Witnessing, then, the great numbers of facts that may be gleaned from the history of savage and civilized nations, concerning the safety with which childbirth and its attending circumstances may be endured by persons in the lower walks of life, it becomes a very important practical question as to what may be accomplished in the higher grades of society. To prove that there is need of a great and thorough reform, both in the habits of society generally, and in the practice of the healing art, I will bring forward some facts, which have occurred in my own experience as a healer of the sick during the past seven years. It has fallen to my lot to study the subject of midwifery with more earnestness and satisfaction to myself, than any other with which my mind has been engaged. It was, moreover, necessary for me to strike out a course of my own, a course which has been attended by a degree of success which has far exceeded the most sanguine expectations of my younger years.
LETTER II.
OF MENSTRUATION.
Puberty—The Menstrual Discharge—The Marriageable Age.
I am now to write you on a most important subject; I mean that which refers to puberty—the menstrual function, and what we call the marriageable age. I think you will agree with me in thinking that there is no period of the whole life of the female which should give a parent more anxiety and solicitude than the one of which I am now to speak. I trust, therefore, that you will give good attention to all I may say on so important a matter, and learn all that you can about it, from whatever source.
Puberty, or the marriageable age of woman, occurs at a somewhat different age in different parts of the world. In temperate climates, the period of puberty may be reckoned as being at from the twelfth to the sixteenth year. In tropical climates it appears to be considerably earlier, as from eight to twelve; and in the frozen regions later than all, from fifteen to twenty years. It has been said that the Turkish women are capable of becoming mothers at the age of seven or eight years; but of this there is at least room for doubt.
There are other circumstances than those of climate that influence the coming on of the period of puberty. Those that lead habitually an inactive life, a life of leisure and luxury, so called; those who, without sufficiently attending to physical and out-door exercise, practice much the imitative arts, such as painting and music; those who frequent theaters, balls, and parties, late at night; read novels and other works that powerfully excite the imagination and feelings; and especially such as are so unfortunate as to have access to obscene pictures and books, arrive at the season of puberty earlier than others.
So also the use of rich, concentrated, and highly stimulating food and drinks, render the young, of whichever sex, far more precocious, in regard to puberty, than a plain and unstimulating diet. Temperance and frugality, with simplicity of manners, especially if the individual lead a rural, or country life, are always more favorable in reference to the coming on of this important period.
Previously to the period of puberty, the general organization of the male and female progresses very much alike. The tastes and habits, however, vary. The little girl is fond of her doll-babies and play-houses, while the boy exhibits a liking for more manly sports. There is, however, no great difference, up to this time, in the physical frame of the two sexes; but as the period of puberty approaches, there is manifested a great difference in the two beings. In the language of an eloquent writer, Velpeau, “the young girl becomes more timid and reserved, her form becomes rounded, her voice alters but to take on a softer and more harmonious tone, and her bosom is developed; the cellular tissue extends from the front of the breast and the hypogastrium, as from two centers, toward the neck, while at the same time it proceeds to form a soft cushion for the upper part of the limbs. Her eyes, which are at once brilliant and languishing, express commingled desires, fears, and tenderness; the sensations she experiences, and the sense of her own weakness, are the reasons why she no longer dares to approach the companions of her childhood but with a downcast look. On the other hand, the gentle modesty that animates her countenance, and the engaging graces of her demeanor, soon disclose a power, the existence of which she never suspected, and which renders it true to say that the marriageable age in the softer sex is the spring-tide of nature, and the season of the pleasures. But a new function—the catamenial—the absolute compass of good or bad health in woman—is established, with more or less difficulty, in the midst of this great revolution; and by the disorders and accidents which it involves, sometimes dashes with bitterness those happy seasons to which it should naturally serve as a prelude. Such are the changes that go on in the female constitution at one of the most important and critical seasons that can occur in the female’s life.”
The period at which woman may be said truly to arrive at her womanhood, is certainly, in the present state of artificial life, fraught with many dangers to the future health. But, on the other hand, we have proof the most positive and indubitable—the proof of facts—that if young girls are brought up in a simple, judicious manner, and if all their habits—social, moral, physiological, and hygienic—be correct, there can be, as a general law, no danger at the coming on of puberty. With judicious management throughout, the girl will pass through this change with as little difficulty, as little danger and derangement of the general health, as occurs at any other season of her whole life. Although the change is a great one, it is yet within the order of nature, a fact which we should always bear in mind.
The foregoing remarks on puberty lead me necessarily to speak of the menstrual function.