Case III. The physically sick woman who displays nervousness.
Though this is one of the most important of the types of nervous housewife the subject is essentially medical. We shall therefore not detail any case, but it is wise to reemphasize some facts.
There are bodily diseases of which the early and predominant symptoms are classed as "nervousness." Hyperthyroidism, or Graves' Disease, a condition in which there is overactivity of the thyroid gland and which is particularly prevalent among young women, is one of those diseases. In this condition excitability, irritability, emotional outbursts, fatigue, restlessness, digestive disorders, vasomotor disorders, appear before the characteristic symptoms do.
Neuro-syphilis is another such disease. This is an involvement of the nervous system by syphilis. One of the tragedies that distresses even hardened doctors is to find some fine woman who has acquired neuro-syphilis through her husband, though he himself may remain well. In the early stages this disease not only has neurasthenic symptoms but is very responsive to treatment, and thus the early diagnosis is of great importance.
What is known as reflex nervousness arises as a result of minor local conditions, such as astigmatism and other eye conditions, trouble with the nose and throat and trouble with the organs of generation. The latter is especially important in any consideration of nervousness in the housewife, particularly in the woman who has borne children. Frequently too the existence of hemorrhoids, resulting from constipation, acts to increase the irritability of a woman who is perhaps too modest to consult a physician regarding such trouble. Where such modesty exists (and it is found in the very women one would be apt to think were the very last to be swayed by it), then a competent woman physician should be consulted. With good women physicians and surgeons in every large community there is no reason for reluctance to be examined on the part of any woman.
Further details are not necessary. Enough has been said to emphasize the fact that the nervousness of the housewife is first a medical problem and then a social-psychological one.
Case IV. A case presenting bad hygiene as the essential factor.
Bad hygiene is something more than exposure to bad air, poor food, contaminated water, etc. It includes habits and times of eating, attention to the bowels, outdoor exercise, sleep, and in the marital state it includes the sexual indulgence.
The housewife under consideration, Mrs. T.F., aged twenty-eight, married five years, two children, complained mainly of headache, occasional dizziness, great irritability, and fatigue, so that quarrels with her husband were very common, though there seemed nothing to quarrel about. The family was not rich, but lived in a comfortable apartment; there were no serious financial burdens, the children were reasonably healthy and good, and the closest questioning revealed the husband as a kindly man who never took the initiative in quarrels but who was never able to keep silent under provocation. The couple was still in love and there seemed to be no essential incompatibility.
Questioned as to her habits, Mrs. F. said she did all her own housework except the washing and ironing and scrubbing. She had a little girl three times a week to take the baby out. Before marriage she had been a stenographer, but never earned high pay and had no love for her work. In fact she gave it up with relief and found housework with its disagreeable features much more to her taste than business. She had been of a placid, pleasant temperament and could not understand the change in her.