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.