The normal activities of the human body are not "disease" -- but women may be pardoned for noticing a strong resemblance.
H. Bowen Partington, F.R.E.S.
IN this article, I deal with the problems of menstruation, pregnancy, childbed and lactation, in relation to marriage. All these processes, although they are actual conditions in the normal course of a woman's life, may nevertheless be regarded, to a certain extent, as diseases; because they are unavoidably associated with pain and functional disturbance, or at least with diminished resistibility.
Taking menstruation first, we find that, even where the phenomena associated with it do not exceed the normal limits, there are still a number of symptoms which constitute a disordered state of health. Before the commencement of the period the woman experiences pain (although moderate in degree) in the loins and in the back, a sensation of heaviness and downward pressure in the abdomen, a feeling of tension in the organs of generation, and often also in the breasts. Accompanying these symptoms there is an increased irritability of the nervous system, an excitation of the sexual faculty, and a depression of the mental condition. The importance of menstruation from the standpoint of married life, which concerns us here, lies principally in the fact that during its presence intercourse is forbidden. But, as the desire in woman towards the end of menstruation is increased, this abstinence is undoubtedly antagonistic to the natural instinct and possibly the cause of the mental depression and nervous irritability which accompany the monthly period.
Husbands should always remember that, in many women, there is, towards the end of menstruation a noticeable, or even a very disturbing, mental depression, and a marked disagreeable temper; and every married man must bear in mind the naturalness and inevitableness of the nervous irritability in the menstruating woman. He must treat his menstruating wife as if she were recovering from some slight illness; he must do all he can to diminish the extent of her worries: he must keep from her bad news or sorrow: he must not encourage occasional outbursts of unjustified temper, but rather try to avert them by tact and good humor. It is almost always during menstruation that the first clouds appear on the matrimonial horizon ; the husband who is aware of the importance of these "critical days" will know how to take the necessary means for prevention of quarrels.
The second of the physiological "diseases" is pregnancy. If pregnant women undergo a certain amount of bodily suffering, this is due to the fact that the fetus lives as a parasite at the expense of its mother, that it consequently draws from her the entire material required for the formation of its body. There is thus caused, in the first instance, more or less complete exhaustion of the reserve substance stored up in the maternal organism, and, secondly, an increased demand of nourishment and oxygen. The necessary consequence of the satisfaction of this demand is an increased activity on the part of the digestive and secreting organs-the stomach, the intestines and the kidneys. All this, in turn, gives the heart of the pregnant woman a greater amount of work to accomplish.
Finally, pregnancy causes dis turbances of a purely mechanical nature. The increasing weight of the pregnant womb interferes with the movements of the body, and is a constant burden to the dorsal region. The abdominal walls become stretched, subcutaneous ruptures occur in them, the muscles get over-distended, and the abdominal pressure is diminished. The bladder is encroached upon and its capacity decreased, and the action of the bowels is rendered more difficult.
From her youth up, woman has a great many things to worry about; some of them never happen, it is true, but man must make a great many allowances for the effect of her physical condition on the mental.
It is certainly true that the organism is capable of adapting itself to a certain extent, to these purely objective changes in the conditions. Nevertheless, this is only partly the case, and it is difficult to say where normality ends and morbidity begins. A number of the disturbances which accompany pregnancy may assume the character of disease proper, necessitating medical attention; though in the majority of cases they are of a far less serious nature. At any rate, they are of enormous importance to the married state.
Where the marriage has been contracted in the expectation that the wife will participate in the earning of the livelihood, pregnancy compels her, at least during part of its duration, to desist from such participation wholly or partly on account of her diminished-working ability. Even the fulfilment of the ordinary home duties may become so difficult that the household is bound to suffer. The lesser resistibility against disease often renders the wife totally unable to do any work, and even necessitates attendance upon her on the part of other people. Moreover, the psychical irritability on the one hand, and the depression, or possibly the melancholia, on the other, make her more or less incapable for other work than mere mechanical duties.
The proper supervision of the entire household, the firm but just management of the domestic servants, the resolute bringing-up of the children, the considerate and patient treatment of the husband who comes home tired from his hard daily work-all these conjugal duties, which are no doubt of the highest importance, may suffer considerable neglect in consequence of such psychical disturbances of pregnancy.