Chapter IV: Part 4

What epithet then belongs to him who makes it a trade to win a woman’s gentle affections, betray her generous confidence, and then, when the consequences become apparent, abandon her to dependence, and the scorn of a cold, a self-righteous, and a wicked world; a world which will forgive anything but rebellion against its tyranny, and in whose eyes it seems the greatest of crimes to be unsuspecting and warm-hearted! I will give my hand freely to a galley-slave, and speak to the highway-robber as to an honest man; but there is one character with whom I desire to exchange neither word nor greeting—the cold-hearted, deliberate, practised, and calculating seducer!

“And, let me ask, what is it gives to the arts of seduction their sting, and stamps to the world its victim? Why is it, that the man goes free and enters society again, almost courted and applauded for his treachery, while the woman is a mark for the finger of reproach, and a butt for the tongue of scandal? Because she bears about her the mark of what is called her disgrace. She becomes a mother; and society has something tangible against which to direct its anathemas. Nine-tenths, at least, of the misery and ruin which are caused by seduction, even in the present state of public opinion on the subject, result from cases of pregnancy.

“If the little being lives, the dove in the falcon’s claws is not more certain of death, than we may be, that society will visit, with its bitterest scoffs and reproaches, the bruised spirit of the mother and the unconscious innocence of the child.

“If, then, we cannot do all, shall we neglect a part? If we cannot prevent every misery which man’s selfishness and the world’s cruelty entail on a sex which it ought to be our pride and honor to cherish and defend; let us prevent as many as we can. If we cannot persuade society to revoke its unmanly and _unchristian_[34] persecution of those who are often the best and gentlest of its members—let us, at the least, give to woman what defence we may, against its violence.

“I appeal to any father, trembling for the reputation of his child, whether, if she were induced to form an unlegalized connexion, her pregnancy would not be a frightful aggravation? I appeal to him, whether a preventive which shall save her from a situation which must soon disclose all to the world, would not be an act of mercy, of charity, of philanthropy—whether it might not save him from despair, and her from ruin? The fastidious conformist may frown upon the question, but to the father it comes home; and, whatever his lips may say, his heart will acknowledge the soundness and the force of the argument it conveys.

“It may be, that sticklers for morality will still demur to the positions I defend. They will perhaps tell me, as the committee of a certain society in this city lately did—that the power of preventing conception ‘holds out inducements and facilities for the prostitution of their daughters, their sisters, and their wives.’

“Truly, but they pay their wives, their sisters, and their daughters, a poor compliment! Is, then, this vaunted chastity a mere thing of circumstance and occasion? Is there but the difference of opportunity between it and prostitution? Would their wives, and their sisters, and their daughters, if once absolved from the fear of offspring, all become prostitutes—and sell their embrace for gold, and descend to a level with the most degraded? In truth, but they slander their own kindred: they libel their own wives, sisters, and daughters. If they spoke truth—if fear were indeed the only safeguard of their relatives’ chastity, little value should I place on virtue like that! and small would I esteem his offence, who should attempt to seduce it.[35]

“That chastity which is worth preserving is not the chastity that owes its birth to fear and to ignorance. If to enlighten a woman regarding a simple physiological fact will make her a prostitute, she must be especially predisposed to profligacy. But it is a libel on the sex. Few, indeed, there are, who would continue so miserable and degrading a calling, could they but escape from it. For one prostitute that is made by inclination, ten are made by necessity. Reform the laws—equalize the comforts of society, and you need withhold no knowledge from your wives and daughters. It is want, not knowledge, that leads to prostitution.

“For myself, I would withhold from no sister, or daughter, or wife of mine, any ascertained fact whatever. It should be to me a duty and a pleasure to communicate to them all I knew myself; and I should hold it an insult to their understandings and their hearts to imagine, that their virtue would diminish as their knowledge increased. Vice is never the offspring of just knowledge, and they who say it is, slander their own nature. Would we but trust human nature, instead of continually suspecting it, and guarding it by bolts and bars, and thinking to make it very chaste by keeping it very ignorant, what a different world we should have of it! The virtue of ignorance is a sickly plant, ever exposed to the caterpillar of corruption, liable to be scorched and blasted even by the free light of heaven; of precarious growth; and even if at last artificially matured, of little or no real value.

“I know that parents often think it right and proper to withhold from their children—especially from their daughters—facts the most influential on their future lives, and the knowledge of which is essential to every man and woman’s well-being.[36] Such a course has ever appeared to me ill-judged and productive of very injurious effects. A girl is surely no whit the better for believing, until her marriage night, that children are found among the cabbage leaves in the garden. The imagination is excited, the curiosity kept continually on the stretch; and that which, if simply explained, would have been recollected only as any other physiological phenomenon, assumes all the rank and importance and engrossing interest of a mystery. Nay, I am well convinced, that mere curiosity has often led ignorant young people into situations, from which a little more confidence and openness on the part of their parents and guardians, would have effectually secured them.

“But if we _could_ prevent the circulation of truth, why _should_ we? We are not afraid of it ourselves. No man thinks _his_ morality will suffer by it. Each feels certain that his virtue can stand any degree of knowledge. And is it not the height of egregious presumption in each to imagine that his neighbor is so much weaker than himself, and requires a bandage which he can do without? Most of all is it presumptuous to suppose, that that knowledge which the man of the world can bear with impunity, will corrupt the young and the pure-hearted. It is the sullied conscience only that suggests such fears. Trust youth and innocence. Speak to them openly. Show them that you respect them, by treating them with confidence; and they will quickly learn to respect and to govern themselves. You enlist even their pride in your behalf; and you will soon see them make it their boast and their highest pleasure to _merit_ your confidence. But watch them, and show your suspicions of them but once,—and you are the jailor, who will keep his prisoners just as long as bars and bolts shall prevent their escape. The world was never made for a prison-house; it is too large and ill-guarded: nor were parents ever intended for jail-keepers; their very affections unfit them for the task.

“There is no more beautiful sight on earth, than a family among whom there are no secrets and no reserves; where the young people confide everything to their elder friends—for such to them are their parents—and where the parents trust everything to their children; where each thought is communicated as freely as it arises; and all knowledge given, as simply as it is received. If the world contain a prototype of that Paradise, where nature is said to have known no sin or impropriety, it is such a family; and if there be a serpent that can poison the innocence of its inmates, that serpent is SUSPICION.

“I ask no greater pleasure than thus to be the guardian and companion of young beings whose innocence shall speak to me as unreservedly as it thinks to itself; of young beings who shall never imagine that there is guilt in their thoughts, or sin in their confidence; and to whom, in return, I may impart every important and useful fact that is known to myself. Their virtue shall be of that hardy growth, which _all_ facts tend to nourish and strengthen.

“I put it to my readers, whether such a view of human nature, and such a mode of treating it, be not in accordance with the noblest feelings of their hearts. I put it to them, whether they have not felt themselves encouraged, improved, strengthened in every virtuous resolution, when they were generously trusted; and whether they have not felt abased and degraded, when they were suspiciously watched, and spied after, and kept in ignorance. If they find such feelings in their own hearts, let them not self-righteously imagine, that they can only be won by generosity, or that the nature of their fellow-creatures is different from their own.

“There are other considerations connected with this subject, which farther attest the social advantages of the control I advocate. Human affections are mutable, and the sincerest of moral resolutions may change.[37] Every day furnishes instances of alienations, and of separations; sometimes almost before the honey-moon is well expired. In such cases of unsuitability, it cannot be considered desirable that there should be offspring; and the power of refraining from becoming parents until intimacy had, in a measure, established the likelihood of permanent harmony of views and feelings, must be confessed to be advantageous.

“It would be impossible to meet every argument in detail, which ingenuity or prejudice might put forward. If the world were not actually afraid to think freely or to listen to the suggestions of common sense, three-fourths of what has already been said would be superfluous; for most of the arguments employed would occur spontaneously to any rational, reasoning being. But the mass of mankind have still, in a measure, everything to learn on this subject. The world seems to me much to resemble a company of gourmands, who sit down to a plentiful repast, first very punctiliously saying grace over it; and then, under the sanction of the priest’s blessing, think to gorge themselves with impunity; as conceiving, that gluttony after grace is no sin. So it is with popular customs and popular morality. Everything is permitted, if external forms be but respected. Legal roguery is no crime, and ceremony-sanctioned excess no profligacy. The substance is sacrificed to the form, the virtue to the outward observance. The world troubles its head little about whether a man be honest or dishonest, so he knows how to avoid the penitentiary and escape the hangman. In like manner, the world seldom thinks it worth while to inquire whether a man be temperate or intemperate, prudent or thoughtless. It takes especial care to inform itself whether in all things he conforms to orthodox requirements; and if he does, all is right. Thus men too often learn to consider an oath an absolution from all subsequent decencies and duties, and a full release from all responsibilities. If a husband maltreat his wife, the offence is venal; for he premised it by making her at the altar, an ‘honest woman.’ If a married father neglects his children, it is a trifle; for grace was regularly said before they were born.

“With such a world as this, it is a difficult matter to reason. After listening to all I have said, it may perhaps cut me short by reminding me, that nature herself declares it to be right and proper, that we should reproduce our species without calculation or restraint. I will ask, in reply, whether nature also declares it to be right and proper, that when the thermometer is at 96°, we should drink greedily of cold water, and drop down dead in the streets? Let the world be told, that if nature gave us our passions and propensities, she gave us also the power wisely to control them; and that, when we hesitate to exercise that power we descend to a level with the brute creation, and become the sport of fortune—the mere slaves of circumstance.[38]

“To one other argument it were not, perhaps, worth while to advert, but that it has been already speciously used to excite popular prejudice. It has been said, that to recommend to mankind prudential restraint in cases where children cannot be provided for, is an insult to the poor man; since all ought to be so circumstanced that they might provide amply for the largest family. Most assuredly all _ought_ to be so circumstanced; but all _are_ not. And there would be just as much propriety in bidding a poor man to go and take by force a piece of Saxony broadcloth from his neighbor’s store, because he _ought_ to be able to purchase it, as to encourage him to go on producing children, because he _ought_ to have the wherewithal to support them. Let us exert every nerve to correct the injustice and arrest the misery that results from a vicious order of things; but, until we have done so, let us not, for humanity’s sake, madly recommend that which grievously aggravates the evil; which increases the burden on the present generation, and threatens with neglect and ignorance the next.

“It now remains, after having spoken of the _desirability_ of obtaining control over the instinct of reproduction, to speak of its _practicability_.

“I have taken great pains to ascertain the opinions of the most enlightened physicians of Great Britain and France on this subject; (opinions which popular prejudice will not permit them to offer publicly in their works;) and they all concur in admitting, what the experience of the French nation _positively proves_, that man may have a perfect control over this instinct: and that men and women may, without any injury to health, or the slightest violence done to the moral feelings, and with but small diminution to the pleasure which accompanies the gratification of the instinct, refrain at will from becoming parents. It has chanced to me, also, to win the confidence of several individuals, who have communicated to me, without reserve, their own experience: and all this has been corroborative of the same opinion.

“However various and contradictory the different theories of generation, almost all physiologists are agreed, that the entrance of the sperm itself (or of some volatile particles proceeding from it) into the uterus, must precede conception. This it was that probably first suggested the possibility of preventing conception at all.”

The eloquent writer, who was at that time unaware of the existence of Desomeaux’s mode of prevention to conception,[39] states the same result was attained by a complete withdrawal on the part of the male previous to emission. But this mode, it will be readily perceived, is attended with, to some, insurmountable difficulties.

In the first place, few men can invariably control themselves in this respect, and to be an effectual preventive, he must ever, and invariably control his passions. Now it cannot be denied, that even those who habitually can, and do control themselves, will inevitably, now and then, in so exciting a passion, lose their self-control. It is impossible to do otherwise. And one moment’s forgetfulness defeats the end. In the second place, even if always and invariably practicable, it makes the act of coition incomplete and unsatisfactory. In the third place it would be almost, nay quite impossible, to prevent an imperceptible and unconscious escape of semen, sufficient however to produce conception, often giving rise to unjust and unfounded suspicions, when, in fact, the cause for the existence of pregnancy is the same as though no withdrawal was practised. And lastly, its effects upon the constitution are frequently not unlike those produced by onanism. In addition to which, it is unsafe, because uncertain; consequently, when indispensable to prevent pregnancy, is of no avail, if not actually dangerous.[40]

To sum up, in brief, why pregnancy should be prevented, the reasons adduced seem to be conclusive to the able and talented writer, in its moral, social, and physiological aspect.

_Morally._ Firstly. It induces early marriages by removing the principal obstacle thereto, viz.: the fear of having offspring before the parents are in a pecuniary condition to support, rear, and educate them. And,

Secondly, By inducing early marriages, seductions would become less frequent, and consequently prostitution, comparatively, become extinct.

_Socially._ Firstly. Young men, instead of seeking excitement and amusement in the intoxicating cup, gaming, night carousals, brothels, &c., acquiring habits of dissipation deadening alike to the keen, fresh susceptibilities belonging to youth—habits too, which often cling to them in after life, habits which, perhaps for ever destroy their health,—as tainting their constitution with some foul and incurable disease,—would, with a view to early marriage, cultivate the social and domestic ties, while yet pure and uncontaminated by contact with the dissolute and vicious. And

Secondly, Young persons, even though with very limited means, would nevertheless marry, and by not becoming parents, be enabled, unitedly, to husband their resources, with the view to the bettering their condition pecuniarily; in the meantime, and in the days of their youth, enjoying all those social endearments which each sex finds in the society of the other, where reciprocity of views, interests, and feelings exists. So too, those in middling circumstances would marry early, merely deferring an increase of family until they will have established themselves in some business, ere the constant accumulating expenses of an increasing family encroach upon, or eat up their small capital, the immediate incurrence of which thus early would, perhaps, for ever destroy the means for the comfortable provision of themselves, as also the future welfare of their children.

_Physiologically._ By inducing early marriages, the dire evils arising from promiscuous sexual intercourse with the tainted or diseased, will gradually disappear, and in a generation or two we would find springing up, in the place of the present sickly, puny race, a healthy, robust, and pure generation.

In regard to the morality of preventing conception it is contended that everything which tends to the amelioration of mankind, to improve their condition physically, morally, and socially, or equalize their condition pecuniarily, cannot be immoral. That the instinct of reproduction should be, like our other appetites and passions, subject to the control of reason,—that when the gratification of this instinct results in evil effects either to ourselves or to our offspring, or even to society—if such evil can be prevented, it is the obligation of morality that it should be.

It is contended, then, that the use of a preventive to conception will make men and women rational, reflecting, thinking beings, regardful alike of their own welfare and the welfare of their offspring. That it will banish poverty, vice and profligacy, by enabling the poor to improve their pecuniary condition and thus engendering habits of frugality, reflection and economy, which the prospect of future competency is so calculated to inspire. Vice so often springing from despair and hopeless poverty will disappear, because the children, by reason of the competence and moral structure of the parents, will not in infancy be thrust upon the world to mingle with the depraved and the licentious. Sexual profligacy and licentiousness will be checked, as early marriages become more prevalent and universal, as there then will exist no reasons as now, why two persons, attached to each other, should not marry, refraining merely from becoming parents. Dishonorable advances therefore would be spurned, seductions thus have no existence, and prostitution, the offspring of seduction, would be unknown, and even the ravages of that disease, engendered by promiscuous sexual intercourse, now carrying off its tens of thousands, transmitting its pestiferous poison to thousands yet unborn, would entirely disappear.

The able author thus concludes his views:

“And now let my readers pause. Let them review the various arguments I have placed before them. Let them reflect how intimately the instinct of which I treat is connected with the social welfare of society. Let them bear in mind, that just in proportion to its social influence, is it important that we should know how to control and govern it; that when we obtain such control, we may save ourselves—and, what we ought to prize much more highly, may save our companions and our offspring, from suffering or misery; that, by such knowledge, the young may form virtuous connexions, instead of becoming profligates or ascetics; that, by it, early marriage is deprived of its heaviest consequences, and seduction of its sharpest sting; that, by it, man may be saved from moral ruin, and woman from desolating dishonor; that by it the first pure affections may be soothed and satisfied, instead of being thwarted or destroyed—let them call to mind all this, and let them say, whether the possession of such control be not a blessing to man.

“As to the cry which prejudice may raise against it as being unnatural, it is just as unnatural (and no more so) as to refrain, in a sultry summer’s day, from drinking, perhaps, more than a pint of water at a draught, which prudence tells us is enough, while inclination would bid us drink a quart. _All_ thwarting of any human wish or impulse may, in one sense, be called unnatural; it is not, however, ofttimes the less prudent and proper on that account.”

As to the practical efficacy of this preventive, the experience of France, where it is universally practised, might suffice in proof. We know, at this moment, several married persons who have told us, that, after having had as many children as they thought prudent, _they had for years employed it with perfect success_. For the satisfaction of our readers, we will select some instances.

A few weeks since, a respectable and very intelligent father of a family, about thirty-five years of age, who resides west of the mountains, called at our office. Conversation turned on the present subject, and we expressed to him our conviction that this preventive was effectual. He told us he could speak from personal experience. He had married young, and soon had three children. These he could support in comfort, without running into debt or difficulty; but, the price of produce sinking in his neighborhood, there did not appear a fair prospect of supporting a large family. In consequence, he and his wife determined to limit their offspring to three. They have accordingly used it for seven or eight years; have had no more children; and have been rewarded for their prudence by finding their situation and prospects improving every year.

The next communication from which we shall copy is from a young man of excellent character, living in a neighboring state, and now one of the conductors of a popular periodical. After suggesting to us the propriety of re-publishing some English works now out of print, he proceeds as follows:

“Had I not been addressing you upon another subject, I should not have ventured to obtrude on you my small need of approbation; but I cannot let slip this opportunity of endeavoring to express how much I feel indebted to you for its publication.

“To know how I am so indebted, it is necessary you should also know something of my situation in life; and when it is described, it is perhaps a description of the situation of two-thirds of the journeymen mechanics of this country.

“I have been married nearly three years, and am the father of two children. Having nothing to depend upon but my own industry, you will readily acknowledge that I had reason to look forward with at least some degree of disquietude to the prospect of an increasing family and reduced wages: apparently the inevitable lot of the generality of working men.

“I had apparently nothing left but to let matters take their own course, when your valuable work made its appearance.

“I read it; and a new scene of existence seemed to open before me. I found myself, in this all-important matter, a free agent, and, in a degree, the arbiter of my own destiny. I could have said to you as Selim said to Hassan,—‘

‘Thou’st hew’d a mountain’s weight from off my heart.’

My visions of poverty and future distress vanished; the present seemed gilded with new charms, and the future appeared no longer to be dreaded. But you can better imagine, than I describe, the revolution of my feelings.

“I have since endeavored to circulate this book as widely as my limited opportunities permit, and shall continue to do so, believing it to be the most useful work that has made its appearance.”

The next extract, from an inhabitant of Pennsylvania, we have selected chiefly as it furnishes a beautiful, and, alas! a rare, example, of that parental conscientiousness which scruples to impart existence where it cannot also impart the conditions necessary to render that existence happy. In this view, the control in question is indeed all-important. Were such virtue as this cultivated in mankind generally, how soon might the very seeds of disease die out among us, instead of bearing, as now, their poison-fruit from generation to generation! and how far might human beings, in succeeding ages, surpass their forefathers in strength, in health, and in beauty!

This view of the subject is to the physiologist, to the philosopher, to every friend of human improvement, a most interesting one. ‘So long,’ to use the words of an eloquent lecturer, ‘as the tainted stream is unhesitatingly transmitted through the channel of nature, from parent to offspring, so long will the text be verified which “visits the sins of the fathers on the children, even to the third and fourth generation.”’ And so long, we would add, will mankind—wise and successful whenever there is question of improving the animal races—be blind in perceiving, and listless in securing, that far nobler object, the physical, and thereby—in a measure—the mental and moral improvement of our own.

Here is the extract which led to these remarks:—

“I was born of poor parents, and early left an orphan. When of age, though my circumstances promised poorly for the support of a family, I desired to marry, knowing that a good wife would greatly add to my happiness. The preventive spoken of in your book presented itself to my mind, and for seven years that I have now been married, it has been used. I was successful in business, and acquired the means of maintaining a family; but still I have been unwilling, because my constitution is such a one as I think a parent ought not to transmit to his offspring. I prefer not to give birth to sentient beings, unless I can give them those advantages, physical as well as moral and intellectual, which are essential to human happiness.”

From the letter of an aged French gentleman, who holds a public office in the western country, I translate the following; and I would to heaven that every young man and woman in these United States could read it:

“I have read your work with much interest; and desire that it may have a wide circulation and that its recommendations may be adopted in practice. If you publish another edition, I could wish that you would add a piece of advice of the greatest importance, especially to young married persons. Many women are ignorant, that, in the gratification of the re-productive instinct, the exhaustion to the man is much greater than to the woman; a fact most important to be known, the ignorance of which has caused more than one husband to forfeit his health, nay, his life. Tissot tells us, that the loss by an ounce of semen is equal to that by forty ounces of blood;[41] and that, in the case of the healthiest man, nature does not demand connexion oftener than once a month.[42]

“How many young spouses, loving their husbands tenderly and disinterestedly, if they were but informed of these facts, would watch over and preserve their partners’ healths, instead of exciting them to over-indulgence.”—Another extract.

“A member of the Society of Friends, from the country, called at our office; he informed me that he had been married twenty years, had six children, and would probably have had twice as many, but for the preventive, which he found in every instance efficacious. By this means he made an interval of two or three years between the births of each of his children. Having at last a family of six, his wife earnestly desired to have no more; and on one occasion, when the preventive was neglected to be used, she shed tears at the prospect of again becoming pregnant. He said he knew, in his own neighborhood, several married women who were rendered miserable on account of their continued pregnancy, and would have given anything in the world to escape, but knew not how.”

Our readers may implicitly depend on the accuracy of the facts we have stated. Though in the present state of public opinion we may not, for obvious reasons, give _names_ in proof.

That most practical of philosophers, Franklin, interprets chastity to mean, _the regulated and strictly temperate satisfaction, without injury to others, of those desires which are natural to all healthy adult beings_. In this sense, chastity is the first of virtues, and one most rarely practised, either by young men or by married persons, even when the latter most scrupulously conform to the letter of the law.

It is all important for the welfare of our race, that the re-productive instinct should never be selfishly indulged; never gratified at the expense of the well-being of our companions. A man who, in this matter, will not consult, with scrupulous deference, the slightest wishes of the other sex; a man who will ever put his desires in competition with theirs, and who will prize more highly the pleasure he receives than that he may be capable of bestowing—such a man appears to me, in the essentials of character, a brute. The brutes commonly seek the satisfaction of their propensities with straight-forward selfishness, and never calculate whether their companions are gratified or teased by their importunities. Man cannot assimilate his nature more closely to theirs, than by imitating them in this.

Again. There is no instinct in regard to which strict temperance is more essential. All our animal desires have hitherto occupied an undue share of human thoughts; but none more generally than this. The imaginations of the young and the passions of the adult are inflamed by mystery or excited by restraint, and a full half of all the thoughts and intrigues of the world has a direct reference to this single instinct. Even those, who like the Shakers, ‘crucify the flesh,’ are not the less occupied by it in their secret thoughts; as the Shaker writings themselves may afford proof. Neither human institutions nor human prejudices can destroy the instinct. Strange it is, that men should not be content rationally to control, and wisely to regulate it.

SEXUAL WEAKNESS

This complaint, commonly called _fluor albus_, or _whites_, to which women are peculiarly subject, must form an important object of attention, since it is always attended with disagreeable symptoms; and, when aggravated, soon spoils the beauty of a fine face, weakens the digestive powers, produces a general bad habit, and occasions sterility.

_Symptoms._

An irregular discharge from the passage leading to the womb, of a fluid, which, in different women, varies much in colour, being of a white, green, yellow, or brown hue. In the beginning it is, however, most usually white and pellucid, and, in progress of the complaint, acquires the various discolourations and different degrees of acrimony, whence proceed a slight smarting on making water. Besides the discharge, the patient is frequently afflicted with severe and constant pains in the back and loins, indigestion, paleness of the face, chilliness, and languor. In process of time, every symptom becomes highly aggravated, the feet and ankles swell, palpitations, and a difficulty of respiration are experienced, the menstrual discharge is rendered irregular, the urine is turbid, the mind is dejected, and either consumption or dropsy supervenes, and terminates a miserable existence.

In some languid habits, the fluor albus returns periodically, instead of the proper menstrual evacuation, until the patient’s constitution is duly invigorated.

_Causes._

It may be produced by any cause which either weakens or irritates the womb and its appendages. It may arise from general debility of the constitution, but it is especially caused by circumstances impairing the power of the womb itself, as, for instance, a severe labour, a miscarriage, or profuse menstruation.

In some instances it appears to depend on a full and irritable habit of body, and, in other cases, of local irritation, such as disorders of the womb, or of the urinary organs, or a collection in the gut, of the small thready worms called ascarides.

Upon the high authority of Dr. Hamilton, this disease is most frequently first brought on by some imprudence in respect to diet and clothing, or exposure to cold or fatigue, or neglect of the bowels about the time when menstruation begins.

_Treatment._

In the treatment of this complaint regard must be had to the apparent cause, and to the state of the patient. The discharge is too often considered by the sex as the effects of general weakness in their habit, and, therefore, they are led to the indiscriminate use of heating medicines, as port wine, balsam copaibæ, &c., without paying attention to the habit of the body, or cause of the disease.

A milk diet, change of air, and the partial cold bath, as sponging the loins and thighs with cold water every morning, with attention to cleanliness and proper exercise, are often sufficient to arrest the disease, if early adopted.

In addition to this plan of treatment, if the patient be of a full habit, a disposition to fever from slight causes, attended with a sense of heat about the passage to the womb, it will be necessary to have recourse to the lancet, cooling cathartics, and febrifuge medicines, and to inject, several times a day, flax-seed tea or milk and water, into the passage of the womb. In the great majority of cases, the complaint arises from general debility or laxity of the vessels of the parts, and in such cases the indications of cure are to increase the vital heat, promote the digestion, and restrain the preternatural discharge. In order to which, recourse must be had to such of the tonic medicines as will be found to agree best with the patient. Of these, the bark and elixir vitriol, the tonic powders or pills, the rust or tincture of steel, and lime-water have usually been employed, and often with good effects. In some instances, however, I have known these medicines to fail, when the nitric acid, diluted, in doses of a wineglassful, three or four times a day, wonderfully succeeded.

Previously to the exhibition of tonic medicines, it is advisable to give a dose of ipecacuanha or antimonial wine. Gentle emetics are supposed to be of singular utility in this complaint, not only by cleansing the stomach and bowels, and making a revulsion of the humors from the inferior part of the body, but likewise by their exciting all the powers of the constitution to a more vigorous action.

The bowels must be kept in a regular state by conjoining a few grains of rhubarb with some of the tonic medicines, or by taking occasionally, at bedtime, one of the aloetic, or aperient or diaphoretic pills; or, in the morning, a teaspoonful of Epsom salts dissolved in a tumbler of water.

If there be a fulness of the stomach after eating, the tincture of rhubarb in small doses will excite digestion. In obstinate cases, it is often expedient to produce a change in the system, by giving a grain or two of calomel, or one of the mercurial pills at bedtime, until the gums become slightly affected, and then the cure may be completed by strengthening medicines, together with the shower bath.

Besides tonics, stimulating medicines, such as commonly determine to the urinary passages, have very frequently been employed with great benefit. Of these, rosin in doses of ten grains in the yolk of an egg, or a spoonful of molasses, or balsam copaibæ in doses of a teaspoonful, or tincture of cantharides in doses of twenty or thirty drops in some mucilaginous drink, and taken three or four times a day, will be found most salutary.

These means strike at the cause of the complaint; but if it do not remove the effect very soon, we are not to trust to them alone. For once a morbid secretion being excited, it is very apt to continue, although the exciting cause cease to operate.

On this account, we ought, without delay, to have recourse to astringent injections, such as a strong decoction of red oak bark, with the addition of a little alum or a solution of alum in water. Half an ounce of the former to be dissolved in a bottle of water; which should be thrown into the vagina by means of a female syringe, two or three times a day. The celebrated Dr. Burns says, after many trials, he satisfied himself, that although assistance may be derived from internal medicines and the cold bath, yet the chief dependence is to be placed on astringent applications to the seat of the discharge; and these, where there is no fulness of the general system, nor any affection of the womb itself, are perfectly safe, and seldom fail in producing a cure.

It will be prudent, when this disease occurs as an early symptom of pregnancy, not to check the discharge suddenly, lest miscarriage be the consequence; but it may be moderated by injections of water, with the addition of a little vinegar, or an infusion of green tea. Neither should the discharge be suddenly suppressed when it has been of long standing, and acquired a considerable degree of acrimony, with an offensive smell. For if it be unseasonably checked, the belly swells, and a train of the most disagreeable symptoms occurs. In such cases, soap suds, or an infusion of chamomile flowers or hops, should be frequently thrown up the vagina; and, as soon as the blood is freed of its impurities, by suitable medicines, and has recovered, in some measure, its soft and balmy quality of which it has been deprived, the astringent injections may be employed with perfect safety.

The application of a blister to the sacrum, has, in some obstinate cases, been attended with advantage.

When the fluor albus proceeds from worms, purgatives and bitter clysters are the proper remedies.

Pain in the back and loins is often mitigated by the application of a large adhesive or strengthening plaster, and by avoiding a standing posture of long continuance, much walking, dancing, or any other violent exertion.

Women should carefully avoid all the remote causes of the disease: they should pay diligent attention to cleanliness, by washing the parts frequently with cold water; and when there are excoriations, milk and water, or lead water, may be employed as a wash.

_Regimen._

The diet should be light, cordial, and nourishing, consisting of isinglass dissolved in milk by boiling it, jellies, custards, rice, milk, soft-boiled eggs, gelatinous broths, and light meats, together with a prudent use of genuine wine, particularly claret or port.

Women, affected with this disease, should by no means indulge in the use of tea and other warm slops of a relaxing nature; but should lie on a mattress in preference to a feather bed; and they should rise early, and take such daily exercise as their strength will admit, particularly on horseback. When there is much languor, with chilliness, friction with the flesh-brush, and wearing flannel next the skin, must not be omitted.

FALLING DOWN OF THE WOMB.

This is a much more common complaint than the former, and takes place in women of every age, and every rank. As its name implies, it consists of change in the situation of the womb, by which that organ lies much lower than it ought to do. In some cases it absolutely protrudes entirely without the parts. The slightest degrees are styled bearing down; and the more violent ones descent or falling down of the womb.

In general, the first symptom of this complaint is an uneasy sensation in the lower part of the back while standing or walking, with now and then a kind of pressure and bearing down.

If these feelings be disregarded, the complaint increases, and the patient becomes incapable of making water without first lying down, or pushing up a swelling which seems to stop the discharge of urine; and if the disease continues to increase, the womb is actually forced out of the parts, and takes on the form of a bulky substance hanging down between the thighs. This extreme degree of the complaint can seldom happen, excepting in women who have had a great many children, but the less degrees of it occur occasionally in very young unmarried women.

The causes of descent of the womb ought to be known to every woman, as many of them may be avoided. Every disease which induces weakness of the habit in general, or of the passage leading to the womb, in particular, must lay the foundation for the complaint. Frequent miscarriages, improper treatment during labour, too early or violent exercise after delivery, are in married women, the most frequent circumstances by which falling down of the womb is produced. In the unmarried, it is apt to take place in consequence of violent exercise, as in dancing, riding, &c., while out of order, a fact that ought to be impressed on the mind of every young woman.

In the treatment of this complaint, the means must be adapted to the degree of its violence. When the descent is inconsiderable, and the case is of recent date, the daily use of the cold bath, invigorating diet, very moderate exercise, and the injection of any mild astringent liquor into the passage, evening and morning, will probably prove successful. But should the disease be in a great degree or of long standing, a course of tonics, with the frequent use of astringent injections, as a strong solution of alum in water, or decoction of red oak bark, must be added to the above means.

Dr. Leak advises, that after the parts are reduced, the intention of contracting the relaxed vagina so as to prevent its future descent, may be effected by the frequent use of the following astringent injection. Take of alum, and white vitriol, each, one drachm, boiling water, one pound, mix and filter through paper. Inject it into the vagina, milk warm, with a womb syringe. At the same time endeavour to strengthen the whole bodily system by nourishing diet, and tonic medicines.

When the complaint resists such remedies, or when, from its degree, it may appear unnecessary to employ them, the only relief which can be afforded, unless the womb become pregnant, is to be obtained by wearing an instrument called a pessary. It is made of wood or ivory, and if properly adapted to the passage, and of a proper construction, it can be worn without much inconvenience, and it never occasions pain. Certain attentions are however necessary, whenever such an instrument is used. Thus, the pessary should never be allowed to remain in the passage above a few days at a time, otherwise it becomes the source of great irritation. It should, therefore, be occasionally withdrawn on going to bed, well cleaned and reintroduced in the morning, before the patient rises. In some instances, after a pessary of a certain size has been worn for several months, one of a smaller size becomes better adapted to the passages, and in other cases one of a larger size is required.

Sponges of such a size as, when expanded, fill up the cavity of the vagina, are very good _pessaries_. They support the uterus, and, by putting a string through them, the end of which is to be left hanging out of the os externum, the woman can take them away and apply them herself very conveniently.

To answer this purpose, a fine sponge, wrung out in alum water, may be dried in a compressed state, and cut into any convenient form, so as to be introduced as high as possible: this will act by its astringency, and by its pressure, in a gentle and uniform manner. During the use of this application, an astringent injection may be used twice a day; and the sponge tent should be made gradually smaller as the vagina contracts.

The application of the bandage round the whole belly, with a moderate degree of firmness, often gives great relief to the uneasy feelings. The T bandage has also been worn in this case with considerable advantage.

If a woman liable to falling down of the womb, become pregnant, there is no occasion for the pessary after the third month, and by proper treatment after delivery, the return of the complaint may be prevented.

MISCARRIAGE OR ABORTION.

We now come to the consideration of a subject, in respect to which there exists much misapprehension and ignorance, causing useless and unnecessary alarm and anxiety to those who may be so unfortunate as to be subject, at particular periods of gestation, to abortion or miscarriage.

The dangers of abortion or miscarriage are often magnified and exaggerated. It is dangerous if produced by a fall, a blow, a kick from a horse, or any other external bodily violence or injury, causing internal contusion, or rupture of some blood-vessels; and, also, but not to the same extent, if produced by sudden fright, violent fits of passion, &c., or from general debility or disease of the uterus; but the danger arises more from the cause which produces the miscarriage, than from the miscarriage itself; as it is well known by those versed in obstetrics that, where it is deemed indispensable to effect a miscarriage, either because of the existence of a deformed pelvis, diseased uterus, or other causes, if skilfully effected, it is attended with no danger, especially in the earlier stages of pregnancy.[43]

_Symptoms._

When miscarriage is about to take place, its first symptoms are generally occasional stinging pains at the bottom of the belly, extending across and around the loins and hips; a feeling of fatigue of the legs, pain in the forehead, burning sensation of the eyes. The breasts, which before were distended, become soft and flabby, hot and cold flashes, attended with thirst, fever, and shiverings. In a day or two after the appearance of these symptoms, a discharge from the womb takes place of yellow matter, tinctured with red. If not arrested at this stage, the pains across the loins become more severe and frequent, attended with a sense of dead weight, and bearing down about the womb, the water is discharged, and the expulsion of the contents of the womb takes place. The symptoms of miscarriage, however, vary with the causes which produce them, or the state of habit, age, or health of the patient; some recovering immediately, and rapidly, and with but little inconvenience. Where miscarriage arises from a serious accident, such as violent falls, bruises, &.c., the symptoms are somewhat aggravated, and more severe, and are often preceded and accompanied with violent and profuse floodings and discharges of coagula, in addition to the other symptoms; although moderate flowing is not an unfrequent symptom in miscarriages.

It is always accompanied with two circumstances, separation of the membranous bag, and expulsive efforts or contraction of the womb itself. The first is productive of discharge, the second of pains like those of labor. Sometimes the separation or detachment of part of the conception takes place before any pain is felt; on other occasions, the pain, or contraction of the womb, takes place first, and produces a separation. In the first of these cases, the symptoms of abortion take place suddenly, and are usually occasioned by fatigue, sudden exertion, or fright. In the second, the pains come on, and there are particular feelings, and changes, which indicate that a miscarriage is likely to take place; as, for instance, the cessation of the morning sickness, the subsidence of the breasts, &c.

Miscarriage is preceded by floodings, pains in the back, loins, and lower part of the abdomen, evacuation of the water, shiverings, palpitation of the heart, nausea, anxiety, fainting, subsiding of the breasts and belly, pain in the inside of the thighs, opening and moisture of the womb.

_Causes._

The principal causes of miscarriage are blows or falls; great exertion or fatigue; sudden frights and other violent emotions of the mind; a diet too sparing or too nutritious; the abuse of spirituous liquors; other diseases, particularly fevers and hæmorrhages; likewise excessive bleeding, profuse diarrhœa or colic, particularly from accumulated fæces; immoderate venery, &c.

_Treatment._

When a woman is threatened with a miscarriage, there are two objects to attend to; the first is, to prevent it if we can; the second is to manage it so that as little blood as possible be lost; and both these are obtained by the same means. With this view, the patient should immediately, on the first alarm, undress and go to bed, lightly covered, with a firm determination not to rise till the process be either checked or completely over. There should be little fire in the room, though it be winter; and in summer, the windows must be opened. Cloths wet with cold water, should instantly be applied to the lower part of the belly, and back: the drink must be cold, and everything stimulating should carefully be avoided.

In robust habits, or when the symptoms have been brought on suddenly by some such cause as a fall or exertion, it is proper to bleed; and, in cases of sickness or great feebleness, to give a dose of laudanum; or, what is better, to administer the anodyne clysters.[44]

Opiates are useful in every case where we hope to prevent abortion, and must be repeated more often or seldom, according to the effect they produce. They are, however, improper in those cases where miscarriages must decidedly take place. Their tendency to occasion costiveness, when employed, must be obviated by clysters, or some gentle laxative medicine, such as calcined magnesia, Epsom salts, or a little castor oil. If there be a continued but trifling discharge, great advantage may be derived from injecting, three or four times a day, up the vagina, a solution of alum. Indeed, in all protracted cases, this is of much benefit. The solution ought to be thrown up pretty high, that it may reach the womb.

When these means produce not the desired effect, and along with the discharge of blood large clots come off attended with bearing down or pains in the back and loins, especially if the symptoms which precede abortion have appeared, there must be every probability that the threatening event cannot be avoided; then we must conduct the patient through the process.

In all cases during the last stage of pregnancy, where our endeavors to stop or repress the hemorrhage prove abortive, it will be advisable to deliver her as soon as possible.

When the whole conception come away at once, the pain and discharge usually go off; but, if only the fœtus come away, all the symptoms either continue and increase till the placenta come away, or, if they be for a time suspended, they are sure to return, except in early miscarriages of ten or twelve weeks pregnancy, when sometimes the fœtus is expelled separately, and the placenta comes immediately after, but the latter frequently remains several days. The most prudent mode in such cases is to leave it to nature, which sooner or later expels this foreign body.

After the process is over, if the discharge be profuse, and do not stop on the application of cold water to the lower part of the belly, it will be proper to plug up the vagina, and this is best done by taking a piece of soft sponge, dipping it in sweet oil, and then wringing it gently. This is to be introduced with the finger, portion after portion, until the lower part of the vagina be well filled. The remainder is then to be firmly pressed on the orifice; and held there some time for the effused blood to coagulate. In obstinate cases, previously to the introduction of the plug, we may insert a little pounded ice, or snow tied up in a rag, if to be procured,[45] but neither of these should be continued so long as to produce pain or much shivering. In addition to this mode of treatment, it will be advisable to have recourse to the astringent medicines, as advised under the head of _Immoderate Flow of Menses_.

_Regimen._

Arrow-root, tapioca, sago, panada, or rice milk, constitute a proper regimen. If the process be protracted, and the strength much impaired, the diet may be more liberal. In every case, ripe fruit is safe and useful. The bowels are to be kept regular, and sleep, if necessary, is to be procured by an anodyne.

_Prevention._