Femina, A Work for Every Woman

by John A. Miller

In some cases we can trace the impoverished condition of the blood to unhealthy dwellings, impure air, want of exercise, improper diet, nervousness, the reading of exciting, amorous novels, and the practice of masturbation or self-abuse. On the contrary, the disease is often developed under the most moral and exacting discipline and hygienic surroundings.

I have known girls who lived in the country, enjoyed horseback riding, ate nutritious and wholesome food, and whose solitary moments were beyond suspicion, yet at the age of puberty they commenced to fade in color, and fail in strength, gradually growing paler and weaker, until they became chlorotic and bloodless. This can only be explained on the theory that the period in which nature was preparing the system for the purposes she had in view, caused a shock to the nervous system, which so disarranged the functions that the sanguineous system did not respond to the growth of the generative system.

Then there is another class of cases, where girls menstruate before they are old enough, and without their bodies showing any visible evidence of developed womanhood, who belong to the most obstinate cases for successful treatment.

The relative diminution of the red blood cells to the healthy standard is in some cases truly alarming. In the average healthy blood, there are, in one thousand parts of blood, one hundred and thirty parts of red blood cells; this falls to sixty, and even forty parts in the thousand in the chlorotic patient.

It is one of the peculiarities of this disease, that while the muscular tissue wastes away, the fatty tissue is not only preserved, but it sometime increases, so that in a family of several girls, the chlorotic girl is considered the ‘most fleshy,’ but as fat is not flesh, the appearance is deceptive.

When we stop to think a moment, that the red blood corpuscles are the messengers which absorb the oxygen in the lungs during the respiratory movements, and carry it to the different organs and tissues of the body, without which all tissue change would cease. And that the same red blood cells must return again to the lungs for exhaling the carbonic acid, one of the waste products of tissue growth, then the diminution of the red blood cells in the proportion above given, must affect the entire system very injuriously.

This is indeed the case; the natural respiratory movements are insufficient on the slightest exertion, so that patients tell us that when they walk a little fast, go up the stairs, or even sweep the room, they feel a shortness of breath.

There are other symptoms that point to carbonic acid poisoning, which it will be interesting to review. A great majority of these symptoms are to be found in every case of chlorosis. The muscles become weak at first, because their nutrition is interfered with, and they waste away, and secondly they become irritable from the poisonous presence of the carbonic acid, and so are often very painful. The patients are easily tired out; some, indeed, feel tired all the time, getting up in the morning as worn out as when they retired at night.

The nervous system suffers as much, because the principal nerve food is oxygen, and if there is no blood, there can be no oxygen; a starved nerve is a painful nerve. We find neuralgias, affecting the different parts of the body, the rule; when these are located in the external muscles, they are easily recognized, but when located in the deep organs, as the ovaries or the womb, they are generally mistaken for something else. The nerves of these individuals being in such an irritable state, it is natural to infer, that hysteria is often to be found as one of the complications, so that habitual sadness, and abnormal longings after chalk, lead pencils, and other indigestible articles are prominent symptoms.

The circulatory system suffers derangements that are characteristic of chlorosis. Palpitation of the heart is a prominent symptom; this is partly due to the irritation of the carbonic acid on the cardiac nerves, and partly to sensitiveness of the patient, owing to a morbidly-increased sensibility of the whole body. Chlorotic patients blush up at times, only to be followed by a green paleness that is peculiar to the disease. Pain in the region of the heart, and disturbances of the digestion, are sometimes prominent symptoms. There is no feeling of hunger; eating is not so much from hunger, but more from a sense of duty to keep up the strength. A heavy or full feeling is often experienced after a meal, and a sourish eructation will give relief to the oppression, because the walls of the stomach are relaxed and in sympathy with the general debility.