Mary Ann Dacomb Bird Scharlieb.

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LOGY LIBRARY




/ar<*!



THE SEVEN AGES OF WOMAN



■gy ihe Same Author

What it

Means to

Marry

("Questions of Sex."
Series)

CASSELL £r CO., LTD

London, New York, Toronto

ana Mtlbourne



THE SEVEN AGES
OF WOMAN

A Consideration of the Successive Phases
of Woman's Life



BY

MARY SGHARLIEB, M.D., M.S.Lond.

Vice-President of the Association of Registered Medical Women
Late Senior Surgeon to the New Hospital for Women and Gynaecologist to the
Royal Free Hospital



CASSELL AND COMPANY, LTD

London, New York, Toronto and Melbourne



First published 19x5



PREFACE

There are many excellent and some time-
honoured manuals for the instruction of young
wives and mothers. My intention in writing
this little book is not so much to add to their
number as to afford a more general guide for
women throughout life.

In my humble and no doubt inadequate
effort to fulfil a somewhat lofty ambition, I
have found it necessary to consider briefly the
life of the young girl with reference to her
health, management, and education. To this
naturally succeed a few chapters of counsel to
the young wife and the young mother that
will, I hope, be of service to them during a
wonderfully interesting but perplexing period
of their life.

A remembrance of my own anxieties and
perplexities has led to a few chapters concerning
the management of children during " the noisy
years "; and the constant requests of my patients
to tell them where they can get a book in



Preface

which they will find some guidance during
and after the climacteric have induced me
to add two short chapters on this subject.

Therefore, to my patients, young, middle-
aged, and old, I respectfully dedicate this book.

Mary Scharlieb

149, Harley Street, W.



^



CONTENTS

PART I
THE YOUNG GIRL

CHAPTER I
THE YEARS IMMEDIATELY PRECEDING PUBERTY

PAQE

Importance of the pre-pubertal period — Development
and growth of the body — Intellectual and spiritual
development — The mother's duty — Go-education
of boys and girls ...... 1

CHAPTER II

THE PERIOD OF PHYSICAL CHANGE

Changes in the skeleton — How the pelvis changes —
The spinal Tcolumn acquiring its adult curves —
Development of the muscles — Deposition of fat —
Development of the breast and of the|pelvic organs
— Changes in the hair, complexion, and eyes . 6

CHAPTER III

ADVENT OF PUBERTY

Signs of the imminency of menstruation — What the girl
should be told — The first period not typical — The
ordinary routine to be altered as little as possible 11
vii



Contents



CHAPTER IV
ABNORMALITIES OF MENSTRUATION

PAGE

Primary amenorrhcea (absence of menstruation) — Occult
menstruation — Secondary amenorrhcea and its
causes — Abnormalities of quantity : Metrorrhagia
and menorrhagia — Irregular menstruation — Dys-
menorrhoea (painful menstruation) and its causes
— Membranous dysmenorrhoea ... . .16

CHAPTER V

DOMESTIC CARE OF THE YOONG GIRL

Unstable condition of the adolescent girl — The choice
of food — Exercise — Team games — Swedish exer-
cises — The " crocodile " walk — Necessity for ample
rest and sleep — Suitable clothing ... 25

CHAPTER VI

EDUCATION, AND CHOICE OF A PROFESSION

Advantages of a home education — Greater advantages
of a school education — Exceptionally sensitive chil-
dren — Mentally or physically defective children —
Future of education for girls — Choice of a profession
— Need for skilled advice — Advantages of training in
domestic economy and mother-craft — A balance
of activities the ideal — Moral education and sexual
physiology — How the truth may be told to children 36

PART 11

THE YOUNG WIFE

CHAPTER I

PREPARATION FOR MARRIAGE

General preparation : Sympathetic companionship —
Making the best of a husband's circumstances —
Joyful acceptance of motherhood — The falling birth-

viii



Contents



FA08



rate — Disadvantages of limitation of the family.
Special preparation for marriage : Physical fitness
— Discretion in choice of a husband ... 60



CHAPTER II

THE DIFFICULTIES OF EARLY MARRIED LIFE

Household difficulties — Selfishness the arch-enemy —
Advent of children — Unwisdom of preventive mea-
sures — The Birth-rate Commission — Continence and
fertility in man — Physical diflBculties — Examina-
tion before marriage — Difficulties arising from dis-
ease ......... 70



CHAPTER III

PREGNANCY

Conception — Development of the pregnant uterus —
— Growth of the embryo — First period of preg-
nancy : Cessation of menstruation — Mammary
development — Morning sickness. Second period :
Increase in size of abdomen and uterus — Quicken-
ing — Sounds of the foetal heart. Third period :
Secretion of milk — Alterations in the imibilicus —
Pigmentary changes — Subsidence of the abdomen .
J)uration of pregnancy , . . . .81



CHAPTER IV

DOMESTIC MANAGEMENT OF PREGNANCY

Pregnancy a normal process with stress and strain —
Value of motherhood to the State — Hygienic pre-
~ cautions — Judicious exercise — Clothing — Marital
relations during pregnancy .... 94



Contents

CHAPTER V
PREPARATION FOR LABOUR

_ PAGE

Preparation of the house and of the birth-chamber — The
patient's clothing during lying-in — The baby's re-
quirements 101



PART III
THE YOUNG MOTHER

CHAPTER I

SIGNS AND SYMPTOMS OF THE THREE STAGES
OF LABOUR

Premonitory pains — True and false labour pains —
Length of the first stage — ^The second stage — How
the pains differ from those of the first — Chloroform
anaesthesia — ^Morphia and scopolamine anaesthesia
- Birth of the child— The third stage . . 108

* CHAPTER II

CARE OF THE YOUNG MOTHER

Bliss after pain — ^The requisite attentions — Exercises and
massage in bed — Lactation — The mother's food —
Puerperal sepsis — Notification and registration of
birth — Ophthalmia of the new-born . . . 123

CHAPTER III

ABNORMAL PREGNANCY

Miscarriage — Its causes, signs, and symptoms — ^Treat-
ment — Premature birth — Care and feeding of the
premature infant . . . . . .132



Contents

CHAPTER IV

DISEASES OF PREGNANCY: TOXIC, NERVOUS, AND
MECHANICAL

FAOB

Toxic diseases : Pernicious vomiting of pregnancy
— Jaundice — Convulsions (eclampsia). Nervous
diseases ; Vomiting — Salivation — Headache — Neu-
ralgia — Disorders of the circulation — Haemorrhoids
— Constipation — Diarrhoea. Mechanical disorders :
Displaced uterus . . . . . .147



PART IV

THE NURSING MOTHER

CHAPTER I

LACTATION AND WEANING

The secretion of milk — Importance of suckling to both
mother and child — Feeding-bottles — Duration of
lactation — How to wean a baby — Abnormalities of
lactation — Abscess of the breast. . . . 168

CHAPTER II

ARTIFICIAL NURSING AND WET-NURSING

The foster-mother — Comparison of cow's milk, ass*s
milk, and goat's milk — Sterilisation and pasteurisa-
tion — Quantity and quality of the infant's meals . 180

CHAPTER III
ARTIFICIAL FOOD AND ANTI-SCORBUTICS

Condensed milk, fluid and desiccated — Substitute pre-
parations — Albumin water — Anti-scorbutics : Fresh
meat-juice and orange-juice .... 186



Contents

CHAPTER IV

THE NURSERY— TEETHING-VACCINATION—
CIRGUxMCISION

FAOE

Preparation of the nursery — The night nursery.
Eruption of the teeth — ^Troubles of dentition — Con-
vulsions — Night terrors — Tetany — ^Asthma of Millar
— Affections of the gums — ^Thrush — Urinary
troubles. Vaccination. Phimosis — Paraphimosis —
Circumcision . . . . . . .189



PART V

THE MOTHER IN ''THE NOISY YEARS''

CHAPTER I

THE CARE OF YOUNG CHILDREN

The period of infancy : Weight at birth — Dawning facul-
ties — Food, clothing, exercise, and sleep. Children
from two to five years of age : The child's experi-
ments — Activity of the brain — Moral and religious
teaching — Bed-wetting. Children from five to ten
years of age : Characteristics and requirements —
When education should begin — Correct attitudes —
Clothing — Exercise — Sleep 213

CHAPTER II

THE CHILD IN SICKNESS

Signs and symptoms — Rate of respiration — Pulse-rate
— Temperature and how to take it — Examination
of the surface of the body — The excreta — Swollen
glands. The sick-room — Its furniture — Ventilation
— HoWito mend the fire — Avoidance of infections
— Chemical disinfection ..... 233
xii



Contents

CHAPTER III
THE COMMONER AILMENTS OF CHILDHOOD

PAOS

Measles — German measles — Influenza — Ghickenpox —
Whooping-cough — Mumps — Diphtheria — Scarlet
fever — Worms 246

PART VI
THE WOMAN IN MIDDLE AGE

Involution the keynote of this period — Changes in the
skeleton, pelvic organs, and personal appearance —
Cessation of menstruation — Difficulties and dangers
of the menopause ...... 264

PART VII

THE WOMAN IN OLD AGE

How to grow old gracefully — Social value of older
women — Their opportunities for useful and dis-
interested work — Care of the health — Adaptation of
mind and body to lessening strength — Evening
shadows and promise of dawn . . . 271

Appendix : List of Formulse 279

Index 283



xm



THE SEVEN AGES OF WOMAN

PART I
THE YOUNG GIRL

CHAPTER I

THE YEARS IMMEDIATELY PRECEDING
PUBERTY

It is impossible to say which period of a woman's
life is the most important. As each age comes
under consideration one is tempted to say,
This is the most important period. But the
years between absolute childhood and the dawn
of adolescence claim a very special attention,
because on the management of the child during
those years depends in a great measure her fitness
for the momentous changes that immediately
follow them.

As we shall have occason to point out in
I a subsequent chapter, the whole human organ-
ism is in a constant state of flux and alteration
during the years of puberty and adolescence.
The few years between the end of childhood and



'^^]:, T of Woman

puberty appear to afford a breathing space inter-
mediate between the rapid growth and develop-
ment which precede and the still more rapid
growth and development which lie immediately-
ahead of them. During these years growth con-
tinues, and so, to some extent, does development ;
but, taken as a whole, these are years of consoli-
dation. Upon the successful management of the
pre-pubertal period depends in a great measure
the ability of the girl to endure without injury
the extraordinary up-rush of developmental
energy that will shortly occur. Much has been
written and taught concerning the necessity for
limiting a girl's activities during the trying
years of adolescence ; but it is well to bear in
mind that much can be done by way of pre-
paration to render her organism fit to stand the
strain. The wise mother will endeavour so to
regulate her child's life that it may be adequately
prepared for the difficulties that lie before it.

Development and growth of the child's
body. —The child's body during the years imme-
diately before puberty grows steadily, although
with intervals of rest. Growth is in excess of
development, and the child still retains much
of its neutral characteristics. There is relatively
little difference between the boy and the girl at
V this time. There is a certain angularity and
^ sometimes a lankiness of appearance ; it is per-
haps not a very prepossessing age, for the girl



The Years Before Puberty

has lost the rounded outline and charm of
infancy, and has not yet acquired the still greater
charm of adolescence.

The task of the mother or guardian during
these years is chiefly one of preparation, of
laying a really solid foundation of health that
will stand the child in good stead later on. In
order that she should be able to fulfil her duty
she ought to know something of the structure
and functions of the child's body. The mother
must remember that her developing children
are neither magnified babies nor small adults.
If the photograph of a normal baby were enlarged
to the same size as the photograph of a child
of 10 or 12, and, still more, if it were compared
with the photograph of a young adult, it would
be seen at once that the powers of Nature secure
not only growth in size, but a very noticeable
alteration in shape and proportion. These
changes in the structure and appearance of the
child's body will be considered in detail in the
next chapter. For the moment it is sufficient
to remember that, great as are the changes
during the years immediately preceding puberty,
they are yet only the commencement of the
transformation scene.

Intellectual and spiritual development.- —
Spiritually and intellectually much the same
quiet growth and development are occurring. The
intellect becomes stronger, more able to fathom

3



The Seven Ages of Woman

the meaning and import of what is learnt, but
there is as yet no marvellous display of extra
power ; that is reserved for the next stage.
The girl still resembles her brother, not only

N^ in body, but also in mind and in general out-
look on life. If she has been favoured both
by heredity and by environment, she is at this

\ stage perfectly frank and open, there are no
concealments, and although affection may be
warm and deep, the mirror of the mind is as
yet undimmed by the breath of passion. There
is probably little appreciation of the beauties
of scenery, and little or no love of art. Here
and there an exceptional child shows a distinct
gift for music, drawing, or other forms of art,
but the whole outlook is calm, quiet ; in a

\ word, the child is matter-of-fact, and the mother
or guardian has a comparatively easy time in
dealing with a nature that still retains much
of the simplicity of childhood.

! The great duty of the mother during these
preparatory years is to assist her child's organ-
ism to gather strength and to collect material
ready for the next stage. Spiritually she will
find that in most instances the young girl at
this period retains the simple, unquestioning
faith of the little child ; there is little or no
questioning as to the why and wherefore of the
facts that she is taught, and still less is
there self-consciousness or introspection. One
/ 4



The Years Before Puberty

of the differences between the years imme-
diately preceding puberty and the period of
adolescence which follows is that in the former
period the mother can see into her child's mind,
while the child herself sees very little ; whereas
later on the youthful personality becomes in-
tensely self-conscious, and is at the same time
more or less completely hidden, even from the
mother's sympathetic eye.

There are those who would have us believe
that sexual feelings and sex consciousness develop
at a very early age. In abnormal children, no
doubt, this may be the case ; but in the healthy
child who has been well brought up, sex feelings
and consciousness are dormant, if not absent,
and boys and girls will associate with each other,
confide in each other, and behave generally in
a way that would be absolutely impossible after
the great awakening.

This neutrality of soul and spirit, this want
of self-consciousness, is the great justification
for those authorities who approve and practise
co-education of boys and girls. There is just
sufficient sex difference to make the boy and girl
mutually stimulating and therefore mutually
helpful from an educational point of view.
Exceptions will, of course, be found to this rule,
but they are exceptions, and therefore do not
necessarily affect the management of children
in the pre-adolescent years.

5



CHAPTER II
THE PERIOD OF PHYSICAL CHANGE

Changes in the skeleton. —During the pubertal
and adolescent years the changes in the skeleton
are so well marked and rapid that they cannot
fail to attract the attention of all who are in
contact with the young ; and yet it is a curious
fact that the phenomenon which appeals most
to the ordinary onlooker is the increase in
the length of the bones, whereas the most
striking change in the skeleton is really the
difference of proportion between the head and
body of the young adult and the head and body
of the little child. The head grows but little
after the end of absolute childhood, and does
not assume the adult proportion of being about
one-twelfth of the total length of the body until
growth is finished. If the adult head had
grown in proportion to the size that it was in
infancy, the effect would be positively grotesque.
Holiday after holiday one hears the remark
addressed to the adolescent girl, " Why, how
you have grown— two or three inches at least ! "
And thus the wonderful change is exaggerated.
It is true that the rate of growth during adoles-

6



The Period of Physical Change

cence is very great, but the changes in proportion
and in moulding are greater still.

In the girl the most wonderful changes occur
in the pelvis. During childhood and early youth
the bones of the pelvis and its angle to the
horizon are much the same in both sexes, but at
the time of puberty great changes occur, the
girl's pelvic bones become relatively lighter,
thinner, and more graceful. The upper part of
the ilium (hip-bone) expands, and instead of
its surfaces facing forwards they tend to face
each other. This change gives width to the
pelvis. At the same time the diameters of the
pelvic brim change. In the male throughout
life, and in the female up .to puberty, the
diameter from front to back is approximately
the same as the diameter from side to side,

I but in the female from puberty onwards the
latter diameter is markedly the longer. The
cavity of the pelvis also enlarges absolutely
and relatively, and the pubic arch becomes
I wider, having approximately the value of the
4 right angle, whereas in the child and in the
male this angle is somewhere about 60° to 70°.
These changes are to a certain extent due to the
i innate tendency of the bones so to develop, but
that they are chiefly due to the great develop-
mental changes in the contained organs, the
womb and its appendages, is proved by the fact
that where these organs are virtually absent or

7



The Seven Ages of Woman

badly developed the female pelvis fails to undergo
the perfect metamorphosis, and remains through-
out life more or less masculine in type.

Another skeletal change of interest is that the
spinal column acquires its adult curves — much
more marked in the female than in the male.
The angle formed at the junction of the spine
with the sacrum increases, and so too does the
inclination of the pelvic brim to the horizon.
All these changes in the female spine and pelvis
have for their object the facilitation of preg-
nancy and parturition, the head of the normal
human infant fitting the normal adult female
pelvis as accurately as the hand fits the glove.

In consequence of the increased width of
the pelvis the heads of the femora (thigh bones)
are carried farther out, their necks become more
oblique, and a greater width is obtained between
the upper extremities of these bones. The knees,
however, in the erect position remain in contact,
and consequently the whole length of the woman's
thigh bone slopes from above downwards and
inwards. To this must be ascribed the typical
feminine gait, which has a grace of its own, but
which, if exaggerated, may lead to an undue
roll, or even a waddle.

The muscles also undergo typical changes,
those around the hip becoming relatively more
developed than do those of the male. This,
again, increases the comparative heaviness and

8



The Period of Physical Change

massiveness of the lower part of the female
figure.

In addition to these changes in the bones of
the skeleton and in the muscles, the girl, as
adolescence progresses, tends to develop a cer-
tain amount of fat. In normal cases this is
only sufficient to add to the beauty of the body,
substituting soft curves and graceful outlines
for the squareness and angularity of the male.

Changes in the organs. — Among the most
obvious outward changes in the organs of the
adolescent girl is the development of the breast.
From birth up to puberty the breasts of the boy
and girl remain flat, small, and undeveloped,
but at the advent of puberty the girl's bust
undergoes a great change. The gland itself in-
creases not only in size, but also in complexity
of structure. In many instances this true develop-
ment is made to appear more marked than it
really is, partly by the development of a certain
amount of fat, and partly by the increase of size
in the large chest muscles which throw the
gland into greater prominence. The nipple, with
its areola of delicately coloured tissue, becomes
more obvious, and it is evident from the altera-
tions in structure and appearance of the girl's
body that the momentous change has been
accomplished, and that we have before us a
potential mother.

The internal changes in organs which cannot

9



The Seven Ages of Woman

be seen during life are also marvellous. The
womb, which had grown but little since infancy,
and which had but a languid circulation, becomes
larger, plumper, more richly supplied with blood,
and its body— the part which is being prepared
for the eventual conception of an infant —
becomes larger in proportion to the neck, which
had hitherto been its equal in length. The
ovaries also undergo growth and development ;
some of the primitive ovules enlarge, and in
doing so begin to protrude a little from the
general surface of the organ. One of them
becomes fully ripe every twenty-eight days, is
seized in the fringed extremity of the oviduct,
and bursts, the contained germ cell passing
along the tube into the uterus. The mucous
membrane of the uterus, in sympathy with these
ovarian changes, becomes greatly congested, and
relief ensues with the occurrence of the periodic
discharge — menstruation.

Changes in personal appearance. — In addi-
tion to the development of the bust and hips,
a very considerable change occurs in the young
girl's appearance. The hair becomes brighter
in hue, glossier, and possibly more disposed to
curl. The complexion clears and brightens, add-
ing greatly to personal charm, while the eyes
acquire a brightness and increased depth of
expression which indicate the subtle changes
occurring in the soul and spirit.

10



CHAPTER III
ADVENT OF PUBERTY

As the word puberty implies, this time of hfe is
associated with an increase in the growth of
hair. Especially is this noticeable on the mons
veneris and about the vulva, and in the axillae
or armpits ; and together with the growth of
hair comes the development in the skin of certain
glands which secrete a somewhat oily material
which is perfectly natural and healthy, but
which necessitates a strict attention to cleanli-
ness and a free use of a non-perfumed and non-
irritating soap, such, for instance, as Castile
soap or olive oil soap. This appearance of hair,
L^ taken in conjunction with possibly a colourless
discharge and the other changes described in the
last chapter, should give the girl's mother ample
warning that menstruation is imminent. She
ought to tell her daughter what to expect, other-
wise the girl may suffer a considerable nervous
shock when the great event occurs. Much of
a girl's happiness and health depends on her
understanding the import of the changes that
are occurring in her body. If she unfortunately
beUeves that menstruation and its attendant

II



The Seven Ages of Woman

phenomena are signs of illness, and if she is
encouraged to treat them as if they were abnor-
malities, the foundation of nervous ill-health is
likely to be laid. If, on the other hand, she
is taught that these changes are beneficent, that
they are necessary to her full development of
womanhood, and that indeed they are the pro-
mise that after a few years she will be fit to
receive the great crown and joy of a woman's
life, motherhood, she will then view her condi-
tion not only with patience, but also with joy.
The motherly instinct is deeply implanted in
every young girl, and she will be wilhng, if
necessary, to suffer restrictions on present enjoy-
ment and activities in order that the change in
her constitution may be satisfactorily accom-
plished, and that her health may be so well
established as to enable her to play her part
in life to the greatest advantage. The girl
ought to be warned that some day she will find
that she has a discharge of blood, or of blood-
stained fluid, from the vagina, and that this


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Online LibraryMary Ann Dacomb Bird ScharliebThe seven ages of woman [microform] ; a consideration of the successive phases of woman's life → online text (page 1 of 17)