( Originally Published 1918 )
IN order to take proper care of herself it is necessary for every woman to have a more or less complete understanding of the special functions of her reproductive system. This is of especial importance for the young wife, and we will, therefore, turn to a consideration of the part played by the reproductive organs in the life of the woman.
By many people, sex is looked upon very largely as though it were not only centered in, but entirely encompassed by, the creative organs. In reality, sex permeates every atom of the body. Every molecule of the woman's organism ex-presses the characteristic of femininity which is, in its essence, passive, negative, constructive. The masculine element, on the other hand, is positive, active and destructive. This difference between the two principles is manifest even in the very lowest forms of life. A one-celled organism which is feminine in its characteristics tends to remain in one spot and to accumulate more cell material than is needed for its immediate existence. As a consequence, this cell is sluggish in its movement and increases in size. A corresponding masculine cell is much smaller because, by its ceaseless activity, it consumes the greater part of the cell material which it is able to build from its food supply.
The problem of life is living, and this problem is the same for every organism, whether unicellular, or multicellular. The continuance of life means, not alone maintaining the life of the individual, but also continuing the life of the species.
We see this problem in its simplest terms when we consider the life of some protozoon, for example. Here we find a one-celled creature which has no organs set apart to perform different functions, but simply exists by means of the absorption of food through the cell wall. Its life depends upon the maintenance of a certain ratio between the amount of surface as compared with the bulk of the organism. When the bulk has increased to such a degree that it can no longer secure a sufficient amount of food through the surface, the life of the individual is doomed unless some means can be found for increasing the amount of surface. There is but one way for this to take place, and this is by the division of the single cell into two smaller ones. It is in this way, therefore, that the stream of life is continued, and this is, fundamentally, the reason for the process of reproduction.
In the higher forms of life, instead of one single cell we find many cells grouped together to make up the organism, and the work which is necessary to sustain the life of this creature is divided up between different groups of cells, which are called organs. Some of these organs are necessary for carrying on the life of the individual and some are essential only to the continuance of the life of the species. In some of the earlier forms, all of the necessary elements for the reproduction of life are found within the one organism. In later forms, however, two different organisms are essential to the reproductive process ; one producing the feminine element, the other, the masculine element. These two must unite in order that a new life may come into existence.
This differentiation between two individuals is an expression of the law of sex, and very evidently has for its purpose the production of greater possibilities of variation and ultimate improvement in the species.
It gives us a truer conception of the rightful place of sex in life when we realize that the manifold varieties of different species owe their origin to this great principle of sex. For example, there was in the first place but one kind of a rose, the wild sweetbrier, and from this, we are told, by the process of selection made possible through the law of sex, have been developed the many hundreds of varieties with which we are familiar today. So we may enumerate the various forms not only of plant life, but also of life in the animal kingdom. We cannot begin to measure the blessings that have come to mankind through this most essential and invaluable law of sex.
It may be of value to us, in arriving at an understanding of the functions of woman's creative organs, to contemplate, for a few moments, the process which takes place in the early development of the embryonic life. As soon as the sperm cell, or the masculine element, has united with the egg cell, or the feminine element, there begins in the resultant single-celled organism a marvellous division and sub-division which, in a remarkably short space of time, results in a form which is composed of a great number of tiny cells, held together in a spherical mass and having the appearance of a mulberry.
If you were to be told that a human body was to develop from this mass of cells, and were asked to apportion the amount which you thought would be needed, in the first place, for the creative organs alone, and, in the second. place, for the entire remaining portion of the body, you would, without doubt, divide the cellular mass into a larger and smaller portion to correspond with the size of the body and the creative organs. It may, therefore, be of interest to you to know that, when this part of the developing process is reached, one single cell is set aside for the purpose of being developed into the whole complicated organism of the body, which grows about and surrounds the remaining mass, des-tined to form the creative organs. It becomes evident that the body, therefore, exists for the purpose of protecting this living germ plasm, which is thus preserved until the time has come for it to take up its special work. This special work, in reality, is but the resumption of the process of division, or of budding, which resulted after the initial union of the masculine and feminine elements.
When the infant is born, this original germ plasm, with its accompanying organs, is enclosed within the body of the individual. The creative portion of the organism, however, is, as it were, asleep, and remains dormant for the first ten years of the life of the individual. Then, at last, it begins to show some activity.
The first work of the creative organs has to do with the making over of the body of the individual to prepare it for its later share in the work of reproducing the life of the race. This first work consists of the secretion of a fluid, called an internal secretion because it is entirely retained within the organism. This marvellous fluid is taken up by the blood and carried to every portion, of the body, which at once begins to undergo changes.
This process is begun at the very center of the being and does not, therefore, make itself evident for several years. There comes a time, however, when we see the body beginning to grow very rapidly and the child becomes, as we say, all arms and legs. In other words, the bony framework has felt the effect of this wonderful fluid and has begun to elongate itself. Sometimes the bones grow more rapidly than do the muscles, resulting in a stretching of the latter that causes what are known as growing pains. Every organ of the body feels the revolutionary effect of this internal secretion, and more evidences of its work become apparent. We find the little girl advancing into womanhood, taking on the curves which are natural to the woman's figure, and all of the other graces which belong to femininity.
In the meantime, the secretion has also been busy building up the creative organs themselves, until, when the little girl has reached twelve, or thirteen, or fourteen years of age, these organs themselves begin to function.
As has been said, the functioning of the creative organs is, in reality, but a continuance of the dividing process which first took place in the germ plasm ; only now, instead of the cells remaining together, once every twenty-eight days approximately, one little cell is budded off from the germ plasm and starts on its own individual journey through the bodily organs.
In the lowest cavity of the body, called the pelvic cavity, are suspended the creative organs. these consist, in the first place, of a small, pear-shaped organ about three inches long, two inches wide, and flattened a little from front to back so that it is only a little more than one inch through at the thickest portion. This is the uterus, or womb, to give it its English name. This organ is suspended with the large end uppermost and the small end entering the canal called the vagina, which leads to the exterior of the body. On either side of the uterus lie two small bodies about the size and shape of an almond. These are the ovaries, and it may be of interest to know that they contain approximately thirty-two thou-sand ova, or egg cells.
The uterus is suspended by means of two broad ligaments which are attached to its sides and pass from it to be fastened to the inner sides of the hip bones. The ovaries lie enclosed in a fold of these broad ligaments. The uterus is attached also by two round ligaments ; one coming from the front of the organ and being attached to the pelvic bone, the other coming from the back and being attached to the end of the spinal column. Thus the uterus hangs suspended by two broad bands and two cords. From the upper and larger end of the organ extend on either side, the Fallopian tubes, which end in what are known as the fimbriated extremities, or, in plain English, a fringe, which is like tiny fingers.
As has been said, approximately every twenty-eight days an ovum which has already risen to the surface of the ovary, ripens, bursts open its particular covering, and comes out into the pelvic cavity where it may be caught by the moving fringe of the Fallopian tube and so be passed into this passageway, through which it progresses slowly toward the uterus. It continues its process of development while advancing through the tube and if, on its way, it encounters one of the living sperm cells, which is the masculine contribution to a new life, The two unite and fertilization takes place. The impregnated ovum thereupon finds for itself a resting place in the soft folds of the lining membrane of the uterus, where it begins at once the marvellous process of di-vision and sub-division which has already been briefly described. Nourishment is needed, how-ever, for the continuance of this new life, and that is furnished by the mother's body. An extra supply of her blood is at once sent to the uterus and goes to the upbuilding of the new organism.
If the ovum is not impregnated, however, it is of no further use and passes on out of the body. In order that no new life shall start, however, without its needed nourishment, every time this process of ovulation is gone through with, an extra supply of blood is sent to the uterus and then, as it is not needed, it also passes on out of the body. This process is called menstruation.
It will be seen from this description that menstruation is not an illness. - It is a perfectly natural bodily process, and, without any doubt, was not intended to be a source of suffering to women, nor to interfere in any marked way with their ordinary activities. That in many cases it has become a cause of pain and a distinct handicap to woman in her activities is due to the unnatural conditions under which the human race has lived ever since the begining of civilization. Without any doubt, primitive woman did not suffer so great a loss of blood each month as does the woman of today and endured no pains there- with, just as childbirth was, to her, a mere transient experience which caused her but little in-convenience.
One of the most widespread misconceptions of this function is that the blood that comes away from the body at this time is, as it is commonly phrased, bad blood, and that the loss of it, therefore, is of benefit to the body. This is a mistaken notion. The blood which is sent to the uterus at this time is of as pure a quality as any in the body, and its excessive loss—beyond a certain natural limit—must always be a detriment to the organism.
It must be understood, in the first place, that the uterus is lined with a membrane which corresponds to the lining membrane of the lips or the eyelids. A moment's scrutiny will show that this thin, transparent membrane is filled full of a fine network of tiny arteries through which the blood flows, giving to it a rich, red color. So also is the lining membrane of the uterus filled full of tiny arteries. At the menstrual period these arteries are filled so full of fluid that their walls are stretched thin, as is a piece of rubber when stretched taut. Through these thin walls the blood slowly exudes, gathering on the inner surface of the uterus until it has gained enough volume to move slowly on its way out of the body. Now, it will readily be understood that when the lining membrane is thus engorged with blood, the organ is very much heavier than at any other time during the month. At the same time, the muscles are more or less relaxed in tone, so that the whole group of pelvic organs tends to sag downward. To relieve this sagging, girls are taught to spend as much time as possible in a reclining posture for the first day or two, when the organ is most heavily weighted with extra fluid. This care will often prevent a permanent sagging of the organs which might ultimately result in increasing the suffering at this period.
It also becomes apparent why it is so necessary to avoid getting the feet wet at this time, or running any risk of taking cold. Sitting upon the damp ground, or upon a cold stone, is particularly dangerous, because it may cause a checking of the flow, resulting in a congestion which may be-come more or less serious.
There have been cases in which young girls have rendered themselves invalids for life be-cause, through ignorance, they attempted by cold bathing to stop what seemed to them a manifestation of some serious hemorrhage. Fortunately, mothers of today are generally aware of the importance of giving their daughters proper instruction before this function has begun, so that such mistakes are much less frequent than they may have been in years gone by.
Girls often resent the necessity for taking special care of themselves at this time, and some-times even seem to think it an indication of a praiseworthy strength of mind and will to refuse to exercise a little common-sense caution.
There are, of course, many young women, and it may be that the number is increasing, who do not find it necessary to pay any especial attention to themselves at this time of the month. They are able to go on about their ordinary occupations without suffering any pain, or any other marked inconvenience. There are others, however, who, if they persist in their customary activities for the first day or two, either suffer a great deal of pain, or else find themselves flowing for an undue length of time. It is generally considered that normally the flow should be ended by about the fourth or fifth day. If the period is extended over a week it should be looked upon as abnormal and an effort made to discover and remove the cause. It will be found, in a good many of these cases that remaining in bed for the first day or two will bring the function to a close within the proper period of time. The young woman who refuses, through a false pride, or for any other reason, to exercise this care over herself, and who finds herself as a consequence flowing for two, or three, or even four weeks at a time, should understand that she is deliberately weakening her system. She can-not afford to lose this amount of blood and will eventually finds herself growing weaker, prone to backaches and headaches and very readily falling a victim to various infections. Instead of foolishly refusing to pay any attention to what she considers to be a negligible weakness, she should begin at once not only to keep herself strictly in bed for the first two or three days of the period, but also to put herself upon a severe regime during the intervening time. She should exercise regularly, have plenty of out-door air and, possibly, a cold spray in the morning.
It is especially important that young girls should exercise this special care over themselves during the first year or two of menstruation. When the function is once thoroughly established, it may not be necessary to be so careful.
The question of bathing at the menstrual period is one upon which a diversity of opinion may be heard. Formerly it was the custom to warn women against any bathing at this time. More recently, however, physicians have begun to agree that it may be possible for baths to be taken at this time without any unfortunate results. The matter is one, probably, which will have to be decided more or less in accordance with the requirements of the individual. For example, the young woman who is in the habit of taking a cold plunge every day will, in all probability, be able, at this time, to take a cold spray without feeling any deleterious effects. On the other hand, a young woman of a less vigorous vitality who, under ordinary circumstances, has difficulty in reacting from a cold spray, could not possibly continue during the menstrual period.
Extremely hot baths also are not desirable, as they induce a larger flow and are more or less weakening. What is called a neutral bath, that is, at about the temperature of the body, is the kind best suited to the majority of women during these periods and may, therefore, be recommended.
The hot sitz bath is often found to relieve pain, especially in cases of delayed and scanty menstruation. In other cases of painful menstruation resulting from an undue congestion in the parts involved, a hot foot bath, which restores the general circulation of the blood, will be found efficacious.
The most potent cause of painful menstruation is the misplacement of the uterus for one reason or another. It may be tipped forward or back, on one side or the other. When only tipped to a slight degree it may cause but little discomfort, but when sharply turned upon itself it may cause great suffering. It is important, therefore, to consider possible causes for the misplacement of this organ.
In the first place it will readily be seen that a wrong standing or sitting posture will be productive of harmful results. The girl who constantly sits upon her spine is tipping the uterus backard into an unnatural position. The same may be said of the one who stands incorrectly.
One other very common cause of displacement of this organ is constipation. It must be remembered that directly over the uterus is the alimentary tract. There are approximately thirty feet of small and large intestines which hang suspended in the abdominal cavity. If these are allowed to become packed full of effete matter, they become very heavy and pull down upon their supporting membranes until they may rest upon the organs beneath in such a way as to push them out of place. For this reason it is most important for young women to learn how to avoid getting the habit of constipation, for constipation, it must be understood, is not an illness. It is simply an unfortunate habit.
While the statement is made that the process of ovulation and menstruation takes place every twenty-eight days, the period is not the same for all individuals, although it should normally be the same for each individual. For example, one young woman will menstruate every twenty-eight days, another one every thirty days, and another one every twenty-seven days. Whatever the period, it should be regular with the individual. If the menstrual period recurs more frequently than every three weeks it would seem to be an indication of an abnormal condition which should be overcome and probably can be mastered by careful, healthful living.
Frequently the statement is made that be-cause a young woman did not establish the function of menstruation she went into a decline ; it may be, had consumption and passed away in her early youth. The truth of the matter is she did not menstruate because she was already in a decline, and did not possess the vitality required for the establishment of this additional function.
It will be found also that a woman who allows herself to become thoroughly run down may stop menstruating and think that something serious has happened to her. Restoration of her general health will re-establish the monthly period.
Connecting the womb with the exterior of the body is a muscular tube called the vagina. The external opening of this tube may, in childhood, be guarded by a thin fold or veil of mucous membrane. This stretches across the opening of the vagina like the head of a drum and is called the hymen. It has been supposed by many to be a complete veil across the entrance and its presence, therefore, to be an indication of virginity. If a man marries with the old idea that the hymen is always present in virgins he may do his wife a great injustice by assuming that she has strayed from the path of virtue because he fails to find this physical sign present in her. It is, therefore, rather important for young men as well as young women to be made acquainted with the real facts in the case.
It is true that sometimes the hymen completely obstructs the vaginal opening. Occasionally, however, the membrane is perforated in several places. More frequently, there is one opening with ragged edges. Normally, however, it is perforated at or near the middle by a round or oval opening which may be easily enlarged by stretching. Sometimes the hymen is but little more than a circular ridge or flange projecting toward the centre of the vaginal tube, or it may be entirely wanting along a part of the circumference. Frequently, it is entirely absent.
It would seem that the customary care of the body exercised by many women also tends to either prevent the development of a distinct hymen or, what is more likely, to destroy it after it has been imperfectly formed. Without doubt, the local douches which are so frequently prescribed and other forms of local treatment may have the same effect.
These being the facts, it becomes evident that the presence or absence of the hymen has practically nothing to do with the question of a young woman's chastity. If this fact were thoroughly understood, it doubtless might have the effect of removing a good deal of the nervousness which brides feel upon the advent of the wedding night.
There is also another reason for definite instruction upon this point. If the hymen is a complete membrane and difficult to penetrate, the husband may have to exercise great consideration to avoid causing intense pain to his wife in the first approaches toward the consummation of marriage. Under such conditions the utmost gentleness on the part of the husband is called for, and in all probability, the wisest thing will be to have the wife examined by a competent physician and the necessary measures taken for relieving the situation. A little local treatment, such as stretching of the hymen, may be all that is necessary. Upon occasion, a slight operation may be needed.