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This case needs very little comment: its teachings are obvious. Miss D--- went to college in good physical condition. During the four years of her college life, her parents and the college faculty required her to get what is popularly called an education. Nature required her, during the same period, to build and put in working-order a large and complicated reproductive mechanism, a matter that is popularly ignored, -- shoved out of sight like a disgrace. She naturally obeyed the requirements of the faculty, which she could see, rather than the requirements of the mechanism within her, that she could not see. Subjected to the college regimen, she worked four years in getting a liberal education. Her way of work was sustained and continuous, and out of harmony with the rhythmical periodicity of the female organization. The stream of vital and constructive force evolved within her was turned steadily to the brain, and away from the ovaries and their accessories. The result of this sort of education was, that these last-mentioned organs, deprived of sufficient opportunity and nutriment, first began to perform their functions with pain, a warning of error that was unheeded; then, to cease to grow; (14) next, to set up once a month a grumbling torture that made life miserable; and, lastly, the brain and the whole nervous system, disturbed, in obedience to the law, if one member suffers, all the members suffer, became neuralgic and hysterical. And so Miss D--- spent the few years next succeeding her graduation in conflict with dysmenorrhoea, headache, neuralgia, and hysteria. Her parents marvelled at her ill-health; and she furnished another text for the often-repeated sermon on the delicacy of American girls.

It may not be unprofitable to give the history of one more case of this sort. Miss E--- had an hereditary right to a good brain and to the best cultivation of it. Her father was one of our ripest and broadest American scholars, and her mother one of our most accomplished American women. They both enjoyed excellent health. Their daughter had a literary training, -- an intellectual, moral, and æsthetic half of education, such as their supervision would be likely to give, and one that few young men of her age receive. Her health did not seem to suffer at first. She studied, recited, walked, worked, stood, and the like, in the steady and sustained way that is normal to the male organization. She seemed to evolve force enough to acquire a number of languages, to become familiar with the natural sciences, to take hold of philosophy and mathematics, and to keep in good physical case while doing all this. At the age of twenty-one she might have been presented to the public, on Commencement Day, by the president of Vassar College or of Antioch College or of Michigan University, as the wished-for result of American liberal female culture. Just at this time, however, the catamenial function began to show signs of failure of power. No severe or even moderate illness overtook her. She was subjected to no unusual strain. She was only following the regimen of continued and sustained work, regardless of Nature's periodical demands for a portion of her time and force, when, without any apparent cause, the failure of power was manifested by moderate dysmenorrhoea and diminished excretion. Soon after this the function ceased altogether; and up to this present writing, a period of six or eight years, it has shown no more signs of activity than an amputated arm. In the course of a year or so after the cessation of the function, her head began to trouble her. First there was headache, then a frequent congested condition, which she described as a "rush of blood" to her head; and, by and by, vagaries and forebodings and despondent feelings began to crop out. Coincident with this mental state, her skin became rough and coarse, and an inveterate acne covered her face. She retained her appetite, ability to exercise and sleep. A careful local examination of the pelvic organs, by an expert, disclosed no lesion or displacement there, no ovaritis or other inflammation. Appropriate treatment faithfully persevered in was unsuccessful in recovering the lost function. I was finally obliged to consign her to an asylum.

The arrest of development of the reproductive system is most obvious to the superficial observer in that part of it which the milliner is called upon to cover up with pads, and which was alluded to in the case of Miss D---. This, however, is too important a matter to be dismissed with a bare allusion. A recent writer has pointed out the fact and its significance with great clearness. "There is another marked change," says Dr. Nathan Allen, "going on in the female organization at the present day, which is very significant of something wrong. In the normal state, Nature has made ample provision in the structure of the female for nursing her offspring. In order to furnish this nourishment, pure in quality and abundant in quantity, she must possess a good development of the sanguine and lymphatic temperament, together with vigorous and healthy digestive organs. Formerly such an organization was very generally possessed by American women, and they found but little difficulty in nursing their infants. It was only occasionally, in case of some defect in the organization, or where sickness of some kind had overtaken the mother, that it became necessary to resort to the wet-nurse or to feeding by hand. And the English, the Scotch, the German, the Canadian French, and the Irish women now living in this country, generally nurse their children: the exceptions are rare. But how is it with our American women who become mothers? To those who have never considered this subject, and even to medical men who have never carefully looked into it, the facts, when correctly and fully presented, will be surprising. It has been supposed by some that all, or nearly all, our American women could nurse their offspring just as well as not; that the disposition only was wanting, and that they did not care about having the trouble or confinement necessarily attending it. But this is a great mistake. This very indifference or aversion shows something wrong in the organization as well as in the disposition: if the physical system were all right, the mind and natural instincts would generally be right also. While there may be here and there cases of this kind, such an indisposition is not always found. It is a fact, that large numbers of our women are anxious to nurse their offspring, and make the attempt: they persevere for a while, -- perhaps for weeks or months, -- and then fail.... There is still another class that cannot nurse at all, having neither the organs nor nourishment requisite even to make a beginning.... Why should there be such a difference between the women of our times and their mothers or grandmothers? Why should there be such a difference between our American women and those of foreign origin residing in the same locality, and surrounded by the same external influences? The explanation is simple: they have not the right kind of organization; there is a want of proper development of the lymphatic and sanguine temperaments, -- a marked deficiency in the organs of nutrition and secretion. You cannot draw water without good, flowing springs. The brain and nervous system have, for a long time, made relatively too large a demand upon the organs of digestion and assimilation, while the exercise and development of certain other tissues in the body have been sadly neglected.... In consequence of the great neglect of physical exercise, and the continuous application to study, together with various other influences, large numbers of our American women have altogether an undue predominance of the nervous temperament. If only here and there an individual were found with such an organization, not much harm comparatively would result; but, when a majority or nearly all have it, the evil becomes one of no small magnitude." (15) And the evil, it should be added, is not simply the inability to nurse; for, if one member suffers, all the members suffer. A woman, whether married or unmarried, whether called to the offices of maternity or relieved from them, who has been defrauded by her education or otherwise of such an essential part of her development, is not so much of a woman, intellectually and morally as well as physically, in consequence of this defect. Her nervous system and brain, her instincts and character, are on a lower plane, and incapable of their harmonious and best development, if she is possessed, on reaching adult age, of only a portion of a breast and an ovary, or none at all.