It is on the basis of the increased vascular and glandular activity and the heightened nervous tension that the special psychic phenomena of pregnancy develop. The best known, and perhaps the most characteristic of these manifestations, is that known as "longings." By this term is meant more or less irresistible desires for some special food or drink, which may be digestible or indigestible, sometimes a substance which the woman ordinarily likes, such as fruit, and occasionally one which, under ordinary circumstances, she dislikes, as in one case known to me of a young country woman who, when bearing her child, was always longing for tobacco and never happy except when she could get a pipe to smoke, although under ordinary circumstances, like other young women of her class, she was without any desire to smoke. Occasionally the longings lead to actions which are more unscrupulous than is common in the case of the same person at other times; thus in one case known to me a young woman, pregnant with her first child, insisted to her sister's horror on entering a strawberry field and eating a quantity of fruit. These "longings" in their extreme form may properly be considered as neurasthenic obsessions, but in their simple and less pronounced forms they may well be normal and healthy.
The old medical authors abound in narratives describing the longings of pregnant women for natural and unnatural foods. This affection was commonly called pica, sometimes citra or malatia. Schurig, whose works are a comprehensive treasure house of ancient medical lore, devotes a long chapter (cap. II) of his Chylologia, published in 1725, to pica as manifested mainly, though not exclusively, in pregnant women. Some women, he tells us, have been compelled to eat all sorts of earthy substances, of which sand seems the most common, and one Italian woman when pregnant ate several pounds of sand with much satisfaction, following it up with a draught of her own urine. Lime, mud, chalk, charcoal, cinders, pitch are also the desired substances in other cases detailed. One pregnant woman must eat bread fresh from the oven in very large quantities, and a certain noble matron ate 140 sweet cakes in one day and night. Wheat and various kinds of corn as well as of vegetables were the foods desired by many longing women. One woman was responsible for 20 pounds of pepper, another ate ginger in large quantities, a third kept mace under her pillow; cinnamon, salt, emulsion of almonds, treacle, mushrooms were desired by others. Cherries were longed for by one, and another ate 30 or 40 lemons in one night. Various kinds of fish—mullet, oysters, crabs, live eels, etc.—are mentioned, while other women have found delectation in lizards, frogs, spiders and flies, even scorpions, lice and fleas. A pregnant woman, aged 33, of sanguine temperament, ate a live fowl completely with intense satisfaction. Skin, wool, cotton, thread, linen, blotting paper have been desired, as well as more repulsive substances, such as nasal mucus and feces (eaten with bread). Vinegar, ice, and snow occur in other cases. One woman stilled a desire for human flesh by biting the nates of children or the arms of men. Metals are also swallowed, such as iron, silver, etc. One pregnant woman wished to throw eggs in her husband's face, and another to have her husband throw eggs in her face.
In the next chapter of the same work Schurig describes cases of acute antipathy which may arise under the same circumstances (cap. III, "De Nausea seu Antipathia certorum ciborum"). The list includes bread, meat, fowls, fish, eels (a very common repulsion), crabs, milk, butter (very often), cheese (often), honey, sugar, salt, eggs, caviar, sulphur, apples (especially their odor), strawberries, mulberries, cinnamon, mace, capers, pepper, onions, mustard, beetroot, rice, mint, absinthe, roses (many pages are devoted to this antipathy), lilies, elder flowers, musk (which sometimes caused vomiting), amber, coffee, opiates, olive oil, vinegar, cats, frogs, spiders, wasps, swords.
More recently Gould and Pyle (Anomalies and Curiosities of Medicine, p. 80) have briefly summarized some of the ancient and modern records concerning the longings of pregnant women.
Various theories are put forward concerning the causation of the longings of pregnant women, but none of these seems to furnish by itself a complete and adequate explanation of all cases. Thus it is said that the craving is the expression of a natural instinct, the system of the pregnant woman really requiring the food she longs for. It is quite probable that this is so in many cases, but it is obviously not so in the majority of cases, even when we confine ourselves to the longings for fairly natural foods, while we know so little of the special needs of the organism during pregnancy that the theory in any case is insusceptible of clear demonstration.
Allied to this theory is the explanation that the longings are for things that counteract the tendency to nausea and sickness. Giles, however, in his valuable statistical study of the longings of a series of 300 pregnant women, has shown that the percentage of women with longings is exactly the same (33 per cent.) among women who had suffered at some time during pregnancy from sickness as among the women who had not so suffered. Moreover, Giles found that the period of sickness frequently bore no relation to the time when there were cravings, and the patient often had cravings after the sickness had ceased.
According to another theory these longings are mainly a matter of auto-suggestion. The pregnant woman has received the tradition of such longings, persuades herself that she has such a longing, and then becomes convinced that, according to a popular belief, it will be bad for the child if the longing is not gratified. Giles considers that this process of auto-suggestion takes place "in a certain number, perhaps even in the majority of cases."[[184]]
The Duchess d'Abrantès, the wife of Marshal Junot, in her Mémoires gives an amusing account of how in her first pregnancy a longing was apparently imposed upon her by the anxious solicitude of her own and her husband's relations. Though suffering from constant nausea and sickness, she had no longings. One day at dinner after the pregnancy had gone on for some months her mother suddenly put down her fork, exclaiming: "I have never asked you what longing you have!" She replied with truth that she had none, her days and her nights being occupied with suffering. "No envie!" said the mother, "such a thing was never heard of. I must speak to your mother-in-law." The two old ladies consulted anxiously and explained to the young mother how an unsatisfied longing might produce a monstrous child, and the husband also now began to ask her every day what she longed for. Her sister-in-law, moreover, brought her all sorts of stories of children born with appalling mother's marks due to this cause. She became frightened and began to wonder what she most wanted, but could think of nothing. At last, when eating a pastille flavored with pineapple, it occurred to her that pineapple is an excellent fruit, and one, moreover, which she had never seen, for at that time it was extremely rare. Thereupon she began to long for pineapple, and all the more when she was told that at that season they could not be obtained. She now began to feel that she must have pineapple or die, and her husband ran all over Paris, vainly offering twenty louis for a pineapple. At last he succeeded in obtaining one through the kindness of Mme. Bonaparte, and drove home furiously just as his wife, always talking of pineapples, had gone to bed. He entered the room with the pineapple, to the great satisfaction of the Duchess's mother. (In one of her own pregnancies, it appears, she longed in vain for cherries in January, and the child was born with a mark on her body resembling a cherry—in scientific terminology, a nævus.) The Duchess effusively thanked her husband and wished to eat of the fruit immediately, but her husband stopped her and said that Corvisart, the famous physician, had told him that she must on no account touch it at night, as it was extremely indigestible. She promised not to do so, and spent the night in caressing the pineapple. In the morning the husband came and cut up the fruit, presenting it to her in a porcelain bowl. Suddenly, however, there was a revulsion of feeling; she felt that she could not possibly eat pineapple; persuasion was useless; the fruit had to be taken away and the windows opened, for the very smell of it had become odious. The Duchess adds that henceforth, throughout her life, though still liking the flavor, she was only able to eat pineapple by doing a sort of violence to herself. (Mémories de la Duchesse d'Abrantès, vol. iii, Chapter VIII.) It should be added that, in old age, the Duchess d'Abrantès appears to have become insane.
The influence of suggestion must certainly be accepted as, at all events, increasing and emphasizing the tendency to longings. It can scarcely, however, be regarded as a radical and adequate explanation of the phenomenon generally. If it is a matter of auto-suggestion due to a tradition, then we should expect to find longings most frequent and most pronounced in multiparous women, who are best acquainted with the tradition and best able to experience all that is expected of a pregnant woman. But, as a matter of fact, the women who have borne most children are precisely those who are least likely to be affected by the longings which tradition demands they should manifest. Giles has shown that longings occur much more frequently in the first than in any subsequent pregnancy; there is a regular decrease with the increase in number of pregnancies until in women with ten or more children the longings scarcely occur at all.
We must probably regard longings as based on a physiological and psychic tendency which is of universal extension and almost or quite normal. They are known throughout Europe and were known to the medical writers of antiquity. Old Indian as well as old Jewish physicians recognized them. They have been noted among many savage races to-day: among the Indians of North and South America, among the peoples of the Nile and the Soudan, in the Malay archipelago.[[185]] In Europe they are most common among the women of the people, living simple and natural lives.[[186]]