LIBRARY OF CONGRESS. Shelf X.-6-& UNITED STATES OF AMERICA. "WOMAN'S MOISTITOE. BY F. W. ENTRIKIN, M. D., MEMBER N. W. O. M. A., PHYSICIAN TO GREEN SFRINGS MEDICAL AND SURGICAL SANITARIUM, ETC. Women of America, seek to add to a knowledge of God a knowledge of yourselves, that your lives may be brought to harmonize with his laws. tf V ir GREEN SPRINGS, O.: F. W. ENTRIKIN & CO. 1881. K> t"* Entered according to the act of Congress, in the year 1881, by F. W. ENTRIKIN, M. D., In the Office of the Librarian of Congress, at Washington, PREFACE TTAVING ] 3een ac tively engaged in the practice of medicine and surgery for many years, it was natural we should look closely into the condition of those with whom professional duty brought us in con- tact. We were early struck with the lack of correct information among the masses on subjects pertaining to their own selves, and a want of knowledge among women .as to the cause of much suffering among them, as well as ignorance as to the best means of prevent- ing the many diseases peculiar to the female organism. We have also been grieved to find young mothers so poorly prepared to understand the wants and capaci- ties of young children. These considerations have induced us to lay before the American public the present work. While such a multitude of books from the ever- teeming press are forced upon the notice of the peo- ple, an apology might appear due from us for claim- ing their attention. I would only say that we have 3 4 PREFACE. long sought, and as yet found but few f books suited to the capacities of the general reader, upon the topics discussed in these pages; books upon whose scien- tific accuracy women can rely, and such as we can place in the hands of our patients, confident that they would find, by ready reference, truthful sug- gestions as to the management of themselves and their offspring. It is our desire in these pages, in a brief and pointed manner, to convey the latest in- telligence known to the profession upon many subjects. It is not our design to make mothers their own physicians, but to assist them to distinguish between the professional gentleman and the impostor, to co- operate with the family physician in the prevention and cure of disease, and to enable mothers to place in the hands of their daughters, before they leave the maternal roof, a book that will assist to prepare them for the high duties of coming years. It often happens that the physician is not consulted until ma- tured disease has done its deadly work. Gradually developing, its premonitory symptoms are overlooked; stealthily advancing, it plants its poisoned arrow deep in the constitution of its victim, from which, perchance, no skill can extract it. To arrest this stealthy march, to point out those premonitory symptoms, and thus put mothers upon their guard, we send these hints PREFACE. 5 and precepts forth, alike to the palace of the rich and the hovel of the poor, hoping they may prove a blessing to thousands who now live and to multiplied thousands yet unborn. We frequently see in the hands of mothers small works written by designing men upon some of the diseases of women. So far as we have observed such they have pandered to low tastes and depraved ideas, or puffed some patent nos- trum. They usually contain some truth and much error, and are calculated to do more harm than good. There is no scarcity of high-toned and exhaustive works on women and children before the public, in- tended for the professional reader. But these are too technical and voluminous to be of any practical account to the masses. The knowledge of every medical man is necessarily made up largely of the thoughts and experience of others. And this work, designed as a companion for women, will but echo the facts and suggestions we have been so often con- strained to communicate at the bedside. That the book may prove a blessing, is the earnest wish of the author. On account of the inconvenience of inserting foot- notes, referring to the various authorities to which we are indebted, we give below a few of the most prominent, whose ideas, and possibly at times whose 6 PREFACE. language, we may have adopted, though we have endeavored to mark our quotations and give proper credit. The following have been invaluable for ref- erence: Flint, Bennett, Wood, Watson, Scudder and Jones, and Sherwood on the Practice of Medicine; Condi and West on Children; Bumstead and Cul- lerier on Venereal Diseases; the Indigestions and Renewal of Life, by Thomas King Chambers; the Surgical Works of Miller, Gross and Smith. In the preparation of the pages on diseases of women we are indebted to Thomas, Scanzoni, West, Meigs, Scudder, King, Dewees, and Brown's Surgical Dis- eases of Women; also to Meigs, Byford, and Ben- nett on the Uterus; Ashton on Diseases of the Rec- tum; Gardner on Sterility, and Acton on the Repro- ductive Organs. Among the popular works to which we are indebted are "Satan in Society," "Physical Life of Women," "Transmission of Life;" "The Pre- ventative Obstacle," by Bergeret; "Why Not," by Storer, and "The Serpent in the Dove's Nest," by Todd; also "Woman and Her Diseases," by Dixon. We should like to make honorable mention of many other authorities, if space permitted, but it does not. CONTENTS. PAGE9. Dress — Bathing — Sleep- Ventilation — Beds — Exercise — Diet — The Skin, Treatment of — Chafed Hands — Complexion — Freckles— Cracked Lips— The Teeth— Catarrh-The Eyes— The Hair 11-42 General Remarks on Woman and Her Diseases — Menstruation, Suppression of — Excessive Menstruation, Painful, etc. — Pu- berty, Age of, Care at 43-83 Secret Vice 83-85 Change of Life 85-90 Miscellaneous Diseases of Females — Constipation — Dyspepsia — Palpitation of the Heart — Sick Headache — Nervous Head- ache — Tympanitis 90-101 Diseases of the Rectum and Anus — Piles — Fissure of the Anus, Fistula of the Anus 102-105 Kidneys, Chronic Inflammation of — Diseases of the Bladder — Diseases of the Urethra 106-107 Pruritus 107-109 Genitals, Eruptive Disease of, Inflammation of 109-112 Diseases of the Neck of the Womb) — Diseases of the Womb — Chronic Inflammation of the Womb — Tumors in and about the Womb, Polypoid and Cancerous — Products of Concep- tion — Displacement of the Womb — Prolapsus of Vagina — Vaginal Fistula — Chronic Ovaritis — Pelvic Abscesses — Ova- rian Tumors — Leucorrhcea — Gonorrhoea 112-150 Hysteria — Epileptic Convulsions 150-153 Diseases of the Breast — Absent from Birth — Atrophy of Breast — Tumors of, Cancers of, Excision of— Removal by Caustics . . 153-159 7 8 CONTENTS. PAGES. Methods of Examination — Auscultation — Percussion — Chemical Tests — Microscope — Speculum — Sound, Method of Using. 159-164 Causes of Disease among Women — Predisposing Causes Opera- ting through the Mother, as Tight Lacing, Excessive Eating, Sexual Frauds — and Connubial Excesses — Physical and Mental Depression — Precreation during Debility from Dis- ease 165-171 Exciting Causes of Disease — Climatic Influence-Improper Dress in Children — Fast Living — Excessive Physical and Mental Labor — Depressing Passions — Narcotic Stimulants — Sexual Frauds and Connubial Excesses — Means of Preventing Preg- nancy 171-211 Sterility— Cause, Treatment of 211-213 Hereditary Transmission 213 How to Have Beautiful and Intelligent Children — Relative Influ- ence of the Father and Mother over the Child — Assimilation of Wife to the Nature of Husband — Directions how to Avoid the Transmission of Disease — The Dangers of Marrying a Reformed Rake 213-220 Mother's Marks 220-222 When to Marry— Whom to Marry 222-232 Pregnancy, Symptoms of, Breast Changes in, Quickening, Dis- eases and Accidents of — Miscarriages, Dangers of to the Mother — Constipation during Maternity — Giddiness during Maternity — Wakefulness — Exercise — Food — Dwarfing the Child — Pain in Labor, how Diminished — Bathing During Maternity — Twins, will there be — Is it a Female or Male — Duration of Maternity — Causes which Protract Labor — Time of Expected Labor— What Controls Sex of Child, Prof. Thury's Theory of — Sex Governed by Predominance of Desire — Preparation for Labor — Symptoms of approach- ing Labor — Symptoms, Actual — Duration of Labor — Duty of Physician and Attendants — Resuscitating the Child — Bandage for the Child— Dressing the Cord 232-268 Directions for the Mother — The Proper time to give Phyisic — Attention Required by Nipples — Inflammation of the Breasts .269-276 CONTENTS. 9 PAGES. Meddlesome Midwifery 276 Ergot — Chloroform — Diet of Mother During Nursing — Nursing and Feeding Child — Analysis of Milk — Infant Indigestion — Soothing Syrup Causes Epilepsy, Causes Insanity — Sore Mouth of Children — Proper Age for Weaning- Vaccination — Teething — Periods of Teething — Rickets — Lung Fever — Croup — Croup, Malignant-Diphtheria-Putrid Sore Throat — Scarlet Fever, Symptoms of, Treatment of — Measles — Chicken Pox — Mumps — Hooping-Cough — Colds — Bron- chitis — Asthma — Cholera Infantum — Cholera Morbus — Diarrhea — Dysentery 277-325 Worms- Varieties, Origin, Symptoms, Treatment-Trichiniasis — Symptoms, Treatment 32 Urinary Difficulties 339-341 Scrofula— King's Evil— Big Neck— Enlarged Tonsils 341-348 Quinsy — Scald Head — Sore Eyes — Sore Ears 34£ Harelip — Cross-Eyes — Frost- Bites — Boils — Ring- Worm — Tet- ter — Common Itch — Chafing of Infants — Scalds — Burns — Warts and Moles 354-362 Poisons from Wounds, Stings, Bites 302-364 Wounds — Cuts — Bruises — Sprains — Dislocations — Fractures — Ruptures 365-368 Foreign Bodies in Nose, Ear, Throat, Windpipe 368-371 Abortion — Criminal Causes which Lead to, Agencies by which Accomplished, Consequences of — Duties of Clergy and Med- ical Men with Reference to — Evil now arrested 371-392 WOMAN'S MONITOR. DRESS. WOMAN'S dress in Christian lands is usually less natural than that adopted by the ladies of civ- ilized pagan nations, and it may be said with truth, that nowhere on the face of the globe does fashion rule the female mind with such relentless sway as in educated and polished America. While the aris- tocracy of France may be said to direct American fashion, the great mass of the French people are more steady in their habits of dress and consult comfort and utility more than we do in this country. Here every man feels himself born a king, and almost every woman in her style of dress must ape as closely as possible the French Queen or some other European aristocrat. In obedience to the dic- tates of fantastic Fashion, she ignores utility and comfort, and exposes her person in a most unbecom- ing manner, or heaps it with useless clothing. Try- ing to improve upon Nature's model of the human 11 12 woman's monitor. Dress-Stays and Corsets. Palpitating Heart and Weak Lungs. frame, she compresses the lungs, heart, and stomach with stays and corsets, and pinches her feet with the most ludicrous styles of shoes ; no matter if the cor- sets and stays are clearly proven to cause dyspepsia, palpitation of the heart, and consumption, and the shoes to be a fruitful source of bunions, corns, and diseased nails, and thus to add to the already full stock of human misery ; no matter if gaunt, spectral Consumption grins horribly at the shrine and beckons away with his bony finger, woman will worship at the shrine of this goddess, though her altars groan with more victims than those of Bacchus, and are known to furnish a more lingering torture than the altars of Moloch. These two causes of disease alone are making sad havoc with the health of millions, sapping the tide of life at life's very fountain. The palpitating heart and weak lungs of the corset-pressed mother are entailed as a heritage upon her children — who too often are born feeble in mind and body — from displaced and compressed wombs, bandaged down with stay and corset, at the behest of fashion. Stomach and bowels, corset-laced, are in sorry plight for the vigorous digestion required to sustain the mother and develop the growing embryo, and if long imposed upon in this manner must become diseased, and unfit to furnish the pabulum of life to the mother, much less to furnish proper material for DRESS. 13 Cancer in the Breast. Flannels. Suspenders for the Clothing bone, muscle, and brain to her offspring, even when those disease-producing appliances are dispensed with during the maternal period. Many poor little im- mortals are compelled to forego the advantages of early sustenance at the fountain whence the God of nature designed they should draw their nutriment, because from early life dress-stays and corsets have been allowed to make injurious pressure upon the mother's breasts ; thus preparing for diseased nip- ples and broken breasts, with their long days and nights of torment, too often resulting in the de- struction of the functions of the gland, and many times developing cancer, whose corroding canker slowly eats out the vitals of what might have been a long and happy life. I pray you deem this no fancy sketch, for every intelligent physician will be able to verify it from his own observation. Away, then, w T ith your lacing- strings and corsets. Protect the neck and chest with proper clothing. Wear flannels in Winter, and if possible silk in Summer, next to the skin, to pre- vent rapid changes in the temperature and electrical condition of the body. Support your clothing by proper suspenders, for the weight of the clothing around the waist will sooner or later tell upon the health of the best constitution. Flannels should not be washed but once a week, but should be changed every day, and the cast-off garment well aired and 14 woman's monitor. Tight Shoes. Tight Garters. Thin-soled Shoes. India Rubber Shoes, etc. put on the next day. Tight shoes interfere with the proper return of blood through the feet, and thus tend to produce disease, as well as to injure the feet. Tight garters are a fruitful source of swollen feet and puffy ankles ; they interfere with the proper re- turn of blood by the veins. Rubber shoes retain the perspiration, and are not healthful; they should never be worn in-doors. Besides, they usually make tender and gall the feet, and soon destroy the texture of the leather or cloth over which they are continually worn. Thin-soled shoes, by allowing a rapid change of temperature when exposed to damp and cold, especially on damp floors and pavements, are a fruitful source of suppressed menstruation and rheu- matism, especially that form of rheumatism which affects the muscular structure of the uterus, causing much suffering at the menstrual period. Have the moral courage, then, to set fashionable folly at defi- ance and wear substantial shoes with double soles in damp and cold weather. Cloth gaiters are prefer- able in-doors in warm weather, as they do not pre- vent evaporation of the perspiration. These should have weak elastics, or be laced loosely, for reasons already given; and by all means, let them have sub- stantial soles, thick enough to protect the feet. A rational observance of these meager suggestions would prevent much suffering and premature death. BATHING. 15 Different kinds of Baths. Best Time for Bathing, etc. BATHING. It is of the utmost importance that the body should be frequently bathed in pure water, with a small quan- tity of good soap, or, what is better, a little soda dis- solved in the water. If the plunge bath is used, bathing should not be prolonged beyond a few mo- ments ; for if warm, the continued application of heat and moisture to the surface of the body will relax the system too much, and if cold it will be liable to pro- duce some internal congestion. The cold shower-bath is an excellent tonic, and may be used in every variety of relaxed and debilitated habit, provided the patient has vitality enough to re- act, even by the assistance of thorough rubbing. Those of very nervous temperament, and those sub- ject to apoplexy, would do well to use some slight protection to the head while under the shower-bath. The sponge or towel bath is the one most usually employed by the masses in this country, and is very efficient, especially when accompanied with the vig- orous application of the flesh brush or crash towel. The morning is the best time for the bath. It re- laxes less than when used just before retiring at night. The bath should not be taken for some hours after a hearty meal, as reaction would be likely to be im- perfect, or if readily established, would interfere with the energy of digestion. As a rule, we prefer the 16 woman's monitor. Kind of Water. How often to Bathe. Sleep, tepid bath, except where heat may be necessary, to relax the surface or develop some receding eruption, or when the cold bath may be advisable to secure tone by reaction; in such cases the shower-bath is the best form. Water readily absorbs noxious gases and vapors ; and hence, water that has stood long in an open vessel is not fit for bathing purposes. Bathing should not be permitted in sluggish streams, foul ponds, nor in creeks or rivers swollen by freshets, as such waters are charged with poisonous gases, and hold in solution much vegetable and animal matter, which is readily absorbed through the skin, poisoning the blood, and producing congestive and other fevers. Every person should bathe the entire surface at least twice a week in warm weather, and once a week in cold, under ordinary circumstances. A bucket or basin of pure water, a small quantity of soda or soap, and a coarse towel is all that is necessary to equip one for this healthy exercise. SLEEP. During sleep pulsation and respiration, and indeed all the forces of the animal economy, are prosecuted with less vigor than when awake. This is nature's method of restoring the equilibrium of the animal forces, and allowing the system, as it were, to get up steam for the exhausting labors of the coming day. Indeed, it is the only method of rest for those organs SLEEP. 17 Amount of Sleep Necessary. Night the Time for Sleep. of the body whose functions require ceaseless activity every moment, from life's first dawn until the heart's last flutter is stilled in the quiet slumber of death. During dreamless sleep the mind is at rest, and the brain also, and has time to repair its exhausted ener- gies. Persons who do much head-work, should sleep more than those whose exercise is principally muscu- lar. But unfortunately for the health and longevity of persons given to intellectual pursuits they usually sleep less. No doubt this is one reason why they usually grow prematurely old, and are more subject to apoplexy, paralysis, and insanity than those who, through life, are more regular in their habits of sleep- ing. Eight hours should be devoted to recreation and sleep out of twenty-four. This, from time immemo- rial, has been regarded by philosophers and sages as the proper average. Some persons can do for many years with much less sleep and still enjoy comparative health, but such is the correlation of the forces of na- ture that their day of reckoning must come, and the balance in the book of life is against them. Children require more sleep than adults, and especially, with them, should rest be regular and unbroken. It is an ordinance of nature that sleep should occur during the night. The exciting influence of the sun's rays are calculated to disturb the quiet play of the vital forces, if the sleeper is exposed to a strong light. This every close observer who has slept late in the 18 woman's monitor. Badly-Ventilated Apartments. Fruitful Sources of Disease. morning, or attempted to make up for a lost night's rest by an afternoon nap, will readily admit. For this reason we say retire early and arise as soon as the sunlight has diffused its radiance over the earth ; and especially should this law be rigidly enforced upon every child of the household. VENTILATION. It is very important that every part of the house, but especially the nursery and the bed-chambers, should be plentifully supplied with fresh air. The fires, the lamps, and the lungs consume the oxygen, upon the presence of which in the air its life-sustain- ing quality depends. The body exhales from millions of pores its insensible perspiration. The lungs con- tinually throw off carbonic acid and decayed and worn-out particles of the body in aqueous solution, to poison the air around us. A person confined to a small, close room soon renders the air unfit to breathe, and many persons confined closely to badly-ventilated apartments, develop the most malignant forms of disease, as typhus and typhoid fevers, etc. Less fla- grant violations of this law of the animal economy are punished by increased susceptibility to colds and lung fever, and increased tendency to contract contagious diseases to which you may be exposed ; because those who habitually breathe impure air are of impure blood, and in their blood is found those elements BEDS. 19 Furnish the Sick-Room with Fresh Air. which foster and develop the germs of disease. If close rooms are bad for the healthy, what shall we say of such places for the sick, whose fluids are poisoned by disease, which is exhaled from the skin, and poured out with the breath from the lungs by Nature in her efforts to remove disease? It is impor- tant to the patient that these be removed, to prevent re-absorption, and to the nurse that they may not en- ter her lungs, and plant there the seeds of disease and death. We say, then, cleanse the sick-room by constant currents of fresh air. Of course these should not be permitted to strike directly upon the patient's bed. More especially should this direction be enforced if the case is one of weak or diseased lungs, for it is cruel to furnish a patient sinking for want of oxygen, on account of diseased lungs, an air deficient in this life-giving, element. Open a transom, or let down a window from the top, or, if you can do no better, re- move a light from the top sash, that the air may be changed continually. Some invalids, in damp weather, may require the air to pass through a room where there is a fire before it reaches the sick chamber, but this in the rarest cases. BEDS. Feather-beds are not so healthy as husk or straw beds, or hair, husk, or elastic sponge mattresses. 20 woman's monitor. Beds. What kind to use. Proper Bedfellows. Moss mattresses are dusty, filthy affairs, and should never be tolerated. Hard beds are regarded as con- ducive to health. If you must have a soft bed, let it be a carefully constructed spring mattress. Beds should be so placed that strong currents of air do not flow over them, and we always prefer that the head be to the north, for reasons well understood by those who have studied the laws of electro-magnetism. Aged persons require more covering than adults or children, but none should sleep under more than is absolutely essential for comfort. By all means let the household be provided with as many beds and sep- arate sleeping apartments as circumstance^ will per- mit, as the sick should never occupy the same bed with other members of the family, no matter what the disease may be. Never permit your children, of either sex, to sleep with any person but those you are quite sure are of pure lives and correct habits. Under no circumstances should a consumptive person or one with an open can- cer sleep in the same bed with one not subject to like disease, and separate rooms should be occupied by such as far as circumstances permit. If the same room must be occupied by a nurse, let it be at the opposite side of the room, and, if possible, let the intervening space be crossed by a current of fresh air. As you value the life and health of your chil- dren, never permit them to sleep for many nights EXERCISE. 21 Proper amount of Exercise. Over-Exertion. in succession with the aged and infirm, as they will be very likely to grow weakly and nervous, possibly, sicken and die. I have no place to argue this ques- tion, but suffice it to say its truth is founded upon an inexorable law of nature. EXERCISE. It has been truthfully said that it is by continued dying that we live. The death and removal of the organic particles of the body from the tissue make room for the new material prepared by digestion, and carried to the parts to be repaired by the arterial sys- tem. It is by this interstitial decay and renewal that the phenomenon of life is perpetuated. Health con- sists in a perfect balance of these chemico-vital forces. Over-exertion causes too rapid destruction of the or- ganic tissue, and, on the other hand, want of proper exercise diminishes the excretion of worn-out materi- als, and calls upon the digestive system for less than the normal supply of nutritive material, thus produc- ing a stagnant condition of the physiological actions of the body, and predisposing to disease. Exerci.se requires an expenditure of force which calls for in- creased functional activity on the part of the heart, lungs, and stomach; decaying and worn-out particles are hurried out of the system by the increased energy of the secretions, and the rejuvenating power of the assimilating functions are increased in proportion. 22 woman's monitor. The best kind of Exercise. Sunlight. Exercise should be or three or four crackers daily, made by mixing one table-spoonful of wheat flour and two table- spoonfuls of sugar with one pint of wheat bran, add- ing sufficient water to make a pasty mixture; make into cakes and bake in an oven until hard. They are not unpleasant when softened by soaking in tea, coffee, water, or milk. Spices and condiments of all kinds should be avoided, nor should late, high-seasoned sup- pers be indulged in. Fruits, berries, and vegetables may be taken freely. Apples, pears, peaches, and like fruits may be used raw at meals, especially if the rind is eaten with the fruit. When grapes, fruits, or melons are used they should constitute a part of the meal, but digestion should not be disturbed by such things between meals. A glass of cold water drank after breakfast will assist to give that sense of full- ness so essential to success in securing an evacuation from the bowels. Free rubbing with the hand will facilitate peristaltic action, so will keeping the mind concentrated upon the necessity for an evacuation for half an hour after breakfast, which is no doubt the best period for attending to this necessity ; and no trivial cause should induce one to neglect attention to the calls of nature in this respect, but as punctually as the hour arrives let the invalid resort to a proper place, secure an easy position, and without reading, or in any other manner absorbing the nervous force, re- sign body and mind to the fulfillment in a proper man- CONSTIPATION. 95 Vital Importance of Regularity in Attending to the Calls of Nature. ner this requirement of nature. No straining e'ffort should be indulged in, for it might cause blindness, apoplexy, or convulsions, by congesting the brain or retina. It might cause deafness, by rupturing dis- eased or delicate ear-drums. Piles, prolapsus of the bowels, and displacements of the womb are frequently produced in this manner.' Be sure, then, and avoid straining; do not be in a hurry; give the tardy pow- ers of nature a chance. No matter if you have to devote one hour to this business every morning. It will amply pay you in diminished suffering. It will also save you time and. money, that would be spent in doctor's bills and sickness, and often save life. Do not be discouraged if weeks or months are required to secure a regular condition of the bowels, and per- severance in correct habits, for the remainder of life, necessary to maintain a healthy action. It is an effort in the right direction, and few cases will long resist these best of all known methods of securing regularity. In long-standing cases the paralyzed bowel will be strengthened by from one to two grains of pulverized nux-vomica, taken after meals, three times daily. This may be safely taken for five or six weeks at a time, and intervals of two weeks should then elapse, when, if necessary, it may be renewed. A very excellent and efficient means of assisting to secure a cure is the use of the syringe. One of the 96 woman's monitor. The Use of the Syringe. Davidson or Ritchison pattern will answer an excel- lent purpose. They can be had at any drug-store. With one of these syringes, from one to three pints of warm water, soap-suds, or as much water containing a handful of salt, may be gently thrown into the bowels. The best position is lying on the right side, limbs drawn up, hips some higher than shoulders. The liquid can in this manner be forced around to the ascending part of the large bowel, and softening of the hardened contents secured. Few invalids are so fee- ble as not to be able themselves to use one of these in- struments. Where the above directions are strictly followed, the syringe may soon be dispensed with. I have said nothing about purgative medicines, because they interfere with digestion, weaken the bowels, and will not effect a cure, in a large majority of cases, without correct habits, and with care, the purging medicine is not necessary. Remember that few can leave the calls of nature to the hazards of chance without suffering some serious trouble sooner or later. We have treated this subject at some length, be- cause we believe it is one of the most fruitful sources of disease among women, and the indirect cause of an immense amount of suffering and premature death. DYSPEPSIA. We do not design to treat of dyspepsia at length. It is usually caused by errors in diet, eating too much, DYSPEPSIA. 9 "7 Dyspepsia. Its Cause and Effects and a want of proper adaptation of food to the circum- stances of life. One who is much exposed to cold re- quires meat, butter, and grease, as the oil furnishes the material to maintain animal heat. A purely vege- table diet, and avoiding grease, may cause dyspepsia in cold weather, because the stomach is overtaxed to furnish proper food to the powers of life out of the coarse fare taken. On the other hand, derangements of the liver and kidneys are produced, and, through their agency on the system, indigestion, by fat meat and strong greasy food when the weather is warm, because material of that kind can not be worked up close by the animal economy, not being necessary for its use in larger quantity. Besides this source of dys- pepsia we may mention over-eating of proper food. The powers of the stomach are not likely to master more than the demands of the system require ; the balance is not perfectly digested, and fermenting, becomes a source of irritation that frequently leads to a diseased state of the mucous membrane of the stomach. The stomach is in direct sympathy with the womb, as proved by the morning sickness in the early periods of pregnancy; and it is common for the stomach to sympathize with the uterus at the menstrual period — witness the number who suffer from sick stomach and loss of appetite during menstruation. But these pe- riodic attacks of indigestion may so injure the stomach as to develop permanent dyspepsia. This is to be 98 woman's monitor. Treatment and Cure. avoided by great care in diet as to quantity and qual- ity at the period. Let the diet be light, avoiding pas- tries and strong meats, as the stomach is sympathizing with the womb, and is weakened and made irritable by that sympathy. Every physician of much experience frequently meets with cases of dyspepsia which resist every resource of his art to permanently benefit, though plied with the best anti-dyspeptic remedy the phar- macy affords. These will usually be found, on careful examination, to suffer from piles, fistula, fissure of the anus, chronic inflammation of the rectum, the relics of a previous dysentery, or more likely from ulceration of the neck of the womb, chronic uterine leucorrhcea, or some other disease of the sexual system. These are a class of troubles peculiarly prone to reflect their irritation to the stomach. We have often found se- rious disease of the womb where it was not suspected by patient or physician, all the symptoms being of dyspepsia that was readily cured by care in diet, and removing, by proper treatment, the disease of the uterus. A large portion of the cases regarded and treated as dyspepsia, are of this kind ; the same may be said of PALPITATION OF THE HEART. Though palpitation is often permanent in its charac- ter, produced by disease of the heart from rheumatism SICK HEADACHE. 99 Proper Treatment for Sick Headache. or other cause, it is oftener sympathetic or nervous palpitation. While it must be admitted that palpita- tion is often produced by sympathy with a deranged or diseased stomach, and hence, more alarming than dangerous, yet it is often a symptom of female disease, as displacements of the womb, and chronic inflamma- tion of the lining membrane of that organ, with or without serious change in the structure of the part. One skilled in the treatment of diseases of women should be consulted if regulating the bowels and care in diet fail to relieve. SICK HEADACHE. This is another trouble that often renders woman's life a burden. Its symptoms are too well understood to require repeating. Great care in diet and regulat- ing the bowels may suffice. If digestion is feeble, much benefit may arise from one tea-spoonful, three times daily before meals, of elixir of pepsin, strychnia, and bismuth, an elegant and efficient remedy found at drug stores. We have also often cured cases with from five to ten drops of fluid extract of ignatia, taken after meals three times daily. But it will be observed that these are directed to the removal of the disease of the stomach with which the head is supposed to be sympathizing. But the indigestion causing the trou- ble in the head may be producod and kept up by some female trouble, as stated when speaking of dyspepsia. 100 woman's monitor. Treatment for Nervous Headache. Distention of the Intestines. NERVOUS HEADACHE. This variety may be known by the dull heavy pain in the head, intolerance of light and sound, and other evidences of irritability of the brain. It is common with those who use stimulants or tea or coffee to ex- cess, who are temporarily deprived of the accustomed beverage. When arising from this cause, it will be relieved by resort to the usual beverage; when from undue mental excitement, or loss of rest, from one to two tea-spoonfuls of the elixir of valerianate of am- monia, repeated at intervals of half an hour, affords prompt relief. TYMPANITES, in a general sense, means a distention of the abdo- men with air. Some persons believe in distention of the womb with air secreted from its surface ; also, in distention of the cavity around the bowels, produced in the' same manner. Permit me to say, I do not be- lieve in this kind of tympanites, except as the result of the decomposition of some substance, as a tumor or portions of a retained placenta. But enormous dis- tention of the intestines occurs, caused by decomposi- tion and fermentation of the partly digested contents of the bowels, and the action of alkaline secretions upon the acids thus formed. It appears frequently to be the result of a species of dyspepsia, caused by TYMPANITES. 101 Mistaken Ideas. Proper Treatment. sympathy with disease of the womb, and is common in hysteric women, and frequently occurs about the change of life. At this period not only the patient, but the careless physician, is often led into the belief that pregnancy has occurred, because the gradual dis- tention of the abdomen is accompanied with sup- pressed menstruation. I have said that this trouble is usually associated with some form of derangement or disease of the womb. This should be sought out and removed, or the' trouble will be liable to recur when removed. Relief is readily obtained by carefully bandaging the abdomen with a flannel roller, and purging with the following mixture, recommended by Prof. Meigs in his letters to his class : # Manna 1 ounce. Anniseed 1 drachm. Boiling water 8 ounces. Mix. Let the mixture rest half an hour, then strain the liquor; to the strained liquor add three or four drachms of carbonate of magnesia; stir well, and take a wine- glassful every three hours, until it operates. Re- peated purging with this mixture will rarely fail to remove the bloating. Twenty-drop doses three times daily, after eating, of liquid bisulphate of soda will prevent the accumulation of the gas while it is used ; and sometimes suffice for a cure. 102 woman's monitor. Cause and Effect of Piles, External and Internal. DISEASES OF THE RECTUM AND ANUS. Many ladies suffer for years from trouble in this part of the body, but from delicacy do not seek med- ical aid. The most common trouble here is PILES. These are external and internal — both are a source of much suffering. The external are caused by the rupture of one of the numerous veins about the anus outside the sphincter muscle that closes the bowel, .and comes on from straining at stool, or in lifting a burden. A clot forms, sometimes quite superficial, at others deep-seated. This may be partly removed by absorp- tion, may suppurate and form an abscess, or inflame, causing a hard tumor, and remain painful many days. The bowels should be regulated and a warm poultice applied, or an ointment made by boiling stramonium (or Jamestown weed) leaves in lard. Prompt relief is obtained by opening the tumor and allowing the blood-clot to escape. The internal variety are one or more hard tumors, or more commonly, soft bleeding tumors, which come down and bleed when at stool. They keep up, by their irritation, pain in the back, sympathetic disease of the womb, bladder, kidneys, and liver. They are said at times to result from con- gestion and other diseases of the liver, which, by pre- venting free return of blood to the general circulation, FISSURE OF THE ANUS. 103 Cure by Surgical Means. Fissure of (be Anus produce congestion in the vessels of the rectum. The bowels should be kept soluble by the syringe, or by very small doses of Epsom salts, taken three times daily, and by proper diet, as recommended when speak- ing of constipation. Balsam of copaiba appears to act as a specific in some cases ; the best form is capsules, of which one or two may be taken three times daily if the. stomach does not revolt, as it sometimes does. The prolapsed part should be well washed with warm water, and the ointment above mentioned applied and pressed carefully up and put far enough back to pre- vent strangulation. A permanent cure may be safely effected by the knife, ligature, or erasure, in the hands of a skillful surgeon, and where the health suffers from the irrita- tion, a cure by one of these radical means should not be delayed. FISSURE OF THE ANUS is a crack or cleft formed at the edge of the anus, and sometimes becoming quite deep, with hard edges. When well developed, it does not tend to cure, but grows gradually worse. The milder forms are mere cracks in the mucous membrane, just within the verge of the anus. Even the deepest clefts, probably two inches long, are seldom more than one-twelfth of an inch wide. The bottom of the ulcer usually exhibits a pale gray appearance. The suffering from this cause 104 woman's monitor. Symptoms and Treatment. often amounts to perfect agony, especially when the bowels are moved. The operations are usually fol- lowed by pain and straining, with a feeling of weight in the parts ; also a sense of weight and soreness in the perineum and thighs. The distress may be ag- gravated by riding, walking, sexual intercourse, and sitting upon a hard cushion. It may produce irrita- bility of the bladder, also a sallow and sickly expres- sion of countenance, and decline in strength. Treatment. — Occasional mild purgative doses of cal- omel, or blue mass, to correct the secretions. A wash made by dissolving two grains of corrosive sublimate in four ounces of lime water. If much pain, bathe frequently with flaxseed tea, to which a table-spoonful of laudanum may be added to the pint. These means failing, any surgeon will divide the bottom of the sore with a knife, and trim the hardened edges with the scissors; a speedy cure is then almost certain. The operation causes but little pain. Chronic ulcers and inflammations upon the mucous surface of the rectum, especially near the anus, are common ; they usually result from piles or chronic dysentery. Care in diet, and careful regulation of the bowels with injections of w T eak solutions of sulphate of zinc, sulphate of copper, or carbolic acid, repeated twice or thrice a day usually suffices for a cure. These failing, the anal speculum may expose the parts, when ulcers will probably be found, and should be touched with nitrate of silver. FISTULA OF THE ANUS. 105 Three Varieties of Fistula of the Anus. Proper Treatment. FISTULA OF THE ANUS are of three kinds: those in which an abscess forms near and breaks into the bowel, forming an internal fistula ; when it opens outside without reaching the bowels, producing external fistula ; when the opening externally exists in connection with an internal open- ing, forming complete fistula. This disease keeps up considerable irritation, and appears in many cases to produce a desponding state of mind. It is difficult to keep clean, yet care in this respect is essential to a cure. I only mention this disease that those afflicted may take warning not to allow such trouble to wear out iife by slow degrees, but resort to a physician who will readily cure by one of the many methods pursued by surgeons. I have tried most of the remedies recommended for injecting the sinuses of fistula, also many caustics which were lauded in the medical journals as curative in these cases ; they are all more severe than the sur- gical method, and by no means so sure. If a person has become exhausted by consumption, or some other disease, in connection with fistula, as often happens, interference is of doubtful propriety. But in cases only threatened or fearing such trouble, the fistula should be cured, as all exhausting discharges tend to break down the system and fasten the development of consumption and like affections. 106 woman's monitor. How to Detect Kidney Disease. Superinducing Causes. __ DISEASE OF THE KIDNEYS may be known by the changes in the color, quantity, and quality of the water, also by pain and weakness in the back, and a tenderness on pressure at the sides of the backbone, just behind the short ribs. Active inflammation of the kidneys will be manifested by pain in the back, usually by suspended secretion, or great diminution of the quantity of urine, sometimes by blood in the water, and more frequently by the presence of albumen, which may be detected by heat- ing a quantity of the water to the boiling point, when it will look more or less milky if albumen is present. Severe constitutional symptoms attend this disease. It is rapidly fatal if not relieved. A minor degree of the same symptoms are usually present in CHRONIC INFLAMMATION OF THE KIDNEYS, to which are added dropsical troubles, anaemia, de- bility, and permanent trouble of the digestive system. Disease of the kidneys may arise from a cold — is com- mon in the course of rheumatism, and frequently oc- curs in the course of, or follows, typhoid fever, cholera, measles, scarlet fever, and similar affections. Kidney disease also frequently arises from injury to the side or back, by blows, falls, etc. All forms of kidney dis- ease should be regarded with suspicion; especially should this be the case if a very large quantity of DISEASES OF THE BLADDER AND URETHRA. 107 Prompt, Energetic, and Skillful Treatment Required. water is passed for many consecutive days, as it may be found to contain sugar, indicating diabetis, which is a very fatal disease. All forms of kidney trouble should be early subject to the care of the highest form of medical talent within reach. No tampering, no patent medicines, or domestic drugging should be allowed. DISEASES OF THE BLADDER AND URETHRA are very common among women, also painful and frequent urinating, sometimes with scalding of the passage and external genitals. This may arise from a highly acid condition of the urine, and is relieved by fifteen or twenty grains of bicarbonate of soda, taken in water three times daily, and care in diet to correct the bad digestion, upon which the acid in the urine depends. Similar symptoms will arise from gravel in the bladder, but this is- not very common among women. The most usual cause of urinary trou- ble is anteversion, or tipping forward of the womb, by which pressure is made upon the bladder. The best treatment is to correct the bad position of the womb by the uterine repositor, and maintain it in place by proper support. PRURITUS. This is an intolerable itching of the genitals. It comes on gradually. At first it may be troublesome 108 woman's monitor. Description of Pruritus. The Cause should be Sought out and Removed only after exertion or when exposed to artificial heat, or just before or after menstruation. It is quite com- mon about the change of life, and not unusual in quite elderly ladies. It is not in itself a disease, but often a symptom of some obscure trouble. It is aggravated by the very counter irritation which it demands for its relief, the rubbing and scratching rendering the parts more sensitive. This trouble often becomes so severe as to render the patient unfit for society, and despond- ing, depressed, and wretched in the extreme, requir- ing opium, or what we prefer, hydrate of chloral, to procure sleep. It may be caused by leucorrhoea, the discharge of cancer, dribbling of urine, eruptions on the vulva, and animal parasites. The cause should be sought out and if possible removed. The most common of these are leucorrhoea. But cases will oc- cur in which no eruption can be discovered upon the parts — no" leucorrhea is known to exist, and yet the itching is at times very severe. In these cases per- verted nervous sensibility is said to be the cause, but I think the perversion is kept up by a discharge, very acrid in its character, though in a very limited quan- tity, for such cases are relieved by placing a lock of cotton against the neck of the womb, to absorb any discharge that may occur. The warm sitz-bath should be used at least twice daily, and while in the bath the vaginal syringe freely employed. Carbolic acid crys- tals, twenty to thirty grains to the pint of soft water, ERUPTIVE DISEASES OF GENITALS. 109 Treatment Eruptive Diseases of the Genitals. or one drachm of borax to the pint of water, and used with a syringe three times daily, often afford relief. But every physician will find cases that will require that the parts shall be brushed with a strong solution, or be touched lightly with the solid lunar caustic, be- fore the disease of the mucous surface upon which the pruritus depends can be relieved. Persons afflicted with pruritus usually require good food, fresh air, and preparations of Peruvian bark and iron. ERUPTIVE DISEASES OF GENITALS. Few afflictions of the skin but may affect the vulva and vaginal mucous surface. These, besides pro- ducing pruritus, as just stated, are a fruitful source of leucorrhoea. Many of these affections yield to care and diet — using principally vegetables and fruit, avoiding meat, pastries, and high-seasoned dishes. Fowler's solution of arsenic taken for several weeks, in doses ranging from one to ten drops, as the stom- ach will bear it, is excellent. The injections men- tioned when treating of pruritus, are often useful in these troubles. Some may require stronger applica- tions, by means of a speculum and brush, but these can only be safely used by the physician. INFLAMMATION, both chronic and acute, of the mucous surfaces of the vulva and vagina, is very common, and may re- 110 woman's monitor. Inflammation of the Vulva and Vagina. Treatment suit from eruptive diseases — onanism, injury, chem- ical irritants, want of cleanliness, and contagion. The parts are at first dry, red, and painful, then a free flow of pus takes place, which bathes the parts, and stains the linen of a yellowish hue. Superficial ulcers may be scattered over the parts, and sometimes a diph- theritic membrane may be seen adhering to them. Sometimes the urinary passage becomes affected, caus- ing pain and scalding when urinating. The trouble may be confined to the vulva, or may extend to the mucous surface of the birth-passage, and even to the w T omb. Many of these cases in good constitutions would recover in time, but would be likely to run a painful and tedious course, and perhaps give rise to some serious complication, as chronic inflammation of the vagina, accompanied with exhausting leucorrhoea, or to inflammation of the womb or its lining mem- brane, when a new class of symptoms would be de- veloped. If properly treated relief should soon be obtained. Treatment. — If the inflammation is active, the pa- tient should be kept in bed upon low diet, and the bowels freely moved with salts or citrate of magnesia. The strictest cleanliness should be observed. The external parts should be frequently bathed in warm water, at least three or four times daily, and a warm poultice of powdered linseed, mush, or grated potato applied. The poultice may be wet with watery ex- INFLAMMATION. Ill Further Directions. tract of opium to advantage. The labia should be kept separated by lint wet with equal parts of lauda- num, glycerine, and water. It is often useful to stir this thick with sub-nitrate of bismuth. If the disease extends to the vagina, a syringe should be used, or lint wet with the last-named preparation may be em- ployed and introduced by means of a sponge repositor, or a small speculum, and a rod to push out the lint as the instrument is withdrawn. In some cases the dis- charges are very offensive ; these should be injected with a very weak solution of permanganate of potassa in water, or fifteen grains of carbolic acid crystals, dissolved in one pint of soft water, may be employed. These injections should be repeated two or three times daily. If the diseased action extends to the cavity of the womb, your injections, though necessary to se- cure cleanliness, will not suffice — a tedious uterine leucorrhcea will harass the patient. If better at times, the acrid discharges from the womb will come down over the partly cured surfaces and soon light up dis- ease again. These must be treated by the physician who, by the aid of the speculum and uterine swab, or the intra-uterine syringe, will carry ointments and astringent liquids into the womb, and by contact with the diseased surfaces, reach the trouble, in which the ordinary routine of .drugging would avail but little. Inflammation of the vulva, if imperfectly cured, may leave a very troublesome pruritus, either by the chronic 112 woman's monitor. Inflammation of the Vulva, etc. trouble left lingering in the uterus, or by some im- pression left upon the nerves of the part, perverting their function. Inflammation of the vaginal mucous surface still more certainly leaves chronic disease, and as this is usually accompanied by a profuse leucorrhoea, the parts become relaxed, so that in addition to the exhausting effect upon the system at large, it induces falling of the womb. As already stated, the contracted vagina forms a column which furnishes support to the womb; when it is relaxed by the debilitating influence of the leucorrhoea, it readily permits the womb to descend, thus becoming one of the most fruitful sources of prolapsus. DISEASE OF THE NECK OF THE WOMB. It must be remembered that the vaginal mucous surface is continuous and in contact with the invest- ing surface of the neck of the womb, w T hich projects some distance into the vagina. Disease of the neck of the womb thus becomes associated with these cases. As the neck of the womb is very vascular and studded with glands, when inflammation attacks these parts, the trouble often becomes deeper seated and its results more serious. Here we often find a granular surface, abrasion, ulcerated and frequently extensive enlarge- ment of parts, a morbid development of the lower part of the womb occurring under the irritating influence DISEASE OF THE NECK OF THE WOMB. 113 Thousands of Purely Imaginary Cases Treated by Physicians. of disease ; this increases the weight, and thus assists to drag down the womb. The strain upon its vessels and nerves furnishes additional sources of congestion, chronic inflammation, and their results, a class of troubles that are frequently reflected to other parts, causing dizziness in the head, confusion or partial loss of sight, mental hallucinations, irritability of temper, and frequently insanity; also, a sense of choking in the throat, palpitation of the heart, difficulty of breath- ing, dyspepsia, bloated abdomen, pain in the back, hips, and thighs, with derangement of liver and kid- neys. Several of these symptoms may appear to- gether, or some one may be very prominent. Thou- sands are treated for some disease that exists only in the imagination of the physician, because the symp- toms indicating the disease for which the patient is treated, are produced by disease in the parts referred to above, and reflected through the spine to the part apparently afflicted, or I should rather have said, sym- pathetically affected. From some peculiarity of nervous constitution there appears to be no direct relation between the amount of disease and the magnitude of its results. I have frequently seen severe nervous disturbance of distant parts, often to the extent of confining one in bed for months, from the irritation of a small pile tumor in the rectum, or a very small but equally irritable tumor at the mouth of the urethra. In like mannei 10 114 woman's monitor. Sympathetic Troubles. Treatment a small ulcer, or a slight abrasion about the neck of the womb, may produce severe palpitation of the heart or dyspepsia, and perpetuate it through months until it becomes a fixed organic disease; and I am of the opinion that much of the lung disease so common in this country has its origin remotely in irritation trans- mitted from the pelvis and working out fatal results, through nervous prostration and bad digestion. Treatment. — The same suppositories and injections recommended in the treatment of disease of the vaginal surface, cautiously used so as to be certainly applied to the neck of the womb, may be successful; but a large majority will be but temporarily benefited — the gen- eral health may be much improved by careful diet, regulating the bowels, and by copious injections of water, as hot as can be borne, against the neck of the womb twice daily. Cases in which the vaginal sur- face is principally involved may be usually known by the free watery leucorrhcea, whereas the discharges coming from the glands at the neck of the womb are more tough and thick. In addition to the prescrip tion recommended while speaking of vaginal disease, we may mention the excellent astringent and tonic effect of injections of water, in which is dissolved from twenty to sixty grains of ammoniated iron alum to the pint. To effect a cure, many of the cases will require careful. applications once a week, for several months, of saturated solutions of ammoniated iron DISEASE OF THE NECK OF THE WOMB. 115 Patched up, but not Cured alum, strong solutions of permanganate of potassa, oint- ments of iodine, acid nitrate of mercury, or better, in many cases, than any of these, solid nitrate of silver, drawn lightly over the diseased surface. But such applications are only safe in the hands of a ju- dicious physician, who alone can judge of their ne- cessity. Fortunately for humanity many very able physi- cians, both male and female, are engaged in careful study and successful treatment of these diseases, and many are now speedily cured who a few years ago would have dragged through a miserable existence, and at last, by slow degrees, yielded to the destroy- ing influence of a local trouble, which will in time undermine the best constitution. I may say with reference to this, as to the forms of uterine disease, shortly to be mentioned, that many go to water-cures and similar places of resort and return much im- proved in health, but soon find that they are relaps- ing into their old invalid habits. This is because the general health has been built up by the course of medicine and change of diet, bathing, etc., but the local uterine affliction remains uncured, and soon re- gains its old influence over the powers of life. Let such look carefully to the state of their uterine and ovarian system. Diseases of the cervical canal are very prevalent, and it must be apparent to every one at all acquainted with anatomy that no injections wiU 116 woman's monitor. Chronic Inflammation, etc., of the Cervical Canal. reach the canal, unless it is very open, if thrown up with an ordinary syringe. Chronic inflammation and ulceration of the mucous surface of this canal, which is from one to one and a half inches long, and reaches from the lower end of the neck of the womb to the cavity in its center, is caused by an extension of in- flammation, as before stated, from the vagina and neck of the womb, by the acrid character of the dis- charges coming from disease in the cavity of the womb, and from injury accruing in childbirth or mis- carriage, and also very frequently from the use of quills, pencils, knitting-needles, or similar measures used by the woman herself or some friend, in an effort to procure abortion. Disease here is a fre- quent cause of sterility, as well as a cause of many of the sympathetic affections mentioned in the last chap- ter. It is a more fruitful source of irregular and pain- ful menstruation than disease of the labia, vagina, or neck of the womb. If disease of this part occur alone, it may not be manifest by any symptom that could lead unerringly to its existence for some time. There will usually, however, be a discharge of thick gummy substance resembling boiled starch. The patient will become nervous, irascible, moody, and often hyster- ical, with diminished power of endurance and capacity for muscular exercise. These, if accompanied with evidences of impaired nutrition, loss of appetite, and imperfect digestion, should excite serious apprehen- ACUTE INFLAMMATION OF THE WOMB. 117 Do not Tamper with such Cases. sion of disease in this locality, especially if no other cause is apparent. We have only to say further as to treatment, do not tamper with such cases until the health is under- mined. Consult your family physician; if he appears to understand your malady, and makes the necessary examination to enable him to treat you intelligently, confide in his prescriptions and follow his directions; if not, seek more skillful aid, at whatever cost of time or money within your reach, as there is no safety but in a perfect cure of your local disease. The sympa- thetic complications will usually vanish when this is accomplished. A cure can only be hoped for by applying some ointment or lotion, similar to those spoken of when treating of disease of the neck of the womb, and this can only be accomplished by a brush or swab, or other suitable instrument. ACUTE INFLAMMATION OF THE WOMB. Inflammation of the womb, both chronic and acute, is common. The acute variety may be caused by childbirth or abortion, injuries, excessive sexual in- dulgence, displacement of the womb, the use of pes- saries, and extension of inflammation through the uterine neck. Inflammation here may involve the muscular structure of the womb, as well as its lining membrane, and cause extensive enlargement. Symptoms. — Chill followed by fever, violent pain 118 woman's monitor. Symptoms and Treatment of Inflammation of tlie Womb. in the lower part of the bowels, also irritation of the bladder and rectum and severe pain in the womb, and usually sickness and vomiting with diarrhea. The pain often extends to the thighs. If the lining membrane is involved a copious discharge of mucous and purulent matter may be expected early in the progress of the case. Treatment. — The patient should be placed on her back in bed and not allowed to sit up under any pre- text whatever, not even to evacuate the bowels. Warm flaxseed, or corn-meal poultice, or cloths wrung out of warm w 7 ater applied to the bowels, and the family physician sent for, whose judicious pre- scriptions will soon arrest the disease. Many weeks should elapse before the patient resumes her usual course of life, as carelessness in this respect may re- sult in a lasting chronic trouble. She should but slowly resume the erect posture, for the enlarged womb is too heavy for its ligaments, and prolapsus or other bad position of the womb may occur. She should be up but a short time and then lie down to rest the uterine ligaments, and so gradually resume her usual habits, always lying down as soon as a sense of weight and fatigue oppress her. CHRONIC INFLAMMATION OF THE WOMB may result from the same causes as the acute, or the acute may terminate in chronic inflammation. The CHRONIC INFLAMMATION OF THE WOMB. 119 Causes, etc., of Chronic Inflammation of the Womb. presence of tumors in the womb may keep up conges- tion, and at last produce chronic inflammation. It is also produced by bad positions of the womb, disturbing the circulation through the organ. Among the causes enumerated as producing the acute variety, we men- tioned childbirth and abortions. While the acute form is sometimes produced in this way, a sub-acute inflam- mation persisting as a chronic disease is frequently found to follow such conditions. If the substance of the uterine body is involved the discharge will usu- ally be tinged with blood, and frequently severe flood- ing will occur. Menstrual irregularities and nervous disorders are seldom absent. Pain in the back and groin, with an annoying and burning sensation over the pubis, is very common. This form of disease seldom gets well when left to itself or w T hen constitutional means alone are resorted to. It may be palliated and relieved in severity by alteratives and tonics. Sometimes the disease remains for a long time con- fined to the mucous surface, but often it tends to involve the uterine body, and gives rise to prolapsus and other complications. Treatment. — Good diet, fresh air, and systematic exercise, avoiding every circumstance calculated to depress the spirits, with change of air and scene, and such medication as may be necessary to improve the general health. If the womb is displaced from weight of the enlarged organ, some form of sup- 120 woman's monitor. Treatment. port, possibly a stem pessary, may be required. Months will elapse under any circumstance before a perfect cure is effected. The medical treatment con- sists in medicated tents applied to the canal of the neck, and ointments and solutions to the uterine cav- ity with a probang or ointment syringe, assisted by hot water injections to the vagina; bathing, hip-bath, and such other means as a physician may prescribe. Allow such troubles to linger and a fearful day of reckoning is not far distant. The change of life will bring great perils if they do not come before. Exhausting floodings are common, which reduce the system, so that it falls an easy prey to other diseases; or the chronic difficulty keeping up a constant irrita- tion develops cancer, which, when once established, speedily results in death. Before dismissing this subject I will add that the curability of all these forms of disease depends much upon the constitutional peculiarities of the individual. If there lurks within the blood a constitutional taint of rheumatism, syphilis, scrofula, or cancer, whether inherited or acquired, the taint gives its peculiar type to the local disease, and stamps its impress upon its every complication. While the progress of such local affections, by reducing the vital powers, tends to de- velop the inherited or acquired vice of the consti- tution, it is apparent that many who might have avoided disease of the sexual system by a judicious TUMORS. 121 Constitutional Taint. Tumors in and about the Womb. and well-regulated life, after disease has been ac- quired, find it more difficult to cure, because of the above-mentioned tendency to some degeneration of tissue, and that such as know that they have lin- gering in their blood such deleterious elements can ill afford to allow chronic diseases to linger, but should use every exertion to remove by judicious treatment the first symptoms of disease. TUMORS. Tumors in and about the womb are not uncom- mon. They are of several kinds, and may develop on the neck of the womb in its substance or within its cavity. Hard, fibrous tumors may occupy any part of the womb, but more usually appear in the body or fundus. The number is almost unlimited, as also the size. They usually appear between the thir- tieth and fiftieth year — are more common in the ster- ile than those who have borne children. Those who suffer from menstrual disorders are more liable to be attacked, because these disorders are caused by some disease of the womb, and all diseased action in the parts tends naturally to the protection of morbid growth. They are usually complicated with piles, difficulty in evacuating the bowels, chronic inflamma- tion of the womb and bladder, and displacements of the uterus. The most prominent symptoms are painful menstruation, profuse leucorrhoea, watery d.is- 11 122 woman's monitor. Symptoms. Treatment. charges from the womb, pains throughout the pelvis, excessive menstruation, or severe flooding. These sometimes degenerate into malignant disease, and nature sometimes effects a cure by absorption, or by expulsion from rupture of attachment, and by sloughing from deprivation of nutrition. An attack of inflammation sometimes destroys them. Their ex- istence may only be determined in many cases by the physician on careful examination. Treatment may be curative or palliative. The for- mer consists in the use of a properly adjusted abdom- inal supporter or pessary, and injections of astringents to control leucorrhoea, and the use of opium or simi- lar means to control pain. The treatment is surgical, and is only justifiable under two circumstances : first, where the growth is so situated as to render the re- moval both easy and safe ; second, where the dis- ease is threatening the patient's life. The means of removal are the ligature, the knife, caustics, and the e'raseur. I may remark before dismissing the subject, that I have frequently known local depletions, astringent in- jections, and the application of iodine to the parts, with tonics and iodide of potassium administered internally, to relieve the urgent symptoms, and several of my old patients are now enjoying comparatively good health, yet still carry quite large uterine fibroids, but which, for several years past, have not grown much, if any. h POLYPOID TUMORS. 123 Tumors and their Treatment. POLYPOID TUMORS. These exist in great variety, and are variously- classified by authors. They may be hard or soft, muscular or fibrous, glandular or cellular, cystic or vascular, etc. Their attachment is as various as their character, sometimes upon the vaginal part of the neck, in the canal of the cervex, or within the cavity. The symptoms are the same as those enumerated when speaking of fibrous tumors, except that painful men- struation is not common only in cases where a polypi acts as a ball valve, preventing the escape of men- strual blood. Nature may possibly expel these from the womb with such force as to rupture their attach- ment, and effect a cure, but in a majority of cases they destroy the patient with anaemia, or more directly by exhausting hemorrhage. They may usually be readily and permanently cured by the surgeon by means of ligature, twisting off with the forceps, or by excision with the knife, or e'raseur. CANCEROUS TUMORS. Persons long subject to disease about the womb, especially if known to possess a hereditary tendency to cancer or malignant tumors of any kind, may well fear the encroachments of cancer of the womb. If to constitutional debility there is added a pallid, sallow face, dark grumous or ichorous and fetid discharges, 124 woman's monitor. Predisposing causes of Cancerous Tumors of the Womb. Avoid Quacks. much hemorrhage, pain through the pelvis, and ten- derness on motion or coition, there is still greater cause for fear. Among the predisposing causes are life in a large city, want of food, pure air and exer- cise, grief and other depressing mental influences, middle or advanced life, and hereditary tendencies. The examination of the discharges from an open sore with the microscope, furnishes a safe guide to the nature of the case, and all cases presenting such seri- ous symptoms should be carefully examined by a physician. If true cancer is found to exist, let no promises to cure on the part of the boasting pretender induce a lady to subject herself to his plasters and ointments, nor hints of hope from surgeons induce her to permit an operation, as all experience has shown that all such management is fraught with imminent danger, and only hastens a fatal issue. The duration of the disease will depend upon the constitution and treatment to some extent, and vary from a few months to several years- — the average about three years — but all terminate in death. A liberal diet should be furnished, anodynes given to relieve pain, and astrin- gent injections to control hemorrhage. Also, copious injections every day of solutions of permanganate of potassa, ten to twenty grains to the pint of warm water, or as much carbolic acid crystals. These de- stroy the fetor of the discharge, and prevent the cor- PRODUCTS OF CONCEPTION. 125 Apply to a Skillful Physician. Blighted Product of Conception. rosive action often troublesome upon the vagina and external genitals. A variety of tumors not mentioned here, of a ma- lignant type, are found in the womb, but their history would be uninteresting, as they are all attended with similar symptoms with those already named. Some are as incurable as cancer, others are amenable to the surgeon's art. But we have said sufficient to guide women to a correct idea as to the probable seat and nature of these troubles, and a more accurate diagno- sis is only attainable by such study and experience as the physician should possess, and to whom all should apply early when afflicted with any of the symptoms denoting serious disease. PRODUCTS OF CONCEPTION. The womb is often filled for months with a blighted product of conception. At first the female considers herself pregnant, and evinces the usual symptoms, but quickening does not come on at the proper time, neither does the development of the abdomen progress as fast as might be expected. At last her situation becomes puzzling in the extreme. The general health appears to be unaccountably disturbed. She is ap- prehensive of danger, and often becomes nervous and prostrated in mind and body. At length pain of a periodic character appears, often, also, exhausting hemorrhage, when the womb throws off a small after- 126 woman's monitor. Sometimes such Product Remains for Months. birth, with no appearance of membranes and foetus. Or there may be a pretty well developed sack of waters without appearance of cord or foetus. Often the flooding is so severe as to call for instrumental as- sistance to clear the womb, and the adoption of meas- ures to arrest the bleeding. Sometimes these products of conception remain for many months, keeping up much flooding, especially if but a small irregular mass of pla- centa remains still attached, and retaining its vitality after the regular menstrual crisis is established. At the "periods" the hemorrhage is profuse, at other times a similar hemorrhage is kept up by a large mass of granulation in the shape of a polypi sprouting from a placental sore. When exhausting hemorrhage has no other assignable cause, and especially if the womb is evincing a tendency to develop, as it will from the irritation of such presence, and the breasts manifest an unusual sympathy with the womb, some in- tra-uterine development may be suspected. The judi- cious physician will use a speculum, and examine with the uterine sound; if need be, dilating the neck of the womb with sea-tangle or sponge tents to enable him to be more accurate in examination, and to re- move any morbid development that may be found. Astringent injections for a few weeks after the uterus is clear and a course of tonics soon effects a cure of the local trouble in the womb, and checks the uterine leucorrhoea so often present in such cases. But there DISPLACEMENTS OF THE WOMB. 127 Causes of Displacements of the Womb. is often a peculiar tendency to repeat these attacks In such cases some serious disease of the womb or ovaria should be suspected, and the case should be submitted to a careful examination by a physician. Delays are fraught with danger, as repeated attacks of hemorrhage may develop something still more dangerous. DISPLACEMENTS OF THE WOMB. These may occur suddenly at any period of life, from falls, blows, or overlifting, especially of weights that must be raised higher than the shoulders, a task imposing peculiar strain upon the miiscles of the abdomen. The uterus from such cause may be at once dislocated, and followed immediately by pain in the abdomen, back, hips, or pelvis, usually in a short time by some fever, pain, and tenderness in the parts. The ligaments are stretched or lacerated, and nothing can relieve but immediate replacement by the fingers, or a suitable instrument, and reclining for some days upon a sofa or bed, also great care for several weeks about such exertion as would be likely to reproduce the trouble. A large majority thus afflicted do not consult a pl^sician. The nature of !he case is not recognized, and I fear too often when they do the doctor is too timid or careless to afford the necessary relief. In many cases the ligaments recover their tone and partly rectify the trouble, and 128 woman's monitor. An Illustrative Case. it is not until the accumulated ills of years are upon her that the lady begins to realize the serious charac- ter of the injury she had suffered. In many cases the poor creature is doomed to a life of suffering, ever after a neglected accident of this kind. I now have under my care a girl of twenty-two years, of excellent build, and originally of sound constitution, the daughter of a farmer. At the age of sixteen years, during a menstrual period, she assisted her father to remove a box from a wagon and put it on a wood-rack. In lifting the box over the wheel she felt something give way in her bowels, and suffered severely from pain in the back and pelvis, with fever and tenderness about the abdomen for some days; since which the menses are irregular, leucorrhcea pro- fuse, nervous system disturbed, she rests badly at night, has a weak back, and pain in the side. These symp- toms, varying in intensity, have harassed her ever since the partial •recovery from the more immediate effect of the accident. At length unable to perforin her part of the household duty, her mother brought her to town for treatment. I found the womb small and flabby, strongly adhering to the rectum by adhesive bands, caused by inflammation. Its position was across the floor of the pelvis, the top lying to the left side. I introduced a small glass speculum, and with some difficulty brought the neck of the womb „o view — it was quite open from relaxation, and dis- DISPLACEMENTS OF THE WOMB. 12$ Course of Treatment Adopted. charging large quantities of glary mucus. The ad- hesions rendered it impossible to correct the disloca- tion. &. course of astringents with an ointment syringe to the cavity and neck of the womb, with daily injections to the vagina of tepid water, relieved the leucorrhcea, and tonics and a course of bathing improved the general health, but a cure is impossi- ble. A young life is blighted and rendered miserable because she had no idea of the nature of her injury, and hence did not know what to do for relief, and, unfortunately for her, the limited capacity of the vil- lage physician who was called to her aid, or his care- lessness, did not permit him to secure a correct idea of her case. I relate this one case at length as an example, not because similar cases are uncommon, but because it illustrates the character of the cases fre- quently occurring in the routine of practice. Severe and sudden symptoms only mark sudden dislocations, but partial or complete displacements in countless multitudes are about us on every hand, produced by too early rising after confinement, or miscarriage, and by the slow T er encroachments of such diseases as we have already described, causing relaxation of the va- gina and uterine ligaments, thus permitting of dis- placements, or by unequal development of the Avomb, under some process of morbid growth by which it is thrown out of balance and gradually inclined to some abnormal position. The variety of displacements most 130 woman's monitor. Causes of Prolapsus of the Womb. common are prolapsus, (falling down;) anteversion, (tipping forward;) and retroversion, (tipping back- ward.) These have each some peculiarities worth noting. PROLAPSUS. The cause of prolapsus, when occurring as a sudden dislocation, has already been considered, also hints as to other causes that might produce it, as relaxation, and hypertrophy of parts, causing increase of weight. It will be apparent that any cause that will increase the weight of the womb will produce prolapsus. Hence all kinds of tumors about the womb or its appendages, as well as hypertrophy from congestion or inflamma- tion, may produce prolapsus, as also may straining efforts at stool, or any violent exercise of the ab- dominal muscles. It is also often produced by con- stipation of the bowels and the pernicious habit of tight lacing, also by the weight of clothes resting on the abdomen, which should be supported by shoulder- straps. The symptoms are a sense of dragging and weight in the pelvis, irritation of the bladder, pain in the back and loins, inability to lift weights, unusual fatigue from walking, leucorrhcea, and oftentimes ex- cessive menstruation. Treatment. — Replace the womb by causing the pa- tient to kneel on a hard lounge or table, resting upon the elbows ; the bladder and rectum being empty, the PROLAPSUS. 131 Treatment for Prolapsus of the Womb. womb, if not adhering to surrounding parts, by adhe- sions from inflammation, may readily be replaced by two fingers well oiled and introduced into the vagina. To prevent its return remove the weight of clothing by skirt-supporters, the weight of the bowels in bad cases by abdominal supporters, and by prohibiting the wearing of tight clothing. Do not allow much accumulation of urine, and regulate the bowels by a course of careful diet. A course of tonic treatment should be pursued to improve the general health. Let all accessible tumors be removed and leucorrhcea cured by appropriate treatment, whether they be vaginal or uterine. Remain much of the time in a recumbent posture and avoid heavy lifting and long walks. Do not take long journeys by carriage or railway, and avoid the sewing-machine. The use of a properly adjusted stem pessary, or such other variety as the physician may suggest, is often a very efficient auxiliary to other treatment. We have promptly cured cases continuing from relaxation of parts, after the leucorrhcea and other accompanying troubles were cured, by brushing the neck of the womb and vaginal surface once in from three to ten days with collodion. It smarts for a few moments, when a decided sense of relief is obtained. The va- gina, regaining its proper tone, contracts, forming a supporting column beneath the uterus, which is thus kept in its proper position. 132 woman's monitor. Cause and Cure of Anteversion. ANTEVERSION. Inclination of the womb forward upon the bladder is very common. Its slightest shades of inclination are of no consequence, but when seriously displaced it gives rise to distress from pressure upon the blad- der, such as frequent desire to urinate, inability to retain the urine long when in the erect position, and when the uterus is much enlarged. There is also trouble in evacuating the bowels, from pressure of the neck upon the rectum. It may also produce painful menstruation and sterility. The same causes that lead to prolapsus may produce the displacement re- ferred to. Constipation of the bowels will be more likely to produce this disease than prolapsus if the vagina is in good tone. The earlier Aveeks of preg- nancy are apt to be burdened with prolapsus or ante- version. Treatment. — Avoid every possible source of irrita- tion by following the directions given when speaking of prolapsus, constipation, leucorrhoea, etc. These should be cured if possible. Also, all complications which may be perpetuating causes. Reclining on the back and allowing the bladder to become quite full may be useful. The physician will replace the womb if badly reclined, and in some rare cases employ a pessary and abdominal supporter to advantage, but RETROVERSION. Causes and Treatment of Retroversion of the Womb. the cure is usually best effected by removing the dis- ease that caused it. RETROVERSION is tipping of the womb backward, so that the fundus rests on the bowel, and, in many cases, naturally ob- structs the passage of fecal matter, especially if the bowels are allowed to become constipated. It is caused by the same influences that produce the forms of displacement already named, to which might have been added rupture of the perineum, carelessness af- ter childbirth, and unusual retention of urine — three causes of displacement that are more likely to pro- duce this variety than ante version, the latter some- times determining whether the case shall be prolap- sus or retroversion. Tumors and inequality of devel- opment under hypertrophical influence may also have their effect. Treatment. — The womb should be replaced by the dextrous use of the fingers, or Sim's uterine reposi- tor, and retained in place by a properly adjusted pessary. In some cases the abdominal supporter may be applied to assist in supporting the weight of the bowels. The bladder should be kept empty by fre- quent urinating, and the patient directed to lie upon the abdomen as often and as long as is convenient. 134 woman's monitor. Sudden Displacements sometimes Readily Restored. OTHER DISPLACEMENTS. Various grades and directions of flexion of the womb exist — a form of displacement in which the womb is bent upon itself. These may occur of vari- ous degrees and in varied direction, own the same parentage, and are amenable to similar treatment with the forms of displacement already described except they are not benefited by the use of pessaries to the same degree, only the intra-uterine variety of pessary being useful, and this a source of no little danger. It must be remembered that displacement may often oc- cur suddenly and be readily restored, but flexions oc- cur slowly. The texture of the womb being changed, a perfect cure may never be attainable, though the accompanying disease and inconvenience may often be removed. PROLAPSUS OF THE VAGINA. Great relaxation of the vaginal walls may allow the posterior wall of the birth-passage to come down, bringing the anterior part of the rectum, and form a protruding mass at or even beyond the vulva. So the anterior vaginal wall may prolapse, bringing the bladder with it, sometimes to such an extent as to form a large tumor projecting from the vulva. The cause is usually difficult and protracted labor, or want of careful management in child-bed, straining at stool, VAGINAL FISTULA. 135 Proper Treatment for Vaginal Fistula. constipated bowels, pelvic tumors, or the presence of stone in the bladder, and leucorrhcea. Treatment. — Remove all known sources of disease, as piles, tumors, and gravel, and all curable diseases that may act as a perpetuating cause. Surgeons have devised some instruments for relieving and operations for curing such cases, which may be resorted to in desperate cases. A physician should be consulted on the first appearance of so grave a trouble. VAGINAL FISTULA. It sometimes happens that the bladder or bowel becomes connected with the vagina by the process of ulceration in malignant disease, so that the urine or fecal matter find their way into the birth-passage. These cases are generally incurable, and the remainder of a wretched existence must be made more tolerable by careful attention to cleanliness, and by frequent in- jections of tepid water. There are cases, and not a few of these forms of fistula, caused by the careless use of obstetrical instruments and pessaries, also by gravel ulcerating through, or the pressure of the child in tedious confinement. As soon as the nature of the accident is discovered, a surgeon should be consulted, scrupulous cleanliness should be observed, and every source of irritation to surrounding parts prevented as much as possible. As soon as the general health will permit the surgeon will close the wound by paring the 136 woman's monitor. The Ovaria subject to Inflammations, etc. edges, and uniting by some kind of stitches. A com- plete cure may be thus effected. OVARIAN DISEASE. You will remember that the ovaria are two glandular bodies situated at either side of the uterus, and whose office is to produce the ovum or egg, Avhich is, in health, thrown off every twenty-eight days, from the period of puberty until the change of life, except during the period of maternity and nursing, and with many women during the entire nursing period. Al- though such are often apparently in excellent health, we regard it as an evidence of over-activity of the sexual function, and are never surprised to see such become the subjects of ovarian or uterine disease. The ovaria are subject to inflammations, both chronic and acute, sometimes resulting in abscess; also, to a variety of tumors, of which the development of nu- merous cysts in clusters, and containing some form of liquid, are the most common. The ovaria are some- times lacking altogether from birth, and are often im- perfectly developed. They may waste away as a result of inflammation, or become unnaturally large from prolonged congestion or a low grade of inflam- mation. Inflammation is very common as a result of child- birth and abortion, and may be caused by disturbed menstruation from cold, by the extension of inflam CHRONIC OVARITIS. 137 Symptoms, Treatment, etc., of Ovarian Inflammation. mation from other parts, especially that form that re- sults from purulent poison. The symptoms are chills, fever, and pain in the lower part of the abdomen or the side affected, and tenderness on pressure. It of- ten terminates in suppuration, the pus being dis- charged either through the walls of the abdomen, or through the rectum, bladder, or vagina. The treat- ment one can adopt for themselves is the same as for other inflammations about the pelvis already de- scribed. All such severe symptoms should at once be brought to the notice of the family physician. CHRONIC OVARITIS. A fixed pain low down in the abdomen, but to one side of the median line, especially if no uterine disease is known to exist, and if increased at the menstrual period, and the parts are tender on pressure, should excite fears of chronic inflammation of the ovaria, a trouble that is very likely to result in abscess under bad treatment, especially in those who are careless of health or depraved in habits, and the more certainly so if af- flicted with scrofula, syphilis, or like constitutional taint, or strongly predisposed to any such- affection. Persons suspecting a tendency to ovarian trouble should keep off of their feet as much as possible, es- pecially about the menstrual period, avoid all sexual irritation, live temperately, and remove every compli- cation as speedily as possible which would be likely 12 138 woman's monitor. Treatment for Chronic Inflammation of the Ovaria. to assist in developing and perpetuating disease. When it is evident from the severe chill, fever, pain, and throbbing that an abscess is forming, the physician will direct warm poultices, warm vaginal injections, and as soon as fluctuation is distinctly perceptible the matter should be evacuated with a bistoury or trocar, and the surgeon will then carefully wash out the cavity daily with a weak solution of carbolic acid, crude pyroligneous acid, or permanganate of potassa, with a suitable apparatus, the patient keeping clean by the frequent use of the syringe with warm water. A liberal diet of toast and tea, fruits and animal jelly, stewed mutton or beef, and eggs should be enjoined, and a liberal allowance of wine, not some miserable, sour, home-made stuff, vile enough to make a well person sick, such as I frequently find persons taking in the rural districts, but the best port, malaga, sherry, or like wines found at the most respectable dealers. PELVIC ABSCESS. . "What I have said with reference to the ovarian ab- scess, applies to all forms of pelvic abscess with equal force as to the symptoms, for they are such as to re- quire an expert to tell the difference, and the general management is the same. OVARIAN TUMORS. 139 Signs and Treatment of Ovarian Tumors. OVARIAN TUMORS. These are, on their first appearance, sometimes con- founded with pregnancy, and with fibrous enlargement of the womb. They are either fluid, solid, or a mix- ture of the two. They may assume a great variety of forms, and are liable to contract adhesions to the surrounding parts. The cysts that develop in the fluid variety of ovarian tumors sometimes attain an enormous size. I have myself tapped one of these containing twenty-two pounds of a clear liquid. In some cases the fluid is brown, red, or like coffee grouaids. Very little is known as to their cause. The predisposing causes generally admitted are men- strual diseases, the scrofulous tendency, and some say child-bearing age. It appears that the period most subject to attack is that of the greatest ovarian activity. I have several times found it to co-exist with cancer in other parts, and also, apparently, as a substitute for that disease in persons belonging to families predisposed to cancer in the form of carci- noma. A dull pain low down in the abdomen, to one side of the median line, with a sense of fullness and throbbing, dragging pain in the pelvis, irritability of the bladder, disturbance of the. lower part of the bowels, especially if attended with less soreness than should accompany chronic inflammation or a swelling in the vagina, should excite fears of ovarian tumors. 140 woman's monitor. Tapping — Surgical Operations. These troubles are sometimes confounded by the ig- norant with rupture or hernia. The treatment is sur- gical, and any serious suspicion of trouble of this kind should secure the counsel of a physician. In cases where large cysts have formed, constituting the en- cysted variety of dropsy, as also in abdominal dropsy, the question often arises, Shall the patient be tapped? It is certain that tapping is not without some danger, and that alone it very seldom effects a cure, but it se- cures comfort by preventing pressure from injuring important organs, and thus diminishes danger of com- plication, and hence should be as early and as fre- quently resorted to as the necessity of the case may require. In twenty years' observation we have never seen any serious trouble from tapping any kind of ab- dominal dropsy. As to operations for the removal of ovarian tumors, we think it must ever remain an operation fraught with great danger to life, and that the danger in- creases every day with the progress of the disease from increased nervous and vascular connections and adhesions. So make up your mind, if afflicted in this way, to at once demand the assistance of the sur- geon's art by some of the methods usually employed, or to trust to nature to the end. It must not be for- gotten, however, that these tumors sometimes attain a considerable size, and then remain stationary for many years. -^ LEUCORRH(EA. 141 Leucorrhoea but a Symptom or Consequence of other Diseases. LEUCORRHCEA is a discharge of mucus and pus, sometimes both, from the mucous surface of the vagina, or the lining mem- brane of the neck or canal through the neck of the womb, or from the lining membrane of the uterine cavity. It is discharged from the surfaces under the influence of disease, and is an evidence of inflam- mation, either chronic or acute, or of abrasion or ulceration of some part of those surfaces. The dis- charge, if copious, is very prostrating; if very thin and watery, it probably is from the surface of the birth-passage; if tough and thick, from the neck of the womb, or its canal; if mingled with blood, it is from the uterine cavity; if with pus, there is likely ulceration. In some cases quite a quantity of blood is discharged from the villi of the vagina. From what I have here stated, and the teachings of preceding chapters, it is quite evident that leucor- rhoea is but a symptom or consequence of other dis- eases, and that a cure can only be expected by remov- ing the disease, displacement, or irritation, upon which the discharge depends. Let tumors be removed, dis- placements corrected, the bowels regulated, sexual excesses refrained from, and the discharge held in check, if thin and watery, by injecting, two or three times daily, one of the following solutions : Sulphate zinc. 30 grains. Soft water 1 pint. Mix 142 woman's monitor. Treatment for Leucorrhcea. Misunderstanding among Married People. Or, twenty grains of tannic acid, thirty grains of sul- phate of copper — blue vitriol — or twenty grains of ammoniated iron alum ; may be substituted for the zinc. Injections of soft water, used cold in the inter- vals of menstruation, are at times of service in giving tone and relieving the relaxation of the vagina, so common in cases of long standing. But great care is necessary lest injurious congestion should accompany the reaction after the application of cold. Nine- tenths of the cases of leucorrhcea are but the conse- quence of the disease, requiring either medical or surgical aid, and should be promptly subjected to the counsel of the family physician. GONORRHOEA. We would not salute ears polite with the word at the head of this article were we not convinced that this form of venereal disease is the source of much misunderstanding among married people, and also a cause of many cases of divorce, through a want of accurate knowledge of its characteristics. No physi- cian of extensive experience but can call to mind many cases where it required great judgment and skill to give such a decision as would be just to all parties. Gon- orrhoea, or clap, is an inflammation of the mucous surface of the urethra in the male, and of the ure- thra, labia, vagina, and uterus, or one or more of the parts alluded to, in • the female. It is a grade of GONORRHOEA. . 143 Symptoms and Sources of Gonorrhoea. inflammation that results in copious secretion of pus from the parts, and the title above should only apply to the disease which results from infection from one similarly afflicted. But the s} r mptoms are the same, no matter how the grade of inflammation is produced, that causes purulent secretion ; it will infect the eyes, producing a severe form of purulent ophthalmy, or the mucous surfaces of a. person brought in contact with the matter, and produce a similar disease. Not all who are exposed to a venereal gonorrhoea are afflicted, and a large per cent, of those exposed to sources of contagion having an honest origin escape, but there is abundant evidence that all do not. The reason for treating on this subject will be apparent at least to all who have in the spirit of philosophic inquiry en- deavored to make themselves acquainted with the' facts. Every community is startled from its pro- priety now and then by some man supposed to be an honest Christian gentleman, under some pretext leaving his wife, with whom he has lived in domes- tic tranquillity for many years. The family physi- cian in such cases is often aware that the cause was jealousy, because he believed he had contracted from his wife a gonorrhoea, or clap. If the physician did not believe in any source of contagion but unclean coitis, he probably charges the party with incon- stancy. Knowing they are innocent, they are left to draw but one conclusion, that their partner is incon- 144 woman's monitor. Serious Misunderstanding between Man and Wife when botli are Innocent. stant. It has been my privilege frequently to bring back joy to a hearth-stone desolated by such misun- derstanding. But the evil does not always stop here. The husband may have much regard for his children, and a true and trusting love for his wife. He does not wish to wrong her. Harassed with doubts and fears, he thinks to conceal his own disease in hopes to learn by careful observation what grounds for sus- picion exist. But the wife, who is not aware that any thing unusual is the matter with her, having discovered the husband's diseased condition, feels sure he has been inconstant, possibly separates from him, sues for a divorce, and thus brings upon the family disgrace and ruin, or they live through weary years of crimination and recrimination, only pre- vented from separating by the children — a mutual pride — not wishing to bring on them public disgrace. If we can heal one such broken heart, reunite one divided family, bring peace and joy to one hearth- stone by this article, we shall be amply repaid for our labor. That these cases are certainly quite com- mon in the bosom of the Church and in every walk of life, both high and low, I know from twenty years' intercourse with society as a physician and from conversation with many of my professional brothers. We say, then, that the presence of dis- ease having all the characteristics of gonorrhoea is not even presumptive evidence of guilt; that every GONORRHOEA. 145 Gonorrhoea not necessarily Presumptive Evidence of Guilt. test, even microscopic examination of the pus, affords but an uncertain guide, as inflammation originating in other causes may produce a disease, with every symptom of the infectious trouble, and that the pus from the disease thus produced will infect another party, and thus a genuine clap, in the family of a truly virtuous man and woman, from disease caused by local irritation, cold, or other variety of sick- ness. Look, then, to the general character, to the usual walk and conversation, for corroborating evi- dence before you put the mark of your displeasure upon one who may be the innocent victim of disease. I purpose to make a few quotations from standard authority to substantiate this view. On pages 182 and 183, of "Sargent's Addition of Druett's Modern Surgery," read : Inflammation and purulent dis- charge from the urethra may be produced by other causes, some of which have no connection with sexual matters. A discharge resembling gonorrhoea may be caused by local irritation. Urethritis, with discharge, may be produced by various disorders of the consti- tution. It has been a symptom of rheumatism, and not unfrequently precedes gout. It may be caused by sympathy with irritation in other parts. It may be occasioned by piles. A discharge is liable to occur in persons afflicted with stricture. Discharges are occa- sionally produced by medicines, as guaiacum and Cay- enne pepper. A man may contract a pretty severe dis- l 14 G woman's monitor. Various Causes of Gonorrhoea among Virtuous People. charge from a woman who is perfectly chaste, and has not been previously infected by a third party. Thus the menstrual flux is capable of causing urethritis, with violent scalding and cordee, and followed by swelled testacies. A considerable degree of irritation may be produced by the vaginal secretion just previous to menstruation. Similar consequences sometimes en- sue, if the female be afflicted with leucorrhcea, or any other discharge of any sort whatever. The question next follows whether there is any means of distinguishing the simple gonorrhoea, that is, a discharge that does not arise from sexual connection, or which a man contracts from some accidental malady in a clean, chaste woman, from a venereal gonorrhoea or clap caught from an infected prostitute. The an- swer is decidedly not. However produced, the dis- ease of the urethra is the same in its nature, the same in its symptoms, and requires the same treatment. Bumstead, in his pathology and treatment of venereal diseases, says there are other means of origin for gon- orrhoea than by unclean coitus. He says he is abso- lutely certain that gonorrhoea in the male may proceed from intercourse with a woman with whom coitus has for months or even years been practiced with safety, and this, too, without any perceptible change in the condition of her genital organs on the most minute examination with the speculum. He asserts that in- tercourse with a woman about the period of menstru- GONORRHOEA. 147 Other Causes Enumerated. Gonorrhoea not Hereditary. ation may give rise to gonorrhoea in the male, and that the views he advocates are by no means novel, but are entertained by many of the most eminent French specialists. (See Bumstead, pages 64 to 72, and 178 and 179.) That the disease may be con- tracted in privies and beds by accidental contact with fresh matter left by a diseased person is also quite certain. This was well known to the ancient He- brews — read the fifteenth chapter of Leviticus. That it may originate from coitus with a woman who has uterine catarrh, is taught by Cullerier, the celebrated surgeon who succeeded Ricord, at Paris, who says, in his illustrated syphilis, "All practitioners, especially those at the head of large hospitals, have observed gonorrhoea as a consequence of connection with a woman afflicted with uterine catarrh, or a discharge caused by simple ulceration of the neck of the uterus, or even leucorrhcea, especially when it occurs at the time of the menses." Those desiring further informa- tion may consult the first chapter of the work above referred to. We might multiply these quotations in- definitely, but deem these sufficient, and will only add that syphilis is a specific disease that must not be confounded with the one above referred to. While gonorrhoea does not contaminate the blood and hence become hereditary, syphilis does. This disease has a vast interest to the honest and honorable portion of the community for the following reasons : it is capa- 148 woman's monitor. Syphilis Hereditary. Innocent People may Contract it. ble of inoculation from drinking cups, hands, surgical or dental instruments, the brush or razor of the bar- ber, flesh brushes, and towels, etc., and by the blood that frequently is dried with the vaccine scale, and introduced in vaccination, by the imperfectly cleansed lance in phlebotomy, a species of surgery practiced in the rural districts quite extensively by the non- professional, and we have great reason to fear that the profession are not always sufficiently careful. This terrible judgment of God upon licentiousness is often communicated to innocent and unsuspecting young women by kissing at parties or in private com- pany. A small sore is found on the lip, and ere long are developed sore throat, eruptions upon the skin, disease of the joints or bones, or some other manifesta- tion of this terrible malady. Besides, the lady thus accidentally afflicted, even if all the worst symptoms have been cured, will stamp the impress of her con- stitutional infirmity upon her offspring — a terrible taint that will cling to her posterity from generation to generation. Be very careful, then, how you asso- ciate with fast young men, how you frequent the re- cesses of hotels. Look carefully to the habits and health of your domestics ; if they have running sores, diseased joints, offensive catarrhs, or a general bad reputation, secure a careful examination to ascertain the facts, and if of syphilitic origin expunge them from your household as you would a deadly plague GONORRH(EA. 149 Look to the Health ot your Domestics. Accidental Contamination. or loathsome leprosy. Ofttimes, in my professional rounds, have I refused to eat at the table of intimate friends because I had reason to suspect the servant in the kitchen was a victim of secondary syphilis, and in repeated instances have known them to be nursing an open chancre. Do not suppose this danger is con- fined to our large cities; especially since our great civil war it is prevalent in every village, and an intru- der in almost every neighborhood all over the land. It is bad enough when poor, frail humanity, crushed beneath the ponderous weight of sin, reeks and fes- ters with this loathsome disease as the legitimate fruit of transgression of the moral law, but when we see the loathsome, copper-colored blotches, and the scabby sores, the incurable catarrhs, or gradually decaying bones in those whom we have reason to believe are the innocent victims of the duplicity and treachery of one who should have been ever zealous to protect their honor and their health, we are filled with horror that is only equaled by the sympathy due to the in- nocent victim of accidentally acquired disease. Al- though it is probable that the number who suffer from accidental cause are few in comparison to the number who are infected through sinful intercourse, yet we are convinced that the cases of accidental contagion are sufficiently numerous to call for the caution we have given. We have given but few of the symptoms and shall say but little of the treatment of this pro- 150 woman's monitor. Hysteria is more Alarming than Dangerous. tean malady, our design being simply to call attention to a few sources of danger, hoping thus to be instru- mental in staying, in some measure, this tide of dis- ease and death. HYSTERIA. This form of disease is more alarming than danger- ous. We often find it in its most fruitful forms in young women of full habit and. robust constitution. It is connected with some deranged or morbid condi- tion of the reproductive function, and may be excited into action by a variety of causes, as by high living, sedentary habits, excitement of the venereal sense, want of sleep, excessive fatigue, disordered digestion, obstinate constipation, and sudden mental shocks, as joy, fear, and grief. The nervous temperament is most subject to it, and those who are single or wid- ows more so than the married. It is sometimes caused by excessive discharges and exhausting dis- eases, but usually by disease of the womb. Hyster- ical females are usually subject to flatulency, dyspep- tic symptoms, and palpitation of the heart. Some have ringing in the ears, confusion of mind, numbness in the limbs, a feeling as if insects were creeping on the top of the head, pain below the left breast, diffi- culty of breathing, and a sense of choking, as if a ball was in the throat. In many cases, especially about the menstrual period, such are attacked with EPILEPTIC CONVULSIONS. 15 1 Symptoms and Treatment of Hysteria. severe convulsions, very frightful to behold, accom- panied with violent contortions of the body. In many cases the body is rigidly bent backward, forming an arch. This may continue for some time, and be suc- ceeded by violent jerkings, or the whole muscular system may be thrown into violent spasms, requiring attention from bystanders to prevent the patient from being thrown out of bed. The attack leaves one sore and exhausted. Treatment. — Remove all irregularity and pain at the menstrual period, by securing a cure of the dis- ease of the womb, which keeps up the irritation. If tenderness is discovered along the spine, let cups or leeches be applied; regulate costive bowels by appro- priate means, as directed when speaking of constipa- tion; reduce fullness of habit by cathartics, cupping, n low diet, and scarification of the uterine neck; re- move debility by tonics, a liberal diet, and wine, and give relief at the paroxysm by subcutaneous injec- tions of morphia, or by full doses of it by the mouth. EPILEPTIC CONVULSIONS. Females are subject to epileptic convulsions from a great variety of causes. Those cases originating in disease of the spine and brain, and so frequently as- suming the epileptic form, do not require much atten- tion here. Many of them are incurable, and such as 152 woman's monitor. Treatment of Epileptic Convulsions. are curable depend upon some sympathetic disease of the brain. If organic changes have occurred in the structure of the brain or its appendages, it is proba- ble the case is incurable ; if not, benefit may be de- rived from perseverance in correct habits of life, and regulating every organic function. If scrofula is present, or is hereditary in the family, the following formula will sometimes effect a cure : R Iodide of potassium 3U. Compound sirup of stillingia ...Oss. Mix. Dose, one tea-spoonful three times daily. This should be continued for several months. In cases where great nervous excitability exists, equal parts of the fluid extract of skull-cap and fluid extract of valerian, given in tea-spoonful doses, are excellent. In cases accompanied with great nervous excitement, menstrual irritation, or sexual irritability and restless- ness at night, from twenty to forty grains of bromide of potassium may be given every four to six hours, until relief is obtained. Heavy doses usually pro- duce drowsiness. The bromide may be dissolved in water. Twenty grains three times daily, for some months, has cured some very bad cases of epilepsy, in my hands. A like success has attained the use of this formula: # Hydrocyanate of iron grains, 20 Pulverized root of valerian " _ 30 Mix. Make thirty powders, and give one three times daily. DISEASE OF THE BREASTS. 153 Other Formulas. Defective Breasts. It is particularly adapted to the treatment of those who are debilitated and have a pale, sallow counte- nance. Valerian, camphor, musk, or other antispas- modics may be useful. Chloroform by inhalation is ofttimes invaluable, as the relaxation it produces per- mits the womb to throw off a retained clot, which by its presence was keeping up irritation. DISEASE OF THE BREASTS. Milk abscess and such troubles as are incidental to the period of maternity and nursing, will be treated of in another chapter. A few general remarks here on other affections of the breast may not be amiss. One or both breasts may be absent from birth, or but a rudimentary development may exist. This defi- ciency appears to be hereditary in certain families, and is coincident with defective development of some part of the sexual apparatus or of the entire body. ,It may be caused by some constitutional malady, as scrofula or chlorosis. We possess no means of over- coming rudimentary development of the mammary gland. Cases are cited in the annals of science where a number of nipples have existed on the fe- male chest. Those supernumerary organs also have been found in the arm-pits, and upon the thighs and abdomen. Such malformations are rare in this coun- try, but are said to be common in the Antilles. They are only injurious to beauty. Atrophy of the gland 154 woman's monitor. Diseased Breasts. occurs usually at the change of life, but may appear at any age from inflammation, injury, or as a sequel of some form of uterine disease, and is a common consequence of the protracted use of the prepara- tions of iodine, but when so produced is not always permanent. When from the latter cause, friction with salt and water, or some slightly stimulating lotion, may be useful by calling more blood to the part, and thus tend to promote development. Hy- pertrophy is an unusual enlargement of the breast, and frequently affects both organs. The excess of size is mostly due to deposits of fat, but in some cases the gland appears to be unusually vascular, its vessels and tubes dilated, and the breast enlarges rapidly. Hypertrophy is rarely a result of inflammation, but is usually preceded or accompanied by some disease of the uterus or ovaries. Treatment. — Careful attention to the treatment of all disease of the pelvic organs — a persistent and steady course of iodine in some soluble shape, as iodide of potassium, iodide of starch, or iodide of lime. To the enlarged gland, ointments of iodide of potassium or mercurial ointment, and the systematic use of adhesive plaster bandage so applied as to keep up gentle pressure. Neuralgia of the breast, known by the intermitting character of the pain, which is sharp and lancinating, is usually met with in young females, especially those who are chlorotic and TUMORS AND CANCERS OF THE BREASTS. 155 Treatment. hysterical. It is sometimes accompanied or alternated with neuralgia in other parts. For this, tonics, as tincture of iron, elixir of Peru- vian bark, or small doses of Fowler's solution of ar- senic, may be used. A belladonna plaster to breast, or a little chloroform on the hand or on a piece of cloth covered with oiled silk, so applied as to prevent evaporation, until the parts are quite red, will bring relief. This is an excellent application for pain any- where. TUMORS AND CANCERS OF THE BREAST. Tumors of the breast are encysted, fibrous, bony, cartilaginous, or cancerous — the latter occurring in sev- eral varieties. Without doubt the breast is the most frequent seat of cancer. It is most often met with between the fortieth and fiftieth years. Though the breast is first attacked, few die until other parts have become implicated in the cancerous affection. Women of dark complexion are more prone to the disease than blondes. Cancer of the breast or of the uterus is more common in the city than in the country. Most authors agree in placing depressing emotions among the ex- citing causes. It is apt to develop in a part that has been injured by abscess. Pressure, blows, and benign tumors in this part may assume a malignant nature. The first appearance of cancer is a small tumor, 156 woman's monitor. Causes of Tumors in the Breast. which gradually develops, loses its regular outline, and becomes incorporated with surrounding parts, losing its clearly defined limits. It becomes painful, especially about the period of the courses. It ap- proaches the surface, pushes up the skin, and forms a tumor without discoloration. At length the skin be- comes a livid red, and adheres to the morbid growth. The cutaneous veins become enlarged, the nipple de- pressed. Lancinating pains now traverse the breast in every direction; bluish spots then appear on the tu-' mor; ulcers form, from which ooze a bloody fluid. These deepen and enlarge, and when once established extend without ceasing. The patient emaciates rap- idly, and may die in two or three months from the first appearance of the tumor, or the fatal result may be delayed for many years. Sometimes the disease progresses so slowly that it does not shorten life, and in very rare cases the parts are attacked with gan- grene, the tumor sloughs off, and a veritable cure is effected. The microscope should be brought to the assistance of the physician to increase the certainty of his knowledge as to the nature of the case. Scan- zoni, a celebrated German author on the diseases of women, says he is persuaded that a correct diagnosis of mammary tumors, if not yet ulcerated, is only certain on anatomical examination. Cancer may be confounded with induration from inflammation and hypertrophy of some of the glandular lobes. Cancer TUMORS AND CANCERS OF THE BREAST. 157 The " Indian Botanic Cancer Plaster." destroys young women much more rapidly than the elderly. Treatment. — Tumors of the breast usually cause great uneasiness of mind on the part of the patient lest they should become cancerous, and for that rea- son, although doing but little if any injury, they should be removed. Extirpation is the least painful and most certain method of getting rid of such growths. After cancers have extensively incorporated surrounding parts or affected the glands of the arm- pit, removal will avail nothing. Among the caustics that have been used only a few are worthy of a trial at the hands of the surgeon. The most reliable are solidified nitric acid, chlorid of zinc, arsenic, and the hot iron. The choice of these must be left to the surgeon, who will select to suit the case. All the celebrated cancer plasters, vaunted by cancer doctors, contain one of these agents, usually arsenic. About sixteen years ago a quack cancer doctor was advertising his wares as the Indian botanic cancer plaster. With this he removed many morbid growths. A medical friend of mine secured an analysis of the remedy, and -it proved to be the hydrated peroxide of iron, arsenic, and lead, equal parts. I have exam ined a number of these celebrated botanic cancer rem- edies since that time, and they all contain arsenic as a dominant element. There is much danger of arsenic poisoning from their use, but probably less when the 158 woman's monitor. Trust not to Plasters, but Resort to the Knife. hyd rated peroxide of iron is combined with the ar- senic, as this is its antidote. Careful observation has taught me that all medicine and even excision is quite uncertain. After the case has made considerable progress no treatment Avill succeed, but excision is, no doubt, the most hopeful method. Trust not to plasters of any kind. If the case is not too far ad- vanced have the very surroundings of the disease removed with the knife. This is the quickest, most certain, and least painful method, and though often followed by fatal results at no distant period from re- turn of the disease, it sometimes succeeds in effecting a cure, and that is more than can be said of any other known remedy; but to succeed, it must be resorted to early, before surrounding parts are too much impli- cated ; after that it is useless to operate. You may then keep the parts clean, washing with solutions of carbolic acid or permanganate of potassa — any drug- gist can prepare it — and take morphia to relieve pain, and patiently wait the inevitable result. In cases where the only chance of success is embraced by early operation, for a long time after, take alteratives, as tea-spoonful doses of compound sirup of stillingia with from one-half to one ounce of iodide of potassium to the pint, or three to five drops three or four times daily of Fowler's solution of arsenic. The last is very useful as a tonic. The solidified nitric acid and the hot iron may have effected cures. I should, as a METHODS OF EXAMINATION. 159 A Surgical Operation less Painful than the use of Caustics. rule, rather trust the arsenic formula above given than any other plaster with which I am acquainted for re- moving tumors and other morbid growths from any part of the body. But all such agents are more dan- gerous and less certain than a surgical operation, and they are more painful. If the operation is done un- der chloroform, the wound from the knife is not so painful as the w T ound from caustic, and the action of the caustic is too slow to admit of chloroform during the entire period of its application, except in the case of the white hot iron. The surgical w T ound heals more kindly, and is not so likely to be followed by a return of the disease. I believe the inflammation set up by the caustic enlarges the capillary vessels, and allows the cancer cells to stray away from the point of their origin, thus scattering the disease. Those attending upon cancer patients should be very careful about bringing abraded surfaces in contact with the matter, as I have no doubt but it may be communi- cated by infection or inoculation. I have not space to detail the experiments and arguments which have led many of our best pathologists to that conclusion. METHODS OF EXAMINATION. It is a matter of no little importance that women should have correct ideas of the methods of examin- ation which it is necessary to pursue in order to have accurate knowledge of the nature of disease. So 160 woman's monitor. Importance of Knowledge in Detecting Quackery. much medical quackery and assuming pretensions are abroad in the land that it is difficult for the people to tell, when they are counseling a physician, whether the opinion they receive is worthy of credence or not. We propose to make a few remarks on this subject, and give some explanation of the nature of the exam- inations and treatment required in serious disease of the uterine system, and some other troubles. In diseases of the lungs, after a careful analysis of the hereditary tendencies and past history of the pa- tient, the present condition of every vital organ should be carefully inquired into, the chest examined in a quiet place, where the sounds elicited by listening to the breathing and by percussing the chest may not be interfered with by outside sounds. The room should be warm enough to prevent the patient from becoming chilled when the garments are all removed from the neck to the waist, except .a soft, unstarched muslin wrapper, that as little obstruction to the sound of the heart and lungs may be in the way as possible. Every part of the chest should then be carefully explored by the ear or some form of stethoscope; none of these are so certain, however, as the direct application of the ear. All examinations of the chest without fall compliance with the above requisitions are uncer- tain or positively useless. The expectorated matter should be repeatedly examined by chemical tests, and METHODS OF EXAMINATION. 161 How to Detect Bladder and Kidney Diseases. with the microscope, to determine as to the presence of tubercle, pus, or blood. Disease of the kidneys, in addition to the careful an- alysis of the case as to its general symptoms, requires repeated and careful examination of the urine by the most careful application of chemical re-agents and re- peated microscopic observation of the deposits. With- out this precaution all opinions are but shrewd guess- ing, and whether by men of high or low degree, unworthy of confidence — as every scientific physician knows full well that it is impossible to arrive at con- clusions to be relied upon in any other manner at present known to the profession. In diseases of the bladder, in addition to the careful examination of the urine by the methods above in- dicated, it is necessary to examine the bladder by pressure above the pubis, also through the vagina, and to do this in a proper manner the patient should lie down upon a bed or sofa with the limbs drawn up so as to relax the muscles of the abdomen. If the presence of gravel is suspected the general symptoms will direct as to the necessity of the use of the sound, which, if thought necessaiy, should be warmed, well oiled, passed under the sheet, which should always completely envelop the patient, and be passed through the urethra into the bladder and the stone carefully searched for. A failure on the first examination should not be 14 162 woman's monitor. A LpZS How to detect Stone in the Bladder, etc. taken as conclusive evidence that no gravel exists The position should be changed and another and an- other effort made until it becomes quite certain no stone is present. These efforts should not be too long continued nor too frequently repeated, as serious inflammation of the bladder may result. The urine should be retained before these efforts with the sound. If the bladder is found empty warm water should be injected, to keep it on the stretch, thus securing more certainty in hitting the gravel with the instrument. Gravel in the female is less common than in the male, because the urethra is so much shorter, and more easily dilated, permitting them to pass while small, and few gravel are found in women that may not be removed by dilating the urethra without the use of the knife. In disease of the liver and spleen careful examination of the sides is necessary to ascertain whether there are tumors or enlargement of those organs. Disease of the ovary may usually be detected by the symp- toms mentioned in a preceding chapter, but the pres- ence of tumors can only be detected by pressure over the lower part of the abdomen, and frequently it is necessary to place the patient on the back, limbs well drawn up, then with the finger in the vagina, passed well up to the right or left of the neck of the womb, as you may wish to examine the left or right ovary, and the fingers of the other hand passed firmly down METHODS OF EXAMINATION. 163 How Examinations should be Conducted. over the lower part of the abdomen. The presence of enlargement of the ovary or tumors in this situa- tion may be readily detected and their character ac- curately defined, especially if the patient is thin. The same method of examination here detailed is often an efficient means of detecting enlargement of the womb, as the organ can be freely balanced between the finger in the vagina and the hand above the pubis. The womb may be examined with the finger in this manner, as to displacements, enlargements, tumors, and hypertrophy of the lower part or neck. But the speculum becomes necessary to reveal the color and condition of the vaginal surface, the pres- ence of eruptive affections, or ulcers on the mucous membrane of the vagina or neck of the womb, and the character of the discharge which issues from the canal leading to the cavity of the womb. Litmus paper and the microscope may be employed to give more accurate account of the nature of the discharges, and then the speculum and the uterine sound may be employed to ascertain the depth of the uterine cav- ity and the presence of foreign bodies, as polypoid and fibrous tumors. Great care should be observed to ascertain beyond a reasonable doubt that the woman is not pregnant, lest you cause abortion by the use of the sound, an accident which, we are told by the best authors, has at times happened in their hands. When it is necessary to carry ointments into or to 164 woman's monitor. Further Information as to Making Examinations. remove tumors from the womb, the neck may be so closely contracted as to require dilating. This is ac- complished by passing a small sponge or sea-tangle tent into the canal leading to the womb, through a specu- lum, and allowing it to remain, until by absorbing moisture it expands, when it may be removed and a larger one applied. During and for some days after this process the lady must keep her room and avoid much exercise, or serious inflammation may occur. THE SPECULUM consists of a metallic or glass tube or metallic blades, so arranged as to be introduced and then separated so as to bring the diseased parts to view, and are in endless variety, to suit the different cases that arise, or the judgment or caprice of the surgeon. Such a selection should be made as could be introduced with- out pain. The patient should lie on the left side or on the back, limbs drawn up, and be covered by a sheet; the instrument, carefully selected to suit the position of the womb — as previously ascertained by examination — should be warmed, well oiled, passed un- der the sheet, and carefully introduced into the vagina. The sheet is then so tucked around the instrument as to avoid all exposure, except the surfaces to be examined, which can be seen through the aperture in the speculum, and through which the applications to the diseased parts may be safely made. CAUSES OF DISEASE AMONG WOMEN. 165 Causes of Disease among Females. CAUSES OF DISEASE AMONG WOMEN. It is our purpose in this chapter to speak of some of the most prominent causes that lead to physical decay of females in this country. These are predis- posing and exciting. Among the predisposing causes we may mention the influence of certain habits on the part of the mother, as lacing, excesses in eating, sexual frauds, and connubial excesses; also the in- fluence of physical and mental depression upon the mother during maternity and nursing. Among the exciting causes climatic influence, improper dress in childhood, want of care about the period of puberty, self-abuse, fast living, excessive physical and mental labor, depressing passions, sexual frauds, and connu- bial excesses may be mentioned ; also narcotic stimu- lants, rapid child-bearing, long nursing, want of care at the period of confinement, and miscarriage. TIGHT LACING. Many mothers ruin the health of their future off- spring while in the womb by an effort to disguise as far as possible the fact of pregnancy, the better to enable them to run the giddy round of fashionable dissipation, or from false modesty, desiring to pre- vent, as long as possible, a knowledge of their condi- tion becoming known to their associates. Lacing- strings are brought to bear upon the abdomen, 166 woman's monitor. Dangers from Tight Lacing. From Excess in Eating. retarding its increase of size, thus preventing the developing uterus from arising out of the pelvis, caus- ing excessive pressure upon the bladder and rectum, and injuring the uterus to such an extent as fre- quently to cause abortion. When it is no longer pos- sible to confine the womb in the pelvis, the same means used even moderately prevent healthy devel- opment on the part of the womb, increasing the dan- gers of child-bed, by predisposing to inflammation, also assisting to produce cramp in the limbs and en- larged veins about the lower extremities, by forcing the uterus against the veins and nerves at the lower part of the abdomen, and what is more to our pres- ent purpose, insures feeble and diseased offspring, thus becoming a predisposing cause of disease to the suc- ceeding generation and an exciting cause of numerous maladies to the mother. EXCESS IN EATING is no uncommon source of disease among women dur- ing maternity, and a predisposing cause of feeble con- stitutions, weak stomachs, and disease of the bowels among children; nay, more — of such maladies in riper years. Many mothers are fond of indulging every whim of appetite under the guise of longings that should be gratified for fear of injuring the foetus, and thus abandon discretion and good judgment as to the quantity and quality of food. The result is EXCESS IN EATING. 167 Bad Habits of the Parent Fastened upon the Child. that the stomach, which is usually vigorous during maternity, and should be supplied with abundance of healthy food, becomes feeble from overwork; flatu- lency, heartburn, and other symptoms of indigestion appear, which speak plainly of a state of the. stom- ach corrupting to the blood, depressing to the nervous power, and hence certain to enfeeble the infant in mind and body. Its organic tissues, formed out of blood containing imperfectly assimilated material, must of necessity be wanting in that perfection of struct- ure so essential to health and longevity. It is im- possible for a woman suffering from indigestion to pre- serve that equanimity of temper and disposition so essential to impress like qualities upon her child; and we shall see, when we come to treat of hereditary transmission, that feeble, diseased organs of the parent, by some mysterious law of the economy, are likely to be entailed upon the children. The mother who gratifies her appetite for improper articles of food or indulges in excess of eating and drinking during maternity, not only injures herself, but stamps her disease and likewise her habits of indulgence upon her offspring — an act of cruelty to the helpless, un- born creature that should bring remorse of conscience to the guilty parent. Of one thing we are certain, such indulgence very frequently brings trouble to parents, from sickly children, also heart-breaking sor- row, when called upon to part with them, though thev 16S WOMAN S MONITOR. Parents Guilty of Sexual Frauds not h* for Procreation. may not always know when the seed was sown that ripened into bitter fruit. SEXUAL FRAUDS AND CONNUBIAL EXCESSES will be treated of more fully as exciting causes of disease; but every one who reflects upon the subject must admit that the diseased condition of both par- ents, caused by these flagrant violations of the laws of life, produce debility and disease on the part of parents that must descend in a multiplied ratio to their children. The father enfeebled by sexual fraud or connubial excess is unfit to assume the responsi- bility of procreation, and the womb diseased by the same cause must be an unfit receptacle for the living germ that is, in fullness of time, to become a think- ing, acting, rational creature. Will not the disease by which it is surrounded become a part of its or- ganic being, interwoven into the warp and woof of every tissue, thus predisposing to certain mental and physical changes in after life, and through the in- fluence of a diseased body upon the mind, leading to intellectual and moral deformity, that must cling to the unfortunate being through ceaseless ages. PHYSICAL AND MENTAL DEPRESSION may be predisposing causes of disease, not only to the mother, who is more liable to become the victim of disease while the power of resistance is enfeebled PHYSICAL AND MENTAL DEPRESSION. 169 The Temper of the Mother Transmitted to the Child by debility from mental depression, but also to the child during maternity and nursing. Just as the dis- ease or weakness of a single organ may be stamped upon the child, so the general debility or depressed mentality of the mother may, nay, most certainly will- be transmitted as an inheritance to her child. Children procreated during debility from disease or mental depression, from loss of friends or other cause, will be likely to be feeble in body, or give evidence of similar depression of mind to that suffered by the parent; more especially will this be true if the causes continue to operate during maternity. The remedy is to desist from procreation until the circumstances are favorable to health of mind and body in the off- spring. You will readily discover that the causes of dis- ease and premature death among American women are not all due to their own violations of the laws of health, but often to certain predisposing causes in- herent in their physical organization. But those sparks of disease, which lie smoldering in the body, are too often fanned into a consuming flame by fla- grant violations of Nature's organic laws ; sometimes through ignorance, but too often these sins are against light and knowledge. Sexual frauds and connubial excesses, as we will endeavor to show when speaking of the exciting causes of disease, are a fruitful source of nervous de- 15 "170 WOMAN S MONITOR. Effects of Connubial Excesses on Parents and Offspring. bility, dyspepsia, consumption, epilepsy, disease of the prostate gland, and kindred affections among males, and of leucorrhoea, uterine displacements, dis- ease of the ovaries, and inflammation of the uterus among women. And as the offspring must inherit a tendency to these constitutional and local diseases of the patient, it is evident that frauds and excesses of the kind alluded to are predisposing causes of dis- ease in the child, Avhen practiced by the parent, as well as an exciting cause of disease, when indulged in by persons of mature years. If healthy persons may develop disease by such excesses, how much more certainly will the individual who has inherited a predisposition to such maladies as are thus pro- duced ! Physical and mental depression during ma- ternity, whether produced by sickness, misfortune, domestic strife, poverty, or other cause, by their en- feebling influence upon the mother, stamp their im- press upon the offspring, diminishing its power to resist endemic and epidemic influences; thus rendering it more liable to such diseases as may prevail, and more likely to perish when disease assails ; also more difficult to cure when afflicted with chronic disease. Its feeble vitality does not enable it to withstand physical and mental shocks so well as the mind and body of the child born of healthy parents, and whose mother's mental and bodily powers were at the healthy standard during maternity. If parents desire to avoid EXCITING CAUSES OF DISEASE. 171 Climatic Influences as Exciting and Predisposing Causes of Disease. sorrow and disappointment in declining years, they must obey Nature's inexorable requirements as to the laws of transmission of qualities, or the consequence of their own weakness and folly will be apparent in the feeble bodies, weak intellects, and moral delin- quency of their children. EXCITING CAUSES OF DISEASE. Climatic influence is potent, both as a predisposing and an exciting cause o£ many maladies which afflict both sexes. Imperfect drainage and damp air, by keeping the body bathed in a moist atmosphere, re- tards perspiration, vitiates the secretion of the kid- neys and liver, thus laying the foundation of disease of those organs, and producing rheumatism or other serious disease. Sudden and frequent changes of temperature disturb the equilibrium of the physiolog- ical powers, and lead to internal congestions and in- flammations, or to catarrhal affections of the throat, or bronchi, which too often become the exciting cause of more serious disease of the respiratory organs, end- ing in consumption and death. Our observation has led us to believe that malarial districts, where ague and chill fevers prevail, are proper places for tuberculous patients to reside, and that those afflicted with throat and lung diseases often get better, and that even incurable disease of the lungs is sometimes retarded for many years by resi- 172 woman's monitor. The Circulation of the Blood Through the Liver. dence in such locality — the force of the diseased actions falling principally upon the abdominal or- gans, producing diseases of the liver, spleen, pancreas, and digestive system, and thus diverting morbid ac- tion from the respiratory system. But for the same reason that such climate is good for the consumptive invalid, it is very bad for those who by temperament or predisposition are prone to diseases of the digestive system, kidneys, or sexual organs. This will be apparent to those whose knowl- edge of anatomy enables them to understand the portal circulation. By the portal circulation is meant the side circulation through the liver. The blood sent out by the arteries of the bowels, instead of be- ing collected by the veins and sent back to the heart direct, after permeating the capillaries of all the or- gans in the abdomen except the kidneys, bladder, and, in the female, the reproductive system, is col- lected into one large vessel, called the portal vein, which passes into the liver, dividing into minute branches, reaches the heart, after passing through the capillaries of the portal circulation in the liver, where important changes occur in the nature of the blood, at the same time that the bile is separated from it. You will perceive that by this arrangement all the blood from the digestive system is passed through the liver before reaching the heart, and EXCITING CAUSES OF DISEASE. 173 Malarial Districts. hence the state of the circulation through the ab- dominal viscera is in no small degree subject to the condition of the liver. Congestion, or any cause that retards the circulation through the capillaries of the liver, must of necessity produce congestion, and tend to cause inflammation in the abdominal viscera. It is for this reason that we find inflammation, both chronic and acute, of the liver, stomach, spleen, and bowels, more common in malarial countries; and it must be confessed that scrofulous and tuberculous degeneration of the liver, spleen, and glandular struct- ure of the mesentery and mesocolon, are more com- mon in districts where miasmatic diseases prevail. The same may be said in reference to chronic dys- entery, chronic inflammation, and ulceration of the rectum, and the several varieties of piles. But we have elsewhere shown that piles, and dis- eases of the rectum, tend to produce disease of the uterus and ovaries, through that sympathy which nervous relation secures between parts. It is also certain that congestion of the abdominal viscera, during malarial fevers, often produces abortion, and thus frequently lays the foundation for chronic dis- ease of the uterus and its appendages. At all events it is sure that uterine displacements, with chronic in- flammations and their consequences, are more preva- lent in malarial than in non-malarial districts. 174 woman's monitor. Low-Necked Dresses, Short Sleeves, and Bare Legs. IMPROPER DRESS IN CHILDHOOD has been referred to as a cause of disease. None doubt the frequent development of lung fever, bron- chitis, croup, and similar diseases, from the too prev- alent fashion of dressing children with low-necked dresses and short sleeves. But it may not be so ap- parent to the non-professional mind that a large per cent, of those who escape the severe diseases which threaten life in childhood, lay the foundation during youth for laryngitis, bronchitis, and consumption, in after years, and that many young girls, even in in- fancy, suffer from inflammatory affections of the mu- cous surface of the labia, vagina, and bladder, often associated with copious mucous, or muco-purulent dis- charges, caused by taking cold from the frail and dainty manner in which their limbs are dressed. Do not forget, fond mother, that every grade of disease, whether mild or severe, produced by such causes in early life, is likely to leave a weakness that predis- poses to similar affections in after years, and that women who expose the feet and limbs insufficiently clothed, are likely to suffer from rheumatism of the uterus, suppressed menstruation, and inflammatory affections of the pelvic organs. SELF-ABUSE. I have alluded to the want of care so frequently manifest on the part of those in charge of young girls SELF-ABUSE. 175 Self-Abuse. Apology for Treatment of the Subject. at the trying period of puberty, a Rubicon on life's rugged way which so many of our daughters fail to pass unscathed. I then noticed a few of the many causes that lay the foundation of bad health at puberty, and a number of the mental and moral dangers that beset the youthful maiden at this period of her pilgrimage. A fear that I should offend the fastidious possibly de- terred me from speaking as plainly on some subjects as the necessity of the case required; and since the article on secret vies was written I have been urged by several intelligent physicians and a number of emi- nent divines to speak more plainly on the subject of self-abuse. Many will say this was useless — nay, . that it may be positively injurious. But who that has thought deeply upon the subject will commit so grave an error? Certainly not the man or woman who has sought for evidence by consulting the reports of our houses for correction and our lunatic asylums; not those who have consulted physicians upon the subject who are engaged in an extensive practice; not those who have questioned postmasters as to the number of letters passing through the mails to those miserable medical mountebanks who fatten by preying upon the credulity of tens of thousands of both male and female, w 7 ho have realized the debasing effect upon mind and body of this source of wretchedness and disease, although the number really injured is not so great as some writers would have us believe. No 176 woman's monitor. Do not Hesitate to Instruct your Children on these Delicate Subjects. man versed in physiognomy can go abroad in the land without marking here and there the haggard lines of the countenance disfigured by this vice. He sees them in the shops, upon the street, and in the public assembly, and knows that their name is legion ; that the debasing literature of the day is accessible to all who will read, and that thousands revel in ex- citing romance and tales of love and amours who would blush to have their parents know they read such trash. We have reason also to fear that Chris- tian parents are not so careful as duty demands in the selection of reading for their children. They permit them to grow up too much by chance, trusting their moral and religious training to the Church and the Sabbath-school, as they do their intellectual develop- ment to the schools and colleges, and when they have furnished the means to defray expenses appear to think they have discharged their whole duty. Moth- ers, blush not to talk to your daughters upon these subjects. Let your warning voice be heard before purity is gone and health is broken . Permit them not to go forth to encounter life's fearful perils unarmed and unshielded by the panoply of truth. We have no patience with that sickly sentiment which teaches that ignorance is the highest order of innocence. Therefore put forth the proper effort to prevent that which the skill of the physician may not cure, be- cause it is so often brought to his notice when too late. SELF- ABUSE. 177 Reform Easy at First, but afterward more Difficult. One fact more. Every philosophic physician knows that the habits to which we allude are often indulged in to a certain extent in early life. When light by accident or design is thrown upon the pathway of the erring one, reform is immediate and recovery ap- parent. But in after years the poor victim to early indiscretion finds that unusual susceptibility to dis- ease exists. The uterus is irritable, menstruation pain- ful or irregular, spinal irritability exists, the stomach, heart, and brain sympathize, and the woman is su- premely miserable. Every gynecologist knows that such cases are hard to cure, because unnatural ex- citement at an early period has produced unusual de- velopment of the nerves and vessels of the ovaries and uterus; even the filaments of the spinal cord, which connect the sexual organs with the brain, are larger and more sensitive than normal, and thus these early indiscretions become a source of puerperal con- vulsions, insanity, and puerperal fever at the maternal period, as well as of a host of minor ills incidental to the non-maternal state. Mother, if your daughter be- comes listless, absent-minded, nervous, and unusually retiring, seeks solitude, and is disposed to retire to her room, and spends days and nights in reading ro- mance, and especially if her bowels are constipated, appetite capacious, is inclining to eat chalk, charcoal, clay, and like articles, with temper unusually irritable, with countenance haggard and care-worn; if she grows 178 woman's monitor. Signs of Self- Abuse. Hot-house Plants. pale, sallow, and anaemic, is restless at night, and com- plains of giddiness and confused vision ; if the lips and eyelids are swollen, especially in the morning; if the skin is damp with cold, clammy perspiration, a symp- tom which is usually first clearly manifest in the hand, then you have grave reason to fear the slow but certain operation of the cause of disease, to which we have invited your attention. Some of these symp- toms may arise from other causes, but many of them grouped together should excite especial concern lest the mad-house or the grave may soon receive another victim. Under such circumstances do not consult some advertised quack, but consult an honest, capa- ble physician. FAST LIVING. Among the wealthy it is no uncommon thing for women to develop disease by too much indulgence in ease and luxury. The stomach is pampered with dainties or stimulated with wine, condiments, or med- icines to secure digestion, which should have been prompted by exercise in the open air, on foot or on horseback. These are veritable hot-house plants, whose cheeks require paint and enamel to secure a sickly semblance of those hues of health which should have been called forth by the fresh breezes of heaven and the glorious sunshine. Reclining all day on rich sofas in parlors carefully protected by heavy curtains FAST LIVING. 179 The Women of Luxury and Fashion. from the encroachment of light and air, with no high purposes, no noble resolves, nothing present or prospective, but ease and luxury, their thin blood creeps lazily through their sluggish veins, no won- der time drags heavily its slow length along. No wonder when the time arrives to dress for the evening entertainment some narcotic stimulant is necessary to drive away the listlessness and ennui that over- shadow with their dark penumbra the luxurious life. The opera, theater, social party, or dancing-hall next taxes their feeble energies during the hours Nature designed as a season of repose. If a better state of morals prevail, the lecture-room or the church may for a few hours vary the monotony of the scene. But these are reached in close carriages, and require but little of that' muscular exertion so much needed to recuperate the failing vital powers. Wretchedly nervous, melancholy, and miserable, unless excited by some new sensation or strung to temporary ten- sion by opium or wine, what wonder if these vic- tims of fashion should be unfit to fulfill the high prerogatives of maternity, and should early fall vic- tims of disease ! Their feeble bodies can not sustain a healthy glow of vitality in their own bloodless frames, much less impart sound health and vital stamina to the offspring they too often assume the responsibility to usher into life. But kind Nature usually releases their children from the weakness and 180 woman's monitor. Totally Unfit for Life's Duties. Excessive Exertion. disease they are forced to accept as the gift of mis- guided parents, their earthly tabernacles are dissolved and the immortal germs transplanted to a more ge- nial clime. The mother, usually the victim of fe- male weakness and disease from early life, produced and fostered by habits of indolence and ease, often falls a victim to the first maternal effort, or making an imperfect recovery, suffers on through a few brief years, and then succumbs to disease indirectly result- ing from erroneous habits of life. Thousands in our large towns and cities pursue just the course we have described, and with similar results, while multi- plied thousands follow as near as their circumstances will permit in this beaten track, which leads to dis- ease and death. EXCESSIVE PHYSICAL AND MENTAL LABOR may also be sources of disease. Stern necessity often prompts to hard work at critical periods, when women, by the laws of their being, are required to abstain from severe exertion. But much may be done by a wise forethought, even by those in indigent circum- stances, to so arrange their household duties as to avoid overwork at the period of menstruation, also during maternity, arid the three months succeeding confinement. Mental labor should be but moderately indulged in by females during menstruation and ma- ternity, as every energy of the physical frame is DEPRESSING PASSIONS NARCOTIC STIMULANTS. 181 Depressing Passions. Narcotic Stimulants. necessary to cany on in a proper manner those im- portant functions. DEPRESSING PASSIONS, as anger, grief, and fear, are fruitful sources of dis- ease, especially of diseases peculiar to the female or- ganization. Almost every physician can point to cases of convulsions, insanity, or epilepsy, as well as floodings, suppressed or painful menstruation, and pre- mature labor from the shock caused by giving way to one of these emotions. That rapid child-bearing, long nursing, want of care at the period of confinement, and miscarriages are sources of disease that require the earnest attention of women and careful study on the part of physicians, will be admitted by all. These will receive attention in the chapter on the diseases and accidents incidental to maternity and nursing. NARCOTIC STIMULANTS, as an exciting cause of disease and death among Amer- ican women, hold no inconsiderable place. Opium and its preparations, tobacco, and alcohol are among the most potent of these agents. They are habitually used by many females to relieve the pains of some real or imaginary ills, or to secure that vivacity of thought and activity of muscle they have failed to acquire from proper diet and exercise. You will observe that I have not mentioned tea and 182 woman's monitor. Excessive Use of Tea and Coffee. Tobacco. Its Use among Women coffee among the agents detrimental to health, though it must be admitted by every unprejudiced observer that a vast number of women are seriously injured by the excessive use of those agents. But the worst that is likely to result from their abuse is dyspepsia, nervous prostration, and such diseases as naturally arise out of those conditions. Their use does not develop an appetite that constantly urges to in- creased gratification by larger and larger portions. They stimulate and call out the activity of the nerv- ous functions, which ofttimes become feeble from over- work, but they do not benumb and stupefy the sys- tem, awakening fires that can not be quenched until body and soul are subject to the devouring flame. TOBACCO, in many sections of the United States, is used by women, young and old, and even by those laying claims to a high order of gentility ^ as a snuff rubbed on the teeth and gums. This is the most debasing and disgraceful manner of using the filthy weed. It is worse than chewing fine cut, because it ruins the teeth and gums, and renders the mouth so filthy and disgusting that persons of refined sensibility can scarcely tolerate the presence of one who rubs snuff. Many women, in both low and high life, are addicted to smoking. This vile habit vitiates the breath, and thus injures the lungs, benumbs and perverts the TOBACCO. 183 Woman Smokers. sense of taste and smell, and, through its impressions upon the nervous system, injures the hearing and sight, as well as the intellect, and thus destroys ap- preciation of the finer sentiments and feelings of the mind, while it hurries to premature decay those facul- ties provided by a munificent Creator to enable us to receive impressions from the world about us. It is thus that the woman addicted to the use of tobacco, under whatever pretext she may cloak this crime against her higher nature, and the nobler attributes of her being, by this self-indulgence, is gradually, but surely, destroying her sense of taste, clouding with smoke the windows of her soul, and shutting her ears to the concord of sweet sounds ; thereby preparing her debased and impoverished nature, to sit down in darkness or dim twilight, with none of the senses capable of appreciating the beauties of surrounding nature. Although the air is redolent with odor of sweet flowers, and made vocal by songs of mirth and gladness, while gorgeous forms of beauty, decked in Nature's richest robes, are ever present to give pleas- ure to those with unperverted senses, they bring no joy to the dimmed eye, nor harmony to the deaf ear. The slow, but deadly influence of this potent narcotic reaches still deeper; permeating every avenue of life, it spreads its withering mildew upon all the functions of the animal economy, perverting absorption and secretion, interfering with healthy digestion, exciting 184 woman's monitor. Fifty Thousand Women Opium Eaters in the United States. then stupefying and enfeebling the nerves, until pa- ralysis, or some other disease, makes an easy prey of the poor victim which tobacco has insnared. OPIUM. From the best sources of information upon which we can draw, we are forced to the conclusion that not less than fifty thousand women in the United States use opium, or some of its preparations, to such an ex- tent as to produce daily inebriation. Many of these are constant sufferers from uterine or other forms of neuralgia, and suppose they are under the necessity of taking morphia or opium to keep down the harass- ing pains of disease. It is possible in some cases, especially of uterine or other forms of cancer, that the use of some narcotic to allay pain is the best that can be done to smooth the pathway to the grave. But we fear where one uses it from necessity hun- dreds do so from habit. A toothache, neuralgia, or painful menstruation, was relieved by a dose of opium; the disease returned, the opium was again resorted to; at last a habit was fortned, the demon appetite aroused, an insatiable longing for the drug estab- lished, and thus the woman has become a slave to this deadly narcotic. Physicians are not sufficiently careful not to foster such appetites, and ladies do not manifest sufficient dread of the drug. Kind friend, have you a painful disease ? Except ALCOHOLIC STIMULANTS. 185 Drunkenness Among Women. it be certainly incurable, and likely soon to prove fatal, seek skillful medical aid for its removal. If your physician resorts to opium to still the pain, and makes no further effort, be sure he is incompetent for the task he has undertaken. Discharge him at once, and seek more skillful advice. ALCOHOLIC STIMULANTS. Many women in aristocratic circles are addicted to wine; and this habit is not confined among them to the irreligious, but is indulged in by members of evangelical Churches, under the pretext that it is necessary as a medicine. I will not stop to moralize upon the condition of those degraded and depraved women who have so far forgotten the noble dignity of womanhood, and the delicacies of their sex, as to indulge an appetite for strong drink to the extent of habitual inebriation. That this withering blight has touched with its pestilential breath many of the fair daughters of this favored land is a fact too well known to require urging upon your attention. If bestiality and debauchery are hideous to behold in men, with how much more horror do we shrink from the spectacle when presented in woman, to whom we instinctively look for that gentleness and correct de- portment that should characterize the conduct of this last best gift of God to man, "made but a little lower than the angels !" 1G 186 woman's monitor. The Moderate Use of Alcoholic Stimulants by Women. Let us turn from the contemplation of woman as an inebriate to consider her as a victim of the moderate use of alcoholic stimulants, in which capacity she figures in every department of society, and in almost every relation of life. Exhausted by excessive labor and loss of sleep, in the ceaseless round of domestic duty, or debilitated by rapid child-bearing and nursing, in addition to the cares of a numerous family, what wonder if she should resort to stimulants to brace her shattered nerves, or attempt to kindle the waning vital fire with alcoholic potions! True, it would be much better to secure rest and gain strength by the digestion of wholesome food, and thus secure ex- emption from those diseases that so certainly result from compelling the exhausted body to labor under the goading of alcohol, which does not give strength to the feeble muscles and exhausted nerves, but only enables the poor woman to hold out a little longer in the unequal contest with labor beyond her strength. The same principle applies to those who are afflicted with leucorrhoea and other exhausting diseases, who too frequently resort to some of the advertised bitters as a remedy for the debility they find gradually di- minishing their ability to perform the duty devolving upon them. A temporary improvement often results. The increased energy of the system appears tem- porarily to have triumphed over the local disease, or the general debility; but too often this is but a de- ALCOHOLIC STIMULANTS. 187 Effects of Stimulants. ceptive appearance. The bitters have not removed the cause, but has called out and used all the reserve forces of the system, and the potions must be in- creased from week to week to prevent the return of the symptoms with increased severity, for which they were first taken. The system once accustomed to such stimulus finds it difficult to carry forward its operations without it. An appetite for narcotic stimulus is thus engendered, which too often follows the unfortunate sufferer like an evil genius, refusing to be appeased until disease and death have destroyed the body, and forever marred the brightness and glory of the soul. It is true but a few of these sink to the depths of in- ebriety; and none, when first adopting these tonics, so called, anticipate such results. But it is none the less certain that a vast multitude of women are daily increasing the amount, or changing the character of the stimulant tonics or bitters with alcoholic base, while disease pursues its desolating career unchecked. We fear physicians, who should know better, too often pander to the tastes of their patients, or, with- out due consideration as to the ultimate consequences, prescribe wine or alcoholic bitters. The honor of our noble profession, no less than duty to humanity, de- mands more care on our part in regard to this matter. One thought more. What must be the conse- quences to the offspring where the mother is con 188 woman's monitor. Effect on Offspring. Sexual Frauds, etc. stantly saturated with alcohol during maternity and nursing ? Will its organic tissues be sound ? Will its brain have that texture that will enable it to be an honor to society, a light to the Church, or a help to the nation? Science, in most emphatic tones, •answers no. Its elementary tissues will be formed out of imperfectly prepared and poisoned material, and hence not likely to maintain a vigorous condition of the physical powers. The mind will likely be weak or imbecile. It may be unusually precocious in early life, but will soon sink below the average; and, worse than all this, an insatiable thirst for stim- ulus will likely be implanted in the nature of the child, that may lead it to a drunkard's grave. SEXUAL FRAUDS AND CONNUBIAL EXCESSES occupy a conspicuous place among the sources of dis- eases of women. Until recently the reformatory journal, the pulpit, and the medical profession have remained comparatively silent upon those important subjects. Here and there a bold spirit has dared to speak out in terms not to be misunderstood ; but these, like . the kindred subject, criminal abortion, have been ignored by the great mass of those whose duty it is to watch over public health and morals. Among the few who have recently spoken out boldly upon these and similar subjects, Professor Ho- ratio R. Stover, of Boston, is deserving of especial SEXUAL FRAUDS AND CONNUBIAL EXCESSES. 189 s * Small Families. notice. His excellent book, entitled, "Why Not?" should be read by every woman. It was published by direction of the American Medical Association — a conclusive proof that the regular profession in the United States are right upon these great questions. Although the book is designed especially to warn mothers, as to the physical and moral dangers of abortion, artificially induced, the Doctor has not failed to show that he is alive to the dangers of sexual frauds. The book can be procured by sending sixty cents to Lee & Shepard, publishers, Boston, Mass. They also publish, and will send by post, for fifty cents, a little book entitled "Serpents in the Dove's Nest," by Rev. John Todd, D. D. It consists of two articles. First, "Fashionable Murder." This pre- sents, in a forcible manner, the sinfulness of destroy- ing the foetus in the womb, as well as its danger to the health of the mother. The second article, entitled "The Cloud with a Dark Lining," discusses the causes which lead to small families among our native American women, and declares it to be, in addition to child-murder, an unwillingness to have children, and taking decided measures to prevent it. Those who are curious to read more extensively upon this subject, can procure, through James Campbell, publisher, Boston, by sending one dollar and fifty cents, the work of L. F. E. Bergeret, physician-in- chief of the Arbois Hospital, Jura, translated from 190 woman's monitor. Conjugal Onanism, etc. the third French edition of P. De Marmon, M. D. The title of the book is, "The Preventive Obstacle, or Conjugal Onanism." It treats, as its title-page de- clares, of the dangers and inconveniences to the individual, to the family, and to society, of frauds in the accomplishment of the generative functions. We would also refer to " Satan in Society," pub- lished by C. F. Vent, Cincinnati. These books show conclusively that many serious diseases of women, arise from the practice of sexual frauds, to prevent offspring. Although a sensitive mind will be disgusted at many of the cases they detail, the authors appear to have been actuated by a deep sense of duty, and none who have been guilty of the practices of which they treat, but must turn from the perusal of the works deeply impressed with the hid- eousness of this crime against nature, which may have already destroyed their constitutions, or planted the germs of cancer or some other incurable disease. I have taken the privilege of referring to those books, hoping that this notice may assist to spread the knowl- edge and warnings they contain for the benefit of those most concerned. "I know it is unpopular to drag from their covert hoary-grown errors, or to speak to the public about vices which it is fashionable to ig- nore." And I think I hear some one say, How could he be so immodest? Kind reader, I could not be, did not the necessity of the case require. But we SEXUAL FRAUDS AND CONNUBIAL EXCESSES. 191 " It is the Wounded Bird that Flutters." know from observation and reading, from converse with professional friends and the confession of scores of unhappy and diseased victims of this vice, that a great necessity exists for those who are in position to speak to the hearts and consciences of their fellow- men, to let the voice of warning be heard in no un- certain tones. There may be those so unfortunately organized that a large organ of modesty, joined to an immense fastidiousness, constitutes the sum total of their scanty brains. Such may accuse the author of immodesty. I would reply in the language of Dr. Todd, when writing upon this subject, "None will ac- cuse me of being immodest except those who commit the sin! It is the wounded bird that flutters. To the pure all things are pure. Those only will be shocked who do what I am to talk about, for many actually do things which they can not bear to hear mentioned. If there is indelicacy it is in the facts, not in calling attention to them. The fact is, all over the land families have few or no children. It has be- come fashionable for parents to be leading around a solitary, lonely child, possibly two, it being well un- derstood, talked about, and boasted of that they are to have no more. The means to prevent it are well understood — instrumentalities shamelessly sold and bought. Married people dare do this who would not dare go to a fashionable abortionist." Dr. Todd then goes on to say in substance, " that it is an agree- 192 woman's monitor. Rev. Dr. Todd on Small Families. merit between husband and wife that they will not have children, and they think it no sin to do so. This fashion threatens to desolate our land and run our American families into non-existence. The colored women at the South, now free, but not knowing how to provide for their offspring, are playing the same game. There are few births among them at the pres- ent time. Why should they not do as their educated respectable white sisters do?" The same practice among the Indian squaws is assisting to hasten the extinction of the race. He says that " in nine cases out of ten where the family is almost childless woman is to blame. But where* is the harm? Whose busi- ness is it?" He answers the question. "It is a wrong done to yourself, dear woman. God has made no law that can be violated with' impunity. What makes these worthless wives so feeble, so puny, so scrawny, so out of health ? What makes the hus- band go into temptation and sin, or else become dys- peptic and nervous? What takes away the glorious sanctity of the marriage relation, and makes the in- stitution distrusted, and honors the man who lives in violation of the most solemn vows? It is impossible to violate the laws of God in the physical as in* the mora) world, and not suffer. The health suffers, disease comes in, and the being becomes unnaturally gnarled and unhappy. The suffering and sorrow among those who refuse to meet the laws of ma- SEXUAL FRAUDS AND CONNUBIAL EXCESSES. 193 Violating the First Commandment of God given to the Race. ternity are vastly greater than among those who do." Again he says : " It is a wrong done to the family. It disappoints the husband. It makes way for the wife to be feeble, sickly, and unhappy, and probably to meet an early death. It brings shadows over the house, which might be full of sunbeams." Once more hear him; he says: "It is a wrong done to the Church of God. You are violating the first com- mandment of God given to the race, and the first after the Flood, and you scorn his wisdom when he says, 'Lo, children are an heritage from the Lord.' It is the design of God that his Church should be propagated, instructed, and fitted for his service in the family ; but if Christian families who were ap- pointed for this purpose, and who have the education and means, do not rear up sons and daughters for Christ, they imperil the deepest interest with which humanity comes in contact. Where are the strong working men, the hard workers in the vineyard of God, to come from if you, Christian husband and wife, feel that you may set aside the great plans of God's mercy? How is it that ye have agreed together to tempt the Spirit of the Lord ?" You sometimes hear people laugh at the large families of clergymen. Yc u see the reason why they are large. They have too much conscience to violate known laws of God. The great object of the marriage institution, the rich blessing left from Eden, is not that the husband may 17 194 woman's monitor. No Danger to be Apprehended from a Spread of Knowledge. live in legal fornication, and the wife in legal prosti- tution, but fulfill the first great command in the Bi- ble. 0, woman ! honored, loved, cherished, and up- held, while you meet the great responsibilities for which yj3u were created, can you be thrust down from the high and holy position of being a true and faith- ful mother, to be a toy, a pla}' thing, and something far lower than that? But I will cease to draw lightnings to scathe the transgressor from "The Cloud with a Dark Lining," for every syllable in the " Serpents in the Dove's Nest " is worthy the prayerful consideration of every lady. Read it, good Avoman, if not for your own benefit, that you may be better able to counsel those who may seek your advice. I now desire to direct your attention to some of the prevalent practices designed to prevent offspring, in order to show their baneful influence over the happiness and health of women. No fears need be entertained that this discussion will spread this vice by giving a knowledge of methods unknown to the masses. Are not our periodicals and newspapers tainted with adver- tisements of preventives and medicines that will re- move suppression from whatever cause produced ? of infallible female pills, " that must not be taken by those desiring offspring, as they will certainly prevent pregnancy," and similar catch-penny dodges of design- ing quacks, who intend by this means to insnare into MEANS OF PREVENTION. 195 Vicious Information Abounds. the use of their vile nostrums those who wish to es- cape the responsibilities of married life ? Are not some of our religious journals, from carelessness or other- wise, guilty of giving publicity to the advertisements of books and tracts which pander in no small degree to this prevailing sin of the age ? The facts are that a knowledge of the means of preventing pregnancy, as well as of procuring abortion, are in possession of nearly every person who has arrived at maturity. Shall the medical and clerical professions then remain silent? Shall the religious press, which hurls its shafts at every other form of vice, continue to ig- nore the existence of this social canker, which is doing more to check the development of Protestant- ism among native Americans than any other cause now operating to deprive evangelical religion of strong arms and stout hearts. " The Catholic Church, ever watchful as to her own best interests, has not only provided for the education and religious training of her children, but to her honor and credit be it known, has cast the shield of ecclesiastical protection over unborn infants, and set the seal of condemnation upon the practice of conjugal frauds within her borders." MEANS OF PREVENTION. The means of preventing pregnancy among the wealthy usually differ somewhat from that pursued by the poorer classes. The sheath, or cundum, named 196 woman's monitor. Condemnation of the Various Means of Prevention. after Dr. Cundum, by whom it was invented, is in very extensive use among married people, and also for purposes of illicit intercourse. Strange as it may appear to the uninitiated, they have an extensive sale in every city, village, and hamlet, in all civilized lands, and are regarded by professing Christians, en- gaged in honorable and respectable business, as legiti- mate objects of traffic. The use of these abominations is not only filthy, but as injurious to the male as mas- turbation, and to the female as self-abuse, from which, in fact, it only differs in degree, affording more ex- citement to the passions than masturbation. But it deprives its votaries of all true gratification in the conjugal act; besides, they are never safe, being liable at all times to rupture; and few physicians of exten- sive practice but can call to mind numerous cases of bastardy, where the unhappy victim has confessed that she had trusted to this unnatural and deceptive protection. Besides, it is certain to produce vaginal leucorrhoea, if not more serious disease of the gener- ative organs. Another means extensively used at one time, but it is hoped not so extensively at present, is the in- troduction of lint or sponge into the vagina, to be removed after intercourse. If we styled the cundum filthy, what shall we say of this iniquity ? The rough sponge, or other substitute, soon produces epithelial abrasion and excoriation of the vaginal mucous mem- MEANS OF PREVENTION. 197 The Use of ihe Syringe. brane and of the neck of the womb. Inflammation, leucorrhoea, and prolapsus are the inevitable conse- quences ; besides, they are liable to be displaced, and hence are a very uncertain means of protection. The use of the syringe, immediately after congress, is probably the least injurious of all the means em- ployed to limit the number of offspring. But the cheap glass and pewter instruments in use by the larger number, who attempt in this manner to defeat the great design of the marital relation, are entirely use- less, because they fail to wash away the spermatic fluid. And where a better constructed instrument is used, if with cold water, it is liable to bring on ute- rine colic, or inflammation, from the chilling of the parts ; and, if warm water is used, by further inviting blood in that direction, and prolonging the period of congestion incidental to the act of congress, must pro- duce disease, if long indulged in, especially a relaxed and prolapsed vagina, and uterine displacement, with leucorrhoea. This means is also uncertain, as the sper- matic molecules may reach the uterus before the in- strument is used; may fail to be washed away, or may be thrown, in the conjugal act, through the open- ing of the neck into the womb, beyond the reach of harm from the fluid used as an injection. Thus it is plain that those who depend upon this means must often lean upon a broken reed. Yet with all its un- certainties, and power to produce disease and death, 198 woman's monitor. All Preventive Methods Uncertain and Dangerous. this is probably the most certain and least injurious method yet devised to thwart the purposes of God in relation to the laws of reproduction. You will allow me in this connection to remark, that although means may be discovered that will prevent conception, it is as impossible as that God should be inconsistent with himself, that any means will ever be discovered that will not work disease and premature death to those who follow it. Many are misled by the idea that there is a time between the monthly periods when a woman can not conceive. It is true that for a few days, after the close of the second week following menstruation, women are free from the presence of a living ovum, and consequently can not conceive ; but it is equally true that there are many exceptions to this rule. In some women, and in certain conditions of health, the ovum is cast off in a very few days after menstru- ation ; but with other women it remains, sometimes until another ovum has ripened, or so near that period that the male principle may retain its vitality until the ovum has developed, and certain changes may cause these conditions to appear at periods not re- mote in the same individual. These considerations make it certain that this method of prevention is not to be relied upon; and husbands and wives should know that science teaches that where pregnancy accidentally occurs, undesigned CONJUGAL ONANISM. 199 Will you Assume the Responsibility of Procreating by Accident? and undesired, at a period remote from menstru ation, the child developed from the germ enfeebled by long retention in the uterus, is not so likely to be sound in body and mind as it would be if con- ceived designed^ at Nature's best period. Kind friends, will you assume the responsibility of procreating by accident? If so, you may blush for shame, when feeble and diseased offspring present evidence of disregard of Nature's laws. We are also of the opinion that dangers of the after-birth being attached at or near the mouth of the womb is largely increased by conception after the second week from menstruation — an accident which always imperils the life of the mother. CONJUGAL ONANISM is the method of prevention which is most exten- sively practiced by married persons of the middle and poorer classes; but its baneful influence may be traced in every department of society — it consists in the im- perfect performance of the conjugal act. By this method the spermatic fluid is prevented from reach- ing the uterus. But the disease-producing tendency of this method upon the male is terrible indeed. The incomplete emission produces congestion of the sexual organs, especially of the vesicular seminales and pros- tate gland, and will, sooner or later, produce chronic inflammation and enlargement of the prostate gland. 200 woman's monitor. Baleful Effects of Conjugal Onanism. We have also frequently found stricture of the ure- thra, enlargement of the veins of the scrotum, and chronic orchitis, resulting from this practice. But such -perversion of Nature's design is frequently vis- ited by more severe penalties, as paralysis, apoplexy, epilepsy, and insanity, in the male, and similar affec- tions in the female. Besides, she is subject to disease of the ovaries and uterus, especially uterine inflam- mation, and its consequent displacements, from this cause. We will not now stop to inquire into the causes that lead to those refinements of debauchery which some suppose to be confined to our large cities, but which Dr. Bergerett, with good reason, declares is extensively practiced by the country people. The history of Onan, as given in the thirty-eighth chapter and fifth and sixth verses of Genesis, finds its coun- terpart with too many families at the present day. Dr. Bergerett records the details of a large number of cases of acute inflammation of the womb, many of them resulting in death, from the practice of this vice. Also, a large number of cases of chronic in- flammation of the uterus and of its lining membrane, have been observed to result from incomplete coitus ; many of those attended with dangerous bleeding, or exhausting leucorrhoea. Science teaches that it is a fruitful source of fibrous tumors and polypi, also of uterine colic and neuralgia, CONJUGAL ONANISM. 201 Frightful Diseases the Result of Conjugal Frauds. which are especially painful at the menstrual periods and about the change of life. Genesiac frauds often cause painful tumors of the breast, also congestion and neuralgia of the mammary glands in consequence of that sympathy which exists between the uterus and breasts. Dr. Bergerett, in his extensive expe- rience, does not recall a case of uterine cancer which was not preceded by sexual frauds; and he says, this cruel disease always kills the woman after a long series of the most painful tortures. " I have seen women still young, die thus at a time when it would seem their lives should have been exempt from such disease. Why did the disease in them anticipate the ravages of time, and in some measure violate its ordi- nary rules ?" For the reason that unnatural frauds had thoroughly exhausted and worn out the genera- tive organs. Sexual frauds and incomplete coitus, alike injurious to both sexes, are no sure guarantee against pregnancy. We have known husbands who practiced frauds, to become jealous when their wives became pregnant; they supposed they had been care- ful, and having long escaped, could not believe they could have made a mistake. And the author above quoted has known girls ruined by frauds, and their lovers refuse to marry, declaring it could not be pos- sible that they were the only parties that had enjoyed the lady's favors, assigning as a reason the extreme care observed. And I may add, that it is but a few 202 woman's monitor. Avoid all Forms of Violation of God's Laws. days since I was consulted by a girl from the country belonging to a wealthy and highly respectable family, who is the victim of misplaced confidence in men's promises and genesiac frauds. Let all such know that frauds afford ])ut uncertain protection. If coitus is repeated before the spermatic. fluid is washed from the urethra, the female will likely conceive. Long- practiced frauds are likely to produce prolapsus ; the womb descending, may even present between the labia, and receive the spermatozoa from about the la- bia. Besides, it is well known to anatomists that some women have conduits leading from the labia to the uterus, and sometimes sending a branch through the broad ligament to the ovaries ; these take up and convey the male element. This may explain the extraordinary aptitude of some women to conceive. Be warned then to avoid all forms of violation of God's laws concerning the sexual relation. If He punishes with loathsome disease, which may even stamp its horrid features upon the children of the dev- otee of passion, and drag, through days and nights of torture, the mutilated and deformed transgressor to a premature grave; if He has so fenced about sexual intercourse that none may with impunity risk any pre- ventive without danger of failure and certainty of incurring a penalty, more or less severe ; if the voice of nature and revelation, and the teachings of science, all conspire to sound the alarm and point to the dan- CONJUGAL ONANISM. 20. An Earnest Appeal to the Women of America. gers in store for those who trample upon the laws of God in relation to the sexual function — women of America, will you, dare you, refuse to meet the high responsibilities of your position as wives and mothers? Will you continue to sin against your own nature and against the moral laws of your being, until the wrath of God is kindled to a consuming flame? or will you act as becomes Christian women, and turn a deaf ear to the jeers of those who would taunt you because of the increase of your family, " allowing the heathen world, if they will, to set their faces toward Sodom?" " What !" says one, " would you have the Christian mother confined at home, year in and year out, pursu- ing the endless drudgery of the household, the family almost yearly increasing, and lose her health by rapid child-bearing?" No; we freely admit that there is such a thing as too rapid increase of family. Some women can sustain the wear upon the vital forces with impunity ; but many American women are of too delicate constitution, and hence should exercise temperance in this as in every other relation of life. But how shall the number of offspring be brought within such limits as the health and circumstances of the parents demand ? "Not by conjugal frauds and criminal abortions, but by remembering that there should be such a thing as continence in married life as well as out of the marriage relation." We know- too many men appear to think that marriage gives 204 woman's monitor. A Limit to Offspring not to be Sought through Conjugal Frauds, etc. license for the exercise of the most unbridled lust, and that Avoman is too frequently the unwilling victim of mans unhallowed passion ; and I fear this is too often in consequence of ignorance on the part of the husband as to the consequences to himself and the object of his deepest and. most cherished regards. These considerations may induce us at no distant day to prepare a small work on the above and kindred subjects addressed to men, appealing to their sense of justice and the higher and holier attributes of their nature, to induce them to pursue as rational a course in regard to their sexual relations as is pursued by the dumb beasts of the field, who are guided by in- stinct alone, and are not guilty of those refinements of debauchery that disgrace man, w T ho is endowed with the noble attribute of reason, and whose pathway may be lighted by the bright beams of revelation. Noble examples of men and women may be found in every community, who, with a conscientious re- gard for duty, refuse to transgress God's law in rela- tion to their physical as well as their moral being, and who enjoy peace of mind and health of body, be- cause they do not exhaust themselves by excesses of any kind. Their children are less liable to disease and premature death, and the energy and power of endurance, wasted by too many in conjugal excesses, is reserved to enable them to battle more successfully with the unavoidable ills of life ; also, to enable them CONNUBIAL EXCESSES. 205 Effects of Connubial Excesses. more zealously to push forward the great moral re- forms of the day, and to build up the Church of God, and advance the kingdom of Christ on the earth : pur- poses infinitely more worthy the attention of rational and intelligent creatures than the exercise of demoral- izing passion. CONNUBIAL EXCESSES are, beyond doubt, a cause of much disease among women as well as among men, to say nothing of the number who are made nervous, feeble, forgetful, and morose, from this cause. It is plain to every ob- server who has made human nature a study, that very many are guilty of such excess as to produce serious disease. If but one family in every thousand were rendered miserable, through ignorance or willful dis- regard of the laws of health in this respect, we should be justified in writing here plain words of warning. But it will be clear to every one who investigates this subject that a much larger per cent, than this estimate would indicate are self-sacrificed upon the altar of Venus, and that a vast multitude of women are annually lost to society for all good and useful purposes, in consequence of disease brought upon them by their husbands in this way. Of course we do not include in this estimate the vast number in- jured indirectly, nor those who become contaminated with loathsome disease. We only speak of virtuous, 206 woman's monitor. The Relics of Barbarism that still Exist. honored womanhood, within the pale of respectability, and would but hint that some of these, after being taught by their husbands all the refinements of de- bauchery, go into forbidden paths because the moral and mental powers are perverted through sympathy \s ith disease produced by excess, for which the hus- band was alone responsible. We have known husbands sometimes to become disgusted with the lewdness they have spent years nurturing into a perfect growth. I am not one of those morose individuals who are always finding fault with the times in which they live, and looking back to the hoary-grown ages of the past for examples of moral purity. But, candid reader, are there not some relics of the dark ages still lurking in secret places, and twining their poison tendrils about the dearest and most vital interests of society? I would not undervalue our institutions, decry our advanced state of knowledge, nor detract from the glory of our modern civilization — a civil- ization that has felt the power of Christianity to chasten every element, and guide it into such chan- nels as will lead the nations to light, liberty, and hap- piness — a Christianity which teaches personal purity, self-denial, and all those cardinal virtues which ele- vate the soul, and might bring man back to the purity of his first estate. "It was not until woman escaped from the harem to sit by man in the public assembly as his equal that CONNUBIAL EXCESSES. 207 Woman the Equal of Man. he ceased to be barbarous and savage." And the crowning glory of the present age is the educated, re- fined, and dignified position of women in Christian lands. In no period of the world's history were women so much appreciated as co-w r orkers with man, in all that tends to elevate the race, as at present. Her exquisite sense of justice has been silently at work, remodeling the civilization of the age by in- stilling love of liberty and equal rights into the minds of the rising generation, until in the might of her power, by the strong arms of her valiant sons, the chains of human bondage have been broken, and liberty proclaimed throughout the land. Shall she not also be disinthralled, and placed as man's equal before the law ? . Shall not every re- straint be removed that prevents her from acquiring knowledge in our colleges and universities, on an equality with the sterner sex? More especially, shall not - every facility be afforded her for acquiring a knowledge of the medical profession, for the practice of which woman has so many peculiar endowments? The deep sympathy of her nature, her delicacy of touch, keenness of perception, and readiness of in- vention, are all qualities essential to success, espe- cially when caring for women of delicate organization, and for tender infants. Is it too much to hope that a new era has dawned upon humanity, in which woman's exalted nature 208 woman's monitor. An Appeal for Woman's Elevation. shall be free to roam through the boundless realms of thought, with equal opportunity with men for educa- tion in all the departments of art, and in all the pro- fessions of life? Her mind will then be unshackled from that sense of dependence that has so long de- prived her of true liberty, by compelling her to look to marriage, and pleasing her husband, as her only means of honorable support. Self-sustaining and in- dependent, she can at leisure make suitable selection of a partner for life's great drama. Then indeed will she marry, not from the necessity of securing sup- port, as too many now do, but for love, and from a sense of duty, the result of "thoughtful deliberation. Such women will not shrink from the high and holy trusts of maternity. Nor can they be induced to submit to those connubial excesses which now de- grade and destroy so many of the women of this land. It is no uncommon thing for healthy persons to marry, and in a few years the blooming maiden is transformed into a faded woman, with haggard look, and feeble, nervous step. The husband we have known to become dyspeptic, feeble, and nervous, with palpitating heart, loss of memory, or worse, become insane or epileptic. Many well-marked cases, whose history I know, marshal themselves before the mind as I pen these lines, the unhappy victims of conjugal excess. Let such remember that the blooming maiden they led to Hymen's altar, and vowed to shield and CONNUBIAL EXCESSES. 209 Not Placed in tlie World Simply to Eat, Drink, Propagate the Species, and Die. protect, is fading like a withered flower, and sinking to the grave, from disease produced and fostered by their unnatural excesses. That which is but a slight tenderness, or a mild leucorrhoea, if you continue to practice frauds, or are guilty of connubial excesses, will ere long be a severe inflammation, serious dis- placement, or a corroding cancer. The experience of ever}' observing physician will furnish ample proof that these excesses often cause abortion, with its manifold dangers, which either leads to sterility, or, by frequent repetition of the accident, to a condition that is quite sure soon to lead to fatal disease. Kind friend, man that was made but a little lower than the angels, and beautiful, exalted, confiding, an- gelic woman, were not created by an all- wise Provi- dence and placed in this beautiful world for no higher purpose than to eat, drink, propagate the species, and die like the unreasoning beast of the field. Much less were they placed here to indulge in debauchery and excess, though in the privacy of the hymeneal chamber and unchallenged by the civil law, and thus call forth the consuming fires of inflammation, a just retribution for such transgression. No! yours is a nobler heritage. The sexual passion was placed deep in the human breast lest in the effort to grasp wealth and power we should forget the command to multi- ply and replenish the earth. Reason was given to enable us to approach God in his works, and look- 1Q 210 woman's monitor. The Two Ways Contrasted. ing through nature up to Him, to behold in all their sublime glory visions of terrestrial beauty, whether displayed in the germination of the seed, in the un- folding of the flower, in the varied phenomena of vegetable and animal life, in the grandeur of the cataract or the tumult of the storm, in the fairy mist that glides upon airy pinions to welcome the god of day at the gates of the morning, or in the grandeur of old ocean lashed to fury by the wind, while the voice of many thunders come up from the bosom of the deep. To eyes, undimmed by transgressions of God's organic laws, and minds untrammeled by Pas- sion's consuming power — these bring a foretaste of joys unspeakable and full of glory. On one hand is the broad way that leads down to a premature grave, from which prayer and fasting and all the forms of religion will not save you if you do not stop to con- sider the necessity of temperance in all things. On the other hand is the narrow path of duty to your self, your neighbor, and your God, that will lead you through darkness and danger unharmed. Protected by the strong arm of omnipotent power, your bodies, free from the ills that are visited as a just retribu- tion upon those who transgress the organic laws of their being; your intellects, bright with the scintil- lations of genius, and your immortal spirits purified and redeemed by grace, your pathway through life's pilgrimage, spanned by the bright bow of promise, STERILITY. 211 Causes and Cure of Sterility. must grow brighter and more joyful at every step, until in the evening of life's journey you may pass through flowery meads surrounded by nature's awe- inspiring grandeur and beauty, made bright and glori- ous by the benignant rays of the Sun of Righteous- ness; and thus the Christian's last hours may be spent in peace and joy amidst surroundings as en- chanting as the garden of the gods — sweet foretaste of the joys of heaven. STERILITY. Many families "are rendered unhappy because off- spring are not produced. The fault usually lies with the female, and many women are rendered sterile by conjugal frauds and sexual excesses, producing chronic inflammation, which keeps a plug of mucous or muco- purulent matter fillijig the neck of the womb, and thus preventing the spermatozoa from passing the uterine neck. The remedy is temperance in sexual relations and astringent and tonic injections, such as was recommended for such diseases in a former chap- ter. Scrofulous disease, severe colds, rheumatism, and all forms of tumors, when affecting the sexual system, may be causes of sterility. We have known many young persons use means to secure abortion the first time enceinte, because they did not yet de- sire offspring — the resulting disease ever after render- ing conception impossible. Later in life, when sur- 212 woman's monitor. Sad Results from Early Indiscretion. rounded with wealth and every other comfort, the household desolate without children, the husband and wife often earnestly desire the presence of those prattlers whose appearance is so necessary to com- plete happiness. But, alas! early disease is slowly destroying her who but for the indiscretion of early married life might have been healthy and happy. Many of these cases are susceptible of cure by a skillful gynecologist, who can remove tumors, correct displacements, cure leucorrhoea, heal up ulcerations, and thus remove the sterility by curing the disease which caused it. Child-bed fever is a frequent cause of incurable sterility, the inflammation causing the fallopian tubes to adhere to the surrounding parts, so as not to be able to grasp the ovum and carry it to the uterus. Another very prevalent cause of sterility is that variety of painful menstruation which alternates with severe floodings, and whose characteristics are the presence of a blood-clot in the womb, retained fre- quently for several months, and when thrown off se- vere floodings occur, which are only arrested when a new clot is formed. This form of sterility is usually curable by a persistent course of treatment and great care on the part of the patient. The treatment of this difficulty was discussed when speaking of pain- ful menstruation. Sterility from constriction of the upper part of the canal through the neck of the womb HEREDITARY TRANSMISSION. 213 The Transmission of Qualities. is of frequent occurrence, and usually readily cured by the sea-tangle tent. From the preceding remarks it must be apparent that a great variety of causes pro- duce the sterile condition, and that a large majority of such cases are amenable to proper treatment. HEREDITARY TRANSMISSION. It is well known that like begets like throughout nature's great realm, and that mankind form no ex- ception to this law. It is equally apparent to the observer of nature's operations, that certain extra- neous influences may modify and deflect from their usual course the operations of the law of transmission. Witness the devices of the patriarch Jacob when 'dealing with his father-in-law Laban's cattle, by which he secured for himself ring-streaked and spotted off- spring in abundance. But these deflections do not become permanent so as to alter the type of the race, but run out in a few generations, the generic law assuming supremacy and holding the type of the race inviolate from age to age, so that accidental peculiarities of constitution or men- tal quality, the result of culture or accident, though frequently transmitted from parent to child, do not become permanent qualities of the family, developing a new type, but run out in a few generations, unless means are perseveringly used to secure permanence of the desired quality. To illustrate this thought: 214 woman's monitor. The Results of Mental Impressions upon the Mother. Quite homely and uncouth individuals may have well- formed and graceful offspring ; every essential ele- ment of bone, muscle, and nerve, each and every one in its proper place, will correspond with that of the parent, if of the same race ; if not, the offspring will be a cross between the two, but the cross of races farthest removed from each other, as the black and the white, obey the laws of hybridity, and the higher or dominant type tends to run out the inferior ele- ment, so as to bring back the offspring in a few gener- ations to pure specimens of the dominant type. In a similar manner a family peculiarity will run out, if it is not a characteristic element of a dominant type of a species. But I said the ill-formed and ungraceful have sometimes beautiful children. These are deflections from the usual course of nature, and are the result of impressions upon the mind of the mother during maternity. The bodily and mental powers may be so changed through the impressions made upon the mind or body of the mother, as to influence the phys- ical, mental, and moral condition of her offspring. Hence it follows that the most cheerful surround- ings should, if possible, be furnished the pregnant fe- male with such society and reading as call forth and keep in exercise the highest and noblest faculties of her nature. She should look earnestly on beautiful statuary" that may be within her reach, spend much HEREDITARY TRANSMISSION. 215 The Period of Conception one of great Importance. time in contemplating fine and graceful pictures and persons, attend the services of the most eloquent and logical divines, and keep the mind as much as pos- sible free from care, from doubts and fears, which de- press the intellectual and moral powers. The period of conception, in a hereditary point of view, is one of great importance to the future indi- vidual. Children conceived of parents, one or both of whom are intoxicated, will usually be weak in mind and body, often deformed and imbecile, or sub- ject to epilepsy or insanity. The same is true if either parent is laboring under disease, acute or chronic, or is feeble and nervous, from recent fevers, or other cause. We have often found one frail, con- sumptive child, in a large family, where all the rest were perfectly healthy, and have seldom failed to dis- cover, upon critical inquiry, that one or both parents were at the time of conception laboring under disease, or its consequences ; sometimes, though rarely, the mother had severe disease during maternity; but women are peculiarly exempt from fevers, and even contagious diseases, during maternity, as if Nature purposely made provision to protect their offspring. When disease of a serious character occurs at this period it is usually fatal to the mother, or miscarriage occurs. Thus Nature appears reluctant to mar the symmetry of her own works in their stage of de- velopment. Beware, then, of taking the responsi 216 woman's monitor. Transmission of Disease. brlity of procreation when imperfectly recovered from serious disease. That cancer, scrofula, syphilis, and consumption are transmitted from parent to child, there is no doubt, as they have been found afflicting the foetus that had not arrived at full period. In many cases of disease supposed to be hereditary, it is probable that the disease is not transmitted direct, but a weakness or constitutional infirmity is impressed upon the offspring, or some of its organs or element- ary tissues that renders it an easy prey to disease; and it is not uncommon, where a family are going one by one with consumption, cancer, epilepsy, or insan- ity, for the disease to be postponed to about the same period of life in several successive generations. Yet who will deny that a carefully regulated life may not keep at bay, nay, entirely prevent, the development of disease, which is strongly marked as a family com- plaint? The cause was some deflection from the ro- bust condition of the ancestral stock, not a generic peculiarity of the race, and hence capable of removal by proper management on the part of individuals, or by careful observation of the laws of life by a few con- secutive generations. How important it becomes, in this view of the transmission of qualities, for every woman assuming the responsibility of maternity to study carefully the laws that regulate the transmis- sion of quality, and endeavor to secure symmetry and HEREDITARY TRANSMISSION. 217 Certain Specific Diseases not Readily Transmitted by the Father. beauty of person, as well as fine moral and mental development ! Certain specific diseases, as syphilis, are not readily inherited from the father, although a constitutional infirmity predisposing to tubercle and other diseases, I doubt not, may be the result of transmission of bad organic tissues caused by the disease in the father. But the case is different as to the mother, who, if affected, will certainly transmit the disease to her off- spring. But diseases which depend on a low state of vitality in the organism of the father, as consump- tion, may be entailed upon the offspring, but not so certainly so, if the mother is healthy; but the dis- ease in the mother has a threefold chance of affecting the child, as the tainted ovum, no doubt, gives the same organic impression as the tainted spermatozoa. The nine months' connection with the mother, de- riving nutriment from her blood through the after- birth, must deepen the impression of her physical characteristics upon its every tissue during the entire period of its intra-uterine life. The period of nursing still continues the connection and dependence upon the mother, to a certain extent, so that the mother's influence in molding the constitution of the new being is no doubt greater than the father's. We may again call attention to the impression made upon her mind during maternity as very important, and calculated, 19 218 woman's monitor. Certain Peculiarities Lost for Generations may Re-appear. when she is afflicted with or anticipating disease, to fasten a tendency to such disease. Your attention is now invited to another peculiarity of the laws of transmission. A certain talent, trait of character, or peculiar tendency to particular dis- ease, as cancer, epilepsy, or consumption, as well as peculiarity of features, may disappear for several generations and then be repeated almost an exact fac- simile of a grand-parent or more remote ancestor. Another peculiarity of the law of transmission is the impression made through the fecundated ovum upon the constitution of the mother, whereby she becomes assimilated in nature to her husband — verily the twain become one flesh. It is not uncommon for a widow who has had a red-haired husband to marry a dark-haired man, with strongly marked bilious tem- perament. Yet it is not unlikely the first birth in the new union will have sandy or red hair, and re- semble the first husband in all its characteristics more than the second. It will not do to attribute this entirely to the influence of the mother's mind or imagination, as it is well known that a consump- tive husband ofttimes entails his disease upon the child of a perfectly healthy man who has married his widow. This impression appears to gradually wear out and usually is at length lost altogether. Ani- mals illustrate this law, as a pure-blooded white sow, in whose veins is not a drop of black blood, raising a HEREDITARY TRANSMISSION. 219 The Husband's Traits Transmitted to the Wife. litter, whose sire is black or spotted, and consequently a mixed litter, will raise mixed litters several times after, though the sire is pure-blooded, the spots be- coming few and at last disappearing altogether. Horse-breeders well understand that it is impossible to get a smooth, sprightly colt from a mare that has bred a mule by a jack. These considerations should deepen the sense of responsibility on the part of every female who con- templates entering the marriage relation. In case of pregnancy she can not escape the impression of the husband's peculiarity of constitution upon her own physical organization; nay, more! through the phys- ical constitution, to some extent, at least, upon every faculty of her mind and every attribute of her soul. And in many cases these impressions are so deeply interwoven into the organization of the female as to leave their impress upon her constitutional powers through the remainder of life, ofttimes preparing her for the development of disease that in a few years must terminate her career. You may have heard it said that a reformed rake makes the best husband. It is true, after his wild oats are sown he may be more attentive to business and a more indulgent husband, but this will be a poor recompense for the pure heart, unsullied mind, and untainted constitutional powers he should have lain upon the hymeneal altar. If he comes to the nuptial couch — as the reformed rake 220 woman's monitor. Reformed Rakes as Husbands. Mother's Marks. almost certainly does — with shattered remnants of broken vows, a heart callous to all the noble senti- ments and more exalted feeling that should thrill the human breast, with bodily and mental powers en feebled by debauchery and excess, he may, by the connubial embrace, instill into the blood of a confid- ing and trusting wife, if not a loathsome disease, a constitutional taint that will not only enfeeble her vital power and prepare her to become an easy prey to disease, but must stamp its hideous impression upon her children, which, if they may not be scrofu- lous or more seriously diseased from birth, are cer- tainly in the most favorable condition possible for the development of that diathesis whenever corroborating influence shall assail the unfortunate victim. MOTHER'S MARKS. From time immemorial it has Been a popular be- lief that accidents to the pregnant female, the view of horrible sights, sudden frights, and severe mental shocks might mark the child in the mother's womb with scars, representations of fruits, serpents, etc. While speaking of hereditary influence and the sur- roundings of woman during maternity, I said enough to forecast my position on this subject. I freely confess that I have often discovered marks where the mother was not aware of any occurrence that could be referred to as the probable cause, a well- mother's marks. 221 Marks may have a Mechanical Origin. marked illustration of which I saw on the child of a lady whom I attended recently, and suspect they are frequently the production of a mark hereditary in the family and accidentally acquired by some an- cestor more or less remote. Some of these marks, as well as deformity of parts, may have a mechanical origin. I have also known mothers to refer fre- quently during parturition to the fear they had en- tertained lest the infant would have a certain mark, but no mark appeared. I will not occupy space rehearsing any of the thou- sands of cases recorded, or which have come under my own observation. Suffice it to say, that I believe the influence of the mind of the mother over the mental and physical powers of the child is founded on laws of nature susceptible of study and control. I have in a previous chapter remarked as to the influ- ence of the mother's surroundings during maternity, developing certain physical and mental qualities in the child. In obedience to the same law marks and peculiarities of the features are produced ; but the marks sometimes go away spontaneously just as the acquired features sometimes change. We have known domestic tranquillity disturbed by the appearance of the child having a strongly marked resemblance to some male friend of the family. The only instance illustrating this principle, which we will relate, hap- pened in the family of a worthy professional friend, 222 woman's monitor. The Results of Mental Impressions. whose wife, during the early period of pregnancy, was very pleasantly impressed with the appearance of a beautiful young lady of her acquaintance, with clear skin, light blue eyes, and beautiful, bright golden hair, which hung in ringlets about her head. The child, when born, was almost an exact fac-simile of the lady in appearance, complexion, features, color of the hair and eyes, bearing not the least likeness nor sem- blance to the balance of the children nor to either parent. So perfect was the resemblance to the young lady that friends- acquainted with her, unacquainted with the mother's peculiar impressions, at once re- marked the striking resemblance. This child is now four and a half years old, and for the last six months has rapidly lost the peculiarity of features, and the color of hair is changing, to correspond with the rest of the family. As before observed, marks resembling fruit and other objects sometimes appear and remain permanent, at other times they go away in a few years, in obedience to the same law of return to pa- rental type manifested in the case above referred to. WHEN TO MARRY. Much has been written, and still more said, about the age at which it is proper for a woman to marry. This must depend in no small degree upon the tem- perament, habits of life, and constitutional vigor of the woman, and will range from twenty to twenty- WHEN TO MARRY. 223 The Proper Age to Marry. five years. Few constitutions are sufficiently ma- tured before twenty safely to permit of the draft on the vital forces necessarily required to develop off- spring and withstand the cares and wear of married life. Besides, when the period of school-girl days is followed immediately by marriage, there is no time to mature the mind, by reading and study, to prepare the woman for the duties of social life, and the cares of the household are apt to so engross her attention after marriage that but little efficient effort is made in this direction. I hear a young miss say to herself, "It will not do to miss an eligible opportunity." Dear girl, if the object of your fancy does not think enough of you to wait until your bodily and mental powers are matured and consolidated he is not the man you want. If engaged do not promise to ex- clude yourself from society, thus depriving yourself of all opportunity of changing your mind. Make your engagement conditional; few men will hesitate to find excuse for breaking an engagement if they should change their mind. The fact is, the best way is not to te engaged too long before marriage. The love of the school-girl days often is as evanescent as the early dew, which is dried up and disappears be- fore the advancing light of the full-blown day. The man that would fascinate you at fifteen or eighteen you may scarcely be able to tolerate when viewing him through eyes less easily dazzled at twenty to 224 woman's monitor. Spring or Autumn the Best Seasons. Wedding Tours twenty-five. The fact is, as Americans we live too fast in every respect, and plunge headlong into busi- ness, speculation, and art without sufficient training and culture. The result is disaster, perhaps ruin. So with American women; they assume the responsi- bility of married life too young, and the result is early decay and premature death. Midwinter and midsummer are objectionable times to marry, especially the latter. Spring and Fall should be chosen in this country, and Spring is pref- erable to Autumn, as offspring should occur within a year if no cause of sterility exist, and the child will pass the most difficult periods of teething at the most favorable seasons of the year. The wedding- day should be about midway between the menstrual periods, that the irritation and congestion of early married life may pass away before the ensuing men- strual crisis. The few weeks succeeding marriage are sufficiently trying upon the constitution of both par- ties without the wear of fatiguing journeys and the giddy whirl of dissipation at some fashionable water- ing-place or at a city hotel. Quiet and privacy with some country friend or at home would be more con- ducive to health. The bridal tour has ruined the health of many thousands of women, developing dis- ease that was never eradicated. WHOM TO MARRY. 225 Common Sense should be used in Selecting a Husband. WHOM TO MARRY. Why, the man you love best, of course. But love should be tempered with good sense and governed by reason, lest when too late you may regret an ill- made match. Many men and women, too, mistake blind passion, inspired by a pretty face or a fine form, for that pure undying love whose holy flame, once lit upon the altar of the heart, goes not out for- ever. Swayed by the blind instinct of passion, too many marry, bewildered by dreams of happiness, which are dissipated by the first adverse gale that drifts from its peaceful moorings the matrimonial bark. Amidst adversity there is not mutual depend- ence, sympathy, and desire to assist each other. Hence the two drift apart, repelled by a lack of affin- ity. They do not love truly. Many women marry from a desire to secure wealth and position, and thus almost certainly lead a life of wretchedness that is pitiful indeed. Persons very similar in temperament, disposition, and bodily conformation should not mayy, for they can not be truly happy, and the offspring will be much like those of blood relations, predisposed to mental and bodily weakness. It is a law of the animal economy that those near akin, as first cousins, should not marry. Though the product of such unions may not show unmistakable evidence of Nature's displeasure, it is sure to appear sooner or later in the 226 woman's monitor. Opposites Attract. descendants of such unions, except where, as some- times happens, they are far removed in temperament from each other. Young women sometimes many, from mercenary motives, men very much their senior in years. Of course true love does not cement the union, and the heart not affiliating perfectly with its mate, is left to wither and sink into premature de- cay for want of those enrapturing sentiments and soul-stirring transports that illuminate with affec- tion's brightest ray the path of true love through the dark and stormy nights on life's tempestuous sea. It is a law of Nature that opposites attract, and in its application to temperaments in marriage this is true. The light and dark, the fat and lean, the tall and shoit, the active and sluggish, within certain lim- its, attract each other. If it were not so the balance of the mental and moral universe would be displaced, and mankind, of the same race, would become almost as far removed from each other as the most diverse races of the earth. It is thus that Nature prompts to unions which bring up to a better standard the progeny of one, while it brings down to a lower grade the posterity of the other. Thus the strong assists the weak, and a proper equilibrium is preserved in the mental, moral, and physical forces of the race. But a just regard for the welfare of our own immedi- ate progeny should induce us to avoid great extremes, as the union of the cultivated and refined with the WHOM TO MARRY. 227 Avoid too Great Extremes. coarse and ignorant, incapable of cultivation, of the very rich and the extremely poor, which destroys all true independence on the part of the one who goes into the partnership without capital. This does much better where the man is rich and the woman poor than the reverse, because it is natural for her to be de- pendent, and look to and lean for support upon him, as the graceful vine twines about and clings for sup- port to the majestic oak. A woman of cultivation and refinement will not be happy with a coarse, blus- tering, ignorant man, though she may make him a virtuous, honored wife. In time she must realize that she is growing into the likeness and image of what in her inner soul she does not love, and before she can be brought to a true, loving trust in such a creature, her nature must be transformed and accommodated to the gross character of her husband. It is a philosophic fact that a woman who is once pregnant by a man never entirely frees herself from the influence of his nature over her. Gradually she may lose the impression, but, if they live together, she becomes shaped more and more to the likeness of his image. Her handwriting, motions, voice, ap- pearance, disposition, and every mental attribute, be- come, in some measure, modified, until after the change of life, she is, if truly married, the counter- part of his being, and whether she will or not, she must be of him and like him in many respects. Nor 228 woman's monitor. Disparity of Education. is this change all on her part, for to some extent he too is changed, partaking in some measure of her nature and attributes. It is thus that man and woman leave father and mother, sisters and brothers, and, cleaving together, " they twain become one flesh." Disparity of education is no bar to happy union, if the capacity to learn and the will to put forth the necessary exertion is not wanting, as the husband may find the most exalted pleasure in training and educating the wife in the principles of a divine phi- losophy that shall mold her to the fashion of his own mind, and enable her to drink from the same well from which he draws knowledge. I know a lawyer of first-class professional ability, who received a knowledge of the first rudiments of an English edu- cation from his wife after marriage, while working at the saddler's bench for support. Let me exhort you, young woman, not to fix your choice upon a reformed rake, for reasons given in a former chapter, nor upon a member of a family in whose blood runs scrofula, consumption, cancer, or like disease. Better that such should remain single, or marry of their kind, until the race in whose blood lurks the corroding poison is extinct from the earth, as it would be in a few years could they not ingraft their blighted germs upon a healthier stalk. Flee from such contamination of your body, and such en- PREGNANCY. 229 Civil Law can not Sever the Tie that Binds those Truly United. tailment upon your children, as you would from the destroying shade of the poison Upas. From the foregoing considerations it will be ap- parent, we believe, that those who truly love and marry are united in such a manner that civil law can not put them asunder, and that the woman who has been fecundated becomes transformed to some extent into the image of the father of her child, though but little sympathy may exist between them, and, if di- vorced, she is a ruined creature, and yet to live with a man she can not respect and admire is a living death. How important, then, that you exercise care before entering upon such entangling alliances ! PREGNANCY. This is the legitimate and proper result of mar- riage, and the woman who enters the married state with any mental reservation as to this matter is un- worthy to fill the position of wife in any household. It is that period of her life to which she should as- pire, as the consummation of the holy bond that is to bind her in perfect unison with him she loves ; to develop a new responsibility, for which all previous training and education was but a preparation, to en- able her in a proper manner to discharge her duty. She has become the receptacle of a germ that in full- ness of time will be dearer to her than her own being. From the hour that the fecundated ovum attaches 230 woman's monitor. The Wife's Responsibility. itself to her person and begins that interesting proc- ess of development that is to produce the future man or woman, its destiny, present and future, is in no small degree within her control. Upon her care and exercise of good sense depend the solution of the all-important questions, Shall it be well formed or gnarled and stunted in its growth ? Shall it be healthy, and attain a good old age, or spend a few brief years in suffering and pass away, leaving the parents' hearts desolate and sad? Shall its counte- nance beam with intelligence, or darken in the track- less void of idiocy ? Shall its proud aspirations arise to the highest point of excellence, and transport the soul, strong in faith and hope, to fairy realms, throng- ing with angels among the stars, and enable it to walk with God amidst Nature's sublimest beauty, or shall the dark pall of intellectual night gather around its blighted and withered spirits, and chain it to the dark realm of wretchedness and woe ? All this and much more, kind parents, in some de- gree, depends upon you, first upon the care you have bestowed upon your own physical, mental, and moral culture ; secondly, upon your study and observance of the laws of maternity, some of which we have feebly portrayed in the course of this work, and which we here recapitulate. It is essential that the pregnancy should have been designed, and at Nature's best period, within ten days PREGNANCY. 231 Pregnancy should be Designed. Important Advice, of the close of the menstrual epoch; that both par- ents should be sound in mind and body, not even temporarily sick, or just recovering from disease. Both should be free from the influence of narcotics or other stimulus ; the mother should recline quietly, undisturbed for sometime after a fruitful congress. Both should maintain entire serenity of mind, if pos- sible, during the entire period of maternity. The passions should be undisturbed, if possible, for the first few weeks after conception. That the too frequent practice of abandonment to excess, because the female is pregnant, and hence the danger, as it is too often called, is removed, is a fruitful source of powerful de- velopment of the passions in the offspring, no physi- ologist can doubt. No father can consistently chide the son or daughter who goes into sin, if he has kept the womb of the mother almost daily congested by libidinous practices. It is certain that many parents do this who could more appropriately put on sack- cloth and ashes for their own sin. While we would not advocate entire continence during maternity, we insist on great temperance in this respect, for the reasons above hinted at. The ideas advanced in the chapter on hereditary transmission furnish all that is necessary, in addition to the above remarks, to complete the directions re- quired by the parents to secure symmetry of person, 232 woman's monitor. Treatment for Nausea Arising from Pregnancy. exemption from disease, and proper mental and moral qualities in the offspring. SYMPTOMS OF PREGNANCY. Many women are able to determine the time of con- ception by certain nervous symptoms peculiar to them- selves ; but a large majority of persons are first noti- fied of the fact by the morning sickness or the cessation of menstruation. It is common for the stomach to sympathize with the womb when the first changes in its structure incidental to the maternal state occur. This is most conspicuous in the morning, and usually subsides in a few weeks, or, at the farthest, when the enlarged womb arises into the cavity of the abdomen at four to four and a half months. Sometimes vomiting continues through the entire period, and greatly re- duces the woman, from want of proper nourishment. It is not uncommon for similar sickness to result from sympathy with a womb enlarged from disease, as chronic inflammation. Treatment. — A cup of coffee and a biscuit before ris- ing, or a cracker and a small allowance of porter or champagne, will often prevent the sickness for the day. Some cases are controlled by three to five grains of sub-nitrate of bismuth three times daily in water. Of late years I have seldom failed to control this symptom by one or two grains of oxalate of BREASTS. 233 Cessation of the Menses. Change in the Breasts. cerium, given in a little water or wine, three times daily. Cessation of the menses, when occurring in a healthy married female, should be taken as indicating preg- nancy, although it may be from other cause. It is not uncommon for women to menstruate once after conception. Many women menstruate up to the fourth month, and some during the. entire period of pregnancy. Cases are recorded where menstruation occurred only during pregnancy. It is evident, then, that this sign can not be relied upon. A terrible practice prevailing in every department of society is to take advantage of this uncertainty and use emmen- agogue teas and other forcing remedies, hoping to se- cure a return of the flow ; and occasionally these means cause abortion, but much oftener produce con- gestion of the uterus and ovaries, laying the founda- tion for serious disease, or cause hydrocephalus or other injury to the child. Considerable change occurs early, in the condition of the BREASTS. The nipples are sore, painful, usually swollen, and consequently more prominent. A peculiar stinging or prickling sensation runs through the breasts, which are larger and firmer than before. The veins beneath the skin are of a deeper blue and more prominent than ordinary. The rose-colored circle around the nipples 20 234 woman's monitor. How to Tell the Time of Quickening. changes to a darker color, and becomes covered with a number of little elevations. The time when these changes are first visible is usually about the third week; at times they do not occur until much later. QUICKENING is the motion of the child in the womb, a symptom which usually appears about the eighteenth week. Some women feel the motions of the foetus as early as the third month, others not until the sixth, or even the eighth month. Motion no doubt occurs, to some extent, at a very early period, but is too feeble to be perceived by the mother. It must be apparent that the vigor of the child, its position, and the amount of liquid, must in some measure determine the period of quickening. Ladies are often deceived, mistaking the motion of gas in the bowels and certain nervous twitching or spasmodic action of the muscles of the abdomen for quickening. Such mistakes are more apt to occur about the change of life, when bloating of the abdomen from collections of gases and sickness of the stomach from sympathy with a diseased womb, is most likely to occur, and consti- tutes a combination of symptoms that has often de ceived women of fair intelligence. No mistakes need occur if it is borne in mind that for the first two months after conception the abdomen is less promi- nent than usual, the navel is depressed, and the QUICKENING. 235 Other Signs of Pregnancy. abdomen flattened. Sometimes about the third month a swelling occurs in the lower part of the abdomen and then disappears, so as to leave the person smaller at the fourth than at the third month, but after this the abdomen gradually enlarges, and the pear-shaped womb, not filling out into the sides, can be readily distinguished from the tense, round, elastic abdomen filled with gas. A variety of symptoms of occasional occurrence may be mentioned, as a change in the con- dition of the skin, a darker appearance than usual of moles and blotches, dark rings beneath the eyes, depraved appetite, longings for unnatural food, ex- cessive formation of saliva in the mouth, and heart- burn for the first three months, sometimes succeeded by a voracious desire for food, compelling the woman to arise at night in order to eat. There may be also palpitation of the heart, pain in the right side, sleepi- ness, toothache, or diarrhea. Many of these symp- toms are of but occasional occurrence. If a married woman ceases to be unwell, has a longing for unnat- ural or unusual articles of diet, with morning sick- ness, and change in the breasts, especially if she add a number of the other signs enumerated, she may be quite sure she is pregnant. Many women when preg- nant are completely changed in disposition; if before gentle and confiding, she may now be bitter, hasty, and jealous. But a change for the better is often observed in those who are naturally fretful and bad- tempered. 236 woman's monitor. Treatment of Various Diseases incident to Pregnancy. DISEASES AND ACCIDENTS OF PREGNANCY. Morning sickness has already been referred to. If the directions given do not relieve, a physician should be summoned. I have frequently met with cases where chronic inflammation and abrasion of the neck of the womb was keeping up a species of dyspepsia, the disease not so bad as to prevent pregnancy, the sickness then becoming so bad as to keep up emesis or vomiting, so as to endanger the patient. This is sometimes promptly relieved by applying through a speculum a lock of lint wet with aqueous extract of opium, saturated with sub-nitrate of bismuth. Occa- sional touches with nitrate of silver will frequently afford prompt relief when all other means have proved unavailing. Constipation may usually be relieved by the means recommended in the chapter on that sub- ject. Occasionally it may be proper to take a seidlitz powder or a course of the effervescing soluble citrate of magnesia. Pain from tension of the abdominal muscles may be relieved by bathing the bowels daily with equal parts of sweet oil and laudanum. Rup- tured and enlarged veins, as well as a pendulous abdo- men, may be relieved by wearing a properly con- structed bandage, made to fit the back and hips, laced below so as to keep under the prominent por- tion of the abdomen, the lace then fastened and the remainder of the band laced more loosely, so as to MISCARRIAGES. Abdominal Bandages. Exciting Causes of Miscarriage. give support to the bowels without fitting so tightly as to make pressure on the womb. The bandage should be kept from slipping up by a T-bandage be- tween the limbs, resting on a soft napkin, and this should have elastic connections with the main band- age. A pair of elastic suspenders should then cross the shoulders and be buttoned to the upper edge of the bandage behind and before, so as to enable the woman to carry the weight of the abdomen in some measure upon the shoulders. This arrangement will enable many to take exercise, when without it they must be confined to the room or even to the bed. It will be obvious that the pressure removed from the vessels and nerves, that the congestion and swelling of the lower limbs, as well as the cramps, must be relieved. When this support is not well borne the woman should recline much, with limbs slightly ele- vated. MISCARRIAGES are very common, even where great care is observed on behalf of all the parties concerned, and may be caused by severe sickness of any kind, especially by congestive chills, or similar affections. Eighteen years' experience in malarious districts has convinced me that large doses of quinine are a powerful emmen- agogue, and will frequently cause abortion, if not combined with opium. Falls, blows, or even a mis- step, will cause abortion \ the membranes may be 238 woman's monitor. Treatment of Accidents, etc., that Induce Miscarriage. ruptured, or the placenta be partially detached ; the former must be followed by abortion, the latter by bleeding, and usually by miscarriage. In case the membranes give way, and the waters are discharged, lie down, keep still, and patiently wait Nature's movements. If flowing occur after an injury of any kind it is likely that the after-birth is partly de- tached, and the woman should take her bed, lie still for some days, and take twenty to thirty drops of laudanum, repeating every six hours, if necessary to control pain. The tampoon should not be used to control the flow, unless it is so severe as to threaten life ; the clothes should be loose, the foot of the bed elevated, and the most perfect rest and quiet enjoined. These means failing, soft cloths should be saturated with the blood or alum-water, and introduced into the birth-passage until it is filled. Of course com- petent medical aid will be secured as soon as possible. FLOODINGS, without any accountable cause, occurring in the last weeks of pregnancy, should excite suspicion that the after-birth may be over or near the mouth of the womb, and its integrity destroyed by the gradual unfolding of the neck, and opening of the mouth of the womb. Fortunately for poor suffer- ing woman this is a rare accident, but one I have several times encountered in the rounds of profes- DANGERS TO THE MOTHER. 239 One Miscarriage Induces Another. sional duty. Under the most skillful management great fears are to be entertained of fatal results. Secure the best medical aid. Do not forget the suggestion that such conceptions probably occur after the close of the second week after menstruation. Miscarriage is more likely to occur in the first than subsequent pregnancies, and when it does occur there is a peculiar tendency to repeat the accident at about the same period. Positive rest for a few days, on the first appearance of the symptoms, assisted by one or- two full doses of opium, say one and a half to two grain doses, will usually suffice to carry one over the critical period, if no serious uterine disease exists. Miscarriages are likely to occur on the period of change; many women feel a fullness in the abdo- men, some distress in the back, and other symptoms of menstruation, during the entire maternal period, when their sick week returns, so that those who have had threatening, with proper care, will probably be exempt for twenty-eight days. But counting care- fully the weeks they would have been unwell if not pregnant, they should exercise unusual care during those periods; all marital relations should be sus pended, and but little exercise taken. DANGERS TO THE MOTHER. Women make too light of miscarriages, and do not exercise care enough in getting up; hence the womb 240 woman's monitor. Too Little Importance Attached to Miscarriage. does not properly return to its natural size, and dis- placements occur. Colds are taken, or too much exer- cise or labor indulged in so early as to insure chronic inflammation of the womb or its lining membrane. From these result a long line of sympathetic affections, prominent among which I may mention dyspepsia, pal- pitation of the heart, ringing in the ears, dizziness, weakness of sight, and in many cases consumption. Because their results follow at some distance their cause is not apparent to the non-medical observer; nor is it any the less true that miscarriage and its conse- quences are fast hurrying to the tomb thousands who little suspect the real cause of their decline in health. CONSTIPATION is often a serious trouble during maternity. This should be removed by the use of the syringe, and a properly regulated diet, as directed in the chapter on constipation. The pendulous abdomen, so common in the advanced stages of pregnancy, and which usually afflicts those of relaxed habits who have borne several children, may be remedied by a properly adjusted bandage, laced close at the lower edge, and supported by elastic suspenders over the shoulders. If left without support, it grows worse during every preg- nancy. The dragging downward of the abdominal viscera causes an all-gone sensation about the stom- ach, and weakness of the back is liable to produce SWOLLEN LIMBS AND ENLARGED VEINS. 241 Remedies for Swollen Limbs, Enlarged Veins, and Giddiness. difficult labors, because the womb does not exert its power in the proper direction to secure the engage- ment of the child in the upper strait of the pelvis. SWOLLEN LIMBS AND ENLARGED VEINS are frequently a source of annoyance for several weeks previous to confinement. The best remedy is the use of the bandage above directed for pen- dulous abdomen, so arranged as to carry the weight to some extent upon the shoulders, and thus diminish the pressure upon the vessels at the groin. When the bandage is not well borne, as sometimes happens, the lady should lie down frequently, and thus remove the weight of the uterus, that the enlarged vessels may be unloaded. The stress upon the vessels is thus temporarily removed. GIDDINESS is usually an indication of excessive fullness of the blood-vessels, and in severe cases may demand the use of the lancet ; but the habit of abstracting blood simply because the woman is pregnant, can not be too severely condemned, as the vessels soon are as full as ever, and the bleeding must be repeated, and its frequent repetition is likely to disturb the equilibrium of the vital forces in such a manner as to lead to apoplexy, paralysis, convulsions, or similar diseases in after years. A more rational treatment is 21 242 woman's monitor. Treatment for Wakefulness, etc. low diet, assisted in bad cases by occasional doses of some mild cathartic, as small doses of Epsom salts, or effervescing soluble citrate of magnesia. WAKEFULNESS AND RESTLESSNESS at night may arise from nervous irritability, and may be relieved by the occasional use of a table-spoonful of elixir of valerianate of ammonia, an elegant prep- aration found in the shops. In some cases it may be necessary to give fifteen or thirty grains of hydrate of chloral dissolved in water, before retiring to secure sleep. The chloral should not be habitually given, but may be necessary occasionally. If such power- ful means are required to secure rest it is likely the bowels are constipated, that the diet is improper, that the patient is exercising too much or too little, or that some other bad habit needs correcting. EXERCISE should be in moderation. The pregnant female should avoid labor that requires much stooping, heavy lifting, or over-fatiguing exertion ; should not attend at child- births, assist to dress wounds, nor be present at sur- gical operations; should avoid as far as possible at- tendance in the sick-room. She should spend much time in the open air and keep body and mind both actively employed. The routine of domestic duties should not be avoided ; her rooms and chambers FOOD DWARFING THE CHILD. 243 Proper Diet for a Pregnant Woman. should be well ventilated, and every means used to secure the highest possible degree of mental and bodily strength. Her FOOD should be plain and abundant, but should not be taken in excess. All kinds of fruit, berries, and melons, as well as meat, eggs, and milk, should be allowed if de- sired. Corn and wheat bread should be supplied abundantly to those whose children have soft bones or are rickety, but to such as produce children, with the openings of the head well closed up, and hence usually have hard labor, because the head does not yield readily to the shape of the pelvis, we would advise to substitute, as far as possible, potatoes, tap- ioca, sago, arrow-root, or rice, for bread of corn or wheat flour, as the latter articles furnish more earthy matter to the blood of the mother, and hence tend to produce more unyielding bones in the offspring. DWARFING THE CHILD may be necessary on account of the small size of the mothers pelvis or an unusual tendency to produce large children. This may be effected by repeated bleedings and keeping the mother much under the in- fluence of opium, so that those who could not have living children may be blessed with offspring. The size of the child may be reduced one-half or more by these means, and such children often thrive well; but 244 woman's monitor. How to Diminish Pain in Labor. it must be confessed that the mother's constitution will be impaired, and the child could not possess the organic qualities it would have possessed if developed under more favorable circumstances. But it may be- come a duty, in order to save the life of the child and diminish the danger to the mother, that both should take these risks. PAIN IN LABOR may be much diminished by careful diet, as above recommended, and by the preservation of good health on the part of the mother from correct habits of life. Severe suffering is usually the result of some bad position of the child, which the accoucheur may cor- rect, or of irregular contraction of the uterus, spas- modic contraction of the lower part of the womb or of the muscles about the perineum, all of which may be prevented by proper attention to diet and care in exercise during maternity. In many cases the suffer- ing may be much diminished by drinking freely of slippery-elm tea for several weeks before confine- ment. It relaxes the system, increases the amount of mucous secretion, and thus facilitates labor. Dur- ing maternity * SEA-BATHING, THE FOOT-BATH, AND THE SHOWER-BATH should be avoided, but the lukewarm sponge-bath is safe and proper. Persons of relaxed habit should WILL THERE BE TWINS? 245 Baths. Twins. Boy or Girl ? not remain long in a warm bath at any time, but should be very cautious in the use of this bath when pregnant. Nervous women with a tendency to rigid- ity of muscle may be much benefited by the fre- quent use of the warm bath during the latter weeks of pregnancy. It calms nervous excitability and re- laxes muscular spasm, and thus tends to facilitate labor. WILL THERE BE TWINS ? is often asked when the woman is very large, or has suffered unusually with morning sickness. The shape of the abdomen is sometimes indicative of the press- ure of twins, but the only infallible sign is furnished to the physician, who by carefully listening may some- times hear two infant hearts beating in opposite sides of the abdomen. IS IT A MALE OR FEMALE ? is frequently the subject of anxious inquiry on the part of the parents, and the size of the abdomen and amount of motion are supposed to be indicative. This is a mistake. The frequency of the beats of the foetal heart is supposed to mark the sex. If over one hundred and thirty beats per minute it is sup- posed to be a girl; if under that number, a boy. This must be very inaccurate, as the temperament and health of both mother and child must affect the 246 woman's monitor. Seven Months' Children, etc. number of pulsations. If the period of conception is known, some persons infer that it is a girl, if the occurrence was immediately after menstruation; if two or more weeks after menstruation, that it is probably a boy. This method of judging will often disappoint us. THE DURATION OF MATERNITY varies considerably. The first pregnancy usually ter- minates from one to three weeks short of the usual average period of forty weeks. A child born at seven months, if tenderly cared for, will usually survive, and in rare cases even earlier. There can be no doubt that pregnancy is often protracted several weeks beyond the usual average. The code Na- poleon declares that a child shall be considered legitimate, that is born within three hundred days after the departure or death of the husband, or one hundred and eighty days after marriage. But this provides that a child born more than three hundred days after the departure or death of the husband, shall not necessarily be declared a bastard, but its legitimacy may be contested. Prof. Charles T>. Meigs publishes a case where the pregnancy was pro- longed to four hundred and twenty days. Dr. Attee and Prof. Simpson, of Edinburgh, as well as many others, have reported similar cases, which they con- sidered trustworthy. PROTRACTED LABOR EXPECTED LABOR. 247 How to Reckon the Time for Labor. THE CAUSE OF PROTRACTED LABOR is usually some defect in the energy of the womb, in- duced by previous disease, the use of narcotic drugs, or some powerful mental impression. As a. rule, the woman whose habits are correct, and who is subject to no unusual influences, will be confined on the period of that menstrual crisis which falls nearest forty weeks from the period of conception; but many cases can be protracted by heavy doses of opium or similar narcotic, and avoiding exercise. THE TIME OF EXPECTED LABOR may be counted from the day of the disappearance of the last monthly sickness — three months are sub- tracted and seven days added; the date thus given will correspond to the period when labor should com- mence. Suppose the cessation was on the twentieth of June ; subtract three months and we have March 20th; add seven days and we have March 27th, of the ensuing year. This method will not usually fail but by a very few days. It gives forty weeks, or two hundred and eighty days. WHAT INFLUENCES CONTROL THE SEX OF THE CHILD. Prof. M. Thury, of Geneva, claims to show how males or females may be produced, as may be desired. 248 woman's monitor. Influences Supposed to Control the Sex of the Child. He says that hens lay female eggs first, that the same is true of bees, and that later male eggs are produced ; that stock-growers have observed that females shown the male in the first period of heat produce females, and at a later period, males. Upon these facts, and similar observations as to the human female, he has announced it as a law that conception occurring within the first few days after menstruation will produce a girl, and when it occurs later the result will be a boy. There are many facts recorded that appear to give color to this supposition. But to my mind there are several serious objections to accepting it as a uni- versal law. First, I have observed that in quite a number of cases, when I had every reason to be- lieve pregnancy occurred immediately after the cessa- tion of the menses, boys were produced. Second, it is a generally received opinion that conception usu- ally occurs within a few days after menstruation, and yet more boys are born than girls, as shown by the statistics of births. From the above and several other considerations, which I have not the space to mention, it appears we should receive Prof. Thury's -theory with many grains of allowance. We have bestowed some attention upon the study of this question, and have adopted the idea that preponderance of desire or dominant ardency of temperament governs the sex of the child. It has been observed that men whose nervous forces are PREPARATIONS FOR LABOR. 249 No Sure Rule. Preparations for Labor. exhausted by disease or excessive study, beget girls; that a feeble, aged father with a young wife usually produces girls. But a few years seniority on the part of the husband often reverses the rule, and boys are begotten. If girls are often produced, when concep- tion occurs about the close of the menstrual epoch, Ave believe it is due to the greater activity of the mother's passions and sexual energies at that period, and that a variety of circumstances may overrule this preponderance so that boys may be produced. PREPARATIONS FOR LABOR These relate first to the mother. Careful attention should be given to the state of her health. The bow- els should be regulated and the stomach should not be oppressed with coarse, indigestible food. The sys- tem should be relaxed by drinking freely of tea made from slippery-elm bark or similar mucilage, if of firm muscle; if of relaxed habits, this is not necessary. As labor approaches, if a slight relaxation of the bowels fail to occur, which is usual, a light cathar- tic should be given — in relaxed habits, rhubarb or castor oil; in persons firm in health and of full habit, with plenty of blood, w T e prefer citrate of mag- nesia or Epsom salts. The nipples should be rubbed between the fingers or with a fine cloth several times daily for a few weeks previous to labor, to harden the skin. Diluted brandy or solution of alum has been rec- 250 woman's monitor. Further Directions Concerning the Lying-in Chamber. ommended, but occasional friction is all that is usually required. The part will be protected by the secretion of more material, forming a thicker epidermis. The room should be as large and well ventilated as possible. If an outdoor exit, it should be closed in damp and cold weather, so as to require persons entering the room to enter through an apartment where there is a fire, that the cold, damp air may not rush into the room and change the temperature too quickly, and that cold and dampness may be removed from the clothing of persons before entering in the lying-in chamber. It should be as retired as possible, that the patient may be kept quiet, and but few visitors should be per- mitted for several days. This rule should be rigidly enforced if the woman had hard labor, lost much blood, or is ftf an excitable, nervous temperament. The bed and clothing should be well aired, and if pos- sible should be occupied by the lady for some days previous to labor. Feather-beds should in no case be allowed; they absorb poisonous effluvia, and are difficult to cleanse. They retain the animal heat and diseased nervo-vital fluids. Being poor conductors of heat and electricity, they thus predispose to wakeful- ness, nervous diseases, and inflammations. The bed should be a mattress of hair, straw, or husk. This should be protected by an oil-cloth, over this a blanket or quilt, under the sheet; upon this a few thicknesses of some soft material should be placed, just under the PREPARATIONS FOR LABOR. 251 Further Directions. hips of the patient, to absorb the liquids and any blood that may escape. A spring-mattress is not firm, and consequently not good, especially in difficult labors. I have frequently seen much confusion at a critical moment by the weight of assistants springing out slats from a common bedstead. This is likely to happen if the slats are not long enough to fit the bed- stead closely. The bed should be so arranged that the accoucheur can approach it with his right hand toward the bed, as most persons are more apt in rendering assistance with the right hand. Hot and cold water should be at hand, also soap, towels, and a basin ; some volatile stimulants, as hartshorn, also a small quantity of good brandy or whisky is sometimes necessary to assist in rallying a patient from a state of exhaustion, but these may usually be dispensed with. Some linen or cotton cloths are required, a towel of sufficient length, or a properly prepared bandage, also a piece of cotton, silk, or linen twine, to tie the cord, and a pair of sharp scissors completes the armament necessary to be provided. The clothing of the child should be large, so as to allow of no unnecessary pressure on its tender frame ; as few pins as possible should be used about its clothing, though some strong pins should be at hand for securing the bandage upon the mother. We prefer these to the lacing-strings so often used, as it is difficult to secure a proper fit with the latter. There is no dress so comfortable for an 252 woman's monitor. Symptoms of Labor. infant as a woolen wrapper, close about the neck, and with long sleeves; it should fit quite loosely. SYMPTOMS OF APPROACHING LABOR. About two weeks before confinement the womb usually drops or descends, so that the upper portion is on a level with or below the umbilicus, and the abdomen appears smaller. The woman is somewhat relieved from the oppression and difficulty of breath- ing, which had previously troubled her, and will be able to take more exercise. If her first experience, she may be tempted to go from home and be over- taken with labor, as has frequently happened. An- other sign of approaching labor is increased fullness of the external genitals, with more abundant secre- tion of mucus. This may amount to a considerable discharge, requiring a napkin to be worn. If this se- cretion is rather abundant it is a good sign, promising an easy labor, as it indicates a relaxed condition, which is favorable. THE FIRST RELIABLE SYMPTOMS OF ACTUAL LABOR are pains caused by the contractions of the womb. These take place at intervals, which are longer at the beginning, and shorter as the labor advances. At first they occur every twenty to thirty minutes; but as the irritation becomes intense, they increase in fre- SYMPTOMS OF ACTUAL LABOR. 253 Causes and Character of Labor Pains. quency, until they are repeated every two to five minutes. The average duration of labor is four hours. The pains are said to be owing to the sensibility of the resisting, and not to that of the propelling organs. The pains of labor are usually felt in the lower part of the abdomen, and in the back ; they are rarely felt in the upper part of the womb ; never unless the muscular contractions are irregular or spasmodic. As the labor advances the pain will be felt lower in the pelvis, until the most agonizing throes are caused by pressure upon the muscles of the -perineum and ad- jacent parts. Those which put the labia and per- ineum on the stretch are represented as absolutely indescribable. As the presenting part of the child presses upon the bowel and bladder some pain is to be expected, if their contents have not recently been evacuated. Urgent desire to do so will now be set up. This desire should be gratified at first, but the pressure will keep up a disposition to arise after the pelvis is filled w 7 ith the presenting portion of the child, and many women will insist on getting up at a time when it would avail nothing, and might be attended with danger to the woman or child. Vomit- ing is frequently met with during labor, and is mostly present during the dilatation of the neck of the womb. Violent tremors of the body and limbs, with chatter- ing of the teeth, as in ague, are very generally ob- served, but are unaccompanied with sensation of chill. 254 woman's monitor. False Labor Pains. Duration of Labor. False pains are very common in persons subject to rheumatism ; they occur in some cases irregularly for weeks previous to confinement, and render the pains of labor teasing, and unusually hard to bear. This often protracts the period of suffering, with harass- ing after-pains. Such patients should be kept in bed for sometime previous to labor, taking five or ten grains of Dover's powder at night; also some alka- line remedy, as bicarbonate of soda, three times daily, and in some cases a course of colchicum and guaia- cum, as equal parts of the tinctures mixed in tea- spoonful doses three times daily. DURATION OF LABOR. It is obvious that the duration and amount of suf- fering in labor must depend on the shape of the pelvis, the character of the pains, the size of the child, the part presenting as a dilating medium ; also, in case of head-presentation, upon the position of the head, and the facility with which it is molded to the shape of the pelvic cavity. This must depend upon the condition of the child's head. If the openings are well closed up, so that pressure does not readily diminish the size of the head, and if that organ is relatively large for the pelvis, the labor must be severe. It is not desirable that labor should be too rapid; the child is more liable to be injured, and the mother suffers more soreness afterward from too DURATION OF LABOR. 255 Labor should not be too Rapid. rapid dilatation of the parts. This is especially true in first labors. I have known young women so seriously injured by rupture of the perineum as to require severe surgical operations for their relief, be- cause the women in attendance, instead of pressing against the perineum, and retarding labor in its last stages, so as to allow the parts time to yield, encour- aged severe expulsive efforts : and hence the disas- trous results. The contraction of the circular fibers about the neck of the womb are the first resistance to the passage of the child ; the long fibers running from the neck over the womb, and back on the other side, by their contraction produce the expulsive effort. The force of the first contractions cause pain about the neck of the womb, gradually opening it. At this period, in addition to shiverings and nausea, you will observe most women grasp the hand of their assistants with a firm pressure — they are not inclined to pull. When severe expulsive pains occur they are likely to pull heavily with their hands. So with a little experi- ence and care in observing symptoms, one can be pretty certain as to the stage of the labor. All such cases should be conducted by an experienced ac- coucheur, either male or female. I may here be allowed to digress sufficiently to remark, that while I freely acknowledge woman's right to practice the art, her ability to acquire the requisite knowledge, and the deeper sympathies of 256 woman's monitor. Female Accoucheurs. her nature, which would seem to peculiarly fit her for the companionship of one of her own sex, while pass- ing this trying ordeal, yet years of observation have convinced me that by reason of that very sympathy, and because of the peculiarities of her nervous or- ganizations, she is by nature unfit to perform many of those operations at times required to carry one safely through an abnormal labor. It is a psychological law inherent in our nature that deep sympathy with one in suffering tends to produce congestion and nerv- ous irritation in a corresponding part of the body, in one brought into full sympathy with the person suf- fering. The educated female midwife must, under trying circumstances, feel the full force of her re- sponsibility, and if she fully realizes the condition of her patient, the very foundations of her womanhood must be stirred to their profoundest depths. Her own uterus and ovarian stroma must feel the shock, and, however great her self-control, by the laws of reflex nervous action, it must affect her mental forces, so that but few indeed could promptly and efficiently execute those operations which, with other surround- ings, they might be fully competent to perform. If, with an iron will, she forces herself to the un- welcome task, every experience but renders her more and more susceptible to the influence of the causes to which I allude. There are but few indeed who do not, sooner or later, abandon a class of asso« DURATION OF LABOR. 257 Male Accoucheurs. ciations that by experience they find so peculiarly de- pressing to their physical and mental powers. Xot so with the male accoucheur. Possessed of human at- tributes, he must deeply sympathize with his suffer- ing patient; but, by the very laws of his mental constitution, he does not feel that bodily suffering that must reach the woman under the same circum- stances. So that in difficult and dangerous labors, at least, I am quite sure women will continue in the future, as they have in the past, to feel safer when assisted by a professional gentleman. I am aware that the same argument will apply, in a certain de- gree, to the treatment of female diseases by female physicians, but not to the same extent, as there are but few cases where disease would be likely to make such sudden and profound impressions upon the sen- sitive female nature as to pervert from their normal channels the flow of her mental forces. While I believe the principles here enunciated to be correct, I do not wish to be understood to oppose woman's practicing the healing art. A wide field for usefulness is before her in general practice, and in several specialities, even if she avoid a certain class of obstetric cases, and some forms of gynecological surgery. All women should have sufficient knowl- edge to render ordinary assistance, in the absence of a physician, as circumstances may often make such knowledge necessary. This general knowledge may 22 258 woman's monitor. Meddlesome Midwifery Fraught with Evil. be gathered from the remarks I shall make as to the duties of the physician, and the nurse, or attendants. DUTIES OF PHYSICIAN AND ATTENDANTS. The duties of the physician, when summoned, will be first to observe the character of the pains. If they are of the expulsive character, or in case the waters have broken, he will institute an examination. The preliminary prerequisites are soap, a basin of water, and towel, for washing his hands, and some lard free from salt. The woman should lie upon her left side, near the edge of the bed, with limbs well drawn up ; the fore-finger, well oiled, is passed into the vagina, reaching the neck of the womb, and the condition of that organ ascertained ; also, if possible, the part of the child presenting. This should be done carefully, that the membranes may not be ruptured. If the labor is natural, which is usually the case, she should then remain undisturbed, as nothing he could possibly do would assist in the least; and unnecessary efforts to assist, so commonly practiced by ignorant accouch- eurs, I suppose for the purpose of keeping up the ap- pearance of doing something, can but injure the soft parts and retard the labor. One of America's greatest obstetricians has well said: "Meddlesome midwifery is fraught with evil." Let the nurses render such little assistance as the patient's wants may require, otherwise let her alone^ — only securing such position DUTIES OF PHYSICIAN AND ATTENDANTS. 259 Minute Directions. as the nature of the labor may demand. Occasion- ally it may be well to note the progress of the labor by an examination. If the labor is tardy on account of feeble pains from over-distension of the womb, as sometimes happens, it may be well to rupture the membranes, but never until the lower part of the womb is well dilated. It is seldom that this pro- cedure is not soon followed by severe expulsive efforts on the part of the womb, when the woman should be encouraged to assist, by filling the lungs and bearing down, making expulsive efforts with the abdominal muscles. As the head gradually puts the external parts upon the stretch, her expulsive efforts should cease, that the passage may not be too sudden ; and in all cases except those where great relaxation ex- ists, a folded napkin should be oiled, laid in the hand, and the parts supported to prevent too rapid delivery. This should be carefully attended to by one of the assistants, especially in first labors, if the delivery is likely to occur before the arrival of the medical at- tendant, and the delivery prevented, if possible, until the arrival of the doctor. This may not always be possible, but the effort will usually so retard the labor as to allow of a safe delivery. As soon as the head is born, the infant's face should be protected from the pressure of the soiled clothes by the hand, and the mucus and blood removed from about the mouth and eyes with a soft cloth. It will usually make an effort 260 woman's monitor. Minute Directions Continued. to cry. If the cord is about the neck it should be carefully removed. No undue force should be used upon the head to hasten delivery, lest the neck be injured. If the shoulders be tardy about passing, and especially if any fears are entertained for the safety of the child, one or two fingers may be in- serted into the most accessible arm-pit, and gentle assistance rendered at the time when the expulsive effort is made. The head and shoulders being sup- ported on the hand, the hips and lower extremities will soon follow. RESUSCITATION OF THE CHILD. If the child fail to breathe, some water or spirits may be sprinkled on its breast, or preferable, because more efficient, a few rapid slaps or thumps may be lightly applied along the spine and over the chest. The ribs may be gently pressed upon and then raised, one hand being under the shoulders in such a way as to cause air to fill the lungs, then turn it over and press out the air. These movements should be repeated at intervals of a few seconds. If it does not yet cry, and the face assume a purple appearance, cut the cord some distance from the body, and allow a small quan- tity of blood to escape, then secure the cord by liga- ture, or knot tied upon it. These efforts should be continued for half an hour or more before life should be despaired of, if the child was known to have been RESUSCITATION OF THE CHILD. 261 Resuscitation of the Child. recently alive or has no appearance of having been dead previous to labor. They should usually be con- tinued, at least until the arrival of the physician. If the child grows cold rapidly, which it is likely to do if it does not breathe, warm water in a tub should be speedily procured, the child placed in the bath, head supported out of the water. If it shows signs of life, raise the chest, and, changing its position, make pressure as above directed, to assist the respi- ratory movements. If not, after some ten minutes in the bath, raise the chest out of the water and dash upon it a small quantity of cold water, then assist any efforts at breathing by artificial inflation, as be- fore directed. But do not blow breath into its mouth, as is often done, and sometimes by physicians, to please the attendants, usually when the child is, in the doctor's opinion, certainly dead, for the air blown from the lungs is unfit to support life, and will go into the stomach and bowels instead of the lungs, or at least as readily, and by filling the stomach and bowels, it will interfere with the descent of the dia- phragm, and this will oppose the feeble efforts of the child to breathe; it will also prevent the success of artificial respiration. I have dwelt thus long upon the resuscitation of the child, because I have so often known valuable lives lost by want of knowledge and care on the part of those whom circumstances forced to assume the 262 woman's monitor. Drections to be followed after the Birth of the Child. responsibility of caring for new-born babes. In nat- ural labor, the child having breathed freely, the pulsa- tions in the cord gradually cease. A stout string should then be tied firmly around the cord about one and a half inches from the body, run the fingers along the cord an inch or two to free it from blood, and apply another ligature, then with a pair of sharp scissors cut the cord near the first string. Lift the new- comer carefully into a blanket, wrap it up, and hand it to an assistant. The mother should be allowed to rest a few minutes, sometimes half an hour or more. The hand placed upon the abdomen will reveal a large hard substance in the abdomen. This is the womb. If the after-birth has passed down to the vagina the womb will not be half so large as in case it has not. If the abdomen feels soft the woman is probably flowing; lightly grasping the uterus with the hand, through the walls of the abdomen, will usually suffice to bring on speedy contraction, and consequently -hardening of the tumor, which arrests the flow. This failing, the hand may bye dipped in cold water and suddenly applied to the bowels. This seldom fails to speedily cause contraction and arrest the flow. If the womb still bleeds, or shows a tend- ency to relax and bleed again, after it was firmly con- tracted, red raspberry-leaf tea, or tea from the uva ursi leaves, or, what is better, some preparation of ergot of rye should be given, to secure firm contraction. TREATMENT OF THE MOTHER. 263 Further Directions for the Treatment of the Mother. Some pain will soon come on, and the after-birth will likely pass into the vagina, from which it may be re- moved by gentle traction on the cord. If this does not suffice it may be brought down by the finger, passed along the cord until the placenta is reached, when it may be removed. In making traction upon the cord care should be observed not to use sufficient force to break it. This is of considerable importance if the after-birth still adhere within the womb, as the cord should be left as a guide for the accoucheur, whose duty it may be to seek and detach it. The membranes which are likely to linger should be twisted together and gently drawn so as to leave no fragments. The application of a soft cloth well greased with lard, to absorb the discharges, and the careful adjusting of the bandage completes the atten- tion due the mother for the present. The woman should not be allowed to make any exertion during the adjusting of the bandage and arranging of the bed; all should be done for her in that quiet, easy way every physician and skillful nurse understands. Usu- ally a folded napkin or two will be required to apply over the lower part of the bowels, to secure a proper fit of the bandage. The bandage should be pinned from below upward and drawn pretty firmly below, but gradually slackened toward the top, that too much pressure be not applied to the womb ; the row of pins should be placed to one side of the center 264 woman's monitor. Further Directions. If the mother is much exhausted a cup of tea or a little wine and water may be allowed. Usually all that is required is a few hours' rest, the length of time depending on the amount of exhaustion, when her clothes may be changed and bed arranged by re- moving the soiled articles; the nurse should then cleanse the soiled parts with a soft cloth and warm water, and adjust another well-oiled napkin. This dressing and cleansing should be continued at least once every day until the lochia cease. The bed will require an extra amount of cover, and in cold weather the fire should be increased immediately be- fore delivery, as the relaxation and diminished animal heat after exertion has ceased is favorable for tak- ing cold. The care of the child is usually intrusted to the nurse. It is not best to use soap in washing it, as the application of lard removes the unctuous substance upon it better than soap. If soap is used, a little Castile or other very mild variety should be allowed, and warm water applied with a soft sponge or cloth. The cord should be dressed with a linen or cotton cloth three or four double, a small aperture made for the cord to pass through, and so fringed around the edge with scissors as to make it fit close around the cord when it is pulled through, that no part of the cord, which will soon be putrid ma- terial, may touch the child. The aperture should be about one-third distant from one end of the cloth; the DRESSING THE CHILD. 265 Directions for Dressing the Child. other end will then fold over the cord. This dress- ing should be oiled with lard or tallow about the cord next to the child, and be secured in position by a band pinned in front. This band, as well as the skirt- bands, should not be drawn tightly, as they make the child cross by interfering with breathing and increasing the dangers of rupture, for it should be remembered that ten children are ruptured at the groin to one at the navel, and a tight bandage across the bowels prevents proper expansion. When the child cries every effort to fill the lungs in a forcible manner pushes the bow- els downward and crowds them into the abdominal rings and other openings for the passage of vessels, and must thus increase the danger of rupture about the groin. In applying the band and also the square to little girls, nurses and mothers should remember that the bones are soft and plastic, easily bent by any force continually applied. The use of tight bandages and squares may so compress the hips and bones of the pelvis as to cause much suffering and sometimes death to the future woman, in consequence of an ill- shaped pelvis produced in this way. Young infants should be dressed close about the neck, and with long sleeves, after the flannel skirts are put on, and the bands pinned loosely. The best possible dress for an infant is a Avoolen wrapper, with a drawing string to bring it up to the neck and sleeves to the hand. This allows of the greatest freedom of 23 266 woman's monitor. Proper Temperature, Clothing, Nursing, etc. motion, and assists to secure that equitable temper- ature so essential to the babe's health and comfort. Thousands of infants are kept so cold as to rendei them cross and miserable. It should be remembered they have just merged from a habitation maintained uniformly at blood-heat, or 98° of the Fahrenheit scale. A room is considered very comfortably warm at 70°. Now this difference of 28° is partly sup- plied by the consumption of oxygen in the infant's lungs ; but digestion and assimilation not being per- fectly established for some days, it is evident the infant requires much cover, and great care as to the temperature of the apartment, or it will be cross and fretful. The child should be put to the breast early, for several reasons : first, it encourages the develop- ment of secretion on the part of the breast ; second, there is usually present a small quantity of secretion, which is the natural purgative for the child, neces- sary to clear its bowels of the secretions which have accumulated during its intra-uterine life ; third, in consequence of that intimate sympathy which exists between the breasts and the womb. The application of the infant to the breast causes firmer contraction of the womb, thus checking any unusual tendency to flow, also expelling retained blood-clots, which might keep up after-pains or excite inflammation. The child should not be fed unless the milk is very tardy in appearing. When allowed the bottle, milk from a FEEDING THE CHILD. 267 Feeding the Child on Cow's Milk. young cow recently fresh is to be preferred. Great care should be observed that she is not fed on pump- kins with the seeds, or turnips, and especially on oil- cake meal. If the latter is fed in any considerable quantity, it will usually soon disturb the stomach and bowels of the child. This often will kill the child, if the milk from a cow fed on oil-cake is not stopped. Children before the period of the first dentition re- quire nothing but milk; if the mother is in good health, and breasts all right, she should afford all that is demanded. If cow's milk is used, it should be made one-third water, and a little white sugar added, just enough to be perceptible to the taste, and the bottle should be carefully cleansed several times daily, that no taint of sour milk may be present to disturb the stomach of the child. The practice prev- alent in some families of feeding little infants a small quantity of various articles can not be too severely condemned, as thousands have their digestive systems ruined in this way during the tender years of infancy. Mothers should nurse their own children, unless some physical inability exists, except those who are scrof- ulous, consumptive, or have cancer, secondary syph- ilis, or like disease. In such cases nursing, if not protracted too long, sometimes benefits the mother, but it is at the expense of the child, whose hered- itary predispositions to disease must be fostered by deriving nutriment during the period of its earliest 268 woman's monitor. Wet-Nurse— The Bottle— The Cradle. development from a source that is tainted with the debris of a decaying and diseased system. The best plan is for such to secure, if possible, a perfectly healthy wet-nurse, whose mental and moral forces are all sound. If such can not be procured, we prefer a bottle used under the fostering care of the mother; but not so in case she is seriously diseased ; for the exhalations of her breath, and her diseased electro- magnetic forces, must seriously impress the tender child. Such should be trusted, even with their bottle, to other hands, provided it is possible they can be fostered by one who is perfectly healthy. These facts are worth remembering, if you value the health and look to the future well-being of your children. We are of the opinion that it is wrong to rock infants to sleep ; rocking produces a sort of diz- ziness that is not conducive to sound, healthy sleep, and the child rocked to sleep is likely to awake as soon as the cradle stops. Little infants are some- times seriously injured by being set up too soon and allowed to be too early upon their feet, especially when the bones are unusually soft and yielding. The medicinal treatment of such cases has been men- tioned in the article on rickets. Indiscretions in this respect are likely to cause distortion of the legs, injury to the feet and ankles, also disease and curv- ature of the spine. DIRECTIONS TO THE MOTHER. 269 Care of the Mother after Confinement, After-Pains, etc. DIRECTIONS TO THE MOTHER. During the first few weeks following delivery ex- treme care on the part of the female is necessary, that she may not take cold, or in any other manner interfere with that process which is immediately set up, to restore the uterine system to its normal con- dition. The lochial discharge will continue for a few days, and is a drainage from the part of the womb where the plaefenta was attached. If the womb has not contracted firmly and regularly, a clot of blood is likely to remain in its cavity for some time. The efforts of the womb to expel such clots cause pains ; these are known as after-pains. They will usually cease when the child is applied to the breast, as a severe pain will then likely expel the clot. In some cases after-pains continue a long time, and with such severity as to prostrate the patient. Such cases are readily relieved by a few drops of laudanum, or a powder containing one grain of pulverized opium and two of camphor, repeated, if necessary, in three or four hours. It must be borne in mind that at the close of labors the womb is many times larger than before impregnation ; vessels, nerves, and all its struct- ure, have enlarged gradually, as the maternal period advanced. It is now too heavy to be supported by its ligaments. If a woman sit up, or arise upon her feet, even for a short time, it will sink low into the 270 woman's monitor. Length of Time to Remain in Bed. pelvis, putting its supporting ligament on the stretch ; hence it is apparent that those who do not arise too soon are less likely to be troubled with uterine dis- placements, and such female weakness as arises from that cause. The period that must elapse before the womb has been reduced by the action of the absorbents to its normal size, will depend upon the care exercised by the lady and nurse. If the patient remain quietly in bed, her diet be light, and of such a quality as not to excite fever, if her bowels are kept regular, and no cold is taken, so that the vital functions of the body and mind are performed in a healthy manner, she may be allowed to sit up for a short time at the end of ten days, but should lie down as soon as a sense of fatigue overtakes her. At the end of three weeks she may be allowed to move about the room and sit up longer at a time each day; this, within certain limits, strengthens the support of the uterine system by exercise, and the effort may be repeated at in- tervals several times daily, until at the end of four weeks the lady may leave her room, but should for four weeks more lie down on feeling a sense of fatigue, or weight across the loins, to enable the uterine liga- ments to secure rest. That many women of firm health arise much earlier, and exercise less care in arising, I well know; but all such are more or less injured, and where one escapes serious injury, many DANGERS TO THE MOTHER. 271 The Results of too Great Haste. are rendered miserable, or destroyed by the con- sequences of such indiscretion after confinement. Suppose a cold is taken, or the woman suffer from some form of child-bed fever, or from milk abscess, or other form of broken breasts. The powers of nature are arrested in their process of repair, the womb be- comes swollen, and, after the disease is subdued, the swollen and enlarged womb returns very slowly to its non-pregnant size. Of course the time required be- fore the lady can safely be about the house must be protracted until disease is subdued, and the swelling caused by the cold or inflammation has passed away. It requires much more time for a womb enlarged by inflammation, and retarded in its proper retrograde movement, to return to its non-pregnant size than it would have done if it had not been inflamed. You will observe I included broken breasts, and all forms of mammary abscess, in the list of causes which re- tard recovery. The reason will be apparent : first, the sympathy which exists between the breast and womb prevents the proper action of the absorbing vessels by keeping the parts congested ; second, the loss of rest, and debility from suffering, relaxes the system, and diminishes the sustaining power of the uterine ligaments. It is in this manner that inflam- mation and abscess of the breast are a source of pro- lapsus and other uterine disease. There appears to be a disposition among women, 272 woman's monitor. Tendency in the Country Districts to get up too soon. especially in the rural districts, to take pride in get- ting up soon, rather than in getting up free from dis- ease, and we fear physicians, who should know better, foster this idea to some extent, because ignorance of the consequence may induce a feeling in the popular mind that extra skill in managing such cases enables the patient of some doctors to be around sooner than others. Nothing is more erroneous, nothing could be more destructive to the future well-being of mothers thus encouraged to arise too soon. A fearful respon- sibility rests upon the adviser of the woman who is encouraged to carelessness at such critical periods, as a single error at such times may be fatal to life, or cause its unhappy victim to drag out a life of wretch- edness pitiful to contemplate. TIME TO GIVE PHYSIC. About the third day after confinement it will usu- ally be proper to give a light dose of castor-oil or citrate of magnesia. If the lady is of full habit and the milk fever runs high, or the breasts are painfully distended, small doses of Epsom salts repeated every four hours answer very well, but this should not be employed for persons who are feeble, relaxed, or anaemic. If the milk fever is developed earlier than the third day the bowels should be moved earlier. THE NIPPLES. 273 Treatment for Sore Nipples. THE NIPPLES are sometimes very painful, from cracks, blisters, or other forms of sore. The best method of preventing these troubles has already been alluded to. In addi- tion to what has been said, we would direct that the $hild should not be allowed to draw the breast long at a time when it is empty, and that the parts be kept dry. They should be anointed after nursing with an ointment made by boiling a small quantity of starch in glycerine, the amount depending on the desired density of the ointment, usually one part of pulverized starch to three of glycerine by measure. To one ounce of this -ointment twenty grains of tan- nic acid and five grains of morphia may be added if the parts discharge much or are very painful. When the morphia is used care should be observed to re- move the ointment before nursing the child. In some cases of abrasion collodion is an excellent application, yet it only answers well when the trouble is very superficial. Much suffering may be prevented by allowing the child to nurse through a prepared heifer's teat or a gum-elastic shield, to be had of any drug dealer. The glass nipple shield should be worn to protect the parts from the pressure of the clothing and to receive any milk that may escape. It often happens that the nipples are ruined by the injudicious use of the breast-pump; this should only be applied by skillful hands. 274 woman's monitor. Causes and Treatment of Inflammation of the Breast. INFLAMMATION OF THE BREAST AND ABSCESS are often caused by obstruction to one or more of the little milk vessels leading from the gland to the nip- ple. This may be the result of injury from a fall, or blow, or the pressure of corsets or dress-stays. It is often produced by previous inflammation, causing de- posits which obstruct the milk-ducts. They may also be obstructed by inspissated secretion; the milk not finding its way out distends that part of the breast which should be relieved by discharge through the obstructed tubes. This causes a painful, hard swell- ing, familiarly known as a cake in the breast. It is evident that one of three things must happen — either the obstruction to the flow of milk must be removed, the secretion stopped in that part of the breast, or the distension must lead to inflammation and abscess. In many cases it may be quite impossible to know the real cause of obstruction in the milk-ducts. For this reason it would be w T ell in all cases to pursue the course best calculated to remove obstruction from in- spissated secretion. This is accomplished as follows: Let the nurse apply one hand so as to support the breast on the opposite side from the place where there is reason to suppose the obstruction exists, then dip the other hand into hot water and draw it lightly over the breast in the direction of the nipple ; keep up the rubbing, occasionally dipping the hand into INFLAMMATION OF THE BREAST AND ABSCESS. 275 Further Treatment. the water as it gets dry. The water acts as a warm relaxing application, and prevents the hand from sticking, so as to injure the parts by friction. The breast will usually be found to become progressively more tolerant of pressure. This should be continued perseveringly for half an hour at a time if necessary, gradually increasing the pressure as it is better borne. If the trouble is from inspissated material in the milk- ducts, as it is in a large majority of cases, you will be rewarded for your trouble by the appearance of from one to a dozen little gummy threads shooting out of the relaxed milk-tubes, having been forced along by the rubbing. This is usually followed by a free flow of milk from the part and relief is almost immediate. If the breast is too full, hot and painful, this method, assisted by gentle pressure, usually will cause the milk to flow and relieve the breast if perseveringly em- ployed, and in a less painful manner than can be done with any breast-pump with which I am acquainted. If a proper effort fails to relieve the obstruction an effort may be made to arrest the inflammation and dry up the milk in that part of the breast. This should consist in the application of tincture of cam- phor or a plaster of soft extract of belladona, a light dry diet, and small doses of salts or senna, repeated so as to keep the bowels loose. When the progress of the case renders it certain that purulent matter is collecting, the sooner the lance is used the better. 276 woman's monitor. Ignorant and Designing Doctors. The tension is removed by lancing, and serious destruc- tion of parts prevented, as well as much suffering dur- ing the period it would have required for the pus to make its way to the surface, and it is plain that the less destruction of the tissue the less time will be required for nature to repair the damage. The above remarks with reference to lancing will apply to every form of abscess of the breast. All forms of inflam- mation of the breast require a supporting bandage, so arranged that the weight of the inflamed organ shall be prevented from dragging upon diseased ves- sels and nerves. The bandage should pass around the neck and below the breast, so as to give gentle support. MEDDLESOME MIDWIFERY has been referred to, and some abuses practiced by many accoucheurs, both male and female, have been mentioned. But many more are deserving of notice. It is no uncommon thing for an ignorant or designing medical attendant to leave the impression upon the mind of a patient, that she has barely escaped with her life, and that she will certainly die if again preg- nant, when in reality she was not in the least danger in her first confinement; and time has proved that the fears which often well-nigh ruin both the mind and body of the mother, and through her psychological forces made a life-long impression upon her child, MEDDLESOME MIDWIFERY. 277 Too Great Attention by the Physician. rendering it fretful, nervous, and sometimes epileptic, was in reality but the fulminating of gross ignorance on the part of her attendant. Mothers should re- ceive such statements with much allowance, as they are nearly always false. It is a prevalent notion in the country that the accoucheur should be continually engaged during labor rendering assistance. This is not true if the labor is natural. The doctor had bet- ter be in an adjoining room, as his presence often em- barrasses his patient, and all notion that any thing he can do to assist in a natural labor during all but the terminating period is perfectly absurd. He may suc- ceed in producing much dryness and tenderness of the parts by injudicious handling, and thus protract the labor, and cause the poor woman much unneces- sary suffering. Under the specious pretext of assist- ing, he may lay the foundation for serious vaginal disease; but to suppose any thing he could do, if the position of the child is normal, until it becomes necessary to support the perineum, could benefit his patient, is evidence of ignorance deplorable indeed. It is true that tardy pains may be rendered more act- ive by rupturing the membranes, and at times it may be proper to give ergot, to increase uterine activity when it is tardy, but this should be done with great caution. Many children are lost in the hands of men who should know better, by the use of this drug. May not this innocent blood be required at their 278 WOMAN S MONITOR. Forcing Labor. hands? Ergot and like forcing remedies secure almost constant activity of the uterus — a kind of tonic spasm. It is therefore useful where there is a tendency to flow in the interval of pains, caused by a partially detached after-birth, and where there is a known tendency to floodings after delivery, as it se- cures firmer contraction. For the same reason that it should be given in those cases to avert dangerous floodings, it should be withheld in ordinary labors, and where the rigidity of parts points to a tedious labor. The almost constant pain keeps the muscles rigid, and thus expels the blood from the vessels of the limbs and great muscles generally. This increases the amount necessarily thrown upon the heart, lungs, and brain, thus tending to produce con- vulsions and disease of the heart or lungs; besides, the constant pressure upon the child, forcing it to accommodate itself too rapidly to the shape of the pelvis, may injure its brain, or it may die from press- ure upon the cord, when it happens to lie between the womb and some hard portion of the child. To these evils may be added the increased soreness of the uterus and external muscles of the mother, from the rapid distension which may have partly ruptured, sometimes divided the structure, which was not al- lowed time for gradual relaxation. CHLOROFORM. 279 When to use Chloroform in Labor. CHLOROFORM. The indiscriminate use of this agent we are con- strained to consider unwarranted. We know much difference of opinion exists among professional men of acknowledged ability with reference to the use of chloroform in labor. Some advocate its use in almost every case, others condemn it altogether. A third party use it to fulfill certain indications, in cases of abnormal labor, and to relieve the pain incidental to severe operations. I believe these are right. If the patient is but partly under the influence of the drug it produces a species of intoxication, and the patient worries more and I think weakens faster than when chloroform is not given. When used to the extent of complete anaesthesia it diminishes the force of the pains. If the pelvis is small in pro- portion to the size of the head, or the bones of the head are unusually developed, leaving the openings or fontanel small, much force will be required to com- pel the head to assume the shape necessary to in- sure its passage through the pelvis. This force being diminished labor must be protracted by chloroform. It will be apparent that the relaxing influence of chloroform is very useful where a rigid, unyielding condition of the neck of the womb or external muscles resist the progress of the labor. It acts by retarding the force of the pains, thus diminishing the 280 woman's monitor. Avoid Hobbyists. Diet. danger of rupture of the muscular fibers from too rapid distension, also by relaxing the muscles, thus facilitating labor by diminishing the resistance offered. It must be apparent to every unprejudiced observer that the use of all drugs should be left to the judg- ment of the attending accoucheur, who alone is sup- posed to know the necessities of each individual case, and we would counsel submission to his judgment, except where it is known he is a hobbyist, and prone to go to extremes in support of particular modes of practice. Such physicians it is safest for patients to avoid. DIET OF MOTHERS DURING NURSING is a matter of no inconsiderable importance. Some persons can eat and properly digest almost any thing in common use, others find difficulty in digesting cer- tain articles. Careful observation will enable one to learn what disagrees, and such articles should be avoided, because any thing that disturbs the diges- tion of the mother is sure to impart deleterious prop- erties to the milk, and thus injure the babe. During the four weeks after confinement the diet should be restricted to panada, toast and tea, light bread pud- dings, bread and butter, with fruits, or other light diet; but after that period only care, as above re- marked, will be necessary. The influence of the mind of the mother over the quality of the mam- NURSING AND FEEDING. 281 Nursing and Feeding the Child. mary secretion is well established, and many cases are on record where a violent fit of anger or other terrible mental emotion has been followed by convul- sions or other severe disease in the child, and re- sulted in death. If the child's bowels are relaxed the mother should be spare in her diet; if the child is constipated let her use fruits in abundance, with a liquid diet, as soups, to secure a more laxative quality in the milk. These means failing, a few tea-spoonfuls of the juice from stewed prunes may be given to re- move constipation, and a small quantity of sirup of blackberrv-root or extract of cranebill, to control diarrhea. But diarrhea usually results from injudi- cious feeding of the child. The well-being of the in- fant must depend in no small degree upon the care and judgment exercised in NURSING AND FEEDING it, and it often happens that the quantity is more at fault than the quality of the food. If a child is sup- posed to be hungry, and is nursed or fed every time it is cross or fretful, it will likely continue cross or become positively ill. If the mother has even tol- erable health her milk is the proper aliment for her child, not only during tender infancy, but for several months. The quality of the milk alters with the ad- vancing age of the child, becoming more rich in casein, thus adapting it to the increasing demands of the 24 282 woman's monitor. Analysis of Human Milk. growing child. We give the mean of eighty-nine an- alyses of human milk by MM. Vernois and Bec- querel, which yielded the following results. It has a specific gravity of 1,032.67, and is composed of Water 889.08 Solid matters 110.92 These solid constituents are made up of Sugar 43.64 Casein and extractive matter 39.24 Butter 26.66 Incombustible salts 1.38 110.92 Says Dr. West, from whose excellent work on children we draw the above table : "How small must be the ef- fort needed to effect the assimilation of this fluid ! The chief of its solid constituents, the casein, differs little if at all from the albumen of the blood, while in com- bination with it is a considerable quantity of phos- phate of lime, a salt that enters largely into the composition of the bones. Among its other compo- nents we find butter and sugar, the former of which probably contributes to the formation of fat, that is so abundantly deposited in the healthy infant, while the remainder of it supplies material for the genera- tion of heat, by being resolved together with the sugar into its ultimate elements of carbonic acid and water. While we advocate mothers nursing their own children, and also the propriety of securing wet- nurses, under circumstances of necessity, we would INDIGESTION. 283 Changing Nurslings. Indigestion. caution against a practice quite prevalent at parties and like gatherings in the rural districts, of mothers changing nurslings and allowing strange babes to have the breast. First, the change of milk may in- jure the babe ; second, the cases are not uncommon where syphilis has been communicated in this way, where the presence pf the subtile poison was least suspected by any but the infected party, sometimes not by them." INDIGESTION, among infants, is the cause of most of those severe bowel affections that afflict them, causing the horrible emaciation familiarly known among the people in the rural districts as "taking off," a trouble for which almost every remedy is tried except the right one- care in diet. The child is cross, acts as though it was hungry, because its stomach feels uneasy; it is given the bottle or the breast, gorges ks stomach, already overloaded, the milk is either ejected by vomiting, or sours, causing irritation of the stomach, which is too feeble to digest the amount forced upon it; the stomach passes the undigested mass into the bowels, where it ferments, causing cholera infantum, or diarrhea, with those ' offensive stools so often no- ticed by those in charge of sick infants. It is a common practice under such circumstances to feed the baby stronger food, assuming that the starved 284 woman's monitor. Treatment for Indigestion. appearance of the child indicates that its food is not sufficiently nutritious. No error could be more fatal to the poor babe; it is not the amount of food put upon the stomach, but the amount well digested, from which the child may draw nutriment to make new blood, that determines the amount of material it really receives into its system to support its failing vital force. It is true healthy breast-milk is digested with wonderful rapidity; the child may fill its stom- ach to distension, and in two or three hours be ready for another meal. Usually the babe should not be nursed oftener than once in three to four hours. As it grows older the distance between feedings may be increased ; for the amount of the casein in the milk increases. One meal should not follow another so quickly as to prevent proper digestion of the one that has possession of the stomach. ' If it becomes evident that the child is failing in flesh for the want of proper digestion, its bowels should be cleared of the sour milk with a small quan- tity of castor-oil, or tea-spoonful doses of aromatic sirup of rhubarb, and but a very small quantity of the milk allowed at intervals of at least three hours, gradually increasing the quantity as the returning power of digestion appears to warrant. Very small doses of pepsin three times daily appear to assist digestion in some cases. A small piece of rennet, such is is used by cheese-makers, if fresh, or not too THE SOOTHING SIRUPS. 285 Do not give Soothing Sirups. salt, may be put into a teacup full of boiling water, and tea-spoonful doses may be given after nursing. This is a very efficient means of using pepsin. In- digestion is always the result of improper methods of feeding, or improper food, and diarrhea is usually the signal of indigestion, and in tender infants will, if taken early, yield to cleansing the bowels, as above directed, and proper care in diet. When infants cry from colic, and are restless from indigestion, too many mothers resort to laudanum, paregoric, or one of the soothing sirups which are advertised all over the country. Mothers ! if you have the well-being of your little ones at heart do not give THE SOOTHING SIRUPS. I know it is convenient to do so at times; but when a child is sick enough to take such powerful drugs, you need the advice of a physician, who, if an intelligent and conscientious man, will resort to such stupefying poisons only to remove danger in extreme cases — certainly not habitually to keep the child quiet. They are all dangerous, under whatever de- ceptive name they may veil their baneful poison, and hundreds of children die from their habitual use, vic- tims of ignorance on the part of mothers, and decep- tive advertisements on the part of heartless venders, at whose hands the blood of thousands of murdered 286 woman's monitor. Again we say, Avoid Soothing Sirups. innocents will be required. But the bad effects of these narcotics are not alone manifest in the number killed outright. Every educated physician knows that convulsions are often produced from slight causes in children long accustomed to such medicines, be- sides the loss of bodily and mental power, epilepsy and insanity, which are more likely to attack in after life those whose early months or years were spent under the depressing influence of potent drugs. Nay, more ; they are apt to stamp upon the delicate nature of the child a craving for morbid stimulant, which in after years is gratified in opium eating, excessive use of tobacco, or alcoholic liquors. It will not do to point to individual instances of escape from these terrible penalties of violated law. Science emphat- ically declares that the reasons upon which these statements are founded are based upon laws of nature that must make exceptions rare, while the great, ap- palling fact, that they are doing much to deteriorate the race, stands out in bold relief. Better that the child should cry when fretful than sleep with its brain congested with opium, which is the anodyne base of all forms of soothing sirups. Better have a troub- lesome diarrhea, if overfed so as to produce such trouble, than to have the irritating contents of the bowels locked up there with narcotics, until their mucous surface is corroded by the fermenting mass, and incurable disease produced. SORE MOUTH. 287 Causes and Treatment of Sore Mouth. SORE MOUTH. We find several varieties of this trouble occurring in infancy. Some are contagious ; others arise from indigestion on the part of the child, imperfect assim- ilation of food on the part of the nurse, or some morbid constitutional condition present in the mother, and inherited by the child. We can not spare space to describe the various forms of this disease, only to give a few general directions. If the mother is re- laxed, bilious, or under the influence of malaria, she should take some mild alterative, as small doses of leptandrin, or extract of dandelion, three times daily; also tincture of iron, twenty drops, in a wineglass full of water, three times daily, and small doses of qui- nine, or some preparation of bark, as tea-spoonful doses of the compound tincture. The child should have its bowels cleared, and its diet should be care- fully regulated. A physician should prescribe all medicines farther than this for the infant, except the local applications to the mouth. A tea of sage and privey, sweetened with honey, is a common domestic remedy ; also a weak tea of the golden seal root. We are much in the habit of using chlorate of potassa, a saturated solution in cold water. A tea-spoonful of this may be put in the child's mouth every hour or two, and it may swallow it. It should be so put into, the mouth as to wet the surface as much as possible. If 288 woman's monitor. When to Wean, etc. the gums are very sore, and foul with matter, much relief may be obtained by washing freely several times daily, with a solution of crystals of carbolic acid two grains to the ounce of water; also with a weak solution of table salt. A few grains of borax to the ounce of water, sweetened with loaf sugar, answers well in some cases. WEANING. The proper age may be stated at one year, and the proper time in the Spring or Fall. If the mother is menstruating, is pregnant, or from any other cause it is apparent in the Spring that she can not nurse until Fall, she should wean, though the child is some months short of one year old, as the dangers to the child of weaning during the Summer months are largely in- creased. When it becomes necessary to wean before the child has become accustomed to a diet of mixed food, and especially if the necessity occur in Summer, great care will be necessary in the choice of the char- acter and quantity of food, lest the child suffer from cholera morbus, diarrhoea, or other bowel affections. Proper intervals of feeding should be most punctually observed, that it may not suffer long from a sense of hunger, and yet that one meal may not be introduced so soon as to disturb the digestion of the one that had preceded it. But little variety should be set before the child. Milk, with boiled rice, soft boiled VACCINATION. 289 Food for ihe Newly Weaned Infant. eggs, roasted potatoes, with milk, oat-meal gruel, simple meat broths, with bread or crackers, fowls, plain, boiled or roasted, plain rice or bread puddings, and such vegetables as potatoes, carrots, beets, and turnips, in moderate quantities, may be allowed ; not at first, of course, in great variety, but gradually adding to the list of articles as the child advances in age, and allowing but little variety at a time. Cold water or milk should, for obvious reasons, be the only drink ; when accustomed to their use they w T ill crave no other drink. Salt and high-seasoned dishes, fat gravies, and all richly cooked food, should be with- held, especially pies, pastries, and sweet cakes. Mothers who have nursed eight to twelve months, and discover pain in the back, and such other symp- toms as denote a tendency to menstruate, should wean immediately, if the season at all permit, as injury to the mother, and ofttimes sickness of the child, results from persistence in nursing under such circumstances. VACCINATION. This important operation is too often neglected or imperfectly performed, and frequently syphilis or other disease is introduced with the vaccine virus. No one but a physician should vaccinate, and the pus- tule should be inspected by the medical man at the end of ten days to make certain that the disease was 25 290 woman's monitor. Vaccination. correctly received. The failures of vaccination to pro- tect have been mostly owing to negligence in this respect. We believe revaccination is often necessary, and that persons traveling abroad or otherwise exposed are wise to revaccinate. Infants should be vaccinated when about four months old, but the prevalence of small-pox or the necessity for making a long journey where the child would be exposed to the dangers of contagion, would justify vaccinating much earlier. The prevalence of erysipelas, diphtheria, scarlet fe- ver, or like epidemics, would deter us from hurrying children under the influence of the virus, except where parties are unusually exposed to small-pox. Most commonly but one vesicle is developed, but oc- casionally several small vesicles appear in the vicin- ity of the point of insertion. COURSE OF VACCINE PUSTULE. On the third day after the insertion of the matter there appears at the point of insertion a red elevation, which on the fourth day is surrounded by a narrow, inflamed base; on the fifth day the skin is elevated into a pearl-colored vesicle, filled with a small quan- tity of transparent fluid. The form of the vesicle depends on the manner of inserting the virus. It continues to enlarge in circumference but not in ele- vation until the eighth day, when it is at its height, with a pit in the center. Its margins are then red COURSE OF VACCINE PUSTULE. 291 Signs of Effectual Vaccination. and prominent, and contain some fluid. Between the eighth and ninth days some fever usually occurs; the neighboring glands are usually swollen and painful. Lassitude and drowsiness with slight creeping chills alternate with flushes of fever. On the tenth day the circle that surrounds the vesicle is broader and of a bright-red color. By the eleventh day the de- pressed center of the vesicle begins to assume a dark hue, and this darkness gradually extends toward the edge of the sore. By the fourteenth day the entire surface of the scab is dark brown. By degrees this becomes hard and separates from the eighteenth to the twenty-fifth day. The scar is not smooth, but marked with indentations. The above is an outline of the progress of the true vesicle. It should be carefully protected from rupture or injury during its progress. The progress of the disease is subject to considerable variation, but any decided variation should excite suspicion that the disease was not genuine, and the patient but imperfectly if at all pro- tected. Many persons suppose the disease must have been genuine if the arm was very sore. This is often a mistake, leading to exposure, unprotected, and pos- sibly to fatal results. I have been particular to give the above directions as to vaccination, because I have observed the want of care among parents with regard to this important matter; and those who neglect or refuse to avail themselves of this means 292 woman's monitor. Directions for Vaccinating. Teething of protection from loathsome disease should be com- pelled by law to be vaccinated at public expense as a means of safety to the public. This is a duty of government for the protection of children, whose des- tiny is yet within the control of parents or guardians. For the benefit of those who may not be able to se- cure the services of a physician we add, use no mat- ter but such as is known to be recently from the cow, and has not passed through scrofulous or diseased children. Crush a small quantity on a piece of glass, moisten with pure water, put a drop of the matter on the arm and scratch or pick through the matter sev- eral little wounds just through the skin, only suffi- cient to start an appearance of blood. Protect the wound by a soft rag or a piece of adhesive plaster, to prevent the child from scratching the sore. TEETHING. The first dentition usually commences at about the sixth month. The period is subject to considerable variation. There is in healthy children considerable variation as to the order in which the teeth appear. Those who develop their teeth at the usual time and in the usual order are less likely to suffer severely. The lower teeth appear two or three months before the upper. The twenty milk-teeth usually appear in the following order: TEETHING. 293 The Order in which the Teeth Appear. First. The two middle front teeth, between the fourth and fifth months. Second. The four upper front teeth appear; first the central, then the two lateral incisors, between the eighth and tenth months. Third. Between the twelfth and sixteenth months six teeth appear nearly at once. They are, first, the two front grinding teeth, in the upper jaw; next, the two lower front teeth, by the side of the two already through, and lastly the two front grinders, of the lower jaw. Fourth. Between the eighteenth and twenty-fourth months the child cuts its stomach and eye-teeth, as they are usually called. Fifth. The second four grinders make their ap- pearance between the thirtieth and thirty-sixth months. This concludes the first dentition. Sometimes chil- dren have already developed two or more teeth at birth, and cases are on record of adults who never cut any teeth. The permanent teeth begin to appear at about the fifth year, commencing with the front grind- ers. Between the fifth and tenth years all the front teeth appear. Before the twelfth year the canines have been added, also the second grinders; and be- tween the sixteenth and twenty-fourth years the four wisdom teeth complete the second dentition. 294 woman's monitor. Treatment During Teething. THE DANGERS OF TEETHING arise from a peculiar irritability of the nervous sys- tem, that appears to prevail at that period, rendering the infant more liable to spasmodic affections and bowel diseases. When the gums are hot, painful, and swollen they should be lanced, not across the crown of the tooth, as is usually done, but perpen- dicular with the gums, in the direction of the length of the tooth, so as to relieve the tension by pretty free bleeding. This is often followed by prompt re- lief, the extreme restlessness giving place to profound sleep. We believe the difficulties of dentition some- times arise from the want of a sufficient amount of the elements which make teeth and bone, in the blood, which may be supplied by small doses of the sirup of the phosphates of soda, potassa, iron, and lime. A very eligible preparation is sold in the drug-stores, sometimes called chemical food. If this is not readily procured take R Phosp. iron grs. 4 Phosphate lime " xx Sirup simplex 3 iv Mix. Shake before using, and give from a half to one tea-spoonful three times daily after eating or nursing. The second dentition usually requires but little care, except the timely removal of such milk-teeth as may be causing the new tooth to come in a bad posi- tion. Some children of feeble, rickety habit may re- RICKETS. 295 Proper Food. Rickets. quire medicine as above directed, increasing the dose to suit the age. It will secure better texture to the teeth and bones. Brown bread, however, will supply these with all the phosphates necessary, and where fresh meat can not be procured it is cruel to the young to bolt out that part of the wheat most needed in their bread and give it to the beast. RICKETS is a soft condition of the bones, or some of them, which allows them to bend under the weight, often causing deformity among children. Such deformity should always be prevented. If a child does not ap- pear strong in its back, nurse it carefully, and keep it strictly in a horizontal position, unless you are giving it proper support with the hands. You should rub and move it much, to give abundant exercise, moving every muscle, for a short time, several times daily. Do not allow such to sit up, to creep, or stand early. Great care, and the use of the phosphates of lime and iron, will usually suffice for a cure. The same preparation recommended to harden the teeth may be used ; the quantity of the phosphate of iron and lime may be considerably increased. • LUNG FEVER. This disease, usually called by physicians pneu- monia, is very common in infancy and childhood, and 296 woman's monitor. Inflammation of the Lungs, Symptoms, etc. frequently associated with hooping-cough or measles — so is bronchitis — and either may prove fatal. We introduce these remarks to call attention to the symptoms of inflammation of the lungs, because we frequently find children with one lung utterly ruined, whose parents, not aware of the nature of the case, supposed the child simply had a bad cold. They only consult a physician when it is apparent that some serious and lasting trouble exists. Of course it is too late then to do more than assist Nature to repair the injury. Too often the health is in this way perma- nently impaired. The symptoms of lung fever, or inflammation of the lungs, may come on gradually, or develop in the course of a bronchitis. The fever is usually worse in the afternoon, with quick breathing, and short, dry, hacking cough. This may be so trifling as scarcely to attract notice. Often a red spot will appear on one or both cheeks; in some cases a dusky hue will pervade the face. Often the lips and sometimes the tip of the tongue are of a florid red ; the tongue is dry, and usually covered in the middle with a thick white fur. The child is rest- less, possibly complains of pain in the head, tosses about, and likely talks while sleeping; does not breathe through the nose; tongue is applied to the roof of the mouth, as in health. Infants £uck by starts; seizing the breast eagerly, then suddenly quit, and begin to cry. Such are some of the croup. 297 A Physician should be Promptly Called. Croup. symptoms of this insidious malady; and several of them grouped together should induce parents to send immediately for the family physician. The disease may usually be readily controlled by enveloping the chest in a warm mush-jacket; not so heavy as to interfere with breathing; controlling the pulse with small doses of fluid extract of veratrum viride, fol- lowed by a little compound sirup of squills occasion- ally, to keep up bronchial secretion. In some cases an occasional dose of Dover's powder may be required. Do not neglect to support the patient with early wine whey; but these should be under the direction of a physician. CROUP. The symptoms of this frightful malady are too well known to require repeating here. Few persons have arrived at mature years who have not heard the hoarse, barking cough, or the difficult, croaking efforts to breathe. The disease is both spasmodic and in- flammatory. The inflammatory variety is most com- mon, and where the spasmodic variety is present, the treatment here recommended will usually relieve promptly. The cause is commonly exposure to damp and cold, and often in consequence of insufficient clothing about the neck. The inflammation which attacks the throat may be of the simple or non-ma- lignant kind, or of the malignant diphtheritic variety. 298 woman's monitor. Treatment for Croup. If the former variety is present the breath will not be putrid, as in diphtheria, and the general appearance at the commencement of the attack will indicate the absence of a severe blood-poisoning. In such cases give of the following prescription from one-fourth to one tea-spoonful every hour, until free vomiting is produced. Then reduce the dose one-half, and repeat every four hours, until the disease is subdued. Large doses will only resuk in severe vomiting. #. Compound sirup squills ^ iii. Tincture of lobelia § i. Mix. Dose as above directed. MALIGNANT CROUP. This variety occurs when putrid sore throat and diphtheria prevail. I have had ample reason to know this is a disease much to be dreaded, and only curable when taken early, except in a few cases. The inter- nal treatment is just the same as that which succeeds with unerring certainty in diphtheria and putrid sore throat, when timely applied, and will be given in full when treating of diphtheria. The local treatment, in addition to the gargles recommended for diph- theria, which has answered a good purpose in the hands of many medical men, is lime-water, used with a steam or hand atomizer. If neither can be pro- cured, slack quick-lime in a tea-pot, and let the patient breathe through the spout, or by some similar method apply the vapor. A solution of carbolic acid is DIPHTHERIA. 299 Symptoms of Diphtheria. worthy of trial, in the same way, for very putrid cases. The only difference between these cases of croup and diphtheria is the location of the local disease. DIPHTHERIA. This scourge I have only seen as it prevails in the Middle and Western States ; but from the reports of others I am convinced it has similar features every- where. In this part of the country it usually com- mences with a chill, often well marked. This is prob- ably preceded by some days of lassitude, in most cases. The breath is putrid, the eye has a small, heavy appearance, the countenance a leaden hue, the tongue is heavily coated with a brown or white and sometimes with a yellowish fur. The glands of the neck, and soft parts about the throat, swell rapidly, and become covered with a white coat of false membrane, which leaves a bleeding surface if pulled off. In malignant cases the color of the membrane is brown or dark, with a tendency to slough — holes in the part appear. This is 'most common in children of scrofulous habit, and those whose blood is deteri- orated with syphilis, hereditary, or acquired by vac- cinating with bad matter, or otherwise. In such con- stitutions it often proves fatal ; but in persons of fair constitution, untainted as above indicated, and taken before the powers of the system are entirely ex 300 woman's monitor. Treatment for Diphtheria. hausted, it yields to treatment as readily as inter- mi ttents do to quinine. Treatment. — Gargles — if the child is old enough to use them effectually — of salt and warm water, or five to ten grains of carbolic acid to a pint of warm water. From five to tw T enty-five drops, according to age, of tincture muriate of iron, taken in from a table-spoon- ful to a wineglass full of water every three hours ; from one-half a grain to two grains of quinine every three hours, and as much solution of chlorate of potassa — made by saturating cold water — as the pa- tient will take ; for an adult a wineglass full every hour the first few hours. If the case is far gone, or very malignant, we add hot whisky toddy quite freely. In diphtheria and malignant croup this course will give the best satisfaction of any before the profession, as I know from ample experience. After twenty- four hours the medicine can usually be given at longer intervals. PUTRID SORE THROAT. We regard this disease as erysipelas in the throat, and treat it just as we do severe forms of erysipelas elsewhere, and we know of no local application equal to creosolje, applied with a camel's hair pencil or a feather. For adults, it should be used pure; for children, re- duced with glycerine or sweet oil one-half or more, according to age. One thorough application usually SCARLET FEVER. 301 Treatment for Putrid Sore Tliro.it. Scarlet Fever. suffices to check the disease. Mild gargles, as recom- mended for diphtheria, may then be employed. In mild cases these may suffice if the internal treatment is perseveringly pursued; the chlorate of potassa, tincture of iron, and quinine, as recommended for diphtheria, adding whisky early in malignant cases, especially if the parts discharge much offensive mat- ter and the pulse is quick and thready. We some- times give carbolic acid internally in this disease with excellent effect. Tea-spoonful doses of a solution made by adding one grain of crystals to an ounce of pure water or glycerine for a child three years old, proportionately less for younger children, will usually be found sufficient to relieve the fetor of the breath and avert general septicenia. SCARLET FEVER. This disease has proved one of the greatest scourges of humanity. One attack usually renders the system exempt from future invasion. It is eminently con- tagious, and usually prevails as an epidemic. The malignancy of the epidemic appears to depend upon the associate endemic or epidemic influences. Under favorable influences, as to climate, condition, etc., it is a very mild disease, usually known as scarlet rash. When associated with putrid sore throat o: diphtheria it is eminently fatal, and is sometimes very severe when the affection of the throat appears to be of an 302 woman's monitor. Scarlet Fever Contagious. Disinfectants inflammatory character. The throat affection is liable to extend along the eustachian tubes to the inner ear, ofttimes producing suppuration in the labyrinth, with destruction of the ear-drum, followed by tedious chronic inflammation, causing incurable deafness. Other causes less severe cause closure of the tube leading from the throat to the ear, producing a par- tial deafness, that may be in some measure remedied b}' perforating the ear-drum so as to admit air. The affection of the throat at times extending to the nasal passages leaves a severe form of catarrh. The con- tagious element will linger about houses and in gar- ments for many months. Hence all who have had the disease about the house should observe great care in cleansing and fumigating with chlorine, carbolic acid, or like agents, and thorough ventilation for some time, be- fore any one subject to the disease should be allowed to be exposed. The disease usually appears about the fifth day after exposure — Condie, on children, says, " From the third to the fifth day, though we have often known it to be postponed until the tenth or twelfth." The symptoms are the same as those manifest on the approach of other forms of fever, as lassitude, restless- ness, uneasy sensation in the head, and weak pulse, with pale face. These symptoms continue from one to three days, when well-defined fever occurs, and about the second day of the fever a rash is developed. This is diffused, not so distinct as in measles, is most SCARLET FEVER. 303 Treatment of Scarlet Fever. Preventive Measures. vivid about the flexures of the joints and around the loins. In malignant cases there is a dark swarthy appearance of the surface, and the skin has a pun- gent, burning feeling to the hand. Small vesicles sometimes appear. On the fourth day the eruption is usually at its height, and is generally entirely gone by the completion of the seventh day. Early in the case the throat is sore; the amount of swelling and character of the sore throat will depend on the asso- ciate epidemic influence, and in some degree upon the constitutional condition of the patient. The lips are red, the tongue dry, red, and pointed. The above description marks the disease in its inflammatory form. We can not trace its various forms, only to say that it is subject to a great many variations, de- pending upon the previous habits of the patient and the character of the disease of the throat. Prevention. — Many physicians have implicit faith in belladonna. When it fails entirely to prevent, it no doubt modifies the disease to some extent. Its method of preparation and administration is as fol- lows: Dissolve two grains of recent alcoholic extract of belladonna in one ounce of aromatic infusion or half an ounce of water, adding half an ounce of whisky, to prevent souring, and of this give two drops twice daily to a child one year old, adding one drop for every additional year up to twelve. This is the largest dose usually required. Give morning and 304 woman's monitor. Treatment. evening. It should be continued for ten or twelve days, then omitted, after a few days' rest resumed again, and again left off, so continuing as long as the epidemic prevails. In addition to this, all mince- pies, sausage, or fat pork, and lard in every form should be prohibited, but a full diet of fruit, vegeta- bles, and lean beef or mutton, with fresh fish (no stale fish) allowed. I usually give also chlorate of potassa to those directly exposed. With careful ob- servance of the above I am convinced that the dis- ease can often be prevented and usually modified. If the rash is slow developing, I always give bella- donna freely until the rash appears. A mild dose of citrate of magnesia, to cleanse the bowels, and the use of from five to twenty drops of liquid bisulphite of soda every three hours, with chlorate of potassa, saturated solution, in cold water as a drink, will suc- ceed in ordinary cases. The internal use of carbolic acid in glycerine, as directed for sore throat, is at times necessary in very malignant cases. If the pulse is very rapid and putrid symptoms severe, whisky toddy appears to save life, and if given at all, should be with a liberal hand. When the burn- ing heat of the skin is severe and the restlessness great, prompt relief may be obtained by thoroughly anointing the body with lard; it checks the rapid oxy- genation of the blood through the skin. This may be washed off with warm soda-water the next day SCARLET FEVER. 305 Treatment Continued. and re-applied if necessary. To the throat, exter- nally, a piece of fat salt bacon is as good as any thing, possibly the very best application. Frequent gargling or washing with salt-water has no superior as a local application, although carbolic acid and cre- osote washes are at times of great service. The old barbarous plan of thrusting hard sponge probangs over the swollen parts, wet with strong caustics, is justly falling into disrepute, but still lingers in cer- tain localities, as a ghastly monument of the cruelty and barbarity practiced in the name of science upon the suffering children of a past age. After the fe- brile disease has passed away, and during the period of scaling, many children become dropsical. These may usually be relieved by keeping the bowels open with small doses of cream of tartar, three times daily, and toning up the system with small doses of tincture of iron — from five to twenty drops, accord- ing to age, in water, three times daily. It will be apparent from the foregoing statements, that the treatment of scarlet fever must depend in its most essential features upon the prevailing epidemic type, as manifest in the condition of the throat. If treated before the disease has destroyed all vital power the cases should be few indeed where a failure to cure would occur. It is one of those diseases of children that should, in all cases, receive the assistance of the best medical aid available. 20 306 woman's monitor. Measles Contagious. Symptoms. MEASLES. This is a contagious, eruptive disease, usually occur- ring but once, and is now generally supposed to have its origin in the mold or sporules developed in damp wheat or rye straw. It is not often fatal without the co-existence of lung fever, or other inflammatory affection, except when it occurs in the malignant form known as black measles. These cases appear to be measles associated with some low, depraved condition of the blood, such as occurs in diphtheria, and putrid sore throat, or typhus fever. In fact, the malignant forms of sore throat often accompany this variety. The disease then requires the same tonic and anti- septic treatment detailed when treating of those affections. In most malignant cases wine whey will be required early to assist in developing the rash, and sustaining the flagging vital powers. The period between exposure and the appearance of the disease varies from three to ten days. The disease commences with the usual symptoms of erup- tive fevers, to which are added all the appearance of a bad cold, as sneezing, watery eyes, and slight swelling of the edge of the eyelids, some degree of hoarseness, a hoarse, dry cough, and drowsiness. The bowels are costive ; sometimes there is vomiting. The eruption appears about the fourth day, first on the face,* then gradually developed over the body, MEASLES. 307 Treatment for Measles. appearing last upon the extremities. The eruption is at its height by the sixth day, and all, only a slight discoloration, has disappeared by the ninth. Some- times the cuticle peels off in minute scales. There is usually a severe bronchial cough, and want of care may cause a severe chronic bronchitis to linger. This is common with those who do not have the disease until after puberty. The eruption appears on the mucous surfaces, as well as upon the skin, and hence the bronchitis. Much difference of opinion exists among medical men as to the treatment of measles ; some giving cold drinks, others warm. We are of the opinion that the dangers of severe bronchitis, or lung fever, are largely increased by allowing the patient cold drinks. Only the mildest of laxatives are ad- missible. Small doses of carbolic acid appear to modify the disease. For a child three years old tea- spoonful doses of a solution of one grain to the ounce of glycerine; varying the dose as per age of child. Expectorant sirups are often required as follows : R Cox's hive sirup 3 j. Paregoric 3 *• Sweet spirits of niter 5 i. Fluid extract glycyrrhiza 3 i. Mix. Dose, tea-spoonful every three to four hours for a child twelve years old; reducing the dose according to age. A large majority of cases require only well- ventilated rooms, free from drafts of cold air on the patient, and plenty of warm drinks. The beverage I 308 woman's monitor. Treatment Continued. Roseola. prefer, because it combines the qualities of both vict- uals and drink, is oat tea, prepared by boiling two quarts of oats in half a gallon of water, until the grains are soft and bursting, adding water to preserve the amount of liquid. I have used this diet and beverage for many hundred little patients with happy effect. They may drink it largely, and will find it pleasant if slightly sweetened. If the breathing be- comes very rapid, and pain in breathing occurs, lung fever should be feared, and the family physician em- ployed. ROSEOLA, OR BASTARD MEASLES, is described in many medical books — r we think erro- neously — as scarlet rash. We prefer to use the term scarlet rash to designate the mildest possible forms of true scarlet fever, as it is usually so understood by the people. Roseola is an eruptive affection, closely resembling measles. It is said not to be con- tagious, an assertion we feel very much inclined to doubt. It is seldom accompanied with much fever or sore throat, and usually requires but little treatment. Many of those supposed to have had measles twice had roseola instead of a second attack of measles. Mild laxatives, and a diet void of greasy, exciting food, is all that is usually required. CHICKEN-POX. 309 Are Chicken-Pox and Small-Pox Identical? CHICKEN-POX. This disease occurs in quite a variety of forms, from a mild, vascular eruption, scattered over the body, and unaccompanied with perceptible consti- tutional disturbance, to a severe papular affection, with fever and all the symptoms of the milder forms of small-pox. Much discussion has taken place among medical men as to identity of origin for the two diseases, and great minds are arrayed on both sides of the question. Professor Bennett, of Edin- burgh, in his Practice of Medicine, edition of 1867, page 967, says : " Small-pox and chicken-pox have been observed in persons inhabiting the same room and sleeping in the same bed. Well-authenticated cases occurred of individuals inoculated with small- pox in whom the eruption assumed the appearance of chicken-pox ; and, again, persons inoculated with chicken-pox had small-pox well characterized. The work of Dr. John Thompson, entitled an Account of the Varioloid Epidemics of Scotland of 1820, con- tains many facts of this description, which were well known at the time, and an account of numerous ex- periments carried on at Castle Garrison, of this place, which have never been controverted, and which fully establish the essential unity in the nature of the two affections. It is evidently inconsistent to suppose that two distinct contagions should exist at the same 310 woman's monitor. Discussion Continued. time, each of which is protective against the other." Those who admit this doctrine must maintain that, whenever the chicken-pox contagion prevailed the small-pox contagion was excluded, or the reverse ; or, on the other hand, they must admit that small- pox is produced by the same contagion that gives rise to chicken-pox. The work of Dr. Thompson fur- nishes ample proof of the correctness of the latter proposition. We have observed a form of pustular disease spread through the country, which physicians called chicken-pox, and which was certainly traceable to contact with well-marked cases of small-pox. Some of these cases were very mild, the eruption being only vascular ; others were quite sick, and had numerous pitting pustules. Such cases would pass for small-pox, if the disease in its severe form was in the house or immediate vicinity. I have also ob- served that the disease becomes less severe as it spread by consecutive contagion to a distance from the original forces of contagion until reaching another village, where, finding among the ill-fed and depraved constitutions in filthy habitations, proper material for its development, it assumed a more malignant type, until well-marked small-pox was developed from germs apparently but chicken-pox. The above views of the identity of the disease will explain the reason why there is so much contention at times among physicians as to the nature of certain CHICKEN-POX. 311 Treatment for Chicken-Pox. How to Prevent Pits on the Face. eruptive affections prevailing. I am seldom disap- pointed in my expectation that vaccination will not take upon a person who has a few well-marked pits from chicken-pox. Such are already protected against small-pox. The milder variety of this disease re- quires no treatment ; only care not to take cold, lest some inflammatory complication occur. If the dis- ease is severe, with a well-marked pustular eruption, more care and treatment will be required. Give cooling, mucilaginous drinks, as gum arabic or slip- pery-elm bark tea. Let the room be well ventilated, and the diet light and nutritious. The bowels may be moved once in two or three days, with rhubarb or castor-oil. No active purgative medicine should be given. Physicians usually give Dover's powders at night to relieve the extreme restlessness so common in all this class of eruptive diseases. If the case is severe, or approaches in malignancy to a genuine small-pox, the bronchial cough, sore eyes, sore mouth and throat, will be more or less marked, and we treat the disease and its complications the same way we would a malignant small-pox, preventing pits upon the face by the daily application, with a feather or earners hair brush, of one part of glycerine and two of compound tincture of iodine. We have the most implicit faith in bisulphite of soda, also in carbolic acid, to modify the disease, and neutralize its malig- nant qualities. For a child twelve years old twenty 312 woman's monitor. Further Treatment. Mumps. drops every six hours of the liquid bisulphite of soda may be given in water. We usually alternate with this tea-spoonful doses of glycerine, seven parts, with Nichol's saturated solution of carbolic acid, one part, or two grains of the crystals of carbolic acid to the ounce of glycerine may be substituted. We have found the above to ameliorate all the severe symp- toms, and lead to a speedy convalescence cases of well-marked small-pox. Having considered chicken- pox and small-pox as but modified forms of the same disease, and given the treatment for the severer forms of chicken-pox, which we believe to be identical with the milder forms of small-pox, we will not treat of small-pox under a separate head, as such cases should be under the care of the family physician. MUMPS. This is inflammation of the glands at the angle of the jaw, whose office is to secrete saliva to moisten the mouth. It seldom occurs a second time in the same individual. It is usually epidemic. The dis- ease is at its height by the fifth day, when it begins gradually to disappear. It seldom terminates in sup- puration. Great care is required not to take cold. No treatment is necessary in ordinary cases. If the swelling of the gland is very painful a mild stimu- lating liniment maybe applied. A curious feature of this disease is its tendency to be transmitted to the HOOPING-COUGH. 313 Treatment for Mumps. Treatment for Hooping-Cough. testicles of the males and to the breasts of females. Cloths wrung out of hot water or a hot mush poultice should be applied to the neck, and cooling lotions to the inflamed organs, also small nauseating doses of tartar emetic may be given. In a few hours the disease will usually re-appear in the glands of the neck, when the suffering organs will be relieved. If this fails, after a fair trial, apply the warm poultice to the infljimed organs, and give a light dose of Ep- som salts. When it operates give full doses of Do- ver's powders, and continue the tartar emetic until relief is obtained. HOOPING-COUGH is a contagious disease of the larynx, usually occur- ring as an epidemic. Its symptoms are too well known to require description. During the early stages it should be treated with mild expectorants, as Cox's hive sirup, in slightly nauseating doses. When the hooping has fairly commenced great relief may be obtained by a few whiffs of a good cigar, also from the use of a sirup of skunk cabbage-root, given freely. If large quantities of mucus are thrown off, when the disease has become chronic, as much pulverized alum as will lie on a three-cent piece may be given in water every few hours to a child two years old, increasing the dose to twice that amount, according to age. This sometimes relieves 27 314 woman's monitor. Vaccination for Hooping-Cough. very promptly. The disease is dangerous in very young children, on account of the danger of associ- ated bronchitis or lung fever. Such cases should be early placed in charge of a physician. This disease is prone to be worse at night. Hooping-cough occur- ring about the period of puberty is apt to develop latent tuberculous troubles, also certain nervous affec- tions. Many remedies have been proposed by the profession, as tincture of Spanish flies, prussic acid, nitric acid, belladonna, aconite, bloodroot, and a host of others, proving by their very number that the pro- fession as yet have devised no certain method of cure. It usually becomes chronic, then the cough continues until it wears itself out with the change of season. In my hands, vaccination, if it has not previously been performed, has proved very efficient as a means of arresting the hooping-cough. This should be done about the close of the second week of the disease. Vaccination was recommended by Prof. Chapman, as far back as 1828, and has been extensively practiced in certain localities since. SEVERE COLDS. Arrested cutaneous secretion from exposure or sud- den chill, especially from going into a cold atmos- phere from overheated rooms, is a means of disturb- ing the equilibrium of the physiological forces, that not unfrequently results in severe disease. Espe- BRONCHITIS. 315 Colds. Treatment. Bronchitis. cially is it likely to produce bronchitis or lung fever. The first symptoms of injury from such causes are denominated, in common parlance, a cold. Among children such difficulties often terminate in a croup, or other disease of the respiratory organs. It is always best to endeavor to break up such trouble by securing a return of the proper secretion of the skin. This may be effected at times by soaking the feet in hot water on retiring and drinking freely of elder- flower, peach-leaf, or marsh-mallow tea. In some cases where coldness of the extremities and a lan- guid condition of the circulation prevails, ginger tea, in limited quantity, may be used to advantage. The spirit vapor-bath, or steaming, by preparing the pa- tient as elsewhere directed for the spirit vapor-bath, and putting a hot brick in a pan of water under the covering (using great care not to scald the patient), is useful. All forms of bath which secure sweating should be followed with a towel wet with tepid water and thorough rubbing with a dry towel. BRONCHITIS is very common during childhood. It is the form of disease most commonly present when a child is sup- posed to have taken a cold upon its lungs, and may be known by the rattling of mucus in the tubes when the child breathes, and by the expectoration of large quantities of tough mucus, the expectoration becom- 316 woman's monitor. Treatment for Asthma and Phthisic. ing thin as the case advances. Emetics of Cox's hive sirup or tartar emetic, are useful in the early stages, also small doses of the expectorant sirup, mentioned when speaking of measles, given every four to six hours, will usually effect a cure, especially if proper care is observed as to dress and ventilation of rooms. ASTHMA OF CHILDREN, or phthisic, as it is popularly called, is sometimes as- sociated with bronchitis, and requires the same treat- ment, except it may be necessary to give a few drops of sulphuric ether, tincture asafoetida, or tincture of valerian, to remove the spasmodic action of the air- tubes, that gives to the bronchial attack its peculiar asthmatic type. Phthisic appears at times to be purely spasmodic, coming on at intervals with much severity. This form of the disease, as well as spasm of the upper part of the air-tube, is sometimes ac- companied with frightful difficulty of breathing. If the mild antispasmodics above named do not relieve, bromide of potassium, ten grains dissolved in water, may be given every two hours until relief is ob- tained, or the same amount of hydrate of chloral, given in the same way. The above dose for a child ten years old should be increased for older and di- minished for younger children, according to age. Children subject to throat and lung troubles should CHOLERA INFANTUM. 317 Consumption among Children. Cholera Infantum. be dressed warmly, with flannels next the skin, at least during the entire cold and damp seasons. While speaking of lung difficulties, permit me to re- mark that very young children, as well as older ones, die of consumption; that the disease is sometimes lingering with children, but more frequently is very rapid in its course. Many children who rapidly de- cline and die with cough, indigestion, and severe diar- rhea, and are supposed to be victims of some bowel disease, really die with consumption. tHOLERA INFANTUM, or Summer complaint of infants, is a disease of very frequent occurrence. It occurs usually during the second Summer, or the period of the first dentition, but may appear as early as the sixth month, and sometimes as late as the fourth year. It appears at times to be dependent upon the change of diet, when deprived of the mother's milk. It is more common when children are raised upon a mixed diet or by the bottle. It is mostly prevalent during the hottest part of Summer. It is usually preceded by a diar- rhea. At first this produces no alarming symptoms. Some slight error in diet, a chill from malarious in- fluence, a sudden change in temperature, or other cause, suddenly aggravates all the symptoms. The discharges become more frequent, and there is con- tinuous nausea, with inability to retain either fluids 318 woman's monitor. Diagnosis of Cholera Infantur or solids upon the stomach. The skin also is harsh and dry, the pulse hard and frequent. Sometimes the skin is covered with a cold, clammy sweat, and has a doughy feel, the extremities cold, and the pulse feeble and frequent. Extreme restlessness, rolling the head from side to side, with stupor, indicate con- gestion of the brain or effusion of serum into the ven- tricles of the brain, or sack of the arachnoid mem- brane, which envelops that organ. The disease is sometimes chronic, commencing with a simple diar- rhea — stools watery, at times mucus or blood in them, often mixed with green strings or shreds of colored mucus. In other cases they are gray or gray colored and very offensive. There is a great desire for drinks, which usually produce vomiting, or appear to excite operations from the bowels. The child wastes to a skeleton, the eyes appear sunken and heavy, with dark eyelids. Ofttimes the counte- nance assumes a sallow or yellowish cast, and the skin appears to be drawn tight across the forehead, having a shining appearance. The child appears worse in the afterpart of the day. The symptoms may be summed up as great prostration, intense de- sire for drinks, vomiting, and loss of flesh. If the case is not complicated with disease of the brain or its membranes, the child will probably recover under proper treatment. Sometimes the brain disease ap- pears to produce the bowel symptoms, and such cases CHOLERA INFANTUM. 319 To Arrest Vomiting are usually fatal. Head complications are apt to occur if the case is neglected in the early stages or badly treated. Treatment. — To arrest the vomiting give from one to four tea-spoonfuls of the following mixture every three hours: R Aromatic sirup of rhubarb ^ ii. Bicarbonate of soda g ss. Peppermint water 3 "■ Mix. This clears the bowels, and thus removes the irri- tating contents. If the vomiting and diarrhea con- tinue, take the bark of young peach-tree limbs, put it into a vessel, and cover with boiling water, and let it stand till cool. In some cases, where great heat is present, it may be necessary to put ice into the tea. Give one-half to one tea-spoonful, according to age, every fifteen to thirty minutes. This remedy is highly spoken of by Professor Scudder, of Cincin- nati, and is a popular remedy in bowel complaints of older children, given in much larger doses by the country people, and is usually given warm. Strong coffee, without sugar or cream, given in tea-spoonful doses every thirty minutes, will often arrest vomiting in these cases. This is especially indicated in such cases as are accompanied with stupor and contracted pupils, a class of nervous symptoms closely resem- bling those from full doses of opium. Where the coffee fails the following will often arrest the vomit- 320 woman's monitor. Diarrhea should not be Arrested too Suddenly. ing : Subnitrate of bismuth one drachm ; Peppermint water two ounces ; shake thoroughly, and give from one to two tea-spoonfuls, according to age, every hour, until the vomiting is arrested. In chronic cases, where the diarrhea persists, one ounce of ge- ranium root boiled in one pint of milk or water, and given in table-spoonful doses every one or two hours, or blackberry root, prepared in the same manner, will often correct the trouble. It should be borne in mind that it is not best to arrest the diarrhea too suddenly, as the discharge is sometimes Nature's method of keeping down irritation from improper diet, or other cause, and fever is excited by arresting the discharges suddenly. If much griping accom- pany the discharges it may be proper to combine with the treatment from one to five drops of -laudanum every four hours, adapting the dose to the age of the child. External applications are not to be forgotten, as wilted horse-radish leaves, light mustard poultices, stimulating liniments, tincture of camphor, or, what I prefer, a few drops of chloroform on the hand, ap- plied over the stomach and bowels, and along the back, until the skin is red. Many other remedies of a more powerful character are in use by physi- cians, both for internal administration and by sub- cutaneous injections. But these are too powerful to be used without the advice of a physician, to whom all bad cases should be intrusted. I have treated CHOLERA MORBUS. 321 Diagnosis of Cholera Morbus. of this dangerous disease at some length for the benefit of persons in the rural districts, who ofttimes find it difficult to secure promptly the services of a physician. CHOLERA MORBUS. This disease is very common among children, as well as adults. It is most common during the Sum- mer months, and among children about the period of the second dentition. Its leading symptoms are vomiting and purging. The evacuations at first con- sist of the contents of the stomach and bowels, sometimes, also, considerable bile. But in some cases they soon assume a dirty yellow color, soon chang- ing to a colorless or milky fluid, not unlike the rice- water evacuations of Asiatic cholera. In bad cases the same cold, clammy condition of the surface ap- pears, accompanied with muscular spasms, closely re- sembling the cramps of the true cholera. Thus the case progresses until the patient sinks into collapse and dies, comatose from exhaustion of the vital forces. After the vomiting and purging have re- moved the irritating contents of the stomach and bowels, the disease is usually arrested by reaction of the vital powers, with or without the promptings of treatment. Sometimes it is associated with the irritation of worms in children. Such are very apt to have convulsions during the attack. The disease 122 WOMAN'S MONITOR. Cause and Treatment of Cholera Morbus. is almost always caused by over-indulgence in melons, fruits, or green succulent vegetables. Fermentation of the undigested mass generates acrid material, which readily excites disease, especially if the patient suffers from sudden suppression of perspiration, or the enervating influence of marsh malaria. Treatment. — In many cases all that is required is to drink freely of warm w T ater, containing in solution a very small quantity of table soda. If the stomach contain irritating material not readily dislodged, it may be proper to give an emetic of ipecacuanha*, ground mustard, eupatorium (bone-set), or lobelia tea. Mustard, or other external counter-irritant, should be applied. If the vomiting and diarrhea continue, a few drops of laudanum may be given, according to age, from five to fifteen drops. This should not be repeated oftener than once in two hours, and no more given after the pain and diarrhea cease. Peppermint or spearmint tea will usually answer, without the laudanum. Small doses of the neutralizing cordial, for which a formula will be found in the article on diarrhea, is very prompt in affording relief. If evi- dence of worms is present, some form of worm med- icine should be given, and an associate ague, or chill fever, should be removed by the use of quinine, as soon as the vomiting and purging are controlled. DIARRHEA. 323 Diarrhea. Treatment. DIARRHEA. This disease may be caused by the irritation of material that should be removed from the stomach and bowels. Such cases should be treated by emetics, if it is desirable to unload the stomach, or by light purging, if the source of irritation is in the bowels. For filling the first of these indications ipecacuanha is probably best. For clearing the bowels, soluble citrate of magnesia, rhubarb, or castor-oil, will answer very well. If the discharges are light, or clay-col- ored, some remedy to act on the liver should be given, as from one-eighth to one-half grain of leptandrin, according to age. As a corrective, no remedy is better than the neutralizing cordial, as it will alone often check diarrhea, cholera morbus, or dysentery. We give the formula. Take Best Turkey rhubarb 2 ounces. Pulverized peppermint plant J " Pulverized allspice | " Bicarbonate of soda |- " Pulverized cinnamon J " Pulverized prickly-ash berries 2 " Crushed geranium root 2 " Soft water two pints ; simmer slowly to one and a half pints ; strain through fine cloth, then add one- half pound of loaf sugar, boil to dissolve the sugar, and when cool add two ounces of the best brandy, stir well, then bottle and cork for use. Dose, from 324 woman's monitor. Dysentery. Treatment. half a tea-spoonful to a table-spoonful, according to age and the effect desired. To a child five years old a tea-spoonful may be given every two to four hours, with the best results, in diarrhea or dysentery. More brandy may be added if the child is much reduced from loss of blood or the exhausting character of the discharge. DYSENTERY, OR BLOODY FLUX, may be known from an ordinary diarrhea by the vio- lence of the symptoms, pain and straining at stool, and the bloody, or mucous discharges. This disease is often accompanied with malarial fever, requiring antibilious physic and quinine, even in young chil- dren; but a large majority may be cured by moving the bowels with castor-oil, and giving small doses of the neutralizing cordial (for which a formula was given p. 323) every three hours, when the pain is severe. A few drops of laudanum in starch-water, thrown into the bowels with a syringe, is very useful, as the cordial may not be at hand, and requires time to make it. We give a formula which is an excellent substitute, which can readily be procured at any drug- store, and which we have prescribed many hundred times for children : # Aromatic sirup of rhubarb oz. ii. Fluid extract of geranium oz. i. Essence of peppermint Z x - Bicarbonate of soda " ss. worms. 325 Worms. Nauseating Drugs. Best brandy to make four ounces. Dose, one- fourth of a tea-spoonful to a tea-spoonful, according to age. We have said but little about the diet of children afflicted with disease of the stomach and bowels, be- cause the rules laid down elsewhere in the course of this book are sufficiently plain as to the necessity of care not to irritate the stomach with any food that would be hard on it, but to confine the child to the mildest- and least irritating diet that the circum- stances admit of. WORMS. Well do we remember the huge doses of nauseating vermifuge which it was fashionable to pour down the throats of children when we were young, and to this day the remembrance of those horrid potions causes a sense of sickening disgust, though reaching us on the wings of memory from beyond the shadows of more than thirty years. Thanks to the. progress of chemical science, those pests of childhood are now removed by agents so pleasant to the taste that chil dren seldom complain when required to take ver- mifuge. Varieties. — There are six varieties usually met with, but several other kinds are occasionally found. For all practical purposes they may be described under six divisions. 326 woman's monitor. Worms Continued. First, the long round worm, sometimes called by physicians, LUMBRICUS. It resembles the earth-worm, and is supposed by some authorities to belong to the same species. Ev- ery one is familiar with its appearance. The female is the largest, while the male is more pointed at the posterior extremity. The males are not so numerous as the females, and it is supposed more difficult to expel. This worm is usually found in the small in- testines, though sometimes it passes into the stom- ach, causing severe vomiting, and by passing up the oesophagus it may cause severe choking and great distress, sometimes convulsions. Worms are often expelled from the stomach b}' vomiting. They sometimes penetrate the walls of the tube, and are found, after death from inflammation or convulsions, in the cavity of the abdomen. It is doubtful whether they ever penetrate a sound intestine, but pass through ulcerated spots, which were nearly through and required but little force to secure a passage — at least, chronic ulceration existed in the two cases that have fallen under my observation, and such was the state of the bowel in all cases reported to me by professional friends. Much diversity of opinion has existed as to the origin of this species of worms, some contending that the doctrine of spontaneous WORMS LUMBRICUS. 327 Cause of Worms. generation is a philosophic necessity, others that they are produced from germs introduced from with- out. Against the latter idea may be urged the fact that they have been found in the intestines of still- born children. We can not spare the space to discuss this point. We believe, however, that the germs are received with the food or water. It is claimed by Eschricht that one female may produce sixty-four million ova. These are either developed in the bow- els or cast off with the stools, to find their way into other individuals and developed there. Abundance of mucus appears to be necessary for their propaga- tion, and the irritation of their presence favors its se- cretion. Indigestion is a fruitful source of worm de- velopment. Indeed, it may well be doubted whether they will breed in a healthy bowel where digestion and chymification is perfectly performed. Overeat- ing and improper food favors their propagation, so does a scrofulous condition, especially that form of the disease which affects the glandular structure of the bowels. The period of life most subject to these parasites is from weaning to the period of puberty, though young babes are at times afflicted, especially those allowed a mixed diet, and adults also are sub- ject to them. It is supposed by some that the ma- ternal state favors the development of worms, and in practice it is often found that women get along badly in consequence of the irritation of worms, and re- 328 woman's monitor. Symptoms of Worms. Treatment cover immediately on their expulsion. This may be accounted for by the indigestion and fermentation of food so common with pregnant females, caused by over-indulgence in food. Symptoms. — The symptoms of worms in the bow- els are the same as those arising from intestinal irri- tation from other causes, such as restless nights, starting in sleep, irregular paroxysms of fever, pale- ness around the mouth, extending up the side of the nose, itching at the anus, a dry, hacking cough, swell- ing of the eyelids and upper lip, especially in the morning; sometimes St. Vitus' dance or epilepsy, frequently convulsions. These symptoms may not all be present, but several of them grouped together should excite suspicion of worms, although it is cer- tain most of these symptoms often arise from other causes. We regard an irregular and at times vora- cious appetite as indicating worms. The influence of worms over the health of children is no doubt vastly overrated, yet it must be admitted that they very frequently by their irritation cause serious disease, and no doubt sometimes destroy young children. The microscope will reveal the eggs in the discharges if a person has worms. Treatment. — The long, round worm may be removed by a variety of medicines. If convulsions are pres ent some antispasmodic should be given. Equal parts of tincture of asafoetida and sulphuric ether is an ex WORMS LUMBRICUS. 329 Treatment Continued. cellent remedy, dose varying from fifteen drops to a tea-spoonful, according to the age of the child. Chlo- roform applied along the spine so as to redden the skin, and a few drops given internally, is sometimes very efficient. If the child can not swallow, the chloroform should be given, by inhalation, until the convulsions are controlled. The bowels should then be cleared with castor-oil, in full doses, to which from ten to sixty drops of turpentine should be added, ac- cording to age. Children over twelve years and adults may safely take one tea-spoonful of turpentine to a table-spoonful of castor-oil for a dose, and repeat in three or four hours until the bowels are effectually cleansed. We then give santonine, from one to five grains, according to age, either sprinkled on bread and butter or combined with sugar. It is almost tasteless, and should be repeated three times daily for four or five days, and the oil and turpentine or other form of purge then given. If thought neces- sary this process may be repeated. We have known large numbers of worms to be found in the bed in the morning, having crawled away from the children under a course of santonine. It causes the water of the patient to present a deep }^ellow color, and if the dose is too large, will disturb the nervous system, and irritate the bowels and kidneys ; hence hhould be used cautiously. It is then perfectly safe, and the only remedy I have found it necessary to resort to 28 330 woman's monitor. Treatment Continued. in an extensive practice for the last ten years. As soon as the worms are expelled a careful diet should be enjoined and some bitter tonic, as gentian, quas- sia, or Peruvian bark tea, or tincture, used three times daily, for some weeks, to restore the tone of the bow- els. Sulphate of iron, in doses ranging from one -half to two grains, added to the tonic dose above men- tioned has proved very effectual in preventing the re- development of the worms, no doubt partially on ac- count of its tonic virtue, and partly because it checks the secretion of mucus so necessary as a nest for hatching the eggs and developing the young para- sites. Pink and senna is a very powerful vermi- fuge, but more severe on the nerves and eyes than santonine. Oil of worm-seed is dreadful to take. It enters into the formula of most all the old-fashioned vermifuges that have of late been supplanted by the worm-lozenges. These are efficient only as they con- tain santonin e. Santonine is the only agent now known that is a powerful vermifuge and nearly taste- less. The dose of the oil of worm-seed is from five to ten drops three times daily. Strong tea made of tansy or wormwood drank freely is an excellent ver- mifuge, much prized among the people in the rural dis- tricts. To effect a cure they must be continued three times daily for several weeks. Many other remedies have been recommended for this variety of worm, but the above are sufficient for all practical purposes. WORMS — ASCARIS VERMICULARIS. 331 The Thread Worm. ASCARIS VERMICULARIS. This worm, sometimes called the thread, seat, or maw-worm, inhabits the iurge intestine. Its length varies from a sixth to half an inch. They occur chiefly in young children, though we have known not a few adults afflicted with them, and occasionally they occur in the aged. They cause an intolerable itching, especially at night. In girls they sometimes migrate into the vagina, and excite inflammation, with copious mucous or purulent discharge. They excite the sex- ual organs, leading to masturbation, and in boys to spermatorrhoea. On examination of the stools they appear adhering to the faeces; on close examination they may usually be found about the anus. They impair the health by causing nervous irritation and loss of rest. Treatment. — The same means may be used to im- prove digestion as are recommended for the long, round worm, and if any, the same vermifuges may be employed. But the best way to rid persons of these worms is to thoroughly inject the bowels twice daily with tansy-tea, or a tea made by adding one pint of boiling water to two ounces of quassia chips. Flint, in his practice, recommends soot-tea injections. A rubber syringe should be used, and not less than half a pint to one pint employed at every injec- tion. This puts the bowel on the stretch, and thus 332 woman's monitor. The Tape- Worm. reaches every fold. After injecting for three or four days, their return may be prevented by occasional in- jections, until every egg is hatched and destroyed. TRICHOCEPH?LUS DISPAR is named from the hair-like appearance of the head extremity. It is from an inch and a half to two inches in length; is male and female, and inhabits the caecum, sometimes the small intestines. It is occasionally found on dissection in persons of all ages, and is said to infest the domestic cat. It is not known that its presence gives rise to any serious trouble. It belongs to the same class as the worms found in such great numbers in the duodenum or lower stomach of the inhabitants at Milan, in Egypt, and which causes anaemia, occasioned by loss of blood, from piercing the wall of the bowel. It has but lit- tle practical importance in this country, and when its presence is suspected the treatment should be the same as recommended for the large round worm. TVENIA SOLIUM. This is the common tape-worm of this country. It may be distinguished by its ribbon-like form, and is composed of numerous sections or joints. As the name indicates, it is usually solitary, but occasionally two or more are found. TWard the head it is attenu- ated to a mere thread. It varies in length from four to WORMS — T^NIA LATA, OR BROAD TAPE-WORM. 333 Description of Tape- Worms. thirty-five feet, and the number of joints, resembling the seed of the gourd, sometimes reach one thousand. The head is very small and round or triangular, and under a good microscope presents four projections or suckers, and a double row of hooklets, numbering twelve or fifteen in each row. The hooks are some- times wanting. The joints are being continually thrown off and appearing in the stools. The exfoli- ated joints contain immense numbers of eggs. Prof. Bennett estimates the number of eggs in the tape- worm of the cat at 12,500,000. The number of ova in a large taenia solium found in the human body would number several millions. It is fortunate they do not develop into worms in the intestines of man or animals. Their origin and treatment will be described when treating of the T^NIA LATA, OR BROAD TAPE-WORM. The first variety prevails in England, France, Spain, Austria, Prussia, Greece, and Italy, where the broad worm, according to Flint, is almost unknown. Both kinds occur in Finland, Norway, Poland, Sweden, and the United States. The broad variety occurs chiefly in Russia and Switzerland. It is most com- mon also on the borders of seas, lakes, and rivers, and hence is supposed to be derived from the cystic entozoon, existing in fish. The common tape-worm irises from receiving into the system the cysticercus B34 woman's monitor. / Origin of Tape- Worm. cellulosae, which are common, especially in swine or sheep. Flint, in his practice of medicine, says it is the presence of these parasites in immense numbers which renders pork " measly." Of course such food eaten raw or partly cooked will produce tape-worm, though one fairly developed appears usually to pre- vent others from maturing. Possibly it may yet be proved that the tape-worm destroys the rudimentary beings of its own species. Thorough cooking de- stroys these germs. It is supposed by some that the cysticercus cellulosae does not exist in the ox, and as eating raw meat of the ox causes tape-worm, it has been denied that the tape-worm originates from that parasite. We think it remains to be proven that the parasite does not exist in beef, but regard the development of tape-worm from its use as evidence that they do exist in beef. Almost every person is afflicted with tape-worm in Abyssinia, no doubt from their habit of eating raw meat. It has been observed that pork butchers and cooks are pecu- liarly prone to tape-worm. The joints of the taenia lata are broader than those of the taenia solium. The tape-worm inhabits the small intestines, sometimes ex- tending into the large bowel. Its presence is denoted by well-marked symptoms, as dimness of vision, giddi- ness, ringing in the ears, itching of the nose and anus, salivation, disordered digestion, colic, neuralgic pains in the bowels, and emaciation. These symptoms mayorig- WORMS T.ENIA LATA, OR BROAD TAPE-WORM. 335 Symptoms of the Presence of Tape- Worms. inate from other morbid conditions of the bowels. The only certain symptom is the presence of fragments of the worm in the stools. A dose of castor-oil, turpentine, or other cathartic has frequently caused fragments of tape-worm to pass from persons who had previously considered themselves perfectly well. After the ex- istence of the worm is ascertained, disorders of all kinds are referred to it. The truth is, the import- ance of the tape-worm as a cause of ill-health has been greatly overrated. Hypochondriac individuals frequently imagine they have tape-worm, a kind of insane delusion which once fixed in the mind can not be readily removed. The worm will live for many years. It develops joints from the neck, and the joints at the tail are cast off. If no joints pass for many months it is probable that the worm is dead. No doubt they frequently die a natural death. When drastic purges break them near the neck the head perishes. The best means of prevention is to avoid uncooked dried beef, and indeed all forms of fish and flesh not cooked, so as to insure that every part has been heated to at least 190° Fahrenheit. Treatment. — Take pumpkin seeds, two ounces — some suppose those grown far South are the best — remove the shell of the seed, put them into a mortar, add half a pint of water, pound up well, strain through a cloth, and drink this mixture in the morning, fast- ins:. If it does not operate in two hours take two 336 woman's monitor. Treatment for Tape-Worm. table-spoonfuls of castor-oil, and one tea-spoonful of turpentine, or take fresh bark of the pomegranate root two and a half ounces, water one and a half pints, boil until reduced one half, when the whole may be given in the course of a few hours. This may be repeated every few days, until the worm is destroyed. It generally produces vomiting and purging. Another purgative medicine that has been given with great success is the hairs and powder from the capsules of rottera tinctoria, the kamela. The dose is from one to two drachms, given in honey or thick gruel. It may be combined with extract of male fern. Pow- dered tin has been used, but is not so reliable as the above. In Abyssinia, where the tape-worm is very common, they depend on the dried flowers of a tree, kousso — brayera anthelmintica. Half an ounce of the powdered flowers are mixed in water, and taken every morning — the sediment being taken with the draught. Another remedy of great reputation is male fern, from one half drachm to a drachm, in divided doses, in the course of a few hours. Of the oil one to two drachms in mucilage ; of the extract twenty to thirty grains. This is usually given in milk. Large doses of oil of turpentine, from one to four table- spoonfuls at a dose, is a remedy that has maintained a reputation for many years. This usually produces symptoms of intoxication and active purging, often difficult urinating, yet the bad symptoms soon pass TRICHINA SPIRALIS. 337 Trichina Spiralis. off. The doses here referred to are for the adult — proportionally smaller doses for children. The above embodies all the most approved remedies against tape-worm known to the profession. TRICHINA SPIRALIS. This terrible scourge has doubtless existed from the earliest ages, and many cases supposed to be typhoid fever and rheumatism of an anomalous char- acter, were no doubt the result of the spread of these worms through the muscles of the body — the real cause of the disease not being suspected. They were discovered by Paget, and described by Owen in 1835. Professor Zenker, of Dresden, was the first to ascer- tain the source of the trichinal disease. They have been found in the muscles at the rate of eighty-four thousand to the cubic inch. They vary in size from A of an inch long, 9 i of an inch thick, to £2 of an inch long, and 6 io of an inch thick. Dr. Flint found in a piece of human muscle sent from Iowa, at the rate of 208,000 to the cubic inch. In experiments made by feeding trichinous muscle to animals it is found that they breed in the bowels at the rate of from 200 to 1000 for every trichina taken into the stomach, and this in the short period of ten days. These little parasites perforate the mucous surface of the bowels, and immediately direct their course to the muscles. 29 338 woman's monitor. Sy.nptoms of Trichinae. Treatment. The first symptoms of their presence is colic pains, with diarrhea and vomiting, caused by the irritation of their presence in the tissues of the bowels. If the patient survive this, pains, like rheumatism, with hardened and contracted muscles next, wear out the patient with intolerable suffering. Little can be done after they have left the bowels but to support the system, and render life tolerable with anodynes. If the patient can endure the pain and irritation until the worms become encysted, that is, inclosed in a sack — a process of nature to keep down the irrita- tion — then the patient makes a partial recovery. Treatment. — If the nature of the case is discovered before the young trichina have commenced to emi- grate, active cathartics should be given. Professor Mosler, of Berlin, recommends benzine; it destroys the trichina when given in such doses as to be readily borne by the patient. He gives it after the follow- ing formula : Benzine, two drachms ; an ounce each of licorice-juice and mucilage of gum arabic, and four ounces of peppermint water. Of this mixture give one table-spoonful every hour or two. Dr. Flint says the efficiency of this remedy in man remains to be established. The carbolic acid, in full doses, should be tried. Recovery will depend much upon the ability of the patient to endure the irritation until they become encysted. These worms are derived principally from pork, URINARY DIFFICULTIES. 339 Derived from Pork. and no process of smoking, pickling, or salting can be. relied upon to destroy the worms. Nothing short of 192° Fahrenheit is safe. I have found them in large numbers near the bone of meat bought in our market, and, after examining several specimens from different shops, found that few hogs raised about town are free from the parasites. This is no doubt due to their devouring the dead rats and cats found about the alleys, as well as the excrements of such a source, from which it is probable most of the trichina of swine is derived. Hog cholera is believed to be acute trichiniasis ; and it is patent to every careful observer that this filthy animal will eat the excrement of its sick neighbors, containing undigested grain, and no doubt millions of trichina, and in turn become afflicted. I am not informed to what extent the excrements of swine afflicted with hog cholera have been examined with the microscope, but believe here is a field for research that would pay for investi- gation. I have introduced this article on trichina to call attention of mothers to the necessity of thor- oughly cooking, to the very center, all the flesh they set before their children or friends. URINARY DIFFICULTIES. It sometimes happens that young infants fail to urinate from deficient action of the kidneys. A tea- spoonful of tea from the parsley root every half-hour, 340 woman's monitor. Treatment for Urinary Difficulties. or juniper berries, one table-spoonful to a teacup full of boiling water, given in tea-spoonful doses every three hours, will usually soon relieve the little one. Five to twenty drops of sweet spirits of niter, accord- ing to age, given in a little sweetened water, is also excellent. For older children these doses must be increased. A powerful agent to act on the kidneys of persons of mature years is table-spoonful doses of a tea made by putting one teacup full of boiling water on from half a dozen to a dozen honey-bees. The dose may be repeated every three hours. In- fants sometimes fail to urinate because the foreskin is closed over the organ, obstructing the passage. Such require the assistance of a surgeon. Many children do not retain their urine well, especially at night ; this may arise from a relaxed condition of the sphincter of the bladder, or from irritability of the bladder. Where the latter cause is operating, indi- gestion, causing acid by fermentation, and hence an acrid state of the urine, is usually the cause of the irritability. Small doses of soda should be given for immediate relief, and the tone of the stomach im- proved by appropriate remedies, and care in diet. Sometimes this trouble is kept up by worms in the bowels ; these should be removed. In other cases it is the result of habit, which may be broken up by proper moral restraint. This is especially true of those children who soil their bed ; it usually occurs SCROFULA. 341 Avoid False Modesty. about the same hour every night. If compelled to arise and evacuate the bladder the habit may be broken up. Where the incontinence is from relax- ation the accident may occur during the day, but is more likely to occur at night, while sleeping soundly. Those who have incontinence during dreams are usually onanists, or masturbators, and their dreams are of an erotic character. It is astonishing at what an early age children are troubled in this way; some- times as early as eight to twelve years. These should be treated as recommended when speaking of private vice. The remarks there made when speak- ing of female offenders will apply also to males. Mothers, do not allow false modesty to prevent you from doing your duty in such cases. When in doubt as to the best course to pursue, consult a physician. It must not be forgotten in the investigation of these cases that the irritation of seat-worms, distension of the bladder, or the acrid character of the urine, may be the cause of dreams leading to voluntary effort to urinate during sleep. SCROFULA. This terrible malady exists in every grade of se- verity, and stamps its peculiar impress upon nearly every disease that can afflict children. Some suppose it to originate in the peculiar constitutional condition inherited by the children of syphilitic parents, who 342 woman's monitor. Causes of Scrofula. have not entailed a true syphilitic trouble, but that this disease in the form of scrofula runs through many consecutive generations. Others claim a large portion of the disease is due to the injudicious use of mercury and similar poisons as medicine, deterio- rating the original elementary tissues of the parent, and enfeebling the offspring, while others attribute the origin of this disease to marriage of blood rela- tions, deteriorating the vitality of the stock. No doubt these causes are all capable of so lowering the vitality of the offspring as to produce the disease or strongly predispose to it. So will every vice of the constitution, as purulent poisoning from wounds, se- vere sickness, as typhus or typhoid fever, or other disease, and the children of those who at the period of conception were imperfectly recovered from dis- ease, will be likely to be scrofulous. We now propose to enumerate some of the diseases that are recognized by physicians as originating in a scrofulous condition, a condition of constitution very closely allied to the cancerous. White swelling, or scrofulous disease of the bones and cartilage, with de- struction of soft parts, hip-joint disease, consumption, sore eyes, ulceration of the ears, abscesses in the groin and arm-pits, enlargement of the glands of the neck, or king's evil, enlarged tonsils, severe catarrh in the nose, and a host of skin diseases, besides several forms of tumors, malignant and benign, maintain a SCROFULA. 343 Diseases arising from a Scrofulous Condition. close analogy to this subject. Hence, after some gen- eral remarks, we must be content with calling atten- tion to a few of the most common forms of scrofu- lous disease. The presence of this element is manifest by the diseases above enumerated, with many more of a similar character, and these local manifestations of the constitutional vice are developed by bad air, un- wholesome food, dampness and filth, depressing men- tal emotions, and by every form of disease incidental to humanity, for the scrofulous child is more prone to contract disease and less able to resist its destructive power. All inflammations in scrofulous subjects are slow in their progress, and do not show violent symp- toms during the formation of matter, or the deposit of curdy-like substance called tubercle, a process which in the scrofulous child is substituted for the plastic deposits, which either become organized, gluing the parts together, or are rapidly absorbed in the healthy subject. Suppuration does not result in true pus, but in a thin puruloid fluid, containing curd-like matter, and the cavities formed in this way are slow to fill with granulation, often break down surrounding structure, and join to other cavities, forming long tortuous sinuses, as in some forms of white swelling about the joints and in the lungs in consumption. It is evident that the malignancy of this destructive process must depend upon the depth of the scrofulous tendency in the system. Hence 344 woman's monitor. Signs and Treatment of Scrofula. some cases are curable, others are not. Scrofulous children are at times very smart and active when young, often have a clear skin, and develop rapidly. These are likely to fall victims to consumption in after life. A strong, marked scrofulous habit may be known by a sallow countenance, cheeks full, tumid, and flaccid, hair coarse and often dark-colored, lips thick and liable to chap, skin harsh and subject to eruptions, eyes dull and watery, eyelids full and drooping, and countenance dull and heavy; digestion is slow and imperfect, bowels usually torpid, and these children possess but little ability to withstand changes of temperature. Treatment. — The general treatment of all forms of scrofulous diseases is the same — fresh air, whole- some food, consisting of meat, brown bread, fruit, eggs, and such food as tends best to support nutri- tion at its highest point. These, with cheerful sur- roundings and change of scenery, careful bathing, and plenty of exercise, will give the best chance of avoid- ing those destructive local inflammations which de- stroy so many children. The internal use of the hypo-phosphites, as a sirup of the hypo-phosphites, of potassa, soda, iron, and lime, or some preparation of Peruvian bark and iron, given three times daily, are excellent, especially in malarious districts. From two to three drops, depending upon age, of the sirup of iodide of iron, given after meals, is often useful, king's evil. 345 Treatment Continued King's Evil. so is the iodide of starch, or of lime, in appropriate doses. Sarsaparilla, yellow dock, burdock, stillingia, etc., are also very good remedies. Compound sirup of stillingia with one drachm of iodide of potassium to the pint is an excellent remedy. The dose is one tea-spoonful to a child twelve years old, less in pro- portion to age of child. At times it is best to give some of these alteratives, and at the same time give some preparation of bark and iron. By a steady course of medicine for many months, leaving an in- terval of a few months, and then resuming or chang- ing the medicine above recommended, all of which can be procured of any apothecary, you will assist even bad cases to outgrow the difficulty and prevent severe disease. If injury or local inflammation has already caused some severe local lesion, the same gen- eral treatment will be proper with such local dressing as the case may require. KING'S EVIL. This is a scrofulous disease of the glands about the neck. The treatment may be pursued for several weeks, as recommended in the article on scrofula, then apply a wash or ointment of iodine, as com- pound tincture of iodine, one part, glycerine, three parts — hog's lard may be substituted for the glyc- erine — then the iodine has to be rubbed into the lard with a case-knife or spatula. This may be 346 woman's monitor. Big Neck. Enlarged Tonsils. rubbed upon the swollen glands twice daily. An ointment of black walnut hulls is said to be excel- lent to discuss these tumors. I have often removed them with a plaster, made by boiling squills in com- mon lye until the squills are dissolved. This may be spread upon cloth and bound upon the tumors. It appears at times to promote suppuration, and this is better than driving the matter into the blood. But those tumors that do not suppurate are usually speed- ily removed. Never apply any thing to the swollen glands until some weeks after commencing the treat- ment by internal remedies. BIG NECK may be removed by the internal use of the same remedies recommended for scrofula and the perse- vering use of the compound ointment of iodine so diluted with lard that it will not irritate the skin. It should be continued several months if necessary. ENLARGED TONSILS. This disease seldom afflicts children who are not of the scrofulous habit. Moderate enlargement may be of no special consequence, and may disappear as the child grows older, but when the enlargement is sufli cient to cause the child to breathe through the mouth, especially at night, its health will be injured, by broken rest, by injury to the respiratory organs, from difficult ENLARGED TONSILS. 347 Treatment for Enlarged Tonsils. breathing, and by the impression upon the system for want of proper oxygenation, which is often quite manifest in the experience of the patient when the glands are swollen from inflammation. The shape of the chest known as a pigeon-breast is usually pro- duced by the difficulty of breathing incidental to en- larged tonsils. Enlarged tonsils not only mechan- ically interfere with the passage of air into the lungs, but they keep up a constant irritation, and thus as- sist to develop disease of the lungs, also of the throat. By extension of the disease from the throat, along the eustachian tube, leading from the throat to the inner ear, they become a fruitful source of deafness, to say nothing of the numerous cases of partial deafness, caused by the pressure of the en- larged glands upon the opening of the eustachian tubes. Treatment. — The same general treatment as for scrofulous children. Locally, nitrate of silver pen- ciling, or touching w r ith tincture of iodine may be tried. These, however, are more difficult and more painful than the removal of the enlarged glands w T ith a properly constructed instrument, which is no more painful or difficult to perform than a single application with the pencil. This is an operation that no parent who has children with enlarged tonsils should neglect to have performed at as early a day as possible. Persons who have been accustomed to make light 348 woman's monitor. Treatment for Quinsy. of this disease should read on that subject West on the Diseases of Infancy and Childhood. QUINSY is inflammation and suppuration of the tonsils. It seldom occurs before the twelfth year; yet inflam- mation without suppuration is very common among children. This affection of the throat is generally caused by exposure to cold and damp, or by the use of cold drinks while the body is overheated. Treatment. — A moderate dose of salts should be given, though the child be still at the breast. This may be repeated in small doses every four hours until the bowels are w r ell moved. A liniment made by putting one tea-spoonful of turpentine, and two of aqua ammonia, in an ounce of sweet-oil, may be applied to the throat. After this from half a grain to three grains of sal ammoniac, dissolved in water, may be givenevery four hours; the age of the child govern- ing the dose. SCALD HEAD. This disgusting affection is one of the pests of child- hood, and sometimes afflicts persons of mature years. It occurs usually on the scalp, but may be trans- planted to other parts of the body by the nails, clothing, towels, combs, or flesh-brush. It may orig- inate spontaneously in certain conditions of the con- SCALD HEAD. 349 Symptoms of Scald Head. stitution, and beyond doubt may be communicated from one person to another by contact of matter, as by using the same towel or brush. There are several varieties of the disease. We will describe the most common form, as it will serve as a type of the rest; they all originate in a similar manner, and are amen- able to about the same treatment. Symptoms. — It commences with an eruption of minute, round, yellow pustules, which appear to be imbedded in the skin. A yellow fluid oozes forth, and concretes into a scab, with a depression in the center. This spreads until, in some cases, the entire scalp is covered with one great scab, with numerous checks, from which issues a fetid, sanies matter, which has a nauseous odor, somewhat resembling the urine of the cat. This concreting upon the surface renders the scab thicker. Beneath this scab the matter burrows, after formirg abscesses of consider- able depth. The matter is often absorbed, causing abscesses in the lymphatic glands about the neck, and not unfrequently developing serious constitutional symptoms. The hair is usually reproduced after a cure has been effected, except at such points as were so seriously diseased as to destroy the hair-bulbs. It often happens that the hair does not come in again of the same character and color as before. In neg- lected cases almost entire baldness may result. The itching is intolerable, and in some cases the fever and 350 woman's monitor. Cause and Treatment of Scald Head. resulting anaemia wears out the child, or renders it an easy prey to other diseases. It is now generally con- ceded that this disease is caused by the growth upon the surface of sporules of a microscopic vegetable fungus. The disease appears to have a preference for scrofulous children, and in many cases has ap- peared to me to produce scrofulous tendencies, or de- velop that disease in some form by poisoning the blood. Treatment. — Improve the general health by occa- sional purging, and great care in diet, avoiding grease, but allowing beef, eggs, and fruits; also, sugar in abundance. Some preparation of iron should be given, also iodine. In many cases a few drops three times of sirup of iodide of iron is excellent. Com- pound sirup of stillingia, with one drachm of iodide of potassium to the half pint, has no superior as a renovator of the blood in such cases. Any druggist can prepare it, and direct as to dose to suit the age of the child. The hair should be cut short, and the scalp washed twice daily, with Castile soap and soft water. In addition to the bathing, diet, and clean- liness above recommended, at times, some bitters as quassia, gentian, or Peruvian bark, may be necessary. After washing with the soap, wetting the surface two or three times daily with concentrated acetic acid, diluted with three or four times its weight of soft water, or (what I prefer) washing the part as often DEAFNESS. 351 Various Causes of Deafness. with the crude pyroligneous acid. It will seldom fail to cure speedily. DEAFNESS. Inflammation of the ear-drum, from cold or foreign bodies, may lead to thickening of that membrane, and consequently cause deafness. Ulceration, the sequel of inflammation, may destroy the drum of the ear, and cause deafness, which may be partially re- lieved by introducing an artificial ear-drum. Diph- theria, putrid sore-throat, and scarlet fever, often ruin the hearing in consequence of the inflammation ex- tending to the labyrinth of the ear, and leaving chronic disease there, or so injuring the structure of the parts as to impair the hearing. The same cause may close the eustachian tubes by thickening the lining membrane, and thus exclude air from the labyrinth. Enlarged tonsils, by pressing on the throat extremity of the eustachian tube, impairs the hearing of many children. Inflammation of the brain or its membranes may injure the origin of the nerve of hearing, or cause plastic deposit to press upon the nerve in such a manner as permanently to destroy the ability to distinguish sounds. So varied are the causes of deafness, and so complicated the diseases of the delicate structure of the organ of hearing, that none but the educated physician should treat dis- eases of the ear. 352 woman's monitor. Treatment for Sore Ears and Ear-Ache. SORE EARS are sometimes accompanied with offensive discharges, They should be kept clean with a syringe and soap- suds, made from Castile soap, and washed daily with a solution of carbolic acid one-half to one grain to the ounce of water. The syringe should not have a bulb on the nozzle, as by fitting the passage to the ear-drum, and preventing the free return of the liquid, the drum might be ruptured. EAR-ACHE may be relieved by a poultice of hops, poppy flower leaves, or camomile flowers, applied to the ear. In severe cases, dissolve one grain of morphia in an ounce of glycerine, and apply a few drops in the ear, or one part of laudanum with two of sweet-oil may be used, if more convenient; but it is not so good. SORE EYES. Children are subject to sore eyes of every conceiv able character, in some cases occurring at a very early age, caused by exposure to strong light, the careless use of soap in washing, or the contact of acrid vaginal secretions when passing through the pelvis. Mothers afflicted with leucorrhcea should have the vagina thoroughly cleansed with soft water to remove irritating secretion, and the infant's eyes SORE EYES. 353 Treatment for Sore Eyes. should receive immediate attention, with a soft rag and warm water. If inflammation arise, great care in cleansing with soft water should be observed. Breast milk is a popular remedy. If the eyes are swollen, and discharge matter, wash them three times daily for a few moments with a tea made from the leaf of the poppy flower, adding to every ounce half a grain of nitrate of silver, or one-eighth of a grain of corrosive sublimate, or one grain of white vitriol. These are all excellent. If the poppy flowers can not be procured, dissolve the agents above named in pure soft water, and lave the eyes well three times daily, being careful to open the eyelids so that the wash may reach the eyes. Scrofulous cases require but little local attention. If painful, poppy-head poultices may be applied. Give internally compound sirup of stillingia, with one drachm of iodide of potassium to a half pint, in doses varying from one-fourth to one tea-spoonful, according to age. I have frequently prescribed with success a formula found in " Gross's Surgery," for a child ten years old : R Sulphate quinine ] £ grain. Sulphate of iron 1 " Tartrate of antimony Y? " Opium £ M Mix and give at a dose three times daily. Any druggist can make the calculation to put up the number of powders required, and graduate the dose BO 354 woman's monitor. Inflammation of the Eyes. Cross-Eyes. to the age of "the child. These medicines may be pre- pared in solution, substituting laudanum for the opium. Inflammation from injury or irritating substances in the eye requires the removal of the exciting cause, and the free use of cloths wet with cold water per- severingly employed. Sometimes a purge of salts or calomel may be necessary. It is a great mistake into which physicians sometimes fall to suppose that be- cause the eyes are inflamed they require to be treated with stimulating eye-washes, regardless of the cause and stage of the disease. Many children lose their sight from neglected chronic disease, the parents hop- ing they would outgrow the trouble. CROSS-EYES are sometimes caused by disease, sometimes congeni- tal. It is seldom that much can be accomplished by training without first restoring antagonism of the mus- cles. It is proper to delay in cases caused by spasms or other disease, until the cause is removed and Nat- ure has had time for repairing as far as she will, un- assisted. The eye most at fault usually grows weak, and an early operation holds out the best prospect of permanent cure. The operation is not severe and not at all dangerous. HARELIP, if the palate is not cleft, may be perfectly restored. In case the palate is cleft, much benefit may be de- FROST-BITES AND CHILBLAINS. 355 Treatment for Harelip. Frost-Bites, etc. rived from an operation. The question most perplex- ing to parents is at what age the operation should be performed. Some surgeons approve of delay, others early operation. If the child is healthy, and espe- cially if the palate is cleft, we think an early opera- tion the best. We have operated as early as the sixth week and as late as the twentieth year. All circumstances being equal, we prefer an early opera- tion. FROST-BITES AND CHILBLAINS. Children who have been frost-bitten should not ap- proach the fire until the circulation is restored. They should be warmed slowly, bathing the frosted parts in cold water or rubbing them with snow. As soon as the frost is out and the burning pain commences, apply one part of turpentine and four parts of sweet- oil or diluted tincture of camphor, and cover the parts with carded cotton. If the parts assume a red or dark-purple and swollen appearance, apply three times in twenty-four hours equal parts of glyc- erine and compound tincture of iodine. In very pain- ful cases take of lead 1 drachm. Laudanum 1 ounce. Soft water 3 « Mix. Wet a soft cloth and bind on the part. Many other remedies have been recommended for frost-bites, but the above will usually cure. 356 woman's monitor. Boils. Ringworm, BOILS are especially prone to afflict children about the pe- riod of teething and when recovering from eruptive fevers. The cause appears to be a septic condition of the blood. Treatment. — Frequent soda-water baths and the free use of chlorate of pota&sa solution. All abnor- mal conditions of the liver, stomach, and bowels should be corrected by careful diet and occasional purging. Never attempt to check the development of a boil, but hasten it with warm poultices, and re- lieve the pain and tension by incision as soon as pur- ulent matter is formed. RINGWORM. This belongs to the same class of diseases with shingles — a class called by physicians herpes. It is so named from the circular form of the blotch. All that class of diseases have a similar origin, and re- quire about the same treatment. I use the names I think will be most readily recognized by the people. Such diseases originate sometimes from sudden sup- pression of perspiration; from the habitual use of too much oily food, as fat pork, short-cakes, pies, dough- nuts, etc. Especially have I seen such diseases ap- pear to prevail as an epidemic in neighborhoods where the children were almost daily feasting on walnuts, TETTER. 357 Ringworm. Tetter. butternuts, or shell-bark nuts. If the blood is charged with the poisonous material necessary to the production of disease, it may be excited by a sudden cold, severe anger or fright, or any severe mental emotion. Treatment. — Care in diet, frequent bathing, light purging by small doses of salts, and the free use of solution of chlorate of potassa is all the internal treatment usually required. The eruption may be touched with a solution of nitrate of silver, twenty grains to the ounce, or a solution of sulphate of zinc (white vitriol) may be made by dissolving two drachms in one-half pint of soft water and binding a cloth wet with the solution on the parts affected. TETTER. This disease of the skin is very common among children, and may be reduced to two classes — the wet and the dry or scaly. In moist tetter the pustules are slightly elevated, and in two or three days after their formation they burst and discharge their con- tents, leaving a red, shiny surface. When from neglect or mismanagement the disease is allowed to proceed, it may extend over a whole limb, which be- comes incrusted in one continuous covering. When the disease extends to the hands or feet, ulcerations are apt to occur about the roots of the nails. The nails drop off and are succeeded by others of imper- 358 woman's monitor. Treatment for Tetter. Common Itch. feet and irregular form. The scaly variety is not at- tended with such intolerable itching as the moist tetter. Its general symptoms are too well known to require repeating here. The treatment of both va- rieties may very properly begin with a brisk cathartic of calomel or podophyllin and leptandrin, afterward the bowels should be kept open with small doses of Epsom salts. In moist tetter a wash made by adding one drachm of bismuth to one ounce of glycerine, to which one-half ounce of the watery extract of opium should be added if the pain and itching are severe, will be all the local treatment required. This may be frequently applied. Glycerine and rose-water, equal parts, is all the local treatment usually neces- sary for dry tetter. If these means fail Fowler's so- lution of arsenic, decoction of bitter sweet, the sul- phur vapor bath, and hydrocyanic acid ointment may be tried under direction of the family physician. COMMON ITCH. The itch makes its appearance on the wrists, backs of the hands, or between the fingers, from which it is often transplanted to the arm-pits, flexures of the joints, and indeed to any part of the body w T here the living insect, which causes the pustule or its germs, are brought in contact with the skin. When the skin is very thin and delicate the disease spreads more readily. If the blood is charged with some morbid COMMON ITCH. 359 Treatment for Common Itch. humor, as scrofula, the irritation they create will be much greater and the local disease much more severe, but in all cases it produces an intolerable itching, especially when the patient is warm in bed. Treatment. — The afflicted person should abstain from pork and all high-seasoned food, if the inflam- mation in the parts affected runs high, and should be kept away from those not afflicted. If the pus- tule is examined with a good glass it will be found that at its summit is a very small aperture. From the pustule to a short distance on one side leads a little tunnel, which marks the track of the parasite. Through this he receives air; and it is said all that is necessary is to rub thoroughly with lard or tallow twice daily for three or four days and then change every garment, all bedding, etc., to insure a cure. I have but a limited experience in this method of treat- ment. Sulphur ointment from time immemorial has been regarded as a specific, but it is very filthy. A less filthy and equally certain remedy is prepared by boiling together a quantity of sulphur and quick- lime. The water becomes saturated with a crude sulphuret of lime. A few washings with this cures the worst cases of genuine itch. It is very offensive to the nostrils, and hence the profession has sought for substitutes. A solution of carbolic acid crystals, one to three grains to the ounce of water, is a very certain means of exterminating these pests. It 360 woman's monitor. Treatment for Chafing, Scalds, and Burns. should be thoroughly applied twice daily for one week. Frequent bathing and complete change of rai- ment should n«rt be neglected. CHAFING OR GALLING OF INFANTS. Many infants are rendered miserable and fretful by galling about the groin, arm-pits, and neck, and all the ingenuity of the nurse, with starch, etc., can not dry up the watery discharge from the skin. Such cases may be speedily cured by wetting the parts two or three times daily with Lime-water , 4 ounces. Corrosive sublimate 4 grains. Mix. This may be reduced with water to half strength for very tender infants. SCALDS AND BURNS. If one-third of the body is burnt over so as to de- stroy the integrity of the skin, the case usually ter- minates fatally, even in the best constitutions, though they may survive for several weeks. Feeble persons often die from shock, convulsions, or other cause from less extensive burns. The first general treatment is to secure reaction by wine or other gentle stimulants. Small doses of laudanum or morphia, repeated every hour or two, are often the best support for the shat- tered nerves under such circumstances. Diluted pep- permint essence or whisky is as grateful as any local application. 'Carded cotton is often gratefully re- ceived by the patient, as it excludes air from the WARTS MOLES. 361 Warts. surface. Rags spread with tallow or lard are better than the cotton, because more easily removed w T hen suppuration has commenced. After sloughing begins the parts should be frequently bathed with soft water and Castile soap. Equal parts of lime-water and flax- seed-oil is a very popular dressing. It is more filthy than lard and no better. For a superficial burn or scald equal parts of the white of eggs and glycerine is an excellent dressing. WARTS. These unsightly growths are quite common on the hands of children. They sometimes go away spon- taneously, but they generally have to be removed. This may be effected almost without pain, by securing a small phial of saturated solution of caustic potash from a druggist, then with a sharp knife shave the surface until the blood starts slightly; dip a slender rod of soft wood into the solution and w T et the top of the wart. After one minute wipe the part, and repeat. In two minutes the wart can easily be re- moved by pressure in a jelly-like mass. The part should then be washed in vinegar, to stop the action of the alkali. Great care should be used to prevent the caustic touching the sound skin. MOLES may be removed in the same manner, though I prefer a similar application of strong nitric acid for such 31 362 woman's monitor. 1 6 Remove Moles. Coins. . Poisons. growths. The parts should be washed afterward with soda-water. Any simple ointment will suffice for a dressing. Never attempt the use of these caustics over a large blood-vessel or near the eye. The potash solution is the painless corn remedy so much hawked about by quacks. Never permit it to be applied to a corn. These are but a thickening of the cuticle, and require the removal of pressure, to be kept thin with a sharp knife, and soft by a rag wet with fish-oil. POISONS. Children not unfrequently swallow poisons acci- dentally. In all such cases a physician should be sent for. But some knowledge of what to do may save life in the rural districts. If poisonous berries or fruit have been taken, or any preparation of opium or other narcotic poison, secure vomiting immediately; if possible, force into the patient, if a child, say ten years old, one table-spoonful of ground mustard mixed with water or as much pulverized alum or common table salt. These are usually at hand and seldom fail to secure severe vomiting. Warm water may be drank after the vomiting has commenced, to assist in cleansing the stomach. If a corrosive poison, as cor- rosive sublimate, or some acid, has been taken, vomit- ing will usually be excited by the poison. This will be true of arsenic if in large doses. If vomiting WOUNDS BITE OF POISONOUS REPTILES, ETC. 363 Treatment for Poisoning. Wounds, etc. does not speedily occur, it should be excited as above directed. In these cases also give soap-suds or white of eggs. Do not falter, but give them with a firm hand. If alkalies, as soda or strong lye, have been taken, give some kind of grease, lard, or sweet- oil, in large quantities. WOUNDS FROM THE STING OF BEES, WASPS, HORNETS, YELLOW-JACKETS, FLIES, SPIDERS, AND MOSQUITOES, ETC. If sickness or fainting result give whisky, brandy, wine, or spirits hartshorn. The wound should be dressed with Cologne water, solution of sugar of lead, tincture of iodine, laudanum, spirits of turpentine, or better, spirits of hartshorn. SCORPION STING. Give stimulus as above directed, and wash the wound with salt water, or volatile liniment, (harts- horn and sweet-oil,) and cover with a poultice. BITE OF POISONOUS REPTILES, SNAKES, ETC. Internally, whisky or other alcoholic stimulus, till the patient is thoroughly drunk, a few drops of liquid hartshorn, with every portion of stimulant, is highly recommended. The mouth should be im- mediately applied to the wound, and as much blood as possible drawn in that way. The wound may 364 woman's monitok. Treatment for Bites of Poisonous Reptiles and Rabid Animals. then be dressed with equal parts of sweet-oil and spirits of hartshorn, or with compound tincture of iodine. We give below the formula for Prof. Bibron's rattlesnake antidote, which is said by United States army surgeons to be the best remedy yet invented for serpent bites : ]£ Bromine 5 drachms. Corrosive sublimate 2 grains. Iodide of potassium 4 " Mix. Keep in a bottle with a ground-glass stopper. Dose, ten drops, repeated every twenty minutes. BITE OF RABID ANIMALS. Contact of saliva from a mad dog with a wound on the body may cause hydrophobia. Its period of latency is from a few weeks to several months. It is probable that the poison is speedily absorbed. As no cure is known attention must be directed to pre- vention. A dog supposed to be mad, if it has bit- ten any one, should not be killed, but properly secured, and its course closely observed. The injured part should, if possible, be cut out immediately after the injury. The flow of blood should then be encouraged with a cupping glass, and the raw surface swabbed with tincture of iodine. It is a consoling reflection that not one in five bitten by animals undoubtedly mad are ever afflicted with hydro- phobia. CUTS PUNCTURED WOUNDS. 365 Cuts. Punctured Wounds, etc CUTS, if about the face, should be dressed by a surgeon with stitches and adhesive plaster, to prevent scars. Ordinary flesh wounds may be drawn together and secured with adhesive plaster after the bleeding has ceased, and the blood-clot has been washed away; a perfect union in a few days may be expected. No stimulants nor ointments should be applied. If a wound bleeds freely — dark blood running in a steady stream — veins have been divided. Press upon the part on the side of the wound farthest from the heart; the flow of blood will soon cease ; cold water may be applied. The wound may then be dressed as above directed. If bright-red blood flows, in spurts or jets, an artery has been divided. Press upon the pulse between the heart and the wound, or place a cord around the limb, and twist tightly with a stick, and send for a surgeon, as the artery must be tied. PUNCTURED WOUNDS, as from stepping on rusty nails and similar sub- stances, are sometimes dangerous. The first serious symptom should be the signal for calling a surgeon. The wound should be cleansed to remove all dirt, and a poultice applied. If the wound is painful wash with strong solution of morphia. 366 woman's monitor. Treatment for Sprains. BRUISES sometimes result in abscess, when neglected. First apply cold water. If the parts assume a dark color, use warm salt water, or tincture of arnica. SPRAINS are injuries received to structure about joints, some- times slight, at others severe. The ligaments being put upon the stretch, are partly lacerated, and at times muscular fibers are broken. Treatment. — Secure an easy position for the part, and keep it at perfect rest. Apply cold water until the inflammation has subsided. Warm salt water, or tincture of arnica, will then be more grateful to the parts. In some cases, especially in the rheumatic hab- it, pain and tenderness remain for a long time, being worse in damp weather. Thorough bathing, several times daily, with old herring-brine, is good treatment, probably on account of the propylamine it contains. DISLOCATIONS may be known by deformity of parts, and severe pain on attempting to move the dislocated joints, with rapid swelling, and impaired function of the limb. FRACTURES furnish the same symptoms as dislocations, and, in addition, by careful listening while the limb is moved, RUPTURE. 367 Fractures. Treatment of Rupture. a grating noise (caused by the rubbing together of the fragments of the broken bone) may be heard. Nature is longer effecting a perfect cure of dislocation than of fracture. I introduce these subjects here to put parents on their guard, as I have frequently been consulted as to fractures and dislocations occurring in small children that had been neglected so long that permanent deformity was inevitable. Where any doubts exist a surgeon should be consulted. RUPTURE. This is a protrusion of the fatty apron that covers the front of the bowels, sometimes accompanied with a portion of the intestine. It has been found to exist at birth, and where it occurs in early life it is probable there existed an imperfect condition of ilie parts. Sometimes the protrusion is at the navel ; in other cases at the groin. When at the navel all that will usually be necessary is to stitch to the under surface of the belly-band a small section of a gum- elastic ball, and retain the elastic upon the parts. In some cases adhesive straps may be necessary to secure the dressing in position. A truss will be necessary to secure in place the parts that come down at the groin. As this form of rupture is often double, a double truss may be required. It is difficult to keep a truss upon a child until it is three or four years old ; but the chances of a permanent cure will be 368 woman's monitor. Foreign Substances in the Nose and Ear. much increased by securing the parts in position as early as possible by an appropriate truss. This should be selected and adjusted by skillful hands. FOREIGN BODIES IN THE NOSE. Children often put corn, peas, pebbles, buttons, or other bodies, up the nostrils so far that it is difficult for the parent to get them out without a properly constructed instrument. They should not be forced back into the throat, as the larynx being open at the moment the body passed into the throat, it might pass into the air-tube. Nor should these substances be allowed to remain, as serious injury would be likely to result to the lining membrane of the nose. If a proper instrument is not at hand the child should be taken to a surgeon, who will readily re- move it without injury to the parts. FOREIGN BODIES IN THE EAR. Children are liable to get bugs, spiders, flies, and other insects in the ear. They also frequently put foreign bodies in the ear. Parents should try to re- move these with a small pair of tweezers, or by bend- ing a fine wire, so as to secure the offending substance in a loop. Great care should be exercised not to push the body against the ear-drum, and not to touch that membrane with the instrument. Bungling ef- forts of this kind often injure the hearing for life. FOREIGN BODIES IN THROAT AND (ESOPHAGUS. 369 Foreign Substances in the Throat; These agents should not be allowed to remain, as de- structive inflammation would be likely to be set up, not only endangering the hearing, but life, from exten- sion of the inflammation to the brain. I have fre- quently removed corn, wheat, insects, beads, and like bodies, some of which had remained a long time, and on one occasion I removed from the inner ear a small pebble that had evaded every effort to extract it at the time it was introduced. The attending gentle- man thought it might work out, but it worked through the drum of the ear, and caused severe dis- ease of the bones of the head. Do not rest until the offending substance is removed. FOREIGN BODIES IN THE THROAT AND (ESOPHAGUS. Children are liable to get foreign bodies fast in the throat. If any article capable of digestion, the doc- tor should push it into the stomach with a probang of sponge and whalebone. If of such a character as to be injurious to the stomach, as pins, needles, buttons, etc., a surgeon should be summoned, who will reach the offending substance if possible with long, curved forceps; if not, all well-equipped surgeons possess other devices for extracting such substances from the passages to the stomach. 370 woman's monitor. How to Extract Foreign Substances from the Windpipe. FOREIGN BODIES IN THE WINDPIPE. It occasionally happens that children get some sub- stance in the air-tubes, most frequently a pea, bean, watermelon-seed, button, grain of corn, wheat, or like article. The amount of irritation and the probability of spontaneous expulsion will depend in no small de- gree upon the nature of the substance. If a bean or similar article, it may swell and so far fill the tube as to make it difficult for it to be spontaneously ex- pelled. Treatment. — The books recommend burning feath- ers under the child's nose, or giving snuff, to cause sneezing; also chloroform, to secure relaxation, and suspending by the feet. This may succeed if the body is a button, a bullet, or other heavy substance. A variety of active emetics have been recommended, as tartar emetic or alum. I believe they often do harm by forcing the foreign body into one of the bronchi and wedging it fast so that no art can reach it. We believe it best to trust to nature, unless it appears that nature is not likely to succeed; then open the throat in the lower part of the neck and re- move the offending substance. It is astonishing how long such substances are retained and then expelled spontaneously. It is quite certain that nature is com- petent to cure a large majority of these cases, but at times not until the seeds of severe disease have been CRIMINAL ABORTION. 371 Criminal Abortion the Curse of tlie Nation. planted in the lungs. The question of operating must be governed by the nature of the case and the urgency of the symptoms. CRIMINAL ABORTION. A variety of causes have in all ages and among all nations conspired to induce women to endeavor to avoid the consequences of sexual intercourse, either by the use of some means of prevention or by secur- ing the premature discharge of the product of con- ception. Silently but surely these disease-producing agencies have been at work, destroying the physical stamina of mankind, and preparing the way for the desolating march of a host of diseases that now threaten the extinction of certain nationalities by the blighting influence of female weakness and dis- ease, predisposing children to sickness and premature death. • We have in a former chapter spoken plainly as to the danger and consequent criminality of all means of prevention, except abstinence from intercourse. It is now our purpose to speak of the prevalence of child-murder — the deep criminality of the practice; the causes which lead to it; the excuses for its com- mission by its aiders and abettors; the diabolical agency by which it is accomplished; its consequences to the mother and to the race; the duty of the clergy and medical profession with reference to the evil, and 372 woman's monitor. Prevalence and Extent of Child-Murder. the manner in which this great scourge to society is to be banished from the land. PREVALENCE OF CHILD-MURDER. The horrid practice of murdering new-born infants has existed from the earliest ages, not only among the savage and barbarous tribes of Africa, Asia, and Oceanica, and the Indians of North and South Amer- ica, but among people far advanced in civilization and the arts, as the ancient Greeks and Romans, and from the earliest dawn of history to the present time among the Japanese, Chinese, and other civilized nations of pagan Asia. Sometimes infanticide has been enforced by law or custom as a restraint upon the rapid increase of population, a practice common in China to-day. In some cases it has been resorted to as a matter of na- tional polity, to prevent society from being taxed, to support the feeble and deformed, as under the bloody Lycurgian code, and among many tribes of American aborigines, where a system of hardening is practiced, which destroys all children so feebly constituted as to be unable to pass the trying ordeal. Dr. Kane assures us that the northern Esquimaux tribes still practice infanticide, but not to so great an extent as formerly, as the influence of the Lutheran and Mora- vian missionaries has improved the morals of the people. Among the aborigines of the Caucasus, ac- cording to Strabo, illegitimate children were either PREVALENCE OF CHILD-MURDER. 373 Infanticide in Heathen Countries. assassinated or sold into slavery. Sanger, in his his- tory of prostitution, states that in central Australia a habit prevails among the savage nations of destroy- ing female children. Dr. Sanger further informs us that when Mr. Smith, a missionary, was in the suburbs of Canton, in 1812, he made inquiries as to the extent of infanticide. A native assured him that within a circle of ten miles the children killed each year would not exceed five hundred, but in some of the neighboring provinces infanticide was more prevalent. Among the lower classes the birth of a female infant is regarded as a calamity. Sev- eral methods are adopted for destroying a child. It may be drowned in warm water; its throat may be pinched; a wet cloth may be pressed over its mouth; it may be choked with rice, or it may be buried alive. The Chinese confess that infanticide is prac- ticed throughout that vast empire, and is regarded as an innocent and proper expedient, to lighten the pressure of poverty. Sometimes infanticide has as- sumed the form of devotion to some deity, as among the ancient Amorites, who caused their children to pass through the fire in sacrifice to Moloch ; and the Hindoos, who cast their infants into the open jaws of the sacred crocodile, in the holy Granges. Kind reader, I know these are the victims of pagan superstition, acts of atrocity against the laws of God and the well-being of society, at which you shudder, 374 woman's monitor. Ante-Natal Infanticide. although committed beyond the seas by savage or half-civilized people, who for untold centuries have been ground beneath the iron heel of caste, poverty, and governmental tyranny. Among all these, as well as many other nations, past and present, a sys- tem of murder has prevailed still more atrocious. I allude to ante-natal murder, to the destruction of the foetus in utero, or its forced premature expulsion. This form of murder appears to have been reserved as a refinement of crime for people far advanced in education, civilization, and the arts. It prevailed in ancient Greece and Rome — flourished as a means of securing small families, and thus enabling the women of Pompeii and Herculaneum to devote themselves to a life of voluptuous ease and fashion. This form of murder has been instrumental in calling down the wrath of God upon many of the most splendid courts of continental Europe, and in no small degree assisted to produce that effeminate condition of constitution that has well-nigh rendered extinct many once noble and powerful families. Among no people upon whom the sun has shone since the morning stars sang together for joy at the creation has this form of infanticide been so univer- sally practiced by all classes as among the native American population of the United States during the last few years. Startling as this statement may ap- pear, we believe it is an awfully appalling truth, that PREVALENCE OF CHILD-MURDER. 375 Its Fearful Prevalence in this Country. should be brought home with full force to the con- science, and held up in all its enormity, that this Herod of the noon of the nineteenth century may be induced to sheath his sword, already so deeply stained with the blood of murdered innocents. We may be charged with having over-estimated the prevalence of this vice. We think we are correct, from twenty years' observation in practice, extensive converse and correspondence with physicians, druggists, and clergy- men, and the statements of men whose opportunity for observation has been better than our own, all of whom testify to the wide-spread prevalence of this crime. Rev. Dr. Todd, in his article on Fashionable Mur- der, says: "If any of my lady readers should com- plain of a want of delicacy, I beg them to remembei three facts : first, that the practice is fearfully com- mon ; second, that probably they are every week associating with those who are guilty of the practice; and, third, that seventy-five per cent, of all the abor- tions produced are caused and effected by females. What, then, of delicacy !" The Doctor then goes on to say, in substance, that he fears our native popu- lation is being sensibly diminished from this cause. Almost every paper, in city and village, throughout the land, offers medicine, to be effectual, "from what- ever causes." "New York city alone has over four hundred establishments fitted up and advertised as places where women may resort to effect the end 376 woman's monitor. More Common Among Protestants than Catholics. Awful Effects. desired. These are well known, and abundantly pat- ronized." This vice is more prevalent among Prot- estants than among Catholics ; not that Protestant- ism encourages or connives at the vice, but the Church having no decrees on the subject, her people appear ignorant of its guilt. Dr. H. R. Storer, in his excel- lent little book, entitled "Why Not," says : "Forced abortions in America are of very frequent occur- rence ; and this frequency is rapidly increasing, not in the cities alone, but also in the country districts." In many localities the number of abortions will be found to largely exceed the natural births. From a desire to escape for sometime after marriage, abor- tion is artificially induced ; chronic uterine leucorrhoea results. Offended Nature may ever after refuse to complete the work of human development, where the uterus has been ruthlessly invaded, and an unfinished immortal creature plucked from the workshop of Nat- ure, and from under the workmanship of the Divine hand. Hence the woman who has once secured an abortion may afterward be barren from repeated mis- carriages until the inroads of disease shall consign her shattered and suffering body to the keeping of the tomb. ITS CRIMINALITY. Many persons are disposed to believe that the destruction of the child in the womb, especially if ITS CRIMINALITY. 377 Criminality of Ante-Natal Infanticide. effected at a very early period, is not murder. They appear to have a vague idea that it may be wrong, and that the sinfulness increases with the stage of development of the new creature. That it ever ac- quires the magnitude of a great crime they deny. Legislators have fallen into this error, and in some of the States the law makes a distinction between quick and not quick with child ; making willful abor- tion before that period a misdemeanor, punishable with fine, and after quickening, manslaughter, pun- ished with a term in the penitentiary. Ohio has abrogated this foolish distinction, and by her laws it is manslaughter to destroy a living human germ at any stage of intra-uterine life; and the aiders and abettors of the crime are also punished. The germ is endowed with human attributes from the moment the fecundated ovum attaches itself to the mother's womb, and begins that interesting process of progressive development whi-ch forecasts the future man or woman. It is not, as some suppose, an ex- crescence upon the mother, which might be removed at pleasure, provided it could be done without injury to her. This position is maintained by the apologists for abortion. They claim that the soul is not im- parted to the new creature until it breathes the breath of life ; endeavoring to sustain it by quoting : "The Lord breathed into his nostrils the breath of life, and man became a living soul." Adam was not 378 WOMAN S MONITOR. The Right to be Born and the Right to Live. made under the laws of -the flesh, but by the miracu- lous exercise of Divine energy; and we learn from the Holy Scriptures that he was made perfect, in the likeness and image of his Maker. God infused into him the breath of life, and he became a living soul. He was endowed with germ power, capable of trans- mitting to posterity a like bodily conformation. We do not believe that this text refers to the breathing of atmospheric air. If so, then as the breath of life is breathed into every living creature, it should im- part to them the attributes of immortality — a posi- tion not likely to be assumed by the advocates of this doctrine. From such considerations we argue that the child's right to be born is as absolute as its right to live after it is born. True, children are created in obedience to the laws of the flesh. In the mutual exercise of the passions or affections they are be- gotten. But are they on this account less sparks struck from the great flint of humanity by the Divine hand? Are they not endowed with vital fire, and the elements of a glorious immortality, capable of in- finite development from the first moment of their intra-uterine existence? From that time onward they grow, develop, and unfold their attributes, with ever- increasing evidence of innate humanity, until the full-grown man or woman stands forth, clothed in their God-given regalia of strength, beauty, and in- telligence. Pray tell me at what stage of this in- ITS CRIMINALITY. 379 The Immortal Principle Planted at Time of Conception. teresting process is the immortal principle implanted in human nature, if not at the moment of conception, which, in a physiological sense, means when the fecundated ovum attaches itself to the mother's womb? Do you say it has no independent existence? Very true. Is that any reason why it may be ruthlessly torn, with bloody hands, from its mysterious abode, and, when in the very act of unfolding its human powers, be hurled back into nothingness ? that the soul should be deprived of that period of earthly pro- bation designed by Omnipotence for every son and daughter of Adam ? What wonder that disease and death should follow in the wake of this mighty evil! If mothers and their abettors in this crime escape the damnation of hell, it will be because wide-spread ignorance and perverted public sentiment has weak- ened their moral obligations, or through the amazing mercy of Him who renders good for evil, and for- gives to the uttermost all who truly repent. It has been urged that there is no life until the period of quickening. Every physiologist knows that quicken- ing is but the first appreciable manifestation of life. The reason infants do not manifest their presence by sensible signs sooner than the eighteenth week is that they are too small before that time to make their feeble struggles sensible to the mother. This period of quickening varies with the strength of the child. The period of viability also varies, that 380 WOMAN'S MONITOR. The Period of Quickening and the Period of Viability. is, the age at which a child may live if born. This must depend upon the vigor of the young creature. We are quite sure that thousands of mothers lose their health, and they, or their friends, and sometimes the family physician, commit dark and damning crime from ignorance of the true nature of intra-uterine life. We know several physicians who, a- few years ago, we have reason to suppose, were not proof against the urgent demand of a wealthy friend or an influential patron; but having since looked carefully into the nature of intra-uterine life, and adopted the theory sustained alike by religion and philosophy, that the soul is imparted at the moment of concep- tion, and with their present views as to the nature of the foetus, could not be induced to do what they may have regarded at one time, under like circumstances, as a duty, for all the wealth of California. More than this, women, who have with their own hands desecrated their own bodies and destroyed their own children, having become acquainted with the dreadful nature of the crime they had committed, have been lashed by an upbraiding conscience until frail, shat- tered reason tottered on its throne, and the lovely creatures who but a few years before were the gay- est of the gay, in shrieking mania dragged out a few brief months in the lunatic asylum — madness per- petuated by uterine disease, caused by infanticide. The tombstone now marks the spot where sleeps ITS CRIMINALITY. 381 Terrible Effects of Abortions upon the Mother. their mortal remains. Would to God this was a fancy sketch ; but, alas, it is too true ! Nor are these cases so unfrequent as the casual observer may sup- pose. True, all do not reach the mad-house, on the way to a premature grave. Some die of hemorrhage, others from cancer of the womb, or ovarian tumors, while thousands fall victims to disease produced by sympathy with disease of the womb, if not before, at the period of "change of life." As a class the medical profession are a unit as to the criminality of forced abortions. The American Medical Associa- tion ordered the essay of Dr. Storer, entitled "Why Not?" to be published under the sanction of the Society, for the purpose of disseminating knowledge on the subject. The Catholic Church, and I believe some branches of the Presbyterian denomination, have taken action in their official capacity to check this swelling tide of disease and death. If all the denominations of Christendom should awake to the necessity of action, there could be no doubt as to their verdict, and the power they could exert would be felt for good. The Roman Catholic Bishop of- Boston says : " The instant conception takes place, there lies the germ of a man ; destined most surely by the will of the Creator to be developed into the fullness of human existence, and he is a criminal and murderer who deals an exterminating blow to the incipient man." The Rev. Dr. Todd, after quoting 382 woman's monitob. Infant-Murder after Birth less Censurable than Abortion. the Bishop at some length, from which the above is an extract, says : " From this it follows that the young woman whose virtue has proved an insufficient guardian to her honor, when she seeks by abortion to save in the eyes of man the honor she has for- feited, incurs the additional and deeper guilt of mur- der in the eyes of God, the Judge of the living and the dead." If these are guilty, what shall we say of the mother, married and surrounded by every comfort, who for the purpose of increasing her ability to live in ease and luxury, or securing leisure to enable her to run the giddy round of fashion, imbrues her own hands in the blood of her unborn child? Thousands do this, ignorant as to the consequences to their health and the sinfulness of their course. Let all such be warned, that they may sin no more. It is certainly less criminal to destroy a child when it has been born than to deal it a cowardly blow w T hen the sacred privacy of its abiding-place renders the offender but too secure from public odium or criminal prosecu- tion. Infant murder after birth, as practiced by the pagan nations, destroys but one life. The Chris- tian refinement of infanticide often destroys both mother and child. The child is certainly sacrificed and the mother's health injured in all cases. A few in consequence of great constitutional vigor, retain toler- able health; but for every one who escapes scores are rendered miserable for years, often for the remainder CAUSES WHICH LEAD TO ABORTION. 383 An Appeal to American Women. of life. Refined, educated American women, will you take the hazards to health, to life, to happi- ness on earth and sacrifice your chances for im- mortal bliss by efforts to escape the consequences of the marital relation? We think not if you once be- hold this sin in all its enormity. If you have har- bored such notions of propriety in the past, banish them at once and forever, before health is broken and moral purity gone. Would that this practice was con- fined to the ignorant and depraved! Not so; it flour- ishes best among the cultivated and refined; yes, more than this, is sheltered by the veil of secrecy within the pale of evangelical Churches, and in many instances aided and abetted by those who believe themselves called to the w r ork of redeeming the world. Read the correspondence of the author of " Satan in Society " with a learned and devout divine, well known to the reading public, and believe that similar perverted notions with reference to this sin are not unfamiliar to medical men in many parts of this country. CAUSES WHICH LEAD TO ABORTION. The causes which lead to abortion and the excuses pleaded for the practice are various indeed. No physi- cian of a few years' experience but could throw-much light upon this subject, did not custom and the ne- cessity of our profession make the most inviolable 384 woman's monitor. Influences which lead to Abortion. secrecy the rule of a physician's life. The suffering, diseased victim often reveals to him that which could only be wrung from him by the stern mandates of the law. He is often prevented from reporting cases of great interest to the profession, fearing some one might apply them, perhaps unjustly, to their neigh- bors, or the feelings of the parties be injured should they see the reports. But we may remark that a disposition to live elegantly, dress well, and have a fine equipage, has rendered popular the use of every possible means to secure small families. This cause more than any other prompts to abortions among mar- ried women. Strange as it may appear, love for children is another motive. The mother yearns to see her children educated and prosperously started in business. She knows full well that the new-comers are a tax upon limited resources, and she desires to prevent further increase, that she may do more for those to whom she is devoted, and she will sacrifice health if need be to prevent or destroy the offspring which in a few brief months she would love with all a mother's devotion. Would she do this if she believed it was a crime? Many suppose they are justified in seeking relief because some ignorant medical man has told them that they would die if they had another child. Their first labor was tedious and painful, per- haps made so by ignorant meddling. What won der if they should believe the doctor, and seek to CAUSES WHICH LEAD TO ABORTION. 385 Influences Continued. Mistaken Views. escape by abortion! Ninety-nine chances to the hun- dred this statement of the doctor, that had caused si much alarm, was born of the same ignorance that produced or magnified the previous peril. Some seek premature delivery under the mistaken idea that it is less painful and less dangerous than labor at full term. It is time that by proper publications and the influence of the medical and clerical pro- fessions this error was corrected. Science and ex- perience alike proclaim abortion more hazardous, and it certainly is more painful. Some seek to abort be- cause they fear they will entail upon their offspring scrofula, consumption, epilepsy, or other diseases. The condition of mind in a female laboring under a mania to prevent such entailment is at times enough to wring pity from the most obdurate heart, and more than a physician would be likely to withstand whose principles are not grounded in a deep conviction of the truth of the views we have taken as to the nature of the crime. If our position is correct, he will an- swer as suggested by the author of "Satan in So- ciety :" " Good woman, your case is one which elicits my deepest sympathy, but the thing you contemplate is murder. If you are resolved to avoid the rearing of your offspring at all hazards, wait a short time, and it will be easy for you to accomplish your pur- pose, as a little arsenic or strychnia will do the work. You are a good Christian woman, and no one will 33 386 woman's monitor. Jealousy and Domestic Intranquillity lead to Abortion. suspect you; thus you will avoid all danger to your- self." It is useless to say that this proposition would be received with horror, and usually have the desired effect, although at times such persons would dismiss their physician, declaring they did not believe it a crime, and secure a man more pliant to their wishes. Too often such men are found — let us hope not at present in the rank of the regular profession. Jealousy and domestic intranquillity are causes lead- ing to abortion. Sometimes the female mind, per- verted by disease and mental conflicts, is prone to forget those early attachments that once rendered her willing to endure pain and privation for him she loved. She no longer feels that buoyant hope under difficulty. She sees her own heart-sorrow but too plainly depicted in the countenance of her children. In fact many wives soon cease to love their husbands, and do not desire to bear them children. From this they shrink with a horror born almost of hate, yet they are usually virtuous, because of that love of truth and duty that is the crowning glory of woman's nature. No wonder such are desirous to escape ma- ternity. But where does the cause of this state of feel- ing originate ? Occasionally in ill-assorted matches — marriages for gain, for influence, or for transient pas- sion. Oftener affection true and undying has only been smothered by the course pursued by the hus- CAUSES WHICH LEAD TO ABORTION. 387 Love Lost in the Bridal Chamber. band toward the wife. Before marriage he was all tenderness, all affability, all kindness ; the prize once secured, he assumes a dictatorial tone, and claims ownership after the manner of the dark ages. She asserts her right to herself, to think and act for her- self. The result is want of harmony in the house- hold. It is also notorious that wives have as a rule but little passion, little sexual feeling, and the cause must be looked for in the excesses of wedded life. If husbands did not approach their wives except at such distant intervals as would enable them by kind attentions and delicate advances to secure reciprocity of feeling, there would be more true devotion on the part of women and greater willingness to sustain the burden of maternity. Another fact we mention. It is this : many a woman loses relish for married life in the bridal chamber, from which she emerges lacerated, nervous, sick, disappointed, and trembling with fear, dreading the returning night, which shall again con- sign her to the embraces of brutal lust. I speak thus plainly because I utter a great truth. From that day he who might have made her happy by gentle approaches and exercise of judgment and com- mon sense, has destroyed forever all hope of recipro- cal passion, if he does not retrace his steps, again lay siege to the citadel of her heart, and show by due appreciation of her feelings that he is willing to sacrifice his wishes to her pleasure. This he will do 388 woman's monitor. Abortions induced by Poverty, Seduction, and Abandonment. if he is wise, and he will often find that in a few brief months she is won again, and her objections to maternity will vanish. It is thus that the errors of the wedding-night often prepare the way for de- termined efforts at abortion. Poverty is another cause which leads to ante-natal murder, especially in our large cities, where it is harder for the poor to rise. Does this cause stimulate the mother to endeavor in this way to prevent raising children to sink into the vortex of vice she sees drawing down to perdition so many children about her? If there is any excuse that could palliate this crime this should cause us to regard it with compassion in these victims of desti- tution and sorrow. Such are some of the causes which lead to criminal abortions, to which we might add seduction and abandonment, a cause that will continue to lead to infanticide in some form to no inconsiderable extent so long as men remain treach- erous and women frail. THE AGENCIES BY WHICH IT IS ACCOMPLISHED. We have already alluded to the newspaper adver- tisements of patent female pills and other nostrums, which are used by thousands, but with very limited success, in securing the end designed. But these agents often produce disease — as inflammation and congestion of the womb, swell the bills of infant mortality by causing their development under dis- ABORTIONISTS. 389 How Abortion is Accomplished. Meddling Woman Abortionists. turbing influence, which produce disease. It is com- mon for women to drink forcing teas, and use every available means to bring on their courses, hoping they may not be pregnant. No doubt they sometimes succeed ; but much oftener they fail ; only securing such disturbance of the delicate embryo as may cause it to be deformed by intra-uterine cramps or spasms. Such medicine may also lay the foundation for epi- lepsy, insanity, or idiocy. We believe such causes are more than doubling our bills of infant mortality in this way. Also, through the influence of disease of the womb from this cause upon future embryo. Were this all it would be bad enough ; but every ob- serving physician knows that almost every village and hamlet has its knowing women, who not only secure abortions for themselves, but teach their neigh- bors how to accomplish this thing — all very privately, of course — but it requires but a little address to un- earth such villainy in almost any section of the United States. Some of these appear to enter this field with missionary zeal. We feel sure they can not realize the criminal nature of their schemes, as not a few who do these things are virtuous, honored members of society, and do not appear to think they are doing wrong ; they profess to believe they are discharging a duty to their suffering friends. It is not uncom- mon for physicians to be consulted by women from the better walks of rural life, who are seriously dis- 390 woman's monitor. The Fearful Consequences of Abortions. eased from injuries caused by lead-pencils, goose-quills, wires, or whale-bones, rudely used by themselves, or an officious lady friend, in an effort to dislodge a foetus during the early months of pregnancy. Every gynecologist of much practice has seen the neck of the womb lacerated or punctured by rude attempts of this kind. THE CONSEQUENCE OF ABORTIONS, especially if artificially produced, are to the mother as fearful as the character of the outrage against nature would seem to suggest. Abortion is liable to produce death from loss of blood or anaemia, to be followed by uterine neuralgia, by uterine and ovarian tumors, by chronic inflammation, with enlargement, and all that train of diseases arising out of sympathy with a diseased womb — as feeble vision, hysteria, in- sanity, palpitation of the heart, dyspepsia, severe headache, pains in the limbs and back, irritability of the bladder, or fatal cancer. These either destroy the patient, or assist the uterine irritation to wear out the constitution, and develop consumption or other fatal diseases. The consequences to the race are feebleness in mind and body, among the host of chil- dren who are either injured by fruitless attempts, or born from wombs diseased by abortions ; and this tide of woe, in the shape of feebleness and disease, goes on, widening and deepening as it rolls down to THE CONSEQUENCE OF ABORTIONS. 391 An Appeal to the Clergy, to Medical Men, and to American Mothers. posterit}*-, to blight the prospects of coming gener- ations with physical, mental, and moral deformity In view of these facts we hold it to be the duty of the clergy and medical men, as the conservators of public health and morals, to exert themselves to disseminate correct information among the people upon these and kindred subjects, not only by spread- ing such books and papers as fearlessly proclaim the truth, but by timely precept, and by securing the action of ecclesiastical denominations in such a man- ner as to directly reach the conscience and the heart of at least all professing Christians. In this manner public sentiment, which is stronger than law, will be changed ; and such influences, assisted by relief as- sociations and foundling hospitals in our cities, will do much to save our nation from a disgrace as dark as any that broods over pagan Asia. Christian mothers, let me close this chapter with an appeal to you. Have you imbibed that fell spirit of destruction that now curses the land ? Reflect that science and religion proclaim it murder. Do you daily call your children around your knee and commend them in prayer to your Heavenly Father ? If so, how can you sincerely pray for God's blessing upon these, while their brothers and sisters lie mold- ering in the garden? — cast aside willfully, just as the budding flower of mortal existence was unfolding. Is it possible for you, Christian father, to pray in 392 woman's monitor. An Appeal to Christian Fathers. faith for the triumph of Christ's kingdom on the earth, and the final conversion of heathen idolaters ; in distant lands, while you permit and encourage in your own family infanticide, as damning in the sight of Heaven as that which makes your blood run cold when its echoes reach you from beyond the seas ? We know that the public conscience has but to be aroused to secure a hearty response to the pleading in behalf of those helpless creatures who can not speak for themselves. INDEX PAGE. Abortion 371 Criminal 371 Prevalence of 372 Its criminality 37G Causes which lead to it 383 Agency by which it is accom- plished 388 Consequences of 390 Duties of clergy and medical men with reference to ... 391 Evil, how arrested 391 Abcess, pelvic 138 Abuses, sexual 168, 174 Alcoholic stimulants 185 Anns, fissure of 103 Fistula 105 Asthma 316 Bathing 15 During maternity 244 Bath, best time for 15 Tepid, time for 16 Plunge 15 Shower 15 Sponge 15 Beds 19 Big neck 346 Bladder and urethra, disease of. 107 Bloody flux 324 Bite of poisonous snakes 363 Rabid animals 364 PAGE. Boils 356 Breasts, diseases of. 153 Cancer of. 155 Treatment of 157 Changes in 233 Inflammation of 274 Bronchitis 315 Bruises 366 Brown bread most nutritious... 25 Catarrh 33 Nasal douche in 36 Consequences of 34 Chafed hands 30 Change of life 85 Childhood, improper dress in... 174 Chicken-pox 309 Child, dwarfing of 243 Is it male or female 245 What controls sex of 247 Theory of 248 Resuscitation of 260 Bandage for 265 Keeping warm 266 Should not be rocked 268 Feeding of 281 Summer complaint of. 317 Treatment of 319 Nursing 281 Strong food forbidden 284 Chilblains 355 393 394 INDEX. PAGE. Chloroform 279 Cholera infantum 3l7 Cholera morbus 321 Treatment of 322 Complexion 30 Constipation 91 During maternity 240 Its consequences 93 Treatment of 94 Connubial excess 205 Convulsions from worms 328 Cord, dressing of. 264 Corns 28 Cordial, neutralizing 323 Cracked lips 31 Croup 297 Cuts 365 Dandruff, treatment for 42 Diarrhea 323 Diarrhea cordial 323 Diet 23 Of mothers during nursing.. 280 Diphtheria 299 Dislocations 366 Dress v 11 Deafness 351 Dyspepsia 96 Dysentery 324 Ears, sore 352 Ache 352 Foreign body in 368 Eating, excesses in 166 Epileptic convulsions 151 Exercise 21 During pregnancy 242 Examinations, mode of 159 Eyes 37 Scrofulous sore 39, 353 Sore 352 Sore, from injury 354 Poultices dangerous in dis- eases of. 39 PAGR. Eyes, cross 354 Ergot, use of 277 Freckles 31 Females, miscellaneous diseases of 90 Food 243 Flannels 13 Fractures 366 Frost-bites 355 Genitals, eruptive disease of... 109 Inflammation of. 109 Mucous surface of. 112 Giddiness 241 Gonorrhoea 142 Hair 39 Oil injurious to 40 Frequent bathing of 40 Curling injurious 41 Treatment for dandruff. 42 Harelip 354 Heart, palpitation of. 98 Headache, sick 99 Nervous , 100 Hooping-cough 313 Vaccination for 314 Hysteria 150 Itch, common 358 Treatment of 359 Indigestion 283 Infants, chafed 360 Introduction 3 Kidneys, disease of 106 King's evil 345 Labor, excessive *. 180 Pain in, how diminished 244 Causes which protract 247 Time of expected 247 Preparation for 219 INDEX. 395 PAGE. Labor, symptoms of approach of. 252 Actual 252 Duration of 254 Duty of physicians and at- tendants in 258 Lacing 12 Leucorrhoea 141 Living, fast 178 Maternity, duration of 246 Measles 306 Sirup, expectorant in 307 Bastard 308 Menstruation 46 Suppression, mechanical 48 from closure vagina 50 from disease 51 from congestion 53 Excessive 55 from debility 56 from congestion and in- flammation 58 from miscellaneous causes. 59 Painful 60 treatment of. 63 from obstruction 64 from congestion and in- flammation 65 treatment of 67 Midwifery, meddlesome 258, 276 Milk, quality depends on diet... 280 Influence of mother's mind on 280 Table of analysis of. 282 Miscarriages 237 Danger of to mother 239 Mother, directions for 269 Physic, time to give 272 Diet during nursing 280 Mother's mark 220 Moles 361 Mumps 312 Nails 29 Narcotic stimulus 181 PAGE. Nasal douche „ 35 Nipples, attention to 273 Nose, foreign bodies in 368 Opium 184 Ovaria, inflammation of. 137 Abscess of 138 Ovarian disease 136 Ozena 35 Palpitation of the heart 98 Passions, depressing 181 Pepsin for indigestion 284 Phthisic 316 Physical and mental depression 168 As exciting causes of disease 171 Climatic influence on 171 Piles 102 Poisons 362 Pregnancy 229 Symptoms of 232 Diseases of 236 Accidents of. 236 Pruritus 107 Puberty 71 Ageof 72 Care required at 75 Putrid sore throat 300 Quickening 234 Quinsy 348 Rabid animals 364 Rickets 295 Ringworm 356 Rooms, small, bad effect of 18 Small, bad for the sick 19 Sick, should be well venti- lated 19 Rupture 367 Santonins for worms 329 Scald head 348 Treatment of 350 396 INDEX. PAGE. Scalds and burns 360 Scarlet fever ... ^ 301 Symptoms of 302 Prevention of 803 Lard, inunction in 304 Scrofula 341 Treatment of 344 Secret vice 83 Sex, predominant desire directs. 248 Sexual frauds and connubial excesses 168, 188 Skin, treatment of. 28 Sleep...... 16 Amount required 17 When to be taken 17 Shoes, tight 14 Gaiters 14 Gum 14 Thin-soled 14 Speculum, use of. 164 Sprains 366 Sore mouth 287 Soothing sirups dangerous 285 Epilepsy from 286 Insanity from 286 Convulsions from 286 Appetite for 286 Sterility 211 Teeth 32 Teething 292 Period of first dentition 292 Period of second dentition... 293 Treatment for 294 Tetter 357 Tape-worm 333 Origin measly pork 334 Tight lacing 165 Tobacco.. 182 Tonsils, enlarged 346 Trachina spiralis 337 Symptoms 338 Treatment for 338 Transmission, hereditary 213 PACT. Twins, will there be. 245 Tympanitis..... 100 Urinary difficulties 339 Uterus and ovaries 44 Vaccination 289 Age for 290 Course of pustule 290 Vagina, prolapsus 134 Fistula 135 Ventilation 18 Wakefulness 242 Warts 361 Weaning, proper age for 288 Windpipe, foreign body in 370 Womb, diseases of neck 112 Treatment of 114 Acute inflammation of 117 Chronic inflammation of 118 Tumors * 121 Polypus 123 Cancer of. 123 Products of conception of..... 125 Displacements of. 127 Prolapsus 130 treatment of 130 Anteversion of. 132 Retroversion 133 Other displacements 134 Women, diseases of 43 Causes of disease among 165 Worm, tape 332 Broad tape 333 Ribbon-like tape 332 Origin derived from uncook- ed meat 334 Treatment of 335 Worms 325 Variety of.. 325 Origin of. 326 Symptoms of 328 Long round 328 INDEX. 397 PAGE. Worms, treatment for 328 Convulsions from 328 Santonine for 329 Wounds, poisonous, from bees.. 363 Scorpion stings 363 PAGE. Wounds, bite from poisonous snakes ... 363 Wounds, punctured 365 When to marry 222 Whom to marry— , 225 GLOSSARY. Abdomen. The cavity containing the bowels. Abnormal. Irregular, unhealthy. Accoucheur. One who practices the art of midwifery. Amenorrhea. Suppression of the menses. Ancesthesia. A state of insensibility to pain. Animalcule. A small animal ; well seen only by means of the microscope. Antispasmodics. Remedies for spasms, or convulsions. Anteversion. Tipping forward. Apoplexy. Sudden loss of sensation, consciousness, and voluntary mo- tion, from some cause operating within the head. Atrophy. Wasting of a part without any sensible cause. Bronchia. The subdivisions of the trachea in the lungs. Bronchitis. An inflammation of the surface of the air-tube in the lungs. Carbon. An elementary combustible substance, the basis of charcoal. Cellular. Composed of cells. Chemico- Vital. Chemical changes under the influences of vital action. Coma. A state of stupor. Connubial. Pertaining to marriage; belonging to the state of husband and wife. Correlation. Reciprocal relation; the dependence of one thing upon another. Cysticercus Celluloses. Germs of entozoa found in cellular membrane. Diathesis. A tendency to some special and peculiar disease. Dysmenorrhea. Painful menstruation. Eczema. An eruption of small vesicles on various parts of the skin. Entozone. Worms. Fallopian Tube. A canal extending on each side from the superior angles of the uterus. Fibroids. Tumors resembling the fibrous, with malignant tendencies. 398 GLOSSARY. 399 Fistula. An unnatural track or passage established between adjacent viscera. Flexion of Uterus. Bending of the uterus upon itself. Foetus. The unborn child. Fontanel. Opening of the head in a new-born child. Gynecology. The doctrine of the nature and diseases of women. Hemorrhage. A discharge of blood from vessels destined to contain it. Hygiene. Health, or the art or science of preserving health. Hymen. A semilunar fold situated at the outer orifice of the vagina ir virgins. Hypertrophy. Excessive nutrition of a part, causing enlargement. Hypochondriac. One entertaining absurd notions with regard to their condition or health. Interstitial. Pertaining to or containing interstices. Interstice. A space between things. Intranquillity. Want of rest. Labyrinth. The inner ear. Leucorrhoza. A flow of mucus from the genital organs of the female — whites. Mammary. Kelating to the breasts. Maternity. The character or relation of a mother. Menses. The regular monthly flow. Menstruation. The flow of the monthly period, or menses. Nervo- Vital. The magnetic life-force generated in the brain. Organic. Relating to an organ or organs. Ovarian Stroma. Substance of the ovary. Ovaries. The organs in which the ova, or eggs, are formed. Ovaritis. Inflammation of the ovary. Ovulation. The formation of ova in the ovary, and the discharge of the same. Paralysis. Loss of voluntary motion. Parturition. The act of bringing forth young — delivery. Pelvic Abscess. A collection of pus in a cavity in the pelvic region. Pelvis. The part of the trunk which bounds the abdomen below. Physiological. Relating to the science of life. Phosphates. Combination of phosphorus with various bases, forming salts. Phosphorus. An elementary substance not metallic. Polypoids. Soft vascular tumors on mucous membranes. Prolapsus Uteri. Falling of the womb. 400 GLOSSARY. Retroversion. Tipping backward. Resuscitation. . The act of reviving from a state of apparent death. Saliva. A liquid secreted from the glands about the mouth, designed to moisten it and the food eaten. Sanguineous. Relating to or containing blood. Spermatic Molecule. Minute living germs found in the spermatic fluid. Spermatic Fluid. The fertilizing principle of the male. Sterility. Barrenness, unfruitfulness. Syphilis. Is an infectious disease, communicable by the contact of parts. Trachea. That portion of the wind-pipe passing through the neck. Trichina Spiralis. A species of entozoa found in muscles of swine and other animals. Trichiniasis. A disease caused by the presence of Trichina. Uterus. The womb. Uterine Colic. Severe pain in the womb. Urethra. The passage leading from the bladder. Vitalizing. Furnishing with the vital principle. Vesicles. An elevation of the cuticle containing lymph or serum. GREEN SPRINGS WATER CURE, MEDICAL AND SURGICAL SANITARIUM. THIS beautiful health resort is now controlled by F. W. Entrikin, M. D., in partnership with the Hygiene Home Company. The new management have refitted the building, lighting it with gas and heating with steam. They have introduced all forms of baths, including the celebrated Sunlight Bath. All medical aud surgical appliances, as well as instruments of precision for diagnosis, are wielded by an experienced medical staff. A steam laundry is attached for convenience of guests. 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