24. – MARRIAGE
THE vast practical importance of the various points included in this Section and the following Sections is our apology for introducing them. In other works, and also to some extent in this one, we have attempted to show the value and bearing of pure air and water, light, exercise, recreation, good food, etc., on health and long life. Here, however, we carry our researches further back and venture to offer suggestions concerning the exercise of those functions of the male and female organs of reproduction on the integrity of which depends, to a great extent, the physical and moral qualities of individuals.
The question of the marriage of unsuitable persons, or of marriage at an unsuitable age, is often either disregarded, or viewed from a too narrow standpoint, as if it only concerned the individuals forming the alliance. Our responsibility, however imposes on us the duty of enforcing the truth that the health, happiness, and material greatness of future generations are involved in such marriages. No one but a physician, who sees human nature in all, even in its darkest aspects, can fully appreciate the subject, or accurately trace its workings in society. The several points, here only briefly alluded to, are of pressing importance, and should be seriously pondered, in all their bearings, by persons contemplating marriage, and by parents and guardians.
Marriageable Age : From twenty to twenty five years of age may be stated as the most suitable time of life for contracting marriage on the part of women. Although the function of menstruation commences from the fourteenth to the sixteenth year, yet the female constitution is not sufficiently formed and matured till twenty or twenty-one years of age to permit of marriage without risk of injury to health and comfort. Some exceptions so this may exist in persons who have acquired at about nineteen that physical and mental perfection which the majority of persons in this country only attain some years later. On the other hand, too late marriages frequently entail much discomfort, and the children of such parents are often sickly, and die prematurely. But these points are more fully and separately considered further on.
Precocious Marriage – Physiology clearly teaches the both animals and plants must, acquire full development before they are capable of reproducing their species in the highest and most vigorous condition. Too early marriage often results in arrest of development, a shattered constitution, and generally impaired health in the mother; such marriages are also generally “less fertile, and the children who are product of them are weak, puny, and have an increased rate of mortality” (Duncan). Further, premature marriage, by anticipating the demands of nature, increases the sufferings and dangers of childbirth.
Anatomical facts may also be briefly cited to confirm the correctness of our conclusions. The perfect ossification of the pelvic bones, and their complete union to one another, do not usually take place till after twenty years of age; not is it till about this period that the pelvis has fully assumed the form, shape, and distinctive sexual features so admirably suited for the functions of child-bearing. It is well known that the pelvis of the two sexes differ but little till puberty; but at that period the female pelvis begins to assume its striking characteristics; its cavity becomes capacious and broad in both its diameters, and an inlet and outlet also enlarge.
These and other characters so necessary for maternity are not fully developed till after that maturity of growth, the process of years, which only fairly commences about the time of puberty. “When I am consulted,” write M. Joulin, “As to the opportuneness of a marriage for subjects who are too young, I am accustomed to respond to the parents that they should not marry their daughter until a year at least after her stature has ceased to increase. This is the epoch that I fix for nubility.” The early exercise of the sexual functions of the lower animals does not disprove our argument. The life of the sheep, for examples, is much briefer, its office much more material, and its sexual propensities are therefore manifested at a much earlier age.
Late Marriages – Under this heading we deem it desirable to make some additional remarks with the view of correcting popular fallacies on so important a subject. “The lateness of marriages.” Graves says “may be generally taken as a good test of an improved state of society, and as exhibiting that power of moral restraint over the passions which should characterise civilised and intelligent beings.” If by late marriages, in the above quotation, is meant marriage contracted many years after the period stated in a previous paragraph as the most fitting, then, from more than one point of view, we must decline to regard it as indicative of, or favorable to, the mortality of society. The political and even the moral philosopher betrays a lack of sound wisdom, and an incomplete view of human nature, if, in his calculations, he ignores or underrates the sensuous element of our nature.
In considering human nature, as medical men, we can scarcely avoid taking all parts of it into view. In the exercise of our profession we have frequently repeated evidence that the great functions of the body and the high aspirations of the soul act and react upon each other. Whatever may be the theories of moral and speculative philosophers, our profession compels us to regard men and women as complementary beings mutually dependent on each other for health, virtue, and happiness, this dependence commencing on the attainment of manhood and womanhood. By observing, as nearly as circumstances permit, the period of marriage before noticed, an important step will be taken towards maintaining the health, happiness, and morals of all classes.
Marriage, moreover, if suitable and happy, lengthens life. The relatives influence of marriage and celibacy on the duration of life has been ascertained. And the result is that the mortality is considerably less, both among men and women, in the married state, than among the celibate and widowed. This opinion has indeed been controverted; and it has been affirmed that longevity, instead of being a consequence of marriage, is simply a correlation of it; that they are concomitant results of the same cause – viz., constitutional vigor. Where the reproductive instincts are strong the surplus vital energy is great, and the organisation is likely to last. This may be true, but we nevertheless think that well-assorted marriage lengthens life.
In thus recording our matured opinion on the subject, we may be excused detailing, in a domestic Manual, the varied kinds of evidence on which it is based. Let the inquiring mind look around, and somewhat beneath the surface of society, carefully examining what will thus come to view, and proof will be ample and varied that deferment of marriage many years beyond the period indicated is not always consistent with physical and moral well-being.
Disproportionate Ages – A considerable disproportion between the ages of the husband and wife is to be avoided. When circumstances are favourable to such an arrangement, there should not be more than three to five years’ difference between the ages of the man and the woman, the husband being the senior.
Ill-health a Contra-Indications – A little reflection will convince anyone of the disastrous consequences likely to spring from the marriage of unhealthy persons. “The fact cannot be disputed, though appreciable with difficulty, that the natural and special dispositions of the individual descend to him in a certain measures from his origin, and that parents transmit in their children such and such moral propensities just as they do such and such physical temperament, or such and such features. Hereditary transmission enters into the moral as well as into the physical order of the world” (M. Guizot). Diseases, then, as well as peculiarities of character, may be transmitted from parents to children. This is no mere theoretical statement, but a truth based on practical observations a hundred times verified; and it should convey a most impressive lesson. If, for example, the consumptive young woman marries, she becomes a mother – for the consumptive are generally prolific – and indelibly imprints her infirmity on her off-spring, while she exposes her off- spring, while she exposes herself to the perils of children a hundred fold heightened in such a disease. The observant medical practitioner only, who can trace effects to their causes, can gauge the suffering and bitter disappointment which result from such marriages, and should be consulted before marriage are arranged. It will be obvious that unless the fountain whence much physical evil flows-hereditary taint-be itself purified, nothing can effectually check the progress of maladies universally prevalent, and destructive to happiness, health, and longevity. so long as a reproducing agent is constantly at work, imprinting at the time of impregnation the elements of disease on countless numbers of children, nothing can prevent the multiplication of the evils consequent on diseases and premature death.
Marriage of Near Kindred – The consequence of the intermarriage of persons of the same blood, such as first or second cousin, is perpetuate and intensify any constitutional infirmity in the next generation. Family weakness or defects perhaps of no grave importance, are confirmed by intermarriage, and may readily become developed into actual disease. The marriage of near relatives in whose families a consumptive cachexia exists leads to a concentration of the disease in the offspring and lays the foundation of some of the most destructive maladies to which the human frame is liable. More than this. A convergence of ancestral inability to disease not tubercular is likely to lead to that disease in it most active form. A large proportion of those children who are born with defective sense – blind, deaf, dumb, etc. – are the offspring of near relations. It has been stated on the highest authority that the marriage of first cousin is undoubtedly the most prolific cause of congenital deaf mutism known and it frequently affects the sight and constitution generally and the mental capacity as well. Of nine children of working man, eight were deaf and dumb, and so weak in constitution that one time the three youngest (though born separately) could not walk.
In a clergyman’s family, out of eight children, four were afflicted, one being deaf and dumb with imperfect sight, another deaf, dumb, and blind two others deaf, dumb, and blind, two others deaf, dumb, and idiotic. Such cases could be multiplied almost indefinitely. They are full of warning against the marriage of blood relations. It has, indeed, been argued that marriage of consanguinity do not of themselves entail any evil. But the preponderating weight of evidence is opposed to this. Persons with a slight hereditary liability to consumption. or other affection, but without any active disease, forming judicious marriages in families of healthy blood, may lead to such an admixture and dilution of the disease; element affecting the one parental side, that, in process of time, it may become altogether inoperative. But there are very few families in a community such as ours, so free from lurking mischief as to be able to venture on such a course.
Restrictions to Marriage – The tendency of the remarks in this Section, it may be objected, is to restrict the personal liberty of individuals in marriage. We candidly admit this to be the case, and although somewhat in advance of the age, the doctrine is, we believe, thoroughly sound. The modern views of evolution especially as propounded by Darwin, prove that our nature, bodily and mental, is the direct outcome of that of preceding generations; and that we, the present generations, are “like the living fringe of the coral reef, resting on an extinct basis afforded by our forefathers, and shall in our own turn form a basis of our descendants.” If it be argued that the future must be allowed to develop itself without any attempts on our part to, mould it, the above authors instances compulsory education, vaccination, and sanitary laws as evidences that we are now making attempts to influence the future; and he justly adds, that as our scientific knowledge becomes wider and more exact, we shall see the wisdom of extending the scope of this kind of legislation. “Simultaneously,” writes Mr. George Darwin, “With the diffusion of the belief in the truth of the doctrine of heredity will come the recognition that it is as much a duty to transmit to the rising generation vigorous minds and bodies, as to hand down to them a finely constituted society and government.”
We have elsewhere enforced this doctrine of restricting the liberty of individuals in marriage,* (*Hereditary Predisposition.” p.26 in “Consumption and Tuberculosis of the Lungs.”) and can only here express the hope that wider diffusion of the doctrines of the hereditary nature of the diseases of humanity may lead individuals to appreciate the extent or which their capacity for weal or woe, and that of their children and their children’s children, depends upon their acting in harmony with the knowledge they enjoy of nature and nature’s laws, and the wonderful power that an existing generation possesses of moulding, to a very high degree, the fates of that which is to succeed it.
The general correctness of the fragmentary observations made in this Section is abundantly established by physiology. It is not presumed that they can or always will be literally acted upon, at least not until the laws of our natural being are more generally studied and better understood. Our object, however, is that they should be instilled as first principles in the minds of the young and their counsellors, in order that their application may facilitated circumstances permit.
There is perhaps no condition in the life of a married woman that more frequently gives rise to reproach and domestic unhappiness than that of Sterility. If she be sterile, she will fail to secure the great purpose of marriage – to “multiply, and replenish the earth.” From circumstances that frequently come before us, we regard the subject as one of sufficient importance to justify the appropriation of a Section to its consideration.
CAUSES – To determine in many cases the causes of Sterility, considerable medical knowledge of necessary, and in particular, the anatomy and physiology of the generative organs. The application of such knowledge not unfrequently enables its possessor to detect and remove causes of Sterility long in existence that would otherwise have escaped observation.
The causes of Sterility may be local, affecting some portion of the generative apparatus; or constitutional, the sexual functions suffering in common with those of the body generally.
Local – The local causes are very varied, and we can only mention a few of the more prominent. Such are – an imperforate hymen, or one only so slightly perforate that effectual congress is prevented; narrowness or partial closure of the vagina, neither as a natural defect or as the consequence of difficult labours; tumours or polypi in the uterus or vagina; closure or partial closure of the neck of the womb, after being torn, as a consequence of difficult labour; the improper use of caustics or aphrodisiacs; the use of purgative drugs; inflammation of the ovaries; adhesion or occlusion of the Fallopian tubes; Subinvolution, displacements, or flexions of the womb; Leucorrhoea; ill-timed or too frequent sexual intercourse; ulceration of the womb, etc.
Leucorrhoea – This discharge may exert considerable influence by diminishing susceptibility of fecundation, either by its profuseness or by its acridity. It seldom exists, however, to an extent sufficient to cause Sterility, without its influence on the general health becoming more or less apparent.
Membranous Dysmenorrhoea may be a cause of barrenness in this wise; conception may take place, but at the return of the menstrual epoch the patient experience an abortion by the throwing off the lining membrane of the womb (which should form the outer membrane of the foetus), and with it the ovum is expelled. The cure of Sterility from this cause can only be accomplished by the correction of the tendency of the lining of the womb to exfoliate.
Constitutional – The constitutional include those in which the general physical powers are exhausted, as the consequence of acute or chronic disease; obesity; severe, protracted, or unaccustomed exertion; too close application to business, or excessive exertion of the brain, thus absorbing an undue amount of nervous power which otherwise would be more equally diffused fro the efficient discharge of the general functions of the body. In this way the generative system may be impaired by the divergence of the nervous influence which its healthy functions demand. Under constitutional causes may be classed very early and very late marriages, which show a large proportion of cases of Sterility.
Luxurious Living – Indolent and luxurious habits, excessive indulgence in the pleasures of the table, and especially the free use of wine, are frequent causes of Sterility. The industrious and frugal portions of the community are, it is well known, far more prolific than the higher ranks of society. In his work on the law of population, Mr. Sadler incontrovertibly proves that the fecundity of the human race is diminished by the indolent and luxurious mode of life prevalent among the rich, whilst it is augmented by the industrial habits and spare diet of the poor; by leading to excessive eating may cause Sterility by leading to excessive accumulation of fat. There is an intimate connection between the sexual and the nutritive functions; and thus ladies, when the child-bearing period has passed, often become corpulent.
Irritability – Defective, or, on the other hand, excessive nervous irritability, may operate as an obstacle to impregnation. Deficient sensitiveness may hinder fecundation; or, the activity of the structures may be in such excess that their vitality is destroyed, as it were, by their own vehemence.
Emotional Causes – We may also notice what may be termed emotional causes of Sterility; and although these are probably less influential than many of the other varieties, they are still sufficient to operate prejudicially to conception. There should be the most perfect harmony and congenitality of taste, temper, and disposition between the husband and the wife, the one responding to the other, without any sense of discord or feeling of repugnance.
TREATMENT – In the treatment of Sterility, an investigation of the cause, which is the first step towards the cure, should be made, so that if possible it may be removed. Sterility from congenital malformation is generally incurable. On the other hand, numerous cases are exceedingly simple in their nature, and quite amenable to treatment. A temporary separation, or a change of diet, habits, or climates, sometimes leads to successful results. The horticulturist, by transplantation to a congenial soil and climate and supplying it with altered and suitable conditions, makes a tree, which had heretofore yielded leaves only, produce blossoms and fruit. So equal care and skill in the application of physiological laws and hygienic conditions may be expected to reward the efforts of the physician to make the human species increase and multiply.
A careful selection of food will aid in the removal of the sterile condition. Whatever is nutritive should be preferred; foods that contain a large proportion of phosphorus; fish, especially shell fish, if it can be digested; these will increase the nerve-power.
REMEDIES for constitutional sterility :- Bary-Carb., Calc-Carb., Cann., Coni., Ferrum, Helonias, Nux -V., Phosphorus, Ac-Phosphorus, Platina, Sabin., Senec., Sepia, Sulphur
One or more of the above remedies may be selected according to the general and local symptoms in the each particular case, and if combined with constitutional treatment, are often sufficient to bring about the desired physiological change.
26 – CONCEPTION
Impregnation depends on the union of certain elements furnished during sexual congress, and which are alike indispensable. And it needs but a superficial acquaintance with human history to know that the future being, in its physical and intellectual powers, during the whole of life, is to great extent determined by the actual condition of the sperm-cell and the germ-cell furnished by the parents. Education, and hygienic connection, it is true, may improve an imperfectly organised embryo; but the fact remains, and its general recognition is of great importance, that the qualities of the germs furnished at the period of impregnation will cling to the individual during the entire period of natural life. The practical lesson to be gathered from this f act is, that sexual connection, at least whenever conception is a possible result, should only take place under favourable conditions. There should be at the time the most perfect health; also freedom from bodily fatigue, mental excitement or depression, and the disturbing influence of active digestion, as after a full meal. The essential conditions, then, necessary for the production of healthy and beautiful children are, good health on both the paternal and maternal sides, and the observance of correct rules, a few of which only are referred to in this work.
The time most favourable to impregnation is that immediately following the cessation of the menstrual discharge. Woman have then a much greater aptitude to conceive. “EVerything seems admirably prepared at this period for the reproduction of the species” (Cazeau). The explanation of this may be here briefly summarised. At every menstrual period an ovum or egg is matured and expelled from its Graafian vesicle, and a woman is only liable to impregnation on its meeting and blending with the necessary fecundating principle. The time occupied by the passage of the ovum from the ovary to the uterus is not accurately known, but varies from five to six to eight or more days, differing probably in different persons and in different conditions of health. When the passage of the ovum is completed, the liability of pregnancy is supposed to cease till after the next menstruation. An entirely different doctrine, however, to that above enunciated is now beginning to prevail, and we will now briefly state the new, and probably correct, doctrine. Modern research tends to prove that a developing ovum or growing embryo does not belong to a menstrual period just past, but rather to one immediately prevented by fecundation. In short, menstruation is now considered to be a degenerative process, a kind of fatty metamorphosis similar to that which takes place at the end of pregnancy, and its occurrence proves that the ovum has already perished. Hence, according to this doctrine, the time most favorable to conception is the few days, preceding the monthly period.