Just above the hips there is no bony structure to protect and support the soft, muscular parts. They yield to pressure, and the internal viscera, deprived of muscular support, sink until they rest on the pelvic organs. If, when you look at your abdomen, you see depressions or hollows on each side below the floating ribs, you may know that the bowels have sagged down out of place. If you feel great weariness, backache, or a dragged down feeling in standing or walking, you may know that the contents of the abdomen are pulling on their attachments or pressing on the pelvic organs. Thus displaced, circulation is hindered and the organs all become congested, or filled with blood that moves very slowly. This congested condition is increased at menstruation, and great pain may result.

It is well to have the counsel of some good, honest physician under such circ.u.mstances, but should you be where it is not possible to have such counsel, you may still be able to do something to help yourself.

In the first place, you can rearrange your clothing so as to relieve all the organs from external weight or pressure, and, in the second place, you can support the abdominal walls by applying pressure from below. I have known cases of painful menstruation entirely relieved by simply supporting the bowels by a bandage, thus relieving the uterus of pressure and allowing a free circulation through all the internal organs.

A very simple and practical bandage can be made at home at almost no cost, either in time or money. Buy some thin, cheap cotton flannel.

Take lengthwise of the goods a strip long enough to go around the body at the hips, which will be a yard or a little over, and wide enough to fit from the thighs up to the waist, perhaps eight inches. Put darts on the sides and in the center of the back, to make it fit the figure.

Make a couple of straps four inches wide and half a yard long; cut off one end of each diagonally. Sew these slanting ends to the lower side of the band about four inches from the center, that is eight inches apart, and so that the short side of the strap will be towards the center. Do not hem either band or straps, but overcast them; then they will not feel uncomfortable.

In order to adjust the band properly it will be well to lie down on the back upon the bandage with the knees raised. Press the hands low down upon the abdomen and raise the contents. Repeat this several times; then draw the bandage around, pin with safety pins, draw the straps up between the limbs and fasten with safety pins to the bandage. The support thus given is found to be very comfortable, and girls who have much trouble in walking or standing during their menstrual periods would find this simple bandage a great help at that time.

When the bandage is removed at night you should rub and manipulate the abdominal walls so as to increase the circulation and stimulate in them a better circulation and thus make you stronger.

By deep breathing in a proper standing att.i.tude the abdominal viscera are lifted upward, and if the firmness of the abdominal walls is at the same time increased by exercise, the difficulties may be largely overcome. Some exercises will be found in Chapter XXIII. which are calculated to strengthen the walls and to lift the internal organs.

I wish to call your attention to a cause of displacement that is quite generally overlooked, and that is, a wrong att.i.tude.

Dr. Eliza Mosher has made a very thorough study of this matter, and she says that the common habit of standing on one foot is productive of marked deformities of both face and body and of serious displacements of internal organs. It is seldom a girl or woman can be found whose body is perfectly symmetrical. By standing on one foot, the hip and shoulder of one side approach each other, and so lessen the s.p.a.ce within the abdomen on that side. On the other side a support has been removed for the contents of the abdomen, and they sag down until they pry the uterus out of place and press it over towards the side where there is less pressure. The broad ligament on one side is stretched from use and on the other side shortened from disuse, and so the uterus remains permanently dislocated.

Dr. Mosher thinks that standing continually with the weight on the left foot is more injurious than bearing it on the right foot, for it causes the uterus and ovaries to press upon the r.e.c.t.u.m and so produces a mechanical constipation, especially during menstruation.

Wrong habits of sitting will produce the same results. If the girl sits at school with one elbow on the desk, the head will be turned to the opposite side and the spine will be inclined from the perpendicular, and a lateral curvature be likely to result. If she carries her books always on the same side, it will tend to increase the curvature. If she sits with both elbows supported, her shoulders will be pushed up. If her body is twisted as she sits, a strain comes upon the muscles, and some ligaments will be lengthened and others shortened, thus producing a lateral curvature.

To sit "on the small of the back," that is, slipping down in the chair, bracing the shoulders against the chair-back, tends to injure the nerves by pressure, and also to create a posterior curvature of the spine.

Does it not seem unfortunate that we should allow ourselves even to form such wrong habits of sitting and standing? And now we ask, How shall we know when we are in a correct att.i.tude?

We have comparatively few correct examples to imitate. I notice people everywhere, and I see that old and young stand incorrectly. The head is poked forward, the shoulders are rounded, the chest is flattened, and the curve in the lower part of the back is straightened. The whole figure is out of balance, and therefore not harmonious. Not only is the beauty of the figure destroyed, but the internal organs are displaced. Many a mother who sees her daughter thus growing round-shouldered keeps telling her to throw her shoulders back; but to follow this command only increases the difficulty. The shoulders are not primarily at fault, but the trouble originates in non-use of the front waist muscles. These muscles, weakened by disease because of tight clothing and corset steels, and also by cramped positions in school or at work, refuse to hold the body erect, and it "lops" just at this point. This "lopping" disturbs the harmonious relation of the weights of shoulders, abdomen, head, and the large lower gluteal muscles with which nature has cushioned the lower part of the body, and so they are obliged to readjust themselves to balance each other, and the awkward, ungainly, unhealthful posture results.

What is needed is to restore the right relation of these weights and all will again be harmonious. Do not interfere with the shoulders, but straighten the front of the body by elevating the chest and raising the head until it is supported directly on the spine, letting the shoulders take care of themselves. If the abdomen is now held back and the gluteal muscles raised, the beautiful curves of the spine will be restored, the shoulders will be straightened, and the internal organs will have a chance to resume their natural position.

A very easy way of finding out if you have the correct att.i.tude is to place your toes against the bottom of the door. Now bring your chest up to touch the door, and throw the lower part of the spine backward so that there will be a s.p.a.ce between the abdomen and the door. Place the head erect, with the chin drawn in towards the neck, and you will have very nearly the correct att.i.tude. It may seem a little tiresome at first, because you will be apt to hold yourself in position with needless tension of muscles, but you will soon learn to relax the unnecessary tension, and then you will find the position the most comfortable possible. You can walk farther without fatigue, and stand longer without backache, because the body is placed in the att.i.tude in which all parts occupy their designed relation to each other.

One very important fact is that in the wrong att.i.tude the abdominal organs crowd down into the pelvis, while in the correct position they are supported and kept from sagging, so that the matter of a correct att.i.tude is not only a matter of beauty, but also of health.

In sitting, also, the most comfortable posture is the most healthful; that is, with the body squarely placed on the seat, and equally supported upon the pelvis--not leaning back against the chair, unless the chair should chance to be so constructed that it supports the lower part of the back and keeps the body erect.

CHAPTER XVII.

"FEMALE DISEASES."

We hear a great deal in these days of "female diseases," by which is meant the displacements of the organs of the reproductive system; that is, of the uterus, ovaries, etc. These displacements are many, for the uterus may not only drop down out of place, but it may be tipped towards one side or the other, to the front or the back; or it may be bent upon itself in various directions. These different displacements cause much pain, and often result in ulcerations and profuse discharges which are known as the "whites," or scientifically as leucorrhea.

I only mention these things incidentally, so that I may call your attention to the things you may do to prevent them.

A great many girls and women are spending large sums of money in being doctored for these difficulties who need not suffer with them at all if they had known how to dress healthfully; and many are bearing much anxiety over the possibility of becoming sufferers with these distressing diseases who could have their burden of fear removed by the knowledge that "female diseases," in the great majority of cases, are the results of wrong habits of dress and life. Leucorrhea is not a disease. It is a symptom of abnormal conditions, and to be cured it is needful that the conditions shall be understood.

Dr. Kellogg says, "Leucorrhea may result from simple congestion of the bloodvessels of the v.a.g.i.n.al mucous membrane, due to improper dress. It may also be occasioned by taking cold, and by a debilitated condition of the stomach."

Leucorrhea is merely an abnormal increase of a normal secretion. All mucous membrane secretes mucus in small quant.i.ties--enough to keep the membrane moist. When from any cause this secretion is increased, we have what is called a catarrhal condition. As all cavities that communicate with the air are lined with mucous membrane, this catarrhal condition may exist in the nose, the throat, the eyes, the ears, the bowels, or the reproductive organs, and will be named according to the location.

A natural increase of this secretion takes place just before and after menstruation, and should occasion no anxiety, but if continued during the remainder of the month, especially if very profuse, of offensive odor, or b.l.o.o.d.y in character, it needs the attention of the skilled physician.

I do not wish to make you think constantly of yourself as diseased, and so I do not give you directions as to local self-treatment. Many symptoms can be overcome by general care of the health-habits of the girl, and if they do not yield to this general care it is better to consult a responsible physician than to tamper with yourself.

And here let me give you a word of warning. If you need medical care, never consult the traveling doctors who advertise to do such wonderful things. They charge big fees and give a little medicine and then move on, and you have no redress if they have not accomplished all that they have promised. They live off the gullibility of people. Again, never take patent medicines. Wonderful discoveries, favorite prescriptions and the like may be harmless, and they may not. And even if they are, how can you judge that they are suited to your special case? That they cured some one else is not proof that they will benefit you, and you run a risk by taking them as an experiment. One very serious danger in the taking of patent medicines is the fact that they are so largely alcoholic in composition, and girls and women have all too often been led into the alcohol habit and become habitual drunkards through taking some advertised remedy.

Another has correctly said: "If you need the consultation and advice of a physician go to your family physician, or, if you prefer, go to some other physician; but always select one whose moral character and acknowledged ability render him a suitable and safe adviser in such a time of need. Above all things avoid quacks. The policy they pursue is to frighten you, to work upon your imagination, and to make such alarming and unreliable statements as will induce you to purchase their nostrums and subject yourself to such a series of humiliations and impositions as will enable them to pilfer your purse and without rendering you in return any value received, but likely leave you in a much worse condition than they found you."

You will probably be advised by your personal friends, who may know of your ailments, to take hot douches, and perhaps you may wonder why I do not prescribe them for leucorrhea, and kindred difficulties.

I do not commend them for the fact that I do not want you to be turning your constantly anxious thought towards yourself in these matters. If you need such treatment, let it be prescribed by your physician, who knows exactly your condition. As far as possible turn your thoughts from the reproductive system. Take care of your general health, dress properly, obey all the rules of hygiene in regard to diet, sleep, bathing, special cleanliness, and care, and then forget as far as possible the physical facts of womanhood.

An excellent addition to your general bathing can be taken once a week in the form of a sitz bath, which is effective for cleanliness, and also for the reduction of congestion. If you have no sitz bath-tub, an ordinary wash-tub can be made to answer by raising one side an inch or two by means of some support. Have the water at a comfortable temperature, say about 98 degrees, and if you have no thermometer you can gauge the heat by putting in three gallons of cold water and add one gallon of boiling water. Sit down in the tub and cover yourself with a blanket. In about ten minutes add by degrees a gallon of cold water. Remain sitting a minute or two longer, then rub dry.

Many people are afraid to use cold water after hot, in bathing, for fear they will take cold, but that is just the way to prevent such a result from the hot bath. The hot water has caused all the pores on the surface of the body to open, and the bodily heat is rapidly lost through this cause. The cold water, quickly applied, causes the pores to close, leaves the skin in a tonic condition, and conserves the bodily heat. One should never take a hot bath without following it with a _quick_ cold application to the surface. It should continue, however, but for a moment.

This kind of a bath is very useful for all chronic congestions of the abdominal and pelvic viscera, such as piles, constipation, painful menstruation, leucorrhea, or other affections of the reproductive organs. It is also very helpful in headaches due to congestion of the brain. If there is too little blood in the brain it might produce wakefulness, but when the brain is too full of blood this bath tends to produce sound and refreshing sleep.

A foot bath may be taken at the same time as the sitz bath, and in this case the water should be warmer than that in the sitz bath, and as the person rises from the sitz bath she should step into it, so that her feet will get the tonic effect of the cold water.

The average age at which menstruation first appears is fourteen, but some girls menstruate as early as eleven, while others may not develop till some years later. Frequently, when the girl does not manifest this symptom of womanly development, the mother becomes anxious and begins to give forcing medicines. She knows that girls often die with consumption in their early young womanhood, and has heard that it was because they did not physically develop, and she fears that such danger threatens her daughter, and imagines that if something can be done to "bring on her courses," as she expresses it, the danger will be averted.

In this case she has reversed cause and effect. The consumptive girl did not menstruate because she had not the vitality to do so. The consumption was the cause, the non-menstruation the effect. To produce hemorrhage from the reproductive system by strong, forcing medicines is only to increase the danger. The only thing to do is to improve the general health, and if the girl can increase in strength until she has more vital force than suffices to keep her alive, the function that is vital--not to her, but to the race--will establish itself.

The failure of the menses to appear at the average age may be due merely to a slow development, and in this case there is nothing to do but wait. If the girl seems well, if she has no backache, no headache, no general la.s.situde, no undue nervous symptoms, the mere non-appearance of the menses need occasion no alarm. If, however, she has these symptoms, it is an evidence that nature is attempting to establish the function and is hindered either by general lack of vitality or by some local condition, and in either case the giving of forcing medicines would be a mistake. The weekly sitz bath would do no harm as a semi-local measure. All proper precautions should be observed as to maintenance of general health and mental serenity, and if these do not prove sufficient the physician should be consulted.

In the case I mentioned, where the reproductive organs were lacking, the girl had been subjected to a long course of home medication which had proven disastrous to her digestion, and yet, as will be readily understood, had not resulted in the establishment of a function that is dependent upon organs which, in this case, did not exist.

Sometimes there are slight mechanical hindrances which can only be determined by the physician, though their presence will be indicated by the symptoms of menstruation without the accompanying sanguineous discharge. In these cases the home medication is dangerous. If the girl regularly has symptoms of approaching menstruation, with pain and bloating, and these subside without flow, it would be wise to consult the physician instead of resorting to domestic remedies or letting the matter go on without attention.

Quite frequently the first appearance of menstruation is followed by weeks or even months of freedom from its reappearance. In these cases no alarm need be felt as long as the general health is not affected.

Again, there may be suspension of the function from change of surroundings. Girls who go away to school often suffer from irregularity. I have known of a case where the girl never menstruated during the school year, but was perfectly regular during vacations.

These cases may be accounted for by the nervous strain, the using up of vital forces in mental effort to such degree that there is nothing left with which to carry on the menstrual function. In all such cases it is wise to watch carefully the general health, and if all functions are not properly conducted, to reduce the strain until the vitality is able to keep all functions in order.

Girls are sometimes disturbed because the flow is scanty, and think they should do something to increase the amount. It is no doubt true that profuse menstrual flow is the result of our artificial lives. If we lived more normally we should have naturally a scanty menstrual flow. Therefore if a girl has good health and no monthly pain and the flow is scanty, she may consider herself as more nearly in a normal state, and be thankful.

If, however, the menses are suddenly less than normal it denotes a suppression, which may be the result of cold, exhaustion of body, weariness of nerves, mental anxiety, or disturbance of the emotions.

If gradual suppression occurs, accompanied by loss of health, it indicates some const.i.tutional difficulty or local trouble which demands professional counsel.

Profuse menstruation is also a relative term, as there is no definite standard as to amount of menstrual flow, nor the length of time it should continue. The profuseness must be measured by the condition of the individual. Where health seems fully maintained there would appear no cause for anxiety. But if there is a marked increase over the amount usual for the individual, if great weakness and prostration is produced, either at the time or afterward, it may be called profuse, and the cause may be either debility, that is weakness, or plethora, which means fullness. If from the latter, there will be throbbing headache, pain in the back, and general signs of fever. If from debility, there will be pallor, weakness, and perhaps an almost continuous flow.

As may be imagined, the treatment in the two cases will differ. The full-blooded girl should be put on a plain, unstimulating diet, with plenty of out-door exercise during the month, but about twenty-four hours before the flow is expected she should have complete mental and physical rest. She should remain in bed, and apply cold wet cloths over the abdomen and between the thighs for an hour at a time, with intervals of at least one-half hour between the applications. The bowels should be freed from all fecal matter, and cool, small enemas be given two or three times a day. If these simple measures do not avail, the doctor should be consulted.