Girl and woman; a book for mothers and daughters

Front matter

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Preface

We have recently awakened to the fact that the most important period in life as regards the formation of character, instead of being the first decade as always supposed, is really the years between childhood and maturity. But although the attention of parents and guardians is now focussed upon this season as one of supreme importance, especially as regards girls, the sources of information concerning it are few and far between. Aside from Dr. Stanley Hall's monumental work, the size and extent of which somewhat restrict its field of usefulness, all information upon the subject of girlhood is sparsely scattered over a wide territory of periodical literature, much of it being contained in psychological and pedagogical journals or similar places remote from the main-traveled road familiar to the general reader. Moreover, these articles are commonly written by specialists in language which requires some interpretation.

To make this mass of scattered and semi-technical information available to the public at large, it required to be reviewed and sifted, in order that the main facts, as well as the more important of the views viii PREFACE

and ideas suggested by them, could be presented in a simple and compact form, easy of assimilation by those most nearly concerned. The preception of this want has led to the preparation of this little volume, which, it is hoped, may place the valuable results obtained through the labors of thoughtful minds at the service of many who lack time or opportunity to seek them along the bye-paths of specialized literature. No pains have been spared to make the investigation complete and to seek authority at the fountain head.

It is with great pleasure that I avail myself of this opportunity to acknowledge the kindness shown me by friends in the course of my work. To Professor W. H. Howell of the Johns Hopkins Medical School I am indebted for council and suggestion concerning the first four chapters and to Dr. Elizabeth Hurdon, Assistant in Gynecology in the same University for criticism of the fifth chapter.

But most especially my thanks are due to Dr. Howard A. Kelly for the interest he has taken in my work and for his kindness in allowing my little book to enter the world under his protection. The service he has rendered me in this instance is but one of many helpful actions, each of which forms a rivet in a friendship which is one of my most valued possessions.

Caroline Wormeley Latimer, M.D.

Baltimore, June 22, 1909.

Introduction

I am glad that Dr. Latimer has undertaken to write this much needed work addressed to women at large, and conveying a mass of useful information in language free from technicalities. I am of opinion that such instruction as is here given, with proper reserve as to special functions, is wiser than that conveyed in many of the popular cheap books touching upon these hitherto forbidden subjects.

A few centuries have wrought great changes in our views upon the training of women. But three hundred years ago the ordering of a girl's life was a matter of interest to nobody and the world at large agreed with Thomas Fuller of that time that " Daughters are silent strings sending no sound to posterity and losing their identity in their husbands." But this view-point is altogether changed, and the thoughtful, conscientious parent to-day holds a daughter's education, in the widest sense, as no less important than a son's. It is only of recent years, however, that we have begun to recognize in girlhood a distinct period in life with characteristic demands and necessities. How much we have neglected this critical age may be gathered from a glance over Poole's Index x INTRODUCTION

of Periodical Literature for the last ten years, where the titles of papers dealing with either childhood or womanhood fill several pages, while those devoted to girlhood as a separate and distinct stage in life occupy only a few lines. During the last year or two of the decade, however, the articles on girlhood steadily increase in number, a significant change, which is due to the fact that the psychologists have recently devoted much attention to adolescence, and the interest thus aroused has extended to the public.

Psychological research has made it plain that no period in a woman's life is so important to herself or so full of interest to her natural guardians as the transition years of development from childhood to womanhood, and it has also shown that her evolution, instead of being extremely brief, as was supposed, is really a process of slow and gradual unfolding of both body and mind, occupying all the years between twelve and twenty-one. Another fact lately made evident is that the impressibility of this period of life is greater than any other, for the mind is more susceptible to influence, and the moral nature more plastic than at any subsequent time, while the individual sense of right and wrong becomes clearer than at an earlier age. For these reasons the principles instilled into a girl's mind at this critical stage of her life's journey are of paramount importance. There are two supreme objects to be kept in view at this

INTRODUCTION xi

period: first, that she shall pass through its changes in a natural, happy, and healthful manner; and second, that her training shall be such as to fit her for the serious burdens of the years that are to follow when she must shoulder the cares and responsibilities of life. The burning question with those interested in securing her health and happiness is the best means of arriving at the desired end, and here there are still some differences of opinion.

In the days of our grandmothers custom decreed the formal separation of the sexes almost from babyhood, and all pursuits, work, and pleasures advanced along different lines, planned to fit the boy to cope with the world and fight his own battles, while the girl, who was no warrior, received no definite training and lived restrained within the narrow limits of her natural physical activities. A generation ago we awakened to the discovery that physical freedom and activity are as good and as necessary for a little girl as for a little boy, and that the principles of elementary education which produced the best results with boys succeeded equally well with girls. This illuminating idea at once deferred the separation of the sexes until adolescence, but as it was then still enforced bodily freedom for a girl ended in most cases with childhood, while her mental training was much less thorough than that of her brother.

To-day we hold that a system which condemns xii INTRODUCTION

outdoor life and activities as unwomanly, and sacrifices sound learning for mere drawing-room accomplishments is fundamentally wrong. We have, therefore, changed our tactics and proceeded to give girls the same advantages as boys, both physically and mentally. The one point now at issue is this : Is a girl best fitted for life by precisely the same training as a boy, or is some modification desirable in conformity with the elementary difference of sex?

I think that those who say : " Let there be no difference whatever," fail to give sufficient weight to the issues involved and overlook the fact that when boys and girls reach puberty the fundamental difference between them, hitherto latent, asserts itself openly and emphatically and cannot henceforth be ignored without serious consequences to the proper development and sound health of both body and mind in the girl. The establishment of puberty in itself is always a strain upon the physical and mental forces, often severe enough to affect the general health or the central nervous system. For both sexes puberty is a period requiring especial care and watchfulness and when it is over, and the fundamental differences between the sexes are fully established, the function of menstruation with its cyclical changes and their demands upon the nervous system continues to call for consideration in young women. Few girls or women can treat this function with entire disregard, except at

INTRODUCTION xiii

their peril. I do not say that the menstrual periods ought seriously to interrupt the routine of daily life in a healthy girl, and any manifest invalidism may be accepted as evidence of depressed health. But undue exertion, prolonged and repeated, at such times almost inevitably results in an exhaustion of the nervous system, manifested, sooner or later, by excessive periodical suffering or by some more general disturbance.

To illustrate this fact take the athletic sports now so general for girls. A boy who plays on his team at school or college is under no necessity for heeding the times and seasons of his games, being as fit to play one day as another, but almost every girl, under like conditions, must consider a regularly recurring interval when her nervous force is so taxed by the demands of her economy that the excessive effort demanded by the game places her at a disadvantage for the moment, beside exposing her to the risk of lasting ill effects, even so great as life-long invalidism. Some strong vigorous girls do sometimes play tennis, basket-ball, and hockey at such times with impunity, but no girl can risk the strain of a match game without danger of suffering from it sooner or later, not only because of the extreme bodily effort, but because of the nervous tension arising from the excitement of competition together with the emotional disturbance inevitably attending- success or defeat.

xiv INTRODUCTION

Excessive nervous strain is, in fact, the key to the whole situation and we find that the sex limit imposed by means of it is as definite on the intellectual side of life as it is in the sphere of the body. The present system of education for women, with all its improvements, has the defects of its qualities in its ever insistent emulation and competition with their resultant tension and excitement. An ambitious girl with examinations awaiting her during the menstrual period is exposed to risks similar to those of the athletic field and is under the same disadvantages as compared with her brother. But while there are many who realize the dangers of physical over-exertion during menstruation, few seem alive to the, perhaps, greater risks of mental high pressure at such times and at an age when the emotional nature is most excitable.

To my mind these observations teach us that a woman's physical well-being, under existing social conditions, depends largely upon her willingness to acquiesce in those moderate and proper restrictions imposed by nature upon her sex. I have used examinations and athletic sports simply as a means to illustrate my position, which is : first, that a woman must avoid excessive effort of body or mind during the menstrual periods and that if she neglects this salutary precaution her health will suffer in the long run; second, that this fact, of necessity, prevents her from

INTRODUCTION xv

standing on a perfect equality with a man engaged in the same occupations. Just what precautions are called for must be determined according to the conditions in each individual case ; this question is fully discussed in one of Dr. Latimer's chapters. We may draw one general conclusion, however, which is that while experience has shown that girls are in every way better for the removal of artificial restrictions upon their activities, it is also plain that any attempt to treat the restrictions imposed by Nature as though they did not exist, results, as a rule, in harm to body and mind.

Some of the partisans of exact uniformity in the training of the sexes who are unwilling to admit any necessity for caution whatever, point with conviction to a certain proportion of women who are able to disregard the menstrual function without suffering for doing so. But this argument overlooks the chief difficulty, which is that the mischief done by the neglect of a periodical conservation of the forces does not usually show itself immediately and may take the form of some disturbance of a general character. Indiscreet and prolonged exertion during the periods, during a series of years, may be a factor of importance in the production of nervous prostration, though the causal link in the chain may have long since disappeared.

But, in my opinion, the greatest harm done by an xvi INTRODUCTION

education which teaches a girl to regard her sphere in life as identical with that of a boy is that by suggestion or implication it encourages her to despise the duties belonging to her sex by right of Nature, thereby striking at the roots of her real happiness. It is not that a woman is in any sense whatever inferior to a man, but that her sphere is a different and a complementary one. A man and a woman each does many things that the other cannot do, but in their respective spheres how distinct, how different they are! The very best our civilization has yet offered has been the higher education of our daughters. But the theory that public offices and public works are as much the business of a woman as of a man, holding public claims as more honorable and more worthy of attention than those of the home, is injurious alike to women and to the public they desire to serve. Philanthropic occupations are of paramount importance under certain conditions, and the woman who does not marry often finds in them her vocation and her salvation from the narrow, gossiping existence once the lot of the old maid. These activities, however, must ever be of secondary importance to the married woman. The woman who devotes herself exclusively to outside interests, I believe, contributes less to life and gets less from it than she whose activities lie mainly or wholly in the sphere of the home. There exist certain conservatives who, while they

INTRODUCTION xvii

fully appreciate the limitations imposed by the difference of sex and the importance of the claims upon women in her own peculiar sphere, are sometimes apt to do our girls an injustice from an entirely opposite point of view. These people incline to the notion that if a girl marries she not only does not need, but may be actually hurt by more than an elementary education; while, on the other hand, they admit that, should she remain single, it is well that her mind should be cultivated extensively in order to open up numerous avenues of interest and activity. If this idea were rational, the difficulties consequent upon it would be serious indeed, since girls cannot be divided at birth into queens and workers like bee larvae. Fortunately, the difficulty, when squarely faced, disappears. Data thus far collected touching higher education for women show that learning in itself does not interfere, but rather adds to a girl's usefulness as a wife or mother, nor does college wisdom, as Matthew Arnold expressed it, " affect her chances " of matrimony. And it is surely but a shallow conception of the marriage state which holds that there is no room in it for knowledge and a diversity of interests. A healthier, saner view is that which holds that whatever develops a girl's faculties and broadens her outlook upon life makes her better fitted for her work in the world, whether that work is ultimately carried on in the single or the married state, and that xviii INTRODUCTION

the more cultivation, the more information, the wider the interests a woman brings to bear upon her intercourse with her husband and her children the more ennobling and elevating are their mutual relationships. Finally, I desire to repeat, that the sum of what I have been saying is this: In their practical, daily, human relations the sexes are never precisely alike except during the earliest years of childhood. For the first ten years of life a boy and a girl may be looked upon and treated as identical, though even then the foreshadowing of the coming changes are always visible to keen eyes. But with the approach of puberty the fundamental differences, everywhere stamped upon the sexes in nature, become sharply defined and the breach thus made widens with the succeeding years until maturity finds the man and the woman two distinct entities, complementary in all their future relations. It is the office of the wise physician, as well as of the philanthropist and of the educator, not to minimize but to recognize these differences and to lead young women wisely into the paths designed for them. The book before us is a notable effort in this direction.

Howard A. Kelly, M.D.

Baltimore, June, 1909.

Contents

CHAPTER

I.— Physical Disturbances of Girlhood II.— Mental Disturbances of Girlhood III.— Moral Disturbances of Girlhood .

IV. — Reproduction

Chapter I Physical Disturbances Of Girlhood

General considerations — Changes in the bones and muscles — Curvature of the spine — Changes in the heart and arteries — Blushing — Anemia ■ — Chlorosis — Changes in the lungs and thorax — Changes in the skin — Eruptions

— Changes in Digestion — Appetite — Teeth — ■ Changes in the organs of special sense — Voice — Smell — Hearing

— Vision — Changes in the nervous system — Chorea — Stammering — Sick headache — Neurasthenia — Epilepsy

— Conclusion.

The period of a girl's passage from childhood to womanhood is characterized by changes of the most radical and far-reaching description. Up to this time her development, both of body and mind, has been steady and uniform, following definite lines and not subject to sudden checks or advances. Now she reaches a point when a hitherto dormant force awakens within her, in response to which she enters upon a phase of what has been called tumultuous grozvth.

The impulse to activity, now making itself felt for the first time, proceeds from the great elemental instinct, sex, which is henceforward to be one of the most powerful agencies in her life. The central feature of this period is, therefore, the development of the reproductive organs and of the functions connected with them, but associated with these primary changes are secondary ones, both mental and physical, which extend their influence in all directions. Almost every organ and system in the body begins to grow with startling rapidity though at different rates of speed, so that relative proportions are everywhere changed, sometimes permanently, in other cases for the time being. The mind, and even more the emotions, show evidence of change to a marked degree, the character develops, the moral sense begins to act independently, the perceptions become more acute, the susceptibilities more active, until finally, in the space of a few brief years, the child has disappeared and a woman, in whom, perhaps, not a trace of the child remains, occupies her place.

It is needless to say that this period of life is one of supreme importance in a woman's life. Not only her immediate well-being but her well-being in the future depend upon the manner in which she passes through it. The phase of development in itself, however, is perfectly natural, and the changes incident to it are only such as lead naturally to a normal womanhood.

Next to the sexual changes, which will be discussed elsewhere, the most striking feature is a sudden and rapid increase in height and weight, that begins about thirteen. The difference in height taking place in the course of a few months may be so great as to make it seems as if we had to do with a different girl; a tremendous interval all at once appears between her and the brothers and sisters next to her in the family, and she outgrows her wardrobe so fast that it is almost impossible to keep her in clothes. This rapid growth in height comes to an end (on an average) about fifteen and the final stature is then nearly, if not quite complete. It is true that a girl may, and not infrequently does, continue to grow for several years longer, but the process is comparatively slow and the addition to her height inconsiderable.

This increase In height is accompanied by an increase in weight, but not commonly a proportionate one, the advance in height being the more rapid of the two. With girls this disproportion between height and weight is not so marked as with boys, because in a girl, the development of the figure and of the hips, with all the attendant curves, does a great deal to conceal the apparent loss of tissue. There is a great deal of difference, however, between individual girls in this respect, some of them showing but slight signs of womanly development until the period of rapid growth is over, when they begin to fill out rapidly; while with others, the womanly changes proceed side by side with the increase in stature.

The basis for all this rapid growth is profound changes in the bones and muscles. The rapidity of these changes, as we have just said, is not proportionate, and the disproportion between them is responsible for much of the awkwardness and clumsiness of movement so characteristic of the age. When the long bones grow more rapidly than the muscles attached to them we have the familiar " growing pains," while when the muscles grow faster than the bones there is extreme mobility of the joints. The various contortions of the limbs and of the fingers and toes, to which girls of thirteen and fourteen are so much addicted, are possible at this time by reason of this mobility, which disappears in the course of a few years. The power of muscular co-ordination also develops greatly, so that this is the time when manual training in all pursuits or trades requiring dexterity and delicacy of touch ought to begin. If it is not undertaken until later, when the mobility has diminished, the same degree of skill can never be attained, but it cannot be carried very far earlier, for the necessary power of co-ordination between brain and muscle is not yet developed.

A danger belonging especially to this period of growth is curvature of the spine. All the bones of the body are first formed in cartilage and gradually converted into true bone by the deposit of lime salts, a process not entirely complete before the twenty-fifth year. While the bones are still largely cartilaginous, they are soft enough to yield easily to pressure, a fact which is made use of by certain races to produce distortions which they consider beautiful. The most familiar example of this practice is the foot-binding of China, and another is the distortion of the shape of the head admired by certain of the North American Indians, who produce it by tying bits of board to a young child's skull. In early girlhood the spinal column is still not fully hardened, and is therefore easily affected by pressure. When the period of rapid growth begins, the increase in height is often so sudden that a girl finds it hard to hold herself erect and is apt to assume slouching, ungainly positions, all the more because she feels herself awkward and uncomfortable. Any attitude which throws the spinal col. umn out of its normal line, such as standing with the weight of the body thrown altogether on one foot, or keeping one leg crossed over the other without reversing the position, is likely to cause a curvature of the spine. The sitting posture is apt to result in spinal curvature when the head rests always on the same hand while reading, or the body is inclined to the right side while writing, both of which attitudes are constantly assumed by school girls. Occupations or trades which require the continual use of the right hand and arm, such, for instance, as dressmaking, have the same result,, if girls begin to work at them while still quite young. Rightsided lateral curvature at about the level of the arm is the result of this particular error of position. It is the most common of all in the different curvatures, no doubt because there are so many occupations which oblige the incessant use of the right arm and hand; but there are other curvatures associated with other faulty attitudes. The best preventive of this state of things is abundance of active physical exercise in the open air, as well as the daily use of systematic exercises, either at home or in a gymnasium. If a curvature has already begun, a great deal can be done to correct it by special gymnastic work under trained supervision, without resort to mechanical appliances.

Next to the changes in bone and muscles those in the heart and arteries are most significant. In childhood the heart is relatively small and the arteries large, but at maturity this state of things has been reversed, the difference being caused by increased growth on the part of the heart in the years between twelve and twenty-five. Not that the arteries cease to grow, but they do so more slowly than before, while the heart grows faster. With the growth of the heart it acquires, of course, additional strength, and as the arteries are but little larger, the pressure of the blood within them is increased; this increased pressure resulting in great activity of both mind and body, which finds physical expression in a craving for movement and muscular action of any kind, which it is cruelty to repress.

The whole circulatory system is in a state of great excitability which manifests itself in many different ways. Coldness of the hands- and feet from feebleness of the circulation in the extremities, is quite frequent and occasionally, though more rarely, there are sudden flushes or chills over the whole body. Another disturbance of the circulation especially frequent in youth because of the peculiar conditions of the period is blushing. The stimulus in the act of blushing is, of course, a mental one, being the consciousness of self aroused by some external impression, but the impulse thus aroused, transmitted through the nervous system to the superficial blood vessels, results in a rush of blood to the face. Exactly why the face should be the locality affected by the impulse has not been satisfactorily explained. We do know, however, that blushing is not necessarily confined to the face or even to the neck, having been observed, in certain cases, to spread over the whole body. Youth, as we shall presently see, is a period of intense self-consciousness, and this fact, together with the disturbed condition of the circulation at that time of life, explains why blushing is so much more common at that time than later in life.

It sometimes happens that the changes in the blood vessels affect the veins as well as the arteries, and when this is the case there may be varicose veins of the lower extremities, although it is a rare occurrence. Bleeding from the nose, which is quite common in girlhood, is partly due to the disturbed state of the circulation and partly to poverty of the blood itself.

It is not surprising that such significant changes in the heart and arteries should sometimes be accompanied by disturbance of the heart's action. As a matter of fact, irregularity and palpitation, with shortness of breath and a feeble or intermittent pulse, are not at all uncommon in young girls. Whenever these symptoms occur a doctor ought to be consulted and his advice followed implicitly. In the large majority of cases there is no disease of the heart, but only a physician can determine whether it is absent; moreover a girl who shows such symptoms requires more hours of rest in the recumbent position than she would under ordinary conditions, and it is for a doctor to decide how many they should be, and also what amount of physical exercise is advisable, too little being nearly as bad as too much.

Changes in the composition of the blood itself are not uncommon in girlhood. The most frequent of these is anemia, or simple poverty of the blood, caused by deficiency in the number of red cells of the blood or in their capacity to nourish the tissues. This condition is marked by pallor, with great languor and disinclination to exertion, both mental and physical, quite out of keeping with the usual activity of the age. Whenever a girl who has hitherto been bright and active, both physically and mentally, begins to feel her school work too much for her, and play such an effort that she would rather sit still and read she is probably anemic, especially if she is losing color. But anemia is sometimes present without pallor. Headache is a common accompaniment of anemia as well as a tendency to hemorrhage, shown usually in bleeding from the nose. Sometimes the blood is seen to be a lighter red than it should be. Simple anemia usually yields readily to treatment, especially iron and cod-liver oil. Another condition associated with changes in the blood and belonging almost exclusively to this period in life, is chlorosis, more commonly known as green-sickness. It is so closely connected, however, with irregularities of menstruation, which are one of its chief symptoms, that it seems better to consider it with that subject.

The vital capacity of the lungs, that is to say, their capacity for holding air, increases very much in early girlhood. There seems to be some difference of opinion as to the exact period between twelve and sixteen when the increase is most decided, but all observers agree that it is greater during these years than at any other period of life. This increase in io GIRL AND WOMAN

vital capacity is accompanied, as we should naturally suppose, by an increase in the size and weight of the lungs, and as the heart is rapidly becoming larger, it is plain the circumference of the chest must enlarge in order to accommodate the growth of the organs within it. As a matter of fact, the ribs do grow rapidly and at the same time harden rapidly from deposit of lime salts. They do not become completely ossified, however, before twenty, and up to that time their shape can be easily modified by pressure, especially during the years just following childhood, when they are still largely cartilaginous. This fact has a most important bearing upon the question of girls' clothing. Any considerable constriction around the ribs will result in a change of their shape, more or less marked according to the degree of pressure and the age at which it occurs. It also interferes with the development of the lungs and makes them more liable to tuberculosis. Tight lacing at this period is productive of much more harm than it is later, for the whole shape of the thorax may be altered by it. There can be no doubt that the digestive organs undergo important changes during girlhood, but the nature of these changes is not clearly understood and it would not be profitable to discuss them here. Indigestion is not so common in youth as it is in later life, and when it does occur is usually of temporary duration, provoked by imprudence of diet. But this