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TALKS TO MY PATMTS 
 
 HIl!fTS 0:isr GETTHsTG WELL Al^TD 
 KEEPI]^a WELL. 
 
 I 
 
 BY 
 
 Mrs. RV^B. GLEASON, M. D. 
 
 NEW YOEK: 
 WOOD & HOLBROOK, PUBLISHERS, 
 
 No. 15 lAIGHT STREET. 
 1870. 
 

 Entered, according to Act of Congress, in the year 1870, by 
 
 Mrs. E. B. GLEASON, M. D., 
 
 In the Clerk's Office of the District Court of the United States for the Southern 
 District of New York. 
 
 D. H. PRIME, PRINTER, 15 LAIGHT STREET, NEW YORK. 
 
 M 
 
 h^ 
 
TO 
 
 ^Y ^OKMEK ^^ATIENTS, 
 
 WITH MAKY GRATEFUL MEMORIES OF THEIR LOVING CONFIDENCi 
 AND GENEROUS APPRECIATION, 
 
 THIS BOOK 
 
 IS AFFECTIONATELY INSCEIBED, 
 
 BY 
 
 TEt© ^.t£tSl@F>e 
 
Il^rTEODTJOTIOI^. 
 
 nv /JTANY of my patients have requested me to put my 
 "Parlor Talks" in print, that they might have them 
 for home reference. Often young wives and mothers, who 
 have been under my care during girlhood, have asked me 
 where they could find a book which contained, in substance, 
 what I had given in my informal lectures, adding, " I am 
 sorry I did not take notes of them ; but, tJien^ the need of 
 much that you said seemed far away ; now it is near, and I 
 have no one at hand to give me the advice, no work to con- 
 sult in reference to these matters of delicacy." 
 
 Letters from the extreme East and the far West have 
 come to me, asking for a book or some advice which should 
 help them to understand and meet the infirmities and func- 
 tions peculiar to womanhood. Hence, in this age of books, 
 when so many are printed that will never be read, and so 
 many more that ought not to be, I have at last concluded to 
 add one to the number, hoping it will not belong to the 
 latter class, though it may be numbered among the former. 
 
 I do not write for the public, or "the profession," but 
 
vi INTEODUGTION. 
 
 for those friends wlio want Hydropathic and Hygienic hints 
 to help them meet their home duties. 
 
 The book is not intended to do away with doctors, but to 
 aid the young wife when there is no experienced mother or 
 intelligent nurse at hand ; to advise in emergencies, or to 
 guide in those matters of delicacy with which woman's life is 
 so replete. The best physicians often feel the lack of some 
 one able to note symptoms, vary treatment, and guide when 
 they are not with the patient. In short, good nursing is 
 the better part of doctoring ; indeed, often supersedes the 
 need of a physician. 
 
 So this is not a medical book, not a learned book, not a 
 show of science, and I trust not «mscientific. It will savor 
 little of the library, more of e very-day life. A simple com- 
 pend of such motherly hints as seem to be needed, and such 
 as, from my long care of the sick, I have found available. 
 
 The book will offer no new theory as to the cause or cure 
 of diseases, but merely practical suggestions how to relieve 
 pain, or, better still, to avoid it ; such means as we have for 
 many years found efficient in our infirmary. 
 
 As I write, scores of faces with whom I have grown famil- 
 iar in the public parlor and private office, or in the sick 
 room, come up before me, and to them I commend this little 
 book. E. B. G. 
 
 Elmiea Watee Cuee, March, 1870. 
 
TABLE OF CONTENTS. 
 
 Dedication 3 
 
 Introduction 5 
 
 GEOWING GIELS. 
 
 The Development of Womanhood 13 
 
 Overwork and Invalidism 14 
 
 Good Blood Necessary for Good Work 15 
 
 Precocity Should ho Held in Check 15 
 
 Lost Mental Power 16 
 
 Lost Physical Power 17 
 
 The Moral Force 17 
 
 Gymnastics for Overworked Students 18 
 
 Piano-Playing 19 
 
 The Season of Changes 19 
 
 A Note of Warning to Mothers 20 
 
 Beligious Nature 21 
 
 MENSTEUATION. 
 
 Commencement and Duration of the Menses 23 
 
 Premature Development 23 
 
 Girls at Puherty 24- 
 
 T>angers of Ignorance of the Menses 24 
 
 Over -Exertion Causes Immaturity 25 
 
 Treatment 27 
 
 Causes of Derangement 28 
 
 (vii) 
 
Viii CONTENTS. 
 
 AMENOEEHEA. 
 
 Its Peculiarities and its Eemedies 29 
 
 Exercise 30 
 
 MENOEEHAGIA. 
 
 Its Character 32 
 
 Symptoms 33 
 
 Causes 34 
 
 Treatment 36 
 
 DTSMENOEEHEA. 
 
 Causes and Cure 38 
 
 Permanent Dysmenorrhea 38 
 
 Treatment 39 
 
 A Caution 40 
 
 PEOLAPSUS UTEEI. 
 
 Its Peculiarities 42 
 
 Imaginary Prolapsus 43 
 
 Supporters, etc 45 
 
 Causes 47 
 
 Treatment ^^. 50 
 
 LEUCOEEHEA. 
 
 Its Character 52 
 
 Location of the Disease 53 
 
 Causes 54 
 
 Means of Cure 56 
 
 PEEGNANCT. 
 
 Indications of ; . . . 59 
 
 Stomach Troubles 60 
 
 *' Longings " 61 
 
 Eemedies for Stomach. Troubles 62 
 
TALKS TO MY FATIENTS. i^ 
 
 Palliative Treatment during the Early Months 63 
 
 Exercise 64 
 
 Nervous Susceptibility 66 
 
 Inheritance 67 
 
 Discomforts of Advanced Pregnancy 71 
 
 Care of the Breasts before Confinement 73 
 
 APPEOACHING CONFINEMENT. 
 
 Premonitory Symptoms 76 
 
 Preparation 79 
 
 DELIVEEY. 
 
 General Remarks 81 
 
 Attention to the Infant 84 
 
 Removal of the After-Birth 85 
 
 Uterine Hemorrhage 86 
 
 AFTEE DELIVEEY. 
 
 After-Pains > 90 
 
 Diet 91 
 
 CAEE OF THE BEEASTS. 
 
 Abscess ► 93 
 
 Care of the Nipples 95 
 
 AFTEE CONFINEMENT. 
 
 Remarks 97 
 
 Hemorrhoids 98 
 
 Local Inflammation 100 
 
 Tonic Treatment 101 
 
 How Long the Patient must Lie in Bed 101 
 
 Importance of Quiet after Confinement 105 
 
 BATHING OF BABIES. 
 
 General Directions 108 
 
TALKS TO MY FATIENTS, 
 
 DEESS OF INFANTS. 
 
 Kemaiks 112 
 
 Tight Dressing ; 113 
 
 Our Fashion 115 
 
 NUESING. 
 
 Begularity as to Time of Nursing 119 
 
 Caution to Nursing Mothers 120 
 
 WEANING. 
 
 General Directions 123 
 
 FEEDING OF INFANTS. 
 
 Remarks 126 
 
 "Wet- Nurses 128 
 
 Foundling Hospitals 128 
 
 Kinds of Food 130 
 
 INFANTINE DISEASES. 
 
 Water Treatment 133 
 
 Other Treatment 136 
 
 DISEASES OF OHILDEEN. 
 
 Teething 139 
 
 Affections of the Throat and Chest 140 
 
 Eruptive Fever 141 
 
 Diseases of the Skin. .... .... .... .... .... 143 
 
 OHILDEEN'S DEESS. 
 
 General Directions . 145 
 
 CONFIDENTIAL TO MOTHEES. 
 
 Eemarks 149 
 
 How to Teach the Young 152 
 
CONTEKTS. 
 
 XI 
 
 INTENTIONAL ABOETION. 
 
 General Eemarks 156 
 
 ACCIDENTAL ABOETION. 
 
 Preventives 164 
 
 Care during an Abortion 165 
 
 Relative Dangers of the Two Classes 167 
 
 STEEILITY. 
 
 HaLit 170 
 
 Local Causes 171 
 
 General Condition 172 
 
 NEEVOUS DEEANGEMENTS. 
 
 Causes 1 7o 
 
 Peculiarities 176 
 
 Help Imparted by Another 178 
 
 Hysteria 178 
 
 Mode of Life 179 
 
 SLEEP. 
 
 Sleep Physiologically Considered • 182 
 
 Influence of Habit 183 
 
 Influence of Sleep on the Senses 186 
 
 Dreams 188 
 
 Sleep Affected by Occupation 189 
 
 Mothers Worn with Night Care 191 
 
 Growing Children 192 
 
 Phases of Sleep : 193 
 
 Lack of Sleep a Cause of Mental Derangement 194 
 
 Effects of Night Work 195 
 
 Failure of Health from Insufficient Sleep 197 
 
 Hints to the Sleepless 200 
 
xii TALKS TO MY PATIENTS. 
 
 INDIGESTION. 
 
 What Shall We Eat ? 203 
 
 Causes of Dyspepsia 205 
 
 Treatment 208 
 
 CONSTIPATION. 
 
 Eesults of Continued Constipation 210 
 
 MENOPAUSE, OE CHANGE OF LIFE. 
 
 Growing Old Gracefully 216 
 
 Precaution , 218 
 
 Varied Phases of Cessation. 219 
 
 Treatment during Menopause 219 
 
 Subsequent Discomforts 221 
 
 Palliative Treatment 222 
 
 Advancing Years 224 
 
 CONCLUSION. 
 
TALKS TO MY PATIENTS. 
 
 GEOWII^a aiELS. 
 
 "TTTHETHEE. budding beauty in this age is being 
 ^ ^ blighted more by ignorance or over-indulgence on 
 the part of the parents, it is difficult to decide. But of 
 this I am sure, that many of the fairest buds are to blossom 
 early, die early, or, worse still, live in misery for the want 
 of good motherly guidance, while passing from girlhood 
 to womanhood. During this period the foundation for 
 health and happiness, or sickness and sorrow, is usually 
 firmly laid. 
 
 In this chapter I shall dwell on matters seemingly small, 
 but life-long in their results. 
 
 THE DEVELOPMENT OE WOMANHOOD. 
 
 When the slight little girl, so boyish in build, takes on 
 as if by magic the size and shape of womanhood, we may 
 know that a new power is being born, new thoughts and 
 new emotions being enkindled. 
 
 (13) 
 
14 TALKS TO MY FATIEKTS. 
 
 The deyelopment of chest and pelvis show that her physi- 
 cal and mental nature is being matured. 
 
 It takes much blood, bone, and muscle to effect all these 
 rapid changes ; hence she needs nourishing food, moderate 
 exercise, and freedom from mental excitement. 
 
 Growing girls are proverbially weak and sensitive, and 
 continue thus for a time, even after they have attained their 
 full growth, for they are in their plump, juicy stage, not 
 yet consolidated, and hence lack that firmness of fiber 
 which gives power of endurance to body and brain. 
 
 ovekwoee: aistd invalidism. 
 
 Being large, they look strong, and are often overtaxed, 
 and seldom recover from the effects of overwork at this 
 age. 
 
 Mental application also, close and long-continued, results 
 often in invalidism. The bright young miss, quick to learn, 
 eats little, sleeps lightly, grows nervous and sensitive, and 
 with sallow skin and morbid appetite is considered bilious 
 and dosed accordingly, when the great trouble really is 
 nervous exhaustion. 
 
 How can she live on pickles and preserves, cakes and 
 candies, chalk and slate pencils, and learn ancient and 
 modern languages, mathematics and natural sciences, and 
 the round of ornamental arts beside ? 
 
 Out of such an incoherent compound, a character con- 
 sistent and comfortable can never be made, even with the 
 combined efforts of D. D.s, M. D.s, and learned Profs. 
 
G p. OWING GIRLS. 15 
 
 GOOD BLOOD NECESSAEY TOIL GOOD WOEK. 
 
 In the first place, good blood is necessary to make even 
 a good head do good work. Now, no human "digester" 
 can make good nutrition out of the material above men- 
 tioned. Nothing short of an ostrich can comfortably dis- 
 pose of it. 
 
 As to the studies, they are all good, if the student has 
 time, taste, and strength to understand them, but most of 
 them are "strong meat,'^ and need a mature mind in a 
 mature body to master them well. 
 
 Of course, a smattering-like parrot talk may be memo- 
 rized, but a clear, abiding sense can not be gained early on 
 these subjects. It is half comprehended and soon forgot- 
 ten. The result of this is that the body, being impoverished 
 by imperfect nutrition, and overtaxed by mental work, the 
 mind and muscle usually fail together. Sometimes the 
 physical asserts its rights and keeps the body in good con- 
 dition, while the mind fails, and so good health and poor 
 scholarship are the results. We have all wondered that so 
 many bright girls turn out positively dull and uninterest- 
 ing, even before they are twenty years old. I have seen 
 many who bore the mental mark of being dwarfed in mind 
 just as distinctly as others in body. We can see that at 
 twelve, fifteen, or eighteen years of age, they cease to 
 grow head-wise and sometimes heart-wise. 
 
 PEECOCITr SHOULD BE HELD IIT CHECK. 
 
 While in a public school, one day, we observed a 
 
16 TALKS TO IfY FATIENTS. 
 
 little girl on tip-toe doing difficult examples on tlie black- 
 board very promptly. We noticed a bright eye, busy bead, 
 and very small limbs. Wbile talking with the principal 
 of the school we said to him that a child with such small 
 calf of the legs ought not to do such large sums, and in- 
 quired what he knew of her family. He said that older 
 sisters of this girl had been in his school for years; that, 
 like her, they were bright and promised wonders at first, 
 but all grew dull and fell below mediocrity in mind, after 
 a few years. 
 
 Now these precocious ones should be held in check, men- 
 tally, and encouraged in that mode of life which develops 
 the muscular. Just as plants, which grow so rank in one 
 direction that they lack symmetry, we prune them that they 
 may send their juices or vegetable blood in the directions 
 most needed, so^^ instead of pushing these mental prodigies, 
 we should try to guide their life-current in the direction of 
 bodily growth. 
 
 LOST MENTAL POWEE. 
 
 Overtaxed mental forces often become permanently ex- 
 hausted, and life-long dullness is the result. Among this 
 latter class, we have in mind one of great scholarly promise 
 in her childhood, who was the pride and joy of her parents. 
 They had great pleasure in giving her the best of educa- 
 tional advantages, and she went on wonderfully well for a 
 while, and then grew, at times, strange and dreamy. This 
 condition has increased, until now she can not be trusted 
 with even the simplest business responsibilities, and her 
 
GROWING GIRLS, 17 
 
 conversation is confined to tlie most ordinary round of 
 topics. She now nears her thirtieth year, and though a 
 woman of good size and good health apparently, yet she 
 has less ability in any direction than most children at ten. 
 Sometimes there is a seeming divorce of the physical and 
 intellectual powers: the former going on well, the latter 
 going out or their growth suspended. 
 
 LOST PHYSICAL POWER. 
 
 In others, the mental burns more and more brilliantly, 
 and the body dies or falls into incurable invalidism. Our 
 modern excellent educational advantages furnish specimens 
 of both classes, but mostly of the latter. 
 
 How often we hear that '' a last year's graduate," or " the 
 first head scholar," has fallen sick of some ordinary acute 
 disease which has proved fatal, simply because the long 
 course of study had so enfeebled the system that it had 
 little power to resist disease or sufficient recuperative force 
 to rally even from slight sickness. 
 
 Perhaps a severe cold sends her off with ^^ quick con- 
 sumption," and every body wonders that ^^such a healthy 
 girl should go so rapidly !" 
 
 THE MOEAL rOECE. 
 
 Many more finish their school course with just life 
 enough left to live, but not enough to use to any purpose 
 the knowledge they have acquired, and so, instead of 
 hearing burdens, they have to be held up the rest of their 
 days. They have neither mental nor muscular force enough 
 
18 TALKS TO MY TATIENTS. 
 
 to grapple with, life's labors, and as for tlie moral force, it 
 is expended more in ideas or emotions than in any distinct 
 grappling with the wants of this *^ sin-stricken world." 
 
 How often we hear persons say, ^^My wrist," or ^*my 
 ankle," or "my back is weak from overwork!" We can 
 say the same of many a mind: it was over- strained, and 
 never recovered its lost power. 
 
 GYMNASTICS FOE OVERWOEKED STUDENTS, 
 
 The introduction of Gymnastics, good and graceful as 
 they are in the work of physical culture, must fall short 
 of their full advantages, when the pupils are pressed too 
 hard in their studies. 
 
 So, we can not eat a cake and have it, too. So, we can 
 not use up all our life-force in mental work, and have it 
 for muscular action. Scholars over-burdened with book 
 work seem languid, lazy even, because the life-force, which 
 goes from brain to body, is so exhausted that muscular 
 inspiration is lacking. 
 
 So, if we wish students to enter with, spirit and profit 
 into physical exercise, they must not be exhausted by study, 
 for exercise does not create nerve-power, but exhausts it in 
 such, a way as to improve appetite, digestion, and assimila- 
 tion, and replenishes the fountain, just as the steam-engine 
 must use part oi its force to supply itself with water, out 
 of which to make steam. So, we must use some of our 
 nerve-power to supply mere bodily wants, or we shall have 
 no steam with which to do our thinking. 
 
GROWING GlELS. 19 
 
 PIANO -PLATING. 
 
 Piano-playing seems to exhaust nerve-power very rapidly, 
 in proportion to the time expended. Dimness of vision, 
 bad sensations in tlie head, numbness of fingers, all show 
 exhaustion of electric force. Sometimes partial paralysis, 
 sometimes involuntary action of the muscles (called Chorea 
 or St. Vitus's Dance, when the motions are more satanic 
 than saint-like), is the result of much practice at the 
 piano, with girls from twelve to twenty years of age. 
 When confined to it earlier than this the body fails to 
 develop, and the little girl keeps little longer than she 
 ought; with a flat chest and undeveloped form she enters 
 her teens looking like a little old lady, poor and sallow. 
 Such withered specimens need baths, bread and beef, men- 
 tal rest and moderate exercise, and they will then mature 
 bodily. 
 
 THE SEASON OP CHANGES. 
 
 Near the ^^ second full seven years" there is a rush of 
 new thoughts, new emotions, new hopes, and new desires. 
 Hence it is important that every young miss has some 
 confidante and counselor older and wiser than herself. For 
 lack of this she is often led astray, in spirit, if not in body. 
 
 Many a young miss forms an attachment which ends in 
 a miserable marriage, or renders her miserable without 
 marriage. Many a wretched wife has said, '^I had no one 
 to advise me when I most needed it. "When I would have 
 taken counsel of my mother, she repelled me j hence I 
 
20 TALKS TO MY TATIENTS, 
 
 thought she had no loving sympathy, and so I rushed to 
 that which I fancied -would give me help, but have found 
 it only a broken reed," 
 
 Others, too loyal to marry without their parents' approval, 
 have nursed a secret love which has proved a life-long sor- 
 row. Had there been a free conference, so that the genu- 
 ine love had been comprehended by the parents, they would 
 perhaps have given consent, or at least have shown such 
 consideration for their daughter's welfare as would have 
 led to an appreciative sympathy, and perchance have satis- 
 fied her that her affections were misplaced. 
 
 A NOTE or WAEI^ING TO MOTHEES. 
 
 I have seen many young ladies broken in health by some 
 secret sorrow, began when they were entering their teens, 
 whose friends had little idea that the daughter's disease 
 was at first mental rather than physical, and now both. 
 The mother thought it was some foolish fondness, which 
 her sharp words or ridicule dispelled at the time; but, 
 though the young lips were silenced, the new emotion lived 
 all the stronger, buried from human eye and ear. 
 
 I have had frequent occasion to say to young ladies, 
 ^^This pain in the back of the head and neck, this sensi- 
 tiveness of spine, this nervous cough, these hysterical 
 spasms, are induced and perpetuated by a morbid emo- 
 tional life. Tou have some chronic heartache, some sorrow 
 not well borne, which is the cause of your disease." Upon 
 this come confessions, which, were they written, would 
 make a large book. 
 
GEOWIKG GIRLS. 21 
 
 I give this as a note of -warning to mothers to encourage 
 the confidence of their daughters. When they were small, 
 mothers, they confided in you, but, somehow, as they neared 
 the age when they most needed counsel and comfort, you 
 began to grow apart. If you -wish your girls to trust you, 
 you must trust in them. Confidence, to be complete, must 
 be mutual. 
 
 Talk with them of your early life, and your early love, 
 that they may realize that you were once young, and had 
 temptations and emotions akin to theirs. 
 
 EELIGIOirS NATUEE. 
 
 The age of which we are speaking is one in which the 
 religious nature is often tried and tempted. The little girl 
 whose loving trust in Jesus has made her indeed a home 
 missionary, now begins to reason, to question — to doubt, 
 perchance. 
 
 All this is a necessary element of her growth. When 
 she has passed the crisis she will stand all the stronger, 
 for she will find there is no rest save in the Gospel, and 
 in her skepticism she will miss her Lord and say, *^To 
 whom shall I go ?" 
 
 So, when this religious unrest comes, do not denounce 
 your daughter as a backslider, a heretic, but deal with her 
 tenderly, remembering that Jesus said to Peter, even after 
 he had been long a loving disciple, *^ Simon, Simon, Satan 
 hath desired to have thee, that he may sift thee as wheat." 
 So our lambs will, as they grow up, be tempted to wander 
 from the Good Shepherd and, perchance, deny him; then 
 
22 TALKS TO MY FATIENTS, 
 
 weep bitterly, and soon thereafter grow strong in tlie Lord. 
 During this transition stage it is impossible for us to 
 decide whereunto they may grow. We can only steady 
 and help to guide them aright, but we can not hold them 
 in all things to our own views and opinions. 
 
MEE"STEU"ATIO]Sr. 
 
 COMMENCEMEITT AND DTJEATIOjS" OF THE MEKSES. 
 
 TTTE will now consider tliat function peculiar to women 
 ^ ^ wMcb. we call Menses, Menstruation, Catamenia, 
 being unwell, etc. Perhaps tlie first term, menses, being 
 tbe Latin for months, is as suggestive and as free from 
 objection as any word we can use to signify that periodical 
 flow which occurs about every twenty-eight days, and con- 
 tinues from one to ten days, according to state of health 
 and constitutional peculiarities. From three to five days 
 is the usual time of duration for those in good health. It 
 commences most frequently about the fourteenth year, 
 though we have seen cases where menstruation commenced 
 at ten, others at twenty, and one at thirty years. 
 
 PEEMATUEE DEVELOPMENT. 
 
 Warm climates, stimulating drinks, social excitement 
 early in life, much reading of highly-colored fiction (com- 
 monly called "love stories"), are all calculated to bring 
 on this function prematurely. 
 
 When childhood is thus shortened, both girlhood and 
 womanhood are more likely to be visited with debility and 
 
 (23) 
 
24 TALKS TO MY PATIENTS. 
 
 disease. The period from twelye to sixteen is an impor- 
 tant one for eyery girl. In a few months after they pass 
 through great changes in their physical, mental, and moral 
 natures. 
 
 GrRLS AT PTJBEETT. 
 
 Girls are shy of mentioning symptoms at this age, and 
 consequently do not speak of a pain in the back, aching 
 of limbs, and such discomforts. I have had several cases 
 of serious trouble with the breasts of young mothers, from 
 their being unduly compressed when they were enlarging. 
 They remembered well the time, but were ashamed to say 
 their dresses were too tight across the chest. 
 
 The menses, coming on sooner than the mother suspects, 
 is sometimes concealed from her knowledge, and the young 
 miss just here begins a life-long trouble from the want of 
 proper care. I have had many a patient who said she 
 was a healthy, happy child before puberty, but not having 
 properly passed that period, her whole system seemed dis- 
 turbed and good health had never since been fully estab- 
 lished 
 
 DAKGEES OF IGNOEAl^^CE OF THE MEKSES. 
 
 Some, having been ignorant of this function until it 
 appeared, supposed that something strange had happened 
 to them, of which they were ashamed, and took special 
 care not to have it known, washing their persons and 
 clothing in cold water, and putting the latter on wet, lest 
 a call for clean clothing should expose their condition. 
 
MEN8TRVATI0K, 25 
 
 One said she had heard mysterious hints about '*bad 
 girls,'' but did not know what it meant, and feared she was 
 one when this strange flow began; so she waded into a 
 broolr, and wore wet linen until the flow ceased. Then 
 suppression ensued, and continued for some years. At 
 thirty years of age she came under my care, when she was 
 a seriously nervous invalid, in consequence of a chronic 
 uterine disease. 
 
 Mothers often intend to give the desired information 
 when needed, but never before, and consequently fail to 
 be in season ; for children, in more ways than one, advance 
 faster than they anticipate. 
 
 OVEB-EXEETI03S" CAUSES IMMATXJEITY. 
 
 We especially need to see that the physical, mental, or 
 emotional nature of young girls is not overtaxed ; for the 
 straining of either may deter the maturity of their bodies 
 so as to delay the menses beyond its normal period, or 
 to induce suppression, when once this function has been 
 established. In either case, the young miss will be quite 
 pale, sensitive, and sufier loss of appetite, loss of spirit, 
 etc. 
 
 A poor girl, aged sixteen, came under my care last year, 
 who had been employed at work too heavy for her; she 
 had been kept up by the use of strong green tea three times 
 a day, and a drink of brandy from the lady of the house 
 on Monday to help her through the washing. Eating 
 very little, and living on the stimulus of the tea, she at 
 2 
 
26 TALKS TO 31 Y FATIEKTS, 
 
 last gave out and " took to bed," at wliicli time slie first 
 came under my care. 
 
 There was not a sliade of color in either her face or lip ; 
 the pulse beat one hundred and eighty a minute, instead 
 of eighty, as it should have done ; the extremities were 
 cold; she had no appetite; her bowels were constipated, 
 and her menses, which was once regular, had now been 
 suppressed for several months. 
 
 Was she sick because she did not menstruate ? No, the 
 reverse of this, rather. She was too much impoverished, 
 too bloodless to have any power to perfect and carry on 
 the function peculiar to womanhood. Here, we think, 
 is where many anxious mothers and injudicious nurses 
 make a great mistake in using all manner of ^'forcing 
 remedies," as they call them, or emmenagogues, as 
 the doctors term them,, to bring about the monthly trib- 
 ute when the system has nothing to spare. If by excit- 
 ing treatment the organs are spurred on to activity, 
 so that the flow is induced, it will do harm rather than 
 good. 
 
 This is especially one of Nature's own operations, and 
 the less we interfere with it the better. Our business 
 is only to watch over the general health, and to let Dame 
 Nature attend to these delicate duties in her own time 
 and way, save in cases of organic obstructions, which are 
 so very rare that we will not dwell upon them in this 
 place. 
 
MUJVSTEUATIOJSr. 27 
 
 TSEATMENT. 
 
 " Well, ^hat did yoii do with the poor girl, and wliat was 
 the result ?" you ask. We gave her warm shallow baths ; 
 that is, she sat up, with limbs extended, in water at one 
 hundred and five degrees, from five to ten minutes, as 
 her strength would bear; then the bath was reduced to 
 ninety degrees, and the patient washed off. 
 
 As she grew stronger, she had pours at eighty-five degrees 
 and seventy-five degrees, after the hot baths ; also a daily 
 sitz bath at eighty degrees, five minutes, with hot foot bath 
 at same time, and back washed down. 
 
 Her diet consisted of bread, beef, vegetables, soup, and 
 fruits. 
 
 As soon as she was able, she took moderate exercise, and 
 kept her person warm, with wrapj)ers and stockings of 
 wool. 
 
 Her face, which was one of the sickest and one of the 
 ,saddest I ever saw at "sweet sixteen," grew bright and 
 cheerful, her flesh and color returned ; but months went by 
 before her menses reappeared, which were but very scanty 
 at first. 
 
 In all cases where strength has been reduced by severe 
 disease, or severe labor, it is usually several months, some- 
 times a year, before this function is reestablished. If the 
 general health is improving, we need feel no anxiety as to 
 the result. 
 
 Women talk about suppression terminating in consump- 
 tion, but it is, rather, depraved digestion and diseased lungs 
 
28 TALKS TO MY FATIENTS. 
 
 wMcli induce the suppression. The latter is more the 
 result than the cause. 
 
 We all pity the poor girl wlioni want obliged to work, 
 and whose mistress, through thoughtlessness or selfishness, 
 kept her at work on tea and brandy, and who at last turned 
 her out to the tender mercies of the poormaster, but who, 
 fortunately, fell into the hands of the city missionary ; but 
 what shall we say, how shall we feel toward those dear 
 daughters of devoted mothers who are going on the same 
 road to serious invalidism; led there by money, instead 
 of the lack of it ? 
 
 CAUSES OE DPEANGEMENT, 
 
 Children's parties, with little beaux, late hours, thin 
 dresses, rich suppers, all combine to invite sickness, quite 
 as severe and more difficult to cure than that of the poor 
 girl above mentioned. 
 
 Or, among the sober class, we find exemplary girls, good 
 scholars, the pride of teachers and the joy of their parents, 
 who eafc little breakfast, no dinner, and study hard all day, 
 and dream they are doing their duty. 
 
 Both classes are likely to sufi'er from menstrual derange- 
 ments, usually suppression, though sometimes the opposite 
 condition appears; periods too profuse and prolonged; the 
 blood being poor, a hemorrhagic tendency is induced. 
 
AMEl^TOKRHEA. 
 
 ITS PECULIAEITIES AliB ITS EEMEDIES. 
 
 npHUS far we have dwelt upon Amenorrliea, or want of 
 -^ menstruation, coming from lack of good blood-making 
 power, or where it was all expended in other directions ; but 
 there are some cases which seem to occur from inactivity of 
 the uterine organs, and not from general exhaustion of the 
 svstem. Those of this type will be readily distinguished from 
 the other class, in that there will be a full habit of body, a 
 flushed face, full pulse, pressure of blood to the head, etc. 
 In such cases we should try to equalize the circulation, invite 
 the blood to the hips and extremities by active exercise and 
 derivative baths. House-work is good; also brisk walks and 
 horseback riding. Avoid much as possible hot rooms and sed- 
 entary employment. If the extremities are cold, give hot 
 sitz and hot foot baths, ten minutes, with a cold dash or pour 
 after. If the limbs are warm, and there is still a pressure 
 of blood to the head, give a sitz bath of twenty or thirty 
 minutes duration, at eighty-five degrees, and reduce the 
 temperature to seventy-five degrees while in the bath. 
 
 These are strongly derivative, and relieve the head more 
 than any other bath, where the warmth of body and reactive 
 
 (29) 
 
80 TALKS TO 3IY PATIENTS. 
 
 power are sufficient. In cases of this kind tliere is usually 
 constipation of the bowels ; so, coarse bread, fruit, and vege- 
 tables are the best food. The baths and exercises above- 
 mentioned tend also to increase the activity of the bow- 
 els. 
 
 EXERCISE. 
 
 Young ladies at boarding-schools, who feel oppressed be- 
 cause of suppression, sometimes crawl down stairs head-fore- 
 most, and say it is quite a sure remedy. Without crinoline, 
 and with wrappers drawn closely about them, they go down 
 one after another, like a string of eels. 
 
 The good laugh, the vigorous exercise necessary to properly 
 accomplish such a feat, so quickens the circulation that it is 
 likely to prove an efficient emmenagogue, though we should 
 greatly prefer running up and down hill, for various rea- 
 sons. But this ludicrous remedy throws light as to the real 
 needs of pent-up school girls, where often the proprieties 
 of the place put out all physical life, and the depravity of 
 the flesh and spirit develop more rapidly, often, than the 
 mental or moral graces. 
 
 Many of our ^^ Schools for Young Ladies" are recogniz- 
 ing this need of exercise, and are making generous provis- 
 ions for it, but they fall short, in many cases, of being 
 really advantageous, because the course of study is so exten- 
 sive that it leaves neither time nor strength for muscular 
 development. Our growing girls can't learn ^^ every thing 
 and more too," and keep in good health beside. 
 
 There are cases of amenorrhea, though rare, where the 
 
AMENORESEA. 31 
 
 whole system is surcliarged witli blood ; even the uterus is 
 cono-ested, and still the menses are scanty, tardy, or entirely 
 suppressed. Such we have found greatly benefited by local 
 depletion. The organ thus relieved resumes its normal 
 monthly secretion. But as this class needs the advice of a 
 physician of experience, and sometimes the aid of the sur- 
 geon, we will not dwell on the ways or means of treat- 
 ment. 
 
MEIsTOEEHAGIA. 
 
 CHAKACTEE. 
 
 TTT'HEN the montlily tribute is excessive we call it 
 
 ^ ^ Menorrliagia, or profuse menstruation. It may occur 
 too frequently, be too prolonged, or be right as to time but 
 excessive in amount. Whatever phase this excess may take, 
 it enfeebles the back, blanches the cheek, makes the nervous 
 system over-sensitive, and visits the subject with varied 
 symptoms of muscular and nervous debility. 
 
 But you ask. What is the right time, and what is the 
 right amount? 
 
 We can not make an exact rule for either, as both vary 
 with different constitutions. The usual habit with those in 
 good health is twenty-eight days from the beginning of 
 one period to the beginning of the next, though some count 
 twenty-eight days from the close of one to the commence- 
 ment of the next. Hence our term, menses, and hence the 
 old notion that the moon had its influence on this period- 
 ical flow, as well as on the weaning of babies, the sowing 
 of onions, salting of pork, etc. 
 
 But as we do not know how the changes of the moon can 
 affect this function, and as we are certain that changes 
 (32) 
 
menoehhagia. 33 
 
 under our own control do modify it, we will confine our 
 remarks to the latter point. 
 
 As to the length of time, it ranges from two to ^yq days 
 among those in good health. Three days we deem about 
 the average. As to quantity, we can give no exact rule ; it 
 varies with individuals ; what is a normal amount for one 
 may be excessive for another. Still there are symptoms 
 which decide the question. 
 
 SYMPTOMS. 
 
 For instance, after the period is passed, if you feel lighter, 
 brighter, and better in every respect, you may be quite sure 
 the function has been correctly performed. 
 
 If, on the contrary, you are weak in the back, eyes sen- 
 sitive to light, with a general feeling of exhaustion, you 
 may be quite certain it has been excessive. This form of 
 menstrual derangement is much more common than for- 
 merly, judging from the testimony of old ladies and older 
 authors. The latter speak of it as peculiar to women worn 
 with over- work, frequent child-bearing, prolonged nursing, 
 etc., and not as common to girls. 
 
 Such is the delicacy of the young miss in speaking of 
 these matters, that modern authors and modern doctors, for 
 the most part, have little idea that this excessive drain has 
 become such a general source of debility. 
 
 The detail of symptoms is not sufficiently definite, so that 
 
 the physician gets an idea of the amount of vital fluid lost 
 
 every twenty-eight days, or oftener. Mothers often fail to 
 
 give the proper supervision on this point, sometimes from 
 
 2* 
 
34 TALKS TO MY TATIENTS. 
 
 lack of knowledge, and often for want of confidential free- 
 dom between theniselres and tkeir daughters on matters of 
 delicacy. Y/e have seen many, very many cases among 
 girls where the flow returned at intervals of only two or 
 three weeks, and continued from ^yq to ten days even. 
 
 CAUSES. 
 
 Now to the question, Why is this menstrual derangement 
 so much more prevalent with the young now than forty or 
 fifty years ago ? 
 
 Among the old wives' notions is this: that the wearing 
 of napkins has induced this tendency to excessive flow; 
 that, as girls grew fastidious and over-nice, they *Hook to 
 them ;" that formerly they were never worn. 
 
 I have seen many persons who were very positive on 
 this point, but it seems to me they have mistaken the con- 
 dition for the cause. The flow was so slight among these 
 hardy women of earlier days that they could dispense with 
 the guard, which is now indispensable. The same is true 
 of Indian women. . 
 
 To my mind there are many causes which commend them- 
 selves to the judgment, much more than those above men- 
 tioned. 
 
 First, our girls lack that bodily exercise which quickens 
 the flow of blood through the extremities ; hence the work- 
 ing muscles, or those which should work, lack a supply, and 
 the excess goes to some of the internal organs, often the 
 uterus. The capillary circulation is weak in the extrem- 
 ities of those who have insufficient exercise. 
 
MENORRHAGIA, 
 
 Again, oui' style of dress for many years has been such 
 as to bring too much weight and heat oyer the back and 
 hips, and thus invites a turgescence of blood to the pelvis. 
 Compression, too, about the waist hinders the returning cir- 
 culation, and makes pelvic congestions, just as a tight arm- 
 size makes a purple hand. 
 
 Crinoline and open sleeves in cold weather, without under 
 dressing of warm flannel, renders the circulation imperfect, 
 and drives the blood to the internal organs. 
 
 Some of the worst cases of monorrhagia I have known 
 have been where a severe cold at the sensitive period has 
 induced hemorrhage, which returned with each month. 
 
 From observation I should judge that colds quite as often 
 induce this derangement as suppression, though the latter, 
 being more alarming, is more frequently reported promptly 
 to the medical adviser, in the fear of congestion of brain or 
 lungs. 
 
 Menorrhagia comes under the physician's care when the 
 case has become chronic, and the debility induced alarms 
 the friends. Hence many such have come under our care. 
 Late hours, hot drinks, exciting books, and social gayety are 
 very likely to induce this trouble in young and sensitive 
 girls, for the reason that the emotional life is too intense 
 and induces congestive fullness of the uterus. 
 
 Besides the causes above mentioned, there is often some 
 disease of this organ which requires special treatment to 
 efPect a cure. This will furnish the topic of another 
 paper. 
 
36 TALKS TO MY FATIENTS. 
 
 TBEATMENT. 
 
 Water treatment is especially beneficial in all cases of ute- 
 rine flooding, from whatever cause. Sitz baths, cool as can 
 be borne witliout after chilliness, of from five to ten min- 
 utes duration, twice per day, beginning at eighty-five de- 
 grees and reducing the temperature from week to week to 
 sixty-five degrees, are very useful. 
 
 If the feet are cold, take a hot foot bath at the time of 
 taking the cool sitz, and keep the head cool with a wet 
 compress. 
 
 Vaginal injections, taken while in the sitz bath, and an 
 enema for the bowels of half a pint of cool water, to be 
 retained as one lies down, are valuable where there is a 
 tendency to flooding. 
 
 A girdle, made of two thicknesses of linen (not very 
 hea^y), about one-third of a yard wide and long enough 
 to pin about the hips and around over the abdomen, wet, 
 with two thicknesses of heavy dry cotton over it, and all 
 fitted comfortably over the hips and pinned over the stom- 
 ach and bowels, will, if changed as often as it gets warm 
 and dry, keep down the tendency to heat in the pelvic 
 region, and be very grateful to the patient. In the ab- 
 sence of nicely-fitting girdles, towels, one wet and the other 
 dry, may be substituted, and worn in comfort. 
 
 When the monthly period commences it is usually safe 
 to take sitz baths, the first day at ninety-five degrees ; the 
 second day at ninety degrees ; the third day at eighty-five 
 degrees, and so on, gradually reducing the temperature as 
 
MUNOEMSAGIA. 37 
 
 heretofore directed, and using tlie yaginal injection in the 
 bath. 
 
 The first day, if there be great pain, it may be necessary 
 to take a sitz bath at one hundred and five degrees, with 
 the usual vaginal injection, and then adopt the range of 
 temperature before indicated. 
 
 Sometimes the hot sitz bath fails, and then fomentations 
 over the region of the pain, from half an hour to an hour, 
 hot as can possibly be borne, will prove effective. 
 
 Let the food be nourishing, but not stimulating. Let the 
 head direct the hands in useful labor, or if the time be 
 employed in reading, let it be historic and scientific, rather 
 than the ideal and emotional, which reacts unfavorably on 
 the uterus. 
 
 Intense love of music, and excessive devotion to the same, 
 often induces too early and too profuse menstruation. 
 
DTSMEl^OEEHEA. 
 
 CAUSES AND CimE. 
 
 "TTT^E will next take under consideration Dysmenorrliea, 
 
 ^ ^ or painful menstruation. 
 
 The causes of these monthly pangs are usually obscure, 
 and the cure very uncertain. Sometimes they are of the 
 neuralgic or rheumatic character. In such cases we can 
 only palliate the pain, and during the intervening weeks do 
 the best we can to improve the general health. 
 
 When there is a constitutional tendency to either of the 
 above diseases, it is very likely to induce painful menstrua- 
 tion, because at that time more blood is sent to the uterus, 
 and it is more highly vitalized ; hence, neuralgic or rheu- 
 matic pains of that organ are more likely to occur then 
 than at any other time. 
 
 PEEIvtANTEKT DYSMENOEEUEA. 
 
 Often an irritable state of the uterus has been induced 
 by wet feet and exposure to cold at the sensitive period, 
 and permanent dysmenorrhea has been the result where 
 there had been no pain before. 
 
 Sometimes there is a chronic inflammation of the uterus. 
 
 m 
 
DYSMJEI^OEEBEA. 
 
 Where this is the case, that disease must be cured before 
 there can be relief from the monthly parox^/sm. But for 
 further particulars as to this condition, see chapter on that 
 subject. 
 
 Again, stricture of the cervix may induce the same trouble, 
 though rarely, and for a better understanding of this topic 
 see chapter on Sterility. 
 
 TEEATMENT. 
 
 But now to the point. What shall we do to palliate these 
 pains when they do come, whatever may be the cause ? 
 
 Hot applications are the most safe and most sure to give 
 relief. Hot sitz and foot baths often ease the pain, as do 
 fomentations applied over the abdomen as hot as they can 
 be borne, and changed as often as they begin to cool ; these, 
 continued from twenty minutes to an hour, will allay the 
 pain. 
 
 If there is a general chill, the sufferer will find a full 
 hot bath at one hundred and five degrees very grateful. 
 Keep the head cool with a wet cloth, and heat up the bath, 
 if pain or chilliness require it. From ten to thirty minutes 
 will prove if such a bath gives the desired relief. 
 
 If these do not suffice, an anodyne must be used. We 
 should first free the bowels with a large enema of water, at 
 blood-heat (ninety-eight degrees), and then administer fif- 
 teen drops of laudanum in two or three spoonfuls of water 
 into the rectum, which is to be retained. We prefer this 
 method for the reason that a less amount of opium will 
 give relief than by any other means ; because, when re- 
 
40 TALKS TO MY TATIENTS. 
 
 tained and absorbed, it comes directly in the region of the 
 painful nerves, the same as we put laudanum in the cavity 
 of an aching tooth instead of the stomach. But it is bad 
 to rely on laudanum injections; for, if used regularly, we 
 are apt to increase the amount, which will disturb digestion 
 and induce constipation. 
 
 We have often used the injection above mentioned as a 
 substitute for morphine, until we could get the case so far 
 under our control that both could be dispensed with. The 
 habit of taking brandy or whisky, morphine or McMunn's 
 Elixir — indeed, any preparation of alcohol or opium — once 
 a month, is greatly to be dreaded ; for the result is often 
 such that the poor girl not only doubles the dose but in- 
 creases its frequency, so that a dram or a dose is taken 
 upon the very slightest symptom. 
 
 A CAIJTIOIf. 
 
 The increase of inebriety and opium-eating among women 
 should make every mother fear to give either of the above 
 nostrums to her growing girls. There are, of course, ex- 
 treme cases where a patient should be steadied by a stim- 
 ulant, or soothed by a sedative ; but let a scientific, con- 
 scientious physician, or discreet, self-possessed mother de- 
 cide when it is necessary. Never give those remedies which 
 are more powerful for evil than good into the hands of 
 indiscreet young misses to be used at will. 
 
 Every woman should realize that, during her monthly 
 illness, her nervous system is more sensitive than at other 
 times. Hence she is then more liable to pain in the head, 
 
dysmenorrhea: 41 
 
 back, loins, or to depression and discontent. If ill at ease 
 in her social relation, once a month she is likely to feel and 
 manifest it more than usual. A shock of severe sorrow 
 coming at this period often induces mental derangement, 
 sometimes suppression, sometimes hemorrhage, and at other 
 times painful menstruation. 
 
PBOLAPSUS UTEEL 
 
 PECT7LIAEITIES. 
 
 TTTE will next consider those infirmities, peculiar to 
 ^ ^ women, whicli bear the disagreeable cognomen of 
 *^ female diseases." Of late years they have become so fre- 
 quent and so obstinate as to make it appear that woman is 
 the ^^ weaker vessel," physically speaking, at least. 
 
 These pelvic troubles are so numerous that professors, 
 doctors, and authors class them imder a special department. 
 Despite the skill of the most learned in the medical profes- 
 sion, these diseases are slow and diScult to cure ; or if cured, 
 the constitution has been so much impaired, by the disease 
 or the remedy, or both, that there is never much power of 
 endurance afterward. 
 
 The most common of this class of complaints is Prolapsus 
 Uteri, or ** falling of the womb," or "bearing down," as it 
 is frequently called. I mean, that we hear more said of 
 this than of any other of the feminine infirmities, yet real 
 displacement of this organ is less frequent than is sup- 
 posed. 
 
 There are several mal- conditions of the pelvic viscera 
 that induce this sensation of weight, weariness, dragging, 
 (42) 
 
TROLAFSUS UTERI. 43 
 
 and bearing down, whicli is very often mistaken for pro- 
 lapsus. 
 
 niAGIITABY PE0LAPSU3. 
 
 Any unpleasant feeling in this region is likely be considered 
 an indication of " falling of tlie womb." During the last 
 twenty years, of the many women wlio have consulted me 
 for this infirmity, not one in ten were suffering from ute- 
 rine displacement. There might have been congestive full- 
 ness, or chronic inflammation of the uterus, vagina, rectum, 
 bladder, or urethra, which caused that dragging weight or 
 sensation of fullness that made the victim suspect that some- 
 thing was out of place, especially if she had a vivid imagi- 
 nation and had heard much of the horrors of *^ falling of 
 the womb.'' But, just as the sore tooth is the longest, or 
 the sore thumb aches most when it hangs down, so any of 
 these local infirmities are increased by much standing, and 
 the feeling of heaviness and dragging gives the impression 
 of displacement. 
 
 Such is the contiguity of these delicate organs, being sup- 
 plied as they are with nerves from the same section of the 
 spine, that it is impossible for even an intelligent patient to 
 decide, by the sensation of pain merely, which organ is 
 diseased, or what is the matter. Even toothache, which is 
 about as definite and positive as any pain we can endure, 
 often can not be located exactly, and the dentist decides for 
 us which is the offending tooth, the *' ringleader," in all 
 this agony. Is it strange, then, that women, to whom the 
 pelvis is a sort of unknown country, save that they know 
 
44 TALES TO 31 T FATIENTS, 
 
 from personal experience tliat it is a locality as productive 
 of misery as a Western marsh of ague — is it strange, I say, 
 that they are often mistaken as to whether it is a mal-posi- 
 tion or a mal-condition of the parts which induces the 
 pain? 
 
 I could fill this little book with cases having a strange 
 mixture of the sad and the ludicrous to illustrate this one 
 point. For instance, a young lady was once brought to us 
 on a bed and carried to her room with great care, as to 
 position, it being supposed that she could not be raised up 
 because she had falling of the womb so badly. 
 
 On going to her room the morning after she came (which 
 was a cold one), I found her lying flat on her back, eating 
 breakfast with white woolen mittens on her hands. When 
 asked why she could not be raised in bed, or lie on her 
 side, she said that the uterus fell from side to side, if she 
 moved either way! From her description one would have 
 supposed that it rolled around, like peas in a basin. 
 
 Now this young lady was really a serious invalid. She 
 had a delicate constitution, worn by close study and teach- 
 ing, until she had become dyspeptic, constipated, and weak- 
 ened in the back by leucorrhea and profuse menstruation ; 
 but there was no mal-position of the parts. 
 
 I asked what made her first think she had " falling of the 
 womb," as she called it. ^' Why," said she, **I felt weak 
 and unable to walk or stand, and some persons, whom I 
 supposed understood all these matters, told me I had falling 
 of the womb ; and so I took to bed to have things get in 
 place, and to keep them there ; but the longer I lay tbe 
 
FROLAFSUS UTERI, 45 
 
 worse I felt, and the less able I was to get up. I could not 
 submit to be examined by a male physician, so I was doc- 
 tored by guess until 1 came to you," 
 
 I need not add, that before twenty-four hours had passed 
 she sat up to eat, to evacuate the bowels, to take a sitz bath, 
 etc., though for several months she had not been otherwise 
 than in a horizontal position, for any purpose whatever; 
 never even lying on her side. 
 
 Though much emaciated, and too weak to stand on her 
 feet, in a few months she was about the house and grounds. 
 This is a sample of many cases of a similar class. 
 
 STJPPOETEES, ETC. 
 
 The large number of utero-abdominal supporters, and 
 of pessaries, which I have removed because they were 
 unsuited to the case, would supply any thing short of a 
 wholesale establishment with these kinds of instruments. 
 The contrivances which I have seen used to support the 
 uterus, which in a normal state weighs less than two ounces, 
 are truly surprising, and suggestive of a very flimsy state 
 of the maternal organs, which in the beginning were able 
 to accomplish a great deal of useful labor without arti- 
 ficial aid. 
 
 The whole range of shoulder braces and abdominal sup- 
 porters are invented to do the work for which muscles were 
 designed, and, of course, at best can but imperfectly supply 
 their places ; because the former is the work of the Infinite, 
 perfect artist, the latter of the finite and fallible. When, 
 from disease or disuse, the muscles become too weak to do 
 
46 TALKS TO 3fY FATIEITTS, 
 
 their T7ork, and we are obliged to resort to artificial sup- 
 port, we get a very imperfect substitute. Besides tbis, tbe 
 longer we rely upon their aid, the less able we are to do 
 without them ; because animal tissue, unused, rapidly loses 
 its vigor. Then, too, the pads and splints lessen the healthful 
 circulation through the parts where they rest, and become 
 a source of debility. More than this, spinal irritation is 
 often induced by undue pressure. I know they give tem- 
 porary relief, a sense of strength, just as the arm of a 
 friend or the back of a rocking-chair may keep one up com- 
 fortably for a time, when too weak to sit up Avithout such 
 aid. 
 
 We should always remember that while all the volun- 
 tary muscles need rest, yet whatever takes their place per- 
 manently does not impart strength, but induces debility, 
 and often most serious injury. 
 
 To illustrate : The fractured limb rests in splints, so that 
 the broken bone may unite properly; but when this is 
 accomplished, and the bandage and splints are removed, the 
 muscles are so wasted by a few week's disuse that the limb 
 is at first well-nigh powerless. 
 
 Many suppose that the uterus rests upon the front pad 
 of the abdominal supporter ; but this is a mistake, for the 
 organ, when unimpregnated, is too small and lies too low to 
 be supported, save indirectly, by any external aid. When 
 the abdomen is large, and the muscles weak, a bandage or 
 a supporter, well adjusted, may prevent the bowels from 
 pressing painfully on the pelvic organs, of which the uterus 
 is one. 
 
PEOLAFSVS VTERI. 47 
 
 As to internal supports called Pessaries, there have been 
 invented thousands of them within the last twenty years ; 
 from the simple soft sponge, the ever-varying kinds of rub- 
 ber, gutta percha, glass, and all manner of metals, up to 
 silver and gold. The variety and number to be found in 
 any wholesale instrument store are sadly suggestive, not 
 only of the infirmities of womanhood, but of the impossi- 
 bility of inventing any thing which will give perfect relief; 
 for had any one of them been a success, there would have 
 been no call for the multitude invented. 
 
 We hate the whole array of pessaries, and as a rule never 
 use them ; still this rule, like all others, has its exceptions. 
 There are cases of Gom.-^\QiQ procidentia^ where the uterus has 
 been external for months, or even years, when we are 
 obliged to use some form of internal support. There are 
 also some instances where this organ has been anteverted 
 or retroverted for a long time, when some support, used 
 temporarily, in connection with general treatment, will facil- 
 itate the cure. But these should only be used by the advico 
 of an intelligent physician, who, having charge of the case, 
 understands just what kind of instrument is required. But 
 to treat any displacement by relying upon mere mechanical 
 means alone^ seems to us a great mistake. 
 
 CAUSES. 
 
 Joints may be dislocated by an unfortunate wrench, but 
 the uterus is so small in its normal state, so nicely sur- 
 rounded and supported by distensible tissue, that it is not 
 liable to be displaced suddenly, though it has occurred some- 
 
48 TALKS TO MY PATIENTS. 
 
 times from a jump or fall, wlien the parts are weak. The 
 organ may lose its proper poise or balance, by some inflam- 
 matory action which increases its weight ; or by constipa- 
 tion of the bowels and straining at stool it may be thrown 
 too low, and from day to day held there so long as to pre- 
 vent its returning readily to its normal position. Especially 
 is this likely to occur, if the parts are relaxed from recent 
 delivery. 
 
 The use of drastic cathartics, or continued constipation 
 after confinement, are more likely to induce prolapsus than 
 sitting, walking about, or even riding. 
 
 Eetention of urine until the bladder is over-distended 
 has a tendency to retro vert the fundus of the uterus, or turn 
 it backward toward the rectum. Also, if the lower bowel 
 be habitually loaded, it may antevert the uterus, that is, 
 turn it forward on to the bladder. I have seen a great 
 many cases of both these forms of displacement which were 
 induced by these neglects. 
 
 Young ladies often come under our care suffering from 
 weak backs, bearing-down pains, supposed prolapsus, etc., 
 induced, they say, by going up long flights of stairs at 
 boarding-schools. On inquiry, we often find that their 
 habit has been to pass several days, even eight or ten, with- 
 out an evacuation of the bowels, which in itself is sufficient 
 to derange the healthful action, if not the healthful position, 
 of all the organs from head to toe. The impacted rectum 
 often induces great irritability of the bladder or of the 
 uterus, or both. 
 
 Among our early patients, we remember a young lady 
 
FEOZAPSUS UTERI. 49 
 
 who came from a city school to our Cure, suffering from an 
 inability to retain urine more than ten or fifteen minutes. 
 
 On examination, we found the rectum distended and 
 heavily loaded with faeces, and consequently the fundus of 
 the uterus pressed forward against the bladder. By keep- 
 in<2: the bowels free with enemas of cold water and cold 
 sitz baths, with much friction upward and backward over 
 the abdomen, the parts regained their normal position, and 
 all irritability of the bladder disappeared. 
 
 A loaded rectum often induces a frequent and even con- 
 stant desire to urinate, although there may be no displace- 
 ment, such is the sympathy of these contiguous organs. 
 Supplied as they are by nerves and vessels from the same 
 section, if one is burdened the other feels bad. So, we often 
 cure cases of severe irritability of the bladder simply by 
 correcting constipation. 
 
 Skirts, unsupported by the shoulders, press the abdomi- 
 nal viscera upon the pelvic organs, and induce varied dis- 
 placements and discomforts in that region, which are ex- 
 pressed by the general term, ^^ a bearing-down feeling." 
 
 Neither long walks nor long flights of stairs, or even 
 heavy work are likely to induce uterine displacements, 
 unless the disease has been first invited by some of the 
 bad habits above named. The good Father made even 
 *Hhe weaker vessels" strong enough for all practical pur- 
 poses, if they are well used. 
 
 But suppose you are like the old lady who was ^'weak 
 in her lower parts," what shall you do to strengthen 
 them ? 
 
 3 
 
50 TALKS TO MT PATIENTS. 
 
 TEEATMENT. 
 
 First of all, adjust your clotliiiig as directed in Mrs. M. 
 M. Jones's book, entitled "Woman's Dress." ^ Then cor- 
 rect yoiu' constipation, about Tvliicli we will speak in 
 another chapter. 
 
 Take two sitz baths a day, of from five to ten minutes 
 duration, beginning with the temperature at about eighty-five 
 degrees and reducing it to sixty degrees as you become 
 accustomed to them, and can bear without being chilled 
 after leaving the bath. While in the bath, rub the bowels 
 with a circidar motion, making the pressure upward. If 
 you have an assistant at hand, just before getting out of 
 the bath have the back washed down the whole length of 
 the spine, which is an excellent tonic when the shoulders 
 are weak and weary, or when there is pain between them. 
 
 The wet girdle, heretofore described, is a valuable aid, 
 worn nights, or both night and day, if it can be worn com- 
 fortably and without chilliness. 
 
 Voluntary action of the abdominal muscles, and those 
 about the pelvis, practiced several times a day, and for sev- 
 eral minutes each time, will give them tone, and thus fur- 
 nish a better support. This can be accomplished by deep 
 inspirations and expirations, which alternately throw out 
 the bowels and then bring them back close to the spine as 
 possible. Also, by the will, contract those muscles which 
 form the floor or bottom of the pelvic basin, those sphinc- 
 
 *Tliis work is published and for sale by Wood & Holbrook, T^os. 13 & 15 Laight 
 Street, New York. Price 30 cents. 
 
PEOLAFSUS UTERI, 51 
 
 fcers wliicli close the rectum, bladder, and vagina. These 
 all act favorably on the prolapsed uterus. 
 
 The impression that reaching or raising the hands above 
 the head induces displacement is incorrect, for it does just 
 the opposite, helps to replace all the prolapsed organs. Any 
 one lightly and loosely clad can feel the muscles grow tense 
 at the bottom of the body as the hands are thrown up with 
 force. Of course, ladies with their arms pinioned at the 
 shoulder, and the floating ribs fastened afc the waist, And 
 all these motions painful or impossible. 
 
 Dio Lewis's Light Gymnastics are excellent to prevent 
 these diseases among those of sedentary habits. Dr. Tay- 
 lor's Swedish Movements are an admirable method of cure, 
 bringing into play and into place disused and displaced 
 muscles and organs. 
 
 Prolapsus is much more frequent among those who have 
 no occupation than among those who do a reasonable amount 
 of active work ; then, the muscular system is kept vigorous, 
 and thus all within and without is in its proper place. 
 
LEUOOEEHEA. 
 
 CHASACTEK. 
 
 AMONG tlie special infirmities wliicli sap the freshness 
 of girlhood and the strength of womanhood, that of 
 Lencorrhea is one of the most prominent and prevalent in 
 these days of physical degeneracy. Ancient medical authors 
 speak of it as a disease incident to women worn with fre- 
 quent child-bearing and prolonged nursing, in connection 
 with over-work, but now it often begins with maturing 
 girlhood. 
 
 In taking the history of patients as to the date of symp- 
 toms, I often find that leucorrhea began with menstruation, 
 and that many ladies suppose it to be a natural and needed 
 drain, till so reduced by it that they were obliged to seek 
 advice, and then learned that it was the result of dis- 
 ease. 
 
 What is leucorrhea, fluor albus, or whites ? All discharges 
 from the vagina, except the regular monthly flow. It may 
 be yeUow or greenish in tint, it may be thick and white — 
 a milky white — or ropy and tenacious, like the white of 
 an egg. 
 
 As to quantity, it may be only a slight soil on ordinary 
 (52) 
 
lEVCORREEA, 53 
 
 linen, or so profuse as to require a guard (napkin), con- 
 stantly. 
 
 As to its cliaracteristics, it may be bland and unirritating, 
 or so acrid as to induce much local soreness and irritation, 
 giving a constant sense of discomfort about the parts. 
 Whateyer its peculiarities, it is attended with debility, and 
 often much positive pain. 
 
 LOCATION OE THE DISEASE. 
 
 The question is often asked, ^^ Where does all this drain 
 come from?" To answer this, you must first understand 
 that all internal cavities of the body that have an external 
 outlet or opening are lined with a skin of delicate struc- 
 ture, which is called the mucous membrane. In its health- 
 ful condition it secretes or manufactures a fluid, which wo 
 call mucus, to lubricate the parts so that they may perform 
 their functions without irritation. Now when this mem- 
 brane or internal skin is diseased the quantity and quality 
 of the secretions are perverted, sometimes suppressed en- 
 tirely, sometimes increased in amount or deteriorated in 
 character. 
 
 To illustrate : With a cold comes dryness of the nasal 
 passages and throat, the result of inflammation, which in 
 due time is followed by an increased secretion that brings 
 relief to the congested surfaces, or as people say, it is ^^the 
 breaking up of a cold." In ordinary cases, this restores 
 the healthful normal condition. But if circumstances are 
 unfavorable, habits imprudent, constitution bad, then this 
 common cold **runs into" catarrh, laryngitis, bronchitis, 
 
54 TALKS TO MY PATIEI^TS, 
 
 etc. That is, the mucous surfaces wliicli line these pas- 
 sages continue to secrete abnormally, and chronic disease is 
 the result. 
 
 So, the organs of which we are writing have the same 
 delicate covering, and become congested or inflamed, and 
 the result is acute or chronic disease, as above described. 
 Of course, every organ has its own peculiar secretion, both 
 in health and in disease ; still the mucous secretions of 
 every part of the body have some characteristics in common 
 and are governed by the same general law. 
 
 Y/hen leucorrhea exists it may come from within the 
 uterus, or from the outside of the cervix uteri, or from the 
 vaginal passage leading to it. The character and quantity 
 of the leucorrhea will vary according to the section affected, 
 the severity of the disease, and the extent of surface in- 
 volved. 
 
 CAUSES. 
 
 The causes which may induce this condition are varied. 
 Some persons inherit a tendency to disease of the mucous 
 surfaces, so that with slight provocation they have conges- 
 tion of the air-passages, or of those we are now consid- 
 ering. 
 
 A severe cold may induce hemorrhage from the lungs or 
 hemorrhage from the uterus. It may cause congestion of 
 one organ or of the other, according to the constitutional 
 tendency or susceptibility at the time. This attack may 
 terminate in a complete cure or chronic disease, according 
 to the treatment or recuperative power of the patient. 
 
LEUCOJRRHEA. 55 
 
 Cold feet and limbs are likely to induce local conges- 
 tion. 
 
 Crinoline, in cold weather, calls for heavy woolen under- 
 drawers, and thick cotton ones over them, to keep up the 
 capillary circulation. If the blood does not circulate freely 
 through the surface, then some of the internal organs must 
 have an excess of blood and become congested. 
 
 Tight dressing also invites local disease, by impeding the 
 returning circulation. 
 
 Constipation, and an undue effort to evacuate the bowels, 
 induces excessive turgescence to the parts, which may be- 
 come permanent. 
 
 The early reading of exciting books, which invites 
 thoughts and feelings unsuited to girlhood, tend to create 
 a fullness of blood in the uterine organs. So also of late 
 hours and social gayety. 
 
 Stimulating food, condiments, wines, and hot drinks have 
 a bad effect at the impressible age. 
 
 Mental emotion has more to do with the inducing of spe- 
 cial disease than is generally supposed. 
 
 We have seen many cases of uterine inflammation evi- 
 dently induced by grief for a husband or lover who had 
 died, or deserted, or proved untrue. A chronic heartache 
 of this sort invites disease of the uterus, and makes it diffi- 
 cult to cure. By this v/e do not mean that all who live 
 under the shadow of some great social sorrow are liable to 
 some special disease. Grief well borne makes every fiber 
 of flesh and spirit the firmer, while that which is brooded 
 over develops an undesirable list of physical and mental 
 
56 TALKS TO MY PATIENTS. 
 
 infirmities. Strength, and comfort comes to desolate hearts 
 just in proportion as they are able to forget themselves and 
 live for others, and bodies diseased and debilitated by mor- 
 bid mental emotion may grow strong and well in the same 
 way 
 
 MEAI^S OP CTJEE. 
 
 As to the treatment of leucorrhea, and of the diseased 
 surfaces from which it proceeds, sitz baths, ranging from 
 sixty to eighty degrees, as can best be borne by the pa- 
 tient and leave her warm after, of from five to ten minutes 
 duration, twice a day, with vaginal injections by use of the 
 force-pump syringe while in the bath, are always safe and 
 serviceable. The wet girdle, described in the chapter on 
 Menorrhagia, is also good, worn night or day, or both, if 
 the patient can keep comfortably warm with it on. 
 
 If the leucorrhea be acrid, warm castile soap-suds is good 
 for vaginal injections ; also, Labaraque's Solution of Chlo- 
 ride of Soda, which may be procured at most druggists. 
 Take of it a table-spoonful in half a pint of soft water, for 
 a daily vaginal injection. If the leucorrhea is profuse but 
 not irritating, use alum- water, or a tea-spoonful of tannin in 
 half a pint of water, for the injection. If there is sensi- 
 tiveness of the parts consequent upon the discharge, use from 
 five to fifteen drops of carbolic acid in half a pint of water. 
 
 In many cases, the uterus and its appendages have been 
 so long diseased that special surgical treatment is required 
 to efi'ect a cure ; but on these we will not dwell, as all such 
 cases must be left to the attending physician. 
 
LEUCOEREEA. 57 
 
 The treatment above suggested will palliate, even when 
 it will not cure, and when used in connection with special 
 treatment, it is of service. Many are prejudiced against 
 speculum treatment, thinking that the general constitution 
 is injured thereby. This has arisen from the fact that 
 many practitioners rely exclusively upon mere local treat- 
 ment, without due attention to those habits which induced 
 the disease, or to such general constitutional measures as 
 are necessary to establish permanent health. 
 
 We have seen many cases where the patients were under 
 special surgery for months, till the local inflammation was 
 quite subdued, but who felt little if any better than at the 
 beginning of the treatment. Sometimes the nervous sys- 
 tem had become exceedingly irritable, from the long-con- 
 tinued local appliances. This has led many to object to all 
 special means, and to rely on general treatment entirely. 
 From long observation of this class of cases, we have no 
 doubt but that the two may be most successfully combined, 
 making the cure both prompt and permanent; numerous 
 cases which would fail under either method alone, succeed 
 where there is due attention paid to both local and general 
 treatment. 
 
 We have had many patients, whom good practitioners 
 had tried in vain to cure at home, who improved rapidly 
 when relieved from their ordinary home cares, and when 
 to such local applications as the case required were added 
 baths, and simplicity of diet, dress, and such mode of life 
 as would tend to improve the general health. Those who 
 are not thus favorably situated for a complete cure, are left 
 3* 
 
58 TALKS TO 3IT TATIEKTS. 
 
 very feeble for montlis after their term of local surgery is 
 ended, and have to go to the sea-side, to mineral springs, 
 or into the country, to rally from the consequent depres- 
 sion. 
 
 Judicious general treatment lessens the amount of special 
 treatment required, and hence the two should be combined. 
 We have known many patients to be lying in bed, cured of the 
 local disease, but whom it was exceedingly difficult, after 
 this tax upon their general health and strength, to restore 
 to a vigorous and healthful tone of body. 
 
PEEGI^AI^rOY. 
 
 IIsTDICATIOKS OE. 
 
 QUPPEESSION of the monthly flow, without any other 
 ^^^ assignable cause, is to the wife a probable sign of preg- 
 nancy. If her health has been good, her menses regular 
 as to time and amount, and if no severe sickness or sudden 
 shock, mental or physical, intervened since the last period, 
 she has good reason to suppose conception has taken 
 place. 
 
 Chills, fever, or other acute disease may delay the men- 
 strual period ; or marked improvement in the general health, 
 by change of place or of treatment, may arrest the flow for 
 several months in women of delicate constitutions. In the 
 one case, the vital current has been too much exhausted to 
 carry on this function; in the other, it is being used in build- 
 ing up the system ; but in either condition, one need not 
 feel anxious if well, or growing better. 
 
 Occasionally, pregnancy and a continued monthly flow like 
 the menses coexist. As to the nature of this secretion doc- 
 tors differ, and we will not discuss the point, but merely add 
 that if there is a drain of bright color when pregnancy is 
 suspected, great care should be taken, not only at the time, 
 
60 TALES TO MY PATIENTS, 
 
 but until after tlie next month, or two has been safely passed. 
 For directions on this point see chapter on Abortions. 
 
 Those who are over-anxious to become pregnant, and 
 those who are over-fearful lest they shall become so, are 
 both liable to exaggerate symptoms, and think they are 
 pregnant when tbey are not. The only comfortable condi- 
 tion is to accept fertility or sterility, knowing that a con- 
 tented spirit makes either of these blessed and beau- 
 tiful. 
 
 Water treatment, properly applied, will prevent or pal- 
 liate many of the discomforts and diseases incident to and 
 subsequent upon pregnancy. 
 
 STOMACH TEOTJBLES. 
 
 First on the list usually stands nausea and vomiting, 
 which, when combined with suspension of the menses, con- 
 firms the suspicion of pregnancy, though they both some- 
 times result from uterine disease. But if the wife is other- 
 wise well, we may decide upon the former condition. 
 
 We are often asked, "Why do so many women vomit 
 during the early period of pregnancy, and seldom after four 
 and a half months ?" The best of physicians speak of the 
 stomach-sickness as arising from sympathy with the uterus, 
 which is a way of saying that it comes through some nerv- 
 ous influence not well understood. True, it is strange that 
 nausea so often attends the first months of pregnancy, and 
 so rarely the last. 
 
 Some physicians think they must always explain every 
 medical mystery. One says the vomiting is to prevent the 
 
FREGNANCT, 61 
 
 plethora wMcli would result from menstrual suppression. 
 Another, that it arises from excess in eating, women being 
 so given to gormandizing during gestation. Both seem to 
 forget that the arrested vital current, and also a good 
 amount of good food are requisite to furnish nourishment 
 for the growth of the new being. Certain it is, had these 
 members of the profession vomited for months, casting up 
 every thing but Jonah, until every part was emaciated save 
 the abdominal region, such preposterous theories would 
 never have been propounded. 
 
 Many a prospective mother has found by experience that 
 the less she ate the more she vomited, or felt like doing so. 
 The retching and lack of nutrition render the stomach 
 more and more irritable, and less and less tolerant of 
 food. 
 
 " LONGINGS." 
 
 If there is any article particularly desired, try it ; for 
 whatever is eaten with a relish is more likely to be retained 
 and digested than that which is taken under protest. This, 
 as a general rule, holds true ; of course, there are mischievous 
 compounds which no human stomach can well dispose of, 
 and which no human appetite will crave unless it has been 
 sadly perverted. 
 
 Sometimes the simplest food will be rejected, while some- 
 thing more appetizing would be retained. We have nothing 
 definite to say about ^^ longings," only that where there is 
 nausea there is a desire for something new, which should 
 be gratified. A traveler on shipboard said he would not 
 
62 TALKS TO MY FATIENT8. 
 
 bid his supper ** good night," as he expected to see it again 
 before morning. Many mothers, starting out on this nine- 
 months voyage, see all meals so many times that they need 
 a great variety in their bill of fare. 
 
 EEIIEDIES FOR STOMACH TEOUBLES. 
 
 Diversion, change of place, out- door life, and baths are 
 beneficial to pregnant ladies. Sometimes the swallowing 
 of bits of ice will allay the nausea ; at other times, cold wet 
 compresses over the stomach will relieve ; again, hot fomen- 
 tations over the stomach and liver for ten or fifteen minutes 
 are serviceable, followed by the wet girdle. 
 
 If the patient be really prostrated for want of food, then 
 broth, beef tea, or chicken tea should be used, and if these 
 are rejected, take a little brandy, or the best stimulus that 
 can be obtained, immediately after eating. I remember 
 having been called to a young wife who had borne her 
 suffering quietly, bravely, until she was so emaciated that 
 her friends became alarmed for her life. She rallied on 
 beef tea and brandy, taking a small amount of the latter 
 immediately after eating. In a short time beefsteak broiled, 
 with a little salt and no butter, was taken twice a day. The 
 brandy was dispensed with as soon as her stomach would 
 retain food without it, and during the last few months she 
 grew plump and strong on graham mrsh, graham bread, 
 etc. 
 
 Sometimes a bitter toniC; or mild preparation of iron may 
 be a good substitute for the stimulus. 
 
 The pregnant woman eats for two, and though one is 
 
FREGNANCY. 63 
 
 small, it is growing and she has a very distressing sense 
 of prostration when the supply is inadequate to the demand. 
 Husbands and friends are often not sufficiently thoughtful 
 on this point, and say with a smile, '^ Oh, there is a good 
 reason for her vomiting!'' But there is also a good reason 
 why she needs to be nourished, and hence her every want, 
 in reference to food, should be anticipated, if possible. 
 
 Something unexpected, something furnished by a friend, 
 is much more grateful than any thing she has herself 
 planned and provided. Of course, we know there are fool- 
 ish, freaky, fastidious women, who take their condition as 
 an apology for making more fuss than is necessary ab-out 
 foodj and other matters, but it is hard to correct such in 
 person, and we will not try to do it through the medium of 
 this book. 
 
 PALLIATIVE TKEATMEJ^-T DTJUIKG THE EAELY MOii^THS, 
 
 Constipation is often an attendant on early pregnancy, 
 sometimes during the entire term. The use of cathartics 
 as a corrective is very undesirable, as they, if continued, 
 irritate the stomach, and if the lady be weak, they tend to 
 induce abortion. Frequently the obstruction of the bowels 
 is merely mechanical, that is, the enlarging uterus remains 
 in the pelvis during the first months, and so presses on the 
 rectum as to interfere with its normal action. Often one- 
 half pint of water, at seventy-five degrees, injected into the 
 bowels will secure an easy evacuation. If the liver is tor- 
 pid, as will be indicated by a sallow skin and a bitter taste 
 in the mouth, see chapter on Constipation. 
 
64 TALKS TO 3IY PATIENTS. 
 
 The position of the gravid uterus, above alluded to, often 
 induces irritability of the bladder, a sense of weight and 
 bearing down, a desire to urinate frequently, backache, etc. 
 All these discomforts are greatly relieved by taking one or 
 two sitz baths a day, as cool as can be borne, and getting 
 a good reaction afterward ; beginning at eighty-five degrees 
 and reducing to seventy degrees, or even sixty degrees, if 
 one readily becomes warm after its use. If there is much 
 backache, wear the wet girdle at night, and by day if it can 
 be worn comfortably. If there is leucorrhea, use vaginal 
 injections in the sitz baths. 
 
 About the fourth month the uterus rises out of the pelvic 
 basin into the abdominal cavity, and relieves the bladder 
 and rectum of this pressure, if the abdominal muscles are 
 strong and furnish due support. 
 
 If the unpleasant symptoms do not subside, the sitz bath, 
 with friction and the wet girdle, should be continued. The 
 dress should be loose at the waist, and so supported as to 
 allow for expansion upward. If the ribs are now pressed 
 in, then the uterus presses downward and outward, too 
 much over-taxing the muscles of the lower abdomen, which 
 often induces great debility after delivery. 
 
 EXERCISE. 
 
 Active exercise is important during pregnancy, but not 
 overwork; the latter often breaks down the mother, or 
 when she endures it, enfeebles the child. Pregnant women 
 are very likely to go to extremes. Sometimes they think 
 that having babies is such heavy work that they can be 
 
:PREGNANGY. 65 
 
 excused from manual labor or any active exercise ; so they 
 lie about, read, dream, do fancy work, etc. By so doing, 
 their general health and strength is lessened, and thereby 
 delivery rendered more difficult. 
 
 Tedious labor is much more common among those who 
 live at ease (if women ever do), than among the laboring 
 classes. That is, women who reside in city or town, and 
 keep servants, suffer more during maternity than those who 
 live in the country and do their own work. 
 
 Natural delivery is accomplished by muscular action on 
 the part of the mother. Hence, other things being equal, 
 its ready performance depends on good, enduring strength 
 as much as any other labor. Those women who have a 
 sensitive, excitable, nervous system, are more liable to con- 
 vulsions than those of a quiet temperament, with good mus- 
 cular development. The good getting up after confinement, 
 also depends largely on good health before. 
 
 There is a class of women who are likely to overwork 
 during pregnancy. Their quickened circulation induces an 
 intense desire to do every thing, or have it done *^just 
 right." They possess so intense a sense of responsibility, 
 and of the importance of every thing in their domain, that 
 neither husband, friends, nor domestics can make life easy 
 for them. Such persons, if they do not wear themselves 
 out, so use up their life-force that they impart too small a 
 share to their offspring. 
 
 One of the smartest women for business 1 ever knew, the 
 mother of a large family, brought me her last daughter, a 
 hopeless invalid, and she still in excellent health, and her 
 
66 TALKS TO MY FATIENTS, 
 
 husband a vigorous man. After we had talked over the 
 ease, she looked at me with peculiar earnestness and said, 
 ^' What is the matter with all my children ; did I kill them 
 before they were born?'' 
 
 The cases are not rare where the finest business women 
 have feeble children. Thus, it will be seen, this tendency to 
 extremes ought to be guarded against. Some need to be 
 encouraged to exercise, and others need to be restrained 
 from work. 
 
 We have in mind many sad cases where two or three 
 little ones have been left motherless, because the young wife 
 had not sufncient physical power to endure frequent child- 
 bearing, and meet all the demands, self-imposed or other- 
 wise, which rested upon her. 
 
 Quick consumption, or some other acute disease, takes off 
 many soon after delivery, and more live enfeebled, feeling 
 old while they are yet young, and finally die of chronic dis- 
 ease, who, with proper consideration at the right time, 
 might have lived for years in good health. 
 
 NEKVOFS SUSCEPTIEILITY. 
 
 Pregnant women are likely to be pecuKarly susceptible, 
 and hence have their strong likes and dislikes in regard to 
 persons, places, and things. We can not explain the cause, 
 except that in some way the increased activity of the uterus 
 reacts on the nervous system, making it super-sensitive. 
 
 Many stories of longings and aversions are both strange 
 and true, yet hard to explain, and the feeling harder still to 
 control. Women can do more toward governing and guid- 
 
FREGJS'ANCr. 67 
 
 ing themselves in their habits of thought and feeling than 
 any one can do for them. How far people are responsible 
 for the freaks and fancies which make fools of them, no 
 one knows but the Father above. My opinion is that many 
 might manage themselves so as to be quite consistent, if they 
 began early to practice self-control ; but that there comes a 
 time when it is impossible to do so ; that they have yielded 
 to these feelings and fancies till they are ruled by them, and 
 it is hard to resume the reins which have long been 
 resigned. 
 
 Simple habits and early hours would save sensitive wo- 
 men from many nervous troubles during pregnancy. They 
 need more sleep then than at other times, and if over-taxed, 
 or over-excited, are made wakeful, so that they get less than 
 usual. A large amount of sleep acts not only as a seda- 
 tive on the mother's over-excited nervous system, but favors 
 the healthful development of the fc^tus. 
 
 INHErilTAITCE. 
 
 About the whole subject of '^mother's marks," as they 
 are termed, there is much mystery. Every woman can tell 
 a series of sad stories of marks and deformities, the result 
 of some vivid impression on the maternal mind during preg- 
 nancy. Of this class there is a long list, well authenticated 
 by the best of medical authority. 
 
 As these terrible incidents are very generally known to 
 exist, I will not dwell on them, for they rather tend to ter- 
 rify and trouble the prospective mother than to help her to 
 a hopeful and cheerful equanimity. 
 
TALKS TO 3fY TATIEKTS. 
 
 The story of Jacob and the peeled rods is still repeated 
 in fact, though not in form. But to all the rules of ante- 
 natal impressions, there are so many exceptions that we 
 must conclude the law is not well understood; that while 
 a very few receive the feared blemish, the many go un- 
 harmed. 
 
 For instance : a friend of mine, frightened by a dog, was 
 haunted for months with the fear that she had marked her 
 baby ; on the contrary, it was the most beautiful child of the 
 seven she had borne, so that her fun-loving husband said, 
 if they had another boy, he ** hoped his wife would think 
 of a dog's head beforehand." 
 
 Thus much for the comfort of those who have been scared 
 and kept scared. Job said the thing he greatly feared had 
 come upon him, but this is not often true with pregnant 
 women, according to my observation; perhaps because most 
 of the ladies who come to stay with me during confinement 
 are invalids, and hence are more likely to be "worried 
 with visions," and "terrified with dreams" which never 
 come to pass. 
 
 ' Do not understand me as speaking lightly of the mental 
 condition of the mother in reference to her unborn. The 
 state of her mind and her surroundings should be the best 
 possible to obtain, because both are likely to impress the 
 child. The point is, the mother is not to worry about that 
 which can not be controlled, but to keep her own body and 
 spirit in the best estate possible, and thus do what she can 
 for her unborn. 
 
 A dear friend of mine, a beautiful young wife, was with 
 
FREGKANCY, 69 
 
 me at medical lectures during the first months of her 
 pregnancy. She was in excellent health and good cheer ; 
 she was one of the most efficient in the dissecting-room, 
 and self-possessed at clinics. Though she never seemed 
 troubled, still I was sometimes anxious on her account, 
 and when any thing peculiarly trying to our sensibilities 
 came before the class, I would propose that we should 
 leave, to which she always replied, "I think we may as 
 well rem-ain," and a look at her pleasant, placid face 
 reassured me and made me feel it was safe for her to do so. 
 About four months after leaving college she gave birth to 
 a beautiful daughter, who is now a young lady of much 
 promise. 
 
 There is a sense of maternal responsibility which digni- 
 fies, steadies, and strengthens, and thus carries mother and 
 child unharmed through the most trying surroundings. 
 There is another sort which wears and worries, and 
 though the blemish feared may not afflict the body, 
 the spirit may bear life-long infelicities, the result of 
 a morbid mental or emotional life on the part of the 
 mother. 
 
 We can say with one of old, *'we do not know how the 
 bones or brain grow in the womb." 
 
 Let the prospective mother be every way as good as she 
 can and then rest in Him who orders all our ways, to bring 
 a blessed result. 
 
 From generations past to generations yet unborn, the 
 sins of the father will be visited upon the children. 
 
 Mothers have an important part in this link of ancestral 
 
70 TALKS TO MY FATIENTS. 
 
 inheritaiice. Let tliem bring in their line of liglit upon this 
 world, shaded by sin, sorrow, and sickness. 
 
 It is a common saying, and for the most part a true one, 
 that to have good children we must have a good mother ; 
 still we are often startled to find wayward girls and wicked 
 boys whose parents were worthy people. Here the fault 
 may be in the family discipline, or rather the lack of it. 
 Or, could we trace the ancestral line, wo might find it to 
 terminate, not in *'a waxed-end, but in some stronger 
 tAvine," as Saxe once said. 
 
 As to whether our children will "turn out well," depends 
 upon a great many combinations, some of which are under 
 our own control, others are too far in the past or future for 
 us to reach. 
 
 I once commended a friend, who was blind, for being so 
 cheerful, and expressing my wonder that he could be so 
 happy when he had lost what was to him so much, he 
 replied: ^^It is a rule of mine to never worry about 
 the past, which I can not recall ; nor of the future, which 
 I don't know about, and to make the most of the present." 
 A good rule for every prospective mother. In all the 
 habits of body, thought, and emotion, let her cherish that 
 which she would like to have reproduced in her child, and 
 then, whatever the result, she will have no occasion for 
 remorse, that sharpest sting in any sorrow. 
 
 Children seem to me often like striped prints — here a 
 line of the father, here of the mother, and there of the rel- 
 atives, more or less remote. 
 
 We laugh about the old lady who said she inherited her 
 
PREGNANCY, 71 
 
 disease from her maiden aunt, and still she told the truth, 
 or nearly so, or rather they both inherited the same in- 
 firmity from sires more or less remote. The vein of indi- 
 rect inheritance runs on, now apparent and now hidden 
 from view, Kke the stream which glides sometimes above 
 ground and sometimes beneath its surface. 
 
 Because peculiarities of inheritance are often mixed or 
 far-fetched, many mothers, therefore, fail to realize their own 
 personal responsibility in the matter. 
 
 Many times, in the care of chronic invalids, I find some 
 peculiar tendency to irritability or mental depression which 
 I can not explain, and ask if there was any thing unfortu- 
 nate in their mother's condition previous to their birth, and 
 often receive for reply, *^I was an unwelcome child, and 
 my mother was very unhappy in the prospect of another 
 baby, and I, too, wish I had never been born." 
 
 Sometimes there comes a sad story of domestic trouble, 
 which gives a peculiar despondency, a bitter hopelessness to 
 the young heart. The ordinary trials of life, family sick- 
 ness, or death even, seldom leave an unfavorable impress 
 on the unborn, if the mother bears her grief with due 
 Christian resignation. 
 
 DISCOMEOETS OF ADVANCED PEEGNANCY. 
 
 During the latter months of pregnancy there is sometimes 
 pressure of blood to the head, which formerly was relieved 
 by bleeding. The modern method is to control such ten- 
 dencies by diet, unless the symptoms are acute and very 
 severe. 
 
72 TALKS TO MY FATIENTS. 
 
 In such cases, both the quality and quantity of food shouW 
 be restricted. Bread, fruit, and vegetables are best, with 
 little or no meat, and neither coffee, stimulants, nor rich 
 food. Many feel burdened and restless at night ; such per- 
 sons will usually sleep better with a late dinner and no 
 supper. 
 
 During the last month of pregnancy, two meals will usu- 
 ally be better than one. Or, if there is a sense of faintness 
 at night without food, a little bread may allay it. It is not 
 that we wish to hold pregnant women to any rigid system 
 of diet, but, with the crowded position of the stomach, di- 
 gestion is slow, and two meals well digested will sustain 
 life better than three imperfectly assimilated. 
 
 During advanced pregnancy, the pressure on the return- 
 ing vessels is such as to induce bloating of the limbs. 
 Where this is the case, they will be greatly relieved by rub- 
 bing them in a shallow bath ; that is, sitting up in a bath 
 with limbs extended, while an attendant with a strong hand 
 briskly rubs the limbs in water at from seventy-five to 
 eighty-five degrees, according to the strength of the patient's 
 reactive power. If there is no tub at hand suitable for this, 
 then, after the sitz bath, sit in a chair and put the feet in 
 the tub, having the limbs well bathed and rubbed once or 
 twice a day. If hot and painful at night, wrap them in wet 
 towels, with dry cotton or flannel over, as may be necessary 
 to keep them comfortably warm. 
 
 If the bowels bloat, so as to make sitting or walking dif- 
 ficult, wear a wet bandage constantly, with a dry one over 
 it, firmly pinned and fitted, so as to furnish the most com- 
 
FBEGNANCT. 73 
 
 plete support possible. If it does not keep in place well, 
 then attach a strap or band about each limb to hold 
 it down. If the bandage be cut bias and gored, so as 
 to fit the form, it will furnish a more perfect support, 
 and keep better in place, than a towel or strip of straight 
 cloth. 
 
 When one approaches full term, restless nights may be 
 relieved by a large enema for the bowels and a sitz bath 
 just before retiring ; also, the wet girdle for the night. 
 Often it is well to leave the sitz bath in the sleeping room, 
 and after the first nap, if pain and restlessness return, 
 another sitz, with the bandage renewed, will secure a second 
 sleep. 
 
 CAEE OE THE BEEASTS BEEOEE CONETKEMENT. 
 
 In many cases, due attention to the breasts during preg- 
 nancy would prevent much trouble after delivery. Soon 
 after conception takes place, usually within a month or six 
 weeks, the breasts become fuller and stinging pains are 
 present. The nipples are more prominent and sensitive, the 
 colored circle about the base becomes broader, and of a 
 darker hue. 
 
 These symptoms sometimes help to decide whether con- 
 ception has taken place. But as they occur to some extent 
 when the menses is near, in cases of uterine disease, and 
 where there is suppression from other causes, we can not 
 rely upon them. Besides this, the appearance of the nip- 
 ples varies in different persons, hence the proof of change 
 4 
 
74 TALKS TO MY FATIENTS. 
 
 in tliem is not clear unless they liave been preyiously 
 examined. 
 
 When there is heat, pain, or much sensitiveness, wash 
 them freely in cold water, and if this does not allay the dis- 
 comfort put on wet compresses. Take especial care that no 
 whalebones, or other means of compression, prevent the full 
 development of the breasts. 
 
 How shall we ward off sore nipples, of which so much is 
 said and more felt ? To prevent such an affliction, I know 
 of nothing better than bathing them freely in cold water 
 every day during pregnancy, and rolling them between 
 thumb and finger to toughen the cuticle and accustom it to 
 pressure. Some use alum-water, tannin, or other astringents ; 
 but we have more faith in friction than in whatever may be 
 applied, as by it the skin on any part of the body thickens 
 and loses its sensitiveness. 
 
 Sometimes the nipple becomes flat, sunken, or retracted 
 as the breasts enlarge. If so, it should be drawn out, 
 7iot by suction or breast pump, as this would be liable 
 to induce a premature delivery, but by gentle traction 
 with thumb and finger, several times a day. If this 
 does not suffice, shields, with broad bases and openings, 
 should be worn. 
 
 If the nipple be rough, like a raspberry, it is more likely 
 to become excoriated or fissured than if it present a smooth 
 surface. Under such circumstances, add a grain of sul- 
 phate of zinc to an ounce of rose-water in a wide-mouthed 
 bottle (like those used for morphine), then tilt the bottle 
 upon the nipple and let it remain for a few minutes, several 
 
rHEGNAKCT, 75 
 
 times a day. If the nipple be smootli, and still there is 
 sensitiveness which water does not allay, then make a solu- 
 tion of 
 
 Borax 20 grs. 
 
 Tannin 5 grs. 
 
 Brandy 1 oz. 
 
 Water 1 oz. 
 
 and apply once or twice per day, in the manner above 
 described. 
 
APPEOAOHIE"a Cd^FIl^rEMElJ^T. 
 
 PEEMOIJITOET SYMPTOMS. 
 
 rriHE symptoms of approacliing confinement vary with 
 -^ different individuals, and with the same person at dif- 
 ferent times. Many feel better than usual a few days pre- 
 vious. So, country doctors expect a call soon, when they 
 know that a pregnant patient is having one of ** Dinah's 
 clairin' up times." Not that the over-exertion hurries on 
 the delivery, but because during the last week or ten days, 
 sometimes two weeks, the uterus contracts insensibly, sub- 
 sides, or settles down ; hence, encroaches less on the stomach 
 and liver. After this change, respiration and digestion go 
 on better, and this lightening up quickens the business sense, 
 and the prospective mother **puts her house in order," be- 
 fore resigning it to other hands. But this sign, like all 
 others, sometimes fails to appear, and hence the question, 
 '^how to count?" is one of interest. 
 
 The normal duration of pregnancy is two hundred and 
 eighty days. Conception usually takes place within a week 
 or ten days after the cessation of the monthly flow, hence 
 forty weeks from this time brings to full term. There are 
 occasional cases where conception occurs just before a 
 (76) 
 
APPEOACSINQ CONFINEMENT. 77 
 
 monthly period. Witli the first child, delivery often occurs 
 two weeks short of the usual term. Then, too, there are 
 well-authenticated cases of pregnancy continuing more 
 than nine months. Of this class I have seen several, 
 and still nothing unfortunate occurred to either mother or 
 child. 
 
 With all these variations, there is uncertainty in the most 
 careful reckoning. Some count correctly from '' the period 
 of quickening;'' that is, when they first feel motion, at 
 four and a half months. But the strength and activity of 
 the little one varies, and so also the sensibility of mothers, 
 and hence some perceive "life within" before the fourth 
 month, and another not until after the fifth. 
 
 I remember well a patient of mine who was sure she 
 had a uterine tumor, because she did not *'feel motion," 
 though I could detect it very distinctly. It was not until 
 after the beginning of the sixth month that she was satisfied 
 as to her condition. 
 
 The first sensation of quickening is like the flutter of a 
 bird, just above the pubis, and sometimes is not recognized. 
 Others mistake some motion of gas in the bowels for action 
 within the uterus. Therefore, the first motion is a point to 
 guess from, but not an exact data. 
 
 Among the positive signs of the approach of labor is the 
 increased fullness of the external parts; also, an augmented 
 amount of mucous secretion. This is a good symptom, in- 
 dicating a tendency to relaxation, and promises an easy 
 labor. 
 
 Another precursory sign is a feeling of anxiety and de- 
 
78 TALKS TO MY PATIENTS, 
 
 pressioa of spirits, without apparent cause, or a sort of 
 nervous chill. 
 
 Among the positive symptoms is the slight show of 
 bloody mucus which escapes from the mouth of the uterus 
 when it begins to dilate, which may occur some time before, 
 at others not till after pain is experienced. Occasionally, a 
 frequent desire to evacuate the bowels or bladder occurs, 
 also nausea and vomiting, which, in the early part of labor, 
 is a good symptom, as it relaxes the system. Along with these 
 come the tremor and \hQ shivering, without sense of cold; 
 and, finally, the rupture and discharge of the sack of wa- 
 ters. This is about the usual order of sensations, but often 
 they are reversed without any bad results beyond the fact 
 that labor is likely to be more lingering, and constitutes 
 what is called '' a dry birth." 
 
 Sometimes, without any premonitory symptoms, the wa- 
 ters may escape, and several hours, even days, pass before 
 pains commence. I well remember my anxiety in reference 
 to one of my first obstetric cases, when a week passed after 
 the discharge of the liquor amni before labor began, and 
 still no harm ensued to mother or child. The unexpected 
 news of the death of a dear friend was the apparent cause 
 of this unusual phenomenon. 
 
 Sometimes there are spurious pains, or *^ a false alarm," 
 as it is called. These are irregular as to the intervals and 
 duration, and are of a wandering character, while in true 
 labor the pains have a definite location, running across the 
 back over the thighs or over the lower part of the abdomen, 
 increasing in frequency and severity. It usually takes a 
 
AFFBOACHING CONFINEMENT. 79 
 
 little time to decide to wHch class they belong, but in either 
 case it is well to take a large enema of tepid water, having 
 an attendant pump slowly, and using from one to two or 
 three quarts, as can be borne, so as to free the bowels per- 
 fectly. This is an important preparation for delivery, and 
 makes one comfortable after confinement without an evacu- 
 ation for two or three days. Sometimes these irregular 
 pains are induced by a loaded state of the bowels, and when 
 they are thus freed the patient may pass twenty-four hours, 
 or several days even, comfortably, before real labor ensues. 
 
 Many times women are worn with these irregular contrac- 
 tions for days before deliver}^, when an enema, a warm sitz 
 bath, and a wet girdle would allay them till the appropriate 
 time. If these do not suffice, an injection of laudanum, 
 from fifteen to twenty-five drops in a little water, taken to 
 retain, may relieve the pain. As to the temperature of the 
 bath, if the patient is chilly, with a bad, indistinct sense of 
 discomfort, a warm bath will be most grateful. 
 
 If there is a feverish state, a sitz bath from eighty-five 
 to seventy-five degrees, according to the habit of the pa- 
 tient as to baths, will be best. If after a free movement 
 of the bowels, and the bath, the patient does not become 
 more quiet, but, on the contrary, the pains increase in 
 severity, become more frequent, and are of longer duration, 
 we may conclude the uterus has begun action, and will not 
 cease until it has completed its work. 
 
 PEEPAEATIOIS'. 
 
 At this stage of advancement the patient should be so 
 
80 TALKS TO MT PATIENTS. 
 
 clad that slie can sit up, walk about, or lie down, as slie pre- 
 fers. Let her dress be such as will bear washing, and can 
 also be easily removed. Her night-dress and chemise may 
 be folded up across the back and fastened in front, so as 
 to be kept dry, and thus save the trouble of removing them 
 immediately after delivery. Next her person a folded sheet 
 should be adjusted, which can be changed during labor, or 
 at the close, as comfort and cleanliness may require. 
 
 The bed should be protected by oil-silk or rubber-cloth, 
 two yards square, and over this an old quilt, folded sheets, 
 or some material which will readily absorb moisture. A 
 piece of carpeting should be placed on the floor in front of 
 the bed. 
 
 It is well to have at hand several sheets, napkins, or 
 towels, some fresh lard or sweet oil ; also, a small woolen 
 blanket or piece of flannel, scissors, and ligature for the ser- 
 vice of the little stranger. 
 
DELIYEEY. 
 
 "1 TNTIL near the end of tlie ninth, month the uterus 
 ^-^ enlarges, not by stretching, like an inflated sack, but 
 increasing in size, retaining about the same thickness of its 
 walls. Why, at the end of the two hundred and eighty 
 days, or thereabouts, it not only ceases to enlarge^ but con- 
 tracts and expels its contents, we do not know, and will say 
 with the devout Frenchman, ^* God wills it so." 
 
 These uterine contractions induce what are called ^' labor 
 pains'' — a strong muscular effort of the uterus, from which 
 it rests alternately and with regularity, as if it had a hard 
 task which could only be accomplished by work and rest in 
 turn. 
 
 When labor has commenced, if it lingers because *Hhe 
 pains," as we say, or the uterine contractions, are weak and 
 inefficient, then a cold sitz bath, with friction over back and 
 bowels, is a good stimulant ; also, a wet bandage with a dry 
 one over, pinned snugly around. We regard the bandage 
 as an important aid to the abdominal muscles when they 
 are weak, especially in those cases where many children 
 have been borne. 
 
 When the first stage of labor, that is, the dilatation of the 
 4* (81) 
 
82 TALKS TO MY FATIEKTS, 
 
 mouLh. of the uterus, is lingering, it is often trying to both 
 physician and patient, because the latter feels as if she was 
 ^^not getting on any," that she suffers all for nothing, and 
 ought to be relieved. Just then the sitz bath helps by 
 making a little change, resting and keeping up the 
 strength. If the feet are cold, a hot foot bath, taken with 
 the sitz, equalizes the circulation and steadies the neryous 
 system. 
 
 Women often feel as if they were too sick to be moved, 
 and yet if they would sit up or walk about their strength 
 would hold out better, and the change of position would 
 often help on the process. 
 
 The left side is the position we prefer during delivery, 
 though we allow the patient to rest on the back, with limbs 
 flexed, if she chooses. But she should not be confined to 
 any place during the first stage of labor. Let her not think 
 her troubles are nearly ended, when they are just begun. 
 She endures much better to know the truth, that while these 
 dilating or ^^ grinding pains," as they are termed, are the 
 most trying to faith and patience, still it is best to make 
 the least of them possible ; to encourage her to sit up, move 
 about, talk a little on subjects rather diverting than other- 
 wise, and so help her over that part of labor for which 
 there can be little relief. 
 
 We have met some cases where the process of dilatation 
 was passed very promptly and easily, sometimes uncon- 
 sciously, but this happy experience is very rare, especially 
 during the first delivery. Sometimes when the pains grow 
 inefficient in the last stage of labor, we spur them on by 
 
DELIVERY, 83 
 
 rubbing ice rapidly over the back and bowels, and tlius 
 stimulate the exhausted energies. 
 
 Many times we should apparently have been obliged to 
 resort to instruments, but for the prompt stimulus of cold 
 to the flagging muscles. If, on the contrary, the pains are 
 strong and the parts rigid and undilatable, the warm sitz 
 bath and warm vaginal injection are of service to relax 
 the tense tissue. 
 
 When labor is too far advanced for these, and still the 
 externals resist so firmly that there is danger of laceration, 
 have, between the pains, warm cloths applied. Of course, 
 we do not dispense with the support which the attendant 
 gives when the pains return. 
 
 Let the *' lying-in" room be kept quiet and cheerful. The 
 old fashion of inviting in as many friends as you would 
 want for a quilting seems to us, now, a foolish one. We 
 once supposed it necessary, and hence had a horrid idea of 
 the process which made a woman so very sick as to require a 
 half-dozen attendants. A physician, husband, and nurse 
 seem to us all that are usually needed. Nervous women, 
 with all manner of fears and foolish suggestions, are a posi- 
 tive nuisance, where cheer, courage, and a little judicious 
 help is usually all that is required. 
 
 A strong sheet thrown around the foot-board, and put 
 within the reach of the patient's hands, may enable her to 
 pull and press downward when necessary. A box or broad 
 stool at her feet to press against, helps to steady her limbs, 
 A large roll, as a quilt or pillow, pinned snugly in a sheet, 
 should be placed between the knees, if the patient occupies 
 
84 TALKS TO MY PATIENTS, 
 
 tlie usual position on the left side. The attendant may sit 
 on the bed, pressing her back against that of the patient, if 
 desired. 
 
 When at medical lectures, a new invention, an obstetrical 
 supporter, was exhibited on the rostrum. We thought we 
 should not like to be harnessed, and though we have had 
 one in our office closet for many years, we have never yet 
 tried it on a patient. Many like them, but we prefer to 
 leave the prospective mother as free as possible, and so 
 let her change position when she desires, and be delivered 
 on her side or back, as seems to her easier. 
 
 ATTEIS'TIOiq' TO THE INFANT. 
 
 Sometimes delivery is accomplished before the physician 
 arrives, and, in such a case, presence of mind and intelli- 
 gence are often needed to save mother and child. 
 
 At such times, as soon as the head appears ascertain if the 
 umbilical cord is about the neck ; if so, loosen and slip it 
 off, allow air to the face, and see that the mouth and nose 
 are &ee from mucus. 
 
 As soon as the child is born lay it on the right side, 
 away from the discharge; see that it breathes freely; if 
 it does not, sprinkle cold water upon the chest and blow 
 in its face. If it looks purple, and the action of the heart 
 is irregular, keep it upon the right side, as this favors the 
 closure of a valve in the heart which may not act perfectly 
 at first. 
 
 When circulation and respiration are well established, tie 
 the umbilical cord, about two inches fi^om the body, with 
 
LELIVEBY, 85 
 
 linen bobbin or other small strong cord; apply a second, 
 one inch from the first, and cut between the two. 
 
 EEMOVAL or THE AFTEE-BIETH. 
 
 Let the mother lie quiet and wait for the return of uterine 
 contractions, to expel the placenta or after-birth. 
 
 If the uterus is tardy about finishing its work, gentle 
 friction over the bowels will sometimes stimulate it to act. 
 If the organ is duly contracted we shall feel a round ball 
 about the size of a baby's head, which we may grasp and 
 press gently. If pain comes on, the mother may hold her 
 breath and bear down, or make an expulsive effort. "With 
 one hand grasping the uterus through the abdominal walls, 
 with the other, gentle traction upon the cord may be made 
 while the pains continue, not after. Any strong effort may 
 sunder the cord or invert the uterus, hence all effort of this 
 sort must be made with great care. 
 
 If the pains return after a little rest, there is not much 
 danger of hemorrhage ; but in case they do not, flooding is 
 likely to ensue. Should this occur, apply cold compresses, 
 or, better still, ice-water over the bowels. If this does not 
 check it, rub ice across the lower part of the abdomen and 
 carry small pieces up within the vagina. 
 
 This is the period of the most peril in the process of deliv- 
 ery, because the patient in a few minutes will be greatly 
 prostrated, perhaps die from the loss of blood. In all cases 
 there is danger of fatal flooding so long as the after-birth 
 remains, whether the case be one of abortion, premature 
 delivery, or confinement at full term^ The uninitiated often 
 
TALKS TO MY FATIEKTS. 
 
 think all trouble is over wlien tlie baby is born, whereas in 
 some cases it has just begun. Where labor is hurried, there 
 is more danger of flooding than when it has been slowly 
 accomplished. 
 
 rXEEINE HEMOEHHAGE. 
 
 Occasionally, when the after-birth has been removed and 
 the uterus once well contracted, it will relax and hemorrhage 
 ensue. Hence, if the patient is feeble, if the delivery has 
 been very rapid, or so protracted as to be exhausting, it is 
 well for physician or nurse to keep an eye on the patient. 
 The mouth of the uterus may be closed by coagula and 
 internal flooding going on, or it may be external, and the 
 patient lie weak and faint and not notice the flow. 
 
 This accident sometimes occurs after the physician has 
 left, thinking the patient past all peril, and has been 
 recalled to find the bright face blanched, the eye dim, the 
 ear dull. Several times I have been called to such a scene, 
 where there had been no physician in attendance, or where 
 he had left, supposing all danger passed. Many times I 
 have introduced my hand and removed the after-birth, or 
 the coagula (clots of blood), with which the uterus was filled, 
 applied ice to stimulate uterine contraction, fed the patient 
 brandy and bits of ice, as the stomach had strength to 
 bear, and watched the slow return of the pulse with an 
 agony of anxiety which I wished I might never again ex- 
 perience. 
 
 I write thus fully from the fact that in so many instances 
 the friends were deluded with the idea that the patient was 
 
DELIVERY. 87 
 
 doing well, because she seemed so perfectly comfortable. 
 Bleeding makes persons feel easy to the point of fainting — 
 dying! I do not dwell on this point to do away with 
 doctors in the *4ying-in" chamber, but rather to impress 
 you with the importance of having one at hand, and also, 
 if you are caught in an emergency, that you may know 
 what to do until you can secure professional aid. You would 
 lack the skill and self-possession necessary to introduce the 
 hand and peel off the after-birth, or empty the uterus of 
 coagula, but in case of flooding you can easily apply ice 
 within and without; or, for lack of this, cold compresses, 
 changed from moment to moment, having two sets ; or, 
 if this fail, pour a stream of cold water from a pitcher 
 over the bowels and externals and also give stimulants, 
 and thus save blood and sustain life till a more skillful 
 hand arrives. Eemember that ice is best, if within your 
 reach, because it is more efficient, and accomplishes its 
 work without chilling the patient or wetting the bedding, 
 as water applied in any other way necessarily would. 
 
AFTEE DELIYEET. 
 
 rr^HE pangs and perils of delivery being well passed, what 
 -^ shall we do to make our patient as comfortable as pos- 
 sible ? Those who are accustomed to water treatment will 
 readily apprehend our modus oj^erandi. To the uninitiated, 
 it may not seem quite as clear. 
 
 Premising that the bed has been duly protected by folded 
 sheets, etc., we will first remove these, by dramng out and 
 replacing them with dry ones, while the patient lies upon 
 the back with limbs flexed, in which position the change can 
 be easily made by raising the hips. Or, we may turn her 
 to one side, remove and replace the sheets, and turn her on 
 the back again. Next, adjust the girdle — the wet with a 
 dry one over, as heretofore described, unless there be a sense 
 of chilliness from exhaustion ; if so, use only the dry ban- 
 dage until reaction is well established. This should be 
 pinned snugly and smoothly ; not to make a small waist, 
 but to support the abdominal muscleS; which are at first left 
 flaccid. 
 
 The sense of exhaustion, which is often described as 
 ** goneness," is greatly relieved by a bandage. If the hip 
 bones are prominent, so that the bandage does not support 
 
AFTER BELIVEItY. 89 
 
 the muscles, lay under several folds of linen. Usually, a 
 bandage that can be worn until the middle of the fifth month 
 will fit well after delivery. Next, place a bed-pan under the 
 hips, and use a vaginal injection of a pint of tepid water, 
 and, by means of a soft sponge or gentle stream, cleanse 
 the parts. . After this, place a small compress of wet linen 
 over the externals, and over this the ordinary guard-nap- 
 kin. The temperature of water for all these purposes may 
 be about ninety-five degrees, unless there is a tendency 
 to flow too profusely; then the water should be sixty-five 
 or seventy degrees, or even ice-cold in case of hemorrhage. 
 The wet girdle and Avet compress are to be renewed as often 
 as comfort requires. 
 
 While the patient is weak, the back should be supported 
 by a pillow when resting on her side. 
 
 After a rest of some hours, or on the following day, give 
 a sitz bath at ninety-five degrees, for ^yq minutes. Put the 
 bath tub close to the side of the bed, draw the patient for- 
 ward to the edge of the same, raise her up gently, place 
 her feet upon the floor, put a strong hand under each arm, 
 and set her down in the tub, with a pillow at her back, a 
 wet compress on her head, and her limbs covered with a 
 blanket. 
 
 Let one attendant arrange the bed, while the other washes 
 back and bowels, or combs her hair, as she may prefer. If 
 feeble, the latter had better not be done while in the tub, 
 until she has had a few baths ; but when strong enough, it 
 will be quite as good a place as the chair. Place a folded 
 sheet on the edge of the bed, on which she can be placed 
 
90 ^ TALKS TO MY FATIENTS. 
 
 when taken out of the bath to be rubbed. It can afterward 
 be drawn out when she is dry. 
 
 Very feeble patients can take a sitz bath with great com- 
 fort in this way, when they are not able to stand or sit up 
 even to be dried. When this is done, the wet girdle and 
 compress may be adjusted as at first. 
 
 One bath will be sufficient for the first day, or even sev- 
 eral days, if the patient is feeble, changing the girdle and 
 bathing the back as comfort requires. After this, two baths 
 per day, for ten or fifteen minutes, gradually diminishing 
 the temperature as it can be borne without being chilled, 
 until sixty-five or seventy degrees are reached. The vagi- 
 nal injection used once or twice a day is a valuable aid, 
 and can be taken in the bath quite as well as with the 
 bed-pan, soon as the patient feels strong enough to help 
 herself to it. 
 
 AFTEU-PAIKS. 
 
 The ^^ after-pains," as they are called, usually grow more 
 and more severe with each confinement. "Why the uterine 
 contractions are painless after the first delivery, and painful 
 after subsequent ones, I can not explain. Suffice it to say, 
 if they continue for several days so as to be wearing, and 
 prevent sleep, hot fomentations applied for a half hour will 
 palliate and often bring perfect relief. If they are nof; 
 sufficient, an injection of fifteen to twenty drops of lauda- 
 num in two or three table spoonfuls of water taken into the 
 rectum to be retained, usually gives the desired freedom 
 from pain. 
 
AFTER DELIVERY. 91 
 
 DIET. 
 
 As to food for the young motlier, it should be very simple 
 for tlie first few days : gruel, beef tea, panada, toast, fruit, 
 graham mush, and cracked wheat. After the first week or 
 ten days are passed the danger of fever is usually over; 
 and she should be well nourished, for the uterine drain, 
 and that from her breasts, tax her system so severely that 
 she should be sustained by plain but nourishing food. So, 
 to the above bill of fare may be added meat, eggs, and veg- 
 etables. We have seen sensitive persons prostrated, and 
 with a tendency to a low nervous fever, simply from the 
 exhaustion of nursing, where the appetite and digestion 
 were impaired. Such should have fresh air, freedom from 
 care, and food to them most appetizing and easy of diges- 
 tion. 
 
OAEE OF THE BEEASTS. 
 
 TT^UEING tlie first few days after delivery, usually about 
 ~^^ tlie third, there is a tendency to a chill, followed by 
 fever and headache, called the '^milk fever." When this 
 occurs, it is often best to omit one bath. 
 
 During the cold stage, give a hot hand bath and a hot 
 foot bath in the bed, or use hot bottles in place of them. 
 The chill is usually followed by fever ; when this appears, 
 sponge off in water of a temperature which is pleasant, 
 remembering that where there is a high fever there is usu- 
 ally a greater sensitiveness to cold, and we should never 
 shock a delicate patient by water at a temperature not 
 agreeable. Often bathing the head and hands, and chang- 
 ing the girdle, will be grateful when a general bath would 
 invite a return of the chill. 
 
 Sometimes the fever is very slight, the cold stage being 
 followed by perspiration ; if so, let the patient lie well cov- 
 ered till the sweating is past, then sponge off quickly with 
 tepid water, or alcohol and water, if she be feeble and feels 
 prostrated. 
 
 When the circulation first tends toward the mammary 
 glands, there is heat, fullness, and pain, usually, before much 
 (92) 
 
CARE OF TEE BREASTS. 93 
 
 milk is secreted. During this period, compresses of wet 
 linen on the breasts, covered with, dry cotton or flannel, will 
 be grateful. Let them be as cool and changed as often as 
 comfort requires. 
 
 When the inflammation runs high we use ice-water, but 
 it is not often required if the first symptoms of heat and 
 pain are promptly met. If the breast is still hard and 
 painful, then foment with flannels wrung from boiling 
 water, changing every five minutes for perhaps a half hour, 
 two or three times a day, as the sensation indicates. Dur- 
 ing the intervals, continue the wet compresses. 
 
 Keep the breasts well drawn. If the baby does not do 
 the work thoroughly, it should be done by the nurse or a 
 pump. Gentle friction over them will facilitate the flow — 
 though not hard enough to hurt, as that will increase in- 
 flammatory action. 
 
 ABSCESS. 
 
 What is called ague in the breast, which is supposed 
 often to come from cold, arises usually from retained milk. 
 That is, the breasts were not exhausted early enough, and 
 distension of the milk ducts and inflammation ensue, which 
 could have been overcome at one stage, but can not be at 
 another, and so an abscess results from retained milk. Then 
 days and nights of terrible pain follow before suppuration 
 is sufficiently advanced to allow of relief by the lance. 
 
 We have had a few cases of scrofulous abscess after con- 
 finement, but never a milk abscess, though many times sorely 
 threatened with such a misfortune by those who have had, 
 
94 TALKS TO MY FATIENTS. 
 
 Buch troubles at previous confinements. By prompt and 
 energetic use of the means above suggested, we liave suc- 
 ceeded in arresting the inflammatory action. 
 
 But, supposing we must have " a gathered breast," from 
 any cause, what shall we do to **help on," as people say, 
 "bringing it to a head?" Every one has some favorite 
 poultice to prescribe. Which is best ? The chief object of 
 a poultice is warmth and moisture, and whatever retains 
 the two longest with least discomfort to the patient is best. 
 A friend of ours told us a story of her own experience, 
 which illustrates the point. Her daughter had a severe 
 scrofulous abscess of the breast ; she used water-dressings, 
 but the dear child suffered sorely. Neighbors began to 
 advise poultices of different kinds. The patient wanted 
 every new one tried. The faithful mother made poultice 
 after poultice of all manner of roots, herbs, barks, and 
 seeds, till she had not a clean dish, spider, or spoon in the 
 pantry, and the bed and patient were about equally smeared, 
 and still the breast was unrelieved. At this stage of affairs, 
 the sick woman said, "Mother, I am thoroughly sick of all 
 this stuff. The smell annoys me, and my breast aches just 
 as bad ; now, if you will wash me up, and change my cloth- 
 ing and the bed, and put on the clean wet compresses, I 
 will never ask for another poultice." 
 
 When one has pain long unrelieved, it is natural to want 
 to try something new, but often it proves an added dis- 
 comfort. 
 
 For an abscess of any kind, our preference is water-dress- 
 ings, of a temperature which, on trial, proves the most sooth- 
 
CARE OF TEE BREASTS, 95 
 
 ing. If there is a sense of dry, burning heat, folds of cool 
 wet linen, frequently changed, are usually most grateful. 
 If there is deep pain, hot fomentations at intervals are a 
 relief. A bowl which will just fit over the breast may be 
 half filled with tepid water, and the patient lean forward 
 over it and thus bring it up quickly over the breast, and 
 then lean back, holding it for ten or fifteen minutes, and it 
 will prove a very grateful local bath. 
 
 Sometimes, to gratify the desire for something new, or to 
 retain moisture for the night, we use poultices of flaxseed, 
 slippery-elm, hop yeast, or bread and milk. 
 
 CAEE OE THE IN^IPPLES. 
 
 When the nipple is sensitive, the dread of having the 
 breasts drawn is such that they are allowed often to become 
 too full, and inflammation is thereby induced. Besides this, 
 an inflamed breast is likely to make the nipple over-sensi- 
 tive, and so one trouble aggravates the other. If we are 
 so unfortunate as to have a sore nipple, it is exceedingly 
 difficult to cure it after confinement, because we can not give 
 it time to get well. The friction prevents healing, and if 
 we stop nursing an abscess ensues from retained milk. We 
 have sometimes found a nipple-shield to be a great relief. 
 One of these applied protects the sore surface from the 
 child's mouth, and still allows the breast to be well drawn. 
 But some babies will not use them, and some breasts will 
 not give out their milk through this artificial appendage. If 
 the symptoms correspond to those described in the chapter 
 on Pregnancy, try those remedies first. 
 
96 TALKS TO MY FATIENTS. 
 
 If there is tenderness and sliglit fissures, the following 
 prescription, applied after nursing, soothes and serves well : 
 
 Borax 2 sc. 
 
 Glycerine 1 oz. 
 
 Eose-water 2 oz. 
 
 If there are deep fissures, with ulcerated edges, they may 
 need to be brushed with a solution of nitrate of silver, by 
 means of a camel's hair pencil drawn just within the crack, 
 not on the healthy surface. 
 
 In all cases, there is usually a chance to try almost every 
 thing before the nipple will get well, and the last remedy 
 has the credit of cure. 
 
AFTER COlsTFIl^EMEE'T. 
 
 A MONGr tlie troubles incident to the puerperal month, 
 -^-^ we find phlegmatia dolens, or milk-leg, so called because 
 the ancients supposed, from the swelling of the limb and 
 the suppression of the milk, that there was a transfer of the 
 lacteal fluid from the breasts to the leg. 
 
 With high fever, from whatever source it may arise, there 
 is a suspension of this secretion; and here is a coincident, 
 not a cause. As to the nature of this disease, doctors differ; 
 so we will not discuss the point, but pass on to those modes 
 of relief which we have found efncient in removing this very 
 painful affection. 
 
 Several ladies have come to us during confinement, because 
 they had in previous years suffered from this disease and 
 wished to avoid its recurrence. We apply hot fomentations 
 to the painful part, or, if necessary, envelop the entire limb 
 in a flannel sheet wrung out of boiling water by two pairs 
 of strong hands, the flannel being laid in a strong cotton 
 sheet and wrung by grasping the dry ends. This process 
 may continue for a half hour or more, changing the sheet 
 ^s often as it becomes cool, and repeating it three or four 
 5 (97) 
 
98 TALKS TO 31 Y PATIENTS, 
 
 times in twenty-four hours. During the interim keep the 
 limb well packed in wet linen, covered with dry flannel, so 
 as to be comfortably warm. Eemove the packings, and 
 wash off the limb in water at an agreeable temperature 
 as often as comfort requires, and give gentle, dry friction 
 after. 
 
 Among our early patients, we remember a lady who told 
 us of her experience with milk-leg. The attack was very 
 severe, and the doctor ordered calomel and salts every other 
 day for a week, and then, being no better, calomel and salts 
 every day for a week ; and still she was the same, when an 
 old lady advised that the limb be enveloped in cat skins. 
 The animals were denuded hurriedly, and the skins applied 
 promptly while warm. For this patient fifteen cats were 
 slaughtered, and she reported herself greatly relieved by 
 the process. We have never tried it, as we prefer warm 
 flannels to warm cat skins, and have thus far found them 
 adequate to such emergencies. 
 
 EE^IOEEHOIDS. 
 
 Hemorrhoidal tumors, or piles, are often inflamed, and 
 sometimes seem to be induced by tedious labor. If there 
 is sensitiveness, swelling, and pain about the anus, warm 
 fomentations applied frequently, or constantly if comfort 
 requires, will allay the inflammation. A compress of wet 
 linen will often suffice, to which we. may add a few drops 
 of laudanum, if there is much pain. But if we wish to pre- 
 vent or cure this troublesome infirmity, we must avoid dras- 
 tic cathartics or straining at stool. Many cases of prolapsus 
 
AFTER CONFINEMENT. 99 
 
 I ■ 
 
 uteri and prolapsus ani have been induced by powerful med- 
 icines, wbich bring on forcing pains, or by long sitting and 
 much effort to evacuate the bowels while the parts are weak. 
 Unless the movements are perfectly easy and painless, we 
 always advise enemas for at least a month or six weeks 
 after delivery. A pint of tepid water injected into the bow- 
 els every morning after breakfast will usually secure a com- 
 fortable action. Occasionally the bowels lack proper peri- 
 staltic motion, and may require a quart or two to prompt 
 them to expel. In such cases, gentle friction over the ab- 
 domen — a sort of quick, vibrating motion by an attendant, 
 after the enema has been given, will be a good stimulant to 
 sluggish bowels. The deep kneading and heavy friction 
 given at other times for constipation should not be used 
 during the first month after delivery, as the uterus might 
 be irritated thereby. 
 
 If there is sensitiveness about the anus, or tumors, the 
 tube of the syringe should be oiled, and carefully intro- 
 duced while the patient lies on the left side. The 
 attendant should pump slowly, and change the direction 
 of the tube slightly, if pain is induced by the force of the 
 stream. 
 
 If there is discomfort after an evacuation, inject half a 
 pint or less of mucilage made of flax-seed or slippery-elm 
 bark, to be retained ; or if these are not at hand, tepid water 
 will serve very well. If the pain is severe, ten or twenty 
 drops of laudanum may be added to the mucilage. 
 
100 TALKS TO MY PATIENTS. 
 
 LOCAL INFLAMMATION. 
 
 We haye just been treating a ease of chronic inflammation 
 of the rectum. The lady has been suffering severely from 
 the affection since her confinement, six months ago. Simple 
 means would have saved her all this suffering, or, at least, 
 have arrested the disease in its acute stage. 
 
 Within the last twenty years we have seen a multitude 
 of cases of local inflammation, which ought to have been 
 cured during the first few weeks after delivery, instead 
 of going on for months, more frequently for years. In 
 many of them the congestion or irritation incident to labor 
 was not allayed at the time, and chronic disease was the 
 result. 
 
 Scores of sick women have said to me, '*I have not seen 
 a well day since the birth of my first child;" perchance 
 years since — often from five to fifteen years of invalidism 
 had been endured. Many of them were suffering from 
 chronic inflammation of the uterus, vagina, and vulva, which 
 made the duties of wife and mother exceedingly painful, 
 and, indeed, unfitted them for the enjoyment of any labor 
 or pleasure. I have seen many who had been suffering from 
 an exhausting discharge ever after, who supposed it to be 
 the necessary sequel of maternity. For further hints on. 
 this subject see chapter on Leucorrhea. 
 
 The discomforts following delivery should pass away dur- 
 ing the subsequent month. If they run beyond this they 
 assume a chronic form, and are not likely to vanish spon- 
 taneously after that period. 
 
AFTER CONFINEMENT, 101 
 
 TOITIC TREATMENT. 
 
 The locliial discharge, which reduces the uterus to its 
 former size, continues about four weeks ; though in cases 
 of debility or disease it is prolonged and gives the patient 
 a sense of prostration, which nothing can relieve while it 
 continues. 
 
 The sitz baths, two a day for ten or fifteen minutes, 
 gradually reduced from week to week to seventy degrees, 
 or even sixty degrees, should be kept up during the month ; 
 also the wet girdle and vaginal injections. If, at the end 
 of this time, the patient feels strong and the discharge has 
 ceased, they may be discontinued. But if, unfortunately, the 
 back is still weak, the abdominal muscles relaxed, and there 
 is a slight flow tinged with red, then the treatment should be 
 continued, making the baths as cool as can be borne, and a 
 good reaction established after. Besides a vaginal injection 
 in the sitz bath, those of alum-water, or of tannin, should be 
 used. If the abdomen is pendulous, a bias girdle should 
 be worn — gored so as to fit and support it. Friction and 
 kneading over the bowels, also deep inspiration and expi- 
 ration, to induce tonic contraction of the abdominal muscles, 
 should be resorted to. 
 
 HOW LONa THE PATIEITT MUST LIE IN BED. 
 
 The question is often asked. How soon can a woman sit 
 up or walk about after confinement ? and it is one to which 
 we can give no definite answer. To illustrate this point I 
 will give an incident which has occurred since I began 
 
102 TALKS TO 31 Y PATIENTS, 
 
 to write this cliapter. A lady, once a medical student of 
 ours, now the wife of a farmer living near us, took an early 
 start one Monday morning for our Ciure. She packed her 
 trunk, j)^t the cream in the churn, helped with the family 
 breakfast, planned the work for the week, rode five miles in 
 an ordinary farm-wagon, and before 2 p. m. of the same 
 day had a nine-pound baby. In a few days she dressed her 
 baby, walked to the bath room ; rode out at the end of a 
 week, and now, at the close of two weeks, returns to her 
 country home. 
 
 The state of health and pursuits of a pregnant woman 
 have much to do with the easy delivery and the good *^ get- 
 ting up" after. The case of the lady above alluded to illus- 
 trates this point. Her first child was born before she had 
 rallied from the effects of hard study and teaching, and it 
 was weeks, or rather months, before she was well. The 
 three born subsequent to her quiet life and the active duties 
 incident to the farm, have been much less tax on her con- 
 stitution, and in every case she has been able to remain at 
 her post of labor till near the time of her delivery, and 
 return to it in two weeks after. 
 
 Missionaries tell me that native women, in all cases of 
 ordinary labor, get up in a few hours after, wash themselves 
 and their infants, and in a few days attend to their ordi- 
 nary duties ; but that these same native women, when they 
 become christianized and take to civilized employments, 
 grow feeble, have tedious labors, and get up slowly. I 
 suppose this unfortunate change is not the result of their 
 new spiritual life, but of the difference in their muscular 
 
AFTER CONFINEMENT, 103 
 
 system. With the change in their religion comes a change 
 in their occupation. Christian husbands excuse them from 
 out-door labor, and they resort to sedentary habits, books, 
 and the needle, and thus lose the stout form, the strong 
 muscles which make child-bearing easy, and a quick return 
 to ordinary health almost certain. 
 
 Some are as able to be up the next day as others the 
 next week, and some are not as strong at the end of thirty 
 days as others are at seven. Our rule is to let the patient 
 sit up and move about the room when she wishes. If all 
 tendency to febrile action is allayed by baths and bandages, 
 and she is not excited by company or family care, she will 
 know when to rest and when to move about moderately. 
 We are speaking now of sane, sensible women, not of those 
 foolish, fidgety ones who, sick or well, want to do every 
 thing they ought not, and nothing that they should. 
 
 On this point, of sitting up so soon after delivery, we 
 differ from many personal friends in the profession, whom 
 we highly respect, and still we have proved our theory by 
 more than twenty years experience, having treated hun- 
 dreds of cases in the manner described, without harm, but 
 rather with positive benefit. Indeed, many of them had 
 repeatedly tried the old method of lying in bed for days 
 and for weeks, and still had not had a good *^ getting up." 
 Under water treatment, they found themselves stronger 
 at the end of one month, than at previous confinements 
 under other treatment, after three or four months had 
 passed. 
 
 Our observations on this point have been among invalids, 
 
10-i TALKS TO 31 Y PATIENTS. 
 
 or those of feeble organization, more than among any other 
 class ; they who, not haying done well at home, wished to 
 try a new course, and so came to us to stay during confine- 
 ment. Often, those who have been previously treated for 
 some severe uterine disease come back to us for confinement, 
 lest the old infirmity should return. 
 
 Eemember that one may sit up for five or fifteen minutes 
 in a sitz bath and be refreshed, when an hour or so in a 
 rocking-chair would weary. 
 
 The sitz tub for a sick room should have a high back, 
 which will allow of a pillow ; in the absence of such an one, 
 an attendant should stand behind and give the needed sup- 
 port. 
 
 The bath cleanses, cools, and favors the tonic contraction 
 of all relaxed muscles. If the abdomen is large and pen- 
 dulous, it is well to have a bandage nicely adjusted before 
 going into the bath, during the first few times of getting 
 up after confinement, and this will also serve for the wet 
 girdle when out. 
 
 Though we never intended to make our home for chronic 
 invalids a ^4ying-in hospital,'' many of our patients who 
 have suffered much from disease or debility during preg- 
 nancy, and after delivery, have desired to pass this proba- 
 tion with us, and we have been both surprised and delighted 
 to note the efficacy of these baths and bandages. 
 
 Ladies from the town, who are pretty well, come in on 
 the week of their delivery, occasionally not until the very 
 day. Those who are feeble in health spend a month or 
 two before confinement, and then return to their homes — 
 
AFTER C0XF1XE3IENT, 105 
 
 often hundreds of miles distant — in from two to four weeks 
 afterward. Of course, the length of time must vary accord- 
 ing to the recuperative powers of the patient. 
 
 From much observation in cases like the above, it has 
 become my opinion that women lose rather than gain 
 strength by remaining long in bed or room ; that the change 
 of position, the tonic infiuence of the bath, the short ride 
 in the easy carriage, or airing on the verandah, improves 
 appetite and digestion, quiets the nervous system, and invites 
 sleep. 
 
 The fear that standing on the feet will induce prolapsus, 
 leads many a one to do what is much harder — sit up in bed 
 in a very trying position for the spine and pelvic organs. 
 Of course, very feeble persons may have the shoulders 
 raised by pillows, or by the back of a chair turned down 
 and covered with pillows ; but if they are really able to sit 
 up, let them have a good chair. 
 
 To stand up, or to walk across the room, with shoulders 
 thrown back, will relieve pain in the chest, loins, and limbs 
 which are incident to long lying in bed. As to the uterus, 
 it will bear either much better than long sitting or much 
 baby-tending while weak. 
 
 IMPOETAliTCE OF QUIET AFTEE COKTI^EMEKT. 
 
 By quiet, we mean rather the mental than physical con- 
 dition. If the young wife is not worried with her family 
 responsibilities, or, worse still, with visitors, she will eat, 
 sleep, rest, rejoice in her safe delivery, be glad in her baby, 
 and with plenty of fresh air, good water, clean clothes, and 
 5* 
 
106 TALKS TO 3IT PATIENTS. 
 
 judicious nursing, gain from day to day, and by Iter own 
 sensations know when to sit up and wlien to walk about. 
 
 But a sensitive woman, with her heart full of the new 
 and exquisite delight of motherhood, whose nerves have 
 been put to a stretch before unknown ; who has been kept 
 cuddled up and cooked in a close room, without bathing, and 
 with secretions which must sicken if unremoved ; who has 
 received the calls and congratulations prompted by curiosity 
 and ceremony, and if she does not get the fidgets, or some 
 worse malady, then she is most surely made of firmer fiber 
 than most women. An amount of mischief is often done 
 during these days which months can not mend. 
 
 Much sleep is very important during the first few days. 
 For want of it, many a patient has had puerperal convul- 
 sions or puerperal mania. Nature makes haste to repair 
 every strain on the nervous system by sleep, if all else is 
 favorable. To prevent the mother from being unnecessarily 
 disturbed, have the baby removed from her at night, if she 
 has no milk. 
 
 The husband, nurse, and some family friend are company 
 enough with ^'the new comer," until the mother is able to 
 sit up, walk about, and ride out. Our family are often sur- 
 prised to see the new mother out riding before her door is 
 open to general calls. Perhaps one reason why our patients 
 endure muscular exercise so well so soon after delivery, is 
 because they are comparatively free from mental excitement. 
 Indeed, many of them say, " My freedom from social and 
 domestic responsibility allows me so much more rest than I 
 can have at home, that I do nothing but eat, sleep, and grow 
 
AFTER confinement: 107 
 
 strong every day." I mention this to prompt ladies in 
 towns to cut loose from company during the convalescence' 
 after confinement. 
 
 Do not have the maid running to your chamber with' 
 visitor's cards, and you perplexed whether to receive or 
 reject company, and thus be made so wide awake that you 
 miss your nap even if you decline the visit ; or, if jou receive 
 it, you are then too tired to be benefited by a bath. Let the 
 girl who answers the door-bell be empowered by your hus- 
 band or family physician to decline calls. 
 
.BATHII^G OF BABIES. 
 
 OOON as tlio little one can be removed from the motlier, 
 ^^^ wrap it warmly, and keep it well covered till ready for 
 washing and dressing. Let it lie upon tlie right side. Look 
 at it occasionally to see that it is breathing well, and that 
 there is no bleeding from the umbilical cord, which some- 
 times occurs. 
 
 As to the temperature of the first bath, we make it about 
 ninety-eight degrees, or^blood heat, so that there shall be no 
 shock, no sense that this is a cold world. We know that 
 Indian women wash their infants in the nearest stream ; but 
 as we are not writing for the squaw, and as the baby we 
 are considering is not a papoose, we propose the plan which 
 has long proved safe in our institution, rather than one 
 untried. 
 
 A large washbowl will serve very well, if there is no tub 
 for babies at hand. While the little one lies on the lap, 
 wash the face and head thoroughly with fine sponge or soft 
 fiannel, then if there is any of the white adhesive paste 
 usual on the body, smear it with sweet oil and rub softly 
 with fine soap. This being removed, lay it gently in the 
 
BATHING OF BABIES. 109 
 
 bath up to tho chin, supporting the head and back with one 
 hand while washing it with the other. When this is well 
 done, lay it on a soft towel spread on the lap, wrap it about 
 the child, and wij^e dry. Let all this be done in a warm 
 room. 
 
 Sometimes the physician or the professional nurse, after 
 washing the face, prefers to wipe the body off with sweet 
 oil or lard, without bathing, and says that it leaves the deli- 
 cate sliin in a more healthful condition, and prevents taking 
 cold from the evaporation of the water. To this method 
 we know no objection, only, with our water proclivities, we 
 prefer the washii^^^ after anointing with oil. 
 
 The umbilical cord should be wrapped in several thick- 
 nesses of soft linen, by passing it through a hole in the same 
 and then folding it over, so as to protect the person and 
 clothing. This need not be removed until the surface is 
 healed, but if wet occasionally, will allay irritation. Within 
 a week this will be accomplished, but the surface will be 
 sensitive, and a little piece of soft linen moistened with sweet 
 oil may be applied. Or, if there is a slight oozing of the 
 blood, as is often the case, sprinkle the surface with a little 
 tannin or burnt alum after the daily bath. 
 
 Soon as the infant is dressed, give it a teaspoonful of cool 
 water to drink. If it seems stomach-sick and inclined to 
 vomit, then give tepid water, which will aid in throwing off 
 mucus, which often disturbs it at intervals for several hours 
 after its advent into a new world. See that the feet and 
 hands are warm. If it is difficult to keep them so, let some 
 one hold the baby, with its tiny feet grasped in one hand 
 
110 TALKS TO MY PATIENTS. 
 
 and its hands in the other. There seems to be a vital 
 force imparted by human warmth, to which sensitive ones 
 are particularly susceptible. 
 
 There are sundry little ways of keeping baby clean and 
 comfortable^ which depend more upon tact than time or 
 means : for instance, two soft sponges always at hand, one 
 to be used about the face, and one for other parts of the 
 body. These, wet, will cleanse without irritation. Pow- 
 dered starch is good to protect sensitive surfaces, but if the 
 skin becomes denuded, or red and irritable, then smear the 
 surface with sweet oil, arnica oil, cold cream, or something 
 of that kind. ^ 
 
 When wet diapers are removed, they may be immedi- 
 ately dropped in cold water, and afterward rinsed and dried. 
 This will prevent the odor in the rooms, and the cloths will 
 be nearly as clean as if they had been washed and boiled, 
 if they are put in water before being allowed to dry. 
 
 When the infant is undressed for the night, rub it gently 
 with the hand ; let it lie upon the lap before the fire and 
 take a good air bath, exercising the limbs unfettered by 
 clothing. Do this also after a bath, to secure a good reac- 
 tion ; or if the room be cool, or the little one is inclined to 
 be blue, then wrap it in a woolen blanket for a half hour 
 or so before dressing. 
 
 As to the temperature of baths during babyhood, begin 
 as we said, at ninety-eight degrees, and from week to week 
 gradually reduce it as they will bear and enjoy. We say 
 enjoy, for, as a rule, babies ought not to cry when they are 
 bathed, and seldom will, if it is done with due discretion. 
 
BATHING OF BABIES. HI 
 
 Very few like being washed all over with a cloth, but a dip 
 in a bath, or remaining in for about a minute and being 
 rubbed, is usually enjoyed, unless the little one has been 
 seared by water too hot or too cold for comfort. One bath 
 a day is sufficient. If the infant is delicate, two or three 
 times a week is better for the first few weeks. Let this be 
 done during the first part of the day. If baby is restless 
 at evening, or has an eruption on the skin, then a second 
 bath may be given. During the first year they will, from 
 habit, enjoy baths at seventy or eighty degrees, according 
 to their reactive power. 
 
 I well remember setting down my baby bath-tub of cold 
 water in midwinter, while I went for hot water to add. 
 When I came back, my little boy had crept to the tub, 
 climbed in and sat down, with a slight shiver and look of 
 surprise, but no outcry. 
 
DEESS OF IE"FANTS. 
 
 /^N referring to *^The Water Cure Journal" of Ncvem- 
 ^^ ber, 1851, I find what I there wrote on this subject is 
 what I would say now. With all the fashions which have 
 come and gone in the last twenty years, I have seen no bet- 
 ter way to clothe babies, hence I reprint what I then wrote. 
 
 Of an infant it is emphatically true, that it is most adorned 
 when unadorned. What sight more beautiful than the 
 happy freedom of a child in its night-dress, or even in no 
 dj-ess, taking an air bath. So prone are we to estimate gar- 
 ments by their cost, rather than their comfort ; to measure 
 beauty by the stitches taken in making, rather than their 
 adaptation to the wants of the body, that the little folks 
 suffer in many ways, if not in the same ways as their seniors. 
 
 The harm done them by this foolish vanity or misplaced 
 pride is often of a date prior to that of their birth. Many 
 a prospective mother spends all her leisure in tucking, em- 
 broidering, affixing edgings, insertings, and the like. To 
 say nothing of the unfavorable effect of sedentary habits on 
 her own health, her offspring have less mental and muscular 
 power than if she worked, walked, read and thought more. 
 (112) 
 
DEUSS OF INFANTS. 113 
 
 After all the labor to prepare tlieir little garments, they 
 seem to me as ill adjusted to the wants of their tiny frames. 
 I fancy they often "cry out" against them, and we misinter- 
 pret their language, and think they complain of colic, of 
 hunger, when they mean to say ^'pinched! priclced P^ 
 
 Many a crying child is fed with pap, anise-seed, or catnip, 
 when merely the allowing it the free use of its lungs and 
 limbs, by removing its clothes, would have put to flight every 
 sign of pain or peevishness, and the little one would have 
 laughingly performed a series of varied and beautiful gym- 
 nastic exercises for the development of its physical system. 
 
 TIGHT DUESSING. 
 
 Taking every woman at her word, no one ever dresses 
 herself or children otherwise than ^^ Vjery loosely. "^^ Por her 
 infant she just has them snug enough to stay up in place 
 and furnish a support to the back, and keep it from grow- 
 ing crooked, and prevent the stomach from growing too 
 "high" and large — that is, the abdomen; only that im- 
 portant part has lost its name, as well as place, in woman's 
 form. 
 
 Now the tightness is pretty tigJit, when this is done so as 
 to suit the idea of most mothers. 
 
 In foetal life the vital organs are most developed. Hence, 
 in infancy the head and chest are larger, in proportion to 
 the hips, than in the adult. For this reason, the bands to 
 skirts, unless suspended from the shoulder, must be pinned 
 snugly, otherwise they will slip down, the lower part of the 
 trunk being so much smaller than the ttpper. 
 
114 TALES TO MY PATIENTS, 
 
 The practice of enveloping our little ones in a series of 
 firm bands for several months, seems to me a remnant of 
 the days of swaddling-cloths. But, as we do not use the 
 salt to which the Prophet alludes, and as we wash and 
 dress our babies every day, instead of letting them lie 
 swathed and salted for seven days, it seems to me best to 
 devise some way of dispatching the business so that they 
 will enjoy it. 
 
 A lady once said to me, ^* Your baby seems to take wash- 
 ing and dressing as one of the pleasures of life ;" to which 
 I replied, **And why should she not ?'' **But," she added, 
 ^^I should be afraid she would grow out of shape, her 
 clothes are so loose." 
 
 Kittens, colts, and lambs are not bound up, and why 
 should babies be, unless they are deformed ? 
 
 The wearing of several folds of unyielding cloth tightly 
 about the body of an infant, to keep it from growing awry, 
 before you have any evidence of its tendency to do so, seems 
 altogether premature. About as consistent this as to sub- 
 ject children to the extensors, elevators, depressors, and 
 compressors of an Orthopedic institution, in fear that they 
 would have spinal curvature or some other deformity. To 
 be sure, some weak, scrofulous, rickety children grow out 
 of due proportion, and some mechanical fixtures or certain 
 exercises may be of use. So some heads grow too fast for 
 the bodies to which they belong, and we might as well tie 
 up all heads as all bodies to make them grow right. '^Dame 
 Nature," if allowed her own way, would do more things 
 right "than are dreamt of in ^fashionable' philosophy." 
 
DRESS^ OF INFANTS. 115 
 
 ' Many mothers who are anxious to leave their infants suf- 
 ficient breathing and growing room, slip their fingers under 
 the inelastic bands as a test of tightness ; when this can be 
 done easily, they feel certain that they are ^^ plenty loose." 
 Such should remember that portions of the ribs, spine, and 
 breast-bone are cartilaginous, not yet made into solid bone ; 
 that they yield to slight pressure, and if that pressure be 
 permanent, assume a form correspondingly. 
 
 The lower ribs, called the false or floating ribs, are left 
 free in front, so as to move outward and upward during 
 inspiration. By compression they are often turned inward, 
 thus diminishing the caliber of the chest ; and, *^ as the twig 
 is bent, the tree is inclined." 
 
 OTJE FASHIOI^. 
 
 As those who find fault with one way are supposed to 
 tliinhj at least that they have found a better, so I will gratify 
 the wishes of my friends by telling them what, on trial, has 
 seemed to me comfortable and convenient. 
 
 For a band next to the body we prefer one thickness of 
 flannel, being more elastic, it will fit the form better than one 
 of double linen, and is more easily adjusted. In ordinary 
 cases this need be worn but a week or ten days. As to the 
 little shirt, we never like those long straight strips which are 
 always out of place, unless held in place by bands. A sack, 
 with a fine cord at the neck, which can be drawn up or out, 
 as the size may require, is preferable. Those of knit 
 worsted are very nice, but in their lack, make them of 
 fine cotton ; linen is too cool for our climate. 
 
116 TALKS TO MY PATIENTS, 
 
 For protection, oil-silk, or rubber-cloth, used about the 
 hips is nice when going out, but if worn constantly keep 
 the parts too warm, and is liable to induce irritation. Un- 
 bleached factory is nearly water- proof, and adjusted over 
 the ordinary napkin is a very good substitute for the arti- 
 cles above named. Next, the foot-blanket, as it is called, 
 should be a width of flannel, three-fourths of a yard in 
 length, plaited at the top and bound with a broad tape, so 
 as to tie about the hips just above the napkin. Thus 
 adjusted, it is easily removed if soiled. 
 
 As to the petticoat, we always considered those broad, 
 unyielding bands a tax on the patience of the nurse, and a 
 discomfort to the baby. To put pins through the fine, 
 firm muslin, so that they will not scratch you or the baby, 
 and have the band just tight enough to keep in place, and 
 not too tight for the baby's comfort — to do all this, while the 
 victim cries and the mother worries, requires more skill 
 than for a surgeon to dress a wound, especially if his sub- 
 ject has taken chloroform. I have often heard ladies say 
 the bands in which babies are bound were a bother, but then 
 what should they use ? Let the skirt be gored, making the 
 top half the size of the bottom. Lay plaits at the back and 
 front, and bind with flannel-ribbon ; make a little arm-size 
 and shoulder-strap of the same. The plaits may be stitched 
 down four or five inches, so as to fit the form loosely. Tie 
 this behind, at the top and three inches below. If the baby 
 is restless or has the colic, you can, without undressing it, 
 carry the hand up under the clothing and rub the back, or 
 stomach and bowels, to its great relief. 
 
DEESS OF INFANTS. 117 
 
 The one band need not be retained after the navel is 
 bealed, if all is right in that region. If not, then the 
 surgeon should advise Tvhat must be worn. Those cases 
 of hernia or breach which we have seen were not where 
 the bands had been removed, but where retained and ad- 
 justed with anxiety. Feeble infants when crying need to 
 have the bowels supported by gentle pressure from an 
 intelligent hand. This will do more to prevent hernia than 
 any band. 
 
 The feet should not be kept closely wrapped in long 
 clothes, but left free to kick as much as they please ; it 
 being their best method to develop the limbs. If the feet 
 are cold, it is better to put on socks than to keep them fet- 
 tered. 
 
 As to dresses with high necks and long sleeves, I need 
 not advise those, because they are just in the fashion, good 
 sense and good style being now in ** sweet accord." 
 
 Besides these, there have been added within twenty years 
 the flannel sacks and double gowns, which are pretty and 
 comfortable for cool weather — much better than the blanket, 
 which affords no freedom for the arms, being first up about 
 the shoulders, and then all off; thus, when used for common 
 wear, causing colds rather than preventing them. If the 
 morning or evening is cool even in midsummer, the sack 
 or double gown should be put on, as a chill at this season 
 is especially liable to induce cholera infantum. 
 
 Bare arms and bare feet may be enjoyed in the heat of 
 the day. We know that genteel dressing allows the former 
 and forbids the latter. Why, we do not know, for there is 
 
118 TALKS TO MY PATIENTS. 
 
 no shoe lialf so pretty as a plump little foot. Many con- 
 sider tlie slioe necessary to prevent tlie foot from growing 
 too large ; but, used for this purpose, T^hat do "we better 
 than the Chinese ? Their standard of littleness is some 
 sizes less than ours, but the principle is the same. The feet 
 as -well as the features should, as to size, suit the form.- A 
 large body with small waist or small foot, to the artist and 
 the anatomist, lack harmony. 
 
 Constant care should be taken to keep infants warm, for 
 their power to generate heat is small during the first months. 
 By this we do not mean that they should live in a hot room, 
 but rather that their clothing should be such that they may 
 be comfortable, and still have the air they breathe pure, both 
 by night and by day. 
 
 When the young mother complains of lack of strength, 
 because she keeps her room so warm for the baby, we know 
 there is a lack of intelligent tact somewhere, for mothers 
 and babies -were intended to thrive together. We have 
 pleasant memories of a baby born in December, who was 
 never out of bed for a single night, and for whom an extra 
 fire was never kept until the scarlet fever came. Of course, 
 if the little one is sick, or has to be fed, then a warmer 
 room is required, and flannel night-gowns or over-sacks 
 should be used. Infants sleep better at night and fall into 
 regular habits of nursing easily, if there is neither fire or 
 light at night, as a usual rule. 
 
ISTUESII^a. 
 
 TF the mother is usually strong, soon as she has rallied 
 -■- from the sense of exhaustion subsequent upon labor, and 
 the baby is rested after its first bath, it may be put to the 
 breast. Should the nipple be flat or retracted, from lack of 
 attention advised in a preceding chapter, it can now be drawn 
 out with a breast-pump, suction by means of a common clay- 
 pipe, or by the mouth of an attendant. 
 
 To encourage the little one to try, we may moisten the 
 nipple with milk or sprinkle it with sugar. If we delay all 
 this till the breasts are filling, and the baby has used the 
 spoon several days, it will be still more difficult to induce it 
 to seize the sunken nipple. Both forethought and tact are 
 necessary in such cases, so as not to weary the mother with 
 ineffectual attempts at nursing. 
 
 EEaiTLAEITY AS TO TOIE OE NIJESING. 
 
 At first let the interval be from two to three hours during 
 the day, when the babe is awake, of course ; if it sleeps, 
 never wake it to eat, when well. If it has a long sleep 
 without food, and then is awake longer than usual^ it need.^ 
 
 (119) 
 
12U TALKS TO M7 PATIENTS. 
 
 to nurse oftener than otherwise. It is particularly impor- 
 tant that the child forms the habit of nursing only once or 
 twice during the night. If more than this, the mother gets 
 too little sleep, and the baby too much to eat. Sleeping 
 with the infant on the arm, is wearisome for the mother, 
 and prompts it to nurse oftener than it would if put aside in 
 the bed or crib, as soon as its want is satisfied. It some- 
 times requires a little tact and positiveness to establish this 
 method, but it is of great advantage to both parties. If the 
 mother is able to furnish a good supply, she will have little 
 trouble in forming regular habits of nursing, the time being 
 gradually prolonged to four and five hours during the day 
 as it grows older. 
 
 But with many the milk is poor in quality, the quantity 
 small, aiid though the little one seems satisfied at the time 
 of nursing, it soon ^* cries for more." In such cases it 
 should be fed once or twice in the twenty-four hours and 
 let the mother accumulate, not mix feeding and nursing at 
 the same meal, for then it is apt to get too much. Micawber 
 said of the twins, '^They no longer draw their nourishment 
 from the maternal fountains, but are supplied from foreign 
 resources." Our American babies have to turn to ^^ foreign 
 resources " very early, and some of them hold on to the 
 *^ maternal fountains" long after the healthful flow has 
 ceased. 
 
 CAUTION TO NITESIlSra MOTHEES. 
 
 The suction stimulates the mammary glands to secrete, 
 even when the system is being unhealthfully impoverished 
 
NURSING, 121 
 
 thereby. In such cases, it is bad for both mother and 
 child. The little one can not long thrive, when the mother 
 is failing in health. Our American women do not endure 
 nursing as well as those of other nations, as a general rule. 
 Sometimes the secretion is insufficient, at others abundant, 
 but the mother fails in health thereby. When either of 
 these phases occur during the first few weeks, we may 
 hope, with attention to diet, and freedom from care, that 
 after the uterine drain incident to the first month or six 
 weeks has passed, she will be able to meet this pleasant 
 duty. 
 
 If the flow of milk be scanty, give her some of the varied 
 preparations of chocolate or cocoa, oat-meal or wheat-meal 
 gruel, whichever she likes best. If the secretion be exces- 
 sive and exhausting, then avoid aU warm drinks, let her have 
 plenty of beefsteak, boiled eggs, and dry toast. Some bitter 
 tonic may be of advantage, a mild preparation of iron, per- 
 haps the muriate tincture, five to fifteen drops three times 
 a day. If a tendency to profuse perspiration exists, as is 
 usual in such cases, bathe in salt and water, or use one part 
 of whisky or alcohol to two parts water. 
 
 Within a month or t^o, if she does not gain decidedly 
 and permanently, wean the baby, else you lose the mother, 
 or make of her a chronic invalid hard to cure. Among the 
 many sick women who have come under our care, we num- 
 ber as most difficult to cui-e, those who have been reduced by 
 prolonged nursing. The nutritive process seems so much 
 impaired, that it is difficult for them to rally and restore ex- 
 hausted energies. There are some women habitually feeble. 
 
122 TALKS TO MY TATIENTS. 
 
 who nurse their children without exhaustion, but whose 
 children do not thrive. They are pallid, or blue, with a soft 
 flabby fiber, and seem starved. In such cases the milk is 
 evidently of poor quality. If beef and iron do not improve 
 the milk, wean the baby. 
 
 The position of the mother during nursing is important. 
 Sitting up in the bed is bad, as it gives back-ache and a 
 sense of '' bearing down," as it is called, tires the shoulders 
 and invites a stoop. It is always easier every way to lie 
 down, or sit up in a chair, which supports well the back and 
 shoulders. Many young wive-s get a stoop, a pain in the 
 chest, from which they are slow to recover, by tending the 
 baby too much when they are weak, nursing when they are 
 not able, or in a position above alluded to. 
 
WEAi^iisra. 
 
 fipHE condition of mother or cliild will indicate the time 
 ■^ for weaning. So long as they both thrive, let them live 
 this sweetly united life. But, as soon as the mother finds 
 nursing a tax, has pain between the shoulders after it, feels 
 weak, wakes in the morning more tired than at night, 
 it is time to turn the little one to other *^ resources." Nurs- 
 ing during pregnancy is bad for the mother and for the 
 born and unborn child, and is also liable to induce an abor- 
 tion. 
 
 Conception rarely takes place before the menses has re- 
 turned, though we have seen a few instances of this class. 
 Usually when menstruation is established it is time to wean 
 the baby. Sometimes the monthly flow continues regular 
 during the whole period of lactation. In such cases the 
 mother is not as strong, the child does not thrive as well, 
 and early weaning is usually advisable. Many mothers, in 
 their desire to give themselves for the sake of their children, 
 continue nursing at the expense of their own health. Such 
 do not realize that their failing powers makes the nourish- 
 ment imparted of an inferior quality. The general rule 
 
 (123) 
 
12-1 TALKS TO 3fT FATIENTS, 
 
 holds good, here as elsewhere, that when the mother does 
 the best she can for her own health, she is doing the best 
 for those she loves. 
 
 As to the time of weaning, we prefer spring and early 
 summer, or autumn. Midsummer, when *' bowel com- 
 plaints" are common, is more trying for the child, and 
 the long nights of midwinter renders the ordeal more se- 
 vere for both parties. 
 
 As to '^the time in the moon!" — for this I have no advice 
 to give. In my childhood, I used to look at the first page 
 in the almanac, with reference to the signs, and tliough 
 I always found the same forlorn man there, surrounded 
 by animals, with lines from them straight into him, still 
 I was never able to learn _ from it when the sign was 
 right for weaning babies, sowing onions, or planting corn. 
 As I grew older, and studied " The Geography of the 
 Heavens," and found these characters stood for constella- 
 tions, I expected light on this mysterious question, but it 
 never came, and hence I long ago decided that Astrology 
 was beyond my comprehension,- and -so have looked t6^ 
 Physiology for light whm to wean babies, and thus far have 
 had little trouble. ' - '■ < •. 
 
 As a preparation for change in the bill of fare, feed thein^ 
 during the day, for a week or two, and let them nurse dur- 
 ing the night, and thus grow accustomed! to the' change of 
 diet. After the baby is weaned, draw the .breasts what "is 
 necessary to keep them comfortable, and thus the secretion 
 will gradually diminish. If there is heat in the breasts, 
 keep on the wet compress. This is better for the mother 
 
WEANING. 125 
 
 than putting on camplior or other remedies, to arrest the se- 
 cretion of milk suddenly. 
 
 Suggestions in regard to the food to be used in case of 
 early weaning will be found in the chapter on Feeding 
 of Infants. 
 
FEEDIlNTa OF IITFAl^TS. 
 
 TXT'HEN infants must derive their nourishment entirely, 
 ^ ^ or in part, from ^* foreign resources," what shall we 
 give, and how shall it be given ? 
 
 Here is an opportunity to write a volume, but as a good 
 one has already been vsritten by George Combe, we will refer 
 to his work on Infancy.* 
 
 For the benefit of those who have not his book, we will 
 give a few suggestions from our own personal experience. 
 If the mother is feeble after delivery, let her rest until 
 the next day before putting her baby to the breast; and 
 then if there is no milk, do not let her be worried by 
 frequent efforts, but now and then let the infant try so as to 
 encourage the flow and keep baby in practice. When the 
 child needs nourishment before the supplies arrive (as is 
 usually the case), give it first a little sweetened water, warm. 
 After that, for subsequent meals, one-quarter milk and three 
 quarters water, slightly sweetened. 
 
 The first milk of the mother is laxative, ani will carry off 
 
 ♦ This work is for sale by Wood & Holbeook, Nos. 13 & 15 Laight Street, New 
 York CitT-. Price $1 25. 
 
 (126) 
 
FEEDING OF INFANTS, 127 
 
 the tar-like excretions -with which the bowels are loaded at 
 birth, called meconium. An over-wise old lady said in ref- 
 erence to thisj that " babies always needed physic to physic 
 away the economy /" But the All- wise Father has provided 
 for all this in the first nourishment from the mother, if she 
 be able to do her duty ; if not, then feed the little one with 
 a spoonful or so of molasses and water. 
 
 If the "maternal fountains" prove permanently inade- 
 quate, how shall we supply the deficiency, by the spoon 
 or bottle ? 
 
 If by the latter method, we have the difficulty of keeping 
 clean, and the danger of breaking, to subtract from the con- 
 venience of laying baby and bottle side by side, and leaving 
 the attendant free. If we use cup and spoon, then an in- 
 telligent person is needed to feed slowly and with care, lest 
 the little one eat too fast and too much. By sipping from 
 the spoon, they early learn to take from the cup slowly, and 
 thus the great trial of weaning from the bottle or breast is 
 avoided. Some learn to feed much more easily than others, 
 so the taste of the baby and convenience of the family must 
 help to decide this important point. 
 
 The wind colic supposed to be induced by air " sucked in" 
 with the spoon, is owing rather to gas generated by indiges- 
 tion. Pood improperly prepared, or given too frequently, 
 too rapidly, or too much at a time, will disturb the stomach 
 of these sensitive ones, and what is called wind colic often 
 ensues. 
 
 A common bottle, with a sponge of very fine texture 
 for a cork, will serve for a baby-bottle, and is easily kept 
 
128 TALKS TO MT FATIENTS. 
 
 clean, but requires a hand to liold it, while one with a long 
 rubber tube can be laid in the crib beside the baby, but 
 is kept sweet with more difficulty. . 
 
 WET-NXmSES. 
 
 About wet-nurses, we have nothing of value to say, be- 
 cause so few honest women serve in that capacity. 
 
 If we had a woman with a good body, and a good spirit 
 ready to serve thus, we might consider the matter favorably, 
 but not otherwise. On the trials of mothers, and the sor- 
 rows of babies, when both are at the mercy of a bad woman, 
 we will not dwell. 
 
 We prefer to trust our little ones to a good cow, rather 
 than a bad woman. The first is not hard to find, and will 
 usually serve the purpose, if intelligence, love, and leisure 
 combine in the care of the child. 
 
 rOTJN^DLINa HOSPITALS. 
 
 Many are afraid of cow's milk, because so few thrive 
 in Foundling Hospitals and Orphan Asylums. To my 
 mind, they do not dio so often for want of breast-milk, 
 nor for the milk of human kindness, as for the lack of 
 human love. 
 
 Little ones draw comfort from the eye, the arms, the 
 heart of a real motherly woman, whether she be their own 
 mother or not, which helps them to thrive. Without this 
 they are half dead while they yet live, as you can see 
 by their sad, soul-starved faces. 
 
 A lady physician in Milwaukee, who for many years at- 
 
FEEDING OF INFANTS. 129 
 
 'tended the sick in tlie Orphan's Home in that city, told me 
 she had spent very many nights at the asylum, taking the 
 poor motherless little ones in her arms to sleep, and thus 
 saved their lives, when other means would have failed, for, 
 she added, *^it was not doctoring they needed, so much as 
 cuddling, comforting, soothing." By this I do not mean to 
 find fault with the managers or nurses at benevolent institu- 
 tions. No hand however efficient, no heart however great, 
 can meet the wants of a dozen babies, because each one 
 needs a mother of its own. 
 
 Sisters of Charity have conferred with us as to food for 
 foundlings, in view of the mortality in their flock, and 
 though they thought it was owing to the milk, we thought 
 the cows did their part the most perfectly of any concerned. 
 Though they were neat, orderly, and. devoted to their work, 
 it was contrary to nature for any one woman to mother 
 so many babies at once. 
 
 - On Blackwell's Island we saw hundreds of babies in one 
 institution, fall depending on breast-milk— one woman to 
 every two babies, and they were doing quite well consider- 
 ing their unfortunate parentage. The city supplies extra 
 rations for the nurses, and their duty is to take care of their 
 two babies, doing nothing beside. In this way more little 
 lives are saved in that great sea of sin than could be done 
 in any other way, because city air and city milk are bad for 
 babies. Here on this island in East Biver, they have a 
 fresh breeze always. Besides this, one nurse for two babies 
 secures more personal care than can be given in ordinary 
 foundling hospitals. Added to this, the nursing of a baby 
 6*' 
 
130 TALKS TO MY FATIENTS. 
 
 prompts and quickens that emotion wliich is most nearly 
 akin to motherly love, and so secures for the infant more 
 tending, snuggling, and caressing than can be given in most 
 asylums. 
 
 However, I am not writing for public institutions but pri- 
 vate homes, and have merely considered this point to refute 
 the impression that the mortality among these waifs with- 
 out father or mother is owing chiefly to cow's milk. Of 
 course, an intelligent, healthy, happy mother makes a para- 
 dise for infants, and the farther they drift from those be- 
 longings the nearer they come to purgatory, for this world ; 
 so near that the good Lord lets many of them through into 
 the better land. But, suppose they are not born to this 
 blessed estate, what next ? 
 
 KINDS OF POOD. 
 
 Get the best new milch-cow, and begin with one part milk 
 to three parts water, for a week or two, gradually increas- 
 ing the proportion of milk, as the stomach will bear. If 
 the baby looks blue and seems hungry too frequently, in- 
 crease the amount of milk. A small amount of white sugar, 
 so slight as to be merely perceptible to the taste, should be 
 added. 
 
 If the bowels are torpid, use brown sugar, or, if necessary, 
 occasionally molasses. When much of the latter is used, 
 acidity of the stomach is likely to be induced. If this does 
 not suffice, graham gruel may be used, made thus : One 
 table-spoonful of graham flour stirred in a little cold water, 
 and poured into one pint of boiling water. Boil twenty 
 
FEEDING OF INFANTS. 131 
 
 minutes, and stir wliile cooliing. Add one pint of milk, but 
 do not let it boil, unless the child has diarrhea. This keeps 
 the bowels in a good condition, and the unbolted wheat 
 supplies the bone and muscle-making material, so very 
 important for delicate children. 
 
 Gruel of farina or oat-meal, well boiled, to which a little 
 milk may be added, is also good, if the baby seems to need 
 a different diet. It should be but slightly sweetened. If 
 the gruel is to be given through the nursing-bottle, it will 
 usually require straining. 
 
 When the child is thriving well, avoid change of diet. 
 Many little stomachs are sorely tried by too many kinds, 
 because one friend advises this and another that. Decide 
 upon some course of feeding, and be careful to have it al- 
 ways prepared alike, and given at regular intervals ; and go 
 on thus, without there is an indication for a change. 
 
 Infants disturbed by some irritation of the stomach or 
 bowels often seem hungry when they are not, and can 
 be quieted by sipping freely of warm water, which has a 
 happy effect in this, that it dilutes and helps to remove 
 acrid secretions. 
 
 Babies often worry from thirst, and food is given instead 
 of drink. Two or three teaspoonfuls of cold water will often 
 satisfy, and thus delay their eating until the proper time. 
 Those who live by the bottle, or the spoon, are likely to get 
 more sugar and salt than those that are supplied from the 
 breast, and hence are more thirsty. 
 
 If there is a tendency to diarrhea, boiled bread, arrow- 
 root, and corn-starch, also unleavened bread, called Pass- 
 
132 TALKS TO MY PATIENTS. 
 
 over or Jew bread, pulverized and boiled in milk, are good. 
 If the drain from tlie bowels induces prostration, tlien weak 
 beef-tea is best; but if the stomach will not retain nour- 
 ishment, the beef-tea may be used in the form of injections. 
 Little ones must be sustained, as they die from: exhaustion 
 much sooner than adults. 
 
IlsTFAI^rTIKE DISEASES. 
 
 WATEE TREATMENT. 
 
 TTTATEE treatmeiit may be adapted to the wants of tlie 
 ^ ^ weak and the strong, the young and the old. Packs, 
 plunges, douches, all cold, were a peculiar feature of 
 the Priessni tz method ; hence, the name " cold-water cure " 
 is very often applied where hot or tepid baths are largely 
 used. 
 
 The temperature of the water maybe so varied, and its 
 uses so regulated, as to soothe the slightest or the severest 
 fever, and relieve chills, creeping or congestive, whatever 
 the age of the sufferer. 
 
 If the little one has a cold, let it be put in a warm bath up 
 to the chin> as warm as its sensitive skin will allow, which 
 will usually be about one hundred degrees; let the bath be 
 five or ten minutes in duration and then be reduced to ninety 
 degrees; then take out the little patient and rub it briskly. 
 This should be done just before tho nap, or on going to bed 
 for the night, because, in either case, it is easier to keep 
 the child warm, which is very important. 
 
 (133) 
 
134 TALKS TO MY FATIENTS. 
 
 When there is a feverish, heat about the body, apply 
 bandages of very soft linen, two thicknesses, reaching from 
 the armpits to the hips; over this put two folds of flan- 
 nel or thick cotton. While this is warm, take care that 
 the general surface of the body is not chilled thereby. To 
 prevent this; put on a long sack or double gown. The 
 bandage may be renewed during the night if the fever 
 returns. 
 
 If the lips are dry, put a roll of wet linen to the mouth ; 
 or, if the gums are swollen, a small ball of pounded ice in a 
 cloth for them to bite now and then will greatly soothe the 
 little one. 
 
 In case of constipation or colic, an injection of water at 
 ninety°eight degrees may be given, having a folded sheet 
 or several napkins under the hips. As to the amount, judge 
 from the indications ; pump slowly, and as soon as there is 
 an effort to expel on the part of the little patient, withdraw 
 the tube. 
 
 If there is diarrhea, sitz baths are very beneficial, even to 
 babies of a few months old. They will sit in a little tub or 
 washbowl with the water from ninety-five to eighty-five de- 
 grees, according to the strength and reactive power of the 
 child, and have the back and bowels washed ; the little pa- 
 tient enjoying it, even when quite feeble. The wet girdle, 
 as above described, is of avail in such cases. 
 . If there is griping or straining, ihjectibns of water at 
 ninety-eight degrees remove acrid matter and relieve inflam- 
 mations. If this does not quiet the little one, we may give 
 
INFANTINE DISEASES. 135 
 
 an anodyne injection of five or ten drops of laudanum in a 
 tablespoonful of starch-water. Immediately after, press a 
 napkin over the anus for ten or fifteen minutes, so that it 
 may be retained and absorbed. 
 
 Let the child live out of doors as much as possible ; riding 
 in a carriage, in the arms of a mother, is better for it than a 
 baby wagon, when it is sick. 
 
 The daily bath for babies, when they are well, should be 
 cool, ranging from ninety-five to seventy-five degrees, ac- 
 cording to their reactive power ; but when they are sick, the 
 temperature should be modified to meet the symptoms, re- 
 membering that in fever the surface is more sensitive to 
 cold ; hence, baths and bandages should be warm enough 
 not to shock the little patient, which does harm and makes 
 it dread what it might enjoy. 
 
 "We have had very sick children, whose parents feared 
 they should have great trouble in giving them the water 
 treatment, because they always cried when they were 
 washed, but after the first few baths they began to enjoy 
 them. 
 
 A little girl taken from the Orphan's Home was very 
 sick with a cough and chronic diarrhea. Every thing in 
 OUT bath rooms being strange to her, she screamed as 
 soon as she entered, and went down into her warm bath as 
 if she were descending into a fiery furnace or a freezing 
 flood. But finding the water comfortable, she grew calm, 
 and ever after begged for baths and bandages. When her 
 daily fever came on she would say, ^^Me feel sick; please 
 
136 TALES TO MY PATIENTS. 
 
 give me batli ;" and wlien it was over, she would tell every 
 one, " Me had nice bath. ; me feel better now !" 
 
 Children who have grown up under water treatment will 
 ask, when sick, for baths and bandages, their own sensations 
 being often the best guide as to what they need. 
 
 A child in the bath is always a sweet picture, and espec- 
 ially a pleasant one when the brightening face says, as well 
 as the words, *' Me feel better now !" 
 
 OTHEK TEEATMENT. 
 
 By contrast, see the subject of pills and castor oil, lying 
 in strong arms, the mother trying to hold the nostrils to- 
 gether and the tongue down, while she gives the pill which 
 perhaps, after all, sticks between the teeth, or the oil which 
 pours out of the mouth rather than in. 
 
 A gentleman who was partial to the Botanic system as 
 it was at first practiced, with its large doses and crude rem- 
 edies, said, when his child was sick he was obliged to call 
 another doctor, as the child's stomach would not hold all 
 the remedies prescribed. 
 
 Prom slight experience, we judge it is very difficult to 
 get any but Homoeopathic remedies within reach of the 
 stomachs of these little ones. Hence we know how glad 
 mothers are of any remedial means which sick children will 
 enjoy. 
 
 "Water may be administered in various ways so as to be 
 both pleasant and beneficial, even to these tender lambs. 
 
INFANTINE DISEASES. 137 
 
 But tact, intelligence, and experience must combine to ren- 
 der it a safe remedy. Arbitrary rules can never be a perfect 
 guide for the care of sensitive ones. A wise head and a 
 warm heart should temper the treatment. 
 
DISEASES OF OHILDEEE". 
 
 n\ yT'ANY mothers have requested that my forthcoming 
 book should give some suggestions in reference to 
 'the care of children. To dwell upon all their liabilities, and 
 the directions for each, would require another volume. But 
 I will try to give some hints, which may be of service to 
 those who have abeady a good degree of Hydropathic and 
 Hygienic intelligence. 
 
 First, bright children are liable to be brought forward too 
 rapidly by being encouraged to *^ show off," for the amuse- 
 ment and admiration of their friends. When such are 
 exposed to disease of any kind, they have not the power 
 to resist or endure, which those possess with less activity of 
 brain. They are more wakeful, more likely to have spasms 
 and various nervous diseases. These bright little ones burn 
 rapidly, die early, or live with such a sensitive organization 
 as to suffer more than others. Such children should have 
 very quiet surroundings, and be encouraged to sleep as much 
 as possible. Avoid much excitement in their diversions. 
 Do not entertain them with thrilling stories. The longer 
 they live without learning to read the better. Let them 
 (138) 
 
DISEASES OF CHILDREN, 139 
 
 grow like little animals till their bodies are robust, and the 
 result will be a better balance of brain-power, 
 
 TEETHING. 
 
 During teething there is a tendency to disturbance of the 
 bowels or the brain. For the former, there are suggestions 
 in the preceding chapter. To direct in reference to the lat- 
 ter is more difficult, but we will give a few hints. 
 
 If there is heat in the head, let the child sit once or twice 
 per day in a warm bath, for five or ten minutes, having the 
 head sponged with cool water during the time or have a 
 little wet cap or linen napkin about the head, as the little 
 patient may prefer. Give a pour at ninety degrees, or 
 reduce the bath to about that temperature before taking out 
 the child. Repeat the wet cap, or the head-washing, as 
 often as the heat requires. 
 
 If there be twitching of the muscles, jerking of the limbs, 
 it indicates great irritability of the nerves. A full warm bath 
 will allay pain and quiet the system, and often prevent 
 spasms. These symptoms are frequently induced by colic, 
 hence an enema of warm water is always safe, and often 
 serviceable. 
 
 In case of convulsions, put the patient in a full warm 
 bath, with cold water to the head. Spasms are very likely 
 to occur in sensitive children from stomach irritation. Hence 
 great care should be taken that the food be given at proper 
 intervals, and of such a quality that it may be easily 
 digested. 
 
 I remember a college professor saying that he was once 
 
140 TALKS TO MY PATIENTS. 
 
 called to a cliild in spasms, and that tlie mother said it had 
 a ** worm fit," but which he declared was a raisin fit; for, 
 after an emetic, a large amount of undigested raisins ap- 
 peared, to the great relief of the little patient. 
 
 The intelligent mother, who watches her child, can best 
 judge what food, and how much should be given, for she 
 knows what is well digested and on what it thrives. As a 
 general rule, milk, farinaceous food, and ripe fruits, each in 
 their season, are best for children. 
 
 The amount of unbolted wheat should be varied according 
 to the state of the bowels. Cakes, pies, puddings, unless 
 they are very simple, should not be used. Children brought 
 up on plain, nourishing food will not, as a general rule, 
 relish unwholesome compounds. 
 
 API'ECTIONS OF THE THEOAT AND CHEST. 
 
 In case of colds, croup, and whooping* cough, there are a 
 few general directions which are good. Keep the extrem- 
 ities warm, the skin active, the bowels open, and supply 
 an abundance of fresh air. A full warm bath on going to 
 bed, hot as can be borne, with a pour after at eighty degrees, 
 is always safe for diseases of this class. 
 
 If there is oppression of the chest, a wet bandage for the 
 same of double linen, with one of dry cotton or flannel over, 
 also double, made so as to fit the form and come up closely 
 about the neck, is of great advantage. Also, a wet cloth 
 about the throat, with a dry one over. These can be 
 changed in the night, if they become dry and the heat of 
 the body requires. 
 
DISEASES OF CHILDREN, 141 
 
 If there is a tight cough, hot fomentations for the chest 
 once or twice during the day, and the chest bandage after, 
 is valuable. The surface of these little ones is so sensitive 
 that care should be taken not to burn them with the hot 
 flannel, and, to guard against such a mishap, one thickness 
 of linen should be laid over the chest during the fomen- 
 tation. 
 
 Sometimes there is much heat of the body, while the 
 limbs are cold. In that case a broad girdle or half pack 
 may be used, also a hot foot bath, and rubbing the limbs 
 with dry flannels after, to equalize the circulation. 
 
 For mumps or other glandular swellings about the neck, 
 the wet bandage or warm fomentations on the part affected, 
 are a relief. Meet the general indications of chill and 
 fever as above described. 
 
 In cases of whooping cough, or catarrh, or colds, we find 
 great benefit from out-door air, if the little one can ride in 
 the arms of another, well wrapped, so as to keep the surface 
 of the skin warm. 
 
 EEIJPTIVE TEVEE. 
 
 The premonitory symptoms of measles, chicken pox, and 
 diseases of this class, are much the same, and a similar 
 course of treatment is safe for each. First, there is chill 
 and fever combined, with a general sense of pain and wea- 
 riness. Warm baths for the chill and wet bandages or wet- 
 sheet packs during the fever, are always good. The sen- 
 sations of the chill are a pretty safe guide. 
 
 Let the baths and bandages be of a temperature which is 
 
142 TALKS TO MY PATIENTS. 
 
 grateful to them. Wlien the skin is hot it is exceedingly 
 sensitive to cold. Hence wring the girdle or the sheet out 
 of hot water, and adjust it as promptly as possible. The 
 portion that the wet sheet covers should always depend 
 on the extent of the feverish surface ; often it is confined 
 to the body only, while the limbs are cold. Sometimes the 
 fever is constant, and the wet bandage or wet sheet should 
 be used much of the time, renewing one or the other every 
 two or four hours. In other cases, there will be fever only 
 once or twice in twenty-four hours. Keep the surface warm, 
 not hot, and the circulation equalized as nearly as possible. 
 
 These means,^ together with plenty of water to drink, 
 taken frequently though not in large quantities at a time, 
 simple nourishment, and fresh air, usually bring the little 
 folks safely through this part of their experience. 
 
 The milder cases of diptheria and scarlet fever are man- 
 aged on the same general principles above described. But 
 in the severer forms of these terrible scourges, there seems 
 to be a peculiar poison which induces great depression of 
 the life forces. In these sad instances, tonics, stimulants, 
 and antiseptics, need to be added to the list of water appli- 
 ances, and then often all means fail. As the attending phy- 
 sician can only decide when and what to use, I will not dwell 
 upon the remedies. 
 
 DISEASES OP THE SKIN. 
 
 There are a great variety of diseases of the skin inci- 
 dent to growing children — sometimes the result of inherit- 
 ance ; in others they arise from bad diet, bad air, etc. It is 
 
DISEASES OF CEILBREIT. 143 
 
 " "i 
 
 impossible in our limited space to describe each, or even to 
 divide them into classes. 
 
 As of the acute eruptive diseases just mentioned, so also of 
 the chronic class, there are general suggestions to be given. 
 There may be a troublesome affection, because the condition 
 of the stomach and bowels is bad. Hence we should first 
 see that these organs perform their functions properly. If 
 the skin is dry and rough, a full warm bath at night, for 
 ten minutes, with a cool pour after, should be given. 
 
 If there are pimples, boils, or patches of ulceration, cover 
 them on going to bed with soft wet linen, and put over this 
 dry cotton or flannel, to keep the surface warm. If the 
 compresses become dry at night and are a source of irrita- 
 tion, they can be removed or renewed, as symptoms may 
 indicate. If the ease is severe, the bandages should be used 
 during the day, when the little one takes a nap, or even 
 constantly if they be comfortably adjusted. If the child is 
 old enough to take a wet pack every day, or two or three 
 times a week, it will be found a valuable aid in all kinds 
 of skin diseases. 
 
 The first result of water treatment is an increase of the 
 eruption, as it brings impurities to the surface more rapidly ; 
 but if the child's habits are healthful, the cure will come 
 after a time, though it may be weeks or months before it is 
 accomplished. 
 
 The half- starved children of abject poverty are fery liable 
 to severe diseases of the skin, especially when they have a 
 change to better fare. As they begin to gain in flesh, some 
 disease of the skin is developed which is sJow of cure. Tho 
 
144 TALKS TO MT FATIEXTS. 
 
 j 
 old and diseased material is being thrown off. On the con- 
 trary, those fed too rich food, which can not be well assim- 
 ilated, are also liable to suffer in a similar way. 
 
 If the bowels or kidneys fail to do their work well, the 
 skin is overburdened with waste material. In all forms of 
 diseases of the skin, the diet should be very simple but nour- 
 ishing. Wheat, unbolted, for bread, mush and gruel, also 
 oat-meal, milk, and ripe fruits are excellent. If meat be 
 used, let it be lean, and cooked without butter or rich gra- 
 vies. No tea, coffee, pastry, or sweetmeats should be used. 
 
 The best way to purify the blood is to render the bowels, 
 skin, and kidneys active, so as to throw off the diseased 
 material while new and better is being made by fresh air, 
 pure water, and good food. 
 
CHILDEEIT^S DEESS. 
 
 /~^OENELIA, daughter of Scipio, motlier of tlie Gracchi, 
 ^-^ was once visited by a lady who displayed, with much 
 pride, whatever was then most fashionable for ornament — 
 gold, silver, diamonds, bracelets, pendants, and all the ap- 
 paratus which the ancients called mundum ^mdiehrum (wo- 
 man's world). 
 
 The guest expected to find much of the same sort, but 
 still more splendid, at the house of so important a person- 
 age, and therefore desired to see her toilet. Cornelia very 
 artfully prolonged the conversation till her sons returned 
 from school, and then, as they entered, said, ''See! here are 
 my jewels /" 
 
 Children, healthful, happy, well-bred, are indeed, to every 
 true mother's heart, jewels more precious than any other ; 
 jewels to which no foreign gem can add beauty or worth. 
 Thus endowed, they are always attractive. Without these, 
 no dress, however elaborate and costly, can render them 
 permanently pleasing. 
 
 Mothers, over-anxious about the dress of their children, 
 lead them to feel that it is of more importance than body 
 7 (145) 
 
146 TALKS TO 317 PATIENTS. 
 
 or soul ; whereas, tliej should be impressed with the fact 
 that tidy, pleasant, truthful ways are to be their chief charm. 
 That, having these, they are always acceptable to friends or 
 strangers. It is sad to see what should be a sweet young 
 face, wearing a frown, or a tear, because the dress is not 
 fashionable. Many a mother teaches, by precept and ex- 
 ample, that the highest duty of life is to dress her family 
 according to the most modern style. 
 
 Children are often so exquisitely attired that it is a won- 
 der how they can be kept tidy in such delicate material. 
 The mother must give her ^^ whole mind to it," as the dandy 
 said he did to the tying of his cravat. All this complex and 
 delicate dressing restrains the little ones in their healthful 
 sports. 
 
 I remember well the sweet little girl from the city, who 
 wished herself a boy, that she might have a nice time play- 
 ing, and not spoil her dress. She has gone now where 
 ** clean robes, white robes," cost no anxious care. 
 
 When health, convenience, and durability are consulted in 
 the clothing of children, it greatly lessens the amount of 
 nursing and washing in the family. 
 
 Such is our present style of dress for both sexes during 
 their early years, that there is an unhealthful exposure of 
 the lower limbs. The stirts are short and full, standing 
 out from the person, so as to afford little protection below 
 the hips ; and the limbs incased in but one thickness of cot- 
 ton, that fine and thin, reaching but little below the knee ; 
 and from thence to the ankle only a stocking, that often of 
 fine texture. A man or woman who should go abroad in 
 
CHILBEEN' S DEESS. 147 
 
 midwinter dressed thus, ^yollld be tlioiiglit to ^^dare death." 
 When fashion sanctions such a suit, even for those who are 
 still " in their tender years," can it be borne with impunity ? 
 Does not the fearful mortality among children show that 
 there is "something wrong somewhere?" and may not the 
 fault in part lie here ? Colds, coughs, croup, and inflam- 
 mation of the lungs are frightfully frequent during childhood. 
 These diseases do not come from want of clothing about the 
 chest, for enough and more than enough is usually worn 
 there, but from the extremities not being well clothed. 
 Fashion furnishes to boys a firmer fabric for their limbs 
 much earlier than to girls ; tht/ have no alternative till their 
 entrance into "teens" demands the long skirts. 
 
 Children should be clad with drawers, as well as dresses, 
 of a material suitable for the season. 
 
 But I seem to hear one and another say, that our little 
 misses would all look like young squaws clad thus. Well, 
 be it so ; they had much better, in cold weather, wear flan- 
 nel than muslin; for of wool, it may in truth be said, "No 
 matter if it is cold and wet, it is always warm and dry." 
 Of this material we have now such a variety of goods of 
 different textures, shades, and colors, that it would seem 
 that something miglit be selected suitable to clothe the lower 
 limbs of young girls and little children every way better than 
 the "thin stuff" they now wear. 
 
 We might as well send our girls forth in the winds of 
 winter clad in thin dresses as thin drawers. If those of 
 muslin are desired, then drawers of woolen or cotton flannel 
 should be worn under, coming down inside the stockings. 
 
148 TALKS TO IfF FATIENTS. 
 
 To prevent pressure of blood to the head, congestion of 
 the throat and lungs or other internal organs, the inferior 
 extremities must be kept warm. 
 
 Consistency in clothing is a jewel, most precious because 
 of its rarity as well as real worth. 
 
COll^FIDEKTIAL TO MOTHEES. 
 
 T CAN not close my liints as to the care of cliilclreii, with- 
 -■- out trying to prompt mothers to the closest supervision 
 possible in reference to their personal habits. For the 
 "olive-plants/' which bless or blight our homes, there is 
 seldom a lack of indulgent love, but often a want of intel- 
 ligent guidance. 
 
 Between the nurse and the governess, day-school and Sun- 
 day-school, our children are so little under the mother's eye 
 that often she knows very little of their true progress — 
 of whither they are tending. "No one can train children, 
 without being where they are the greater share of their 
 waking hours. They must be within reach of the eye or 
 ear, without the necessity of going to look or listen. 
 
 Children are shut up in the nursery, and young misses are 
 banished early to boarding schools, which makes too broad 
 a breach between them and their mother during their im- 
 pressible years. To be sure, out of this class some grow 
 up good, but many more get blemishes on body and spirit 
 that no after culture can efface. 
 
 Little ones are often given up to the care of a servant 
 
 (149) 
 
150 TALKS TO MY PATIENTS, 
 
 witk wliom tlie lady of tlie house would not trust her family 
 silver. At all ages we are more or less marked by the com- 
 pany we keep, but mostly during the tender, growing years. 
 Not only coarse ways, coarse words, but impure associations 
 are often implanted, which no after religious teaching can 
 perfectly eradicate. On this point I speak what I hioWj 
 not a mere theory, but a conviction, which is the result of 
 personal confession on the part of others. 
 
 Secret sin is often begun in the nursery, or at school, and 
 carried on until the victim becomes insane, imbecile, epilep- 
 tic, or suffers from some other very disagreeable nervous 
 affection. Many young men with broken health, minds 
 impaired, and life prospects that once were bright but now 
 blighted by this terrible sin against the body, have con- 
 sulted my husband. 
 
 Young women are not as often led astray, or are less 
 ready to confess their sin and shame ; still, some have told 
 me their sad story. How a playmate, or servant girl, first 
 led them to trifle with theh' own organization ; and how, 
 when they came to know it was wrong, they tried in vain to 
 correct the habit. The remorse, the hopeless wretchedness 
 which results from this practice can not be described. 
 
 Many intelligent Christian mothers have told me their 
 trials on this point : that the brightest in the family group 
 without any apparent cause was growing weak, sick, dis- 
 pirited, morbid ; and, at last, she detected the distressing 
 fact that little hands were working the worst mischief that 
 can be done to the human body. It is exceedingly difficult 
 to correct a habit in young children about which they are so 
 
CONFIDENTIAL TO MOTSEES. 151 
 
 sly. In older ones, the excitability will continue long after 
 tlie habit which induced it has been abandoned. 
 
 I might fill pages with the sad stories, the almost hope- 
 less struggles against this sin ; but I shrink from writing 
 and you from reading on this subject, and both will be in 
 vain, unless I can help mothers to live on more confidential 
 terms with their children. There should be freedom of 
 speech between them on all matters of delicacy, so that the 
 young may be informed, if temptation comes ; for when it 
 does come, the mother is not there to give warning. For 
 instance, say to a child that these delicate organs are never 
 to be trified with ; that all handling of them, save when 
 absolutely necessary, does harm ; that they are so con- 
 nected with the spine and brain by nerves that, if they are 
 irritated, they make a weak back, weak eyes, bad head, 
 spasms, etc. ; that God has commanded us to keep our- 
 selves pure, and if we do not we are punished by loss of 
 power in body and mind. All this may be put in simple 
 language, and so impressed on the child that it will be 
 remembered, if any one tries to lead it into these habits. 
 Do not delude yourselves with the idea that your children 
 are so closely guarded, that their associations are so select, 
 that they are in no danger. 
 
 Victims of this vice are to be found in the best of homes. 
 In many cases, the companion chosen by parents as a suit- 
 able associate for their little flock has been the one who has 
 brought this sin into what seemed a secure fold- Try to 
 help your children to feel so much at home with you that 
 they will find it easy to tell you their little trials and temp- 
 
152 TALES TO MT PATIENTS, 
 
 tafcions. For lack of this freedom they often confide in 
 those who can not give them good counsel. Children are 
 social, and they must have somebody to talk with. We, of 
 riper years, have often found the twilight hour the one best 
 suited to confidential talk. So children, if drawn from their 
 sports before they are tired, will enjoy a short story, a little 
 Bible reading, and perchance be led to some confessions 
 before the little prayer. Then there are the incidents of 
 the day, calling for commendation or criticism. 
 
 HOW TO TEACH THE TOUITa. 
 
 As to those matters of delicate mystery about which little 
 folks often inquire and get no information, let me say, tell 
 them the truth, if you tell them any thing. If you think 
 that they are too immature to understand or to make good 
 use of the truth, tell them so, and assure them when they 
 are old enough that you will explain it all to them, and be 
 sure to make good your promise. If they ask you where 
 babies come from, do not say that ^Hhe doctor brings them," 
 or that ** papa finds them under a black stump." 
 
 A little girl of my acquaintance once asked the man who 
 came into the field with his stump-machine, to *^ please save 
 all the babies" he found, '^ for mamma said they were hid 
 under the stumps!" 
 
 ' A new mother was asked, one Christmas morning, by a 
 little boy, how Santa Claus could get a real live baby in 
 her stocking! ^^Why," he added, ^^ mine had only a few 
 nuts, candies, and a little sugar dog, and it was chuck full." 
 
 Sooner or later, children find out all these fibs, and it les- 
 
CONFIDENTIAL TO MOTHERS, 153 
 
 . i 
 
 sens their respect for truth, or, at least, for the truthfulness 
 of the parent. Besides this, it is likely to incite a prurient 
 curiosity, and lead them to think there is something disrep- 
 utable in regard to all matters pertaining to maternity. A 
 little is learned, and that often from persons *^low and 
 vulgar," the imagination then supplies the rest, and, of 
 course, it can never be so pure to the mind as simple, scien- 
 tific truth. 
 
 An eminent clergyman once said to me that whatever his 
 mother told him on matters of delicacy always seemed 
 chaste, but that there were many subjects that he could 
 never disconnect from the low associations with which the 
 knowledge of them was first allied. 
 
 I once asked a physician, for whom I had great respect, 
 if he CO aid suggest some work suitable for a widowed 
 friend to give her son, who was just coming to manhood 
 and was in need of fatherly guidance. ^*Is your friend a 
 lady of intelligence and refinement?" asked the doctor. 
 "Yes," I replied. ^^Then tell her to talk to him herself. 
 She can do him more good than any book." 
 
 ** But," you ask, *^ why do children, now, need to know so 
 much more on these matters than when we were young ? 
 I knew nothing and came up unharmed." *'Well," as 
 we old folks always say, " the times have changed." Chil- 
 dren in these days have less manual labor to perform, and 
 more mental excitement. Food, books, social habits, all are 
 of a more stimulating character. Hence the nervous sys- 
 tem is more excitable, and nerve-power is not expended by 
 slow muscular action, as in those early days when the 
 
154 TALKS TO MY PATIENTS. 
 
 young were of necessity brouglit up to work. Therefore, 
 there is a greater tendency to unrest and passional excite- 
 ment. 
 
 Many mothers know their children need this information, 
 but feel in doubt how to impart the same. Krst, keep up 
 as far as possible the freedom of love incident to early child- 
 hood between yourself and little ones, and from time to 
 time impart instruction in an easy way, incidentally, when 
 some circumstance prompts, not as if you had some terrible 
 secret, which it was almost a disgrace to impart. 
 
 In Scripture reading you will find just the texts which, 
 when explained, will give children the needed information. 
 Let your earlier Bible lessons be the sweet stories of Jesus, 
 which, with a little explanation, the youngest will enjoy. 
 Avoid reading that which they can not comprehend. En- 
 courage their asking questions, and have them tell you what 
 they have been reading, in their own language, so as to be 
 sure they catch the meaning. In this way they will acquire 
 the habit of looking for the significance of every word, and 
 to inquire, if they do not comprehend. When they are old 
 enough, let them first read, with you alone, the story of the 
 birth of Jesus, or of John, and then after this, the Old 
 Testament history. 
 
 If they have been in the habit of understanding what 
 they read, they will ask questions which will call forth 
 explanations as to the mystery of birth, and the relations of 
 father and mother. If you meet this duty before the sexual 
 element is developed, before impure thoughts have been 
 implanted by others, they will listen with a simple scientific 
 
COjSFIBJEKTIAL to mothers. 155 
 
 interest, and be pleased with the analogies of nature. Ex- 
 plain to them that it takes two elements in the animal and 
 yegetable kingdom to perpetuate life ; that in blossoms the 
 pollen must fall upon the pistils to perfect the seed ; that 
 the eggs of the domestic fowl and the birds of the air must 
 be impregnated, or no little chickens or little birds will come; 
 that an e^^^ perfected either within or without the body, is 
 the great source of life for beasts, birds, fishes, and men. 
 Thus, let your little learner look up to the great law, and 
 the great Lawgiver, before lust and low associates have 
 taken him captive. 
 
 While you encourage freedom between yourself and chil- 
 dren, tell them that these matters are not topics for general 
 conversation, that it is right for them to talk with you, to 
 ask you all they wish to know, and as fast as they can 
 understand you will explain, but that they should not talk 
 with others; that each child should learn from its own 
 mother. You ask. At what age should this instruction be 
 imparted? **That must depend upon the symptoms," as 
 the doctors say. Some children develop in intelligence, and 
 in moral sense, much earlier than others. The faithful 
 mother knows best when knowledge will be well used, and 
 how soon it is needed. May she be wise in time. 
 
lE'TEI^TIOI^AL ABOETION. 
 
 A MANUAL to meet the Tvants of women would be 
 ■^-^ incomplete without a chapter on Abortions, or ^^Mis- 
 carriages," as they are called. Vv^e will consider them under 
 two classes — the induced and the accidental. 
 
 We have been consulted by many women who wished to 
 know how to produce a miscarriage, and by many more who 
 would prevent such a mishap. Young married women often 
 lack child-like repose in wedded love, and in the great 
 Father who orders the result, and so are anxious to avert 
 pregnancy. They fear the pain, the peril, the incumbrance, 
 or the expense. They married for the pleasure of ^^hus- 
 bandly petting," not being ready for the responsibility of a 
 parent. Now, no woman should marry unless she is will- 
 ing to accept all the possibilities of wifehood. Mothers 
 should well instruct their daughters on this point : that 
 little ones will be likely to come, and that it will be a 
 sin against the body and the soul to try to shirk the respon- 
 sibilities. 
 
 Many young wives, being anxious in this particular, 
 watch for the return of the menses, grow worried if they 
 (156) 
 
INTEKTIONAL ABORTION. 157 
 
 do not appear, and take violent exercise, powerful purga- 
 tives, patent nostrums, *^ female pills," etc., or, still worse, 
 resort to some mechanical means to stimulate the uterus 
 to expel its contents. All these means make mischief of 
 many kinds. Often the woman is not pregnant, but the 
 course of stimulants and irritants induce an excessive men- 
 strual flow, which becomes chronic, and is a source of debil- 
 ity, and frequently of severe disease. 
 
 But suppose conception had taken place—Nature's work 
 can not be thus abruptly arrested, without reacting un- 
 favorably upon the organs thus employed. I have seen 
 many cases of severe uterine disturbances induced in this 
 way. An abortion during the early months is likely to be 
 a'ttended with profuse, sometimes fatal flooding. But escap- 
 ing this, the uterus is left congested, and menstruation is 
 apt to be profuse afterward ; and it often requires a long 
 course of general and special treatment to cure the chronic 
 congestion, granulation, or enlargement which has been 
 induced. 
 
 Women, for lack of information, are often misled. Many 
 suppose that the earlier the period of delivery the less the 
 peril, while the truth is just the opposite. Nature's way is 
 the best way. Delivery at the ninth month is the safest 
 time, and the nearer we come to that the better. The most 
 serious cases of hemorrhage I have ever seen have been at 
 six weeks, or two or three months. The uterus is then so 
 small, that the removal of the placenta, or after-birth, by 
 artificial means is exceedingly difficult, and, until this is 
 removed, the patient is liable to die of flooding, or from 
 
158 TALKS TO 31 Y FATIENTS. 
 
 inflammatioii induced by the absorption of the decaying 
 placenta. 
 
 Those interested in inducing abortions, for the sake of the 
 fee, usually make light of these dangers. I have many times 
 been called in counsel when the case had taken a serious 
 turn, and found that the young wife was evidently ignorant 
 of the liabilities, and supposed that the bougie or the tent 
 would bring on a sickness like that of the ordinary monthly 
 period. 
 
 There are cases of induced abortions, where there is no 
 apparent immediate injury. Judgment is not always exe- 
 cuted speedily, therefore abortionists make the most of 
 these cases to secure confidence in their evil work. But the 
 violence done to the nervous and circulatory systems will 
 tell in time. Physicians should be like ministers — guides 
 to the people, and when their patients want to go wrong, 
 they should lead and hold them to the right. 
 
 I know many a wife who has lost her health, and some 
 who have lost their lives, when I felt that the physician was 
 the greater sinner of the two, in that he sinned against 
 greater light and with less temptation than beset the gay 
 young wife, or the already overburdened mother. I have 
 no words to express how I regard those who, having knowl- 
 edge, use it for the sake of the fee, to blight, and not to 
 bless. 
 
 I know the arguments of these worried women, how each 
 will depict her needs, and make hers an exceptional case, 
 and promise pay, and assure you that '^ It must be done ! 
 You can do it better than any one else, and now that it is 
 
INTENTIONAL ABORTION, 159 
 
 80 early, there is no life, hence no sin," etc. As to the lasfc 
 argument, there is life, human life, as truly during the first 
 month as at the ninth, only not as vigorous. The fact is, 
 that the impregnated ovum lives and grows according to 
 the laws which regulate the human body, makes it a human 
 being, and an attack with intent to kill is crime, whether 
 the victim be large or small. 
 
 "But," says our client, "quickening is not till the four- 
 and-a-half month, and so, abortion before that time is no 
 sin." True, that is about the time that the mother becomes 
 conscious of motion, but it lives, moves, and grows just as 
 truly before as after, only the motions are so slight as not 
 to be appreciated. "But," some one says, "what shall 
 we poor, sick, overworked women do, who have now 
 more children than we can well look after — more than 
 our husbands can well provide for ?" For such I have 
 no advice. I can only commend them to a husband's con- 
 sideration, and the counsel of a conscientious family phy- 
 sician. 
 
 There are conditions when it seems as if pregnancy should 
 be avoided. Eemember, I say avoided, not interrupted. 
 Once begun, go if possible to the close; that is the only 
 safe way for body or spirit. I know your burdens are 
 heavy, but sin is heavier. Be the true mother, whether 
 you are among the weary ones of earth, or those so worn 
 that the dear Lord gives them an early release from mortal 
 care. 
 
 Where one woman, having healthful habits and a cheer- 
 ful spirit, suffers from too frequent child-bearing, scores are 
 
160 TALKS TO MY PATIENTS. 
 
 broken in health by efforts to prevent conception, or to in- 
 duce abortion. 
 
 The German women welcome babies, have them in great 
 numbers, and are robust. The French, with their preven- 
 tions, have very few children and are delicate and sen- 
 sitive. 
 
 While writing this chapter, a young wife called ; she had 
 a sick face, and eyes expressive of great mental agony. *^I 
 have done wrong," she said, " and am very sorry ; I have 
 come to you for counsel. I had excellent health until a 
 few months ago, when my monthly period not coming so 
 soon as expected, I began to be fearful I was pregnant, 
 and as we had two little children, and my husband's means 
 are moderate, I did not want any more just yet ; so I sent 
 to the doctor to give me some medicine to bring on my 
 menses, thinking if I was in a family-way it would do no 
 harm, as it was only a few days over my time. The doctor 
 said he thought I was pregnant, and it was a pity to have 
 another baby when this one was so young, and that he 
 would use an instrument to bring me around all right, which 
 would do no harm ; that there was nothing wrong in so 
 doing. I yielded, and have never been well since. I have 
 had a bad leucorrhea, a weak back, pain and pressore in 
 front, and I am so afraid that terrible instrument has done 
 some harm which can never be cured ; that I shall never 
 have any more children, and then I should be so sorry. 
 Besides all this, I have such remorse that I can not eat or 
 sleep as I used to, and have lost my flesh, strength, and 
 cheerfulness of spiiit." 
 
IlS^TEKTIONAL abortion. 161 
 
 I assured her that she could be cured, and that though 
 she had done wrong, the dear Lord forgave all the truly 
 penitent ; that she could not ^Qi well if she continued 
 thus to worry about the injury done, or the sin committed. 
 During this conversation hope dawned in her darkened 
 countenance, and she said, " You have done me good, and 
 I will try to get well, and will welcome the little ones, few 
 or many." 
 
 I have given you this instance to illustrate what I have so 
 often seen, that the fear of injury done, and remorse for 
 the deed, drives women almost or quite to despair. There 
 is a peculiar look in the eye which I note, and dread the 
 confessions of such patients when they come for consulta- 
 tion. 
 
 In my early practice I was often asked to induce abor- 
 tions, for the impression seemed to prevail then that the 
 important part of woman's work in the medical profession 
 was to prevent pregnancy or procure abortion. With ad- 
 vancing years, I find myself the mother-confessor of many 
 who have done mischief, and now want to be absolved from 
 the mental and physical misery entailed. 
 
 Many are victims of a melancholy which amounts to mono- 
 mania. When children die, or troubles come, they think 
 they are being punished for this sin against their mother- 
 hood. There are two causes of this mental condition — the 
 sense of wrong, which invites remorse, and the uterine dis- 
 ease that is likely to ensue from an intentional abortion, 
 which brings mental depression. 
 
162 TALKS TO MY PATIENTS, 
 
 Since writing the foregoing chapter, a prize essay on this 
 subject has come under my eye. If my readers wish to 
 know more on this point, let them read the book entitled 
 '' Why Not ?" by Dr. H. E. Storer, of Boston. The mani- 
 fold miseries resulting from produced abortions there por- 
 trayed accord with my personal observations. 
 
AOOIDEE'TAL ABOETION. 
 
 "YTTE will BOW consider our second class, that is, when 
 ' ' an abortion is not desired, but dreaded. The present 
 enfeebled condition of American women furnishes many 
 such. Some who haye been sinners of the first class, find 
 themselves sufferers in the second. Many of those who did 
 not want children early or rapidly, in after years often 
 desire offspring ; but the uterus has been so often prompted 
 to ^^cast its fruit before the time," that the habit is formed, 
 and it will do so without artificial aid. I have seen many 
 a mother in deep grief, not only for the children she had 
 lost by death, but for those she might have had. 
 
 There are various phases of chronic uterine disease that 
 render the organ irritable, so that hemorrhages and spas- 
 modic contractions occur, endangering pregnancy. We have 
 seen many of these pass on to full term after the uterine 
 disease was cured, who had previously had several abor- 
 tions, despite all means to prevent it. Usually, they were of 
 the class requiring local treatment, which we will not dwell 
 upon, as we are writing for the patient, and not for the 
 
 medical profession. 
 
 (163) 
 
164° TALKS TO 3IY PATIENTS. 
 
 PEEVE]S'TiyES. 
 
 When tlie hahifc of abortion at a given time has been 
 established, it is better to let two or three years pass with- 
 out pregnancy. During the time, improve the general 
 health, and then the mother will be much more likely to 
 go on safely than when frequent conceptions occui\ If 
 there is any special disease of the uterus, it is better to have 
 it cured lefore impregnation takes place, though there are 
 means which will serve to help, in case one is so unfortu- 
 nate as to have pregnancy and uterine disease combined. 
 
 When the patient has leucorrhea, weak back, and a sense 
 of bearing down, the sitz bath, bandages, and vaginal injec- 
 tions, as described in the chapters on Prolapsus Uteri and 
 Leucorrhea, will be of great advantage. 
 
 Those subject to profuse menstruation are more likely to 
 miscarry than those in whom the flow is moderate. To such, 
 we commend the chapter on Menorrhagia, Those who have 
 had previous abortions are more liable to the accident at 
 about the same date of their pregnancy. There is also 
 more danger at the period in the month when menstruation 
 would have occurred, hence there should be especial care 
 at these times about over-exertion or mental excitement. 
 
 When there is habitual constipation, the accumulation of 
 faeces, the presence of hemorrhoids may irritate the uterus, 
 in a sensitive person, so as to induce a miscarriage. Also, 
 conjugal excess has the same liabilities. 
 
 Avoid straining at stool. On retiring at night, half a 
 pint of cool water taken into the bowels, and retained, will 
 
ACCIDENTAL ABORTION. 165 
 
 often secure a free movement in tlie morning; otherwise, 
 it is best to resort to an enema of tepid water, large as can 
 be taken when lying on the left side, so as to relieve the 
 bowels perfectly. 
 
 Many might escape a miscarriage if they had been better 
 informed on this subject. For instance, those who are weak 
 often find, during the second or third month, that they have 
 a slight flow, and, supposing that an abortion is inevitable, 
 take no care to prevent it ; others take an opposite view, and 
 think if they have no pain there is no danger, and so they 
 go on until it is too late to prevent it. 
 
 Now the truth lies between the two extremes ; there is 
 danger, but there is also hope. If there is any flow of 
 bright color, however slight, the prospective mother should 
 take to bed or couch. Use two or three cool sitz baths a 
 day, wear the wet girdle, and keep the bowels free with 
 enemas. If there is any tendency to pelvic pain, after the 
 bowels have been evacuated by a large enema of tepid 
 water, take fifteen drops of laudanum in a table- spoonful 
 of water into the rectum, to retain. I have known many 
 threatened abortions prevented by these simple methods, i 
 
 In case the flooding becomes profuse, there is little hope 
 for the child, and, unless it is promptly arrested, the mother 
 is in peril ; and if there is no physician at hand, use cold 
 compresses across the abdomen, rub ice over the pelvis, and 
 introduce bits of ice into the vagina. 
 
 CAEE nUEING AN ABOETION. 
 
 Sometimes, despite the best of treatment, the little one is 
 
166 TALKS TO MY PATIENTS. 
 
 lost. If pain continues and tlie flow increases, we may be 
 quite sure this will be the result, and a physician should 
 be summoned immediately. 
 
 In case of flooding before medical aid arrives, follow 
 the directions given for uterine hemorrhage after delivery 
 at full term. 
 
 Occasionally, the foetus escapes without premonitory symp- 
 toms, the after-birth being retained. In such cases, the 
 patient is in peril until it is removed, for severe and fatal 
 flooding may ensue when least expected. 
 
 I remember a call at midnight to a wife in the country, 
 from whom, two weeks previously, a foetus at about the third 
 month had been passed, without pain and without flow, as 
 she arose in the morning. She kept the bed for a day, but 
 as no pain or flow appeared, she went about her work as 
 usual, not realizing that she could be in danger when she 
 felt so well, and when trouble came she had no physician 
 near, and no one at home to summon aid. When I reached 
 her, no pulse at the wrist was perceptible. Ice was applied 
 over the pelvis, and the after-birth promptly removed by 
 the hand. Brandy, tea, and such restoratives as her stom- 
 ach would retain, were administered. For hours she hung 
 between life and death, and at last rallied sufficiently to 
 retain beef tea, but it was months before the color returned 
 to her lips, or strength to her limbs. 
 
 I have given this instance to impress the fact that, long 
 as the after-birth is unremoved, there is danger from flood- 
 ing. I find many who suppose the placenta is so small in 
 early pregnancy, that it will do no harm if retained. Hem- 
 
ACCIDENTAL ABOnTlOK, 167 
 
 orrhage is the usual result, thougli occasionally it decay$ 
 and induces irritation and inflammation by absorption. 
 
 The general treatment after an abortion should be much 
 the same as that described after delivery at the end of nine 
 months : sitz baths, bandages, vaginal injections, quiet, etc. 
 The same care in reference to over-exertion should also be 
 observed, till the next monthly illness is well passed, which 
 is liable to be more profuse than usual. Through lack of 
 care at this point many are left confirmed invalids. 
 
 There is more danger of disease after an abortion than 
 after delivery at full term. Women not realizing this, fail 
 to take the long rest they need. They resume the duties 
 of wife and mother while the uterus is still sensitive, and 
 the organ remains congested. Then ensues leucorrhea, pro- 
 lapsus, profuse menstruation, etc. 
 
 EELATIVE DANGEES OF THE TWO CLASSES. 
 
 The peril from intentional abortions is much greater 
 than from the accidental. You ask, Why ? The latter class 
 have no remorse to endure, no sense of sin or shame to 
 cover. These sins wear rapidly on a sensitive organization. 
 Moreover, Nature completes her work, or repairs her fail- 
 ures best when least interfered with. 
 
 In the spring every orchard produces millions of blos- 
 soms, which never set to fruit, and of the little apples well 
 begun many will fall to the ground before they ripen ; some 
 because there is not life enough to sustain all, others be- 
 cause their attachment to the parent stem was too slight. 
 Meanwhile, the great tree stands unharmed by the dropping 
 
168 TALKS TO MY PATIENTS. 
 
 off. But let it be hurriedly deprived of untimely fruit by 
 rude boys, and it will be bereft of leaves, twigs, bark, and 
 branches. So of the fruit of the womb. If the natural 
 supply fails, if the ovum be blighted, or if the attachment 
 to the uterus be imperfect, then Nature will cast it off in the 
 best time and the best way, or at least give indications when 
 scientific aid is required. 
 
 If, *' without cause or provocation," pregnancy be forcibly 
 interrupted while the blood is setting vigorously toward the 
 uterus, for its own supply and that of its inmate, we arrest 
 a strong nervous and circulating force in the discharge of 
 its duty, and hence must do great violence to the established 
 order of things. Unless there is a tendency to miscarriage, 
 it is not easily accomplished. Severe drugging and serious 
 injury to the uterus may be inflicted, still the little life 
 within may go on undisturbed. But if, for any reason, there 
 is a proclivity in that direction, a slight accident may induce 
 an abortion. 
 
STEEILITT. 
 
 r I ^HE scarcity of children in tlie halls of the rich, the 
 -^ abundance of little folks in and around the hovels of 
 the poor, is a matter of common observation. Men have 
 written long and learned articles on the law of human in- 
 crease, showing much thought and extended research. Doc- 
 tors of Divinity and of Medicine talk and write of the dwin- 
 dling of the true American race, giving us statistics of the 
 ratio of increase as it once was, and now is, among our own 
 '^people. To review this ground would be to write a large 
 book instead of a short chapter, so I shall simply confine 
 myself to a few suggestions which have occurred to me 
 from the care of those who longed for childi'en, but to 
 whom they were denied. 
 
 There are many who, for selfish reasons, ward off the 
 responsibilities of maternity. Besides these, there is a larger 
 class than is usually supposed to exist, who long for a 
 son as did Hannah of old, and to whom the little Samuel 
 has never come. Some of these did not want little ones in 
 their early wedded years, but later would have gladly wel- 
 comed them. 
 
 (169) 
 
170 TALKS TO MY PATIEKTS. 
 
 Girls grown up indulgently, with little thought save to 
 get the most pleasure possible out of life, are apt to feel 
 when they are first married that they can not and will not 
 bear children. But when the freshness of young wifehood 
 begins to fade, they want some new interest, and feel that 
 they have nothing in particular to live for. Then the moth- 
 erly yearning developjS, and they desire offspring. Doubtless 
 many of these might once have become mothers. 
 
 HABIT. 
 
 When marriage has been made unfruitful by varied 
 means for a series of years, it is likely to continue thus, 
 even if the preventives are discontinued. The uterus is 
 influenced by habit, evidently quite as much as any other 
 organ of the body. So when it has been, year after year, 
 accustomed to cast its ovum at a given time because im- 
 pregnation has been prevented, it is likely to continue to do 
 so when preventives are not u.sed. Hence those who by 
 the simplest and safest of means prevent conception, often 
 find in after years that when they wish children they are 
 denied. 
 
 The uterine habit of expelling the ovum seems to be estab- 
 lished, even when no positive disease can be detected. There 
 are many others who, by using vaginal injections of water 
 too cold, or improperly medicated, in order to prevent con- 
 ception, have thereby induced uterine congestion or spas- 
 modic irritability, which may result in sterility. Water, 
 pure or medicated, can be used of varying temperature by 
 means of a syringe to meet certain diseased conditions with 
 
STERILITY, 171 
 
 advantage, but applied without discrimination wlien the 
 organs are in a peculiarly sensitive condition, often in- 
 duces serious disease. 
 
 LOCAL CAUSES. 
 
 There are others who take remedies as they near the 
 monthly period, "to be sure," as they say, "to bring it 
 on,'' fearing impregnation has taken place. The result may 
 be uterine irritation by a hastening of the period, or increase 
 of the flow terminating in a slight congestion, which, re- 
 peated for successive months, becomes severe. No doubt 
 many an impregnated ovum is lost in this way, when there 
 is no symptom beyond that of being a little sicker than 
 usual, which habit continues long after the means which 
 were first used to induce it have been discontinued. 
 
 Besides these, the use of sponges, bougies, and other me- 
 chanical means, to prevent conception or induce abortion, 
 result in more or less of uterine inflammation, or irritability, 
 or both. Hence the varied ways taken to prevent preg- 
 nancy for the present, often induce permanent steriKty. 
 !Firstj the more impressible period for procreation is past, 
 and a habit of rejecting the ovum also established. Be- 
 sides this, organic disease is induced which does not neces- 
 sarily preclude pregnancy, but makes it less probable, and 
 also renders a miscarriage much more liable to occur. 
 
 On the precise nature of those local conditions which pre- 
 vent conception I will not dwell, as they can only be de- 
 tected or corrected by the experienced physician having th^ 
 
172 TALKS TO MY FATIENTS, 
 
 patient in charge. Suffice it to say, that we have seen cases 
 of apparent sterility overcome by curing disease or displace- 
 ment of the uterus, also by correcting flexion, and stric- 
 tures of the cervix. The latter is sometimes remedied 
 by dilatation, sometimes by incision, according to the pe- 
 culiarity of the case, and the preference of the attending 
 physician. Excessive menstruation, profuse leucorrhea, or 
 tenacious lymph secreted within the os uteris may prevent 
 conception. 
 
 ' GENEEAL COXDITION. 
 
 Besides the local troubles, there are constitutional condi- 
 tions which have an important bearing on the law of human 
 increase. A well-balanced temperament renders procrea- 
 tion much more probable ; or, in other words, if the brain 
 is developed at the expense of the body, babies are likely to 
 be scarce. Mind and muscle must go together to make 
 womanhood complete. Hence those wives who are intensely 
 absorbed in literary pursuits, so as to impair bodily vigor, 
 have few if any children. So, too, those devoted to fash- 
 ionable life exhaust their nervous power in their round of 
 gayeties, and are less likely to become mothers. Besides 
 this, their style of dress usually interferes seriously with the 
 nutritive processes of the system, of which we will speak 
 in the succeeding chapter. 
 
 The kind of food used has also an important influence on 
 procreation. The horticulturist knows if his soil is too rich 
 the blossoms will produce more petals, but diminish in the 
 amount of seed furnished, and if long over-nourished the 
 
STERILITY. 173 
 
 latter will fail entirely. The French fable of the woman 
 and her one hen, which she feci abundantly hoping for more 
 than a daily eg^^ and which soon failed to produce any, 
 is like most fables, founded on fact. Animals fed on too 
 rich, or too concentrated food, greatly diminish in their 
 procreative power. Babbits fed on fine sugar chiefly cease 
 to breed, and dissection shows a fatty degeneration of the 
 ovary. 
 
 It is a general law that adipose tissue, or fat, increases 
 as the reproductive power decreases. After the menopause, 
 women grow stout, unless some diseased condition or con- 
 stitutional proclivity prevents. Those who are very fleshy 
 have few if any children. 
 
 The delicacies so relished by ladies of leisure are to their 
 organization what fine sugar is to the rabbit. Soft cellular 
 tissue rather than muscular fiber results from their mode 
 of life. They may be plump, but are not strong. Is it 
 any wonder, then, that children are few on Fifth Avenue, 
 while they swarm in great numbers about the Five Points, 
 and that the same rule holds true in reference to every town, 
 large or small ? Indeed, women of wealth in the country 
 have adopted so many of the sins of their city sisters, that 
 they, too, have childless homes. The higher the grade of 
 civilization, or rather the greater the excesses which wealth 
 and leisure bring, the lower will be the ratio of reproduc- 
 tion. 
 
 New England, as it was^ furnished the best of mothers- 
 women with active brains and busy bodies, women who bore 
 children and literally ** brought them up," who ruled their 
 
174 TALKS TO MY PATIENTS. 
 
 own homes and did their own work. With them there was 
 a healthful activity of mind and body, which secures what 
 physiologists call a well-developed and harmoniously exer- 
 cised organization, which is especially favorable to repro- 
 duction. 
 
I^EEYOUS DEEAl^GEMEI^T. 
 
 W 
 
 CAUSES. 
 
 ITHIN the last half century there has been a great 
 increase in the variety and frequency of what are 
 termed nervous diseases. Mrs. Child once told an amusing 
 story of an old lady who had some symptoms not well un- 
 derstood, which the physician pronounced nervous. ^^Oh, 
 no," said the lady, '' that can not be, for I was born before 
 nerves were in fashion!" Many of us have painful evidence 
 that we were born since that time. 
 
 The advance of civilization brings greater cultivation of 
 the mental powers, sentiments, and passions. Added lux- 
 uries, indulgencies, and plans for business or pleasure, all 
 tend to a higher development of the nervous system, and 
 hence render it more susceptible and more easily deranged. 
 Modern physicians have spent much time in investigating 
 the pathology of nervous diseases, and still they are usually 
 a perplexity. 
 
 An over-taxed nervous system often shows itself by some 
 sensitiveness, the cause of which is obscure. It may be pain 
 in the face (tic-douloureux), or in the leg (sciatica) ; the eye 
 7 (175) 
 
I7G TALKS TO MY FATIENTS, 
 
 may be super-sensitive to liglit, the ear to soimd, or a tooth 
 may ache without any visible defect. Frequent attacks of 
 neuralgia, severe nervous headache, or periods of peculiar 
 depression may occur without apparent cause. Besides these, 
 there is a long list of indescribable sensations, annoying to 
 the physician, and distressing to the patient. 
 
 PECULIARITIES. 
 
 An invalid young lady coming under my care, brought a 
 letter from her family physician which read thus: *^The 
 patient I send you is a sufferer from some anomalous ner- 
 vous disease, which I have not been able to reach, but hope 
 you will be more fortunate." 
 
 Now, these anomalous nervous diseases are like the con- 
 tents of Pandora's box. When we find ourselves being vis- 
 ited by any of them we should at once inquire, What is 
 unhealthful in our habits ? Do we work, or worry too 
 much ? Are we properly nourished by food, and refreshed 
 by sleep ? Have we a chronic heartache, which wears by 
 day and night ? 
 
 The cause of these nervous troubles is sometimes mental 
 and sometimes physical. Many a serious invalid could be 
 cured by cheerful resignation and healthful occupation, but 
 discarding these, there is no physician who can reach the 
 case. 
 
 Sometimes a bad spirit makes a bad body, and sometimes 
 a bad body makes a bad spirit. So intimate is the connec- 
 tion between them, that if one is wrong it disturbs the 
 other. Often it is as difficult to tell where the mischief 
 
NERVOVS DERANGEMENT, 177 
 
 began, as it is to find out, when two boys have a quarrel, or 
 two girls a ^^fuss,'' who began it. But in either instance, by 
 keeping a sharp eye on both parties, and on all the points 
 in the case, we shall soon see which leads the way into 
 trouble. 
 
 Dyspepsia, derangements of the liver, diseases of the ute- 
 rus, induces nervous disturbance and mental depression, and 
 the spirit brightens as the body improves. On the contrary, 
 certain morbid emotions invite and perpetuate diseased con- 
 ditions. 
 
 The affections called hysterical are so varied in their man- 
 ifestations that we can say nothing definite respecting them. 
 They simulate so perfectly other diseases as often to de- 
 ceive for a time the best physician. True currency has 
 usually a counterfeit. So most forms of chronic disease 
 have their similitudes in the form of hysterical symptoms. 
 
 We have seen all manner of spasms, spinal irritations, 
 cramps and colics, which seemed to arise from an unhealth- 
 ful mental rather than physical condition. Patients thus 
 afflicted are usually honest in their statement of symptoms. 
 
 Morbid sensations have been magnified by much thought 
 and care, and the patient needs diversion, change of place, 
 and hygienic help. Some persons desire to be considered 
 delicate, and for lack of work or diversion want to be doc- 
 tored. These have so lively an imagination that they can 
 not tell the truth in regard to their own case, though they 
 may be trustworthy in reference to other matters. When 
 the moral as well as physical sense has become perverted, 
 they are more difficult of cure. 
 
178 TALKS TO MY PATIENTS, 
 
 HELP IMPAETED PT AKOTHEE. 
 
 All classes of nervous patients are greatly helped by tlie 
 personal superyision of some one who, in character, is quiet, 
 self-possessed, contented, and positive. For instance, hys- 
 teria, insanity, screams, and spasms, in a great variety of 
 cases, can be controlled without a single remedy, save that 
 of sending away all troubled and excited persons, and hav- 
 ing some suitable individual sit beside the patient. The 
 less done at the time the better. The cure must come by 
 correcting the habits of mind or body which induced the 
 attacks. 
 
 Many women who have been confined to the bed for 
 months will walk without the least protest, under the influ- 
 ence of a positive person for whom they have respect. How 
 far the poor patient is responsible for all these freaks is 
 often difficult to decide. They may so long have lost self- 
 control, that they can not regain it without help. 
 
 HYSTEEIA. 
 
 The question is often asked, '^Can a person help having 
 the hysterics?" No doubt many might, if they tried early 
 enough, but once having given way to their feelings, it is 
 difficult if not quite impossible to resume control before the 
 nervous paroxysm has expended its force, unless some strong 
 will comes to the rescue. Eits of laughing, crying, and 
 cramping can be guarded against, by avoiding what unduly 
 excites or exhausts the nervous system ; but when self-pos- 
 session is once lost, the patient is like a frightened horse, who 
 
NERVOTIS DERANGEMENT, 179 
 
 runs all the faster wlien be finds his master no longer holds 
 the reins. 
 
 Hysterical persons, for the most part, should neither be 
 blamed or petted, but rather steadied in those healthful 
 habits of body and mind which secure self-control. Avoid 
 all severe measures if possible, but if the case is desperate, 
 we do sometimes put the patient into the plunge, or dash 
 with cold water, with the best results, and seldom have to 
 repeat the process. The shock on the nervous system arrests 
 the spasmodic action for the time, and proves such an alter- 
 ative that it is not likely to return. 
 
 MODE or LIPE. 
 
 The fast ways of the American people, with their hurried 
 lives, late hours, and varied excesses, wear upon the nervous 
 system of all, especially that of sensitive, impressible women. 
 Those who are brilliant and fascinating early become frail, 
 freaky, fidgety — a condition difficult to cure, but which could 
 be prevented by leading a quiet life, with more of simple, 
 useful work, of which this world furnishes an abundance. 
 
 Anxiety as to dress, social position, calls and company, 
 wears one more than needed work, and the exhausted system 
 craves some stimulus. It makes one wakeful, and deprives 
 of a relish for plain, nourishing food. Nerves exhausted, 
 and then over-stimulated, soon get beyond the control of 
 patient or physician. After tea, coffee, wine, and brandy 
 have been her reliance for a time, the subject finds herself 
 unable to ^^keep up" without their aid. Of this class we 
 have seen many sad cases. 
 
180 TALKS TO Iir PATIENTS, 
 
 By all this, we do not mean to prove that the ^^ former 
 days" were better than these, but would rather say, in the 
 language of the children's hymn : 
 
 '' I thank tiie goodness and the grace 
 That on my biith have smiled.*' 
 
 We rejoice in the added facilities given women for general 
 culture. Statistics tell us the length of human life is on the 
 increase. The light of popular physiology has not been in 
 vain. We have more leisure, more means, more books, and 
 better schools than our grandmothers enjoyed. For all 
 these we give thanks, and are grateful. The point we dep-. 
 recate is that so much time and means are expended in pur- 
 suits not ennobling, not invigorating to body or soul. Our 
 good things, given by the ^^ Father of Lights," should not 
 bring feebleness in any respect, but a more fully-developed 
 womanhood in all directions. 
 
 As want of sleep is the one great source of nervous de- 
 rangement, we will next present our thoughts on this sub- 
 ject as given in The Herald of Health for 186 T. 
 
SLEEP. 
 
 " Tired nature's sweet restorer, balmy sleep ! 
 Who, like the world, his ready visit pays 
 Where fortune smiles ; the wretched he forsakes* ; 
 Swift on his downy pinion flies from woe, 
 And lights on lids unsullied by a tear." — Young. 
 
 TTTOMEN are supposed to be most largely endowed 
 ^ ^ with the soothing elements. Hence, among the 
 household divinities, the wife should be as the goddess of 
 sleep, giving every one their portion in due season, or, at 
 least, so ordering the ways of her household as will best 
 conduce to this happy result. The peace and prosperity of 
 every family depends largely upon each member having 
 the requisite amount of sleep. Hence, the lady of the 
 house should look after all — from master to servant, from 
 mistress to maid, from the youngest child to the grown-up 
 lads and misses— with reference to this all-important point : 
 that is, do they sleep long and well ? The mother often 
 says, by way of excuse : " The baby is cross for want of a 
 nap." The same apology might often well be made for 
 children of larger growth ; they, too, are often so tired 
 they can't be good, and still do not know that it is sleep 
 they need. During the early years of our work in the in- 
 valid world, I was impressed with the idea that much 
 
182 SLEEP. 
 
 irritability and multiplied infirmities were induced by lack 
 of sufficient sleep. Subsequent observation has confirmed 
 these early opinions. 
 
 SLEEP PHYSIOLOGICALLY CONSIDEEED. 
 
 Let us take a physiological view of our sleepy subject. 
 
 Those organs which connect us with the w )rld about us 
 tire by use, by activity, and hence the need of that tem- 
 porary suspension of action which we call sleep. Thus the 
 mind, muscles, eye, ear, and indeed every sense, every vol- 
 untary power, must have its period of rest, that the system 
 may repair the waste of nervous force induced by their 
 action. The nutritive functions continue their work from 
 the beginning to the end of life with little variation. Or, 
 in other words, the involuntary forces of our bodies go on, 
 with but slight modification, both when we wake and when 
 we sleep, year in and year out. To illustrate : — The heart 
 keeps up its steady tick-tack by night and day, like a true 
 time-keeper, to the end of our pilgrimage, even if it be 
 four-score years or more, while our voluntary powers weary 
 with use. Thus the feet tire with walking, the hands with 
 working, the eyes with seeing, the ear with hearing, and 
 even the tongue with talking. Then the only perfect rest 
 which can come must be by sleep, which is a torpitude of 
 the voluntary organs, while the involuntary continue their 
 customary action. It is by this means that the great ner- 
 vous center of animal life is renovated. Hence, sleep is as 
 needful as food to sustain life, and it is supposed persons 
 
TALES TO MY PATIENTS. 183 
 
 can live longer without eating than without sleeping. 
 Among the inventions of the Chinese for human torture, 
 that of keeping the victim awake till death ensued, is said 
 to be the most terrible. This we may well believe, for some 
 of the most distressing nervous diseases arise from want of 
 sufficient sleep, and those, too, which it is quite impossible 
 to relieve by any remedial means. 
 
 THE INFLUEKCE OF HABIT. 
 
 Noise and mental excitement tend to keep the brain 
 aroused to activity ; but at length, if we are well, sleep 
 draws on, even when the internal effi)rt and external sur- 
 roundings conspire to ward it off. So the fatigued soldier 
 has often fallen asleep amid the discharge of artillery. An 
 engineer slept within a boiler while heavy hammers were 
 riveting on the outside. In sleep, as in other things, we 
 are influenced by habit. If accustomed to sleep in still- 
 ness, we are greatly disturbed by noise. If accustomed to 
 noise, we are disturbed by stillness. A proprietor of ex- 
 tensive iron-works sleeps sweetly within the sound of tilt- 
 hammers, forges, and explosions, but awakes immediately 
 if any interruption occurs during the night. The motion 
 of the cradle and the singing of the nurse, which are 
 soothing to an infant accustomed to that sort of quietus, 
 would wake a child unused to them. We also have a story 
 of the snoring husband, whose wife tried in vain to sleep 
 when her " gude man" was away, until " Betty the cook" 
 bethought that the sound of the coffee-mill wab similar to 
 
184 TALKS TO MY PATIENTS, 
 
 that made by her snoring master, "and so kept that 
 a-going" until it soothed her mistress to sleep. It is a bad 
 habit to become dependent on books, coffee-mills, cradles, 
 or any external aid to invite sleep. 
 
 Children who must be rocked, read to, lain with, or have 
 a light in the room till they are asleep, are usually nervous, 
 excitable, over-sensitive — a heavy tax on mother, aunty, 
 nurse, and all hands. We remember one such who was al- 
 ways walked to sleep in the arms of a nurse ; the child grew 
 heavy, and the nurse grew tired ; and so one day she gave 
 out, and the baby could not go to sleep. The mother tried 
 the work, but found it too heavy ; next, the fond father un- 
 dertook the task, but grew weary of the steady to and fro 
 in his own private room, and for a change went to the wood- 
 house and mounted the horse-power for wood-sawing. And 
 so papa walked, the machine rolled, baby laughed, and all 
 went well for a time. But, by-and-by, the father grew tired 
 of playing horse, but, not being way-wise in machines, 
 he did not know how to stop it, or to get off when it was 
 going. Pat being just then out of hearing, he called a 
 long time in vain for help, and so got a good sweat on a 
 warm summer's day, and was never known to say again 
 that it was easy work to keep baby quiet. 
 
 If we remember rightly, little ones get more tending 
 now than when we were of that class. The result of 
 all this attention is too much excitement, too little rest. 
 But even in these " degenerate days" we know a beautiful 
 blue-eyed baby in the Chemung Valley, who of her own free 
 will sleeps sixteen or eighteen hours out of the twenty-four, 
 
SLEEP. 185 
 
 and when awake is bright, lively, and happy as possible. 
 From 8 in the evening till 9 or 10 in the morning she sleeps 
 sweetly. She then breakfasts, and lies on the floor amusing 
 herself with her own private gymnastics, for her limbs are 
 not fettered by long, heavy skirts. At about 12 o'clock she 
 dines, and then sleeps until 2 or 3 o'clock. 
 
 Thus the long summer days go by, the happy mother 
 finding time to not only attend to her baby, but also to her 
 household cares — a mother w^hose early medical training 
 has not blighted any domestic grace, but rather brightened 
 and ripened them all, so that she not only makes the best 
 butter in the valley, but also takes the most intelligent, 
 loving care of her children. If they are sick or irritable, 
 she knows whether it is food, sleep, or a 'bath that they 
 need. Here, often, a boy is sent to his room for a nap for 
 some perversity of spirit, which would have cost him quite 
 another kind of discipline with a mother less judicious. 
 
 We trust our readers will not deem that ours is an iron 
 rule — that children should never be soothed to sleep by any 
 other. Of course, there are emergencies of sickness, over- 
 weariness, peculiarities of temperament to be met with. 
 But, as a general rule, children wall sleep and eat with- 
 out much petting, if they are well managed. We remem- 
 ber a little fellow who from his earliest infancy onward w^as 
 seldom " put to sleep," but was simply picked up and laid 
 in his crib, and so took his nap without rocking or crying. 
 One sultry summer's day he tried in vain to take his after- 
 noon nap. He cooled himself by turning first on one side and 
 then on the other \ next, holding up one leg and then the 
 
186 TALKS TO MY PATIENTS. 
 
 othei\ Xow he soothed himself by counting his fingers and 
 toes, and next by putting his thumb in his mouth. But all 
 to no purpose ; he was too restless to sleep. At last he 
 called out : " Mamma, please give me a love pat, and that 
 will help me to go to sleep, I guess." The love pats, a 
 series of them, were given, and a kiss too. Soon after, the 
 fringed lids lay quietly over those twinkling eyes, and the 
 restless limbs were resting in sleep. Many a child of larger 
 growth has felt just this want of being soothed when wearied 
 and " worried." 
 
 Very few of us are strong enough to always stand 
 alone, or even rest alone. Sometimes we are not willing 
 to ask this aid ; perchance we may not know we need it, 
 or who can give it. But we have at all times felt an infu- 
 sion of strength, of resignation, of returning self-possession 
 coming from the heart, the eye, the word of another. 
 Sometimes we fall beneath a load which the finger of a 
 friend would have lightened, or, better still, have steadied 
 us in bearing, by soothing us to sleep, and so Avith sleep 
 would come the strength to do the work or endure the 
 sorrow. 
 
 IISTTLITENCE OF SLEEP ON THE SENSES. 
 
 When we sleep too little our sensibilities often grow 
 abnormally acute, so that sleep is well-nigh impossi- 
 ble. But if our habits are healthful, the need of sleep 
 makes all our senses more and more obtuse until they fail 
 to act. The power of the will over the muscles is lessened 
 or lost — so eyelids fall and, if sitting up, arms drop, nod- 
 
SLEEP. 187 
 
 ding ensues, as seen in church when the brain has been 
 soothed by a good sermon, or narcotized by bad air. Sight 
 fails first when we go to sleep, then taste, next smell, and 
 lastly touch. The awakening is the reverse of this 
 order — that is, the last is first. The sense of feeling is 
 the first aroused, so we change our position if we do not 
 lie comfortably, and draw up the bed-clothes if we are cold, 
 even when we are in every other respect asleep. This sense 
 seems to be a sort of sentinel, which sleeps so lightly that 
 it can look after our physical wants and personal safety 
 while our more delicate powers rest soundly. 
 
 Of this we had a most amusing illustration a few nights 
 since in our large family. A little boy went to his room at 
 an early hour, locked the door, and fell asleep. When his 
 mother came she tried in vain to arouse him, and was soon 
 joined by her friends along the hall, and such a concert of 
 calls, raps, kicks, and rattling of the door was never heard 
 before in our quiet household. The pass-key could not be 
 used, for the key v/as left in the inside of the lock. By means 
 of a ladder the window was reached, but the blinds were fast- 
 ened on the inside. Next, heads were thrust in at the ven- 
 tilator above the door, and calls by voices sharp and soft, 
 familiar and unfamiliar, were tried in vain, making not the 
 least impression on the sleeper. At last it was suggested 
 that, though his ears were locked, the sense of touch never 
 slept as soundly. So a tall man, with long arms and a 
 longer fishing-rod, mounted a chair and thrust head and 
 shoulders through the only orifice, the open ventilator, 
 giving the sleeper sundry taps, or " pokes," as he said, 
 
188 TALKS TO MT PATIENTS. 
 
 Avitb the fishing-pole, which operation soon proved efficient, 
 without harm to the patient. 
 
 During sleep respiration and circulation are retarded; 
 hence heat is generated more slowly, and so, if insufficient- 
 ly covered, we take cold more readily than when awake 
 and active. Digestion, too, is more tardy, so we eat three 
 meals in the twelve working-hours, and none for the next 
 twelve. Good sleep is so refreshing that we have the old 
 French proverb : " Who sleeps, dines." But a watcher 
 w^ants a second supper or an early breakfast. 
 
 DREAMS. 
 
 When sleep is complete, the brain seems to be in a state 
 of perfect rest ; but when only partial, as in slumber, ideas 
 flit in a disorderly manner, constituting a sort of delirium. 
 During this kind of incomplete sleep the external sensa- 
 tions are not wholly at rest, hence impressions made on 
 them may excite the most exaggerated impressions on the 
 brain in the shape of dreams. So Descartes thought the 
 bite of a flea to be the point of a sword. An uneasy posi- 
 tion of the neck may give the idea of strangulation. An 
 undigested supper may cause the sleeper to feel as if a 
 heavy weight were resting on his stomach instead of in it. 
 A person having a blister applied to his head dreamed that 
 he was scalped by the Indians — a slight mistake ! Many 
 times our mental work marks our dreams. The minister 
 writes sermons, the student solves problems, and the doc- 
 tor decides what to do with his patient. These things 
 
SLEEP. 189 
 
 dreamed out are often better done than when we are awake. 
 But this sort of night-work rapidly wears us out, because 
 it keeps the mind at work when it is abeady over-weary ; 
 and, however correct those solutions are which we seem to 
 sleep out, they show that the tired head needs rest or a 
 change of occupation. 
 
 SLEEP AFFECTED BY 0CCUPATI0:N'. 
 
 Persons of much mental activity are more likely to be 
 wakeful than those given to manual labor, while the former 
 need more sleep, for the head-work expends nervous force 
 more rapidly than that of the hands. Solomon says, 
 " Much study is weariness to the flesh ;" and the kind of 
 weariness which comes from an overworked brain with too 
 little sleep is the worst kind to bear, and the various ner- 
 vous affections which arise thereby often make the sufferer 
 very inconsistent and unreasonable. The " blue Monday" 
 of the minister is occasioned by the intense intellectual 
 and emotional life of the previous day, which prevented 
 his sleeping well the succeeding night. To be sure, we 
 often get so weary in body and spirit that it takes more 
 ,than one night to rest us " all right." But if we get a 
 good rest the first night, we are not blue and tired the next 
 day, but sensible and full of courage that we shall soon be 
 rested. Ministerial labors would be less wearing if the last 
 Sabbath service were held at an earlier hour, so that the 
 head could " cool off" and get quiet, and thus be ready for 
 sleep at bed-time. But now that evening worship must be 
 
190 TALKS TO MY PATIENTS, 
 
 at 8 o'clock (the genteel time for fashionable amusements), 
 instead of " early candlelight," or, better still, 5 o'clock, 
 as of old, it must be near " the small hours" before a min- 
 ister who has thrown his whole mental and spiritual force 
 into his subject can get ready to sleep. So, too, his hearers, 
 if they are held in head and heart to the point of devo- 
 tional interest till 9 o'clock, certainly are not ready to go 
 to sleep at that good old-fashioned hour for retiring. 
 
 Age, temperament, and constitutional tendencies make a 
 difference with the amount of sleep required, and with the 
 facility with which we can turn to it. Some kinds of 
 mental labor expend nervous force more rapidly than 
 others. The inirely intellectual is less exhaustive than 
 when combined with the emotional. Scientific persons live 
 longer, sleep better, and are much more healthful and happy 
 than those who belong to what is called "the literary 
 world.'"' The former seem to be cooled, steadied, and 
 strengthened by the study of Nature as she is. The latter 
 live more in the ideal, the imaginative, and so write " out 
 of their own heads." 
 
 The finest descriptions of scenery, of love, of domestic 
 peace, are not usually written by those who enjoy it, but 
 by those who long for it. Hence their pictures are not of 
 what is about them, but of their own intense inner life, 
 which burns too brilliantly to burn long or steadily. So, 
 if we had more good sleepers, the world would lack many 
 a thrilling romance, and many a reader would miss a sleep- 
 less niofht. 
 
SLEEP. 191 
 
 MOTHERS WOKIT WITH NIGHT CAEE. 
 
 There have been varied opinions as to whether men or 
 women need more sleep ; but it does not seem that sex can 
 decide the question, but rather temperament, age, occupa- 
 tion, state of health, etc. It is said that women bear 
 watching better than men, and it is no doubt true, often, 
 that their more intense affectional nature, their more sensi- 
 tive organization, Avill enable them to keep awake more 
 easily ; but these very conditions make them really need 
 more sleep, in that they expend life-force more rapidly. 
 The cares of maternity wear more from the loss of sleep, 
 which often comes with them, than from any other cause. 
 So, if I were writing to husbands, I should say : If you 
 want to keep your wives fresh and cheery, try to lighten 
 their night care, or plan for them a morning nap by being 
 mother pro tern, when the little ones have kept them 
 awake. Women, while nursing, need much sleep, if they 
 are of delicate organization, otherwise they grow morbid, 
 sensitive, and depressed ; have a pain between the shoul- 
 ders, in the back of the head and neck. For these pains 
 they try all manner of plasters, braces, washes, etc., when 
 more sleep would best mend the weak place. Mothers 
 often tell me that since the birth of such a child, or such a 
 siege of family sickness years ago, they have been poor 
 sleepers. The facts are these : they have been kept awake 
 when sickness, sorrow, or solicitude, rendered them over- 
 sensitive, till their nervous system became so irritable, that, 
 
192 TALKS TO MY PATIENTS. 
 
 when there was no longer need to keep awake, they could 
 not sleep. 
 
 GE0A7ING CHILDEEX. 
 
 Mothers often fail to realize how much sleep their grow- 
 ing children need, and so when they are sick or out of sorts 
 give them all kinds of remedies but the right one. 
 
 There is a theory that the bones grow only when we 
 are asleep. If this be true, those boys who wish to "in- 
 crease in wisdom and stature" had better go to bed in sea- 
 son. Every mother has noticed that her children have their 
 times of growing tall and then of growing stout, and that 
 they are much more sensitive and likely to be sickly when 
 growing lengthwise than when growing breadthwise. While 
 the former changes are being perfected, a larger amount of 
 both bone and nerve matter must be furnished than for 
 the latter. Hence, when your children are " running up 
 tall," as you say, keep them from heavy work and late 
 hours. If they complain of being tired, seem lazy or irri- 
 table, encourage them to sleep, as this is 
 
 " Man's rich restorative, his balmy bath, 
 That supples, lubricates, and keeps in play 
 The various movements of that nice machine 
 Which needs such frequent periods of repair.'* 
 
 When we are weary in body or brain, whether worn by 
 manual or mental labor, sleep is a safe and sure panacea. 
 Not the sleep which drunkenness, narcotics, and cordials 
 bring, but such as Nature gives to those who invite and 
 accept her gifts. 
 
SLEEP. 193 
 
 PHASES OF SLEEP. 
 
 The wise man has well described the various kinds of 
 sleep. So, he says of him who walks in wisdom's way : 
 " When thou liest down, thou shalt not be afraid ; yea, 
 and thy sleep shall be sweet." Of the sluggard : " Yet 
 a little sleep, a little slumber, a little folding of the hands 
 to sleep." Again : " The sleep of the laboring man is sweet, 
 whether he eat little or much ; but the abundance of the 
 rich will not suffer him. to sleep." 
 
 How often have we all, when excited by joy or sorrow, 
 felt the truth and beauty of these words : " I sleep, but my 
 heart waketh !" Sleep is sometimes seasoned by the sweet 
 sense that the beloved are near, and sometimes with the sad 
 sense of separation. "When looking on the placid face of a 
 sleeping infant, where smiles play so sweetly, we may easily 
 fancy angels are whispering in its ears, but the sleeping 
 sufferer has suppressed anguish written there. 
 
 There is the dead sleep which dissipation induces, the 
 sluggish state which a full stomach and a lazy head invites. 
 There is the sighing sleep, which comes tardily, but comes 
 at last to the grief- worn spirit. And there is excessive joy, 
 which puts to flight all desire for sleep. This goddess often 
 says to the happy : " Burn on through midnight like the 
 stars — ye have no need of me;" but to the wretched : "I 
 will fold you in my mantle, and bury you in sweet oblivion 
 till the morning comes." 
 
 In certain states of despair there lies a power which 
 " draws down irresistibly the coverlet of sleep." The dig- 
 9 
 
194 TALKS TO MT PATIENTS. 
 
 ciples slept in " the garden" just before their Lord was 
 crucified, and the beloved Physician says of them that they 
 were " sleeping for sorrow," and when Jesus admonished 
 them " to watch and pray, lest they enter into temptation," 
 he also added, as if in tender apology, "the spirit indeed is 
 willing, but the flesh is weak." Deep grief often brings on 
 that peculiar de]3ression of vital force which invites sleep. 
 
 Hope is a tonic on which we can work with little food 
 and little rest ; but despair depresses all the life-energies, 
 and hence much sleep is a messenger of mercy. 
 ' Solicitude makes us wakeful ; head and heart are think- 
 ing, yearning to do something ; but great sorrow proves 
 often a sedative, so that the afflicted sometimes sleep more 
 than usual, and then both body and brain are safe. 
 
 Those who are rendered sleepless by trouble, are liable 
 to be thereby impaired, mentally or physically. 
 
 LACK OF SLEEP A CAUSE OF MENTAL DEEAISTGEMENT. 
 
 The statistics of lunatic asylums show that want of sleep 
 is the most frequent and immediate cause of insanity. As 
 you look over the history of the inmates, and note the 
 peculiar trials which have shattered their poor heads or 
 hearts, you see that nothing has happened to them save 
 what is common in the varied experiences of this life. Many 
 have passed under the same rod, or a heavier one, and 
 come out unharmed, even steadier and stronger for the 
 chastisement. But these sad subjects, from bad habits or 
 bad inheritance, seem to possess some peculiarity of nervous 
 irritability; so when sleep, like a loving mother, would 
 
SLEEP. 195 
 
 soothe and save them, she can not. IsTo doubt many might 
 have been saved by judicious care at the right time. Need- 
 ful work is an excellent solace for earthly sorrow. Hence 
 we note that those burdened by labor and care bear grief 
 best; not that their sensibilities, are less acute, not from 
 lack of enduring love, but because weary muscles lead to 
 sleep, Nature's balmy bath, which soothes aching hearts 
 as well as bodily pain. As the head which aches with 
 thinking can only be cured by sleep, so the heart which 
 thrills with agony needs to be soothed in the same way. 
 
 I am always sorry for those disappointed in early love, 
 who are so at ease that they need not earn either food or 
 raiment. Nothing to do but nurse their grief, till they 
 grow broken in health and bitter in spirit. I am sorry, too, 
 for those bereaved in maturer years, whose chief responsi- 
 bility is in reference to their crape. Both classes are likely 
 to grow nervous, sleepless, often incurably sick and sad, and 
 sometimes insane. The danger of mental wreck from sorrow 
 or care, comes more from wakefulness at night than from 
 the heaviness of the load carried by day. 
 
 EFFECTS OF NIGHT WOEK. 
 
 Those who work by night and sleep by day wear out more 
 rapidly than others in proportion to the work they perform. 
 For several years I have taken testimony as to this point 
 from railroad conductors, telegraph operators, etc., and 
 they all agree that, though they try to take all the sleep 
 they need during the day, it is less refreshing, and that 
 after a few years they feel the need of a change of work, 
 
196 TALKS TO MY PATIENTS, 
 
 or rather of hours. As to why sleep is less sweet and sound 
 when the sun shines, we can only say, God has set in order 
 day and night, each for its purpose. We might suggest 
 that light makes us sleep more lightly, that noise disturbs, 
 and the sense that all the world is astir stirs the sleeper. 
 
 Some years since we went through the dark highways and 
 by-ways of the Tamaqua coal-mines, where the work is kept 
 up daily during the twenty-four hours. I said to one of the 
 miners : " As it is just so dark here night and day, it makes 
 no difference when you work ?" To which the son of Erin 
 replied : " Indade, miss, an' a man's constitution knows the 
 difference amazin' quick." While conversing with the su- 
 perintendent of the mines on this point, he told me the 
 Irishman was correct ; that the night-workmen were much 
 more liable to sickness, and sooner failed in strength than 
 those for the day, though they all had precisely the same 
 work, and all came out of the mines alike, to eat and sleep. 
 
 I have no doubt that one reason why lawyers and men in 
 public life so often resort to stimulus is to supply that sense 
 of nervous exhaustion which comes from late hours in 
 crowded court-rooms. By alcohol they make the brain 
 burn most brilliantly, just as it should be quieting down 
 for a good night's rest. 
 
 Our finest lecturers are, after a few months, worn and 
 haggard, though seemingly having little care and but little 
 mental labor ; for often the same lecture goes from the 
 ocean at the east to the " father of waters" in the west, 
 with improvised modifications. And much of this wear is 
 for the reason that after speaking the lecturer can not sleep till 
 
SLEEP, 19'J 
 
 midnight, or more often till into the small hours, and some 
 not even till day dawns. Such think intensely, feel deeply, 
 sleep lightly, and are Avrecked early. Teachers who are 
 earnest, progressive, and devoted to the interests of their 
 pupils — their school cares are their " night thoughts," and 
 long evenings and little sleep are the result. Many of our 
 most useful mental and moral workers are laid aside from 
 their labors far too early, because they do not take sleep 
 enough. Manual labor, combined with enough mental 
 to give it interest, is far less exhausting to the nervous 
 system than brain work alone. Hence those engaged in the 
 latter require the most sleep, but seldom take it. The 
 couch invites those weary in body, and sleep ensues ; but 
 those weary in brain are often excited, intoxicated by their 
 intensity of thought, and think they do not need it. Many 
 a weary head finds that it can not rest, though it tries "ever 
 so hard" to do so. When abnormal activity of the brain has 
 been induced by over-exertion, -the thoughts run on, as 
 if human machinery went by force of acquired velocity, 
 instead of being quieted and controlled by the will. 
 
 FAILUEE or HEALTH FEOM INSUFFICIENT SLEEP. 
 
 Some one says that "men of mind are mountains 
 whose heads are sunned long ere the rest of earth." But 
 these same mountains are often clouded. early. Prior to this 
 shadow we often see an activity of brain, an excitability 
 of the nervous system, combined too often with an irrita- 
 bility of temper, which tells the physician that trouble is 
 near, while the prospective patient fancies his health to be 
 
198 TALKS TO MT PATIENTS. 
 
 \ 
 
 as firm as ever; but all at once his system gives out — his 
 head will not think, his stomach will not digest, he is rest- 
 less and wretched. Many sad illustrations of this class 
 have we seen in our infirmary during the last twenty years. 
 Among these was a man, once of giant frame and iron 
 nerve, Avho with proper care would have retained his vigor 
 till four-score years, but at half that age found himself a 
 poor, miserable dyspeptic, shattered in mind and body. 
 Year after year he had worked eighteen hours out of 
 twenty-four. He went to his mill at 3 o'clock in the 
 morning and stayed till 10 o'clock at night, and then sat 
 up and read for two or three hours, so that he had but four 
 hours sleep out of the twenty- four, and often but 07ie, Thus 
 he went on year after year, maintaining that " nothing hurt 
 him," and a perfect marvel to all around him. But at 
 length his memory began to fail ; his mind became anxious 
 and fearful, his extremities numb, and he too timid to stay 
 in a room alone, by night or day. We found body and 
 brain rickety beyond repair, and so passed him on to the 
 insane asylum. 
 
 Many years since there was an early-rising mania. Phi- 
 losophers wrote and poets sung of its virtues. Had they 
 given us, also, sermons and sonnets on the benefits of 
 early retiring, we should then have had both sides of 
 the question. But the result was, that many concluded 
 that time spent in sleep was wasted, provided they could 
 so goad their energies as to keep awake. While midnight 
 oil was consumed, the lamp of life was being exhausted 
 when it should have been being replenished. We have all 
 
SLEEP. 199 
 
 our fixed quantum of life-force, of vital fluid, which we may 
 use more or less rapidly at our will. There are various 
 ways in which we may waste this fountain, and want of 
 sleep is one. 
 
 To retire at 9 o'clock — once the old-fashioned hour for 
 grown folks — is now too early for children, even. Society 
 calls us away from home just when we most need its quiet. 
 We dress for parties just when we should "wrap the dra- 
 pery of our couch about us and lie down to pleasant dreams." 
 If our friends are worthy of our attention, let us give them 
 our best thoughts, our sane moments — not the products of 
 a brain exhausted by the labors of the day, and then ex- 
 hilarated by the dissipation of the night. The influences 
 of these nightly gatherings are more deleterious to the 
 young than to those matured in body. 
 
 " Late sitting up has turned her roses white : 
 Why went she not to bed ?— because 't was night." 
 
 The bloom of many a young girl has withered in the 
 gayety of her first winter in society ; and though from 
 summer to summer it may be for the time " restored" by a 
 trip to the mountains, or the sea-side, or a Water Cure, it 
 soon settles into a sickly yellow, quite past " freshening up." 
 Such may well say, as did one looking in the glass, " How 
 shallow I look !" when she meant to say sallow. 
 
 Those overtaxed in early life are slow of cure and seldom 
 have much power of endurance. Such need more sleep, 
 more rest, in all after years. An increased tendency to 
 sleep is a hopeful sign in nervous invalids. Dim eyes, dull 
 
200 TALKS TO 31 Y PATIENTS. 
 
 ears, and super-sensitive nerves are often improved, cured 
 even, by this alone, where there is no organic disease. 
 
 HINTS TO THE SLEEPLESS. 
 
 " But how shall we wakeful ones find the way to sleep ?" 
 asks one — yes, many, I fear. First, let us remember the 
 lesson of our youth, which said that " the day was for labor, 
 and" the night for sleep and repose." When the open fire, 
 a pine knot, or a tallow candle were the only facilities for 
 a nightly illumination, the temptation to late sitting up was 
 much less than now, when the brilliancy of gas or kerosene 
 invites us to sit up at night that we may enjoy its ex- 
 hilarating splendor. I have been interested to notice how 
 music, gay colors, beautiful pictures, and bright lights keep 
 us wide awake. Place the same persons in a room, and 
 with but little about it to attract the eye, and they fall 
 into easy, quiet chit-chat, and soon begin to yawn, and by 
 mutual consent retire early, saying: "Somehow I feel 
 sleepy to-night." 
 
 What can we say that is new on the necessity of venti- 
 lating sleeping apartments ? Not any thing, but many are 
 still afraid of night air, damp air, and cold air, forgetting 
 that of all air, that is worst which they have breathed over 
 and over again ; and so they get uj) with a headache and a 
 bad taste in the mouth, simply from bad air breathed 
 during the night. If the house has none of the modern 
 means for perfect ventilation, then have an opening in two 
 sides of the room, or have one window down at the top and 
 raised at the bottom, and so secure a current of air. 
 
SLEEP. 201 
 
 Those inclined to wakefulness will find a cold drip- 
 sheet rubbing for a minute, or a towel bath before re- 
 tiring, to prove a most happy and healthful anodyne. 
 Cold foot baths for ^yq minutes in the evening are also 
 useful. If the head is hot and the feet cold, lie down and 
 take a head bath at seventy degrees for five minutes, having 
 the back of the head in the water and the feet in a hot foot 
 bath at the same time. A wet napkin around the head 
 will often suffice. A cool sitz bath for fifteen minutes, with 
 a cold cloth to the head and the feet in hot water, equalizes 
 the circulation and quiets the nervous system so as to 
 induce sleep. A full bath at ninety-eight degrees, for 
 twenty minutes or half an hour, has often cured the most 
 obstinate cases of sleeplessness, provided the habits of the 
 day were healthful. A brisk walk in the open air will 
 often quiet the head and tire the body, so that sweet sleep 
 will ensue. Then, too, let all subjects of thought, amuse- 
 ments, and employments for the evening be of a kind least 
 exciting. Finally, "Somnus lets her poppies fall most 
 plentifully on those having a cool head, an empty stomach, 
 tired muscles, a quiet conscience, and warm feet." 
 
 Jesus has promised to give " his beloved sleep" — sleep 
 so sweet, that at the awakening there shall be no aching of 
 the head or heart because of the labors, the sorrows, or 
 the sins of our earthly days. Until then, let us each, in 
 our small way, try to give to our beloved sleep, as the best 
 solace for the past, the best source of strength for the future. 
 
IKDIGESTIOK 
 
 T CAN NOT close my words to women without consider- 
 -^- ing Indigestion and Constipation. Though not classed 
 among those special infirmities which first prompted me to 
 write, still they are so closely allied to them, that to cure 
 the one, we must correct the other. 
 
 Derangements of the stomach and bowels are usually 
 caused by habits under our own control, yet when long 
 continued they induce other diseases which are hard to 
 cure. Tight, or improperly adjusted dress, interferes serious- 
 ly with the nutritive functions. There is much important 
 work to be done just beneath the lower ribs, for which am- 
 ple room is required. These having no bony attachment 
 in front, are easily compressed, even after mature years. If 
 not thrown inward by external pressure, they are often 
 held fixed by the tight belt, so that they can not play freely 
 upward and outward, as they should, at each inspiration. 
 N ow this sli^-ht oscillation aids the oro;ans beneath in the 
 performance of their duties. We might add, that restriction 
 just in the region of the diaphragm also interferes with the 
 action of the lungs ; hence, slow congestion, incipient con- 
 sumption begins here. Poor digestion and imperfect nutri- 
 (202) 
 
INDIGESTION. 203 
 
 tion, also favor tubercular deposit, and thus furnish the first 
 step toward incurable disease of the lungs. 
 But on this point we will not dwell. 
 
 WHAT SHALL WE EAT ? 
 
 A good old divine once said, "Eat with a cheerful and 
 thankful heart, and think it won't hurt you, and I guess it 
 won't." This is a good answer for over-anxious ones, who 
 expend time and nerve-jDOwer in wondering what they shall 
 eat, and then worry as to whether it will digest. 
 
 After having settled u]3on what course of diet to pursue, 
 do not talk about it, farther than to praise the cook, if pos- 
 sible. To say grace before meals, and grumble while eat- 
 ing, is no way to bring the blessing asked. Let the con- 
 versation at table be of a free, easy, cheerful character. 
 Fretting and fault-finding impair ajDpetite and digestion, 
 while a cheerful, grateful spirit helps both. We can not 
 give any system of diet which is adapted to every one. 
 Food must vary with climate, age, and occupation. What 
 is best at one period in life may not be at another. 
 
 The young, as a usual rule, thrive best on milk, vegeta- 
 bles, fruit, and farinaceous food. 
 
 Those in advanced years, or persons recovering from 
 severe illness, ordinarily feel better with a more stimulating 
 diet, meat, etc. When having much responsible care, anx- 
 iety, or night-watching, we need food for the time which 
 supplies nerve-power, as steak, eggs, oysters, fish — that 
 which the chemists say contains phosphorus. 
 
 If we have taken to sedentary habits, and the bowels are 
 
204 TALKS TO MY PATIENTS. 
 
 becoming tori^id, then coarse bread and acid fruits should 
 predominate. Those of simple habits with unperverted 
 tastes, having their desires in subjection to their intelli- 
 gence, possess often an innate sense of what is good food 
 for them. " The willing and the obedient shall eat the 
 good of the land," for to them is given the power to relish 
 and digest what the system requires. Such, with all their 
 apparent self-denial, really enjoy the pleasures of their 
 plain table more than the epicure, and are certainly hap- 
 pier after. 
 
 Invalids with slow digestion are able to take more food 
 at two than three meals a day, thu-s giving the stomach 
 more tim.e for rest. So, also, as years advance, and mind 
 and body are more quiet, eating twice, with seven hours 
 between, will sustain the system best, as then merely the 
 icaste of the body needs to be repaired. 
 
 In youth, material for both growth and waste is required, 
 and the more active the habits, the more rapid the waste. 
 The young need to be well nourished, even when their full 
 stature has been attained, because the system is not consoli- 
 dated until later years. Digestion, assimilation, and excretion 
 go on more rapidly than later in life ; hence, s-uch need 
 the three full meals, while two will suffice for those past 
 forty, unless they have very active habits, or much man- 
 ual labor. If there be " faintness of the stomach" for lack 
 of supper, it may be relieved by a piece of bread, a cup of 
 broma or gruel, or even a glass of water. Those suffering 
 from a tendency to acidity or flatulence, will find dry food 
 preferable at all times. 
 
INDIGESTION. 205 
 
 Roast-beef, steak without butter or gravy, dry toast, 
 unleavened cakes, and soft boiled eggs, eaten slowly, with- 
 out taking any fluid at the meal, is advisable. 
 
 If warm drink is required, let a small cup of breakfast- 
 tea be taken at the close of the meal, rather than while eat- 
 ing. If the stomach is sensitive, drink moderately of cold 
 water a half hour or so before eating, and two or three 
 hours after ; or if long unused to cold drinks, it will be ne- 
 cessary to begin with a wine-glass full, or even less. N^ever 
 take so much as to induce local pain, or a general sense of 
 chilliness. If there be great thirst, water may be taken fre- 
 quently, but in small quantities. 
 
 In health, a glass or two of fresh water is always an ex- 
 cellent tonic for the stomach when it is empty, time beino- 
 given for its absorption before eating. It improves the 
 appetite, helps the breakfast or indeed any meal to relish 
 without other drink, and prompts the liver and kidneys 
 to healthful action. 
 
 Corpulent persons have an excess of fatty tissue and a 
 lack of muscular fiber, hence little strength in proportion 
 to their size. Such are often relieved by Banting's system 
 of diet, in which food containing sugar, starch, and animal 
 oil are avoided. 
 
 CAUSES OF DYSPEPSIA. 
 
 Many have poor appetite or bad digestion, when the 
 fault is not in their food. Excessive anxiety, or overwork 
 of body and brain, may take away the relish for even fa- 
 vorite dishes, or the ability to digest them comfortably. 
 
206 TALKS TO MY PATIENTS. 
 
 We must have nerve-power to carry on the nutritive func- 
 tion; and if it has been exhausted through the mind or 
 muscle, the stomach will lack a supply, and hence can not 
 do its work well. 
 
 Those who are very weary should rest twenty or thirty 
 minutes, both before and after eating, the length of time 
 varying according to the severity of manual labor or in- 
 tensity of mental application which their business requires. 
 In case of chronic invalidism, perfect rest for a half hour 
 or more after eating, followed by moderate exercise, will 
 allow the stomach the best chance to do its work. 
 
 When there is nausea and vomiting, either from uterine 
 sympathy or from debility of the stomach, to rest on the 
 back for half an hour after food is taken, will frequently 
 save the meal and secure good digestion. Mothers, ex- 
 hausted by prolonged nursing, by family cares, suffer from 
 loss of appetite and indigestion. Such should not be re- 
 stricted in food, but have rest, change of scene, and a gen- 
 erous diet. Students, ministers, and members of the bar 
 often become dyspeptic through excess of brain-work, when 
 their habits are otherwise healthful. Such should under- 
 stand that as the nutritive power diminishes, so also the 
 ability to endure either thought or emotion. 
 
 Intense mental or spiritual activity induces waste, which 
 must be supplied by good food, well digested, or a head- 
 ache, neuralgia, distress of the stomach, or great de- 
 pression of mind and body, will ensue. Fasting will pro- 
 mote mental and spiritual life in those addicted to excess 
 in eating, but not otherwise. 
 
INDlGESTIOIf. 207 
 
 Those imperfectly nourished may burn brightly for a 
 short time^ but soon go out in almost hopeless darkness. 
 
 The saddest eases of dyspepsia that I have ever seen, 
 were among those who had taken to some dietetic extreme, 
 in the hope of cure. The less they ate the more deluded 
 they became, the more they suffered, till the skin, eye, and 
 whole bearing reminded one painfully of our poor im- 
 prisoned soldiers, who became imbecile from inanition. As 
 we said above, indigestion may be induced by any kind 
 of over-work; but that of the brain is most severe, most 
 difficult of cure, because nerve-power impaired is more 
 difficult to restore than wasted muscular tissue. Many a 
 noble, self-denying, self-supporting student, has established 
 life-long invalidism while in school, by studying too hard, 
 with food too limited in variety and amount. We might 
 dwell on late suppers, eating between meals, highly sea- 
 soned food, pastry, rich cake, strong coffee, and green tea, 
 as among the causes of indigestion ; but so much has been 
 said against these, that no words of ours will be of ser- 
 vice to this class. They are joined to their idols, I fear. 
 Dyspepsia may arise from inflammation of the lining mem- 
 brane of the stomach, induced by improper food, eating 
 hurriedly, or at irregular intervals ; also from re23elled 
 eruption, or a constitutional tendency to disease of the 
 mucous surfaces. 
 
 Again, the trouble may be located in the nerves that 
 supply the stomach, which may have been caused by over- 
 work or stimulation. Sometimes we find both these phases, 
 that is, mucous and nervous dyspepsia combined. To de- 
 
208 TALK 8 TO MY PATIENTS. 
 
 fine the peculiar characteristics of these classes would be 
 to perplex the reader, and prompt the patient to watch 
 pulse and tongue, which would be very bad business for 
 a dyspeptic. The less they think of their symptoms the 
 better. 
 
 TREATMENT. 
 
 The first step toward the cure of dyspepsia is the cor- 
 recting: of such habits as induced the disease. There is no 
 system of diet, no course of medication, which can alone 
 overcome indigestion. The impression that there is " some- 
 thing to take," which will set the digestive apparatus all 
 right, has led to a great amount of injudicious medication. 
 As the phases of this disease are so varied, we can not give 
 any definite course of treatment, but merely some sugges- 
 tions, which, together with the above hints, may palliate, 
 perhaps cure. Gentle friction across the stomach and liver 
 for five minutes, given by an attendant within a half-hour 
 after each meal, while the patient lies upon the back, will 
 promote digestion in feeble persons ; or, later, two or three 
 hours after eating, walk erect with shoulders thrown back, 
 take full inspirations, and then hold the breath for a few 
 seconds ; at the same time percuss over the sides in the re- 
 gion of the floating ribs, with the hands alternately. If 
 there is pain in the region of the stomach or liver, about 
 three hours after eating, hot fomentations for twenty min- 
 utes, followed by a cool sitz bath or the wet girdle, will 
 prove serviceable. 
 
 In severe dyspepsia the skin is dry, sallow, inactive, with 
 
INDIGESTION. 209 
 
 a decided tendency to chilliness. In such cases the wet 
 sheet pack for about forty-five minutes daily, followed 
 with the drip sheet, is beneficial, if the patient becomes 
 warm in it, and remains so after;, otherwise, warm baths, 
 vapors, or Turkish baths, with cool pours or cold plunge 
 after, taken two or three times a week, are better. 
 
 When food lies undigested, inducing distress of the 
 stomach, it should be thrown ofi* by drinking in quick suc- 
 cession a half-dozen glasses of warm water ; or when par- 
 oxysms of pain occur from acidity, they may be relieved 
 by a single glass of hot water, which dilutes the acrid se- 
 cretions, and acts also as an anti-spasmodic. 
 
 Moderate exercise, mental diversion, cheerful surround- 
 ings, and good sleep, are indispensable aids to the cure of 
 such diseases as we have enumerated in this chapter. 
 
OOI^STIPATIOK 
 
 CAUSES. 
 
 rriO prevent or cure constipation we must correct what- 
 -^ ever is wrong in the condition of the stomach or liver. 
 A good old doctor said truly, " the bile is Nature's physic." 
 Hence, if the liver is torpid, we must expect the bowels 
 will be also. The alimentary canal requires a proper amount 
 of bulk to stimulate it to action ; therefore, food should not 
 be so concentrated as to allow too little waste. For instance, 
 fine flour, — white sugar, if used to the exclusion of fruit, 
 vegetables, and unbolted wheat, will induce constipation. 
 
 Fseces are made up of the waste material of the body, 
 excreted within the colon ; also of undigested food, like the 
 skin and seed of fruits. Hence, the stool may be scanty in 
 amount because there may be too little indigested material 
 to give bulk, or the old worn-out elements are not excreted 
 from the blood. Sometimes persons who are bloodless and 
 have poor appetite have very little excrementitious matter. 
 They take in a very scanty sujDply of new material, and so 
 the old is thrown off slowly. In other cases the proper 
 amount of material is eliminated from the blood, but the 
 
CONSTIPATION. 211 
 
 feces are retained too long in tho alimentary canal, till the 
 watery portions are reabsorbed into the system. One 
 fruitful cause of this form of constipation is the tight dress- 
 ing which restricts abdominal respiration, and deprives the 
 whole twenty-four feet of intestines of that motion which 
 is so important to maintain a healthful action of the bowels ; 
 also the muscles which form the abdominal walls, lack due 
 exercise and lose their tone. 
 
 Heavy, unsupported skirts, rest upon the bowels and de- 
 prive them of their natural position and normal motion. 
 The corsets of modern days — " so loose," " so easy," — are 
 doing more harm to the abdominal viscera than to those of 
 the chest, though both suffer from their close embrace. 
 They are never worn tight, so their subjects say ; still, as 
 they are not supported by the shoulders they must rest upon 
 the abdomen, restricting the free motion of the muscles 
 without and of the organs within. 
 
 If the nervous system is exhausted by overwork, consti- 
 pation is likely to ensue, even though the labor be active in 
 kind, and the other habits are correct. The brain must 
 impart a due amount of vital force ; without this, even 
 the bowels can not perform their function properly. 
 
 Persons intensely absorbed in their duties, fail to note 
 the descent of the fsecal matter, and it becomes impacted, 
 the rectum over-distended, and it is retained there for 
 many days. 
 
 Sometimes for want of requisite conveniences, or freedom 
 to use them, the stool is delayed when it would have easily 
 escaped ; but afterward it becomes dry, hard, and rests in 
 
212 TALKS TO MY PATIENTS, 
 
 the pelvis, giving a sense of discomfort without power to 
 evacuate. 
 
 CUEE. 
 
 From what has been said of causes, you will readily see 
 how hopelessly foolish and positively injurious it is to ex- 
 pect to cure constipation with cathartics. 
 
 These, long continued, irritate the stomach and often the 
 whole length of the alimentary canal. The label on the 
 top of a box of Brandreth's pills used to read " good in 
 all cases, dose from two to twenty." This tells in brief the 
 indiscriminate way in which patent medicines are taken by 
 those who dream if they have a daily evacuation they are 
 on the road to health, without reference to the means em- 
 ployed. In many instances there are no fseces in the 
 bowels, and those remedies merely stimulate a watery ex- 
 udation. Often the patient is feeble and could not afford 
 this drain. Those who digest but little can not supply the 
 material for a daily evacuation without a sense of prostra- 
 tion. 
 
 Many persons consider themselves bilious, and medicate 
 accordingly, when their sallow skin is the result of poor 
 digestion, and poor blood induced by nervous exhaustion. 
 The first step toward curing constipation is to give due at- 
 tention to the stomach and liver, as suggested in the pre- 
 ceding chapter. 
 
 Clothing should be loose, and so suspended that a full 
 inspiration can always be taken without a sense of restric- 
 tion ; thus imparting motion to every organ, from the top 
 
CONSTIPATION. 213 
 
 of the chest to the base of the pelvis. Otherwise we are 
 dead, or dying for want of air. For further suggestions in 
 regard to dress, see chapter on Prolapsus Uteri. 
 
 The voluntary respiratory exercises therein suggested, 
 are also useful in case of constipation. Friction — deep, 
 slow, steady — across the region of the stomach and liver, 
 given by an assistant, the patient lying on the back, is ex- 
 cellent when the upper section of the digestive organs is 
 torpid ; or, if the lower bowels are sluggish, a circular 
 motion corresponding to the direction of the colon is ser- 
 viceable ; also kneading, deep and strong, though not with 
 sufficient pressure to give pain or even a sense of discomfort, 
 is an excellent aid. Regularity as to time of evacuating 
 the bowels is important. In the morning soon after break- 
 fast is best. Remember this physical need, and if in- 
 clined to delay, encourage expulsion by quick, deep, and 
 rapid inspirations and expirations. Do not sit and strain 
 at stool, but rather walk briskly to and fro in the fresh air, 
 if possible, for a few moments ; or, if employed, keep the 
 necessity in mind, and send the vital force in that direction, 
 by thought and slight effi)rt. This function, as well as any 
 other, requires both nerve and muscular power for its accom- 
 plishment. Those of sedentary habits and active minds 
 often fail to supply them. If constipation is owing to a 
 sluggish state of the lower bowel, then an injection of a 
 pint or two of tepid water will secure an evacuation ; but 
 if these are long continued, or if the faeces have not reached 
 this point, they are of little avail. 
 
214 TALKS TO MY PATIENTS. 
 
 RESULTS OF CONTINUED COXSTIPATION. 
 
 When the bowels fail to perform their appropriate duty 
 in freeing the system of waste material, then the other 
 organs of excretion have an excess of work. 
 
 The kidneys are taxed, the skin is oppressed and dis- 
 colored by dead and diseased matter, which should have 
 been removed by fsecal evacuations. 
 
 The odor from the person is fetid, the face sallow or 
 marred with pimples, the surface of the body dry, scaly, 
 or covered with eruptions. The foundation for permanent 
 invalidism is often laid during school days. A busy brain, 
 inactive body, and want of thought in reference to the 
 needs of the system, all tend to induce torpid bowels. To 
 increase muscular exercise while the mind is overworked, 
 will rather aggravate than relieve the trouble. Constipa- 
 tion is not apt to be considered a serious trouble in its 
 early stages, because other organs struggle to free the 
 system, and hence for a time the person seems very well. 
 But as months and years go on, the whole system becomes 
 involved more or less seriously in the general derangement. 
 Pain in the head, sleeplessness, languor, mental depression, 
 and a complication of local troubles which involve the pel- 
 vic organs are likely to ensue. 
 
 Drastic cathartics, straining at stool, bowels habitually 
 loaded, are liable to induce inflammation of the rectum, 
 fissures or cracks at the anus, hemorrhoids or piles. All 
 these are most painful affections and difficult of cure. The 
 latter are formed by deposit of fatty tissue from continued 
 
CONSTIPATION, 215 
 
 inflammation, or by veins enlarged by long congestion. By 
 overcoming constipation, the use of sitz baths, and enemas 
 taken on retiring, of one half-pint of water or mucilage, to 
 be retained, they may be relieved, perhaps cured. So long 
 as the liver is torpid the hemorrhoidal veins will be con- 
 gesKftl, and piles can only be palliated, not cured. When 
 these tumors burst, and to any extent bleed, a surgical 
 operation will be required to efiect a perfect cure. 
 
MENOPAUSE, OE CHANaE OF LIFE. 
 
 GEOWING OLD GRACEFULLY. 
 
 rriHE period of menstrual decline is an important one in 
 •^ the life of woman, and may truly be called " the 
 critical age." This well passed, and she may have a sec- 
 ond career, less brilliant than her first, but not less beauti- 
 ful, speaking after the manner of the spirit. When a wise 
 head, a warm heart, and comfortable health combine, there 
 is much to be done, much to be enjoyed, even when our 
 early enthusiasm in reference to this life has all come and 
 gone. Some one, commenting on the delicacy of our 
 young ladies, remarked, " We must take good care of the 
 old ones, for we shall never have any more." The object 
 of this chapter is to show how we can have some more, and 
 have life with them not only endured but enjoyed. The 
 proverb, " Old men for counsel, young men for war," is in 
 fact, though not in form, equally applicable to women. 
 Our young women have beauty, activity, enthusiasm. 
 The old should have patience, forgiveness, wisdom ; so as 
 to guide the younger through the same sorrows which they 
 have experienced and whereby they have ripened, I am 
 
MENOPAUSE, OB CHANGE OF LIFE, 217 
 
 sorry to see women try to conceal from themselves and 
 their friends the fact that they are growing old. Why, if 
 we use well this life, the Lord will give us another — a 
 better. 
 
 The menopause tells us that we are looking toward the 
 sunset. But is there not a new and brighter morning in that 
 land where there is no night, where none are sick, none are 
 sad, and all are satisfied ? But some one says, " It is not 
 the dying I dread ; it is the liting old, faded, and forlorn." 
 But you need never be thus. To be sure, the charms of 
 youth will fly with the years to which they belong, but the 
 good Spirit will implant in us other graces, if we ask for 
 and cultivate them. 
 
 A young miss, when looking at several women who 
 were nearing their fiftieth year, and listening to their con- 
 versation, remarked aside, " How nice those ladies look ; 
 how well they converse ; they don't act green, like us 
 girls ;" and then added, " When I write romance, my hero- 
 ines will be old ladies." Truly, the great Father is good. 
 Every age and place has its charms, its compensations. 
 Spring and summer do not gather all the gifts that crown 
 the year. So of life. The lily and the rose will come and 
 go, but they do not comprise all the beauty of the changing 
 seasons or of growing character. But why do I dwell on the 
 spiritual when writing of that which pertains to the physi- 
 cal ? Because heart and flesh are apt to fail together, and 
 each can help up, or hold down the other. During the age 
 of which we are speaking, there is a great tendency to 
 mental depression, owing to constitutional changes, and 
 
 10 
 
218 TALKS TO MY PATIENTS. 
 
 sometimes because beauty is going, and no more babies 
 are coming. 
 
 PEECAUTIO^q'. 
 
 As women approach the period for menstrual decline, 
 they should take care to keep their general health up to the 
 highest possible j)oint ; because, if once down, it is more 
 difficult to rally than at any other age. If there is a con- 
 stitutional tendency to morbid action, it is likely to take to 
 the weakest organ. Hence, many die of disease of the 
 lungs, liver, or some of the varied forms of scrofulous af- 
 fections, between the fortieth and fiftieth years. There- 
 fore women should be impressed with the truth that dan- 
 gers await them, while at the same time they should com- 
 prehend the fact that with proper care they can usually 
 escape and pass through with comfortable health. Un- 
 fortunately, it often happens that they give little or no 
 intelligent attention to the subject, until serious disturbance 
 has occurred, which it is hard to cure. When the critical 
 period will begin it is impossible to say, as it varies from 
 thirty-five to fifty-five, although the usual age is forty-five. 
 Most women, as they approach their fortieth year, feel their 
 " natural force abating," a little more languid during and 
 after menstruation, and, if overworked at the time, do not 
 feel as well for a month after. 
 
 These are admonitions to take life easier, to be especially 
 careful about over-exertion during the monthly flow, for 
 thereby it will be rendered too profuse or too prolonged. 
 Sometimes we notice a peculiar sensitivejiegs of the nervous 
 
MENOPAUSE, OB CHANGE OF LIFE, 219 
 
 system, a tendency to headache, neuralgia, wakefulness, 
 over-anxiety about trifles, before there is any derangement 
 of the " monthlies," which are notes of warning. 
 
 YARIED PHASES OF CESSATION. 
 
 There are many different modes of the termination of the 
 menstrual function. Sometimes a gradual diminution of 
 the amount, in others a succession of floodings, occasionally 
 one terminal flooding, more rarely a sudden cessation. The 
 most common method is a flow irregular in amount at irreg- 
 ular intervals, longer or shorter than the usual interim. I 
 have known a few instances where it did not return after the 
 birth of a child late in life, and a few where it ceased suddenly 
 without any local or general disturbance. But in most cases 
 the flow is irregular, from one to seven years. During this 
 time there is more tendency to disease, debility, and mental 
 depression. Soon as the monthly tribute becomes more 
 profuse or prolonged than usual, or even if there is no ex- 
 cess of flow, only an unusual sense of prostration after it, 
 then great care should begin. Many, by neglecting these 
 symptoms, become so reduced by loss of blood that it takes 
 years to recover ; some remain always enfeebled, and others 
 die of uterine hemorrhage. 
 
 TEEATMENT DURING MENOPAUSE. 
 
 Cool sitz baths, and vaginal injections while in them, are 
 always good when the flow induces a sense of exhaustion. 
 For directions for their use, see chapter on Menorrhagia. 
 Where there is a tendency to cold feet, use the hot foot 
 
220 TALKS TO MY PATIENTS. 
 
 bath, and keep the head cool with wet compresses. Also 
 the wet gh'dle is of great advantage here. If these do not 
 suffice to check the flow, then keep on compresses of cold 
 water, or ice-water, over the pelvis. The bowels should 
 be freed by an injection, and then one of a half-pint 
 of cold water taken into the rectum after, to retain. For 
 vaginal injections, alum-water or a teaspoonful of tannin 
 in a half-pint of water, would be valuable astringents. 
 
 There may be chronic uterine congestion, or some other 
 form of local disease, which may require special attention ; 
 if so, then the remedies above mentioned will be safe palli- 
 atives, but may not be sufficient. To dwell on these mor- 
 bid conditions would only perplex. An intelligent phy- 
 sician attending the case must decide and direct when these 
 exist. 
 
 After the cessation of the menses, an acrid leucorrhea 
 often appears, making the vagina and vulva very uncom- 
 fortable from a constant sense of irritation. In many cases, 
 if it is allowed to continue, the vagina becomes constricted 
 from continued inflammation of the mucous surfaces. This 
 often occurs when there has been no disease in previous 
 years. 
 
 It could be prevented in most cases by vaginal injections 
 in sitz baths, or of castile soapsuds once or twice a day. 
 If this is not sufficient, some form of medicated injection 
 may be required. For directions, see chapter on Leucor- 
 rhea. In some cases the disease is so severe as to require 
 more vigorous means, which we can not well advise without 
 personal attention. 
 
MENOPA USE, OB CHANGE OF LIFE, 221 
 
 SUBSEQUENT DISCOMFOETS. 
 
 After menstruation has ceased, several months, some- 
 times years elapse, before the nervous and circulatory sys- 
 tem becomes quiet and settled. Creeping chills, flashes of 
 heat, followed by perspiration, annoy, as if the powers of 
 the system which had been hitherto expended on the ute- 
 rine functions were rushing to and fro making mischief, not 
 having found their normal action. The nervous influence 
 which used to prompt this flow is still in force and induces 
 pain in the head, back, and pelvis. This often simulates some 
 local infirmity, and makes the poor victim suppose she must 
 have som^ severe uterine disease. The bladder and rectum 
 being supplied with vessels and nerves from the same sec- 
 tion, are often the seat of irritation, and this sense of dis- 
 comfort is mistaken for a diseased condition. If severe 
 remedies are used, they aggravate rather than allay the 
 symptoms. The suppression of uterine action affects the 
 portal circulation, and hence there is often disturbance of 
 the liver, indigestion, constipation. But with simple diet 
 and good habits this will pass away. If, on the contrary, 
 the sense of pressure at the stomach, the bitter taste in the 
 mouth, prompt to the trial of a variety of patent remedies, 
 such usually get into trouble faster than they get out. 
 Many times the increased or irregular action of the heart 
 is supposed to indicate organic disease, when it is merely 
 sympathetic with some other organ. I have in mind an 
 array of fidgety women, at the uncertain age, who have 
 worried me by night and by day with their incurable in- 
 
222 TALKS TO MY PATIENTS. 
 
 firmities, until I almost wished their fears were true, so that 
 I could send them home to die, instead of keeping them until 
 they got well. But I fancy I hear some of the sisterhood 
 saying, " We understand all about the symptoms, now ; 
 what we want is to know how to get rid of them." 
 
 Well, some can be lessened, some cured, some must be 
 endured. Those of the nervous system are usually more 
 disagreeable than dangerous. If, after consulting your 
 family j)hysician, you find they belong to this class, the 
 less you say about them the better for yourself and for all 
 your friends. Do not worry, and so wear yourself and 
 others by dwelling on them. Patience and palliatives will 
 cure them, if you don't pet them too much. The sensations 
 incident to this period are peculiarly trying to patient, phy- 
 sician, and friends. As no one can talk women out of the 
 crooked, crotchety, crazy notions which sometimes possess 
 them at this age, it will be of no use for me to try to 
 erase them with the pen. 
 
 PALLIATIVE TREATMENT. 
 
 There are simple methods which greatly soothe certain 
 symptoms, and at the same time conduce to a return to 
 health and strength. As the skin has now to perform much 
 of the labor once accomplished by the uterus, it is important 
 that it be kept in an active condition. If there is feverish ex- 
 citement and nervous irritability, a full bath at from ninety- 
 five to one hundred degrees, a half-hour, with the head 
 sponged with cold water, is very beneficial, and if taken just 
 before retiring will often secure a good night's sleep for those 
 
ME 2^0 PA USE, OR CHANGE OF LIFE. 223 
 
 who suffer mucli from wakefulness. The bath not only re- 
 moves the excretions from the skin, but acts as a sedative on 
 the nervous system, and seems to absorb, so to speak, that 
 morbid irritability arising from an undue activity of the mind 
 at the expense of the body. Of course, the bath should be 
 followed by brisk friction, so that not a chill, but a pleasant 
 sense of grateful warmth should follow. If there be heat in 
 the head, keep on the wet compress for the night. A wet-sheet 
 pack of half or three-quarters of an hour with a drip-sheet rub- 
 bing after, at ninety degrees, one minute, will answer a good 
 purpose in place of the full bath, keeping a cold compress to 
 the head while in the pack, and after it, if the heat requires. 
 The periods of perspiration act as a safety-valve for the 
 system, and save from internal disease. The sense of de- 
 bility and discomfort which follows can be relieved by a 
 quick cold bath with towel, or in a tub, as is convenient. If 
 they are so frequent and profuse as to be prostrating, then 
 sponge off with salt and water, or alcohol and water, and rub 
 briskly with a towel. If there is much heat and pain in the 
 head, take head baths at seventy-five degrees, five minutes. 
 When there is a tendency to mental depression, the diversion 
 of travel and out-door exercise are much better than the 
 excitement of ordinary social life, as the former invites to 
 sleep, which is the great safeguard against insanity from 
 real or imaginary troubles. If the cessation is sudden and 
 followed by plethora, pressure of blood to the head, then the 
 diet should be simple — coarse food and fruit; avoid fat 
 meat, gravies, or much of butter and sugar. 
 
 Keep the bowels free, feet warm, and head cool, by 
 
224 TALKS TO MY PATIENTS, 
 
 cheerful, active occupation ; cool sitz baths of half or three- 
 quarters of an hour, reduced in temperature while sitting 
 in them, with cold to the head, and feet, if cold, in hot water, 
 are valuable. Make the skin and kidneys active by daily 
 bathing and free water-drinking. Use no coffee, and but 
 little tea. Keep mentally quiet and take as much moderate 
 exercise as possible. 
 
 ADVANCING TEAKS. 
 
 Women of business, as years advance, are apt to be over- 
 anxious about their home duties, and feel that they must 
 keep about and " see to things" just as they have always 
 done, that they can not trust either grown-up daughters or 
 hired girls with their affairs, and so forfeit their health for 
 years to come (if not their lives), when both might have 
 been saved by " discretion," which " is the better part of 
 valor." Those accustomed to manual labor, and who enjoy 
 it, pass this trying period (if they do not overwork) much 
 better than those women who are so " well to do" that they 
 are not prompted to active duties. 
 
 Now and then we meet one, whose house of brown stone 
 is so finished and furnished as to leave no want, real or 
 imaginary, un^upplied, nothing better to expect, and where 
 servants and handmaids allow little occasion for self-help. 
 
 Still, the mistress of the mansion is a miserable invalid, 
 and her case is more tedious, more difficult to manage than 
 that of the honest housewife who does her own work. The 
 life led by this class is such as would exhaust the nervous 
 system without developing the muscular, hence, when the 
 
MENOPAUSE, OB CEAJSfQE OF LIFE, 225 
 
 trying time comes, they are sadly out of balance, all nerves, 
 and those running in the wrong direction, judging from the 
 great magnitude and the extreme minuteness of their many 
 miseries. 
 
 Those who have lived for gayeties which they can no 
 longer endure or enjoy, are forlorn indeed when they reach 
 this point in the life-journey which marks their decline. 
 While, on the contrary, those who have devoted their 
 days to earnest useful work, stand on the hill-top, take a 
 pleasant retrospect of duties done, of things enjoyed, pause 
 and rest till they have become adjusted to their changed 
 physical condition, and then look cheerfully down the hill 
 they are to descend, seeing deeds of kindness and works of 
 love with which to keep their hands busy and their hearts 
 warm, all the way to the brink of the river. 
 
 I know many who after months, even years of invalidism, 
 at the changing period have settled into good health and 
 good cheer. Some of them, as their home duties diminished, 
 enlarged their sphere of active labor, helping such as need 
 help, by public or private charity. 
 
 Childless women often ask, " What shall I do when I am 
 old ?" Those with children say, " What shall I do when 
 my little ones are grown up and gone ?" 
 
 I do not know what you will do, but of this I am sure, 
 
 if you are in earnest to work, the strength will come, the 
 
 way will open when you are ready, if you do not despise 
 
 the small duties given for your development or discipline. 
 
 Perhaps, instead of active labor the wise Father has lessons 
 
 of patient resting and quiet waiting, for you to give to 
 
 10* 
 
226 TALKS TO MY PATIENTS, 
 
 those you most love — lessons Avhich you could not illus- 
 trate in your best working clays. 
 
 A good spirit is always needed more than good deeds; 
 hence, strong or weak, sick or well, by the help of the All- 
 merciful, declining days need never be useless. 
 
OOl^OLUSIOR 
 
 T CLOSE these pages with a pleasant feeling of having 
 -^ finished a long-promised series of letters to dear per- 
 sonal friends. They will seem often incomplete, but you 
 who know so well the busy life I lead, will understand that 
 it has been quite impossible for me to " read up" with the 
 view of writing a book ; hence, I have merely given, in 
 familiar language, the results of personal observation. 
 
 Those having daughters approaching marriage may wish 
 I had written something more especially for them ; to such 
 I commend " The Physical Life of Women," by Geo. H. 
 Napheys, M. D. 
 
 Some, unaccustomed to the details of water treatment, 
 may be in doubt how to apply it when herein advised. 
 Such will find specific instructions in a small work entitled 
 " How to Bathe," by E. P. Miller, M. D., and for sale by 
 the publishers of this volume. 
 
 In response to numerous requests, I have often said, " I 
 w^ill write a book for you, as soon as I am a lady of leisure." 
 Years have come and gone, and my time and strength 
 have all been required for the sick about me. Our Cure 
 
228 TALKS TO MY PATIENTS, 
 
 being closed for the winter, and my husband seeking rest 
 and recreation in Florida, I have found my diversion in 
 these pen-talks, by our quiet family fireside. 
 
 With the opening spring, the excursionist and the ama- 
 teur author resume their life-work — the care of chronic 
 invalids. 
 
A CATALOGUE OF BOOKS 
 
 PUBLISHED AND TOK SALE BY 
 
 WOOD Si. HOLBROOK, 
 
 No. 1^ ILiaig-lit Street, I^e^w^-^STorli:. 
 
 Any one of which will be sent by mail^ post-paid^ on receipt of the price. 
 
 MORAL, INTELLECTUAL, AND PHYSICAL CULTURE ; 
 
 Or 9 The Tliilosopliy of True Living. 
 
 By Prof. F. G. Welch, Instructor of Gymnastics in Yale College. 
 
 This work is the most Complete Guide to Gymnastics ever published. 
 Parts m. and lY. comprise important thoughts on Moral and Intellectual Cul- 
 ture. It is beautifully printed and bound, and contains nearly 500 pages. 
 Price, $2 ; postage extra, 24 cents. The following table of contents will give 
 an idea of the work : 
 
 Part I.— The Gymnasium.— 1. How to Build a Gymnasium. 2. The 
 Gymnasium 3. Exercises with Parallel Bars. 4. Exercises on Horizontal 
 Bar. 5. Exercises with Rings, Ladders, etc. 6. Exercises with Weights, Ropes, 
 etc. 7. Forty Weeks' Exercises, 8. The Home Gymnasium. 9. Training. 
 10. Indian Club Exercises. 
 
 Part II.— The Dig Lewis System op Gymnastics.— 1. Gymnastics. 
 2. The Dio Lewis System. 3. Shorthand. 4. Marches. 5. Percussion. 6. Mis- 
 cellaneous Exercises. 7. Music. 8. Address to Teachers. 9. Hints and Sug- 
 gestions to Teachers and Pupils. 
 
 Part HI.- The House we Live in.— 1. Health. 2. The Body. 3. Physi- 
 cal Culture. 4. Bathing. 5. Air and Ventilation. 6. Food — Eating and Drink- 
 ing. 7. Sleep. 8. Fashion. 9. Beauty. 10. Amusements and Exercises. 11. 
 Man. 12. Woman. 13. Husband and Wife. 14. Parents and Children. 15. 
 Religion. 16. Education. 17. Manners. 18. Character. 19. The Physician and 
 Medicine. 20. Voice Culture. 21. Hints and Rules. 
 
 Part IV.— Mental and Moral Culture.— 1. General Readings. 2. Pro- 
 verbs of all Nations. 
 
 THE PROPER OBJECT OF AMERICAN EDUCATION. 
 
 Illustrated by a Lecture of Cardinal Wiseman on the Relation of the Arts 
 of Design with the Arts of Production. 
 
 Addressed to American Workingmen and Educators, with an Essay on 
 FroebePfl Reform of Primary Edncation. 
 
 By ELIZABETH P. PEABODY 
 
 rrice, by mail, 25 cents. 
 
 16 
 
SEXUAL PHYSIOLOGY. 
 
 A SCIENTIFIC AND POPULAR EXPOSITION 
 
 OP THE 
 
 FUNDAMENTAL PROBLEMS IN SOCIOLOGY. 
 
 By K. T. TRALL, M.D 
 
 The great interest now being felt in all subjects relating to Human Devel- 
 opment, will make the book of interest to every one. Besides the infor- 
 mation obtained by its perusal, the practical bearing of the various subjects 
 treated in improving and giving a higher direction and value to human life 
 
 CAN NOT BE OVER-ESTIMATED. 
 
 This work contains the latest and most important discoveries in the An- 
 atomy and Physiology of the Sexes ; Explains the Origin of Human Life ; How 
 and when Menstruation, Impregnation, and Conception occur ; giving the laws 
 by which the number and sex of offspring are controlled, and valuable infor- 
 mation in regard to the begetting and rearing of beautiful and healthy children. 
 It is high-toned, and should be read by every family. With eighty fine en- 
 gravings. Agents wanted. 
 
 SYNOPSIS OP TABLE OP CONTENTS. 
 
 Chapter I.— The Male Organs of Generation. 
 
 Chapter IT.— The Female Organs of Generation. 
 
 Chapter m.— The Origin of Life. 
 
 Chapter lY.— Sexual Generation. 
 
 Chapter V. — The Physiology of Menstruation. 
 
 Chapter YI. — Impregnation, 
 
 Chapter YII.— Pregnancy. 
 
 Chapter VHI.— Embryology. 
 
 Chapter IX.— Parturition. 
 
 Chapter X.— Lactation. 
 
 Chapter XI.— The Law of Sex. 
 
 Chapter XH. — Eegulation of the Number of Offspring. 
 
 Chapter XHL— The Theory of Population. 
 
 Chapter XTV".- The Law of Sexual Intercourse. 
 
 Chapter XV.— Hereditary Transmission. 
 
 Chapter XYI.— Philosophy of Marriage. 
 
 This work has rapidly passed through ten editions, and the demand is con- 
 etautly increasing. No such complete and valuable work has ever before been 
 issued from the press. Price, by mail, $2. 
 
A WINTER IN FLORIDA; 
 
 Or, Otsenations on tie Soil, Climate, and Productions of our Semi-Tropical State. 
 
 With Sketches of the Principal Towns and Cities in Eastern Florida, 
 
 to which is added a brief Historical Summary, together with 
 
 Hints to the Tourist, Invalid, and Sportsman. 
 
 By led yard BILL. 
 
 lUustrated with Maps and beautiful Wood-cuts. 
 
 In speaking of this book, The New-YorJc Tribune says : " Mr. Bill has fur- 
 Diehed in this neat little volume a great amount and variety of the sort of in- 
 fonnation which people visiting Florida for health or amusement, or with a 
 view to permanent settlement, are most likely to require. He has paid due 
 attention to the soil, climate, productions, and natural advantages of the State ; 
 he gives clear and minute directions about routes, and sketches the aspects 
 of social life." 
 
 The thousands who would know all about Florida before going there will 
 find this book just the thing, whether they are Invalids, Tourists, Sportsmen, 
 or those seeking a Home away from cold Winters in a delightful clime. The 
 following condensed table of contents gives a general view of the work : 
 
 What to Expect and How to Go ; Early History of Florida ; Miscellaneous Topics ; 
 Up the St. Johns to Jacksonville ; Home of Harriet Beecher Stowe ; The 
 Celebrated Spring at Green Cove ; Central Florida and the Upper St. Johns ; 
 Alligator Shooting ; The Old City of St. Augustine ; Climate and its Effect 
 on Invalids ; Character and Kind of Soil ; The Orange, Lemon, and Lime ; 
 The Social Condition of the People ; Sketches of Jacksonville, Green Cove, 
 Picolata, Enterprise ; Abundance of Fish and Wild Game ; The Mocking 
 Bird's Home ; Incidents of Travel ; Hints to those Going to Florida. 
 
 The work contains about 250 pages 12mo, beautifully illustrated with 
 map and full-page cuts, and retails at $1.25. Copies sent to any address by mail 
 ou receipt of the price. 
 
 THE TREE OF LIFE; 
 
 Or, Human Degeneracy, its Nature and Remedy. 
 
 By Isaac Jennings, M.D. 
 
 The author of this book was for thirty years an Allopathic physician, but 
 becoming convinced that medicines did more hann than good, he substituted 
 placebos of bread pills and colored water in his practice, and the record of his 
 cases show that the latter treatment was eminently succesfiil in removing dis- 
 eases. It contains the following table of contents ; 
 
 Man's Spiritual Degeneracy; Physical Depravity; Physiological and Psycho- 
 logical Eeform ; Remedy for Man's Spiritual Degeneracy; Man's Physical 
 Degeneracy ; Constitution of Human Physical Life ; Vital Economy, or Or- 
 
 fanic Laws of Life ; Source and Mode of Transmission of the Principle of 
 [uman Physical Life ; Predisposition to Disease ; Hereditary Diseases ; 
 Mode of Renovation of Impaired and Feeble Vital Machinery ; Analysis of 
 a Few of the Most Prominent Symptoms of Disease ; I^aw of Contagion 
 and General Causation; Medical Delusion; Remedy for Man's Physical 
 Degeneracy; General Directions Resumed; Specific Directions — Croup- 
 Dysentery— Cholera ; Final and Efi'ectual Remedy for Man's Physical De* 
 generacy. 
 
 Price, by mail, $1.50. 
 
THE PHILOSOPHY OF HUMAN BEAUTY; 
 
 Or, Hints Toward Physical Perfection. 
 
 Sliowing how to Acquire and Retain Bodily Symmetry, Health, and Vigor, Seu 
 cure Long Life, and Avoid the Infirmities and Deformities of Age. 
 
 By D. H. JAQUES. 
 
 Motto.— 7%e idea of Beauty of Person is synonymous with that of Health 
 and a Perfect Organization. 
 
 LIST OF CHAPTERS. 
 
 I. Structure of the Human Body. 
 n. The Perfect Man and Woman. 
 m. The Temperaments. 
 IV. Embryology. 
 V. Childhood. 
 i VI. Moral and Emotional Influences. 
 VII. Social Conditions and Occupa- 
 tions. 
 
 This hook contains nearly one hundred beautiful illustrations, and the 
 whole is elegantly bound. Price, by mail, $1.50. 
 
 Vm. Effects of Climate and Society. 
 rX. Direct Physical Culture. 
 X. Practical Hygiene. 
 XI. Womanhood. 
 Xn. Secret of Longevity. 
 Xm. Arts of Beauty. 
 XIV. External Indications of Figure. 
 
 NEW HYGIENIC COOK BOOK. 
 
 By Mrs. M. M. JONES, M.D. 
 
 This work contains Recipes for making Unleavened Bread, Biscuits of 
 Wheat, Com, Oat, and Rye Meal, Graham Crackers, Wheaten Mush, Hominy, 
 Samp, Indian Meal Mush, Oatmeal Mush, Farina Mush, Rice Mush, Blanc 
 Mange, Molded Farinacea, Wheat and Oatmeal Porridge, every variety of Pie, 
 with the most wholesome and delicious crust, and directions so minute that 
 those who have no acquaintance with Hygienic Cookery will find it easy to 
 carry out the details. Recipes for more than forty kinds of Puddings, an Essay 
 on Emits and their use as food, with ample directions for canning, drying, and 
 cooking, numerous hints on cooking Vegetables, the preparation of dishes from 
 whole grains and seeds, recipes for Graels of Wheat-Meal, Oatmeal, Farina, 
 Tapioca, Sago, Arrowroot, Rice, Green and Split Peas, Barley Vegetable Broth, 
 Barley Broth, etc., etc. The Recipes for washing and removing stains are those 
 which experience has proved to be best, and are worth many times the cost 
 of tke book. 
 
 I^rice, postage free, 30 cents* 
 19 
 
WO^Ai^'S DRESS; 
 
 Its IMoral and. I^liysical [Relations. 
 
 By Mrs. M. M. JONES, M.D. 
 
 This Essay was read at the World's Health Convention, and produced a 
 profound impression at the time. It gives full and accurate directions for 
 beautiful and healthful clothing. 
 
 Price, by mail, 30 cents. 
 
 MANUAL OF LIG-HT GYMNASTICS; 
 
 For Instruction in Classes and Private Use. 
 
 By W. L. rathe, 
 Graduate of the Boston Institute for Physical Education. 
 
 *' Training, if it does not impart strength, fosters and increases it, renders 
 it serviceable, and prevents its running to Y^^aete.''— Guesses at Ti-uth. 
 
 " It is better to seek to develop the entire nature, intellectual, moral, and 
 physical, than to push one part of it into a prominence that stunts and kills the 
 TQ&V—The Country Parson, 
 
 Price, by mail, 40 cents. 
 
 WATER-CURE FOR THE MILLION. 
 
 Tlie Processes of Water- Cure Explained, 
 
 POPULAR ERRORS EXPOSED. 
 
 Hygienic and Drug-Medication Contrasted ; Eules for Bathing, Dieting, Exer 
 
 cising, etc. ; Kecipes for Cooking ; Directions for Home-Treatment ; 
 
 Eemarkable Cases to Illustrate, etc. 
 
 By R. T. TRALL, M.D. 
 
 Fourth Edition. 
 Pncfe, by mail, 30 cents. 
 
 DIPHTHERIA. ; 
 
 Its Nature 9 History , Causes y Frevention^ and 
 Treatment on Hygienic JPrinciples* 
 
 With a Resume of the various Theories and Practices of the Medical Profession. 
 
 By R. T. TRALL, M.D. 
 Price, by mail, $1. 
 
 20 
 
TOBACCO AND ITS EFFECTS. 
 
 BEINa 
 
 JBhowing ttat tlie Use of Tobacco is a Physical, Mental, Moral, and Social Evil. 
 
 By Henry Gibbons, M.D., Editor Pacific Medical and Surgical Journal. 
 
 CONTENTS. 
 
 I. Tobacco : Its Nature and Proper- 
 ties. 
 n. Effects on the Body. 
 III. Effects on the Mind. 
 
 Price, by mail, 20 cents. 
 
 rV". Moral Effects. 
 V. Social Effects. 
 VI. What Good does it Do ? 
 VII. Conclusion. 
 
 THE USE OF TOBACCO, 
 Mi tlie Evils, Pliyslcal, Mental, Moral, Social, Eesultiiig ffierefrom, 
 
 By JOHN H. GRISCOM, M.D., 
 
 President of the New- York Association for the Advancement of Science 
 and Art, etc. 
 
 It is a valuable worTc. Price. 25 cents. 
 
 *' To emry human being there is a natural lifeiwie.'^'' 
 Already acTtnowledged to he a Standard WorTc. 
 
 SECOND EDITSON PiOW READY. 
 
 Flexible Cloth, 8vo, $1 ; postage prepaid, 
 
 Paet I. BioaiETUT : The ]\Ieasure or Span op Lipe. A New Philosopht. 
 Contains an Exposition of the Laws that govern the duration of human 
 life — or " lifetime ;" a Description of the External Personal Marks of a Long or 
 Short " Lifetime ;" Interesting Facts concerning Long-lived Kaces, Families, 
 and Individuals, showing the relations of Longevity lo Eiches, by T. S. Lam- 
 bert, M.D., LL.D. ; Two Prize Essays ($500 each) on the Physical Signs of 
 Longevity in Man, by J. V. C. Smith, M.D., of Boston, and by John H. Gris- 
 com, M.D., New-York; and Striking Word Pictures, by which to recognize 
 some incipient diseases, consimiption, etc., by C. L. Hubbell, M.D. 
 
 Part II. The Phtlosopht and Practice of Life Insurance. 
 Its Relations to Biometry, or the Natural Span of Life ; True Value of 
 Insurance, and the Sources of that Value ; Correct Methods of Insurance, with 
 Positive Proofs and Conclusive Demonstrations of their Correctness and Equity ; 
 " The Laborer Worthy of his Hire ;" Agents too Well Paid for Poor Work, and 
 too Poorly Paid for Good Work ; " Lead us not into Temptation ;" No Man 
 •an Afford to be Tempted. 
 
AND JOURNAL OF PHYSICAL CULTURE. 
 
 Ay the intelligent fanner can not afford to be without an agricultural paper, 
 so no intelligent household should be without a Health Journal. 
 The Hekajld of Health is preeminently 
 
 THE JOURNAI. OF ITS KIND. 
 
 No other at all approaches it in value. It does not at all smack of sick- 
 room odor, but of healthy, happy, bright life. Every body feels better bodily 
 and mentally who reads it. The sick learn how to get well by proper living. 
 The well how to keep so, by good habits. Parents leara how to rear healthy 
 children, and how to educate and train them to good habits. This Monthly 
 does not limit its field to health topics, but goes over the whole ground of life, 
 and is so broad and comprehensive that it has won the universal esteem of 
 
 THOUSAlfDS ON THOUSANDS OF PEOPLE. 
 
 "We can always commend this journal without qualification." — ITeic-Torh 
 Evening Post. (Edited by William C. Bryant, the Poet.) 
 
 " The Herald of Health is a journal which contains more sensible arti- 
 cles on subjects of a practical moral bearing, than are to be found in any other 
 monthly that comes to our sanctum." — Scientific American. 
 
 " The Herald of Health w^ell sustains the high standard which it has 
 held forth since the commencement of the new series. In fulfilling its task as 
 a 'preacher of righteousness ' in the department of Physical Culture, it enjoys 
 the aid of numerous sound thinkers and able writers." — Neiv-YorJc Tribune. 
 
 Its corps of Contributors includes scores of the best men and women in 
 the country. Each month we have a contribution from HENRY WAED 
 BEECHER. His articles alone ou practical topics are worth the entire cost for 
 one year. 
 
 A few pages each month will be devoted to brief prescriptions for all forms 
 of disease, not of drugs, but of Hygienic Agencies. Queries on health topics 
 answered free every month in the Journal. 
 
 To give greater variety, and add to its attractiveness for 1870, we shall 
 publish 
 
 By Mrs. Elizabeth Oakes Smith. 
 
 It will be a story full of thought and wisdom, and will furnish delightful 
 reading for the Home Circle. This story will continue through the year. 
 The motto of this magazine is : 
 
 *' A Higher Type of Manhood, Physically, Intellectually, and Morally," 
 
 and it will work faithfully to make this motto good. 
 
 For 35 subscribers and $70, we will give a Grover & Baker Sewing-Machine 
 worth $60. 
 
 For $3.35 we will send the Herald of Health and The New-Yorlc Weekly 
 Trihune one year. For $3 we will send the Herald and The American Agri- 
 culturist one year. 
 
 We have had engraved for our subscribers for 1870, a splendid steel en- 
 graving of 
 
 ALEXANDER VON HUMBOLDT, 
 
 TO BB GIVEN AWAY 
 
 to each subscriber who sends us $2. It is finely engraved, prijited on good 
 paper, and vrill be an ornament to any room. The picture is ccpied after an 
 original oil painting, owmed by A. T." Stewart, of New- York. Persons who 
 choose can have choice plants or seeds in place of the picture. 
 
 $2 a Year. Samples, 20 cents. 
 
 22 
 
Herald of Health Premium List for 1870. 
 
 To eyery Single SubscriheVf who Bends us $2, we will send A Vert Fin:f 
 Kew Steel Engraving of the Philosopher and Scientist. ALEXANDER 
 VON HUMBOLDT, after an Original Painting owned by A. T. Stewart, Esq. 
 
 Fo7* Tu'o Suhscrihei'Sf (one old and one netv,) and $4, a copy of 
 "A Winter in Florida," worth $1.25; or one copy of "Physical Pbb- 
 TECTiON," worth $1.50. 
 
 For Three Suhscriherst (one old and two new,) and $6, a copy of 
 Prof. Welch's New Book, ''Moral, Intellectual, and Physical Cul- 
 ture," worth $2.25. 
 
 JFor Four Subscribers, and 
 
 Holder, worth $4. 
 
 S, a Gold Pen, with strong Silyer-coiu 
 
 For Seven. Subscribers, and $14f we will send, post-paid, one of Prang's 
 beautiful Chromos, worth $5, called The Barefooted Boy, after an oil 
 painting by Eastman Johnson. This is an illustration of the familiar lines 
 of Whittier : 
 
 " Blessings on thee, little man, 
 Barefoot boy, with cheeks of tan." 
 It is tne portrait of a " Young America " in homespun clothing, barefooted, 
 and with that self-reliant aspect which characterizes the rural and back- 
 woods children of America. It is very charming. Size, 9^^ x 15. 
 
 For Nine Subscribers, and $18, we will send, post-paid, one of Prang's 
 beautiful Chromos, called A Friend in Need, worth $6. This is a coun- 
 try scene, composed of a village in the distance, with trees in the middle, 
 and the village pump in the immediate foreground. A happy looking vil- 
 lage boy lends his friendly aid to a pretty rustic damsel, who is quenching 
 her thirst at the pump, the handle of which he is plying vigorously. The 
 position of these figures, in connection with the dog, who also enjoys the 
 cooling draught, forms a most interesting group, which is excellently ren- 
 dered m strong, effective colors. Size, 13 x 17. 
 
 For Fifteen Subscribers, and $30, we will give one op Webster's Pic- 
 TORiAii Unabridged Dictionaries, Illustrated with 3000 cuts, worth $12. 
 
 For Thirty 'five Subscribers , and $70, we will give a splendid E^ipire 
 Sewing-Macetene, worth $60. This is as good as any machine in the mar- 
 ket, and can not fail to give the best satisfaction. 
 
 For Sixty Subscribers, and $120, we will give the New American En- 
 cyclopedia, in twenty volimies, worth $100 1 
 
 For Fighty-five Subscribers, and $170, we will send one of Mason & 
 
 Hamlin's Five-Octave Organs, worth $125, with Five Stops, Viola, 
 Diapason, Melodia, Flute, Tremulant, with two sets of Vibrators through- 
 out, and Knee Swell. 
 
 For One Hundred Subscribers, and $200, we will give one of Estey's 
 FrvE-OcTAVE Cottage Organs. Black Walnut, Double Reed, Harmonic 
 Attachment, and Manual Sub Bass, Three Stops, worth $200 ! 
 
 For Three ^Hundred Subscribers, and $600, we will give a Bradbukt 
 Piano, worth $600 ! 
 
 CLUBBING WITH OTHER MAGAZINES.— We will send The Herald 
 OP Health and any one of the following Journals one year, for the sum below 
 mentioned. The order and money for both must be sent at the same time. 
 
 The Herald of Health, $2, and 
 Atlantic Monthly, ... $4 00 for $5 00 
 
 Harper's Monthly, 4 00 for 5 00 
 
 Harper's Bazar, ....... 4 00 for 5 00 
 
 Harper's Weekly 4 00 for 5 00 
 
 PhrenologicalJoumal, 3 00 for 4 00 
 
 The Herald of Health, $2, and 
 Our Young Folks, . . $2 00 for $3 50 
 Ne w- York Tribune,. . . 2 00 for 3 35 
 Amer'n Agriculturist, . 1 50 for 3 00 
 Packard's Monthly,... 2 00 for 3 00 
 Christian Union, 3 00 for 3 50 
 
 10 Subscribers, $15 ; 4 Subscribers^ $7 ; 1 Subscriber, $2 ; Single numbers, 20 cis. 
 
 23 
 
LIST OF ARTICLES FOR SALE BY 
 
 WOOD & HOLBROOK, No. 15 Laight Street, Nei-Yort. 
 
 BACON'S HOIVIE GYMNASIUM, with book of explanation and one hun 
 dred cuts, $10. 
 
 -Trapeze Adjustment, with thirty-two illustrations, $3.50. 
 -Swing Adjustment, for children, $1.50. 
 
 Each part sold separately. The whole, $15. 
 
 This is the most valuable piece of Gymnastic apparatus for home use eve? 
 invented. Any one can use it. For weak chests, backs, and sides, its use is 
 the best remedy known. A half hour's use of it daily would prevent and cure 
 many cases of dyspepsia and consumption. 
 
 SYRINGES.— The best styles in market. Usual style, by mail, $3. For chil- 
 dren, with Eye and Ear Douche for sores, etc., $2. The Spray Syringe, $3. 
 The Trade supplied. 
 
 BREAD PANS— for making light, aerated Bread without soda, saleratus, yeast, 
 or other poisonous compounds. Only by Express, $1. 
 
 HERALD OF HEALTH COVERS— so that every one can bind their numbers 
 and preserve them neatly. 60 cents. 
 
 HAND MILLS— for cracking Wheat, making Rusk, Hominy, etc. ByExpress,$3. 
 ELECTRIC MACHINES— Kidder's— best manufactured, $20 to $22. 
 FILTERS— Kedzie's— Family Size, $10.50. 
 SPIR0:METER— for Strengthening the Lungs. 
 
 We are now able to supply our friends with a first-class Spirometer, with 
 which to enlarge and strengthen the lungs. It is so arranged that the person 
 using it can measure the capacity of the lungs for air in cubic inches with each 
 test, thus showing their strength and the amount of increase. The value of 
 the careful daily use of such an instrument for those who have weak lungs or 
 incipient consumption is very great. The inventor of this instrument cured 
 himself of consumption by its use, as have many others, and we have no hesi- 
 tation in saying, that if rightly used, it well do more to prevent and curb 
 
 THIS DISEASE THAN ALL, THE MEDICINES OF THE WORLD. 
 
 The Spirometers are light, ornamental, portable, durable, and any body can 
 use them. They have been highly commended by many leading physicians. 
 Every Physician, Student, Sedentary Person, Professional Man, and Family 
 should have one. 
 
 Sent only by Express. Price, $10. Orders for any of the above, by mail* 
 promptly filled. 
 
 FOBTHCOMING- BOOK. 
 
 tJ^lME TMMB 1# ^aSilS. 
 
 We shall publish in March, 1870, Mrs. Dr. Gleason's work, entitled Par- 
 lor Talks to Ladies f upon the diseases of women. Mrs. Gleason is so well 
 known to the readers of The Herald of Health that this announcement 
 will be hailed with delight. The book is destined to meet with a very exten- 
 sive sale. Pure and chaste in its diction, hardly a woman in the land but will 
 want a copy. Ladies who wish to canvass for a work of this kind will find it 
 just the book for them. A hundred could be sold in almost any neighborhood. 
 The price has not yet been decided upon, but it will be somewhere from one 
 dollar to one dollar and fifty cents, postage extra. Should any one, however, 
 remit three dollars for The Herald of Health for 1870 and this book, befoce 
 the first of January, we will send it, whether the price is more or not. 
 
 24 
 
NEW YORE HYGIENIC INSTITUTE, 
 
 Nos. 13 & 15 Laight Street, 
 
 E"EW TOEK CITY. 
 
 A. L. WOOD, M. D., Physician. 
 
 WOOB & H<3LBH<3<3K, Proprietors. 
 
THE NEW YORK HYGIENIC INSTITUTE. 
 
 The objects of this institution, whicli has been in successful operation 
 for more than twenty years, are two-fold, viz. : 
 
 1. TEE TREATMENT AND CUBE OF TEE SICK WITEOUT 
 POISONING TEE3f, BY EYGIENIC AGENCIES ALONE, 
 
 2. TO FVBNISE A FLEAS ANT, GENIAL HOME TO 
 FRIENDS OF EYGIENE TEBOUGEOUT TEE WORLD, WEEN- 
 EVER TEEY VISIT TEIS CITY. 
 
 CURE DEPARTMENT. 
 
 Thousands of invalids have been successfully treated at this institu- 
 tion during the past twenty years, and its fame extends wherever the 
 English language is spoken. Its appliances for the treatment of dis- 
 ease without the use of poisonous drugs are the most extensive and com- 
 plete of any institution in America. They comprise the celebrated 
 
 Swedisli Movement Ciir^, 
 
 TURKISH BATHS, ELECTRIC BATHS, VAPOR BATHS, 
 
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 Tfe© ¥apladi 8:n:(J is^t©rts[\^© Rts^Kjre^s @f tEt© Wat©?- (^m@^ 
 
 LSFTiNQ CURE, MAQNETiSM, 
 
 EEALTEFJJL FOOD, A FLEASANT EOME, ETC, ETC. 
 
 Particular attention is given to the treatment of all the forms of 
 CHRONIC DISEASE, especially of Rheumatism, Gout, Dyspepsia, 
 C )nstipation. Torpidity of the Liver, Weak Lungs and Incipient Con- 
 sumption, Paralysis, Poor Circulation, General Debility, Curvature ot 
 the Spine, Scrofula, Diseases of the Skin, Uterine Weaknesses and Dis- 
 placements, Spermatorrhea, etc. 
 
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