In a study of one hundred and twenty-five American high school girls Dr. Helen Kennedy refers to the "modesty" which makes it impossible even for mothers and daughters to speak to each other concerning the menstrual functions. "Thirty-six girls in this high school passed into womanhood with no knowledge whatever, from a proper source, of all that makes them women. Thirty-nine were probably not much wiser, for they stated that they had received some instruction, but had not talked freely on the matter. From the fact that the curious girl did not talk freely on what naturally interested her, it is possible she was put off with a few words as to personal care, and a reprimand for her curiosity. Less than half of the girls felt free to talk with their mothers of this most important matter!" (Helen Kennedy, "Effects of High School Work upon Girls During Adolescence," Pedagogical Seminary, June, 1896.)
The same state of things probably also prevails in other countries. Thus, as regards France, Edmond de Goncourt in Chérie (pp. 137-139) described the terror of his young heroine at the appearance of the first menstrual period for which she had never been prepared. He adds: "It is very seldom, indeed, that women speak of this eventuality. Mothers fear to warn their daughters, elder sisters dislike confidences with their younger sisters, governesses are generally mute with girls who have no mothers or sisters."
Sometimes this leads to suicide or to attempts at suicide. Thus a few years ago the case was reported in the French newspapers of a young girl of fifteen, who threw herself into the Seine at Saint-Ouen. She was rescued, and on being brought before the police commissioner said that she had been attacked by an "unknown disease" which had driven her to despair. Discreet inquiry revealed that the mysterious malady was one common to all women, and the girl was restored to her insufficiently punished parents.
Half a century ago the sexual life of girls was ignored by their parents and teachers from reasons of prudishness; at the present time, when quite different ideas prevail regarding feminine education, it is ignored on the ground that girls should be as independent of their physiological sexual life as boys are. The fact that this mischievous neglect has prevailed equally under such different conditions indicates clearly that the varying reasons assigned for it are merely the cloaks of ignorance. With the growth of knowledge we may reasonably hope that one of the chief evils which at present undermine in early life not only healthy motherhood but healthy womanhood generally, may be gradually eliminated. The data now being accumulated show not only the extreme prevalence of painful, disordered, and absent menstruation in adolescent girls and young women, but also the great and sometimes permanent evils inflicted upon even healthy girls when at the beginning of sexual life they are subjected to severe strain of any kind. Medical authorities, whichever sex they belong to, may now be said to be almost or quite unanimous on this point. Some years ago, indeed, Dr. Mary Putnam Jacobi, in a very able book, The Question of Rest for Women, concluded that "ordinarily healthy" women may disregard the menstrual period, but she admitted that forty-six per cent, of women are not "ordinarily healthy," and a minority which comes so near to being a majority can by no means be dismissed as a negligible quantity. Girls themselves, indeed, carried away by the ardor of their pursuit of work or amusement, are usually recklessly and ignorantly indifferent to the serious risks they run. But the opinions of teachers are now tending to agree with medical opinion in recognizing the importance of care and rest during the years of adolescence, and teachers are even prepared to admit that a year's rest from hard work during the period that a girl's sexual life is becoming established, while it may ensure her health and vigor, is not even a disadvantage from the educational point of view. With the growth of knowledge and the decay of ancient prejudices, we may reasonably hope that women will be emancipated from the traditions of a false civilization, which have forced her to regard her glory as her shame,—though it has never been so among robust primitive peoples,—and it is encouraging to find that so distinguished an educator as Principal Stanley Hall looks forward with confidence to such a time. In his exhaustive work on Adolescence he writes: "Instead of shame of this function girls should be taught the greatest reverence for it, and should help it to normality by regularly stepping aside at stated times for a few years till it is well established and normal. To higher beings that looked down upon human life as we do upon flowers, these would be the most interesting and beautiful hours of blossoming. With more self-knowledge women will have more self-respect at this time. Savagery reveres this state and it gives to women a mystic awe. The time may come when we must even change the divisions of the year for women, leaving to man his week and giving to her the same number of Sabbaths per year, but in groups of four successive days per month. When woman asserts her true physiological rights she will begin here, and will glory in what, in an age of ignorance, man made her think to be her shame. The pathos about the leaders of woman's so-called emancipation, is that they, even more than those they would persuade, accept man's estimate of this state."[[27]]
These wise words cannot be too deeply pondered. The pathos of the situation has indeed been—at all events in the past for to-day a more enlightened generation is growing up—that the very leaders of the woman's movement have often betrayed the cause of women. They have adopted the ideals of men, they have urged women to become second-rate men, they have declared that the healthy natural woman disregards the presence of her menstrual functions. This is the very reverse of the truth. "They claim," remarks Engelmann, "that woman in her natural state is the physical equal of man, and constantly point to the primitive woman, the female of savage peoples, as an example of this supposed axiom. Do they know how well this same savage is aware of the weakness of woman and her susceptibility at certain periods of her life? And with what care he protects her from harm at these periods? I believe not. The importance of surrounding women with certain precautions during the height of these great functional waves of her existence was appreciated by all peoples living in an approximately natural state, by all races at all times; and among their comparatively few religious customs this one, affording rest to women, was most persistently adhered to." It is among the white races alone that the sexual invalidism of women prevails, and it is the white races alone, which, outgrowing the religious ideas with which the menstrual seclusion of women was associated, have flung away that beneficent seclusion itself, throwing away the baby with the bath in an almost literal sense.[[28]]
In Germany Tobler has investigated the menstrual histories of over one thousand women (Monatsschrift für Geburtshülfe und Gynäkologie, July, 1905). He finds that in the great majority of women at the present day menstruation is associated with distinct deterioration of the general health, and diminution of functional energy. In 26 per cent. local pain, general malaise, and mental and nervous anomalies coexisted; in larger proportion come the cases in which local pain, general weak health or psychic abnormality was experienced alone at this period. In 16 per cent. only none of these symptoms were experienced. In a very small separate group the physical and mental functions were stronger during this period, but in half of these cases there was distinct disturbance during the intermenstrual period. Tobler concludes that, while menstruation itself is physiological, all these disturbances are pathological.
As far as England is concerned, at a discussion of normal and painful menstruation at a meeting of the British Association of Registered Medical Women on the 7th of July, 1908, it was stated by Miss Bentham that 50 per cent. of girls in good position suffered from painful menstruation. Mrs. Dunnett said it usually occurred between the ages of twenty-four and thirty, being frequently due to neglect to rest during menstruation in the earlier years, and Mrs. Grainger Evans had found that this condition was very common among elementary school teachers who had worked hard for examinations during early girlhood.
In America various investigations have been carried out, showing the prevalence of disturbance in the sexual health of school girls and young women. Thus Dr. Helen P. Kennedy obtained elaborate data concerning the menstrual life of one hundred and twenty-five high school girls of the average age of eighteen ("Effect of High School Work upon Girls During Adolescence," Pedagogical Seminary, June, 1896). Only twenty-eight felt no pain during the period; half the total number experienced disagreeable symptoms before the period (such as headache, malaise, irritability of temper), while forty-four complained of other symptoms besides pain during the period (especially headache and great weakness). Jane Kelley Sabine (quoted in Boston Medical and Surgical Journal, Sept. 15, 1904) found in New England schools among two thousand girls that 75 per cent. had menstrual troubles, 90 per cent. had leucorrhœa and ovarian neuralgia, and 60 per cent. had to give up work for two days during each month. These results seem more than usually unfavorable, but are significant, as they cover a large number of cases. The conditions in the Pacific States are not much better. Dr. Mary Ritter (in a paper read before the California State Medical Society in 1903) stated that of 660 Freshmen girls at the University of California, 67 per cent. were subject to menstrual disorders, 27 per cent. to headaches, 30 per cent. to backaches, 29 per cent. were habitually constipated, 16 per cent. had abnormal heart sounds; only 23 per cent. were free from functional disturbances. Dr. Helen MacMurchey, in an interesting paper on "Physiological Phenomena Preceding or Accompanying Menstruation" (Lancet, Oct. 5, 1901), by inquiries among one hundred medical women, nurses, and women teachers in Toronto concerning the presence or absence of twenty-one different abnormal menstrual phenomena, found that between 50 and 60 per cent. admitted that they were liable at this time to disturbed sleep, to headache, to mental depression, to digestive disturbance, or to disturbance of the special senses, while about 25 to 50 per cent. were liable to neuralgia, to vertigo, to excessive nervous energy, to defective nervous and muscular power, to cutaneous hyperæsthesia, to vasomotor disturbances, to constipation, to diarrhœa, to increased urination, to cutaneous eruption, to increased liability to take cold, or to irritating watery discharges before or after the menstrual discharge. This inquiry is of much interest, because it clearly brings out the marked prevalence at menstruation of conditions which, though not necessarily of any gravity, yet definitely indicate decreased power of resistance to morbid influences and diminished efficiency for work.
How serious an impediment menstrual troubles are to a woman is indicated by the fact that the women who achieve success and fame seem seldom to be greatly affected by them. To that we may, in part, attribute the frequency with which leaders of the women's movement have treated menstruation as a thing of no importance in a woman's life. Adele Gerhard, and Helene Simon, also, in their valuable and impartial work, Mutterschaft und Geistige Arbeit (p. 312), failed to find, in their inquiries among women of distinguished ability, that menstruation was regarded as seriously disturbing to work.