Kirkes remarks, that "although conception is not confined to the periods of menstruation, yet it is more likely to occur within a few days after cessation of the menstrual flux than at other times."--"Handbook of Physiology," p. 725.

"The husband of a lady who was obliged to absent himself many months in consequence of the embarra.s.sment of his affairs, returned one night clandestinely, his visit being only known to his wife, his mother, and myself. The consequence of this visit was the impregnation of his wife.

The lady was at that time within a week of her menstrual period; but as this did not fail to take place, she was led to hope that she had not suffered by the visit of her husband. But her catamenia not appearing at the next period, gave rise to a fear that she had not escaped! and the birth of a child nine months and thirteen days from the night of the clandestine visit proved her apprehensions too well grounded."

I think this case is an exception to a general rule; and, furthermore, favors an idea which reason and a limited observation, rather than positive knowledge, has led me to advance, the above, namely, that a woman is more likely to conceive, other things being the same, after being deprived for a season of those intercourses she had previously enjoyed. Had this lady's husband remained constantly at home, she would probably either not have conceived at all, or have done so a fortnight sooner than she did.

This case is also remarkable for two other facts: one, "that a woman in perfect health, and pregnant with a healthy child, may exceed the period of nine months by several days; the other, that a check is not always immediately given to the catamenial flow by an ovum being impregnated."

Probably it is not so generally so as many suppose.

The term of utero-gestation, or the length of time from conception to the commencement of labor, is not precisely determined by physiologists.

"It seems, however," says Dr. Dewees, "from the best calculations that can be made, that nine calendar months, or forty weeks, approaches the truth so nearly that we can scarcely need or desire more accuracy, could it be obtained." Unquestionably, however, some cases exceed this period by many days, or even weeks, and it has been a question much agitated, how far this period is ever exceeded. It is a question of some moment in a legal point of view. Cases are reported where the usual period was exceeded by five or six months; cases, too, where the circ.u.mstances attending them and the respectability of their reporters are such as to command our belief. Dr. Dewees has paid much attention to this subject, and he declares himself entirely convinced "that the commonly fixed period may be extended from thirteen days to six weeks, under the influence of certain causes or peculiarities of const.i.tution."*

* See tables in Dr. Bull's "Hints to Mothers," pp. 130-141.

--Publishers' note.

These occasional departures from the general rule will, perhaps, be the more readily admitted when we consider that they are not confined to the human species. From the experiments of Tessier, it appears that the term of utero-gestation varies greatly with the cow, sheep, horse, swine and other animals to which his attention was directed.

Properly connected with the subject of generation are the signs of pregnancy. Dr. Dewees remarks that "our experience furnishes no certain mark by which the moment conception takes place is to be distinguished.

All appeals by the women to particular sensations experienced at the instant should be very guardedly received, for we are certain they cannot be relied upon; for enjoyment and indifference are alike fallacious. Nor are certain nervous tremblings, nausea, palpitation of the heart, the sensation of something flowing from them during coition, etc, more to be relied upon." Burns, however, says, "Some women feel, immediately after conception, a peculiar sensation, which apprises them of their situation, but such instances are not frequent, and generally the first circ.u.mstances which lead a woman to suppose herself pregnant are the suppression of the menses;" a fickle appet.i.te, some sickness, perhaps vomiting, especially in the morning; returning qualms, or languor in the afternoon; she is liable to heartburn, and to disturbed sleep. The b.r.e.a.s.t.s at first often become smaller and sometimes tender; but about the third month they enlarge, and occasionally become painful.

The nipple is surrounded with an aureole or circle of a brown color, or at least of a color sensibly deeper or darker than before. She loses her looks, becomes paler, and the under part of the lower eyelid is often somewhat of a leaden hue. The features become sharper, and sometimes the whole body begins to emaciate, while the pulse quickens. In many instances particular sympathies take place, causing salivation, toothache, jaundice, etc. In other cases very little disturbance is produced, and the woman is not certain of her condition until the time of quickening, which is generally about four months from conception. It is possible for a woman to mistake the effects of wind for the motion of the child, especially if they have never borne children, and be anxious for a family; but the sensation produced by wind in the bowels is not confined to one spot, but is often felt at a part of the abdomen where the motion of a child could not possibly be felt. Quite as frequently, perhaps, do fleshy women think themselves dropsical, and mistake motions of the child for movements of water within the abdominal cavity. The motion of the child is not to be confounded with the sensation sometimes produced by the uterus rising out of the pelvis, which produces the feeling of fluttering. At the end of the fourth month, the uterus becomes so large that it is obliged to rise out of the pelvis, and if this elevation takes place suddenly, the sensation accompanying it is pretty strong, and the woman at the time feels sick or faint, and in irritable habits; even a hysterical fit may accompany it After this the morning sickness and other sympathetic effects of pregnancy generally abate, and the health improves.

Very soon after impregnation, if blood be drawn and suffered to stand a short time undisturbed, it will become sizy, of a yellowish or bluish color, and somewhat of an oily appearance. But we cannot from such appearances of the blood alone p.r.o.nounce a woman pregnant, for a suppression of the menses, accompanied with a febrile state, may give the blood a like appearance as pregnancy, so also may some local disease. Of the above-mentioned symptoms, perhaps there is no _one_ on which we can place more reliance than the increased color of the circle around the nipple.*

* See "Advice to a Wife," P. H. Chava.s.se, pp. 115-124, where many details are given.--Publishers' note.

Six or eight weeks after conception, the most sure way of ascertaining pregnancy is to examine the mouth and neck of the uterus, by way of the v.a.g.i.n.a. The uterus will be found lower down than formerly, its mouth is not directed so much forward as before impregnation, and is more completely closed, and the neck is felt to be thicker, or increased in circ.u.mference. When raised on the finger it is found to be heavier or more resisting. Whoever makes this examination must have examined the same uterus in an unimpregnated state, and retained a tolerably correct idea of its feeling at that time, or he will be liable to uncertainty, because the uterus of one woman is naturally different in magnitude from another, and the uterus is frequently lower down than natural from other causes than pregnancy.*

* No one but a doctor, or one trained in physiology could, of course, make any such examination with safety and utility.--Publishers' note.

It has not been fully ascertained how long it is after a fruitful connection before an effect is produced upon the ovaria, that is before any alteration could be discovered, were the female to be dissected.

But Brighton's experiments have established the fact, that with rabbits, whose term of utero-gestation is but thirty days, no effect is propagated to the ovaria until nearly fifty hours after coition; we should judge, therefore, that with the human species it must be several days, and it is generally estimated by physiologists that the ovum does not reach the uterus until the expiration of twenty days from the time of connection.*

* "The time occupied in the pa.s.sage of the ovum from the ovary to the uterus," says Dr. Kirkes, "occupies probably eight or ten days in the human female."--"Handbook of Physiology," p. 741.--G. R.

It is probable that in all cases in which any matter is absorbed from any part of the animal system, some little time is required for such matter, after its application, to stimulate and arouse the absorbent vessels to action; hence it is probable that after the s.e.m.e.n is lodged in the v.a.g.i.n.a, it is many minutes, possibly some hours, before any part of it is absorbed.

CHAPTER III. OF PROMOTING AND CHECKING CONCEPTION

Sterility depends either on imperfect organization, or imperfect action of the organs of generation. In the former cases, which are rare, the menses do not generally appear, the b.r.e.a.s.t.s are not developed, and the s.e.xual desire is inconsiderable. There is no remedy in these cases.

The action may be imperfect in several respects. The menses may be obstructed or sparing, or they may be too profuse or frequent. It is extremely rare for a woman to conceive who does not menstruate regularly. Hence where this is the case the first step is to regulate this periodical discharge. For this purpose the advice of a physician will generally be required, for these irregularities depend upon such various causes and require such a variety of treatment that it would be inconsistent with the plan of this work to give instructions for remedying them. A state of exhaustion or weakness of the uterine system, occasioned by too frequent intercourse, is a frequent cause of sterility. The sterility of prost.i.tutes is attributed to this cause, but I doubt it being the only one. With females who are apparently healthy, the most frequent cause is a torpor, rather than weakness of the genital organs.

For the removal of sterility from this cause, I shall give some instructions, and this I do the more readily because the requisite means are such as will regulate the menses in many cases, where they do not appear so early in life, so freely or so frequently as they ought.

In the first place, it will generally be necessary to do something toward invigorating the system by exercise in the open air, by nourishing food of easy digestion, by sufficient dress, particularly flannel, and especially by strict temperance in all things. With this view, also, some scales which fall from the blacksmith's anvil, or some steel filings may be put into old cider or wine (cider the best), and after standing a week or so, as much may be taken two or three times a day as can be borne without disturbing the stomach.

All the while the bowels are to be kept rather open by taking from one to three of _Pill rufi_ every night on going to bed. These pills consist of four parts of aloes, two parts of myrrh, and one of saffron, by weight.

These measures having been regularly pursued until the system be brought into a vigorous state, medicines which are more particularly calculated to arouse the genital organs from a state of torpor may be commenced, and continued for months if necessary. The cheapest, most simple (and I am not prepared to say it is not the most effectual in many cases) is cayenne. All the virtues of this article are not generally known even to physicians. I know it does not have the effect upon the coats of the stomach that many have conjectured. It may be taken in the quant.i.ty of from one to two rising teaspoonsful, or even more, everyday up on food or on any liquid vehicle. Another medicine of much efficacy is Dewees'

Volatile Tincture of Guaiac. It is generally kept by apothecaries, and is prepared as follows:

Take of Gum Guaic.u.m, in powder, eight ounces; carbonate of Potash, or of Soda, or (what will answer) Saleratus, three drachms; Allspice, in powder, two ounces; any common spirits of good strength, two pounds, or what is about the same two pints and a gill. Put all into a bottle, which may be shaken now and then, and use of it may be commenced in a few days. To every gill of this, at least a large teaspoon-ful of Spirits of Ammonia is to be added. A teaspoonful is to be taken for a dose, three times a day, in a gla.s.s of milk, cider or wine. It is usually given before eating; but if it should chance to offend the stomach when taken before breakfast, it may in this case be taken an hour after.

Dr. Dewees found this tincture, taken perhaps for months, the most effectual remedy for painful menstruation, which is an obstinate complaint. If there be frequent strong pulse, heat, thirst, florid countenance, etc., it is not to be taken until these symptoms be removed by low diet, a few doses of salts, and bleeding, if required.

A third medicine for arousing the genital organs, is tincture of Spanish Flies. But I doubt its being equal, in sterility, to the above mentioned medicines, though it may exceed them in some cases, and may be tried if these fail. A drachm of them may be put to two gills of spirits. Dose, 25 drops, in water, three times a day, increasing each one by two or three drops, until some degree of stranguary occurs, then omit until this pa.s.s off, as it will in a day or two. Should the stranguary be severe, drink freely of milk and water, slippery elm, or flaxseed tea.

In many cases of sterility, where the general health is considerably in fault, and especially when the digestive organs are torpid, I should have much faith in a Thomsonian course. It is calculated to arouse the capillary vessels throughout the whole system, and thus to open the secretions, to remove obstructions, and free the blood of those effete and phlegmy materials which nature requires to be thrown off. The views of the Thomsonian as to heat and cold appear to me unphilosophical. But this has nothing to do with the efficiency of their measures.

In relation to sterility, I would here bring to mind, what has before been stated, that a woman is most likely to conceive immediately after a menstrual turn. And now, also, let me suggest the idea that Nature's delicate beginnings may be frustrated by the same means that put her a going. This idea is certainly important when the woman is known to have miscarried a number of times. Sterility is sometimes to be attributed to the male, though he apparently be in perfect health. It would be an interesting fact to ascertain if there be no seminal animalculae in these cases; and whether medicines of any kind are available.

It has been ascertained that a male and female may be sterile in relation to each other, though neither of them be so with others.

The foregoing measures for sterility are also suitable in cases of impotency. This term, I believe, is generally con-lined to, and defined as a want of desire or ability, or both on the part of the male; but I see no good reason why it should not comprehend the case in which there is neither desire nor pleasure with the female. Such females, it is true, may be fruitful; but so, on the other hand, the s.e.m.e.n may not have lost its fecundating property. Impotency, at a young or middle age, and in some situations in life especially, is certainly a serious misfortune, to say the least of it. The whole evil by no means consists, in every case, in the loss of a source of pleasure. All young people ought to be apprised of the causes of it--causes which, in many instances, greatly lessen one's ability of giving and receiving that pleasure which is the root of domestic happiness. I shall allude to one cause, that of premature, and especially solitary gratification, in another place. Intemperance in the use of spirits is another powerful cause. Even a moderate use of spirits, and also of tobacco, in any form, have some effect It is a law of animal economy, that no one part of the system can be stimulated or excited, without an expense of vitality, as it is termed. The part which is stimulated draws the energy from other parts. And hence it is, that close and deep study, as well as all the mental pa.s.sions when excessive, impair the venereal appet.i.te.

All excesses, all diseases and modes of life which impair the general health, impair this appet.i.te, but some things more directly and powerfully than others.

As to the remedies for impotency, they are much the same as for sterility. It is of the first importance that the mind be relieved from all care and anxiety. The general health is to be improved by temperance, proper exercise in the open air, cheerful company, change of scenery, or some occupation to divert the mind without requiring much exercise of it; nourishing food of easy digestion; flannel worn next to the skin. The cold bath may be tried, and if it be followed by agreeable feelings, it will do good. The bowels may be gently stimulated by the pills before mentioned; and the preparation of iron also, already mentioned, should be taken.

To stimulate the genital organs more directly, cayenne, Dewees' tincture of guaiac, or tincture of flies, may be taken. I have given directions for making and taking the tincture of flies, chiefly because it is esteemed one of the best remedies for impotency caused by or connected with nocturnal emissions, to which I have before alluded.

It is in cases where little or no pleasure, nor erection, attend these emissions--cases brought on by debauchery, or in elderly persons--that I would recommend tincture of flies, and the other measures above mentioned. In some bad cases, enormous doses of this tincture are required, say two or three hundred drops. Yet the best rule for taking it is that already given, namely, begin with small doses, and gradually increase until some stranguary be felt, or some benefit be received. In this affection, as well as in all cases of impaired virility, the means I have mentioned are to be pursued for a long time, unless relief be obtained. These have cured after having been taken for a year or more without the result. In all cases of impotency not evidently depending upon disease of some part besides the genital organs, I should have much confidence in blisters applied to the lower part of the spine.

Occasional nocturnal emissions, accompanied with erection and pleasure, are by no means to be considered a disease, though they have given many a one such uneasiness. Even if they be frequent, and the system considerably debilitated, if not caused by debauch, and the person be young, marriage is the proper measure.

There have been several means proposed and practiced for checking conception. I shall briefly notice them, though a knowledge of the best is what most concerns us. That of withdrawal immediately before emission is certainly effectual, if practiced with sufficient care. But if (as I believe) Dr. Dewees' theory of conception be correct, and as Spallanzani's experiments show that only a trifle of s.e.m.e.n, even largely diluted with water, may impregnate by being injected into the v.a.g.i.n.a, it is clear that nothing short of entire withdrawal is to be depended upon. But the old notion that the s.e.m.e.n must enter the uterus to cause conception, has led many to believe that a partial withdrawal is sufficient, and it is on this account that this error has proved mischievous, as all important errors generally do. It is said by those who speak from experience that the practice of withdrawal has an effect upon the health similar to intemperance in eating. As the subsequent exhaustion is probably mainly owing to the shock the nervous system sustains in the act of coition, this opinion may be correct. It is further said that this practice serves to keep alive those fine feelings with which married people first come together. Still, I leave it for every one to decide for himself whether this check be so far from satisfactory as not to render some other very desirable.

As to the baudruche, which consists in a covering used by the male, made of very delicate skin, it is by no means calculated to come into general use. It has been used to secure immunity from syphilitic affections.

Another check which the old idea of conception has led some to recommend with considerable confidence, consists in introducing into the v.a.g.i.n.a, previous to connection, a very delicate piece of sponge, moistened with water, to be immediately afterward withdrawn by means of a very narrow ribbon attached to it, But, as our views would lead us to expect, this check has not proved a sure preventive. As there are many little ridges or folds in the v.a.g.i.n.a, we cannot suppose the withdrawal of the sponge would dislodge all the s.e.m.e.n in every instance. If, however, it were well moistened with some liquid which acted chemically upon the s.e.m.e.n, it would be pretty likely to destroy the fecundating property of what might remain. But if this check were ever so sure, it would, in my opinion, fall short of being equal, all things considered, to the one I am about to mention--one which not only dislodges the s.e.m.e.n pretty effectually, but at the same time destroys the fecundating property of the whole of it.

It consists in syringing the v.a.g.i.n.a immediately after connection with a solution of sulphate of zinc, of alum, pearl-ash, or any salt that acts chemically on the s.e.m.e.n, and at the same time produces no unfavorable effect on the female.

In all probability a vegetable astringent would answer--as an infusion of white oak bark, of red rose leaves, of nut-galls, and the like. A lump of either of the above-mentioned salts, of the size of a chestnut, may be dissolved in a pint of water, making the solution weaker or stronger, as it may be borne without any irritation of the parts to which it is applied. These solutions will not lose their virtues by age.

A female syringe, which will be required in the use of the check, may be had at the shop of an apothecary for a shilling or less. If preferred, the s.e.m.e.n may be dislodged as far as it can be, by syringing with simple water, after which some of the solution is to be injected, to destroy the fecundating property of what may remain lodged between the ridges of the v.a.g.i.n.a, etc.

I know the use of this check requires the woman to leave her bed for a few moments, but this is its only objection; and it would be unreasonable to suppose that any check can ever be devised entirely free of objections. In its favor it may be said, it costs nearly nothing; it is sure; it requires no sacrifice of pleasure; it is in the hand of the female; it is to be used after, instead of before the connection, a weighty consideration in its favor, as a moment's reflection will convince any one; and last, but not least, it is conducive to cleanliness, and preserves the parts from relaxation and disease. The v.a.g.i.n.a may be very much contracted by a persevering use of astringent injections, and they are constantly used for this purpose in cases of _procidentia uteri_, or a sinking down of the womb; subject as women are to _fluor albus_, and other diseases of the genital organs, it is rather a matter of wonder that they are not more so, considering the prevailing practices. Those who have used this check (and some have used it, to my certain knowledge with entire success for nine or ten years, and under such circ.u.mstances as leave no room to doubt its efficacy) affirm that they would be at the trouble of using injections merely for the purposes of health and cleanliness.

By actual experiment it has been rendered highly probable that pregnancy may, in many instances, be prevented by injections of simple water, applied with a tolerable degree of care. But simple water has failed, and its occasional failure is what we should expect, considering the anatomy of the parts, and the results of Spallanzani's experiments heretofore alluded to.

This much did I say respecting this check in the first edition of this work. That is what I call the chemical check. The idea of destroying the fecundating property of the s.e.m.e.n was original, if it did not originate with me. My attention was drawn to the subject by the perusal of "Moral Physiology." Such was my confidence in the chemical idea that I sat down and wrote this work in July, 1831. But the reflection that I did not know that this check would never fail, and that if it should, I might do someone an injury in recommending it, caused the ma.n.u.script to lie on hand until the following December. Some time in November I fell in with an old acquaintance, who agreeably surprised me by stating that to his personal knowledge this last check had been used as above stated. I have since conversed with a gentleman with whom I was acquainted, who stated that, being in Baltimore some few years ago, he was there informed of this check by those who have no doubt of its efficacy. From what has as yet fell under my observation, I am not warranted in drawing any conclusion. I can only say that I have never known it to fail. Such are my views on the whole subject, that it would require many instances of its reputed failure to satisfy me that such failures were not owing to an insufficient use of it. I even believe that quite cold water alone, if thoroughly used, would be sufficient. In Spallanzani's experiments warm water was unquestionably used. As the seminal animalcule are essential to impregnation, all we have to do is to change the condition of, or, if you will, to kill them; and as they are so exceedingly small and delicate, this is doubtless easily done, and hence cold water may be sufficient.

What has now been advanced in this work will enable the reader to judge for himself or herself of the efficacy of the chemical or syringe check, and time will probably determine whether I am correct in this matter. I do know that those married females who have much desire to escape will not stand for the little trouble of using this check, especially when they consider that on the score of cleanliness and health alone it is worth the trouble.

A great part of the time no check is necessary, and women of experience and observation, with the information conveyed by this work, will be able to judge pretty correctly when it is and when it is not. They may rest a.s.sured that none of the salts mentioned will have any deleterious effect. The sulphate of zinc is commonly known by the name of white vitriol. This, as well as alum, have been extensively used for leucorrhae. Acetate of lead would doubtless be effectual--indeed, it has proven to be so; but I do not recommend it, because I conceive it possible that a long continued use of it might impair the instinct.

I hope that no failures will be charged of efficacy of this check which ought to be attributed to negligence or insufficient use of it. I will therefore recommend at least two applications of the syringe, the sooner the surer, yet it is my opinion that five minutes' delay would not prove mischievous--perhaps not ten.