Other Typical Cases
Case VII. The ambitious woman discontented with her husband's ability.
In the American marriage relationship the woman makes the home and the man makes the fortune. In some countries the wife is an active business partner. This is notably true in France, among the Jews in Russia, and many immigrant races in the United States. The wife may even take the leadership if her superiority clearly shows up. Perhaps the American method works well enough in a majority of cases, but there are superior women yoked to inferior men who finally despair of their husband's advancement, and who, as the phrase goes, ought to be "wearing the trousers" themselves.
Mrs. D.J., thirty-nine years old, married fourteen years, two children, had excellent health before marriage. Her family, originally poor, had been characterized by great success. Her brothers occupy important places in the business world and are wealthy. One of her sisters is married to a man who is successful in law, and the other sister is an executive in a department store.
Before marriage Mrs. J. was in her brother's business, and at the time of her marriage earned a comfortable salary. She married a man who inherited a small business, and when they married she was enthusiastic over the prospects of this business. But unfortunately her husband never followed her plans; he listened impatiently and went ahead in his own way. As a result of his conservatism they had not advanced at all financially. Though they were not poor as compared with the mass of people, they were poor as compared with her brothers and brother-in-law.
In addition to the exasperation over her husband's attitude toward her counsel (which was approved by her brothers), she developed a disrespect for him, a feeling that he was to be a failure and a certain contempt crept into her attitude. Against this she struggled, but as the time went on the feeling became almost too strong to be disguised and caused many quarrels. It is probable that if her own brothers and sisters had not done so well her feeling toward her husband would not have reached the proportions it did, for she became envious of the good things they enjoyed and to a certain extent resented her sisters-in-law's attitude toward her husband and herself as poor. The part futile jealousy and envy play in life will not be underestimated by those who will candidly view their own feelings when they hear of the success of those who are near them. One of the reasons that ostentation and bragging are in such disfavor is because of the unpleasant envy and jealousy they tend involuntarily to arouse.
With disrespect came a distaste for sexual relations, and here was a complicating factor of a decisive kind. She developed a disgust that brought about hysterical symptoms and finally she took refuge in refusal to live as a wife. This aroused her husband's anger and suspicions; he accused her of infidelity and had her watched. The disunion proceeded to the point of actual separation, and she then passed into an acute nervous condition, marked by fear, restlessness, sleeplessness, and fatigue.
The analysis of this patient's reactions was difficult and as much surmised as acknowledged. With her breakdown her husband's affection immediately revived and his solicitude and tenderness awoke her old feeling, together with remorse for her attitude towards his lack of business success. It was obvious to me in the few times I saw her that she was working out her own salvation and that no one's assistance was necessary after she understood herself. Intelligence is a prime essential to cure in such cases,—an ignorant or unintelligent woman with such reactions cannot be dealt with. Gradually her intelligence took command, new resolves and purposes grew out of her illness, and it may confidently be said that though she never will be a phlegmatic observer of her husband's struggles she has conquered her old criticism and hostility.
Case VII. The nondomestic type and the mother-in-law.
That there is a nondomestic type of woman to-day is due to the rise of feminism and the fascination of industry. Where a woman has once been in the swirl of business, has been part of an organization and has tasted financial success, settling down may be possible, but is much more difficult than to the woman of past generations. Such a woman probably has never cooked a meal, or mended a stocking, or washed dishes,—and she has been financially independent. For love of a man she gives all this up, and even under the best of circumstances has her agonies of doubt and rebellion.
Mrs. A. O'L. had added to these difficulties the mother-in-law question. She was an orphan when she married, and was the private secretary of a business man who because she was efficient and intelligent and loyal gave her a good salary. She knew his affairs almost as well as he did and was treated with deference by the entire organization.
She married at twenty-six a man entirely worthy of her love, a junior official in a bank, looked on as a rising man, of excellent personal habits and attractive physique. She resigned her position gladly and went into the home he furnished, prepared to become a good wife and mother.
Unfortunately there already was a woman in the house, Mr. O'L.'s mother. She was a good lady, a widow, and had made her home with the son for some years. She was a capable, efficient housewife, with a narrow range of sympathies, and with no ambitions. There arose at once the almost inevitable conflict between mother-in-law and daughter-in-law.
Some day perhaps we shall know just why the husband's mother and his wife get along best under two roofs, though the husband's father presents no great difficulties. Perhaps in the attachment of a mother to a son there is something of jealousy, which is aroused against the other woman; perhaps women are more fiercely critical of women than men are. Perhaps the mother, if she has a good son, is apt to think no woman good enough for him, and if she is not consulted in the choosing is apt to feel resentment. Perhaps to be supplanted as mistress of the household or to fear such supplantment is the basic factor. At any rate, the old Chinese pictorial representation of trouble as "two women under one roof" represents the state in most cases where mother-in-law and daughter-in-law live together.
The senior Mrs. O'L. began a campaign of criticism against the younger woman. There was enough to find fault with, since the wife was absolutely inexperienced. But she was entirely new to hostile criticism, and it impeded her learning. Furthermore, she was not inclined to try all of the mother-in-law's suggestions; she had books which took diametrically the opposite point of view in some matters. There were some warm discussions between the ladies, and a spirit of rebellion took possession of the wife. This was emphasized by the fact that she found herself very lonely and longed secretly for the hum and stir of the office; for the deference and the courtesy she had received there. Further, the distracted husband, in his rôles of husband and son, found himself displeasing both his wife and his mother. He tried to get the girl to subordinate herself, since he knew that this would be impossible for his mother. To this his wife acceded, but was greatly hurt in her pride, felt somehow lowered, and became quite depressed. The house seemed "like a prison with a cross old woman as a jailer", as she expressed it.
Another factor of importance needs some space. The bridal year needs seclusion, on account of a normal voluptuousness that attends it. No outsider should witness the embraces and the kisses; no outsider should be present to impede the tender talks and the outlet of feeling. It sometimes happens that the elderly have a reaction against all love-making; having outlived it they are disgusted thereby, they find it animal like, though indeed it is the lyric poetry of life. So it was in this case; the mother was a third party where three is more than a crowd, and she was a critical, disgusted third party. The young woman found herself taking a similar attitude to the love-making, found herself inhibiting her emotions and had a furtive feeling of being spied on.
The previously strong, energetic girl quickly broke down. Physical strength and energy may come entirely from a united spirit; a disunited spirit lowers the physical endurance remarkably. She became disloyal to matrimony, rebelled against housework, and yet loved her husband intensely. A prey to conflicting ideas and emotions, she fell into a circular thinking and feeling, where depressed thoughts cannot be dismissed and depressed energy follows depressed mood. Prominent in the symptoms were headache, sleeplessness, etc., for which the neurologist was consulted.
How to remedy this situation was to tax the wisdom of a Solomon. It probably would have remained insoluble, had not the statement I made that the main element in the difficulty was the mother-in-law vs. daughter-in-law situation come to the ears of the old lady. Conscientious and well-meaning, that lady announced her determination to take up her residence with a married daughter who already had a well-organized household, and whose husband was a favorite of the mother's. Despite the mother-in-law joke of the humorists, the mother-in-law is far more friendly to a daughter's husband than to a son's wife.
This solved part of my patient's problem. There remained the adjustment to domestic life. This was hard, and though in part successful, it was delayed by the sterility of the marriage. The husband and wife agreed that pending a child she might well become active again in the larger world. Though the best place would have been her old work, pride and convention stood in the way, and so she entered upon more or less amateurish social work. Finally, perhaps as an unconsciously humorous compensation for her own troubles, she became an ardent and thoroughly efficient secretary to a league of housewives that aimed at better conditions. This work took up her time except for the supervising of a servant, and this nondomestic arrangement worked well since she had no children.
Case VIII. The childless, neglected woman.
It happened that two of the severest cases I have seen occurred, one in a Jewish woman and the other in a young Irish woman, with such an identity of symptoms and social domestic background that either case might have been interchanged for the other without any appreciable difference. The factors in the cases might simply be summarized as childlessness, anxiety, neglect, and loneliness, and in each case the main symptoms were anxiety, attacks of cardiac symptoms, fatigue, and sleeplessness.
The young Jewish woman, thirty years of age, had been married since the age of twenty. Before marriage she worked in the needle trades, was well and strong and had no knowledge of any particular nervous or mental disease in her family. She married a man of twenty-four, who had also been in the tailoring business and had branched out in a small way in business. This business required him to go to work at about seven-thirty in the morning and he finished at nine-thirty in the evening. In the earlier years of their marriage he came home rather promptly at the end of his long day and the pair were quite happy.
At about the third year after marriage the woman became quite alarmed at her continued sterility. She commenced to consult physicians and in the course of the next three years underwent three operations with no result. She began to brood over this, especially since about this time her husband began to show a decided lack of interest in the home. He would come home at twelve and later, and she found that he was playing cards,—in fact had become a confirmed gambler. When she first discovered this, she became greatly worried; made a trip to New York where his people lived and induced them to bring pressure to bear on him for reform. This they did, with the result that for about six months he remained away from cards and gave more attention to his wife.
The reform lasted only for a short period and then the husband plunged deeper into gaming than ever, and there were periods of three and four days at a stretch when he would not return home at all. At such times the lonely wife, who still loved her husband, fell into a perturbed and agitated frame of mind, the worse because she confided her difficulties to no one. When he would return, shamefaced and repentant, she would reproach him bitterly and this would bring about renewed attention, gifts, etc., for a week or so,—and then backsliding. Finally even the brief spasmodic reforms grew less common, her reproaches were answered hotly or listened to with indifference, and she became "practically a widow" except for the occasions when the sexual feeling mastered them both.
The neurosis in this case approached almost an insanity. The dwelling alone, the desperate obsessive desire for a child to bring back his love and attentions and to satisfy her own maternal instinct, the pain the sight of happy couples with children gave her and which made her shun other women and their company, the fear that her husband was unfaithful (which fear was probably justified), and the lack of any fixed or definite purpose, the lack of a great pride or self-sufficiency, brought on symptoms that necessitated her removal to a sanitarium.
This of course pricked the conscience of her husband. He visited her frequently, vowed a complete change, promised to bring his business to the point where he would be able to come home at six, etc., etc. Gradually she improved and finally made a partial recovery.
Whether or not the husband kept his promises I cannot say. On the chances he did. Most confirmed gamblers, however, remain gamblers. The lure of excitement is more potent to such men than a wife whose charm has gone, through familiarity, through time itself, through the inconstancy of passion and love. The gambler usually knows no duty; he is kind and generous but only to please himself. He is easily bored and his sympathies rarely stand the disagreeable long; he knows only one constant attraction,—Chance.
The other woman suffered in much the same way except that she was fortunate enough finally to be deserted by her husband. This ended her doubts and fears, broke her down for a short while, and then she went back to industry. In this I have no doubt she found only an incomplete satisfaction for her yearnings and desires, but she had something to take up her time, and built up contacts with others in a way that was impossible in her lonely home.
Case IX. The will to power through weakness; a case of hysteria in the home.
This case is classic in the outspoken value of the symptoms to the woman. It is not of course typical, except as the extreme is typical, and that is what is usually meant, Roosevelt, we say, was a typical American, meaning that he represented in extreme development a certain type of man. So this case shows very clearly what is not so clear at first in many cases of conflict between man and wife.
The woman in question was twenty-seven, of French-Canadian origin, but thoroughly American in appearance and speech. She was of a middle-class rural family and had married a farmer who finally had given up his farm and was a mechanic in a small city.
The young woman had always been irritable, egoistic, and sensitive. As a girl if anything happened to "shock her nerves", i.e. to displease her, she fainted, vomited, or went into "hysterics." As a result her family treated her with great caution and probably were well pleased when she married off their hands and left the home.
Married life soon provided her with sufficient to displease her. Her husband drank but not sufficiently to be classed as a heavy drinker. He was a quiet, rather taciturn man, utterly averse to the pleasures for which his wife longed. She wanted to go to dances, to take in the theaters, to live in more expensive rooms, and especially she became greatly attached to a group of people of a sporty type whom her husband tersely called "tinhorn bluffs" and whom he refused to visit.
They quarreled vigorously and the quarrels always ended one way,—she became sick in one way or other. This usually brought her husband around to her way of thinking, at least for a time, and much against his will he would go with her to her friends.
Finally, however, she set her heart on living with these people, and he set his will firmly against hers. She then developed such an alarming set of symptoms that after a while the physician who asked my opinion had made up his mind that she had a brain tumor. She was paralyzed, speechless, did not eat and seemed desperately ill.
The diagnosis of hysteria was established by the absence of any evidence of organic disease and by the history of the case. The relief of symptoms was brought about by means which I need not detail here, but which essentially consisted in proving to the patient that no true paralysis existed and in tricking her into movement and speech.
When she was well enough to be up and about and to talk freely, she and her husband were both informed that the symptoms arose because her will was thwarted, and that part of their function was to bring the man to his knees. He agreed to this, but she took offense and refused to come any more to see me,—a not unnatural reaction.
The outlook in such a case is that the couple will live like cats and dogs. Such a temperament as this woman's is inborn. She is essentially, in the complete meaning of the word, unreasonable. Her nature demands a sympathetic attention and consideration that her character does not warrant. Throughout life she demands to receive but has no desire to give. Nor is she powerful enough to take, so there arise emotional crises with marked disturbance in bodily energy, and especially symptoms that frighten the onlooker, such as paralyses, blindness, deafness, fainting spells, etc. Whatever is the source of these symptoms, they are frequently used to gain some end or purpose through the sympathy and discomfort of others.
Not all hysteria, either in men or women, is united with such a character as this woman's. Sufficient stress and strain may bring about hysterical symptoms in a relatively normal person and short hysterical reactions are common in the normal woman. The height of cynicism may be found in the discovery that war causes hysteria in some men in much the same way that matrimony causes hysteria in some women. A humorous review of a paper on the domestic neuroses was entitled "Kitchen Shell Shock." But severe hysteria, when it arises in the housewife, springs mainly from her disposition and not from the kitchen.
Case X. The unfaithful husband.
Monogamous marriage is based upon the assumption that loyalty to a single male is moral and possible. It is probable that in no age has this agreement been loyally carried out by the husbands; it is probable that in our own time the single standard of morals has first been strongly emphasized. With the rise of women into equality one of the important demands they have made is that men remain as loyal as themselves. Therefore the reaction to unchastity or unfaithfulness on the part of the man is apt to be more severe than in the past, on the theory that where more is demanded failure in performance is felt the keener.
The housewife, Mrs. F.C., aged thirty-five, is a prepossessing woman, the mother of two children, and has been married for nine years. Her health has always been fairly good, though in the last four years she has been somewhat irritable. She attributed this to struggle to make both ends meet, her husband being a workman with wages just over the border line of sufficiency. They quarreled "no more than other couples do", were as much in love "as other couples are", to use her phrases. She was above her class in education, read what are usually called advanced books, was "strong for suffrage", etc. However she was a good housekeeper, devoted to her children and faithful to her husband. Their sexual relations were normal and up till six months before I saw her she thought herself a well-mated, rather fortunate woman.
Out of a clear sky came proof of long-continued unfaithfulness on the part of her "domestic" husband: a chance bill for women's clothes fluttered out of his pocket and under the bed, so that next morning she found it; an unbelieving moment and then a visit to the address on the bill, and proof plenty that he had been disloyal, not only to her but to the children, who had been obliged to scrimp along while he helped maintain another woman. Humiliated beyond measure by her disaster, unable to endure her past memories of happiness and faith, with an unstable world rocking before her, through the revelation that a quiet, contented, loving man could be completely false, she found no adequate reason for living and became a helpless prey to her troubled mind. "A temporary unfaithfulness, a yielding to sudden temptation" she could understand, but a determined plan of duplicity shattered her whole scheme of values. A very severe psychoneurosis followed, and her children and she were taken over by her parents and cared for.
Sleeplessness was so prominent in her case and so evidently the central physical symptom that its control was difficult and required a regular campaign for success. With sleep restored and the resumption of eating, the most of her acute symptoms were passed, though a profound depression remained.
Her husband, thoroughly abashed and ashamed, made furtive attempts at reconciliation. These were absolutely rejected, and from her attitude it was obvious that no reconciliation was possible. "Had he not been found out," said the wife, "he would still be living with her. I can never trust him again; I would die before I lived with him."
Little by little her pride recovered, for in such cases the deepest wound is to the ego, the self-valuation. The deepest effort of life is to increase that valuation by increasing its power and its respect by others; the keenest hurt comes with the lowering of the valuation of one's own personality. A woman gives herself to a man, without lowering a self-feeling if he is tender and faithful; if he holds her cheap, as by flagrant disloyalty, then her surrender is her most painful of memories.
With the recovery of pride came the restoration of her interest in her children, and her purposes reshaped themselves into definite plans. Part of the process in readjustment in any disordered life is to centralize the dispersed purposes, to redirect the life energies. She agreed that she would accept aid from the husband, as his duty, but only for the children. For herself, as soon as the children were a year or so older, she would go back to industry and become self-supporting. Her plans made, her recovery proceeded to a firm basis, and I have no doubt as to its permanence. Nevertheless, life has changed its complexion for her, and there will be many moments of agony. These are inevitable and part of the recovery process.
I shall not attempt to settle the larger problem of whether she should have forgiven her husband and returned to him. Granting that his repentance was genuine, granting that no further lapse would occur, she would never be able to forget that when he deceived her he had acted the part of a devoted husband. She would never be able fully to trust him, and this would spoil their married happiness entirely. "For the children's sake," cry some readers; well, that is the only strong argument for return. But on the whole it seems to me that an honest separation, an honest revolt of a proud woman is better than a dishonest reunion, or a "patient Griselda" acceptance of gross wrong.
Case XI. The unfaithful wife.
In such cases as the preceding and the one now to be detailed, the difficulties of the physician are multiplied by his entrance into ethics. Ordinarily medicine has nothing to do with morals; to the doctor saint and sinner are alike, and the only immorality is not to follow orders. To do one's duty as a doctor, with one's sole aim the physical health of the patient, may mean to advise what runs counter to the present-day code of morals. This is the true "Doctor's Dilemma." In such cases discretion is the safest reaction, and discretion bids the physician say, "Call in some one else on that matter; I am only a doctor."
A true neurologist must regard himself as something more than a physician. He needs be a good preacher, an astute man of the world, as well as something of a lawyer. The patient expects counsel of an intimate kind, expects aid in the most difficult situations, viz., the conflicts of health and ethics.
Mrs. A.R., thirty-one years of age and very attractive, has been married since the age of eighteen. She has two children, and her husband, ten years her senior, is a man of whose character she says, "Every one thinks he is perfect." A little overstaid and over dignified, inclined to be pompous and didactic, he is kind-hearted and loyal, and successful in a small business. He is an immigrant Swiss and she is American born, of Swiss parentage.
Always romantic, Mrs. A.R. became greatly dissatisfied with her home life. At times the whole scheme of things, matrimony, settled life, got on her nerves so that she wanted to scream. She was bored, and it seemed to her that soon she would be old without ever having really lived. "I married before I had any fun, and I haven't had any fun since I married except"—Except for the incident that broke down her health by swinging her into mental channels that made her long for the quiet domesticity against which she had so rebelled. Her daydreaming was erotic, but romantically so, not realistic.
There are in the community adventurers of both sexes whose main interest in life is the conquest of some woman or man. The male sex adventurers are of two main groups, a crude group whose object is frank possession and a group best called sex-connoisseurs, who seek victims among the married or the hitherto virtuous; who plan a campaign leisurely and to whom possession must be preceded by difficulties. Frequently these gentry have been crude, but as satiation comes on a new excitement is sought in the invasion of other men's homes. Undoubtedly they have a philosophy of life that justifies them.
Since this is not a novel we may omit the method by which one of these men found his way to the secret desires of our patient, and how he proceeded to develop her dissatisfaction into momentary physical disloyalty. She came out of her dereliction dazed; could it be she who had done this, who had descended into the vilest degradation? She broke off all relations with the man, probably much to his surprise and disgust, and plunged into a self-accusatory internal debate that brought about a profound neurasthenia.
Naturally she did not of her own accord speak of her unfaithfulness,—largely because no one knew of it. Her husband did not in the least suspect her; he thought she needed a rest, a change, little realizing how "change" had broken her down. (For after all, the most of infidelity is based on a sort of curiosity, a seeking of a new stimulus, rather than true passion.) The truth was forced out of her when it was evident to me that something was obsessing her.
When she had confessed her difficulty the question arose as to her husband. She was no longer dissatisfied, no longer eager for romance; but could she live with him if she had been unfaithful? Ought she not to tell him; and yet she feared to do this, feared the result to him, for she felt sure he would forgive her. In reality the conflict in her mind arose first from self-depreciation and second from indecision as to confession.
As to the self-accusation, I told her that though she had been very foolish she had punished herself severely enough; that her reaction was that of an essentially moral person; that an essentially immoral woman would have continued in her career, and at least would not have been so remorseful. As to confessing, I told her that I believed that if she came to peace without such a confession wisdom would dictate not to make it, and that perhaps a little romanticism was still present in the quixotic idea of confession. Discretion is sometimes the better part of veracity, and I felt sure that she would not find it difficult to forget her pain.
It may be questioned whether such advice was ethical. I am sure no two professors of ethics could agree on the matter, and where they would disagree I chose the policy of expediency. Moreover, I felt certain that Mrs. R.'s remorse did not need the purge of confession to her husband, that she was not of that deeply fixed nature which requires heroic measures. Her confession to me was sufficient, and since it was apparent that she would not repeat her folly it was not necessary to go to extremes.
The last two cases make pertinent some further remarks on sex. It has previously been stated that the sex field is the one in which arise many of the difficulties which breed the psychoneuroses. It would not be the place here to give details of cases, though every neurologist of experience is well aware of the neuroses that arise in marriage, among both men and women. Some day society will reach the plane where matters relating to the great function by which the world is perpetuated can be discussed with the freedom allowed to the discussion of the details of nutrition.
No one seriously doubts that women are breaking away from traditional ideas in these matters. There was a time (the Victorian Age) in the United States and England when prudery ruled supreme in the manners and dress of women. That this has largely disappeared is a good thing, but whether there is a tendency to another extreme is a matter where division of opinion will occur. A transition from long skirts to dress that will permit complete freedom of movement and resembling in a feminine way the garments of men would be unqualifiedly good. It would remove undue emphasis of sex and accentuate the essential human-ness of woman. But a transition from long skirts to short tight ones, impeding movement, is the transition from prudery to pruriency and is by no means a clear gain. Plenty of scope for art and beauty might be found in a costume of which pantalettes of some kind are the basis. I doubt if women will ever be regarded quite as human beings so long as they paint, wear fantastic coiffures, hobble along on foolish heels, and are clad in over tight short skirts.
Similarly with the literature of the period. The so-called sex story, the sex problem, obsesses the writers. Nor are these frank, free discussions of the essential difficulties in the relation between man and woman. Usually the stories deal with the difficulties of the idle rich woman without children, or concern themselves with trivial triangles. In the type of interminable continued stories that every newspaper now carries, the woman's difficulties range around the most absurd petty jealousies, and she never seems to cook or sew or have any responsibility, and they always end so "sweetly." On the stage the epidemic of girl and music shows has quite displaced the drama. Here sex is exploited to the point of the risque and sometimes beyond it.
Sex is overemphasized by our civilization on its distracting side, its spicy and condimental values, and underemphasized so far as its realities go. The aim seems to be to titillate sex feeling constantly, and a precocious acquaintance with this form of stimulation is the lot of most city children. Such things would have no serious results to the housewife if they did not arouse expectations that marriage does not fulfill at all. This is the great harm of prurient clothes, literature, art, and stage,—it unfits people for sex reality.
In how far the delayed marriages of men and women are good or bad it is almost impossible to decide. That unchastity increases with delay is a certainty, that fewer children are born is without doubt. Whether the fixation of habit makes it harder for the wife to settle down to the household, and the man less domestic, cannot be answered with yes or no. There seems to be no greater wisdom of choice shown in mature than in early marriages, though this would be best answered by an analysis of divorce records.
That contraceptive measures have come to stay; that they are increasing in use, the declining birth rate absolutely evidences. I take no stock in the belief that education reduces fertility through some biological effect; where it reduces fertility it does so through a knowledge of cause, effect, and prevention. Some day it will come to pass that contraceptive measures will be legal, in view of the fact that our jurists and law makers are showing a decline in the size of their own families. When that time comes the discussion of means of this kind consistent with nervous health will be frank, and some part of the neurasthenia of our modern times will disappear. The vaster racial problems that will arise are not material for discussion in this book.
Though not perhaps completely relevant to the nervousness of the housewife, it is not without some point to touch on the "neurosis of the engaged." The freedom of the engaged couple is part of the emancipation of youth in our time. Frankly, a love-making ensues that stops just short of the ultimate relationship, an excitement and a tension are aroused and perpetuated through the frequent and protracted meetings. Sweet as this period of life is, in many cases it brings about a mild exhaustion, and in other cases, relatively few, a severe neurosis. On the whole the engagement period of the average American couple is not a good preparation for matrimony. How to bring about restraint without interfering with normal love-making is not an easy decision to make. But it would be possible to introduce into the teaching of hygiene the necessity of moderation in the engaged period; it would be especially of service to those whose engagement must be prolonged to be advised concerning the matter. Here is a place for the parents, the family friend, or the family physician.
Men and women as they enter matrimony are only occasionally equipped with real knowledge as to the physiology and psychology of the sex life. That a great deal of domestic dissatisfaction and unhappiness could be obviated if wisdom and experience instructed the husband and wife in the matter I have not the slightest doubt. The first rift in the domestic lute often dates from difficulties in the intimate life of the pair, difficulties that need not exist if there were knowledge. That reason and love may coexist, that the beauty of life is not dependent on a sentimentalized ignorance are cardinal in my code of beliefs. He who believes that sentiment disappears with enlightenment is the true cynic, the true pessimist. He who believes that intelligence and knowledge should guide instinct and that happiness is thus more certain is better than an optimist; he is a rationalist, a realist.