Part 4
3. Since so many women are inclined to produce one child only, and since miscarriages are more common among male children, there is a large predominance of girls as first or only children. I have collected statistics of hundreds of such cases.
4. There are more sets of girl-twins born than boy-twins; since the former, being easier to rear if premature, more easily survive their birth. Similarly in twins of mixed sex (and these are of more frequent occurrence than any) the boy is the more difficult to rear than the girl.
A usual form of in-breeding in human beings or animals is the predominance of female progeny. This is especially noticeable with toy-dogs of various descriptions; out of every litter there may be only one male dog, frequently none. I have heard several complaints on account of this anomaly. In pedigree “catteries” the same condition has been freely observed.
In Turkey there is a vast predominance of girls born, and the death-rate amongst boys is stupendous. Though all the women are married, it is rare to find anything but small families among the well-to-do classes, and where there are many wives, one child apiece is the usual result.
It is now becoming more generally recognised by students of this branch of science that the first child is usually inferior to the second or third, and accordingly, when a nation is largely composed of _enfants d’essai_, as the French call them, race degeneracy and possibly even depopulation are not far off. This explains why the one child system has proved so calamitous to a country like France, which is vainly struggling in the vice-like grip of the Malthusian theory.
Another evil closely concerning the birth-rate of females is that of illegitimacy; many more girls than boys are born out of wedlock. In 1922, 60,000 illegitimate infants were born in Great Britain, and among these there were 106 females for every 100 males, which is almost exactly the reverse proportion of the legitimate birth-rate. For this state of affairs there are several reasons:
1. Large numbers of them are _first children_, and of these 70 per cent. are girls.
2. In such confinements too little care is generally given both to mother and child, and the male child, having a larger head and being therefore more difficult to bring into the world, is frequently still-born. That, moreover, half the still-born children are not registered, may further help to account for the disparity.
3. A _male abortion_ is fairly easily brought about, but female issue is infinitely more difficult to get rid of.
4. Illegitimate children have obviously less chance of surviving than those born in wedlock, since their upbringing is necessarily rather irregular. Boys succumb more readily than girls to the evils which attend upon their undesired presence in an unfriendly world.
And here, by way of digression, I would point out that much misconception prevails regarding the normal prevalence of illegitimacy in England. It is not necessarily the product of either poverty or of city life. It is far more common in rural districts than in urban areas, and, even in cities, it is by no means the poorest parishes that produce the most illegitimate children. The urban artisan class as a whole is far more rigid in observing the sanctities and prescriptions of marriage than any other section of the community. In the country there are many more families who live comfortably with the illegitimate baby in their midst, and only a minimum of shame or compunction is experienced either by the mother or grandparents.
The fact that some 60,000 illegitimate children annually appear in England is well calculated to destroy some of our pharisaical complacency. In such a godly country, one would somehow have expected better things. It is true that in Germany, where the population is to that of England as 5 to 3, the illegitimate births are as 5 to 1—and that in Austria, the illegitimate birth-rate in 1916 was as high as 50 per cent., but both these countries, like many others, are burdened with impossible marriage-laws, and many are the obstacles in the way of a legal union for every citizen, rich or poor.
“God sends not ill; if rightly understood, all partial ill is universal good.” We must economize our babies; whether born in wedlock or out of it, every child has a right to some share of our consideration, and every mother, whether married or single, should have the right to demand such care as will save the children she bears from death in infancy.
It is estimated that 70,000 children are actually still-born each year, and there is little doubt that a very large proportion of these could be saved by a national scheme for the protection of mother and child. What we need is a kind of institution which would ensure that undesired male infants were privately removed from their surroundings and brought up under proper supervision and care. Thus only could we save the greater part of those boy lives at present thrown away, and which ought to go to fulfil the needs of our under-populated dominions, crying for settlers. The girl-babies could more safely be left with their mothers, or to the hazard which seems to regard bastard girls more kindly than boys.
It may seem something of a digression to add that, with regard to the causes of illegitimacy a very potent factor might be found in the countless public-houses of every town and village in the country. Remove excessive drink, and two-thirds of the immorality in the world will likewise disappear. This would prove especially true in Great Britain, where the ideals of morality are high, and religion is still a real safe-guard.
Shakespeare said: “A man who goes to bed drunk begets a daughter.” Whatever the theory on which he based this assertion, there remains very little doubt that many unwanted lives are brought into existence as a direct result of over-indulgence. It has often been stated that the ill-kept public-house is one of the greatest disseminators of consumption. How much might also be said of drink in connection with the spread of venereal disease!
But my main point is that intemperance means a high illegitimate birth-rate, which in its turn is the direct cause of the preponderance of girl-babies which survive and so accentuate this unfortunate disproportion.
VII
STERILITY
“Sterility does not necessarily prove that the sexual organs or functions in either the male or the female must be in an abnormal condition.”—A. W. EDDIS.
The causes of sterility are so multiple and diverse, and such countless volumes have been written on the subject, that I do not consider it necessary here to enter fully into all the particulars connected with the condition. According to Chavasse one wife out of every eight is barren, and the majority of these are to be found among the richer members of society.[9] Mr. Arthur Eddis reckons that in Great Britain alone there are over 500,000 sterile married women.[10] Only 7 per cent. of the fertile bear their first children after the third year of marriage. Therefore, if the first year has gone by with no sign of pregnancy, the young wife should bestir herself to examine the possible causes of failure in this direction.
Dr. Marion Sims, who devoted much attention to the treatment of sterility, laid down several general rules as essential to fecundity. One of the most important is that “Semen with living spermatozoa should be deposited in the vagina at the proper time,” or, in simple words, healthy fluid or seed from the male should be deposited at the proper time in the passage of the female. Now it may seem at first sight extraordinary, but many a childless couple remain so for the simple reason that never once in their connubial life have they hit on the suitable day on which, rather than any other, they could beget offspring. And that is precisely why so much help can be obtained _from a suitable choice of days_.
One lady I was asked to treat had been married nine years and at thirty-eight still remained childless. She was a healthy woman, but had complained of severe pains in her back and right side at certain times. Her periods were regular, so that it was easy to ascertain and utilize the _day before the period was actually due_. A slight flow ensued, but stopped on the third day—the patient went off to the seaside immediately and stayed there alone for some time. In three weeks she experienced much nausea, and the usual signs of pregnancy were soon detected. At the end of nine months from the day mentioned, she gave birth to a very fine little girl.
I would like to emphasise the marvellous effects of sea-air on the health of certain women. I have known the most obstinate childlessness cured simply by four to six weeks spent by the seaside.
A lady came to see me once who had been married for fifteen years without—so far as she knew—having ever conceived; she was over forty, her health was indifferent and she slept and ate little. The first thing to attend to was the regulation of a faulty diet, and certain other changes in her mode of living were recommended. A few weeks later I chose the sixth day of menstruation as most favourable in her particular case, and afterwards packed her off to rest and enjoy the sea-breezes alone at Margate.
Within nine months she gave birth to a girl weighing close on 10 lbs. I should add that in both of the above cases I considered as a result of my experience that there was little likelihood of a healthy male pregnancy, and deemed it preferable to make sure of a girl to begin with.
The mother who can bear children early and late and is most prone to male issue is the wide-hipped, deep-chested woman, who has shouldered her share of out-door work or regular exercise, whose digestive organs are unimpaired by rich food, and whose arteries are sound and young even into old age. The little woman who holds herself erect, slight yet agile and well-built, may have a son or two, but the bent-over, “crumpled up,” delicate, nervy, and small-made mother will be far more subject to female issue.
The young girl, who from childhood has been ashamed of her sex-development and who, to look more “boyish,” reduces her hips and chest to a minimum, will never have a healthy and normal motherhood. There are thousands of British girls (and it is in these islands that the species flourish most noticeably) who deliberately try to look mannish, by shoving forward their hips, shoulders and head. With sunken breasts and rounded backs they “slouch” along, mere shadows of what a well-developed woman should be.
Where a surgeon finds “nothing apparently wrong” in a woman who is still young and whose husband is normal, it may mean that everything about her and her way of living is “not quite right.” She may be suffering from habitual constipation and malnutrition. She may simply need good nourishing food in the shape of plentiful fruit, milk, vegetables, eggs, etc., with fresh meat once a day, instead of unwholesome “made dishes,” and rich dainties three times a day.
It is often noticed that fat women are inclined to sterility. They usually imbibe great quantities of liquid, and seem to hanker after thick soups, milk and cream, and all such fattening diet. Their digestion is naturally good, but their nerves are bad, and they suffer from perpetual attacks of extreme exhilaration or depression. Their confinements are difficult and rarely normal, recovery being slow. If they happen to conceive a boy, miscarriages are more than likely to occur.
Another type of woman who is prone to sterility is the lymphatic, lazy and intensely selfish female, who is wrapped up in herself. If she has a child it will be in the early twenties and rarely is the effort repeated.
Sterility may of course occur in both the fat and flabby woman, and the thin and weakly one. The chances of impregnation in both types are encouraged by a healthy mode of living, the avoidance of rich indigestible food, moderation in the consumption of strong tea and coffee, and extreme temperance in the matter of alcohol.
How much ill-health in the married woman is due to the lack of care taken by young girls during their early periods! To be on the safe side, it is often desirable every month to take a day or two off, either in bed or lying on a sofa. This precaution, if made a regular habit, may well help to prolong a woman’s life by ten years or more. In the young girl a little rest at such times might prevent much illness in later years, and add enormously to her chances of child-bearing by giving the virgin organs every opportunity of development without let or hindrance.
On looking into certain cases one often finds that trouble is due to irregularity or prolonged absence of periods, accompanied by a more or less continuous white discharge. Pregnancy is not likely to take place while this is allowed to continue, and it is astonishing how many women suffer it to go on without troubling to effect a cure. When this condition becomes chronic, professional advice is most necessary, and should immediately be resorted to.
A fact which I believe has not hitherto been recorded, but is fully substantiated by my own experience, is that women who habitually suffer from profuse and too frequent periods are more inclined to produce female children, while conversely those women whose periods tend to be scanty and arrive late more generally have male children.
In this connection, I might quote a letter which a lady wrote to me two years ago from India:
I have three little girls and my periods are quite four or five days before the fourth week and always very profuse. I am very anæmic, partly owing to the climate out here. I do so long for a son....
I sent her the advice she requested. Last year she had her wish fulfilled, and, since his birth, the periods are much more normal and rather inclined to be “late” than “early.”
On the other hand I received a letter from another lady saying:
My periods are usually every five or six weeks. Yet I am quite healthy and have never had a miscarriage. I have five sons ... my periods are always rather “late,” but I am very strong and well.
And this leads me to the subject of menstruation, which is generally so closely allied to that of ovulation. In England most girls begin menstruating at 13 years, though large numbers start at 14 or 15, or even later. But according to the record kept by Mr. Robertson of 450 cases, 10 menstruated in their 11th year, 19 in their 12th and 53 in their 13th. He also gives us particulars of great numbers of women menstruating well on to the age of 55, two cases of women doing so till 60, and one of a woman menstruating up to her 70th year.[11]
In cold climates, women frequently menstruate three or four times a year only, and they begin later and end later. In Russia it is not unusual for women to bear children as late as 60, whereas with us it is rare to have a child after 45. Capuron quotes several cases of child-bearing in advanced age. Among these he gives the case of Cornelia, as recorded in Pliny. She was a member of the family of Scipio, and at the age of 60 she bore a son, Volusius Saturinus. Another case he quotes is that of a Venetian physician named Marsa, who treated a woman of 60 for pregnancy, having previously, owing to her age, diagnosed her trouble as dropsy. He adds that a woman in Paris bore a daughter at the age of 63 and nursed it.[12]
It is rare in England to conceive for the first time at 45, but I have known three women who had a _first child_ at 47, and two at 48. Yet so great is the latitude in the ages of women’s fruitful period that a girl may be a mother at 12, or even earlier in hot climates.
La Motte delivered of a child a girl who had not completed her 13th year, and who had not menstruated.[13] Dr. Paris states that during the year 1816 some girls of 13 were admitted into the Maternité at Paris,[14] and recently the Matron of a London home has given me particulars of two or three cases of mothers of 13 and 14.
Dr. Rowlett, of Kentucky, reports the case of a certain Sally Deweese, born in 1824, who began to menstruate at a year old. At nine years old she became pregnant, and in 1834 gave birth to a female child weighing 7¼ lbs., the mother then being 4 ft. 7 in. in height.[15] It should be noted that in cases where the mother is quite elderly or where she is a mere child, the progeny is rarely healthy or strong. In the former category the child more often suffers from lack of full mental development, and in the latter it rarely survives its birth.
Having made a brief survey of the question of sterility in women, I may now state my conclusion that most disabilities are remediable, or at least capable of great modification. Much depends on the woman herself—her health, mode of life and temperament. Conditions and the proper choice of a day can help, but where there is some organic or anatomical disability, the advice of a surgeon or a doctor should immediately be sought. In few cases, from my experience, is sterility absolutely hopeless, though in many instances where a girl-child can be conceived, a boy would be impossible, and the attempt should not be made, as it might cause lasting injury to the mother.
I must confess that when the causation of sex loomed large on the horizon of my mind I little thought that the simple natural laws I had discovered would prove such an efficient aid in the treatment of sterility as has since been shown so abundantly to be the case.
VIII
SEX-CAUSATION
“The sex of the child is fixed before it is fertilised.”—LENHOSICK.
Before I go on to describe the simple law of nature on which the pre-determination of sex depends, it is essential that a few anatomical details should be explained and understood. A fundamental truth to be borne in mind is the absolute completeness of the maternal organs. They harbour from the first moment of actual existence the potentialities of both sexes alike, _entirely independent of the fertilisation of the male parent_. Of what then do the uterine organs consist? Let us first treat of the position of the _uterus_ or _womb_. This organ begins to develop with the first beginning of menstruation, and it goes on growing until the twenty-first year. Once it has borne a fœtus it never entirely regains its virgin form, but remains slightly enlarged. It lies rather to the right, so that when a woman is on her back, the right ovary and the uterine opening of the right oviduct or Fallopian tube are lower down in the pelvis than the left ovary and oviduct. On either side of the womb are the _Fallopian tubes_, their average length being four inches. These tubes are dilatable, smaller at the uterine opening and thicker at the abdominal opening near the ovary. Each tube is lined with mucous membranes which, containing special hair-like fibres called “cilia,” impel the ovum, or egg, onwards down the tube by a movement always in one direction, towards the uterus. These tubes are the excretory ducts of the ovaries.
The _ovaries_ grow and mature earlier than the womb. Each ovary is a solid oval-shaped organ more or less encircled by the outer end of its corresponding Fallopian tube, and each enlarges when about to discharge an ovum. The right ovary is larger than the left. In each are a large number of cysts known as ovisacs or “Graafian follicles,” so called after R. de Graaf, a Dutch anatomist, who died in 1673. Each Graafian follicle contains an ovum floating in a clear albuminous fluid, called “liquor folliculi.” At birth there are thousands of ova in the ovaries, but by the time of puberty only one-third remain. Each follicle contains an ovum and each ovum a vital structure called the germinal vesicle or nucleolus. This, when fertilised by the corresponding contribution from the male, grows and develops into the ultimate child.
Ovulation, i.e. the discharge of a ripe ovum from an ovary, is brought about by the development and maturing of a Graafian follicle, its rupture and the discharge of the ovum it contained. The enlarged follicle having gradually approached the ovarian surface, its walls become congested and thinned at one part. It then bursts; the “liquor folliculi” is poured out, and the ripened ovum set free. Ova, one or more at a time, are expelled from the ovary at regular monthly intervals, from puberty to the climacteric, for some 35 years. Before puberty a girl’s ovaries are pearl-grey and smooth, but later each ovulation leaves a little scar. For every monthly period a scar remains, and, as there are some 500 menstrual periods in a woman’s life, there should be in all some 250 scars on each ovary, though most of these are entirely obliterated in the course of time.
As the ovaries are formed in the embryo fœtus so is their sex determined, and they are potentially male or female from the start. The ova, in their thousands, lie latent in each ovary of the female until puberty supervenes. Then, alternately, every month or thereabouts, starting always from the left, each ovary expels its ovum, and does so with increasing regularity as adolescence ripens into womanhood. _According to the sex_, if at any time the ovum be fertilised and pregnancy ensues, an indelible scar will be left on the _one ovary or the other_.
It is only of late years that the theory of the alternate action of the ovaries has been recognised by certain eminent gynæcologists. The evidence afforded by the ovaries themselves admits of little possible doubt as to the fact of equal division of activity between right and left side of the womb. Such action is not simultaneous, but definitely alternating in character.
A woman doctor in Geneva, 35 years ago, made a close study of the fact that young girls frequently complained of pains one month in the right side and the next month in the left. She also pointed out a dissimilarity between the two periods for two months running. These observations combined with others, carried weight in the minds of many prominent doctors, hitherto sceptical of the alternate working of the ovaries, and the theory of “sides.”
To my mind, as the result of long and close investigation, the conclusion is definitely established that the side theory cannot be seriously questioned, and any attempt to overthrow it would result only in putting back the hands of the clock.
Dr. Rumley Dawson’s clearly stated account of the alternate working of the ovaries is too well known to need reiteration in this treatise.[16] It is entirely consistent with the principle, by which as Professor Gamble lately stated, Nature makes provision for all parts of the human body to rest at intervals while other parts are employed, thereby enabling the organs to “work in shifts.”[17] The theory in itself is time-honoured, and many authors can be quoted in support of it. The left side is the first to operate in the young girl, and it is usually the first to push forward the work of conception in the woman. Hence the preponderance of _females_ among all _first_-born creatures.
In the early stages of life most children are left-handed, they even start walking left foot foremost. As they grow, however, the right side in time takes precedence. The right leg is the strong one to jump from, the right arm wields the weapon with which we work or fight. Similarly the whole right side of the human body is definitely superior in enduring power to the side where beats the heart. In more ways than one must this organ be held responsible for the weaker fibre of the position it dominates.
If there is one exception to this rule it is the brain, of which the left side gets a more rapid supply of blood, and thus shows more activity than the right.