition to which they secure a diversity of scenery. I know not how it is that so much benefit is secured by having the eye feast itself on " living green," as it does a part of the year, when BATHING, SWIMMING, &c. 187 we go abroad, especially on horseback and in an open carriage. But exercises more passive, where those cannot be had, will answer a tolerable purpose, such as riding in a chaise, on a canal, in a vessel or boat, &c. Many have great confidence in sea bathing, mineral bathing, &c. I think well of bathing in these cases; but except the bathing and the pleas- ant conversation which is secured, I doubt whether these fashionable places of resort have many ad- vantages. I am here reminded of swimming, as an exercise. Were the people of the United States to pay as much attention to the preparation of artificial ponds and streams, in proportion to the facilities they possess, as the Oriental nations, every young woman would not only be taught to swim as an amuse- ment, but still more as a remedy in various diseases. I have in my possession a book printed about one hundred and fifty years ago, entitled " Medi- cina Gymnastica," the object of which is to teach that most diseases may be modified, and many cured, by mere muscular exercise. Swimming, of course, comes in for a share of the benefit. One object to be gained by the use of a pretty large amount of exercise, is a due preparation for healthful and quiet sleep. In chlorosis the sleep is apt to be dreamy and unsound. Now, it were 188 YOUNG WOMAN'S BOOK OF HEALTH. highly desirable that every young woman should retire early and rise early. She should have from seven to eight hours of sound, healthy sleep; and if she can be sure her sleep is really such as it ought to be, no one should reproach herself for sleeping fully eight hours. It is no uncommon thing for chlorotic people to be fond of going abroad to evening amusements, such as balls, assemblies, parties, concerts, shows, and the like. In these instances, it often happens that a warm, comfortable dress is exchanged for a lighter one, thick shoes and stockings for thinner ones, &c. There is a tendency also to retire at late hours. This is highly objectionable throughout. All delicate — especially all chlorotic — young women should retire by nine or ten o'clock in the evening. Nor should they go abroad too much in the evening, even though they return and retire early. In truth, home is the best place for them, except occasionally in the afternoon. Reading novels and romances, especially those which are high wrought, is injurious both to mind and body. It renders the sleep unsound, and it excites too much the sensibilities. But novels and romances which are pure — if any such there be — are not so objectionable as those books and prints which have a lascivious tendency. Much is to be expected in the way of preventing HOPES FROM EDUCATION. 189 all female diseases — chlorosis in particular — by early and correct physical education. May we not indulge the hope that the time is not distant when this great subject will receive a measure of the attention it deserves ? CHAPTER XII. LEUCORRHEA. No female complaint is more common — I was going to say more universal — than leucorrhea. It is found at every age from fifteen to fifty, and even before and beyond those ages. It is, however, less frequent after forty-five or fifty; and that species of the disease which prevails below the age of fourteen or fifteen, might more properly be de- nominated catarrh, or cold, than proper leucorrhea. I need not describe it. The loss of the system in this way varies greatly — from a slight increase of the natural mucous secretion to several ounces in twenty-four hours. The color, too, is almost as various as the quantity ; for it sometimes acquires not merely a reddish tinge, but even a green or a brown appearance. I have said that it is extremely common. Meigs says, " Leucorrhea is so very common that it is, perhaps, as rare to meet with a woman who has never had any form of it, as to find one who has never in her life had a cold in the head, or the slightest increase of discharge from the nose." This disease occasionally precedes the appearance of the menses by about two, or three, or four CAUSES OF THE DISEASE. 191 months. During suppression it is sometimes a sub- stitute for nature. On occasions it continues during the intervals of natural menstruation, and some- times entirely supersedes them. " Excess," in a few instances, has its origin in leucorrhea. Lastly, it is, on occasions, vicarious of the menses. I might mention many more circumstances under which leucorrhea makes its appearance, especially during matrimonial life ; but it is hardly necessary, especially in a book for young women. Besides, the management required will be essentially the same at every age. Cases where the cause may be referred to polypus, prolapsus, &c, belong to another part of this volume. Leucorrhea is sometimes constitutional. It is, however, most frequently so in those who possess a scroful6us tendency grafted into a lymphatic or lymphatic and nervous temperament. In these cases, the habit of taking cold, when early formed, seems to pave the way for leucorrhea ; or rather, as I should say, the catarrh or cold, by determining to the vagina, becomes itself a species of leucor- rhea. Excess in the common indulgences of life, — in food, drink, sleep, bathing, dress, &c, —by ener- vating the system, may, and often does, produce similar results. In fact, the scrofulous constitution is often acquired in this very way. Much is said by writers of the danger of foot stoves; but re- 192 YOUNG WOMAN'S BOOK OF HEALTH. marks of this sort would be more applicable to Holland and Belgium than to the United States, in 1850. I have mentioned bathing, but I mean warm bathing. Nor am I sure that even warm bathing is practised often enough to do much mischief. In some countries, it is used in excess, as often as hot tea and coffee. As a cold, humid atmosphere, joined to the influ- ence of bad gases, is often a means of causing chlorosis, and many of the diseases already men- tioned, so it is in the present case. So, also, is a neglect of cleanliness, especially local cleanliness. Among the more infrequent causes of leucorrhea at the present day, especially in low society and in large towns and cities, is masturbation. It is less common in the new world than in the old ; but, unhappily, becoming quite too common even with us, particularly in manufacturing regions. Next to the causes of leucorrhea already named, I am inclined to place medicine and medicated food. If high-seasoned — that is, medicated — food and drink produced no other evil than leu- corrhea, it would deserve to be banished from civic life, as more fruitful of curses to our race than Pandora's box itself ever was. In truth, so common is leucorrhea, so fruitful are its causes, that some have thought the evil both hereditary and constitutional. An eminent French EVILS OF CITY LIFE. 193 physician, whom Dr. Morrill quotes, has the fol- lowing remarks on this subject : — "The mode of life to which the social condition condemns women in large cities, delivers them over, so to speak, defenceless against the numerous causes of chronic inflammation of the utero-vaginal mu- cous membrane. Thus, in populous cities, idle- ness, effeminacy, or sedentary life, the constant contact of the sexes, and the frequenting of places where every thing inspires pleasure; prolonged watching; excessive dancing; frivolous occupa- tion, and the study of the arts that give too great activity to the imagination; erotic reading ; the pernicious establishment of an artificial puberty ; the premature shock of the genital system ; the concentration of the sentiments and thoughts on objects which keep the genital system in a state of permanent excitation; finally, a number of vicious habits, and excesses of all kinds, which, by intro- ducing modifications more or less profound into the general constitution, react more particularly upon the sensibility of the womb, which, in the female, is not only the organ most apt to lend itself to the fluxionary movements, but likewise the centre to- wards which all the morbific aetions seem princi- pally to tend." Notwithstanding the writer of the above was levelling his " artillery " at cities, and large cities too, yet his remarks are not inapplicable to mankind 17. 194 YOUNG WOMAN'S BOOK OF HEALTH. generally. For who does not know and regret the fact that city life now-a-days is not confined to cities ? In other words, the world is becoming a city; only, like one of the cities of the Celestial Empire, its walls contain, as yet, woods, swamps, mountains, and valleys. Some are afflicted with the disease only when their systems are excited, as by sudden joyful intelligence ; or by a sudden burst of passion ; or by exciting food or drink; or by a dose of med- icine. But some, as we have before seen, suffer continually from the beginning of life to life's end. The schoolmaster is abroad, we are often told; but the schoolmaster is not always a public bene- factor. In a work entitled " The School and the Schoolmaster," at p. 296, we find it stated that " the introduction of tea and coffee has justly been considered as one of the great advances in the art of living of modern times, and one cause, among others, of the increase in the duration of life." This does not entirely accord with the state- ments of medical men, of which the following is no more than a fair sample : Dr. Morrill, at p. 143 of his " Physiology of Woman, and her Dis- eases," in speaking of these articles, observes, " We are well satisfied that they exhaust the ner- -ous system, weaken the stomach, and derange digestion." Can they, then, increase the duration of human life ? TREATMENT OF LEUCORRHEA. 195 Leucorrhea is not very easy of cure. As I have said of nearly all other female diseases, dependent upon general debility or derangement, that the most important treatment consists in putting the patient " under law," so I may say, more emphatically, in the present case than in any other. What I mean by placing " under law," the reader already knows. CHAPTER XIII. HYSTERIA. Hysteria, or hysterics, has, in former times, been thought by many a disease of the imagina- tion merely, and the sufferer has been regarded as an object of reproach rather than of commisera- tion. So it was, at a former period, in regard to hypochondria, a disease of males as well as fe- males. But mankind are growing wiser, at least in some few particulars. Hysteria, no less than hypochon- dria, is now known to be a bodily disease, as much as rheumatism, or gastritis, or small-pox. We even know where its seat is, viz., in the brain and ner- vous system. Concerning its causes, however, there is more of doubt and uncertainty. Many have regarded it as having its origin in an irritated state of the uterus. Indeed, this is the more popular doctrine, so far as I know. Perhaps it is the true one. In any event, it would seem to originate in some portion of the reproductive system. Many have supposed it to be a disease almost peculiar to married life. This is quite a mistake. For though the conjugal state does not always cure SEAT AND CAUSES OF HYSTERIA. 197 it, when the habit has been early superinduced, it is certainly less common in married life than in single. It is also to be observed, that it attacks, most readily, the precocious, scrofulous, and sen- sitive. And it is peculiarly apt to make its attacks immediately after some immoderate evacuation, whether natural in its character or otherwise. Thus, excessive bleeding, whether from the arm or the interior of the lungs, might bring it on in those who were predisposed to it. Perhaps one reason why these attacks supervene upon debility is, that there is at the same time a heavy draught upon the brain and nervous energy. One thing is certain, that, other things being equal, it is most apt to come on when, by excess of sen- suality or otherwise, the nervous energy is greatly exhausted. Herein, perhaps, is the strongest proof that the disease has its seat in the brain. For the same causes which give rise to attacks of palsy, epilepsy, chorea, &c, in those who are predisposed that way, may give rise to hysteria in hysterical females. Now, as the former are, beyond the possibility of debate, nervous diseases, why should not the latter be so ? But let us come to particulars. What is hys- teria ? For if it have an existence beyond mere imagination, we ought to be able, whenever we 17* 198 YOUNG WOMAN'S BOOK OF HEALTH. choose to do so, to describe it. The task is diffi- cult ; but we may at least follow the best writers, among whom is Dr. Hooper. " The disease attacks in paroxysms or fits. These are sometimes preceded by dejection of spirits, anxiety of mind, effusion of tears, difficulty of breathing, sickness at the stomach, and palpita- tion at the heart. But it more frequently happens that a pain is felt on the left side ; about the flexure of the colon, with a sense of distention advancing upwards till it gets into the stomach ; and removing from thence into the throat, it occasions by its pressure a sensation as if a ball was lodged there, called by some globus hystericus. " The disease having arrived at this height, the patient appears to be threatened with suffocation, becomes faint, and is affected with stupor and in- sensibility, while, at the same time, the trunk of the body is turned to and fro ; the limbs are vari- ously agitated; wild and irregular actions take place, in alternate fits of laughter, crying, and screaming ; incoherent expressions are uttered; a temporary delirium prevails, and a frothy saliva is discharged from the mouth. " The spasms at length abating, a quantity of wind is evacuated upwards, with frequent sighing and sobbing, and the woman recovers the exercise of sense and motion, without any recollection of what has taken place during the fit, feeling, how- DESCRIPTION OF THE DISEASE. 199 ever, a severe pain in her head, and a soreness over her whole body-. " In some cases, there is little or no convulsive motion ; the person appears to lie in a profound sleep, without sense or motion. ■• Hickup is a symptom which likewise attends, in some cases, on hysteria; and now and then it hap- pens that a fit of hysteria consists of this alone. In some cases of this nature, it has been known to continue two or three days, during which it fre- quently seems as if it would suffocate the patient; and proceeds, gradually weakening her, till it either goes off, or else occasions death by suffocation. But this last termination is exceedingly rare. " Besides hickup, other slight spasmodic affections sometimes wholly form a fit of hysteria, which perhaps continue for a day or two, and then either go off of themselves, or are removed by the aid of medicine. In some cases, the patient is attacked by violent pains in the back, which extend from the spine to the sternum, and at length become fixed upon the region of the stomach, being evi- dently of a spasmodic nature, and often prevailing in so high a degree, as to cause clammy sweats, a pale, cadaverous look, coldness of the extremities, and a pulse hardly perceptible." The causes of hysteria are essentially the same as those in chlorosis, leucorrhea, &c. They are almost as numerous as the varied items of modern 200 YOUNG WOMAN'S BOOK OF HEALTH. miseducation. I have said that, in general, what- ever draws largely upon the nervous energy, pre- disposes the system to its attacks. But grief, envy, hatred, jealousy, &c, long in- dulged, and even forge tfuhiess, over-anxiety, or apprehension of evil, sudden fright, disappointed love and hope, exciting drinks, as tea, coffee, beer, wine, &c, high-seasoned food, and habits too sed- entary, — these, and many other things, may come in for a share in predisposing females to the disease. So, also, may precocity, reading works of imagina- tion, masturbation, hot rooms, feather beds, and the use of medicine and drugs. According to the views of some of our modern writers, —among whom I might name Dr. Clarke, the author of a popular English work on pulmo- nary consumption, — a susceptibility to this disease may be inherited from debilitated parents, especially those who have suffered from dyspepsia, scrofula, consumption, epilepsy, gout, and asthma. One medical writer observes, "Hysteria is un- doubtedly mostly due to an indolent, luxurious, and enervating mode of life; and we may thank for this those well-meaning (it may be) but short- sighted persons who so studiously oppose every effort for enlightening females upon the laws which govern their being, while they fill their hands and heads with mawkish and sentimental trash, yclept • the light literature ' of the day. This absorbs SOCIAL INFLUENCES. 201 their sleeping and waking moments, to the frequent exclusion of a proper attention to exercise and cleanliness. What, then, can be expected, in our enervating climate, but a predisposition to nervous diseases ?" There can be no doubt that, from the influence of luxury, indolence, sedentary habits, personal in- dulgence, and imaginative reading, — to say noth- ing of a thousand other things,—the susceptibility to hysteria, of which this writer speaks, is becom- ing a characteristic among us, both in city and country. It is even gaining ground in our own sex. Formerly, hysteria, in males, was hardly known ; now, it is by no means uncommon. What is said above of the tendency of the cli- mate in England to predispose to the disease, is at least equally applicable to the climate of New England. We live, says Mr. Mann, on the battle ground between " the Arctic and the Frigid." No wonder, then, that so many of us perish prematurely. Thus far I have spoken of influences which pre- dispose to this afflictive, but not generally fatal, disease. Let us now turn to those things which excite it.* * I ought, perhaps, before now, to have stated more distinctly than I have done, that we generally reckon two classes of causes in the production of disease, viz., predisposing and exciting. Sometimes, indeed, as we shall see above, a cause may both pre- dispose and excite. In general, however, mere predisposition wall 202 YOUNG WOMAN'S BOOK OF HEALTH. In the case of hysteria, it often happens that the causes which predispose to it, where they act sud- denly, become excitants, as well as predisponents. Of this class, says Morrill, are mental emotions, of whatever kind, as sudden grief, anger, fright, joy, or surprise of any kind, unrequited affection, jeal- ousy, disappointment, novel-reading, erotic con- versation, the sight of ghastly and bloody specta- cles, sombre or too animated music ; finally, all the causes that produce violent emotions, or suddenly recall painful and lasting impressions. The weaker a person is at any time, whether th debility may have been induced in one way or an- other, the more excitable. Very slight causes, such as, in other circumstances, would have but little effect or influence, are quite sufficient to bring on a paroxysm of hysteria, when the system is duly prepared for it, both by general feebleness and par- ticular predisposition. The sight of ghastly and bloody spectacles has been mentioned above, as being an exciting cause of disease. I knew a female, who would either faint or fall into a paroxysm of hysteria at the sight no more produce a disease, than the mere loading of a piece of artillery will produce the discharge. There must, in both cases, be something applied to excite, or there will be no explosion. A person may be moderately predisposed to consumption, or gout, or mania, and yet, if he avoids the exciting causes, may live to old age. POPULAR MISTAKES. 203 of the smallest amount of fresh blood, even that which was caused by a trifling cut of the finger. The formation of gases in the stomach * (the result of imperfect digestion) is one frequent ex- citing cause of hysteria; or, if this is doubted, one thing is certain, that it is a concomitant. They always coexist. High-seasoned and exciting food, very crude substances, such as pickles and salads, salt meat and fish, ice creams, and worms in the intestines, are also among the list of exciting causes of this disease. I might present, here, a very long list; but I forbear. I will just mention two or three classes of excitants of the disease, of a very differ- ent nature. One is diseases and obstructions in contiguous parts. Whether the indurated contents of the ali- mentary canal, retained too long, are adequate to the production of so terrible a result, I am not quite certain. But cancers, obstructions of the kidneys, liver, spleen, and ovaries, may most certainly do it. Some individuals are powerfully affected by sympathy. Thus, instances are on record, in hos- * This doctrine, that all flatulence, or wind in the stomach and intestines, is the result of imperfect digestion, may be new to some ; for I have met with many who entertain quite a contrary opinion. They suppose that gas in the intestines, at least when freely disengaged, is a sign of good health. The same remark might be made concerning the presence of worms in the bodies of living animals. 204 YOUNG WOMAN'S BOOK OF HEALTH. pital practice, where all the patients in a ward have been thrown into hysteria, solely from beholding a paroxysm of the disease in another person. Nor is the disease any more easily got rid of, in such cases, than when excited in a more usual manner. Finally, some are thrown into hysteric fits by the smell of certain substances, or by the utterance of certain sounds. Musk, ambergris, and even pleasant odors and emanations, have excited the disease. The sudden and unexpected striking of a town bell, or even of the parlor clock, has been known, occasionally, in the case of very nervous young females, to produce hysteric paroxysms. The treatment of hysteria is exceedingly diffi- cult, on account of the peculiar state of the mind. Some physicians have succeeded, by the use of placeboes, such as bread pills, colored water, and the like. But these cures operate best when there is no other disorder coupled with hysteria, or when the disease has not been of long standing. Another species of placebo — I give it this name for want of a better—is sometimes made use of. Thus Dr. Watson relates a case, which he found in the English journals, of a young woman whose recovery was so remarkable, as to be deemed by many quite miraculous. She was affected, it would seem, with paralysis of the lower extremities. A preacher, who knew her, had influence enough with her to make her EFFECTS OF PLACEBOES. 205 believe that if, on a certain day, she should pray for her recovery, with strong faith, her prayer would be heard, and she would recover. The result verified his expectations. A case like this occurred in the commonwealth of Massachusetts. A Methodist minister, at one of his official visits to a young female friend of his, at length contrived to raise her hopes of recovery by a similar assurance. I had the story from his own lips. He said, however, that the prayer was to be offered by himself, rather than the young woman. There was, moreover, a long preparation for it. But as the result, the young woman began to mend immediately, and soon entirely recovered. I might mention many more cases of the placebo kind, but it is by no means necessary. My belief is, that medicine, properly so called, is seldom, if ever, needed, and never during the paroxysm. In truth, I would seldom, if ever, attempt to remove the fit, after it has come on ; but content myself with what I could do during the intervals. In other words, I would rely, principally, on prevention. In this instance, moreover, my views do not differ materially from those of other physi- cians. A medical writer, in whom the public are accustomed to place confidence, —one, too, who is by no means backward to give medicine very freely, whenever there is the slightest indication of its necessity, — observes as follows : — 18 206 YOUNG WOMAN'S BOOK OF HEALTH. " The susceptibility to hysteria may be more easily prevented than cured. In a great majouty Of instances, it is the result of injudicious manage- ment in early life. Parents do not foresee the misery they are laying up for their daughters, in pampering them with stimulating food, allowing modes of dress which unduly compress the most important organs of life, and filling them with fashionable accomplishments." Another says, " Boys are sent, at an early age, to school, where a large portion of their time is passed in taking exercise in the open air ; while their sisters are confined to heated rooms, taking little exercise out of doors, and often none at all, except- ing in a carriage. There, for the most part, the latter spend much more of their time in actual study than the former. The mind is ever educated at the expense of the physical structure.1' These views, which I most fully endorse, indi- cate the course to be taken during the intervals of hysteric paroxysms. The patient should be, as much as possible, uneducated. In other words, we should endeavor to counteract the wrong tenden- cies of a perverted early education. No pains should be spared to train the suiferer to that hardness of which I have spoken so freely in another chapter. One highly important instru- mentality for effecting this object, is the co'd shower bath. This should be used dniiy. REACTION FROM COLD BATHING. 207 The common belief with these patients is, that they cannot endure cold water, —or, at least, can- not secure a reaction. And, when driven, by the force of conviction, to use it, they are often found using it a little warm. Instead of 40°, they will often raise the temperature to 80°, 90°, or even 100°. Now, were it not for the fears which are enter- tained of the cold water, every nervous and deli- cate patient would get a much better reaction, after the shower bath at 40° than at 80°. True, the chill is not so great when the water first strikes the body. But then, too, the sensibility to the cold air is greater in proportion ; added to which, there is not so much power within to generate new heat. These hysteric patients —and many other people besides them—forget that the great source of hu- man heat is the human machinery; that we are warmed from within, and not with clothes, or by means of fires ; at least, not directly. They for- get, also, that the warm bath, as a general rule, weakens the power within to generate heat, — the calorific function, — while the cold shower bath, if taken in a proper manner, always increases it. The author is no hydropathist; and yet he has always been struck with observing how readily the feeble and delicate react upon the wet sheet, as it is called. Why, one who had no faith in cold 208 YOUNG WOMAN'S BOOK OF HEALTH. water might think these poor creatures would be killed outright by the wet sheet. And yet, when they get their feelings up to the work, and have great faith in its beneficial influence, they will very often not only endure it, but seem to go beyond themselves in enduring it. The system appears to be roused up beyond the most sanguine expecta- tions of physician or patient; nor is the excitement followed by very much debility. But I have spoken of this elsewhere. There are sundry directions — some of them minute ones — to be given to those who are nov- ices in the work of cold bathing. The common impression is, that the best time for this form of bath is at rising in the morning. This certainly is a convenient time, and, for those who cannot attend to it at any better hour, will an- swer very well. Still, if it can be done, a better time is about two or three hours after breakfast. And the worst time is late in the day, or when we have recently undergone a good deal of fatigue, or have been greatly overheated. But why, it may be asked, is two or three hours after breakfast a better time than at rising ? There is, in the human circulation, indeed in all parts and functions of the system, what may be called a tide. When we retire to rest, it is com- monly, so to speak, low water. When we rise in the morning, the tide has risen somewhat, but is PARTICULAR DIRECTIONS. 209 not full. It is not till we have been up a while, and eaten moderately, and enjoyed one. or two, or three hours of exercise after breakfast, that we have flood tide. Or, to drop the similitude, the vigor of the circulation, the flow of nervous energy, and the power of muscular action, are least at the hour of rest, and greatest at the time of the forenoon which I have mentioned. The heart, arteries, brain, stomach, and muscles, are all strongest at that time. And it is when these are all at the highest point of vigor, that the feeble will get the best reaction after the free use of cold water. I have more than intimated that the colder the water, the better, other things and circumstances being equal, the reaction. To this rule I know, in truth, of no exception. You cannot, of course, have it at a lower temperature than about 30°. There are, indeed, certain little indulgences, to which I know of no objection ; such as going from the cold bath to a warm room. Indeed, I think that for the feeble, when commencing the practice, it is, on the whole, desirable to use the towel, brush, &c, and restore the dress, in a moderately warm room. But bathing is not the only instrumentality by means of which hysteric patients can be invigor- ated ; though it is, as I said before, one of the most efficient. When the shower bath is not to be had, 18* 210 YOUNG WOMAN'S BOOK OF HEALTH. or cannot be borne, the sponge bath should be sub- stituted. Of this I have already spoken. Walking, and riding on horseback, are next, in point of importance, to cold bathing. Next to these is riding in a carriage, not on springs or cush- ions, or under coverings which exclude every breath of fresh air ; but in circumstances which permit a full expansion of the chest. Heaven has not girted this globe with a layer of air forty or fifty miles thick wholly in vain. Let us, then, use it, especially when needed for remedial purposes. Retiring to rest early can never be too much commended, either in hysteric, or any other dis- ease which has its origin in cerebral and nervous debility. For every person, sick or well, has more or less of febrile tendency toward evening. The pulse beats faster, being weakened in proportion. There is usually some increase.of heat and thirst, with more or less of languor and lassitude. Now, those who retire early, sleep away, most success- fully, this miniature fever. And to no person is this habit of retiring early of more importance, than to the patient in hysteria. " The bowels must be kept regular," says a writer, whose name I purposely withhold,* " by the employment of aperients, composed of aloes and * I do it out of respect to him. For he will live, as I humbly hope, to see the dawn, at least, of a more rational practice. REMARKS ON CONSTIPATION. 211 rhubarb." But such advice is horrible. Every time the medicine is repeated, it leaves the bowels a little more torpid than they Avere before, and the practitioner, in general, knows it. How, then, can he persist in it ? I know, full well, how undesirable costiveness is; and, for this very reason, am unwilling to in- crease it. But this is precisely what most aperient medicines do ; such, at least, as rhubarb and aloes. Better, by far, to use a more active diet, and more abundant exercise. The danger of costiveness, though considerable, is not so great, after all, as many suppose. I knew an individual, who, in the progress of a slow fever, had no movement of the bowels for fourteen days ; and yet his physician — a zealous orthopathist — steadily refused to interfere. And after the move- ment on the fifteenth day, of which I have spoken, there was no more action till the end of the seventh day. An interval of two or three days followed, at the end of which, Nature resumed her usual course. I have very recently received a letter from an orthopathic physician in the west, in which he says, "Judge F------- had a long illness; took medicine to his heart's content; was given over by the doctors ; learned my views ; abandoned the use of medicine, and is now gradually recovering health and strength. Since he gave up medicine, 212 YOUNG WOMAN'S BOOK OF HEALTH. there have been two periods, of twenty-one days each, without a passage of the bowels; and several times, fifteen days." Let it not be thought I attach too little impor- tance to regularity of the bowels ; for I subscribe most fully to the popular doctrine that there should be a diurnal movement. Dr. H., an aged practi- tioner in Connecticut, insists that nothing in the world is more conducive to health, than regular, daily, peristaltic action. And I am half of his opinion. The philosopher Locke was of opinion that children should be trained to attend to this matter daily, at a particular time. And I have ascertained that some of the healthiest men in our country have trained themselves to this habit. A late mayor of one of our cities, a man of very high health, told me he had not departed from his daily rule in twenty years. Now, the education of modern days — that of females in particular — is opposed to this habit. Very few persons have any rule at all, or know the importance of having any. Young women should study physiology, were it only to ascertain the im- portance of the rule I have alluded to. There would be less hysteria in the world, if this rule were observed inviolate. But I may be regarded as digressing. For miseducation has done its work already, I shall REMARKS ON DIGESTION. 213 doubtless be told, for the hysteric person, so that prevention comes too late. But this is not so. Prevention never comes too late. And much may be done during the intervals of health, in hysteric patients, to prevent a recurrence of the disease, by establishing healthy habits. Let me say, then, once for all, that our band-box education must be given up. Our children, male and female, must be trained to more hardness. If, however, they are already fifteen, twenty, twenty- five, or even thirty years of age, still we must not despair. Much may be done, even at the eleventh hour. It was my intention to say something about the food and drink of hysteric persons. But the reader has my general views already. I will therefore detain her, on this part of my subject, but a few moments. The advice usually given to hysteric patients is, Eat what you find to be easy of digestion. But no hysteric patient can tell for herself what is easy of digestion. What is so bad as to give her great pain, she knows enough to avoid; but there are many things which give no pain, and yet are hard of digestion. They may, indeed, dissolve easily; but solution, I have told you, is not digestion. Bread made of unbolted wheat meal is one of the best articles of food, in cases of hysteria. Among the best, did I say ? It is, without doubt, 214 YOUNG WOMAN'S BOOK OF HEALTH. the very best, not only for hysteric people, but for every, body. That bread is the staff of life, has been endorsed by the experience of thousands of years; nor is the sentiment likely to be soon re- versed. CHAPTER XIV. UTERINE MADNESS, OR NYMPHOMANIA. This disease, most happily, is rare. I have not seen half a dozen cases of it in twenty-five years. Indeed, I am not without hope that it is less fre- quent than formerly. And yet, as long as a single case of so dreadful a disease can be found, the young should be apprised of its existence and character. It is almost unnecessary to pain the reader by a description of the symptoms of nymphomania. The name is suggestive of its nature. Besides which I shall allude to its character, in speaking of its causes and treatment. The best account I have seen of the causes of this disease is as follows. The writer, having made the usual division into predisposing and exciting causes, thus goes on : — " In the former should be included all circum- stances capable of producing an exaltation of excitement in the brain and nervous system, such as the reading of lascivious and impassioned works, viewing voluptuous paintings, romantic conversa- tions, associating with corrupt companions, frequent 216 YOUNG WOMAN'S BOOK OF HEALTH. visits to balls or theatres, disappointed love, the too assiduous cultivation of the fine arts, the influence of imitation on beholding it in others, the abuse of aphrodisiac remedies, or of spirituous liquors, or of aromatics and perfumes, which excite too much the brain and general sensibility. " The causes which act directly upon the genital organs, (the exciting causes,) and which may after- wards act sympathetically upon the brain, are masturbation, the abuse of coition, pruritus of the vulva, inflammation of the nymphas, clitoris, neck of the uterus and ovaries; to which we may add the irritation of ascarides in the rectum; and, finally, the use of drastic purgatives, and the inter- nal or extensive external employment of can- tharides." One thing should be mentioned, in passing, concerning its resemblance to pruritus—men- tioned above, as one of its causes. They are sometimes mistaken for each other. But they need not be. Nymphomania is accompanied by venereal desire; but in pruritus, though there is a most intolerable itching, there is seldom any sexual im- pulse or desire; indeed, it is usually the very reverse of all this. Warm baths have been recommended in this disease ; but, as it seems to me, without due con- sideration. I do not believe that any sensible practitioner would be willing to risk them. The DUE REGULATION OF THE MIND. 217 cold bath — I mean the use of cold water on the whole surface of the body — is far preferable. Indeed, the whole treatment, both external and internal, should be cooling. None but cooling drinks are at all admissible, and none but the most bland food. Farinaceous food, — bread of various kinds, arrowroot, sage, tapioca, rice, and potatoes, — with mild sub-acid fruits, and milk, is the best. Animal food, especially salted animal food, and old salted butter, should be avoided as carefully as if they were rank poison. Opposed as I am to the use of medicine in most female diseases, my views of its application in nymphomania will be easily guessed. I regard it as not only useless in this disease, but positively and greatly hurtful. I never knew the least benefit derived from it. There is one surgical operation which has occa- sionally been resorted to ; but in a book for young women, it is entirely unnecessary to describe it. What they need is, to know the causes, that they may know how to prevent it. For here, if nowhere else in the wide world, prevention is better than cure — immensely better. The Scriptures speak of a period in the early history of our world when the thoughts of mankind were only evil, and that continually. The thoughts and imagination of every female afflicted with this species of madness are in the same predicament. 19 218 YOUNG WOMAN'S BOOK OF HEALTH. It often happens, moreover, that these unhallowed thoughts and feelings are fed and nurtured by read- ing doubtful romances, if not even those books which are printed with a special design to excite lascivious feelings. This suggests an important item in the treatment of these persons. It consists in watching over and endeavoring to control and direct about their mental food, no less than their physical. If the mind cannot be rightly directed in any other way, it may be advisable to travel, but not without a judicious companion, as a protector. But even in this there will be some danger of too great excitement. The country is preferable to the city, to travel in ; and a private carriage better than the tumult and whirl of railroads and steamboats. My views of feather beds are already fully known; but if there be a case in which, more than any other, they are inadmissible, it is that of nymphomania. The coarsest, most porous, and coolest beds are to be secured ; and if a companion is admissible at all, a judicious selection should be made. Better sleep entirely alone than with those whose imprudence will tend to perpetuate the disease. Nor should there be the least indulgence in late hours in the morning. The patient should leave the bed the instant she wakes. One evil connected with comfortables and feather beds is, that, by their ARTIFICIAL HEAT. 219 unnatural warmth and stimulus, they tempt to late hours in the morning. Artificial heat in sleeping-rooms for young women who are afflicted with this disease is also to be shunned with the greatest care and solicitude. They are of doubtful utility to any body; but here there is no apology for them. The frequent recommendation to marry, as a means of removing the tendency to this disease, must not be received and acted upon without a good deal of qualification. It may be useful ; but it is also true that it may be utterly inadmissible. On this point, consult the proper authorities. CHAPTER XV. HYSTERALGIA. About thirty years ago, — certainly not much more, — it was as uncommon to hear of neuralgia, especially that form of it commonly called tic douloureux, as it was to hear of the approach of a comet. But now, in 1850, neuralgia, in some part of the system, is as common, or nearly so, as the toothache. Hysteralgia is neither more nor less than neural- gia' of the uterus. It may be described as a painful and tender condition of that organ, without any tendency to change in its structure. A scirrhous or cancerous state of the uterus, so frequent a dis- ease in modern times, may possibly accompany hysteralgia, but does not necessarily belong to it. The hysteralgic patient is never free from pain, though the suffering is much greater at certain times than at others. It is especially so after great mental excitement, or over-exercise of the body; also immediately before or soon after menstruation. Hysteralgia may attack persons of every age and temperament, but is most common and severe in persons of a nervous temperament, and who are not above thirty-five years of age. It may con- CAUSES OF HYSTERALGIA. 221 tinue months and years, or it may subside spon- taneously and suddenly. It does not usually de- stroy life, but it is sure to make life miserable while it continues ; besides, it is a sure cause of sterility. The causes of this disease are not, in every in- stance, well ascertained. Excessive bodily effort, and becoming over-heated during menstruation, is undoubtedly one source of the disease ; but it is only one among many. Whatever draws largely upon the nervous energy, in nervous females, may, as it appears to me, be sufficient to excite the dis- ease in those who are predisposed to it; but of what this predisposition consists, we are nearly, if not utterly, ignorant. Among the things that tax, suddenly and largely, the nervous energies of the female system, are the more powerful emetics and cathartics. And yet many families keep them in their houses, and ad- minister them to their children and young people with as much freedom as if they were no more likely to excite other diseases than a potato or an apple. But these are not alone ; very far from it. Local applications, to allay immediate suffering, — under an attack of hysteralgia, I mean, — are often pro- ductive of great mischief. Except fomentations, and perhaps injections of warm water, they but 19* 222 YOUNG WOMAN'S BOOK OF HEALTH. corroborate the frequent remark, that the remedy is worse than the disease. Astringent injections, sometimes injudiciously administered for certain conditions of the system, have been known to produce the disease in all its force. And I think that excessive quantities of laudanum, or, indeed, of any other anodyne, given in the same manner, are equally liable to do mis- chief; or if they give temporary relief, it is only to invoke a return of the suffering in still greater violence than before. My own method of treatment is merely palliative. I would soothe the brain and nervous system by flannels wrung out in hot poppy-water, and applied to the stomach and bowels, and relieve existing constipation by injections made of Epsom salts, molasses, and water. The patient should be re- quired to keep her bed, and to move as little as possible till the paroxysm is over. When this is over, great reliance should be placed on a judicious exposure to the open air. For this purpose, moderate carriage exercise is the best. There will be some gain in maintaining a horizon- tal position while exercising, or, at least, a half- recumbent one. Walking is frequently too severe as an exercise. The warm bath may be taken three times a week, on retiring to rest. Thus used, it is soothing, and, TREATMENT OF THE DISEASE. 223 at the same time, invigorating. Still, the cold shower bath is chiefly to be relied on between the paroxysms. It should, however, in order to make it as efficacious as possible, be used about two hours after breakfast. The diet should be generous, but should not in- clude fish, flesh, or wine. The food should consist of choice vegetable preparations, principally farina- ceous. If fruit is used, it should be cooked. Ev- ery thing known to be difficult of digestion should be carefully avoided. Iron has been used in this disease ever since it was first known; but I never knew it do much good. Nor have I as much confidence in iodine as many physicians. The truth is, however, I have long ago given up the hope of doing much to re- move this disease, when once established. If the patient is young, and will turn to the laws of God, physical and moral, and obey them, she will proba- bly, in due time, wear out the disease ; but if this should not be the result, I would still pursue the path of obedience. CHAPTER XVI. STERILITY. Sterility and impotence are sometimes con- founded with each other, or at least treated as if they were associates. The truth is, however, that sterility often exists where there is no impotence ; although it is a general fact that impotence includes sterility. Impotence is a mere want of external power ; but sterility is an internal incapacity to complete the purposes which the Divine mind in- tended by that power. The causes of sterility are not, in every instance, well understood, though we know what some of them are. Self-abuse, or masturbation, unwilling marriages, premature matrimony, frequent or inor- dinate indulgence of any of the appetites, intense application of the mind, as well as the constant influence of the depressing passions, are among the number. Disease is also a frequent cause. Among the diseases which produce this result are, first, cancer, polypus, dropsy, &c, of the uterus; secondly, hysteralgia, painful menstruation, excess, leucorrhea, and suppression. Climate has also been mentioned by some writers as a cause; but I doubt whether CAUSES OF STERILITY. 225 with good reason; or, if it does this, it is only by inducing consumption or some other disease. As a general rule, I have found the appetites go together. Thus he who has a strong appetite for food, generally has his other appetites very strong also. On the contrary, when the appetite for food and the powers of digestion are weak, the other appetites generally tend in the same direction. But strong appetites are seldom accompanied by sterility. But that feebleness of appetite alone is a very frequent cause of sterility, may be doubted. For the truth is, that if a person has a feeble appe- tite, there is a cause. To the perfectly healthy, so far as I know, God always gives a good appetite. So that it seldom, as I said before, comes alone. I have already admitted that it is often difficult to find out the cause or causes of sterility. Nev- ertheless it may be well to examine the matter as far as we can. The ovaria may be diseased, or may even be wanting ; the Fallopian tubes may be wanting, or may be obliterated; the uterus may be diseased in a great variety of ways besides those mentioned above ; there may, at least, be chronic inflammation of the organ. There are a few individuals in whom the men- strual discharge is wholly absent. Sometimes, in addition to this, there is also an entire malformation of the reproductive system. When the natural functions of the human being are suspended, — or 226 YOUNG WOMAN'S BOOK OF HEALTH. at least when they never existed,—nothing but sterility should be expected. Similarity of temperament is by no means an uncommon cause of sterility. This is especially true of those who, on the one hand, are both highly sanguine, and on the other are both cold and phlegmatic. The Author of nature has wisely or- dered that the parties should be in some respects dissimilar, in order to the best possible results in regard to offspring. Disparity of age is a cause mentioned by many writers. So, also, the extremes of opulence and indigence. So, likewise, much taking medicine, particularly at an early age, when the first great change of character is about to take place. But we must speak of treatment. Yet here, even more than elsewhere, medicine is powerless, almost entirely so. Not one man in a hundred, of any standing or character, believes in specifics for directly removing sterility, whether known and vended by one name or another. Indeed, it is a most melancholy fact that, although, in a few in- stances, it may be true that medicine, by acting as an irritant, may have proved the cause of concep- tion, where nothing but sterility had before existed, yet for one who has been aided in this way, it is quite within bounds to say that scores have been injured. And even in those rare cases where medicine TREATMENT FOR STERILITY. 227 has triumphed, it is still an unsettled question whether there is any gain in the end. Dr. Morrill observes, concerning several popular medicines, that they can never be employed with advantage, be- cause, although they may act temporarily as irritants, they serve to prostrate, in the end, the " very powers designed to be restored." The proper course to be pursued may be inferred from what has been said of causes ; and this is one reason why I am thus minute in mentioning them. It will be obvious that in some cases, such as malformation, nothing can be done but be resigned to one's condition. In other instances, however, when the cause is known, and within our reach, it must be removed. Thus, if there is repeated indulgence, — or, in delicate persons, if there is any thing in the treat- ment of any of the three appetites which is beyond what would be properly regarded as a reasonable abstinence, — it must immediately cease. No per- son who gives herself up to high living of any kind, or to sensuality in any form, can claim the right to escape the penalty attached to it; and sterility is oftentimes that penalty. So of what might be called mean living, if long persisted in. I grant that what we sometimes call the poor are the most prolific ; but then we must not forget that, in this country of abundance, what we call the poor, really live more in accordance with 228 YOUNG WOMAN'S BOOK OF HEALTH. the physical and moral laws of God than the rich. Our poor people are not very poor after all; I mean generally. Young women should understand the causes of sterility, not so much that they may know what to do when they find themselves condemned to it, as that they may know how to prevent it, as far as Providence may have put it in their power. This subject should not be withheld from them, so care- fully as it often is, till information is too late to be valuable. And if those whom God has set over them as their legitimate tutors fail to do their duty, — whether it be from ignorance, or negligence, or wilfulness, — it is desirable that they should learn the truth in some other way. Whenever a young woman finds herself living in such a way as may be likely to end in sterility, her duty is to refrain from it at once. Every means of gaining a knowledge of the laws of health, such as are faintly indicated, at least in part, in Chapter III., should at once be laid hold of, and improved to the best possible advantage. To those who tell us — and sometimes I doubt not with as much sincerity as recklessness — that they prefer to be sterile, I have nothing to say. To their own master they stand or fall. It is only to those who have consciences and some correct notions of human responsibility, that I address myself. SUFFERINGS OF THE STERILE. 229 And these individuals must suffer me, in this connection, to say that whatever tends to sterility tends also to ill health in other forms. So that while they pursue the crooked ways of transgres- sion, and say they "don't care," they should re- member that, if they escape what they regard as the evils of gestation and parturition by it, they only avoid one rock by running on another still more dangerous. There can be no doubt that the prolific suffer far less, as a whole, than the sterile. I speak now of positive pain and suffering — saying nothing of the loss of those simple, pure pleasures of maternal life which the sterile can never know. Would that the truths of the last paragraph could be uttered wherever there are human beings, and a voice that could be heard and would be duly re- garded ! How strange it is that young women should shrink from the consideration of a subject which they know, or ought to know, is of immense importance to them — a subject from ignorance of which they doom themselves to unhappiness through life, and entail a world of misery on those who come after them! 20 CHAPTER XVII. EXTERNAL DISEASES. INFLAMMATION, ABSCESS, AND ADHESION. We come now to the consideration of a class of diseases which, though more frequent in married women than single, are yet sometimes the lot of the latter. It is necessary, then, that young women should be informed on the subject, that they may, as far as possible, prevent them. Besides, as it is the general rule that young women, in the end, become married women, it is on this account greatly desirable that they should know what is to be done where prevention has failed. Slight inflammation of the most external parts of the reproductive system, is not at all infrequent among the young. In some instances it is accom- panied by itching, which is mitigated by friction in the usual manner. The result occasionally is, that the parts become greatly swollen, and the in- flammation high and violent. In general, if friction is not allowed, the inflam- mation goes off gradually of itself; but if there is much irritation applied, abscesses may arise. These, too, if let alone, will generally run their course without danger, and even with comparatively little A COMMON ERROR EXPOSED. 231 trouble. There are instances, however, in which they run on to suppuration with the utmost ra- pidity. There is one more way in which the inflamma- tion may terminate, which is in adhesion of the parts. This, in young girls, is by no means un- common ; at least it is so common that we should never be surprised at it. The treatment of mere straightforward inflam- mation is exceedingly simple. The patient must be kept quiet in mind and body ; to which, if there is much itching, I would add a bread and milk poultice. The crumb of wheat bread, somewhat stale, is usually preferred. With this treatment I suppose that about five cases in six will terminate as favorably as could be desired. But suppose it proceeds to the formation of an abscess, which becomes extremely painful. Even here the most I would do would be to apply the bread and milk poultice. If the person is healthy, nothing more could be desired ; if otherwise, noth- ing more would do any good. It may be necessary to remind the reader, at this point, that the common belief concerning the pe- culiar virtues of external applications to any part of the human system is exceedingly erroneous. That one kind of poultice or plaster is drawing, another cleansing, another scattering, another heal- ing &c., has no more foundation in truth than the 232 YOUNG WOMAN'S BOOK OF HEALTH. veriest popular superstition which time and expe- rience have universally exploded. For how can a plaster draw, for example ? Place it over a nail, in a board, wall, or partition, — will it draw out the nail ? However loose in the wall, will it have the least effect upon it ? You will say it is different when applied to the living body. But wherein is it different ? Nature pushes out the offending substance, and the poultice does not hin- der it. This is nearly all that can be said. I am not disposed, however, to deny that the poultice does any good. By keeping the surface, to which it is applied, soft and warm, it may be that Nature can do her work to better advantage, and push out the offending substance a little quicker for it. It makes no great difference, however, of what the poultice consists. I have as much con- fidence in bread and milk as any thing—chiefly because it keeps up an equable warmth. But I entreat the reader, who has the direction of a little inflammation of the kind alluded to in the second paragraph of this chapter, not to treat it in such a manner as to make it ten times as bad as if it had been let entirely alone. Many are alarmed, and in their fears make applications to which they would be entirely averse in their sober and more reflective moments. Nor are physicians always wise in this matter. In the belief that they must do something, or they TREATMENT OF ADHESIONS. 233 shall be thought unskilful, and with a sort of con- fused belief in the omnipotent power of medicine, they go very much too far. Old physicians, who are wise, give but very little medicine, and are giving less and less every year. It is with diseases within the body as with those without. Nature must heal them from the bottom, so to speak, or they cannot be healed at all. Let the young woman read, ponder, and beware. Na- poleon said, " Do not counteract the living prin- ciple." See that you obey the injunction — not the less important because it came from one who had never studied medicine and disease. But I was to say something, in this chapter, of adhesion. In young girls I have stated that this is quite common. It is so where they are greatly given to taking cold, and having the cold settle, so to speak, on this portion of mucous membrane. It is so, moreover, where there has been a great neglect of cleanliness. When the adhesion is not extensive, and is quite recent, the parts may be separated by the mere ap- plication of the end of a probe. In other cases, however, a simple surgical operation may become necessary. To young children, however, such violence is seldom required. In general, great attention should, from the first, be paid to this matter of cleanliness. Those who have been trained to daily ablutions in cold water, 20* 234 YOUNG WOMAN'S BOOK OF HEALTH. need not hesitate in regard to duty. Those who have not, should still wash themselves daily ; but warm, or at least tepid, water may be preferable. This necessity is not diminished, but rather in- creased, by the arrival of puberty. Some have supposed it dangerous at the time of menstruation; and to those who had never been accustomed to cold water, it might be so. There are those, how- ever, of robust constitutions, who can make the application, and wipe themselves dry immediately, not only without suffering, but with evident ad- vantage. And as for those who have been trained to cold bathing, I say again, they need have no fears at all. Or, if this were expecting too much of them, they may, at least, use tepid or warm water. There is no excuse for neglect of cleanliness in young women, nor any certain remission of the penalty which God, in nature, has attached to it. CHAPTER XVIII. PRURITUS. Some may smile at the idea of making so trifling a disease as pruritus, or itching of the vulva, the subject of a whole chapter. But let me say to them, that, had they ever experienced the suffer- ings which this disease, trifling as it seems, brings with it, they would not feel much disposition to smile. For I have seen individuals in whom the disease was so severe that we might almost mistake it for nymphomania. Like the latter disease, it seems, for the time, to absorb all the feelings and thoughts. The patient, in spite of herself, sometimes so con- ducts, even in mixed company, as almost to " put decency at defiance." True it is that young women are less liable to it than others ; but they are by no means exempt. Sometimes it exists by itself; at others, it is symp- tomatic of diseases of the uterus, bladder, and rectum. The causes of pruritus are numerous and various. Among these are hot and acrid substances used for food and drink ; worms in the intestines ; want of 236 YOUNG WOMAN'S BOOK OF HEALTH. due cleanliness; and acrid secretions from the mucous membrane lining the parts ; in addition to which, authors mention eruptions of various kinds. The treatment is more than indicated by due attention to the above list of causes. Where acrid substances form a part of the diet, they must be withheld. Vinegar, pepper, mustard, horseradish, pickles, long-salted meats and fish, and salted but- ter, are among the principal. All these, and many more, must be sedulously avoided. Of drinks which are to be avoided I hardly need to speak. Fermented drinks are the most objec- tionable ; and of these, cider and ale are the worst. Coffee and tea are less injurious, except on account of the heat, which is, of itself, an excitement, and adds to the mischief done. The tepid bath, taken on going to bed, and the cold shower bath in the morning, are both useful in pruritus. Taken in the way I have mentioned, they are both tonics, while they conduce, at the same time, to cleanliness. Moderate exercise is an important item of treat- ment ; but care should be taken to avoid great fatigue, and, still more, great heat. In short, what- ever heats the system, externally or internally, increases the pruritus. It has been made a grave question, whether this disease is mitigated or increased by endeavoring to relieve ourselves by scratching ; but on this point TREATMENT OF PRURITUS. 237 there can be but one opinion. In the effort to relieve ourselves, the acrid secretion from the erup- tions of the diseased part, being extended to the healthy part, poison it, and extend the disease. This, as it seems to me, settles the question. Great reliance is placed by many practitioners of medicine on a wash for the part, made of borax. In some instances, it may have been useful; but it can only be useful as an adjunct to the more im- portant treatment above recommended. CHAPTER XIX. INTERNAL DISEASE. INFLAMMATION OF THE UTERUS AND OTHER PARTS. Young women are not so often afflicted with this disease as older ones; yet even the former some- times suffer from it. It is generally spoken of as existing in two forms — the acute and the chronic. It is the chronic form of which I shall principally treat. Chronic inflammation of the uterus is often found complicated with various other diseases of this organ, which not only adds to the suffering, but renders it somewhat difficult of detection. In some instances, it is almost impossible to detect it with any degree of certainty. The symptoms are as follows: The attack com- mences with chills, succeeded by heat and thirst, and considerable uneasiness in the region of the pelvis. There is also pain in the back and lower part of the abdomen, extending to the groins and down the thighs, with more or less tenderness on pressure. The uterus will generally be found in- creased in size, the mouth more open than natural, and the neck very tender. SYMPTOMS AND CAUSES. 239 Certain mental and moral changes, also, take place, as symptomatic of this disease. The fe- male who is constitutionally of equable and cheer- ful temper suddenly becomes fretful, capricious, and even hysterical. Strange, perhaps, that it should be so ; but so we certainly find it. The ancients were accustomed to say that the uterus was " an animal within an animal; " so well were they convinced of its surprising power over the affections and sentiments. The causes are of two kinds, as usual — predis- posing and exciting. Among the former are the depressing passions, a scrofulous or consumptive tendency, damp, cold, and unventilated rooms, im- proper food, tight dress, undue mental excitement, and a syphilitic inheritance. Among the exciting causes, the following is the most approved list, and is sufficiently formidable : — " Irritating injections ; suppression of the dis- charge of piles; leucorrhea; the use of violent medicine to force the menses or to procure abortion; too frequently repeated indulgence ; solitary vice; celibacy; widowhood ; sudden cooling of the ex- tremities ; cold bathing of the lower parts of the body ; cold general baths, and iced drinks, especial- ly during menstruation ; fatiguing walks; violent exercise on horseback, or in carriages without springs ; excessive dancing ; loss of sleep; wounds; the application of a pessary; heating and stimulating 240 YOUNG WOMAN'S BOOK OF HEALTH. food ; spirituous drinks ; coffee ; wine ; and strong moral disturbances, which may suspend the flow of the menses, the lochia, &c" Concerning the treatment of this disease, I have little to say. Left to themselves, a considerable portion of those who are affected by it would probably recover. Dr. Morrill says inflammation of the uterus frequently terminates in resolution. In plain English, divested of technics, it is dis- persed without the usual process of suppuration, ulceration, and the like. The diet in this disease, like most others where there is internal inflammation, must be simple and unstimulating. And yet a meagre, innutritious, or scanty diet would not be favorable. " Light and easy, yet nourishing," is the best description of the diet which would be most suitable in these cases. We have seen that, at an early stage of the dis- ease, its resolution, in a natural way, may be hoped for. Of course, no reasonable person would think of giving medicine at this stage ; for it might, and probably would, defeat Nature's plan. But at an advanced stage, medicine is still less called for. The best writers tell us that the great thing to be done, at this stage, is to be diligent in the employment of all those means which are cal- culated to improve the general health. Where, then, have we much room for medicine ? DISEASE OF THE FALLOPIAN TUBES. 241 Inflammation of the Fallopian tubes, and of the ovaria, sometimes happens as a separate disease from the foregoing; but it is difficult to distinguish them till after death. Nor would the distinction be of much practical importance. 21 CHAPTER XX. PROLAPSUS UTERI. If the position is true, that the whole tendency of modern physical education is to render females precocious, nervous, and delicate, then it follows that the general tendency, also, is to render them the subjects of premature and afflictive diseases, such as those which are described in many of the preceding chapters. Suppression, excess, difficulty, and pain, in connection with menstruation, together with leucorrhea, chlorosis, hysteria, &c, are among its legitimate fruits. And then, again, it is true, not only that these same educational errors tend to prolapsus uteri, but also that those very diseases themselves have a similar tendency. Every thing which lessens the energy of the female abdominal system, in any of its parts, favors prolapsus. Nothing has surprised me more, in my observa- tions upon society, (and few men have enjoyed better opportunities for making those observations than myself,) than the frequency of prolapsus, the last-mentioned disease. I have not often found it existing in single life, and yet I have met with occasional instances of the kind. And others give WHY PROLAPSUS IS FREQUENT. 243 the same reports, as the result of their observation and experience. I have read of one well-authen- ticated case, which occurred in a child only three years old. Were it even true that young women were al- ways to remain young women, it would still be necessary they should be informed of the nature, causes, and management of prolapsus. If only one in ten, or even one in twrenty, is to suffer, the causes of suffering and means of prevention should be fully pointed out to them. But much more than this is true ; for most young women expect one day to be old women; and, as Dr. Hamilton .has well said, of all the chronic diseases arising from a local cause, to which women in civilized society are liable, prolapsus uteri, or displacement of the womb, is perhaps the most frequent. I have said that the whole tendency of modern education is, directly or indirectly, to induce female disease, especially prolapsus. But perhaps it may be well to show, more particularly, why this is so. Although the structure, position, and circum- stances of the uterus are most admirably adapted to the free, and proper, and perfect discharge of all its offices when healthy, yet, in order to render it most efficient, it has been so arranged as to be some- what exposed to disease whenever the usual causes of ill health, whether general or local, come to be applied. 244 YOUNG WOMAN'S BOOK OF HEALTH. For, in the first place, it is suspended, as it were, in the cavity of the abdomen, by four ligaments, which, though naturally firm enough to hold it up, are yet easily extended ; and whenever they extend or yield, the uterus sinks down lower than is nat- ural in the pelvis. Then, secondly, the weight of the stomach and intestines adds to the downward impulse, especial- ly when overloaded, and sluggish in their action. And then, again, thirdly, the bladder, especially when not regularly and properly evacuated, lying in front and above it, has a tendency to crowd it downward, in a backward direction. And, finally, the overloaded rectum may, and does often, so press upon the parts, as to increase the same downward impulse. Under these circumstances, what is to be ex- pected by those who know any thing of the habits of civic life, and especially of female life ? What, indeed, but just what is seen and experienced — a world of female woe and suffering, and, of conse- quence, a world of physical deterioration ? For when females, as a race, are suffering, all are so, and must be so, inevitably. Is this an exaggerated representation ? My great- est fear is, not that I shall be convicted of exagger- ation, but of coming short of the truth. For think of the errors in the quantity and quality of our food, by means of which the bowels are distended PREMATURE DECLINE. 245 and overloaded, till their superincumbent weight is twice as great as it should be. And think, too, of the constipation which is so frequent, which adds to the weight. And, lastly, think of the neglect, every where, to keep the bladder and rectum duly evacuated. Is it, then, I ask once more, to be wondered at, that so many people, being already weakened in their reproductive function, should, whenever they are subjected to the abuses mentioned in the pre- ceding paragraph, become feeble, and sickly, and bedridden, and even, in a sense, superannuated ? It is said, that, owing to early abuses and the enervating tendency of the climate, in some parts of Asia, a woman in married life is old and wrin- kled at thirty. True, we are not told how much this premature old age is owing to disease ; but I have little doubt that it has much to do with it. But we need not go so far as Asia to find the same tendency. Men of observation, in certain parts of our own country, where the habits of life run counter to the laws of health in the greatest de- gree, gravely say that a man is as old now at forty- five, as he was formerly at sixty. And my own observation would go very far towards confirming the sentiment. But of one thing we may be sure, that one sex cannot suffer long in this way, and does not, without the other. Like causes must produce like effects upon both. 21* 246 YOUNG WOMAN'S BOOK OF HEALTH. But what is prolapsus uteri — that is, physiologi- cally ? For I find that very few, even of those who suffer from it, and who have been subjected to medical treatment, and have thus had opportunities to ask for information, are able to form any thing like a correct notion of its character. By prolapsus, then, we mean the falling or slid- ing down of the uterus, so that its mouth — the os tincae — is too near the outside of the body. Sometimes, indeed, it slides down so far as actually to protrude as large as a child's head. In such cases, the vagina, or passage to the uterus, is turned inside out. This, however, is not all. The internal organs that lie in the vicinity of the uterus, being thrown out of their respective places, also suffer much ; especially the bladder and the ovaria. For the bladder is drawn down along with the uterus, and sometimes so situated, that the patient is compelled to make use of a catheter. The Fallopian tubes and ovaria also will be dragged down in a similar manner. From what has been said of the weakness of the reproductive system in females, and of the causes which operate to produce it. may be readily in- ferred what might otherwise be repeated here, con- cerning the immediate or direct causes of prolapsus. The parts not only become weakened, but, by the pressure upon them, actually more thin and deli- cate than is natural. TREATMENT OF PROLAPSUS. 247 The parts which suffer most, however, in this way, are the muscles and other machinery, which constitute the floor of the pelvis. These, with the vagina, seem to yield to the superincumbent pres- sure, to an extent of which, beforehand, few could have any adequate idea. And these supports being gone, all is gone, so to speak; and nothing remains for the sufferer but a sea of troubles, from which she is seldom able to extricate herself. But we must come to the treatment of this dis- ease ; for whatever it is necessary to add concerning the causes and symptoms of prolapsus, may be presented in this connection. There are women who conceal this painful dis- ease for many years, and even reach a very consid- erable old age in spite of it. And there can be little doubt that if, from the first of its appearance, such a course were pursued as a wise physician might prescribe, the number of this class might be greatly increased. Owing, however, to ignorance, pride, fastidious- ness, morbid delicacy, carelessness, and reckless- ness, very few ever pursue this wise course. Or, if they pursue it a little way, they soon tire. People in general are unwilling to wait, where the process is slow. They look for immediate and large results. In regard to the power of nature to effect a cure, Dr. Morrill observes, " In slight cases of prolapse, 248 YOUNG WOMAN'S BOOK OF HEALTH. a method calculated to invigorate the general health would be far more likely to produce a cure than dependence upon a pessary." To which he sub- joins, in another place, the following remarks, which deserve to be written in letters of gold : — " Hence such patients should take exercise in the open air, live upon a nutritious diet, avoiding all depressing and injurious circumstances, disregard- ing, as much as possible, the annoying sensations proceeding from the prolapsus; and when the gen- ral health improves, the local disorder will grad- ually lessen, and finally disappear." It will be said, perhaps, that it is slight cases, alone, to which the above remarks apply. Admit- ted ; but are not most cases of prolapsus merely slight cases, at first? The true wisdom of the practitioner will be seen in his so managing them as to prevent their becoming any thing but slight cases. But will not some cases, it may be asked, form exceptions to the general rule above indicated, and run on to severe disease, requiring medical treat- ment ? Undoubtedly. But I have one more method of preventive treatment, which, it may be hoped, would restore a part, even of these. It has been found that young women, whether in wedlock or out of it, when afflicted with pro- lapsus which seemed to be incurable, have, by be- coming mothers, been entirely restored to health. TREATMENT IN EXTREME CASES. 249 In truth, it is even affirmed that some severe cases have been restored in this way. Now, in some one of these three ways I think prolapsus uteri ought to be, and may be, restored; I mean when the matter is attended to in proper season. Where it is neglected for a long course of years, no one ought to expect speedy recovery. Still less ought we to expect it, when the system has been injured by medicine. But when the uterus has descended so far as to begin to protrude, and there is much pain and dis- tress in the region of the pelvis, together with great difficulty in voiding the urine and faeces, a different course is to be pursued. What this course is, must depend, in no small degree, upon circum- stances. The patient must, as the first thing, take the re- cumbent position. This relieves, in a measure, the pain and distress, but does not remove the prolap- sus. In these circumstances, the appetite is apt to fail; the stomach and bowels to become flatulent, and perhaps acid; the mind becomes depressed, and life is almost a burden. Other circumstances there are which add greatly to the burden. These are, ulceration of the neck of the uterus, cancer, polypus, dropsy, marasmus, deformity of the pelvis, relaxation and descent of the vagina, stone in the bladder, &c. When matters have gone so far that the patient 250 YOUNG WOMAN'S BOOK OF HEALTH. is obliged to betake herself to a recumbent position, one thing is quite evident — that either her days of usefulness to others are at an end, or she must receive prompt and skilful attention. Two things may, and should be aimed at. First, to restore the uterus to its natural place and posi- tion. Secondly, to keep it there, till Nature can do her part. To restore the suffering organ to its place, the pelvis must be raised somewhat higher than the head, which will partly relax the muscles of the abdomen, and prepare the way for what remains to be done. This is neither more nor less than the restoration of the organ to its natural situation and condition. To keep it there, pessaries are used. These have their difficulties ; but if made right, and used prop- erly, are sometimes successful; though in a few instances, they prove a mere source of irritation. But in order to accomplish either of these great ends, medical aid must be called; so that I might have been dismissed, before I wrote the preceding paragraphs. My province of prevention is suffi- ciently broad, without invading that of cure. Be- sides, it is my steadfast conviction, as the reader may have seen, that, were we wise enough, pre- vention would, in nineteen of twenty cases, be entirely sufficient, and entirely and fully successful. Our medical books on this subject, even those STUDYING THE LAWS OF HEALTH. 251 which are intended for popular reading, are filled, so to speak, with directions about medicine, and the application of mechanical means of correction, especially pessaries. Why, I have now before me a small volume of the kind, which devotes no less than four or five pages to this part of the subject; while not more than half a page is occupied with remarks bearing on prevention. In this same work, moreover, — and this work is far enough from being alone, —I notice the recom- mendation of " wine and malt liquors," in order to give permanent strength. Now, this might have done better a hundred years ago, or even fifty. But to talk thus in eighteen hundred and fifty, is not only an outrage upon good sense, but an inhu- manity. I must once more insist on the importance of requiring every female to study anatomy and phys- iology, and, still more carefully, hygiene. Anatomy is the study of structure ; physiology, of functions; and hygiene, of relations. The latter might be made so comprehensive as to embrace enough of anatomy and physiology for female purposes. But how shall a work so desirable be accom- plished ? How is the young female to obtain in- struction so valuable? The works which are studied in our schools do not include those details which are most important. They are wholly omitted. Parents do not furnish it. Books for 252 YOUNG WOMAN'S BOOK OF HEALTH. females, beyond the elementary school book, either do not often furnish it, or, if they do, these details include so many hard names, and technical words and phrases, as render them almost unintelligible. And public lecturers on the subject, both male and female, in their anxiety to be esteemed learned and eloquent, sometimes shoot over the heads of those who most need the information they might other- wise communicate. This book, it is humbly hoped, may do some- thing towards preparing the way for such labors as the cause of health, and virtue, and happiness de- mands. May it fulfil its mission. May it be as a light shining in a dark place, till the more perfect day dawn upon us, and the sun of science — bright morning star to the sun of righteousness — rise upon us, with healing in his beams, to bring back to Eden the diseased and suffering nations. CHAPTER XXI. INVERSION OF THE UTERUS. Happily for human nature, uterine inversion is a rare disease ; for whenever it occurs, it is the cause of very great suffering. Prolapsus is bad enough, but inversion is much more dreadful. This disease differs entirely from prolapsus; for whereas the latter is a mere falling down of the uterus into the vagina, inversion is a turning of the organ inside out. At least, there is always a ten- dency to this condition. Indeed, there is every degree of the disease, from a mere indentation of the fundus, or upper part of the organ, to what is called complete inversion, or complete turning in- side out. I grant, as I have before done in regard to sev- eral other female diseases, that young women less frequently need instruction on that subject than women in conjugal life. And yet, for reasons already given under other heads, it is needful that something should be said. I will, however, be brief. Whenever you find any tendency to inversion, place yourself at once in a recumbent position; and, if possible, on the back. I say, if possible, 22 254 YOUNG WTOMAN'S BOOK OF HEALTH. because, owing to imperfect training, many indi- viduals, however healthy, cannot lie long in this position (some not five minutes) without great suffering. The next thing to be done is, to call for a physi- cian,— not a mere druggist, but a man of good common sense, as well as great practical skill, and sound science. What is wanted is not drugs or medicines, but judicious manual interference. And the sooner you have such aid, the better. Delays may be safe, but they are not so in general; and sometimes they are fatal. It would be entirely out of place for me to at- tempt to describe the duties of the physician in these troublesome cases ; indeed, of what service would it be ? Woman, as yet, is seldom so trained as to be equal to these trying exigencies. Besides, I am not writing for female physicians, were they ever so numerous; but for the multitude of those who know nothing at all, either of the human con- stitution, or of the nature and power of medicine. Medical writers, indeed, tell us that there have been many spontaneous recoveries in this disease, — some, even, where the inversion has been com- plete. But the latter are extremely rare ; and the former are not frequent enough to justify the entire neglect of professional counsel and aid. In regard to this disease, as well as many others, our great aim should, after all, be prevention. THE CAUSES OF INVERSION. 255 Abuses, at the period of parturition, once so com- mon, and even now more frequent than they should be, must be avoided. The light of science must shine upon the human mind, and dispel the more than pagan darkness, which, on this subject, yet hangs over it. Errors at childbirth have been the cause of end- less mischiefs in society. Thousands of children, and not a few mothers, perish as the consequence. And still greater numbers are, on the same account, born into the world, and carried through it, weakly and miserable. The disease is more terrible still, if possible, when complicated with polypus. But on this sub- ject, I may have occasion to say something in an- other place. There are also other complications to be dreaded, but less so than that which I have mentioned. Were young women trained according to law,— physical and moral law both, —and were they treated according to law in parturition, as well as under all other diseases, not three generations would pass away, before inversion of the uterus would be as rare as it was a century ago. In truth, if there be a panacea for female ills, it is correct female education and management. CHAPTER XXII. RETROVERSION AND ANTEVERSION. Retroversion of the uterus is the displacement of the organ in a particular manner, so that the upper and larger end is behind the smaller and lower portion. In other words, it is a displacement backwards ; and hence the term retroversion. The upper part, or fundus, becomes lodged in the hollow of the sacrum, while the lower part, or mouth, is thrown upward and forward, and brought behind the symphysis pubis. Anteversion is exactly the reverse of retrover- sion. The fundus falls forward, behind the sym- physis pubis, while the mouth is towards the sa- crum. Retroversion is the most frequent, but is seldom found in young women. Anteversion, on the contrary, though less frequent, is chiefly con- fined to the young and unimpregnated. The principal cause of displacements, of either of these kinds, is a natural or acquired feebleness of the uterus and its appendages, which leaves it somewhat loose and unconfined in the pelvic cav- ity. There are, however, numerous other causes of trouble of this sort, such as an unnatural curva- ture of the sacrum, amounting to deformity, and AN ERROR IN EDUCATION. 257 the pressure of the bowels upon the sides or the fundus of the uterus. In these circumstances, other causes may, and do often, excite the disease, so as to bring it on in a moment. The most frequent of these is an over- distention of the uterus. Yet nothing is more common. I have spoken of errors of education. One mon- strous error bears upon the point before us. Young women, from over-delicacy, induced by a band- box education, often neglect those natural calls of the system, which it is of immense importance should be promptly obeyed. The more this is done, the more it may be; till at length the laws of the system pointing in this direction, come to be violated with impunity. The results of this form of habitual transgres- sion are dreadful. The bladder loses its integrity, and, instead of giving warning, as it formerly did, yields to the superincumbent pressure, till it becomes very greatly distended. True it is, that displacement of the uterus does not always follow in train, on these occasions; but there is always great danger. Suppose, for example, a person with distended bladder should jump from the step of a carriage, or from a chaise, or trip and fall on the pavement, or even laugh violently, or sneeze, or cough. The uterus, in these circumstances, being thrown back- 22* 258 YOUNG WOMAN'S BOOK OF HEALTH. ward by the distended bladder, may be suddenly pushed under the promontory, as it is called, of the sacrum ; and thus we have retroversion. It may indeed happen, that if the person be young, and comparatively vigorous, and the bladder be immediately emptied, the uterus may become spontaneously elevated to its natural position, and the sufferer may be immediately relieved. But in case of polypus, or pregnancy, or any thing which gives unnatural weight to this organ, Nature will probably be unsuccessful in her efforts. It is even said that sudden and violent vomiting, in circumstances like those above mentioned, may occasion retroversion. But such results are cer- tainly very rare. Indeed, I have never seen a single case of the kind. Nor have I known a case of retroversion from mere effort to expel the fasces or the urine; although such cases are mentioned by writers, as though they were of frequent occur- rence. When this serious disease occurs, or is even strongly suspected, no time should be lost in pro- curing that medical or surgical aid, on which we are accustomed to rely. This injunction will, of course, preclude the necessity of further direction, in a work like this. But the medical aid should not be long delayed. I will only add, here, that the great object of every wise medical man or woman, in such cases, TREATMENT. 259 will be to replace the suffering organ, in the gen- tlest, though most expeditious manner which is compatible with entire safety. The patient should, in the mean time, keep as quiet as possible ; for this very quiet, and a recumbent posture, may do much towards effecting a cure. CHAPTER XXIII. HEMORRHOIDS, OR PILES, AND PROLAPSUS OF THE RECTUM. Hemorrhoids, in both sexes, is become one of the most frequent, not to say troublesome, diseases of our country. It is, however, to females, of course, and to the young woman in particular, that my remarks on this subject will be addressed. Hemorrhoids often exist in connection with pro- lapsus of the rectum, though they are occasionally met with as the result of other causes. In order, therefore, to a full understanding of the case, it is necessary to say, that, by prolapsus of the rectum, I mean both a falling down of the mucous mem- brane alone, and a falling down of the rectum. Either is sufficient to produce hemorrhoids, or piles, which are little tumors or excrescences, that arise about the edge of this protruded rectum. They are of two kinds, viz., blind and bleeding. When they are mere tumors, and do not discharge at all, they are called blind piles ; but when, upon straining, or without it, they discharge more or less of blood, they are called bleeding piles. They are external or internal, according to circumstances. These affections not only coexist, as I have be- DEFINITION OF TERMS. 261 fore said, but they often run into each other. Pro- lapsus of the rectum is most common in the begin- ning and towards the end of life, while piles occur at every age, but are much more common with females than with males. When I say that prolapsus is most frequent in early life, and near its termination, I feel impelled to announce a fact which, to some, may be not a little startling. It is, that the beginning and end of life, though evidently designed by the Creator to be several hundred years apart, have been, by long-continued transgression, through successive and numerous generations, brought very near to- gether. Or, if this is saying too much, we may at least affirm, that the beginning of life and the com- mencement of its decline approximate very closely. Thousands among us, who might once have kept old age at a distance, at least till the climacterical period of sixty-three, now begin to be old at least by forty-five or forty-eight. So that, when we speak of old age as liable to this or that disease, we must remember that old age now is not what old age was four thousand years ago, or even four hundred. If you ask the causes, I must refer you to the errors in education, to which I have so freely al- luded in Chapter II., and indirectly in Chapter III. They are found in the numerous early and later transgressions of divine law, physical, intellectual, 262 YOUNG WOMAN'S BOOK OF HEALTH. social, and moral, — but especially the former,— with which we begin and end our lives, and with which our earth is, as it were, filled. But I will here add one item to the long list of errors in education to which I have just referred. I have indeed spoken of some of the evils of com- plicated or made dishes, and have mentioned a lienteric condition of the alimentary canal, which extensively prevails. But I have not dwelt, at least with much emphasis, on another condition of the alimentary canal, which, if Broussais, and Beaumont, and a score of physiologists, are correct, is a source, indirectly, of much severe and fatal disease, as well as of much suffering which falls short of it. This canal is about thirty feet in length. Of this whole extent, four fifths, or about twenty-four feet, are affected, or perhaps I should say concerned, in the digestive process. Now, such are our habits in civic life, that a vast majority of our race who have arrived at adult years, have the lining or mu- cous membrane of these twenty-four feet in a state of irritation, or, as physicians would say, of sub- inflammation, for the rest of their whole lives. If the experiment could be made, without dan- ger to life and health, of laying open this whole portion of the alimentary canal, I have not a doubt that the reddened, angry, sub-inflamed appearance, in t.hie great mass of mankind, would strike every CAUSES OF HEMORRHOIDS. 263 beholder with surprise. He would not wonder that so much bowel disease exists among us; nor that it is so severe; nor that medicine, when given, has so little effect, and, in too many cases, falls in with and aggravates the disease. Nor need he wonder, if he rightly understood the laws of sympathy, that piles, under these cir- cumstances, become so frequent, troublesome, and permanent. A recovery, while the alimentary canal remains in this condition, could hardly be expected, or even hoped for. They who have followed me through the last three or four paragraphs, will not wonder at all when they find the following list of causes which predispose to or excite the disease, as laid down by a modern medical writer. The predisposing causes of hemorrhoids, he says, "are a sedentary and luxurious life, producing general plethora and a costive habit,"—involving, without doubt, that sub-inflamed condition of things which I have just mentioned, — "habitual consti- pation, drastic purgatives, frequent pregnancies, and difficult labors ; obstructions in the liver, or venous circulation ; a lymphatic temperament; masturba- tion, and general debility from any cause. The exciting causes are the accumulation of fasces in the colon and rectum; the determination of blood to the rectum, from the operation of powerful ca- thartics ; straining, at stool; from constipation, and long-continued dysentery," 264 YOUNG WOMAN'S BOOK OF HEALTH. In pursuing our reasonings upon the causes of this harassing complaint, and in recurring to files of statistics, and other papers, I find the following thoughts, from a source which I cannot now as- certain, which seem as just as they are pertinent. " When we reflect that, in an ordinary state of health, we consume, each day, an amount of food that we know, from occasional intervals in which the bowels perform their proper functions, should yield, without effort, five or six times the quantity of the customary discharge, the immense conse- quence of a sufficient daily evacuation of the bow- els is too plain for us to view its constant deficiency without alarm. " It is true we observe many persons, who seem to enjoy a pretty fair state of health, who never have more than two or three evacuations a week; yet a critical investigation would show a very dif- ferent state than that of health in such individuals. A fevered tongue, an aching head, and inability for active bodily or intellectual effort, is an almost in- variable attendant on this state ; and its next result will, almost to a certainty, be either piles, a perma- nent weakness, or falling of the rectum, or an ab- scess, with a fistulous opening at its side. " Anatomy informs us that the length of the in- testinal tube is nearly six times that of the entire body; and that four fifths of it are appropriated to the reception from the stomach of the nutritious RESULTS OF QUACKERY. 265 parts of the food, and the bile ; while the lower fifth, ending in the rectum, is designed to contain the waste parts, or that which is to be thrown out of the body.* " The general character of our diet, and experi- ence, are such as to assure us that at least one quar- ter of the food we swallow is excrementitious, or intended by nature to be evacuated from the system. The experience of persons who are habitually con- stipated, proves that no such amount, or indeed any approach to it, is ordinarily discharged. " What, then, becomes of it ? There can be no question that it is reabsorbed into the system ; for there are a sufficient number of absorbents opening into the'lower intestine, to effect this mischief, if the bowels remain long unmoved. It is unneces- sary for us to point out the injurious effects of this poisoning the blood with a substance so different from that pure fluid found in the upper tract of the intestines. " Is it wonderful that designing and knavish in- dividuals should avail themselves of the indolence of the half-enlightened and physic-consuming class * A later and highly popular physiological doctrine is, that the faces, in a healthy state, should be secreted from the impure blood of the lower intestines; and that if our food were right, there should be very little of what I have here called the waste parts of our- food. But the course of reasoning I have pursued will be found correct, whether we adopt the new or the old theorv 23 266 YOUNG WOMAN'S BOOK OF HEALTH. of society; those who, having a mere suspicion of the truths they occasionally hear from physicians, and from partial observation of their own systems, dare not entirely neglect this most important func- tion, but console themselves by taking enormous quantities of quack pills ? "These pills are all made of stimulating sub- stances, which act by forcing the intestines to throw out from their surfaces so large a quantity of the serum, or watery part of the blood, as to liquefy the hard contents of the bowels. By the excessive irritation they cause the whole nervous system of the bowels, they force them to contract, and throw off their contents, leaving the whole tract in a partial, and, eventually, in a state of per- manent inactivity." Nowhere have I seen any thing which better exposes the dangers of quackery. In general, nine tenths of the medicine which is~ taken, especially by females, including, of course, their tea and cof- fee, while it has the effect to relieve present suffer- ing from fatigue, or partial derangement of the nervous, or some other function, only aggravates, in the end, the very troubles it temporarily obviates. But we must come to treatment. Here the first thing, as in all other chronic cases of disease, is to adopt a system of hygiene ; or, in other words, to put ourselves under law. Without this, no course of medical treatment will succeed perfectly; with PUTTING OURSELVES UNDER LAW. 267 it, almost any system, judiciously administered, and patiently persevered in, will seem to afford relief. At least, it will not seriously interrupt the efforts of Nature to effect a partial or complete cure. What, then, is that system of law, or hygiene, to which I would fain direct your attention ? What, in other words, — to bring ourselves directly to the question before us, — shall be done to obviate the evil tendency, and, if possible, utterly remove piles from the human system? The answer is already given. It may be found in the very nature of the case, as may the treat- ment of every other disease. The causes are to be avoided, and their tendency counteracted by that course of conduct which is more than intimat- ed in Chapters II. and III. The causes of the disease will be found described on the preceding pages. By recurring to the causes of piles, and also to the general system of hygiene, in Chapter III., it will not be difficult to see that constipation is at the foundation of this disease ; but that this constipa- tion, too, has its sources in debility and derange- ment of the bowels, induced by other and numer- ous transgressions. And yet plain as all this is, — I mean that what we are to meet, in order to put ourselves under law, is constipation and its causes,—a great many 268 YOUNG WOMAN'S BOOK OF HEALTH. mistakes are made by those who, being suddenly convicted of duty, have been in so much haste that their change of habits has been in advance of their knowledge. Hence, in avoiding one rock of error, they often run upon another. For example, with all the horrors which, in their awakened condition, a constipated state of the system presents to them, they fly to purgatives. Not, indeed, the most drastic ones, — for of these they have a general fear, — but to the milder sort — some family pill, made up, perhaps, of conserve of roses, senna, and aloes. Or, whatever may be the mildness of its main constituents, aloes must come in for a basis ! Now, aloes, though sure, leaves the bowels a little worse than it found them, in more than one partic- ular. Perhaps the individual finds it out, in pro- cess of time, and resorts to something else, as Warner's or Hopkins's Elixir. Still, the powers of Nature are not at all improved. In truth, although the person may have experienced temporary relief, Nature is more embarrassed in her operations, not to say more crippled, than before. By the advice of somebody, or, perhaps, by get- ting a deeper insight into law, she is led to another change. Medicine, properly so called, is abandoned, and coarse bread, either with or without molasses, is freely used. Baked fruit, too, is added, or per- haps fruit uncooked. A POPULAR MISTAKE. 269 Elated with the success of this new method, things go well again for some time, probably for months, possibly for years. Still, all is not quite right. There is action enough, it may be ; but ten to one there is heartburn, or other indications of acidity. Unless too large a proportion of the coarse food is used, and the quantity is increased, the disease is liable to return. Where, now, is the error? Is it in the coarse- ness of the food itself? Is it in omitting medicine entirely ? Not at all. The error lies in reforming only one habit. It consists in putting ourselves under one law only. The law of exercise has not been duly attended to. Instead of using the muscles more than before, they have probably been used less. As if a strict regard to one rule of hygiene would atone for a multitude of other transgressions ! As if, a proper diet being adhered to, we may sit still all day long! This will never do. I mean to say that is not to place ourselves, in the fullest sense of the term, under law. We must not only conform to all the laws of digestion, but to those, also, of exercise and rest. The laws of respiration, too, in their place, must be remembered. For, strange as it may possibly seem to those who have never thought on this subject, pure air is necessary to the best condi- tion of even the stomach and bowels. In short, — for I repeat that it maybe remembered, 23* 270 YOUNG WOMAN'S BOOK OF HEALTH. — they who would get entirely wrell of the trouble- some complaint whose name stands at the head of this chapter, must learn and obey all known law, and abandon forever all confidence in nostrums, or even legitimate medicine. They must at least have abundant and ever-varying exercise.* But if this is so, how greatly are the public mis- taken, and even misguided! For, though piles are very frequent, — almost universal, — there are hardly more cases of the disease than there are medicines to cure it. Even some of our wisest teachers, as they would fain believe themselves, at the end of a course of lectures on anatomy, phys- iology, and hygiene, during which they have lev- elled much of their dread artillery at medicine and physicians, in some moment and place of supposed seclusion, recommend their medicine for piles, and not only recommend, but vend it. I have represented piles as not likely to be benefited by the use of medicine. And yet some- thing may be done at times in the way of manual interference. When there is protrusion of the rec- tum, the tumor may be gently and gradually re- moved, by compression with the thumbs. They * Some attention must be paid to the kind of exercise which is taken. Thus walking will sometimes increase the prolapsus of the bowel; and whatever tends to cause protrusion of the bowel increases the hemorrhoids. Prolonged exercise, of any kind, is by no means desirable. HARSH PURGATIVES EXPOSED. 271 should, however, be well oiled in the first place. And where there is much swelling and inflamma- tion of the protruded part, cold poultices may be used; or if these should give pain, we may try fomentations, with a decoction of poppies, or even bread and milk poultices. At other times, and to prevent a recurrence of the prolapsus, cloths wet in a cool decoction of oak bark, or in a solution of alum, may, by their astrin- gency, be of some service. In general, however, they will be of little use, except temporarily. The food should be cooling and opening, and should, in general, be coarse and simple. Much is said by authors of the importance of keeping the bowels open; but I must dissent from one common mode of doing this. For if I could permit a free use of Ward's Paste, or some similar electuary, I certainly could not subscribe to the doc- trine that rhubarb, or rhubarb and aloes, are the proper substances to be used. On the contrary, they seem to me the very worst which could be applied. They are, indeed, slow and sure; but then they are irritating and heating. The nearer the medicine used for laxative pur- poses, in these cases, approaches to the character of that residuum of our food which, after the action of the bile and pancreatic juice upon it, be- comes nature's own physic, the better, in the end, for health. It is in this belief, that so many have 272 YOUNG WOMAN'S BOOK OF HEALTH. used pills from the dried gall of the ox, or of some other domestic animal. These, however, often nauseate. A due regard to diet and drink will often succeed far better; and the results, when favorable, are always more permanent. Before I close this article, I must enter my pro- test against food of every kind made of fine flour, and eaten almost as soon as it is taken from the oven. The great majority of mankind are ex- tremely fond of this strange, unnatural, and un- wholesome food; but consumptive and scrofu-' lous persons, together with those who suffer from piles, are peculiarly so. When I have witnessed the suffering which arises from this error, I have often involuntarily wished, that no meal, of any kind, might ever again be bolted, at least for hu- man use. But there is another kind of bolting, little if at all less injurious to female health, and, in truth, to the health of both sexes, than that which I have already mentioned. I allude to the custom of our hasty New England people of bolting their food into the stomach. Proper mastication is of im- mense importance to all; but to those who have disease in the lower portion of the abdomen, espe- cially disease of the rectum, it is indispensable. CHAPTER XXIV. UTERINE DROPSY. Uterine dropsy is not very common among sin- gle women, and yet it is occasionally found. It is most frequent with married women of middle age, especially during gestation. The quantity of water which collects in the ab- domen, in these cases, is sometimes very great. The statements of authors on this subject seem almost incredible. More than twenty gallons have been reported. Why the mouth and neck of the uterus should close, so as to prevent the water which collects in this cavity from escaping, is not easily ascertained. Indeed, it usually happens that for a time, at least, the superincumbent weight actually forces a pas- sage, and the dropsy is spontaneously removed. In other cases, however, it continues to increase, till the frightful results are experienced which have been mentioned in the preceding paragraph. The causes of this disease are somewhat obscure ; especially the predisposing causes. In general, we may say, however, that the main predisposing cause is constitutional debility. Or perhaps it would be 274 YOUNG WOMAN'S BOOK OF HEALTH. more correct to say it is a debility of the absorbents of the lining membrane of the uterus. The secer- nents — the vessels which furnish the natural, healthful supply of fluid to lubricate this surface, — perform their office properly enough, but the absorbents do not take it away as fast as they should ; and hence, the balance of action being destroyed, there is an undue accumulation. It is not very difficult to distinguish between this disease and pregnancy, polypus, &c. ; and yet, as mistakes might here and there occur, wise medical counsel should be sought and heeded. For when the uterine cavity becomes loaded with the enor- mous quantity of from twenty to thirty gallons of watery fluid, and no spontaneous change occurs to afford relief, the uterus may be ruptured from mere weight, and speedy death close the scene. All that the laws of health, duly enforced and obeyed, can accomplish, should be put in requisi- tion. The vigor of the constitution should be kept up, and, if possible, increased. Proper ex- ercise in the open air is of great service. Yet, for obvious reasons, this exercise should be as pas- sive as possible. A very easy carriage, a canal- boat, or vessel, or a railroad car, will be preferable to those exercises which are more violent. We may find, in some of the books on this sub- ject, encouragement to the patient to throw herself, if she can, into a fit of sneezing, coughing, or even A CAUTION. 275 vomiting. This may sometimes succeed, no doubt; but when the uterus is greatly distended, it might also be a means of sudden rupture, with all its deplorable consequences. CHAPTER XXV. MOLES AND HYDATIDS. Moles are loose, floating, shapeless masses, lying in the uterus, or, from time to time, making their exit from that cavity. If they are discharged within too or three months, they seldom bear the slightest appearance of organization ; but if longer detained, they become fibrous or fleshy, and are more or less organized. In the former case, they are moles, simply ; in the latter case, they are called fleshy moles. One fruitful source of moles is blighted or false conceptions. The vitality of the foetus having by some means been destroyed, it becomes, in reality, a foreign body, and as such should be expelled. Every thing which concerns shape and form has been lost by absorption and otherwise. Another species of mole has its origin in hyda- tids. These vary in size, from small globules, which the naked eye can hardly discover, to sub- stances as large as a small bird's egg. They some- what resemble a cluster of grapes on the stem, and are, at times, exceedingly numerous. They are not, however, always round like a grape, but occa- sionally oval or elliptical. TREATMENT FOR MOLES, &c. 277 The causes of these moles and hydatids, espe- cially the latter, are very obscure. Hydatids were, indeed, once believed to be living animals ; but even this theory, had it not long ago been given up, would not explain the matter. We should still be ignorant of the whys and wherefores in the case. As to moles, I repeat, there is reason to believe they are the result of conception, and a degree, greater or less, of foetal progress. I have stated already that they sometimes remain in the uterus several months before expulsion. But the hydatid is re- tained, in a few instances, as many years. At first, for a few months, the symptoms very closely resemble those of pregnancy. The wise medical man, however, will ere long be able to make a distinction. But the distinction is of little practical importance. Wherever nature is not tam- pered or interfered with, the mole will be expelled before the general health materially suffers. Much is said by authors about the treatment in the case of moles. And yet there is little to do except to wait patiently the slow but due efforts of nature. Or if, in a few instances, the health begins to sink under it, judicious counsel should be prompt- ly sought and faithfully heeded. And here suffer me to protest against the custom of heeding the fears and following the counsels of the ignorant. The remark will indeed apply to 24 278 YOUNG WOMAN'S BOOK OF HEALTH. other diseases as well as that under consideration. It is not in human nature to avoid a degree of anxiety in these cases ; and yet over-anxiety is productive of serious and lasting evil. Over-anxiety and fear cause an undue contraction and shrinking of the skin, which is far enough from being favorable to health. For when the skin is shrivelled, the effete or waste matter which ought to be eliminated from the system, to purify and to cleanse it, is retained to clog and poison it. All persons, therefore, during natural gestation, — and equally so when moles, or hydatids, or dropsy, exists, — need consolation and encourage- ment, and faith and hope. Every thing which tends to depress or discourage should be studiously avoided. There should not be too great a solicitude about the rightful medicine to be taken. When new and strange feelings arise, the ever-busy, ever-anxious mind is apt to raise the inquiry, What shall be done ? And if, as sometimes happens, it is uttered loud enough to be heard, there are enough ready to respond, and that immediately. Were the physician to be consulted, he would say, Use more gentle exercise ; or encourage cheer- fulness ; or keep the skin of an equal temperature. He would not, in one case of five, say a word about medicine. For after his long and ample experi- ence, he is apt, in such cases as these, to doubt its efficacy. PRETENDERS AND CROAKERS. 279 But there is ever a class of bystanders — or, if not always standing by, they are apt to be on hand rather frequently — who will tell their thousand and one stories about individuals who have been just like the person before them ; and how they took such or such a medicine, and what a wondrous effect it had on their system. They know exactly what ails the patient, and can suggest the very medicine needed, and the only one that will cer- tainly cure. They know nothing at all of the true nature of medicine, or of the human constitution, in health or sickness; and yet, in their own esti- mation, they are wiser than seven men — or even seven hundred — that can render a reason. Science -— medical science among the rest — is modest, sometimes diffident. She wishes to con- sider well the case before she prescribes, and would gladly ask a hundred questions. But the fool, who knows just nothing at all in the case, hardly wishes to ask a single question. Ignorance is as bold, as assuming, and as presumptuous, as science is modest and scrupulous. Shun, then, as you would the plague or the cholera, these pretenders to knowledge on the one hand, and on the other those ignorant croakers who only foretell evil and suffering. If you must seek counsel, endeavor to seek that counsel which science, and experience, and long and patient ob- servation alone can afford. CHAPTER XXVI. UTERINE POLYPUS. Polypus, whether in one cavity or another of the human body, is a serious disease. In the nose it gives rise, in both sexes, to great and often pro- longed suffering. It is, however, with polypus of the uterus alone, that I have to treat in this chapter. By the term polypus, then, is here meant a fleshy tumor growing from the inside of the uterus. It is usually pear-shaped, but sometimes oval. In size and color, no less than in shape, it varies greatly. Sometimes it is reddish, at others brown. It is fre- quently found no larger than a pea; but, in general, when once it has an existence, it proceeds from step to step, till its size becomes considerable, and not only fills the cavity of the uterus, but actually pro- trudes into the vagina. Its manner of attachment to the inner walls of the uterus is by means of a root or pedicle ; though sometimes a polypus of long standing has two or three roots. They may be found adhering to any part of the uterus. Veins are occasionally seen on their surface ; but, in general, they are very poorly supplied with blood-vessels, either externally or internally ; and their surface is smooth. SYMPTOMS OF POLYPUS. 281 The earliest symptom of this disease consists in a species of leucorrhea, varying much in character and quantity, but often purulent. But this symp- tom, so equivocal, is sooner or later followed by a bloody discharge —not at particular seasons, but on any and every occasion where blood is determined to the uterus. This last symptom should always awaken suspicion. But the symptoms which follow are still more alarming and certain. In the language of Dr. Mor- rill, " the appetite becomes impaired, the bowels relaxed, and dropsy of the extremities occurs. The blood may be discharged in a fluid state or in clots, some of them being actual moulds of the polypus ; it may also be retained till it becomes putrid. It would seem that small polypi bleed quite as profusely as larger ones. These symptoms are liable to be mistaken for those of simple leucor- rhea or menorrhagia. " As the polypus increases, the symptoms become aggravated. Menstruation is very uncertain, as re- gards time and quantity. There are weight, drag- ging sensations and pain in the back and loins ; vomiting, with an increase of the dyspeptic symp- toms ; and, finally, great debility. The patient may sink under the continued discharge, unless the bearing down pains that occur break the stalk and expel the polypus, which sometimes happens — when the symptoms abate. When the tumor is 24* 282 YOUNG WOMAN'S BOOK OF HEALTH. large, there is pressure on the bladder or rectum, producing dysuria and tenesmus." I have been thus particular in the description of this serious disease, because, though not usual in very early life, it is as liable to attack the single as the married. Besides, it is necessary that both the married and the single should understand its char- acter and danger, and be able, if possible, to dis- tinguish it from other diseases. Whenever polypus of the uterus is suspected strongly, there should be a careful examination. The treatment required is so different from that which is required in pregnancy, prolapsus, inversion, cancer, cauliflower excrescence, and hernia of the bladder and vagina, that wise counsel should be immediately solicited, and every examination, which the nature of the case requires, actually submitted to. Most happily the weight of the polypus often detaches it, and this without dangerous hemorrhage. More happily still, the disease is not very frequent in those who are wise and temperate, and who inherit a good constitution. A case of polypus is not found, according to my own observation, in one of a thousand persons. Still, it should be known that the disease exists, and requires wise, and careful, and strictly scientific treatment. In order to know how to treat this formidable disease, or rather to prevent it, (since treatment, CAUSES OF POLYPUS. 283 properly so called, belongs to the province of the physician,) it is necessary that young women should, in the first place, know its more frequent causes. According to the best authors, these are, 1. Leucorrhea. 2. A scrofulous or lymphatic temperament. 3. Celibacy. 4. Abortion. 5. Bar- renness. 6. Sedentary employments. And, as in part the result or consequence of the latter, 7. Con- stipation, or costiveness. Age is also mentioned by some as having its influence, — polypus being most frequent between the ages of thirty and fifty. These, I say, are among the causes most com- monly mentioned as predisposing to this disease. But it is not to be denied that the whole subject, both of predisposing and exciting causes of poly- pus, is involved in obscurity. Abusus coitus, for example, is often set down among the exciting causes, and so is injury during parturition ; yet they are but doubtful causes, after all, since the unmarried are universally admitted to be as liable to the disease as the married. Or, if they are ad- mitted to be frequent causes, they are only as one or two among many. I should like to dwell a little on the medical treatment of this disease, and describe the most efficient modes of cure. Such description, while it would gratify curiosity, would not be without other uses. I might speak of torsion, or twisting off these excrescences; and of expelling by the 284 YOUNG WOMAN'S BOOK OF HEALTH. ligature, and by excision; of which modes, the latter two are undoubtedly the most common and most successful. But I may not do so. It would fill that space in a work whose size must be lim- ited, which is wanted more for other purposes. I will only add, that in case of suffering from polypus, the patient should have nutritious food; not of necessity high seasoned, or even animal food ; nor yet tonics, properly so called ; nor, above all, wine and brandy. And yet the medical books talk of all these. Good bread, of various kinds and suitable age, and good fruits, with rice, milk, sago, tapioca, and arrowroot, and plain water for drink, are among the best and most nutritious arti- cles of diet for these, as well as many other inva- lids. If they do not enable Nature to expel the offending substances, they will greatly aid her in bearing her heavy burden. CHAPTER XXVII. FIBROUS UTERINE TUMORS. The term " fibrous tumors of the uterus" is ap- plied to a kind of lump or swelling, which, while it does not ulcerate, nor become cancerous, nor, if let alone, cause death, is yet, from its mechanical effects, quite inconvenient. It has some resem- blance to polypus, and yet is, in a few particulars, essentially different from it. In the first place, polypus always has one or more roots or pedicles, while the fibrous tumor has none. Secondly, polypus, as we have seen, is seldom, if ever, round, but pear shaped or elongated; while the fibrous tumor is, for the most part, globular. Thirdly, the latter seems more deeply imbedded than the former in the uterine membranes. But there is another and still more striking dif- ference. The tumors we are considering frequently contain bony or earthy matter in their substance, which, I believe, is never the case with polypi. Indeed, their general arrangement, composition, and color, are as entirely unlike as if they had no natural affinity. Like the polypus, however, they are found of almost all sizes. Some are not larger than a pea, 286 YOUNG WOMAN'S BOOK OF HEALTH. while others have been known to attain to the size of a child's head. Occasionally, as we are even told, they are found to weigh thirty or forty pounds. The causes of these tumors, both predisposing and exciting, so far as understood, are essentially the same as those of polypi. The symptoms, however, many of them, differ. They are, more- over, of slower growth than polypi, as well as less dangerous. The treatment is much more different than the symptoms. The polypus is often cured, as we have seen, by extirpation, — the fibrous tumor, never. The treatment should be palliative. Nutri- tious, yet plain living ; a quiet, yet cheerful mind ; the influence of elevating, rather than depressing passions ; — these are the principal means within our power for retarding the progress of the disease, or preventing an unfavorable termination. CHAPTER XXVIII. CAULIFLOWER EXCRESCENCE OF THE UTERUS. This is a disease of the mouth of the uterus, externally. It may affect the whole circumference of this orifice, or a part only. Sometimes, though very rarely, it is found in the lining membrane of this organ. Cauliflower excrescence is said to affect females of all ages, temperaments, and conditions of life. I do not know that married life is more exposed to it than celibacy. Perhaps, however, it may justly be said to be a little more frequently grafted upon a nervous temperament than upon any other, espe- cially where there is a scrofulous tendency. Its causes, like those of several female complaints we have noticed, are obscure. Whatever induces a cachectic habit of body, as the books term it, — that is, a state of the system which renders it ex- ceedingly frail — hardly able to hold itself together, — must certainly be a predisposing cause. Some- times, moreover, it is believed to be inherited. Cauliflower excrescence is of a bright flesh color, with a smooth surface, every where abounding with vessels. Amid these vessels, moreover, are numerous small projections, or papilla* The struc- 288 YOUNG WOMAN'S BOOK OF 'HEALTH. ture is somewhat granulated and soft, but is predis- posed to bleed. The first symptom of the disease, which is no- { ticeable, is the copious discharge, from time to time, of a watery fluid, which is soon discovered to be mixed with blood, and to produce a most distressing and unaccountable exhaustion. The mouth of the uterus becomes also exceedingly ten- der and susceptible. It is not at all difficult to distinguish the disease from polypus, and, indeed, from nearly every other disease. In none of these last is there such a con- stant liability to pour forth water, or water and blood, or blood alone, as in the case of cauliflower excrescence. In none of them, moreover, is there so much liability to derangement of the stomach and bowels, and to vomiting. The tumor varies in size, from that of a chestnut to that of a small melon, and it sometimes even protrudes from the body. It may be extirpated, and has been; nor is the excision attended with much danger. The worst difficulty about it is, that it is liable to grow again. And yet our hope of entire cure rests on this operation.. If this does not succeed, vain is our hope from the medical and surgical art. The pa- tient may recover ;* but recovery is hardly to be expected. But we need not despair of palliation, if we TREATMENT AND MANAGEMENT. 289 cannot hope for cure. Life may be prolonged, and even made comfortable. Some have even gone on to a tolerable old age ; and their latter days, not- withstanding their disease, have proved, both to themselves and others, their best days. They who learn, by their sufferings, to obey not only moral but physical law, — who find that this frame is not only fearfully and wonderfully made, but fearfully and wonderfully preserved, —may al- most congratulate themselves and thank God that they have been afflicted. But to obey the laws of God, as applicable to their own case and circumstances, they must avoid all mental, moral, or physical excitement as much as possible. They must even live, as medical au- thors would say, absque marito. - The diet, though nutritious, must be mild and unstimulating. The bowels must be kept open and free — not by acrid purgatives, but by other and gentler means ; that is, by proper exercise and a due regulation of the diet. As much time as circumstances and the laws of health will permit should be spent in a recumbent posture. The blood should not be driven too largely either to the sexual organs or the head. Locally, something may be done by cold sponging, by the douche or dash, and by astringent injections. I shall have occasion hereafter to speak of Dr. 25 290 YOUNG WOMAN'S BOOK OF HEALTH. Lambe's treatment of cancer. The same treatment may be applicable here, and would save, I doubt not, quite as many lives, in the case of cauliflower excrescence, as in the case of cancer. CHAPTER XXIX. CANCER OF THE UTERUS. This disease is one of the most fearful to which humanity is subject. It is, moreover, as fearful to single women —though not to very young women — as to those in married life ; nay, much more so. It attacks, usually, the glands of the neck of the uterus, beginning by a hard, morbid deposit in them, which is followed, in time, by a softening of the gland, and by ulceration in the centre. The most dangerous period of life, with respect to uterine cancer, is about the age of forty-five, or that of the cessation of the menstrual discharge. Cancer of the uterus is commonly described in two stages : first, the scirrhous, or hard stage j secondly, the ulcerated, or cancerous stage. The scirrhous stage may be distinguished by its low grade of action. The diseased part is pale, as well as hard, and as cold and insensible as it is pale. There is an almost entire absence of red vessels. It is of a light gray color externally, but, when sliced thinly, almost transparent. In the cancerous state, properly so called, the gland, having softened centrally, becomes a slow, unhealthy ulcer. True, it does not now increase 292 YOUNG WOMAN'S BOOK OF HEALTH. in size ; for the discharge seems to keep down the swelling. But then this discharge itself is fright- ful, as it shows, beyond the possibility of doubt, that the disease is not within the reach of remedy. Besides, the cancerous condition soon extends to other parts, especially the glands of the groin and the pelvis ; nay, even, in some instances, to the vagina, bladder, rectum, ovaria, and Fallopian tubes. The first symptoms of a true scirrhus are a de- gree of irregularity about the menses, accompanied by leucorrhea. There is also a sensation of bear- ing or dragging down, as well as of compression, together with pain during the expulsion of the faeces and urine ; to which sensations are some- times added acute pains in the breasts and in dif- ferent parts of the body, with many singular nervous sensations, and sometimes all those strange longings and aversions which often accompany pregnancy. The concurrence of all these symptoms — to which might be added a few which are peculiar to the conjugal relation — should ever lead us to sus- pect the approach of dangerous if not fatal disease ; and no time should be lost in doing all in our power to arrest its progress. The cancerous stage is ushered in by lancinating or darting pain in the lower part of the abdomen and in the loins, and running down the thighs. Sometimes, however, instead of these sharp rending AN EXTREME CASE. 293 pains, there is a sensation as of burning. Early in this stage, moreover, there is hemorrhage preceding the pain. Sometimes it is mistaken for monor- rhagia ; at others, it excites great fear and alarm. The hemorrhage, though it produces temporary relief, only hastens, by inducing debility, the ter- mination of the disease. The discharges become more and more foul and fetid, till they are almost insupportable, as well as poisonous to the patient herself. And now follows a scene which language would fail to describe — a series of sufferings which it is quite too much to attempt to portray. Besides, of what avail would it be ? They in whom the disease has proceeded to the point referred to at the close of the preceding paragraph, are already be- yond all reasonable hope of return to health, except by miracle. Let us, then, attend to the causes of cancer, and see if something cannot be done to prevent what, when too late, we " would give a thousand worlds to cure." And here I can hardly do better than to quote once more from Dr. Morrill. "Badly regulated women—those who are ner- vous and subject to vivid emotions ; those of an erotic temperament, who give themselves up to masturbation or venery ; those who pass their lives tumultuously in fashionable society ; those in whom an habitual leucorrhea and neuralgia, or rheumatic 25* 294 YOUNG WOMAN'S BOOK OF HEALTH. pains, have suddenly ceased; finally, women who have borne many children, or have had numerous abortions, are more liable than others to cancer of the womb. "We should also mention, as belonging to this class, sterility, celibacy, violent grief, strong parox- ysms of anger and joy, &c. Although no temper- ament is exempt, it would seem that women of high color and sanguineous constitution are its most frequent subjects. "The exciting causes are all those which give rise to inflammation of the uterus —mechanical vio- lence, as blows; long-continued and inordinate local pressure; criminal attempts to prevent con- ception and produce abortion; the presence of a foreign body in the vagina ; masturbation arid venery before puberty, and after the critical age ; and finally, all causes capable of producing inflam- matory and congestive engorgements of these organs." It is doubtful, as I have already more than inti- mated, whether this formidable disease, once estab- lished, can ever be cured. And yet, perhaps, we ought not to despair. Dr. Lambe, of London, with his vegetable diet and his boiled or distilled water, would hold out encouragement even at a very late period in the history of this disease. Certain it is that, by universal concession of the best English medical authorities, no man in England has greater success. TREATMENT. 295 Indeed, every author is wont to lay great stress, in the treatment of this disease, on diet and regi- men. Milk and vegetables are the food commonly prescribed. Not crude vegetables, however; but light, farinaceous substances; such as bread of various kinds, rice, sago, arrowroot, and the like. The extent to which any writer I have before me would seem to go in the line of stimulation, is to white meats and fish. But the diet should not only be mild and simple, — it should be restricted as to quantity. Dr. Morrill says the patient should be gradually deprived of about one half of her ordinary food. Is this re- mark just ? It is so, certainly, if, like most persons, she has been accustomed to use twice as much food as nature requires. Yet she should be suitably nourished : starvation will never cure her. I do not fully believe in the good effects of a very low diet, even in cancer. I like much better the usual prohibition of all things which are stimulating, whether food or drink. Much repose; the tepid bath three, four, or six times a week on retiring to rest; the careful prevention of costiveness ; the use for this, and for other purposes, of the fruits of the season, when ripe and perfect, and when not difficult of digestion ; __all these hygienic measures should be resorted to and diligently persevered in. For if they do nothing more, they smooth a rugged path down to a premature grave. 296 YOUNG WOMAN'S BOOK OF HEALTH. One thing more must be remembered. I refer to cleanliness, local and general, especially the for- mer. The good sense of all young female readers will acquiesce in the importance of this suggestion, as it will in the omission of any more detail. Medical advice may be useful in these terrible cases; and yet, alas ! how impotent their art when cancer has seated itself in this frail frame ! It can point to law, and exhort obedience ; but much far- ther than this the greatest skill cannot go. CHAPTER XXX. CORRODING ULCER. The uterus, as I have already repeatedly ob- served, like all cavities of the human body that have communication with the atmosphere, is lined by mucous membrane. This membrane is liable to be attacked by various diseases, some of which have been already mentioned. Among them is that most formidable of all diseases to which female life is liable — cancer alone excepted — corroding ulcer of the neck of the uterus. The causes of this disease, too, are involved in ' much obscurity. As it has a striking resemblance to cancer, and usually attacks those of similar tem- perament— viz., the lymphatic or nervous — so there is reason to believe it has its origin in similar causes. It seldom appears before the age of forty or forty-five ; or about what is called the turn of life. The first appearance of the disease consists in a small ulcer, which, though usually found at the neck of the uterus, is apt to extend itself, not only to the fundus, or large extremity, but also to the bladder, vagina, and rectum. The result, if not arrested, spontaneously or otherwise, is the destruc- tion of the uterus and of life. 298 YOUNG WOMAN'S BOOK OF HEALTH. As with several other female diseases, so with this; it is early accompanied by profuse hemor- rhage, which is apt to be mistaken, at first, for mon- orrhagia. In a few instances, however, the flooding is preceded by pain and leucorrhea. Nor is it till a medical examination is made, that the disease can be clearly distinguished from several others. On examination, the neck of the uterus will be found, to a considerable extent, ulcerated. Another circumstance, which serves to mark the disease, is worthy of note. A thin but offensive discharge alternates with the bleeding, which from its quan- tity, and for other reasons, greatly exhausts the patient. The digestive system now becomes affected. There is nausea and loss of appetite, with great irregularity of the bowels. The individual be- comes feverish ; the skin is dry and sallow ; there are weakness and pain in the back, and great ema- ciation. The suffering is often much increased by excoriations of the parts more external than the ute,rus. What the final issue will be. is now no longer uncertain. The tendency is, and must be, down- ward. And yet, where there is much native strength of constitution, the final catastrophe may be long deferred. In some cases, death does not occur till after the lapse of a long series of years. Of the treatment I have little to say. All that PROPER TREATMENT. 299 can be done, short of wise medical counsel, — I had almost said with it, — may be comprised in a very few words. The patient must obey all known law, moral or physical. She must be particularly careful to obey the law of cleanliness ; and to use a mild, bland, but nutritious diet. One consolation to the female reader of these pages, should be found in the fact that neither can- cer, ulcer, &c, of the uterus, nor of any other part or organ, is very frequent among the healthy, and in the belief that the time may come when, by strict obedience, it will be banished from society. CHAPTER XXXI. CANCER OF THE OVARIA. The ovaria, like the uterus and the breasts, (see the next chapter,) are subject to cancer; and the disease, in this case, is as formidable, to say the least, as when it fastens itself on these organs. It is, moreover, nearly as frequent as either of those diseases. It appears a little earlier in life. Cancer of the ovaria is usually a slower disease than cancer of the uterus. In other respects, dur- ing its rise and progress, the symptoms of the two diseases very nearly resemble each other. Both are equally distressing and painful, and equally un- favorable in their tendency. In respect to treatment, also, the cases are by no means dissimilar. There is little hope of final re- covery, and yet much may be done to palliate the disease, and prolong life, by a wise application of the laws of hygiene. CHAPTER XXXII. OVARIAN DROPSY. One of the diseases to which female life is most liable, is known, in books, by the name of encysted dropsy of the ovaria. It does not often attack the young female, it is true ; and yet such instances have occurred. This renders it necessary, in a book for young women, to treat, briefly, on this subject. Dropsy of the ovaries consists in an unnatural accumulation of fluid in one or more cysts or bags formed by an enlargement of what are called the Graafian vesicles.* Occasionally, however, the morbid accumulation is in the Fallopian tubes. These cysts are fibrous in their structure. Sometimes they are thick; at others, thin. Their size depends, of course, upon the quantity of fluid they contain. At first, this is trifling, but in time it may become enormous. We are told, on good authority, that from twelve to fifteen gallons of fluid have been found collected in different cysts, * The Graafian vesicles, enclosed in the ovaria, contain the germ or rudiments, in egg-Kke form, of the future child. The Fallopian tubes connect these ovaria and their contents with the interior of the uterus. 26 302 YOUNG WOMAN'S BOOK OF HEALTH. in the same individual. A single cyst has con- tained many gallons. The character of this fluid varies greatly. In general, it is watery. In process of time, however, it may become thick, ropy, gelatinous, or even bloody, or purulent. Sometimes, also, it has a strong resemblance to coffee-grounds, and actually approaches a state of putrefaction. The causes of this disease are, no doubt, various ;.j. though it has generally been supposed to have some connection with age,—I mean the age of forty- five. It is excited by violence, as blows, falls, and self-abuse ; perhaps also by deranged menstruation, and the depressing passions. It is not always easy, even for the medical man, to distinguish this diseased condition of the ovaries from other diseases ; and for a time it is still more difficult to distinguish it from pregnancy. When, however, the contents of the abdomen become excessive, and evidently watery, and there is no motion, and when constipation and painful urina- tion prevail, there can be little doubt, even in the case of married women. In a state of celibacy, the diagnosis is still more easy. The first thing to be done, when this disease is suspected, is to place the sufferer under those laws of health and hygiene, which have already been too long neglected. Even a low diet — to which, in general, I have strongly objected — may be tried MANAGEMENT. 303 here. It may not, and probably will not, effect a cure ; but it will at least palliate. The remainder of the treatment a sense of duty compels me to leave to the physicians. My hope, indeed, will be, that they will not follow up the old custom of giving acrid purgatives, such as croton oil, jalap, aloes, &c. I hope also that they will not delude themselves or the patient with iodine or any 0/ its compounds. Tapping, as a means of prolonging life, and ren- dering that existence tolerable and comfortable, is often resorted to, and with success. One individ- ual, of whom I have read, became afflicted with this species of dropsy at the age of twenty-seven, who, by frequent tapping, lived twenty-six years longer. During this time, and at eighty different operations, she lost upwards of thirteen hogsheads of fluid. Twenty-six gallons were taken away in one instance, at a single tapping. But this is a case, in all probability, which is without parallel. CHAPTER XXXIII. CANCER OF THE BREAST. So fearful are the community, both males and females, in regard to cancer, that a thousand things 1*^ which have nothing of the cancer about them are mistaken for it. If we are to believe some among -> us, they have been afflicted with a dozen, if not a score of them, and have been as many times cured. Most unhappily for fallen and diseased humanity, cancer is not so easily cured as many imagine. It is those little swellings of the glands, which simu- late cancer in its incipient stages, that are so often mistaken for the genuine disease, and which so often get well, in spite of both the quacks and the patients themselves. The wisest way is not to trouble ourselves too early about every little pimple or sore that has an irregular or strange aspect, but, if possible, forget it. If we are sinning against any known law, however, there is one thing we may do, which is, to repent and reform our lives. Cancerous tumors in the breast are not, at first, apt to be very sensitive. On the contrary, they are hard, indolent, insensible to pressure ; and the skin remains of a natural color. This consideration SYMPTOMS OF CANCER. 305 should put to rest those apprehensions so frequent among us, at the appearance of irritability in the glands of the breast, especially when these glands are at first exceedingly sensitive and tender. But Avhen these indolent tumors have existed a / long time, in a system which is predisposed to scrofula, and has become the seat of frequent acute A^f or lancinating pains, it is time to look about us. And when, beyond this, the tumor not only enlarges, * " but softens, and the disease spreads to the armpit, and affects the glands there, the danger is still more obvious and certain. If there were any doubt in regard to the nature of the disease thus far, however, it is soon dissi- pated. The tumor breaks, the skin puts on a straw- colored appearance, and the health gives way. It is now an open and inveterate cancer. The prog- ress will be, inevitably, from bad to worse. The most important part of the treatment of this disease is what may be called the preventive treat- ment. Thus, if a female finds in herself a ten- dency to glandular swellings, or even to eruptions of the skin, she will act the wiser part in endeav- oring to remove the causes of this tendency. These last are numerous. I have seen this tendency disappear after an abstinence of only a few months from certain kinds of food or drink. Thus the abandonment of all drinks but water, of all food which is permeated with grease, of all 26* 306 YOUNG WOMAN'S BOOK OF HEALTH. high-seasoned food, pies and pastry, has been richly repaid by a corresponding immunity from all ten- dency to glandular and cutaneous difficulties. In particular does it become me to recommend to all, who have reason to fear cancer of the breast or uterus, to abstain from long salted meats, butter, &c, and to use food which is mild, bland, and un- stimulating. For if this should not succeed in preventing the development of so dangerous a disease, it will at least prevent its rapid progress, and greatly diminish the usual amount of suffering. We must not only strive to avoid the predisposing causes of the disease, but the exciting ones also. Among these are usually reckoned tight dress, and all those appliances which tend to push aside or depress the breasts ; all those positions of body, while at study or labor, which also tend to prevent a free circulation in these organs; and all discutient, or, as they are usually termed, scattering medicines. There is one more class of causes. These are uterine irregularities of long standing ; the sudden suppression of customary or salutary evacuations ; and the too sudden abandonment of customary (though they may be unhealthy) stimuli. Any thing, in short, which gives a severe shock to the nervous system, and greatly cripples its energies, may, in time, give rise to cancer. All these causes of disease, or of a diseased ten- dency, must, as I said before, be removed, if pos- TREATMENT OF CANCER. 307 sible, in the first place. But this is not all, by any means. We must not only avoid or abandon all the known causes of disease, but we must promptly yield to and obey all the known laws of health. The laws of exercise, cleanliness, respiration, ven- tilation, digestion, &c, must be duly heeded and strictly obeyed. Here, as well as in other severe female diseases, we may, if we choose, apply the very stringent rules of Dr. Lambe, elsewhere ad- verted to. Cheerful society, healthful amusement, and the full influence of the whole tribe of elevat- ing affections and passions, will also be desirable, not to say indispensable. Let me here caution my readers to avoid, in these cases, the dangers of quackery and humbug- gery. For in just proportion as these terrible diseases excite our apprehensions, in the same pro- portion are ignorance and quackery ready with their nostrums to proffer relief. More than even this might be said. In proportion to the entire ignorance of these persons, in regard to a proper and safe course to be pursued, will their confident assurances and bold and impudent promises of cure be reiterated. The best plaster, as a general rule, for cancer, is good, plain bread and milk, and other light food, applied, after suitable mastication and a salivation, to the inside of the stomach. And woe, woe, woe to those who use acrid and poisonous plasters exter- 308 YOUNG WOMAN'S BOOK OF HEALTH. nally, in the vain hope of eradicating a disease which is rooted in the whole system. There may be recovery, it is true, but it may be only avoiding one rock to fall on another ; or, what is more likely still, it may be a recovery in spite of the plaster, and not on account of it. CHAPTER XXXIV. REFLECTIONS. The writer of the foregoing pages has had fre- quent occasion to protest against the custom, so exceedingly prevalent, of reading on medicine and disease, with the hope of being one's own physi- cian. " Every Man his own Doctor," is a title which has so many charms as to have secured a greater sale for this than for all the rest of Dr. Buchan's works ; and yet it is probably less valua- ble, out of the medical profession, than any one of the rest which could be named. Life is not long enough to enable those who have their various callings, and are dependent on the la- bor of their own hands to support themselves and families, to understand that in which the most com- petent and scientific practitioner of half a century feels himself a mere child. It is worse than vain to expect the mass of mankind even to understand the nature and power of medicine, or the theory and practice of disease. It is on this account, and in this view, that I have forborne the temptation—greatly predomi- nant in our nature— to prepare books on disease for old or young. Of the great number of works 310 AN APOLOGY. I have prepared for the various classes of society, only one (the "Mother's Medical Guide") will be suspected of such a tendency. And this, even, is a work on prevention much more than cure. Perhaps it may be thought that I have once more fallen into the very error I am so ready to coin demn. For I have described a long list — some twenty or more — of the forms of female disease. And will not the book have a tendency, I shall doubtless be asked, to rouse the fears of females, and either lead them to injudicious dosing and drugging, or make them moping and melancholy ? Is it right, some will say, to point out to the young woman the dangers and pitfalls which beset the way of life she is to pass ? Ought I not to scatter flowers in her path, and endeavor, by every possible means, to awaken, and develop, and culti- vate hope, and expectancy, and cheerfulness ? Now, I do not believe that the course I have taken in this work will at all conflict either with woman's cheerfulness or her happiness. On the contrary, I am confident it will serve to enhance both. Seeing, as she must by what I have here written, to how great an extent God has placed her happiness and her misery within the range of her own choice, will she not be led the more earnestly to secure the one and avoid the other ? For it must never be forgotten, that what I have quoted from the late Timothy Flint, in my " Letters 27* YOUNG WOMAN'S BOOK OF HEALTH. 311 to a Sister," is ever applicable to females, and to female life, and can by no means be too deeply impressed. The sentiment is this —that if the world is ever to become a better and happier world, woman, enlightened, elevated, invigorated, and en- abled, must be a prime mover in the great work. THE END. THE TRUE RELATION OFTHEjSEXES. New and Valuable Book, that should be owned by every young person. Price 25 cents. Hints to Young People on the True Relation of the Sexes. By JOHN WARE, M. D., and for sale by Tappan, Whittemore & Mason, Boston, and all other Booksellers. RECOMMENDATIONS. From the Portland Transcript. This little work contains facts arid suggestions of the utmost importance to the young, and on a subject which false delicacy has heretofore prevented many from treating in a proper manner. It should be read by every young person, and by parents, too.. From Zion's Herald. This little volume is designed to counteract one of the most prevalent and most destructive vices of youth. A committee of gentlemen, comprising Dr. S. G. Howe, Theophilus Parsons, Rev. Dr. Vinton, Geo. B. Emerson and Rev. Dr. Waterbury, were appointed by a meeting of citizens to procure the preparation of a suitable volume on the subject. They appointed Dr. Ware, and he has produced a work which the most fastidious parent may put into the hands of his children. The vice of masturba- tion, if we may judge from the testimony of medical authorities, is quite general—it is appaling in its physical, mental and moral consequences; such a work as the present is, therefore, of incal- culable importance. We bespeak for it the attention of teachers and parents. From the Christian Times. This little book should be read by every youth in the United States. It was Written at the special request of a committee of gentlenten, appointed sometime since for the purpose of causing a book to be prepared, which should be unexceptionable on the spore of correct taste, adapted to a wide circulation, and which ' should faithfully caution the young against the practice of vice, by ajust exposition of its nature, its danger and its effects. From the Evening Traveller. Hints to Young Men, on the Relation of the Sexes, prepared at the request of a committee of gentlemen in Boston to consider what could be done to lessen immorality and promote the well- being of the young. The book is an excellent one; full of important truth on a delicate subject, and yet so expressed, as to be free from the objections usually made to treatises of that kind. From the Albany State Register. Dr. Ware's Book is free from many of the objections which can be advanced against other works on the same subject, and is probably executed with as much delicacy as possible. It may hold up a warning to some, who would be undeterred by any arguments of religion or morality. /i-^A, A