So greatly has the school curriculum encroached upon the home that the girl has no longer time to share its responsibilities, nor is there longer time for the family reading-circle, or music, or games for the maintenance of the unity and fellowship of the home. This condition cannot but react unfavorably upon the nervous system. If the brain is not rested and the emotions satisfied by the relationships in the home, a feverish unrest, a nervous irritability, a futile search supplant the calmness of spirit, stableness of reactions and depth of contentment which must be long continued to become a habit of mind.
Our school systems of to-day are designed for a girl as strong physically as a boy; in fact stronger than most of our city boys. Our girls should possess as much vitality as our boys; but until we change our methods of dealing with girls, we must treat them as they exist and not as the normal individuals we hope some day to evolve. Most girls have disorders,—"nervousness," headache, backache, constipation, colds, fatigue, or pain at the menstrual period. So common are these disturbances that we consult a physician only in extreme cases, and rarely seek the cause of the condition or attempt more than temporary relief. A pain which under ordinary circumstances would receive medical attention is viewed with resignation when coincident with the menses. As a consequence of this neglect, many girls suffer unnecessary drains upon their vitality.
We find all degrees of menstrual pain. It may be so mild as to be little more than discomfort, or so intense that unconsciousness results. The pain may be sharp and knife-like, or it may be a dull ache. It may be localized, low down in one or both sides, distributed over the whole abdomen or concentrated in the back. With this pain, there may be headache, or a headache may be the only symptom. Frequently there is gastro-intestinal disturbance—nausea, vomiting, diarrh[oe]a, or constipation. In anæmic cases fainting is common.
Local or operative treatment is not as a rule necessary, for the majority of cases yield to a strict régime of hygienic living. The régime should include regulation of sleeping, of eating, of hours of work and relaxation, of dressing and of exercise. The exercise should be prescribed and directed by a person trained in medical gymnastics.
Frequently mental disturbances are associated with the phenomenon of menstruation. The most usual symptoms are heightened irritability, hysterical manifestations and depression. Depression is often the only symptom; to some girls the premonitory "blues" signify the approach of the period. Occasionally we encounter the reverse, an excessive stimulation and feeling of well-being and strength. There is some loss in the power of concentration. In normal cases, however, this loss is less than many people suppose it to be. Lassitude and a feeling of general debility are confined chiefly to the anæmic cases.
The mental symptoms clear up as the physical condition is improved, aided by a sensible attitude toward the whole process. Often girls who suffer some pain live through the whole month in dread of the period. This attitude should be changed, by lessening the pain and by psychic therapy. Psychic therapy has proved successful in obstinate cases.
The girl who suffers considerably from any of these disorders at the monthly period should be relieved from the strain of examinations, the classroom, and lessons which must be learned, although mental hygiene requires that her mind be kept active and her interests in quiet pleasures stimulated. She should not be left to introspection and morbidness or to the sickly sentimental thoughts often recommended for her. This alone would cause her to exhibit some of the so-called "phenomena" of adolescence. Many of these phenomena are abnormal and are traceable to low physical vitality and lack of strong mental interests. The menstrual period should not be attended by pain or discomfort; nor should our girls be brought up to regard it as a time of sickness. When our girls are taught that normal girls experience no indisposition at this time, they will not be resigned to pain. The high-school life of the girl below the average in physical vitality cannot be regulated to her advantage in a co-educational school. Cities should maintain girls' high schools, taught by women teachers, for all girls upon whom the stress and strain of competition with normal individuals would react unfavorably. In the majority of cases, menstrual pain in girls is due to nerve tension, anæmia and poor circulation, improper clothing, and mental attitude. The girls who experience no pain are those who have led an active out-of-door life and have never stopped playing.
The character and arrangement of a girl's clothing is one of the most important matters in her whole regimen. Clothing may neutralize the beneficial effects of her otherwise hygienic habits. The long-continued even though light pressure of the corset—and it is seldom light—interferes with the free circulation of the blood. The alteration in intro-abdominal pressure is conducive to misplacements of abdominal and pelvic organs; the anterior pressure on the iliac bones, the result of the modern long hip corset, is a fruitful source of partial separation of sacro-iliac joints—the cause of many backaches. Respiration is limited, the free play of abdominal muscles is prevented, constipation is promoted, and digestion is impaired. The strain on muscles and nerves caused by high-heeled shoes is a prolific source of headache and backache and reduced efficiency. Women have no conception how greatly their susceptibility to fatigue is increased and their total efficiency reduced by their methods of dress. The pity is that the majority will not learn unless the decrees of fashion change.
The hygienic problems of girls in industry will largely disappear when it becomes a matter of common knowledge that industrial efficiency is dependent upon physical efficiency. The physical efficiency of the worker cannot be maintained at its highest standard when the period allotted to rest is too short to allow the body to rebuild its tissues and dispose of the toxic products of fatigue. All activity must be balanced by rest. If this equilibrium between expenditure and income is disturbed, exhaustion ensues. If long continued, it results in permanent impairment of health. The organism poisoned by its own toxic products is incapable of productive effort and the output will steadily diminish as the fatigue increases. The present long working day causes a progressive diminution in the vitality of the worker, defeats its own end, and leaves the girl weak in the face of temptations.
The housing of unmarried girls is a very serious question. Homes for working-girls require skillful management and a matron of insight and sympathy. The bedrooms may be small, but well lighted and ventilated. There should be a sunny dining-room, a library, several small parlors, attractively furnished, a gymnasium which could be used for dancing, shower baths, and an assembly room for concerts, lectures, and moving pictures. This should be in charge of a trained social leader who would direct entertainments and stimulate wholesome interests. With an establishment of this kind we should not find so many of our girls on the streets or seeking diversion in cheap theaters and dance halls. When girls are able to live,—not simply exist in the deadening monotony of alternation between work and sleep,—their heightened mental activity, interest, and enthusiasm will prove a valuable asset to employers.