Studies in the Psychology of Sex, Volume 6 Sex in...

The great though capricious educator, Basedow, to some extent a pupil of Rousseau, was an early pioneer in both the theory and the practice of giving school children instruction in the facts of the sexual life, from the age of ten onwards. He insists much on this subject in his great treatise, the Elementarwerk (1770-1774). The questions of children are to be answered truthfully, he states, and they must be taught never to jest at anything so sacred and serious as the sexual relations. They are to be shown pictures of childbirth, and the dangers of sexual irregularities are to be clearly expounded to them at the outset. Boys are to be taken to hospitals to see the results of venereal disease. Basedow is aware that many parents and teachers will be shocked at his insistence on these things in his books and in his practical pedagogic work, but such people, he declares, ought to be shocked at the Bible (see, e.g., Pinloche, La Rèforme de l'Education en Allemagne au dixhuitième siècle: Basedow et le Philanthropinisme, pp. 125, 256, 260, 272). Basedow was too far ahead of his own time, and even of ours, to exert much influence in this matter, and he had few immediate imitators.

Somewhat later than Basedow, a distinguished English physician, Thomas Beddoes, worked on somewhat the same lines, seeking to promote sexual knowledge by lectures and demonstrations. In his remarkable book, Hygeia, published in 1802 (vol. i, Essay IV) he sets forth the absurdity of the conventional requirement that "discretion and ignorance should lodge in the same bosom," and deals at length with the question of masturbation and the need of sexual education. He insists on the great importance of lectures on natural history which, he had found, could be given with perfect propriety to a mixed audience. His experiences had shown that botany, the amphibia, the hen and her eggs, human anatomy, even disease and sometimes the sight of it, are salutary from this point of view. He thinks it is a happy thing for a child to gain his first knowledge of sexual difference from anatomical subjects, the dignity of death being a noble prelude to the knowledge of sex and depriving it forever of morbid prurience. It is scarcely necessary to remark that this method of teaching children the elements of sexual anatomy in the post-mortem room has not found many advocates or followers; it is undesirable, for it fails to take into account the sensitiveness of children to such impressions, and it is unnecessary, for it is just as easy to teach the dignity of life as the dignity of death.

The duty of the school to impart education in matters of sex to children has in recent years been vigorously and ably advocated by Maria Lischnewska (op. cit.), who speaks with thirty years' experience as a teacher and an intimate acquaintance with children and their home life. She argues that among the mass of the population to-day, while in the home-life there is every opportunity for coarse familiarity with sexual matters, there is no opportunity for a pure and enlightened introduction to them, parents being for the most part both morally and intellectually incapable of aiding their children here. That the school should assume the leading part in this task is, she believes, in accordance with the whole tendency of modern civilized life. She would have the instruction graduated in such a manner that during the fifth or sixth year of school life the pupil would receive instruction, with the aid of diagrams, concerning the sexual organs and functions of the higher mammals, the bull and cow being selected by preference. The facts of gestation would of course be included. When this stage was reached it would be easy to pass on to the human species with the statement: "Just in the same way as the calf develops in the cow so the child develops in the mother's body."

It is difficult not to recognize the force of Maria Lischnewska's argument, and it seems highly probable that, as she asserts, the instruction proposed lies in the course of our present path of progress. Such instruction would be formal, unemotional, and impersonal; it would be given not as specific instruction in matters of sex, but simply as a part of natural history. It would supplement, so far as mere knowledge is concerned, the information the child had already received from its mother. But it would by no means supplant or replace the personal and intimate relationship of confidence between mother and child. That is always to be aimed at, and though it may not be possible among the ill-educated masses of to-day, nothing else will adequately take its place.

There can be no doubt, however, that while in the future the school will most probably be regarded as the proper place in which to teach the elements of physiology—and not as at present a merely emasculated and effeminated physiology—the introduction of such reformed teaching is as yet impracticable in many communities. A coarse and ill-bred community moves in a vicious circle. Its members are brought up to believe that sex matters are filthy, and when they become adults they protest violently against their children being taught this filthy knowledge. The teacher's task is thus rendered at the best difficult, and under democratic conditions impossible. We cannot, therefore, hope for any immediate introduction of sexual physiology into schools, even in the unobtrusive form in which alone it could properly be introduced, that is to say as a natural and inevitable part of general physiology.

This objection to animal physiology by no means applies, however, to botany. There can be little doubt that botany is of all the natural sciences that which best admits of this incidental instruction in the fundamental facts of sex, when we are concerned with children below the age of puberty. There are at least two reasons why this should be so. In the first place botany really presents the beginnings of sex, in their most naked and essential forms; it makes clear the nature, origin, and significance of sex. In the second place, in dealing with plants the facts of sex can be stated to children of either sex or any age quite plainly and nakedly without any reserve, for no one nowadays regards the botanical facts of sex as in any way offensive. The expounder of sex in plants also has on his side the advantage of being able to assert, without question, the entire beauty of the sexual process. He is not confronted by the ignorance, bad education, and false associations which have made it so difficult either to see or to show the beauty of sex in animals. From the sex-life of plants to the sex-life of the lower animals there is, however, but a step which the teacher, according to his discretion, may take.

An early educational authority, Salzmann, in 1785 advocated the sexual enlightenment of children by first teaching them botany, to be followed by zoölogy. In modern times the method of imparting sex knowledge to children by means, in the first place, of botany, has been generally advocated, and from the most various quarters. Thus Marro (La Pubertà, p. 300) recommends this plan. J. Hudrey-Menos ("La Question du Sexe dans l'Education," Revue Socialiste, June, 1895), gives the same advice. Rudolf Sommer, in a paper entitled "Mädchenerziehung oder Menschenbildung?" (Geschlecht und Gesellschaft, Jahrgang I, Heft 3) recommends that the first introduction of sex knowledge to children should be made by talking to them on simple natural history subjects; "there are endless opportunities," he remarks, "over a fairy-tale, or a walk, or a fruit, or an egg, the sowing of seed or the nest-building of birds." Canon Lyttelton (Training of the Young in Laws of Sex, pp. 74 et seq.) advises a somewhat similar method, though laying chief stress on personal confidence between the child and his mother; "reference is made to the animal world just so far as the child's knowledge extends, so as to prevent the new facts from being viewed in isolation, but the main emphasis is laid on his feeling for his mother and the instinct which exists in nearly all children of reverence due to the maternal relation;" he adds that, however difficult the subject may seem, the essential facts of paternity must also be explained to boys and girls alike.

Keyes, again (New York Medical Journal, Feb. 10, 1906), advocates teaching children from an early age the sexual facts of plant life and also concerning insects and other lower animals, and so gradually leading up to human beings, the matter being thus robbed of its unwholesome mystery. Mrs. Ennis Richmond (Boyhood, p. 62) recommends that children should be sent to spend some of their time upon a farm, so that they may not only become acquainted with the general facts of the natural world, but also with the sexual lives of animals, learning things which it is difficult to teach verbally. Karina Karin ("Wie erzieht man ein Kind zür wissenden Keuschheit?" Geschlecht und Gesellschaft, Jahrgang I, Heft 4), reproducing some of her talks with her nine-year old son, from the time that he first asked her where children came from, shows how she began with telling him about flowers, to pass on to fish and birds, and finally to the facts of human pregnancy, showing him pictures from an obstetrical manual of the child in its mother's body. It may be added that the advisability of beginning the sex teaching of children with the facts of botany was repeatedly emphasized by various speakers at the special meeting of the German Congress for Combating Venereal Disease devoted to the subject of sexual instruction (Sexualpädagogik, especially pp. 36, 47, 76).

The transition from botany to the elementary zoölogy of the lower animals, to human anatomy and physiology, and to the science of anthropology based on these, is simple and natural. It is not likely to be taken in detail until the age of puberty. Sex enters into all these subjects and should not be artificially excluded from them in the education of either boys or girls. The text-books from which the sexual system is entirely omitted ought no longer to be tolerated. The nature and secretion of the testicles, the meaning of the ovaries and of menstruation, as well as the significance of metabolism and the urinary excretion, should be clear in their main lines to all boys and girls who have reached the age of puberty.

At puberty there arises a new and powerful reason why boys and girls should receive definite instruction in matters of sex. Before that age it is possible for the foolish parent to imagine that a child may be preserved in ignorant innocence.[25] At puberty that belief is obviously no longer possible. The efflorescence of puberty with the development of the sexual organs, the appearance of hair in unfamiliar places, the general related organic changes, the spontaneous and perhaps alarming occurrence in boys of seminal emissions, and in girls of menstruation, the unaccustomed and sometimes acute recognition of sexual desire accompanied by new sensations in the sexual organs and leading perhaps to masturbation; all these arouse, as we cannot fail to realize, a new anxiety in the boy's or girl's mind, and a new curiosity, all the more acute in many cases because it is carefully concealed as too private, and even too shameful, to speak of to anyone. In boys, especially if of sensitive temperament, the suffering thus caused may be keen and prolonged.

A doctor of philosophy, prominent in his profession, wrote to Stanley Hall (Adolescence, vol. i, p. 452): "My entire youth, from six to eighteen, was made miserable from lack of knowledge that any one who knew anything of the nature of puberty might have given; this long sense of defect, dread of operation, shame and worry, has left an indelible mark." There are certainly many men who could say the same. Lancaster ("Psychology and Pedagogy of Adolescence," Pedagogical Seminary, July, 1897, pp. 123-5) speaks strongly regarding the evils of ignorance of sexual hygiene, and the terrible fact that millions of youths are always in the hands of quacks who dupe them into the belief that they are on the road to an awful destiny merely because they have occasional emissions during sleep. "This is not a light matter," Lancaster declares. "It strikes at the very foundation of our inmost life. It deals with the reproductory part of our natures, and must have a deep hereditary influence. It is a natural result of the foolish false modesty shown regarding all sex instruction. Every boy should be taught the simple physiological facts before his life is forever blighted by this cause." Lancaster has had in his hands one thousand letters, mostly written by young people, who were usually normal, and addressed to quacks who were duping them. From time to time the suicides of youths from this cause are reported, and in many mysterious suicides this has undoubtedly been the real cause. "Week after week," writes the British Medical Journal in an editorial ("Dangerous Quack Literature:

The Moral of a Recent Suicide," Oct. 1, 1892), "we receive despairing letters from those victims of foul birds of prey who have obtained their first hold on those they rob, torture and often ruin, by advertisements inserted by newspapers of a respectable, nay, even of a valuable and respected, character." It is added that the wealthy proprietors of such newspapers, often enjoying a reputation for benevolence, even when the matter is brought before them, refuse to interfere as they would thereby lose a source of income, and a censorship of advertisements is proposed. This, however, is difficult, and would be quite unnecessary if youths received proper enlightenment from their natural guardians.

Masturbation, and the fear that by an occasional and perhaps outgrown practice of masturbation they have sometimes done themselves irreparable injury, is a common source of anxiety to boys. It has long been a question whether a boy should be warned against masturbation. At a meeting of the Section of Psychology of the British Medical Association some years ago, four speakers, including the President (Dr. Blandford), were decidedly in favor of parents warning their children against masturbation, while three speakers were decidedly against that course, mainly on the ground that it was possible to pass through even a public school life without hearing of masturbation, and also that the warning against masturbation might encourage the practice. It is, however, becoming more and more clearly realized that ignorance, even if it can be maintained, is a perilous possession, while the teaching that consists, as it should, in a loving mother's counsel to the child from his earliest years to treat his sexual parts with care and respect, can only lead to masturbation in the child who is already irresistibly impelled to it. Most of the sex manuals for boys touch on masturbation, sometimes exaggerating its dangers; such exaggeration should be avoided, for it leads to far worse evils than those it attempts to prevent. It seems undesirable that any warnings about masturbation should form part of school instruction, unless under very special circumstances. The sexual instruction imparted in the school on sexual as on other subjects should be absolutely impersonal and objective.

At this point we approach one of the difficulties in the way of sexual enlightenment: the ignorance or unwisdom of the would-be teachers. This difficulty at present exists both in the home and the school, while it destroys the value of many manuals written for the sexual instruction of the young. The mother, who ought to be the child's confidant and guide in matters of sexual education, and could naturally be so if left to her own healthy instincts, has usually been brought up in false traditions which it requires a high degree of intelligence and character to escape from; the school-teacher, even if only called upon to give instruction in natural history, is oppressed by the same traditions, and by false shame concerning the whole subject of sex; the writer of manuals on sex has often only freed himself from these bonds in order to advocate dogmatic, unscientific, and sometimes mischievous opinions which have been evolved in entire ignorance of the real facts. As Moll says (Das Sexualleben des Kindes, p. 276), necessary as sexual enlightenment is, we cannot help feeling a little skeptical as to its results so long as those who ought to enlighten are themselves often in need of enlightenment. He refers also to the fact that even among competent authorities there is difference of opinion concerning important matters, as, for instance, whether masturbation is physiological at the first development of the sexual impulse and how far sexual abstinence is beneficial.

The girl at puberty is usually less keenly and definitely conscious of her sexual nature than the boy. But the risks she runs from sexual ignorance, though for the most part different, are more subtle and less easy to repair. She is often extremely inquisitive concerning these matters; the thoughts of adolescent girls, and often their conversation among themselves, revolve much around sexual and allied mysteries. Even in the matter of conscious sexual impulse the girl is often not so widely different from her brother, nor so much less likely to escape the contamination of evil communications, so that the scruples of foolish and ignorant persons who dread to "sully her purity" by proper instruction are exceedingly misplaced.

Conversations dealing with the important mysteries of human nature, Obici and Marchesini were told by ladies who had formerly been pupils in Italian Normal Schools, are the order of the day in schools and colleges, and specially circle around procreation, the most difficult mystery of all. In England, even in the best and most modern colleges, in which games and physical exercise are much cultivated, I am told that "the majority of the girls are entirely ignorant of all sexual matters, and understand nothing whatever about them. But they do wonder about them, and talk about them constantly" (see Appendix D, "The School Friendships of Girls," in the second volume of these Studies). "The restricted life and fettered mind of girls," wrote a well-known physician some years ago (J. Milner Fothergill, Adolescence, 1880, pp. 20, 22) "leave them with less to actively occupy their thoughts than is the case with boys. They are studiously taught concealment, and a girl may be a perfect model of outward decorum and yet have a very filthy mind. The prudishness with which she is brought up leaves her no alternative but to view her passions from the nasty side of human nature. All healthy thought on the subject is vigorously repressed. Everything is done to darken her mind and foul her imagination by throwing her back on her own thoughts and a literature with which she is ashamed to own acquaintance. It is opposed to a girl's best interests to prevent her from having fair and just conceptions about herself and her nature.

Many a fair young girl is irredeemably ruined on the very threshold of life, herself and her family disgraced, from ignorance as much as from vice. When the moment of temptation comes she falls without any palpable resistance; she has no trained educated power of resistance within herself; her whole future hangs, not upon herself, but upon the perfection of the social safeguards by which she is hedged and surrounded." Under the free social order of America to-day much the same results are found. In an instructive article ("Why Girls Go Wrong," Ladies' Home Journal, Jan., 1907) B. B. Lindsey, who, as Judge of the Juvenile Court of Denver, is able to speak with authority, brings forward ample evidence on this head. Both girls and boys, he has found, sometimes possess manuscript books in which they had written down the crudest sexual things. These children were often sweet-faced, pleasant, refined and intelligent, and they had respectable parents; but no one had ever spoken to them of sex matters, except the worst of their school-fellows or some coarse-minded and reckless adult. By careful inquiry Lindsey found that only in one in twenty cases had the parents ever spoken to the children of sexual subjects. In nearly every case the children acknowledged that it was not from their parents, but in the street or from older companions, that they learnt the facts of sex.

The parents usually imagined that their children were absolutely ignorant of these matters, and were astonished to realize their mistake; "parents do not know their children, nor have they the least idea of what their children know, or what their children talk about and do when away from them." The parents guilty of this neglect to instruct their children, are, Lindsey declares, traitors to their children. From his own experience he judges that nine-tenths of the girls who "go wrong," whether or not they sink in the world, do so owing to the inattention of their parents, and that in the case of most prostitutes the mischief is really done before the age of twelve; "every wayward girl I have talked to has assured me of this truth." He considers that nine-tenths of school-boys and school-girls, in town or country, are very inquisitive regarding matters of sex, and, to his own amazement, he has found that in the girls this is as marked as in the boys.

It is the business of the girl's mother, at least as much as of the boy's, to watch over her child from the earliest years and to win her confidence in all the intimate and personal matters of sex. With these aspects the school cannot properly meddle. But in matters of physical sexual hygiene, notably menstruation, in regard to which all girls stand on the same level, it is certainly the duty of the teacher to take an actively watchful part, and, moreover, to direct the general work of education accordingly, and to ensure that the pupil shall rest whenever that may seem to be desirable. This is part of the very elements of the education of girls. To disregard it should disqualify a teacher from taking further share in educational work. Yet it is constantly and persistently neglected. A large number of girls have not even been prepared by their mothers or teachers for the first onset of the menstrual flow, sometimes with disastrous results both to their bodily and mental health.[26]

"I know of no large girl's school," wrote a distinguished gynæcologist, Sir W. S. Playfair ("Education and Training of Girls at Puberty," British Medical Journal, Dec. 7, 1895), "in which the absolute distinction which exists between boys and girls as regards the dominant menstrual function is systematically cared for and attended to. Indeed, the feeling of all schoolmistresses is distinctly antagonistic to such an admission. The contention is that there is no real difference between an adolescent male and female, that what is good for one is good for the other, and that such as there is is due to the evil customs of the past which have denied to women the ambitions and advantages open to men, and that this will disappear when a happier era is inaugurated. If this be so, how comes it that while every practical physician of experience has seen many cases of anæmia and chlorosis in girls, accompanied by amenorrhæa or menorrhagia, headaches, palpitations, emaciation, and all the familiar accompaniments of breakdown, an analogous condition in a school-boy is so rare that it may well be doubted if it is ever seen at all?"

It is, however, only the excuses for this almost criminal negligence, as it ought to be considered, which are new; the negligence itself is ancient. Half a century earlier, before the new era of feminine education, another distinguished gynæcologist, Tilt (Elements of Health and Principles of Female Hygiene, 1852, p. 18) stated that from a statistical inquiry regarding the onset of menstruation in nearly one thousand women he found that "25 per cent. were totally unprepared for its appearance; that thirteen out of the twenty-five were much frightened, screamed, or went into hysterical fits; and that six out of the thirteen thought themselves wounded and washed with cold water. Of those frightened ... the general health was seriously impaired."

Engelmann, after stating that his experience in America was similar to Tilt's in England, continues ("The Health of the American Girl," Transactions of the Southern Surgical and Gynæcological Society, 1890): "To innumerable women has fright, nervous and emotional excitement, exposure to cold, brought injury at puberty. What more natural than that the anxious girl, surprised by the sudden and unexpected loss of the precious life-fluid, should seek to check the bleeding wound—as she supposes? For this purpose the use of cold washes and applications is common, some even seek to stop the flow by a cold bath, as was done by a now careful mother, who long lay at the point of death from the result of such indiscretion, and but slowly, by years of care, regained her health. The terrible warning has not been lost, and mindful of her own experience she has taught her children a lesson which but few are fortunate enough to learn—the individual care during periods of functional activity which is needful for the preservation of woman's health."

In a study of one hundred and twenty-five American high school girls Dr. Helen Kennedy refers to the "modesty" which makes it impossible even for mothers and daughters to speak to each other concerning the menstrual functions. "Thirty-six girls in this high school passed into womanhood with no knowledge whatever, from a proper source, of all that makes them women. Thirty-nine were probably not much wiser, for they stated that they had received some instruction, but had not talked freely on the matter. From the fact that the curious girl did not talk freely on what naturally interested her, it is possible she was put off with a few words as to personal care, and a reprimand for her curiosity. Less than half of the girls felt free to talk with their mothers of this most important matter!" (Helen Kennedy, "Effects of High School Work upon Girls During Adolescence," Pedagogical Seminary, June, 1896.)

The same state of things probably also prevails in other countries. Thus, as regards France, Edmond de Goncourt in Chérie (pp. 137-139) described the terror of his young heroine at the appearance of the first menstrual period for which she had never been prepared. He adds: "It is very seldom, indeed, that women speak of this eventuality. Mothers fear to warn their daughters, elder sisters dislike confidences with their younger sisters, governesses are generally mute with girls who have no mothers or sisters."

Sometimes this leads to suicide or to attempts at suicide. Thus a few years ago the case was reported in the French newspapers of a young girl of fifteen, who threw herself into the Seine at Saint-Ouen. She was rescued, and on being brought before the police commissioner said that she had been attacked by an "unknown disease" which had driven her to despair. Discreet inquiry revealed that the mysterious malady was one common to all women, and the girl was restored to her insufficiently punished parents.

Half a century ago the sexual life of girls was ignored by their parents and teachers from reasons of prudishness; at the present time, when quite different ideas prevail regarding feminine education, it is ignored on the ground that girls should be as independent of their physiological sexual life as boys are. The fact that this mischievous neglect has prevailed equally under such different conditions indicates clearly that the varying reasons assigned for it are merely the cloaks of ignorance. With the growth of knowledge we may reasonably hope that one of the chief evils which at present undermine in early life not only healthy motherhood but healthy womanhood generally, may be gradually eliminated. The data now being accumulated show not only the extreme prevalence of painful, disordered, and absent menstruation in adolescent girls and young women, but also the great and sometimes permanent evils inflicted upon even healthy girls when at the beginning of sexual life they are subjected to severe strain of any kind. Medical authorities, whichever sex they belong to, may now be said to be almost or quite unanimous on this point. Some years ago, indeed, Dr. Mary Putnam Jacobi, in a very able book, The Question of Rest for Women, concluded that "ordinarily healthy" women may disregard the menstrual period, but she admitted that forty-six per cent, of women are not "ordinarily healthy," and a minority which comes so near to being a majority can by no means be dismissed as a negligible quantity.

Girls themselves, indeed, carried away by the ardor of their pursuit of work or amusement, are usually recklessly and ignorantly indifferent to the serious risks they run. But the opinions of teachers are now tending to agree with medical opinion in recognizing the importance of care and rest during the years of adolescence, and teachers are even prepared to admit that a year's rest from hard work during the period that a girl's sexual life is becoming established, while it may ensure her health and vigor, is not even a disadvantage from the educational point of view. With the growth of knowledge and the decay of ancient prejudices, we may reasonably hope that women will be emancipated from the traditions of a false civilization, which have forced her to regard her glory as her shame,—though it has never been so among robust primitive peoples,—and it is encouraging to find that so distinguished an educator as Principal Stanley Hall looks forward with confidence to such a time. In his exhaustive work on Adolescence he writes: "Instead of shame of this function girls should be taught the greatest reverence for it, and should help it to normality by regularly stepping aside at stated times for a few years till it is well established and normal. To higher beings that looked down upon human life as we do upon flowers, these would be the most interesting and beautiful hours of blossoming. With more self-knowledge women will have more self-respect at this time. Savagery reveres this state and it gives to women a mystic awe.

The time may come when we must even change the divisions of the year for women, leaving to man his week and giving to her the same number of Sabbaths per year, but in groups of four successive days per month. When woman asserts her true physiological rights she will begin here, and will glory in what, in an age of ignorance, man made her think to be her shame. The pathos about the leaders of woman's so-called emancipation, is that they, even more than those they would persuade, accept man's estimate of this state."[27]

These wise words cannot be too deeply pondered. The pathos of the situation has indeed been—at all events in the past for to-day a more enlightened generation is growing up—that the very leaders of the woman's movement have often betrayed the cause of women. They have adopted the ideals of men, they have urged women to become second-rate men, they have declared that the healthy natural woman disregards the presence of her menstrual functions. This is the very reverse of the truth. "They claim," remarks Engelmann, "that woman in her natural state is the physical equal of man, and constantly point to the primitive woman, the female of savage peoples, as an example of this supposed axiom. Do they know how well this same savage is aware of the weakness of woman and her susceptibility at certain periods of her life? And with what care he protects her from harm at these periods? I believe not. The importance of surrounding women with certain precautions during the height of these great functional waves of her existence was appreciated by all peoples living in an approximately natural state, by all races at all times; and among their comparatively few religious customs this one, affording rest to women, was most persistently adhered to." It is among the white races alone that the sexual invalidism of women prevails, and it is the white races alone, which, outgrowing the religious ideas with which the menstrual seclusion of women was associated, have flung away that beneficent seclusion itself, throwing away the baby with the bath in an almost literal sense.[28]

In Germany Tobler has investigated the menstrual histories of over one thousand women (Monatsschrift für Geburtshülfe und Gynäkologie, July, 1905). He finds that in the great majority of women at the present day menstruation is associated with distinct deterioration of the general health, and diminution of functional energy. In 26 per cent. local pain, general malaise, and mental and nervous anomalies coexisted; in larger proportion come the cases in which local pain, general weak health or psychic abnormality was experienced alone at this period. In 16 per cent. only none of these symptoms were experienced. In a very small separate group the physical and mental functions were stronger during this period, but in half of these cases there was distinct disturbance during the intermenstrual period. Tobler concludes that, while menstruation itself is physiological, all these disturbances are pathological.

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 leucorrhœa 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 diarrhœa, 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]