TRANSCRIBER’S NOTE:

—Obvious print and punctuation errors were corrected.

JOHN A. MILLER, M. D.

FEMINA,

A WORK FOR EVERY WOMAN

ILLUSTRATED.

A perfect woman, nobly plann’d,
To warn, to comfort and command;
And yet a spirit still, and bright,
With something of an angel light.

—Wordsworth.

——BY——

JOHN A. MILLER, M. D.

Graduate Medical Department University of California, also holding
Credentials from the Universities of Berlin and
Heidelberg, Germany.

SAN FRANCISCO,
THE FEMINA COMPANY,
1893.

Entered According to Act of Congress, in the Year 1893
BY JOHN A. MILLER,
In the Office of the Librarian of Congress,
at Washington, D. C.

TO
THE LATE
DR. CARL SCHROEDER,
PROFESSOR OF DISEASES OF WOMEN
IN THE FREDERICK WILLIAM UNIVERSITY, BERLIN
MY TEACHER AND FRIEND.

PREFATORY NOTE.

The publication of this volume was suggested by the astonishing ignorance displayed and the antiquated ideas entertained upon questions of health and disease by most persons with whom I came in professional contact, even by those who were accomplished in other subjects of a scholastic and scientific nature. The practical importance of the subject naturally led me to the consideration of diseases that are essentially inflammatory, for over seventy-five per cent of all diseases of women are of an inflammatory nature. In this respect the book differs from other works on similar subjects.

In discussing this class of diseases I have aimed to present a treatise simple in style, and easily understood by the casual reader. While I have endeavored to impart strictly scientific information, I have tried to impart it in familiar language, avoiding the use of technical terms as far as possible, and carefully defining them when their use became indispensable.

JOHN A. MILLER, M.D.

No. 1137 Geary Street, San Francisco, Cal.

BY THE SAME AUTHOR.

MEDICAL EDUCATION IN THE UNITED STATES AND AN OUTLINE OF THE GERMAN SYSTEM. Essay read before the Alumni Association of the Medical Department of the University of California, March, 1886.

EROSIONS OF THE VAGINAL PORTION OF THE CERVIX, OR ULCERATION OF THE SAME PART. Pacific Medical and Surgical Journal, January, 1887.

RETROVERSIO-FLEXIO AND A NEW INSTRUMENT FOR THE REPOSITION OF THE UTERUS. American Journal of Obstetrics and Diseases of Women and Children, February, 1887.

UTERINE HEMORRHAGE AND LIGATION OF THE UTERINE VESSELS AS A THERAPEUTIC EXPEDIENT. The New York Medical Record, September, 1889.

PHLEGMASIA ALBA DOLENS, OR MILK LEG; ITS PATHOLOGY AND TREATMENT BY MEANS OF COLD WATER COMPRESSES AND ICE BAGS. Pacific Medical Journal, June, 1891.

CONTENTS.

CHAPTER I.

THE REASON WHY.

I see a large field of usefulness which has not been covered by competent authorities. I propose, therefore, to offer a plain, simple statement of the most common causes of physical suffering in women, and a simple and reliable method of home or domestic treatment, to be carried out by the patients themselves, which, in the great majority of cases, is easily applied.

The first nine years of my professional life was an untiring and incessant devotion to the arduous demands of a large family practice, after which I decided to go to Europe, and there prosecute such studies in two German universities as my experience as a practitioner had fully convinced me to be of the greatest practical and scientific importance; hence, I offer no excuse or apology for aught I may say on a subject with which I have taken especial pains to familiarize myself. Having in a measure established my identity, I am more fully prepared to proceed in a more congenial way.

In the realm of thought there is no monopoly, and it is, after all, at the bar of public opinion that a final judgment must decide the merits of my course.

The question is not what to teach, but whom to teach. This may seem, at first sight, an easy matter to determine, but a more careful inquiry will show the complexity.

The platform of a medical college is considered by some the only legitimate place from which a medical man may impart his knowledge, but here the opportunity is limited, notwithstanding the abnormally great number of these institutions. This, however, is not the only reason. Medical colleges are becoming so numerous, that they should be discouraged by all honest and high-minded medical men, because in this country they are private institutions, with very few exceptions, and subserve sinister purposes, in furthering the interests of their promoters either as advertising schemes or money-making institutions, or both.

Of course they are incorporated under State laws, which make them quasi-public institutions, but the State exercises no authority over them, and their self-constituted professors conduct them to suit their own private ends. They are not limited by law, nor is a required course for their students imperative, so that the public have no guarantee of the fitness or competency of their graduates. There is, also, an unhealthy rivalry among our colleges for students, improper material is taken in, and correspondingly poor material is turned out; this in turn causes a rivalry among their graduates in making spoil of the sick.

Every self-respecting and competent medical man has an utter contempt for these doctor mills. This will never be different in this country until we follow the plan of European governments, and make medical colleges State institutions, and their professors officers of the State, with liberal salaries.

The medical press has a comparatively limited opportunity for imparting information to the public, unless the editor of the secular press happens to make a quotation.

The exclusiveness that has characterized the learned professions generally, and the medical profession particularly, is rapidly passing away. Only half a century ago, the medical lectures in Germany were mostly delivered in the Latin language, and, while we now often suffer, in listening to medical lectures in bad English, the latter may still be the lesser evil. In fact, so great is the deference to public opinion in favor of diffusing knowledge that medical faculties court popular favor by delivering a course of lectures on medical subjects, and consider these the best-drawing card of the institution.

Information that is not sensational nor untruthful cannot fail to do incalculable good to the class for whom it is intended, namely, our wives, mothers, daughters, and sisters, so that they may avoid errors, that entail suffering and disease; information that will teach them how to cure themselves of the commoner and simpler ailments, and thus avoid running to the doctor, who cannot always afford to tell them the truth. Some would not if they could.

The Darwinian theory is of wider application than to mere animal or plant life; it extends itself to the overcrowded professions, and the increasing “struggle for existence” in the ranks of the profession makes men dishonest and greedy for any opportunity to raise a fee, so that patients are being treated for diseases which are created for them by the cunning and dishonesty of their doctors.

A little common sense and a knowledge of the elementary principles of disease would be the best protection against these deceptions; but, as a rule, sick persons are inclined to throw aside all good sense, and give themselves up entirely to their feelings or to their doctor. This is a very wrong thing to do, and opens the door for all manner of impositions.

The general practitioner of thoughtful and studious habits finds that, in the course of years, a diversified reading on the different diseases which in the routine of his work he is called upon to treat makes him a generally well-informed man, but not a thoroughly exact man, either in theory or in the details of his treatment.

Fifty to sixty years ago the entire field of medicine was comparatively so small that it was easier for a brilliant mind then, to comprehend all that was believed to be known, than it is for the same quality of mind to understand any of the subdivisions of medicine to-day.

Those were the days of doctrines and rules. Little that was absolutely correct or true was then known about disease, otherwise such absurd theories as the “dynamization or spirit-like” influence, causing disease on the one hand, or that the “great source” of chronic diseases was psora, or itch, on the other, as Hahnemann would have them believe, could never have gotten a foothold.

These are the days of scientific deductions from microscopical and physiological research, in laboratories connected with great universities, and the result is, that any of the specialties or subdivisions of medicine is as large and interesting a field as the entire area was some time ago. It thus happens, that some thoughtful persons, after years of general practice, drift almost involuntarily into some one department of medical art and science. To this they become gradually wedded, and in it they grow in knowledge and experience far beyond their previous anticipations. What they read on the subject is better understood, and new ideas are constantly formed, which enlarge the scope of their knowledge. In this manner the writer drifted into the domain of diseases peculiar to women, which was as unhappy on the one hand, as it is interesting on the other, for the phrase “diseases of women” has fallen into disrepute because every superficial practitioner professes to know all about them, and it often is but another name for criminal abortion.

But for all that, there is a legitimate and scientific specialty of women’s diseases. The time-serving specialist must be exposed in every department of medical science. Whether the pretender is labeled, a professor in a college, or labels himself through glaring newspaper advertisements, one is just as much a catch-penny as the other.

The object of educating the laity cannot be reasonably confined to a few medical truths, but the perversion of the truth must also be understood, so that the false can be detected. It is necessary to point out the dangers and frauds which are the unhealthy outgrowths or excrescences of established truths, and there must be no veneering of the wicked and sinful with ambiguous phrases to shield the guilty; the truthful and innocent require no apologist.

The honest observer can pursue no middle way in a work to which he has devoted the best years of a studious life, and hence he may seem radical in his opinions. While policy often dictates a conservative course, that which conscience and reason dictate to be true is prompted by loftier motives, namely, to subserve the highest purpose of moral integrity.

It has often been said that this is a mechanical age. How true is this even in the furtherance of science! How true is this of the science of astronomy, which was revolutionized by the construction of good telescopes! Mechanical genius has perfected a lens for Mount Hamilton thirty-six inches in diameter, and one is now in course of construction for Mount Wilson, in Southern California, which is to measure forty inches. Through these means scientists hope to decipher the complexion of remote planets.

Microscopic lenses have been equally perfected, and, by means of achromatic condensers and immersion lenses, great magnifying power can be obtained with perfect distinctness. That this mechanical spirit of the age should also have obtained a foothold in medical art and science, is but natural. Surgical and other mechanical methods have entered so boldly into the field of diseases of women that the writer feels constrained to sound a note of alarm. Great strides have been made in a more perfected technique in abdominal operations, and, by favorable recoveries from grave and severe operations, the field of surgical usefulness became enlarged, but this has degenerated into a license for notoriety and personal aggrandizement of not over-scrupulous and selfish surgeons who are over-anxious to operate so as to be able to boast of the great number of their capital operations, or laparotomies.

I was enthusiastic in abdominal and pelvic surgery, but not until I entered the field as a specialist in this department of medicine did I see and hear of daily abuses and misuses of this branch of surgery. In many instances it degenerated into criminal malpractice. It will be instructive information to cite a few cases which occurred under my observation, and present the actual facts to the reader.

It was in the month of February, in the year 1888, that a business trip to the southern part of the State forced an absence of several weeks upon me. Some two months before this time I had been called to see a young woman, who had then been sick for several months. She informed me that she had been married nine years, and, not having had any children, she concluded to see a noted specialist of female diseases. By this physician she was told that her sterility was owing to a closure or contraction of the mouth of the womb. This was obviously a wrong diagnosis, and for these reasons: she had always menstruated regularly and without pain, which excludes a constriction; and, secondly, no physician can honestly call a woman sterile until he has examined her husband, who, in the majority of instances, is the cause of his wife’s sterility, because it is he who is sterile. This woman and the doctor agreed, however, on a course of treatment, which was to forcibly open or stretch the mouth and cervical canal of the womb. This by itself is neither a dangerous nor a severe operation, if carefully performed, but care in this case was evidently not exercised, because the young woman was taken with severe inflammation, which caused a pelvic abscess.

I found her after two months of suffering. The discharge had become extremely offensive, her body emaciated, and her strength exhausted.

I enlarged the opening of the abscess, placed a large drainage tube in the cavity, through which it was washed out, by means of an antiseptic solution of bichloride of mercury, 1 part to 2,000 parts of water, and, by further giving her simple, nutritious food, she improved rapidly, so that the day before I left the city she was at my office, and told me that she felt as well as ever, although not thoroughly recovered. I was absent two weeks, and a few days after my return I incidentally met her husband, who told me that a week after I had left, his wife felt unwell and called in one of her former doctors, who, by the way, rides a hobbyhorse on surgery. This man found a few pimples on her body, which can be found on almost any healthy person, these, he said, were signs of blood poisoning from her abscess, and that an operation to extirpate the abscess, with one or both of her ovaries, was of urgent necessity to save her life from blood poisoning. The deceived woman was of course frightened into giving her consent to the operation, which was undertaken immediately, and, as luck would have it, she recovered; but she might have easily died, which she undoubtedly would have done had this knife-man got her sooner, or before I had restored to her a splendid physical condition, which withstood the unnecessary butchery to which she was induced to submit.

Some doctors seem to have a perfect mania for cutting operations, just as though the entire science and art of medicine were exhausted in surgery alone. To assume this for an instant is manifestly ridiculous. More lives are annually saved by a scientific application of other methods of cure than the most elaborate and brilliant statistics of surgery can approach. There is science and skill in selecting proper medicines, in the employment of hygiene or the rules of health, in the practice of obstetrics, and in a variety of other ways to demonstrate the triumphs of the art of healing.

The rash and unnecessary resort to the knife has brought surgery into general distrust, so that some patients would rather die, or wait until they are almost dead, before they allow an operation to be performed on them, in cases where surgery is, indeed, the only possible method of cure.

A lady recently called at my office for a consultation. I found her uterus and other pelvic organs in a perfectly healthy condition, although she suffered pain there. This was due to neuralgia from a generally exhausted and debilitated condition. I was not a little surprised to learn, from her own lips, that she had been treated for womb disease, and was about to undergo an operation for a tear in the mouth of her womb. This was manifestly absurd, because no laceration existed at all, and if there had it might not have been necessary, because it is quite natural for women who have borne children to have the scars of old lacerations on the mouths of their wombs, and they are not any the worse for them.

It is important for mothers to know something about themselves and of the common diseases to which they are liable, for then they will not be so easily persuaded to permit the use of caustics, or the cutting, stitching, or scraping of their wombs, which is quite likely to excite complicated inflammations, more serious in their results than the diseases for which these operations were performed. I know of what I write, and there is no one who can successfully deny it.

Dr. William Goodell, who stands as high in the department of diseases of women as any American, had an article in one of the medical journals on “The Abuses of Uterine Treatment.” He says: “From a large experience I humbly offer to the reader the following watchwords as broad helps to diagnosis: 1. Always bear in mind what another has pithily said, that ‘woman has some organs outside of the pelvis.’ 2. Each neurotic case will usually have a tale of fret or grief, of cark and care, of wear and tear. 3. Scant or delayed or suppressed menstruation is far more frequently the result of nerve exhaustion than of uterine disease. 4. Anteflexion of the womb, per se, is not a pathological condition. It is so when associated with sterility or painful menstruation, and only then does it need treatment. 5. An irritable bladder is more a nerve symptom than a uterine one. 6. In a large number of cases of supposed or actual uterine disease, which display marked gastric disturbance, if the tongue be clean the essential disease will be found to be neurotic, and it must be treated so. 7. Almost every supposed uterine case, characterized by excess of sensibility and by lack of will-power, is essentially a neurosis. 8. In the vast majority of cases in which the woman takes to her bed, and stays there indefinitely, from some supposed uterine lesion, she is bedridden from her brain and not from her womb. I will go further, and assert that this will be the rule even when the womb is displaced, or it is disordered by a lesion or disease, that is not in itself exacting or dangerous to life. Finally, uterine or womb symptoms are not always present in cases of uterine disease, nor, when present and even urgent, do they necessarily come from uterine disease, for they may be merely nerve counterfeits of uterine disease.”

There is not a physician of any extended experience in the land who, if he be true to his better judgment, will not indorse every word of Professor Goodell’s propositions. But the chances are they will never accomplish the good for which they were intended if the mothers, wives, and daughters are not permitted “a little peep” behind the curtain, and learn for themselves. For those who are wealthy and have plenty of money, doctoring may be a luxury or an amusement, but there the line must be drawn for the benefit of the deserving poor, with whom any treatment is a hardship. Stupidity of the masses is one of the causes of the abuse of surgical treatments, for they always look upon a surgical or bloody operation as one of the greatest achievements of modern medical art. Then there is the cupidity of the professional classes, who trade upon this popular error and delusion, and charge correspondingly large fees, which, as a rule, are exorbitant, particularly when the working classes are the sufferers.

A little cutting or stitching is much more quickly done, and the patient may be dismissed as cured, or left under the impression “that everything was done that could have been done,” than a conservative medical or hygienic treatment, which involves more thought, labor, and patience, qualities which are not as eagerly cultivated as the art to wring out a good fee by a little surgery, with less labor and skill.

There is not only too much mischievous doctoring, but there is too much of every kind, whether good, bad, or indifferent. The trouble is there are too many in the ranks of the medical profession; and this is not only true of this country, but is raising a cry of warning in Europe. The struggle for existence is a natural law, and nature is immutable. I do not mean to say, that it is a humane law, or that competition is a virtue; in fact, I believe quite the reverse. But much that is natural from a physical standpoint might not be so from a moral or spiritual plane; thus the two natures are distinct.

It is reasonable to suppose that, if the natural crop of diseases falls short of supplying the demands of those who hunger for an opportunity to treat disease, and it lies within their power to create disease, they will certainly do so. The deficiency must be supplied, or one of two things must be done by the doctor: he must either starve, or go to work at something else. This may be cruel logic, but I know that these are the actual facts.

Now let me ask how many persons who have some sort of a diploma will be self-sacrificing enough or sufficiently unselfish to prefer to starve or honestly work for a living, if they can avoid either, by defrauding someone out of a fee, for pretending to cure some manufactured disease? It seems almost a waste of time to argue such a self-evident proposition. I have known physicians of high standing who treated women for womb diseases which never had a real existence, and surgeons of large incomes to remove the female breast for a “supposed cancer;” and, that being the case, what would you expect from a less fortunate brother practitioner who is eking out a miserable existence?

How many a case of simple sore throat or tonsilitis is being paraded as a case of diphtheria. Why, I know of doctors who built up their reputations in that way. It is quite an easy matter, to call an ordinary, simple case of bronchitis, pneumonia. Harmless swellings, no matter of what sort, are treated and palmed off every day as cancers. The quack cancer doctor is almost ubiquitous. Some would much rather part with the village parson, or their regular old town doctor, than to part with the cancer doctor. Diseases that are conjured up in the minds of susceptible or hypochondriac persons have for them a real existence, because if a person believes he has a certain disease, it becomes a reality, as far as his own state of mind is concerned, and as far as the treatment is concerned to him who created the delusion, it is much more desirable than if the disease were real, because you can cure an imaginary disease, which may be impossible when a real one comes under treatment. This is another method of making a reputation for extraordinary cures that really never occurred.

When I contemplated writing a book, which I hoped to make a vade mecum for those who felt interested in the subject, I felt that it would be a duty which I should reluctantly perform, for it would be a criticism on the status of the medical profession of this country. I was convinced that whatever I said that would lower the tone of the profession in the estimation of my countrymen would naturally reflect on me as unfavorably as upon any other member, for I never claimed to be anything else but an American physician, and, as such, I have an ambition to elevate the rank and file to honor and respectability.

There is also a motive that underlies a work of this nature which should appear justifiable to the author. It is absolutely necessary that side-lights should be thrown into dark corners and recesses that are usually screened from public notice. If there is a growing deterioration in methods of proficiency and morals, the public should know it, for who is the greater villain, he who trifles with human life through officious ignorance and venturous operations, or the midnight assassin, who, under cover of darkness, waylays his unwary victim? The title “doctor,” from the Latin doceo, “I teach,” has a halo of learning that it derives from the original significance that was attached to it when it was first sanctioned at Bologna University, about the middle of the twelfth century, where it first passed into the faculty of divinity. It was afterwards introduced into the universities of Northern Europe, and remained ever since a degree of distinction in theology, law, philosophy, and medicine. In the German universities doctor implies also a license to teach within the university, as a privat-docent.

When we now consider that no person can matriculate in a German university who has not graduated from the gymnasium or high school, it is clear that, under the above conditions, the title “doctor” guarantees that the possessor is an educated person, not only of the high school, but added thereto is the accomplishment in the specialty of which he holds the doctor degree.

What may a “doctor degree” mean in this country? The title of an illiterate and utterly incompetent person, who was by natural environment and occupation a teamster, saloon keeper, barber, tailor, or patent-medicine vender, etc.

If a woman, she may be retraced to an ignorant nurse, midwife, or quacksalver, the conceited wife of a man who indulges her in the freak of “learning to be a doctor,” for she had demonstrated her genius for the profession by successfully treating a case of measles, which started the doctor’s bee a-buzzing in her bonnet, until she passed through a medical college; last, but not least, are the winsome daughters of the millionaire or successful business man, who imagine themselves too smart to make useful housewives and good mothers.

There is not a medical college in this State, and there are few, if any, in the United States, that would not eagerly take in all of this material, and guarantee to them beforehand, that they can graduate as medicinæ doctor in twelve months to three years, a five months’ course being considered a year.

The above comparison is a disgraceful commentary on the degree of doctor in this country, and the public should learn to know the difference.

“The United States and Its Doctors” is the title of an editorial in the July number of the New York Medical Record, and it says: “There is certainly no more curious social phenomenon than that of the extraordinary popularity of the medical profession in this country as a means of securing a livelihood.

“This subject is one that is often dwelt upon, but we doubt if many even yet realize the grotesque misproportion which medicine in the United States holds to other bread-winning occupations. Here are some of the naked facts in the matter:—

“France has 38,000,000 of population, 11,995 doctors, while it graduates 624 medical students in one year. Germany has 45,000,000 of population, about 30,000 doctors, and graduates 935 students in one year. The United States has about 60,000,000 of population, 100,000 doctors, 13,091 medical students, and graduates 3,740 students in one year.

“Germany, which has relatively less than half as many doctors as America, is already groaning over its surplus. When one compares France with this country, the excess of medical men here seems most astonishing.

“A comparison of the United States with European countries, in whatever way it is made, leads one to think that there is something almost alarming in our medical productiveness.”

In connection with the above comparison, in which it is shown that Germany has proportionately less than half as many doctors as the United States, it will be interesting to learn the views of the German profession. The Berlin correspondent of the Medical Press writes that the “Deutcher Ærztebund,” Society of German physicians, felt it to be their duty to warn the guardians of young men studying in the gymnasiums or high schools, against entering the medical profession, the state of overcrowding being so great as to insure disastrous consequences. In glancing over the above figures, there is one very important point which is greatly in favor of the German profession and militates against the Americans. It is the enormous patent-medicine trade and quacking that is done through it in the United States; on the whole, this has been calculated to amount to at least fifty per cent of all the doctoring that is done; that means, that where one hundred doctors now practice for a living, fifty more could make a similar living, were it not for the patent and quack medicine trade, which, in some of the German States, is almost prohibited, and in others I know it is entirely inhibited.

When the Society of German physicians warns the German people that an overcrowding “insures disastrous consequences,” what does it mean?

This is a question which, we presume, was answered in Germany, and it is certainly worth our while that we should answer it here, and in this we have decidedly the advantage, because in that country the answer was entirely based upon what was anticipated, while in this we can answer from what we have already realized, namely, disastrous consequences to honor and to integrity on the one side, and to health and security against imposition on the other. To this I have already referred. Everyone competent of judging, and who has lived in that country, knows from study and observation that the arrangements and conveniences there for treating the sick are in a much higher state of perfection than with us. Hospitals and physicians are as accessible to all classes as the most humane and philanthropic heart can desire, and now we learn that if this wholesome state of affairs shall continue with less than half the proportion of doctors that we have here, there must be no further increase of physicians, or it would insure disaster. This statement and warning a close and careful observer clearly appreciates. The writer was personally acquainted with a large number of German practitioners while in that country, and knows as an actual fact that while their fees were and are much smaller than anything ever paid in this country, they had not overmuch to do, and were only leisurely employed. This applies to some of the greatest and world-renowned medical professors, as well as to the ordinary general practitioners. But there is a reason for all this, too. These men as a rule are honest, they are no money grabbers, they are thoroughly competent and scientific and manufacture no diseases to suit emergencies nor conjure up complaints that have no real existence. If their number were doubled, if the normal proportion were disturbed, the disaster would surely follow, professional demoralization would ensue. So the German profession sounds a timely note of warning ere the canker of selfishness has destroyed the noble altruistic principles of physicians, without which the doctor is as likely to be a messenger from hell as a ministering servant from heaven.

Medical legislation in this country has been nothing less than a farce, partly because the general public is not aware how abased the profession is, and partly that Americans are extremely jealous of what they term personal liberty. It is being attempted to remedy some of the abuses of the medical profession by regulating the practice of medicine by State Examining Boards. Experience has demonstrated that these boards are but the excrescences of the various medical colleges, who are themselves the root of the very evils that are sought to be remedied. The duties of these boards are simply to make themselves officious, and to inquire into the source of the credentials or diplomas of the applicants for a license to practice medicine, and not into the qualifications or competency of the applicants. All that is necessary under such laws is simply to present a diploma of some sort; whether it was stolen, or the diploma of a dead man, or gotten from any of the numerous worthless colleges, is not made the subject of inquiry; and as by far the greatest number of quack-salvers in this country have diplomas, the law falls short of remedying quackery.

There are, usually, enough boards of examiners, representing the different schools, so that the different interests of the diploma manufacturers are well represented. A medical examining authority whose functions and powers do not go higher or beyond the mere granting of licenses, or which does not examine into the qualifications of the persons who possess diplomas, is utterly absurd, because it is no protection against ignorance and imposition. A law that presumes that all persons holding diplomas are qualified and competent to practice medicine, is essentially wrong, or inadequate to fulfill the purpose for which it was designed. I have known graduates from what were considered good colleges who could neither write a safe prescription nor diagnose a case.

There is only one way towards an approach to an efficient and intelligent board of medical examiners, and that is, one single State board in which the different schools may be represented as to their pet theories of prescribing medicines, but in all other departments of medical science and art there must be a uniformity of talent and qualification.

There must be a standard of excellence established by the State, which is higher than and above the recognized standard of any medical college, for no medical college is trustworthy in this respect.

The State in its sovereignty must prescribe what shall constitute a medical education, and the requirements should be embodied in the statutes. A license or degree from that source, after a final examination, should be the only legitimate license to practice medicine.

Such a method would establish a system that would clearly define the status of every medical practitioner. The board must have the power, and it must be their duty, to examine each and every applicant for a license, as all candidates for the army medical service are examined. All this noise and talk about a preliminary examination and an extended course of medical study are simply the vaporings of superficial minds. It is neither the preliminary course, nor the length of time that a person consumes in trying to become a doctor, in which the public is interested, but what kind of doctor a person is when he hangs out his shingle and begins to practice, whether he is competent to do that which is expected from him in the hour of sickness or great peril, irrespective of any diploma or any medical college. Foreign graduates should be amenable to the same examination, for behind these, too, belongs the interrogation point. The gushing mediocrity of some of these diploma holders gives rise to the suspicion that their credentials are not genuine.

As an American to the manor born, I would not for a moment deny the humblest citizen an opportunity to elevate himself to the highest professional honors; but why can he not be required to thoroughly equip himself and prove, by oral and written examinations on subjects of preliminary education, that his mind has become disciplined for broader or special studies, irrespective of any course in a college? After the State has satisfied itself of the proficiency of the applicant in scholastic acquirements, it should go further, and examine into the qualifications for a degree of medicine, just as they do in the U. S. Army, only with this exception, that no diploma of any medical college should be required from the candidate, and if he has one it should not be recognized.

This would simply incorporate in the State laws the distinctive feature of the University of London, which examines and confers graduation on persons who have received instruction in such institutions at home and in the colonies as have satisfied a Secretary of State with regard to their studies.

This university also has and exercises a power of examining for degrees persons who have not been at any institution. Nothing could be more democratic than for the State to make such a provision for State medical examinations. The German Government does precisely the same thing, with the exception that it makes graduation from the medical department an essential prerequisite. It has a State board of examiners to examine all graduates in medicine of their own universities, to further prove if they are really qualified. A diploma in Germany is of no value; it is the so-called ærzliche Approbationspruefung, State’s examination, that gives the license to practice legally.

When this is found necessary, notwithstanding the high standard of German medical schools, how much more is this safeguard against incompetency needed with us? I have endeavored to prove from the methods of Germany and the course of the United States medical department that diplomas cannot be accepted as bona-fide evidence of a medical education. With us a half dozen doctors can get together any time, incorporate a medical college, call themselves professors, and start out advertising themselves and their college for the purpose of manufacturing diplomas and doctors. Why, a diploma under these conditions should not be worth the parchment it is written on, as evidence of a medical education, unless attested by a higher and perfectly independent authority!

If the public once understood that too many doctors are dangerous to the morals and health of society, they would be quite as anxious as the most enthusiastic medical educator to remedy the evil.

The question of too many doctors is one of economical and social science, not of medical science, and, therefore, it can only be intelligently considered from these philosophical standpoints. It is a well-understood and accepted law of political economy that in the industrial pursuits, whether in the manufacturing departments or in agricultural production, the surplus or glut in the market of any of the products of industry, reduces the price and stimulates consumption, which, in the course of time, is regulated by a suspended or reduced production, thus restoring a healthy equilibrium. It would be an absurdity to apply the same rule to a surplus of doctors, because human ills or diseases do not increase in proportion to the surplus of doctors, nor will fees be any less. But the surplus, in order to live, must live on the earnings of the community, and here the disastrous consequences appear.

The credulous, and those who often may imagine that they require medical advice, become the unconscious victims of the unhealthy disproportion, for the doctor seizes the opportunity to make a case, while the normal proportion of cases do not reach around. Thus, it is calculated that at least fifty per cent. of all the diseases for which patients are treated are fictitious as far as actual disease is concerned, and the remaining fifty per cent. are, in the majority of instances, overdosed and overdoctored. For this reason medical legislation would not make a privileged class of physicians, nor throw unusual safeguards around medical practitioners, but medical legislation is to protect the people themselves from imposition and quackery.

The reason for the overcrowded state of the profession is not alone the laxity of medical laws, or the low standard of medical education in most of our colleges, but the general tendency of the country population to drift into the cities. Honest labor has not the dignity which its importance demands, and a radically faulty method of common-school education is another reason. Utilitarian manual methods, in which the hands are educated for useful employment and the minds to habits of industry, are to be wished for. Young men who have acquired a technical education in mechanics and arts will learn to respect labor in every department, and their ambition in life will be greater than to swing a cane or wear a silk tile.

In proportion as the productive employments are made respectable, this questionable ambition to become M. D.’s will fall off.

History tells us that the opulence of Rome was speedily accompanied by a decline of its agriculture, after which came the fall of the Roman Empire, because the country population became too indolent and restless and flocked to the cities for an easier and luxurious living. History in this respect seems to be repeating itself. We are always talking of encouraging the beauty and growth of our cities, but not one word of encouraging agriculture; no one talks of encouraging farm life and making it profitable and attractive, so that men and women would prefer the more independent subsistence in the country to a shabby gentility in the city. Some reader may ask, What has all this to do with doctoring? I say that the answer must already have been apparent; it becomes the duty of everyone to interest himself, that the division of labor shall be apportioned so as to do the greatest good to society.

We have a national characteristic which shows itself in an abnormal conceit for everything American in a degree that is not essential for true patriotism and love of country. But when by comparisons we learn that there are abuses and errors which are destructive to a healthy intellectual and material growth, we must have the honesty and independence to acknowledge them, and busy ourselves to find a remedy for existing evils.

The physician who can assist in the amelioration of society by administering to human ills which are the result of unwise laws, is accomplishing as much good as if he writes prescriptions or bleeds patients. The sooner everybody recognizes the fact that the time has come to deflect the current of ambition from the practice of medicine as a means of making a living, the sooner will untold suffering be lessened, and there is no honest-minded physician who does not heartily agree with me. Mercenary persons, and ignorant or unscrupulous doctors who run diploma mills, may criticise severely the honest sentiments here expressed, but the truth is so apparent, that he who runs may see the inevitable consequence of this unhealthy competition. Professors of colleges have a direct interest in the ignorance and incompetency of their graduates, because they are the means of calling them into consultation on every possible occasion in trifling ailments, and if the disease belongs to some specialty, they have the cases entirely turned over to them, because, in the mind of the incompetent and newly-made doctor, the professor who was the means of getting him a diploma, poses as the beau ideal of medical wisdom. In this way it becomes exceedingly profitable to be a professor. If there are not enough medical colleges in a community to afford places for the ambitious, it is considered to be one of the best-paying financial investments for a company of physicians to start one, and in most of these concerns it is easier to get a diploma as a doctor than to learn to be a good dressmaker or shoemaker.

Hence there is only one remedy to control the educational aspect of this evil, and that is to take medical colleges entirely out of the hands of private individuals and make the State the only source of the necessary credentials to practice medicine.

An American system of medical education fostered by the State would be productive of grand results, because, under the shadow of our free institutions, the mind transcends the circumscribed sphere of despotism. This has already been proven in numerous instances, notwithstanding unfavorable surroundings.

Forming the galaxy of great names that illumine the milky way of science, there are none brighter than a Gross, a Flint, a Sims, and some others. These were great American authors and physicians, who never pretended anything else; they never dreamt of the Don Quixotic escapade of pretending to be American professors while they appended to their names initials or abbreviations of questionable credit from foreign institutions. The brilliancy of true genius was their only passport to fame.

CHAPTER II.

DELUSIONS AS TO THE CURATIVE VALUE OF DRUGS.

Medicines that are sure cures for all the diseases to which humanity is heir, are not the spurious discoveries of the quacksalver and patent-medicine vender alone, but some very intelligent persons believe that if there is not a panacea, there is at least a remedy, for every disease. In cases where the patient does not recover, they believe that either the disease was not thoroughly understood or the medicines which were given were not properly selected.

This is a great error, because there is no such thing as a specific or infallible remedy for any disease, and, on the other hand, it is quite possible that most patients, with proper nursing and diet, would naturally recover without any drugs or medicines whatever. Outside of those drugs, like ether, chloroform, opium, or morphine, that are employed for the purpose of deadening the sensibility of the nerves, so as to render them insensible to pain, there is not another drug that is absolutely sure and true in its medical effects. Some few are very useful at times, but the great bulk of medicines do much more harm than good.

Medicine in its broad sense means a knowledge of the cause, course, treatment and ultimate results of disease. The study of medicine cannot be circumscribed by dogma or theory, nor can it be mastered in a few short years of study at the very best medical schools. It requires a mind adapted by nature for a plodding investigation of her laws, and incessant application, long after the college curriculum is ended. In fact, the student must unlearn much of the stereotyped lessons of the text-books, and this is particularly true of the supposed medicinal effects of drugs, which are always exaggerated. When physicians really have a threatening case, under their observation and care, the attributed therapeutic action of drugs is nearly always disappointing, and very often injurious, and they are forced to let the drugging entirely alone, and bring their skill to bear on measures which support the strength and vitality of the system, so that nature can effect a cure in her own way. This may seem to some simple doctoring, but I can assure the reader that it requires the highest degree of medical skill, notwithstanding the droll sarcasm of Voltaire, that “medical science is the art of amusing the patient while nature performs the cure.” There is neither skill nor much learning required to give an ordinary prescription; that the average apothecary could do with the greatest exactness. But science and medical skill can be exhausted in managing and husbanding the resources of nature, in order to effect a cure.

Medicine no longer stands alone as a simple art, based on theoretical deductions, as it was less than a hundred years ago, but it has become a department of natural science, a part of the natural history of the human race.

Disease is as much a vital process as health, only in one case the vital function is perverted, or destructive, while in health it is constructive. The germ theory of disease and cellular pathology are clearly within the domain of biological research, while chemistry has solved many physiological processes. Mental philosophy has been no less serviceable in the department of medicine, by teaching the wonderful influence of thought and emotions on the physiological functions of the organs.

A one-sided education is inadequate to appreciate the subject of healing or teaching. A comprehensive knowledge of all that bears on the subject of health and disease has several important objects in view, namely, it thoroughly acquaints the doctor with all of nature’s resources for the amelioration or cure of disease; and it gives him judgment in all cases to avoid irreparably wrong treatment, which places obstacles in the road of nature’s efforts to heal spontaneously. The quack or professional imbecile will, in the ordinary course of diseases, be accredited with remarkable cures; in fact, the cures wrought by a quack or an ignorant person are just as welcome and valuable to the patient interested as if they were accomplished under the advice of the most erudite and skillful physician, but the invalid ran the chances of malpractice or bad treatment at the hands of the quack, which might have cost him his life, because the incompetent healer does not know when his method of treatment does mischief. Every method of cure may possess merits of its own, which are beneficial when the disease or conditions for its employment are present, whether this is mind cure, water cure, or anything else that you may name. All that any system of treatment can do is simply to stimulate the curative force of nature, which is the only first cause of any cure.

The reparative energy of nature has never been duly recognized, because the selfishness and pride of the doctors will not concede this as often as they ought. The doctor should be the most useful as a monitor to the sick, in guiding and controlling thought and conduct, in harmony with the curative energy of nature. From this point of view the pretensions of anyone effecting this or that cure are only a delusion, because the doctor effects nothing, he only assists, guides, and directs towards effecting a cure. What this curative force is has by no means been understood. Some believe it identical with life or vital action, which manifests itself only in organized substances, but even if we admit this identity, we are balked again, because we do not really know what life is, any more than we know what electricity is. Descartes resolved life into matter and motion; this, however, is rather the phenomena of life and gives us no idea of the real essence of the force that we call life. There is another theory, that all life whenever or wherever found is a spiritual force, ethereal and universal. For our purpose, the discussion of this question has no particular value, were it not for the fact that life, or vital activity, wherever we find it in organized substances, whether in the lowest living thing or in the highest type of physical development, is accompanied by or is endowed with the natural tendency to repair defects or injuries in that in which it is active.

Regeneration, or the curative process of nature, is always the handmaid of vital activity. It is present at the earliest formation and division of a cell, which constitutes the unit of all organisms. Just as one brick is laid on the other with mortar or cement between them, so as to make a whole wall of a building, so are our bodies built up of minute cells, one added to the other, with cement between them, until the entire structure is completed. There is no tissue of the living body which was not at one time during its existence a cell. This curative force is beautifully illustrated in the lower animals, where parts of organs are replaced to a far greater extent than among warm-blooded animals.

Professor L. Landois, in his work on “Human Physiology,” says that “when a hydra is divided into two parts, each part forms a new individual—nay, if the body of the animal be divided into several parts in a particular way, each part gives rise to a new individual. The planarians also show a great capacity for producing lost parts. Spiders and crabs can reproduce lost feelers, limbs, and claws; snails, part of the head, feelers, and eyes, provided the central nervous system is not injured. Many fishes reproduce fins, even the tail fin. Salamanders and lizards can produce an entire tail, including bones, muscles, and even the posterior part of the spinal cord, while the triton reproduces an amputated limb, the lower jaw, and an eye. This reproduction requires that a small stump be left, while total extirpation of the parts prevents reproduction. In amphibians and reptiles the regeneration of organs and tissues, as a whole, takes place after the type of embryonic development, which is by cell division, and the same is true as regards the histological processes which occur in the regenerated tail and other parts of the body of the earth worm.” Comparative pathological anatomy clearly demonstrates the inherent curative power of nature, and this is also apparent in the vegetable kingdom, and together they deliver a lecture on the “art of healing” from the stage of creation, in silent and modest language, but eloquently instructive to the thoughtful observer.

The question now naturally arises How far this curative energy of nature operates in warm-blooded animals, and especially in man? The answer must be that, while it falls short of reproducing parts of organs or even tissues in the same degree of perfection as in the lower orders, the innate tendency towards regeneration and recovery from injury and disease is, on certain lines, practically the same. There is not the slightest doubt that ninety per cent. of all cures, whether the invalid took this, that, or the other medicine, or whether the method of treatment was homeopathic, allopathic, or mind cure, are entirely due to this inherent curative energy; and the other ten per cent. may have required some active remedy, but this, too, alone, without nature’s healing force, would have been ineffectual.

What is ordinarily termed mind cure is not mind cure in the sense that the term implies, but it is simply the mind toying or playing with the idea of a cure, for while the mind is thus engaged, nature’s energy is accomplishing the result or cure. This is the only rational explanation, and corresponds with the cures that nature is continually making in the lower orders of animals. If the recovery of the sick depended entirely upon the caprice and wisdom of the doctor, and not on the reparative forces of nature, the race would soon die out. I fully recognize the fact that the curative force can be stimulated; this may be done through the influence of nourishing food, alcoholic stimulants, a drug or medicine, or through purely mental influences. No physician can estimate how much merit he can accredit to the methods or substances he employs in any particular case that recovers, and how much to the lady physician, Dame Nature. This old lady doctor is ever active, and the most inert drugs, employed or administered with her assistance, have achieved wonderful cures; this the history of medicine confirms. The tar water cure of Bishop Berkeley is an illustration how an inert substance is capable of making for itself an enviable reputation for curing ailments, like pleurisy, pneumonia, erysipelas, asthma, indigestion, hypochondria, and other diseases. This remedy had the vehement indorsement of one of the greatest metaphysicians of the English-speaking world, and that the cures reported by him were genuine no one will doubt for a moment; but the bishop, like many of our day, was determined to have a remedy to cure disease, where none was required, but the mind had to be humored, while nature was actively repairing the disorder. To-day almost everyone is satisfied, that the virtues ascribed to tar water by Berkeley were a delusion, which was shared by all those who believed as he did.

The Weapon Ointment affords another instance where the credulity of the public was supported by abundant facts to prove the efficacy of the remedy, yet it was based on the wildest superstition. This ointment was employed for the healing of wounds, but instead of being applied to them, the weapon with which the wound was inflicted was carefully anointed and hung up in a corner, and the wound was washed and bandaged without the salve being allowed to touch it. This ointment created such a furor that eminent medical men indorsed its virtues as a healing agent. Another example of superstition and charlatanry was the equally famous Sympathetic Powder, which, when applied to the blood-stained garments of wounded persons, cured their injuries even when miles away. That dukes and knights vied with each other to obtain the secret of its preparation and ingredients is a matter of history. Instances of delusions on medical subjects could be multiplied a thousand fold, but they prove nothing but ignorance and superstition on the one side, and the inherent all-powerful curative force of nature on the other. While I wish to avoid wounding the fastidious and sensitive in the matter of their faith in their cherished system of cure, I cannot refrain from classing homeopathy as a similar delusion.

I am glad to admit at the outset that I have read Hahnemann’s “Organon of the Art of Healing” with a great deal of interest and some profit. I am convinced that his theory of infinitesimal dilutions is as absurd and ridiculous as either the Weapon Ointment or the Sympathetic Powder treatment already referred to.

If we consider the harsh, or, preferably-termed, heroic treatments, then in vogue, we need not be surprised that the pendulum of medication should have swung in the opposite extreme. Blood was drawn from the already enfeebled body, emaciated by disease; emetics were administered to sensitive and inflamed stomachs, and only aggravated into greater disorder; blisters, or the burning moxa, scorched into greater agony the suffering mortal, while large doses of drastic cathartics depleted the waning forces of nature. There was a tendency of the medical profession about that time to entirely ignore the curative forces of nature, and to attack disease as you would a midnight marauder, with the most powerful and dangerous weapons at command; and there is no doubt that with these powerful expedients, disease was destroyed, but life also. Under these conditions Hahnemann appeared on the scene, and I am frank to admit that he rendered suffering humanity invaluable service by espousing a system of cure which had the merit of being harmless. If we take into account that physiological studies were then in their infancy, and that the word “Biologie,” from the Greek words which signify a discourse upon life and living things, was made use of for the first time by Lamarck, in a work published in 1801, it will not seem altogether strange that even learned men were mystified into beliefs which, in the light of our present knowledge of the subject, appear preposterous. This was a most opportune time to fasten on the healing art any doctrine or dogma, however absurd, and on this tide of ignorance and superstition, the doctrine of infinitesimal dilutions floated into popularity. Homeopathy affords us one of the most striking illustrations of the uselessness of drugs in ordinary ailments, and conclusively proves that nature possesses inherent curative powers. Cases treated under this system make splendid recoveries, and often much better than when the powers of nature are opposed or weakened with nauseating drugs and poisonous doses, prescribed by incompetent persons.

Hahnemann truthfully observed that existing diseases are liable to become aggravated, complicated or replaced by drug diseases.

There is no doubt of the truth of this statement where drugs are heedlessly administered. When I was a student I was told that calomel was par excellence a babies’ medicine without any qualification. I was credulous enough to believe it and prescribed it for my own children for its purgative effect whenever it was deemed necessary. In later childhood, when the second dentition set in, the germs of the permanent teeth were so injured, evidently from the calomel that had been absorbed into the system, that the teeth were ragged and defective. The glands of the neck were also inclined to swell and suppurate, and there is no doubt in my mind that a great deal of what is generally supposed to be scrofula in young children, is nothing more nor less than a “drug disease.” I believe that Hahnemann was cognizant of the potency of nature under ordinary circumstances to cure disease. I believe that he absorbed this view of the philosophy of healing from the writings of Paracelsus, which he had studied, and from which he drew his inspiration, but he also appreciated the practical necessity that success depended on satisfying the superstitious belief of the times, and that consisted in offering some tangible remedy. Hahnemann proved himself equal to the emergency by formulating his doctrine of potentizing drugs or medicinal substances by reducing them to a wonderful degree of minuteness.

The preparation of these dilutions was directed to be carried out in a ceremonial sort of way. Chalk from an oyster shell, sulphur, charcoal, or any other substance, was potentized by taking one grain of the drug and mixing it with one hundred grains of sugar of milk. Of this mixture one grain was taken and mixed in the same manner with another hundred grains sugar of milk. This gave the ten-thousandth of a grain of the drug. Take one grain of this with another hundred grains of sugar of milk and the powder will contain the millionth of a grain of the substance, or the first potency, which forms the bases of other dilutions. This is reducing the doses of any drug to an absurdity, and Hahnemann was too brilliant a mind not to know this. It might be mentioned in connection with these dilutions, that if one grain of the most powerful drug, strychnine, aconitin, arsenic, or any other chemical that is known, is mixed with six hundred grains of sugar of milk, one grain of this powder, or the one six-hundredth of a grain of this substance, cannot be detected by any test or chemical reagent; or, in other words, the quantity of the drug or chemical contained is so small that the most delicate chemical test fails to show it; yet, in homeopathy, the dilutions are carried to the decillionth of a grain, from which important medical effects are expected.

Drugs are physical agents, and if they are diluted so as to destroy their chemical or physical properties, it is sheer nonsense to expect any physical result from them on the system. Chemical and physical facts conclusively prove the utter inertness of certain drugs either in themselves or in the manner in which they are employed, and the indisputable evidence of biological science demonstrates the natural curative tendency of nature observable in the lowest living thing to the highest, so that we should stultify our reason were we to arrive at any other conclusion than that the doctrine of this therapeutic creed is one of the most irrational delusions that ever befogged the mental horizon of a thinking being.

The supposed cures effected through the employment of the Weapon Ointment, the Sympathetic Powders, the endless dilutions of the Hahnemann system, and, indeed, most other remedial agents from any school or source, whether offensive powders, mixtures, or patent medicines, or the more agreeable and tasteless pellets, have but one role to play, that is, to assuage the apprehensions of the mind while nature is performing the cure; that is, to engage the mind with the thought or idea that something tangible is being done to bring about a certain result.

If the patient has pinned his faith to the curative value of mind alone, the mind is for the time being engaged with idea that mind is performing the cure. This is a delusion quite similar to the previous one, in which medicines are taken, with only this difference, that while you pin your faith on drugs in the one case, you pin it to mind cure in the other.

CHAPTER III.

WHAT IS MIND CURE?

This subject has given rise to an endless variety of contradictory discussions, and while it has won for itself fanatical devotees on one side, it has been ridiculed on the other. This is not at all surprising, when an inquiry is made into the competency of the parties to the controversy. To be informed in metaphysical philosophy, or fully equipped in scriptural lore, but without a practical study in the art and theory of medical science, precludes the possibility of presenting the theme in a logical manner, or establishing a relevancy between medical science and mind cure. A medical education that is based on strictly physical characteristics of disease, as they are studied at the bedside, or in a microscopical laboratory, is equally inadequate; for the question of mind cure goes beyond the physical into the metaphysical, and not until the operations of the mind have been closely followed to the bodily or organic functions, can the intimacy of their relations be thoroughly appreciated. Medical men betray their incapacity for observation if they contemptuously dismiss the subject of mind cure by some superficial, disparaging illustration, for there is much more in the subject than is dreamt of, even in the mind of the average college professor.

“The mind,” says Dr. W. F. Evans, “can be made the plastic or formative principle of the body, and that thought can retard, pervert, or stimulate and correct the different functions of the human organism.” The relation of spirit and matter is very intimate, and some very clever thinkers resolve all matter into spirit, in its ultimate analysis.

Bishop Berkeley affirms this in his “Principles of Human Knowledge.” In section seven he says “there is not any other substance than spirit.”

If we view nature from a materialistic standpoint, we see only one-half of what we think we do, and even that must be very imperfectly judged by our senses. Friedrich Wilhelm Joseph Schelling states the relation of matter and spirit, in very simple and plain words, so that a child can understand what he says: “Nature is spirit visible, and spirit, is invisible nature.” This may be illustrated in physical science from what chemistry teaches of the physical properties of the diamond, whose atoms or molecules are so perfectly continuous and closely aggregated that it forms one of the hardest substances known to physicists. These atoms of pure carbon may be made to repel each other, so that the diamond assumes a gaseous state, which is imperceptible to our senses.

I am aware that the definition of a gas is not that which metaphysicians would accept as applicable to spirit, and yet it illustrates the idea from a physical standpoint. It is much better to illustrate a question with something with which people are generally familiar. The body and every organ and tissue forming a constituent part of it, is simply the plain ordinary matter in motion, vitalized by what we call life, and this life principle is a mystery, and what is true of the diamond is true of the human body in its entirety. If placed in a crematory, it is reduced to a few ounces of bone ash, and, with the addition of a little acid, this too would soon disappear into invisible gases, so that the doctrine of philosophers, that matter is spirit, is, after all, not so far removed from physical evidence.

Physiological science gives abundant proof that the mind has a powerful influence over the body. By mind is meant all that class of mental phenomena called reason, and the emotions and passions. Doctor Evans says “the body is included in the being of the mind,” or, in other words, that matter is included in the being of spirit.

The thinking quality of the mind is undoubtedly the mainspring of its action, of which the formation of ideas is the highest kind of mental activity. These originate either within the mind or are brought within its sphere by transformed impressions from without, but through the power of the Will these are more or less modified, and may, indeed, be entirely suspended, so that the mind may become entirely passive and not think of anything. It is the exercise of this Will power which may make the operations of thought conducive to health or disease.

Cogito ergo sum, “I think, therefore I am,” is a maxim of Descartes. What we think and give shape to in thought has for us a real existence, and we have it in our power to create thoughts that will have either a painful or pleasurable sensation. Painful sensations have occurred to persons by the conviction of the existence of a cause which would, when present, have produced certain results. Of this several examples are given in W. B. Carpenter’s physiology: “A clergyman told me that some time ago suspicions were entertained in his parish of a woman who was supposed to have poisoned her newly-born infant. The coffin was exhumed, and the coroner, who attended with the medical men to examine the body, declared that he already perceived the oder of decomposition, which made him feel faint, and in consequence he withdrew. But on opening the coffin it was found to be empty, and it was afterwards ascertained that no child had been born, and consequently no murder committed.” The second case is yet more remarkable: “A butcher was brought into the drug store of Mr. Macfarlan, from the market-place opposite, laboring under a terrible accident. The man, on trying to hook up a heavy piece of meat above his head, slipped, and the sharp hook penetrated his arm, so that he himself was suspended. On being examined he was pale, almost pulseless, and expressed himself as suffering acute agony. The arm could not be moved without causing excessive pain, and in cutting off the sleeve he frequently cried out. Yet when the arm was exposed, it was found to be quite uninjured, the hook having only traversed the sleeve of his coat.” In this, and similar cases, the sensation was perfectly real to the individual who experienced it, but it originated in the mind by an impression through the nerves of internal sensation which created the idea or image in the brain, and the external senses to which it was referred had nothing to do in causing the feeling. Diseases are thus created every day, either by ourselves or by those to whom we go for advice. I call to mind a lady who had gone to a distinguished practitioner for a supposed womb disease for some six months. She experienced no change for the better, but kept on growing continually worse, so that she no longer had a refreshing sleep, and her appetite for food was entirely gone. On examination I found her womb entirely healthy, in fact, exceptionally so, thanks to her attending physician, because, after a certain amount of useless doctoring, the rule is quite the other way. I told this lady of her error or delusion respecting her womb, and prescribed a quieting mixture for the night and a tonic for the day. She began at once to improve, and when I saw her again, six weeks afterwards, she had so fleshed up that I failed to recognize in her traces of her former delusion. The disease of which this woman was suffering was imaginary, and had no real existence for anyone outside of herself. She was the victim of the harrowing symptoms which her mind conjured into shape, and an attempt to brush aside the disease, with the flippant remark that “there was nothing the matter with her,” would have been cruel, unscientific, and absurd. The ailment which she thought she had, had as much an existence as though the most malignant disease was destroying her life; for her imaginary disease was doing the same thing, only in a different way.

Imagination is the most powerful function of the human brain. Associated with thought, it constitutes the empire of the soul, which recognizes neither time nor space. With it we are brought into communion with everything that is grand and beautiful in nature. Imagination is the architect of our souls; it continually creates and projects into the beyond; it enlarges the sphere of our thought in building up artificial structures for our pleasure and entertainment. When it becomes perverted and abnormal from false impressions, either through the nerves of internal sensation or through the nerves of external sense, or, what quite often occurs, from morbid thoughts or ideas received from others, it becomes equally potent in causing misery and disease.

Expectation or attention influences, in a remarkable degree, the bodily functions. There are a great many persons who keep themselves in misery and disease by always thinking of their imaginary or real sickness. I had a profitable experience some years ago in my own case, which conclusively proved to my mind the aggravating tendency which constant attention has on disease. I had contracted an ordinary catarrh of the pharynx, or what is generally called a sore throat. At first I did not mind it, but in the course of time, from continued exposure in all kinds of inclement weather, at all hours of the day or night, it fastened itself upon me so that it was at times very annoying by its dryness and pain. I do not know of anything that I did not use, but, after a trial of several years, I was convinced that the more I looked at it and the more I treated it with sprays, gargles, etc., the worse it became, so that one day I resolved to let it alone, and not think about it. I took a teasponful of glycerine once in a while when it became too dry. For years I have not looked at it, and for all I know, it is perfectly well. I stopped bundling up my neck, used light bedcovering, so as not to sweat, and by this simple method accomplished what the very best selected drugs utterly failed to do.

The great English authority, Daniel Hack Tuke, in his work, “The Influence of the Mind on the Body in Health and Disease,” quotes from Unzer’s work, published in Germany in the year 1771: “Expectation of the action of a remedy often causes us to experience its operation beforehand.” And John Hunter said as early as 1786: “I am confident that I can fix my attention to any part until I have a sensation in that part.” A great number of cases are recorded where complete insensibility to bodily pain has been induced without the use of drugs. The intention of administering a certain drug was made known in this manner. Bread pills have acted as decided cathartics, and an empty chloroform or ether bottle put the sensitive into a profound stupor or insensibility.

Dr. Woodhouse Braine, of the Charing Cross Hospital, writes: “During the year 1862 I was called upon to give chloroform to a very nervous and highly hysterical girl, who was about to have two fatty tumors of the scalp removed. On going into the operating room, it was found that the bottle containing the chloroform had been removed to the dispensary, and on testing the Snow’s inhaler, which at that time I was in the habit of using, I found it to be quite devoid of even any smell of chloroform. Then, having sent for the bottle, in order to accustom the girl to the face-piece, I applied it to her face, and she at once began to breathe rapidly through it. When she had done this for about half a minute, she said, ‘Oh, I feel it, I feel I am going off,’ and as the chloroform bottle had not arrived, she was told to go on breathing quietly. At this time her hand, which had been resting across her chest, slipped down by her side, and as she did not replace it, I thought I would pinch her arm gently to see the amount of discomfort her hysterical state would induce her to bear. She did not notice a gentle pinch, and so I pinched her harder, and then as hard as I could, and to my surprise I found that she did not feel at all. Finding this was the case, I asked the operator to begin, and he incised one of the tumors, and then, as the cyst was only slightly adherent, peeled it away. At this time I had removed the face-piece, and, wishing to see the effect of her imagination, I said to the operator, who was going to remove the second tumor, ‘Wait a minute; she seems to be coming round.’ Instantly her respiration, which had been quite quiet, altered in character, becoming rapid as when I first applied the inhaler, and she commenced moving her arms about. I then replaced the face-piece, and her breathing again became quiet, and she submitted to the second operation without moving a muscle. When the water dressing and bandages were applied, in answer to the question as to whether she had felt anything, she said, ‘No; I was quite unconscious of all that was done.’” The mental phenomenon that we observe in this case clearly shows how completely the sensation of the patient was suspended by the imaginary chloroform, which existed only in her mind, yet the real drug could not have been more potent in its effects.

Phenomena of the same mental process, like the different colors of the solar spectrum coming from one source, constitute the different stages or degrees of what is generally called mesmerism or somnambulism, until the sensitive arrives at that condition of complete double consciousness now commonly called hypnotism, in which state the will power of the person becomes entirely suspended, so that he acts only from suggestions of another person, regardless of propriety or consequences. When a subject who has been completely hypnotized is restored to his normal condition, he remembers nothing of what has transpired during the somnambulistic state. We all have acquaintances of whom we speak as being easily led; by that we mean that they have no will or mind of their own. These persons are truly unfortunate, because they are at the complete mercy of every designing person or cunning rogue. They constitute the large army of dupes who support the great number of idle women and lazy men, who claim to be clairvoyants, life readers and fortune tellers. In sickness they are equally as credulous, and when they are a little out of sorts, they would a great deal rather be told that some dangerous or severe illness has hold of them than to hear the truth that, outside of not eating properly, or clothing themselves improperly, or being out late at nights when they should be in their beds, there is nothing the matter with them.

These are the dupes who fill up the chairs in the doctor’s waiting rooms, on regular days, for local or special treatment for diseases which could be much better treated by themselves at home, if they only were fortunate enough to fall into a physician’s hands who had the honesty to tell them so. This can be further illustrated by an experience of which every one of us has been a victim at least once in our lives. When we were trying on a pair of new shoes, we felt that they pinched, or were too short and generally uncomfortable; but the salesman insisted that they were a “perfect fit” and that after a little wearing they would surely suit. The shoes were bought, and we were convinced, after a few days, that our impression of the smallness of the shoes was correct, because they continued to pinch us; but we were for the time mesmerized or psychologized by the clerk into buying what we were satisfied in our own minds to be not what we wanted. This should be constantly guarded against, and our conscious will power should always be exercised on all occasions.

Parents should take particular pains to cultivate the will power of their children, in the right direction, of course. To stifle the will of children, when the exercise of it entails no bad consequences, is wrong, because it weakens their character, and makes them the prey of the wicked and selfish when they are grown to adult age. This influence which one person may exercise over another is not due to any particular force or magnetism, as was supposed by Mesmer, and which is yet claimed by ignorant frauds and pretenders, but it is simply a suspension of your own will, or a sacrifice of force of character. Dr. J. M. Charcot, of France, has lately taken up this subject, and has given it a great deal of attention. His researches have confirmed the experiments and conclusions of Braid, an English surgeon of Manchester, who, in 1841, showed that, in order to produce artificial somnambulism, there was no need of any extraneous influence, and that any person of moderate sensibility can easily produce in himself the “magnetic sleep” without any aid or act of another.

Braid discovered that to simply fix the eyes for a few minutes on some shining object, placed a little higher than the ordinary plane of vision, and five or six inches from the eyes, caused that total abstraction which Doctor Braid called “hypnotism,” and which now, in honor of the experimenter, is often called “Braidism.” This Doctor Charcot calls “impersonal” sleep, artificially produced by mechanical means. He remarks: “The psychic characteristic of the state of somnambulism is an absolute trust, a boundless credulity on the part of the subject toward the one who has hypnotized him. Take one example from among a thousand: I present to a woman patient in the hypnotic state a blank leaf of paper, and say to her: ‘Here is my portrait; what do you think of it? Is it a good likeness?’ After a moment’s hesitation she answers, ‘Yes, indeed; your photograph! Will you give it to me?’ The image being now fixed in her mind, I take the leaf of paper, with a private mark, and mix it with a score of other leaves precisely like it. I then hand the whole pack to the patient, bidding her to go over them and let me know whether she finds among them anything she has seen before. She begins to look at the leaves one after another, and as soon as her eyes fall upon the one first shown, she exclaims, ‘Look! your portrait!’” This is the latest phenomenon, and proves how the mind may print an image on a substance, as the sun prints on a negative.

For persons of casual thought or reading, hypnotism may at first appear complicated and mysterious, but if you will only bear in mind that the different mental processes operating between two persons always resolve themselves into a weaker will power yielding and a stronger will power controlling, you have a key which unlocks the different manifestations of minds in their relations one with the other. This does not relate to action alone, but to the creation and meaning of our thoughts.

The cures effected by the royal touch, which prevailed in England from the time of Edward, the confessor, to Queen Anne, were but a disguised hypnotism, or a sort of mind cure. Soothsayers, or magnetic healers, who claim a healing magnetism, are either knaves or fools, and often both. They undoubtedly can report cures, but these are due to the natural tendency of some diseases to get well, and to the hopeful thoughts which these persons inspire by their promises of a cure; sometimes these hopes are heightened by the different movements or passes which the healer makes. The greatest healer of whom we have any reliable record never claimed any abnormal power or force. Christ healed by the Word, that means by the thought or mind. Faith in anything creates a curative or healing thought in the mind of the patient, which stimulates the reparative or healing force of nature, and in this manner wonderful cures are effected.

The faith, or confidence, which you have in a physician stimulates you at once into a better or stronger feeling. This has been the experience of every sick person, but this is not due to any power or force that this person possesses, which departs from him and goes over to you, but is entirely due to the confidence, which stimulates your own nerve centers, and especially the brain. The soothing and quieting influence which the “Weapon Ointment” had on the injured person was not due to any virtue of this ointment, because it was never applied to the wound, but to the weapon or implement which caused the wound. Its operations were entirely mental or psychical. It pacified the excited and anxious mind into the faith or belief that the best possible thing to do was being done, and nature went on triumphantly and effected the cure, for which, of course, she never got any credit. When a doctor or healer enters the chamber of the sick, putting on a wise air, or indulges in affectation, and when he succeeds in making a good impression, that alone assuages the pain. But if, on the other hand, he impresses his patients unfavorably, the sooner he gets out of their sight, the better they feel, because his presence has inspired neither confidence nor hope.

Hysteria constitutes a peculiar group of diseases which belong to that class of nervous ailments that are included among functional affections; they are oftener amenable to faith or mind cures than to drugs. A great number of diseases of women belong to this class and these poor deluded creatures never had anything real or serious the matter with them, until they went to some doctor who began to apply irritating drugs to their delicate organs, which made them ever afterwards habitues of doctors’ offices.

Functional diseases have a wide range. As their name implies, they are characterized by a disturbance of the function of an organ or system, without any visible alteration of its tissue or texture; there are no pathological or histological changes, which the most careful microscopic examination can detect. They constitute a scapegoat for our ignorance; it appears to be in the majority of instances a disturbance between the psychic or spiritual forces as they operate on the tissues. The normal and harmonious relations between the mind and the body or any particular organ are disarranged. Such are the hysterical convulsions or spasms which we see in women who have suffered great mental strain, especially grief, and often it is due to pure “cussedness,” or unbridled passion. In men there is also a hysteria; it was formerly believed that this peculiar nervous derangement was confined to women only, hence the name, but this was an error. I was once called to attend a physician of more than average ability, who located in this city for the purpose of enlarging his field of labor and usefulness; from where he came he had been very successful. His reputation as a surgeon was enviable and deservedly so, but here, in this city, among strangers and strange customs, he was a failure. This preyed on his mind so that he became despondent and gloomy. He failed in flesh and strength. I found him in his room convulsively sobbing, which shortly turned into a paroxysm of laughter. I prevailed upon him to return to his former residence among his friends and admirers, which he did, and he told me afterwards that from the moment he struck his “old stamping-ground” he felt stronger and better, and shortly recovered his former mirth and healthfulness.

Girls show this abnormal nervous function in different ways. I have known a case where a sensitive girl accidentally saw another girl in an epileptic fit; the contortions became so real and fixed in her mind, or imagination, that they were transmuted into motions or epileptic fits. I tried remedies but without any beneficial results. The parents afterwards went the rounds of the “fits doctors,” but with the same negative results. A Christian scientist or faith healer cured her, by cultivating or strengthening her will power.

There is a class of these faith healers, composed of silly, loquacious women and men, who know nothing at all of the principle governing their cures, and they glibly tell their patients, “You must say or think there is no disease, or I have no pain, or there is no body; all is well; all is good,” and a great deal of similar nonsense. All is not good, and all is not well by any means. I would say, Indeed there is pain, disease, and a body, but by striving to live a healthful moral life, and thinking healthful thoughts, of the good, the pure, and the beautiful, the curative energy of nature will become stimulated to repair the defects, to harmonize the functions and dissipate disease.

A person who is troubled with dyspepsia cannot get well if he thinks of nothing but an acid or sour stomach, or feels the food disagreeing with him before he has it in his mouth. He must have thoughts quite remote from these, and the chances are nine out of ten he will not feel what he eats. There is the same state of mind about “catching cold.” Some persons are forever on the alert to catch a cold, and why should they not, when they are always watching out for it? If you dress so that you do not sweat, and do not use too thick bedcovering, and are not constantly on the catch or lookout, I assure you you will not catch cold, nor will it catch you.

Terror or fright causes or cures diseases. Dr. Toad reports the case of a boy, in Tuke’s work, nine years of age, who was frightened into chorea, or St. Vitus’ dance, by his sister, who had covered herself with a white sheet and appeared before him unexpectedly, while he was in bed. I know, also, a case of functional bladder weakness of a child who wet his bed at night during sleep. There appeared no signs of any local disease, nor was any remedy which I employed of the slightest advantage. The father of the child, becoming exasperated, gave the child a severe thrashing one morning. The mother remonstrated at what she considered cruel and useless chastisement. But, strange yet true, that child never wet the bed after that; it was entirely cured by fright.

Sympathy will often make persons sick; of this I had in my own experience an opportunity for a very interesting observation. It was the husband of a woman who had been retching and vomiting incident to the early months of her pregnancy. So great was the sympathy of her husband that he retched and vomited exactly like his wife, not only when in her presence, but when separated from her, the impressions or thought exciting the excito-motor nerves of the stomach. This sympathetic sickness lasted as long as that of his wife.

Dr. H. C. Sawyer, author of “Nerve Waste,” has kindly shown the writer another form of functional or hysterical disorder, which was, or is even yet, considered by many general practitioners a scrofulous enlargement of the joints; but the doctor discovered the peculiarity of metastasis, which means a sudden or complete removal of a disease from one part to another. This gave the disease what he termed a hysterical or functional character. It would be the swelling of the elbow of one arm and the knee of the opposite side at one time; and in the course of a few weeks or months these would feel and appear entirely well, while the disease had located itself in other joints. This case the doctor considered could be only reached through the mind, or some faith cure. He further believed that many of these enlarged and swollen joints among the wealthier classes were due to a nervous trouble. Indeed, it would be an easy matter to cite case after case, from my own experience, or quote cases from the highest medical authorities, illustrating in every conceivable manner how the mind, the imagination, the emotions, or the different passions, are continually causing disease and suffering.

It must naturally follow that what is potent to induce diseases will, under different conditions, be a means of curing them.

A serious question now arises with reference to the selection of cases suitable to mind-cure treatment. Bigoted fanaticism is quite incompetent, so are the great majority of spiritual healers, owing to their absolute ignorance of the scientific aspects of disease. The first prerequisite for intelligent and proper treatment is to establish the precise nature of the disease under consideration. It must be distinctly grouped or classed, whether it be a functional or hysterical disease, or a zymotic or contagious affection.

In diphtheria or typhoid fever mind cure subserves no purpose; the treatment must be avowedly antiseptic and stimulating.

If it be a physical injury, say a fractured bone, it must be treated on mechanical principles.

A woman suffering in the pangs of labor, which is being delayed from some abnormal position or some other physical obstruction, can only be delivered through mechanical methods; and here the enthusiastic mind healer may commit serious errors, sacrificing limb and life by unnecessary delay. So I would lay down this broad maxim, that the mind healer must either be a competent, educated physician, or a physician should be a competent metaphysician.

Note.—In the year 1887 Mrs. A. C. Hurrell was a healthy, middle-aged woman and the mother of two children. When the youngest was ten months old she contracted a severe cold. The coughing spells “took her breath,” and from these exaggerated expiratory paroxysms she drifted into spasmodic asthma, at least that was the diagnosis of prominent medical men of Sacramento and of this city. Change of climate was advised and tried, so were also the different drugs which experience had taught to be useful, even operations were performed on her nasal passages by enterprising specialists, but all to no purpose. Morphine was prescribed by the first medical attendant, and when her suffering became unbearable she had to fall back on this drug for relief. In May, 1890, I was consulted, but a most careful examination revealed nothing which I could assign as a cause and upon which to base a hopeful treatment.

In October, 1891, she was persuaded to take treatment from a lady who claimed to cure through Christian Science (a mind healer). The treatment commenced on a Thursday afternoon. The lady impressed on her that the morphine, of which she now consumed, hypodermically, the enormous quantity of ninety grains a week, was injurious, and that if she made up her mind that there was no disease the asthma would leave her. Friday night the patient was in great agony, both from the withdrawal of the drug and the asthmatic attack, and this double pressure weakened the faith of both patient and healer, but the husband stood firm and insisted that she have no morphine. The struggle for breath and the narcotic continued until four o’clock Sunday morning, when she began to get easier; the improvement continued, and in ten days she had “outgrown” both. I saw her two months later, entirely recovered, and the most brilliant specimen of the efficiency of mind cure that one could wish to see.

CHAPTER IV.

GENERAL CAUSES OF UTERINE AND PELVIC DISEASES OF WOMEN.

Why are womb diseases so prevalent? is a question which we are not infrequently called upon to answer. At first sight this would strike one as a casual or commonplace remark, but a moment’s reflection makes it one of vital interest, for a truthful and intelligent reply lays bare the causes which undermine the health, strength and character of the mothers of our citizens, and when a disease of this sort becomes common, it threatens the morality, health and life of our nation.

The causes which operate in producing these diseases of the female differ widely in their origin; some are due to ordinary imprudence, while others are deeply rooted in moral depravity and marital abuses and for this reason I consider it convenient to arrange them into three distinct classes or groups.

The first class is characterized by comprising those causes which are for the most part accidental. They are peculiar to confinement and motherhood, and may be in a great degree controlled or averted by the skillful and competent accoucheur. They have principally a scientific interest, and do not fall within the scope of the non-professional reader.

The second class is entirely beyond anyone’s control. The causes belonging to this category are innate to the human organism; they induce those numerous afflictions which here and there sprout up in previously healthy persons, and are, in all probability, due to some specific hereditary taint. They are to be attributed to the natural imperfections of humanity, and are a constant reminder that the body is simply the transient abode of the soul, or spiritual man, and as such only perfect in its imperfections. Like the causes of the first class, these, too, have principally a scientific interest.

The third class of causes of uterine diseases constitutes a very large group, and has a popular or general interest. For this reason it should be freely discussed, because the causes of this class are avoidable.

They are entirely within the control of the average sensible person, and for that reason should be known and understood by everyone. These causes superinduce inflammatory diseases, which are not confined to the womb alone but take in the entire pelvic appendages, the Fallopian tubes and ovaries. They are the greatest source of revenue to the doctors, and vary in symptoms in different persons, from a slight casual reminder of something wrong to harassing pains and physical suffering; and that these all are brought about through ignorance, wanton carelessness, or sinful disrespect of nature’s or God’s law, is the characteristic feature of the causes under investigation.

Exercise in the open air is so essential in strengthening the nervous and muscular systems that where this is neglected it predisposes to womb disease. I consider the differently-devised indoor or room calisthenics or exercises as totally inadequate and no substitute whatever for healthful outdoor movement, and for the following reason: that while it irritates the muscular and nerve fibers, it lacks the stimulating and tonic influence of pure oxygen-laden air, so that the blood becomes still more deteriorated and overloaded by excessive waste material, which is not thrown off. If a person exercise at all with a view of deriving physical benefits, let it always be in the open air. Like walking, riding, rowing, to which bicycling should be added as one of the very best of outdoor exercises, the mind can then be engaged at the same time, though it must not be overstrained. The great obstacle nowadays arises from a fashionable and morbid desire to cultivate an appearance of delicacy; if, instead, recreations which required muscular exertions were more fashionable, the results in developing strong and hardy women would be astonishing.

No exercise can be profitable which is not interesting to the person who practices it.

It is not the bodily exertion alone which can profit a person, but the happy associations, the abandonment of self thought, the mental relaxation, and the pleasure which accompanies it. With one or two companions we can have a jolly time, while taking a swimming bath or floundering in the surf, but alone it soon becomes tiresome. If we take a stroll with an agreeable companion, we can walk a distance which, when undertaken alone, would fatigue and tire us completely out, while, when with an associate or friend, we cover the same distance refreshed and invigorated, because the mind is entertained while the body is exercised. This must have been the experience of everyone, and if it teaches anything worth remembering, it teaches that monotonous exercises should be avoided and entertaining ones sought and practiced. Walks over hills in small, friendly groups is one of the best modes of exercise I know of. And then there remain the many outdoor games. The pernicious systems of training which are observed in some female seminaries often plant the seeds for future disease. All the school hours are employed in reading, drawing, music, and other brain work, while the evenings are devoted to preparing lessons for the following day. This is very injurious, and should never be permitted.

After school hours the mind should have complete respite from study, so that the forces can recuperate themselves for the next day.

Nervousness or neurasthenia is often a result of this excessive mental application. Where the mind is constantly engaged in intellectual pursuits, the result often is a too rapid development of the brain and nervous system.

When the thoughts and memory of girls of tender age are too long and too laboriously engaged, there will be an abnormal development of the nervous centers; they will grow or develop beyond the muscular or physical strength, and a morbid impressibility, great feebleness of the muscular system, and a marked tendency to disease of the pelvic organs, is established. Parents may refer with pride to the precocious talents, the refined and cultivated tastes, of their daughters, as qualities to be admired and appreciated, but without a physical substratum it is a dreamy delusion. It would be much better for the children if their parents took more pride in rotund figures and robust constitutions, for these would ever be a source of joy, while the cultivated talents, especially at the expense of their health, will not only be of little practical value to them in after years, but often incapacitate them for wives and mothers, by making them restless, discontented, and physically unfit for maternal functions.

There is entirely too much scholastic education imparted to our girls, and not enough domestic education. I believe that the most favored should not have too much of one and not enough of the other, because if parents do not prepare girls for household duties in early life, they run desperate chances of laying the foundation for a failure in the remote future.

Children must be constantly reminded that they are in this world to serve a useful purpose, and that co-equal with every accomplishment is a utilitarian training.

We take a pride if our boys trade pocketknives, especially when our own gets the better one of the two, because we appreciate the natural business trait. He will be no less a good candidate for some of the learned professions, and, indeed, it has come to this, that material success in the professions depends as much on shrewd business tact as it does upon proficiency in professional attainments.

The knowledge or even wisdom of a person is of no earthly use to himself or the world if he or she do not possess the faculty of letting the people know of this superior wisdom; and that is why some persons often become more celebrated and even renowned than others, who are intellectually their superiors, because the former possess the faculty and cunning to make people believe in their superiority. By this I simply desire to impress upon parents not to be over-anxious about their daughters standing first in their class room, but, rather, to be very anxious that they attain a healthy and vigorous growth, and that sufficient practical knowledge of domestic affairs be imparted to them so that they can creditably fill their mother’s places some day. This I consider the best legacy.

The time to commence to train mothers is from the moment they are born. The minds of parents should be disabused of the false delicacy about this aspect of a girl, and while no one expects daily lectures to be given to children or young girls upon the responsibilities which await them, such information should not be studiously avoided. I insist that this important fact should not be lost sight of, motherhood is the ultimatum of feminine existence.

Mistaken conceptions of woman’s education, in pinning girls to a life of close mental application, is often productive of uterine disease, by lowering the tone of the nervous system; while others who are ambitious to acquire a professional education in later life, fall by the wayside as hopeless invalids.

I do not disparage her capacity to study with equal proficiency the arts and sciences, often with more ardor and closer application, than her male colleagues, but she is simply striving to accomplish that which the men can and do willingly accomplish for her, while at the same time she is neglecting the education of those qualities which are the sole inheritance of her sex, and which man could not usurp if he would.

This class of uterine diseases develops in a few years into melancholy, which closes the windows of the soul to the sunlight of hope, and gradually drags the sufferer into a decline, that nothing but an entire change in the habits and thoughts of the patient will ameliorate or cure.

I would have our girls as independent of our boys as the latter are of our girls. I would have it understood that each, in their specialty for which God and nature has ordained them, is as honorable and important in the social and industrial conditions of mankind as the other. I would give woman the right, and deem it her privilege, to frankly and unrestrainedly profess her fondness or desire to marry the man who she believes would make her a desirable husband, because woman’s intuition transcends man’s reason.

A reform in this direction would, indeed, elevate the woman to man’s estate, where she belongs. A little less sentiment and more sense is a wholesome panacea for some of the abuses of the marital contract.

I fully subscribe to the view that a woman shall at all times receive the same wages for her mental and physical labor that men receive for the same work, but I am entirely opposed to that modern tendency and false social philosophy which is constantly striving to make a man out of a woman. There is something so grossly absurd and unnatural in this artificial readjustment of the natural duties of the sexes, in their industrial and social relations, that it has degenerated in many instances into fanaticism.

Women are organizing everywhere for the purpose of increasing the facilities of their sisters in the studies of science and philosophy. Large sums are offered to the faculties of universities to gain admission to female students on an equal footing with the male students, for the purpose of studying some of the already overcrowded professions. In the main, all this abnormal rivalry does not contribute a single advantage to either sex.

There was a time in the history of civilized nations, and that time is not more than twenty or twenty-five years ago, when an academical education gave an immense advantage to its possessor over his less-informed contemporary, but this is not true in our time, because there is now an overproduction of college-bred men. The man who can decline a Greek noun or conjugate a Latin verb is no longer a rarity, because the sons of European tradesmen and American farmers have deserted the pursuits of their progenitors—which, in the case of the American farmers, is to be deplored—and obtained a collegiate education, that is no longer the inheritance of the privileged few, so that in our time and day an academical education has run to seed among the men. And now the attempt is being made, under the guise of social progress, to burden our girls with the same wisdom that has incapacitated many of our boys from making an honest and independent living. It would be much better for the State if two-thirds of our universities or high schools were changed into manual training schools or polytechnical colleges, where the foundations for the industrial pursuits may be laid, so that labor will be made not only respectable but intelligent.

We would then hear of educated mechanics or artisans, and scientific farmers, which, to my mind, requires the same order of intelligence to excel, that it does in the professions generally qualified as “learned.”

Why crowd our girls, then, into the professions for which they are not only unsuited by nature, but which are already demoralized by the keen competition within their ranks? It is, certainly, an open secret, in the profession to which I have now devoted the best years of my life, that the methods in vogue to get business have descended to the level of the “confidence trickster,” and that, no matter what ability or merit a person may possess, without the natural instincts and elements of the quack and charlatan he can gain neither a livelihood nor fame. This theatrical demeanor of the profession, this aping the gaudy display of European aristocrats by riding in closed coaches, driven by liveried coachmen, is but the outward symptom of the internal disease of contention for notoriety and success.

If, instead of all this false and demoralizing philosophy, termed “woman’s rights”—which is more appropriately designated “woman’s wrongs”—we turn the thoughts and ambitions of women towards domestic economy and domestic virtue, which alone should be and ever will be the ideal of noble womanhood, there will be, then, much less disease, more happiness, and less discontent. There is enough on God’s earth for all of his children to eat, wear, and work, if the labor and the subsistence are fairly and wisely apportioned.

The growing sentiment, which is as vicious as it is absurd, is that a girl, to be educated or accomplished, must be either a teacher, lawyer, or doctor, or anything else except an accomplished housekeeper, just as though it required less talent or ability to raise a child, cook a wholesome or digestible meal, and cut or sew a garment.

Why, there is much more thought and judgment required in making an angel mother than in administering or prescribing a dose of medicine and filing a legal brief, and there is not a lawyer or doctor who has given sufficient thought to the duties and requirements of maternity who disputes it for a moment. If our strong-minded women would preach this doctrine, which would tend to make household duties respectable, they would be benefactors instead of mischief makers, and then our comely girls would prefer to cultivate habits of domesticity, which should and would become as honorable an occupation as that of a doctoress or lawyeress.

Improprieties of dress are to be found in excessive or deficient clothing, in an improper adjustment, and in an inherent defect of the undergarments. I will reserve some of my views on these questions, for the chapter that is devoted to hygienic measures. In the main, the custom or manner of dressing women in Christian countries does not deserve that sweeping denunciation that some radical dress reformers make. I would not, if I could, change the very becoming and graceful modern female dress, for it possesses the merit of displaying the beauties of the figure in a modestly delicate manner, and it hides its defects from the vulgar gaze.

As a rule, there is too much pressure on the abdomen, from the weight of heavy skirts that are suspended from the hips, and not sufficient room for the chest to expand, so as to accommodate the respirating movements of the lungs. In the absence of shoulder bands, to which the skirts should all be fastened, the much-decried corset has its redeeming qualities, for it serves the purpose of a yoke or support for the different undergarments, and when not tightly laced is rather a benefit than an injury, and if the corset had a shoulder strap fastened to it over both shoulders so as to keep the garments from dragging on the hips, there could then be no objection to it whatever. The corset must always be so loosely worn as to permit the wearer’s hands to be easily passed between it and the waist. It then becomes a useful brace to a weakly woman and entirely harmless to a strong or healthy one. We can imagine how a tightly-fitting corset will cause mischief by compressing the ribs and abdominal walls, and that this absurd fettering will prevent the lateral expansion of the chest, and also injuriously press upon the internal organs, but this is not due to an inherent property of the corset itself, but to an abuse of it. One might as well advocate a return to the Roman sandal, on the ground that some persons are foolish and vain enough to wear shoes altogether too small for their feet, thereby causing deformities and corns. For my part, I admire a nice, well-shaped, healthy foot, incased in a low, broad-heeled, comfortable shoe, even if its size were one or two numbers larger than a pinched-up, deformed one. But no one would be enthusiastic enough on the question of healthy feet to have us all wear sandals again.

Warmth of the lower extremities is a very important point in a female’s apparel, and of more importance than all the other questions raised on this subject. The exposures endured by women, from ignorance or indifference to this fact, is, in my experience, a fruitful source of disease. The chilling blast which sweeps under the skirts must be mitigated and the moist vapor arising from a damp and cold earth neutralized. If the limbs are only protected by thin cotton fabrics, they are insufficiently clad to avoid the evils above mentioned. It is of the greatest importance that the limbs of women should be incased in flannel drawers, and these can be worn underneath the white muslin or linen ones, and the hose, especially in cold or damp weather, should be made of woolen material; the soles of the shoes should be sufficiently heavy so as not to be permeable by the moisture from the ground, and in wet or rainy weather rubber overshoes are always a necessity. When the feet and lower limbs are kept warm, the whole body is more or less protected against cold.

Superfluous or too warm garments are the cause of an endless variety of diseases. The rule is this, that any garment which by its weight or thickness excites perspiration when the wearer sits quietly or exercises moderately, is either superfluous or too thick or heavy, and, as perspiration relaxes and softens the skin, it makes one susceptible to take cold. It is reported on good authority that sealskin wraps cause more deaths among those who wear them than typhoid fever and for the reason above mentioned. Loosely-woven woolen goods make the best wraps and the best underwear. If we were called upon to state a single proposition which we considered of the greatest importance in preventing disease, we would frankly say that, next to an irregular and unwholesome diet, excessive clothing is the most mischievous factor in causing or predisposing to disease.

The same rule applies to bedcovering; if it be so heavy as to make the sleeper sweat during the night, he is almost sure to take cold from the sudden change, from a warm, moist bed to the cool room or comparatively chilled clothing.

Imprudence during menstruation. A heedless disregard, ignorance, or carelessness of the precautions above referred to is, during the catamenial days, quite sure to lay the foundation for disease. Every practitioner has met with a great number of cases where the disease originated during menstruation from some indiscretion, and it ran on for years, until a condition of affairs was developed which was well-nigh incurable.

The female organism is particularly sensitive about this time and much easier affected than at any other.

During this period the ovaries and uterus are intensely congested, and the Fallopian tubes which connect the former with the latter share this condition, and if a cold should suddenly check or interfere with the natural functions of these organs, it might result in inflammation of the ovaries or in a catarrh of the tubes and womb. Any one of these conditions is painful and often troublesome to cure, but when all these organs are complicated in the diseased process, which we frequently find to be the case, it may entail serious consequences.

Dysmenorrhea, or painful menstruation, will be a prominent symptom, if any of the above organs have suffered from imprudence, during this period, and I have known of cases which gave me no end of trouble before they were restored to health.

Measurements of the healthy uterus. In a grown person the average length is three inches, two inches in breadth and an inch in thickness. It weighs from an ounce to an ounce and a half. The size of the uterus is an important guide to the physician in establishing the presence or absence of certain diseases.

In the child-bearing period measurements and weight change, because the organ grows correspondingly large to accommodate the growth of the child.

Growth of the uterus from the moment of conception is one of the most interesting physiological studies. All its tissues, muscles, nerves, vessels, and lymphatics are increased in bulk and multiplied in number. The human ovum is an extremely minute microscopic cell, from one two-hundred-and-fortieth to one one-hundred-and-twentieth of an inch in diameter. This grows so rapidly that at the end of nine months we often have the average nine-pound baby. The growth of the muscular fibers of the womb is truly remarkable. They grow eleven times longer and twice to four times thicker, so that the growth of the womb keeps pace with that of the child.

Changes immediately after confinement. Women as a rule, and their husbands also, are wofully ignorant of the condition of the womb just after confinement, and at this point it will be opportune to impart the necessary information illustrating that it is one of the most critical periods of the entire process, because the pelvic organs are again very sensitive, somewhat akin to the menstrual condition, namely, one of engorgement, or congestion.

After the child is in the world, the uterus usually contracts to about the size of a cocoanut; its measurements and weight as compared with what it was before pregnancy have materially increased.

The diameter is now about four inches, and its weight a little over two pounds. If we now stop to reflect that its weight was formerly an ounce to an ounce and a half, to which size and weight it must again return, we can readily appreciate the important changes that must take place to accomplish this object. The scientific world has only learned how this is effected within the last thirty years. It was a very important discovery. The superfluous or excessive tissues are converted into fat—the process is called fatty degeneration—and as fat the tissues are absorbed into the blood and disposed of, and thus gradually is the superabundant substance removed, until its measurements are as they were formerly and its weight as it was before.

Involution is the name given to this process by medical writers. It signifies a rolling back of the size and substance of the womb to where it was before pregnancy. It is the physiological activity in the tissues of the organ to restore it to its former size and healthfulness. The time usually required for nature to accomplish this remodeling varies in different individuals from six weeks to three months.

Subinvolution is a term employed to designate a partial or complete cessation of this restorative action. The prefix sub means always under; in this case the same thing is meant, under-involution or incomplete involution.

When, in six weeks to three months after confinement, the womb has not returned to its previous healthy size, weight and state, or if the enlargement of the womb incident to pregnancy lasts longer than already specified, we have the disease termed subinvolution. It generally becomes complicated with inflammation of either the cavity of the womb or of its entire substance, and often the inflammation extends to all the other organs and tissues in the pelvis.

Indiscretion in getting up too soon may cause this state of affairs. Taking cold and excessive exertion should be guarded against.

A mother who has just been delivered must gradually feel her way as to how much and what she may or can do without jeopardizing her recovery. Pains in the pelvis, back, and thighs, or a heavy, dragging sensation after getting up, indicate a subinvolution. These symptoms should be attended to, because the longer they last the more obstinate the disease becomes.

Lying on the back after confinement for ten or twelve days is not only injurious but an unnecessary hardship for every mother. It is one of the most fruitful causes of an abnormal position or falling back of the womb, and very often this excites diseases which greatly complicate the improper location of the organ.

Retroversion and retroflexion of the womb will be considered more minutely later on. It is generally caused by this common error of nurses and physicians, who allow the delivered woman to lie and often insist on her lying on the back. Thus the womb gradually sinks backwards, instead of falling forwards, where it belongs: see Plate IV.

Women will not generally feel that anything is wrong until some time after they are up and around. The first few weeks or months after confinement, persons are inclined to attribute their weakness, pains in the back or thighs, and other disagreeable sensations, to the natural consequences of what they have gone through. But after weeks roll into months, and their former strength and health do not return, then they seek the advice of a doctor, who will disclose to them the cause of their suffering. This can be avoided every time by changing the positions of lying, from one side to the other, and from the back to the stomach for a change; then naturally the womb will gradually resume its normal position, which is inclined forward and rests with its body over and on the bladder. All of these displacements should receive early and prompt attention.

Antiseptic precautions. Only a few years ago this phrase was entirely unknown. It originated with the modern antiseptic treatment of wounds, and from the domain of surgery it has been transplanted into the department of obstetrics, in which the application of antiseptic principles has achieved the most brilliant triumphs. From this conception has sprung the germ theory of disease, which is now, beyond doubt, an established fact.

I never can forget my first case of childbed fever. It is only fourteen years ago, and then there was as yet no one who could give a scientifically truthful interpretation of the disease. My patient was a young mother, who was being rapidly consumed by a fever, but beyond that science had not unlocked the causes lurking in the organism, which had doomed the young woman, on the threshold of motherhood, to a premature grave.

Thousands of lives were yearly destroyed by puerperal fever. Volumes of literature had been written on the subject, but as yet no one had deciphered its origin.

Now the whole scene has shifted; we know that the fever is essentially a blood poison, a septic infection of the patient, precisely similar to a wound infection anywhere else on the body. The act of parturition causes wounds or abrasions; these, then, place the woman in imminent danger of infection of every sort, and it is this infection which it is now possible to avoid. There is the greatest precaution necessary on her part and on the part of her attendants, that she be not contaminated by suspicious-looking finger nails, or dirty hands, or soiled linen, or unhealthy and unclean surroundings.

The German Government has a compulsory law for a system of antiseptic precautions, which is incumbent upon all who attend lying-in women. The importance of a rule to guide midwives and others in carrying out strictly antiseptic measures was recognized in that country some ten years ago, and the statistics show a remarkable diminution of diseases peculiar to the childbed period. The sources of these infectious micro-organisms are very different. They may be derived from the body of another person, sick or having died from an infectious disease, from suppurating wounds and even from the secretions of healthy lying-in patients. The patient or person herself may have improperly bathed or neglected cleanliness and ablutions, but the greatest danger arises from the neglected and unclean hands and sleeves of the midwives and physicians, and from the instruments usually employed under these circumstances, like forceps, catheters, or the nozzle of a syringe. The law above referred to requires all these instruments to be thoroughly scalded, washed, and brushed every time they have been used, and by such a complete system of disinfection, the chances of infection are reduced to the minimum. I hope some day our legislators will be wise enough to give us similar laws.

CHAPTER V.

UNCLEANLINESS AS A CAUSE OF DISEASES IN WOMEN.

The custom of washing and bathing has existed from the earliest times. Among the Egyptians it was a part of their religious worship. Among the Jews it formed part of the ceremony of purification prescribed by Moses. The Greeks considered it a sanitary expedient, and among the Romans it was instituted for similar purposes. All virtues when carried to extremes degenerate into folly or vice, so bathing in the days of the Roman Empire, became immoderate and degenerated into enervating luxury and unbridled debauchery, in which indiscriminate bathing of both sexes was one of the demoralizing features.

The bath was usually taken after exercise and before the principal meal, which rule holds good to-day, as the very best and proper time. The gorgeous splendor of the Thermæ, which was a palatial edifice constructed by Agrippa, was adorned with beautiful statues and fine paintings, while luxuriant green foliage of great variety formed enchanting bowers of fairy splendor. This was thronged by the Roman citizens for the pleasures of gymnastic exercises and bathing.

In those countries which have adopted the religion of the Arabian prophet, Mohammed, people bathe as a part of their devotions, and a religion which has for a part of its ritual the washing of the body, goes a great way towards cleansing the spirit.

Among the Northern nations the introduction of the bath dates back to the period of the Crusaders, although Tacitus speaks of the river bathing of the Germans, which was one of the strengthening methods employed by the early Saxons. That filth and dirt generate crime and moral depravity seems to be apparent, where squalid misery has dulled the sensitiveness to unwholesome surroundings.

Sanitary science has also demonstrated that filth is the most fruitful source of diseases that are called infectious, because their origin is due to germs of the lowest forms of vegetable life. The brightest page in the medical history of the nineteenth century is that which records the discovery of these micro-organisms as the cause of such diseases as septicæmia or blood poisoning, pyæmia, diphtheria, tuberculosis or consumption and others. All forms of fermentation and putrefaction are due to the presence of some germs, and upon this fact antiseptic surgery bases its scientific premises.

The germ theory of disease, like every new discovery, which supplants the accustomed and deeply-rooted theories of the speculative philosophers, met with opposition, criticism, ridicule and misconstruction, but the brilliant achievements of Lister and Koch have established its founders upon a pinnacle of fame, which promises to be an immortal monument to their genius, and not only in surgery has its beneficial influence been exerted, but the entire field of medicine has been enriched by the germ theory, which plays so formidable a part in the causation of many diseases.

The great boon that medical science will confer upon humanity, in the future, will not be so much in improved methods of treatment, as in the means and methods which medical science will devise for preventing disease. One ounce of prevention will always be worth a pound of cure. When we look back fifteen or twenty years, we must even now acknowledge that preventive medicine has accomplished greater results than curative measures, because the former can be made in the very nature of things absolute, while curative agents are only relative. Puerperal, or childbed fever, which is an infectious disease, was at times a pestilence, which destroyed women by the score, in maternity hospitals, or in certain neighborhoods, by the infection being carried by midwives or accoucheurs from house to house, yet no one had the least suspicion that it was possible to carry the germs of this disease under the fingernails of the attendant, or on the clothing or a syringe, or on some other little instrument, from one patient to another, and, indeed, there are a great many to-day who are practicing midwifery who are still ignorant of the importance of refined cleanliness.

But for this ignorance, there is no longer an excuse, because the infectiousness of this and other diseases is so positively established, and even the physical characteristics of the micro-organisms have become familiar to the microscopists. This knowledge of the causation of puerperal fever has been applied to the employment of preventive measures, so that this dreadful malady is becoming a rarity, particularly in countries where scrupulous care and cleanliness are enforced by governmental rules and regulations. I refer to this particular fever, because it is, to my mind, one of the most brilliant illustrations of the efficacy of preventive or antiseptic medicine.

There is a gynecological hygiene with which women should become familiar; it is based on the principle of antiseptic precautions applied to the daily lives of their sex. The object of this is to keep the body and reproductive organs that are exposed to contamination or infection from the outer world in the most refined and scrupulous cleanliness. The vaginal douche or syringe is as important an auxiliary to a refined woman’s toilet case as her tooth brush, because the cleanliness of the genitals is as essential to the preservation of health and comfort, as the possession of a sweet breath and the preservation of the teeth. I am therefore convinced of the hygienic value of familiarizing little children with washing or sponging their external genitals; in a few years this will have become second nature, and they are thus protected for all future time from contracting diseases which have their origin in personal uncleanness. It behooves mothers to avoid all delicacy on this subject, so that their little ones may grow up with the sentiment that to the pure in heart all things are pure. It is false modesty and ignorance which degenerate into vice and excesses; the scientific truth is always pure and holy, because it is based on reason, while abnormal delicacy is only emotional, and is quite likely to shoot into the other extreme, namely, licentiousness.

As the world grows wiser, the physiology of the reproductive organs should form a part of its wisdom, and in proportion to this knowledge, will their functions become questions of sense, instead of sentiment and nonsense.

The vagina is a membranous canal. It is situated in the cavity of the pelvis, below and behind the bladder, and in front and above the rectum. Its direction is curved from before backwards and a little upwards; its walls are flattened and ordinarily in contact with each other. Its length is about four inches along its anterior wall, and an inch or two longer along its posterior wall. In introducing a nozzle of a syringe it must always be remembered, that the tube is to be introduced directly backward on a horizontal plane with the body in the erect posture; by attempting to introduce it directly upwards, you meet with resistance from the anterior wall of the vagina.

In this cavity the secretion is susceptible of decomposition, owing to the accessibility of air laden with germs, which excite fermentation. A day or two after the cessation of the menstrual flow, there still lingers a little blood in the cavity of the vagina; this becoming infected with the germs in the vagina, a decomposition is the result, which is recognized by an offensive smell. The naturally soothing and harmless secretion is now changed into an acrid, irritating fluid, which not only may cause an inflammation of the membrane of the vagina, but also excoriate the skin at the orifice of the canal.

Leucorrhœa, or what is commonly called whites, is the most distressing symptom of this condition. In the course of months or in some instances a few years, the inflammation spreads from the vagina to the mouth and lining membrane of the uterus. Inflammation of the endometrium or lining of the womb will excite another complication, the so-called ulceration, but more correctly termed erosion. Who will deny the usefulness of any advice that will teach girls or women to avoid all these diseases? It is all contained in the simple phrase, Keep clean. Young girls must be taught by their mothers or guardians, not only the necessity of keeping the external genitals clean by daily ablutions, but a few days after menstruation, upon the slightest indication of offensiveness, she must resort to the employment of the vaginal douche or syringe, so as to wash out the seeds of disease, that are rapidly multiplying themselves, and if allowed to remain will entail the consequences to which I have already referred.

As an antiseptic wash, there is nothing so simple, efficacious and healing, as a solution of borax in previously boiled water, that has been allowed to cool to the proper temperature, which is between 103 and 106 degrees Fahr., one teaspoonful of the powdered article to the half gallon of water, to be used as a rinsing for each time.

Directions for administering vaginal douches will be given elsewhere. The proper time of the day for the employment of the wash is always at bedtime; and once or twice a week is quite often enough in the majority of instances.

Married women are more exposed to infectious contamination than single ones, because they are constantly liable to have infectious microbes introduced into the vagina during the ordinary course of marital relations. Men, as a rule, are neither cleanly nor careful in their habits, and approach their wives without any thought of serious consequences in their sexual relations. I had a married woman under treatment for an offensive discharge from her vagina which I traced to her husband, thence to a suppurating wound on his horse, which the husband had under his treatment. This can happen, of course, only through carelessness. By getting some of the matter or pus on the fingers, which incidentally contaminates his person, or not washing and brushing the finger nails, the husband may directly convey the infection to his wife, and thus inaugurate, unconsciously, an inflammation of the vagina, which becomes complicated, as the primary disease is neglected, leading to inflammation of the womb and ovaries, and often to abscesses, that compromise not only the health but the life of the sufferer.

To preclude the possibility of innocent infection, between husband and wife, there is only one means of prevention, and that is a careful toilet, which thoroughly cleanses the bodies in general and the genitals in particular.

Another fruitful source of disease of women, in this country and to an alarming extent in Europe, to which the elder Martin of Berlin called the attention of the profession over thirty years ago, is the specific or gonorrhœal infection of wives by their unfaithful husbands. The number of poor women whose health has been irretrievably ruined, by their husbands having had illicit relations with lewd, diseased women, is only known to those who have made this class of diseases a special object of inquiry. I have nothing to do with the moral aspect of this question, but only with the physical suffering that such men inflict upon their innocent wives and the mothers of their children, for the brief indulgence of libidinous pleasure. To think that any man would take the chances of making his wife a suffering and perhaps incurable invalid, just for the purpose of gratifying temporary animal passions, is to place him beneath the brute creation, which has not the intelligence to reason on the fearful consequences. No man who has been guilty of illicit relations should return to his wife until seven days have elapsed, and even not then until he has repeatedly washed himself by means of a syringe with some cleansing or disinfecting fluid, like borax water, or, what is preferable, a weak solution of the bichloride of mercury.

The wife and mother who entertains the slightest suspicion, must insist upon these precautions, and then not neglect to thoroughly wash and cleanse herself in the manner previously referred to. It is the height of hypocrisy to be mealy mouthed on this subject; the wives and mothers who are fortunate to have husbands beyond suspicion, should learn that some of their sisters have dangers to encounter and heartaches to suffer, with which their own lives are not marred, but perhaps the lives of their daughters may be; for the unhappy woman who becomes the wife of the blear-eyed sensualist, there is only one relief, and that is education in these subjects.

I know of no disease in which a correct and early diagnosis or recognition is of greater importance to avoid the frightful consequence and serious complications, than this one. It begins with a mild vaginal catarrh, which, when it is as yet locally confined to the vagina, can be easily cured. In course of time it spreads itself along the vaginal tract to the cavity of the womb. When it gets there, the treatment becomes more complicated, and for this reason; in order to reach the disease now, the cavity of the womb must be dilated, and this is an operation which the average physician can only accomplish in a bungling and imperfect manner. But even in this stage of the disease, in the hands of a skillful physician, the course of the disease can be checked and the patient readily cured. When the disease gets beyond the womb, when it invades the Fallopian tubes and the ovaries, the picture has entirely changed.

The organs affected are then inaccessible to local treatment, so that the disease invariably continues until the organs are more or less destroyed by inflammation, which results in the tissues breaking down into an abscess. In this stage of the disease it has become quite the fashion to operate in this class of cases, offering as an excuse a sure and speedy cure. Here I would interpose a word of warning to sufferers belonging to this class, not to be too willing to comply with surgical methods, because I know from careful observations, that promises of this nature end often in disappointment and death, while an intelligent conservative treatment can only disappoint but never kill, and with patience and perseverance in the application of electricity and hygienic rules of health, a cure is almost certain. The sick in body and mind are often beguiled into operations of a very serious nature, which are entirely unnecessary, because better results can be accomplished by other methods of cure, in which the possibility of a fatal termination is excluded.

Some women feel tired and languid from morning until night; they feel as tired in the morning when they get up as they were in the evening when they retired. If we tell them that it is entirely due to negligence of their own persons in not using vaginal washings regularly, they will undoubtedly feel surprised. In the great majority of these cases, this is owing to putrefactive changes going on in the cavity of the vagina. In the process of fermentative decomposition, the so-called ptomaines are developed; these are chemical poisons, which are absorbed into the blood, and by their depressing influences on the nervous system are the cause of the weakness and tired feeling. There are no remedies which, when taken into the stomach, will do the slightest good for this condition, and it is a waste of both time and money to expect relief from drugs.

This can easily be remedied by cleanliness, so that the secretions are not long enough retained in the vagina, to decompose and develop these ptomaine poisons.

During and after confinement is another important time for the employment of vaginal washes. The lochial discharge, which is one of the ordinary accompaniments of the newly-delivered woman, is a discharge from the uterus, which continues for several days, growing less and less, for a few weeks, when, in a normally healthy state of affairs, it should cease entirely. The lochia is the oozing from the mouths of the blood-vessels of the womb where the placenta or afterbirth was attached, together with the passing off of the old lining membrane of the womb, while the organ is returning to its original condition. At first the discharge is bloody, and it may retain this character for two or more days after delivery; then the color is changed, partaking more or less of a watery nature and presenting a yellowish hue; it then becomes whitish and ultimately ceases altogether. After the first four or five days the lochial discharge often becomes very offensive; this is a sign of putrescence or decomposition, and the only remedy in this, as in all other similar instances, is to wash the vagina thoroughly with borax water, or with a preparation for which a prescription will be given further on.

In every case of delivery, the mouth of the womb is more or less torn or lacerated; this is unavoidable, and it is generally harmless. One of the surgical humbugs is to sew or stitch, or attempt to stitch, these little harmless tears together, not of course for the good it will do the patient, because she is more likely to be injured by this meddlesome surgery, but to make a business and a fee. The common practice of these and kindred surgical expedients is one of the crying evils of an overcrowded profession which is trying to keep itself employed at all hazards.

The vagina also receives more or less injury during an ordinary confinement; if the midwife or the doctor is too meddlesome or in too big a hurry to get through, he will use the forceps, which simply means, to pull the child out and through the vagina, before nature has had time to dilate or stretch the parts sufficiently, to allow the child to pass through the maternal organs without injuring them. As a result of this brutal haste, frightful lacerations are incurred, which require immediate attention, but small lacerations heal without any further treatment than to keep clean.

After every confinement there is considerable sore or raw surface, with which the offensive discharge comes in contact, to become readily absorbed or taken up into the system, giving rise to fevers or inflammations of the womb and other pelvic organs. If one has a wound on any part of the body, the first thought would, or rather should, be to keep it clean; exactly the same treatment is required for wounds of the womb and vagina.

When the discharge becomes offensive, it also becomes dangerous and poisonous, and the only and proper thing to do is to thoroughly wash out the entire vaginal cavity until all offensive smell has disappeared. The only sure sign that anyone can have of the completeness and thoroughness of the vaginal washings, is that there is no longer any fetid or offensive smell perceptible.

It requires no particularly trained nurse or expert to administer a cleansing vaginal injection, yet it is more likely to be done in a bungling, inefficient manner than in a proper workmanlike manner; for this reason, it would be well to remember a few of the necessary details of carrying out the douching. In the first place, the room in which the vaginal douche is administered must be comfortably warm, so as to preclude the possibility of chilling the patient; the windows or any other opening liable to cause draft must be closed. The nozzle of the syringe, whether it be a fountain or a family syringe, must have been thoroughly brushed and cleansed with soap water, before and after each use; if the instrument is old, or has been used for questionable purposes, or, perchance, made the rounds of the neighborhood, it had better be thrown into the ash barrel, and an entirely new syringe, the “Alpha,” be employed, which, by its sure and continuous stream, I consider the most suitable female syringe. The bulb of a syringe must be compressed in the palm of the hand slowly and deliberately.

The position of the patient is of considerable importance; a vessel is placed under her, which is carefully adjusted, so as not to tip too far backwards, otherwise it will overflow and drench the bed or the patient’s clothing. Beneath the small of her back a few extra pillows are placed, and thus she comfortably reclines on her back, while the attendant manages the disinfecting wash and syringe, placed in a basin between her thighs. Half a gallon of the fluid is usually sufficient. The temperature of the wash is very important and may range between 103 and 106 degrees Fahrenheit.

The recumbent position is only intended for women who are confined to their beds; others, who are around and about on their feet, can sit comfortably over a chamber, on the edge of a low chair, having the vessel underneath them, and the wash of course in a separate basin. In the course of my experience I have been called to mothers, five to eight days after delivery, who were in a raging fever, presumably from the ptomaines which had developed in the vagina and poisoned the blood. After a few vaginal injections, sometimes after the first, the fever subsided entirely. These remarkable results we owe to the antiseptic treatment of disease, and when it once becomes generally known that this is only another word for cleanliness, infectious diseases will grow correspondingly less, and the cure for those that exist will be less experimental and more reliable.

CHAPTER VI.

MARITAL EXCESSES AND PREVENTION OF CONCEPTION.

In a previous chapter, the physiology of conception was explained, and it was shown to be an organic function, independent of and remote from the sexual act, and over which the parties to the act have no control. From this scientific statement of the actual fact, it becomes at once apparent that conception or pregnancy may result without natural sexual congress, by simply injecting the sperm of the male, by means of a uterine syringe, into the womb of the female, while she is in a state of unconsciousness. It is also quite probable that a criminal conspiracy of this nature could be carried out, without any violation to the delicate anatomy that is involved in the natural process; a detailed account of all the probabilities which the ingenuity of a scientifically-trained mind could devise, belongs more properly to the department of medical jurisprudence. It is, however, of sufficient general importance that the reader should have at least an idea of the door that has been unlocked through physiological researches.