most anxiety about the size of their waists, and to take most pains with them. As to the general condition in regard to flesh being unaffected, or not so much so, and the rapidity with which recovery takes place, the explanation, I think, must be that the altered state of the blood cannot have been of very long duration."
I have read the above with peculiar pleasure, because I believe Dr. Williams to be perfectly right. Some time ago my own observations led me to write in a similar sense. Thus I find, on page 491 of my "Manual of Midwifery"[1]: "Many cases of toxæmia can be directly traced to the use of the corset. The injury to the liver is often caused by tight lacing before pregnancy."
… Some forms of anæmia are closely related to hepatic toxæmia. They resist all treatment until the liver is relieved from pressure by loosening the corset, when the addition of calomel to the ordinary treatment is quickly followed by success. Anæmia of this kind is a frequent forerunner of toxæmic troubles during pregnancy."
I have by me some manuscript on a cognate subject hitherto unpublished, part of which I may offer in support of the conclusion briefly expressed by myself in the above lines, and worked out by Dr. Williams in his recent paper. My notes are as follows:—
"Innumerable women doubtless alter the outward conformation of their bodies, and also the shape size and arrangement of their livers and other viscera, without causing any derangement of health which Can be directly traced to tight lacing. In any variation from health, however, the habit goes against the patient, aggravates alimentary, respiratory and circulatory disturbances, and often prevents complete restoration. In short, the fashion weakens the strong;, and may cause positive disease in the weak. Take, for example, this common form of anæmia known as chlorosis. As to sex, this condition is practically confined to females. As to age, it is commonest in the decade following puberty, It occurs mainly in young women and girls who live by bodily work, and accordingly have, as a rule, good muscular development. Again, chlorotic women are well nourished in general. They belong to a class which feeds well, though not always judiciously, and if starved it is not by want of food, but by inability to digest it—by the dyspepsia which is secondary to the anæmia. The condition is not hereditary. What is the prime factor in its causation? I have made a habit of measuring the waists of anæmic patients, who appear very often as out-patients at hospitals for women. Two measurements are taken; one over the corset, one after it has been removed, The result of prolonged observation shows that the waists of young women of the working classes measure on an average three inches more without the corset than with it. The patients are never conscious of any compression, and firmly believe that their clothes are loose. If, however, they are kept in bed two or three weeks, the waist measurement increases, and the pressure of the corset is plainly felt for a few days after ordinary clothing is resumed. I believe the sequence of events to be as follows:— The 'grown-up' corset is adopted at the age of puberty. when the girl is thin and undeveloped. During the years that follow the chest and the pelvis enlarge, but
- ↑ Clay, Edinburgh. Second Edition, 1900.
