As far as England is concerned, at a discussion of normal and painful menstruation at a meeting of the British Association of Registered Medical Women on the 7th of July, 1908, it was stated by Miss Bentham that 50 per cent. of girls in good position suffered from painful menstruation. Mrs. Dunnett said it usually occurred between the ages of twenty-four and thirty, being frequently due to neglect to rest during menstruation in the earlier years, and Mrs. Grainger Evans had found that this condition was very common among elementary school teachers who had worked hard for examinations during early girlhood.
In America various investigations have been carried out, showing the prevalence of disturbance in the sexual health of school girls and young women. Thus Dr. Helen P. Kennedy obtained elaborate data concerning the menstrual life of one hundred and twenty-five high school girls of the average age of eighteen ("Effect of High School Work upon Girls During Adolescence," _Pedagogical Seminary_, June, 1896). Only twenty-eight felt no pain during the period; half the total number experienced disagreeable symptoms before the period (such as headache, malaise, irritability of temper), while forty-four complained of other symptoms besides pain during the period (especially headache and great weakness). Jane Kelley Sabine (quoted in _Boston Medical and Surgical Journal_, Sept. 15, 1904) found in New England schools among two thousand girls that 75 per cent. had menstrual troubles, 90 per cent. had leucorrhoea and ovarian neuralgia, and 60 per cent. had to give up work for two days during each month. These results seem more than usually unfavorable, but are significant, as they cover a large number of cases. The conditions in the Pacific States are not much better. Dr. Mary Ritter (in a paper read before the California State Medical Society in 1903) stated that of 660 Freshmen girls at the University of California, 67 per cent. were subject to menstrual disorders, 27 per cent. to headaches, 30 per cent. to backaches, 29 per cent. were habitually constipated, 16 per cent. had abnormal heart sounds; only 23 per cent. were free from functional disturbances. Dr. Helen MacMurchey, in an interesting paper on "Physiological Phenomena Preceding or Accompanying Menstruation" (_Lancet_, Oct. 5, 1901), by inquiries among one hundred medical women, nurses, and women teachers in Toronto concerning the presence or absence of twenty-one different abnormal menstrual phenomena, found that between 50 and 60 per cent. admitted that they were liable at this time to disturbed sleep, to headache, to mental depression, to digestive disturbance, or to disturbance of the special senses, while about 25 to 50 per cent. were liable to neuralgia, to vertigo, to excessive nervous energy, to defective nervous and muscular power, to cutaneous hyperæsthesia, to vasomotor disturbances, to constipation, to diarrhoea, to increased urination, to cutaneous eruption, to increased liability to take cold, or to irritating watery discharges before or after the menstrual discharge. This inquiry is of much interest, because it clearly brings out the marked prevalence at menstruation of conditions which, though not necessarily of any gravity, yet definitely indicate decreased power of resistance to morbid influences and diminished efficiency for work.
How serious an impediment menstrual troubles are to a woman is indicated by the fact that the women who achieve success and fame seem seldom to be greatly affected by them. To that we may, in part, attribute the frequency with which leaders of the women's movement have treated menstruation as a thing of no importance in a woman's life. Adele Gerhard, and Helene Simon, also, in their valuable and impartial work, _Mutterschaft und Geistige Arbeit_ (p. 312), failed to find, in their inquiries among women of distinguished ability, that menstruation was regarded as seriously disturbing to work.
Of late the suggestion that adolescent girls shall not only rest from work during two days of the menstrual period, but have an entire holiday from school during the first year of sexual life, has frequently been put forward, both from the medical and the educational side. At the meeting of the Association of Registered Medical Women, already referred to, Miss Sturge spoke of the good results obtained in a school where, during the first two years after puberty, the girls were kept in bed for the first two days of each menstrual period. Some years ago Dr. G.W. Cook ("Some Disorders of Menstruation," _American Journal of Obstetrics_, April, 1896), after giving cases in point, wrote: "It is my deliberate conviction that no girl should be confined at study during the year of her puberty, but she should live an outdoor life." In an article on "Alumna's Children," by "An Alumna" (_Popular Science Monthly_, May, 1904), dealing with the sexual invalidism of American women and the severe strain of motherhood upon them, the author, though she is by no means hostile to education, which is not, she declares, at fault, pleads for rest for the pubertal girl. "If the brain claims her whole vitality, how can there be any proper development? Just as very young children should give all their strength for some years solely to physical growth before the brain is allowed to make any considerable demands, so at this critical period in the life of the woman nothing should obstruct the right of way of this important system. A year at the least should be made especially easy for her, with neither mental nor nervous strain; and throughout the rest of her school days she should have her periodical day of rest, free from any study or overexertion." In another article on the same subject in the same journal ("The Health of American Girls," Sept., 1907), Nellie Comins Whitaker advocates a similar course. "I am coming to be convinced, somewhat against my wish, that there are many cases when the girl ought to be taken out of school entirely for some months or for a year _at the period of puberty_." She adds that the chief obstacle in the way is the girl's own likes and dislikes, and the ignorance of her mother who has been accustomed to think that pain is a woman's natural lot.
Such a period of rest from mental strain, while it would fortify the organism in its resistance to any reasonable strain later, need by no means be lost for education in the wider sense of the word, for the education required in classrooms is but a small part of the education required for life. Nor should it by any means be reserved merely for the sickly and delicate girl. The tragic part of the present neglect to give girls a really sound and fitting education is that the best and finest girls are thereby so often ruined. Even the English policeman, who admittedly belongs in physical vigor and nervous balance to the flower of the population, is unable to bear the strain of his life, and is said to be worn out in twenty-five years. It is equally foolish to submit the finest flowers of girlhood to a strain which is admittedly too severe.
It seems to be clear that the main factor in the common sexual and general invalidism of girls and young women is bad hygiene, in the first place consisting in neglect of the menstrual functions and in the second place in faulty habits generally. In all the more essential matters that concern the hygiene of the body the traditions of girls--and this seems to be more especially the case in the Anglo-Saxon countries--are inferior to those of youths. Women are much more inclined than men to subordinate these things to what seems to them some more urgent interest or fancy of the moment; they are trained to wear awkward and constricting garments, they are indifferent to regular and substantial meals, preferring innutritious and indigestible foods and drinks; they are apt to disregard the demands of the bowels and the bladder out of laziness or modesty; they are even indifferent to physical cleanliness.[29] In a great number of minor ways, which separately may seem to be of little importance, they play into the hands of an environment which, not always having been adequately adjusted to their special needs, would exert a considerable stress and strain even if they carefully sought to guard themselves against it. It has been found in an American Women's College in which about half the scholars wore corsets and half not, that nearly all the honors and prizes went to the non-corset-wearers. McBride, in bringing forward this fact, pertinently remarks, "If the wearing of a single style of dress will make this difference in the lives of young women, and that, too, in their most vigorous and resistive period, how much difference will a score of unhealthy habits make, if persisted in for a life-time?"[30] "It seems evident," A.E. Giles concludes ("Some Points of Preventive Treatment in the Diseases of Women," _The Hospital_, April 10, 1897) "that dysmenorrhoea might be to a large extent prevented by attention to general health and education. Short hours of work, especially of standing; plenty of outdoor exercise--tennis, boating, cycling, gymnastics, and walking for those who cannot afford these; regularity of meals and food of the proper quality--not the incessant tea and bread and butter with variation of pastry; the avoidance of overexertion and prolonged fatigue; these are some of the principal things which require attention. Let girls pursue their study, but more leisurely; they will arrive at the same goal, but a little later." The benefit of allowing free movement and exercise to the whole body is undoubtedly very great, both as regards the sexual and general physical health and the mental balance; in order to insure this it is necessary to avoid heavy and constricting garments, more especially around the chest, for it is in respiratory power and chest expansion more than in any other respect that girls fall behind boys (see, e.g., Havelock Ellis, _Man and Woman_, Ch. IX). In old days the great obstacle to the free exercise of girls lay in an ideal of feminine behavior which involved a prim restraint on every natural movement of the body.
At the present day that ideal is not so fervently preached as of old, but its traditional influence still to some extent persists, while there is the further difficulty that adequate time and opportunity and encouragement are by no means generally afforded to girls for the cultivation and training of the romping instincts which are really a serious part of education, for it is by such free exercise of the whole body that the neuro-muscular system, the basis of all vital activity, is built up. The neglect of such education is to-day clearly visible in the structure of our women. Dr. F. May Dickinson Berry, Medical Examiner to the Technical Education Board of the London County Council, found (_British Medical Journal_, May 28, 1904) among over 1,500 girls, who represent the flower of the schools, since they had obtained scholarships enabling them to proceed to higher grade schools, that 22 per cent, presented some degree, not always pronounced, of lateral curvature of the spine, though such cases were very rare among the boys. In the same way among a very similar class of select girls at the Chicago Normal School, Miss Lura Sanborn (_Doctors' Magazine_, Dec., 1900) found 17 per cent, with spinal curvature, in some cases of a very pronounced degree. There is no reason why a girl should not have as straight a back as a boy, and the cause can only lie in the defective muscular development which was found in most of the cases, sometimes accompanied by anæmia. Here and there nowadays, among the better social classes, there is ample provision for the development of muscular power in girls, but in any generalized way there is no adequate opportunity for such exercise, and among the working class, above all, in the section of it which touches the lower middle class, although their lives are destined to be filled with a constant strain on the neuro-muscular system from work at home or in shops, etc., there is usually a minimum of healthy exercise and physical development. Dr. W.A.B. Sellman, of Baltimore ("Causes of Painful Menstruation in Unmarried Women," _American Journal Obstetrics_, Nov., 1907), emphasizes the admirable results obtained by moderate physical exercise for young women, and in training them to care for their bodies and to rest their nervous systems, while Dr. Charlotte Brown, of San Francisco, rightly insists on the establishment in all towns and villages alike of outdoor gymnastic fields for women and girls, and of a building, in connection with every large school, for training in physical, manual, and domestic science. The provision of special playgrounds is necessary where the exercising of girls is so unfamiliar as to cause an embarrassing amount of attention from the opposite sex, though when it is an immemorial custom it can be carried out on the village green without attracting the slightest attention, as I have seen in Spain, where one cannot fail to connect it with the physical vigor of the women. In boys' schools games are not only encouraged, but made compulsory; but this is by no means a universal rule in girls' schools. It is not necessary, and is indeed highly undesirable, that the games adopted should be those of boys. In England especially, where the movements of women are so often marked by awkwardness, angularity and lack of grace, it is essential that nothing should be done to emphasize these characteristics, for where vigor involves violence we are in the presence of a lack of due neuro-muscular coördination. Swimming, when possible, and especially some forms of dancing, are admirably adapted to develop the bodily movements of women both vigorously and harmoniously (see, e.g., Havelock Ellis, _Man and Woman_, Ch. VII). At the International Congress of School Hygiene in 1907 (see, e.g., _British Medical Journal_, Aug. 24, 1907) Dr. L.H. Gulick, formerly Director of Physical Training in the Public Schools of New York City, stated that after many experiments it had been found in the New York elementary and high schools that folk-dancing constituted the very best exercise for girls. "The dances selected involved many contractions of the large muscular masses of the body and had therefore a great effect on respiration, circulation and nutrition. Such movements, moreover, when done as dances, could be carried on three or four times as long without producing fatigue as formal gymnastics. Many folk-dances were imitative, sowing and reaping dance, dances expressing trade movements (the shoemaker's dance), others illustrating attack and defense, or the pursuit of game. Such neuro-muscular movements were racially old and fitted in with man's expressive life, and if it were accepted that the folk-dances really expressed an epitome of man's neuro-muscular history, as distinguished from mere permutation of movements, the folk-dance combinations should be preferred on these biological grounds to the unselected, or even the physiologically selected. From the æsthetic point of view the sense of beauty as shown in dancing was far commoner than the power to sing, paint or model."
It must always be remembered that in realizing the especial demands of woman's nature, we do not commit ourselves to the belief that higher education is unfitted for a woman. That question may now be regarded as settled. There is therefore no longer any need for the feverish anxiety of the early leaders of feminine education to prove that girls can be educated exactly as if they were boys, and yield at least as good educational results. At the present time, indeed, that anxiety is not only unnecessary but mischievous. It is now more necessary to show that women have special needs just as men have special needs, and that it is as bad for women, and therefore, for the world, to force them to accept the special laws and limitations of men as it would be bad for men, and therefore, for the world, to force men to accept the special laws and limitations of women. Each sex must seek to reach the goal by following the laws of its own nature, even although it remains desirable that, both in the school and in the world, they should work so far as possible side by side. The great fact to be remembered always is that, not only are women, in physical size and physical texture, slighter and finer than men, but that to an extent altogether unknown among men, their centre of gravity is apt to be deflected by the series of rhythmic sexual curves on which they are always living. They are thus more delicately poised and any kind of stress or strain--cerebral, nervous, or muscular--is more likely to produce serious disturbance and requires an accurate adjustment to their special needs.
The fact that it is stress and strain in general, and not necessarily educational studies, that are injurious to adolescent women, is sufficiently proved, if proof is necessary, by the fact that sexual arrest, and physical or nervous breakdown, occur with extreme frequency in girls who work in shops or mills, even in girls who have never been to school at all. Even excesses in athletics--which now not infrequently occur as a reaction against woman's indifference to physical exercise--are bad. Cycling is beneficial for women who can ride without pain or discomfort, and, according to Watkins, it is even beneficial in many diseased and disordered pelvic conditions, but excessive cycling is evil in its results on women, more especially by inducing rigidity of the perineum to an extent which may even prevent childbirth and necessitate operation. I may add that the same objection applies to much horse-riding. In the same way everything which causes shocks to the body is apt to be dangerous to women, since in the womb they possess a delicately poised organ which varies in weight at different times, and it would, for instance, be impossible to commend football as a game for girls. "I do not believe," wrote Miss H. Ballantine, Director of Vassar College Gymnasium, to Prof. W. Thomas (_Sex and Society_, p. 22) "women can ever, no matter what the training, approach men in their physical achievements; and," she wisely adds, "I see no reason why they should." There seem, indeed, as has already been indicated, to be reasons why they should not, especially if they look forward to becoming mothers. I have noticed that women who have lived a very robust and athletic outdoor life, so far from always having the easy confinements which we might anticipate, sometimes have very seriously difficult times, imperilling the life of the child. On making this observation to a distinguished obstetrician, the late Dr. Engelmann, who was an ardent advocate of physical exercise for women (in e.g. his presidential address, "The Health of the American Girl," _Transactions Southern Surgical and Gynæcological Association_, 1890), he replied that he had himself made the same observation, and that instructors in physical training, both in America and England, had also told him of such cases among their pupils. "I hold," he wrote, "precisely the opinion you express [as to the unfavorable influence of muscular development in women]. _Athletics_, i.e., overdone physical training, causes the girl's system to approximate to the masculine; this is so whether due to sport or necessity. The woman who indulges in it approximates to the male in her attributes; this is marked in diminished sexual intensity, and in increased difficulty of childbirth, with, in time, lessened fecundity. Healthy habits improve, but masculine muscular development diminishes, womanly qualities, although it is true that the peasant and the laboring woman have easy labor. I have never advocated muscular development for girls, only physical training, but have perhaps said too much for it and praised it too unguardedly. In schools and colleges, so far, however, it is insufficient rather than too much; only the wealthy have too much golf and athletic sports. I am collecting new material, but from what I already have seen I am impressed with the truth of what you say. I am studying the point, and shall elaborate the explanation." Any publication on this subject was, however, prevented by Engelmann's death a few years later.
A proper recognition of the special nature of woman, of her peculiar needs and her dignity, has a significance beyond its importance in education and hygiene. The traditions and training to which she is subjected in this matter have a subtle and far-reaching significance, according as they are good or evil. If she is taught, implicitly or explicitly, contempt for the characteristics of her own sex, she naturally develops masculine ideals which may permanently discolor her vision of life and distort her practical activities; it has been found that as many as fifty per cent. of American school girls have masculine ideals, while fifteen per cent. American and no fewer than thirty-four per cent. English school girls wished to be men, though scarcely any boys wished to be women.[31] With the same tendency may be connected that neglect to cultivate the emotions, which, by a mischievously extravagant but inevitable reaction from the opposite extreme, has sometimes marked the modern training of women. In the finely developed woman, intelligence is interpenetrated with emotion. If there is an exaggerated and isolated culture of intelligence a tendency shows itself to disharmony which breaks up the character or impairs its completeness. In this connection Reibmayr has remarked that the American woman may serve as a warning.[32] Within the emotional sphere itself, it may be added, there is a tendency to disharmony in women owing to the contradictory nature of the feelings which are traditionally impressed upon her, a contradiction which dates back indeed to the identification of sacredness and impurity at the dawn of civilization. "Every girl and woman," wrote Hellmann, in a pioneering book which pushed a sound principle to eccentric extremes, "is taught to regard her sexual parts as a precious and sacred spot, only to be approached by a husband or in special circumstances a doctor. She is, at the same time, taught to regard this spot as a kind of water-closet which she ought to be extremely ashamed to possess, and the mere mention of which should cause a painful blush."[33] The average unthinking woman accepts the incongruity of this opposition without question, and grows accustomed to adapt herself to each of the incompatibles according to circumstances. The more thoughtful woman works out a private theory of her own. But in very many cases this mischievous opposition exerts a subtly perverting influence on the whole outlook towards Nature and life. In a few cases, also, in women of sensitive temperament, it even undermines and ruins the psychic personality.
Thus Boris Sidis has recorded a case illustrating the disastrous results of inculcating on a morbidly sensitive girl the doctrine of the impurity of women. She was educated in a convent. "While there she was impressed with the belief that woman is a vessel of vice and impurity. This seemed to have been imbued in her by one of the nuns who was very holy and practiced self-mortification. With the onset of her periods, and with the observation of the same in the other girls, this doctrine of female impurity was all the stronger impressed on her sensitive mind." It lapsed, however, from conscious memory and only came to the foreground in subsequent years with the exhaustion and fatigue of prolonged office work. Then she married. Now "she has an extreme abhorrence of women. Woman, to the patient, is impurity, filth, the very incarnation of degradation and vice. The house wash must not be given to a laundry where women work. Nothing must be picked up in the street, not even the most valuable object, perchance it might have been dropped by a woman" (Boris Sidis, "Studies in Psychopathology," _Boston Medical and Surgical Journal_, April 4, 1907). That is the logical outcome of much of the traditional teaching which is given to girls. Fortunately, the healthy mind offers a natural resistance to its complete acceptation, yet it usually, in some degree, persists and exerts a mischievous influence.
It is, however, not only in her relations to herself and to her sex that a girl's thoughts and feelings tend to be distorted by the ignorance or the false traditions by which she is so often carefully surrounded. Her happiness in marriage, her whole future career, is put in peril. The innocent young woman must always risk much in entering the door of indissoluble marriage; she knows nothing truly of her husband, she knows nothing of the great laws of love, she knows nothing of her own possibilities, and, worse still, she is even ignorant of her ignorance. She runs the risk of losing the game while she is still only beginning to learn it. To some extent that is quite inevitable if we are to insist that a woman should bind herself to marry a man before she has experienced the nature of the forces that marriage may unloose in her. A young girl believes she possesses a certain character; she arranges her future in accordance with that character; she marries. Then, in a considerable proportion of cases (five out of six, according to the novelist Bourget), within a year or even a week, she finds she was completely mistaken in herself and in the man she has married; she discovers within her another self, and that self detests the man to whom she is bound. That is a possible fate against which only the woman who has already been aroused to love is entitled to regard herself as fairly protected.
There is, however, a certain kind of protection which it is possible to afford the bride, even without departing from our most conventional conceptions of marriage. We can at least insist that she shall be accurately informed as to the exact nature of her physical relations to her future husband and be safeguarded from the shocks or the disillusions which marriage might otherwise bring. Notwithstanding the decay of prejudices, it is probable that even to-day the majority of women of the so-called educated class marry with only the vaguest and most inaccurate notions, picked up more or less clandestinely, concerning the nature of the sexual relationships. So highly intelligent a woman as Madame Adam has stated that she believed herself bound to marry a man who had kissed her on the mouth, imagining that to be the supreme act of sexual union,[34] and it has frequently happened that women have married sexually inverted persons of their own sex, not always knowingly, but believing them to be men, and never discovering their mistake; it is not long indeed since in America three women were thus successively married to the same woman, none of them apparently ever finding out the real sex of the "husband." "The civilized girl," as Edward Carpenter remarks, "is led to the 'altar' often in uttermost ignorance and misunderstanding of the sacrificial rites about to be consummated." Certainly more rapes have been effected in marriage than outside it.[35] The girl is full of vague and romantic faith in the promises of love, often heightened by the ecstasies depicted in sentimental novels from which every touch of wholesome reality has been carefully omitted. "All the candor of faith is there," as Sénancour puts it in his book _De l'Amour_, "the desires of inexperience, the needs of a new life, the hopes of an upright heart. She has all the faculties of love, she must love; she has all the means of pleasure, she must be loved. Everything expresses love and demands love: this hand formed for sweet caresses, an eye whose resources are unknown if it must not say that it consents to be loved, a bosom which is motionless and useless without love, and will fade without having been worshipped; these feelings that are so vast, so tender, so voluptuous, the ambition of the heart, the heroism of passion! She needs must follow the delicious rule which the law of the world has dictated. That intoxicating part, which she knows so well, which everything recalls, which the day inspires and the night commands, what young, sensitive, loving woman can imagine that she shall not play it?" But when the actual drama of love begins to unroll before her, and she realizes the true nature of the "intoxicating part" she has to play, then, it has often happened, the case is altered; she finds herself altogether unprepared, and is overcome with terror and alarm. All the felicity of her married life may then hang on a few chances, her husband's skill and consideration, her own presence of mind. Hirschfeld records the case of an innocent young girl of seventeen--in this case, it eventually proved, an invert--who was persuaded to marry but on discovering what marriage meant energetically resisted her husband's sexual approaches. He appealed to her mother to explain to her daughter the nature of "wifely duties." But the young wife replied to her mother's expostulations, "If that is my wifely duty then it was your parental duty to have told me beforehand, for, if I had known, I should never have married." The husband in this case, much in love with his wife, sought for eight years to over-persuade her, but in vain, and a separation finally took place.[36] That, no doubt, is an extreme case, but how many innocent young inverted girls never realize their true nature until after marriage, and how many perfectly normal girls are so shocked by the too sudden initiation of marriage that their beautiful early dreams of love never develop slowly and wholesomely into the acceptance of its still more beautiful realities?