Tag: Pregnancy

  • Caffeine and Pregnancy: How much is too much

    One of the first things most of us women prepare to say goodbye to once we see those two pink lines on our pregnancy tests is caffeine. Many women will stop their caffeine habit cold turkey out of the sheer fear of doing some sort of damage to the new life growing inside of them. These women will swear off anything that has caffeine in it from coffee, and soda to even chocolate.  Then there are some of us who will still drink caffeine but cut back.  Instead of drinking five cups of coffee a day, we might cut back to at least one cup of coffee to get us through the day.

    Our mothers and grandmothers will probably tell us that they drank the same amount of caffeine pregnant as they did when they were not pregnant and their children turned out fine.  However a lot more research has been done since their time and studies are showing that too much caffeine can cause some complications such as preterm labor and/or low birth weight.

    So how much caffeine is too much caffeine? Doctors are telling their patients that a moderate amount of caffeine will not harm their babies.  Even though caffeine does cross the placenta, anything less than 300 milligrams a day (an 8 ounce cup of strong coffee) will not do any harm.  Anything over 300 milligrams puts your baby at risk and studies have also shown that women who drink more than 300 milligrams of caffeine a day during their first trimester have a slightly higher risk of a miscarriage.

    Studies have also shown that women who had over 500 milligrams of caffeine a day had babies who had faster heart rates and faster breathing rates.  These babies also spent more time awake in their first few days of life rather than peacefully sleeping after their long journey.

    There are a number of other reasons why we women might want to cut back on the amount of caffeine we drink during pregnancy.  For starters, it has no nutritional value.  If there is ever a time for us to be aware of our nutritional needs it is when we are pregnant.  Second, caffeine is a stimulant which will increase your heart rate and can cause insomnia and headaches which can put some stress on your growing little one.  Third,  caffeine can cause heartburn.  If you have been pregnant before you know that heartburn can be a burden to begin with,  and caffeine just makes it worse.  Lastly it is a diuretic which means it can cause you to lose fluids which can put you at a risk of becoming dehydrated.

    While it is not necessary for you to give up all caffeine through out the duration of your pregnancy, you should learn how to drink it in moderation or don’t drink it at all.  If you can not handle having only one cup of coffee a day,  then you might be better off drinking no coffee at all.  Stick with caffeine free sodas and even decaf coffee.  Remember though that decaf  coffee still contains small traces of caffeine so make sure you take that into consideration.

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  • How Menopause can Decrease Sexual Desire for Women over 60

    There are some significant changes that take place in a woman’s life. One of them is menopause. This marks the end of her ability to conceive a child. There will be no more menstrual cycles once the woman is in complete menopause. Yet it can take years to go from the start of menopause to completely finishing it. Most women start the process around 45 and finish around 60. It can be sooner or later though as each woman is different.

    There is a common misconception that women who have gone through menopause no longer have any sexual desire. They may continue to engage in the activity to keep their partner happy, but they don’t get any pleasure out of it. This is certainly not the truth though.

    Many women over the age of 60 are involved in very fulfilling sexual relationships. They love not having to worry about their period. They also don’t have to worry about an unwanted pregnancy very late in life. This new found freedom for them means they are able to fully focus on the act of sexual activity and not the various repercussions of it.

    Some women do experience a drop in their sexual desire though after menopause. Many women experience problems with the vagina being dry after menopause. This can make it hard for them to get pleasure out of sexual activity. There are some great products on the market though that will allow you to moisturize the vagina without any negative side effects.

    It is a good idea for a woman with such issues to see a gynecologist for a complete evaluation though. They may be able to help come up with a natural remedy that can prevent ongoing issues having to be addressed with it. For many women, dealing with vaginal dryness can cause a mental block with sexual intercourse.

    They may connect it with being undesirable now that they are in their 60’s. This low self confidence can cause women to shy away from sexual intercourse as well. Being able to really enjoy your body and your sexual desires when you are over 60 is very important. It will encourage you to do what you can to be able to bring back a high level of sexual desire to your life.

    Sometimes something over the counter though isn’t enough for a woman to get back the sexual desire she once had. Your doctor may offer you supplements of hormones in the form of estrogen. Since the level of it in the body drops dramatically due to menopause, replacing it definitely can be helpful.

    Menopause doesn’t have to hinder your sex life though for women over 60 years of age. If you enjoy sex and you want to continue doing so, there are remedies out there that can help. Don’t be embarrassed to discuss the issue with your doctor either. They deal with such issues all the time. They will know how to help you get back to where you want to be sexually.
    For many older couples, menopause can throw a wrench into what was once a very enjoyable part of their intimate relationship. It is important to discuss what has taken place. A woman doesn’t want her partner to assume the lack of sexual responsiveness has anything to do with them not being attractive anymore. Find a good solution that works for you so that menopause won’t stop you from engaging your sexual relationship.

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  • Massive proportion of world’s population are living with herpes infection

    Massive proportion of world’s population are living with herpes infection

    Virus causing genital herpes may put millions of people at greater risk of infection with HIV

    About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show.

    Authored by staff at the University of Bristol, World Health Organization (WHO), and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization,
    the new study estimates the global infection prevalence and incidence of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 2016. 

    “Herpes infection affects millions of people across the globe and can have far-reaching health effects. We need more investment and commitment to develop better treatment and prevention tools for this infection.” says Dr Sami Gottlieb, Medical
    Officer at WHO and an author of the study.

    Prevalence and incidence

    An estimated 491.5 million people were living with HSV-2 infection in 2016, equivalent to 13.2% of the world’s population aged 15 to 49 years. HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital
    herpes).

    An estimated 3.7 billion people had HSV-1 infection during the same year – around 66.6% of the world’s population aged 0 to 49. HSV-1 is mainly transmitted by oral to oral contact to cause infection in or around the mouth (oral herpes). However,
    HSV-1 can also be transmitted to the genital area through oral-genital contact – during oral sex – to cause genital herpes. Most HSV-1 infections were oral; however, between 122 million to 192 million people were estimated to have genital
    HSV-1 infection, depending on the assumptions used in the estimation model.

    Because herpes is a lifelong infection, estimated prevalence increased with age; HSV-2 prevalence was also higher among women and in the WHO African Region.

    Health and social impacts

    Most people living with herpes, caused by either HSV-1 or 2, are unaware they have the infection.

    When symptoms do occur however, oral herpes infection can lead to painful sores around the mouth (“cold sores”). Genital herpes infection can cause recurring, often painful, genital sores, often referred to as genital ulcer disease. 

    WHO and partners published a study in March 2020 estimating that around 5% of the world’s population (187 million people) suffered from at least one episode of herpes-related genital ulcer disease in 2016 (1). Most of these episodes were due to
    HSV-2, which can recur frequently over many years.

    Recurrent symptoms of genital herpes can lead to stigma and psychological distress, and can have an important impact on quality of life and sexual relationships. However, in time, most people with herpes adjust to living with the infection.

    “Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive health”
    says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at WHO. 

    Herpes and HIV

    A strong association exists between HSV-2 infection and HIV infection. In 2019, WHO commissioned a modeling study to estimate how much HSV-2 infection might contribute to HIV incidence. The study estimated that almost 30% of new sexually acquired HIV
    infections in 2016 worldwide were likely attributable to HSV-2 infection (2). 

    Evidence shows that people with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. HSV-2 leads to inflammation and small breaks in the genital and anal skin that can make it easier for HIV to cause infection.
    In addition, people with both HIV and HSV-2 infection are more likely to spread HIV to others.

    Women have higher biologic susceptibility to both HSV-2 and HIV. Women living in the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection, with negative implications for their health
    and well-being. 

    For people living with HIV (or who are living with other conditions that compromise their immune systems) as well as HSV-2, the symptoms of herpes can be more severe and more frequent. 

    Neonatal herpes

    Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery. This is a rare condition, occurring in an estimated 10 out of every 100,000 births globally, but can lead to lasting neurologic disability or death. The risk
    for neonatal herpes is greatest when a mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants.

    No cure – better treatment and prevention needed

    There is no cure for herpes. At present, antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

    As well as increasing awareness about HSV infection and its symptoms, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally. 

    In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines. WHO and partners are working to accelerate research to develop new strategies for prevention and control of HSV infections. Such research includes
    the development of HSV vaccines and topical microbicides. Several candidate vaccines and microbicides are currently being studied.

    “A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed
    and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

    Related publications

    WHO guidelines for the treatment of Genital Herpes Simplex Virus

    WHO preferred product characteristics for herpes simplex virus vaccines

     

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    (1) Looker KJ, Johnston C, Welton NJ, et al. The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history modelling study. BMJ Glob Health. 2020;5(3):e001875. doi: 10.1136/bmjgh-2019- 001875.

    (2) Looker KJ, Welton NJ, Sabin KM, et al.Global and regional estimates of the contribution of herpes simplex virus type 2 infection to HIV incidence: a population attributable fraction analysis using published epidemiological data. Lancet Infect Dis.2020;20(2):240-249. doi: 10.1016/S1473-3099(19)30470-0.

    Massive proportion of world’s population are living with herpes infection
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  • Maternal infections in health facilities

    Maternal infections in health facilities

    A clearer picture of the global impact 

    New research from the Global Maternal Sepsis Study (GLOSS), a major WHO/HRP initiative, shows that infection has a much larger impact on global maternal mortality and morbidity than previously thought.

    Logo of the Lancet Global HealthThe
    results from GLOSS, published in The Lancet Global Health, are the first to provide data on frequency of maternal infections and
    sepsis across the pregnancy and post-pregnancy period, in a large number of health facilities around the world. 

    Around 11 women per 1000 live births had an infection which resulted in or contributed to what is known as a severe maternal outcome – either they died or nearly died – during their hospitalization. 

    Urgent improvement is needed to manage this life-threatening risk faced by all pregnant and recently pregnant women, wherever they are in the world. 

    What is maternal sepsis and how does it lead to maternal death?

    Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, child-birth, post-abortion or the postpartum period.

    The latest global estimates place sepsis due to obstetric infections as the third most common cause of maternal mortality. However, this only includes infections as a direct result of pregnancy, such as endometritis or post-caesarean wound infections.

    Few
    previous studies include post-abortion infections. Neither do they address indirect infections such as respiratory and meningitis, which are aggravated by pregnancy but not directly caused by it.

    A better understanding of maternal infection

    GLOSS was a massive facility-based data collection effort led by WHO, accompanied by a ‘STOP SEPSIS!’ campaign to increase awareness among healthcare providers.

    The study gathered data on women who were admitted with suspected or confirmed infection during pregnancy or post-pregnancy over a one-week period in 2017. More than 2800 women participated in the study in 52 countries.

    GLOSS included healthcare facilities that care for women during pregnancy, childbirth or at the end of pregnancy, as well as facilities without maternity service but where women could be hospitalized during or after pregnancy, and data on infections
    which are not usually recorded as maternal sepsis, including post-abortion and indirect infections. 

    The result is a more complete understanding of the frequency and impact of maternal infections in health facilities. 

    GLOSS calls attention not only to the wider range of risks faced by pregnant women but also to the long period of time during which they are at risk. 

    Putting global numbers on maternal infection and sepsis

    Overall, around 70 pregnant or recently-pregnant women per 1000 live births were found to have a maternal infection needing hospital management. 

    Across the study, 11 women with either direct or indirect infection per 1000 live births developed a severe maternal outcome, but in low- and middle-income countries up to 15 women per 1000 births were affected.

    Infections were the underlying cause of most of the deaths recorded during the study, primarily post-abortion infection and indirect infections. Infections were also present in about a third of deaths attributed to other causes, such as postpartum
    haemorrhage.

    This suggests that the contribution of infection to global maternal mortality and morbidity may be larger than current reports of maternal sepsis mortality suggest.

    Preventing, identifying and treating maternal infection and sepsis

    Some of the most common maternal infections found in the study, such as urinary tract infections, post-caesarean and post-abortion infections, are largely preventable and treatable.

    GLOSS results suggest that current levels of monitoring and clinical care across health facilities are not enough to prevent, identify and treat levels of maternal infection effectively. 

    For instance, a complete set of vital signs was not reported for a third of the women in the study, on the day their infection was suspected or diagnosed. Delays in antimicrobial therapy were frequent.

    GLOSS also shows marked differences across countries, with the highest burden in low- and middle-income countries, compared with high-income countries.

    This may reflect the impact of broader health determinants in different country contexts. Challenges of overcrowding, limited access to water and sanitation and constraints to safe births by skilled birth attendants can reduce the ability of healthcare
    providers to manage the frequency and outcome of maternal infections.

    An opportunity to implement evidence-based practice

    GLOSS gives healthcare providers, policy-makers, and the public at large an opportunity: to mobilise around these data improve evidence-based practice, and save lives. 

    WHO has produced a number of resources which can support timely action to prevent, diagnose and treat maternal infection, as well as activities such as the upcoming SAVE LIVES: Clean Your Hands campaign
    on 5 May which celebrates the central role played by nurses and midwives in clean health care. 

    In addition, WHO will publish a global sepsis epidemiology report around the 73rd World Health Assembly (WHA) in May, as requested in the
    2017
    WHA Resolution on Improving the prevention, diagnosis and clinical managementof sepsis.

    Understanding why and how infection affects women is essential for equipping healthcare providers with life-saving knowledge and enabling health care systems to bring down global maternal mortality and morbidity.

    Related publications

    WHO recommendations for prevention and treatment of maternal peripartum infections

    WHO Clinical practice handbook for safe abortion

    Global guidelines on the prevention of surgical site infection

    WHO statement on maternal sepsis

    World Health Assembly resolution on Improving the prevention, diagnosis and clinical management of sepsis

    Health Topics

    Antimicrobial resistance

    Infection Prevention and Control

    Water Sanitation Hygiene

    Other links

    Global Maternal Sepsis Study

    SAVE LIVES: Clean Your Hands 5 May 2020

     

     

    Maternal infections in health facilities
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  • What matters to women in the postnatal period?

    What matters to women in the postnatal period?

    The right to a positive maternity healthcare experience at every stage 

    Each pregnancy is unique and clinical needs can change across the pregnancy, childbirth and postnatal periods. One thing that never changes is the right to a positive experience at every stage. 

    Achieving the best possible physical, emotional, and psychological outcomes for every individual and newborn requires health systems to take a human rights-based approach: not only preventing maternal death and morbidity, but prioritising person-centred
    care and well-being.

    WHO is developing new guidelines for a positive experience of postnatal care, due to be published next year. To inform these guidelines and ensure that postnatal services can better meet the needs of women and their babies, WHO undertook a qualitative
    systematic review on what matters to women in the postnatal period.

    Joys and challenges in the postnatal period

    There is limited research about values and preferences in the postnatal period, defined by WHO as the first six weeks after childbirth. Studies have often focused on the results of specific postnatal interventions, rather than on the individuals who use
    them. 

    ‘What matters to women in the postnatal period: A meta-synthesis of qualitative studies,’ published in PLOS ONE, gives long-overdue respect to the authority of women’s own experiences. The authors review first-hand data from 15 countries
    and 36 studies published after the year 2000 relating to women’s beliefs, expectations and values at this significant time of life.  

    These studies affirm that a positive postnatal experience can result in joy, self-confidence and enhanced capacity to thrive as both a person and a parent.

    They are also vocal about the potential challenges of adjusting to a ‘new normal’ following childbirth, including changes in self-identity, relationships, and sexual behaviour.

    What is a positive postnatal experience? 

    A positive postnatal experience for a woman will be one that responds to her specific context and preferences. 

    It will provide the confidence, knowledge and skills women need in the weeks following childbirth, supporting them to adjust to any changes in their intimate relationships and build new family ones. Women will be better equipped to navigate physical and
    emotional challenges and to experience the dynamic achievement of personal growth. 

    This should be a shared responsibility, not a solitary one. Community has a critical role in enabling a positive postnatal experience, including partners, family and elders.

    It is crucial that healthcare providers meet each woman’s needs, as well as those of their babies. 

    Supporting choices and rights to improve postnatal health outcomes

    There are an estimated 303 000 maternal deaths annually, according to recent WHO figures. Most of these deaths occur postnatally. 

    The postnatal period is therefore a vital opportunity to improve both maternal and neonatal health and wellbeing: supporting healthy behaviors, providing life-skills education, facilitating breastfeeding, counselling women about family planning options,
    supporting good mental health, preventing and treating childbirth-related complications. 

    Health care systems that empower individuals by supporting their values, preferences and rights are fundamental to improving maternal and newborn health outcomes. 

    WHO’s guidance for positive maternity care

    WHO has recently released recommendations on antenatal care for a positive pregnancy experience, and on intrapartum care for a positive childbirth experience.

    These publications made important clinical updates, including an increase from four to eight recommended antenatal contacts, and a revision to the decision-making process for interventions to accelerate labour. 

    They also uphold every woman’s right to a positive maternity care experience: one where her pregnancy does not erase her competency, autonomy and right to participate in decision-making for her own care and the care of her newborn. 

    Women’s choices and rights to sexual and reproductive health care, including maternity care, should be respected at every stage of the continuum of maternal and newborn care. This is true across all income settings, as well as in humanitarian settings
    and during public health emergencies.

    When WHO’s postnatal guidelines are released next year, they will complete the maternity care series built around what matters to women.

    Rather than dividing care into three periods of antenatal, intrapartum and postnatal, these publications can be used to establish a model in which health systems support women, their baby and wider network physically, psychologically, socially and emotionally
    through this significant life event. 

    Other resources

     

    What matters to women in the postnatal period?
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  • PRE-NATAL INFLUENCES

    PRE-NATAL INFLUENCES

    The term “Pre-Natal” of course means “before birth,” and Pre-Natal Influences are those influences exerted upon the child before its birth into the world. The students of Eugenics are vitally interested in the subject of Pre-Natal Influences, as they recognize that therein is to be found the secret of much which will work along the line of “better offspring,” and general race-betterment.

    Pre-Natal Influences (as the term is used in the present consideration of the subject) may be considered as manifesting in three phases, as follows:

    (1) The influence of the physical, mental, and moral “family characteristics” of the parents, transmitted to the child along the lines of heredity.

    (2) The influence of the acquired personal characteristics of the parents (particularly the acquired characteristics which are especially active at and just previous to the time of actual conception), transmitted to the child along the lines of heredity.

    (3) The influence of “maternal impressions” (after conception, and during the period of gestation or pregnancy) transmitted to the child physiologically and psychologically.

    I shall now ask you to proceed with me to a consideration of the various phases of Pre-Natal Influences coming under the above name three general classes, and the principal factors involved therein.

    Heredity in General.

    By “heredity” is meant “the tendency which there is in each animal or plant, in all essential characters, to resemble its parents”; or “the hereditary transmission of physical or psychical characteristics of parents to their offspring.”

    There is a great disagreement among the authorities as to how far the principle of heredity really extends, and the real causes of heredity are in dispute. In the present consideration we shall, of course, pass over the technical phases of the subject, and shall touch only upon the general features and principles involved.

    Shute, in his work entitled “Organic Evolution,” says: “That an offspring always inherits from its parents many of their characteristics is well known; that it always varies, more or less, from them, is also equally well known. Heredity and variation are twin forces that play upon every creature, holding it rigidly true to the parental type or compelling more or less divergence therefrom, according to the strength of the one or other power; so that every creature is the resultant of the activities of these two great parallel forces. Variation is co-extensive with heredity, and every living creature gives evidence of the existence of variations.

    “Mental heredity can be illustrated by studying the genealogies of such persons as Aristotle, Goethe, Darwin, Coleridge, Milton, etc. Probably the Bach family, of Germany, supply one of the best illustrations of the inheritance of intellectual character that we know of. The record of this family begins in 1550, lasting through eight generations to 1800. For about two centuries it gave to the world musicians and singers of high rank. The founder was Weit Bach, a baker of Presburg, who sought recreation from his routine work in song and music. For nearly two hundred years his descendants, who were very numerous in Franconia, Thuringia, and Saxony, retained a musical talent, being all church singers and organists. When the members of the family had become very numerous and widely separated from one another, they decided to meet at a stated place once a year. Often more than a hundred persons—men, women, and children—bearing the name of Bach were thus brought together. This family reunion continued until nearly the middle of the eighteenth century. In this family of musicians, twenty-nine became eminent.

    “Inheritance of moral character is well known. Heredity, in its relation to crime and pauperism, has been thoroughly investigated by Mr. Dugdale in his most instructive little work entitled “The Jukes.” In this work the descendants of one vicious and neglected girl are traced through a large number of generations. It reveals that a large proportion of the descendants of this woman became licentious, for, in the course of six generations, fifty-two percent of the children were illegitimate. It shows also that there were seven times more paupers among the women than among the average women of the state, and nine times more paupers among the male descendants than among the average men of the state. The inheritance of physical peculiarities is so obvious as to need no illustration. Among the ancients the Romans stereotyped its truth by the use of such expressions as ‘the labiones’ or thick-lipped; ‘the nasones,’ or big-nosed; ‘the capitones,’ or big-headed, and ‘the buccones,’ or swollen-cheeked, etc. In more recent times we read of the Austrian lip and the Bourbon nose.”

    But in all considerations of the subject of heredity, one must always remember that the inheritance of physical, mental, and moral characteristics is not alone from the immediate parents, but rather from many ancestors further removed in order and time. Back of each person there is a long line of paternal and maternal ancestors, extending back to the beginning of the race. And in that line there are influences for good and evil, awaiting favorable environment for awakening into new life unless restrained by the will of the individual.

    As Shute says: “There will come a time when the fertilized ovum will have a highly complex nucleus composed of many different ancestral groups of hereditary units. One often hears the expression that a child is a chip of the old block; but this is only a very partial truth, for the child is pre-eminently a composite chip of many old blocks.” And Luther Burbank has well said: “Heredity means much; but what is heredity? Not some hideous ancestral spectre, forever crossing the path of a human being. Heredity is simply the sum of all the environments of all past generations on the responsive ever-moving life-forces.”

    Transmission of Acquired Characteristics.

    One of the great disputes of biology is that concerning the question of whether or not parents may transmit to their offspring their personal “acquired characteristics” as well as those inherited from their line of ancestors. One side of the controversy points to the observed cases of children and grandchildren resembling each other, physically, mentally, and morally, in acquired characteristics; but the other side explains these facts as due to environment rather than to heredity.

    The best authorities seem to favor a middle-view, holding that acquired characteristics may be and are transmitted as “tendencies” in the offspring. Thus as each succeeding generation manifests the acquired tendency, it adds a cumulative force to the family heredity. At the same time they hold that “environment” is needed to “draw out” the inherited “tendency.” For instance, a child born with evil tendencies, and placed in an evil environment, will most likely manifest evil conduct. The same child, if placed in a good environment, will not have the evil tendencies “drawn out” by the environment, and will probably not manifest evil conduct. The same rule applies to the child drawn with good “tendencies.” In short, it is held that heredity and environment tend to balance each other—the “something within” is called out (or not called out) by the “something without.” The life of the individual is held to be a continuous action and reaction between heredity and environment, and both of these elements must be taken into consideration when we think of the subject.

    Shute says: “As influencing a man’s life and character, which is the strongest factor, heredity or environment?” In our opinion, as the result of long study and reading, where we have an average man of a sound mind in a sound body, there environment will be the strongest factor whether for good or evil—that is, in men in general, who have no organic defect, such as insanity or idiocy, and allied affections, the stronger force is environment; but in those having such defect, heredity is the controlling power, and we may add, the destroying power.

    The Eugenic Rule Regarding Heredity.

    It is one of the cardinal principles of Eugenics that those with a bad family history should not become parents. By this it is not meant that the manifestation of undesirable tendencies, physical, mental, and moral, on the part of certain individuals of a family necessarily constitutes a “bad family history.” On the contrary, many of the best families have, from time to time, individuals who manifest undesirable tendencies, and who are in general out of harmony with the general family standard. It is an old axiom that “there is a black sheep in every flock”; and the flock must be measured by its general standard, and not by its exceptional black sheep.

    A “bad family history” is one in which the family has clearly manifested certain undesirable physical, mental, and moral traits in a marked degree, and in a sufficientnumber of instances to establish a standard. Some families have a “bad family history” for inebriety; others for epilepsy; others for licentiousness; others for dishonesty—the history extending over several generations, and including a marked number of individuals in each generation. Individuals of such a family should refrain from bearing children; and if children be born to such the greatest care should be exercised by the parents in the matter of surrounding the child with the environment least calculated to “draw out” the undesirable characteristic. The child has a right to be well born, and to be protected from being brought into the world subjected to the handicap of a “bad family history.” If individuals cannot endow their children with a good family history, they should refrain from bearing children—such is the Eugenic advice on the subject.

    The same rule applies to the question of “acquired characteristics” of the parents—especially those acquired characteristics which are especially active at or just before the time of the contemplated conception. Though the family history of both husband and wife be ever so good, it is held that if one or both of the parents have acquired undesirable and transmissible characteristics, physical, mental, or moral, then the question of bringing children into the world should be carefully considered, and conscientiously decided, after competent authorities have been consulted concerning the case. The prospective child should always be given the benefit of the doubt in such cases. To bring children into the world merely to gratify personal pleasure or pride, regardless of the welfare of the child, is something utterly unworthy of an intelligent and moral human being.

    Fitness for Parenthood.

    In determining the “fitness” for parenthood, on the part of husband and wife, the mental, physical, and moral qualities should all be taken into consideration. Weak or abnormal mentality; chronic immorality or perverted moral sense; or diseased or abnormal physical conditions—these should always be regarded as bars to parenthood. To violate this principle is to deliberately violate the fundamental laws of Nature, as well as those principles which are accepted as representing the best thought and customs of the race. A mental, moral, or physical “pervert” or “defective” is manifestly an “unfit,” considered as a prospective parent. Parenthood on the part of such individuals is not only a crime against society, but always a base injustice perpetrated upon the offspring.

    A very interesting phase of the general subject now before us for consideration is that which touches upon the effect of those particular acquired characteristics which are especially active at the time, or just before the time of conception. The best authorities hold that the influences manifest and active in the prospective father and mother during the period immediately preceding conception will have a marked effect upon the character of the child. The following quotations from authorities on the subject will serve to illustrate this idea.

    Riddell says: “The transient physical, mental and moral conditions of the parents, prior to the initial of life, at the time of inception, do affect offspring.” Dr. Cowan says: “Through the rightly directed wills of the mother and father, preceding and during ante-natal life, the child’s form of body, character of mind, and purity of soul are formed and established. That in its plastic shape, during ante-natal life, like clay in the hand of the potter, it can be molded into absolutely any form of body and soul the parents may knowingly desire.” Newton says: “Numerous facts indicate that offspring may be affected and their tendencies shaped by a great variety of influences, among which moods and influences more or less permanent may be included.”

    Riddell says: “The influence of environmental conditions and pre-natal training are ever evident. Colts from dams that have been under regular training are faster than those from the same mother foaled before she had been trained. The puppies of the trained shepherd dog learn much more rapidly than do those from the untrained animal. No sportsman would think of paying a high price for a puppy, the mother of which was stupid and untrained. The same law applies, only with greater effect, to the human family.” Greer says: “No married couple will desire, design and love a babe into existence without the first requisite—good physical health.” Grant Allen says: “To prepare ourselves for the duties of maternity and paternity by making ourselves as vigorous and healthful as we can be, is a duty we owe to children unborn.” Holbrook says: “It is essential, therefore, that if children are to be well-born, the parents should be careful that at the moment of procreation they are fitted for the performance of so serious an act.” Another authority says: “Generation should be preceded by regeneration.”

    Cowan says: “In the conception of a new life, the mass of mankind observes no law unless it be the law of chance. Out of the licentious or incontinent actions of a husband’s nature, conception after a time is discovered to take place. No preparation of body, mind, or soul is made by either parent. Not more than one child in perhaps ten thousand is brought into the world with the consent and loving desire of its parents. The other nine thousand, nine hundred, and ninety nine children are endowed with the accumulated sins of the parents. Is it any wonder that there is so much sin, sickness, drunkenness, suffering, licentiousness, murder, suicide, and prematuredeath, and so little of purity, chastity, success, goodness, happiness and long life in the world?”

    Preparation for Parenthood.

    The ancient Greeks attached great importance to the mental, moral and physical condition of the parents at the moment of conception, and for a period preceding the same. The Investigations of modern scientists have tended to corroborate the facts upon which the ancient theories were based. Modern science teaches that the life-cells of each parent are impressed with the condition of the respective parents, and retain this impression until they meet and finally coalesce and combine, the combined cell then receiving the result of the original impressions.

    The best authorities on the subject claim that a reasonable time of self-restraint and continence should be observed by the prospective parents before the conception of the child. This contention is borne out by the experience of the breeders of fine horses and cattle, who have discovered that the best offspring are produced when the animals have been restrained from sexual intercourse for a reasonable time; this precaution being particularly observed in the case of the male parent animal. Writers on the subject cite a number of instances to prove that this law maintains in human as well is in animal life. It is claimed that Sir Isaac Newton was conceived after a period of over a year of total sexual abstinence on the part of his parents. Many other celebrated men are said to have been conceived after an absence from home on the part of the father, or a temporary absence from home on the part of the mother. Many physicians are able to cite many similar cases observed in the course of their own experience.

    The prospective parents should endeavor to bring themselves up to a high degree of physical health and well-being. The blood of the mother should be enriched byproper nutrition, and the organs of the body should be brought to a state of normal functioning along the lines of digestion, assimilation, and elimination.

    The minds of both parents should be exercised by reading the right kind of books, and by paying attention to natural objects of interest. A little change of scene will tend to awaken the powers of observation and attention. Riddell says: “If the prospective parents will habitually exercise the reasoning faculties and inventive powers, usually the offspring will have a fair degree of inventive talent and originality, even where these qualities are originally deficient in the parents. When there is a considerable natural talent or where there are latent inventive powers, constant training on the part of the parents will usually give the offspring exceptional powers in this direction.”

    The prospective parents should also develop and exercise their moral faculties in the period preceding conception. This course will tend to reproduce the same quality in the child. The reverse of this, alas, is also true. A case is cited of a man who procreated a child while plotting a nefarious crime; and the child in after life manifested a tendency toward theft, roguery and rascality, even at a very early age. The lack of moral fibre so often noticed in the sons of rich men who have attained their success through questionable methods is perhaps as much attributable to these pre-conceptual influences as to the “spoiling” environment of the child after birth.

    In the period of physical, mental, and moral preparation for parenthood the leading thought of both parents should be: “Do we wish our child to be like this?” This thought, if carried as an ideal, will act both in the direction of self-restraint and self-development.

    The actual time of the conception of the new life should be carefully chosen, so that it may occur under the best circumstances and conditions. The suggestions embodied in the preceding paragraphs should have been carefully observed; and the time chosen should be one in which a peaceful and happy state of mind is possessed by both parents. The ovum of the woman is believed to have its greatest vitality about the time of the close of each menstrual period, and many good authorities hold that this is not only the natural period for sexual intercourse, but is also the exact period in which the life-forces in the ovum are strongest; and that, consequently, the child conceived at this period is likely to be stronger and more vigorous than the one conceived at a later time between the menstrual periods.

    Dr. Stall says: “Medical authorities attach great importance to the mental condition at the moment of conjunction and conception. It is quite universally believed that this is a moment of unparalleled importance to the welfare of the future being. It is an awful crime to beget life carelessly, and when in improper and unworthy mental states. Some people seem to think that the matter of begetting a child, like the matter of selecting a wife, should be left wholly to blind chance. Neither of these two important events can be too much safeguarded by wise and thoughtful consideration. If conception is permitted to take place when either one or both of the parents are in bad health; if the wife is an unwilling mother, and the embryo is developed by her while her whole nature rebels against the admission into the family of a child who is not wanted, the children begotten and born under such circumstances can never be other than sickly, nervous and fretful during their entire childhood, and cross and uncompanionable throughout their whole lives.

    “Much of the differences which exist between children of the same parents may be easily attributed to the different bodily and mental conditions of the parents at theperiod of conjunction, the changed physical, intellectual and emotional states of the parents at the different periods of conception producing the corresponding differences in their offspring. The results of purposed and prepared parenthood are so great and so desirable that a husband and wife should consider these matters carefully, making preparations, and approach the period when they would beget offspring and bring immortal beings into the world with the greatest thoughtfulness, consideration, and also with prayer.”

    Dr. Hufeland says: “In my opinion, it is of the utmost importance that the moment of conception should be confined to a period when the sensation of collected powers, ardent passion, and a mind cheerful and free from care, invite to it on both sides.” Riddell says: “The law of initial impressions is well established. It has been understood and applied by stock-raisers for centuries. Experiments prove that the qualities most highly excited in animals prior to their union are most fully transmitted. The speed of horses and the acquired characters of the dog have been improved by the applications of the law. History and classic literature contain many references that recognize its importance, like Shakespeare’s ‘Come on, ye cowards; ye were got in fear.’ Ancient laws forbade union while parents were intoxicated, because such unions resulted in the production of drunkards and monstrosities. The asylums for the feeble-minded contain hundreds of unfortunate ones that are the product of such unions. The law of initial impressions, like the other laws of heredity, is traced most easily where morbid conditions are transmitted; but fortunately it is quite as potential in the production of desirable qualities. Unusual excitement to the social, intellectual or religious powers on the parents just prior to the inception of the new life frequently produce in the child corresponding tendencies.”

    Dr. Stockham says: “Many a drunkard owes his lifelong appetite for alcohol to the fact that the inception of his life could be traced to a night of dissipation on the part of his father.” Fleming says: “Not only do drunkards transmit to their descendants tendency toward insanity and crime, but even habitually sober parents who at the moment of conception are in a temporary state of drunkenness beget children who are epileptic or paralytic, idiotic or insane, very often microcephalic, or with remarkable weakness of mind, which is transformed at the first favorable occasion into insanity.”

    The time of conception should undoubtedly be chosen to correspond to a time in which the sex-powers of both parents are at their maximum. This is arrived at by a reasonable period of previous continence and abstinence from sexual relations between the married couple, and by an observance of the natural law which renders the woman most strong sexually at the close of the menstrual period. The husband, as well as the wife, is most strong sexually at this period, as under normal conditions his sex-power is most actively called forth by that of the woman at this period. At this period the wave of sex-power is at its height, and this is the best time for the beginning of the new life. As Riddell says: “Strong, vigorous, chaste sexuality at the time of conception is of supreme importance; it is indispensable to good results. No number of other conditions or factors can be so favorable as to justify the creation of a new life when the vitality of either parent is low. Parents transmit their physical constitution, intellect and morals only to the extent of the sex-power at the time of inception.”

    It is needless to say that there should exist between the prospective parents a strong bond of affection and attraction. By an irony of civilized life, the term “love child” is applied only to the offspring of unmarried lovers—men and women whose affection or passion have run away with their judgment, and who have “loved not wisely, but too well.” Some of the world’s greatest men and women have been “love children” of this kind; and in such cases it is probably true that their physical and mental strength has been the result of the ardent feeling animating the parents at the moment of conception. Such children seldom result from the “tired bed” or worn-out passion, love killed by sexual excesses, indifference on the part of one of the participants of the union, “duty” intercourse without affection or passion, or forced sexual relations. Every child should be a “love child” in the true sense of the term. The term should be one of respect, not of reproach. There should be no children but “love children.” The fruit of the perfect mating and marriage should be the perfect “love child”—and it would always be so if husbands and wives would but observe the laws of the normal, natural, sex-life.

    And, last of all—and perhaps more important than all—is the fact that at the moment of conception the minds and hearts of both of the prospective parents should be united in a strong love and desire for the hoped-for child. At that moment their best natures should blend into each other, and their love for each other fuse into a new love—the love of the child of the union. Under such circumstances, in such act the Cosmic Forces flow unhindered through the beings of the parents, and the new life is begun under the approving smile of Nature.

    Maternal Impressions.

    One of the oldest and most firmly-rooted beliefs of the race is that which holds that the pregnant mother may, and often does, consciously or unconsciously, impress upon her unborn child certain mental, moral, or physical traits. The majority of persons accept this idea as self-evident, and are able to cite cases within their own personal experience which go to prove the correctness of the popular belief. But certain modern authorities have sought to tear down this belief, and to discredit the general idea. Let us briefly consider both sides of this question.

    On the side of the generally accepted belief, Riddell says: “The more I study the influence of maternal impressions upon the life, mentality and character of men, the more I am led to believe that the education and moral training that a child receives before it sees the light of day are the most influential, and, therefore, the most important part of its education.” Newton says: “A mother may, during the period of gestation, exercise some influence, by her own voluntary mental and physical action, either unwittingly or purposely, in determining the traits and tendencies of her offspring. This is now a common belief among intelligent people. Every observant teacher could doubtless bear witness to the same general facts, and it would be easy to fill a volume with testimonials from various sources illustrative and confirmatory of the law under discussion. Such facts establish beyond question the conviction that the mother has it largely in her power to confer on her child such a tendency of mind and conformation of brain as shall not only facilitate the acquisition of knowledge in any specific direction, but make it certain that such knowledge will be sought and acquired.”

    Dr. Fordyce Baker says: “The weight of authority must be conceded to be in favor of the idea that maternal impressions may effect the growth, form and character of a forming child.” Dr. Rokitansky says: “The question whether mental emotions do influence the development of the child must be answered ‘Yes!’” Dr. Brittain says: “The singular effects produced on the unborn child by the sudden mental emotions of the mother are remarkable examples of a kind of electrotyping on the sensitive surface of living forms. It is doubtless true that the mind’s action in such cases may increase or diminish the molecular deposits in the several portions of the system. The precise place which each separate particle assumes may be determined by the influence of thought or feeling. If, for example, there exists in the mother any unusual tendency of the vital forces to the brain at the critical period, there will be a similar cerebral development and activity in the offspring.”

    Newton says: “The human embryo is formed and developed in all its parts, even to the minutest detail, by and through the action of the vital, mental, and spiritual forces of the mother, which forces act in and through the corresponding portions of her own organism. And while this process may go on unconsciously, or without the mother’s voluntary participation or direction, yet she may consciously and purposely so direct her activities as, with a good degree of certainty, to accomplish specifically desired ends in determining the traits and qualities of her offspring.” Professor Bayer says: “The influence of the mind of a prospective mother upon her child, before its birth, is of tremendous importance to its active existence as a member of society, from the fact that it lies in the mother’s power to shape its mentality, that it may be a power for good or for evil.”

    The views of that school of thought which is opposed to this old and generally accepted idea of material impressions, are ably presented by Dr. Saleeby, as follows: “Consider the case. The baby is at this time already a baby, though rather small and uncanny, floating in a fluid of its own manufacture. Its sole connection with the mother is by means of its umbilical cord—that is to say, blood-vessels, arterial and venous. There is no nervous connection whatever; absolutely nothing but the blood-stream, carried along a system of tubes. This blood is the child’s blood, which it sends forth from itself along the umbillical cord to a special organ, the placenta or afterbirth, half made by itself and half made by the mother, in which the child’s blood travels in thin vessels so close to the mother’s blood that their contents can be interchanged. Yet the two streams never mix. The child’s blood, having disposed of its carbonic acid and waste products to the mother’s blood, and having received therefrom oxygen and food, returns so laden to the child. Pray how is the mother’s reading of history to make the child a historian? We see now how the learning of geometry on the part of the mother before its birth will not set her baby upon that royal road to geometry of which Euclid rightly denied the existence—any more than after its birth. Such a thing does not happen—unless we are to call in Telepathy.”

    All this argument may seem quite convincing—at first. But when we begin to consider the matter carefully, we begin to perceive the weak places in the argument as above presented. In the first place, it is known that emotions powerfully affect the condition, quality, and “life” of the blood. We know that cheerful emotions impart certain uplifting qualities to the blood, while depressing emotions correspondingly react upon it. Fear, worry, fright, jealousy, etc., are actual poisons to the blood, and have brought on diseased conditions to the persons manifesting these emotions. Moreover, it is known that impaired quality of the blood reacts upon the brain. Is it so unreasonable, then, to hold that emotional states in the mother may react upon the mental and physical condition of the unborn child, through the blood? Does not something similar occur in the case of the babe, after its birth, when it is affected by the conditions of its mother’s milk brought on by her depressing emotions, fright, etc.? This would seem to explain at least the matter of emotional reactions between mother and unborn babe.

    But the case is not closed with the presentation of the evidence of physiology, important though that may be. There is an entirely different field of science to be drawn upon before the case is closed. The orthodox physiologist makes the mistake of supposing that all mental impulses and transmission of psychic energy require the service of nerves as channels of transmission. While such channels are usually required, we have good reasons for believing that there are exceptions to the rule. There have been found tiny creatures, possessing life and energy, performing the functions of nourishment, elimination, and even of reproduction—and yet without a nervous system. In one well-known instance, that of the moneron, we find not only an absence of a nervous system but also the lack of organs of any kind—and yet the creature lives, acts, moves, eats, thinks, and reproduces itself.

    Then, again, consider the moving cells of the blood, unconnected with the brain, unattached to the nervous system, and yet rushing to the work of repairing a wound, or of repelling an intruding germ, in obedience to a mental command from the controlling subconscious mental regions of the living creature. How does the mental impulse reach these cells and others of similar nature in the system? If we were not so sure of the facts, might we not feel inclined to say with Dr. Saleeby, in the above quoted sentence: “Such a thing does not happen—unless we are to call in telepathy.”

    Moreover, examining Dr. Saleeby’s statement, we see mention made of the placenta at being “half made by the embryo, and half made by the mother.” How does this co-operation and co-ordination of effort and subconscious will arise? How does the subconscious mentality of the embryo know that the subconscious mentality of the mother is making its half of the placenta, or vice versa? Again, how is the subconscious mentality of the mother affected by the presence and development of the child—how do her mammary glands respond to the growth and development of the child? In short, how is the manifest co-operation and co-ordination between the “nature” of the mother and the “nature” of the child possible, unless there exists some psychical, as well as some physical, relation between the two beings.

    The person conscientiously considering this subject must include in his thought the discoveries of modern psychology concerning what is known as the “subconscious mind,” which controls the unconscious and instinctive functions of the physical body, and also receives impressions and suggestions from the surface consciousness of its owner. This factor being admitted to our thought on the subject, we may find it possible to accept the idea of material impressions from mother to child operating from the subconscious mind of the mother to that of the child. In other words, that there is a subconscious mental connection, as well as the physical connection, between the mother and her unborn child.

    Many careful thinkers (and observers) find it just as easy to accept the fact of this strange “sympathetic co-ordination” between a mother and her unborn child as it is to accept the very frequent “sympathetic sickness” of the husband during the pregnancy of his wife—or of the “sympathetic labor pains” so often experienced by the husband during the confinement of his wife. Both of the latter two cases occur too often to permit the phenomenon to be denied off hand by those who would set aside all facts not agreeing with their particular personal theories. There is no nervous system connecting husband and wife, and of such cases the critic like Dr. Saleeby might say: “Such a thing does not happen—unless we call in telepathy!” The fact remains that many things actually happen which according to the orthodox physiological theories “cannot happen.” But they DO happen, nevertheless, whether we call it “telepathy” or merely label it “certain facts, the exact causes of which Science in the present state of its knowledge (or ignorance) cannot definitely determine.” One irrefutable fact outweighs a ton of mere general denials of possibility.

    It is recorded that the mother of Charles Kingsley believed in maternal impressions, and during her period of pregnancy exercised her imagination and emotions in the direction of wishing, and imagining, that the coming child should have the same love of Devonshire scenery that so delighted her. The result proved her theory, for though Kingsley never saw Devonshire until he was a man of thirty years of age, every Devonshire scene had a mysterious charm for him throughout his entire life. It is said that Robert Burns was so strongly impressed parentally by the old Scotch songs and ballads that his mother sung during her pregnancy, that his whole nature longed to express itself in like measure and substance. He always believed that his poetic spirit was kindled by this tendency on the part of his mother during the period preceding his birth.

    The mother of Napoleon Bonaparte during several months of her pregnancy, accompanied her husband during his military campaigns in Corsica, and during the entire term she lived in an atmosphere of battles, military strategy, and troops. When the boy was very young he manifested an unusual interest in war and conquest, and his whole mind had the military bent, although his brothers were in no wise remarkable in this direction. The artist, Flaxman, stated that his mother had related to him how for several months prior to his birth she had spent many hours each day studying drawings and engravings, and endeavoring to visualize by memory the beautiful figures of the human body drawn by the masters. The result was that from early childhood Flaxman manifested an intense delight in drawing; and in after life his drawings were regarded as masterpieces. He, and his mother, always attributed his talent to the parental impressions above mentioned.

    “Buffalo Bill” was believed to owe his characteristics to the mental states of his mother, the family living in Missouri during the days of frontier fights and disturbances, the mother being called upon several times to exercise resourceful courage and fortitude. A well-known worker along the lines of liberal Christianity is said to have attributed his tendencies in that direction to the prayers of his mother, during her pregnancy, that the child might be true to the teachings of the Christ, and should be a laborer in the cause of human brotherhood. This man, relating the fact, said: “I may have been converted before I was born.” A well-known writer along the lines of moral philosophy is believed by friends to owe his talent to the earnest thoughts and hopes of his mother during pregnancy—she is said to have pictured the child as a son destined to become a great moral philosopher, her mind being so firmly fixed on this fact that she felt it was already an assured fact.

    The Greeks were wont to surround the pregnant women with beautiful statuary, and it is recorded that in many cases the children afterward born closely resembled these works of art and beauty. It is claimed that many Italian women closely resemble the face shown in Raphael’s “Madonna,” copies of this celebrated picture being quite common in Italian households. Frances Willard, the temperance worker, is said to have very closely resembled a young woman of whom her mother was very fond. Many family resemblances are believed to have arisen in this way, rather than by heredity. Zerah Colburn, the mathematical prodigy whose feats astounded the scientific world in the early part of the last century, is said to have derived his wonderful faculty from maternal impressions of this kind; his mother is said to have occupied much of her time during her pregnancy in studying arithmetic and working problems, the study being quite new to her and proving very interesting.

    Cases similar to those above quoted might be duplicated almost indefinitely. The story is practically the same in each and every case. The principle involved is always that the pregnant mother took a decided interest in certain subjects, studies, and work, and that the child when born manifested at an early age similar tastes and inclinations. But far more important to the average prospective parent is the fact that many authorities positively claim that any pregnant mother may consciously and deliberately influence and shape the character, physical, mental, and moral of her unborn child.

    Newton well says, on this subject: “In the cases usually given to the public bearing on this topic, the moulding power appears to have been exercised merely by accident or chance; that is, without any intelligent purpose on the part of mothers to produce the results. Can there be any doubt that similar means, if purposely and wisely adopted, and applied with the greater care and precision which enlightened intention secure, would produce under the same law even more perfect results. Is it not altogether probable that an intentional direction of the vital or mental forces to any particular portion of the brain will cause a development and activity in the corresponding portion of the brain of the offspring? There seems to be no reasonable ground on which these propositions can be denied. The brain is made up of a congeries of organs which are the organs of distinct faculties of the mind or soul. It follows, then, that if the mother during gestation maintains a special activity of any one brain organ, or group of organs, in her brain, she thereby causes more development of the corresponding organ or group in the brain of the fetus. She thus determines a tendency in the child to special activity of the faculties, of which such organs are the instruments. It is plain, furthermore, that if any one organ or faculty may thus be cultivated before birth, and its activity enhanced for life, so may any other—and so may all. It would seem, then, clearly within the bounds of possibility that a mother, by pursuing a systematic and comprehensive method, may give a well-rounded and harmoniously developed organism to her child—notwithstanding her own defects, which, under the unguided operation of hereditary law, are likely to be repeated in her offspring. Or it is within her power to impart a leading tendency in any specific direction that she may deem desirable, for a life of the highest usefulness. In this way ancestral defects and undesirable hereditary traits, of whatever nature or however strong, may be overcome, or in a good degree counterbalanced by giving greater activity to counteracting tendencies; and, in this way, too, it would appear the coveted gifts of genius may be conferred. In other words, it would seem to be within the mother’s power, by the voluntary and intelligent direction of her own forces, in orderly and systematic methods, both to mold the physical form to lines of beauty, and shape the mental, moral, and spiritual features of her child to an extent to which no limit can be assigned.”

    I think that in the pages of this particular part of the book the prospective parent may find hints and general directions toward a clearly defined ideal, which is carefully studied, and as carefully put into practice will produce results far beyond the dreams of the average man and woman. The hope is a magnificent one, and the best testimony is in favor of the possibility of its actual realization.

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • GESTATION OR PREGNANCY

    GESTATION OR PREGNANCY

    Gestation is “the act of carrying young in the Uterus, from the time of conception to that of parturition.” Conception occurs at the moment of the impregnation of the ovum; parturition is the act of delivery, or childbirth. Pregnancy is “the state of being with child.” The terms “period of gestation,” and “period of pregnancy,” respectively, are employed by medical authorities to designate the time during which the mother carries the young within her own body—from the moment of the impregnation of the ovum until the moment of the final delivery of the child into the outer world.

    The term of pregnancy in woman continues for over nine calendar months (or ten lunar months)—from about 275 to 280 days, though in exceptional cases it may be terminated in seven calendar months, or on the other hand may continue for ten calendar months. The usual method is to figure 280 days from the first day of the last menstruation. A simple method of calculating the probable date of delivery is as follows: Count back three months, and then add seven days, and you will have the date of probable delivery. Example: A woman’s first day of last menstruation is March 28. Counting back three months gives us December 28; and adding seven days to this gives us January 4, as the date of probable delivery. There will always be a possible margin of a few days before or after the ascertained probable date—but the delivery will very closely approximate said date. Ignore the shortage of days of February in this calculation, the same being covered by the general margin allowed.

    Development of the Impregnated Ovum. In the preceding lesson we terminated our consideration of the impregnated ovum at the point at which, after the process of segmentation, the “primitive trace” had appeared. This primitive trace appears as an opaque streak, or straight line, formed of an aggregation of cells of a distinctive quality. This delicate “trace” or “streak” is the first indication of the form of the coming child. It is the basis, pattern, or mould, in or around which the spinal column is to be formed, and around which the entire young body is to be developed by the wonderful and intricate processes of dividing and reduplication, and the folding and combination of cells. From one end of this “trace” develops the head; from the other end develops the lower end of the spine. At a later stage there appear tiny “buds” in the positions at which the arms and legs should be; these gradually develop, and their ends split into tiny fingers and toes, and finally are transformed into perfect little arms and legs, miniatures of those of the adult human being.

    The term “the embryo” is employed to designate the developing young creature in the earlier stages of its development, particularly before the end of the third month of its existence. After the end of the third month the embryo is called “the fetus.” In the short space of 280 days the young creature evolves and develops from a single simple cell into a complex organism—a perfect miniature human being. Nature works a wonderful miracle here, and yet so common is it that we take it all as a matter of course, and lose sight of the miracle. From the most simple forms are formed in the developing creature the most complex organs and parts. The heart is formed from a tiny straight line of cells, by enlargement and partition. The stomach and intestines, likewise, develop from a tiny straight line of cells arranged as a tiny tube—the stomach is formed by dilation of one part of the tube, while the large intestine experiences a similar though lesser distention and a greater growth in length; the smaller intestines being formed by growth in length and circumference. The other organs evolve from similar simple beginnings.

    The embryo is nourished during its earlier stages by means of the “yolk sack,” or “umbilical vesicle,” which is outside the body of the embryo, being joined to it by means of the umbilical duct. This yolk sack (originally formed by a “drawing together” in the ovum, which thus separates itself into two portions or areas) is an important feature of the life of the embryo, as it nourishes and sustains it in its earlier stages. Blood vessels form in this yolk sack, and after a time its fluid is absorbed, and after the third month the sack gradually disappears.

    After the passing away of the yolk sack, the embryo is nourished and sustained by the “allantois,” another peculiar sack which is formed. This sack readily becomes filled with blood-vessels, and serves to nourish the embryo by sustenance obtained from the body of the mother through the walls of the Uterus, a direct communication with the blood-vessels of the mother thus being secured. The blood in the embryo, and that in the mother, come into close contact, thus allowing the embryo to be nourished by the blood of the mother. After a time, in turn, the allantois diminishes and dwindles away, its offices being taken up and performed by the “placenta” or “afterbirth.”

    The Placenta or Afterbirth. The Placenta, or afterbirth, is a round, flat substance or organ, contained within the Uterus, by which communication and connection is established and maintained between the fetus and the mother, by means of the umbillical cord. It is a flat, circular mass, about seven inches in diameter, and weighing about sixteen ounces. It is attached to the sides of the Uterus of the mother during the period of gestation, and is expelled from the body of the mother, as “the afterbirth,” after the birth of the child.

    Let us pause a moment, and reconsider the several steps in Nature’s plan for nourishing the embryo and fetus. In the first place, as we have seen, there is the yolk sack or umbillical vesicle, filled with a fluid which nourishes the embryo. This gradually disappears in time, and is replaced by the “allantois” which by connection with the walls of the Uterus is enabled to nourish the fetus from and by the blood of the mother. For a short time, however, the embryo is nourished by both the yolk sack and the allantois. Then the allantois assumes the entire task, and the yolk sack passes away. Then, later, the placenta replaces the allantois, and the latter passes away as did its predecessor. The placenta works along the same general lines as the allantois, but is a far more complex way and with a much higher degree of efficiency, as we shall see presently.

    The placenta is connected with the body of the fetus by what is known as “the umbillical cord.” The “umbillicus” or “navel” in the human being marks the place at which the umbillical cord entered the body of the fetus, from which it was severed after the birth of the child. The purpose of the umbillical cord is to contain and support the umbillical arteries and veins through which the fetus obtains nourishment from the placental substance, and through which the return blood flows. The rich red arterial blood is carried from the placenta to the fetus, and is then distributed over the body of the fetus, nourishing and building it up; the dark venous blood, laden with the waste products of the body of the fetus, is carried back to the placenta, there to be repurified and rendered again rich and nourishing.

    The story of the circulation of the blood of the fetus is most interesting. Although the fetal blood is derived from that of the mother, as we have said, yet the maternal blood does not pass directly from the circulatory system of the mother into that of the fetus; nor does the blood of the fetus return directly into the circulatory system of the mother. In fact, the fetal blood never comes in direct contact with that of the mother, or vice versa. The fetus has an independent circulatory system of its own, and yet, at the same time, from the moment of the placental connection until the moment of childbirth, all its nourishment is derived from its mother.

    The secret of the above paradoxical statement is made apparent when we understand the meaning of the scientific term “osmosis.” Osmosis is “the passage of a fluid through a membrane”; it is a chemical process, caused by the chemical affinity between two liquids or gases separated one from the other by a porous diaphragm or substance. In the process of osmosis in the case before us, the fetal blood takes up nourishing substances and oxygen from the blood of the mother, and passes on to the latter the waste products of the fetal system, by means of passing these substances through the thin porous membranes which separate the two independent systems of blood vessels, i. e., the system of the fetus, and that of the mother. Before birth, in fact, the fetus has its blood nourished and oxygenated by means of the food partaken of by its mother, and the oxygen taken in by the mother in her breathing. After its birth, the infant eats and breathes for itself, and thus nourishes its blood supply directly, instead of receiving it indirectly from the mother.

    The Placenta begins to be formed about the third month of gestation, and continues to develop steadily from that time. At the time of the delivery of the child the Placenta covers nearly or quite one-third of the inner space of the distended Uterus of the mother. The total “afterbirth” consists of the Placenta, the umbillical cord, and the remaining membranes of the ovum, all of which are expelled after the birth of the child.

    The Amnion. An important appendage contained in the Uterus in connection with the developing fetus is that known as “The Amnion.” This is an inner sack which forms within the womb, and which serves to enclose the fetus, and also to sheath the umbillical cord. The Amnion encloses the embryo very snugly during the early stages of its development, but it gradually becomes distended with a pale watery fluid, known as “the amniotic fluid,” the purpose of which is to “float” the fetus and to give it mechanical support on all sides. This fluid is composed of water carrying in solution small quantities of albumin, urea, and salt.

    Sex in the Embryo and Fetus. It is impossible to determine the sex of the embryo during its early stages. During the fourth week the first traces of the sexual glands appear, but not until the fifth week can the sex be determined even by the microscope. If the embryo is to become a male, certain ducts are transformed into convoluted tubules, and each is attached to the testes which have been formed from the genital nucleus. If the embryo is to become a female, the ducts join to form the uterus and vagina, other portions being transformed into the fallopian tubes and connecting with the ovaries which have been formed otherwise. The outer genitals appear in the early stages of the embryo, but there is no apparent distinction between the sexes, the external organs being the same in all cases, and consisting of a small tubular organ with a small lateral fold of skin on either side. Later, in the male, a groove appears on the under side of this primitive organ, thus forming the urethra, the scrotum being formed from the folded skin at the side. In the female, the primitive organ ceases to develop as in the male, and thus becomes proportionately smaller, and evolves into the clitoris of the female; the two lateral folds, on each side, being transformed into the labia majora, or “outer lips” of the female external genitals.

    Position of the Fetus. During the period of gestation the fetus lies “curled up” in the bag of the amnion. The head is usually relaxed and inclined forward, the chin resting on the breast; the feet are bent up in front of the legs, the legs bent up on the thighs, the knees separated from each other, but the heels almost touching on the back of the thighs; the arms bent forward and the hands placed between them as though to receive the chin between them. The folded-up fetus forms an oval, the longest diameter of which is about eleven inches at its greatest stage of growth. Nature here shows a wonderful ability to pack the fetus into as little space as possible, and in such a position as to protect it from injury, and to discommode the mother as little as possible.

    The following interesting statement made by Helen Idleson, M. D., in a European medical journal several years ago, gives a very clear idea, expressed in popular terms, of the appearance and characteristics of the embryo or fetus in the various stages of its development:

    “The growth of the embryo after fecundation is very rapid. On the tenth day it has the appearance of a semi-transparent grayish flake. On the twelfth day it is nearly the size of a pea, filled with fluid, in the middle of which is an opaque spot, presenting the first appearance of an embryo, which may be clearly seen as an oblong or curved body, and is plainly visible to the naked eye on the fourteenth day. The twenty-first day the embryo resembles an ant or a lettuce seed. Many of its parts now begin to show themselves, especially the cartilaginous beginnings of the spinal column, the heart, etc. The thirtieth day the embryo is as large as a horse-fly, and resembles a worm, bent together. There are as yet no limbs, and the head is larger than the rest of the body. When stretched out it is nearly half an inch long. Toward the fifth week the heart increases greatly in proportion to the remainder of the body, and the rudimentary eyes are indicated by two black spots toward the sides, and the heart exhibits its external form, bearing a close resemblance to that in an adult. In the seventh week, bone begins to form in the lower jaw and clavicle. Narrow streaks on each side of the vertebral column show the beginning of the ribs. The heart is perfecting its form, the brain enlarging, and the eyes and ears growing more perfect, and the limbs sprouting from the body. The lungs are mere sacks, and the trachea is a delicate thread, but the liver is very large. In the seventh week are formed the renal capsules and kidneys.

    “At two months, the forearm and hand can be distinguished, but not the arm; the hand is larger than the forearm, but it is not supplied with fingers. The distinction of sex is yet difficult. The eyes are prominent. The nose forms an obtuse eminence. The nostrils are rounded and separated. The mouth is gaping, and the epidermis can be distinguished from the true skin. The embryo is from one-half to two inches long, the head forming more than one-third of the whole. At the end of three months, the eyelids are distinct but shut; the lips are drawn together; the forehead and nose are clearly traceable, and the organs of generation prominent. The heart beats with force; the larger vessels carry red blood; the fingers and toes are well defined, and the muscles begin to be developed.

    “At the fourth month, the embryo takes the name of ‘fetus.’ The body is six to eight inches in length. The skin has a rosy color, and the muscles produce a sensible motion. A fetus born at this time might live several hours. At five months the length of the body is from eight to ten inches. At six months, the length is twelve and one-half inches. The hair appears on the head, the eyes closed, the eyelids somewhat thicker, and their margins, as well as their eyebrows, are studded with very delicate hairs. At seven months, every part has been increased in volume and perfection; the bony system is nearly complete; length, twelve to fourteen inches. If born at this period, the fetus is able to breathe, cry and nurse, and may live if properly cared for.

    “At eight months, the fetus seems to grow rather in length than in thickness; it is only sixteen to eighteen inches long, and yet weighs from four to five pounds. The skin is very red, and covered with down and a considerable quantity of sebaceous matter. The lower jaw, which at first was very short, is now as long as the upper one. Finally, at term, nine months, the fetus is about nineteen to twenty-three inches long, and weighs from six to eight pounds. The red blood circulates in the capillaries, and the skin performs the functions of perspiration; the nails are fully developed.”

    Another writer says: “There is a superstition that a child born at eight months is not as liable to live as if born at seven months; indeed, many suppose that an eight months’ child never survives. Facts do not prove this idea to be correct. Personally, I have known several eight months’ babies to live and do well, and I believe that their chance of life is much greater than if born at seven months.”

    Children born in the seventh month of gestation are capable of living, though great care is required to rear them for the first few months after birth. The “incubators” now so common in large cities have greatly increased the chances of the “seven months’ child,” and, for that matter, of those born even earlier. There are a number of cases of record where children have been born after six months of gestation, and a few even before the six months, but these cases are rare and unusual, and such children usually die soon after birth.

    The following table, given by a good authority, shows the average length and weight of the human embryo and fetus:

    Age. Length in inches. Weight.
    2 weeks 0.1 Not given
    3 weeks 0.2 3 grains
    4 weeks 0.3 Not given
    5 weeks 0.5 Not given
    6 weeks 0.7 Not given
    7 weeks 0.9 Not given
    8 weeks 1.5 4 drachms
    3 months 3.0 2 ounces
    4 months 6.0 5 ounces
    5 months 9.0 10 ounces
    6 months 12.0 1 pound
    7 months 15.0 3 pounds
    8 months 17.0 5 pounds
    9 months 20.0 6 to 9 pounds

    Professor Clark holds that if at birth the infant weighs less than 5 pounds, it rarely thrives, though the records show that many infants weighing much less than this have lived and thrived. In very rare cases, infants have been known to weigh no more than one pound at birth, and to have still survived and thrived. And, on the other hand, many cases are known where infants were born, and thrived, who weighed more than twice the average weight. So, at the last, it is difficult to lay down hard and fast rules in the case.

    Delivery. At the termination of the period of gestation, the child is born into the world, and, instead of depending upon the blood of the mother for nourishment and oxygen, it begins to ingest its own food, to eliminate its own waste matter through the regular channels of the body, and to use its own lungs for the purpose of obtaining oxygen for its blood and to burn up the waste products in the lungs.

    The process of bringing a child into the world is called “parturition.” The fetus is expelled from the body of the mother by the contraction of the muscles of and around the Uterus, and also by the contraction of the abdominal walls. In the early stages of labor, the uterine muscles are brought into play; but when the fetus enters into the vaginal passage the abdominal muscles manifest their energy. The uterine and abdominal muscular movements are purely involuntary, although the mother may aid in the delivery by voluntary muscular movements. The involuntary muscular movements are due to the reflex action originating, probably, in a part of the spinal cord.

    The uterine contractions are rhythmical, and have been compared to the contraction of the muscles of the heart. Each “labor pain” begins with a minimum of contraction, the activity increasing until a maximum is reached, when it gradually decreases, only to be followed a little later by a new contraction. When the fetus is finally expelled from the Uterus (followed later by the placenta or “afterbirth”) that organ begins a gradual contraction to its normal size, shape, and condition, the restorative process usually lasting over several weeks.

    The Physical Signs of Pregnancy. The physical signs of pregnancy in the case of women of normal health are as follows:

    (1) Cessation of the menses, or menstruation. While it is true that a non-pregnant woman may occasionally pass over a menstrual period, yet as a general rule the complete cessation of a period by a married woman, particularly when the woman has previously been regular in this respect, may be considered a probable indication of pregnancy; and when the second period has been passed the probability merges almost into a certainty. An examination by a competent physician will set all doubts at rest.

    (2) Enlargement of the breasts. This indication usually manifests itself in about six or eight weeks after conception. This enlargement is usually preceded by a sensation of tingling and throbbing. The enlargement is manifested in the form of a rather hard and knotty increase, differing from the ordinary fatty increase; the lobules, arranged regularly around the nipple, are plainly distinguishable beneath the skin by means of the touch of the fingers.

    (3) Darkening of the areolar tissue surrounding the nipple. In the unimpregnated condition this tissue is of a pinkish shade; but after impregnation the shade grows darker and the circle increases in size. However, when the woman bears several children in somewhat rapid succession, this dark color may become permanent and accordingly ceases to be an indication.

    (4) Enlargement of the abdomen. This indication manifests itself about the second month, at which time the Uterus begins to elevate the intestines by rising up from the pelvis. In the fourth month the Uterus has risen so far out of the pelvis that it assumes the form and appearance of a hard round tumor. The entire abdomen then begins to enlarge. The Uterus causes an enlargement in the region of the navel at the sixth month, and the region of the diaphragm at the ninth month.

    (5) Quickening, or “signs of life.” This indication manifests first from the fourth month to the fifth—at about the exact half of the entire period of gestation. At this time, and afterward, the movements of the embryo are plainly discernable to the mother.

    The Disorders of Pregnancy. There are a number of physical disorders usually accompanying pregnancy, some of which are trifling, but some of which require the advice of a competent physician. The best plan is for the woman to consult a physician shortly after she discovers herself to be pregnant, and thereafter to visit him occasionally for advice during the period of gestation. The too common plan of postponing the call upon the physician until the eighth or ninth month is not a wise one, for in many cases the advice of a competent physician at an earlier stage of the pregnancy will obviate serious complications. The call upon the physician should usually be made not later than the third or fourth month, and positively not delayed longer than the fifth month. The physician should make an examination to ascertain whether the child is in the normal position in the Uterus, and should also examine the urine each month to ascertain whether the kidneys are functioning normally.

    What is called “morning sickness” is one of the most common of the disorders of pregnancy. It is marked by nausea or vomiting, or both, early in the morning, usually shortly after arising. Some women have at least faint symptoms of this disorder from the very beginning of conception, but usually it does not manifest until the third, fourth, or fifth week of pregnancy. It usually ceases at the end of the third or fourth month. Except in very severe cases, in which the physician should be consulted, the disorder is not serious, and requires but a little common-sense treatment, and rational habits of living. An authority says: “Eat of some fruit that best agrees with palate or stomach; drink hot water; eat nothing until a real hunger demands food. Where nausea occurs after eating, a tart apple or orange is good.” Another authority says: “Let women suffering from morning sickness try acid fruit—apples, oranges, or even lemons, if their sourness is not unpleasant. If a single orange or apple after each meal does not suffice, let them try two; let them eat ten if that number is necessary to conquer the distress. The principle is a correct one, and the relief certain. Let fruit be eaten at all hours of the day—before meals and after, on going to bed at night and at getting up in the morning. If berries are in season, let them be eaten in the natural state—that is, without sugar. If the sickness still continues, omit a meal now and then, and substitute fruit in its stead. By persistence in this course, not only will nausea be conquered, but an easy confinement guaranteed.”

    The pregnant woman often develops a capricious appetite. This disorder may manifest in one or more of several forms, as for instance: the woman may lose her appetite, and take but little food; or she may develop an abnormally large appetite, and eat much more than is necessary; or she may take a dislike to certain kinds of food—many women have an aversion toward meat during pregnancy; or she may have a “craving” for certain articles of food, sometimes for kinds of food not liked at other times, such as sour pickles, sour cabbage, etc. A little common sense, and the presence of attractive articles of fruits, etc., will do much to relieve these troubles; in extreme cases the physician’s advice will help.

    The pregnant woman should have her teeth put in good order as soon as possible, as troubles with teeth sometimes manifest themselves during pregnancy, and give much trouble and annoyance. Difficulty in urination, constipation, piles, irritation or itching of the genital organs, varicose veins, liver spots, and similar disorders, which are sometimes manifest during pregnancy, in some form or degree, should receive the attention and care of a competent physician.

    The following general advice from a competent authority is worthy of being followed: “If everything is satisfactory, if there is no severe vomiting, kidney trouble, etc., the usual mixed diet may continue. The only changes I would make are the following: Drink plenty of hot water during the entire time of pregnancy: a glass or two in the morning, two or three glasses in the afternoon, the same at night. From six to twelve glasses may be consumed. Also plenty of milk, buttermilk and fermented milk. Plenty of fruit and vegetables. Meat only once a day. For the tendency to constipation, whole wheat bread, rye bread, bread baked of bran, or bran with cream. As to exercise, either extreme must be avoided. Some women think that as soon as they become pregnant, they must not move a muscle; they are to be put in a glass case, and kept there until the date of delivery. Other women, on the other hand, of the ultra-modern type, indulge in strenuous exercise, and go out on long fatiguing walks up to the last day. Either extreme is injurious. The right way is moderate exercise, and short, non-fatiguing walks. Bathing may be kept up to the day of the delivery. But warm baths, particularly during the last two or three months, are preferable to cold baths.”

    Childbirth. The first indication of approaching delivery of the child is that of the descent of the child into the pelvis of the mother, from its former position up near the diaphragm. When this occurs, the mother usually experiences a feeling of relief, and a greater ease in breathing because of the relaxation of the former pressure on the diaphragm. Sometimes this occurs several days preceding delivery, while in other cases it occurs only a few hours before delivery. There usually occurs about the same time a slight discharge of mucus tinged with blood. The latter is called “the show,” and is caused by the unsealing of the mouth of the womb, and indicates that the Uterus is preparing to discharge its contents.

    Labor, in childbirth, consists of three stages. In the first stage, the Uterus alone contracts, and the mouth of the womb dilates; in the second stage, the abdominal muscles assist the Uterus in expelling the child; in the third stage, the Placenta (afterbirth) and membranes are expelled.

    After the delivery of the child, and after the pulsation in the umbillical cord has ceased (usually from ten to thirty minutes after delivery), the umbillical cord is severed and tied by the physician. In natural labor, the expulsion of the afterbirth occurs from within a few minutes to an hour after the delivery of the child. Nature is sometimes slow in expelling the afterbirth, but caution should be exercised in the matter of using force to assist Nature in this matter, for injury to the Uterus has often resulted from malpractice in such a case. The afterbirth is not firmly attached to the womb, but is like the peel of an orange which Nature sloughs off in due time.

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • ANATOMY OF THE FEMALE SEX ORGANISM

    ANATOMY OF THE FEMALE SEX ORGANISM

    Every woman should be given plain, practical, sane, sensible instruction concerning the sex organism of woman, its functions, its laws, its use, and its abuse. This important feature of the physical organism plays an all powerful part in the life of every woman, and particularly in the life of the married woman. It is nature’s mechanism for the reproduction of the race. Every child that is born into the world is conceived, gestated, and finally delivered as a result of the functioning of this organism. Therefore, such instruction and knowledge is vitally necessary, not only for the intelligent performance of the duties of parenthood, but also for the best interests of race-preservation, race-culture, and the physical well-being and health of the individual woman.

    And yet, custom and ancient prejudice have drawn the veil over this most important subject, so that it is difficult for the average woman to find practical, clean information concerning her own anatomy and physiological functions concerned with her sex-life. To many it has appeared that the particular organs and parts of the body concerned with the reproductive functions of the woman are base, unclean, and impure, and that any woman discussing them, or seeking information regarding them, must be immoral or at least not “respectable.” Anatomical charts and physiological treatises on the subject are tabooed outside of the doctor’s office. Women are considered immodest if they seek to acquaint themselves with the facts of life concerning one of their most important classes of physical functions. It is considered “not nice” for a young woman to know anything about her physical being in those phases which play the most important part in her life. Can there be anything more ridiculous and insane? This is a matter which excites the most intense surprise, disgust, and despair in the average person possessing a scientific tendency. But the dawn is breaking, and a better day is ahead of the race concerning these things.

    The sex organs of the woman are divided into two classes, as follows: (1) The external organs; and (2) the internal organs. Let us consider each of these classes in turn.

    THE EXTERNAL SEX ORGANS OF THE WOMAN.

    The external sex organs of the woman are as follows: The Mons Veneris; the Labia Majora; the Labia Minora; the Clitoris; the Meatus Urinarius; and the Vaginal Orifice. The term “the Vulva” is applied to the external sex organs of the woman in general, but more particularly to the Labia Majora and the Labia Minora (the larger and smaller “lips,” respectively). The term “Vulva” is the Latin term meaning “folding doors.”

    The Mons Veneris is the fatty eminence or elevation just above the other external organs, which forms a mount from which its name (literally, “The Mount of Venus”) is derived. At puberty it becomes covered with hair.

    The Labia Majora are the large “outer lips” or folds of skin which enclose the Vaginal Orifice, and which are situated just below the Mons Veneris.

    The Labia Minora are the small “inner lips” of folds of membrane, which are concealed within the Labia Majora, or “outer lips,” and are seen only when the latter are parted.

    The Clitoris is a small organ, about an inch in length, situated at the upper part of the Labia Minora or “inner lips,” and usually being partly or wholly covered by the upper borders thereof. At its extremity it has a small rounded enlargement which is extremely sensitive and excitable, and which is the principal seat of sensation in the woman’s sexual organism.

    The Meatus Urinarius is the orifice of the urethra of the woman, the purpose of which is to afford an exit for the urine. It is located about an inch below the Clitoris and is just above the Vaginal Orifice. It is a common error among uninformed women that the urine passes out through the Vagina; but this, of course, is incorrect, as the two canals and their respective orifices are entirely separate from each other, though situated closely together.

    The Vaginal Orifice is the outer entrance to the Vagina, or Vaginal Canal or Channel. This orifice is located just below the Meatus Urinarius. In the virgin it is usually partly closed by what is known as “The Hymen,” (vulgarly known as the “maiden head”), although in many cases the latter is absent even in the case of young girl infants. It was formerly regarded as an infallible sign of virginity, and its absence was regarded as a proof that virginity was lacking. But this old superstition is passing away, for science has shown that the Hymen is often absent even in the case of young children and infants, and, on the other hand, is sometimes present after several years of married life, and even during pregnancy. Much unhappiness has been caused in some cases where the husband has doubted the virginity of his wife because of the absence of the Hymen, but consultation with a capable physician usually removes this misunderstanding.

    The Hymen is a membranous fold, sometimes circular in shape, with an opening in the center, though in other cases it extends only across the lower part of the orifice. The opening in the center is for the purpose of allowing the menstrual blood and the other secretions of Uterus and Vagina to flow through. In a few cases this opening is absent, the Hymen being what is called “imperforate”; in which case the girl experiences difficulty when menstruation begins, and a physician is required to make a slit or opening in it. In some girls and women the Hymen is quite tough, while in others it is very thin and is easily broken. In the latter cases the young girl frequently breaks the membrane during vigorous exercise, such as jumping rope, etc. And, as has before been said, in some cases infant girls are born without even a trace of the Hymen. Under the circumstances, it is seen that the presence or absence of the Hymen is far from being an infallible proof of the presence or absence of virginity, and the belief in the same is now regarded as almost a superstition of the past.

    THE INTERNAL SEX ORGANS OF THE WOMAN.

    The internal sex organs of the woman are as follows: The Vagina; the Uterus and its appendages; the Fallopian Tubes; the Ovaries, and their ligaments, and the round ligaments.

    The Vagina is the canal or channel leading from the Vaginal Orifice to the Uterus or womb. It is situated in front of the rectum, and behind the bladder. In length, it averages from three to five inches; and it curves upward and backward, reaching to the lower part of the neck of the womb, or Uterus, which part of the neck is enclosed by it. It is a strong fibro-muscular structure, lined with mucous membrane; and is not smooth inside, but is arranged in inner folds or rings which are capable of great extension.

    On either side of the Vagina, near the outer orifice, are two small glands, about the size of a pea, which secrete a peculiar fluid, and which are known as the Glands of Bartholine. The office of the Vagina is that of a complementary to the male organ during the copulative process; to also sustain the weight of the Uterus; to also afford a passage for the infant at the time of its birth; and also to serve as a passage for the menstrual fluid.

    The Uterus, or Womb, is the internal sex organ of the woman which serves to hold the fertilized ovum, or egg, from the time of impregnation, during the period of pregnancy during which the ovum develops into the young child, and until the time of the delivery of the child.

    The Uterus is a hollow pear-shaped muscular organ, about three inches in length, nearly an inch thick, and about two inches broad across its upper part, or fundus; the lower part, or cervix, being much narrower. The cervix, or “neck” of the womb, projects into the Vagina, forming the “os uteri,” or “mouth of the womb,” at that point. The Uterus is composed chiefly of a muscular coat, its walls consisting of strong muscular fibres which contract independently of the will, as do similar muscles in the stomach and bladder. These muscular walls are capable of enormous distention during pregnancy. The muscles of the healthy womb are capable of a tremendous pressure and resistance, and are capable of expelling the child with but slight labor at the time of delivery.

    The Uterus is located just behind and slightly above the bladder, and is supported by eight ligaments which, in a healthy condition, hold it firmly and easily in place. Displacements of the Uterus are due to the weakening or relaxing of some or all of these ligaments, generally caused by general weakness or else by excessive physical exercise or labor. The principal Displacements of the Uterus are as follows: Prolapsus, or lowering of the womb in the vagina; Antroversion, or the bending forward of the womb; Anteflexion, or the “doubling up” of the womb forward on itself; Retroversion, or the bending backward of the womb; and Retroflexion, or the “doubling up” of the womb backward on itself. Extreme degrees of the last four mentioned forms of displacement often interfere with impregnation.

    The internal surface of the Uterus is lined with mucous membrane thickly studded with minute hairlike cells which manifest continuous motion. This motion, in the lower part of the womb, is in the direction of the fundus or upper part of the womb; in the upper part of the womb, the motion is in the opposite direction; the purpose of these opposing movements being to carry the male elements toward that portion of the womb into which the Fallopian Tubes discharge the products of the Ovaries, as we shall see presently.

    The Uterus is supplied with follicles around its neck which secrete a very firm, adhesive mucus substance, which serves as a gate or door across the mouth of the womb during the period of pregnancy, and which also serves to prevent the accidental displacement of the ovum or egg. During and just after menstruation, the Uterus becomes enlarged and more vascular. During pregnancy, it largely increases in weight. After delivery, it resumes its normal size, but the cavity is larger than before conception. In old age, it becomes atrophied and denser in structure.

    The Fallopian Tubes are the ducts of the Ovaries, and serve to convey the ova, or eggs, from the Ovaries to the cavity in the Uterus. They are two in number, one on each side, each tube being about four inches in length. They extend from either side of the fundus of the womb, through the broad ligaments which hold them and the Ovaries in position until they communicate with the Ovaries. They are lined with a membrane composed of the same kind of peculiar hair-like cells which are found in the lining of the womb, the purpose in this case being to urge forward the ova or eggs toward the Uterus.

    At the ovarian end of the tubes the latter expand into a fringed, trumpet-shaped extremity, the fringe being known as “the fimbria.” The tubes are only about one-sixteenth of an inch in diameter, and their small caliber makes it easy for them to clog up as the result of slight inflammation, or to become clogged up or sealed at their mouths or openings, thus causing sterility or inability of the woman to conceive. If the tubes are clogged, or sealed up, it of course is impossible for the ova or eggs to reach the uterus.

    The Ovaries are the two oval-shaped bodies lying one on either side of the Uterus. In them the ova, or eggs, are formed. They are each about one and one-half inches long, about one inch wide, and about one-half an inch thick. In addition to their attachment to the broad ligament, they are held in position by folds or ligaments running to the fundus of the Uterus and to the fimbriated extremities of the Fallopian Tubes. The Ovaries are covered by a dense, firm coating which encloses a soft fibrous tissue, abundantly supplied with blood-vessels, which is called the stroma. Imbedded in the mesh-like tissue of the stroma are found numerous small, round, transparent vesicles, in various stages of development, known as the Graafian follicles, which are lined with a layer of peculiar granular cells. These Graafian follicles are the receptacles or sacs which contain the ova, or eggs, which constitute the female reproductive germ. Each vesicle contains a single ovum or egg.

    Summary.

    From the foregoing, it is seen that we may enumerate the sex organs of the woman as follows, proceeding from the external to the internal organism: First, the Mons Veneris, or prominent eminence above the more important external sex organs; then the Labia Majora, or large outer “lips” or folds, which are plainly discernable to the ordinary view; then the Labia Minora, or smaller inner “lips” or folds, and the Clitoris or small sensitive organ, and the Meatus Urinarius or urinary orifice, all of which are discernable only when the folds of the Labia Majora are parted or opened. Then, proceeding upward and backward from the Vaginal Orifice, we find the Vagina, or channel or canal leading to the Uterus or Womb; then we find the Uterus or Womb at the upper end of the canal or channel of the Vagina. Then extending from either side of the Uterus or Womb we find those two important sets of organs known as the Fallopian Tubes, and the Ovaries, respectively. The Ovaries discharge their ova, or eggs, into the Fallopian Tubes, from whence they are conveyed to the Uterus or Womb, with which the tubes are connected and into which they open at its upper and large end.

    The Pelvis is that bony arch in the cavity of which are contained the internal sex organs of the woman. The Pelvis is a bony basin which holds and supports the pelvic organs, and is composed of three important parts, as follows: (1) The Sacrum, consisting of five sections of the vertebral column, or spine, fused together so as to constitute the solid part of the lower spine and the back of the Pelvis; (2) the two Hip-Bones, one on each side of the Pelvis; (3) the Pubic Arch, or the front part of the Pelvis, formed by the junction of the two Hip-Bones in front. Attached to the Hip-Bones are the thighs, and also the large Gluteal Muscles which constitute the buttocks, or “seat.”

    The Pelvis of the woman is quite different from that of the man. It is shallower and wider, and lighter in structure than that of the male, and the margins of the Hip-Bones are more widely separated, thus making the hips of the woman far more prominent than those of the man. Also, the Sacrum is shorter than that of the man, and the Pubic Arch wider and more rounded than his. This difference in the bony structure is made necessary by the demand for larger space in the female Pelvis required for the purposes of childbirth. These differences are not so perceptible in childhood, but become marked and pronounced at puberty.

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • Making available free paediatric medicine can accelerate elimination of congenital Chagas disease

    Making available free paediatric medicine can accelerate elimination of congenital Chagas disease

    The donation of an essential antiparasitic medicine can potentially accelerate the elimination of Chagas disease infection in children. A pediatric presentation of benznidazole with accurate dosage and will soon be made available freely to address
    a long-standing gap in the treatment of congenital infections of Chagas disease.  

    The donation, by the Mundo Sano Foundation1 and INSud Pharma2 group to the World Health Organization (WHO), is expected to become effective soon.

    “Making benznidazole freely available for the treatment of newborns and children until the age of 19 will be a game-changer in the fight against Chagas disease” said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control
    of Neglected Tropical Diseases. “This can save future generations from developing life-threatening and fatal complications and also boost up diagnosis and treatment contributing to congenital Chagas disease elimination.”

    The three-year agreement will make available 108 000 tablets of benznidazole3 – one of the two antiparasitic medicines against Chagas disease. Treatment4 with benznidazole in the early stages of infection can cure Chagas
    disease, prevent or curb disease progression and prevent congenital transmission in pregnant women.

     “We have now added the systematic detection and treatment of all newborns and children under 19 which was not part of  our recent switch from control to elimination of congenital Chagas disease” said Dr Pedro Albajar
    Vinas, Medical Officer, WHO Department of Control of Neglected Tropical Diseases. “In addition, screening of pregnant women at risk of infection who have not had past antiparasitic treatment provides an excellent opportunity for prevention of posterior transmission throughout pregnancy and birth.”

    Each year, an estimated 15 000 children are born from infected mothers. 

    The agreement

    The donation by Mundo Sano Foundation for the duration of the agreement comprises benznidazole:

    • 105,000 tablets of 100mg
    • 3,000 tablets of 12.5mg

    Furthermore, the Foundation may donate funds to support activities associated with distribution of medicines and is ready to consider extending this agreement beyond the specified duration of three years.

    The disease

    Chagas disease, also known as American trypanosomiasis, is a potentially life-threatening illness caused by the protozoan parasite Trypanosoma cruzi (T. cruzi).

    Although considerable progress has been achieved, particularly in reducing vector transmission and screening of blood and organ supply, reaching, diagnosing and providing healthcare for people most affected has been a challenge.

    Currently, under-diagnosis of Chagas disease cases is as high as 90% and under-diagnosis of congenital and paediatric cases is believed not to be lower.

    Globally, an estimated 6-7 million people are infected with T. cruzi.

    The disease is found mainly in endemic areas of 21 continental Latin American countries5. But movement of people to urban areas and to other continents has expanded its transmission through non vectorial routes, such as blood transfusion,
    congenital transmission, organ transplants and oral transmission through food contamination.

    Considering that neglected tropical disease as a growing public health problem in many countries, the World Health Assembly – WHO’s decision-making body – decided in May 2019 to commemorate World Chagas Disease Day on 14 April.

    The inaugural celebration happens this year.


    1Mundo Sano is a nonprofit international foundation working with the public and private sectors, academia, and other international organizations to provide solutions to the affected communities and generate scientific knowledge.
    In 2012, it led a public-private consortium in 2012 to produce benznidazole in Argentina.

    2Insud Pharma (formerly known as Chemo Group) specializes in research, development, manufacture, sale and marketing of active pharmaceutical ingredients and medicinal products for human and veterinary use.

    3In 2017, the United States Food and Drug Administration (FDA) approved benznidazole for the treatment of children aged 2–12, making it the first treatment approved in the United States for Chagas disease.

    4Nifurtimox is also 100% effective in curing Chagas disease if given soon after onset of infection, including cases of congenital infection. It is donated by Bayer who pledged more than 7.5 million tablets for the period 2012-2021.

    5Argentina, Belize, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, French Guiana, Guatemala, Guyana, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Suriname, Uruguay, and Venezuela
    (Bolivarian Republic of).

     

     

     

     

    Making available free paediatric medicine can accelerate elimination of congenital Chagas disease
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    https://www.who.int/news-room/detail/02-04-2020-making-available-free-paediatric-medicine-can-accelerate-elimination-of-congenital-chagas-disease

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